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LTD.</SupplierName></Supplier><Supplier><SupplierCode>VO</SupplierCode><SupplierName>RIGICON PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>RB</SupplierCode><SupplierName>ROCHE DIABETES CARE AUSTRALIA PTY LIMITED</SupplierName></Supplier><Supplier><SupplierCode>RK</SupplierCode><SupplierName>Rocket Medical</SupplierName></Supplier><Supplier><SupplierCode>RQ</SupplierCode><SupplierName>RQSOLUTIONS MEDICAL DEVICES DISTRIBUTION SUPPORT PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>RI</SupplierCode><SupplierName>RTI Surgical Australia Pty Ltd</SupplierName></Supplier><Supplier><SupplierCode>UY</SupplierCode><SupplierName>SALUDA MEDICAL PTY LIMITED</SupplierName></Supplier><Supplier><SupplierCode>YF</SupplierCode><SupplierName>SANATUS MEDICAL PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>SF</SupplierCode><SupplierName>SIGNATURE ORTHOPAEDICS PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>XG</SupplierCode><SupplierName>SILONY SPINE PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>VX</SupplierCode><SupplierName>SIRTEX MEDICAL LIMITED</SupplierName></Supplier><Supplier><SupplierCode>TY</SupplierCode><SupplierName>Slade Health Pty Ltd</SupplierName></Supplier><Supplier><SupplierCode>YG</SupplierCode><SupplierName>SMITH &amp; NEPHEW PTY LIMITED</SupplierName></Supplier><Supplier><SupplierCode>SI</SupplierCode><SupplierName>Smiths Medical Australasia Pty Ltd</SupplierName></Supplier><Supplier><SupplierCode>SAA</SupplierCode><SupplierName>Southern Adelaide Local Health Network Incorporated</SupplierName></Supplier><Supplier><SupplierCode>UT</SupplierCode><SupplierName>SOUTHERN CROSS SURGICAL PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>IC</SupplierCode><SupplierName>Southern Implants Australia Pty Ltd</SupplierName></Supplier><Supplier><SupplierCode>UI</SupplierCode><SupplierName>SPECIFICA PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>SO</SupplierCode><SupplierName>Spectrum Surgical</SupplierName></Supplier><Supplier><SupplierCode>DU</SupplierCode><SupplierName>SPINEART AUSTRALIA PTY. LTD.</SupplierName></Supplier><Supplier><SupplierCode>SHV</SupplierCode><SupplierName>ST. VINCENT'S HOSPITAL SYDNEY LIMITED</SupplierName></Supplier><Supplier><SupplierCode>BW</SupplierCode><SupplierName>STABLE ORTHOPAEDICS PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>WV</SupplierCode><SupplierName>STERIS AUSTRALIA PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>SB</SupplierCode><SupplierName>STRAUMANN PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>JV</SupplierCode><SupplierName>STRYKER AUSTRALIA PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>SQ</SupplierCode><SupplierName>Surgical Specialties Pty Limited</SupplierName></Supplier><Supplier><SupplierCode>ZW</SupplierCode><SupplierName>Surgical Supplies Australia Pty Ltd</SupplierName></Supplier><Supplier><SupplierCode>BR</SupplierCode><SupplierName>Surgien Pty Ltd</SupplierName></Supplier><Supplier><SupplierCode>VU</SupplierCode><SupplierName>SURGIVISION PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>TW</SupplierCode><SupplierName>SWISSMED PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>SAC</SupplierCode><SupplierName>Sydney Local Health District</SupplierName></Supplier><Supplier><SupplierCode>WQ</SupplierCode><SupplierName>SYMBIOS ORTHOPAEDICS PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>TK</SupplierCode><SupplierName>Tekmed Pty Ltd</SupplierName></Supplier><Supplier><SupplierCode>TX</SupplierCode><SupplierName>TELEFLEX MEDICAL AUSTRALIA PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>TU</SupplierCode><SupplierName>Terumo Australia</SupplierName></Supplier><Supplier><SupplierCode>UP</SupplierCode><SupplierName>The Trustee for BRAXTON INVESTMENT FUND</SupplierName></Supplier><Supplier><SupplierCode>WL</SupplierCode><SupplierName>The Trustee for CMJH FAMILY TRUST</SupplierName></Supplier><Supplier><SupplierCode>UK</SupplierCode><SupplierName>The Trustee for Giorgios and Katarina Loizou Family Trust</SupplierName></Supplier><Supplier><SupplierCode>YH</SupplierCode><SupplierName>The Trustee for LIFE SYSTEMS MEDICAL TRUST</SupplierName></Supplier><Supplier><SupplierCode>WP</SupplierCode><SupplierName>The Trustee for The Ophthalmopro Unit Trust</SupplierName></Supplier><Supplier><SupplierCode>YX</SupplierCode><SupplierName>TOUCHSTONE MEDICAL SCIENCE PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>TS</SupplierCode><SupplierName>TREWAVIS SURGICAL INSTRUMENTS PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>YY</SupplierCode><SupplierName>TRI DENTAL ANZ PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>XK</SupplierCode><SupplierName>VANTIVE PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>VN</SupplierCode><SupplierName>Varian Medical Systems Australia</SupplierName></Supplier><Supplier><SupplierCode>VB</SupplierCode><SupplierName>VICKI PARTRIDGE PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>YI</SupplierCode><SupplierName>VIDERA SURGICAL &amp; DIAGNOSTICS PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>VM</SupplierCode><SupplierName>Vitramed Pty Ltd</SupplierName></Supplier><Supplier><SupplierCode>WB</SupplierCode><SupplierName>W 9 PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>GT</SupplierCode><SupplierName>W L GORE &amp; ASSOCIATES (AUSTRALIA) PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>WC</SupplierCode><SupplierName>WILLIAM A. COOK AUSTRALIA PTY. LTD.</SupplierName></Supplier><Supplier><SupplierCode>YA</SupplierCode><SupplierName>YPSOMED AUSTRALIA PTY LIMITED</SupplierName></Supplier><Supplier><SupplierCode>ZH</SupplierCode><SupplierName>ZIMMER BIOMET PTY LTD</SupplierName></Supplier><Supplier><SupplierCode>NW</SupplierCode><SupplierName>ZIMVIE AUSTRALIA PTY LTD</SupplierName></Supplier></Suppliers><Categories><Category><CategoryID>6</CategoryID><CategoryDescription>01 - Cardio-thoracic</CategoryDescription></Category><Category><CategoryID>1</CategoryID><CategoryDescription>01 - Ophthalmic</CategoryDescription></Category><Category><CategoryID>22</CategoryID><CategoryDescription>02 - Ear, Nose &amp; Throat</CategoryDescription></Category><Category><CategoryID>41</CategoryID><CategoryDescription>02 - Ophthalmic</CategoryDescription></Category><Category><CategoryID>21</CategoryID><CategoryDescription>03 - General Miscellaneous</CategoryDescription></Category><Category><CategoryID>3</CategoryID><CategoryDescription>03 - Orthopaedic</CategoryDescription></Category><Category><CategoryID>28</CategoryID><CategoryDescription>04 - Dermatologic</CategoryDescription></Category><Category><CategoryID>25</CategoryID><CategoryDescription>04 - Neurosurgical</CategoryDescription></Category><Category><CategoryID>26</CategoryID><CategoryDescription>05 - Urogenital</CategoryDescription></Category><Category><CategoryID>13</CategoryID><CategoryDescription>06 - Specialist Orthopaedic</CategoryDescription></Category><Category><CategoryID>23</CategoryID><CategoryDescription>07 - Plastic and Reconstructive</CategoryDescription></Category><Category><CategoryID>27</CategoryID><CategoryDescription>08 - Cardiac</CategoryDescription></Category><Category><CategoryID>20</CategoryID><CategoryDescription>09 - Cardiothoracic</CategoryDescription></Category><Category><CategoryID>24</CategoryID><CategoryDescription>10 - Vascular</CategoryDescription></Category><Category><CategoryID>18</CategoryID><CategoryDescription>11 - Hip</CategoryDescription></Category><Category><CategoryID>17</CategoryID><CategoryDescription>12 - Knee</CategoryDescription></Category><Category><CategoryID>19</CategoryID><CategoryDescription>13 - Spinal</CategoryDescription></Category></Categories><SubCategories><SubCategory><SubCategoryID>140</SubCategoryID><SubCategoryDescription>01.01 - ANTERIOR CHAMBER INTRAOCULAR LENSES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>141</SubCategoryID><SubCategoryDescription>01.02 - POSTERIOR CHAMBER INTRAOCULAR LENSES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>142</SubCategoryID><SubCategoryDescription>01.03 - INTRAOCULAR FLUIDS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>143</SubCategoryID><SubCategoryDescription>01.04 - CAPSULAR TENSION RINGS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>144</SubCategoryID><SubCategoryDescription>01.05 - GLAUCOMA DRAINAGE</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>145</SubCategoryID><SubCategoryDescription>01.06 - EYELID PROSTHESES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>146</SubCategoryID><SubCategoryDescription>01.07 - LACRIMAL DUCT DRAINAGE PROSTHESES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>147</SubCategoryID><SubCategoryDescription>01.08 - ORBITAL PROSTHESES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>148</SubCategoryID><SubCategoryDescription>01.09 - RETINAL DETACHMENT PROSTHESES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>262</SubCategoryID><SubCategoryDescription>01.10 - Artificial Iris</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>196</SubCategoryID><SubCategoryDescription>02.01 - EAR</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>197</SubCategoryID><SubCategoryDescription>02.02 - NOSE</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>198</SubCategoryID><SubCategoryDescription>02.03 - THROAT</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>187</SubCategoryID><SubCategoryDescription>03.01 - BRACHYTHERAPY</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>188</SubCategoryID><SubCategoryDescription>03.02 - DRUG DELIVERY DEVICES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>189</SubCategoryID><SubCategoryDescription>03.03 - ENTERAL TUBES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>190</SubCategoryID><SubCategoryDescription>03.04 - GASTRIC BANDS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>191</SubCategoryID><SubCategoryDescription>03.05 - HAEMOSTATIC DEVICES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>192</SubCategoryID><SubCategoryDescription>03.06 - LUMINAL STENTS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>193</SubCategoryID><SubCategoryDescription>03.07 - PULMONARY/PERITONEAL DEVICES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>194</SubCategoryID><SubCategoryDescription>03.08 - CLOSURE DEVICES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>294</SubCategoryID><SubCategoryDescription>03.10 - Electronic Controlling Devices (Insulin)</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>218</SubCategoryID><SubCategoryDescription>04.01 - ANEURYSM CLIPS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>219</SubCategoryID><SubCategoryDescription>04.02 - DURA DEFECT REPAIR</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>220</SubCategoryID><SubCategoryDescription>04.03 - HYDROCEPHALUS DEVICES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>221</SubCategoryID><SubCategoryDescription>04.04 - DEEP BRAIN STIMULATION (DBS)</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>222</SubCategoryID><SubCategoryDescription>04.05 - NEUROSTIMULATION THERAPIES FOR PAIN MANAGEMENT</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>223</SubCategoryID><SubCategoryDescription>04.06 - INTRATHECAL DRUG DELIVERY SYSTEM</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>224</SubCategoryID><SubCategoryDescription>04.07 - NEUROSTIMULATION THERAPIES FOR SEIZURE CONTROL</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>225</SubCategoryID><SubCategoryDescription>04.08 - NEURO INTERVENTION</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>253</SubCategoryID><SubCategoryDescription>04.09 - Intracranial Pressure (ICP) Monitoring</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>255</SubCategoryID><SubCategoryDescription>04.10 - Cerebrospinal Fluid (CSF) Diversion</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>226</SubCategoryID><SubCategoryDescription>05.01 - Incontinence Prostheses</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>227</SubCategoryID><SubCategoryDescription>05.02 - Ureteric Stents</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>256</SubCategoryID><SubCategoryDescription>05.03 - Voiding Dysfunction Prostheses</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>230</SubCategoryID><SubCategoryDescription>05.05 - Penile Prostheses</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>231</SubCategoryID><SubCategoryDescription>05.06 - Testicular Prostheses</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>232</SubCategoryID><SubCategoryDescription>05.07 - Sacral Neuromodulation</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>233</SubCategoryID><SubCategoryDescription>05.08 - Tubal Obstruction Devices</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>234</SubCategoryID><SubCategoryDescription>05.09 - Nephrostomy Catheters</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>235</SubCategoryID><SubCategoryDescription>05.10 - Vesicoureteral Reflux Prostheses</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>124</SubCategoryID><SubCategoryDescription>06.01 - ANKLE AND FOOT</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>131</SubCategoryID><SubCategoryDescription>06.02 - UPPER LIMB</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>123</SubCategoryID><SubCategoryDescription>06.03 - SKELETAL RECONSTRUCTION</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>199</SubCategoryID><SubCategoryDescription>07.01 - CRANIOMAXILLOFACIAL RECONSTRUCTION &amp; FIXATION</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>200</SubCategoryID><SubCategoryDescription>07.02 - CRANIOMAXILLOFACIAL IMPLANTS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>201</SubCategoryID><SubCategoryDescription>07.03 - DENTAL IMPLANTS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>202</SubCategoryID><SubCategoryDescription>07.04 - DISTRACTOR SYSTEMS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>203</SubCategoryID><SubCategoryDescription>07.05 - SOFT TISSUE &amp; TISSUE EXPANDERS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>204</SubCategoryID><SubCategoryDescription>07.06 - MAMMARY IMPLANTS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>236</SubCategoryID><SubCategoryDescription>08.01 - Single Chamber ICDs</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>237</SubCategoryID><SubCategoryDescription>08.02 - Dual Chamber ICDs</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>238</SubCategoryID><SubCategoryDescription>08.03 - ICDs with CRT</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>239</SubCategoryID><SubCategoryDescription>08.04 - Single Chamber Pacemakers</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>240</SubCategoryID><SubCategoryDescription>08.05 - Dual Chamber Pacemakers</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>241</SubCategoryID><SubCategoryDescription>08.06 - CRT Pacemakers</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>242</SubCategoryID><SubCategoryDescription>08.07 - ICD Leads</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>243</SubCategoryID><SubCategoryDescription>08.08 - Pacemaker Leads</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>244</SubCategoryID><SubCategoryDescription>08.09 - Pacemaker/ICD Adaptors</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>245</SubCategoryID><SubCategoryDescription>08.10 - Pacemaker/ICD Extenders</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>246</SubCategoryID><SubCategoryDescription>08.11 - Pacemaker/Lead Accessories</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>247</SubCategoryID><SubCategoryDescription>08.12 - Coronary Stents</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>248</SubCategoryID><SubCategoryDescription>08.13 - Special Purpose Percutaneous Cardiovascular Devices</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>293</SubCategoryID><SubCategoryDescription>08.14 - Implantable Cardiac Event Recorders</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>257</SubCategoryID><SubCategoryDescription>08.15 - Stents For Treatment Of Coarctation Of The Aorta</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>266</SubCategoryID><SubCategoryDescription>08.16 - Remote Monitoring System</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>267</SubCategoryID><SubCategoryDescription>08.17 - Catheter Delivery</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>290</SubCategoryID><SubCategoryDescription>08.18 - Cardiac Ablation</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>297</SubCategoryID><SubCategoryDescription>08.19 - Percutaneous Coronary Interventions</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>178</SubCategoryID><SubCategoryDescription>09.01 - Mechanical Valves</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>179</SubCategoryID><SubCategoryDescription>09.02 - Tissue Valves</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>180</SubCategoryID><SubCategoryDescription>09.03 - Valve Conduits</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>181</SubCategoryID><SubCategoryDescription>09.04 - Atrio-Ventricular Rings and Bands</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>182</SubCategoryID><SubCategoryDescription>09.05 - Patches</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>183</SubCategoryID><SubCategoryDescription>09.06 - Membranes</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>251</SubCategoryID><SubCategoryDescription>09.08 - Cardiac Assisted Fixation Devices</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>186</SubCategoryID><SubCategoryDescription>09.09 - Aorta and Side Branch Grafts</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>252</SubCategoryID><SubCategoryDescription>09.10 - Skeletal Fixation Devices</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>259</SubCategoryID><SubCategoryDescription>09.11 - Implant Ventricular Assist System</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>264</SubCategoryID><SubCategoryDescription>09.12 - Pectus Bar</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>265</SubCategoryID><SubCategoryDescription>09.13 - Chordal Replacement Devices, fixed and adjustable</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>291</SubCategoryID><SubCategoryDescription>09.14 - Surgical cardiac ablation</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>206</SubCategoryID><SubCategoryDescription>10.01 - Vascular Stents</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>207</SubCategoryID><SubCategoryDescription>10.02 - Stent Grafts</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>208</SubCategoryID><SubCategoryDescription>10.03 - Grafts</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>209</SubCategoryID><SubCategoryDescription>10.04 - Vascular Patches</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>210</SubCategoryID><SubCategoryDescription>10.05 - Vessel Bands</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>211</SubCategoryID><SubCategoryDescription>10.06 - Embolic Protection Devices</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>212</SubCategoryID><SubCategoryDescription>10.07 - Arterial Closure Devices</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>213</SubCategoryID><SubCategoryDescription>10.08 - Occlusion Devices</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>214</SubCategoryID><SubCategoryDescription>10.09 - Long Term Vascular Access Devices</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>215</SubCategoryID><SubCategoryDescription>10.10 - Peritoneal Dialysis, Long Term Implantable Catheters</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>296</SubCategoryID><SubCategoryDescription>10.11 - Vascular Reconstruction</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>161</SubCategoryID><SubCategoryDescription>11.01 - FEMORAL COMPONENTS - PRIMARY AND REVISION</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>162</SubCategoryID><SubCategoryDescription>11.02 - FEMORAL HEADS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>163</SubCategoryID><SubCategoryDescription>11.03 - ACETABULAR COMPONENTS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>164</SubCategoryID><SubCategoryDescription>11.04 - ACCESSORIES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>149</SubCategoryID><SubCategoryDescription>12.01 - FEMORAL COMPONENT: TOTAL KNEE ARTHROPLASTY</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>150</SubCategoryID><SubCategoryDescription>12.02 - FEMORAL COMPONENT: UNI-COMPARTMENTAL KNEE ARTHROPLASTY</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>151</SubCategoryID><SubCategoryDescription>12.03 - TIBIAL TRAY COMPONENT - TOTAL KNEE ARTHROPLASTY</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>152</SubCategoryID><SubCategoryDescription>12.04 - TIBIAL TRAY COMPONENT: UNI-COMPARTMENTAL KNEE ARTHROPLASTY</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>153</SubCategoryID><SubCategoryDescription>12.05 - TIBIAL INSERT: TOTAL KNEE ARTHROPLASTY</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>154</SubCategoryID><SubCategoryDescription>12.06 - TIBIAL INSERT: UNI-COMPARTMENTAL ARTHROPLASTY</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>155</SubCategoryID><SubCategoryDescription>12.07 - PATELLO FEMORAL REPLACEMENT - FEMORAL COMPONENT</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>156</SubCategoryID><SubCategoryDescription>12.08 - PATELLAR COMPONENT</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>157</SubCategoryID><SubCategoryDescription>12.09 - TUMOUR PRODUCTS</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>159</SubCategoryID><SubCategoryDescription>12.11 - KNEE ACCESSORIES</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>165</SubCategoryID><SubCategoryDescription>13.01 - Bone Screws</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>166</SubCategoryID><SubCategoryDescription>13.02 - Accessories for bone screws and connector components</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>167</SubCategoryID><SubCategoryDescription>13.03 - Connector</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>168</SubCategoryID><SubCategoryDescription>13.04 - Hook</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>169</SubCategoryID><SubCategoryDescription>13.05 - Plate</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>170</SubCategoryID><SubCategoryDescription>13.06 - Rod</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>171</SubCategoryID><SubCategoryDescription>13.07 - Plate-Rod</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>172</SubCategoryID><SubCategoryDescription>13.08 - Washer/Staple</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>173</SubCategoryID><SubCategoryDescription>13.09 - C-Ring</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>174</SubCategoryID><SubCategoryDescription>13.10 - Fusion Cage</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>175</SubCategoryID><SubCategoryDescription>13.11 - Disc Replacement</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>176</SubCategoryID><SubCategoryDescription>13.12 - Vertebral Body Replacement</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>177</SubCategoryID><SubCategoryDescription>13.13 - Interspinous Fixation</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>261</SubCategoryID><SubCategoryDescription>13.14 - Sacroiliac Joint Fixation</SubCategoryDescription></SubCategory><SubCategory><SubCategoryID>263</SubCategoryID><SubCategoryDescription>13.15 - Annular closure/reconstruction</SubCategoryDescription></SubCategory></SubCategories><Groups><Group><GroupID>1324</GroupID><GroupDescription>01.01.01 - Aphakic</GroupDescription></Group><Group><GroupID>1325</GroupID><GroupDescription>01.01.02 - Phakic</GroupDescription></Group><Group><GroupID>1326</GroupID><GroupDescription>01.02.01 - Rigid</GroupDescription></Group><Group><GroupID>1327</GroupID><GroupDescription>01.02.02 - Foldable</GroupDescription></Group><Group><GroupID>1328</GroupID><GroupDescription>01.02.03 - Pseudo-phakic, piggy-back</GroupDescription></Group><Group><GroupID>1329</GroupID><GroupDescription>01.03.01 - Viscoelastic</GroupDescription></Group><Group><GroupID>1330</GroupID><GroupDescription>01.03.02 - Non Viscous</GroupDescription></Group><Group><GroupID>1331</GroupID><GroupDescription>01.04.01 - Simple</GroupDescription></Group><Group><GroupID>1332</GroupID><GroupDescription>01.04.02 - Complex</GroupDescription></Group><Group><GroupID>1333</GroupID><GroupDescription>01.05.01 - Ab Externo Long Tube /Reservoir</GroupDescription></Group><Group><GroupID>1334</GroupID><GroupDescription>01.05.02 - Ab Externo</GroupDescription></Group><Group><GroupID>1802</GroupID><GroupDescription>01.05.03 - Ab Interno Glaucoma Drainage Device</GroupDescription></Group><Group><GroupID>1335</GroupID><GroupDescription>01.06.01 - Spacers</GroupDescription></Group><Group><GroupID>1336</GroupID><GroupDescription>01.06.02 - Weights</GroupDescription></Group><Group><GroupID>1337</GroupID><GroupDescription>01.07.01 - Intracanalicular</GroupDescription></Group><Group><GroupID>1803</GroupID><GroupDescription>01.07.03 - Balloon Dilatation Catheters</GroupDescription></Group><Group><GroupID>1339</GroupID><GroupDescription>01.08.01 - Intrascleral</GroupDescription></Group><Group><GroupID>1340</GroupID><GroupDescription>01.08.02 - Extrascleral</GroupDescription></Group><Group><GroupID>1341</GroupID><GroupDescription>01.08.03 - Fascial - solid and permeable</GroupDescription></Group><Group><GroupID>1342</GroupID><GroupDescription>01.09.01 - Buckles, bands, tyres and sponges</GroupDescription></Group><Group><GroupID>1344</GroupID><GroupDescription>01.09.03 - Sleeves</GroupDescription></Group><Group><GroupID>1345</GroupID><GroupDescription>01.09.04 - Intraocular Gases</GroupDescription></Group><Group><GroupID>1346</GroupID><GroupDescription>01.09.05 - Intraocular Heavy Liquids</GroupDescription></Group><Group><GroupID>1347</GroupID><GroupDescription>01.09.06 - Intraocular Silicone Oils</GroupDescription></Group><Group><GroupID>1822</GroupID><GroupDescription>01.10.01 - Foldable</GroupDescription></Group><Group><GroupID>1526</GroupID><GroupDescription>02.01.01 - Cochlear Implants</GroupDescription></Group><Group><GroupID>1528</GroupID><GroupDescription>02.01.02 - Speech Processors</GroupDescription></Group><Group><GroupID>1560</GroupID><GroupDescription>02.01.04 - Implantable Bone Conduction Hearing System</GroupDescription></Group><Group><GroupID>1565</GroupID><GroupDescription>02.01.05 - Ossicle/Middle Ear Prosthesis</GroupDescription></Group><Group><GroupID>1566</GroupID><GroupDescription>02.01.06 - Ventilation Tube/Grommet</GroupDescription></Group><Group><GroupID>2521</GroupID><GroupDescription>02.01.08 - Tympanic Membrane Grafts</GroupDescription></Group><Group><GroupID>2960</GroupID><GroupDescription>02.01.09 - Implantable Piezoelectric Bone Conduction Hearing System (all components)</GroupDescription></Group><Group><GroupID>1568</GroupID><GroupDescription>02.02.01 - Septal Button</GroupDescription></Group><Group><GroupID>1817</GroupID><GroupDescription>02.02.02 - Nasal Valve Stent</GroupDescription></Group><Group><GroupID>2969</GroupID><GroupDescription>02.02.03 - Absorbable Nasal Implant</GroupDescription></Group><Group><GroupID>1569</GroupID><GroupDescription>02.03.01 - Tracheal Speaking Valve</GroupDescription></Group><Group><GroupID>1570</GroupID><GroupDescription>02.03.02 - Vocal Chord Medialisation Implant</GroupDescription></Group><Group><GroupID>1571</GroupID><GroupDescription>02.03.03 - Tracheal Stents</GroupDescription></Group><Group><GroupID>1573</GroupID><GroupDescription>02.03.04 - Thyroplasty</GroupDescription></Group><Group><GroupID>1574</GroupID><GroupDescription>02.03.05 - Cannula</GroupDescription></Group><Group><GroupID>1576</GroupID><GroupDescription>02.03.06 - Injectable Material for Vocal Fold Augmentation / Laryngeal Reconstruction</GroupDescription></Group><Group><GroupID>1520</GroupID><GroupDescription>03.01.01 - Hepatic, Yttrium 90, Standard Dose</GroupDescription></Group><Group><GroupID>1521</GroupID><GroupDescription>03.01.02 - Prostatic I-125</GroupDescription></Group><Group><GroupID>1792</GroupID><GroupDescription>03.01.03 - Tissue Expander/Separator</GroupDescription></Group><Group><GroupID>1522</GroupID><GroupDescription>03.02.01 - Infusion Ports</GroupDescription></Group><Group><GroupID>1524</GroupID><GroupDescription>03.02.02 - Infusion Pumps, Balloon Based</GroupDescription></Group><Group><GroupID>1525</GroupID><GroupDescription>03.02.03 - Infusion Pumps, Battery Powered</GroupDescription></Group><Group><GroupID>1540</GroupID><GroupDescription>03.02.04 - Infusion Pumps, Spring Powered</GroupDescription></Group><Group><GroupID>1541</GroupID><GroupDescription>03.02.05 - Infusion Pump Accessories</GroupDescription></Group><Group><GroupID>1542</GroupID><GroupDescription>03.02.06 - Pharmaceutical Beads</GroupDescription></Group><Group><GroupID>1544</GroupID><GroupDescription>03.03.01 - Feeding Tubes</GroupDescription></Group><Group><GroupID>1545</GroupID><GroupDescription>03.03.02 - Gastrostomy Tubes</GroupDescription></Group><Group><GroupID>1546</GroupID><GroupDescription>03.03.03 - Jejunostomy Tubes</GroupDescription></Group><Group><GroupID>1547</GroupID><GroupDescription>03.03.04 - Caecostomy Tubes</GroupDescription></Group><Group><GroupID>1548</GroupID><GroupDescription>03.04.01 - Adjustable Gastric Band with Port</GroupDescription></Group><Group><GroupID>1781</GroupID><GroupDescription>03.04.02 - Gastric Band without Port</GroupDescription></Group><Group><GroupID>1779</GroupID><GroupDescription>03.04.03 - Replacement Injection Ports</GroupDescription></Group><Group><GroupID>1551</GroupID><GroupDescription>03.05.01 - Occluder Pin</GroupDescription></Group><Group><GroupID>1552</GroupID><GroupDescription>03.05.02 - Powder</GroupDescription></Group><Group><GroupID>1553</GroupID><GroupDescription>03.05.03 - Sponges</GroupDescription></Group><Group><GroupID>1554</GroupID><GroupDescription>03.05.04 - Pliable Patches</GroupDescription></Group><Group><GroupID>1555</GroupID><GroupDescription>03.05.05 - Matrix</GroupDescription></Group><Group><GroupID>1797</GroupID><GroupDescription>03.05.06 - Foam</GroupDescription></Group><Group><GroupID>1556</GroupID><GroupDescription>03.06.01 - Biliary Stents</GroupDescription></Group><Group><GroupID>1557</GroupID><GroupDescription>03.06.02 - Colonic Stents</GroupDescription></Group><Group><GroupID>1558</GroupID><GroupDescription>03.06.03 - Oesophageal Stents</GroupDescription></Group><Group><GroupID>1561</GroupID><GroupDescription>03.06.04 - Pancreatic Stents</GroupDescription></Group><Group><GroupID>1562</GroupID><GroupDescription>03.06.05 - Enteral Stents</GroupDescription></Group><Group><GroupID>1563</GroupID><GroupDescription>03.06.06 - Tracheobronchial Stents</GroupDescription></Group><Group><GroupID>1564</GroupID><GroupDescription>03.06.07 - Nerve Repair Stents</GroupDescription></Group><Group><GroupID>1577</GroupID><GroupDescription>03.07.01 - Drainage Catheters</GroupDescription></Group><Group><GroupID>1578</GroupID><GroupDescription>03.07.02 - Endobronchial Valve</GroupDescription></Group><Group><GroupID>1793</GroupID><GroupDescription>03.07.03 - Drainage Shunts, Peritineovenous</GroupDescription></Group><Group><GroupID>1579</GroupID><GroupDescription>03.08.01 - Adhesion Barriers</GroupDescription></Group><Group><GroupID>1580</GroupID><GroupDescription>03.08.02 - Internal Adhesives</GroupDescription></Group><Group><GroupID>1581</GroupID><GroupDescription>03.08.03 - Ligating Devices</GroupDescription></Group><Group><GroupID>1582</GroupID><GroupDescription>03.08.04 - Staples &amp; Tackers</GroupDescription></Group><Group><GroupID>1782</GroupID><GroupDescription>03.08.05 - Polypropylene/Polyester Mesh</GroupDescription></Group><Group><GroupID>1783</GroupID><GroupDescription>03.08.06 - Composite Mesh</GroupDescription></Group><Group><GroupID>1798</GroupID><GroupDescription>03.08.07 - Complete Biomaterial Mesh</GroupDescription></Group><Group><GroupID>1691</GroupID><GroupDescription>03.08.09 - Plugs</GroupDescription></Group><Group><GroupID>1771</GroupID><GroupDescription>03.08.10 - Anastomosis Clip</GroupDescription></Group><Group><GroupID>1799</GroupID><GroupDescription>03.08.11 - Dynamic Wound Closure Devices</GroupDescription></Group><Group><GroupID>2964</GroupID><GroupDescription>03.10.01 - Personal Diabetes Manager</GroupDescription></Group><Group><GroupID>20002</GroupID><GroupDescription>03.10.02 - Personal Diabetes Manager with capability to automatically adjust the insulin delivery based on continuous glucose monitoring data</GroupDescription></Group><Group><GroupID>1655</GroupID><GroupDescription>04.01.01 - Aneurysm Clip</GroupDescription></Group><Group><GroupID>1656</GroupID><GroupDescription>04.01.02 - AVM Clip</GroupDescription></Group><Group><GroupID>1657</GroupID><GroupDescription>04.02.01 - Repair, Graft, Small (≤10cm²)</GroupDescription></Group><Group><GroupID>1658</GroupID><GroupDescription>04.02.02 - Repair, Graft, Medium (&gt;10 to 50cm²)</GroupDescription></Group><Group><GroupID>1659</GroupID><GroupDescription>04.02.03 - Repair, Graft, Large (&gt;50 to 100cm²)</GroupDescription></Group><Group><GroupID>1660</GroupID><GroupDescription>04.02.04 - Repair, Graft, Extra Large (&gt;100cm²)</GroupDescription></Group><Group><GroupID>1661</GroupID><GroupDescription>04.02.05 - Repair, Liquid Sealant (0 to 3ml)</GroupDescription></Group><Group><GroupID>1662</GroupID><GroupDescription>04.02.06 - Repair, Liquid Sealant (&gt;3 to 6ml)</GroupDescription></Group><Group><GroupID>1664</GroupID><GroupDescription>04.02.08 - Repair, Self-Adhesive Membrane Sealant, Medium (&gt;10 to 50cm²)</GroupDescription></Group><Group><GroupID>1695</GroupID><GroupDescription>04.02.09 - Repair, Self-Adhesive Membrane Sealant, Large (&gt;50 to 100cm²)</GroupDescription></Group><Group><GroupID>1666</GroupID><GroupDescription>04.03.01 - Valves</GroupDescription></Group><Group><GroupID>1667</GroupID><GroupDescription>04.03.02 - Unitised shunt assembly, with proximal/distal catheter</GroupDescription></Group><Group><GroupID>1668</GroupID><GroupDescription>04.03.03 - Catheter</GroupDescription></Group><Group><GroupID>2961</GroupID><GroupDescription>04.03.04 - Antisyphon Device</GroupDescription></Group><Group><GroupID>1670</GroupID><GroupDescription>04.03.05 - Reservoir/Priming Device</GroupDescription></Group><Group><GroupID>1671</GroupID><GroupDescription>04.03.06 - Shunt Attachment</GroupDescription></Group><Group><GroupID>1672</GroupID><GroupDescription>04.04.01 - Implantable Pulse Generator</GroupDescription></Group><Group><GroupID>1673</GroupID><GroupDescription>04.04.02 - External Components</GroupDescription></Group><Group><GroupID>1674</GroupID><GroupDescription>04.04.03 - Leads</GroupDescription></Group><Group><GroupID>1675</GroupID><GroupDescription>04.04.04 - Microtargetting Electrodes</GroupDescription></Group><Group><GroupID>1676</GroupID><GroupDescription>04.04.05 - Accessories</GroupDescription></Group><Group><GroupID>1677</GroupID><GroupDescription>04.05.01 - Pulse Generators</GroupDescription></Group><Group><GroupID>1678</GroupID><GroupDescription>04.05.02 - External Components</GroupDescription></Group><Group><GroupID>1679</GroupID><GroupDescription>04.05.03 - Leads</GroupDescription></Group><Group><GroupID>1680</GroupID><GroupDescription>04.05.04 - Lead Extension</GroupDescription></Group><Group><GroupID>1690</GroupID><GroupDescription>04.05.05 - Accessories</GroupDescription></Group><Group><GroupID>1681</GroupID><GroupDescription>04.06.01 - Implantable Infusion Pump </GroupDescription></Group><Group><GroupID>1682</GroupID><GroupDescription>04.06.02 - Patient Programmer</GroupDescription></Group><Group><GroupID>1683</GroupID><GroupDescription>04.06.03 - Intrathecal Catheter</GroupDescription></Group><Group><GroupID>1684</GroupID><GroupDescription>04.06.04 - Accessories</GroupDescription></Group><Group><GroupID>1685</GroupID><GroupDescription>04.07.01 - Vagal nerve stimulators</GroupDescription></Group><Group><GroupID>1687</GroupID><GroupDescription>04.08.01 - Stent</GroupDescription></Group><Group><GroupID>1688</GroupID><GroupDescription>04.08.02 - Coils</GroupDescription></Group><Group><GroupID>1689</GroupID><GroupDescription>04.08.03 - Assist Devices</GroupDescription></Group><Group><GroupID>1794</GroupID><GroupDescription>04.09.01 - Transducer</GroupDescription></Group><Group><GroupID>1796</GroupID><GroupDescription>04.10.01 - External Ventricular Drain</GroupDescription></Group><Group><GroupID>1696</GroupID><GroupDescription>05.01.01 - Inflatable</GroupDescription></Group><Group><GroupID>1786</GroupID><GroupDescription>05.01.02 - Permanently Adjustable</GroupDescription></Group><Group><GroupID>1698</GroupID><GroupDescription>05.01.03 - Sling</GroupDescription></Group><Group><GroupID>1699</GroupID><GroupDescription>05.01.04 - Injectable, Synthetic</GroupDescription></Group><Group><GroupID>1701</GroupID><GroupDescription>05.02.01 - Fixed length</GroupDescription></Group><Group><GroupID>1702</GroupID><GroupDescription>05.02.02 - Multi-length</GroupDescription></Group><Group><GroupID>1703</GroupID><GroupDescription>05.02.03 - Urinary diversion</GroupDescription></Group><Group><GroupID>1800</GroupID><GroupDescription>05.03.01 - Urethral Stents</GroupDescription></Group><Group><GroupID>1801</GroupID><GroupDescription>05.03.02 - Prostatic Retractor</GroupDescription></Group><Group><GroupID>2971</GroupID><GroupDescription>05.03.03 - Radiofrequency (RF) Delivery Devices for Transurethral Water Vapour Ablation</GroupDescription></Group><Group><GroupID>2958</GroupID><GroupDescription>05.03.04 - Temporary Implant</GroupDescription></Group><Group><GroupID>1721</GroupID><GroupDescription>05.05.01 - Malleable</GroupDescription></Group><Group><GroupID>1710</GroupID><GroupDescription>05.05.03 - Inflatable - Three component</GroupDescription></Group><Group><GroupID>1711</GroupID><GroupDescription>05.06.01 - Testicular prostheses</GroupDescription></Group><Group><GroupID>1712</GroupID><GroupDescription>05.07.01 - Primary Cell Pulse Generator (non-rechargeable)</GroupDescription></Group><Group><GroupID>1713</GroupID><GroupDescription>05.07.02 - External Components</GroupDescription></Group><Group><GroupID>1714</GroupID><GroupDescription>05.07.03 - Lead</GroupDescription></Group><Group><GroupID>1715</GroupID><GroupDescription>05.07.04 - Accessories</GroupDescription></Group><Group><GroupID>2950</GroupID><GroupDescription>05.07.05 - Rechargeable Pulse Generator</GroupDescription></Group><Group><GroupID>1716</GroupID><GroupDescription>05.08.01 - Extraluminal</GroupDescription></Group><Group><GroupID>1718</GroupID><GroupDescription>05.09.01 - Nephrostomy Catheters</GroupDescription></Group><Group><GroupID>1719</GroupID><GroupDescription>05.10.01 - Vesicoureteral Reflux Prostheses</GroupDescription></Group><Group><GroupID>1269</GroupID><GroupDescription>06.01.01 - Ankle joint component</GroupDescription></Group><Group><GroupID>1219</GroupID><GroupDescription>06.01.02 - Sinus Tarsi Implant</GroupDescription></Group><Group><GroupID>1460</GroupID><GroupDescription>06.01.03 - Ankle joint</GroupDescription></Group><Group><GroupID>1461</GroupID><GroupDescription>06.01.04 - Replacement of other joints of the foot including articulations</GroupDescription></Group><Group><GroupID>1273</GroupID><GroupDescription>06.02.01 - Wrist</GroupDescription></Group><Group><GroupID>1274</GroupID><GroupDescription>06.02.02 - Finger Joint Articulations</GroupDescription></Group><Group><GroupID>1275</GroupID><GroupDescription>06.02.03 - Elbow</GroupDescription></Group><Group><GroupID>1276</GroupID><GroupDescription>06.02.04 - Shoulder - Humeral</GroupDescription></Group><Group><GroupID>1277</GroupID><GroupDescription>06.02.05 - Shoulder - Glenoid</GroupDescription></Group><Group><GroupID>1278</GroupID><GroupDescription>06.02.06 - Shoulder - Accessories</GroupDescription></Group><Group><GroupID>1228</GroupID><GroupDescription>06.03.01 - Intramedullary Nails</GroupDescription></Group><Group><GroupID>1229</GroupID><GroupDescription>06.03.02 - Intramedullary Nail Accessories</GroupDescription></Group><Group><GroupID>1694</GroupID><GroupDescription>06.03.03 - Plates</GroupDescription></Group><Group><GroupID>1231</GroupID><GroupDescription>06.03.04 - Screws</GroupDescription></Group><Group><GroupID>1772</GroupID><GroupDescription>06.03.05 - Surgical Accessories</GroupDescription></Group><Group><GroupID>1773</GroupID><GroupDescription>06.03.06 - Staples</GroupDescription></Group><Group><GroupID>1774</GroupID><GroupDescription>06.03.07 - Soft Tissue Fixation Devices</GroupDescription></Group><Group><GroupID>1776</GroupID><GroupDescription>06.03.08 - Soft Tissue Substitute</GroupDescription></Group><Group><GroupID>1237</GroupID><GroupDescription>06.03.11 - External Fixateurs</GroupDescription></Group><Group><GroupID>2945</GroupID><GroupDescription>06.03.12 - Internal Fixator</GroupDescription></Group><Group><GroupID>1279</GroupID><GroupDescription>06.03.14 - Bone Cement</GroupDescription></Group><Group><GroupID>1241</GroupID><GroupDescription>06.03.15 - Bone Graft Substitute</GroupDescription></Group><Group><GroupID>1777</GroupID><GroupDescription>06.03.16 - Meshes</GroupDescription></Group><Group><GroupID>1778</GroupID><GroupDescription>06.03.17 - Tumour / Limb Deficiency</GroupDescription></Group><Group><GroupID>1585</GroupID><GroupDescription>07.01.01 - Mesh - Metal</GroupDescription></Group><Group><GroupID>1586</GroupID><GroupDescription>07.01.02 - Mesh - Non-metal</GroupDescription></Group><Group><GroupID>1587</GroupID><GroupDescription>07.01.03 - Mesh - Composite</GroupDescription></Group><Group><GroupID>1588</GroupID><GroupDescription>07.01.04 - Non-mesh</GroupDescription></Group><Group><GroupID>1589</GroupID><GroupDescription>07.01.05 - Fracture or Reconstruction Plates</GroupDescription></Group><Group><GroupID>1590</GroupID><GroupDescription>07.01.06 - Screws</GroupDescription></Group><Group><GroupID>1591</GroupID><GroupDescription>07.01.07 - Ancillary Components</GroupDescription></Group><Group><GroupID>1901</GroupID><GroupDescription>07.01.08 - Non-mesh, non-resorbable</GroupDescription></Group><Group><GroupID>1592</GroupID><GroupDescription>07.02.01 - Chin</GroupDescription></Group><Group><GroupID>1593</GroupID><GroupDescription>07.02.02 - Cranium</GroupDescription></Group><Group><GroupID>1594</GroupID><GroupDescription>07.02.03 - Ear</GroupDescription></Group><Group><GroupID>1595</GroupID><GroupDescription>07.02.04 - Malar</GroupDescription></Group><Group><GroupID>1596</GroupID><GroupDescription>07.02.05 - Mandible, Maxilla and Temperomandibular Joint (TMJ)</GroupDescription></Group><Group><GroupID>1597</GroupID><GroupDescription>07.02.06 - Nose and Zygoma</GroupDescription></Group><Group><GroupID>1598</GroupID><GroupDescription>07.02.07 - Orbit</GroupDescription></Group><Group><GroupID>1599</GroupID><GroupDescription>07.02.08 - External Prostheses, Bone Attachment</GroupDescription></Group><Group><GroupID>1807</GroupID><GroupDescription>07.02.09 - Anatomical Biomodel</GroupDescription></Group><Group><GroupID>1600</GroupID><GroupDescription>07.03.01 - Abutment</GroupDescription></Group><Group><GroupID>1601</GroupID><GroupDescription>07.03.02 - Zygomatic Bone Implant</GroupDescription></Group><Group><GroupID>1602</GroupID><GroupDescription>07.03.03 - Endosseous Implant</GroupDescription></Group><Group><GroupID>2968</GroupID><GroupDescription>07.03.04 - Subperiosteal</GroupDescription></Group><Group><GroupID>1603</GroupID><GroupDescription>07.04.01 - Complete</GroupDescription></Group><Group><GroupID>1604</GroupID><GroupDescription>07.04.02 - Component</GroupDescription></Group><Group><GroupID>1606</GroupID><GroupDescription>07.05.02 - Tissue Expanders</GroupDescription></Group><Group><GroupID>1607</GroupID><GroupDescription>07.05.03 - Skin, Artificial</GroupDescription></Group><Group><GroupID>1608</GroupID><GroupDescription>07.05.04 - Coupler</GroupDescription></Group><Group><GroupID>1609</GroupID><GroupDescription>07.06.01 - Saline Filled</GroupDescription></Group><Group><GroupID>1610</GroupID><GroupDescription>07.06.02 - Gel Filled</GroupDescription></Group><Group><GroupID>1723</GroupID><GroupDescription>08.01.02 - Features of 8.1.1 plus auto test sensing parameters, auto capture threshold test, lead impedance test, wireless remote analysis</GroupDescription></Group><Group><GroupID>1812</GroupID><GroupDescription>08.01.03 - Single Chamber, Subcutaneous</GroupDescription></Group><Group><GroupID>20000</GroupID><GroupDescription>08.01.05 - Extravascular</GroupDescription></Group><Group><GroupID>1725</GroupID><GroupDescription>08.02.02 - Features of 8.2.1 plus auto test sensing parameters, auto capture threshold test, lead impedance test, wireless remote analysis</GroupDescription></Group><Group><GroupID>1727</GroupID><GroupDescription>08.03.02 - Features of 8.3.1 plus auto test sensing parameters, auto capture threshold test, lead impedance test, wireless remote analysis</GroupDescription></Group><Group><GroupID>1730</GroupID><GroupDescription>08.04.03 - SSIR with small/compact size, multi-programmability &amp; longevity, &amp; four or more advanced features</GroupDescription></Group><Group><GroupID>2965</GroupID><GroupDescription>08.04.04 - Leadless pacemaker</GroupDescription></Group><Group><GroupID>1734</GroupID><GroupDescription>08.05.04 - DDDR with continuous threshold monitoring in atrium + ventricle with ability to adapt pacing outputs accordingly, &amp; with four or more advanced features</GroupDescription></Group><Group><GroupID>1736</GroupID><GroupDescription>08.06.02 - Features of 8.6.1 plus continuous threshold monitoring in atrium &amp; ventricle with ability to adapt pacing outputs accordingly</GroupDescription></Group><Group><GroupID>1737</GroupID><GroupDescription>08.07.01 - Coronary Sinus</GroupDescription></Group><Group><GroupID>1738</GroupID><GroupDescription>08.07.02 - Subcutaneous</GroupDescription></Group><Group><GroupID>1741</GroupID><GroupDescription>08.07.05 - Transvenous/Steroid/Passive</GroupDescription></Group><Group><GroupID>1743</GroupID><GroupDescription>08.07.06 - Transvenous/Steroid/Active</GroupDescription></Group><Group><GroupID>1745</GroupID><GroupDescription>08.07.07 - Epicardial Patches</GroupDescription></Group><Group><GroupID>1746</GroupID><GroupDescription>08.08.01 - Non-transvenous, Bi-Polar, Steroid</GroupDescription></Group><Group><GroupID>1747</GroupID><GroupDescription>08.08.02 - Non-transvenous, Uni-Polar, Steroid</GroupDescription></Group><Group><GroupID>1748</GroupID><GroupDescription>08.08.03 - Non-transvenous, Uni-Polar, Non-Steroid</GroupDescription></Group><Group><GroupID>1751</GroupID><GroupDescription>08.08.06 - Transvenous, Uni-Polar, Passive, Steroid, Left Ventricular</GroupDescription></Group><Group><GroupID>1753</GroupID><GroupDescription>08.08.08 - Transvenous, Bi-Polar, Passive, Steroid, Right Ventricular/Atrial</GroupDescription></Group><Group><GroupID>1756</GroupID><GroupDescription>08.08.09 - Transvenous, Bi-Polar, Active, Steroid, Right Ventricular/Atrial</GroupDescription></Group><Group><GroupID>1759</GroupID><GroupDescription>08.08.11 - Transvenous, Multi-Polar, Passive, Steroid, Left Ventricular</GroupDescription></Group><Group><GroupID>1763</GroupID><GroupDescription>08.09.01 - Pacemaker/ICD Adaptors</GroupDescription></Group><Group><GroupID>1764</GroupID><GroupDescription>08.10.01 - Pacemaker/ICD Adaptors</GroupDescription></Group><Group><GroupID>1765</GroupID><GroupDescription>08.11.01 - Pacemaker/Lead Accessories</GroupDescription></Group><Group><GroupID>1829</GroupID><GroupDescription>08.11.02 - Antibacterial Envelope</GroupDescription></Group><Group><GroupID>1766</GroupID><GroupDescription>08.12.01 - Drug Eluting</GroupDescription></Group><Group><GroupID>1767</GroupID><GroupDescription>08.12.02 - Bare Metal</GroupDescription></Group><Group><GroupID>1768</GroupID><GroupDescription>08.13.01 - Cardiac Defect Occluders</GroupDescription></Group><Group><GroupID>2181</GroupID><GroupDescription>08.13.03 - Left Atrial Appendage Closure</GroupDescription></Group><Group><GroupID>2962</GroupID><GroupDescription>08.14.01 - Implantable Cardiac Event Recorders</GroupDescription></Group><Group><GroupID>1804</GroupID><GroupDescription>08.15.01 - Uncovered</GroupDescription></Group><Group><GroupID>1805</GroupID><GroupDescription>08.15.02 - Covered</GroupDescription></Group><Group><GroupID>1832</GroupID><GroupDescription>08.16.01 - Remote Monitoring System</GroupDescription></Group><Group><GroupID>20001</GroupID><GroupDescription>08.16.02 - Implantable Cardiac Event Recorders</GroupDescription></Group><Group><GroupID>2641</GroupID><GroupDescription>08.17.01 - Transcatheter Aortic Valve Implantation</GroupDescription></Group><Group><GroupID>2952</GroupID><GroupDescription>08.17.02 - Mitral Valve Repair</GroupDescription></Group><Group><GroupID>2946</GroupID><GroupDescription>08.18.01 - Radio frequency (RF) Ablation</GroupDescription></Group><Group><GroupID>2947</GroupID><GroupDescription>08.18.02 - Cryoablation</GroupDescription></Group><Group><GroupID>2966</GroupID><GroupDescription>08.18.03 - Pulsed Field Ablation</GroupDescription></Group><Group><GroupID>2970</GroupID><GroupDescription>08.19.01 - Coronary Drug Coated Balloon Catheters</GroupDescription></Group><Group><GroupID>1497</GroupID><GroupDescription>09.01.01 - Bi-Leaflet, rotatable</GroupDescription></Group><Group><GroupID>1499</GroupID><GroupDescription>09.02.01 - Stented, anatomical</GroupDescription></Group><Group><GroupID>1500</GroupID><GroupDescription>09.02.02 - Stented, non anatomical</GroupDescription></Group><Group><GroupID>1501</GroupID><GroupDescription>09.02.03 - Non-Stented</GroupDescription></Group><Group><GroupID>1815</GroupID><GroupDescription>09.02.04 - Rapid deployment aortic valve with dedicated single use tools</GroupDescription></Group><Group><GroupID>1502</GroupID><GroupDescription>09.03.01 - Mechanical Valve</GroupDescription></Group><Group><GroupID>1503</GroupID><GroupDescription>09.03.02 - Tissue Valve, stented anatomical</GroupDescription></Group><Group><GroupID>1841</GroupID><GroupDescription>09.04.04 - Atrio-Ventricular Ring or Band, Standard</GroupDescription></Group><Group><GroupID>1842</GroupID><GroupDescription>09.04.05 - Atrio-Ventricular Ring or Band, Modified</GroupDescription></Group><Group><GroupID>1507</GroupID><GroupDescription>09.05.01 - Tissue</GroupDescription></Group><Group><GroupID>1508</GroupID><GroupDescription>09.05.02 - Synthetic</GroupDescription></Group><Group><GroupID>1509</GroupID><GroupDescription>09.06.01 - Non-cardiovascular &lt; 100cm²</GroupDescription></Group><Group><GroupID>1510</GroupID><GroupDescription>09.06.02 - Non-cardiovascular ≥100cm² and &lt;200cm²</GroupDescription></Group><Group><GroupID>1511</GroupID><GroupDescription>09.06.03 - Non-cardiovascular  ≥200cm²</GroupDescription></Group><Group><GroupID>1790</GroupID><GroupDescription>09.08.02 - Surgical closure devices (atrial appendage)</GroupDescription></Group><Group><GroupID>1517</GroupID><GroupDescription>09.09.01 - Modified Tube (end modified eg valsalva)</GroupDescription></Group><Group><GroupID>1518</GroupID><GroupDescription>09.09.02 - Tube with one side branch</GroupDescription></Group><Group><GroupID>1519</GroupID><GroupDescription>09.09.03 - Tube with multiple side branches (more than 1)</GroupDescription></Group><Group><GroupID>1811</GroupID><GroupDescription>09.09.04 - Hybrid stent graft (unbranched)</GroupDescription></Group><Group><GroupID>2601</GroupID><GroupDescription>09.09.05 - Hybrid stent graft (Branched)</GroupDescription></Group><Group><GroupID>2957</GroupID><GroupDescription>09.09.06 - Straight Tube</GroupDescription></Group><Group><GroupID>1791</GroupID><GroupDescription>09.10.01 - Skeletal fixation, sternum</GroupDescription></Group><Group><GroupID>1819</GroupID><GroupDescription>09.11.01 - Ventricular Assist System</GroupDescription></Group><Group><GroupID>1830</GroupID><GroupDescription>09.11.02 - External Components</GroupDescription></Group><Group><GroupID>1831</GroupID><GroupDescription>09.11.03 - Patient Mobility Accessories</GroupDescription></Group><Group><GroupID>1824</GroupID><GroupDescription>09.12.01 - Pectus Bar</GroupDescription></Group><Group><GroupID>1825</GroupID><GroupDescription>09.12.02 - Stabilisers</GroupDescription></Group><Group><GroupID>1828</GroupID><GroupDescription>09.13.01 - Chordal Replacement Devices, fixed and adjustable</GroupDescription></Group><Group><GroupID>2948</GroupID><GroupDescription>09.14.01 - RF Ablation</GroupDescription></Group><Group><GroupID>2949</GroupID><GroupDescription>09.14.02 - Cryoablation</GroupDescription></Group><Group><GroupID>1622</GroupID><GroupDescription>10.01.01 - Bare Metal Stents</GroupDescription></Group><Group><GroupID>1624</GroupID><GroupDescription>10.01.02 - Drug Eluting Stents</GroupDescription></Group><Group><GroupID>20004</GroupID><GroupDescription>10.01.03 - Bioresorbable Drug Eluting Stent</GroupDescription></Group><Group><GroupID>1625</GroupID><GroupDescription>10.02.01 - Tube (Thoracic Aorta)</GroupDescription></Group><Group><GroupID>1626</GroupID><GroupDescription>10.02.02 - Tube (Abdominal Aorta)</GroupDescription></Group><Group><GroupID>1627</GroupID><GroupDescription>10.02.03 - Tube (Aorto-uni-iliac)</GroupDescription></Group><Group><GroupID>1628</GroupID><GroupDescription>10.02.04 - Bifurcated</GroupDescription></Group><Group><GroupID>1629</GroupID><GroupDescription>10.02.05 - Branched</GroupDescription></Group><Group><GroupID>1630</GroupID><GroupDescription>10.02.06 - Fenestrated</GroupDescription></Group><Group><GroupID>1631</GroupID><GroupDescription>10.02.07 - Accessory Component (Aortic)</GroupDescription></Group><Group><GroupID>1632</GroupID><GroupDescription>10.02.08 - Accessory Component (Other including iliac limb and extension)</GroupDescription></Group><Group><GroupID>1634</GroupID><GroupDescription>10.02.10 - Tube, Peripheral, Balloon Expandable</GroupDescription></Group><Group><GroupID>1635</GroupID><GroupDescription>10.02.11 - Tube, Peripheral, Self Expandable</GroupDescription></Group><Group><GroupID>1636</GroupID><GroupDescription>10.03.01 - Tube</GroupDescription></Group><Group><GroupID>1637</GroupID><GroupDescription>10.03.02 - Bifurcated</GroupDescription></Group><Group><GroupID>1638</GroupID><GroupDescription>10.03.03 - Branched or Fenestrated</GroupDescription></Group><Group><GroupID>1639</GroupID><GroupDescription>10.03.04 - Tapered or End-modified</GroupDescription></Group><Group><GroupID>1640</GroupID><GroupDescription>10.04.01 - Vascular Patches</GroupDescription></Group><Group><GroupID>1641</GroupID><GroupDescription>10.05.01 - Vessel Bands</GroupDescription></Group><Group><GroupID>1642</GroupID><GroupDescription>10.06.01 - Venous</GroupDescription></Group><Group><GroupID>1643</GroupID><GroupDescription>10.06.02 - Arterial</GroupDescription></Group><Group><GroupID>1644</GroupID><GroupDescription>10.07.01 - Arterial Closure Devices</GroupDescription></Group><Group><GroupID>1645</GroupID><GroupDescription>10.08.01 - Particle</GroupDescription></Group><Group><GroupID>1646</GroupID><GroupDescription>10.08.02 - Coil, Peripheral</GroupDescription></Group><Group><GroupID>1647</GroupID><GroupDescription>10.08.03 - Polymer</GroupDescription></Group><Group><GroupID>1648</GroupID><GroupDescription>10.08.04 - Complex Occlusion Devices, including detachable balloon, sphere or umbrella</GroupDescription></Group><Group><GroupID>1692</GroupID><GroupDescription>10.08.05 - Liquid</GroupDescription></Group><Group><GroupID>1693</GroupID><GroupDescription>10.08.06 - Delivery Device For Occlusion Media</GroupDescription></Group><Group><GroupID>1649</GroupID><GroupDescription>10.09.01 - Percutaneous Catheters, Single Lumen</GroupDescription></Group><Group><GroupID>1650</GroupID><GroupDescription>10.09.02 - Percutaneous Catheters, Multiple Lumen</GroupDescription></Group><Group><GroupID>1651</GroupID><GroupDescription>10.09.03 - Percutaneous Catheters, Multiple Lumen for Haemodialysis</GroupDescription></Group><Group><GroupID>1652</GroupID><GroupDescription>10.09.04 - Infuser Ports, Single Chamber</GroupDescription></Group><Group><GroupID>1653</GroupID><GroupDescription>10.09.05 - Infuser Ports, Multiple Chamber</GroupDescription></Group><Group><GroupID>1654</GroupID><GroupDescription>10.10.01 - Peritoneal Dialysis, Long Term Implantable Catheters</GroupDescription></Group><Group><GroupID>2967</GroupID><GroupDescription>10.11.01 - Drug-coated Balloon Catheter</GroupDescription></Group><Group><GroupID>1404</GroupID><GroupDescription>11.01.01 - Cemented</GroupDescription></Group><Group><GroupID>1405</GroupID><GroupDescription>11.01.02 - Cemented, Long Lengths (≥200mm)</GroupDescription></Group><Group><GroupID>1406</GroupID><GroupDescription>11.01.03 - Uncemented</GroupDescription></Group><Group><GroupID>1407</GroupID><GroupDescription>11.01.04 - Uncemented, HA Coated</GroupDescription></Group><Group><GroupID>1408</GroupID><GroupDescription>11.01.05 - Uncemented, Long Lengths (≥200mm)</GroupDescription></Group><Group><GroupID>1409</GroupID><GroupDescription>11.01.06 - Uncemented, Long Lengths, HA Coated (≥ 200mm)</GroupDescription></Group><Group><GroupID>1410</GroupID><GroupDescription>11.01.07 - Uncemented, Modular</GroupDescription></Group><Group><GroupID>1411</GroupID><GroupDescription>11.01.08 - Uncemented, Modular, HA Coated</GroupDescription></Group><Group><GroupID>1412</GroupID><GroupDescription>11.01.09 - Uncemented, Modular, Long Lengths (Stem ≥200mm;  Body ≥75mm;  Cone ≥70mm;  Spacer/Sleeve ≥50mm)</GroupDescription></Group><Group><GroupID>1413</GroupID><GroupDescription>11.01.10 - Uncemented, Modular, HA Coated, Long Lengths (Stem ≥200mm;  Body ≥75mm;  Cone ≥70mm;  Spacer/Sleeve ≥50mm)</GroupDescription></Group><Group><GroupID>1416</GroupID><GroupDescription>11.01.13 - Monoblock Hemis</GroupDescription></Group><Group><GroupID>1417</GroupID><GroupDescription>11.01.14 - Femoral Neck</GroupDescription></Group><Group><GroupID>1419</GroupID><GroupDescription>11.02.01 - Conventional Femoral Heads, ≤32mm</GroupDescription></Group><Group><GroupID>1420</GroupID><GroupDescription>11.02.02 - Conventional Femoral Heads, &gt;32mm</GroupDescription></Group><Group><GroupID>1422</GroupID><GroupDescription>11.02.04 - Resurfacing, Cemented</GroupDescription></Group><Group><GroupID>1424</GroupID><GroupDescription>11.02.06 - Bipolar/Multipolar</GroupDescription></Group><Group><GroupID>1425</GroupID><GroupDescription>11.03.01 - Cups, Cemented</GroupDescription></Group><Group><GroupID>1426</GroupID><GroupDescription>11.03.02 - Shells, Uncemented</GroupDescription></Group><Group><GroupID>1427</GroupID><GroupDescription>11.03.03 - Shells, Uncemented, HA</GroupDescription></Group><Group><GroupID>1428</GroupID><GroupDescription>11.03.04 - Insert/Liner</GroupDescription></Group><Group><GroupID>1429</GroupID><GroupDescription>11.03.05 - Bonded Shell/Liner</GroupDescription></Group><Group><GroupID>1431</GroupID><GroupDescription>11.03.07 - Resurfacing Cup</GroupDescription></Group><Group><GroupID>1432</GroupID><GroupDescription>11.03.08 - Acetabular Reconstruction Devices</GroupDescription></Group><Group><GroupID>1433</GroupID><GroupDescription>11.04.01 - Augment</GroupDescription></Group><Group><GroupID>1434</GroupID><GroupDescription>11.04.02 - Bolt</GroupDescription></Group><Group><GroupID>1435</GroupID><GroupDescription>11.04.03 - Bone Screw</GroupDescription></Group><Group><GroupID>1436</GroupID><GroupDescription>11.04.04 - Calcar Block</GroupDescription></Group><Group><GroupID>1437</GroupID><GroupDescription>11.04.05 - Cement Restrictor</GroupDescription></Group><Group><GroupID>1438</GroupID><GroupDescription>11.04.06 - Centraliser</GroupDescription></Group><Group><GroupID>1439</GroupID><GroupDescription>11.04.07 - Claw</GroupDescription></Group><Group><GroupID>1440</GroupID><GroupDescription>11.04.08 - Connector</GroupDescription></Group><Group><GroupID>1441</GroupID><GroupDescription>11.04.09 - Dome Plug</GroupDescription></Group><Group><GroupID>1442</GroupID><GroupDescription>11.04.10 - Head Taper Insert</GroupDescription></Group><Group><GroupID>1443</GroupID><GroupDescription>11.04.11 - Neck Adapter</GroupDescription></Group><Group><GroupID>1444</GroupID><GroupDescription>11.04.12 - Nut</GroupDescription></Group><Group><GroupID>1445</GroupID><GroupDescription>11.04.13 - Pin</GroupDescription></Group><Group><GroupID>1446</GroupID><GroupDescription>11.04.14 - Plug - Including Dome Plug</GroupDescription></Group><Group><GroupID>1447</GroupID><GroupDescription>11.04.15 - Plug and Hood</GroupDescription></Group><Group><GroupID>1449</GroupID><GroupDescription>11.04.17 - Ring</GroupDescription></Group><Group><GroupID>1450</GroupID><GroupDescription>11.04.18 - Screw</GroupDescription></Group><Group><GroupID>1451</GroupID><GroupDescription>11.04.19 - Sleeve</GroupDescription></Group><Group><GroupID>1452</GroupID><GroupDescription>11.04.20 - Spacer- Unique</GroupDescription></Group><Group><GroupID>1454</GroupID><GroupDescription>11.04.22 - Trochanter Plate</GroupDescription></Group><Group><GroupID>1456</GroupID><GroupDescription>11.04.24 - Washer</GroupDescription></Group><Group><GroupID>1457</GroupID><GroupDescription>11.04.25 - Wire - Cobalt Chrome</GroupDescription></Group><Group><GroupID>1458</GroupID><GroupDescription>11.04.26 - Wire - Stainless Steel</GroupDescription></Group><Group><GroupID>1806</GroupID><GroupDescription>11.04.27 - Insert Orientation Spacer Ring</GroupDescription></Group><Group><GroupID>1820</GroupID><GroupDescription>11.04.28 - Acetabular Stem or equivalent</GroupDescription></Group><Group><GroupID>1348</GroupID><GroupDescription>12.01.01 - Cemented, Alloy</GroupDescription></Group><Group><GroupID>1349</GroupID><GroupDescription>12.01.02 - Cemented, Alloy, PMMA Coating</GroupDescription></Group><Group><GroupID>1350</GroupID><GroupDescription>12.01.03 - Cemented, Non-Alloy</GroupDescription></Group><Group><GroupID>1351</GroupID><GroupDescription>12.01.04 - Uncemented, Alloy</GroupDescription></Group><Group><GroupID>1352</GroupID><GroupDescription>12.01.05 - Uncemented, Alloy, HA Coating</GroupDescription></Group><Group><GroupID>1353</GroupID><GroupDescription>12.02.01 - Cemented, Alloy</GroupDescription></Group><Group><GroupID>1354</GroupID><GroupDescription>12.02.02 - Cemented, Non-Alloy</GroupDescription></Group><Group><GroupID>1355</GroupID><GroupDescription>12.02.03 - Uncemented, Alloy</GroupDescription></Group><Group><GroupID>1356</GroupID><GroupDescription>12.03.01 - Cemented, All polyethylene</GroupDescription></Group><Group><GroupID>1357</GroupID><GroupDescription>12.03.02 - Cemented, Alloy</GroupDescription></Group><Group><GroupID>1359</GroupID><GroupDescription>12.03.04 - Cemented, Alloy, for Mobile Insert</GroupDescription></Group><Group><GroupID>1360</GroupID><GroupDescription>12.03.05 - Uncemented, Alloy</GroupDescription></Group><Group><GroupID>1362</GroupID><GroupDescription>12.03.07 - Uncemented, Alloy, for Mobile Insert</GroupDescription></Group><Group><GroupID>1363</GroupID><GroupDescription>12.04.01 - Cemented, Alloy Polyethylene</GroupDescription></Group><Group><GroupID>1364</GroupID><GroupDescription>12.04.02 - Cemented, Alloy</GroupDescription></Group><Group><GroupID>1365</GroupID><GroupDescription>12.04.03 - Cemented, Alloy, Moulded Polyethylene</GroupDescription></Group><Group><GroupID>1366</GroupID><GroupDescription>12.04.04 - Cemented, Alloy, for Mobile Insert</GroupDescription></Group><Group><GroupID>1367</GroupID><GroupDescription>12.04.05 - Uncemented, Alloy</GroupDescription></Group><Group><GroupID>1368</GroupID><GroupDescription>12.04.06 - Uncemented, Alloy, for Mobile Insert</GroupDescription></Group><Group><GroupID>1369</GroupID><GroupDescription>12.05.01 - Minimally Stabilised</GroupDescription></Group><Group><GroupID>1370</GroupID><GroupDescription>12.05.02 - Posterior Stabilised</GroupDescription></Group><Group><GroupID>1371</GroupID><GroupDescription>12.05.03 - Totally Constrained</GroupDescription></Group><Group><GroupID>1372</GroupID><GroupDescription>12.06.01 - Tibial Insert: Uni-Compartmental Arthroplasty</GroupDescription></Group><Group><GroupID>1374</GroupID><GroupDescription>12.07.01 - Alloy</GroupDescription></Group><Group><GroupID>1375</GroupID><GroupDescription>12.07.02 - Non-Alloy</GroupDescription></Group><Group><GroupID>1376</GroupID><GroupDescription>12.08.01 - Cemented, All Polyethylene</GroupDescription></Group><Group><GroupID>1378</GroupID><GroupDescription>12.08.03 - Uncemented, Polyethylene, Metal Backed</GroupDescription></Group><Group><GroupID>1380</GroupID><GroupDescription>12.09.01 - Distal Femur</GroupDescription></Group><Group><GroupID>1381</GroupID><GroupDescription>12.09.02 - Proximal Tibia</GroupDescription></Group><Group><GroupID>1382</GroupID><GroupDescription>12.09.03 - Diaphyseal Extension Piece (Femoral or Tibial)</GroupDescription></Group><Group><GroupID>1383</GroupID><GroupDescription>12.09.04 - Bone Anchorage Piece</GroupDescription></Group><Group><GroupID>1384</GroupID><GroupDescription>12.09.05 - Tibial Inserts</GroupDescription></Group><Group><GroupID>1385</GroupID><GroupDescription>12.09.06 - Augments</GroupDescription></Group><Group><GroupID>1386</GroupID><GroupDescription>12.09.07 - Stems</GroupDescription></Group><Group><GroupID>1387</GroupID><GroupDescription>12.09.08 - Couplers or adaptors, incorporating stem extenders, sleeves and other couplings</GroupDescription></Group><Group><GroupID>1390</GroupID><GroupDescription>12.11.01 - Augments</GroupDescription></Group><Group><GroupID>1391</GroupID><GroupDescription>12.11.02 - Axles for hinged prostheses</GroupDescription></Group><Group><GroupID>1392</GroupID><GroupDescription>12.11.03 - Bolts</GroupDescription></Group><Group><GroupID>1393</GroupID><GroupDescription>12.11.04 - Connectors for hinged prostheses</GroupDescription></Group><Group><GroupID>1395</GroupID><GroupDescription>12.11.06 - End caps</GroupDescription></Group><Group><GroupID>1396</GroupID><GroupDescription>12.11.07 - Offset couplers/adaptors</GroupDescription></Group><Group><GroupID>1397</GroupID><GroupDescription>12.11.08 - Pegs, lugs, etc</GroupDescription></Group><Group><GroupID>1398</GroupID><GroupDescription>12.11.09 - Screws</GroupDescription></Group><Group><GroupID>1399</GroupID><GroupDescription>12.11.10 - Stems - straight or offset</GroupDescription></Group><Group><GroupID>1400</GroupID><GroupDescription>12.11.11 - Stem Extenders, Sleeves and other couplings</GroupDescription></Group><Group><GroupID>1401</GroupID><GroupDescription>12.11.12 - Temporary Spacers</GroupDescription></Group><Group><GroupID>1462</GroupID><GroupDescription>13.01.01 - Pedicle, Monoaxial</GroupDescription></Group><Group><GroupID>1463</GroupID><GroupDescription>13.01.02 - Pedicle, Polyaxial</GroupDescription></Group><Group><GroupID>1464</GroupID><GroupDescription>13.01.03 - Standard</GroupDescription></Group><Group><GroupID>1465</GroupID><GroupDescription>13.02.01 - Nut/Set Screw/Locking Screw</GroupDescription></Group><Group><GroupID>1466</GroupID><GroupDescription>13.02.02 - Collar/Sleeve</GroupDescription></Group><Group><GroupID>1467</GroupID><GroupDescription>13.02.03 - Cap/Cover Plate</GroupDescription></Group><Group><GroupID>1468</GroupID><GroupDescription>13.02.04 - Cap/Cover Plate, Complex</GroupDescription></Group><Group><GroupID>1469</GroupID><GroupDescription>13.02.05 - Block/Screw head</GroupDescription></Group><Group><GroupID>1470</GroupID><GroupDescription>13.02.06 - Cross Link Rod</GroupDescription></Group><Group><GroupID>1471</GroupID><GroupDescription>13.02.07 - Hook/Clamp/Plate</GroupDescription></Group><Group><GroupID>1816</GroupID><GroupDescription>13.02.08 - Sublaminar Cable</GroupDescription></Group><Group><GroupID>1472</GroupID><GroupDescription>13.03.01 - In-Line</GroupDescription></Group><Group><GroupID>1473</GroupID><GroupDescription>13.03.02 - Offset</GroupDescription></Group><Group><GroupID>1474</GroupID><GroupDescription>13.03.03 - Transverse (Rod-to-Rod)</GroupDescription></Group><Group><GroupID>1475</GroupID><GroupDescription>13.04.01 - Hook</GroupDescription></Group><Group><GroupID>1476</GroupID><GroupDescription>13.05.01 - Integral Fixation</GroupDescription></Group><Group><GroupID>1477</GroupID><GroupDescription>13.05.02 - No Integral Fixation</GroupDescription></Group><Group><GroupID>1478</GroupID><GroupDescription>13.06.01 - Standard</GroupDescription></Group><Group><GroupID>1480</GroupID><GroupDescription>13.06.03 - Dual Unit</GroupDescription></Group><Group><GroupID>1826</GroupID><GroupDescription>13.06.05 - Rod, Percutaneous Controlled Expansion</GroupDescription></Group><Group><GroupID>1481</GroupID><GroupDescription>13.07.01 - Plate Rod</GroupDescription></Group><Group><GroupID>1482</GroupID><GroupDescription>13.08.01 - Washer</GroupDescription></Group><Group><GroupID>1483</GroupID><GroupDescription>13.08.02 - Staple</GroupDescription></Group><Group><GroupID>1484</GroupID><GroupDescription>13.09.01 - C-Ring</GroupDescription></Group><Group><GroupID>1485</GroupID><GroupDescription>13.10.01 - Interbody, Integral Fixation</GroupDescription></Group><Group><GroupID>1486</GroupID><GroupDescription>13.10.02 - Interbody, No Integral Fixation</GroupDescription></Group><Group><GroupID>1487</GroupID><GroupDescription>13.10.03 - Facet Joint</GroupDescription></Group><Group><GroupID>1488</GroupID><GroupDescription>13.11.01 - System</GroupDescription></Group><Group><GroupID>1489</GroupID><GroupDescription>13.11.02 - End Plate</GroupDescription></Group><Group><GroupID>1490</GroupID><GroupDescription>13.11.03 - Core</GroupDescription></Group><Group><GroupID>1492</GroupID><GroupDescription>13.12.01 - Telescoping Cage</GroupDescription></Group><Group><GroupID>1493</GroupID><GroupDescription>13.12.02 - Stackable Cage</GroupDescription></Group><Group><GroupID>1494</GroupID><GroupDescription>13.12.03 - Mesh</GroupDescription></Group><Group><GroupID>1495</GroupID><GroupDescription>13.12.04 - Mesh, End Plate</GroupDescription></Group><Group><GroupID>1814</GroupID><GroupDescription>13.12.05 - Non Stackable Cage, other</GroupDescription></Group><Group><GroupID>1496</GroupID><GroupDescription>13.13.01 - Interspinous Fixation Device</GroupDescription></Group><Group><GroupID>1821</GroupID><GroupDescription>13.14.01 - Sacroiliac Joint Fixation Device</GroupDescription></Group><Group><GroupID>1823</GroupID><GroupDescription>13.15.01 - Annular closure/reconstruction device</GroupDescription></Group></Groups><SubGroups><SubGroup><SubGroupID>3887</SubGroupID><SubGroupDescription>01.01.01.01 - Rigid</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3888</SubGroupID><SubGroupDescription>01.01.02.01 - Rigid</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3889</SubGroupID><SubGroupDescription>01.01.02.02 - Foldable</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3890</SubGroupID><SubGroupDescription>01.02.02.01 - Microincision</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3892</SubGroupID><SubGroupDescription>01.02.02.03 - Edge modification</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3893</SubGroupID><SubGroupDescription>01.02.02.04 - Presbyopia correcting</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3895</SubGroupID><SubGroupDescription>01.02.03.01 - Monofocal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3896</SubGroupID><SubGroupDescription>01.02.03.02 - Multi-focal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3897</SubGroupID><SubGroupDescription>01.03.01.01 - Dual Fluids</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3898</SubGroupID><SubGroupDescription>01.05.02.01 - Cannulated</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6441</SubGroupID><SubGroupDescription>01.05.03.01 - at Schlemm's canal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6442</SubGroupID><SubGroupDescription>01.05.03.02 - external to Schlemm's canal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3900</SubGroupID><SubGroupDescription>01.06.02.01 - Gold &lt;1.8 grams</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3901</SubGroupID><SubGroupDescription>01.06.02.02 - Gold ≥1.8 grams</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3902</SubGroupID><SubGroupDescription>01.06.02.03 - Platinum</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3903</SubGroupID><SubGroupDescription>01.08.02.01 - Complex and permeable</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3905</SubGroupID><SubGroupDescription>01.09.01.01 - Sponges</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4145</SubGroupID><SubGroupDescription>02.01.02.01 - Initial</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4147</SubGroupID><SubGroupDescription>02.01.02.02 - Replacement</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4150</SubGroupID><SubGroupDescription>02.01.04.01 - Sound Processor</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4151</SubGroupID><SubGroupDescription>02.01.04.02 - Osseointegration</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4152</SubGroupID><SubGroupDescription>02.01.04.03 - Cover Screw</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4154</SubGroupID><SubGroupDescription>02.01.05.01 - Stapes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4155</SubGroupID><SubGroupDescription>02.01.05.02 - Malleus</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4156</SubGroupID><SubGroupDescription>02.01.05.03 - Partial Ossicle Replacement (one or two)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4157</SubGroupID><SubGroupDescription>02.01.05.04 - Total Ossicle Replacement (three)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6521</SubGroupID><SubGroupDescription>02.01.05.05 - Active Middle Ear Implants</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6742</SubGroupID><SubGroupDescription>02.01.08.01 - Xenografts, Small (≤10cm2)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6743</SubGroupID><SubGroupDescription>02.01.08.02 - Xenografts, Medium (&gt;10cm2 to 50cm2)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4162</SubGroupID><SubGroupDescription>03.01.02.01 - Standard Dose</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4163</SubGroupID><SubGroupDescription>03.01.02.02 - Single Seed or Partial Dose</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6061</SubGroupID><SubGroupDescription>03.01.03.01 - Gel 3ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6281</SubGroupID><SubGroupDescription>03.01.03.02 - Gel 10mL or Balloon</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4164</SubGroupID><SubGroupDescription>03.02.01.01 - Single Lumen</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4437</SubGroupID><SubGroupDescription>03.02.01.02 - Multiple Lumen</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5358</SubGroupID><SubGroupDescription>03.02.02.01 - Fixed Flow Rate</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5359</SubGroupID><SubGroupDescription>03.02.02.02 - Variable Flow Rate</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4183</SubGroupID><SubGroupDescription>03.02.03.02 - Insulin infusion pump (as 3.2.3.1) with integral calculator to determine boluses and active insulin</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4187</SubGroupID><SubGroupDescription>03.02.03.03 - Device has capability to automatically adjust the insulin delivery based on continuous glucose monitoring data</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4185</SubGroupID><SubGroupDescription>03.02.03.04 - Other Pharmacology</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4186</SubGroupID><SubGroupDescription>03.02.03.05 - Programmable/Reprogrammable Flow Rate and Bolus</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7360</SubGroupID><SubGroupDescription>03.02.03.06 - Insulin Infusion Pump - accessories subsequent annual supply</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4188</SubGroupID><SubGroupDescription>03.02.04.01 - Fixed Flow Rate</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4190</SubGroupID><SubGroupDescription>03.02.05.01 - Kit</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4191</SubGroupID><SubGroupDescription>03.02.05.02 - Administration Cassette</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4192</SubGroupID><SubGroupDescription>03.02.05.03 - Administration Reservoir</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4193</SubGroupID><SubGroupDescription>03.02.05.04 - Administration Set</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4194</SubGroupID><SubGroupDescription>03.02.05.05 - Other</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4195</SubGroupID><SubGroupDescription>03.02.06.01 - Single Units</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4197</SubGroupID><SubGroupDescription>03.03.02.01 - Initial</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4198</SubGroupID><SubGroupDescription>03.03.02.02 - Subsequent</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6037</SubGroupID><SubGroupDescription>03.03.02.03 - Placement set</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5984</SubGroupID><SubGroupDescription>03.05.02.01 - Integrated Delivery System</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5985</SubGroupID><SubGroupDescription>03.05.02.02 - Delivery Catheter</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4199</SubGroupID><SubGroupDescription>03.05.03.01 - Absorbable ≤75cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4200</SubGroupID><SubGroupDescription>03.05.03.02 - Absorbable &gt;75cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6008</SubGroupID><SubGroupDescription>03.05.04.01 - Absorbable ≤50cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6009</SubGroupID><SubGroupDescription>03.05.04.02 - Absorbable 51 cm² – 75cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6010</SubGroupID><SubGroupDescription>03.05.04.03 - Absorbable &gt;75cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4213</SubGroupID><SubGroupDescription>03.05.05.01 - Liquid ≤6ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4214</SubGroupID><SubGroupDescription>03.05.05.02 - Liquid &gt;6ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4215</SubGroupID><SubGroupDescription>03.05.05.03 - Non-liquid ≤50cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4216</SubGroupID><SubGroupDescription>03.05.05.04 - Non-liquid &gt;50cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4217</SubGroupID><SubGroupDescription>03.05.05.05 - Accessory Extender</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7345</SubGroupID><SubGroupDescription>03.05.05.06 - Powder &gt;6ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4218</SubGroupID><SubGroupDescription>03.06.01.01 - Non-reinforced Wall</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4234</SubGroupID><SubGroupDescription>03.06.01.02 - Reinforced Wall, Uncovered/Bare Metal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4235</SubGroupID><SubGroupDescription>03.06.01.03 - Reinforced Wall, Covered</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4237</SubGroupID><SubGroupDescription>03.06.03.02 - Reinforced Wall, Uncovered/Bare Metal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4238</SubGroupID><SubGroupDescription>03.06.03.03 - Reinforced Wall, Covered</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6025</SubGroupID><SubGroupDescription>03.06.03.04 - Biodegradable</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6011</SubGroupID><SubGroupDescription>03.06.04.01 - Self-expanding metal, Covered</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4242</SubGroupID><SubGroupDescription>03.07.01.01 - Pleural</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4243</SubGroupID><SubGroupDescription>03.07.01.02 - Intraperitoneal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5489</SubGroupID><SubGroupDescription>03.07.01.03 - Biliary</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6000</SubGroupID><SubGroupDescription>03.07.01.04 - Para/Thoraceulesis</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6001</SubGroupID><SubGroupDescription>03.07.01.05 - Percutaneous</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7363</SubGroupID><SubGroupDescription>03.07.01.06 - Anal Fistula</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5431</SubGroupID><SubGroupDescription>03.08.01.01 - Sheet ≤100cm2</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5432</SubGroupID><SubGroupDescription>03.08.01.02 - Sheet &gt;100cm2</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4246</SubGroupID><SubGroupDescription>03.08.01.03 - Spray</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5433</SubGroupID><SubGroupDescription>03.08.01.04 - Gel/Liquid</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4247</SubGroupID><SubGroupDescription>03.08.02.01 - Adhesive ≤2ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4248</SubGroupID><SubGroupDescription>03.08.02.02 - Adhesive &gt;2-5ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4249</SubGroupID><SubGroupDescription>03.08.02.03 - Adhesive &gt;5ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4250</SubGroupID><SubGroupDescription>03.08.02.04 - Adhesive Accessory</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4251</SubGroupID><SubGroupDescription>03.08.02.05 - Adhesive Peristrips</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4252</SubGroupID><SubGroupDescription>03.08.02.06 - Pleurodesis Powder</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5424</SubGroupID><SubGroupDescription>03.08.02.07 - Sponge ≤10cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5425</SubGroupID><SubGroupDescription>03.08.02.08 - Sponge 10-40cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5426</SubGroupID><SubGroupDescription>03.08.02.09 - Sponge &gt;40cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5768</SubGroupID><SubGroupDescription>03.08.02.12 - Pleural Sealant</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4256</SubGroupID><SubGroupDescription>03.08.03.01 - Clips</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4257</SubGroupID><SubGroupDescription>03.08.03.02 - Clip Applier</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4258</SubGroupID><SubGroupDescription>03.08.03.03 - Clips with Disposable Applier</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4259</SubGroupID><SubGroupDescription>03.08.03.04 - Clip Reload Cartridge</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4260</SubGroupID><SubGroupDescription>03.08.03.05 - Sutures</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5490</SubGroupID><SubGroupDescription>03.08.03.06 - Ligating Bands with Disposable Applier</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5769</SubGroupID><SubGroupDescription>03.08.03.07 - Cinched suture applier</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6101</SubGroupID><SubGroupDescription>03.08.03.08 - Suture with cinch</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7361</SubGroupID><SubGroupDescription>03.08.03.10 - Laparoscopic Suturing Device</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4317</SubGroupID><SubGroupDescription>03.08.04.01 - Staples, Non-bone (Reload)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4318</SubGroupID><SubGroupDescription>03.08.04.02 - Staplers</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4319</SubGroupID><SubGroupDescription>03.08.04.03 - Staples, Reinforcer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4320</SubGroupID><SubGroupDescription>03.08.04.04 - Staples, Non-bone with Disposable Applier</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4331</SubGroupID><SubGroupDescription>03.08.04.05 - Tackers</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5988</SubGroupID><SubGroupDescription>03.08.04.06 - Suture Fasteners</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6003</SubGroupID><SubGroupDescription>03.08.04.07 - Tacks, Reload</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6004</SubGroupID><SubGroupDescription>03.08.04.08 - Adhesive Tackers</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5434</SubGroupID><SubGroupDescription>03.08.05.01 - ≤200cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5435</SubGroupID><SubGroupDescription>03.08.05.02 - 201-400cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5437</SubGroupID><SubGroupDescription>03.08.05.04 - &gt;600-&lt;2500cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5438</SubGroupID><SubGroupDescription>03.08.06.01 - ≤200cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5439</SubGroupID><SubGroupDescription>03.08.06.02 - 201-400cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5440</SubGroupID><SubGroupDescription>03.08.06.03 - 401-600cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5503</SubGroupID><SubGroupDescription>03.08.06.04 - 601cm²-1000cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5505</SubGroupID><SubGroupDescription>03.08.06.05 - &gt;1000cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5491</SubGroupID><SubGroupDescription>03.08.07.01 - ≤200cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5492</SubGroupID><SubGroupDescription>03.08.07.02 - 201-400cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5493</SubGroupID><SubGroupDescription>03.08.07.03 - 401-600cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5494</SubGroupID><SubGroupDescription>03.08.07.04 - 601-800cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5495</SubGroupID><SubGroupDescription>03.08.07.05 - &gt;800cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4519</SubGroupID><SubGroupDescription>03.08.09.01 - Fistula Closure</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5499</SubGroupID><SubGroupDescription>03.08.11.01 - Closure Set</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5500</SubGroupID><SubGroupDescription>03.08.11.02 - Extension Kit</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4468</SubGroupID><SubGroupDescription>04.03.01.01 - Valve, Externally Adjustable</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4469</SubGroupID><SubGroupDescription>04.03.01.02 - Valve, Non-externally adjustable</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5978</SubGroupID><SubGroupDescription>04.03.01.03 - Valve and gravitational unit, externally adjustable</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4470</SubGroupID><SubGroupDescription>04.03.06.01 - Connector</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4471</SubGroupID><SubGroupDescription>04.03.06.02 - Right Angled Guide</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4472</SubGroupID><SubGroupDescription>04.04.01.01 - Primary Cell Pulse Generator (non-rechargeable)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4473</SubGroupID><SubGroupDescription>04.04.01.02 - Rechargeable Pulse Generator</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4474</SubGroupID><SubGroupDescription>04.04.02.01 - Patient Programmer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4475</SubGroupID><SubGroupDescription>04.04.02.02 - Recharger</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4476</SubGroupID><SubGroupDescription>04.04.03.01 - Permanent Lead</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4477</SubGroupID><SubGroupDescription>04.04.03.02 - Lead Extension</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4478</SubGroupID><SubGroupDescription>04.04.05.01 - Burr Hole Cover</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4479</SubGroupID><SubGroupDescription>04.04.05.02 - Connectors and cables</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4498</SubGroupID><SubGroupDescription>04.04.05.03 - Intraoperative accessories</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4480</SubGroupID><SubGroupDescription>04.05.01.01 - Primary Cell Pulse Generator (non-rechargeable)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4481</SubGroupID><SubGroupDescription>04.05.01.02 - Rechargeable Pulse Generator</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4483</SubGroupID><SubGroupDescription>04.05.02.01 - Patient Programmer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4484</SubGroupID><SubGroupDescription>04.05.02.02 - Patient Programmer Antenna</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4485</SubGroupID><SubGroupDescription>04.05.02.03 - On/Off switching device</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4497</SubGroupID><SubGroupDescription>04.05.02.04 - Recharger</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5854</SubGroupID><SubGroupDescription>04.05.02.05 - External Neurostimulator</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4486</SubGroupID><SubGroupDescription>04.05.03.01 - Permanent Lead</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4487</SubGroupID><SubGroupDescription>04.05.03.02 - Trial Lead</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4499</SubGroupID><SubGroupDescription>04.05.05.01 - Revision Kits</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4500</SubGroupID><SubGroupDescription>04.05.05.02 - Plug</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4501</SubGroupID><SubGroupDescription>04.05.05.03 - Intraoperative Accessories</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4502</SubGroupID><SubGroupDescription>04.05.05.04 - Lead Delivery System</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5484</SubGroupID><SubGroupDescription>04.05.05.05 - Connectors and Cables</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4492</SubGroupID><SubGroupDescription>04.06.03.02 - Two piece</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4503</SubGroupID><SubGroupDescription>04.06.04.01 - Revision Kit</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5483</SubGroupID><SubGroupDescription>04.06.04.02 - Refill/Catheter Access Kits</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4493</SubGroupID><SubGroupDescription>04.07.01.01 - Implantable pulse generator</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5351</SubGroupID><SubGroupDescription>04.07.01.02 - Lead</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4495</SubGroupID><SubGroupDescription>04.08.03.02 - Coil detachment device</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6022</SubGroupID><SubGroupDescription>04.08.03.04 - Vascular embolisation balloon</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5306</SubGroupID><SubGroupDescription>05.01.01.01 - Pump</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5307</SubGroupID><SubGroupDescription>05.01.01.02 - Occlusive cuff</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5308</SubGroupID><SubGroupDescription>05.01.01.03 - Regulating Balloon</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5310</SubGroupID><SubGroupDescription>05.01.01.05 - Accessory kit</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5311</SubGroupID><SubGroupDescription>05.01.01.06 - System</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5450</SubGroupID><SubGroupDescription>05.01.02.01 - Single</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5451</SubGroupID><SubGroupDescription>05.01.02.02 - Double</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5987</SubGroupID><SubGroupDescription>05.01.02.03 - Port</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5314</SubGroupID><SubGroupDescription>05.01.03.01 - Male</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5315</SubGroupID><SubGroupDescription>05.01.03.02 - Female</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5318</SubGroupID><SubGroupDescription>05.01.04.03 - 2 ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5319</SubGroupID><SubGroupDescription>05.01.04.04 - 2.5 ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5321</SubGroupID><SubGroupDescription>05.02.01.01 - Polyurethane</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5322</SubGroupID><SubGroupDescription>05.02.01.02 - Other synthetic</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5323</SubGroupID><SubGroupDescription>05.02.01.03 - Metal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5324</SubGroupID><SubGroupDescription>05.02.02.01 - Polyurethane</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5325</SubGroupID><SubGroupDescription>05.02.02.02 - Other synthetic</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5501</SubGroupID><SubGroupDescription>05.03.01.01 - Metal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5502</SubGroupID><SubGroupDescription>05.03.01.02 - Paediatric</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5330</SubGroupID><SubGroupDescription>05.05.03.01 - Cylinder</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5331</SubGroupID><SubGroupDescription>05.05.03.02 - Reservoir</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5332</SubGroupID><SubGroupDescription>05.05.03.03 - Pump</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5333</SubGroupID><SubGroupDescription>05.05.03.04 - Deactivation set</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5334</SubGroupID><SubGroupDescription>05.05.03.05 - Accessory kit</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5335</SubGroupID><SubGroupDescription>05.05.03.06 - Pump and cylinder</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7380</SubGroupID><SubGroupDescription>05.07.01.01 - Extended Battery Life</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5337</SubGroupID><SubGroupDescription>05.07.02.01 - Programmer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5518</SubGroupID><SubGroupDescription>05.07.02.02 - External Neurostimulator</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7367</SubGroupID><SubGroupDescription>05.07.02.03 - Recharger</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5339</SubGroupID><SubGroupDescription>05.07.03.01 - Permanent</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5340</SubGroupID><SubGroupDescription>05.07.03.02 - Trial</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5341</SubGroupID><SubGroupDescription>05.07.03.03 - Extension</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6036</SubGroupID><SubGroupDescription>05.07.03.04 - Trial kit including leads</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5342</SubGroupID><SubGroupDescription>05.07.04.01 - Implant/Revision Kits</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5343</SubGroupID><SubGroupDescription>05.07.04.02 - Foramen Needle</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5517</SubGroupID><SubGroupDescription>05.07.04.03 - Connectors and Cables</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5344</SubGroupID><SubGroupDescription>05.08.01.01 - Clip</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3645</SubGroupID><SubGroupDescription>06.01.01.01 - Liner - fixed bearing</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3646</SubGroupID><SubGroupDescription>06.01.01.02 - Liner - mobile bearing</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3261</SubGroupID><SubGroupDescription>06.01.02.01 - Metal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4040</SubGroupID><SubGroupDescription>06.01.03.01 - Talar component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4041</SubGroupID><SubGroupDescription>06.01.03.02 - Tibial component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4042</SubGroupID><SubGroupDescription>06.01.03.03 - Tibial component, cemented/uncemented, fixed bearing</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6021</SubGroupID><SubGroupDescription>06.01.03.04 - Stem extension</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4048</SubGroupID><SubGroupDescription>06.01.04.05 - Great toe, resurfacing hemi articulation, phalangeal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4049</SubGroupID><SubGroupDescription>06.01.04.06 - Great toe, non articulating articulation (for silastic implant replacement)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3664</SubGroupID><SubGroupDescription>06.02.01.01 - Carpal component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3665</SubGroupID><SubGroupDescription>06.02.01.02 - Radial component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3666</SubGroupID><SubGroupDescription>06.02.01.03 - Carpal spacer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3667</SubGroupID><SubGroupDescription>06.02.01.04 - Distal ulnar stem</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3668</SubGroupID><SubGroupDescription>06.02.01.05 - Distal ulnar head</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4050</SubGroupID><SubGroupDescription>06.02.01.06 - Tendon Spacer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5530</SubGroupID><SubGroupDescription>06.02.02.05 - Thumb, carpometacarpal - proximal component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6041</SubGroupID><SubGroupDescription>06.02.02.06 - Thumb, carpometacarpal - distal component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6044</SubGroupID><SubGroupDescription>06.02.02.09 - Finger, metacarpophalangeal - proximal component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6143</SubGroupID><SubGroupDescription>06.02.02.10 - Finger, metacarpophalangeal - distal component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6144</SubGroupID><SubGroupDescription>06.02.02.11 - Finger, interphalangeal - proximal component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6145</SubGroupID><SubGroupDescription>06.02.02.12 - Finger, interphalangeal - distal component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6146</SubGroupID><SubGroupDescription>06.02.02.13 - Interpositional Devices</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3673</SubGroupID><SubGroupDescription>06.02.03.01 - Distal humeral component/s</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3674</SubGroupID><SubGroupDescription>06.02.03.02 - Proximal radial stem</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3675</SubGroupID><SubGroupDescription>06.02.03.03 - Proximal radial head/neck</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3676</SubGroupID><SubGroupDescription>06.02.03.04 - Proximal ulnar component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3678</SubGroupID><SubGroupDescription>06.02.03.06 - Elbow pin</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4052</SubGroupID><SubGroupDescription>06.02.03.07 - Accessories - bushing / insert / spool</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4053</SubGroupID><SubGroupDescription>06.02.03.08 - Accessories - circlips</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4055</SubGroupID><SubGroupDescription>06.02.03.10 - Accessories - cement restrictor</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4057</SubGroupID><SubGroupDescription>06.02.04.02 - Humeral component - cemented</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4058</SubGroupID><SubGroupDescription>06.02.04.03 - Humeral component - uncemented </SubGroupDescription></SubGroup><SubGroup><SubGroupID>4059</SubGroupID><SubGroupDescription>06.02.04.04 - Modular humeral component - metaphyseal, cemented</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4060</SubGroupID><SubGroupDescription>06.02.04.05 - Modular humeral component - metaphyseal, uncemented</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4062</SubGroupID><SubGroupDescription>06.02.04.07 - Modular humeral component - diaphyseal, uncemented, long (&gt;220mm)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4063</SubGroupID><SubGroupDescription>06.02.04.08 - Modular Humeral component - diaphyseal, cemented, short (≤220mm)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4064</SubGroupID><SubGroupDescription>06.02.04.09 - Modular Humeral component - diaphyseal, uncemented, short (≤220mm)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4067</SubGroupID><SubGroupDescription>06.02.04.12 - Standard humeral head</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4068</SubGroupID><SubGroupDescription>06.02.04.13 - Resurfacing humeral head </SubGroupDescription></SubGroup><SubGroup><SubGroupID>4069</SubGroupID><SubGroupDescription>06.02.04.14 - Humeral cup</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4073</SubGroupID><SubGroupDescription>06.02.04.18 - Special purpose/tumour prosthesis - tumour section</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4076</SubGroupID><SubGroupDescription>06.02.04.21 - Necks/collar (modular)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3701</SubGroupID><SubGroupDescription>06.02.05.01 - Glenoid component, All poly</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3702</SubGroupID><SubGroupDescription>06.02.05.02 - Glenoid component, Metal backed</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3704</SubGroupID><SubGroupDescription>06.02.05.04 - Glenoid insert</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4078</SubGroupID><SubGroupDescription>06.02.05.05 - Reverse glenoid component, Base plate, uncemented</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4079</SubGroupID><SubGroupDescription>06.02.05.06 - Glenosphere</SubGroupDescription></SubGroup><SubGroup><SubGroupID>20003</SubGroupID><SubGroupDescription>06.02.05.07 - Modular Glenoid, Uncemented Post</SubGroupDescription></SubGroup><SubGroup><SubGroupID>20004</SubGroupID><SubGroupDescription>06.02.05.08 - Modular Glenoid Baseplate, Metal Back</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4080</SubGroupID><SubGroupDescription>06.02.06.01 - Humeral sleeve</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4081</SubGroupID><SubGroupDescription>06.02.06.02 - Humeral spacer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4083</SubGroupID><SubGroupDescription>06.02.06.04 - Taper assembly</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4084</SubGroupID><SubGroupDescription>06.02.06.05 - Eccentrical adaptor</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5428</SubGroupID><SubGroupDescription>06.02.06.06 - Definition screw / Locking Screw</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4086</SubGroupID><SubGroupDescription>06.02.06.07 - Reverse humeral tray</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7378</SubGroupID><SubGroupDescription>06.02.06.08 - Spacer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3326</SubGroupID><SubGroupDescription>06.03.01.01 - Femoral, Proximal short (&lt;220mm)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3327</SubGroupID><SubGroupDescription>06.03.01.02 - Femoral, Proximal long (≥220mm)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3328</SubGroupID><SubGroupDescription>06.03.01.03 - Femoral, Distal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3329</SubGroupID><SubGroupDescription>06.03.01.04 - Tibial/Fibular</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3330</SubGroupID><SubGroupDescription>06.03.01.05 - Humeral</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3331</SubGroupID><SubGroupDescription>06.03.01.06 - Arthrodesis knee</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3332</SubGroupID><SubGroupDescription>06.03.01.07 - Arthrodesis ankle</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5360</SubGroupID><SubGroupDescription>06.03.01.08 - Flexible/paediatric</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5361</SubGroupID><SubGroupDescription>06.03.01.09 - Radial/Ulnar</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5362</SubGroupID><SubGroupDescription>06.03.01.10 - Dynamic distraction - electronic</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5474</SubGroupID><SubGroupDescription>06.03.01.11 - Arthrodesis Other</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6561</SubGroupID><SubGroupDescription>06.03.01.13 - Arthrodesis</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7362</SubGroupID><SubGroupDescription>06.03.01.14 - Calcaneal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3341</SubGroupID><SubGroupDescription>06.03.02.01 - Intramedullary nail lag screw</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3712</SubGroupID><SubGroupDescription>06.03.02.02 - Reconstruction screw</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3713</SubGroupID><SubGroupDescription>06.03.02.03 - Set screw/Locking bolt</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5363</SubGroupID><SubGroupDescription>06.03.02.04 - End caps and extension caps</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5255</SubGroupID><SubGroupDescription>06.03.03.01 - Standard (screw size ≥4.5mm)≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5256</SubGroupID><SubGroupDescription>06.03.03.02 - Standard (screw size ≥4.5mm) ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5257</SubGroupID><SubGroupDescription>06.03.03.03 - Standard (screw size ≥4.5mm) ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5258</SubGroupID><SubGroupDescription>06.03.03.04 - Small (screw size 2.71mm – 4.49mm) ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5259</SubGroupID><SubGroupDescription>06.03.03.05 - Small (screw size 2.71mm – 4.49mm) ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5260</SubGroupID><SubGroupDescription>06.03.03.06 - Small (screw size 2.71mm – 4.49mm) ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5261</SubGroupID><SubGroupDescription>06.03.03.07 - Mini (screw size ≤2.7mm) ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5262</SubGroupID><SubGroupDescription>06.03.03.08 - Mini (screw size ≤2.7mm) ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5263</SubGroupID><SubGroupDescription>06.03.03.09 - Mini (screw size ≤2.7mm) ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5264</SubGroupID><SubGroupDescription>06.03.03.10 - Dynamic - Hip ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5265</SubGroupID><SubGroupDescription>06.03.03.11 - Dynamic - Hip ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5266</SubGroupID><SubGroupDescription>06.03.03.12 - Dynamic - Hip ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5267</SubGroupID><SubGroupDescription>06.03.03.13 - Dynamic - supracondylar ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5268</SubGroupID><SubGroupDescription>06.03.03.14 - Dynamic - supracondylar ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5269</SubGroupID><SubGroupDescription>06.03.03.15 - Dynamic - supracondylar ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5270</SubGroupID><SubGroupDescription>06.03.03.16 - Periarticular - Clavicle plate ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5271</SubGroupID><SubGroupDescription>06.03.03.17 - Periarticular - Clavicle plate ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5272</SubGroupID><SubGroupDescription>06.03.03.18 - Periarticular - Clavicle plate ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5273</SubGroupID><SubGroupDescription>06.03.03.19 - Periarticular - Humerus ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5274</SubGroupID><SubGroupDescription>06.03.03.20 - Periarticular - Humerus ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5275</SubGroupID><SubGroupDescription>06.03.03.21 - Periarticular - Humerus ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5276</SubGroupID><SubGroupDescription>06.03.03.22 - Periarticular - Radius ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5277</SubGroupID><SubGroupDescription>06.03.03.23 - Periarticular - Radius ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5278</SubGroupID><SubGroupDescription>06.03.03.24 - Periarticular - Radius ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5279</SubGroupID><SubGroupDescription>06.03.03.25 - Periarticular - Ulna ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5280</SubGroupID><SubGroupDescription>06.03.03.26 - Periarticular - Ulna ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5281</SubGroupID><SubGroupDescription>06.03.03.27 - Periarticular - Ulna ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5282</SubGroupID><SubGroupDescription>06.03.03.28 - Periarticular - Hand-phalangeal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5283</SubGroupID><SubGroupDescription>06.03.03.29 - Periarticular - Pelvis ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5284</SubGroupID><SubGroupDescription>06.03.03.30 - Periarticular - Pelvis ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5285</SubGroupID><SubGroupDescription>06.03.03.31 - Periarticular - Pelvis ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5286</SubGroupID><SubGroupDescription>06.03.03.32 - Periarticular - Femur ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5287</SubGroupID><SubGroupDescription>06.03.03.33 - Periarticular - Femur ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5288</SubGroupID><SubGroupDescription>06.03.03.34 - Periarticular - Femur ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5289</SubGroupID><SubGroupDescription>06.03.03.35 - Periarticular - Fibula ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5290</SubGroupID><SubGroupDescription>06.03.03.36 - Periarticular - Fibula ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5291</SubGroupID><SubGroupDescription>06.03.03.37 - Periarticular - Fibula ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5292</SubGroupID><SubGroupDescription>06.03.03.38 - Periarticular - Tibia ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5293</SubGroupID><SubGroupDescription>06.03.03.39 - Periarticular - Tibia ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5294</SubGroupID><SubGroupDescription>06.03.03.40 - Periarticular - Tibia ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5295</SubGroupID><SubGroupDescription>06.03.03.41 - Periarticular - Calcaneal ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5296</SubGroupID><SubGroupDescription>06.03.03.42 - Periarticular - Calcaneal ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5297</SubGroupID><SubGroupDescription>06.03.03.43 - Periarticular - Calcaneal ≥ 16 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5298</SubGroupID><SubGroupDescription>06.03.03.44 - Periarticular - Foot</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5299</SubGroupID><SubGroupDescription>06.03.03.45 - Periarticular - Cable plate (hook/grip) ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5300</SubGroupID><SubGroupDescription>06.03.03.46 - Periarticular - Cable plate (hook/grip) ≥ 7 to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5302</SubGroupID><SubGroupDescription>06.03.03.48 - Periarticular - Cable plate with integrated cables - 2 or less, ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5303</SubGroupID><SubGroupDescription>06.03.03.49 - Periarticular - Cable plate with integrated cables - &gt; 2, ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5994</SubGroupID><SubGroupDescription>06.03.03.50 - Cable plate with 1 or more cables, ≤ 6 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5996</SubGroupID><SubGroupDescription>06.03.03.51 - Cable plate with 1 or more cables, ≥ 7 holes to ≤ 15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3369</SubGroupID><SubGroupDescription>06.03.04.01 - Standard ( ≥4.5mm)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3370</SubGroupID><SubGroupDescription>06.03.04.02 - Small (2.71mm – 4.49mm)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3371</SubGroupID><SubGroupDescription>06.03.04.03 - Mini (2.01 – 2.7 mm)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3372</SubGroupID><SubGroupDescription>06.03.04.04 - Micro (≤ 2.0mm)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3373</SubGroupID><SubGroupDescription>06.03.04.05 - Dynamic</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3374</SubGroupID><SubGroupDescription>06.03.04.06 - Screw Washers</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4521</SubGroupID><SubGroupDescription>06.03.04.07 - Screw post/peg</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4522</SubGroupID><SubGroupDescription>06.03.04.08 - Screw Accessories - Nuts</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4523</SubGroupID><SubGroupDescription>06.03.04.09 - Screw Accessories - Locking Nuts / Insert</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3732</SubGroupID><SubGroupDescription>06.03.04.10 - Screw Accessories - Caps</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5364</SubGroupID><SubGroupDescription>06.03.05.01 - Pins and Wires, diameter ≤∅1.6 mm</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5365</SubGroupID><SubGroupDescription>06.03.05.02 - Pins and Wires, diameter &gt;∅1.6 mm</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5366</SubGroupID><SubGroupDescription>06.03.05.03 - Cables</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5367</SubGroupID><SubGroupDescription>06.03.05.04 - Cables - with in-built locking device</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5368</SubGroupID><SubGroupDescription>06.03.05.05 - Cables - with &gt;1 locking device</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5369</SubGroupID><SubGroupDescription>06.03.05.06 - Wire forms (including washers/screws) - all sizes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5370</SubGroupID><SubGroupDescription>06.03.05.07 - Cerclage bands</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5371</SubGroupID><SubGroupDescription>06.03.05.08 - Locking device for wires/cables</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5372</SubGroupID><SubGroupDescription>06.03.05.09 - Hook/Grip for wires/cables</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5373</SubGroupID><SubGroupDescription>06.03.05.10 - Grooved Button for wires/cables</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5457</SubGroupID><SubGroupDescription>06.03.05.11 - Wedges</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5938</SubGroupID><SubGroupDescription>06.03.05.12 - Chest Wall Reconstruction Plates</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6181</SubGroupID><SubGroupDescription>06.03.05.13 - Chest Wall Reconstruction Plate Accessories</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5514</SubGroupID><SubGroupDescription>06.03.06.01 - Staples</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5382</SubGroupID><SubGroupDescription>06.03.07.01 - Anchor only (without suture), dart or arrow</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5384</SubGroupID><SubGroupDescription>06.03.07.02 - Small Anchors (≤ 2.3 mm) with suture</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5385</SubGroupID><SubGroupDescription>06.03.07.03 - Medium Anchors (2.4 mm – 3.9 mm) with suture</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5387</SubGroupID><SubGroupDescription>06.03.07.04 - Large Anchors (≥4.0 mm) with suture</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5389</SubGroupID><SubGroupDescription>06.03.07.05 - Button/thread/tape or Button/thread/button</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5390</SubGroupID><SubGroupDescription>06.03.07.06 - Button</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5391</SubGroupID><SubGroupDescription>06.03.07.07 - Interference Screw (± sleeve)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5394</SubGroupID><SubGroupDescription>06.03.07.08 - Screw/Pin/Post</SubGroupDescription></SubGroup><SubGroup><SubGroupID>20006</SubGroupID><SubGroupDescription>06.03.07.09 - Suspensory graft fixation, tape and screw</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5398</SubGroupID><SubGroupDescription>06.03.08.02 - Non-biological</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3401</SubGroupID><SubGroupDescription>06.03.11.02 - Frame Complete - Monoplanar &amp; Modular Frames</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3402</SubGroupID><SubGroupDescription>06.03.11.03 - Frame Component - Monoplanar, Clamp</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3756</SubGroupID><SubGroupDescription>06.03.11.04 - Frame Component - Monoplanar, Body</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3404</SubGroupID><SubGroupDescription>06.03.11.05 - Frame Component - Monoplanar, Adaptor</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3405</SubGroupID><SubGroupDescription>06.03.11.06 - Frame Component - Full Circular Ring</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3406</SubGroupID><SubGroupDescription>06.03.11.07 - Frame Component - Partial Circular Ring</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3757</SubGroupID><SubGroupDescription>06.03.11.08 - Frame Component - Circular Coupling Device</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4505</SubGroupID><SubGroupDescription>06.03.11.09 - Frame Component - Circular Frame Strut Device</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4506</SubGroupID><SubGroupDescription>06.03.11.10 - Frame Component - Foot Plate</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4507</SubGroupID><SubGroupDescription>06.03.11.11 - Frame Component - Circular Frame, Nuts &amp; Spacers</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4508</SubGroupID><SubGroupDescription>06.03.11.12 - Frame Component - Coupling Device</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4509</SubGroupID><SubGroupDescription>06.03.11.13 - Frame Component - Rods</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4510</SubGroupID><SubGroupDescription>06.03.11.14 - Frame Component - Pins</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4511</SubGroupID><SubGroupDescription>06.03.11.15 - Frame Component - Pin Clamp Assembly</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4512</SubGroupID><SubGroupDescription>06.03.11.16 - Frame Component  - Pin Clamp Assembly Post</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4513</SubGroupID><SubGroupDescription>06.03.11.17 - Articulating Hinge</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5508</SubGroupID><SubGroupDescription>06.03.11.18 - Upper body kit</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5509</SubGroupID><SubGroupDescription>06.03.11.19 - Lower body kit</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6401</SubGroupID><SubGroupDescription>06.03.11.20 - Simple fixture kit - Lower body (Uniplanar)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7348</SubGroupID><SubGroupDescription>06.03.12.01 - Elbow</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4087</SubGroupID><SubGroupDescription>06.03.14.01 - Cement only</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4088</SubGroupID><SubGroupDescription>06.03.14.02 - Cement with Antibiotic</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4089</SubGroupID><SubGroupDescription>06.03.14.03 - Cement with Complex Delivery System</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4090</SubGroupID><SubGroupDescription>06.03.14.04 - Cement with Antibiotic and Complex Delivery System</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4091</SubGroupID><SubGroupDescription>06.03.14.05 - Accessories - Restrictors</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4092</SubGroupID><SubGroupDescription>06.03.15.01 - Ceramic, 0-5cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4093</SubGroupID><SubGroupDescription>06.03.15.02 - Ceramic, &gt;5cc - 10cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4094</SubGroupID><SubGroupDescription>06.03.15.03 - Ceramic, &gt;10cc - 20cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4095</SubGroupID><SubGroupDescription>06.03.15.04 - Ceramic, &gt;20cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4111</SubGroupID><SubGroupDescription>06.03.15.06 - Demineralised Bone Matrix, 2 – 5cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4112</SubGroupID><SubGroupDescription>06.03.15.07 - Demineralised Bone Matrix, &gt;5cc - 10cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4114</SubGroupID><SubGroupDescription>06.03.15.09 - Composite (Extracellular Collagen Matrix with DBM or Ceramic), 0 - 5cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4115</SubGroupID><SubGroupDescription>06.03.15.10 - Composite (Extracellular Collagen Matrix with DBM or Ceramic), &gt;5cc - 10cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4116</SubGroupID><SubGroupDescription>06.03.15.11 - Composite (Extracellular Collagen Matrix with DBM or Ceramic), &gt;10cc - 20cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4117</SubGroupID><SubGroupDescription>06.03.15.12 - Composite (Extracellular Collagen Matrix with DBM or Ceramic), &gt;20cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5399</SubGroupID><SubGroupDescription>06.03.16.01 - Metallic</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5402</SubGroupID><SubGroupDescription>06.03.17.02 - Spacer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5404</SubGroupID><SubGroupDescription>06.03.17.04 - Central Screw</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5405</SubGroupID><SubGroupDescription>06.03.17.05 - Healing Cylinder</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5406</SubGroupID><SubGroupDescription>06.03.17.06 - Healing Screw</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5407</SubGroupID><SubGroupDescription>06.03.17.07 - Fixture</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5408</SubGroupID><SubGroupDescription>06.03.17.08 - Abutment</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5409</SubGroupID><SubGroupDescription>06.03.17.09 - Abutment Screw</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5410</SubGroupID><SubGroupDescription>06.03.17.10 - Oncology Humeral Stem</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5411</SubGroupID><SubGroupDescription>06.03.17.11 - Humeral Ancharge Piece</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5412</SubGroupID><SubGroupDescription>06.03.17.12 - Humerus Extension Piece</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5414</SubGroupID><SubGroupDescription>06.03.17.14 - Humerus Connection Piece</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5415</SubGroupID><SubGroupDescription>06.03.17.15 - Oncology Humeral Body</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5416</SubGroupID><SubGroupDescription>06.03.17.16 - Wedge</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5417</SubGroupID><SubGroupDescription>06.03.17.17 - Humerus Connecting Screw</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5418</SubGroupID><SubGroupDescription>06.03.17.18 - Humerus Hex Socket Bolt</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5419</SubGroupID><SubGroupDescription>06.03.17.19 - Plug Screw Axis</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5421</SubGroupID><SubGroupDescription>06.03.17.21 - Humeral Bearing</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5422</SubGroupID><SubGroupDescription>06.03.17.22 - Humeral Head/Cap</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5423</SubGroupID><SubGroupDescription>06.03.17.23 - Distal Humerus Flange</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5458</SubGroupID><SubGroupDescription>06.03.17.24 - Humeral Collar Round Smooth</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5459</SubGroupID><SubGroupDescription>06.03.17.25 - Humeral Component for use with Hemi Head</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5460</SubGroupID><SubGroupDescription>06.03.17.26 - Humeral Head Fixation Screw</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5461</SubGroupID><SubGroupDescription>06.03.17.27 - Humeral Component with Liner and re-attachment</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5462</SubGroupID><SubGroupDescription>06.03.17.28 - Humeral Collar Round Coated</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5463</SubGroupID><SubGroupDescription>06.03.17.29 - Humeral Stem</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5464</SubGroupID><SubGroupDescription>06.03.17.30 - Humeral Shaft</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5465</SubGroupID><SubGroupDescription>06.03.17.31 - Humeral Intergral Shaft &amp; Stem Coated</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5467</SubGroupID><SubGroupDescription>06.03.17.33 - Humeral Component with Liner</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5468</SubGroupID><SubGroupDescription>06.03.17.34 - Humeral Component with Reattachment for use with Hemi Head</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5469</SubGroupID><SubGroupDescription>06.03.17.35 - Glenoid / Glensophere component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5470</SubGroupID><SubGroupDescription>06.03.17.36 - Humeral Hemi-Head</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5475</SubGroupID><SubGroupDescription>06.03.17.37 - Femoral Stem - Uncemented</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5477</SubGroupID><SubGroupDescription>06.03.17.39 - Tibial Stem - Uncemented</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5479</SubGroupID><SubGroupDescription>06.03.17.41 - Valgus Sleeve</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4201</SubGroupID><SubGroupDescription>07.01.01.01 - &lt;0.2mm thick, 1-50cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4202</SubGroupID><SubGroupDescription>07.01.01.02 - &lt;0.2mm thick, 51-100cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4203</SubGroupID><SubGroupDescription>07.01.01.03 - 0.2-0.49mm thick, 1-10cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4204</SubGroupID><SubGroupDescription>07.01.01.04 - 0.2-0.49mm thick, 11-50cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4205</SubGroupID><SubGroupDescription>07.01.01.05 - 0.2-0.49mm thick, 51-200cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4206</SubGroupID><SubGroupDescription>07.01.01.06 - 0.2-0.49mm thick, &gt;200cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4207</SubGroupID><SubGroupDescription>07.01.01.07 - 0.5-0.8mm thick, 1-10cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4208</SubGroupID><SubGroupDescription>07.01.01.08 - 0.5-0.8mm thick, 11-50cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4209</SubGroupID><SubGroupDescription>07.01.01.09 - 0.5-0.8mm thick, 51-200cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4210</SubGroupID><SubGroupDescription>07.01.01.10 - 0.5-0.8mm thick, &gt;200cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4220</SubGroupID><SubGroupDescription>07.01.02.02 - &lt;0.2mm thick, 11-25cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4221</SubGroupID><SubGroupDescription>07.01.02.03 - 0.2-0.49mm thick, 1-10cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4222</SubGroupID><SubGroupDescription>07.01.02.04 - 0.2-0.49mm thick, 11-25cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4223</SubGroupID><SubGroupDescription>07.01.02.05 - 0.2-0.49mm thick, 26-50cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4225</SubGroupID><SubGroupDescription>07.01.02.07 - 0.5-0.8mm thick, 1-10cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4226</SubGroupID><SubGroupDescription>07.01.02.08 - 0.5-0.8mm thick, 11-25cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4227</SubGroupID><SubGroupDescription>07.01.02.09 - 0.5-0.8mm thick, 26-50cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4228</SubGroupID><SubGroupDescription>07.01.02.10 - 0.5-0.8mm thick, 51-100cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4229</SubGroupID><SubGroupDescription>07.01.02.11 - 0.5-0.8mm thick, 101-200cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4230</SubGroupID><SubGroupDescription>07.01.02.12 - &gt;0.8mm thick, 1-10cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4231</SubGroupID><SubGroupDescription>07.01.02.13 - &gt;0.8mm thick, 11-25cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4232</SubGroupID><SubGroupDescription>07.01.02.14 - &gt;0.8mm thick, 26-50cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4233</SubGroupID><SubGroupDescription>07.01.02.15 - &gt;0.8mm thick, 51-100cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4496</SubGroupID><SubGroupDescription>07.01.02.16 - &gt;0.8mm thick, 101-200cm2</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4239</SubGroupID><SubGroupDescription>07.01.03.01 - 0.5-0.8mm thick, 1-25cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4241</SubGroupID><SubGroupDescription>07.01.03.03 - &gt;0.8mm thick 26-50cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4253</SubGroupID><SubGroupDescription>07.01.04.01 - Resorbable</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4254</SubGroupID><SubGroupDescription>07.01.04.02 - Polymer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4255</SubGroupID><SubGroupDescription>07.01.04.03 - Block</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4261</SubGroupID><SubGroupDescription>07.01.05.01 - &lt;0.5mm thick, &lt;4 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4263</SubGroupID><SubGroupDescription>07.01.05.02 - &lt;0.5mm thick, 4-7 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4265</SubGroupID><SubGroupDescription>07.01.05.03 - &lt;0.5mm thick, 8-15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4266</SubGroupID><SubGroupDescription>07.01.05.04 - &lt;0.5mm thick, 16-32 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4267</SubGroupID><SubGroupDescription>07.01.05.05 - 0.5-0.99mm thick, &lt;4 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4271</SubGroupID><SubGroupDescription>07.01.05.06 - 0.5-0.99mm thick, 4-7 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4277</SubGroupID><SubGroupDescription>07.01.05.07 - 0.5-0.99mm thick, 8-32 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4284</SubGroupID><SubGroupDescription>07.01.05.08 - 0.5-0.99mm thick, &gt;32 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4286</SubGroupID><SubGroupDescription>07.01.05.09 - 1.0-1.99mm thick, &lt;4 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4288</SubGroupID><SubGroupDescription>07.01.05.10 - 1.0-1.99mm thick, 4-7 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4293</SubGroupID><SubGroupDescription>07.01.05.11 - 1.0-1.99mm thick, 8-15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4296</SubGroupID><SubGroupDescription>07.01.05.12 - 1.0-1.99mm thick, 16-32 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4300</SubGroupID><SubGroupDescription>07.01.05.13 - 1.0-1.99mm thick, &gt;32 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4301</SubGroupID><SubGroupDescription>07.01.05.14 - 2.0-2.99mm thick, 4-7 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4303</SubGroupID><SubGroupDescription>07.01.05.15 - 2.0-2.99mm thick, 8-15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4307</SubGroupID><SubGroupDescription>07.01.05.16 - 2.0-2.99mm thick, 16-32 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4310</SubGroupID><SubGroupDescription>07.01.05.17 - 2.0-2.99mm thick, &gt;32 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4311</SubGroupID><SubGroupDescription>07.01.05.18 - ≥3mm thick, 4-7 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4312</SubGroupID><SubGroupDescription>07.01.05.19 - ≥3mm thick, 8-15 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4314</SubGroupID><SubGroupDescription>07.01.05.20 - ≥3mm thick, 16-32 holes</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4321</SubGroupID><SubGroupDescription>07.01.06.01 - Diameter ≤1.24mm</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4323</SubGroupID><SubGroupDescription>07.01.06.02 - Diameter 1.25-3.24mm</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4334</SubGroupID><SubGroupDescription>07.01.07.03 - Washer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4335</SubGroupID><SubGroupDescription>07.01.07.04 - Wedges and Burr Hole Covers</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4336</SubGroupID><SubGroupDescription>07.01.07.05 - Anchor Bone</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4337</SubGroupID><SubGroupDescription>07.01.07.06 - Clamps</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4338</SubGroupID><SubGroupDescription>07.01.07.07 - Screws</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4340</SubGroupID><SubGroupDescription>07.01.07.09 - Probe</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6201</SubGroupID><SubGroupDescription>07.01.08.01 - &lt;6cm2</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6202</SubGroupID><SubGroupDescription>07.01.08.02 - &gt;6cm2 - &lt;8cm2</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6203</SubGroupID><SubGroupDescription>07.01.08.03 - &gt;8cm2</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4343</SubGroupID><SubGroupDescription>07.02.02.01 - Complex</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4346</SubGroupID><SubGroupDescription>07.02.02.02 - Polymer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4348</SubGroupID><SubGroupDescription>07.02.02.03 - Composite</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5496</SubGroupID><SubGroupDescription>07.02.02.04 - Surgical Guide</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4350</SubGroupID><SubGroupDescription>07.02.03.02 - Ear Base</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4351</SubGroupID><SubGroupDescription>07.02.04.01 - Complex</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4352</SubGroupID><SubGroupDescription>07.02.04.02 - Polymer</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4353</SubGroupID><SubGroupDescription>07.02.05.01 - Mandible, Full</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4354</SubGroupID><SubGroupDescription>07.02.05.02 - Fossa Replacement</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4355</SubGroupID><SubGroupDescription>07.02.05.03 - Mandibular Angle</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4357</SubGroupID><SubGroupDescription>07.02.05.04 - Condylar Device</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4358</SubGroupID><SubGroupDescription>07.02.05.05 - Plate</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5498</SubGroupID><SubGroupDescription>07.02.05.07 - Surgical Guide</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5782</SubGroupID><SubGroupDescription>07.02.05.08 - Maxilla</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6741</SubGroupID><SubGroupDescription>07.02.05.09 - Hemi-mandible</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4360</SubGroupID><SubGroupDescription>07.02.06.01 - Nasal Dorsum</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4361</SubGroupID><SubGroupDescription>07.02.06.02 - Nasal Arch</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4362</SubGroupID><SubGroupDescription>07.02.06.03 - Nasal Shell Shape</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4363</SubGroupID><SubGroupDescription>07.02.06.04 - Nasal Valve Support</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4364</SubGroupID><SubGroupDescription>07.02.06.05 - Naso-orbital Ethmoid Implant</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5783</SubGroupID><SubGroupDescription>07.02.06.07 - Zygoma Plate</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4366</SubGroupID><SubGroupDescription>07.02.07.01 - Complete Orbital Shape</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4367</SubGroupID><SubGroupDescription>07.02.07.02 - Orbital Floor</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4370</SubGroupID><SubGroupDescription>07.02.07.03 - Rim</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4371</SubGroupID><SubGroupDescription>07.02.07.04 - Wedge for Orbit</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6023</SubGroupID><SubGroupDescription>07.02.07.05 - Surgical Guide</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4373</SubGroupID><SubGroupDescription>07.02.08.01 - Endosseous Implant</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4385</SubGroupID><SubGroupDescription>07.03.01.01 - Permanent</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4386</SubGroupID><SubGroupDescription>07.03.01.02 - Temporary</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4387</SubGroupID><SubGroupDescription>07.03.01.03 - Cover Screw/Cap</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4389</SubGroupID><SubGroupDescription>07.03.03.01 - Screws</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4390</SubGroupID><SubGroupDescription>07.03.03.02 - Plates</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4392</SubGroupID><SubGroupDescription>07.03.03.03 - Implants and Fixtures</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4393</SubGroupID><SubGroupDescription>07.03.03.04 - Graft Material &lt;0.5ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4394</SubGroupID><SubGroupDescription>07.03.03.05 - Graft Material 0.5ml-&lt;1.0ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4395</SubGroupID><SubGroupDescription>07.03.03.06 - Graft Material ≥1.0ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4396</SubGroupID><SubGroupDescription>07.04.01.01 - External Midface System</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4399</SubGroupID><SubGroupDescription>07.04.01.03 - Internal/Intraoral</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4402</SubGroupID><SubGroupDescription>07.04.02.01 - Distractor Body</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4403</SubGroupID><SubGroupDescription>07.04.02.02 - Footplate</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4406</SubGroupID><SubGroupDescription>07.04.02.03 - Cross Bar/Rod</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4408</SubGroupID><SubGroupDescription>07.04.02.05 - Pin</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4409</SubGroupID><SubGroupDescription>07.04.02.06 - Screws</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4410</SubGroupID><SubGroupDescription>07.04.02.07 - External Distractor Component</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4411</SubGroupID><SubGroupDescription>07.04.02.08 - Body Extension</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4414</SubGroupID><SubGroupDescription>07.05.02.01 - Skin or Mammary</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4419</SubGroupID><SubGroupDescription>07.05.03.01 - &lt;50cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4420</SubGroupID><SubGroupDescription>07.05.03.02 - 50-149cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4421</SubGroupID><SubGroupDescription>07.05.03.03 - 150-400cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4422</SubGroupID><SubGroupDescription>07.05.03.04 - &gt;400cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4423</SubGroupID><SubGroupDescription>07.06.01.01 - &lt;500cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4426</SubGroupID><SubGroupDescription>07.06.01.02 - ≥500cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4429</SubGroupID><SubGroupDescription>07.06.02.01 - &lt;500cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4432</SubGroupID><SubGroupDescription>07.06.02.02 - ≥500cc</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5346</SubGroupID><SubGroupDescription>08.12.01.01 - General Purpose</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5349</SubGroupID><SubGroupDescription>08.12.02.02 - Special Purpose for specific indications</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7365</SubGroupID><SubGroupDescription>08.17.02.01 - Leaflet</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7349</SubGroupID><SubGroupDescription>08.18.01.01 - Irrigated Cardiac Ablation Catheter</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7350</SubGroupID><SubGroupDescription>08.18.01.02 - Patch</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7351</SubGroupID><SubGroupDescription>08.18.01.03 - Mapping Catheter</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7372</SubGroupID><SubGroupDescription>08.18.01.04 - Non-irrigated cardiac ablation catheter</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7375</SubGroupID><SubGroupDescription>08.18.01.05 - Intracardiac Electrophysiology Catheter</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7352</SubGroupID><SubGroupDescription>08.18.02.01 - Ablation Catheter</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7353</SubGroupID><SubGroupDescription>08.18.02.02 - Mapping Catheter</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7379</SubGroupID><SubGroupDescription>08.18.03.01 - Ablation and Mapping Catheter</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5452</SubGroupID><SubGroupDescription>09.05.01.01 - &lt; 25cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5453</SubGroupID><SubGroupDescription>09.05.01.02 - 25-75cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5454</SubGroupID><SubGroupDescription>09.05.01.03 - &gt;75cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4141</SubGroupID><SubGroupDescription>09.05.02.01 - Cardiovascular &lt; 75cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4142</SubGroupID><SubGroupDescription>09.05.02.02 - Cardiovascular ≥ 75cm²</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7369</SubGroupID><SubGroupDescription>09.09.06.02 - 11-20cm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7370</SubGroupID><SubGroupDescription>09.09.06.03 - 21-49cm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7371</SubGroupID><SubGroupDescription>09.09.06.04 - ≥50cm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6028</SubGroupID><SubGroupDescription>09.11.02.01 - System Controller</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6030</SubGroupID><SubGroupDescription>09.11.02.03 - Battery Set</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6032</SubGroupID><SubGroupDescription>09.11.02.04 - Battery Clip Set</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6031</SubGroupID><SubGroupDescription>09.11.03.01 - Stabilisation Belt</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6033</SubGroupID><SubGroupDescription>09.11.03.02 - Modular Belt</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6034</SubGroupID><SubGroupDescription>09.11.03.03 - Shower Bag</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6013</SubGroupID><SubGroupDescription>09.12.02.99 - No SubGroup</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7354</SubGroupID><SubGroupDescription>09.14.01.01 - Monopolar</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7355</SubGroupID><SubGroupDescription>09.14.01.02 - Bipolar</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7356</SubGroupID><SubGroupDescription>09.14.01.03 - System</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7358</SubGroupID><SubGroupDescription>09.14.02.01 - Probe</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7359</SubGroupID><SubGroupDescription>09.14.02.02 - System</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4439</SubGroupID><SubGroupDescription>10.01.01.01 - Balloon Expandable</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4440</SubGroupID><SubGroupDescription>10.01.01.02 - Self Expandable, &lt;150mm</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4441</SubGroupID><SubGroupDescription>10.01.01.03 - Self Expandable, ≥150mm</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5471</SubGroupID><SubGroupDescription>10.01.01.04 - Self-Expanding, large diameter for treatment of aortic dissection disease</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7364</SubGroupID><SubGroupDescription>10.01.01.05 - Catheter with 4 or 6 stents</SubGroupDescription></SubGroup><SubGroup><SubGroupID>6562</SubGroupID><SubGroupDescription>10.01.02.01 - Self Expandable</SubGroupDescription></SubGroup><SubGroup><SubGroupID>20005</SubGroupID><SubGroupDescription>10.01.03.01 - Everolimus Eluting BTK Resorbable Scaffold System</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4442</SubGroupID><SubGroupDescription>10.02.01.01 - &lt;180mm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4443</SubGroupID><SubGroupDescription>10.02.01.02 - ≥180mm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4444</SubGroupID><SubGroupDescription>10.02.04.01 - Body and 2 limbs</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4445</SubGroupID><SubGroupDescription>10.02.04.02 - Body and 1 limb</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4446</SubGroupID><SubGroupDescription>10.02.04.03 - Body only</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5516</SubGroupID><SubGroupDescription>10.02.05.02 - Multiple Branch</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4447</SubGroupID><SubGroupDescription>10.02.07.01 - Thoracic</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4448</SubGroupID><SubGroupDescription>10.02.07.02 - Abdominal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4449</SubGroupID><SubGroupDescription>10.02.10.01 - ≤12mm diameter</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4450</SubGroupID><SubGroupDescription>10.02.10.02 - &gt;12mm diameter</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4451</SubGroupID><SubGroupDescription>10.02.11.01 - &lt;150mm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4452</SubGroupID><SubGroupDescription>10.02.11.02 - 150-249mm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4453</SubGroupID><SubGroupDescription>10.02.11.03 - ≥250mm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4454</SubGroupID><SubGroupDescription>10.03.01.01 - ≤10cm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4455</SubGroupID><SubGroupDescription>10.03.01.02 - 11-20cm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4456</SubGroupID><SubGroupDescription>10.03.01.03 - 21-49cm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4457</SubGroupID><SubGroupDescription>10.03.01.04 - ≥50cm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4458</SubGroupID><SubGroupDescription>10.04.01.01 - 0 - 100 sq cm</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4459</SubGroupID><SubGroupDescription>10.04.01.02 - 101 - 150 sq cm</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4460</SubGroupID><SubGroupDescription>10.04.01.03 - &gt;150 sq cm</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4461</SubGroupID><SubGroupDescription>10.04.01.04 - Pledgets</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5472</SubGroupID><SubGroupDescription>10.08.02.01 - ≤200mm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5473</SubGroupID><SubGroupDescription>10.08.02.02 - &gt;200mm length</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4467</SubGroupID><SubGroupDescription>10.08.03.03 - 2ml</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7041</SubGroupID><SubGroupDescription>10.08.05.02 - Cyanoacrylate</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5507</SubGroupID><SubGroupDescription>10.08.06.02 - Detachment Controller</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3939</SubGroupID><SubGroupDescription>11.01.01.01 - Unpolished</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3941</SubGroupID><SubGroupDescription>11.01.01.03 - Polished</SubGroupDescription></SubGroup><SubGroup><SubGroupID>7374</SubGroupID><SubGroupDescription>11.01.01.04 - Polished and Unpolished, Modular</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3944</SubGroupID><SubGroupDescription>11.01.02.01 - Polished and Unpolished, Conventional</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3945</SubGroupID><SubGroupDescription>11.01.03.01 - Grit Blast</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3948</SubGroupID><SubGroupDescription>11.01.03.04 - Plasma</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3949</SubGroupID><SubGroupDescription>11.01.04.01 - Grit Blast</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3950</SubGroupID><SubGroupDescription>11.01.04.02 - Beaded</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3952</SubGroupID><SubGroupDescription>11.01.04.04 - Plasma</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3953</SubGroupID><SubGroupDescription>11.01.05.01 - Grit Blast</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3957</SubGroupID><SubGroupDescription>11.01.06.01 - Grit Blast</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3960</SubGroupID><SubGroupDescription>11.01.06.04 - Plasma</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3961</SubGroupID><SubGroupDescription>11.01.07.01 - Grit Blast</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3962</SubGroupID><SubGroupDescription>11.01.07.02 - Beaded</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3964</SubGroupID><SubGroupDescription>11.01.07.04 - Plasma</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3965</SubGroupID><SubGroupDescription>11.01.07.05 - Unpolished and Polished</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3966</SubGroupID><SubGroupDescription>11.01.08.01 - Grit Blast</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3967</SubGroupID><SubGroupDescription>11.01.08.02 - Beaded</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3969</SubGroupID><SubGroupDescription>11.01.08.04 - Plasma</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3970</SubGroupID><SubGroupDescription>11.01.08.05 - Unpolished and Polished</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3971</SubGroupID><SubGroupDescription>11.01.09.01 - Grit Blast</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3974</SubGroupID><SubGroupDescription>11.01.09.04 - Plasma</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3975</SubGroupID><SubGroupDescription>11.01.09.05 - Unpolished and Polished</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3979</SubGroupID><SubGroupDescription>11.01.10.04 - Plasma</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3988</SubGroupID><SubGroupDescription>11.02.01.01 - Stainless Steel</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3989</SubGroupID><SubGroupDescription>11.02.01.02 - Cobalt Chrome</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3990</SubGroupID><SubGroupDescription>11.02.01.03 - Alumina</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3992</SubGroupID><SubGroupDescription>11.02.01.05 - Ceramic Mix</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3993</SubGroupID><SubGroupDescription>11.02.01.06 - Ceramicised Metal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3994</SubGroupID><SubGroupDescription>11.02.02.01 - Stainless Steel</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3995</SubGroupID><SubGroupDescription>11.02.02.02 - Cobalt Chrome</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3996</SubGroupID><SubGroupDescription>11.02.02.03 - Alumina</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3998</SubGroupID><SubGroupDescription>11.02.02.05 - Ceramic Mix</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3999</SubGroupID><SubGroupDescription>11.02.02.06 - Ceramicised Metal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4000</SubGroupID><SubGroupDescription>11.02.04.01 - Metal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>20000</SubGroupID><SubGroupDescription>11.02.04.02 - Ceramic Mix</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4004</SubGroupID><SubGroupDescription>11.02.06.01 - Bipolar</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4005</SubGroupID><SubGroupDescription>11.02.06.02 - Tripolar/Multipolar</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4006</SubGroupID><SubGroupDescription>11.03.01.01 - Unmodified polyethylene</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4007</SubGroupID><SubGroupDescription>11.03.01.02 - Modified polyethylene</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4008</SubGroupID><SubGroupDescription>11.03.01.03 - Constrained, modified and unmodified polythylene</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4009</SubGroupID><SubGroupDescription>11.03.01.04 - Metal Shell</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4010</SubGroupID><SubGroupDescription>11.03.02.01 - Grit Blast</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4011</SubGroupID><SubGroupDescription>11.03.02.02 - Beaded</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4012</SubGroupID><SubGroupDescription>11.03.02.03 - Mesh</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4013</SubGroupID><SubGroupDescription>11.03.02.04 - Plasma</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4014</SubGroupID><SubGroupDescription>11.03.02.05 - Porous Metal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4015</SubGroupID><SubGroupDescription>11.03.03.01 - Grit Blast</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4016</SubGroupID><SubGroupDescription>11.03.03.02 - Beaded</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4017</SubGroupID><SubGroupDescription>11.03.03.03 - Mesh</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4018</SubGroupID><SubGroupDescription>11.03.03.04 - Plasma</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4020</SubGroupID><SubGroupDescription>11.03.04.01 - Unmodified polyethylene</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4021</SubGroupID><SubGroupDescription>11.03.04.02 - Modified polyethylene</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4022</SubGroupID><SubGroupDescription>11.03.04.03 - Ceramic</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4023</SubGroupID><SubGroupDescription>11.03.04.04 - Metal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4024</SubGroupID><SubGroupDescription>11.03.04.05 - Constrained</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4025</SubGroupID><SubGroupDescription>11.03.04.06 - Ceramic Mix</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4026</SubGroupID><SubGroupDescription>11.03.05.01 - Unmodified polyethylene</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4027</SubGroupID><SubGroupDescription>11.03.05.02 - Modified polyethylene</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4030</SubGroupID><SubGroupDescription>11.03.05.05 - Ceramic Mix</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4032</SubGroupID><SubGroupDescription>11.03.07.02 - Metal, HA Coated</SubGroupDescription></SubGroup><SubGroup><SubGroupID>20001</SubGroupID><SubGroupDescription>11.03.07.03 - Ceramic, Plasma, HA Coated</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4034</SubGroupID><SubGroupDescription>11.03.08.01 - Shell</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4035</SubGroupID><SubGroupDescription>11.03.08.02 - Cage</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3906</SubGroupID><SubGroupDescription>12.01.01.01 - Minimally Stabilised</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3907</SubGroupID><SubGroupDescription>12.01.01.02 - Posterior Stabilised</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3908</SubGroupID><SubGroupDescription>12.01.01.03 - Totally Constrained</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3909</SubGroupID><SubGroupDescription>12.01.02.01 - Minimally Stabilised</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3911</SubGroupID><SubGroupDescription>12.01.03.01 - Minimally Stabilised</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3912</SubGroupID><SubGroupDescription>12.01.03.02 - Posterior Stabilised</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3913</SubGroupID><SubGroupDescription>12.01.03.03 - Totally Constrained</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3914</SubGroupID><SubGroupDescription>12.01.04.01 - Minimally Stabilised</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3915</SubGroupID><SubGroupDescription>12.01.04.02 - Posterior Stabilised</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3917</SubGroupID><SubGroupDescription>12.01.05.01 - Minimally Stabilised</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3918</SubGroupID><SubGroupDescription>12.01.05.02 - Posterior Stabilised</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3919</SubGroupID><SubGroupDescription>12.02.01.01 - PMMA Coating</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3920</SubGroupID><SubGroupDescription>12.02.03.01 - HA Coating</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3923</SubGroupID><SubGroupDescription>12.03.05.01 - HA Coating</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3924</SubGroupID><SubGroupDescription>12.03.07.01 - HA Coating</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3925</SubGroupID><SubGroupDescription>12.04.05.01 - HA Coating</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3926</SubGroupID><SubGroupDescription>12.04.06.01 - HA Coating</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3929</SubGroupID><SubGroupDescription>12.08.03.02 - Moulded</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3930</SubGroupID><SubGroupDescription>12.09.01.01 - Condylar only (only when combined with a proximal tibial replacement)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3931</SubGroupID><SubGroupDescription>12.09.01.02 - Condylar, including metaphyseal and/or diaphyseal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3932</SubGroupID><SubGroupDescription>12.09.02.01 - Condylar only (only when combined with a proximal tibial replacement)</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3933</SubGroupID><SubGroupDescription>12.09.02.02 - Condylar, including metaphyseal and/or diaphyseal</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3934</SubGroupID><SubGroupDescription>12.09.03.01 - Incorporating Bone Fixation</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3935</SubGroupID><SubGroupDescription>12.09.04.01 - With Compression</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3936</SubGroupID><SubGroupDescription>12.09.08.01 - Collar</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3937</SubGroupID><SubGroupDescription>12.09.08.02 - Adaptor</SubGroupDescription></SubGroup><SubGroup><SubGroupID>3938</SubGroupID><SubGroupDescription>12.09.08.03 - Stem extender</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4123</SubGroupID><SubGroupDescription>13.03.03.01 - Fixed</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4124</SubGroupID><SubGroupDescription>13.03.03.02 - Adjustable</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4125</SubGroupID><SubGroupDescription>13.05.01.01 - Cervical</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4126</SubGroupID><SubGroupDescription>13.05.01.02 - ThoracoLumbar / Lumbar / Lumbosacral</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4127</SubGroupID><SubGroupDescription>13.05.02.01 - Cervical</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4128</SubGroupID><SubGroupDescription>13.05.02.02 - ThoracoLumbar</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4129</SubGroupID><SubGroupDescription>13.05.02.03 - Occipital</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4131</SubGroupID><SubGroupDescription>13.05.02.05 - Laminoplasty Plate</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4132</SubGroupID><SubGroupDescription>13.06.03.01 - Thoracolumbar</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4133</SubGroupID><SubGroupDescription>13.06.03.02 - Occipital</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5485</SubGroupID><SubGroupDescription>13.10.01.01 - Cervical</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5486</SubGroupID><SubGroupDescription>13.10.01.02 - ThoracoLumbar / Lumbar</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4134</SubGroupID><SubGroupDescription>13.10.02.01 - Cervical</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4135</SubGroupID><SubGroupDescription>13.10.02.02 - ThoracoLumbar / Lumbar</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5487</SubGroupID><SubGroupDescription>13.11.01.01 - Cervical</SubGroupDescription></SubGroup><SubGroup><SubGroupID>5488</SubGroupID><SubGroupDescription>13.11.01.02 - Lumbar</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4136</SubGroupID><SubGroupDescription>13.12.01.01 - Integral Fixation</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4137</SubGroupID><SubGroupDescription>13.12.01.02 - No Integral Fixation</SubGroupDescription></SubGroup><SubGroup><SubGroupID>4138</SubGroupID><SubGroupDescription>13.12.01.03 - End Plate</SubGroupDescription></SubGroup></SubGroups><ProsthesisItems><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FY001</BillingCode><PriorBillingCodes><PriorBillingCode>MQ038</PriorBillingCode></PriorBillingCodes><Name>Purastat</Name><Description>Haemostatic material in the form of a pre-filled syringe</Description><Size>1ml, 3ml, 5ml</Size><SupplierCode>FY</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4213</SubGroupID><ARTGs><ARTG>267486</ARTG></ARTGs><MinimumBenefit>343</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FY002</BillingCode><PriorBillingCodes><PriorBillingCode>MQ039</PriorBillingCode></PriorBillingCodes><Name>PuraStat Applicator</Name><Description>PuraStat is used as an adjunct to haemostasis when control of bleeding by ligature or conventional surgical procedures is ineffective or impractical.</Description><Size>250mm</Size><SupplierCode>FY</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Rigid Delivery System</Suffix><ARTGs><ARTG>283717</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FY003</BillingCode><PriorBillingCodes><PriorBillingCode>MQ040</PriorBillingCode></PriorBillingCodes><Name>PuraStat Applicator Type E</Name><Description>PuraStat is used as an adjunct to haemostasis when control of bleeding by ligature or conventional surgical procedures is ineffective or impractical.</Description><Size>1600mm, 2200mm</Size><SupplierCode>FY</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4217</SubGroupID><ARTGs><ARTG>283717</ARTG></ARTGs><MinimumBenefit>28</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK007</BillingCode><Name>3D Fusion integral fixation ATP Cage with screws and locking cap</Name><Description>Titanium ATP fusion cage with integral fixation including screws and locking cap</Description><Size>Width: 18-24mm  Length - 35mm-60mm  Height - 3mm-30mm and angle 0-35 as per patient specific requirements for the designed cage.      </Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK002</BillingCode><Name>3D fusion lumbar cage</Name><Description>Stand-alone anterior lumbar interbody fusion (ALIF) fixation system: cage, screws and locking caps.        3DMorphic ALIF integral screw fixation device (cage) is intended to immobilize, stabilize and maintain the space between instrumented segments and support loading in the lumbar spine until fusion occurs. The 3DMorphic ALIF device has a trapezoidal, ring shaped footprint, and features a central graft window that can receive bone graft. The superior and inferior surfaces of the device are adapted to match the patient’s vertebral endplate anatomy and feature serrated teeth to resist expulsion from the interbody space. The anterior surface of the device features screw holes and threaded locking cap holes as the device is designed for use with integral fixation screws and locking caps. The cage is offered in a variety of footprints, heights, lordotic and scoliotic angles according to the patient’s anatomy and surgeon’s specifications.</Description><Size>Footprints: 20mm to 36mm L x 19mm to 58mm W. Minimum anterior height is 10mm.     L = Anterior-posterior depth (DD in the catalogue), W = width (WW in the catalogue), height, angle and number of screws vary according to surgeon request and patient anatomy as the devices are custom-made.    Please see attached catalogue for full list of sizes.</Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK012</BillingCode><PriorBillingCodes><PriorBillingCode>KB011</PriorBillingCode></PriorBillingCodes><Name>AnyPlus and AnyPlus II Rods</Name><Description>Straight and Pre-bent Rods</Description><Size>Diameter: 5.5mm  Length: 40-200mm</Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>353891</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK005</BillingCode><Name>3D Fusion TLIF Cage  </Name><Description>Titanium TLIF cage </Description><Size>Length: 25-60mm     Width: 8-16mm       Height: 3-30mm    Angle 0-35 degrees as per patient specific requirements for the designed cage.  </Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK013</BillingCode><PriorBillingCodes><PriorBillingCode>KB012</PriorBillingCode></PriorBillingCodes><Name>AnyPlus II Poly Screw</Name><Description>Polyaxial pedicle screws and reduction screws</Description><Size>Diameter:4.5-7.5mm  Length: 35-55mm</Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>353891</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK009</BillingCode><Name>3D Fusion LLIF Cage </Name><Description>Titanium Lateral Lumbar Interbody Fusion cage </Description><Size>Width: 18-24mm  Length - 34mm-60mm  Height - 3mm-30mm angle 0-35 degrees as per patient specific requirements for the designed cage.</Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK008</BillingCode><Name>3D Fusion Lumbar Plate </Name><Description>Titanium Lumbar Fusion Plate</Description><Size>Length: 18-24mm    Width: 10-24mm     thickness: 2-4mm </Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK006</BillingCode><Name>3D Fusion PLIF Cage</Name><Description>Titanium PLIF cage </Description><Size>Length: 18-26mm    Width: 8-12mm           Height: 7–25mm      angle 0-35 degrees  as per patient specific requirements for the designed cage   </Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK016</BillingCode><PriorBillingCodes><PriorBillingCode>KB015</PriorBillingCode></PriorBillingCodes><Name>AnyPlus II Mono Screw</Name><Description>Monaxial Pedicle Screw and Mono Reduction Screws</Description><Size>Diameter: 4.5-7.5mm  Length: 35-55mm</Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>353891</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK014</BillingCode><PriorBillingCodes><PriorBillingCode>KB013</PriorBillingCode></PriorBillingCodes><Name>AnyPlus and AnyPlus II Set Screw</Name><Description>Set Screw</Description><Size>One size only  </Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>353891</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK011</BillingCode><Name>3DFusion Non-Integral Fixation ACDF cage</Name><Description>Patient specific interbody device </Description><Size>Small, Medium, Large</Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK015</BillingCode><PriorBillingCodes><PriorBillingCode>KB014</PriorBillingCode></PriorBillingCodes><Name>AnyPlus Long Arm Screw</Name><Description>Polyaxial cannulated pedicle screws</Description><Size>Diameter: 5.0 - 7.5mm  Length 25 -100mm</Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>353891</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ302</BillingCode><Name>3DFusion VCL Core </Name><Description>3DFusion VCLCore is part of the 3DFusion VCL System, a patient-specific thoraco-lumbar vertebrectomy system intended to immobilize, stabilize and maintain the space between instrumented spinal segments in order to allow bone fusion in the thoraco-lumbar, lumbar or lumbo-sacral spine. </Description><Size>22mm-92mm </Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1814</GroupID><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>3340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK001</BillingCode><Name>3D fusion ACDF</Name><Description>Stand-alone anterior cervical discectomy and fusion (ACDF) fixation system: cage, screws and locking cap.    The 3DMorphic ACDF integral screw fixation device (cage) is intended to immobilize, stabilize and maintain the height between instrumented segments and support loading in the cervical spine until fusion occurs. The 3DMorphic ACDF device has a trapezoidal, ring shaped footprint with a central graft window that can receive bone graft. The superior and inferior surfaces of the device are made to fit the patient’s vertebral endplate anatomy and feature serrated teeth to resist expulsion from the interbody space. The anterior surface of the device features screw holes and a threaded locking cap hole as the device is designed for use with integral fixation screws and a locking cap. The device is offered in a variety of footprints, heights, lordotic and scoliotic angles according to the patient’s anatomy and surgeon’s specifications. </Description><Size>Footprints: 10mm to 23mm L x 08mm to 30mm W. Minimum anterior height is 6mm.         L = Anterior-posterior depth (DD in the catalogue), W = width (WW in the catalogue), height and angle vary according to surgeon request as the devices are custom-made.     Please refer to attached catalogue for full size range.     </Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK004</BillingCode><Name>3D fusion cervical screw</Name><Description>The 3D Fusion cervical screw is part of the integral fixation mechanism for the 3D Fusion cervical System (also consisting of the 3D Fusion ACDF Cage and Locking Cap). These components are part of separate applications.    The 3D Fusion ACDF Bone Screws intend to immobilize and stabilize the 3D Fusion ACDF Cage and facilitate spinal fusion between two adjacent lumbar vertebral bodies. The 3D Fusion ACDF Bone Screws are self-drilling, dual thread bone screws designed to fit with integral fixation features of the 3D Fusion cervical system. The threaded locking cap system establishes an intrinsic link between the cage and the fixation screws, creating a rigid locked system, without distortion of the screw head     </Description><Size>Length = 12mm – 20mm  Diameter = 4.0mm &amp; 4.5mm   </Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK003</BillingCode><Name>3D Fusion Lumbar Bone Screw</Name><Description>Stand-alone anterior lumbar interbody fusion (ALIF) fixation system: cage, screws and locking caps. The 3D Fusion lumbar bone screw is intended to be used as part of the integral screw fixation system and immobilize and stabilize the 3D fusion lumbar cage to facilitate spinal fusion between two adjacent vertebral bodies. The 3D fusion lumbar bone screws are self-drilling, self-tapping, dual thread bone screws designed to fit with threaded features of the 3D Fusion lumbar Cage to secure and stabilise the fusion cage in place with patient’s endplate anatomy.  </Description><Size>Length – 20mm, 25mm, 30mm, 35mm, 40mm, 45mm    Diameter – 5.5mm, 6mm   </Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GK010</BillingCode><Name>3DFusion Cervical Plate</Name><Description>Custom-made associated device (plate) </Description><Size>Small, Medium, Large</Size><SupplierCode>GK</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>406173</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YR004</BillingCode><PriorBillingCodes><PriorBillingCode>WJ004</PriorBillingCode></PriorBillingCodes><Name>Roca J-Fil &amp; Mini J-Fil</Name><Description>Ureteral PigTail Suture Stent &amp; Simple / Connectable Pusher &amp; Without / With GuideWire</Description><Size>4.8Fr / 7.0Fr ( 00cm - 16cm )</Size><SupplierCode>YR</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>381055</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YR003</BillingCode><PriorBillingCodes><PriorBillingCode>WJ003</PriorBillingCode></PriorBillingCodes><Name>Roca JJ</Name><Description>Soft / Firm Ureteral Stent &amp; Simple / Connectable Pusher &amp; Without / With GuideWire</Description><Size>4.8Fr / 6Fr / 7Fr / 8Fr ( 24cm - 30cm )  </Size><SupplierCode>YR</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>381055</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YR002</BillingCode><PriorBillingCodes><PriorBillingCode>WJ002</PriorBillingCode></PriorBillingCodes><Name>Roca Endo-Sil</Name><Description>Silicone Ureteral Stent &amp; Simple / Connectable Pusher &amp; Without / With GuideWire</Description><Size>6Fr / 7Fr / 8Fr ( 24cm-30cm )</Size><SupplierCode>YR</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>SP</Suffix><ARTGs><ARTG>381055</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YR001</BillingCode><PriorBillingCodes><PriorBillingCode>WJ001</PriorBillingCode></PriorBillingCodes><Name>Roca Multi-Length</Name><Description>Soft / Firm Ureteral Stent &amp; Simple / Connectable Pusher &amp; Without / With GuideWire</Description><Size>4.8Fr / 6Fr / 7Fr ( 22cm-32cm )</Size><SupplierCode>YR</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1702</GroupID><SubGroupID>5325</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>381055</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YT001</BillingCode><PriorBillingCodes><PriorBillingCode>WK001</PriorBillingCode></PriorBillingCodes><Name>PLASTI-MED HydroPhilic</Name><Description>HydroPhilic Ureteral Stent</Description><Size>4Fr / 4.8Fr / 6Fr / 7Fr ( 12cm - 28cm )</Size><SupplierCode>YT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>389186</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YT002</BillingCode><PriorBillingCodes><PriorBillingCode>WK002</PriorBillingCode></PriorBillingCodes><Name>PLASTI-MED Multi-Length</Name><Description>Multi-Length Ureteral Stent</Description><Size>3Fr / 3.5Fr / 4Fr / 4.7Fr / 4.8Fr / 6Fr / 7Fr ( 8cm - 32cm )</Size><SupplierCode>YT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1702</GroupID><SubGroupID>5324</SubGroupID><Suffix>P</Suffix><ARTGs><ARTG>389186</ARTG></ARTGs><MinimumBenefit>241</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ067</BillingCode><Name>PAUL® Glaucoma Implant        </Name><Description>Micro-sized tubed aqueous shunt glaucoma drainage device</Description><Size>Length 44.9mm  Width 23mm  Extraocular plate surface area of 342.1mm²</Size><SupplierCode>ZZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>144</SubCategoryID><GroupID>1333</GroupID><ARTGs><ARTG>303466</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ093</BillingCode><PriorBillingCodes><PriorBillingCode>WH020</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate, Locking, Complex Shape</Description><Size>2.0-2.99mm thick, &gt;32 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4310</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>1414</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ098</BillingCode><PriorBillingCodes><PriorBillingCode>WH003</PriorBillingCode></PriorBillingCodes><Name>Materialise Titanium 3D Printed Plates</Name><Description>Patient specific Titanium 3D printed plates for maxillofacial applications</Description><Size>Personalized so the size is variable</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>2952</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ091</BillingCode><PriorBillingCodes><PriorBillingCode>WH018</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate, Locking</Description><Size>2.0-2.99mm thick, 8-15 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4303</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>926</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ108</BillingCode><Name>Materialise Titanium 3D Printed Guides</Name><Description>Patient specific maxillofacial guides for specific use with Materialise  peronalised implants and plates included in rebate codes ZZ096, ZZ097, ZZ098, ZZ099, ZZ100, ZZ101, and standard plates and screws ZZ081, ZZ082, ZZ083, ZZ084, ZZ085, ZZ086, ZZ087, ZZ088, ZZ089, ZZ090, ZZ091, Z092, ZZ093, ZZ094, ZZ095 and ZZ102</Description><Size>Custom</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>377044</ARTG><ARTG>410054</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ084</BillingCode><PriorBillingCodes><PriorBillingCode>WH011</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate</Description><Size>1.0-1.99mm thick, &amp;lt;4 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4286</SubGroupID><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>107</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ110</BillingCode><PriorBillingCodes><PriorBillingCode>PN023</PriorBillingCode></PriorBillingCodes><Name>ACCERO Stent</Name><Description>ACCERO Stent is a highly visible,braided self-expanding stent with BlueXide® surface technology.The self-expanding braided stent is characterised by an excellent opening behaviour,  superior wall apposition and a very smooth surface. It is intended for use with embolization materials in the treatment of intracranial aneurysms. Accero’s full range of sizes can be delivered through a small 0.0170” microcatheter and can be resheathed up to 95%.    </Description><Size>Stent Diameter (mm): 2.5, 3.0, 3.5,4.0, 4.5           Stent Length (mm): 10, 15, 20, 25</Size><SupplierCode>ZZ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1687</GroupID><ARTGs><ARTG>321603</ARTG></ARTGs><MinimumBenefit>6769</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ099</BillingCode><PriorBillingCodes><PriorBillingCode>WH004</PriorBillingCode></PriorBillingCodes><Name>Materialise PorousiTi - Maxilla</Name><Description>Patient specific Titanium 3D printed implant for maxilla</Description><Size>Personalized so the size is variable</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5782</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>6337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ109</BillingCode><PriorBillingCodes><PriorBillingCode>PN022</PriorBillingCode></PriorBillingCodes><Name>ACCLINO Flex Plus Stent</Name><Description>Acclino Flex Plus Stent is a self-expanding lasercut Nitinol stent for aneurysm neck bridging in case of stent assisted coiling procedures. It is intended for use with embolisation materials for the treatment of intracranial aneurysms. It provides an increased range and is suitable for vessel diameters from 1.5 to 7.0 mm. For an easy handling all sizes from 3.0  - 6.5 mm are deliverable through microcatheters with 0.0165 -   0.021  ID. This allows a sequential stent and coil placement without the changing of the microcatheter. The 8.0 mm diameter devices are deliverable through  microcatheters with 0.027 ID.</Description><Size>Diameter: 3.0 - 8.0mm  Length: 15 - 60 mm</Size><SupplierCode>ZZ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1687</GroupID><ARTGs><ARTG>312950</ARTG></ARTGs><MinimumBenefit>6769</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ081</BillingCode><PriorBillingCodes><PriorBillingCode>WH007</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate</Description><Size>0.5-0.99mm thick, 4-7 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Compression</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ085</BillingCode><PriorBillingCodes><PriorBillingCode>WH013</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate, S-shape</Description><Size>1.0-1.99mm thick, 4-7 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ086</BillingCode><PriorBillingCodes><PriorBillingCode>WH012</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate</Description><Size>1.0-1.99mm thick, 4-7 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><Suffix>Compression</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ102</BillingCode><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium Plate, Locking</Description><Size>1.0mm-1.99mm thick, 16-32 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>798</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ087</BillingCode><PriorBillingCodes><PriorBillingCode>WH014</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate, Locking</Description><Size>1.0-1.99mm thick, 4-7 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>345</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ095</BillingCode><PriorBillingCodes><PriorBillingCode>WH009</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Screws</Name><Description>Titanium Screw</Description><Size>Diameter 1.25-3.24mm</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ092</BillingCode><PriorBillingCodes><PriorBillingCode>WH019</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate, Locking</Description><Size>2.0-2.99mm thick, 16-32 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4307</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>1073</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ115</BillingCode><Name>CRYO3 – AtriCure Cryoice </Name><Description>Aluminum Enhanced Malleable Cryoablation Probe </Description><Size>10cm</Size><SupplierCode>ZZ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2949</GroupID><SubGroupID>7358</SubGroupID><Suffix>AA-Med cryoICE</Suffix><ARTGs><ARTG>311095</ARTG></ARTGs><MinimumBenefit>3800</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ057</BillingCode><Name>cryoICE Cryoablation Surgical Probes</Name><Description>Surgical Cryoablation probes for atrial fibrillation surgery</Description><Size>One size only</Size><SupplierCode>ZZ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2949</GroupID><SubGroupID>7358</SubGroupID><Suffix>AA-Med cryoICE</Suffix><ARTGs><ARTG>202110</ARTG><ARTG>311095</ARTG></ARTGs><MinimumBenefit>3800</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ100</BillingCode><PriorBillingCodes><PriorBillingCode>WH005</PriorBillingCode></PriorBillingCodes><Name>Materialise Titanium 3D Printed Plates - Zygoma</Name><Description>Patient specific Titanium 3D printed plates for zygoma reconstruction</Description><Size>Personalized so the size is variable</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1597</GroupID><SubGroupID>5783</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>4095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ101</BillingCode><PriorBillingCodes><PriorBillingCode>WH006</PriorBillingCode></PriorBillingCodes><Name>Materialise PorousiTi - Orbital</Name><Description>Patient specific Titanium 3D printed implant for orbital reconstruction</Description><Size>Personalized so the size is variable</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4367</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>4095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ080</BillingCode><Name>EPi-Sense Guided Coagulation System with VisiTrax Device CDK-1413 </Name><Description>Surgical Radio Frequency (RF) catheter for Atrial Fibrillation surgery</Description><Size>EPi-Sense Probe: 3cm (end effector) </Size><SupplierCode>ZZ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2948</GroupID><SubGroupID>7356</SubGroupID><Suffix>AA-Med Episense</Suffix><ARTGs><ARTG>347670</ARTG></ARTGs><MinimumBenefit>6040</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ089</BillingCode><PriorBillingCodes><PriorBillingCode>WH015</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate</Description><Size>1.0-1.99mm thick, 8-15 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4293</SubGroupID><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ096</BillingCode><PriorBillingCodes><PriorBillingCode>WH001</PriorBillingCode></PriorBillingCodes><Name>Materialise PorousiTi - Cranium</Name><Description>Patient specific Titanium 3D printed implant for cranial reconstruction</Description><Size>Personalized so the size is variable</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>4343</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>9682</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ082</BillingCode><PriorBillingCodes><PriorBillingCode>WH016</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate, Complex shape</Description><Size>0.5-0.99mm thick, 8-32 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ083</BillingCode><PriorBillingCodes><PriorBillingCode>WH010</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate</Description><Size>0.5-0.99mm thick, 8-32 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><Suffix>Compression</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>195</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ065</BillingCode><Name>Atricure Isolator Linear Pen</Name><Description>Surgical Radio Frequency (RF) Isolator Linear Pen for Atrial Fibrillation surgery</Description><Size>One size only</Size><SupplierCode>ZZ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2948</GroupID><SubGroupID>7355</SubGroupID><Suffix>AA-Med - Isolator Linear Pen</Suffix><ARTGs><ARTG>326626</ARTG><ARTG>326627</ARTG></ARTGs><MinimumBenefit>2000</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ055</BillingCode><Name>ATRICURE ISOLATOR SYNERGY RF CLAMPS</Name><Description>Surgical Radio Frequency (RF) Clamps for Atrial Fibrillation surgery</Description><Size>Short, Long</Size><SupplierCode>ZZ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2948</GroupID><SubGroupID>7355</SubGroupID><Suffix>AA-Med - Isolator Synergy</Suffix><ARTGs><ARTG>163534</ARTG></ARTGs><MinimumBenefit>4200</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ094</BillingCode><PriorBillingCodes><PriorBillingCode>WH021</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Screws</Name><Description>Titanium Screw, Locking</Description><Size>Diameter 1.25-3.24mm</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>88</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ064</BillingCode><Name>ATRICURE COOLRAIL LINEAR PEN</Name><Description>Surgical Radio Frequency (RF) Irrigated Linear Pen for Atrial Fibrillation surgery</Description><Size>One size only</Size><SupplierCode>ZZ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2948</GroupID><SubGroupID>7355</SubGroupID><Suffix>AA-Med - Coolrail</Suffix><ARTGs><ARTG>326625</ARTG></ARTGs><MinimumBenefit>2600</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ097</BillingCode><PriorBillingCodes><PriorBillingCode>WH002</PriorBillingCode></PriorBillingCodes><Name>Materialise PorousiTi - Mandible</Name><Description>Patient specific Titanium 3D printed implant for mandible</Description><Size>Personalized so the size is variable</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4353</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>5119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ056</BillingCode><Name>Isolator Synergy Access</Name><Description>Articulating Surgical Radio Frequency (RF) Clamp for Atrial Fibrillation Surgery</Description><Size>One size only</Size><SupplierCode>ZZ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2948</GroupID><SubGroupID>7355</SubGroupID><Suffix>AA-Med - Isolator Synergy</Suffix><ARTGs><ARTG>167710</ARTG><ARTG>297560</ARTG></ARTGs><MinimumBenefit>4200</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ088</BillingCode><PriorBillingCodes><PriorBillingCode>WH008</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate, Locking</Description><Size>1.0-1.99mm thick, 8-15 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4293</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ066</BillingCode><Name>AtriClip Left Atrial Appendage Exclusion System</Name><Description>Gillinov-Cosgrove LAA Clip for open occlusion of the left atrial appendage mounted on a disposable applier</Description><Size>35mm, 40mm, 45mm, 50mm,</Size><SupplierCode>ZZ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>251</SubCategoryID><GroupID>1790</GroupID><ARTGs><ARTG>308862</ARTG></ARTGs><MinimumBenefit>1097</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ090</BillingCode><PriorBillingCodes><PriorBillingCode>WH017</PriorBillingCode></PriorBillingCodes><Name>Materialise Standard+ Solutions - Plates</Name><Description>Titanium plate</Description><Size>2.0-2.99mm thick, 4-7 holes</Size><SupplierCode>ZZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4301</SubGroupID><ARTGs><ARTG>377044</ARTG></ARTGs><MinimumBenefit>604</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ZZ114</BillingCode><Name>Supraflex Cruz</Name><Description>Sirolimus Eluting Cobalt Chromium Coronary Stent System pre-mounted onto a delivery catheter.</Description><Size>Length: 8-48mm, Diameter:  2.00-4.50mm</Size><SupplierCode>ZZ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>462346</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ366</BillingCode><Name>Endurity MRI PM2172</Name><Description>Dual Chamber MR Conditional Rate Responsive Pacemaker</Description><Size>10.4cc, 20g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>i</Suffix><ARTGs><ARTG>440993</ARTG></ARTGs><MinimumBenefit>5448</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ452</BillingCode><PriorBillingCodes><PriorBillingCode>AY033</PriorBillingCode></PriorBillingCodes><Name>Proglide</Name><Description>Suture Mediated Closure Device</Description><Size>5 - 8 French</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>212</SubCategoryID><GroupID>1644</GroupID><ARTGs><ARTG>300736</ARTG></ARTGs><MinimumBenefit>290</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ035</BillingCode><Name>SJM Tailor Annuloplasty Ring</Name><Description>Fully Flexible</Description><Size>25mm - 35mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1841</GroupID><ARTGs><ARTG>123490</ARTG></ARTGs><MinimumBenefit>2090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ449</BillingCode><PriorBillingCodes><PriorBillingCode>AY018</PriorBillingCode></PriorBillingCodes><Name>Emboshield</Name><Description>Embolic Protection Device, including delivery system, device specific procedural wire, filter for capturing embolic matter and retrieval system</Description><Size>Large and small. Two wire lengths: 190cm for Monorail system and 315cm for Over the wire</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>211</SubCategoryID><GroupID>1643</GroupID><ARTGs><ARTG>168012</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ458</BillingCode><Name>Abbott Medical Electrophysiology mapping catheter - 4/5 pole</Name><Description>Steerable mapping catheter - Inquiry</Description><Size>4 pole, 5 pole</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Abbott - 4/5 pole</Suffix><ARTGs><ARTG>398717</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ466</BillingCode><Name>Supreme Electrophysiology Catheters</Name><Description>Abbott Medical fixed diagnostic mapping catheter 4 pole</Description><Size>Size(s):* various</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Abbott fix 4 pole</Suffix><ARTGs><ARTG>463486</ARTG></ARTGs><MinimumBenefit>225</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ337</BillingCode><Name>Allure RF PM3222</Name><Description>CRT Rate Responsive Pacemaker with RF Telemetry</Description><Size>14cc, 24g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>i</Suffix><ARTGs><ARTG>430873</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ243</BillingCode><Name>Quartet</Name><Description>Quadripolar, Left Ventricular Pacing Lead with Optim Lead Insulation</Description><Size>75, 86 and 92cm, 5 French introducer</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1759</GroupID><ARTGs><ARTG>171332</ARTG></ARTGs><MinimumBenefit>2028</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ208</BillingCode><Name>Quick Flex µ 1258T</Name><Description>4F Bipolar Left Ventricular Pacing Lead</Description><Size>75cm, 86cm, 92cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1759</GroupID><Suffix>j</Suffix><ARTGs><ARTG>161391</ARTG></ARTGs><MinimumBenefit>2028</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ403</BillingCode><Name>Quadra Allure MP MRI</Name><Description>CRT Quadripolar, Rate Responsive Pacemaker with multipoint pacing</Description><Size>26g, 15cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>i</Suffix><ARTGs><ARTG>430872</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ484</BillingCode><Name>UltiPace LPA1231 Pacing Leads with accesories</Name><Description>Steroid eluting, bipolar, implantable, nonretractable screw-in, atrial/ventricular, catheter delivered, transvenous pacemaker lead including accessories.</Description><Size>Length (cm) 46, 52, 58, 65cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1756</GroupID><Suffix>CSP (conduction system pacing leads listed together with all required accessories)</Suffix><ARTGs><ARTG>411892</ARTG><ARTG>432292</ARTG><ARTG>445794</ARTG><ARTG>456406</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ238</BillingCode><Name>Tendril STS 2088TC</Name><Description>Endocardial Bi-polar Steroid-Eluting Active Fixation Pacing Leads</Description><Size>34cm-100cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1756</GroupID><ARTGs><ARTG>170587</ARTG></ARTGs><MinimumBenefit>441</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ653</BillingCode><Name>UltiPace LPA1231 Pacing Leads</Name><Description>Endocardial Bi-polar Steroid-Eluting Active Fixation Pacing Leads</Description><Size>Length (cm) 46, 52, 58, 65cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1756</GroupID><ARTGs><ARTG>445794</ARTG></ARTGs><MinimumBenefit>441</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ375</BillingCode><Name>HeartMate Left Ventricular Assist System - Battery Clip Set</Name><Description>Battery clip set</Description><Size>one size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>259</SubCategoryID><GroupID>1830</GroupID><SubGroupID>6032</SubGroupID><ARTGs><ARTG>167134</ARTG></ARTGs><MinimumBenefit>1520</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ446</BillingCode><PriorBillingCodes><PriorBillingCode>AY043</PriorBillingCode><PriorBillingCode>DE376</PriorBillingCode></PriorBillingCodes><Name>Supera Peripheral Stent System</Name><Description>Interwoven Self-Expanding Nitnol Stent</Description><Size>Stent inner diameter: 4.0 mm - 8.0 mm  Stent outer diameter: 4.5 mm - 7.5 mm  Stent length: 20 mm - 120 mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>227976</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ493</BillingCode><Name>Advisor HD Grid X Mapping Catheter, Sensor Enabled</Name><Description>Mapping Catheter - Sensor Enabled</Description><Size>8F</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Abbott</Suffix><ARTGs><ARTG>478489</ARTG></ARTGs><MinimumBenefit>2300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ456</BillingCode><Name>Abbott Medical electrophysiology mapping catheters - 20 pole</Name><Description>Steerable mapping catheter - Livewire, Inquiry </Description><Size>20 pole</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Abbott - 20 pole</Suffix><ARTGs><ARTG>398717</ARTG><ARTG>458586</ARTG></ARTGs><MinimumBenefit>1549</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ491</BillingCode><Name>Epic Plus</Name><Description>Stented Porcine tissue valve</Description><Size>Aortic Valves - Tissue Annulus Diameter - 21 - 29mm; Mitral Valves - Tissue Annulus Diameter - 25-33 mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>490625</ARTG><ARTG>490626</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ445</BillingCode><PriorBillingCodes><PriorBillingCode>AY041</PriorBillingCode></PriorBillingCodes><Name>Absolute Self Expanding Peripheral stent</Name><Description>Laser cut nitinol self expanding stent, 20mm - 120mm lengths</Description><Size>Size ranges from:  5.0X20MM, 80CM - 8.0x120MM, 135CM</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>146848</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ381</BillingCode><PriorBillingCodes><PriorBillingCode>ER269</PriorBillingCode></PriorBillingCodes><Name>HeartMate II Left Ventricular Assist System - Stabilization Belt</Name><Description>Fabric belt for Stabilizing percutaneous lead</Description><Size>Small / medium; set of 2 
large; set of 2</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>259</SubCategoryID><GroupID>1831</GroupID><SubGroupID>6031</SubGroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>221217</ARTG></ARTGs><MinimumBenefit>95</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ202</BillingCode><Name>Brio DBS Implantable Pulse Generator 6788</Name><Description>Dual Channel 16 Contact rechargeable IPG</Description><Size>29g, 17cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1672</GroupID><SubGroupID>4473</SubGroupID><Suffix>Dual Channel</Suffix><ARTGs><ARTG>397017</ARTG></ARTGs><MinimumBenefit>17283</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ489</BillingCode><Name>Epic Max</Name><Description>Triple-composite Bioprosthetic heart valve for supra-annular placement in the aortic position</Description><Size>Tissue Annulus Diameter - 19mm-27mm. Total Height 15mm-20mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>490631</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ490</BillingCode><Name>Epic Plus Supra</Name><Description>Triple-composite Bioprosthetic heart valve for supra-annular placement in the aortic position
</Description><Size>Tissue Annulus Diameter - 19mm-29mm. Total Height 14mm-20mm.</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>490627</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ405</BillingCode><Name>Reflexion Spiral Variable Radius Catheter</Name><Description>mapping catheter</Description><Size>5F-8F</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Abbott</Suffix><ARTGs><ARTG>145053</ARTG></ARTGs><MinimumBenefit>2300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ201</BillingCode><Name>Epic FlexFit Supra</Name><Description>Triple-composite Bioprosthetic heart valve for supra-annular placement in the aortic position</Description><Size>Tissue Annulus Diameter - 19mm-23mm. Total Height 14mm-16mm.</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>164943</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ393</BillingCode><Name>Lead Adaptor Kit</Name><Description>Lead adaptors/extender for ICD/Pacemakers</Description><Size>one size per model</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>244</SubCategoryID><GroupID>1763</GroupID><ARTGs><ARTG>131928</ARTG><ARTG>160470</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ467</BillingCode><Name>Supreme and Response Electrophysiology Catheters</Name><Description>Abbott Medical fixed diagnostic mapping catheter 6-10 pole </Description><Size>various</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Abbott fix 6-10 pole</Suffix><ARTGs><ARTG>463486</ARTG><ARTG>463487</ARTG></ARTGs><MinimumBenefit>365</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ459</BillingCode><Name>Perclose ProStyle Suture Mediated Closure and Repair System </Name><Description>Suture-Mediated Closure and Repair System</Description><Size>One size</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>212</SubCategoryID><GroupID>1644</GroupID><ARTGs><ARTG>300736</ARTG></ARTGs><MinimumBenefit>290</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ192</BillingCode><Name>Epic Flexfit</Name><Description>Triple-composite Bioprosthetic heart valve</Description><Size>Aortic Valves 21-29mm tissue annulus diameter, 14-20mm total height. Mitral Valves 25-33mm tissue annulus diameter, 15-20mm total height.</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>164941</ARTG><ARTG>164942</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ406</BillingCode><Name>Advisor mapping catheter</Name><Description>mapping catheter</Description><Size>5F-8F</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Abbott</Suffix><ARTGs><ARTG>282186</ARTG><ARTG>282187</ARTG><ARTG>308920</ARTG><ARTG>327686</ARTG><ARTG>327732</ARTG><ARTG>327761</ARTG><ARTG>334635</ARTG><ARTG>334636</ARTG></ARTGs><MinimumBenefit>2300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ392</BillingCode><Name>Lead Cap Kit</Name><Description>Caps used to protect lead terminal connector pin</Description><Size>one size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1765</GroupID><ARTGs><ARTG>124950</ARTG></ARTGs><MinimumBenefit>54</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ480</BillingCode><Name>Pacing Lead Suture Sleeve</Name><Description>Suture sleeve used to provide secure fixation and protection of pacing/ICD leads</Description><Size>One size only, 6F</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1765</GroupID><ARTGs><ARTG>393221</ARTG></ARTGs><MinimumBenefit>54</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ391</BillingCode><Name>Pacemaker port safety plug</Name><Description>Plug that seals unused IS-1, DF-1 and DF- 4 port</Description><Size>one size per model</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1765</GroupID><ARTGs><ARTG>124950</ARTG><ARTG>200956</ARTG></ARTGs><MinimumBenefit>54</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ326</BillingCode><Name>Ellipse VR CD1377-36C</Name><Description>Single Chamber Cardioverter Defribrillator</Description><Size>31cc, 66g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>401131</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ496</BillingCode><Name>Liberta Rechargeable DBS Implantable Pulse Generator Model 62400</Name><Description>Dual Channel 16 Contact, zero volt rechargeable IPG</Description><Size>38.7mm x 48.1mm x 92mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1672</GroupID><SubGroupID>4473</SubGroupID><Suffix>Dual Channel</Suffix><ARTGs><ARTG>476627</ARTG></ARTGs><MinimumBenefit>17283</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ462</BillingCode><PriorBillingCodes><PriorBillingCode>AY015</PriorBillingCode></PriorBillingCodes><Name>Xact/ Xact Flex Carotid Stent</Name><Description>Nitinol Self-Expanding stent on rapid exchange delivery system</Description><Size>Diameter 7-10mm Length 20 + 30mm Straight; Diameter 8-6, 9-7, 10-8mm Length 20 + 30mm Tapered</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>168620</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ380</BillingCode><PriorBillingCodes><PriorBillingCode>ER271</PriorBillingCode></PriorBillingCodes><Name>HeartMate II Left Ventricular Assist System - Shower Bag</Name><Description>Shower Bag</Description><Size>One size only; set of 2</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>259</SubCategoryID><GroupID>1831</GroupID><SubGroupID>6034</SubGroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>272795</ARTG></ARTGs><MinimumBenefit>428</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ397</BillingCode><Name>Heart Mate 3 Shower Bag</Name><Description>Shower Bag</Description><Size>One size only; set of 2</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>259</SubCategoryID><GroupID>1831</GroupID><SubGroupID>6034</SubGroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>272795</ARTG></ARTGs><MinimumBenefit>428</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ404</BillingCode><Name>Inquiry Optima Diagnostic Catheter</Name><Description>mapping catheter</Description><Size>5F-8F</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Abbott</Suffix><ARTGs><ARTG>136233</ARTG></ARTGs><MinimumBenefit>2300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ199</BillingCode><Name>NEUTRINO NxT VR ICD Model CDVRA600Q</Name><Description>Single Chamber Cardioverter Defibrillator    </Description><Size>30cc, 69g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>394064</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>24100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ457</BillingCode><Name>Abbott Medical electrophysiology mapping catheters - 10 pole</Name><Description>Steerable mapping catheter Livewire, Inquiry</Description><Size>10 pole</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Abbott - 10 pole</Suffix><ARTGs><ARTG>398717</ARTG><ARTG>458586</ARTG></ARTGs><MinimumBenefit>829</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ332</BillingCode><Name>Ellipse VR CD1377-36QC</Name><Description>Single Chamber Cardioverter Defibrillator with 36 J delivered energy</Description><Size>67g, 30cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d, e</Suffix><ARTGs><ARTG>207184</ARTG><ARTG>401132</ARTG></ARTGs><MinimumBenefit>22650</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ407</BillingCode><Name>Afocus II EB Inquiry Steerable Catheter</Name><Description>mapping catheter</Description><Size>5F-8F</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Abbott</Suffix><ARTGs><ARTG>136211</ARTG></ARTGs><MinimumBenefit>2300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ463</BillingCode><PriorBillingCodes><PriorBillingCode>AY017</PriorBillingCode></PriorBillingCodes><Name>Starclose</Name><Description>6 Fr Exchange Sheath, Dilator, Guidewire, implantable nitinol clip pre-mounted on a Clip Applier</Description><Size>6 Fr</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>212</SubCategoryID><GroupID>1644</GroupID><ARTGs><ARTG>240055</ARTG></ARTGs><MinimumBenefit>290</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ604</BillingCode><Name>Navitor Vision</Name><Description>Self-expanding transcatheter aortic tissue valve, nitinol stent, bovine valve with delivery system and loading system</Description><Size>23-29</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>267</SubCategoryID><GroupID>2641</GroupID><ARTGs><ARTG>396571</ARTG><ARTG>410058</ARTG><ARTG>449265</ARTG></ARTGs><MinimumBenefit>22932</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ333</BillingCode><Name>Fortify Assura VR CD1359-40/CD1359-40C</Name><Description>Single Chamber Cardioverter Defibrillator with 40J delivered energy</Description><Size>76g , 35cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>207195</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ547</BillingCode><Name>Aveir VR Transcatheter Leadless Pacemaker Model LSP112V</Name><Description>Single chamber transcatheter leadless pacemaker, MRI-ready, 243 mAh battery capacity, chronically retrievable, active helix fixation, expandable to dual chamber, including delivery catheter (LSCD111).</Description><Size>3.8cm length, 0.65 outer diameter and 2.4 grams weight</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>2965</GroupID><ARTGs><ARTG>464035</ARTG><ARTG>464036</ARTG></ARTGs><MinimumBenefit>10083</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ395</BillingCode><Name>Amplatzer Left Atrial Appendage Closure Device</Name><Description>Amplatzer Amulet Occluder, Amplatzer Cardiac Plug. Nitinol wire mesh</Description><Size>16-34 mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>248</SubCategoryID><GroupID>2181</GroupID><ARTGs><ARTG>216398</ARTG><ARTG>345210</ARTG></ARTGs><MinimumBenefit>11268</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ451</BillingCode><PriorBillingCodes><PriorBillingCode>AY034</PriorBillingCode><PriorBillingCode>AY016</PriorBillingCode></PriorBillingCodes><Name>Prostar</Name><Description>Suture Mediated Closure Device - Closure of Large holes</Description><Size>Up to 24 French</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>212</SubCategoryID><GroupID>1644</GroupID><Suffix>L (Large)</Suffix><ARTGs><ARTG>300736</ARTG></ARTGs><MinimumBenefit>608</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ488</BillingCode><Name>Aveir RV Single Chamber Transcatheter Pacemaker Model LSP202V</Name><Description>Single chamber transcatheter leadless pacemaker, MRI-ready, 243 mAh battery capacity, chronically retrievable, 
active helix fixation, expandable to dual chamber, including a delivery catheter (LSCD201).  
</Description><Size>3.8cm length, 0.65 outer diameter and 2.4 grams weight</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>2965</GroupID><ARTGs><ARTG>491086</ARTG><ARTG>491087</ARTG></ARTGs><MinimumBenefit>10083</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ486</BillingCode><Name>Neutrino NxT VR ICD Model CDVRA600T</Name><Description>Single Chamber Cardioverter Defibrillator DF1     </Description><Size>35cc, 76g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a,d Remote Monitoring Service</Suffix><ARTGs><ARTG>478828</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>23670</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ417</BillingCode><Name>Gallant VR ICD Model CDVRA500Q</Name><Description>Single Chamber Cardioverter Defibrillator    </Description><Size>30cc, 69g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>395510</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>24100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ432</BillingCode><Name>Proclaim XR IPG</Name><Description>Implantable pulse generator</Description><Size>55mm and 68mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1677</GroupID><SubGroupID>4480</SubGroupID><Suffix>Multi waveforms</Suffix><ARTGs><ARTG>396984</ARTG><ARTG>396985</ARTG></ARTGs><MinimumBenefit>21660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ389</BillingCode><Name>Proclaim DRG</Name><Description>Implantable Pulse Generator</Description><Size>one size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1677</GroupID><SubGroupID>4480</SubGroupID><Suffix>Multi waveforms</Suffix><ARTGs><ARTG>396987</ARTG></ARTGs><MinimumBenefit>21660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ382</BillingCode><PriorBillingCodes><PriorBillingCode>ER270</PriorBillingCode></PriorBillingCodes><Name>HeartMate II Left Ventricular Assist System - Modular Belt</Name><Description>Modular belt to hold System Controller and Batteries</Description><Size>Small / Medium 
Large</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>259</SubCategoryID><GroupID>1831</GroupID><SubGroupID>6033</SubGroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>272795</ARTG></ARTGs><MinimumBenefit>328</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ399</BillingCode><Name>Heart Mate 3 Holster Vest</Name><Description>Holster Vest</Description><Size>Small, medium and large</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>259</SubCategoryID><GroupID>1831</GroupID><SubGroupID>6033</SubGroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>272795</ARTG></ARTGs><MinimumBenefit>328</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ185</BillingCode><PriorBillingCodes><PriorBillingCode>AV028</PriorBillingCode></PriorBillingCodes><Name>Lamitrode S Series</Name><Description>Lamitrode S Series, 8 Channel</Description><Size>60 cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>8 electrodes</Suffix><ARTGs><ARTG>384012</ARTG></ARTGs><MinimumBenefit>3817</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ169</BillingCode><PriorBillingCodes><PriorBillingCode>AV012</PriorBillingCode></PriorBillingCodes><Name>ANS Spinal Cord Stimulation System (SCS)</Name><Description>Lamitrode Dual 8 Plate Electrode Lead</Description><Size>One size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>greater than 8 and less than 32 electrodes</Suffix><ARTGs><ARTG>377340</ARTG></ARTGs><MinimumBenefit>6895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ474</BillingCode><Name>Slim Tip DRG lead kit</Name><Description>Implant Lead kit</Description><Size>50-90cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>4 electrodes</Suffix><ARTGs><ARTG>333462</ARTG><ARTG>333463</ARTG></ARTGs><MinimumBenefit>3041</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ359</BillingCode><PriorBillingCodes><PriorBillingCode>OD021</PriorBillingCode><PriorBillingCode>RQ060</PriorBillingCode></PriorBillingCodes><Name>Axium Neurostimulator System - Implant Lead Kit</Name><Description>Implant lead kit and Implant lead kit, slim tip</Description><Size>Package containing either 50cm or 90cm lead</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>4 electrodes</Suffix><ARTGs><ARTG>333462</ARTG><ARTG>333463</ARTG></ARTGs><MinimumBenefit>3041</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ162</BillingCode><PriorBillingCodes><PriorBillingCode>AV003</PriorBillingCode></PriorBillingCodes><Name>ANS Spinal Cord Stimulation System (SCS)</Name><Description>Quattrode Lead. 4 Electrode.</Description><Size>60cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>4 electrodes</Suffix><ARTGs><ARTG>381328</ARTG></ARTGs><MinimumBenefit>3041</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ161</BillingCode><PriorBillingCodes><PriorBillingCode>AV002</PriorBillingCode></PriorBillingCodes><Name>Octrode Leads </Name><Description>Octrode Lead. 8 Electrode (thoracic or cervical placement).</Description><Size>30cm, 60cm, 90cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>8 electrodes</Suffix><ARTGs><ARTG>374775</ARTG><ARTG>374776</ARTG><ARTG>490125</ARTG></ARTGs><MinimumBenefit>3817</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ231</BillingCode><Name>Penta Leads</Name><Description>Penta Paddle Lead</Description><Size> 60cm length, 16 electrodes placed in a 5 column array</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>greater than 8 and less than 32 electrodes, Bifurcated proximal tail</Suffix><ARTGs><ARTG>377339</ARTG></ARTGs><MinimumBenefit>8123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ378</BillingCode><Name>Infinity directional lead</Name><Description>Lead with 8 electrode segmented contacts. Steerable and directional current.</Description><Size>30-40cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4476</SubGroupID><Suffix>Current steering</Suffix><ARTGs><ARTG>381327</ARTG></ARTGs><MinimumBenefit>4120</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ146</BillingCode><Name>Isoflex 1944T &amp; 1948T</Name><Description>Passive-Fixation, Bipolar, Steriod Eluting, Endocardial Pacing Lead with Optim insulation</Description><Size>46cm, 52cm, 58cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1753</GroupID><ARTGs><ARTG>159532</ARTG><ARTG>159533</ARTG></ARTGs><MinimumBenefit>420</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ494</BillingCode><Name>Charger Model 16000 </Name><Description>Charging Kit 66000 is used to charge Liberta DBS IPG.</Description><Size>One size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4475</SubGroupID><ARTGs><ARTG>440131</ARTG></ARTGs><MinimumBenefit>1782</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ351</BillingCode><Name>Brio LE Charging System 6722</Name><Description>Charging system for Brio Deep Brain Stimualtion Device</Description><Size>One size only </Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4475</SubGroupID><ARTGs><ARTG>231655</ARTG></ARTGs><MinimumBenefit>1782</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ199</BillingCode><Name>Guardian Burr Hole Cover System</Name><Description>Cranial Burr Hole Cover</Description><Size>Diameter 24.89 mm; Height 3.81 mm.</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4478</SubGroupID><ARTGs><ARTG>353744</ARTG></ARTGs><MinimumBenefit>497</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ448</BillingCode><PriorBillingCodes><PriorBillingCode>AY042</PriorBillingCode><PriorBillingCode>DE375</PriorBillingCode></PriorBillingCodes><Name>Supera Peripheral Stent System</Name><Description>Interwooven Self-Expanding Nitinol Stent</Description><Size>Stent inner diameter: 4.0 mm - 6.0 mm  Stent outer diameter: 4.5 mm - 6.5 mm  Stent length: 150 mm - 200mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>227976</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ447</BillingCode><PriorBillingCodes><PriorBillingCode>AY036</PriorBillingCode></PriorBillingCodes><Name>Absolute Pro (Long Length)</Name><Description>Laser cut nitinol self expanding stent ≥150</Description><Size>Diameter 5mm to 10mm; length 150mm, 170mm, 200mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>146848</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ661</BillingCode><Name>Patient Programmer</Name><Description>Patient programmer for use with Eterna rechargeable implantable pulse generator</Description><Size>One size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4483</SubGroupID><ARTGs><ARTG>440133</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ177</BillingCode><PriorBillingCodes><PriorBillingCode>AV020</PriorBillingCode></PriorBillingCodes><Name>ANS Spinal Cord Stimulation System (SCS) GENESIS</Name><Description>QuikLink Patient Programmer Model 3860</Description><Size>One Size Only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4483</SubGroupID><ARTGs><ARTG>106669</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ388</BillingCode><Name>Patient Programmer</Name><Description>Patient Programmer - bluetooth</Description><Size>iPod Touch</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4483</SubGroupID><Suffix>Bluetooth</Suffix><ARTGs><ARTG>364131</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ502</BillingCode><Name>NeuroSphere Patient Programmer App (model 3876) loaded onto the 15500ANS patient handset</Name><Description>The NeuroSphere Patient Programmer(model 3876) is loaded onto the 15500ANS patient handset and communicates with implantable pulse generators (IPGs) to manage prescribed stimulation programs.</Description><Size>One size only </Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4483</SubGroupID><ARTGs><ARTG>508905</ARTG><ARTG>508906</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ037</BillingCode><Name>Masters Series Heart Valve Mitral and Aortic - Expanded Cuff/Hemodynamic Plus</Name><Description>Aortic Expanded Cuff, Aortic Hemodynamic Plus Cuff, Mitral hemodynamic Cuff, Aortic &amp; Mitral Rotatable Cuff</Description><Size>Aortic Expanded 19 - 31mm, Aortic Hemodynamic 17 - 27mm, Mitral Hemodynamic 17 - 27mm, Rotable 17 - 33mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>178</SubCategoryID><GroupID>1497</GroupID><ARTGs><ARTG>129879</ARTG><ARTG>129925</ARTG><ARTG>129926</ARTG><ARTG>443170</ARTG><ARTG>443171</ARTG><ARTG>443172</ARTG></ARTGs><MinimumBenefit>4962</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ317</BillingCode><Name> Regent Mechanical Heart Valve with FlexCuff</Name><Description>Aortic bi-leaflet mechanical heart valve prosthesis</Description><Size>The devices have a tissue annulus diameter of 17-29mm and a cuff outer diameter of 25.0-37.0mm. </Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>178</SubCategoryID><GroupID>1497</GroupID><ARTGs><ARTG>482606</ARTG></ARTGs><MinimumBenefit>4962</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ352</BillingCode><Name>Eon Charging System 3726</Name><Description>Eon Charging System </Description><Size>One size</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4497</SubGroupID><ARTGs><ARTG>233616</ARTG></ARTGs><MinimumBenefit>1215</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ342</BillingCode><Name>Eon Mini Charger </Name><Description>Charger to recharge Implantable Pulse Generator</Description><Size>One size</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4497</SubGroupID><ARTGs><ARTG>221544</ARTG></ARTGs><MinimumBenefit>1215</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ659</BillingCode><Name>Eterna Charger</Name><Description>Eterna charger for use with Eterna IPG</Description><Size>One size</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4497</SubGroupID><ARTGs><ARTG>440131</ARTG></ARTGs><MinimumBenefit>1215</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ373</BillingCode><Name>St Jude Deep Brain Stimulation System</Name><Description>Extension Lead for DBS</Description><Size>50-90cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4477</SubGroupID><ARTGs><ARTG>377341</ARTG><ARTG>381326</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ234</BillingCode><Name>Pocket Adaptor</Name><Description>IS-1 Pocket Adaptor</Description><Size>25cm and 50cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4477</SubGroupID><ARTGs><ARTG>383123</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ350</BillingCode><Name>8-Channel Adapter</Name><Description>8-Channel Adapter</Description><Size>10cm and 60cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4477</SubGroupID><ARTGs><ARTG>378144</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ483</BillingCode><Name>GRAFTMASTER RX Coronary Stent Graft</Name><Description>Stainless Steel/PTFE</Description><Size>16-26 mm x 2.8 - 4.8 mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1767</GroupID><SubGroupID>5349</SubGroupID><Suffix>l, m</Suffix><ARTGs><ARTG>398152</ARTG></ARTGs><MinimumBenefit>2146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ660</BillingCode><Name>Eterna IPG</Name><Description>Implantable pulse generator</Description><Size>Volume 13.9 cc  Weight 26g</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1677</GroupID><SubGroupID>4481</SubGroupID><Suffix>Multi waveform, Recharge protection</Suffix><ARTGs><ARTG>440130</ARTG></ARTGs><MinimumBenefit>23465</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ354</BillingCode><PriorBillingCodes><PriorBillingCode>OD016</PriorBillingCode><PriorBillingCode>RQ055</PriorBillingCode></PriorBillingCodes><Name>Axium Neurostimulator System - 22cm Delivery Sheath Kit - small curve and big curve</Name><Description>22cm delivery sheath kit - small curve and big curve.</Description><Size>2 sizes (2 presentations)  1 x Big Curve -MN23950AU  1 x Small Curve - MN23850AU</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4502</SubGroupID><ARTGs><ARTG>197024</ARTG><ARTG>296964</ARTG><ARTG>329240</ARTG><ARTG>329301</ARTG></ARTGs><MinimumBenefit>658</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ468</BillingCode><Name>DRG Delivery Sheath  </Name><Description>Small and Big Curve</Description><Size>22cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4502</SubGroupID><ARTGs><ARTG>329240</ARTG><ARTG>329301</ARTG></ARTGs><MinimumBenefit>658</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ283</BillingCode><Name>Epiducer - Lead Delivery System</Name><Description>Lead Delivery System</Description><Size>13cm, 19cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4502</SubGroupID><ARTGs><ARTG>352928</ARTG></ARTGs><MinimumBenefit>658</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ475</BillingCode><Name>DRG Large Needle and Sheath Kit</Name><Description>Lead Accessories Kit  </Description><Size>1 size  </Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4499</SubGroupID><ARTGs><ARTG>329428</ARTG></ARTGs><MinimumBenefit>492</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ356</BillingCode><PriorBillingCodes><PriorBillingCode>OD018</PriorBillingCode><PriorBillingCode>RQ057</PriorBillingCode></PriorBillingCodes><Name>Axium Neurostimulator System - Lead accessories kit</Name><Description>Lead accessories kit.</Description><Size>1 size (1 presentation)</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4499</SubGroupID><ARTGs><ARTG>197024</ARTG><ARTG>297581</ARTG><ARTG>329428</ARTG></ARTGs><MinimumBenefit>492</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ433</BillingCode><Name>ANS Spinal Cord Stimulation System (SCS) GENESIS</Name><Description>Communication Magnet 1210</Description><Size> One type only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4485</SubGroupID><ARTGs><ARTG>267026</ARTG><ARTG>342820</ARTG></ARTGs><MinimumBenefit>1264</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ036</BillingCode><Name>Coated Aortic Valved Graft</Name><Description>Coated Aortic Valved Graft </Description><Size>19mm - 33mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>180</SubCategoryID><GroupID>1502</GroupID><ARTGs><ARTG>429890</ARTG></ARTGs><MinimumBenefit>6603</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ265</BillingCode><PriorBillingCodes><PriorBillingCode>ME182</PriorBillingCode></PriorBillingCodes><Name>Amplatzer Vascular Plug</Name><Description>Self expandable nitinol wire mesh</Description><Size>Diameter 4mm - 16mm, Length 7 &amp; 8mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1648</GroupID><ARTGs><ARTG>114855</ARTG><ARTG>345216</ARTG></ARTGs><MinimumBenefit>1268</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ268</BillingCode><PriorBillingCodes><PriorBillingCode>ME192</PriorBillingCode></PriorBillingCodes><Name>Amplatzer Vascular Plug III</Name><Description>AVP III is a self-expanding, Nitinol mesh occlusion device.</Description><Size>Size: (mm): 4, 6, 8, 10, 10, 12, 12, 14, 14  Long Axis (mm): 4, 6, 8, 10, 10, 12, 12, 14, 14 Length (mm): 6.5</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1648</GroupID><ARTGs><ARTG>169352</ARTG></ARTGs><MinimumBenefit>1268</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ266</BillingCode><PriorBillingCodes><PriorBillingCode>ME186</PriorBillingCode></PriorBillingCodes><Name>AMPLATZER Vascular Plug - II</Name><Description>The AMPLATZER Vascular Plug II is a self-expandable, multi-lobed cylindraical device made from a nitinol wire mesh.</Description><Size>3mm-22mm Diameter, 6mm-18mm Plug Length</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1648</GroupID><Suffix>ids (integral delivery system)</Suffix><ARTGs><ARTG>156560</ARTG><ARTG>345217</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ269</BillingCode><PriorBillingCodes><PriorBillingCode>ME194</PriorBillingCode></PriorBillingCodes><Name>AMPLATZER Vascular Plug 4</Name><Description>The AMPLATZER Vascular Plug 4 (AVP4) is a self-expanding, Nitinol mesh occlusion device. The Device has a radiopaque marker band at each end and a micro screw attachment at one end for attaching to the delivery wire. The AVP4 fits through a 0.038 guidewire compatible diagnostic catheter allowing the use of the same catheter throughout the procedure rather than having to exchange the diagnostic catheter for a second delivery catheter to place a plug.</Description><Size>4mm 4 diameter 10.0 length  5mm 5 diameter 10.5 length  6mm 6 diameter 11.0 length  7mm 7 diameter 12.5 length  8mm 8 diameter 13.5 length</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1648</GroupID><ARTGs><ARTG>168673</ARTG><ARTG>345218</ARTG></ARTGs><MinimumBenefit>1268</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ104</BillingCode><Name>Masters Series Aortic Valved Prosthesis - VAVGJ</Name><Description>Mechanical Heart Valve sewn into the base of a woven polyester fibre graft which has been impregnated with bovine-derived gelatin</Description><Size>Annulus Diameter 19-29mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>180</SubCategoryID><GroupID>1502</GroupID><ARTGs><ARTG>429891</ARTG></ARTGs><MinimumBenefit>6603</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ453</BillingCode><Name>MitraClip System</Name><Description>Steerable Guide Catheter, Clip Delivery System (Delivery Catheter, Steerable sleeve and the MitraClip Implant) </Description><Size>NTR MitraClip Implant: 15-17 mm  XTR MitraClip Implant: 18-22 mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>267</SubCategoryID><GroupID>2952</GroupID><SubGroupID>7365</SubGroupID><ARTGs><ARTG>309700</ARTG><ARTG>309701</ARTG></ARTGs><MinimumBenefit>26386</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ460</BillingCode><Name>MitraClip G4 system</Name><Description>Transmitral valve repair clip, steerable guide catheter, clip delivery system</Description><Size>9 - 12 mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>267</SubCategoryID><GroupID>2952</GroupID><SubGroupID>7365</SubGroupID><ARTGs><ARTG>357023</ARTG><ARTG>443605</ARTG><ARTG>443606</ARTG></ARTGs><MinimumBenefit>26386</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ497</BillingCode><Name>MitraClip G5 system</Name><Description>Transmitral valve repair clip, steerable guide catheter, clip delivery system, stabiliser, lift and support plate.
</Description><Size>9 - 12 mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>267</SubCategoryID><GroupID>2952</GroupID><SubGroupID>7365</SubGroupID><ARTGs><ARTG>441252</ARTG><ARTG>495785</ARTG><ARTG>495786</ARTG></ARTGs><MinimumBenefit>26386</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ455</BillingCode><Name>ViewFlex™ Xtra ICE mapping Catheter</Name><Description>Intracardiac Echocardiography (ICE) Catheter</Description><Size>9 F catheter size, 10 F introducer, 90cm insertable length</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7375</SubGroupID><ARTGs><ARTG>214203</ARTG></ARTGs><MinimumBenefit>2549</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ358</BillingCode><PriorBillingCodes><PriorBillingCode>OD020</PriorBillingCode><PriorBillingCode>RQ059</PriorBillingCode></PriorBillingCodes><Name>Axium Neurostimulator System - Lead Extension Kit</Name><Description>Lead extension kit.</Description><Size>1 size (1 presentation)</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1680</GroupID><ARTGs><ARTG>333448</ARTG></ARTGs><MinimumBenefit>1362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ160</BillingCode><PriorBillingCodes><PriorBillingCode>AV001</PriorBillingCode></PriorBillingCodes><Name>ANS Spinal Cord Stimulation System (SCS)</Name><Description>Dual 4 and Single 8 Extensions</Description><Size>10cm, 30cm, 60cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1680</GroupID><ARTGs><ARTG>375832</ARTG><ARTG>375833</ARTG></ARTGs><MinimumBenefit>1362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ204</BillingCode><Name>Brio DBS Patient Controller 6856</Name><Description>Patient Controller for DBS</Description><Size>One size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4474</SubGroupID><ARTGs><ARTG>164509</ARTG></ARTGs><MinimumBenefit>1264</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ503</BillingCode><Name>NeuroSphere Patient Programmer App (model 3876) loaded onto the 65600ABT patient handset</Name><Description>The NeuroSphere Patient Programmer(model 3876) is loaded onto the 65600ABT patient handset and communicates with implantable pulse generators (IPGs) to manage prescribed stimulation programs for DBS.
</Description><Size>One size only </Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4474</SubGroupID><ARTGs><ARTG>508905</ARTG><ARTG>508906</ARTG></ARTGs><MinimumBenefit>1264</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ495</BillingCode><Name>Liberta NeuroSphere Patient Controller 55500</Name><Description>Liberta RC App (Model 55500) is pre-installed on the dedicated patient controller handset.</Description><Size>One size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4474</SubGroupID><ARTGs><ARTG>440133</ARTG></ARTGs><MinimumBenefit>1264</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ431</BillingCode><Name>Abbott Non Irrigated Ablation Catheters – 4mm</Name><Description>Non Irrigated Ablation catheter</Description><Size>4mm tip</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>482985</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ430</BillingCode><Name>Abbott Non Irrigated Ablation Catheters – 8mm</Name><Description>Non Irrigated Ablation catheter</Description><Size>8mm tip</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>482926</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ376</BillingCode><Name>Infinity IPG</Name><Description>Implantable Pulse Generator</Description><Size>55mm, 68mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1672</GroupID><SubGroupID>4472</SubGroupID><Suffix>Dual Channel</Suffix><ARTGs><ARTG>397015</ARTG><ARTG>397016</ARTG></ARTGs><MinimumBenefit>13592</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ396</BillingCode><Name>HeartMate 3 System Controller</Name><Description>System Controller</Description><Size>One size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>259</SubCategoryID><GroupID>1830</GroupID><SubGroupID>6028</SubGroupID><ARTGs><ARTG>289763</ARTG><ARTG>443220</ARTG></ARTGs><MinimumBenefit>4275</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ408</BillingCode><Name>EnSite Patch</Name><Description>Surface Electrodes</Description><Size>Patch/Kit</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7350</SubGroupID><Suffix>Abbott</Suffix><ARTGs><ARTG>195707</ARTG><ARTG>274633</ARTG></ARTGs><MinimumBenefit>399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ500</BillingCode><Name>Neutrino NxT HF CRT-D Model CDHFA600D DF4/IS1</Name><Description>Cardiac Resynchronisation Therapy Cardioverter Defibrillator</Description><Size>78g, 34cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>487170</ARTG></ARTGs><Note>The Prescribed List benefit payable for the billing code includes a component for remote monitoring services provided via inbuilt remote monitoring system or smart device application. When the benefit is claimable in respect to this billing code, no additional or separate claims are allowed in respect to any billing codes listed in the Prescribed List Part C subcategory 08.16 - Remote Monitoring System.</Note><MinimumBenefit>30319</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ286</BillingCode><PriorBillingCodes><PriorBillingCode>SJ170</PriorBillingCode><PriorBillingCode>AV013</PriorBillingCode></PriorBillingCodes><Name>Anchor</Name><Description>Butterfly &amp; Long lead anchors; Cinch &amp; Swift Lock Anchors</Description><Size>One size only for each anchor type</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>353993</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ305</BillingCode><Name>Tunneling Tool</Name><Description>A tool used to creat a subcutaneous passage to pass the lead from the lead implant site to the IPG pocket site.</Description><Size>12", 20"</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>134305</ARTG><ARTG>353157</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ087</BillingCode><Name>St Jude Medical Rigid Saddle Ring</Name><Description>Rigid Annuloplasty Ring</Description><Size>24 - 34mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1842</GroupID><ARTGs><ARTG>124255</ARTG></ARTGs><MinimumBenefit>2280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ472</BillingCode><Name> Straight Stylet</Name><Description>Straight Stylet</Description><Size>50-90 cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>353082</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ424</BillingCode><Name>Gallant HF CRT-D Model CDHFA500Q</Name><Description>Cardiac Resynchronisation Therapy Defibrillator  </Description><Size>34cc, 81g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>463491</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>30319</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ477</BillingCode><Name>DRG Straight Needle</Name><Description>Straight needle  </Description><Size>4.5 inch  </Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>329428</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ487</BillingCode><Name>Neutrino NxT DR ICD Model CDDRA600T</Name><Description>Dual Chamber Cardioverter Defibrillator DF1</Description><Size>35cc, 76g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d, Remote Monitoring Service</Suffix><ARTGs><ARTG>478829</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>25960</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ200</BillingCode><Name>Neutrino NxT DR ICD Model CDDRA600Q</Name><Description>Dual Chamber Cardioverter Defibrillator</Description><Size>31cc, 71g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>394112</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>26404</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ315</BillingCode><Name>Standard Trial Cable Octrode and Quattrode</Name><Description>Connector which connects implanted lead to external stimulator</Description><Size>One size</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>133958</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ478</BillingCode><Name>XIENCE Skypoint Everolimus Eluting Coronary Stent System</Name><Description>Drug eluting coronary artery stent</Description><Size>Stent diameters 2.0 - 4.0 mm in lengths 8 mm - 38 mm;  Stent diameters 2.5 - 4.0 mm in 48 mm length; Stent diameters 4.5 - 5.0 mm in lengths 12 mm - 33 mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>393511</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ498</BillingCode><Name>Esprit BTK Everolimus Eluting Resorbable Scaffold System</Name><Description>Esprit BTK is a Bioresorbable Drug Eluting Stent system indicated for improving luminal diameter in infrapopliteal lesions in patients with chronic limb-threatening ischemia (CLTI).</Description><Size>Diameter: 2.5mm - 3.75mm, Length: 9 mm - 38 mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>20004</GroupID><SubGroupID>20005</SubGroupID><ARTGs><ARTG>490185</ARTG></ARTGs><MinimumBenefit>2477</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ164</BillingCode><Name>Neutrino NxT HF CRT-D Model CDHFA600Q</Name><Description>Cardiac Resynchronisation Therapy Defibrillator  </Description><Size>34cc, 81g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>394114</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>30319</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ428</BillingCode><Name>Guide Wire for Percutaneous Leads</Name><Description>A tool used to establish and/or access the appropriate pathway in the epidural space before implanting the lead. </Description><Size>One size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>196837</ARTG><ARTG>352921</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ434</BillingCode><PriorBillingCodes><PriorBillingCode>AY037</PriorBillingCode></PriorBillingCodes><Name>Xience PRIME LL Everolimus Eluting Coronary Stent; Xience PRIME Everolimus Eluting Coronary Stent;  Xience PRIME SV Everolimus Eluting Coronary Stent</Name><Description>Coronary Artery Stent, Drug Eluting</Description><Size>XIENCE PRIME LL 2.50; 2.75; 3.00; 3.50; 4.0 x 33MM;  XIENCE PRIME LL 2.50; 2.75; 3.00; 3.50; 4.0 x 38MM;  XIENCE PRIME SV 2.25 x 08; 12; 15; 18; 23; 28MM; XIENCE PRIME 2.50 x 08; 12; 15; 18; 23; 28MM;  XIENCE PRIME 2.75 x 08; 12; 15; 18; 23; 28MM;  XIENCE PRIME 3.00 x 08; 12; 15; 18; 23; 28MM;  XIENCE PRIME 3.50 x 08; 12; 15; 18; 23; 28MM;  XIENCE PRIME 4.00 x 08; 12; 15; 18; 23; 28MM</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>167859</ARTG><ARTG>167878</ARTG><ARTG>167879</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ499</BillingCode><Name>Neutrino NxT HF CRT-D Model CDHFA600B</Name><Description>Cardiac Resynchronisation Therapy Defibrillator DF1 IS1</Description><Size>37cc, 79g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d, Remote Monitoring Service</Suffix><ARTGs><ARTG>487169</ARTG></ARTGs><Note>The Prescribed List benefit payable for the billing code includes a component for remote monitoring services provided via inbuilt remote monitoring system or smart device application. When the benefit is claimable in respect to this billing code, no additional or separate claims are allowed in respect to any billing codes listed in the Prescribed List Part C subcategory 08.16 - Remote Monitoring System.</Note><MinimumBenefit>29919</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ501</BillingCode><Name>Assert IQ with myMerlin Mobile Monitor</Name><Description>Insertable Cardiac Monitor with myMerlin mobile remote monitoring </Description><Size>46.5mm x 9.4mm x 3.1mm and  49mm x 9.4mm x 4.4mm </Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>293</SubCategoryID><GroupID>2962</GroupID><Suffix>Remote Monitoring Service for ICM</Suffix><ARTGs><ARTG>401858</ARTG><ARTG>401859</ARTG><ARTG>451345</ARTG><ARTG>451346</ARTG><ARTG>451347</ARTG></ARTGs><Note>The benefit payable for the billing code includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. When the benefit is claimable in respect to this billing code, no additional or separate claims are allowed in respect to any billing codes listed in Part C group 08.16.02 –Remote Monitoring System - Implantable Cardiac Event Recorders.</Note><MinimumBenefit>3388</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ464</BillingCode><PriorBillingCodes><PriorBillingCode>AY022</PriorBillingCode></PriorBillingCodes><Name>Cobalt Chromium Balloon Expandable Peripheral Stent</Name><Description>Cobalt Chromium</Description><Size>Diameter 4-10mm, Length 12-58mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4439</SubGroupID><ARTGs><ARTG>146848</ARTG></ARTGs><MinimumBenefit>1053</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ441</BillingCode><PriorBillingCodes><PriorBillingCode>AY024</PriorBillingCode></PriorBillingCodes><Name>Omnilink Stainless Steel Balloon Deployable Peripheral Stent</Name><Description>Stainless Steel Balloon Expandable Peripheral Stent on 018/035 system</Description><Size>018 &amp; 035 system: 5-10mm diameter by 12, 16, 18, 28, 38, 58mm length</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4439</SubGroupID><ARTGs><ARTG>146848</ARTG></ARTGs><MinimumBenefit>1053</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ481</BillingCode><Name>Jot Dx</Name><Description>Insertable Cardiac Monitor - with integrated remote monitoring capability via the myMerlin smart device App, including accessories for insertion (an incision tool and an insertion tool)</Description><Size>49 x 9.4 x 3.1 mm  </Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>293</SubCategoryID><GroupID>2962</GroupID><ARTGs><ARTG>401857</ARTG></ARTGs><MinimumBenefit>2886</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ304</BillingCode><Name>Introde-AK Lead Introducer</Name><Description>A flexible tool passed over a partially-implanted lead or guide wire in order to establish the appropriate pathway for a lead to follow in the epidural space despite obstructions.</Description><Size>4" and 9"</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>133910</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ308</BillingCode><Name>Torque Wrench</Name><Description>A tool to set or release the IPG setscrew that connects an implanted lead to the IPG header.</Description><Size>One size</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>353637</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ492</BillingCode><Name>Neutrino NxT HF CRT-D Model CDHFA600T</Name><Description>Cardiac Resynchronisation Therapy Defibrillator DF1</Description><Size>37cc, 81g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d, Remote Monitoring Service</Suffix><ARTGs><ARTG>478830</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>29919</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ346</BillingCode><Name>Optisure ICD Lead LDP210Q/220Q/230Q</Name><Description>Passive fixation ICD lead with DF-4 connector.</Description><Size>52cm-65cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1741</GroupID><Suffix>e</Suffix><ARTGs><ARTG>221013</ARTG><ARTG>221037</ARTG></ARTGs><MinimumBenefit>2012</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ365</BillingCode><Name>Endurity MRI PM1172</Name><Description>MR Conditional Single Chamber Pacing System</Description><Size>9.7cc, 19g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><Suffix>i</Suffix><ARTGs><ARTG>440992</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ245</BillingCode><Name>Durata 7170Q, 7171Q and 7172Q</Name><Description>7170Q/7171Q - passive fixation, bipolar, dual coil, 7172Q - passive fixation, bipolar - single coil steroid eluting endocardial defibrillation leads with Optim insulation overlay and SJ4 quadripolar lead connector</Description><Size>52, 58 and 65cm, 7F introducer</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1741</GroupID><Suffix>e</Suffix><ARTGs><ARTG>170592</ARTG><ARTG>170593</ARTG><ARTG>170594</ARTG></ARTGs><MinimumBenefit>2012</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ442</BillingCode><PriorBillingCodes><PriorBillingCode>AY046</PriorBillingCode></PriorBillingCodes><Name>Omnilink Elite Vascular Balloon-Expandable Stent System</Name><Description>Omnilink Elite Vascular Balloon-Expandable Stent System is a balloon- expandable stent system  indicated for the treatment of atherosclerotic iliac artery lesions with reference vessel diameters of ≥ 5.0 mm and ≤ 11.0 mm, and lesion lengths up to 50 mm.</Description><Size>6.0mm x (12,16,19,29,39,59)mm x 80cm                       7.0mm x (12,16,19,29,39,59)mm x 80cm                      8.0mm x (19,29,39,59)mm x 80cm                                 9.0mm x (19,29,39,59)mm x 80cm                                10.0mm x (19,29,39,59)mm x 80cm                              6.0mm x (12, 16,19,29,39,59)mm x 135cm                 7.0mm x (12, 16,19,29,39,59)mm x 135cm                  8.0mm x (19,29,39,59)mm x 135cm                              9.0mm x (19,29,39,59)mm x 135cm                              10.0mm x (19,29,39,59)mm x 135cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4439</SubGroupID><ARTGs><ARTG>269609</ARTG></ARTGs><MinimumBenefit>1053</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ437</BillingCode><PriorBillingCodes><PriorBillingCode>AY047</PriorBillingCode></PriorBillingCodes><Name>XIENCE Sierra Everolimus Eluting Coronary Stent System</Name><Description>Drug eluting coronary artery stent</Description><Size>Diameter: 2.00mm to 4.0mm. Length: 8mm to 38mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>313811</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ363</BillingCode><Name>Assurity MRI PM1272</Name><Description>MRI Conditional RF Single Chamber Rate Responsive Pacemaker</Description><Size>10.4cc, 20g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><Suffix>i</Suffix><ARTGs><ARTG>440990</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ320</BillingCode><Name>Unify Assura CD3361-40C</Name><Description>Cardiac Resynchronisation Therapy Cardioverter Defibrillator</Description><Size>78g, 36cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>401139</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ471</BillingCode><Name>Hex Key</Name><Description>Hex Key</Description><Size>One Size</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>329360</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ357</BillingCode><PriorBillingCodes><PriorBillingCode>OD019</PriorBillingCode><PriorBillingCode>RQ058</PriorBillingCode></PriorBillingCodes><Name>Axium Neurostimulator System - Connector Cable Kit</Name><Description>Connector cable kit.</Description><Size>1 size (1 presentation)</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>197025</ARTG><ARTG>296963</ARTG><ARTG>329119</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ470</BillingCode><Name>DRG Torque Wrench</Name><Description>A tool to set or release the IPG setscrew that connects an implanted lead to the IPG header.  </Description><Size>One Size</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>353637</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ409</BillingCode><Name>FlexAbility Ablation Catheter</Name><Description>Sensor Enabled and Non-Sensor Enabled</Description><Size>D, F, J, D-F, F-J, D-D, F-F, J-J</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>Abbott</Suffix><ARTGs><ARTG>327822</ARTG><ARTG>327823</ARTG><ARTG>327824</ARTG><ARTG>327825</ARTG></ARTGs><MinimumBenefit>3700</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ361</BillingCode><PriorBillingCodes><PriorBillingCode>OD024</PriorBillingCode></PriorBillingCodes><Name>Axium Neurostimulator System - Curved Needle</Name><Description>A curved needle (one size 14G,4.5in), a single use accessory, providing access to the epidural space during the surgical procedure of inserting a Neurostimulation System.</Description><Size>One Size - (14G, 4.5in)</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>296962</ARTG><ARTG>338752</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ302</BillingCode><Name>Epidural Needle</Name><Description>A tool used to introduce a lead percutaneously.</Description><Size>14-15 Gauge, 4-6 inch</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>133910</ARTG><ARTG>352928</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ465</BillingCode><Name>TactiFlex™ Ablation Catheter, Sensor Enabled™  </Name><Description>Contact Force Sensor Enabled  </Description><Size>DD, DF, FF, FJ, JJ, D, F, J</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>Abbott</Suffix><ARTGs><ARTG>380981</ARTG><ARTG>380982</ARTG></ARTGs><MinimumBenefit>3700</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ436</BillingCode><PriorBillingCodes><PriorBillingCode>AY044</PriorBillingCode></PriorBillingCodes><Name>XIENCE Alpine Everolimus Eluting Coronary Stent System</Name><Description>Drug eluting coronary artery stent</Description><Size>2.00 mm x (08, 12, 15, 18, 23, 28) mm  2.25 mm x (08, 12, 15, 18, 23, 28) mm  2.50 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm  2.75 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm  3.00 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm  3.25 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm  3.50 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm  4.00 mm x (08, 12, 15, 18, 23, 28, 33, 38) mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>266175</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ410</BillingCode><Name>TactiCath™ Contact Force Ablation Catheter</Name><Description>Sensor Enabled and Non-Sensor Enabled catheter</Description><Size>DD, DF, FF, FJ, JJ, D, F.</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>Abbott</Suffix><ARTGs><ARTG>327316</ARTG><ARTG>327321</ARTG></ARTGs><MinimumBenefit>3700</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ360</BillingCode><PriorBillingCodes><PriorBillingCode>OD022</PriorBillingCode><PriorBillingCode>RQ061</PriorBillingCode></PriorBillingCodes><Name>Axium Neurostimulator System - Tunneling Tool</Name><Description>Tunneling tool.</Description><Size>30cm or 51cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>197024</ARTG><ARTG>296964</ARTG><ARTG>329360</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ307</BillingCode><Name>Straight and Curved Stylet</Name><Description>A tool used to aid in positioning and repositioning the lead intra-operatively to ensure accurate placement.</Description><Size>30cm - 90cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>124057</ARTG><ARTG>353082</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ435</BillingCode><PriorBillingCodes><PriorBillingCode>AY040</PriorBillingCode></PriorBillingCodes><Name>XIENCE Xpedition Everolimus Eluting Coronary Stent System</Name><Description>Coronary Artery Stent, Drug Eluting</Description><Size>Xience Xpedition DES - 2.25 x (8,12,15,18,23,28) RX CE, 2.50 x (8,12,15,18,23,28,33,38,48) RX CE; 2.75 x (8,12,15,18,23,28,33,38,48) RX CE; 3.00 x (8,12,15,18,23,28,33,38,48) RX CE; 3.25 x (8,12,15,18,23,28,33,38) RX CE; 3.50 x (8,12,15,18,23,28,33,38,48) RX CE; 4.00 x (8,12,15,18,23,28,33,38) RX CE;</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>215602</ARTG><ARTG>215603</ARTG><ARTG>215604</ARTG><ARTG>264373</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ469</BillingCode><Name>DRG Tunneling Tool</Name><Description>Tunneling Tool </Description><Size>30cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>329360</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ321</BillingCode><Name>Quadra Assura MP CD3371-40QC</Name><Description>Cardiac Resynchronisation Therapy Defibrillator</Description><Size>80gm, 38cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>401138</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ364</BillingCode><Name>Assurity MRI PM2272</Name><Description>MR Conditional RF Dual Chamber Rate Responsive Pacemaker</Description><Size>10.4cc, 20g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>i</Suffix><ARTGs><ARTG>440991</ARTG></ARTGs><MinimumBenefit>5448</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ401</BillingCode><Name>HeartMate 3 Implant Kit</Name><Description>Left ventricular assist device</Description><Size>one size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>259</SubCategoryID><GroupID>1819</GroupID><ARTGs><ARTG>300895</ARTG><ARTG>443219</ARTG></ARTGs><MinimumBenefit>95000</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ429</BillingCode><Name>Amplatzer Piccolo Occluder</Name><Description>Single use implantable transcatheter device for minimally invasive closure of Patent Ductus Arteriosus</Description><Size>0.2cm-0.6cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>248</SubCategoryID><GroupID>1768</GroupID><ARTGs><ARTG>332782</ARTG></ARTGs><MinimumBenefit>7436</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ479</BillingCode><Name>Amplatzer Talisman PFO Occluder</Name><Description>Nitinol wire mesh</Description><Size>18-35mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>248</SubCategoryID><GroupID>1768</GroupID><Suffix>o</Suffix><ARTGs><ARTG>398663</ARTG></ARTGs><MinimumBenefit>7436</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ325</BillingCode><Name>Fortify Assura DR CD2359-40Q/CD2359-40QC</Name><Description>Dual Chamber Cardioverter Defibrillator with 40J delivered energy</Description><Size>75g, 35cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>207192</ARTG><ARTG>207194</ARTG></ARTGs><MinimumBenefit>24954</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ261</BillingCode><PriorBillingCodes><PriorBillingCode>ME066</PriorBillingCode></PriorBillingCodes><Name>Amplatzer Septal and Amplatzer Multi-Fenestrated Septal - Cribriform Occluders</Name><Description>Self-expanding nitinol mesh, double-disc occlusion device for use in atrial septal defects</Description><Size>Waist diameter 4-40mm; Waist length 3-4, Disc diameter 18-40</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>248</SubCategoryID><GroupID>1768</GroupID><Suffix>o</Suffix><ARTGs><ARTG>345212</ARTG><ARTG>345214</ARTG></ARTGs><MinimumBenefit>7436</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ331</BillingCode><Name>Ellipse DR CD2377-36QC</Name><Description>Dual Chamber Cardioverter Defibrillator with 36J delivered energy</Description><Size>68g, 31cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>401129</ARTG></ARTGs><MinimumBenefit>24954</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ260</BillingCode><PriorBillingCodes><PriorBillingCode>ME065</PriorBillingCode></PriorBillingCodes><Name>Amplatzer Duct Occluder</Name><Description>Nitinol Wire Mesh</Description><Size>5 - 24mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>248</SubCategoryID><GroupID>1768</GroupID><Suffix>o</Suffix><ARTGs><ARTG>134070</ARTG><ARTG>345211</ARTG></ARTGs><MinimumBenefit>7436</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ327</BillingCode><Name>Ellipse DR CD2377-36C</Name><Description>Dual Chamber ICD</Description><Size>66g, 31cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>401128</ARTG></ARTGs><MinimumBenefit>24510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ262</BillingCode><PriorBillingCodes><PriorBillingCode>ME067</PriorBillingCode></PriorBillingCodes><Name> Amplatzer Muscular and P.I. Muscular VSD Occluders</Name><Description>Self-expanding double disc devices made of nitinol wire for the occlusion of muscular ventricular septal defects (VSD)</Description><Size>4 - 24mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>248</SubCategoryID><GroupID>1768</GroupID><Suffix>o</Suffix><ARTGs><ARTG>345231</ARTG><ARTG>345232</ARTG></ARTGs><MinimumBenefit>7436</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ369</BillingCode><Name>Merlin@Home wireless</Name><Description>Home cardiac monitor (RF) with landline, cellular and broadband connectivity</Description><Size>one size</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>266</SubCategoryID><GroupID>1832</GroupID><ARTGs><ARTG>161670</ARTG></ARTGs><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ267</BillingCode><PriorBillingCodes><PriorBillingCode>ME187</PriorBillingCode></PriorBillingCodes><Name>AMPLATZER Duct Occluder II</Name><Description>Self expandable multiple Nitinol wire mesh PDA occlusion device</Description><Size>Waist diameter 3-6mm, Nominal length 4-6mm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>248</SubCategoryID><GroupID>1768</GroupID><Suffix>o</Suffix><ARTGs><ARTG>154956</ARTG><ARTG>348711</ARTG></ARTGs><MinimumBenefit>7436</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ418</BillingCode><Name>Gallant DR ICD Model CDDRA500Q</Name><Description>Dual Chamber Cardioverter Defibrillator</Description><Size>31cc, 71g</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>395511</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>26404</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ385</BillingCode><PriorBillingCodes><PriorBillingCode>ER268</PriorBillingCode></PriorBillingCodes><Name>HeartMate Left Ventricular Assist System - Battery Set</Name><Description>Rechargeable HeartMate specific batteries</Description><Size>One size only, set of 4</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>259</SubCategoryID><GroupID>1830</GroupID><SubGroupID>6030</SubGroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>167134</ARTG></ARTGs><MinimumBenefit>2295</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ157</BillingCode><Name>Durata 7120, 7121, 7122</Name><Description>Active fixation bipolar, dual-coil/single coil Steroid-eluting Endocardial Defibrillation Leads</Description><Size>60, 65, 75cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><ARTGs><ARTG>159843</ARTG><ARTG>159845</ARTG><ARTG>159846</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ370</BillingCode><Name>Merlin@Home Inductive</Name><Description>Home cardiac monitor (inductive) with landline, cellular and broadband connectivity</Description><Size>one size </Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>266</SubCategoryID><GroupID>1832</GroupID><ARTGs><ARTG>163472</ARTG></ARTGs><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ400</BillingCode><Name>HeartMate Left Ventricular System - Battery Charger</Name><Description>Battery Charger for HeartMate Batteries</Description><Size>one size</Size><SupplierCode>SJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>259</SubCategoryID><GroupID>1830</GroupID><SubGroupID>6030</SubGroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>167132</ARTG></ARTGs><MinimumBenefit>2295</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ473</BillingCode><Name>DRG guidewire</Name><Description>Guide Wire for Percutaneous Leads</Description><Size>one size</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>352921</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ344</BillingCode><Name>Optisure ICD Lead LDA210Q/220Q/230Q</Name><Description>Active fixation ICD lead with DF-4 connector</Description><Size>52cm-65cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><Suffix>e</Suffix><ARTGs><ARTG>221011</ARTG><ARTG>221036</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ319</BillingCode><Name>Quadra Assura MP CD3371-40C</Name><Description>Cardiac Resynchronisation Therapy Cardioverter Defibrillator</Description><Size>83g, 40cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>401137</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ285</BillingCode><PriorBillingCodes><PriorBillingCode>SJ170</PriorBillingCode><PriorBillingCode>AV013</PriorBillingCode></PriorBillingCodes><Name>Strain Relief</Name><Description>Strain Relief</Description><Size>One size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>354001</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ230</BillingCode><Name>Durata 7120Q, 7121Q and 7122Q</Name><Description>7120/1Q - Adtive fixation, true bipolar; 7122Q - Active fixation true bipolar - single coil steroid eluting endocardial defibrillation leads with Optim insulation overlay and SJ4 quadripolar lead connector.</Description><Size>52cm, 58cm and 65cm</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><Suffix>e</Suffix><ARTGs><ARTG>170589</ARTG><ARTG>170590</ARTG><ARTG>170591</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ329</BillingCode><Name>Unify Assura CD3361-40QC</Name><Description>Cardiac Resynchronisation Therapy Cardioverter Defibrillator</Description><Size>77g, 36cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>401140</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ324</BillingCode><Name>Fortify Assura DR CD2359-40C</Name><Description>Dual Chamber Cardioverter   Defibrillator</Description><Size>75g, 35cc</Size><SupplierCode>SJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>207193</ARTG><ARTG>401133</ARTG></ARTGs><MinimumBenefit>24510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ476</BillingCode><Name>DRG Anchor</Name><Description>Lead Anchor</Description><Size>One size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>329428</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SJ287</BillingCode><PriorBillingCodes><PriorBillingCode>SJ170</PriorBillingCode><PriorBillingCode>AV013</PriorBillingCode></PriorBillingCodes><Name>Anchor (Cinch)</Name><Description>Cinch Anchor</Description><Size>One size only</Size><SupplierCode>SJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>353993</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ051</BillingCode><PriorBillingCodes><PriorBillingCode>AW027</PriorBillingCode></PriorBillingCodes><Name>XEN Glaucoma Treatment System</Name><Description>The XEN Glaucoma Treatment System consists of an injector device that is preloaded with a XEN Gel Implant. The XEN Gel Implant creates a new subconjunctival outflow pathway to reduce intraocular pressure in patients with mild to advanced primary open-angle glaucoma where previous treatments have failed.</Description><Size>XEN Gel Implant is 6mm long, 150µm outside diameter and 45µm inside diameter.</Size><SupplierCode>KK</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>144</SubCategoryID><GroupID>1802</GroupID><SubGroupID>6442</SubGroupID><ARTGs><ARTG>297899</ARTG></ARTGs><MinimumBenefit>1264</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KK001</BillingCode><PriorBillingCodes><PriorBillingCode>AW008</PriorBillingCode><PriorBillingCode>DE110</PriorBillingCode></PriorBillingCodes><Name>Natrelle® INSPIRA® TruForm™ Smooth Mammary Implant</Name><Description>Round implants with smooth surface. Available in four projections: low, moderate, full and extra-full; and two cohesive gel types: TruForm™ 1 Responsive Gel and TruForm™ 2 Soft-Touch™ Gel.</Description><Size>110 - 800 grams</Size><SupplierCode>KK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><ARTGs><ARTG>175421</ARTG><ARTG>175426</ARTG></ARTGs><MinimumBenefit>595</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KK002</BillingCode><PriorBillingCodes><PriorBillingCode>AW019</PriorBillingCode></PriorBillingCodes><Name>BRST Round MICROCELL™ Micotextured cohesive gel filled mammary implant</Name><Description>Round-shaped implants with MICROCELL™ microtextured surface, silicone elastomer barrier layer and cohesive silicone gel.   Available in three profiles:  moderate, high and extra high.</Description><Size>175 - 700 g</Size><SupplierCode>KK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><ARTGs><ARTG>220900</ARTG></ARTGs><MinimumBenefit>595</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ049</BillingCode><PriorBillingCodes><PriorBillingCode>ER411</PriorBillingCode></PriorBillingCodes><Name>TIGR Matrix Surgical Mesh-Medium</Name><Description>TIGR Matrix Surgical Mesh-Medium, biosynthetic</Description><Size>15x20 cm</Size><SupplierCode>BP</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5492</SubGroupID><Suffix>Contoured</Suffix><ARTGs><ARTG>202446</ARTG></ARTGs><MinimumBenefit>1399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP029</BillingCode><Name>Tyber Medical Trauma screw washer</Name><Description>Screw washer intended to be used with bone screws to improve fixation. Sterile or Non sterile, Titanium or stainless steel</Description><Size>2.0mm -7.5mm</Size><SupplierCode>BP</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>324373</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP027</BillingCode><Name>Tyber Medical Trauma headed screw</Name><Description>Headed trauma screw for compression and fixation of bone  Sterile or Non sterile, Titanium or stainless steel</Description><Size>2.5mm</Size><SupplierCode>BP</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>324189</ARTG><ARTG>324190</ARTG></ARTGs><MinimumBenefit>156</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP004</BillingCode><Name>PEEK Interbody system – Cervical</Name><Description>ACIF Implants; Sterile and Non Sterile</Description><Size>Diameter 14mm; 16mm: 
Height (5mm, - 12mm): 
Lordosis Angle 0 - 7.5 degrees: 
Curevd , Straight</Size><SupplierCode>BP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>273366</ARTG><ARTG>273367</ARTG><ARTG>273374</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP008</BillingCode><Name>TiPEEK Interbody system – Cervical</Name><Description>ACIF Implants; Sterile
Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima®)</Description><Size>Size: small, standard, large, extra large
Width 12.5mm – 19mm
Length 11.5mm – 16mm
Height 5-12mm: 
Lordosis Angle 0 - 20°: 
Curved, Straight, Convex</Size><SupplierCode>BP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>273366</ARTG><ARTG>273367</ARTG><ARTG>273374</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP028</BillingCode><Name>Tyber Medical Trauma headless screw</Name><Description>Headless trauma screw for compression and fixation of bone Sterile or Non sterile, Titanium or stainless steel</Description><Size>2.5mm</Size><SupplierCode>BP</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>324189</ARTG><ARTG>324190</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP005</BillingCode><Name>PEEK Interbody system – Lumbar PLIF/TLIF (single)</Name><Description>Sterile and Non sterile                                               
PLIF Implants
TLIF Implants</Description><Size>Width 8-12mm: 
Length 22-34mm: 
Height 7-17mm:  
Lordosis Angle 0-8 degrees</Size><SupplierCode>BP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>273366</ARTG><ARTG>273367</ARTG><ARTG>273374</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP010</BillingCode><Name>TiPEEK Interbody system   Lumbar ALIF</Name><Description>Sterile                                                                    ALIF Implants  Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima )</Description><Size>Width 24-28mm:   Length 28-38mm:   Height 8-17mm:    Lordosis Angle 6-8 degrees,</Size><SupplierCode>BP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>273366</ARTG><ARTG>273367</ARTG><ARTG>273374</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP003</BillingCode><Name>Ti PEEK Interbody System – Lumbar PLIF/TLIF (Paired)</Name><Description>Sterile                                                                
PLIF Implants
TLIF Implants
Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima®)</Description><Size>Width 8-12mm: 
Length 22-34mm: 
Height 7-17mm:  
Lordosis Angle 0-8 degrees</Size><SupplierCode>BP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>273366</ARTG><ARTG>273367</ARTG><ARTG>273374</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP002</BillingCode><Name>PEEK Interbody System – Lumbar ALIF</Name><Description>Sterile and Non sterile
ALIF Implants</Description><Size>Width 24-28mm: 
Length 28-38mm: 
Height 8-17mm: 
Lordosis Angle 6 - 8 degrees</Size><SupplierCode>BP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>273366</ARTG><ARTG>273367</ARTG><ARTG>273374</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP001</BillingCode><Name>Ti PEEK Interbody system – Lumbar PLIF/TLIF (single)</Name><Description>Sterile                                                                
PLIF Implants
TLIF Implants
Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima®)</Description><Size>Width 8-12mm: 
Length 22-34mm: 
Height 7-17mm:  
Lordosis Angle 0-8 degrees</Size><SupplierCode>BP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>273366</ARTG><ARTG>273367</ARTG><ARTG>273374</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP032</BillingCode><Name>Tyber Medical Trauma Headless screw</Name><Description>Headless trauma screw for compression and fixation of bone Sterile or Non sterile, Titanium or stainless steel</Description><Size>2.0mm</Size><SupplierCode>BP</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>324189</ARTG><ARTG>324190</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP030</BillingCode><Name>Tyber Medical Trauma headed screw</Name><Description>Trauma headed screw for compression and fixation of bone  Sterile or Non sterile, Titanium or stainless steel</Description><Size>1.5mm-2.0mm</Size><SupplierCode>BP</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>324189</ARTG><ARTG>324190</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP006</BillingCode><Name>TiPEEK Interbody system Lumbar DLIF</Name><Description>Sterile                                                                    DLIF Implants  Commercially Pure Titanium and Polyetheretherketone (PEEK-Optima )</Description><Size>Width 18-22mm:  Length 40-60mm:  Height 8-17mm:  Lordosis Angle 0 - 8 degrees</Size><SupplierCode>BP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>273366</ARTG><ARTG>273367</ARTG><ARTG>273374</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP036</BillingCode><Name>Tyber Medical Trauma headed screw</Name><Description>Trauma headed screw for compression and fixation of bone Sterile or Non sterile, Titanium or stainless steel</Description><Size>2.00MM</Size><SupplierCode>BP</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>324189</ARTG><ARTG>324190</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP035</BillingCode><Name>Tyber Medical Trauma Headless screw</Name><Description>Headless trauma screw for compression and fixation of bone Sterile or Non sterile, Titanium</Description><Size>2.0mm</Size><SupplierCode>BP</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>324189</ARTG><ARTG>324190</ARTG></ARTGs><MinimumBenefit>346</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP009</BillingCode><Name>PEEK Interbody System – DLIF Lumbar</Name><Description>Sterile and Non sterile 
DLIF Implants</Description><Size>Width 18-22mm:
Length 40-60mm:
Height 8-17mm:
Lordosis Angle 0 - 8 degrees</Size><SupplierCode>BP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>273367</ARTG><ARTG>273374</ARTG><ARTG>273366</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP007</BillingCode><Name>PEEK Interbody System – Lumbar PLIF/TLIF (Paired)</Name><Description>Sterile and Non sterile
PLIF Implants
TLIF Implants</Description><Size>Width 8-12mm: 
Length 22-34mm: 
Height 7-17mm:  
Lordosis Angle 0-8 degrees,</Size><SupplierCode>BP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>273366</ARTG><ARTG>273367</ARTG><ARTG>273374</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ050</BillingCode><PriorBillingCodes><PriorBillingCode>ER410</PriorBillingCode></PriorBillingCodes><Name>TIGR Matrix Surgical Mesh-Small</Name><Description>TIGR Matrix Surgical Mesh-Small, biosynthetic</Description><Size>10x15 cm</Size><SupplierCode>BP</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5491</SubGroupID><Suffix>Contoured</Suffix><ARTGs><ARTG>202446</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP034</BillingCode><Name>Tyber Medical Trauma headless screw</Name><Description>Headless trauma screw for compression and fixation of bone  Sterile or Non sterile, Titanium</Description><Size>3.0mm-4.0mm</Size><SupplierCode>BP</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>324189</ARTG><ARTG>324190</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP033</BillingCode><Name>Tyber Medical Headed Trauma screw</Name><Description>Headed trauma screw for compression and fixation of bone  Sterile or Non sterile, Titanium or stainless steel</Description><Size>3.0mm - 4.0mm</Size><SupplierCode>BP</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>324189</ARTG><ARTG>324190</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP026</BillingCode><Name>Tyber Medical trauma headless screw</Name><Description>Headless trauma screw for compression and fixation of bone  Sterile or Non sterile, Titanium or stainless steel</Description><Size>4.5mm-9.0mm</Size><SupplierCode>BP</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>324189</ARTG><ARTG>324190</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ048</BillingCode><PriorBillingCodes><PriorBillingCode>ER412</PriorBillingCode></PriorBillingCodes><Name>TIGR Matrix Surgical Mesh-Large</Name><Description>TIGR Matrix Surgical Mesh-Large, biosynthetic</Description><Size>20x30 cm</Size><SupplierCode>BP</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5493</SubGroupID><Suffix>Contoured</Suffix><ARTGs><ARTG>202446</ARTG></ARTGs><MinimumBenefit>3204</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BP031</BillingCode><Name>Tyber Medical Trauma headed screw</Name><Description>Trauma screw for compression and fixation of bone  Sterile or Non sterile, Titanium or stainless steel</Description><Size>4.5mm-7.5mm</Size><SupplierCode>BP</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>324189</ARTG><ARTG>324190</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ028</BillingCode><Name>Actis Engage Suture Anchor</Name><Description>Actis Engage Suture Anchor, PEEK (w/ blue tape and #2 blue/white suture), with and without needles</Description><Size>4.5mm, 5.5mm, 6.5mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>439731</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ011</BillingCode><PriorBillingCodes><PriorBillingCode>QQ079</PriorBillingCode><PriorBillingCode>ER383</PriorBillingCode><PriorBillingCode>AE266</PriorBillingCode></PriorBillingCodes><Name>Hintermann Series H3™ Total Ankle Prosthesis-Talar Component</Name><Description>Hintermann Series H3™ Total Ankle Prosthesis-Talar component, left or right, primary or revision, CoCr, plasma sprayed titanium coating and a hydroxyapatite coating</Description><Size>0-6</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1460</GroupID><SubGroupID>4040</SubGroupID><ARTGs><ARTG>289321</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ525</BillingCode><PriorBillingCodes><PriorBillingCode>ER523</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, standard ( ≥4.5mm), cannulated, locking</Name><Description>Paragon 28 Monster Screw System-Joust Beaming Screws, standard, cannulated, locking, headless, Titanium</Description><Size>dia (5.0-7.2mm) x Length (50-185mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,LK</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>246</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ493</BillingCode><PriorBillingCodes><PriorBillingCode>ER421</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, fibular (≤ 6 holes)</Name><Description>Paragon 28 Gorilla Plating System-Plate, fibular, tubular,anatomic, titanium</Description><Size>thickness 1.5mm; multi screw diameter purchase 2.7/3.5/4.2mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5289</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ473</BillingCode><PriorBillingCodes><PriorBillingCode>ER391</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, standard ( ≥4.5mm)</Name><Description>Paragon 28 Monster Screw System-Screws, headed, blunt tip, solid, various thread lengths</Description><Size>dia (4.5-7.0 mm) x length (18-200 mm) x thread length (6-200 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ004</BillingCode><PriorBillingCodes><PriorBillingCode>ER674</PriorBillingCode></PriorBillingCodes><Name>Paragon Silverback Straddle Plate-posterior TTC</Name><Description>Silverback Straddle Plate-posterior TTC, flat or contoured, left or right, Ti</Description><Size>Various lengths</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ497</BillingCode><PriorBillingCodes><PriorBillingCode>ER484</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, mini (≤ 6 holes);variable angle locking, complex</Name><Description>Paragon 28 Gorilla Plating System-Plate, titanium mini plate, compression, variable angle locking, complex</Description><Size>thickness 1.1mm; multi screw diameter purchase</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ478</BillingCode><PriorBillingCodes><PriorBillingCode>ER381</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Phantom Lapidus Nail-Screws, small (2.71mm – 4.49mm), dual thread, locking</Name><Description>Paragon 28 Phantom Lapidus Nail-Screws, small (2.71mm – 4.49mm), dual thread, locking</Description><Size>dia 3.5 mm x length (10-26 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>290443</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ496</BillingCode><PriorBillingCodes><PriorBillingCode>ER483</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, mini (≤ 6 holes); variable angle locking</Name><Description>Paragon 28 Gorilla Plating System-Plate, titanium mini plate, compression, variable angle locking, variable sizes and shapes</Description><Size>thickness 1.1/1.3 mm; multi screw diameter purchase 2.0/2.5mm or 2.7/3.5/4.2 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ018</BillingCode><Name>Grappler Suture Anchor, Titanium 4.5 mm</Name><Description>The Grappler Titanium Suture Anchor System is intended for the fixation of soft tissue to bone i.e. fixation of ligament and tendon graft tissue and tendon transfers in surgeries of the shoulder, elbow, knee, foot/ankle, and hand/wrist. Anchors are supplied either pre-loaded with suture, or two sutures, or suture and tape, or packed with suture/tape.</Description><Size>4.5 x 15 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>469707</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ002</BillingCode><PriorBillingCodes><PriorBillingCode>ER672</PriorBillingCode></PriorBillingCodes><Name>Paragon Silverback Straddle Plate-lateral TC</Name><Description>Silverback Straddle Plate-lateral TC, long, left or right        </Description><Size>one size</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5257</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ005</BillingCode><PriorBillingCodes><PriorBillingCode>ER676</PriorBillingCode></PriorBillingCodes><Name>Gorilla Silverback Spanning Plates-Anterior/Lateral</Name><Description>Silverback Spanning Plates-Anterior/Lateral, flat, standard or long, left or right</Description><Size>69-109 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ022</BillingCode><Name>Paragon 28 Precision MIS Bunion System Chamfer Screws</Name><Description>Precision MIS Bunion System - Cannulated Chamfer Screws used for bone reconstruction/osteotomy.</Description><Size>3.0 - 4.0mm in diameter, 12-70mm lengths</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>289308</ARTG><ARTG>498048</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ026</BillingCode><Name>Actis Advance Suture Anchors</Name><Description>Actis Advance Suture Anchor, 4.5mm (w/blue tape and blue/white suture).
Suture anchors and sutures/tapes are provided together as single devices.</Description><Size>4.5mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>439731</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ529</BillingCode><PriorBillingCodes><PriorBillingCode>ER492</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Proximal Rotational Metatarsal Osteotomy (“PROMO”) Plating System</Name><Description>PROMO left or right contoured plates designed specifically around the angle of the osteotomy, allowing space for optimal cross screw trajectory. Plates are used with  Paragon 28 Baby Gorilla or Mini Monster screws.</Description><Size>Size 1-4, osteotomy angles 13-55°</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ023</BillingCode><Name>Actis Revolve Suture Anchor</Name><Description>Actis Revolve Suture Anchor (w/blue tape and #2 blue/white suture)
</Description><Size>4.75mm, 5.5mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>439731</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ510</BillingCode><PriorBillingCodes><PriorBillingCode>ER568</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, tibial (≤ 6 holes)</Name><Description>Paragon 28 Gorilla Silverback tibiotalar posterior(TT) ankle fusion plate, left or right</Description><Size>≤ 6 holes</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ006</BillingCode><PriorBillingCodes><PriorBillingCode>ER677</PriorBillingCode></PriorBillingCodes><Name>Gorilla Silverback Spanning Plates-Posterior</Name><Description>Silverback Spanning Plates-posterior, flat, standard or long, left or right</Description><Size>various lengths</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ016</BillingCode><Name>Grappler Suture Anchor, PEEK</Name><Description>The Grappler PEEK Suture Anchor System is intended for the fixation of soft tissue to bone i.e. fixation of ligament and tendon graft tissue and tendon transfers in surgeries of the shoulder, elbow, knee, foot/ankle, and hand/wrist. Anchors are provided with suture passers and pre-loaded with suture tape.</Description><Size>4.5 mm and 5.5 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>469491</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER530</BillingCode><Name>Paragon 28 Monster Screw System-Screws, standard ( ≥ 4.5mm), locking</Name><Description>Paragon 28 Monster Screw System-Joust Beaming Screws, standard, locking, headless, Titanium</Description><Size>dia (5.0-7.2mm) x Length (50-185mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ508</BillingCode><PriorBillingCodes><PriorBillingCode>ER611</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, tibial ( ≥ 7 to ≤ 15 holes), Periarticular, Posterior, TTC</Name><Description>Paragon 28 Gorilla Silverback tibiotalarcalcaneal (TTC) posterior ankle fusion plate, left or right, variable ankle locking, complex shape, flat or contoured, left or right</Description><Size>( ≥ 7 to ≤ 15 holes); 65-109 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>290443</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ507</BillingCode><PriorBillingCodes><PriorBillingCode>ER609</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, tibial ( ≥ 7 to ≤ 15 holes), Periarticular, Posterior, TT</Name><Description>Paragon 28 Gorilla Silverback tibiotalar (TT) posterior ankle fusion plate, left or right</Description><Size>( ≥ 7 to ≤ 15 holes); 65-109 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>290443</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ001</BillingCode><PriorBillingCodes><PriorBillingCode>ER671</PriorBillingCode></PriorBillingCodes><Name>Paragon Silverback Straddle Plate-anterior TT</Name><Description>Silverback Anterior Straddle Plate, TT, Contoured or flat, standard or long, left or right        </Description><Size>various sizes</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ015</BillingCode><Name>GRAPPLER Knotless Suture Anchor, PEEK, </Name><Description>The GRAPPLER Knotless Suture Anchor System is intended for the fixation of soft tissue to bone i.e. fixation of ligament and tendon graft tissue and tendon transfers in surgeries of the shoulder, elbow, knee, foot/ankle, and hand/wrist. Anchors are provided with suture passers and pre-loaded with suture tape.</Description><Size>4.5 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>469491</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ474</BillingCode><PriorBillingCodes><PriorBillingCode>ER392</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, Standard ( ≥4.5mm), cannulated</Name><Description>Paragon 28 Monster Screw System-Screws, standard ( ≥4.5mm), cannulated, headed, with and without blunt tip</Description><Size>diameter (4.5-7.0 mm) x length (18-200 mm) x length of thread (6-200 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ527</BillingCode><PriorBillingCodes><PriorBillingCode>ER405</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-washer</Name><Description>Paragon 28 Monster Screw System-washer, deep well, flat/dome</Description><Size>dia 2-7 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>289309</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ030</BillingCode><Name>Gorilla Supramalleolar (SMO) Osteotomy  System - Medial Tibia Plates</Name><Description>The Gorilla Supramalleolar Osteotomy System was designed with instrumentation to facilitate repeatable and controlled anterior dome and medial opening or closing wedge osteotomies. All plate holes accept 2.7, 3.5, or 4.2 mm locking or non-locking screws or 3.5 mm locking or non-locking compact thread screws. Screws can be inserted off-axis up to 15 degrees in non-compression holes. </Description><Size>1.5mm thick, length 15-25mm, 6 holes</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ477</BillingCode><PriorBillingCodes><PriorBillingCode>ER382</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Phantom Lapidus Nail-Screw, small (2.71mm – 4.49mm)</Name><Description>Paragon 28 Phantom Lapidus Nail-Screw, small</Description><Size>dia 3.5 mm x length (10-46 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>290443</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ524</BillingCode><PriorBillingCodes><PriorBillingCode>ER400</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, mini (2.01 – 2.7 mm), cannulated, dual thread, locking</Name><Description>Paragon 28 Monster Screw System-screws, mini, cannulated, dual thread, locking, headless, partially threaded, Titanium</Description><Size>dia 2.5 mm x length (8-100 mm) x length of thread (3-32 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ490</BillingCode><PriorBillingCodes><PriorBillingCode>ER605</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plates- ≥ 16 holes, medial, anterolateral</Name><Description>Paragon 28 Gorilla Plates- tibia  ≥ 16 holes, medial, anterolateral, left or right, variable angle locking, complex shapes</Description><Size>≥ 16 holes, thickness 1.8 mm; multi screw diameter purchase</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>810</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ468</BillingCode><PriorBillingCodes><PriorBillingCode>ER397</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, mini (2.01 – 2.7 mm)</Name><Description>Paragon 28 Monster Screw System-Screws, mini, headed, with or without a blunt tip, recon/Tuffneck, Titanium</Description><Size>dia (2.5-2.7 mm) x length (10-100 mm) x length of thread (3-100 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ010</BillingCode><PriorBillingCodes><PriorBillingCode>QQ078</PriorBillingCode><PriorBillingCode>ER385</PriorBillingCode><PriorBillingCode>AE265</PriorBillingCode></PriorBillingCodes><Name>Hintermann Series H3™ Total Ankle Prosthesis-Inlay</Name><Description>Hintermann Series H3™ Total Ankle Prosthesis-Inlay, UHMW Polyethylene</Description><Size>0-6, thickness 5-9 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1269</GroupID><SubGroupID>3646</SubGroupID><ARTGs><ARTG>289319</ARTG></ARTGs><MinimumBenefit>591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ515</BillingCode><PriorBillingCodes><PriorBillingCode>ER425</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Screws, small</Name><Description>Paragon 28 Gorilla Plating System-Screws, small, locking; compact, recon/Tuffneck</Description><Size>dia (3.5-4.2 mm) x length (8-100 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ008</BillingCode><PriorBillingCodes><PriorBillingCode>ER686</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Phantom Hindfoot TTC Nail System-Internal Compression Screw</Name><Description>Compression screw</Description><Size>one size</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>402229</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ009</BillingCode><PriorBillingCodes><PriorBillingCode>ER687</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Phantom Hindfoot TTC Nail System-Threaded Peg</Name><Description>Tibial, calcaneal or subtalar threaded peg/crossing screw</Description><Size>Diameter: 5.0mm; Length: 20mm – 70mm in 2mm increments.   Diameter: 7.2mm; Length: 45mm – 120mm in 5mm increments.</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>402229</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ021</BillingCode><Name>CanLoop Interference Screw</Name><Description>PEEK Interference Screw</Description><Size>6-12mm diameter, 23-35mm length</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>439731</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ467</BillingCode><PriorBillingCodes><PriorBillingCode>ER398</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screw, mini (2.01 – 2.7 mm), breakoff</Name><Description>Paragon 28 Monster Bite screw, mini, snap-off, 1/2 threaded, Titanium</Description><Size>dia 2.7mm x length (8-24 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>295</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ013</BillingCode><Name>Grappler All-Suture (Soft) Anchors System - 1.4 mm</Name><Description>The Grappler All Suture Anchor System is intended for the fixation of soft tissue to bone i.e. fixation of ligament and tendon graft tissue and tendon transfers in surgeries of the shoulder, elbow, knee, foot/ankle, and hand/wrist. Anchors are supplied either pre-loaded with suture, or two sutures, or suture and tape, or packed with suture/tape.</Description><Size>Small Suture anchor, 1.4 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>469707</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ513</BillingCode><PriorBillingCodes><PriorBillingCode>ER503</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, tibial (≥ 16 holes)</Name><Description>Paragon 28 Gorilla Silverback Plating System-Plate, tibial, lateral TTC, left or right</Description><Size>≥ 16 holes, 113-154 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ494</BillingCode><PriorBillingCodes><PriorBillingCode>ER423</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, fibular (≥ 16 holes)</Name><Description>Paragon 28 Gorilla Plating System-Plate, fibular, tubular, anatomic, titanium</Description><Size>thickness 1.5mm; multi screw diameter purchase 2.7/3.5/4.2mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5291</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ528</BillingCode><PriorBillingCodes><PriorBillingCode>ER478</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Olive Wires</Name><Description>Paragon 28 Olive wire (Gorilla Plating System), smooth or threaded, standard or short tip</Description><Size>dia 1.3-1.8 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><Suffix>OL</Suffix><ARTGs><ARTG>289488</ARTG></ARTGs><MinimumBenefit>117</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ526</BillingCode><PriorBillingCodes><PriorBillingCode>ER522</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, standard ( ≥4.5mm), dual thread, locking</Name><Description>Paragon 28 Monster Screw System-Joust Beaming Screws, ( ≥4.5mm), headless, dual thread, locking, Ti</Description><Size>dia (5.0-7.2mm) x length (50-185mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>DT</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ519</BillingCode><PriorBillingCodes><PriorBillingCode>ER477</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 K wires</Name><Description>Paragon 28, K wire (for Phantom, Gorilla and Monster systems), smooth, grooved  or threaded, trocar/double trocar</Description><Size>dia 0.9-3.0 mm, length (100-250 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>290442</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ475</BillingCode><PriorBillingCodes><PriorBillingCode>ER393</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, standard ( ≥4.5mm), cannulated, dual thread, locking</Name><Description>Paragon 28 Monster Screw System-screws, cannulated, dual thread, locking, headless, partial thread, Titanium</Description><Size>dia (4.5-7.2 mm) x length (50-200mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ020</BillingCode><PriorBillingCodes><PriorBillingCode>ER427</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Screws, micro</Name><Description>Paragon 28 Gorilla Plating System-Screws, locking, baby</Description><Size>dia 2.0 mm x length (8-40 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ514</BillingCode><PriorBillingCodes><PriorBillingCode>ER426</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Screws, mini</Name><Description>Paragon 28 Gorilla Plating System-Screws, mini, locking; recon/Tuffneck/baby</Description><Size>dia (2.5-2.7 mm) x length (8-50 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ469</BillingCode><PriorBillingCodes><PriorBillingCode>ER399</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, mini (2.01 – 2.7 mm), cannulated</Name><Description>Paragon 28 Monster Screw System-Screws, mini, cannulated, partially or fully threaded</Description><Size>dia 2.5mm x length (10-100 mm) x length of thread (3-100 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>156</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ521</BillingCode><PriorBillingCodes><PriorBillingCode>ER402</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, micro (≤ 2.0mm), breakoff</Name><Description>Paragon 28 Monster Bite Screws, micro (≤ 2.0mm), snap-off, 1/2 or 3/4 threaded</Description><Size>dia 2.0 mm x length (8-24 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ520</BillingCode><PriorBillingCodes><PriorBillingCode>ER401</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, micro (≤ 2.0mm)</Name><Description>Paragon 28 Monster Screw System-Screws, micro, headed, blunt tip, solid, partially or fully threaded</Description><Size>dia 2.0 mm x length (8-100 mm) x length of thread (3-100 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ516</BillingCode><PriorBillingCodes><PriorBillingCode>ER510</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Screws, standard ( ≥ 4.5mm)</Name><Description>Paragon 28 Gorilla Plating System-Screws, standard ( ≥ 4.5mm)</Description><Size>dia (4.5-5.2 mm) x length (14-60 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ019</BillingCode><Name>Paragon 28 Phantom Hindfoot TTC Nail</Name><Description>Phantom Hindfoot TTC Ankle arthrodesis nail, sterile; left or right</Description><Size>Diameter: 10-13 mm Length: 150-300mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3332</SubGroupID><ARTGs><ARTG>402216</ARTG></ARTGs><MinimumBenefit>3300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ523</BillingCode><PriorBillingCodes><PriorBillingCode>ER404</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, micro (≤ 2.0mm), cannulated, dual thread, locking</Name><Description>Paragon 28 Monster micro screws, cannulated, dual thread, locking, headless, partially threaded</Description><Size>dia 2.0 mm x length (8-100 mm) x length of thread (3mm-32 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>346</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ517</BillingCode><PriorBillingCodes><PriorBillingCode>ER504</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Screws, standard ( ≥ 4.5mm), locking</Name><Description>Paragon 28 Gorilla Plating System-Screws, standard ( ≥ 4.5mm), locking, recon/Tuffneck</Description><Size>dia (4.5-5.2 mm) x length (14-60 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ522</BillingCode><PriorBillingCodes><PriorBillingCode>ER403</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, micro (≤ 2.0mm), cannulated</Name><Description>Paragon 28 Monster Screw System-screws, micro, cannulated, headed</Description><Size>dia 2.0 mm x length (8-100mm) x length of thread (3-100 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ492</BillingCode><PriorBillingCodes><PriorBillingCode>ER424</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, Calcaneal ( ≥ 7 to ≤ 15 holes)</Name><Description>Paragon 28 Gorilla Plating System-Plate, Calcaneus fracture, MTP various shapes, Titanium,</Description><Size>thickness 1.1mm; multi screw diameter purchase 2.7/3.5/4.2mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5296</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1373</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ025</BillingCode><Name>R3FLEX Stabilisation System Kit</Name><Description>The R3FLEX Stabilization System is the next generation of flexible fixation for the syndesmosis. The instrumentation provides surgeons the ability to assess and adjust the tension of the repair intra-operatively. The preparation is performed tri-cortically with a 2.8 mm drill bit to alleviate the risk of injury to the saphenous nerve or vein on medial distal tibia. The knotless implant is designed to enable motion across the syndesmosis to better match the native kinematics of the fibula.
The R3FLEX Stabilization System consists of the R3FLEX Implant (All-Suture Anchor with #2 UHMWPE Suture) on inserter (which includes Release Button, Handle Loop, Inserter Body, Tension Indicator, Inserter Tip), and 2.8mm Solid Drill, 3.8mm solid drill, and angled drill guide.</Description><Size>2.8mm All-Suture Anchor with #2 Suture</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>469490</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ029</BillingCode><Name>Actis Engage Suture Anchor</Name><Description>Actis Engage Suture Anchor, PEEK (w/ blue tape and #1 blue/white suture or #2 blue/white suture), with and without needles.
</Description><Size>2.5mm, 3.5mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>439731</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ489</BillingCode><PriorBillingCodes><PriorBillingCode>ER684</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla LisFranc Plating System</Name><Description>Gorilla LisFranc/TMT Plates, dual ray, anatomically contoured, variable angle locking, left or right, small/medium</Description><Size>small/medium, 8 Hole with 2 Compression Slots. thickness 1.4 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ017</BillingCode><Name>Grappler Suture Anchor, Titanium 3.0 mm</Name><Description>The Grappler Titanium Suture Anchor System is intended for the fixation of soft tissue to bone i.e. fixation of ligament and tendon graft tissue and tendon transfers in surgeries of the shoulder, elbow, knee, foot/ankle, and hand/wrist. Anchors are supplied either pre-loaded with suture, or two sutures, or suture and tape, or packed with suture/tape.</Description><Size>3.0 x 12 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>469707</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ031</BillingCode><Name>Gorilla Supramalleolar (SMO) Osteotomy System - Anterior Tibia Plates</Name><Description>The Gorilla Supramalleolar Osteotomy System was designed with instrumentation to facilitate repeatable and controlled anterior dome and medial opening or closing wedge osteotomies. All plate holes accept 2.7, 3.5, or 4.2 mm locking or non-locking screws or 3.5 mm locking or non-locking compact thread screws. Screws can be inserted off-axis up to 15 degrees in non-compression holes.</Description><Size>1.5mm thick, 13-18mm long, 8 holes</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ518</BillingCode><PriorBillingCodes><PriorBillingCode>ER439</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 JAWS Nitinol Staple System</Name><Description>Paragon 28 JAWS Nitinol Staple System</Description><Size>bridge width 8-25 mm, angle 0 or 30, step height 4-12 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><Suffix>MM</Suffix><ARTGs><ARTG>291681</ARTG></ARTGs><MinimumBenefit>507</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ491</BillingCode><PriorBillingCodes><PriorBillingCode>ER604</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plates- ≥ 7 to ≤ 15 holes, medial, anterior, anterolateral</Name><Description>Paragon 28 Gorilla Plates- tibia  ≥ 7 to ≤ 15 holes, medial, anterior, anterolateral. left or right, variable angle locking, complex shapes</Description><Size>≥ 7 to ≤ 15 holes, thickness 1.8 mm; multi screw diameter purchase</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>290443</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ506</BillingCode><PriorBillingCodes><PriorBillingCode>ER502</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, tibial ( ≥ 7 to ≤ 15 holes)</Name><Description>Paragon 28 Gorilla Silverback tibiotalar (TT) anterior or lateral ankle fusion plate, left or right</Description><Size>( ≥ 7 to ≤ 15 holes); 65-109 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>1489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ498</BillingCode><PriorBillingCodes><PriorBillingCode>ER420</PriorBillingCode><PriorBillingCode>ER499</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, mini (≥ 16 holes);variable angle locking</Name><Description>Paragon 28 Gorilla Plating System-Plate, mini, titanium, compression, variable angle locking, various shapes and sizes (small-extra large)</Description><Size>thickness 1.1-2.0 mm; multi screw diameter purchase</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ014</BillingCode><Name>Grappler All-Suture (Soft) Anchors System - 2.8 mm</Name><Description>The Grappler All Suture Anchor System is intended for the fixation of soft tissue to bone i.e. fixation of ligament and tendon graft tissue and tendon transfers in surgeries of the shoulder, elbow, knee, foot/ankle, and hand/wrist. Anchors are supplied either pre-loaded with suture, or two sutures, or suture and tape, or packed with suture/tape.</Description><Size>Medium Suture anchor, 2.8 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>469707</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ503</BillingCode><PriorBillingCodes><PriorBillingCode>ER482</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, small ( ≥ 7 to ≤ 15 holes); variable angle locking, complex</Name><Description>Paragon 28 Gorilla Plating System-Plate, small, titanium, malleus/column/ rescue/stradle/arch (proximal or distal), variable angle locking, complex</Description><Size>Thickness 1.5/2.0 mm; multi screw diameter purchase</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ024</BillingCode><Name>Actis Revolve Suture Anchor</Name><Description>Actis Revolve Suture Anchor, 3.5mm (w/ tape and #2 suture)
</Description><Size>3.5mm, varied suture lengths</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>439731</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ502</BillingCode><PriorBillingCodes><PriorBillingCode>ER481</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, small ( ≥ 7 to ≤ 15 holes); variable angle locking</Name><Description>Paragon 28 Gorilla Plating System-Plate, small, titanium, malleus/column rescue/stradle/arch (proximal or distal)</Description><Size>Thickness 1.5/2.0 mm ; multi screw diameter purchase 2.7/3.5/4.2mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ512</BillingCode><PriorBillingCodes><PriorBillingCode>ER610</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, tibial (≤ 6 holes), Periarticular, Posterior, TT</Name><Description>Paragon 28 Gorilla Silverback tibiotalar (TTC) posterior ankle fusion plate, left or  right, variable ankle locking, complex shape, left or right</Description><Size>≤ 6 holes</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>826</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ530</BillingCode><PriorBillingCodes><PriorBillingCode>ER454</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Titan 3-D Wedge</Name><Description>Paragon 28 Titan 3-D Cotton or Evans Wedge, Anatomical,  Titanium metal scaffold for angular correction,  Sterile</Description><Size>5-8 mm (Cotton); 6-12 mm (Evans)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5457</SubGroupID><ARTGs><ARTG>290444</ARTG></ARTGs><MinimumBenefit>1468</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ012</BillingCode><PriorBillingCodes><PriorBillingCode>QQ080</PriorBillingCode><PriorBillingCode>ER384</PriorBillingCode><PriorBillingCode>AE267</PriorBillingCode></PriorBillingCodes><Name>Hintermann Series H3™ Total Ankle Prosthesis-Tibial Component</Name><Description>Hintermann Series H3™ Total Ankle Prosthesis-Tibial Component, left or right, primary or revision, CoCr, plasma sprayed titanium coating and a hydroxyapatite coating</Description><Size>0-6, 8 or 12mm thickness (revision)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1460</GroupID><SubGroupID>4041</SubGroupID><ARTGs><ARTG>289424</ARTG></ARTGs><MinimumBenefit>1900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ511</BillingCode><PriorBillingCodes><PriorBillingCode>ER670</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, tibial (≤ 6 holes),  anterior, TT  </Name><Description>Silverback anterior mini-open plate, TT, contoured or flat, left or right, Ti, complex, variable angle locking</Description><Size>65-109 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>Com,VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1473</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ499</BillingCode><PriorBillingCodes><PriorBillingCode>ER420</PriorBillingCode><PriorBillingCode>ER500</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, mini (≥ 16 holes);variable angle locking, complex</Name><Description>Paragon 28 Gorilla Plating System-Plate, mini, titanium, compression, variable angle locking, various complex shapes and sizes, left or right</Description><Size>thickness 2.0mm; multi screw diameter purchase</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ466</BillingCode><PriorBillingCodes><PriorBillingCode>ER387</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Hammer Tube System</Name><Description>Paragon 28 Hammer tube, proximal interphalangeal joint arthrodesis; solid or cannulated, Peek, sterile</Description><Size>dia (2.50-3.75 mm); angle 0-10°; length (14-16mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5474</SubGroupID><ARTGs><ARTG>290441</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ476</BillingCode><PriorBillingCodes><PriorBillingCode>ER380</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Phantom Lapidus Nail System-Intramedullary nail, foot</Name><Description>Phantom Lapidus intramedullary nail, foot, left or right</Description><Size>dia 5.5 mmx length (38-60 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5474</SubGroupID><ARTGs><ARTG>290443</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ027</BillingCode><Name>Actis Advance Suture Anchors</Name><Description>Actis Advance Suture Anchor (w/blue tape and blue/white suture).
Suture anchors and sutures/tapes are provided together as single devices.</Description><Size>2.5 - 2.9mm anchors</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>439731</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ495</BillingCode><PriorBillingCodes><PriorBillingCode>ER422</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, fibular (≥ 7 to ≤ 15 holes)</Name><Description>Paragon 28 Gorilla Plating System-Plate, fibular, tubular, anatomic, titanium</Description><Size>thickness 1.5mm; multi screw diameter purchase 2.7/3.5/4.2mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5290</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1238</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ472</BillingCode><PriorBillingCodes><PriorBillingCode>ER396</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, small (2.71mm – 4.49mm), cannulated, dual thread, locking</Name><Description>Paragon 28 Monster Screw System-Screws, small, cannulated, dual thread, locking, headless, Titanium</Description><Size>dia (3.0-4.0) x length (10-100 mm) x length of thread (3.5-100 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ509</BillingCode><PriorBillingCodes><PriorBillingCode>ER541</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, tibial ( ≥ 7 to ≤ 15 holes), Tibiotalarcalcaneal (TTC)</Name><Description>Paragon 28 Gorilla Silverback tibiotalarcalcaneal (TTC) anterior ankle fusion plate, left or right, variable ankle locking, complex shape, flat or contoured, left or right</Description><Size>( ≥ 7 to ≤ 15 holes); 65-109 mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>Com,VAL</Suffix><ARTGs><ARTG>290443</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ505</BillingCode><PriorBillingCodes><PriorBillingCode>ER480</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, small (≤ 6 holes);variable angle locking, complex</Name><Description>Paragon28 Gorilla, small titanium compression plates; universal; variable angle locking; compression; various complex shapes</Description><Size>thickness 1.3 - 2.0 mm; multi screw diameter purchase</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ471</BillingCode><PriorBillingCodes><PriorBillingCode>ER395</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, small (2.71mm – 4.49mm), cannulated</Name><Description>Paragon 28 Monster Screw System-Screws, small, cannulated, headed, partial or full thread</Description><Size>dia (3.0-4.0) x length (10-150 mm) x thread length (3-150 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ470</BillingCode><PriorBillingCodes><PriorBillingCode>ER394</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Monster Screw System-Screws, small (2.71mm – 4.49mm)</Name><Description>Paragon 28 Monster Screw System-Screws, small, headed, with and without blunt tip, solid, recon/Tuffneck</Description><Size>dia (3.0-4.2 mm) x length (10-150 mm) x thread length (3-150 mm)</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>289308</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ003</BillingCode><PriorBillingCodes><PriorBillingCode>ER673</PriorBillingCode></PriorBillingCodes><Name>Paragon Silverback Straddle Plate-lateral TTC</Name><Description>Paragon Silverback Straddle Plate-lateral TTC, long, left or right.</Description><Size>one size</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5257</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ504</BillingCode><PriorBillingCodes><PriorBillingCode>ER479</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, small (≤ 6 holes), variable angle locking</Name><Description>Paragon28 Gorilla, small titanium compression plates; universal; variable angle locking; compression; various shapes</Description><Size>Length 15-35 mm; thickness 1.15 - 2.0 mm; multi screw diameter purchage 2.7/3.5/4.2mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ500</BillingCode><PriorBillingCodes><PriorBillingCode>ER485</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, mini (≥ 7 to ≤ 15 holes); variable angle locking</Name><Description>Paragon 28 Gorilla Plating System-Plate, mini, Titanium, compression, variable angle locking, various shapes (e.g. straight/oblique, right/left)</Description><Size>thickness 1.1 mm, multi screw diameter purchase 2.0/2.5mm</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KQ007</BillingCode><PriorBillingCodes><PriorBillingCode>ER685</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Phantom Hindfoot TTC Nail System-End Cap</Name><Description>Shouldered or compression end cap</Description><Size>short or long</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>5363</SubGroupID><ARTGs><ARTG>402215</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ501</BillingCode><PriorBillingCodes><PriorBillingCode>ER486</PriorBillingCode></PriorBillingCodes><Name>Paragon 28 Gorilla Plating System-Plate, mini (≥ 7 to ≤ 15 holes); variable angle locking, complex</Name><Description>Paragon 28 Gorilla Plating System-Plate, mini, Titanium, compression, variable angle locking, complex shapes</Description><Size>thickness 1.1mm; multi screw diameter purchase</Size><SupplierCode>KQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>289248</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XL001</BillingCode><Name>Symbol Dual Mobility Acetabular Shell Cemented</Name><Description>Dual Mobility Cemented Cup</Description><Size>44mm to 68mm</Size><SupplierCode>XL</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4009</SubGroupID><ARTGs><ARTG>417507</ARTG></ARTGs><MinimumBenefit>1511</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XL002</BillingCode><Name>Symbol Dual Mobility Polyethylene Liner</Name><Description>UHMWPE DM Liner</Description><Size>Head Diameter 22.2mm and 28mm, 44mm to 68mm</Size><SupplierCode>XL</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4024</SubGroupID><ARTGs><ARTG>417506</ARTG></ARTGs><MinimumBenefit>1540</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU026</BillingCode><PriorBillingCodes><PriorBillingCode>MO360</PriorBillingCode><PriorBillingCode>MO279</PriorBillingCode></PriorBillingCodes><Name>Anatomic Midshaft Forearm Plates</Name><Description>Internal Fixation Plate Anatomic Forearm, Ulna</Description><Size>≥7 to ≤15 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU053</BillingCode><PriorBillingCodes><PriorBillingCode>MO404</PriorBillingCode><PriorBillingCode>MO278</PriorBillingCode></PriorBillingCodes><Name>Acumed Locking Calcaneal Plates</Name><Description>Locking Calcaneal Plates</Description><Size>≥ 7 to ≤ 15 LK</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5296</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1149</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU066</BillingCode><PriorBillingCodes><PriorBillingCode>MO422</PriorBillingCode></PriorBillingCodes><Name>ACUMED Hexalobe 1.5mm Lag Screws</Name><Description>ACUMED Hexalobe 1.5mm Lag Screw</Description><Size>1.5mm in diameter, 5mm to 20mm in length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU034</BillingCode><PriorBillingCodes><PriorBillingCode>MO369</PriorBillingCode><PriorBillingCode>MO273</PriorBillingCode></PriorBillingCodes><Name>Acumed Tap-Loc</Name><Description>Tap screws, Tap-Loc Screws</Description><Size>2.7mm 36mm-60mm length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU067</BillingCode><PriorBillingCodes><PriorBillingCode>MO423</PriorBillingCode></PriorBillingCodes><Name>ACUMED Hexalobe 2.3mm Lag screw</Name><Description>ACUMED Hexalobe 2.3mm Lag screw</Description><Size>2.3mm in diameter, 5mm to 20mm in length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU064</BillingCode><PriorBillingCodes><PriorBillingCode>MO420</PriorBillingCode></PriorBillingCodes><Name>ACUMED Hexalobe 1.5mm Multiscrews</Name><Description>ACUMED Hexalobe 1.5mm locking Multiscrew</Description><Size>1.5mm in diameter, 5mm to 20mm in length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU017</BillingCode><PriorBillingCodes><PriorBillingCode>MO349</PriorBillingCode><PriorBillingCode>MO272</PriorBillingCode></PriorBillingCodes><Name>Acumed Tap Loc Elbow plates</Name><Description>Variable angle locking plates</Description><Size>≤6 holes Coronoid</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5279</SubGroupID><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU044</BillingCode><PriorBillingCodes><PriorBillingCode>MO380</PriorBillingCode><PriorBillingCode>MO150</PriorBillingCode></PriorBillingCodes><Name>Acumed Congruent Plate System</Name><Description>Foot and Ankle Plate Titanium</Description><Size>≤ 6 hole</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU054</BillingCode><PriorBillingCodes><PriorBillingCode>MO405</PriorBillingCode><PriorBillingCode>MO278</PriorBillingCode></PriorBillingCodes><Name>Acumed Locking Calcaneal Plates</Name><Description>Locking Calcaneal Plates</Description><Size>&lt;6 Hole LK</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5295</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1149</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU059</BillingCode><PriorBillingCodes><PriorBillingCode>MO414</PriorBillingCode><PriorBillingCode>MO156</PriorBillingCode></PriorBillingCodes><Name>Acumed Screws</Name><Description>Locking Screws</Description><Size>&gt;4.5mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU047</BillingCode><PriorBillingCodes><PriorBillingCode>MO383</PriorBillingCode><PriorBillingCode>MO180</PriorBillingCode></PriorBillingCodes><Name>Acumed Headless Compression Screw</Name><Description>Acutrak 6/7 screw, Acutrak Plus</Description><Size>&gt;4.5mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU079</BillingCode><PriorBillingCodes><PriorBillingCode>MO435</PriorBillingCode></PriorBillingCodes><Name>RibLoc Dual Locking Screw</Name><Description>Locking Screws</Description><Size>2.7mm diameter,6mm to 14mm length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>158694</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU037</BillingCode><PriorBillingCodes><PriorBillingCode>MO372</PriorBillingCode><PriorBillingCode>MO319</PriorBillingCode></PriorBillingCodes><Name>Acumed Locking Scapula plate System</Name><Description>Locking Bone Plate, Scapula</Description><Size>≥7 to ≤15 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU025</BillingCode><PriorBillingCodes><PriorBillingCode>MO357</PriorBillingCode><PriorBillingCode>MO274</PriorBillingCode></PriorBillingCodes><Name>Acutrak 2</Name><Description>Headless compression screw</Description><Size>&gt;4.5mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU029</BillingCode><PriorBillingCodes><PriorBillingCode>MO363</PriorBillingCode><PriorBillingCode>MO279</PriorBillingCode></PriorBillingCodes><Name>Anatomic Midshaft Forearm Plates</Name><Description>Internal Fixation Plate Anatomic Forearm, Radius</Description><Size>≥7 to ≤15 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU062</BillingCode><PriorBillingCodes><PriorBillingCode>MO417</PriorBillingCode></PriorBillingCodes><Name>Motec Wrist Joint Prosthesis</Name><Description>Radius Threaded Implant</Description><Size>Radius threaded Implant, lengths 32-70mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1273</GroupID><SubGroupID>3665</SubGroupID><ARTGs><ARTG>194619</ARTG></ARTGs><MinimumBenefit>3111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU012</BillingCode><PriorBillingCodes><PriorBillingCode>MO280</PriorBillingCode></PriorBillingCodes><Name>Acumed Fibula Rod System</Name><Description>Intramedullary Nail, fibula lower limb specific</Description><Size>3.00mm &amp; 3.6mm diameter left and right specific rods with lengths of 110mm, 145mm, 180mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3329</SubGroupID><ARTGs><ARTG>99822</ARTG></ARTGs><MinimumBenefit>963</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU031</BillingCode><PriorBillingCodes><PriorBillingCode>MO366</PriorBillingCode><PriorBillingCode>MO257</PriorBillingCode></PriorBillingCodes><Name>Acu-Loc Distal Radius Plating System</Name><Description>Volar, Dorsal, Distal Ulna, Standard, Long, Extra long, wide, narrow, left, right, extra-articular plates</Description><Size>Radius ≤6 holes`</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU078</BillingCode><PriorBillingCodes><PriorBillingCode>MO434</PriorBillingCode><PriorBillingCode>MO419</PriorBillingCode></PriorBillingCodes><Name>ACUMED Hand Fracture System</Name><Description>1.3mm Rolando Fracture Hook Plate</Description><Size>1.3mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU081</BillingCode><PriorBillingCodes><PriorBillingCode>MO437</PriorBillingCode></PriorBillingCodes><Name>Acu-Loc Distal Radius Plating System</Name><Description>Frag-Loc Cannulated Compression Screw with Compression Sleeve</Description><Size>Standard 16mm to 24mm,Long 20mm to 28mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>177</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU032</BillingCode><PriorBillingCodes><PriorBillingCode>MO367</PriorBillingCode><PriorBillingCode>MO179</PriorBillingCode></PriorBillingCodes><Name>Acumed Fixation Screw</Name><Description>Acutrak Compression Screw Titanium</Description><Size>≤2mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>Breakoff, DT</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>404</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU006</BillingCode><PriorBillingCodes><PriorBillingCode>MO194</PriorBillingCode></PriorBillingCodes><Name>Acumed Congruent Plate System</Name><Description>Elbow plate  titanium, locking radial head</Description><Size>Locking radial head, 3 hole std curve 31mm, 5 hole std curve 46mm, 3 hole curve 31mm, 5 hole curve 46mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>126428</ARTG></ARTGs><MinimumBenefit>1113</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU058</BillingCode><PriorBillingCodes><PriorBillingCode>MO413</PriorBillingCode><PriorBillingCode>MO156</PriorBillingCode></PriorBillingCodes><Name>Acumed Screws</Name><Description>Screws</Description><Size>&gt;4.5mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU089</BillingCode><PriorBillingCodes><PriorBillingCode>MO446</PriorBillingCode></PriorBillingCodes><Name>Acumed Small Fragment Plates</Name><Description>One Third Tubular Plates</Description><Size>3 to 6 Holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU072</BillingCode><PriorBillingCodes><PriorBillingCode>MO428</PriorBillingCode></PriorBillingCodes><Name>ACUMED Total Wrist Fusion Plating System</Name><Description>Total Wrist Fusion System</Description><Size>Plates available in 9 and 10 hole configurations</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU002</BillingCode><PriorBillingCodes><PriorBillingCode>MO159</PriorBillingCode></PriorBillingCodes><Name>Polarus Humeral Rod System</Name><Description>Polarus Ulna Rod Titanium</Description><Size>210 to 270mm length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5361</SubGroupID><ARTGs><ARTG>99822</ARTG></ARTGs><MinimumBenefit>1381</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU091</BillingCode><PriorBillingCodes><PriorBillingCode>MO448</PriorBillingCode></PriorBillingCodes><Name>Acumed Small Fragment Plates</Name><Description>2.7mm Fragment Plates</Description><Size>7 to 15 Holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU019</BillingCode><PriorBillingCodes><PriorBillingCode>MO351</PriorBillingCode><PriorBillingCode>MO272</PriorBillingCode></PriorBillingCodes><Name>Acumed Tap Loc Elbow plates</Name><Description>Variable angle locking plate system</Description><Size>≥16 holes Olecranon</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5281</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1433</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU041</BillingCode><PriorBillingCodes><PriorBillingCode>MO376</PriorBillingCode><PriorBillingCode>MO249</PriorBillingCode></PriorBillingCodes><Name>Acu-Loc Distal Radius Plate System</Name><Description>Locking screws</Description><Size>2.01-2.7mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU076</BillingCode><PriorBillingCodes><PriorBillingCode>MO432</PriorBillingCode><PriorBillingCode>MO419</PriorBillingCode></PriorBillingCodes><Name>ACUMED Hand Fracture System</Name><Description>0.8mm Offset Plate</Description><Size>0.8mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU018</BillingCode><PriorBillingCodes><PriorBillingCode>MO350</PriorBillingCode><PriorBillingCode>MO272</PriorBillingCode></PriorBillingCodes><Name>Acumed Tap Loc Elbow plates</Name><Description>Variable angle locking plate system</Description><Size>≥7 to ≤15 holes Olecranon</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5280</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1198</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU061</BillingCode><PriorBillingCodes><PriorBillingCode>MO416</PriorBillingCode></PriorBillingCodes><Name>Motec Wrist Joint Prosthesis</Name><Description>Metacarpal Threaded Implant</Description><Size>45-70mm lengths in 5mm increments, both in Small and Large sizes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1273</GroupID><SubGroupID>3664</SubGroupID><ARTGs><ARTG>194619</ARTG></ARTGs><MinimumBenefit>1710</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU007</BillingCode><PriorBillingCodes><PriorBillingCode>MO200</PriorBillingCode></PriorBillingCodes><Name>Polarus Humeral Fixation System</Name><Description>End cap screw, titanium</Description><Size>0-6mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>5363</SubGroupID><ARTGs><ARTG>99822</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU071</BillingCode><PriorBillingCodes><PriorBillingCode>MO427</PriorBillingCode></PriorBillingCodes><Name>ACUMED ACU-LOC Wrist Spanning Plate</Name><Description>Wrist Spanning Plate</Description><Size>Plates available in 13 hole configerations.</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1397</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU027</BillingCode><PriorBillingCodes><PriorBillingCode>MO361</PriorBillingCode><PriorBillingCode>MO279</PriorBillingCode></PriorBillingCodes><Name>Anatomic Midshaft Forearm Plates</Name><Description>Internal Fixation Plate Anatomic Forearm, Ulna</Description><Size>≤6 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU065</BillingCode><PriorBillingCodes><PriorBillingCode>MO421</PriorBillingCode></PriorBillingCodes><Name>ACUMED Hexalobe 2.3mm Multiscrews</Name><Description>ACUMED Hexalobe 2.3 Multiscrew</Description><Size>2.3mm in diameter, 5mm to 20mm in length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU074</BillingCode><PriorBillingCodes><PriorBillingCode>MO430</PriorBillingCode></PriorBillingCodes><Name>ACUMED Hand Fracture System, plates</Name><Description>Hand plating System, including plates and screws</Description><Size>Plates available in 7 to 12 hole configurations</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU040</BillingCode><PriorBillingCodes><PriorBillingCode>MO375</PriorBillingCode><PriorBillingCode>MO249</PriorBillingCode></PriorBillingCodes><Name>Acu-Loc Distal Radius Plate System</Name><Description>Threaded, non-threaded,locking, non-locking screw peg, titanium</Description><Size>2.3 mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU013</BillingCode><PriorBillingCodes><PriorBillingCode>MO320</PriorBillingCode></PriorBillingCodes><Name>Acumed Hexalobe Locking Screws</Name><Description>Acumed Hexalobe Locking Screws</Description><Size>2.7mm diameter, 8-65mm length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU057</BillingCode><PriorBillingCodes><PriorBillingCode>MO408</PriorBillingCode></PriorBillingCodes><Name>Acu-Sinch Repair System</Name><Description>This is a suture-and-anchor soft tissue repair system designed to complement the Acumed Clavicle Plating system by treating coracoclavicular ligament repair injuries associated with clavicle fractures and is used in conjuction midshaft or distal clavicle plate. All Acu-Sinch kits come in a sterile procedure pack.</Description><Size>Titanium Anchor: D=5.5mm, L=12mm
Titanium Suture Retainer: L=5.3mm, W=4mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>206552</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU073</BillingCode><PriorBillingCodes><PriorBillingCode>MO429</PriorBillingCode></PriorBillingCodes><Name>ACUMED POLARUS* 3 Solution, Humeral Plates, Sterile and Non-Sterile</Name><Description>ACUMED POLARUS 3 SOLUTION, includes plates, intramedullary nails, screws and accessories designed to address fractures, fusions and osteotomies of the humerus</Description><Size>16 , 18 , 22 , 26  and 30 hole plates</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5275</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU085</BillingCode><PriorBillingCodes><PriorBillingCode>MO442</PriorBillingCode></PriorBillingCodes><Name>Acumed Ankle 3 Plating System</Name><Description>Periarticular Anatomic variable angle locking tibial plates</Description><Size>2 to 6 Holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5292</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1474</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU022</BillingCode><PriorBillingCodes><PriorBillingCode>MO354</PriorBillingCode><PriorBillingCode>MO272</PriorBillingCode></PriorBillingCodes><Name>Acumed Tap Loc Elbow plates</Name><Description>Variable angle locking plate system</Description><Size>≥16 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5275</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1643</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU024</BillingCode><PriorBillingCodes><PriorBillingCode>MO356</PriorBillingCode><PriorBillingCode>MO274</PriorBillingCode></PriorBillingCodes><Name>Acutrak 2</Name><Description>Headless compression screw</Description><Size>2.5mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU028</BillingCode><PriorBillingCodes><PriorBillingCode>MO362</PriorBillingCode><PriorBillingCode>MO279</PriorBillingCode></PriorBillingCodes><Name>Anatomic Midshaft Forearm Plates</Name><Description>Internal Fixation Plate Anatomic Forearm, Radius</Description><Size>≤6 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU010</BillingCode><PriorBillingCodes><PriorBillingCode>MO270</PriorBillingCode></PriorBillingCodes><Name>Acumed Total Radial Head</Name><Description>Head</Description><Size>20-28mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1275</GroupID><SubGroupID>3675</SubGroupID><ARTGs><ARTG>126428</ARTG></ARTGs><MinimumBenefit>1267</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU049</BillingCode><PriorBillingCodes><PriorBillingCode>MO385</PriorBillingCode><PriorBillingCode>MO211</PriorBillingCode></PriorBillingCodes><Name>Acumed Locking Clavical Plating System</Name><Description>Locking Clavicle Plates Mid Shaft, Anterior and Distal</Description><Size>= &gt; 7  to  = &lt; 15 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5271</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1260</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU021</BillingCode><PriorBillingCodes><PriorBillingCode>MO353</PriorBillingCode><PriorBillingCode>MO272</PriorBillingCode></PriorBillingCodes><Name>Acumed Tap Loc Elbow plates</Name><Description>Variable angle locking plate system</Description><Size>≥7 to ≤15 holes medial lateral</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU087</BillingCode><PriorBillingCodes><PriorBillingCode>MO444</PriorBillingCode></PriorBillingCodes><Name>Acumed Ankle 3 Plating System</Name><Description>Periarticular Anatomic variable angle locking tibial plates</Description><Size>7 to 15 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU086</BillingCode><PriorBillingCodes><PriorBillingCode>MO443</PriorBillingCode></PriorBillingCodes><Name>Acumed Ankle 3 Plating System</Name><Description>Periarticular variable angle locking plate fibula</Description><Size>7-15 holes, left and right</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5290</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1238</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU069</BillingCode><PriorBillingCodes><PriorBillingCode>MO425</PriorBillingCode></PriorBillingCodes><Name>ACUMED POLARUS® 3 Solution Plates</Name><Description>ACUMED POLARUS 3 SOLUTION, includes plates, intramedullary nails, screws and accessories designed to address fractures, fusions and osteotomies of the humerus</Description><Size>12 and 14 hole plates</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU063</BillingCode><PriorBillingCodes><PriorBillingCode>MO418</PriorBillingCode></PriorBillingCodes><Name>Motec Wrist Joint Prosthesis</Name><Description>Modular Radius Cups available with 15mm PEEK insert bearing and Cobalt Chromium Molybdenum coated with Ceramic Chromium Nitride 15mm &amp; 18mm. Modular Metacarpal Heads available with 4 neck lengths</Description><Size>Modular Radius Cup PEEK 15mm Ceramitised 15mm &amp; 17mm.  Modular Metacarpal Head 15mm short, med, long &amp; Extra long Neck - 18mm short medium &amp; long Neck</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1273</GroupID><SubGroupID>3666</SubGroupID><ARTGs><ARTG>194619</ARTG></ARTGs><MinimumBenefit>2043</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU088</BillingCode><PriorBillingCodes><PriorBillingCode>MO445</PriorBillingCode></PriorBillingCodes><Name>Acumed Small Fragment Plates</Name><Description>One Third Tubular Plates</Description><Size>7 to 15 Holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>113</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU056</BillingCode><PriorBillingCodes><PriorBillingCode>MO407</PriorBillingCode><PriorBillingCode>MO365</PriorBillingCode><PriorBillingCode>MO257</PriorBillingCode></PriorBillingCodes><Name>Acu-Loc Distal Radius Plating System</Name><Description>Volar, Dorsal, Distal Ulna, Standard, Long, Extra long, wide, narrow, left, right, extra articular plates</Description><Size>≥ 7 to ≤ 15</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU001</BillingCode><PriorBillingCodes><PriorBillingCode>MO158</PriorBillingCode></PriorBillingCodes><Name>Polarus Humeral Fixation System</Name><Description>Polarus Washer</Description><Size>3.8mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>169180</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU090</BillingCode><PriorBillingCodes><PriorBillingCode>MO447</PriorBillingCode></PriorBillingCodes><Name>Acumed Small Fragment Plates</Name><Description>2.7mm Fragment Plates</Description><Size>6 Hole</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU035</BillingCode><PriorBillingCodes><PriorBillingCode>MO370</PriorBillingCode><PriorBillingCode>MO273</PriorBillingCode></PriorBillingCodes><Name>Acumed Tap-Loc</Name><Description>Tap screws, Tap-Loc Screws</Description><Size>3.6mm -60 mm Length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU093</BillingCode><PriorBillingCodes><PriorBillingCode>MO450</PriorBillingCode></PriorBillingCodes><Name>Cannulated Screw  New Information - Acumed Cannulated Screws</Name><Description>4.0mm Cannulated Screw</Description><Size>4.0mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU084</BillingCode><PriorBillingCodes><PriorBillingCode>MO440</PriorBillingCode></PriorBillingCodes><Name>RibLoc U+ Chest Wall Plate</Name><Description>RibLoc U+ Chest Wall Plate</Description><Size>8 Hole,12 Hole</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5938</SubGroupID><ARTGs><ARTG>158695</ARTG></ARTGs><MinimumBenefit>1010</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU055</BillingCode><PriorBillingCodes><PriorBillingCode>MO406</PriorBillingCode><PriorBillingCode>MO365</PriorBillingCode><PriorBillingCode>MO257</PriorBillingCode></PriorBillingCodes><Name>Acu-Loc Distal Radius Plating System</Name><Description>Volar, Dorsal, Distal Ulna, Standard, Long, Extra long, wide, narrow, left, right, extra-articular plates</Description><Size>&gt;7 - &gt;15</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1126</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU045</BillingCode><PriorBillingCodes><PriorBillingCode>MO381</PriorBillingCode><PriorBillingCode>MO150</PriorBillingCode></PriorBillingCodes><Name>Acumed Congruent Plate system</Name><Description>Foort and Ankle Plate titanium</Description><Size>≥7 to ≤15 hole</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5298</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>693</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU015</BillingCode><PriorBillingCodes><PriorBillingCode>MO322</PriorBillingCode></PriorBillingCodes><Name>Acumed Hexalobe Locking Screws</Name><Description>Acumed Hexalobe Locking Screws</Description><Size>Small (2.71mm-4.49mm)</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU082</BillingCode><PriorBillingCodes><PriorBillingCode>MO438</PriorBillingCode></PriorBillingCodes><Name>RibLoc U+ Chest Wall Plate</Name><Description>RibLoc U+ Chest Wall Plate</Description><Size>4 Hole</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5938</SubGroupID><ARTGs><ARTG>158695</ARTG></ARTGs><MinimumBenefit>1010</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU080</BillingCode><PriorBillingCodes><PriorBillingCode>MO436</PriorBillingCode></PriorBillingCodes><Name>Acumed Hand Fracture System</Name><Description>Straight Plates Variable Angle Locking</Description><Size>6 hole</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU083</BillingCode><PriorBillingCodes><PriorBillingCode>MO439</PriorBillingCode></PriorBillingCodes><Name>RibLOc U+ Chest Wall Plate</Name><Description>RibLoc U+ Chest Wall Plate</Description><Size>16 Hole, 22 Hole</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5938</SubGroupID><ARTGs><ARTG>158695</ARTG></ARTGs><MinimumBenefit>1010</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU008</BillingCode><PriorBillingCodes><PriorBillingCode>MO202</PriorBillingCode></PriorBillingCodes><Name>Acumed Bone Plate</Name><Description>MCP Fusion Plate - Titanium</Description><Size> 4 Hole</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>417</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU033</BillingCode><PriorBillingCodes><PriorBillingCode>MO368</PriorBillingCode><PriorBillingCode>MO179</PriorBillingCode></PriorBillingCodes><Name>Acumed Fixation Screw</Name><Description>Acutrak Compression Screw Titanium</Description><Size>2.71mm - 4.49mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU077</BillingCode><PriorBillingCodes><PriorBillingCode>MO433</PriorBillingCode><PriorBillingCode>MO419</PriorBillingCode></PriorBillingCodes><Name>ACUMED Hand Fracture System</Name><Description>0.8mm Avulsion Hook Plate</Description><Size>0.8mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU046</BillingCode><PriorBillingCodes><PriorBillingCode>MO382</PriorBillingCode><PriorBillingCode>MO180</PriorBillingCode></PriorBillingCodes><Name>Acutrak Headless Compression Screw</Name><Description>Acutrak 4/5 screw</Description><Size>2.71mm - 4.49mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU023</BillingCode><PriorBillingCodes><PriorBillingCode>MO355</PriorBillingCode><PriorBillingCode>MO274</PriorBillingCode></PriorBillingCodes><Name>Acutrak 2</Name><Description>Headless compression screw</Description><Size>2.71mm - 4.49mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU042</BillingCode><PriorBillingCodes><PriorBillingCode>MO377</PriorBillingCode><PriorBillingCode>MO249</PriorBillingCode></PriorBillingCodes><Name>Acu-Loc Distal Radius Plate System</Name><Description>Cortical Screw</Description><Size>3.5mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU039</BillingCode><PriorBillingCodes><PriorBillingCode>MO374</PriorBillingCode><PriorBillingCode>MO178</PriorBillingCode></PriorBillingCodes><Name>Acutrak Fusion Screws</Name><Description>Fusion Screws Titanium</Description><Size>2.71mm - 4.49mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>DT</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>245</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU052</BillingCode><PriorBillingCodes><PriorBillingCode>MO395</PriorBillingCode></PriorBillingCodes><Name>RibLoc Rib fracture plating System</Name><Description>RibLoc Plate</Description><Size>46mmL X 8-14mm W</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>158695</ARTG></ARTGs><MinimumBenefit>993</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU014</BillingCode><PriorBillingCodes><PriorBillingCode>MO321</PriorBillingCode></PriorBillingCodes><Name>Acumed Hexalobe Non Locking Screws</Name><Description>Acumed Hexalobe Non Locking Screws</Description><Size>3.0mm,3.5mm and 4.0mm diameter, 8-65mm length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU075</BillingCode><PriorBillingCodes><PriorBillingCode>MO431</PriorBillingCode></PriorBillingCodes><Name>ACUMED Small Bone External Fixation System</Name><Description>Designed for Metacarpal and Phalangeal bones</Description><Size>mini</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3401</SubGroupID><Suffix>Mini</Suffix><ARTGs><ARTG>101930</ARTG></ARTGs><MinimumBenefit>1405</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU011</BillingCode><PriorBillingCodes><PriorBillingCode>MO271</PriorBillingCode></PriorBillingCodes><Name>Acumed Total Radial Head</Name><Description>Stem</Description><Size>Standard Stems 6-10mm diameter 0-8mm neck height, Long Stems 6-12mm diameter</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1275</GroupID><SubGroupID>3674</SubGroupID><ARTGs><ARTG>126428</ARTG></ARTGs><MinimumBenefit>1259</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU060</BillingCode><PriorBillingCodes><PriorBillingCode>MO415</PriorBillingCode><PriorBillingCode>MO156</PriorBillingCode></PriorBillingCodes><Name>Acumed Screws</Name><Description>Screws</Description><Size>2.71mm - 4.49mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU068</BillingCode><PriorBillingCodes><PriorBillingCode>MO424</PriorBillingCode></PriorBillingCodes><Name>ACUMED POLARUS® 3 Solution Nails</Name><Description>ACUMED POLARUS 3 SOLUTION HUMERAL NAILS</Description><Size>A range of proximal and distal nails, 150mm, 200mm, 220mm, 240mm, 260mm, 280mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3330</SubGroupID><ARTGs><ARTG>99822</ARTG></ARTGs><MinimumBenefit>878</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU020</BillingCode><PriorBillingCodes><PriorBillingCode>MO352</PriorBillingCode><PriorBillingCode>MO272</PriorBillingCode></PriorBillingCodes><Name>Acumed Tap Loc Elbow plates</Name><Description>Variable angle locking plate system</Description><Size>≤6 holes lateral</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5273</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1488</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU070</BillingCode><PriorBillingCodes><PriorBillingCode>MO426</PriorBillingCode></PriorBillingCodes><Name>ACUMED Hexalobe Low Profile 4.3mm screws</Name><Description>ACUMED Hexalobe low profile 4.3mm locking screws, Titanium, fully threaded</Description><Size>4.3mm in diameter, 18mm to 64mm in length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU043</BillingCode><PriorBillingCodes><PriorBillingCode>MO378</PriorBillingCode><PriorBillingCode>MO249</PriorBillingCode></PriorBillingCodes><Name>Acu-Loc Distal Radius Plate System</Name><Description>Cortical Screw Locking</Description><Size>3.5mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU016</BillingCode><PriorBillingCodes><PriorBillingCode>MO323</PriorBillingCode></PriorBillingCodes><Name>Acumed Hexalobe Non Locking Screws</Name><Description>Acumed Hexalobe Non Locking Screws</Description><Size>2.7mm diameter,8-65mm length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU030</BillingCode><PriorBillingCodes><PriorBillingCode>MO364</PriorBillingCode><PriorBillingCode>MO257</PriorBillingCode></PriorBillingCodes><Name>Acumed Acu-Loc Radius Plating system</Name><Description>Volar, Dorsal, Distal Ulna, Standard, Long, Extra long, wide, narrow, left, right, extra-articular plates</Description><Size>≥16 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5278</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1234</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU092</BillingCode><PriorBillingCodes><PriorBillingCode>MO449</PriorBillingCode></PriorBillingCodes><Name>Acumed Ankle 3 Plating System</Name><Description>Periarticular variable angle locking plate fibula</Description><Size>16-18 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5291</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU005</BillingCode><PriorBillingCodes><PriorBillingCode>MO177</PriorBillingCode></PriorBillingCodes><Name>Acumed Wires and Pins</Name><Description>Wire Kirschner Stainless Steel</Description><Size>0.70mm to 2.4mm diameter, 4 to 9.25in (10 to 24cm) length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>99820</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU009</BillingCode><PriorBillingCodes><PriorBillingCode>MO209</PriorBillingCode></PriorBillingCodes><Name>Acumed Congruent Plate System</Name><Description>Threaded K-Wire - Titanium</Description><Size>WT-1606STT: Length 15cm x Diameter 0.62"; WT-0906STT: Length 15cm x Diameter 0.35"; WS-2408STT length 20.32cm x Diameter 0.24cm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><Suffix>TH</Suffix><ARTGs><ARTG>99820</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU004</BillingCode><PriorBillingCodes><PriorBillingCode>MO162</PriorBillingCode></PriorBillingCodes><Name>Tension Band Pin</Name><Description>Stainless Steel</Description><Size>50 to 90mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><Suffix>OL</Suffix><ARTGs><ARTG>99821</ARTG></ARTGs><MinimumBenefit>117</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU050</BillingCode><PriorBillingCodes><PriorBillingCode>MO386</PriorBillingCode><PriorBillingCode>MO211</PriorBillingCode></PriorBillingCodes><Name>Acumed Locking Clavical Plating System</Name><Description>Lockinh Clavicle Plates Mid Shaft, Anterior and Distal.</Description><Size>≥ 16 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5272</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU048</BillingCode><PriorBillingCodes><PriorBillingCode>MO384</PriorBillingCode><PriorBillingCode>MO211</PriorBillingCode></PriorBillingCodes><Name>Acumed -Locking Clavical Plating System</Name><Description>Locking Clavicle Plates Mid Shaft Anterior and Distal</Description><Size>= &lt; 6 holes</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5270</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1208</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU036</BillingCode><PriorBillingCodes><PriorBillingCode>MO371</PriorBillingCode><PriorBillingCode>MO319</PriorBillingCode></PriorBillingCodes><Name>Acumed Locking Scapula Plate System</Name><Description>Locking Bone Plate, Scapula</Description><Size>≤6 hole</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5270</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>99824</ARTG></ARTGs><MinimumBenefit>1208</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU038</BillingCode><PriorBillingCodes><PriorBillingCode>MO373</PriorBillingCode><PriorBillingCode>MO178</PriorBillingCode></PriorBillingCodes><Name>Acutrak fusion Screws</Name><Description>Fusion Screws Titanium</Description><Size>2.01mm - 2.7mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>DT</Suffix><ARTGs><ARTG>99823</ARTG></ARTGs><MinimumBenefit>247</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU003</BillingCode><PriorBillingCodes><PriorBillingCode>MO161</PriorBillingCode></PriorBillingCodes><Name>Polarus Humeral Rod System</Name><Description>Polarus Radius Rod Titanium</Description><Size>190 to 230mm length</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5361</SubGroupID><ARTGs><ARTG>99822</ARTG></ARTGs><MinimumBenefit>1381</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YU051</BillingCode><PriorBillingCodes><PriorBillingCode>MO394</PriorBillingCode></PriorBillingCodes><Name>RibLoc rib fracture plating system screws</Name><Description>RibLoc Screws</Description><Size>Mini 2.01-2.7mm</Size><SupplierCode>YU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>158694</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XM001</BillingCode><Name>ClickaV Polymer Ligating clips </Name><Description>ClickaV ligating clips are implantable medical devices made of an advanced polymer to ensure a high level of biocompatibility along with the structural and dimensional stability over time necessary for long-lasting patient safety. They are designed to combine the speed of the metal clip with outstanding security comparable to 2 suture This combination leads to extreme time savings.</Description><Size>M 2mm to 7mm, ML 3mm to 10mm, L 5mm to 13mm, XL 7mm to 16mm and XXL 10mm to 22mm</Size><SupplierCode>XM</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><Suffix>Polymeric Non-resorbable</Suffix><ARTGs><ARTG>435831</ARTG><ARTG>446892</ARTG></ARTGs><MinimumBenefit>40</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JG015</BillingCode><Name>CanFIX Titanium Alloy Suture Anchor</Name><Description>Titanium Anchor with sutures, with or without needles.</Description><Size>4.5mm, 5.0mm, 5.5mm and 6.5mm</Size><SupplierCode>JG</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>411055</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JG019</BillingCode><Name>PorOssity LLIF Integrated 3D printed titanium fusion cage including screws</Name><Description>3D Printed LLIF Titanium Cage with integrated screws (LLIF Screws and LLIF Rescue Screws) that are included in the system. </Description><Size>Cage size: Length: 40mm to 60mm Width: 20mm to 25mm Height: 8mm to 18mm Angle: 0 to 25 degrees. Screw size: Diameter 5.0-5.5 mm Length: 20-50 mm. </Size><SupplierCode>JG</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>522449</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JG016</BillingCode><Name>PorOssity PLIF Cage</Name><Description>Titanium 3D printed interbody fusion cage</Description><Size>Width: 9,11mm Angles: 0,7,15,20 degrees Height: 7-16mm Length: 22,26</Size><SupplierCode>JG</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>522449</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JG018</BillingCode><Name>PorOssity 3D Printed TLIF Fusion Cage</Name><Description>PorOssity Banana Fusion Cage and PorOssity Oblique TLIF Interbody Fusion Cage (Single cage only)</Description><Size>Cage Sizes range from 26-34mm x 9-11mm. Height is 7-16mm. Lordosis is 0-20 degrees.</Size><SupplierCode>JG</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>522449</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JG020</BillingCode><Name>PorOssity LLIF 3D Printed Titanium Cage</Name><Description>3D Printed LLIF  Titanium Cage</Description><Size>Length: 40mm to 60mm Width: 20mm to 25mm Height: 8mm to 18mm Angle: 0 to 25 degrees</Size><SupplierCode>JG</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>522449</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JG022</BillingCode><Name>PorOssity Integrated ALIF Interbody Fusion Cage</Name><Description>Integrated ALIF Fusion Cage, with integrated locking mechanism and included screws</Description><Size>Fusion Cage (26mm-34mm) and (34mm to 42mm), 10-25 degrees, 10-18mm height. Integrated Screw 5.0-5.5mm in diameter and 15-35mm in length.</Size><SupplierCode>JG</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>522449</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JG014</BillingCode><Name>CanFIX Titanium Alloy Suture Anchor</Name><Description>Titanium Anchor with sutures, with or without needles</Description><Size>2.8mm, 3.5mm</Size><SupplierCode>JG</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>411055</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JG024</BillingCode><Name>PorOssity ALIF Cage</Name><Description>3D Printed Titanium ALIF Interbody Fusion Cage, Non Integrated</Description><Size>26mm-34mm and 34mm to 42mm, 10-25 degrees</Size><SupplierCode>JG</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>522449</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JG017</BillingCode><Name>PorOssity PLIF Cage 30mm</Name><Description>Titanium 3D printed interbody fusion cage</Description><Size>Width: 9,11mm Angles: 0,7,15,20 degrees Height: 7-16mm Length: 30</Size><SupplierCode>JG</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>522449</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JG023</BillingCode><Name>PorOssity Integrated ACIF Cage</Name><Description>Integrated Cervical (ACIF) Interbody Fusion cage. Screws and Locking mechanism included in the system.</Description><Size>(14mm-18mm) and (12mm-16mm), 0-15 degrees, 5mm-12mm Height. Integrated Screws are 3.0-3.5mm in diameter and 10-20mm in length.</Size><SupplierCode>JG</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>522448</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JG021</BillingCode><Name>PorOssity ACIF Cage</Name><Description>3D Printed Titanium Cervical Interbody Cage</Description><Size>Width and Depth are (14mm-18mm) and (12mm-16mm).Height is 4-12mm with 0-15 degrees lordosis</Size><SupplierCode>JG</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>522448</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT048</BillingCode><Name>Pantheon Shaft</Name><Description>Stem extension pieces for the Pantheon Limb Salvage System - Titanium alloy</Description><Size>35mm - 140mm</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3938</SubGroupID><ARTGs><ARTG>340801</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT001</BillingCode><PriorBillingCodes><PriorBillingCode>TZ016</PriorBillingCode><PriorBillingCode>OO069</PriorBillingCode></PriorBillingCodes><Name>Hydra Hip Stem</Name><Description>Tapered, Titanium, HA Coated, Modular Uncemented Femoral Stem</Description><Size>Sizes 9 - 18</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>315264</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT036</BillingCode><Name>Genus Fixed Bearing Tray Cemented</Name><Description>Cemented Tray for Genus Fixed Bearing Inserts</Description><Size>1-7-Plus</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>291770</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT059</BillingCode><Name>Pantheon Salvage Proximal Tibia</Name><Description>Proximal Tibia Component CoCr Alloy with or without a TiNbN coating compatible with the Genus Pantheon Femur, Pantheon Distal Femur.</Description><Size>Small, Medium, TiNbN</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1381</GroupID><SubGroupID>3933</SubGroupID><ARTGs><ARTG>488998</ARTG><ARTG>488999</ARTG></ARTGs><MinimumBenefit>7006</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT058</BillingCode><Name>Pantheon Salvage Connector </Name><Description>Total Femur Segment Component (Male/Male)</Description><Size>1</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3937</SubGroupID><ARTGs><ARTG>340801</ARTG></ARTGs><MinimumBenefit>1482</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT004</BillingCode><PriorBillingCodes><PriorBillingCode>TZ005</PriorBillingCode><PriorBillingCode>OO073</PriorBillingCode></PriorBillingCodes><Name>Fixa Ti-Por Cup</Name><Description>Porous Matrix Titanium, Screw Holes with Plugs, Hemispherical Acetabular Cup</Description><Size>42-66mm</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4014</SubGroupID><ARTGs><ARTG>207934</ARTG></ARTGs><MinimumBenefit>2812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT035</BillingCode><Name>Genus Fixed Bearing PS Insert</Name><Description>Genus PS inserts for Fixed Bearing Trays</Description><Size>1-7</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>291765</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT009</BillingCode><PriorBillingCodes><PriorBillingCode>TZ006</PriorBillingCode><PriorBillingCode>OO074</PriorBillingCode></PriorBillingCodes><Name>Adler Bone Screw</Name><Description>Bone Screw for Acetabular Cup</Description><Size>6.5 and 8.5mm Diameter.  15-65mm Length.</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>237073</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT030</BillingCode><PriorBillingCodes><PriorBillingCode>TZ003</PriorBillingCode><PriorBillingCode>OO071</PriorBillingCode></PriorBillingCodes><Name>Adler Ceramic Head</Name><Description>Delta Alumina Ceramic Head</Description><Size>Short, Medium, Long, Extra Long; 36mm to 48mm</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>206143</ARTG><ARTG>296607</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT050</BillingCode><Name>Genus Pantheon Insert</Name><Description>UHMWPE Insert for use with Pantheon Baseplates and Pantheon Proximal Tibia.</Description><Size>1-6, 10-20mm</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1384</GroupID><ARTGs><ARTG>489000</ARTG></ARTGs><MinimumBenefit>2007</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT026</BillingCode><PriorBillingCodes><PriorBillingCode>TZ030</PriorBillingCode></PriorBillingCodes><Name>Pantheon Flat Plate Compression Screw</Name><Description>Ti6Al4V Screw </Description><Size>Short, Medium, Long</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>237073</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT025</BillingCode><PriorBillingCodes><PriorBillingCode>TZ029</PriorBillingCode></PriorBillingCodes><Name>Pantheon Shaft</Name><Description>Ti6Al4V Smooth Shaft Extension Pieces</Description><Size>35 - 140mm</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1412</GroupID><SubGroupID>3975</SubGroupID><Suffix>Spacer, Tumour</Suffix><ARTGs><ARTG>340801</ARTG></ARTGs><MinimumBenefit>3054</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT022</BillingCode><PriorBillingCodes><PriorBillingCode>TZ001</PriorBillingCode><PriorBillingCode>OO143</PriorBillingCode></PriorBillingCodes><Name>Genus Knee System - Genus PE Tibial Insert</Name><Description>Genus PE Insert</Description><Size>1-7 in thickness; 10mm, 12mm, 14mm, 17mm, 20mm, 24mm</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>232062</ARTG><ARTG>232063</ARTG><ARTG>232064</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT034</BillingCode><PriorBillingCodes><PriorBillingCode>TZ036</PriorBillingCode></PriorBillingCodes><Name>Pantheon Cementless Stem</Name><Description>Titanium Fluted</Description><Size>Diameters 11-24mm, Lengths 115-145mm</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3965</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>389895</ARTG></ARTGs><MinimumBenefit>2954</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT056</BillingCode><Name>Pantheon Distal Femur</Name><Description>Distal Femoral Component of Pantheon limb salvage system with or without a TiNbN coating</Description><Size>Left, Right, Small, Medium, Large, TiNbN </Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1380</GroupID><SubGroupID>3931</SubGroupID><ARTGs><ARTG>488990</ARTG><ARTG>488991</ARTG></ARTGs><MinimumBenefit>6984</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT023</BillingCode><PriorBillingCodes><PriorBillingCode>TZ027</PriorBillingCode></PriorBillingCodes><Name>Pantheon Bridging Collar</Name><Description>Ti6Al4V  additive manufactured porous collar  </Description><Size>Collar Diameters 26 - 36mm, for Stem diameters 10 to 24 mm, without or with plate attachment or cylindrical.</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3965</SubGroupID><Suffix>Spacer, Tumour</Suffix><ARTGs><ARTG>340803</ARTG><ARTG>342977</ARTG></ARTGs><MinimumBenefit>3591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT032</BillingCode><PriorBillingCodes><PriorBillingCode>TZ034</PriorBillingCode></PriorBillingCodes><Name>Pantheon Proximal Body</Name><Description>Titanium alloy proximal body for Pantheon limb salvage system</Description><Size>Offset in Short, Medium, Long. Lengths 50 and 90 in Smooth or Flat</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3965</SubGroupID><Suffix>Body, Tumour</Suffix><ARTGs><ARTG>389891</ARTG><ARTG>389892</ARTG></ARTGs><MinimumBenefit>4322</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT046</BillingCode><Name>Genus Pantheon Stem</Name><Description>Cemented and Cementless Stems for use with Genus Pantheon Femur &amp; Tibia and Pantheon Salvage Tibia</Description><Size>Diameter 10 - 24mm, Lengths - 55 to 145mm</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>202374</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT028</BillingCode><PriorBillingCodes><PriorBillingCode>TZ032</PriorBillingCode></PriorBillingCodes><Name>Hydra-Fix  </Name><Description>Forged titanium alloy stems with HA coating 12/14 taper  </Description><Size>8 - 18, standard, offset </Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>325181</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT047</BillingCode><Name>Genus Pantheon Augments</Name><Description>Distal Femoral, Posterior Femoral and Tibial Augments for use with Genus Pantheon system</Description><Size>RL/LM, LL/RM, 1-6, 5mm to 10mm </Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>428891</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT049</BillingCode><Name>Genus Pantheon Femur</Name><Description>Cemented Femoral Component for use with Pantheon Proximal Tibia, Pantheon Salvage Tibia with and without TiNbN coating</Description><Size>1-6, Left, Right TiNbN</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Hinged</Suffix><ARTGs><ARTG>462829</ARTG><ARTG>462830</ARTG></ARTGs><ChangeExplanation>Change to ARTG, Description, Size</ChangeExplanation><MinimumBenefit>5887</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>Insert</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT008</BillingCode><PriorBillingCodes><PriorBillingCode>TZ017</PriorBillingCode><PriorBillingCode>OO166</PriorBillingCode></PriorBillingCodes><Name>Adler Revision Sleeve</Name><Description>Adler revision femoral head titanium sleeve</Description><Size>Short, Medium, Long, X-Long</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1442</GroupID><ARTGs><ARTG>296609</ARTG></ARTGs><MinimumBenefit>266</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT029</BillingCode><PriorBillingCodes><PriorBillingCode>TZ002</PriorBillingCode><PriorBillingCode>OO067</PriorBillingCode></PriorBillingCodes><Name>Adler Ceramic Head</Name><Description>Ceramic Femoral Heads. Biolox Delta</Description><Size>Short, Medium, Long, Extra Long, 22 - 32mm Outer Diameter 12/14 Taper</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>206143</ARTG><ARTG>296607</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT019</BillingCode><PriorBillingCodes><PriorBillingCode>TZ020</PriorBillingCode><PriorBillingCode>OO182</PriorBillingCode></PriorBillingCodes><Name>Genus Uni Tibial Insert</Name><Description>Genus Uni Tibial Insert for use with Genus Uni Tibial Tray</Description><Size>Heights 9-14, Size 1-6, RM/LL, LM/RL</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>154</SubCategoryID><GroupID>1372</GroupID><ARTGs><ARTG>287900</ARTG></ARTGs><MinimumBenefit>689</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT037</BillingCode><Name>Genus PS Femur Cemented</Name><Description>Cemented PS Femur </Description><Size>1-7 </Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>291768</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT027</BillingCode><PriorBillingCodes><PriorBillingCode>TZ031</PriorBillingCode></PriorBillingCodes><Name>Cortical Plate </Name><Description>Titanium plate either rough with HA or porous Ti-Por used as a flange for femoral or tibial prosthesis</Description><Size>30 to 70mm</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1454</GroupID><ARTGs><ARTG>340794</ARTG></ARTGs><MinimumBenefit>387</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT024</BillingCode><PriorBillingCodes><PriorBillingCode>TZ028</PriorBillingCode></PriorBillingCodes><Name>Pantheon Flat Plate with Spikes</Name><Description>Ti6Ai4V Plate with spikes on inner surface, screw and cable compatibility for Trochanter</Description><Size>L50, L70</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1454</GroupID><ARTGs><ARTG>340794</ARTG></ARTGs><MinimumBenefit>387</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT031</BillingCode><PriorBillingCodes><PriorBillingCode>TZ033</PriorBillingCode></PriorBillingCodes><Name>Pantheon Cementless Stem HA</Name><Description>Ti6Al4V stem with HA Coating</Description><Size>Diameters 11-24mm, Length 115-145mm </Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1411</GroupID><SubGroupID>3966</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>389893</ARTG></ARTGs><MinimumBenefit>2376</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT005</BillingCode><PriorBillingCodes><PriorBillingCode>TZ007</PriorBillingCode><PriorBillingCode>OO077</PriorBillingCode></PriorBillingCodes><Name>Adler PE Acetabular Liners</Name><Description>XLPE Liners - for Fixa Cups</Description><Size>Neutral, 15 degree, in 22,28,32,36mm ID,   </Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>208840</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT044</BillingCode><Name>Pantheon Bridging Collar</Name><Description>Pantheon Salvage system porous endosteal collars  </Description><Size>26, 30 ,36mm diameter for Stems 10mm to 24mm</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3936</SubGroupID><ARTGs><ARTG>340803</ARTG></ARTGs><MinimumBenefit>3923</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT015</BillingCode><PriorBillingCodes><PriorBillingCode>TZ010</PriorBillingCode><PriorBillingCode>OO151</PriorBillingCode></PriorBillingCodes><Name>Genus Knee System - Genus Cementless Tibial Tray + HA</Name><Description>Mobile Bearing Cementless Tibial Tray with HA coating</Description><Size>1-7</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1362</GroupID><SubGroupID>3924</SubGroupID><ARTGs><ARTG>232061</ARTG></ARTGs><MinimumBenefit>2409</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT010</BillingCode><PriorBillingCodes><PriorBillingCode>TZ009</PriorBillingCode><PriorBillingCode>OO150</PriorBillingCode></PriorBillingCodes><Name>Genus Knee System - Genus Cemented Femoral Component</Name><Description>Femoral Component for Total Knee Arthroplasty</Description><Size>1-7 right, 1-7 left, Minus</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>232056</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT021</BillingCode><PriorBillingCodes><PriorBillingCode>TZ022</PriorBillingCode><PriorBillingCode>OO184</PriorBillingCode></PriorBillingCodes><Name>Genus Uni Tibial Screw</Name><Description>Bone Screws for use with the Genus Uni Tibia</Description><Size>6.5mm 20-50mm</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1398</GroupID><ARTGs><ARTG>237073</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT017</BillingCode><PriorBillingCodes><PriorBillingCode>TZ024</PriorBillingCode><PriorBillingCode>OO186</PriorBillingCode></PriorBillingCodes><Name>Genus Uni Tibial Tray Cemented</Name><Description>Genus Uni Tibial Component Cemented is part of the Genus Uni Unicompartmental system.</Description><Size>Sizes 1-6 RM/LL and LM/RL</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>152</SubCategoryID><GroupID>1364</GroupID><ARTGs><ARTG>287898</ARTG></ARTGs><MinimumBenefit>1352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT018</BillingCode><PriorBillingCodes><PriorBillingCode>TZ026</PriorBillingCode><PriorBillingCode>OO181</PriorBillingCode></PriorBillingCodes><Name>Genus Uni Tibial Tray Cementless</Name><Description>Genus Uni Tibial Tray for cementless fixation using Ti-Por powder printed monolithic construct with HA Coating.</Description><Size>Sizes 1-6 RM/LL and LM/RL</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>152</SubCategoryID><GroupID>1367</GroupID><SubGroupID>3925</SubGroupID><ARTGs><ARTG>287899</ARTG></ARTGs><MinimumBenefit>1570</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT006</BillingCode><PriorBillingCodes><PriorBillingCode>TZ008</PriorBillingCode><PriorBillingCode>OO078</PriorBillingCode></PriorBillingCodes><Name>Adler Ceramic Acetabular Liners</Name><Description>Ceramic Liners - for Fixa Cups</Description><Size>Delta, 28,32,36 &amp; 40 mm ID</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4022</SubGroupID><ARTGs><ARTG>206130</ARTG></ARTGs><MinimumBenefit>1636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT007</BillingCode><PriorBillingCodes><PriorBillingCode>TZ018</PriorBillingCode><PriorBillingCode>OO163</PriorBillingCode></PriorBillingCodes><Name>Agilis Tipor</Name><Description>AGILIS Ti-POR is an uncemented monoblock hemispherical acetabulum cup designed to articulate with ceramic heads of large diameter.</Description><Size>42 – 66 mm diameter</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1429</GroupID><SubGroupID>4030</SubGroupID><ARTGs><ARTG>292345</ARTG></ARTGs><MinimumBenefit>4381</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT020</BillingCode><PriorBillingCodes><PriorBillingCode>TZ013</PriorBillingCode><PriorBillingCode>OO154</PriorBillingCode></PriorBillingCodes><Name>Genus Knee System - Genus PE Patella</Name><Description>Polyethylene Patella</Description><Size>20 to 39mm</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>232065</ARTG><ARTG>232066</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT013</BillingCode><PriorBillingCodes><PriorBillingCode>TZ025</PriorBillingCode><PriorBillingCode>OO180</PriorBillingCode></PriorBillingCodes><Name>Genus Uni Cementless Co-Por Femoral Component</Name><Description>Genus Uni Cementless Femoral Component manufactured using CoPor - (CoCr powder manaufacturing) to provide a monolithic structure with three dimensional porous matrix at the bone interface which is then HA coated.</Description><Size>Sizes 1-6 RM/LL and LM/RL</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>150</SubCategoryID><GroupID>1355</GroupID><SubGroupID>3920</SubGroupID><ARTGs><ARTG>287897</ARTG></ARTGs><MinimumBenefit>2180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT033</BillingCode><PriorBillingCodes><PriorBillingCode>TZ035</PriorBillingCode></PriorBillingCodes><Name>Pantheon Cemented Stem</Name><Description>Ti6Al4V Mirror polished</Description><Size>Diameter 10-16mm Length 115</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>7374</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>389894</ARTG></ARTGs><MinimumBenefit>2648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT057</BillingCode><Name>Pantheon Hinge </Name><Description>Hinge Mechanisms For Pantheon Semi Mobile Tray and Genus Pantheon Tray, Pantheon Proximal Tibia with or without a TiNbN coating</Description><Size>Small, Medium, Large. 70mm, 40mm, TiNbN</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1393</GroupID><ARTGs><ARTG>488992</ARTG><ARTG>488993</ARTG><ARTG>488994</ARTG><ARTG>488995</ARTG></ARTGs><MinimumBenefit>2454</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT012</BillingCode><PriorBillingCodes><PriorBillingCode>TZ023</PriorBillingCode><PriorBillingCode>OO185</PriorBillingCode></PriorBillingCodes><Name>Genus Uni Cemented Femoral Component</Name><Description>Genus Uni - unicompartmental Knee Femoral Component - Cemented</Description><Size>RM/LL and LM/RL Sizes 1-6</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>150</SubCategoryID><GroupID>1353</GroupID><ARTGs><ARTG>287896</ARTG></ARTGs><MinimumBenefit>2007</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT062</BillingCode><Name>Pantheon Ti-Por Cone</Name><Description>Metaphyseal/Diaphyseal Cones with the TiPor three-dimensional surface with fully interconnected porosity. For use with the Pantheon and Genus Pantheon systems</Description><Size>ML 30-58mm, Height 30-40mm</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>428891</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT063</BillingCode><Name>Pantheon Ti-Por Sleeves </Name><Description>Sleeves, Porous Titanium Alloy. For use with the Pantheon and Genus Pantheon systems</Description><Size>Sleeves A to K </Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>340803</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT014</BillingCode><PriorBillingCodes><PriorBillingCode>TZ011</PriorBillingCode><PriorBillingCode>OO152</PriorBillingCode></PriorBillingCodes><Name>Genus Knee System - Genus Cemented Tibial Tray</Name><Description>Cemented Mobile Bearing Tibial Tray</Description><Size>1-7</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><ARTGs><ARTG>232058</ARTG></ARTGs><MinimumBenefit>2005</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT011</BillingCode><PriorBillingCodes><PriorBillingCode>TZ012</PriorBillingCode><PriorBillingCode>OO153</PriorBillingCode></PriorBillingCodes><Name>Genus Knee System - Genus Cementless Femoral Component + HA</Name><Description>Cementless Femoral Component with HA coating</Description><Size>1-7 right, 1-7 left, Minus</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1352</GroupID><SubGroupID>3917</SubGroupID><ARTGs><ARTG>232071</ARTG></ARTGs><MinimumBenefit>3575</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT060</BillingCode><Name>Pantheon Semi-Mobile Tray Cemented</Name><Description>Salvage tibial baseplate with and without TiNbN coating, polished insert interface for mobile bearing insert. Part of the Pantheon Limb Salvage System </Description><Size>Small, Medium, Large, TiNbN</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>488996</ARTG><ARTG>488997</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT043</BillingCode><Name>Genus Pantheon Mobile Tibial Tray</Name><Description>Tibial Tray for use with Pantheon Limb Salvage System</Description><Size>1-7 Std, TiNbN</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>462827</ARTG><ARTG>462828</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT003</BillingCode><PriorBillingCodes><PriorBillingCode>TZ014</PriorBillingCode><PriorBillingCode>OO175</PriorBillingCode></PriorBillingCodes><Name>S.F Modula Neck</Name><Description>S.F Modula Neck. Titanium for use with Adler Modular Hip Stems</Description><Size>OX, OY, OZ, OA, OB, OC, 9X, 9Y, 9Z, 9A, 9B, 9C, 9AA, 9BB, 9CC</Size><SupplierCode>HT</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1417</GroupID><ARTGs><ARTG>289075</ARTG></ARTGs><MinimumBenefit>1029</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT016</BillingCode><PriorBillingCodes><PriorBillingCode>TZ021</PriorBillingCode><PriorBillingCode>OO183</PriorBillingCode></PriorBillingCodes><Name>Genus Uni All Poly tibial Component</Name><Description>Genus Uni All Poly cemented Tibial Component</Description><Size>Sizes 1-6, RM/LL and LM/RL Heights 9-14mm</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>152</SubCategoryID><GroupID>1363</GroupID><ARTGs><ARTG>287901</ARTG></ARTGs><MinimumBenefit>1090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HT045</BillingCode><Name>Genus Pantheon Offset Adaptor</Name><Description>Connector for stems to alter stem offset morse taper but also including screw for additional fixation, titanium</Description><Size>2mm, 4mm, 6mm</Size><SupplierCode>HT</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1396</GroupID><ARTGs><ARTG>202374</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BD030</BillingCode><Name>HiRes Ultra 3D Cochlear Implant</Name><Description>The HiRes Ultra 3D Cochlear Implant is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlear. It consists of receiving/transmitting coil, Stimulator electrodes and two electrode variations HiFocus MidScala or HiFocus SlimJ Electrode array</Description><Size>Implant Size: 56.2mm (L) x 28.5mm (w) x 4.5mm (thickness).   HiFocus MidScala Electrode: Active length 15mm, Tip diameter 0.5mm, Basal diameter 0.7mm. Total length of electrode array 23.7mm  HiFocus SlimJ Electrode: Electrode size: Active length 20mm, Tip diameter 0.26mm, Basal electrode diameter 0.56mm. Total length of electrode array 23.7mm</Size><SupplierCode>BD</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>375483</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BD029</BillingCode><PriorBillingCodes><PriorBillingCode>BD024</PriorBillingCode><PriorBillingCode>BD026</PriorBillingCode></PriorBillingCodes><Name>HiRes Ultra Cochlear Implant</Name><Description>The HiRes Ultra Cochlear Implant  with HiFocus is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlear. It consists of receiving/transmitting coil, Stimulator electrodes and either HiFocus Mid-Scala Electrode array or HiFocus SlimJ electrode array</Description><Size>Implant Size: 56.2mm (L) x 28.5mm (w) x 4.5mm (thickness).     HiFocus Mid-Scala Electrode: Active length 15mm, Tip diameter 0.5mm, Basal diameter 0.7mm. Total length of electrode array 23.7mm.  HiFocus SlimJ Electrode: Electrode size: Active length 20mm, Tip diameter 0.26mm, Basal electrode diameter 0.56mm. Total length of electrode array 23.7mm</Size><SupplierCode>BD</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>295250</ARTG><ARTG>301320</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BD020</BillingCode><Name>HiRes90K Advantage Cochlear Implant with HiFocus 1j Electrode</Name><Description>The HiRes90K Advantage Cochlear Implant  with HiFocus 1j Electrode is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlear. It consists of receiving/transmitting coil, Stimulator electrodes and HiFocus 1j Electrode array</Description><Size>Implant Size: 56mm (L) x 28mm (w x5.7mm (thickness). Electrode size: Active length 17mm, Tip diameter 0.4mm, Basal diameter 0.8mm. Total length of electrode array 25mm</Size><SupplierCode>BD</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>220306</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BD022</BillingCode><Name>HiRes90K Advantage Cochlear Implant with the HiFocus Mid-Scala Electrode</Name><Description>The HiRES90K Advantage Cochlear Implant with HiFocus Mid-Scala electrode is the implanted component of the HiResolution Bionic Ear System. It receives information through an RF transmission coil, processes the information and then sends the resulting signal to an electrode array implanted in the cochlea. It consists of receiving/transmitting coil, Stimulator electrodes and HiFocus Mid-Scala Electrode array</Description><Size>Implant Size: 56mm (L) x 28mm (w) x 5.7mm (thickness. Electrode size: Active length 15mm, Tip diameter 0.5mm, Basal diameter 0.7mm. Total length of electrode array 23.7mm</Size><SupplierCode>BD</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>220306</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BD031</BillingCode><Name>Naida CI M90 / Sky CI M90 Sound Processor</Name><Description>Naida CI M90 Sound Processor  The Naída CI M90 and Sky CI M90 Sound Processors are behind-the-ear (BTE) sound processors for use with an Advanced Bionics cochlear implant. They feature direct connectivity to wireless accessories and Bluetooth® technology enabled devices. They offers multiple power options and wearing options for the user. The system is designed to provide useful hearing to individuals with severe-to-profound hearing loss. The coupling can be included to enable electro-acoustic stimulation. The Sky CI M90 Sound Processor is for paediatric application</Description><Size>27.5 x 29.2 x 9.2 (sound processor only)</Size><SupplierCode>BD</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4145</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>411570</ARTG><ARTG>411571</ARTG></ARTGs><MinimumBenefit>11392</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BD027</BillingCode><Name>Naida CI Electric Acoustic Solution</Name><Description>The Naida CI Q90 sound processor is one part of a cochlear implant system that enables hearing. The other necessary parts of the system are the  implantable Cochlear Stimulator (ICS), headpiece and headpiece cable. The sound processor consists of two parts: the sound processor and battery power source. The Naida CI Q90 is compatible with the Naida CI Acoustic Earhook, supplying both electric and acoustic stimulation.</Description><Size>The Naida CI Sound Processor comes in one size. The Naida CI Acoustic Earhook comes in 5 length options, and is available for left and right ear (10 configurations).</Size><SupplierCode>BD</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4145</SubGroupID><Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>282255</ARTG><ARTG>300028</ARTG></ARTGs><MinimumBenefit>12796</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BD023</BillingCode><Name>Naida CI Q90 Sound Processor (Initial Order)</Name><Description>The Naida CI Q90 Sound processor is a BTE Sound Processor to communicates with the internally implanted HiRes Family implants. It facilitates electro-acoustic stimulation of the cochlea, as well as being compatible with a range of wireless devices.</Description><Size>There is one size of the sound processor unit with 4 battery options/sizes.</Size><SupplierCode>BD</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4145</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>282255</ARTG></ARTGs><MinimumBenefit>11392</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BD015</BillingCode><Name>Neptune Sound Processor replacement part is the external part of the cochlear implant system. Also includes Neptune Connect</Name><Description>The Neptune Processor is an external component of the HiRes Bionic Ear System. The processor is intended to deliver HiResolution sound to a cochlear implant. Also includes Neptune Connect.</Description><Size>One size. 
Processor: H x W X D: 26 x 18 x 60mm
Neptune Connect Size:  H x W x D: 17 x 18 x 58mm</Size><SupplierCode>BD</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>Generation 4</Suffix><ARTGs><ARTG>198825</ARTG></ARTGs><MinimumBenefit>7648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BD032</BillingCode><Name>Naida CI M90 / Sky CI M90 Sound Processor</Name><Description>Naida CI M90 Sound Processor The Naída CI M90 and Sky CI M90 Sound Processors are behind-the-ear (BTE) sound processors for use with an Advanced Bionics cochlear implant. They feature direct connectivity to wireless accessories and Bluetooth® technology enabled devices. They offers multiple power options and wearing options for the user. The system is designed to provide useful hearing to individuals with severe-to profound hearing loss. The Sky CI M90 Sound Processor is for paediatric application</Description><Size>27.5 x 29.2 x 9.2 (processor only)  Size H x W x D in Millimeters</Size><SupplierCode>BD</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>411570</ARTG><ARTG>411571</ARTG></ARTGs><MinimumBenefit>8114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BD028</BillingCode><Name>Naida CI Electric Acoustic Solution</Name><Description>The Naida CI Q90 sound processor is one part of a cochlear implant system that enables  hearing. The other necessary parts of the system are the implantable Cochlear Stimulator  (ICS), headpiece and headpiece cable. The sound processor consists of two parts: the  sound processor and battery power source. The Naida CI Q90 is compatible with the Naida CI Acoustic Earhook, supplying both electric and acoustic stimulation.</Description><Size>The Naida CI Sound Processor comes in one size. The Naida CI Acoustic Earhook comes  in 5 length options, and is available for left and right ear (10 configurations).</Size><SupplierCode>BD</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>282255</ARTG><ARTG>300028</ARTG></ARTGs><MinimumBenefit>9078</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BD025</BillingCode><Name>Naida CI Q90 Sound Processor (Replacement Order)</Name><Description>The Naida CI Q90 sound processor is one part of a cochlear implant system that enables hearing. The other necessary parts of the system are the Implantable Cochlear Stimulator (ICS), headpiece and headpiece cable. The sound processor consists of two parts: the sound processor and battery power source. There are four battery options, including four sizes of Lithium Ion rechargeable PowerCel™ batteries. This facilitates electro-acoustic stimulation to the cochlear and wireless capability.</Description><Size>There is only one size of the sound processing unitl.  There are four sizes of the battery.</Size><SupplierCode>BD</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>282255</ARTG><ARTG>300028</ARTG></ARTGs><MinimumBenefit>8114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA015</BillingCode><Name>Optetrak Logic Total Knee System, RBK Tibial Baseplate</Name><Description>Tibial Baseplate, titanium with polished insert surface, cemented, for a mobile insert</Description><Size>Size 1F/1T - 5F/5T</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><ARTGs><ARTG>285906</ARTG></ARTGs><MinimumBenefit>2005</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA001</BillingCode><Name>Equinoxe Replicator Plate</Name><Description>The Equinoxe Replicator Plate is intended to connect the humeral head to the stem and to position the replacement humeral head in a variety of positions to match patient’s anatomy.</Description><Size>0mm – 4.5mm Offset</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4084</SubGroupID><ARTGs><ARTG>266159</ARTG><ARTG>278519</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA025</BillingCode><Name>Optetrak Logic Total Knee System Femoral Augments</Name><Description>Femoral Augments for Logic CC femoral component, distal and posterior blocks, titanium, screw fixation</Description><Size>Size 1 - 5</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>250092</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA022</BillingCode><Name>Optetrak Logic Total Knee System Tibial Augments</Name><Description>Tibial Augments for Logic CC tibial component, half and third blocks, titanium, screw fixation</Description><Size>Size 0 - 6</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>250092</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA012</BillingCode><Name>Optetrak Logic Total Knee System, Tibial Insert, PS</Name><Description>Tibial Insert, UHMWPE, Fixed (Posterior Stabilised)</Description><Size>Size 0 - 6, 9-15mm</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>285502</ARTG><ARTG>285503</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX046</BillingCode><Name>Equinoxe Compression Screw</Name><Description>The compression screw compresses the glenoid plate to the bone while providing 30 degrees of angular variability</Description><Size>4.5x18mm white, 4.5x22mm black, 4.5x26mm orange, 4.5x30mm blue, 4.5x34mm red, 4.5x38mm green, 4.5x42mm yellow, 4.5x46mm purple</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>252473</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX006</BillingCode><Name>Novation Crown Cup Screws</Name><Description>Titanium cortical bone screws</Description><Size>Full radius tip: 6.5mm x 15mm, 6.5mm x 20mm, 6.5mm x 25mm, 6.5mm x 30mm, 6.5mm x 35mm, 6.5mm x 40mm, 6.5mm x 45mm, 6.5mm x 50mm, 6.5mm x 55mm, 6.5mm x 60mm, 6.5mm x 70mm; Peripheral Rim screw: 4.5mm x 25mm, 4.5mm x 30mm, 4.5mm x 35mm, 4.5mm x 40mm, 4.5mm x 45mm, 4.5mm x 50mm, 4.5mm x 55mm, 4.5mm x 60mm, 4.5mm x 65mm, 4.5mm x 70mm; Pointed tip: MBA 6.5mm x 15mm, MBA 6.5mm x 20mm, MBA 6.5mm x 25mm, MBA 6.5mm x 30mm, MBA 6.5mm x 35mm, MBA 6.5mm x 40mm, MBA 6.5mm x 45mm, MBA 6.5mm x 50mm, MBA 6.5mm x 55mm, MBA 6.5mm x 60mm</Size><SupplierCode>FA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>250113</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA014</BillingCode><Name>Optetrak Logic Total Knee System, RBK Tibial Insert</Name><Description>Tibial Insert, UHMWPE, mobile, posterior stabilised</Description><Size>Size 1 - 5, 9 - 15mm</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>285911</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX022</BillingCode><Name>Exactech Femoral Head</Name><Description>Cobalt Chrome Head</Description><Size>-3.5mm to +10mm, 22mm to 32mm</Size><SupplierCode>FA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>293800</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX025</BillingCode><Name>Optetrak Total Knee System Tibial Augments</Name><Description>Tibial Augments for CCK tibial component, half and third blocks, titanium, screw fixation</Description><Size>Size 1 - 6</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>250092</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX065</BillingCode><Name>Equinoxe Torque Definition Screw Kit.</Name><Description>Torque Definition Screw with Drive.</Description><Size>One size only.</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>5428</SubGroupID><ARTGs><ARTG>252473</ARTG></ARTGs><MinimumBenefit>1132</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA033</BillingCode><Name>Equinoxe HRP Distal Stem Modular</Name><Description>Distal stem, cemented, modular</Description><Size>6mm - 13mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4063</SubGroupID><ARTGs><ARTG>396476</ARTG></ARTGs><MinimumBenefit>3755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX062</BillingCode><Name>Equinoxe Reverse Torque Definition Screw Kit</Name><Description>Reverse Torque Definition Screw with Drive</Description><Size>One size only</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>5428</SubGroupID><ARTGs><ARTG>252473</ARTG></ARTGs><MinimumBenefit>1132</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX026</BillingCode><Name>Optetrak Total Knee System Femoral Augments</Name><Description>Femoral Augments for CCK femoral component, distal and posterior blocks, titanium, screw fixation</Description><Size>Size 1-6</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>250092</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA030</BillingCode><Name>Vantage Total Ankle System - Talar component</Name><Description>Talar component, left and right, uncemented, plasma sprayed titanium coating</Description><Size>Left and Right, size 1-5</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1460</GroupID><SubGroupID>4040</SubGroupID><ARTGs><ARTG>308700</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX051</BillingCode><Name>Equinoxe Humeral Long Stem</Name><Description>The long/revision stem is intended for cemented fixation only. The long/revision stem is advised when the distal bone quality is insufficient to adequately anchor the primary stems (typically as a result of mid-humeral fractures)</Description><Size>8x175mm, 8x215mm, 10x200mm, 12x200mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4063</SubGroupID><ARTGs><ARTG>264382</ARTG></ARTGs><MinimumBenefit>3755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA036</BillingCode><Name>Equinoxe HRP Distal Stem Collar</Name><Description>Distal stem collar is used with the distal stems to provide external fixation and rotational stability within the intramedullary canal.</Description><Size>17.5 - 33.5</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5458</SubGroupID><ARTGs><ARTG>396475</ARTG></ARTGs><MinimumBenefit>2200</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX027</BillingCode><Name>Optetrak Total Knee System Femoral and Tibial Stems</Name><Description>Femoral and Tibial Stems for Optetrak Knee System, titanium, cemented or uncemented, femoral stem requires stem extension adapter on every occasion, tibial stem requires screw fixation</Description><Size>Size 1 - 6</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>250112</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA024</BillingCode><Name>Exactech Femoral Head CoCr</Name><Description>Cobalt Chrome Femoral Head</Description><Size>36mm, -3.5mm to +10mm</Size><SupplierCode>FA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>293800</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA006</BillingCode><PriorBillingCodes><PriorBillingCode>BJ008</PriorBillingCode><PriorBillingCode>GM125</PriorBillingCode></PriorBillingCodes><Name>Xonit X-PE Acetabular Liner</Name><Description>Highly Cross-Linked Acetabular Insert</Description><Size>Standard/Dysplasia:
39-52mm/28mm
39-52mm/32mm
44-52mm/36mm
48-52mm/40mm</Size><SupplierCode>FA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>285483</ARTG><ARTG>285959</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA013</BillingCode><Name>Optetrak Logic Total Knee System, Tibial Baseplate</Name><Description>Tibial Baseplate, titanium, fixed insert, cemented</Description><Size>Size 0 - 6</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>285441</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA035</BillingCode><Name>Equinoxe HRP Proximal Body</Name><Description>Anatomically shaped proximal bodies are designed to help restore the locations of the rotator cuff muscle insertions and increase deltoid wrapping to improve joint stability.</Description><Size>Extra-small, small, medium, large and extra-large</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><ARTGs><ARTG>396474</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA037</BillingCode><Name>Equinoxe HRP Taper Locking Screw</Name><Description>A range of sizes of locking screws to secure the proximal body to the distal stem after all taper segments have been individually impacted and engaged.</Description><Size>0mm - 162.5mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>396477</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA020</BillingCode><Name>Optetrak Logic Tibial Tray</Name><Description>Tibial Baseplate, titanium, fixed insert, cemented, fit and trapezoid. The tibial tray accepts augments and stem extensions with offset couplers (if needed).</Description><Size>0F/0T - 6F/6T</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>285441</ARTG><ARTG>285505</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA005</BillingCode><PriorBillingCodes><PriorBillingCode>BJ007</PriorBillingCode><PriorBillingCode>CR158</PriorBillingCode></PriorBillingCodes><Name>Biolox Delta Acetabular Liner</Name><Description>Biolox Delta ceramic acetabular liner</Description><Size>28mm, 32mm, 36mm, 40mm</Size><SupplierCode>FA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4025</SubGroupID><ARTGs><ARTG>285506</ARTG></ARTGs><MinimumBenefit>1690</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX030</BillingCode><Name>Optetrak Total Knee System Tibial Stem Extension Screw</Name><Description>Tibial Stem Screw for Tibial stem fixation</Description><Size>One size only</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1398</GroupID><ARTGs><ARTG>252474</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX058</BillingCode><Name>Equinoxe Humeral Head</Name><Description>The humeral head is used in hemi-shoulder and total-shoulder joint replacement procedures and for use in fractures of the proximal humerus and for use in total-shoulder joint replacement procedures in conjunction with an irreparable or nonfunctional rotator cuff. Multiple head heights for each diameter provides surgeon flexibility in patients with soft tissue challenges</Description><Size>38mm - 53mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><ARTGs><ARTG>265513</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA021</BillingCode><Name>Optetrak Logic Stem Extension Femoral and Tibial</Name><Description>Femoral and Tibial Stems for Logic CC System, titanium, cemented or uncemented</Description><Size>10mm - 24mm, length 25mm - 160mm</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>250112</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA004</BillingCode><PriorBillingCodes><PriorBillingCode>BJ005</PriorBillingCode><PriorBillingCode>CR179</PriorBillingCode></PriorBillingCodes><Name>Ceramic Modular head</Name><Description>Biolox Delta Ceramic heads  &gt; 32mm</Description><Size>36, 40 and 44mm</Size><SupplierCode>FA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>285507</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA032</BillingCode><Name>Vantage Total Ankle System - Tibial Component</Name><Description>Tibial component, mobile bearing, CoCr, plasma sprayed titanium coating</Description><Size>Left and right, size 1-4</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1460</GroupID><SubGroupID>4041</SubGroupID><ARTGs><ARTG>308700</ARTG></ARTGs><MinimumBenefit>1900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX047</BillingCode><Name>Equinoxe Glenosphere Locking Screw</Name><Description>Glenosphere screw</Description><Size>One size, 4.8mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>252473</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX049</BillingCode><Name>Equinoxe Glenoid Plate</Name><Description>The glenoid plate provides multiple options for screw insertion</Description><Size>0 degree, 8 degree, 10 degree</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4078</SubGroupID><ARTGs><ARTG>262854</ARTG><ARTG>284693</ARTG><ARTG>284694</ARTG><ARTG>284695</ARTG></ARTGs><MinimumBenefit>1991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX048</BillingCode><Name>Equinoxe Humeral Liner</Name><Description>The Equinoxe Reverse Shoulder System includes a reverse semi-constrained prosthesis for use in total-shoulder joint replacement procedures in cases with an irreparable or nonfunctional rotator cuff.</Description><Size>Liner: 36mm+0, 36mm+2.5, 38mm+0, 38mm+2.5, 40mm+0, 40mm+2.5, 42mm+0, 42mm+2.5, 46mm+0, 46mm+2.5  Constrained Humeral Liner: 36mm+0, 36mm+2.5, 38mm+0, 38mm+2.5, 40mm+0, 40mm+2.5, 42mm+0, 42mm+2.5, 46mm+0, 46mm+2.5</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>264172</ARTG><ARTG>279721</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA040</BillingCode><Name>Equinoxe Small Reverse, Baseplate</Name><Description>Reverse glenoid plate</Description><Size>Standard, 8-degree Posterior Augment, 10-degree Superior Augment, +10mm Extended Cage Peg, 10-degree Superior/8-degree Posterior Augment</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4078</SubGroupID><ARTGs><ARTG>479046</ARTG><ARTG>479047</ARTG><ARTG>479048</ARTG><ARTG>479049</ARTG><ARTG>479050</ARTG></ARTGs><MinimumBenefit>1991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX055</BillingCode><Name>Equinoxe Humeral Stem, Fracture</Name><Description>The fracture stem is intended for cemented fixation only and is advised for 3 &amp; 4 part fractures of the proximal humerus</Description><Size>Fracture: left: 6.5mm - 12.5mm, right 6.5mm- 12.5mm Long stem fracture: left
6.5mmx200mm right 6.5mmx200mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4057</SubGroupID><ARTGs><ARTG>293561</ARTG><ARTG>293562</ARTG></ARTGs><MinimumBenefit>3771</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA011</BillingCode><Name>Optetrak Logic Total Knee System, Femoral Component, PS, Cemented</Name><Description>Femoral Component, PS, Cemented</Description><Size>Size 0 - 6, Left and Right</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>285440</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX050</BillingCode><Name>Equinoxe Glenosphere</Name><Description>The glenosphere aids in glenosphere insertion and protects any remaining intact soft tissues.</Description><Size>36mm, 38mm, 42mm &amp; 46mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>266161</ARTG><ARTG>279903</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA039</BillingCode><Name>Equinoxe Small Reverse Glenosphere</Name><Description>Reverse glenosphere</Description><Size>36mm, 40mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>479045</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA026</BillingCode><Name>Optetrak Logic Offset Stem Extension Couplers</Name><Description>Cemented Offset Couplers with 2, 4, 6, or 8mm of offset</Description><Size>2mm - 8mm</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1396</GroupID><ARTGs><ARTG>250092</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX029</BillingCode><Name>Opetrak Total Knee System Femoral Stem Extension Adpater</Name><Description>Femoral Stem Extension Adapter that provides for set changes in angulation of stem needs to be used on every occasion</Description><Size>2 - 7 Degree</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><ARTGs><ARTG>250092</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA009</BillingCode><Name>Optetrak Logic Total Knee System, Femoral Component, CR, Porous</Name><Description>Femoral Component, CR, Porous Coated</Description><Size>Size 0 - 6, Left and Right</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1351</GroupID><SubGroupID>3914</SubGroupID><ARTGs><ARTG>285901</ARTG></ARTGs><MinimumBenefit>3226</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX028</BillingCode><Name>Optetrak Total Knee System Tibial Insert</Name><Description>Tibial Insert, UHMWPE, fixed and totally stabilised with peg and reinforced with screw/post fixation (Spine stiffening screw)</Description><Size>Size 1 - 5, 1 Delta</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1371</GroupID><ARTGs><ARTG>277743</ARTG></ARTGs><MinimumBenefit>1090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA031</BillingCode><Name>Vantage Total Ankle System - Tibial Insert</Name><Description>Inlay, Mobile Bearing, UHMWPE</Description><Size>Left and Right, size 1-5, thickness 6mm - 12mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1269</GroupID><SubGroupID>3646</SubGroupID><ARTGs><ARTG>308700</ARTG></ARTGs><MinimumBenefit>591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA034</BillingCode><Name>Equinoxe HRP Middle Segment</Name><Description>HRP middle segment is used to reconstruct the humerus due to the varying levels of humeral resections</Description><Size>25mm - 75mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4073</SubGroupID><ARTGs><ARTG>396473</ARTG></ARTGs><MinimumBenefit>10877</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX064</BillingCode><Name>Equinoxe Reverse Shoulder Humeral Adapter Tray.</Name><Description>Reverse humeral adapter tray.</Description><Size>+0mm, +5mm, +10mm, +15mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4086</SubGroupID><Suffix>Metaphyseal component</Suffix><ARTGs><ARTG>244994</ARTG></ARTGs><MinimumBenefit>1840</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA023</BillingCode><Name>Optetrak Logic Femoral Metaphyseal Cones</Name><Description>3D printed titanium femoral metaphyseal cones to achieve metaphyseal fixation in cases where bone stock is compromised.</Description><Size>Femoral cones: small, medium, large, and x-large with heights 32mm, 42mm, and 52mm</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>250092</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX066</BillingCode><PriorBillingCodes><PriorBillingCode>OH024</PriorBillingCode></PriorBillingCodes><Name>Optetrak Total Knee System CCK (Constrained Condylar Knee) Femoral Component</Name><Description>Femoral Component, cemented, CoCr, totally stabilised</Description><Size>Size 1 - 6</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Revision</Suffix><ARTGs><ARTG>277741</ARTG></ARTGs><MinimumBenefit>5450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA002</BillingCode><PriorBillingCodes><PriorBillingCode>BJ006</PriorBillingCode><PriorBillingCode>CR180</PriorBillingCode></PriorBillingCodes><Name>Ceramic modular head</Name><Description>Biolox Delta Ceramic heads 32mm or less</Description><Size>28 and 32mm</Size><SupplierCode>FA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>285507</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA038</BillingCode><Name>Equinoxe Preserve Humeral Stem</Name><Description>Press fit humeral stem</Description><Size>6 - 14mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><ARTGs><ARTG>409490</ARTG></ARTGs><MinimumBenefit>3325</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA008</BillingCode><Name>Optetrak Logic Total Knee System, Femoral Component, CR, Cemented</Name><Description>Femoral Component, cemented, CoCr</Description><Size>Size 0 - 6, Left and Right</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>285439</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA027</BillingCode><Name>Optetrak Logic Tibial Metaphyseal Cones</Name><Description>3D printed titanium tibial metaphyseal cones to achieve metaphyseal fixation in cases where bone stock is compromised.</Description><Size>29, 32, 39, 48, 57, and 65mm</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>250092</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA010</BillingCode><Name>Optetrak Logic Total Knee System, Tibial Insert, CR</Name><Description>Tibial Insert, UHMWPE, Fixed (Cruciate retained), Neutral, Slope +, Slope ++</Description><Size>Size 0 - 6, 9 - 15mm</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>284907</ARTG><ARTG>285442</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FA007</BillingCode><Name>Equinoxe Humeral Stem, Primary, Press-Fit</Name><Description>Press-Fit Humeral Stem</Description><Size>7 – 19mm</Size><SupplierCode>FA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><ARTGs><ARTG>244995</ARTG></ARTGs><MinimumBenefit>3325</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EX038</BillingCode><Name>Optetrak Total Knee System</Name><Description>Patellar</Description><Size>26-41mm</Size><SupplierCode>FA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>279041</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>VK053</BillingCode><PriorBillingCodes><PriorBillingCode>VG001</PriorBillingCode></PriorBillingCodes><Name>CERAMENT BVF</Name><Description>Bone substitute with hydroxyapatite and iohexal</Description><Size>5ml</Size><SupplierCode>VK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>372270</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>VK039</BillingCode><Name>C-Nail</Name><Description>C-Nail is an intramedullary nail for minimal-invasive fixation of intraarticular calcaneal fractures. The principle is to stabilise with the nail the four to five main fragments of the fractured calcaneus in conjunction with up to seven interlocking screws and thus creating angular stable fixation. The maximum stability is achieved by fixing the sustentacular fragment towards the nail with two interlocking screws guided by a very precise aiming devise. The design of the nail is clearly marked "L" for left foot and "R" for right foot. The nail length is 65mm with a diameter of 8mm. The nail can be extended and closed with an end cap that comes in 0mm, 5mm, 10mm, 15mm and 20mm sizes.</Description><Size>C-Nail: 65mm length x 8mm diameter (Left and Right option).</Size><SupplierCode>VK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>7362</SubGroupID><ARTGs><ARTG>301836</ARTG><ARTG>305133</ARTG><ARTG>308207</ARTG><ARTG>308208</ARTG><ARTG>308209</ARTG><ARTG>308210</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>VK036</BillingCode><Name>C-Nail Bone Screws</Name><Description>C-Nail is an intramedullary nail for minimally invasive fixation of intraarticular calcaneal fractures. The principle is to stabilise with the nail the four to five main fragments of the fractured calcaneus in conjunction with up to seven interlocking screws and thus creating angular stable fixation. The maximum stability is achieved by fixing the sustentacular fragment towards the nail with two interlocking screws guided by a very precise aiming device. The design of the nail is clearly marked "L" for left foot and "R" for right foot. The nail length is 65mm with a diameter of 8mm. The nail can be extended and closed with an end cap that comes in 0mm, 5mm, 10mm, 15mm and 20mm sizes.</Description><Size>Self-tapping cortical bone screws 3.5mm in diameter with 2.5mm hexagonal head. Lengths 22mm, 24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm, 38mm, 40mm, 42mm, 44mm 46mm, 48mm, 50mm, 52mm, 54mm, 56mm, 58mm, 60mm, 62mm, 64mm, 66mm, 68mm, 70mm.</Size><SupplierCode>VK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3712</SubGroupID><ARTGs><ARTG>308210</ARTG></ARTGs><MinimumBenefit>222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>VK037</BillingCode><Name>C-Nail End Caps</Name><Description>C-Nail is an intramedullary nail for minimally invasive fixation of intraarticular calcaneal fractures. The principle is to stabilise with the nail the four to five main fragments of the fractured calcaneus in conjunction with up to seven interlocking screws and thus creating angular stable fixation. The maximum stability is achieved by fixing the sustentacular fragment towards the nail with two interlocking screws guided by a very precise aiming device. The design of the nail is clearly marked "L" for left foot and "R" for right foot. The nail length is 65mm with a diameter of 8mm. The nail can be extended and closed with an end cap that comes in 0mm, 5mm, 10mm, 15mm and 20mm sizes.</Description><Size>End Cap: 0mm, 5mm, 10mm, 15mm, 20mm.</Size><SupplierCode>VK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>5363</SubGroupID><ARTGs><ARTG>308209</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>VK054</BillingCode><PriorBillingCodes><PriorBillingCode>VG002</PriorBillingCode></PriorBillingCodes><Name>CERAMENT BVF</Name><Description>Bone substitute with hydroxyapatite and iohexal</Description><Size>10ml</Size><SupplierCode>VK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>372270</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>VK055</BillingCode><PriorBillingCodes><PriorBillingCode>VG003</PriorBillingCode></PriorBillingCodes><Name>CERAMENT BVF</Name><Description>Bone substitute with hydroxyapatite and iohexal</Description><Size>18ml</Size><SupplierCode>VK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>372270</ARTG></ARTGs><MinimumBenefit>4370</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>VK035</BillingCode><Name>Telescopic Nail</Name><Description>The Telescopic Nail consists of two parts, D profile bar (male nail) and suitable D profile tube (female nail) with threaded end. It is made of high grade medical stainless steel. The male and female nails have five different diameter choices. The male nail comes in one length for each diameter. The female nails have five different length choices for each diameter. The Telescopic Nail includes a special designed corkscrew end on the distal part of the male nail that holds the nail firmly in the bone and prevents damage to the growth plate. The Telescopic Nail is indicated for children with long bone deformity corrections, fracture stabilisation, patients with osteoporotic bone and for children older than 18 months who are diagnosed with osteogenesis imperfecta.</Description><Size>Female Nail 3.5mm diameter 110, 120, 130, 140, 150mm lengths.  Angled Female Nail 3.5mm diameter 110, 130, 150mm lengths.  Male Nail 2.0mm diameter 180mm length.    Female Nail 4.0mm diameter 150, 170, 180, 190, 200mm lengths.  Angled Female Nail 4.0mm diameter 150, 180, 200mm lengths.  Male Nail 2.5mm diameter 250mm length.    Female Nail 5.0mm diameter 150, 200, 210, 230, 250mm lengths.  Angled Female Nail 5.0mm diameter 150, 210, 250mm lengths.  Male Nail 3.5mm diameter 300mm length.    Female Nail 6.0mm diameter 250, 270, 280, 290, 300mm lengths.  Angled Female Nail 6.0mm diameter 150, 210, 250mm lengths.  Male Nail 4.0mm diameter 350mm length.    Female Nail 6.5mm diameter 190, 200, 250, 280, 300mm lengths.  Angled Female Nail 6.5mm diameter 150, 210, 250mm lengths.  Male Nail 5.0mm diameter 350mm length.</Size><SupplierCode>VK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3330</SubGroupID><Suffix>Gth</Suffix><ARTGs><ARTG>305115</ARTG><ARTG>307686</ARTG><ARTG>307748</ARTG><ARTG>308017</ARTG><ARTG>310263</ARTG></ARTGs><MinimumBenefit>3348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL030</BillingCode><Name>AcrySof IQ ReSTOR SN6AD1, SV25T0 and MN6AD1</Name><Description>Posterior Chamber, UV absorbing, foldable, acrylic, single piece lens with apodised diffractive optic and blue light protection</Description><Size>+6 D to + 34 D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL004</BillingCode><PriorBillingCodes><PriorBillingCode>AL003</PriorBillingCode><PriorBillingCode>AL012</PriorBillingCode></PriorBillingCodes><Name> Acrysof Multipiece Models MA50BM, MA60AC, MA60MA</Name><Description>Foldable Acrylic Multi-piece Lens</Description><Size> -5 D to +30 D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>214</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL049</BillingCode><Name>Clareon AutonoMe Toric</Name><Description>Clareon AutonoMe Toric consists of a Clareon Toric Aspheric Hydrophobic Acrylic Intraocular Lens (Clareon Toric IOL) pre-loaded on the AutonoMe Automated Delivery System.</Description><Size>+6.0 to +30.0 diopters</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, t1, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>585</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL064</BillingCode><Name>Clareon Vivity Toric Extended Vision Hydrophobic Intraocular Lens with AutonoMe(Model CNAET2-CNAET6)</Name><Description>Toric, presbyopia correcting, UV-absorbing, blue light filtering, foldable, single-piece posterior chamber IOL, pre-loaded on the AutonoMe Automated Delivery System. </Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); Cylinder 1.00 to 3.75 diopters</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL038</BillingCode><Name>Acrysof Aspheric UV-absorbing IOL</Name><Description>Foldable Acrylic Single-piece Lens with UV Absorbing and Aspheric Correction</Description><Size>+ 6.0 D to +30.0 D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL006</BillingCode><Name>PROVISC VISCOELASTIC SOLUTION</Name><Description>PROVISC contains sodium hyaluronate</Description><Size>0.85mL pack</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>511605</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL005</BillingCode><Name>DUOVISC VISCOELASTIC SYSTEM</Name><Description>ProVisc contains sodium hyaluronate, Viscoat contains chondroitin sulfate and sodium hyaluronate</Description><Size>1 unit 0.50ml Viscoat and 1 unit 0.55ml ProVisc</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><SubGroupID>3897</SubGroupID><ARTGs><ARTG>141482</ARTG></ARTGs><MinimumBenefit>66</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ638</BillingCode><Name>Clareon Aspheric UV Absorbing IOL (Model CC60WF)</Name><Description>Clareon Aspheric UV Absorbing IOL (Model CC60WF) is a UV-absorbing, foldable, single-piece, posterior chamber intraocular lens.</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments)</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL075</BillingCode><Name>Clareon PanOptix Pro Trifocal Toric IOL with AutonoMe (Model PXYAT2-PXYAT6)</Name><Description>The Clareon PanOptix Pro Trifocal Toric IOL with the AutonoMe Automated Pre-loaded Delivery System (Model PXYAT2-PXYAT6) is a toric, presbyopia correcting, ultraviolet and blue light filtering, foldable, single-piece posterior chamber multifocal IOL, pre-loaded on the AutonoMe Automated Delivery System.</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments). Cylinder: 1.00 to 3.75 diopters.</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL046</BillingCode><Name>AcrySof IQ Vivity Toric Extended Vision Intraocular Lens</Name><Description>Vivity Toric Models DFT215, DFT315, DFT415, DFT515 and DFT615 are a toric, extended vision, non-diffractive, UV-absorbing and blue light filtering, single-piece, foldable, hydrophobic, posterior chamber intraocular lens.</Description><Size>+10.0 to +30.0 diopters;   Cylinder: 1.0 to 3.75 diopters</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL043</BillingCode><Name>AcrySof IQ PanOptix Toric Trifocal IOL</Name><Description>Trifocal posterior chamber, toric, UV absorbing, foldable, acrylic, aspheric, single piece lens with apodised diffractive trifocal optic and blue light protection.  The apodised diffractive trifocal optic (anterior) provides two diffractive focal points (+3.25D near focus and 2.17D intermediate focus).</Description><Size>+6.0 to +30.0D in 0.5 Diopter increments and +31.0 to +34.0D in 1.0 Diopter increments. Cylinder: +1.0; +1.50; +2.25; +3.00 and +3.75 D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL050</BillingCode><Name>AcrySof IQ Vivity Extended Vision Intraocular Lens</Name><Description>Vivity Model DFT015 is an extended vision, non-diffractive, UV-absorbing and blue light filtering, single-piece, foldable, hydrophobic, posterior chamber intraocular lens</Description><Size>+10.0 to +30.0 diopters</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL029</BillingCode><Name>DisCoVisc Ophthalmic Viscosurgical Device</Name><Description>Sodium hyaluronate 17 mg/mL and chondroitin sulfate 40mg/mL</Description><Size>1.0 mL</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>141141</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL070</BillingCode><Name>Clareon Vivity Toric Extended Vision UV Absorbing Intraocular Lens (Model CCWET2 – CCWET6) </Name><Description>Toric,  presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber IOL which provides an extended range of vision from distance to near while maintaining a low incidence of visual disturbances. </Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopters (in 1.0 diopter increments). Cylinder: 1.00 to 3.75 diopters.</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL056</BillingCode><Name>Clareon Toric Aspheric Hydrophobic Acrylic IOL </Name><Description>The Clareon Toric Aspheric Hydrophobic Acrylic IOL is a toric, UV-absorbing, blue light filtering, foldable, single-piece posterior chamber intraocular lens.</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments). Cylinder 1.00 – 6.00 diopters</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>471</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL036</BillingCode><Name>ISPAN retinal gases</Name><Description>Tamponade gases for retinal surgery C3F8 and SF6</Description><Size>125 g cylinder, dispensed in single dose syringe</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1345</GroupID><ARTGs><ARTG>115487</ARTG></ARTGs><MinimumBenefit>67</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL051</BillingCode><Name>Clareon PanOptix Trifocal Hydrophobic Intraocular Lens (Model CNWTT0) </Name><Description>The Clareon PanOptix Trifocal Hydrophobic Intraocular Lens (Model CNWTT0) is a presbyopia correcting, ultraviolet and blue light filtering, foldable, single-piece posterior chamber, multifocal IOL </Description><Size> +6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopter in 1.0 diopter increments</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL079</BillingCode><Name>Clareon PanOptix Pro Trifocal UV Absorbing IOL (Model PXCWT0)</Name><Description>The Clareon PanOptix Pro Trifocal UV Absorbing IOL (Model PXCWT0) is a presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber, multifocal IOL.</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopters in 1.0 diopter increments.</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL035</BillingCode><Name>ISPAN Retinal Gases for Constellation® Vision System</Name><Description>Tamponade gases for retinal surgery C3F8 and SF6</Description><Size>125g cylinder, dispensed in single dose syringe</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1345</GroupID><ARTGs><ARTG>115487</ARTG></ARTGs><MinimumBenefit>67</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL015</BillingCode><Name>Cellugel Ophthalmic Viscosurgical Device</Name><Description>2% Hydroxypropyl Methylcellulose (HPMC)</Description><Size>1ml</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>115487</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL045</BillingCode><Name>AcrySof Aspheric UV Absorbing Toric Intraocular Lens</Name><Description>AcrySof UV Absorbing Toric is a biconvex, toric, aspheric, UV-absorbing, single-piece, foldable, hydrophobic monofocal intraocular lens</Description><Size>+6.0 to +34.0 diopter</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL073</BillingCode><Name>Clareon PanOptix Pro Trifocal IOL (Model PXYWT0)</Name><Description>The Clareon PanOptix Pro Trifocal Intraocular Lens (Model PXYWT0) is a presbyopia correcting, ultraviolet and blue light filtering, foldable, single-piece posterior chamber, multifocal IOL.</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopters in 1.0 diopter increments.</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL031</BillingCode><Name>AcrySert C Model SN6CWS</Name><Description>Posterior chamber, UV absorbing, foldable, acrylic, single piece lens with blue light protection and aspheric correction, in cartridge</Description><Size>+6.0 to +30.0 D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL003</BillingCode><Name>MTA2UO - MTA6UO</Name><Description>PMMA</Description><Size>+5 to +30 D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>140</SubCategoryID><GroupID>1324</GroupID><SubGroupID>3887</SubGroupID><ARTGs><ARTG>144332</ARTG></ARTGs><MinimumBenefit>126</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL082</BillingCode><Name>UNIPURE SF6 Ophthalmic Gas in the UNIFEYE Gas Delivery System</Name><Description>Integrated UNIPURE SF6 Ophthalmic Gas pico-cylinder in the UNIFEYE Gas Delivery System, designed to deliver sterile gas/air mixtures for intraocular injection </Description><Size>1 mL</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1345</GroupID><ARTGs><ARTG>517085</ARTG></ARTGs><MinimumBenefit>67</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL061</BillingCode><Name>Clareon PanOptix Toric Trifocal Hydrophobic IOL with AutonoMe (Model CNATT2-CNATT6) </Name><Description>Toric, presbyopia correcting, ultraviolet and blue light filtering, foldable, single-piece posterior chamber IOL, pre-loaded on the AutonoMe Automated Delivery System, which provides a range of vision from distance to intermediate to near, and also corrects preexisting corneal astigmatism. </Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments). Cylinder 1.00 to 3.75 diopters. </Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL081</BillingCode><Name>UNIPURE SF6 Ophthalmic Gas in the UNIPEXY Gas Delivery System</Name><Description>Integrated UNIPURE SF6 Ophthalmic Gas pico-cylinder in the UNIPEXY Gas Delivery System, designed to deliver sterile gas for intraocular injection </Description><Size>1mL</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1345</GroupID><ARTGs><ARTG>514886</ARTG></ARTGs><MinimumBenefit>67</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL083</BillingCode><Name>UNIPURE C3F8 Ophthalmic Gas in the UNIPEXY Gas Delivery System</Name><Description>Integrated UNIPURE C3F8 Ophthalmic Gas pico-cylinder in the UNIPEXY Gas Delivery System, designed to deliver sterile gas for intraocular injection </Description><Size>1mL</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1345</GroupID><ARTGs><ARTG>514885</ARTG></ARTGs><MinimumBenefit>67</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL040</BillingCode><Name>AcrySof IQ PanOptix Trifocal IOL</Name><Description>Trifocal posterior chamber, UV absorbing, foldable, acrylic, aspheric, single piece lens with apodised diffractive trifocal optic and blue light protection.  The apodised diffractive trifocal optic (anterior) provides two diffractive focal points (+3.25D near focus and 2.17D intermediate focus).</Description><Size>+6.0 to +30.0D in 0.5 Diopter increments and +31.0 to +34.0D in 1.0 Diopter increments</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL080</BillingCode><Name>UNIPURE C3F8 Ophthalmic Gas in the UNIFEYE Gas Delivery System</Name><Description>Integrated UNIPURE C3F8 Ophthalmic Gas pico-cylinder in the UNIFEYE Gas Delivery System, designed to deliver sterile gas/air mixtures for intraocular injection </Description><Size>1 mL</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1345</GroupID><ARTGs><ARTG>517086</ARTG></ARTGs><MinimumBenefit>67</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ639</BillingCode><Name>Clareon Vivity Toric  UV Absorbing IOL with AutonoMe (Model CCAET2-CCAET6) </Name><Description>Clareon Vivity Toric Extended Vision UV Absorbing IOL is a toric, presbyopia correcting, UV-absorbing,  foldable, single-piece posterior chamber IOL, pre-loaded on the AutonoMe Automated Delivery System. </Description><Size>+10.0 to +25.0 diopters (in 0.5 diopter increments). Cylinder 1.00 to 3.75 diopters. </Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>918</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL077</BillingCode><Name>Clareon PanOptix Pro Trifocal Toric IOL (Model PXYWT2 - PXYWT6)</Name><Description>The Clareon PanOptix Pro Trifocal Toric Intraocular Lens (Model PXYWT2- PXYWT6) is a toric, presbyopia correcting, ultraviolet and blue light filtering, foldable, single-piece posterior chamber, multifocal IOL.</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopters in 1.0 diopter increments Cylinder: 1.00 to 3.75 diopters</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL053</BillingCode><Name>Clareon PanOptix Trifocal UV Absorbing IOL with the AutonoMe Automated Pre-loaded Delivery System</Name><Description>The Clareon PanOptix Trifocal UV Absorbing IOL with the AutonoMe Automated Pre-loaded Delivery System is a presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber, multifocal IOL, pre-loaded on the AutonoMe Automated Delivery System </Description><Size>+6.0 to +30.0 diopters </Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL058</BillingCode><Name>Clareon PanOptix Toric Trifocal Hydrophobic Intraocular Lens (Models CNWTT2 – CNWTT6) </Name><Description>Clareon PanOptix Toric Trifocal Hydrophobic IOL is a toric, presbyopia correcting, hydrophobic, UV-absorbing, blue light filtering, foldable, single-piece, posterior chamber, multifocal IOL</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopter in 1.0 diopter increments with a +2.17 diopter intermediate and a +3.25 diopter near add power; Cylinder 1.00 to 3.75 diopters.</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL068</BillingCode><Name>Clareon Vivity Extended Vision UV Absorbing Intraocular Lens (Model CCWET0) </Name><Description>Presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber IOL which provides an extended range of vision from distance to near while maintaining a low incidence of visual disturbances. </Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopters (in 1.0 diopter increments).</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL076</BillingCode><Name>Clareon PanOptix Pro Trifocal Toric UV Absorbing IOL (Model PXCWT2-PXCWT6)</Name><Description>The Clareon PanOptix Pro Trifocal Toric UV Absorbing IOL (Model PXCWT2-PXCWT6) is a toric, presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber, multifocal IOL.</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopters in 1.0 diopter increments. Cylinder: 1.00 to 3.75 diopters</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ647</BillingCode><Name>Clareon Vivity UV Absorbing IOL with AutonoMe Automated Pre-loaded Delivery System (Model CCAET0)</Name><Description>Clareon Vivity Extended Vision UV Absorbing IOL is a presbyopia correcting, UV-absorbing,  foldable, single-piece posterior chamber intraocular lens, pre-loaded on the AutonoMe Automated Delivery System. </Description><Size>+10.0 to +25.0 diopters (in 0.5 diopter increments). </Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ637</BillingCode><Name>Clareon Vivity Toric  Extended Vision Hydrophobic IOL with AutonoMe (Model CNAET2-CNAET6)</Name><Description>Clareon Vivity Toric Extended Vision Hydrophobic IOL with AutonoMe (Model CNAET2-CNAET6) is a toric, presbyopia correcting, UV-absorbing, blue light filtering, foldable, single-piece posterior chamber IOL, pre-loaded on the AutonoMe Automated Delivery System. </Description><Size>+10.0 to +25.0 diopters (in 0.5 diopter increments). Cylinder 1.00 to 3.75 diopters. </Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL033</BillingCode><Name>AcrySof IQ ReSTOR multifocal toric IOL (SND1T2-T6; SV25T2-T6)</Name><Description>Posterior chamber UV absorbing foldable, acrylic, aspheric, toric single piece lens with apodised diffractive optic and blue light protection.</Description><Size>+6  to +34 D spherical; 1.00 to 3.75 D cylinder</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL037</BillingCode><PriorBillingCodes><PriorBillingCode>DE279</PriorBillingCode></PriorBillingCodes><Name>Ex-Press Glaucoma Filtration Device</Name><Description>Miniature glaucoma shunt</Description><Size>50 microns; 200 microns</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>144</SubCategoryID><GroupID>1334</GroupID><SubGroupID>3898</SubGroupID><ARTGs><ARTG>319620</ARTG></ARTGs><MinimumBenefit>645</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL063</BillingCode><Name>Clareon PanOptix Toric Trifocal UV Absorbing IOL with AutonoMe (Model CCATT2-CCATT6)</Name><Description>Toric, presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber IOL, pre-loaded on the AutonoMe Automated Delivery System, which provides a range of vision from distance to intermediate to near, and also corrects preexisting corneal astigmatism. </Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments).  Cylinder: 1.00 to 3.75 diopters.</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>918</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL069</BillingCode><Name>Clareon Vivity Toric Extended Vision UV Absorbing IOL with AutonoMe (Model CCAET2-CCAET6)</Name><Description>Toric, presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber IOL, pre-loaded on the AutonoMe Automated Delivery System, which provides an extended range of vision from distance to near while maintaining a low incidence of visual disturbances, and also corrects preexisting corneal astigmatism. </Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); Cylinder: 1.00 to 3.75 diopters </Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>918</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL060</BillingCode><Name>Clareon Vivity Extended Vision Hydrophobic IOL (Model CNWET0) </Name><Description>Presbyopia correcting, ultraviolet and blue light filtering, foldable, single-piece posterior chamber IOL which provides an extended range of vision from distance to near while maintaining a low incidence of visual disturbances </Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopters (in 1.0 diopter increments)</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL074</BillingCode><Name>Clareon PanOptix Pro Trifocal UV Absorbing IOL with AutonoMe (Model PXCAT0) </Name><Description>The Clareon PanOptix Pro Trifocal UV Absorbing IOL with the AutonoMe Automated Pre-loaded Delivery System (Model PXCAT0) is a presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber, multifocal IOL, pre-loaded on the AutonoMe Automated Delivery System.</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments)</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ640</BillingCode><Name>Clareon Vivity Toric Extended Vision UV Absorbing IOL (Model CCWET2 – CCWET6) </Name><Description>Clareon Vivity Toric Extended Vision UV Absorbing IOL (Model CCWET2 – CCWET6) is a toric,  presbyopia correcting, UV absorbing, foldable, single-piece posterior chamber IOL which provides an extended range of vision from distance to near while maintaining a low incidence of visual disturbances. </Description><Size>+10.0 to +30.0 diopters; Cylinder:1.00 to 3.75 diopters.</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL013</BillingCode><Name>Perfluoron Kits</Name><Description>Perfluoro-n-octane for use as a retinal surgery additive</Description><Size>5mL</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1346</GroupID><ARTGs><ARTG>327862</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL014</BillingCode><Name>Perfluoron Kits</Name><Description>Perfluoro-n-octane for use as a retinal surgery additive</Description><Size>7mL</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1346</GroupID><ARTGs><ARTG>327862</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL002</BillingCode><Name>Model CZ70BD</Name><Description>Other:PMMA</Description><Size>Range of Powers: +10.0D to +30.0D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1326</GroupID><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>126</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL078</BillingCode><Name>Clareon PanOptix Pro Trifocal Toric UV Absorbing IOL with AutonoMe (Model PXCAT2-PXCAT6)</Name><Description>The Clareon PanOptix Pro Trifocal Toric UV Absorbing IOL with the AutonoMe Automated Pre-loaded Delivery System (Model PXCAT2-PXCAT6) is a toric, presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber multifocal IOL, pre-loaded on the AutonoMe Automated Delivery System.</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments) Cylinder: 1.00 to 3.75 diopters.</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>918</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL059</BillingCode><Name>Clareon Vivity Toric Extended Vision Hydrophobic IOL (Models CNWET2 - CNWET6)</Name><Description>Presbyopia correcting, ultraviolet and blue light filtering, foldable, single-piece posterior chamber IOL which provides an extended range of vision from distance to near while maintaining a low incidence of visual disturbances, and also compensates for corneal astigmatism
</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopters (in 1.0 diopter increments). Cylinder:1.00 to 3.75 diopters</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL007</BillingCode><Name>VISCOAT Viscoelastic Fluid</Name><Description>Chondroitin sulfate and sodium hyaluronate</Description><Size>0.75mL</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>141142</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL011</BillingCode><Name>Acrysof Model SA60AT</Name><Description>Foldable Acrylic Single-piece Lens, asymmetric optic/consistent edge</Description><Size>Range of Powers: +6 to +40 D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>214</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL071</BillingCode><PriorBillingCodes><PriorBillingCode>ER501</PriorBillingCode><PriorBillingCode>OQ002</PriorBillingCode></PriorBillingCodes><Name>Hydrus Microstent</Name><Description>Intracanalicular scaffold, made from a biocompatible alloy, for the treatment of primary open angle glaucoma</Description><Size>8 mm in length</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>144</SubCategoryID><GroupID>1802</GroupID><SubGroupID>6441</SubGroupID><Suffix>smp</Suffix><ARTGs><ARTG>301403</ARTG></ARTGs><MinimumBenefit>1264</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL067</BillingCode><Name>Clareon Vivity  UV Absorbing IOL with AutonoMe Automated Pre-loaded Delivery System ( Model CCAET0)</Name><Description>Presbyopia correcting, UV-absorbing,  foldable, single-piece posterior chamber IOL, pre-loaded on the AutonoMe Automated Delivery System</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments). </Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL044</BillingCode><Name>Clareon AutonoMe</Name><Description>The Clareon Aspheric Hydrophobic Acrylic Lens is an ultraviolet and blue light filtering foldable single-piece posterior chamber intraocular lens, provided in the AutonoMe Pre-loaded Delivery System.</Description><Size>+6.0 to +30.0D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL021</BillingCode><Name>Alcon AcrySof SN60WF</Name><Description>Foldable Acrylic Single-piece Lens with Blue Light Protection and Aspheric Correction</Description><Size>+ 6.0 D to +30.0 D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>221</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL072</BillingCode><Name>Clareon PanOptix Pro Trifocal IOL with AutonoMe (Model PXYAT0)</Name><Description>The Clareon PanOptix Pro Trifocal IOL with the AutonoMe Automated Pre-loaded Delivery System (Model PXYAT0) is a presbyopia correcting, ultraviolet and blue light filtering, foldable, single-piece posterior chamber multifocal IOL, pre-loaded on the AutonoMe Automated Delivery System.</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments).</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL065</BillingCode><Name>Clareon Toric Aspheric UV Absorbing IOL with AutonoMe (Moded CCAOT2-CCAOT9)</Name><Description>Toric, ultraviolet -absorbing, foldable, single-piece posterior chamber IOL, pre-loaded on the AutonoMe Automated Delivery System, which provides improved uncorrected distance vision and also corrects pre-existing corneal astigmatism.</Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments). Cylinder: 1.00 to 6.00 diopters.</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>530</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL039</BillingCode><Name>AcrySof IQ Aspheric IOL with UltraSert pre-loaded delivery system</Name><Description>Pre-loaded foladable Acrylic Single-piece Lens with Blue light protection and Aspheric correction (SN60WF)</Description><Size>+6.0D to +30.0D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL016</BillingCode><Name>Alcon Acrysof Natural Model SN60AT</Name><Description>Foldable Acrylic Single-piece Lens, asymmetric optic/consistent edge, with blue light protection</Description><Size>+6 to +40D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL052</BillingCode><Name>Clareon PanOptix Trifocal UV Absorbing Intraocular Lens (Model CCWTT0) </Name><Description>The Clareon PanOptix Trifocal UV Absorbing Intraocular Lens (Model CCWTT0) is a presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber, multifocal IOL </Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments); +31.0 to +34.0 diopter in 1.0 diopter increments</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL032</BillingCode><Name>AcrySof IQ Toric IOL</Name><Description>Posterior chamber, UV absorbing, foldable, acrylic, toric, single piece lens with blue light protection and aspheric correction</Description><Size>+6 to +30 D spherical, +31.0 to +34.0 (1.0 D increments); 1.00 to 	6.00 D cylinder.</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>471</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL025</BillingCode><PriorBillingCodes><PriorBillingCode>AL021</PriorBillingCode><PriorBillingCode>AL026</PriorBillingCode></PriorBillingCodes><Name>AcrySof Multipiece Models MN60MA, MN60AC</Name><Description>Foldable Acrylic multi-piece Lens with Blue light Protection</Description><Size>- 5 D to + 30 D</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL057</BillingCode><Name>Clareon Aspheric Hydrophobic Acrylic Intraocular Lens (Model SY60WF) </Name><Description>Clareon™ Aspheric Hydrophobic Acrylic IOL Model SY60WF is an ultraviolet and blue light filtering, foldable, single-piece, monofocal intraocular lens. </Description><Size>+6.0 to +30.0 diopters</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>221</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ634</BillingCode><Name>Clareon Vivity Extended Vision UV Absorbing Intraocular Lens (Model CCWET0) </Name><Description>Clareon Vivity Extended Vision UV Absorbing IOL (Model CCWET0)  is a presbyopia correcting, UV-absorbing, foldable, single-piece posterior chamber IOL which provides an extended range of vision from distance to near while maintaining a low incidence of visual disturbances. </Description><Size>+10.0 to +30.0 diopters (in 0.5 diopter increments).</Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ636</BillingCode><Name>Clareon Vivity Hydrophobic Intraocular Lens with the AutonoMe Automated Pre-loaded Delivery System</Name><Description>Clareon Vivity Extended Vision Hydrophobic IOL with AutonoMe (Model CNAET0) is a presbyopia correcting, UV-absorbing, blue light filtering, foldable, single-piece posterior chamber IOL, pre-loaded on the AutonoMe Automated Delivery System. </Description><Size>+10.0 to +25.0 diopters (in 0.5 diopter increments). </Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL066</BillingCode><Name>Clareon Vivity Extended Vision Hydrophobic Intraocular Lens with AutonoMe (Model CNAET0)</Name><Description>Presbyopia correcting, UV-absorbing, blue light filtering, foldable, single-piece posterior chamber IOL, pre-loaded on the AutonoMe Automated Delivery System. </Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments). </Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AL062</BillingCode><Name>Clareon PanOptix Trifocal Hydrophobic IOL with AutonoMe (Model CNATT0)</Name><Description>Presbyopia correcting, ultraviolet and blue light filtering, foldable, single-piece posterior chamber IOL, pre-loaded on the AutonoMe Automated Delivery System, which provides a range of vision from distance to intermediate to near. </Description><Size>+6.0 to +30.0 diopters (in 0.5 diopter increments). </Size><SupplierCode>AL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>92318</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FP001</BillingCode><Name>StimRouter Neuromodulation System Kit</Name><Description>Implantable multi-electrode lead with integrated receiver, delivery tools, external pulse transmitter, patient programmer, and charger set.</Description><Size>One size only</Size><SupplierCode>FP</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1677</GroupID><SubGroupID>4481</SubGroupID><Suffix>Integrated Leads</Suffix><ARTGs><ARTG>313344</ARTG></ARTGs><MinimumBenefit>18032</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>VA001</BillingCode><PriorBillingCodes><PriorBillingCode>IM001</PriorBillingCode></PriorBillingCodes><Name>Venous Valve Ring</Name><Description>Dacron/silicone variable diameter ring</Description><Size>52mmx15mmx0.09 mm</Size><SupplierCode>VA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>210</SubCategoryID><GroupID>1641</GroupID><ARTGs><ARTG>64017</ARTG></ARTGs><MinimumBenefit>921</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ074</BillingCode><PriorBillingCodes><PriorBillingCode>AE148</PriorBillingCode></PriorBillingCodes><Name>ASDM Clavicle Plating System - Plates</Name><Description>Clavicle fracture plating system consisting of anatomic pre-contoured stainless steel locking compression plates and screws (cortical, cancellous &amp; locking)</Description><Size>6 holes(L&amp;R),</Size><SupplierCode>KR</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5270</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>258572</ARTG></ARTGs><MinimumBenefit>1208</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ073</BillingCode><PriorBillingCodes><PriorBillingCode>AE153</PriorBillingCode></PriorBillingCodes><Name>ADSM Clavicle Plating System - Plates</Name><Description>Clavicle fracture plating system consisting of anatomic pre-contoured stainless steel locking compression plates and screws (cortical, cancellous &amp; locking)</Description><Size>8-13 holes (L &amp; R),</Size><SupplierCode>KR</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5271</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>258572</ARTG></ARTGs><MinimumBenefit>1260</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ076</BillingCode><PriorBillingCodes><PriorBillingCode>AE155</PriorBillingCode></PriorBillingCodes><Name>ASDM Clavicle Plating System - Screws</Name><Description>Fixation Device, Internal, Locking, Stainless Steel, Cortical Screw Size: 3.5mm</Description><Size>3.5mm Locking Screws, 10-30mm (2mm increments)</Size><SupplierCode>KR</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>137369</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ077</BillingCode><PriorBillingCodes><PriorBillingCode>AE149</PriorBillingCode></PriorBillingCodes><Name>ASDM Clavicle Plating System - Screws</Name><Description>Fixation Device, Internal, Non-locking, Stainless Steel, Cortical Screw Size: 2.7mm</Description><Size>2.7mm Low-profile cortex screws, 10-30mm (2mm increments)</Size><SupplierCode>KR</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>134456</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ075</BillingCode><PriorBillingCodes><PriorBillingCode>AE154</PriorBillingCode></PriorBillingCodes><Name>ASDM Clavicle Plating System - Screws</Name><Description>Fixation Device, Internal, Non-locking, Stainless Steel, Cortical Screw Size: 3.5mm &amp; Cancellous Screw sizes 4.0mm</Description><Size>3.5mm Low-profile Cortex Screws, 10-30mm (2mm increments)
4.0mm Low-profile Cortex Screws, 10-30mm (2mm increments)</Size><SupplierCode>KR</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>137369</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ127</BillingCode><PriorBillingCodes><PriorBillingCode>AE069</PriorBillingCode></PriorBillingCodes><Name>Threaded wires &amp; pins</Name><Description>Threaded wires &amp; pins</Description><Size>1.0-5.0mm diameters
various threaded lengths</Size><SupplierCode>KR</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><Suffix>TH</Suffix><ARTGs><ARTG>164927</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AE099</BillingCode><Name>Active Knee Tibial Baseplate</Name><Description>Tibial Baseplate, HA, uncemented, beaded, stemmed , CoCr</Description><Size>Sizes 1 to 5 (A-Narrow &amp; B-Wide)</Size><SupplierCode>AE</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1360</GroupID><SubGroupID>3923</SubGroupID><ARTGs><ARTG>276963</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AE251</BillingCode><Name>Active Knee Tibial Insert</Name><Description>Tibial Insert, UHMWPE</Description><Size>Sizes 1 - 5 Thickness 6 - 17.5mm</Size><SupplierCode>AE</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>276961</ARTG><ARTG>276964</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AE041</BillingCode><Name>Active Knee Femoral Component</Name><Description>Femoral Component, uncemented, distally beaded with HA</Description><Size>Sizes 00 -- 5 Left &amp; Right</Size><SupplierCode>AE</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1352</GroupID><SubGroupID>3917</SubGroupID><ARTGs><ARTG>282290</ARTG></ARTGs><MinimumBenefit>3575</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AE040</BillingCode><Name>Active Knee Tibial Baseplate</Name><Description>Tibial baseplate, Cemented, CoCr</Description><Size>Sizes 1-5</Size><SupplierCode>AE</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>276957</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AE039</BillingCode><Name>Active Knee Femoral Component </Name><Description>Femoral Component, Cemented, CoCr </Description><Size>Sizes 00 - 5 Left &amp; Right</Size><SupplierCode>AE</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>164032</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AE050</BillingCode><Name>Active Knee Patella</Name><Description>Patella, cemented, UHMWPE</Description><Size>Sizes 1 - 5</Size><SupplierCode>AE</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>276965</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AA008</BillingCode><Name>Bioring Gastric Band Replacement Port</Name><Description>Bioring gastric band access port with catheter and connector</Description><Size>Diameter 34mm; height 10.4mm</Size><SupplierCode>AA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1779</GroupID><ARTGs><ARTG>163167</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AA010</BillingCode><Name>Adhesix Bioring Gastric Band</Name><Description>Adjustable gastric band system with mesh fixation of port</Description><Size>Small, Large and Extra Large</Size><SupplierCode>AA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1548</GroupID><ARTGs><ARTG>181215</ARTG></ARTGs><MinimumBenefit>2791</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK037</BillingCode><PriorBillingCodes><PriorBillingCode>UQ036</PriorBillingCode><PriorBillingCode>SP095</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Screws</Description><Size>Locking Screw Inserts, Other ancillary</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1591</GroupID><SubGroupID>4338</SubGroupID><ARTGs><ARTG>130509</ARTG></ARTGs><MinimumBenefit>137</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK014</BillingCode><PriorBillingCodes><PriorBillingCode>UQ011</PriorBillingCode><PriorBillingCode>SP076</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Midface &amp; Mini</Description><Size>Straight Plate - 2 Hole, Plate &lt; 4 holes.</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4261</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>63</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK025</BillingCode><PriorBillingCodes><PriorBillingCode>UQ024</PriorBillingCode><PriorBillingCode>SP027</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Plates - Fracture</Description><Size>8 Hole Fracture Plate, 4 &amp; 6 hole locking fracture plate, 4 to 7 hole locking plate.</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>345</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK045</BillingCode><PriorBillingCodes><PriorBillingCode>UQ048</PriorBillingCode></PriorBillingCodes><Name>PMT Tissue Expander (Integra/Accuspan)</Name><Description>Smooth tissue expander with remote or internal port</Description><Size>Volume 5cc to 1600cc</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1606</GroupID><SubGroupID>4414</SubGroupID><ARTGs><ARTG>337350</ARTG></ARTGs><MinimumBenefit>653</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK047</BillingCode><PriorBillingCodes><PriorBillingCode>JK046</PriorBillingCode><PriorBillingCode>UQ043</PriorBillingCode></PriorBillingCodes><Name>Impleo gel-filled Nagor mammary implant range - smooth - IMP-SMR, IMP-SHR and IMP-SEHR</Name><Description>Smooth Round</Description><Size>520 to 620ml</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><ARTGs><ARTG>277759</ARTG></ARTGs><MinimumBenefit>668</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK044</BillingCode><PriorBillingCodes><PriorBillingCode>UQ041</PriorBillingCode><PriorBillingCode>SP045</PriorBillingCode></PriorBillingCodes><Name>Logic Distraction System</Name><Description>Distractor, spacers &amp; activation set</Description><Size>Straight, Curved 18-52mm</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1603</GroupID><SubGroupID>4399</SubGroupID><Suffix>Multivector</Suffix><ARTGs><ARTG>130510</ARTG></ARTGs><MinimumBenefit>2608</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK040</BillingCode><PriorBillingCodes><PriorBillingCode>UQ039</PriorBillingCode><PriorBillingCode>SP069</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Mini, Maxi</Description><Size>Angled EDC Plate, Angled Long EDC Plate, 40mm 6 Hole Fracture Plate, 6 Hole Curved EDC Plate, 33mm &amp; 38mm 4 Hole EDC Plate, 48mm 6 Hole EDC Plate, Mandible, Mandible/Reduction, Mandible Angle</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4355</SubGroupID><Suffix>Compression</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>148</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK027</BillingCode><PriorBillingCodes><PriorBillingCode>UQ025</PriorBillingCode><PriorBillingCode>SP086</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Mini &amp; Maxi</Description><Size>12 Hole Straight Plate 1.0 mm thick, 8 Hole Straight Plate 1.0 mm thick, Plates 8 to 15 holes</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4293</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK041</BillingCode><PriorBillingCodes><PriorBillingCode>UQ045</PriorBillingCode><PriorBillingCode>SP024</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Plates - Reconstruction</Description><Size>5 x 16 Hole plate Right &amp; Left</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Hemimandible</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>453</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK048</BillingCode><PriorBillingCodes><PriorBillingCode>JK046</PriorBillingCode><PriorBillingCode>UQ043</PriorBillingCode></PriorBillingCodes><Name>Impleo gel-filled Nagor mammary implant range - smooth - IMP-SMR, IMP-SHR and IMP-SEHR</Name><Description>Smooth Round</Description><Size>150 to 460ml</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><ARTGs><ARTG>277759</ARTG></ARTGs><MinimumBenefit>595</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK028</BillingCode><PriorBillingCodes><PriorBillingCode>UQ028</PriorBillingCode><PriorBillingCode>SP118</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Mandible Locking Plates</Description><Size>16-32 Hole Plates, 1.0-1.99 mm thick</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>798</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK029</BillingCode><PriorBillingCodes><PriorBillingCode>UQ027</PriorBillingCode><PriorBillingCode>SP067</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Mini, Maxi</Description><Size>16 Hole Straight Plate, 1.0mm thick, Plate 15 to 32 holes</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK024</BillingCode><PriorBillingCodes><PriorBillingCode>UQ023</PriorBillingCode><PriorBillingCode>SP123</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Plates - Fracture</Description><Size>1.0-1.99mm thick, 4-7 holes</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><Suffix>Compression</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK008</BillingCode><PriorBillingCodes><PriorBillingCode>UQ009</PriorBillingCode><PriorBillingCode>SP126</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Micro, Mini, Maxi</Description><Size>0.2-0.49mm thick, 11-50cm²</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4204</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>584</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK009</BillingCode><PriorBillingCodes><PriorBillingCode>UQ010</PriorBillingCode><PriorBillingCode>SP129</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Plates</Description><Size>0.2-0.49mm thick, 51-200cm²</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4205</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>1229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK023</BillingCode><PriorBillingCodes><PriorBillingCode>UQ022</PriorBillingCode><PriorBillingCode>SP018</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Midface, Mini &amp; Maxi</Description><Size>Chin Plate 2, 3, 4, 6, 8, 10 &amp; 12mm, Plates 4 to 7 holes.</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK018</BillingCode><PriorBillingCodes><PriorBillingCode>UQ019</PriorBillingCode><PriorBillingCode>SP033</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Compression Plates - Micro, Mini &amp; Maxi</Description><Size>Micro: 2 x 3 Hole Compression T Plate, Oblique Left &amp; Right Compression T Plate, 4 Hole Straight Compression Plate; 5 Hole Straight Plate, 13mm Left &amp; Right L Plate, 19mm T Plate, 2 x 3 Hole Quad Plate; Mini: 4 Hole Left &amp; Right L Plate, 4 Hole Left &amp; Rig</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Compression</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK013</BillingCode><PriorBillingCodes><PriorBillingCode>UQ015</PriorBillingCode><PriorBillingCode>SP112</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Plates</Description><Size>125 x 180mm Mesh Plate, 150 x 300mm Mesh Plate, Mesh &gt;200cm2 area.</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4210</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>2072</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK003</BillingCode><PriorBillingCodes><PriorBillingCode>UQ003</PriorBillingCode><PriorBillingCode>SP132</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Screws - Cannulated Lag</Description><Size>Diameter 2.71mm – 4.49mm</Size><SupplierCode>JK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>130509</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK017</BillingCode><PriorBillingCodes><PriorBillingCode>UQ044</PriorBillingCode><PriorBillingCode>SP070</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Mini, Maxi</Description><Size>Gap Plates, Plates 4 to 7 holes</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK016</BillingCode><PriorBillingCodes><PriorBillingCode>UQ018</PriorBillingCode><PriorBillingCode>SP072</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Mini, Maxi</Description><Size>Burr Hole Plates, Calvarium Plate - Small &amp; Large - Calvarium Plate, Plates 4 to 7 Holes</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Burr</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK010</BillingCode><PriorBillingCodes><PriorBillingCode>UQ047</PriorBillingCode><PriorBillingCode>SP106</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Plates</Description><Size>111 x 191mm Mesh Plate, Mesh &gt; 200cm2 area.</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4206</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>1462</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK019</BillingCode><PriorBillingCodes><PriorBillingCode>UQ017</PriorBillingCode><PriorBillingCode>SP128</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Midface, Mini, Maxi, BSSO, TR BSSO</Description><Size>0.5-0.99mm thick, 4-7 holes</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK002</BillingCode><PriorBillingCodes><PriorBillingCode>UQ002</PriorBillingCode><PriorBillingCode>SP029</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Plates - Fracture; Screws - Cannulated Lag</Description><Size>6 Hole Fracture Plate 47 - 52mm; 2 x 2 Hole Angled Fracture Plate; 3 x 3 Hole Angled Fracture Plate; 6.5mm x (30 -150)mm; 7.3mm x (30 - 150)mm</Size><SupplierCode>JK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>130508</ARTG><ARTG>130509</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK012</BillingCode><PriorBillingCodes><PriorBillingCode>UQ014</PriorBillingCode><PriorBillingCode>SP110</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Plates</Description><Size>90 x 90mm Osteoform Mesh, Mesh 51 to 100cm2 area.</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4209</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>1146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK031</BillingCode><PriorBillingCodes><PriorBillingCode>UQ030</PriorBillingCode><PriorBillingCode>SP026</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Plates - Fracture</Description><Size>Rigid Comminuted Fracture Plate</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4307</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>1073</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK006</BillingCode><PriorBillingCodes><PriorBillingCode>UQ005</PriorBillingCode><PriorBillingCode>SP133</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Screws - Cannulated Lag</Description><Size>Diameter 2.01 – 2.7 mm</Size><SupplierCode>JK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>130509</ARTG></ARTGs><MinimumBenefit>156</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK033</BillingCode><PriorBillingCodes><PriorBillingCode>UQ031</PriorBillingCode><PriorBillingCode>SP088</PriorBillingCode></PriorBillingCodes><Name>Screws</Name><Description>Micro, Maxi &amp; Self Drilling</Description><Size>"Size 1.2mm self-drilling screws, 1.2mm x (2 - 14)mm, Screws diameter &lt; 1.24mm"</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4321</SubGroupID><ARTGs><ARTG>130509</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK042</BillingCode><PriorBillingCodes><PriorBillingCode>UQ040</PriorBillingCode><PriorBillingCode>SP079</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Mini</Description><Size>Orbital Plate, Orbital Plate Large</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4367</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>868</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK043</BillingCode><PriorBillingCodes><PriorBillingCode>UQ049</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Orbital Floor Plates</Name><Description>Preformed titanium mesh orbital floor plates</Description><Size>Small Left,  Small Right,  Large Left,  Large Right</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4367</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>868</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK032</BillingCode><PriorBillingCodes><PriorBillingCode>UQ032</PriorBillingCode><PriorBillingCode>SP031</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Lag Screws - Micro, Mini</Description><Size>1.2mm x (6 - 16)mm; 1.6mm x (10-12)mm; 2.0mm x (8 - 22)mm;</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4321</SubGroupID><Suffix>Compression</Suffix><ARTGs><ARTG>130509</ARTG></ARTGs><MinimumBenefit>78</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK007</BillingCode><PriorBillingCodes><PriorBillingCode>UQ006</PriorBillingCode><PriorBillingCode>SP121</PriorBillingCode></PriorBillingCodes><Name>ExtremiFix Screws</Name><Description>Headless Cannulated Compression Screw</Description><Size>Diameter 2.0mm, 2.4mm. Length 10mm to 52mm; Diameter 2.01mm - 2.7mm</Size><SupplierCode>JK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>130509</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK001</BillingCode><PriorBillingCodes><PriorBillingCode>UQ001</PriorBillingCode><PriorBillingCode>SP002</PriorBillingCode></PriorBillingCodes><Name>Testicular Implant</Name><Description>Silicone Elastomer</Description><Size>Small / Medium / Large</Size><SupplierCode>JK</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>231</SubCategoryID><GroupID>1711</GroupID><ARTGs><ARTG>137352</ARTG></ARTGs><MinimumBenefit>620</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK005</BillingCode><PriorBillingCodes><PriorBillingCode>UQ004</PriorBillingCode><PriorBillingCode>SP032</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Lag Screws - Maxi, MMF, 3.0mm</Description><Size>2.4mm x (8 - 42)mm; 2.4 x (12 - 18)mm; 3.0mm x (12 - 36)mm;</Size><SupplierCode>JK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>130509</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK022</BillingCode><PriorBillingCodes><PriorBillingCode>UQ012</PriorBillingCode><PriorBillingCode>SP081</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Mini</Description><Size>40 Hole Straight Plate, Mesh 18 row, Plate &gt;32 holes.</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4284</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>271</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK036</BillingCode><PriorBillingCodes><PriorBillingCode>UQ035</PriorBillingCode><PriorBillingCode>SP096</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Screws</Description><Size>MMF / Anchorage Screws 1.2/1.6/2.0mm Anchor, Bone</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1591</GroupID><SubGroupID>4336</SubGroupID><ARTGs><ARTG>130509</ARTG></ARTGs><MinimumBenefit>137</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK030</BillingCode><PriorBillingCodes><PriorBillingCode>UQ029</PriorBillingCode><PriorBillingCode>SP120</PriorBillingCode></PriorBillingCodes><Name>OsteoMed  Plating &amp; Fixation System</Name><Description>Mandible locking plates</Description><Size>4-7 Holes, 2.0-2.99 mm thick</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4301</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>604</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK015</BillingCode><PriorBillingCodes><PriorBillingCode>UQ016</PriorBillingCode><PriorBillingCode>SP075</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Midface &amp; Mini</Description><Size>Straight Plate - 2 Hole, Plate &lt; 4 holes.</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4267</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>76</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK035</BillingCode><PriorBillingCodes><PriorBillingCode>UQ033</PriorBillingCode><PriorBillingCode>SP124</PriorBillingCode></PriorBillingCodes><Name>Screws</Name><Description>Micro, Maxi &amp; Self Drilling</Description><Size>Diameter 1.25-3.24mm</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>130509</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK034</BillingCode><PriorBillingCodes><PriorBillingCode>UQ034</PriorBillingCode><PriorBillingCode>SP130</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Locking Screws</Description><Size>Diameter 1.25-3.24mm</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>130509</ARTG></ARTGs><MinimumBenefit>88</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK011</BillingCode><PriorBillingCodes><PriorBillingCode>UQ013</PriorBillingCode><PriorBillingCode>SP127</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Plates</Description><Size>0.5-0.8mm thick, 11-50cm²</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4208</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>388</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK004</BillingCode><PriorBillingCodes><PriorBillingCode>UQ046</PriorBillingCode><PriorBillingCode>SP122</PriorBillingCode></PriorBillingCodes><Name>ExtremiFix Screws</Name><Description>Headless Cannulated Compression Screw</Description><Size>Diameter 3.0mm, 4.0mm. Length 10mm to 52mm; Diameter 2.71mm - 4.49mm.</Size><SupplierCode>JK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>130509</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK039</BillingCode><PriorBillingCodes><PriorBillingCode>UQ038</PriorBillingCode><PriorBillingCode>SP092</PriorBillingCode></PriorBillingCodes><Name>Osteo Plating &amp; Fixation System</Name><Description>Plates - Reconstruction</Description><Size>5 x 20 x 5 Hole Full Mandible Plate; 5 x 16 x 5 Hole Full Mandible Plate; Mandible, Full</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4353</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>915</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK038</BillingCode><PriorBillingCodes><PriorBillingCode>UQ037</PriorBillingCode><PriorBillingCode>SP113</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Plates</Description><Size>90 x 90mm, 95 x 165mm, &amp; Large Pre-formed Osteoform Mesh, Cranium.</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>4348</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>2535</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK021</BillingCode><PriorBillingCodes><PriorBillingCode>UQ020</PriorBillingCode><PriorBillingCode>SP125</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Midface, Mini, Maxi</Description><Size>0.5-0.99mm thick, 8-32 holes</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK020</BillingCode><PriorBillingCodes><PriorBillingCode>UQ021</PriorBillingCode><PriorBillingCode>SP071</PriorBillingCode></PriorBillingCodes><Name>Plates</Name><Description>Micro, Mini, Maxi</Description><Size>Quad Plates, Medium 2 x 4 Hole Quad Plate, Plates 8 to 15 holes</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><Suffix>3D</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>205</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JK026</BillingCode><PriorBillingCodes><PriorBillingCode>UQ026</PriorBillingCode><PriorBillingCode>SP117</PriorBillingCode></PriorBillingCodes><Name>OsteoMed Plating &amp; Fixation System</Name><Description>Mandible Locking plates</Description><Size>8-15 Hole Plates, 1.0-1.99 mm thick</Size><SupplierCode>JK</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4293</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>130508</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ085</BillingCode><PriorBillingCodes><PriorBillingCode>JQ018</PriorBillingCode></PriorBillingCodes><Name>IdentiTi LIF Porous Ti Spacer </Name><Description> IdentiTi Porous Ti Spacer Lateral Ti Interbody,  Ti </Description><Size>(4-14)mm  x (25-60)mm footprint  x (0-30)degree lordosis x (16-26)mm Height</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>397837</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KN001</BillingCode><PriorBillingCodes><PriorBillingCode>JQ023</PriorBillingCode></PriorBillingCodes><Name>AMP Screw</Name><Description>Bone Screw; Ti Alloy</Description><Size>(5.5- 6.5)mm Diameter x (25 - 65)mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>398793</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ679</BillingCode><Name>Invictus Polyaxial Pedicle Screw  </Name><Description>Polyaxial Screw, Fenestrated &amp; Cannulated, Cortical-Cancellous Thread.  Std and Reduction Tulip.   Ti Alloy</Description><Size>(4.5 - 12.5) mm diameter x (30-120 )mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>426650</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ084</BillingCode><PriorBillingCodes><PriorBillingCode>JQ058</PriorBillingCode></PriorBillingCodes><Name>IdentiTi Cervical SA Spacer</Name><Description>Integral Fixation Spacer including two Fixation Screws. Ti Alloy</Description><Size>Cage: (5 - 10)mm x (14 - 18)mm footprint  x (12 -  16)mm height,  (7- 15) degrees lordosis   Screws: (3.5 - 4)mm diameter x (12-18)mm length self tapping or self drillling, single or dual lead </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>397510</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ081</BillingCode><PriorBillingCodes><PriorBillingCode>JQ026</PriorBillingCode></PriorBillingCodes><Name>IdentiTi ALIF Porous Ti Interbody System </Name><Description>Spacer, Anterior Lumbar .Ti </Description><Size>(34-42)mm x (24-30)mm footprint x (4-11)mm height x (10-20) degree lordosis</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>397837</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ444</BillingCode><PriorBillingCodes><PriorBillingCode>JQ046</PriorBillingCode></PriorBillingCodes><Name>Invictus Cross Connector </Name><Description>(Head to Head) or (Rod To Rod) Fixation Style, Adjustable, Ti Alloy</Description><Size>(9-101)mm  width  +/-  3mm travel </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ451</BillingCode><PriorBillingCodes><PriorBillingCode>JQ039</PriorBillingCode></PriorBillingCodes><Name>Invictus OCT Tulip</Name><Description>Occipital Plate Tulip,  Ti Alloy</Description><Size>Single or Dual Tulip </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1467</GroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>391</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ447</BillingCode><PriorBillingCodes><PriorBillingCode>JQ034</PriorBillingCode></PriorBillingCodes><Name>Invictus Hinged Rod</Name><Description>Hinged Rod. Ti Alloy</Description><Size>Cranial: (3.5, 4.0) mm diameter x 90mm length   Caudal, (3.5, 4.0)mm diameter  x 210mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1480</GroupID><SubGroupID>4133</SubGroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>1350</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KN002</BillingCode><PriorBillingCodes><PriorBillingCode>JQ024</PriorBillingCode></PriorBillingCodes><Name>AMP Plate Centre Screw</Name><Description>Cage locking Screw , Ti Alloy </Description><Size>10-20mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>398793</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ452</BillingCode><PriorBillingCodes><PriorBillingCode>JQ062</PriorBillingCode></PriorBillingCodes><Name>Invictus Osseoscrew</Name><Description>Pedicle Screw, Cannulated, Std, Extended, Reduction Tab. Ti Alloy</Description><Size>(6,.5 - 7.5)mm dia x (40-55)mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KN005</BillingCode><Name>Trauma Plate </Name><Description>Trauma Plate Bone Screw </Description><Size>5.0-6.0mm x 25mm-60mm</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>490272</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ486</BillingCode><PriorBillingCodes><PriorBillingCode>JQ059</PriorBillingCode></PriorBillingCodes><Name>IdentiTi NanoTec Interbody System </Name><Description>Spacer, Cervical. Ti ,Ha</Description><Size>(14-22)mm x (12- 19)mm x (4- 14)mm height x (0-15)degree lordosis</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>397837</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ448</BillingCode><PriorBillingCodes><PriorBillingCode>JQ040</PriorBillingCode></PriorBillingCodes><Name>Invictus Modular Tulip </Name><Description>Polyaxial.  Ti Alloy</Description><Size>Std, std Reduction,  Extended tab reduction </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ082</BillingCode><PriorBillingCodes><PriorBillingCode>JQ057</PriorBillingCode></PriorBillingCodes><Name>IdentiTi ALIF Standalone Interbody System </Name><Description>Integrated Fixation Cage Including 2 Lateral Fixation Screws and 1 (Centre Screw or Cannulated Fixation Bolt), Ti Alloy </Description><Size>Cage: (34 - 42)mm x (24 - 30)mm footprint x (4 - 13)mm height, (10 - 30) degree lordosis. Screw: (5 - 6)mm diameter  x (25 - 35)mm length. Bolt: (8.5 - 9)mm diameter x (25 - 35)mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>397510</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ087</BillingCode><PriorBillingCodes><PriorBillingCode>JQ027</PriorBillingCode></PriorBillingCodes><Name>IdentiTi PC Porous Ti Interbody System </Name><Description>Spacer, Posterior Curved, Ti </Description><Size>(9-14)mm x (25-35)mm footprint  x (6-15)mm height  x (5-15)degree lordosis </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>397837</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ487</BillingCode><PriorBillingCodes><PriorBillingCode>JQ060</PriorBillingCode></PriorBillingCodes><Name>Transcend NanoTec Interbody System </Name><Description>Spacer, Posterior Oblique.  PEEK Ti Alloy HA</Description><Size>10mm width x (25-35) length x (7-15)mm height x (0-15)degree lordosis</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>398574</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ092</BillingCode><PriorBillingCodes><PriorBillingCode>JQ033</PriorBillingCode></PriorBillingCodes><Name>Transcend Nanotec Lateral </Name><Description>Spacer, Lateral, PEEK Ti Alloy HA </Description><Size>(18-22)mm x (45-60)mm footprint x (4-14)mm height  x (0-10)degree lordosis</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>398574</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ450</BillingCode><PriorBillingCodes><PriorBillingCode>JQ048</PriorBillingCode></PriorBillingCodes><Name>Invictus Occiptal Plate </Name><Description>Occipital Plate ,Ti Alloy</Description><Size>48 - 66 mm</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ453</BillingCode><PriorBillingCodes><PriorBillingCode>JQ041</PriorBillingCode></PriorBillingCodes><Name>Invictus Polyaxial  Pedicle Screw</Name><Description>Polyaxial or Favoured Angle (Medial /Lateral or Cranial/Caudal) Pedicle Screw , Full or Partial Thread.   Ti Alloy</Description><Size>(3.5 - 12.5)mm x (8-130)mm</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ083</BillingCode><PriorBillingCodes><PriorBillingCode>JQ030</PriorBillingCode></PriorBillingCodes><Name>IdentiTi Cervical Porous Ti Interbody System</Name><Description>Spacer,  Anterior  Ti</Description><Size>(14-20)mm x (12-16)mm footprint x (5-12)mm height x (5-15) degree lordosis</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>397837</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ456</BillingCode><PriorBillingCodes><PriorBillingCode>JQ042</PriorBillingCode></PriorBillingCodes><Name>Invictus Set Screw </Name><Description>Locking Set Screw  Ti Alloy</Description><Size>3.5mm - 6.5mm  polyaxial screw set screws, open or closed</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ459</BillingCode><PriorBillingCodes><PriorBillingCode>JQ047</PriorBillingCode></PriorBillingCodes><Name>Invictus Spinal Fixation System - Connectors</Name><Description>Open/Open , Open/Closed,  Open/Side, Closed/Side, Closed/Closed, Domino Revision, Modular Satellite Axial Revision, Tulip. Ti Alloy</Description><Size>11-18mm, 30-60mm</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KN004</BillingCode><Name>Invictus Spinal Cement System </Name><Description>Radio Opaque Bone Cement with Mixing and Injection System.  Poly Methylmethacrylate Styrene Copolymer </Description><Size>25.8gm powder, 9.2 gms monomer</Size><SupplierCode>KN</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4089</SubGroupID><ARTGs><ARTG>409679</ARTG></ARTGs><Note>No Prescribed List benefit is payable for the billing code, if the device is used for kyphoplasty surgery, as there is no evidence presented and no MBS item available for this procedure.</Note><MinimumBenefit>437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ086</BillingCode><PriorBillingCodes><PriorBillingCode>JQ056</PriorBillingCode></PriorBillingCodes><Name>IdentiTi NanoTec Interbody System </Name><Description>Spacer, LIF. Ti HA </Description><Size>(16-26)mm x (40-65)mm x (4-16)mm height x (0-20) degrees lordosis</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>397837</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ296</BillingCode><Name>Invictus Spinal Fixation System</Name><Description>Monoaxial Pedicle Screw, Ti Alloy </Description><Size>(4.5 - 12.5) mm diam x (20 - 130) mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ454</BillingCode><PriorBillingCodes><PriorBillingCode>JQ037</PriorBillingCode></PriorBillingCodes><Name>Invictus Polyaxial Pedicle Screw</Name><Description>Cannulated, complete polyaxial screw, Ti Alloy</Description><Size>( 4.5 -10.5 )mm diameter  x  (20-130)mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ446</BillingCode><PriorBillingCodes><PriorBillingCode>JQ063</PriorBillingCode></PriorBillingCodes><Name>Invictus Favored Angle</Name><Description>Polyaxial Pedicle Screw, Cannulated , Open or Closed Tulip.  Ti Alloy</Description><Size>(6.5- 10.5)mm dia x (60-110)mm length</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KN006</BillingCode><Name>Trauma Plate </Name><Description>Trauma Plate Static </Description><Size>17mm-50mm</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4128</SubGroupID><ARTGs><ARTG>490272</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ091</BillingCode><PriorBillingCodes><PriorBillingCode>JQ032</PriorBillingCode></PriorBillingCodes><Name>Transcend Nanotec Cervical </Name><Description>  Spacer, PEEK Ti Alloy HA </Description><Size>(14-18)mm x (12-16)mm footprint x (5-10)mm height x 7-10) degrees lordosis </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>398574</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ458</BillingCode><PriorBillingCodes><PriorBillingCode>JQ064</PriorBillingCode></PriorBillingCodes><Name>Invictus SI Core </Name><Description>Polyaxial Pedicle Screw, Cannulated, Dual Lead,  Radial Fenestration.  open or closed tulip. Ti Alloy</Description><Size>( 9.0-11.5)mm Dia x (60-100)mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ443</BillingCode><PriorBillingCodes><PriorBillingCode>JQ038</PriorBillingCode></PriorBillingCodes><Name>Invictus  Shank </Name><Description>Polyaxial , solid or cannulated Ti Alloy </Description><Size>(4-12.5)mm dia x (20-130)mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ457</BillingCode><PriorBillingCodes><PriorBillingCode>JQ035</PriorBillingCode></PriorBillingCodes><Name>Invictus Shaped Rod</Name><Description>OCT Prebent, S,  Z  and J rods </Description><Size>(5.5 - 6.0)mm diameter x (300-600)mm lemgth , CoCr Ti Alloy</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ455</BillingCode><PriorBillingCodes><PriorBillingCode>JQ043</PriorBillingCode></PriorBillingCodes><Name>Invictus Rod </Name><Description>Rod, straight, curved Ti Alloy or CoCr</Description><Size>(3.5 - 6.0) mm diameter x  (20-600)mm length</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KN003</BillingCode><PriorBillingCodes><PriorBillingCode>JQ025</PriorBillingCode></PriorBillingCodes><Name>AMP Plate </Name><Description>Antmigration Plate for ATEC Cages,  Ti Alloy</Description><Size>Size 4 to 23  - (19.35 to 36.3)mm length, 1 or 2 screw hole. </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1468</GroupID><ARTGs><ARTG>398793</ARTG></ARTGs><MinimumBenefit>560</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KN009</BillingCode><Name>Ascend TL Vertebral Body Replacement System</Name><Description>Vertebral Body Static Core</Description><Size>18-26mm</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1814</GroupID><ARTGs><ARTG>490271</ARTG></ARTGs><MinimumBenefit>3340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ090</BillingCode><PriorBillingCodes><PriorBillingCode>JQ031</PriorBillingCode></PriorBillingCodes><Name>Transcend Lateral </Name><Description>Spacer, PEEK Ti Alloy</Description><Size>(16-26)mm x(25-60)mm Footprint x (4-10)mm height  x(0-15)degrees lordosis</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>398574</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KN007</BillingCode><Name>Ascend TL Vertebral Body Replacement System</Name><Description>Vertebral Body End Plates 0-10 degrees</Description><Size>Round diameter (18-22mm); Lateral (16-22mm) x (30-60mm); Banana (16mm) x (25-50mm)</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4138</SubGroupID><ARTGs><ARTG>490271</ARTG></ARTGs><MinimumBenefit>928</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ088</BillingCode><PriorBillingCodes><PriorBillingCode>JQ028</PriorBillingCode></PriorBillingCodes><Name>IdentiTi PO Porous Ti Interbody System</Name><Description>Spacer, Posterior Oblique,  Ti</Description><Size>10mm x (25-35)mm footprint x (7-15)mm height x (5-15)degree lordosis</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>397837</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ449</BillingCode><PriorBillingCodes><PriorBillingCode>JQ049</PriorBillingCode></PriorBillingCodes><Name>Invictus Occipital Screw </Name><Description>Occipital Screw  Ti Alloy</Description><Size>(4.5 - 5.0)mm diameter x (6-16)mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ488</BillingCode><PriorBillingCodes><PriorBillingCode>JQ061</PriorBillingCode></PriorBillingCodes><Name>Transcend NanoTec Interbody System. Transcend-PS with Advanced NanoTec Treatment.  </Name><Description>Spacer,  Posterior Straight, PEEK Ti Alloy HA</Description><Size>9mm width x (22-25)mm length x (7-14)mm height x (0-20) degree lordosis</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>398574</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ438</BillingCode><PriorBillingCodes><PriorBillingCode>JQ019</PriorBillingCode></PriorBillingCodes><Name>Insignia Anterior Cervical Plating System </Name><Description>Plate, 1-3 level, Ti Alloy</Description><Size>16 - 54mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>398575</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ460</BillingCode><PriorBillingCodes><PriorBillingCode>JQ036</PriorBillingCode></PriorBillingCodes><Name>Invictus TL Hooks</Name><Description>Lamina, Pedicle, Offset, Angled  Ti Alloy</Description><Size>(5.5 - 6.0)mm rod diameter x 5.5 - 12.5 mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KN008</BillingCode><Name>Ascend TL Vertebral Body Replacement System</Name><Description>Vertebral Body Expandable Core expandable cage and Core Expandable Modular Endplates</Description><Size>26-105mm (Core Expandable Cage); size 21 (Modular Endplate 21-29mm; Round diameter 18mm; Lateral/ Banana – 16-18mm x 30-45mm)</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>490271</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ445</BillingCode><PriorBillingCodes><PriorBillingCode>JQ044</PriorBillingCode></PriorBillingCodes><Name>Invictus Dual Diameter Rod </Name><Description>Straight, Dual Diameter , Ti Alloy  or CoCr </Description><Size>(3.5 or 4.0 or 5.5 )mm to (5.5 or 6.0)mm diameters  x (200 - 600) mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KN010</BillingCode><Name>IdentiTI II LIF Interbody System</Name><Description>IdentiTi II Spacer, Lateral Interbody Fusion, Ti Alloy </Description><Size>Spacer: (16-26)mm Width, (4-12)mm Height, (35-65)mm Length, (0-15) Degrees Lordosis</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>397837</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ440</BillingCode><PriorBillingCodes><PriorBillingCode>JQ021</PriorBillingCode></PriorBillingCodes><Name>Insignia Anterior Cervical Plating System</Name><Description>Screw,  fixed/variable angle,  Self-drilling/Self Tapping. single lead Ti Alloy</Description><Size>(4.0-4.5)mm diameter x (10-18)mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>398575</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ089</BillingCode><PriorBillingCodes><PriorBillingCode>JQ029</PriorBillingCode></PriorBillingCodes><Name>IdentiTi PS Porous Ti Interbody System</Name><Description>Spacer, Posterior Straight  Ti</Description><Size>9mm x (22-30)mm footprint x (7-14)mm height x (0-15) degree lordosis</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>397837</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ442</BillingCode><PriorBillingCodes><PriorBillingCode>JQ045</PriorBillingCode></PriorBillingCodes><Name>Invictus  Offset Connector </Name><Description>Side Loading  or Open or Closed or Offset .Ti Alloy, CoCr</Description><Size>10-200mm </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>398576</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ439</BillingCode><PriorBillingCodes><PriorBillingCode>JQ020</PriorBillingCode></PriorBillingCodes><Name>Insignia Anterior Cervical Plating System </Name><Description>Plate, 3 - 5 level, Ti Alloy</Description><Size>&gt; 55mm length</Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>398575</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ441</BillingCode><PriorBillingCodes><PriorBillingCode>JQ022</PriorBillingCode></PriorBillingCodes><Name>Insignia Anterior Cervical Plating System </Name><Description>Screw,  fixed/variable angle,  Self-drilling/Self Tapping. Dual lead Ti Alloy</Description><Size>(4 - 4.5)mm diameter x (10- 18)mm length </Size><SupplierCode>KN</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>398575</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO042</BillingCode><PriorBillingCodes><PriorBillingCode>AO039</PriorBillingCode><PriorBillingCode>AO031</PriorBillingCode></PriorBillingCodes><Name>Tecnis Toric 1-Piece Pre-Loaded IOL</Name><Description>1-piece IOL Posterior chamber Intraocular lens , incorporates a proprietary wavefront designed toric aspheric optic with a squared posterior optic edge designed to provide 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects.</Description><Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments. Cylinder power: 1.00 diopter, 1.50 diopter, 2.25 diopter, 3.00 diopter, 3.75 diopter, 4.00 diopter, 4.50 diopter, 5.25 diopter and 6.00 diopter (as measured at the IOL plane). Overall diameter 13mm, Optic size 6mm.</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>181845</ARTG></ARTGs><MinimumBenefit>530</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO024</BillingCode><Name>Tecnis® One Piece (ZCB00)</Name><Description>One piece intraocular lens with edge modification and 360 degree square edge</Description><Size>+5 to +34 diopter powers in 0.5d increments. Overall diameter 13mm, Optic size 6mm</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>170331</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO002</BillingCode><Name>SENSAR IOL with OptiEdge Design</Name><Description>3-Piece, soft hydrophobic acrylic, foldable, UV absorbing, posterior</Description><Size>-10.0 D to +30.0 D in 0.5 D increments</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><ARTGs><ARTG>170331</ARTG></ARTGs><MinimumBenefit>214</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO053</BillingCode><Name>TECNIS Odyssey IOL with TECNIS SIMPLICITY delivery system (DRN00V) </Name><Description>Preloaded 1-piece continuous multifocal IOL</Description><Size>5.0 D to 34.0 D in 0.5 diopter increments</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>170331</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO054</BillingCode><Name>TECNIS Odyssey Toric II with TECNIS SIMPLICITY delivery system (DRT) </Name><Description>Preloaded 1-piece continuous multifocal toric IOL</Description><Size>5.0 D to 34.0 D in 0.5 D increments, Cyl1.00D to 3.75D. Overall diameter 13.0mm, optic size of of 6.0 mm</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>181845</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ152</BillingCode><Name>TECNIS PureSee IOL with Simplicity Delivery System</Name><Description>Pre-loaded, 1-piece posterior chamber, presbyopia correcting, UV absorbing hydrophobic acrylic with violet-light filter, Non Toric IOL offering extended vision</Description><Size>Diopter range +5.0 D to +34.0 D. in 0.5 diopter increments</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>426290</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO047</BillingCode><Name>TECNIS® Eyhance Toric IOL</Name><Description>1-piece enhanced monofocal toric IOL</Description><Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments. Overall diameter 13mm, Optic size 6mm. Cylinder power: 7.00 and 8.00 diopter (as measured at the IOL plane).</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t2</Suffix><ARTGs><ARTG>181845</ARTG></ARTGs><MinimumBenefit>753</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO037</BillingCode><Name>TECNIS® Symfony Extended Range of Vision (ZXR00)</Name><Description>Extended Range of Vision Posterior Chamber IOL</Description><Size>+5.0 to 34.0 diopter powers in 0.5 diopter increments Overall diamter 13mm, Optic size 6mm</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>170331</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO044</BillingCode><Name>TECNIS Synergy IOL</Name><Description>1-piece continuous multifocal IOL</Description><Size>+5.0 to 34.0 diopter powers in 0.5 diopter increments. Overall diameter 13mm, optic size 6mm</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>170331</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO051</BillingCode><Name>TECNIS Eyhance Toric II Simplicity</Name><Description>1-piece enhanced monofocal pre-loaded IOL</Description><Size>+05.0 D to +34.0 D in 0.5 D increments. overall diameter: 13mm, optic size 6mm. Cylinder power: 7.00 D, 8.00 D</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t2, pl</Suffix><ARTGs><ARTG>412991</ARTG></ARTGs><MinimumBenefit>793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO049</BillingCode><Name>TECNIS Synergy Toric II Simplicity</Name><Description>Preloaded 1-piece continuous multifocal toric IOL</Description><Size>+5.0 Diopters to +34.0 Diopters in 0.5 Diopter increments. Overall diameter 13mm, optic size 6mm  Cylinder powers 1.00 D, 1.50 D, 2.25 D, 3.00 D, 3.75 D.</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>411930</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO045</BillingCode><Name>TECNIS® Synergy Toric IOL</Name><Description>1-piece continuous multifocal toric IOL</Description><Size>+5.0 Diopters to +34.0 Diopters in 0.5 Diopter increments.  Overall diameter 13mm, optic size 6mm  Cylinder powers 1.00 D, 1.50 D, 2.25 D, 3.00 D, 3.75 D, 4.50 D, 5.25 D, and 6.00 D (as measured on the IOL plane).</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>181845</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO052</BillingCode><Name>TECNIS Synergy Simplicity</Name><Description>Preloaded 1-piece continuous multifocal IOL</Description><Size>5.0 Diopters to +34.0 Diopters in 0.5 Diopter increments. Overall diameter 13mm, optic size 6mm</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>411514</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO046</BillingCode><Name>TECNIS® Eyhance Toric IOL</Name><Description>1-piece enhanced monofocal toric IOL</Description><Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments.  Overall diameter 13mm, Optic size 6mm.  Cylinder power: 1.00, 1.50, 2.25, 3.00, 3.75, 4.00, 4.50, 5.25 and 6.00 diopter (as measured at the IOL plane). </Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>181845</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO034</BillingCode><Name>TECNIS® 1-Piece Pre-Loaded IOL</Name><Description>1-piece IOL Posterior Chamber Intraocular lens, incorporates a proprietary wavefront-designed aspheric optic with a squared posterior optic edge designed to provide a 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects. Supplied pre-loaded in either a screw style disposable injector or in a pre-loaded cartridge.</Description><Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments.  Overall diameter 13mm, Optic size 6mm</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>377171</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO043</BillingCode><Name>TECNIS® Eyhance IOL</Name><Description>1-piece enhanced monofocal IOL</Description><Size>+5.0 to 34.0 diopter powers in 0.5 diopter increments. Overall diamter 13mm, optic size 6mm</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>170331</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO048</BillingCode><Name>TECNIS® Eyhance Pre-Loaded IOL</Name><Description>1-piece enhanced monofocal pre-loaded IOL</Description><Size>+5.0 to 34.0 diopter powers in 0.5 diopter increments. Overall diameter 13mm, optic size 6mm</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>377170</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO041</BillingCode><PriorBillingCodes><PriorBillingCode>AO039</PriorBillingCode><PriorBillingCode>AO031</PriorBillingCode></PriorBillingCodes><Name>TECNIS Toric II 1-Piece IOL</Name><Description>1-piece IOL Posterior chamber Intraocular lens , incorporates a proprietary wavefront designed toric aspheric optic with a squared posterior optic edge designed to provide 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects.</Description><Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments. Cylinder power: 1.00 diopter, 1.50 diopter, 2.25 diopter, 3.00 diopter, 3.75 diopter, 4.00 diopter, 4.50 diopter, 5.25 diopter and 6.00 diopter (as measured at the IOL plane). Overall diameter 13mm, Optic size 6mm.</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>181845</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO040</BillingCode><PriorBillingCodes><PriorBillingCode>AO031</PriorBillingCode></PriorBillingCodes><Name>TECNIS Toric II-Piece IOL</Name><Description>1-piece IOL Posterior chamber Intraocular lens, incorporates a proprietary wavefront designed toric aspheric optic with a squared posterior optic edge designed to provide a 360 degree barrier. The edge of the optic has a frosted design to reduce potential edge glare effects.</Description><Size>+5.0 to +34.0 diopter powers in 0.5 diopter increments.  Cylinder power: 7.00 diopter, 8.00 diopter (as measured at the IOL plane). Overall diameter 13mm, Optic size 6mm.</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t2</Suffix><ARTGs><ARTG>181845</ARTG></ARTGs><MinimumBenefit>753</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO050</BillingCode><Name>TECNIS Eyhance Toric II Simplicity</Name><Description>1-piece enhanced monofocal pre-loaded IOL</Description><Size>+05.0 D to +34.0 D in 0.5 D increments. overall diameter: 13mm, optic size 6mm. Cylinder power: 1.00 D, 1.50 D, 2.25 D, 3.00 D, 3.75 D, 4.5 D, 5.25 D, 6.00 D</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>412991</ARTG></ARTGs><MinimumBenefit>530</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ318</BillingCode><Name>TECNIS PureSee IOL Toric II with TECNIS Simplicity Delivery System (DET)</Name><Description>Pre-loaded, 1-piece posterior chamber, presbyopia correcting, UV absorbing hydrophobic acrylic with violet-light filter, Toric IOL</Description><Size>+5.0 D to +34.0 D in 0.5 D increments, Cyl: 1.00D to 6.00D (as measured in the IOL plane) Overall diameter 13.0mm, optic size of of 6.0 mm</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>440190</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-08-08</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO038</BillingCode><Name>TECNIS Symfony Toric Extended Range of Vision (ZXT00)</Name><Description>Extended Range of Vision Toric Multifocal Posterior Chamber IOL</Description><Size>+6 to +30 in 0.5d steps Available Cyl powers +1.0d, 1.5d, 2.25d, 3.00d, 3.75d, 4.5d, 5.25d, 6.00d</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>181845</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO014</BillingCode><Name>TECNIS® Intraocular Lens (ZA9003)</Name><Description>Foldable Intraocular Lenses - Ultraviolet light absorbing posterior chamber intraocular lenses, Silicone/Acrylic</Description><Size>+10.0  to +30.0 D in 0.5 D increments</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>170331</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO012</BillingCode><Name>Baerveldt Glaucoma Implant BG 101-350, Baerveldt Glaucoma Implant BG 103-425, Baerveldt Glaucoma Implant BG 103-250</Name><Description>Non-valved artificial drainage device, composition silicone - smooth, tumble-polished finish</Description><Size>Surface area 250, 350, 425mm2</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>144</SubCategoryID><GroupID>1333</GroupID><ARTGs><ARTG>168768</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO008</BillingCode><Name>HEALON PRO, Intraocular Viscoelastic Fluid</Name><Description>Sodium Hyaluronate 10mg/ml</Description><Size>0.55ml &amp; 0.85ml</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>413192</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO009</BillingCode><Name>Healon 5 Pro, Intraocular Viscoelastic Fluid</Name><Description>HEALON 5 PRO 2.3% Sodium hyaluronate </Description><Size>0.6ml</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><Suffix>hmw</Suffix><ARTGs><ARTG>413672</ARTG></ARTGs><MinimumBenefit>64</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO010</BillingCode><Name>Healon GV PRO Intraocular Viscoelastic Fluid</Name><Description>Sodium Hyaluronate 18mg/mL</Description><Size>0.85ml</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><Suffix>hmw</Suffix><ARTGs><ARTG>413673</ARTG></ARTGs><MinimumBenefit>64</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AO032</BillingCode><Name>Healon Endocoat</Name><Description>Viscoelastic</Description><Size>0.85ml</Size><SupplierCode>AO</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>198813</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI127</BillingCode><Name>E2 Femoral Stem</Name><Description>Cemented Femoral Stem</Description><Size>Size 0 - 4  Offset 35.5mm, 37.5mm, 44mm and 50mm</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>383710</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI119</BillingCode><Name>EVOK Stem</Name><Description>Cementless Stem with HA</Description><Size>Sizes 7 to 20  Collared and Collarless</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>315774</ARTG><ARTG>315775</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI059</BillingCode><PriorBillingCodes><PriorBillingCode>CR159</PriorBillingCode></PriorBillingCodes><Name>Saturne Cemented Tripolar Cup</Name><Description>Stainless steel cemented acetabular cup with an anatomical anti-disloction profile</Description><Size>Sizes 44 - 60 in 2mm increments</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4009</SubGroupID><ARTGs><ARTG>210137</ARTG></ARTGs><MinimumBenefit>1511</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI094</BillingCode><PriorBillingCodes><PriorBillingCode>AX105</PriorBillingCode></PriorBillingCodes><Name>Ampllitude CoCr Femoral Head</Name><Description>Femoral Heads, CoCr</Description><Size>Diameter 22.2mm, 28mm, 32mm  Short, Medium, Long and XLong.</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>389273</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI061</BillingCode><PriorBillingCodes><PriorBillingCode>CR161</PriorBillingCode></PriorBillingCodes><Name>Saturne Press Fit Dual Mobility Acetabular Cup</Name><Description>A cementless, stippled and peripherally expanded, acetabular cup.  Flattened pole and an elevated rim to help prevent dislocation.</Description><Size>Sizes: 44 - 64 in 2mm increments</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1427</GroupID><SubGroupID>4018</SubGroupID><ARTGs><ARTG>216969</ARTG></ARTGs><MinimumBenefit>2079</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI051</BillingCode><PriorBillingCodes><PriorBillingCode>CR195</PriorBillingCode></PriorBillingCodes><Name>Optimal Revision Stem</Name><Description>Cementless, modular revision / reconstruction stem</Description><Size>Sizes 1-5</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1413</GroupID><SubGroupID>3979</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>135326</ARTG></ARTGs><MinimumBenefit>4968</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI121</BillingCode><Name>Anatomic Cementless Femur</Name><Description>Posterior-Stabilised Cementless Femur Plasma-Sprayed Titanium and HAP</Description><Size>Sizes 0 to 8 left and right</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1352</GroupID><SubGroupID>3918</SubGroupID><ARTGs><ARTG>222528</ARTG></ARTGs><MinimumBenefit>3663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI070</BillingCode><PriorBillingCodes><PriorBillingCode>CR108</PriorBillingCode></PriorBillingCodes><Name>Score Knee System Tibial Insert  </Name><Description>Tibial Insert, mobile bearing, UHMWPE</Description><Size>7 sizes, 5 thicknesses</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>271353</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI072</BillingCode><PriorBillingCodes><PriorBillingCode>CR103</PriorBillingCode></PriorBillingCodes><Name>Score Knee System Patella Component </Name><Description>All poly patella UHMWPE, cemented   Resurfacing and Inset</Description><Size>7 Diameters</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>210604</ARTG><ARTG>216375</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI067</BillingCode><PriorBillingCodes><PriorBillingCode>CR111</PriorBillingCode></PriorBillingCodes><Name>Score Knee System Offset Connector</Name><Description>Connector for stems to alter stem offset morse taper but also including screw for additional fixation, titanium</Description><Size>2mm, 4mm, 6mm</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1396</GroupID><ARTGs><ARTG>242001</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI069</BillingCode><PriorBillingCodes><PriorBillingCode>CR102</PriorBillingCode></PriorBillingCodes><Name>Score Knee System Tibial Baseplate </Name><Description>Tibial baseplate, CoCr, uncemented, stippled surface, titanium plasma spray with HA</Description><Size>9 Sizes</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1362</GroupID><SubGroupID>3924</SubGroupID><ARTGs><ARTG>271352</ARTG></ARTGs><MinimumBenefit>2409</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI117</BillingCode><Name>Ceramic Head Revision Sleeve</Name><Description>Titanium Sleeve</Description><Size>10/12 and 12/14 Taper  Short, Medium, Long and Extra-Long</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1451</GroupID><ARTGs><ARTG>281067</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI065</BillingCode><PriorBillingCodes><PriorBillingCode>CR112</PriorBillingCode></PriorBillingCodes><Name>Score Knee System Tibial and Femoral Augments </Name><Description>Femoral blocks, tibial blocks cemented </Description><Size>31 sizes  Size A-D, Thickness 4-8mm  Size 1/2, 3/4/5, 6/7, Thickness 5-10-15mm</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>241999</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI066</BillingCode><PriorBillingCodes><PriorBillingCode>CR104</PriorBillingCode></PriorBillingCodes><Name>Amplitude Femoral and Tibial Stems</Name><Description>Femoral and Tibial Stems, Titanium, cemented</Description><Size>7 diameters (10-22), 4 lengths (75-200mm)</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>275851</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI120</BillingCode><Name>Anatomic Knee Tibial Half Blocks</Name><Description>Tibial Half Blocks Cemented</Description><Size>Sizes 0/1/2, 3/4/5, 6/7/8  Thickness 5mm to 15mm  </Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>241999</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI076</BillingCode><Name>Horizon II Delta Ceramic Insert</Name><Description>Ceramic Insert, Biolox Delta</Description><Size>9 sizes for 28, 32 and 36mm heads</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4022</SubGroupID><ARTGs><ARTG>223258</ARTG></ARTGs><MinimumBenefit>1636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI112</BillingCode><Name>Anatomic Cemented Tibial Baseplate</Name><Description>Cemented fixed bearing tibial baseplate with the ability to attach stem extensions</Description><Size>Size 0 to 8</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>222531</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI045</BillingCode><PriorBillingCodes><PriorBillingCode>CR162</PriorBillingCode></PriorBillingCodes><Name>Saturne acetabular liner</Name><Description>Polyethylene liner for double mobility cup</Description><Size>42/22- 66/22 (13 sizes)  48/28- 66/28 (10 sizes)</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4024</SubGroupID><ARTGs><ARTG>217778</ARTG></ARTGs><MinimumBenefit>1540</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI064</BillingCode><PriorBillingCodes><PriorBillingCode>CR107</PriorBillingCode></PriorBillingCodes><Name>Score Knee System Femoral Component</Name><Description>Femoral Component, CoCr, uncemented, stippled surface, titanium plasma spray with HA, pegged </Description><Size>7 Sizes</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1352</GroupID><SubGroupID>3917</SubGroupID><ARTGs><ARTG>210576</ARTG></ARTGs><MinimumBenefit>3575</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI128</BillingCode><Name>SATURNE II Dual Mobility Liner A.X.P.E.</Name><Description>Antioxidant XLPE liner for dual mobility cup</Description><Size>42/22-66/22 (13 sizes)  48/28-66/28 (10 sizes)</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4024</SubGroupID><ARTGs><ARTG>401502</ARTG></ARTGs><MinimumBenefit>1540</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI096</BillingCode><PriorBillingCodes><PriorBillingCode>AX099</PriorBillingCode></PriorBillingCodes><Name>Amplitude CoCr Femoral Head</Name><Description>Femoral heads, CoCr</Description><Size>Diameter 36mm, -4, 0, +4, +8</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>389273</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI126</BillingCode><Name>Austral XL Polyethylene Liner</Name><Description>XL Polyethylene Liner</Description><Size>Neutral and Hooded  44/28mm - 52/28mm; 48/32mm - 64/32mm; 52/36mm - 68/36mm</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>386912</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI122</BillingCode><Name>Amplitude C2 Acetabular Cup Base Hole Cover</Name><Description>Titanium Base Hole Cover</Description><Size>One size only</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1446</GroupID><ARTGs><ARTG>368571</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI068</BillingCode><PriorBillingCodes><PriorBillingCode>CR106</PriorBillingCode></PriorBillingCodes><Name>Score Knee System Tibial Baseplate </Name><Description>Tibial Baseplate, Cemented, CoCr, polished insert surface for mobile insert </Description><Size>9 Sizes</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><ARTGs><ARTG>210578</ARTG></ARTGs><MinimumBenefit>2005</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI075</BillingCode><Name>Large Delta Ceramic Head</Name><Description>Biolox Delta Head</Description><Size>36mm heads
10/12 and 12/14</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>281064</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI124</BillingCode><Name>C2 Cross-Linked PE Liner</Name><Description>Neutral and Hooded Cross-Linked PE Liner</Description><Size>ID 32mm and 36mm  Sizes 48mm to 68mm (Neutral and Hooded)</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>379311</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI052</BillingCode><PriorBillingCodes><PriorBillingCode>CR101</PriorBillingCode></PriorBillingCodes><Name>Modular Neck for Acor &amp; Integrale Femoral Stems</Name><Description>Titanium neck, with varying alignments &amp; tapers</Description><Size>4 sizes</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1417</GroupID><ARTGs><ARTG>210537</ARTG></ARTGs><MinimumBenefit>1029</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI116</BillingCode><Name>Biolox Delta Ceramic Revision Head</Name><Description>Biolox Delta Femoral Head</Description><Size>36mm</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>281065</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI071</BillingCode><PriorBillingCodes><PriorBillingCode>CR110</PriorBillingCode></PriorBillingCodes><Name>Score Knee System Tibial Insert  </Name><Description>Tibial Insert, mobile bearing, posterior stabilised with reinforcement post</Description><Size>20 sizes</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>210526</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI113</BillingCode><Name>Anatomic Fixed Bearing Insert</Name><Description>Posterior stabilised, fixed bearing polyethylene insert</Description><Size>Size 0 to 8  Heights 10 to 20</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>222532</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI048</BillingCode><PriorBillingCodes><PriorBillingCode>CR121</PriorBillingCode></PriorBillingCodes><Name>Amplitude Orthopaedic Bone Screw</Name><Description>Titanium cancellous bone screw</Description><Size>Diam 6.5mm, lengths 15 - 55 mm</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>242000</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI047</BillingCode><PriorBillingCodes><PriorBillingCode>CR116</PriorBillingCode></PriorBillingCodes><Name>Femoral Shaft Locking Screw</Name><Description>Titanium femoral locking screw</Description><Size>6.2 diameter, 13 lengths 20-80 in 5mm increments</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>135326</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI125</BillingCode><Name>Austral Acetabular Shell</Name><Description>Titanium Cup with sintered titanium coating</Description><Size>44 - 68mm</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4014</SubGroupID><ARTGs><ARTG>386911</ARTG></ARTGs><MinimumBenefit>2812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI123</BillingCode><Name>C2 Acetabular Cup</Name><Description>Uncemented Acetabular Cup with Titanium Porous Coating</Description><Size>48mm to 68mm</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4014</SubGroupID><ARTGs><ARTG>379310</ARTG></ARTGs><MinimumBenefit>2812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI114</BillingCode><Name>AClip Femoral</Name><Description>Ligament or tendon anchoring device</Description><Size>One size only</Size><SupplierCode>LI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>294174</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI092</BillingCode><PriorBillingCodes><PriorBillingCode>AX104</PriorBillingCode></PriorBillingCodes><Name>E2 PMMA Centraliser</Name><Description>PMMA distal Centraliser</Description><Size>20mm</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1438</GroupID><ARTGs><ARTG>260435</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI058</BillingCode><PriorBillingCodes><PriorBillingCode>CR143</PriorBillingCode></PriorBillingCodes><Name>metallic femoral head</Name><Description>M30NW femoral head with 10/12 taper</Description><Size>22.2mm - 32mm short, medium, long</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3988</SubGroupID><ARTGs><ARTG>210159</ARTG></ARTGs><MinimumBenefit>671</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI062</BillingCode><PriorBillingCodes><PriorBillingCode>CR105</PriorBillingCode></PriorBillingCodes><Name>Score Knee System Femoral Component</Name><Description>Femoral component, Cemented, CoCr, with extended patellar groove </Description><Size>7 sizes</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>210577</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI074</BillingCode><Name>Delta Ceramic Head</Name><Description>Biolox Delta Head</Description><Size>28 and 32mm heads
10/12 and 12/14</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>281064</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI115</BillingCode><Name>Biolox Delta Ceramic Revision Head</Name><Description>Biolox Delta Femoral Head</Description><Size>28mm and 32mm</Size><SupplierCode>LI</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>281065</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI110</BillingCode><Name>Comete Anchor</Name><Description>ACL Femoral Cortical Fixation</Description><Size>Length 15mm to 40mm</Size><SupplierCode>LI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>285471</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI109</BillingCode><Name>Eclipse BCP Screw</Name><Description>Absorbable, osteoconducting interference screw</Description><Size>Diameter 7mm to 12mm  Length 20mm to 35mm</Size><SupplierCode>LI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>284239</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI111</BillingCode><Name>Anatomic Cemented Femur</Name><Description>Cemented Posterior Stabilised Femoral Component</Description><Size>0 to 8</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>222529</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LI063</BillingCode><PriorBillingCodes><PriorBillingCode>CR109</PriorBillingCode></PriorBillingCodes><Name>Score Knee System Femoral Component</Name><Description>Femoral Component, CoCr, cemented, Posterior Stabilised</Description><Size>4 sizes in left and right</Size><SupplierCode>LI</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><Suffix>Revision</Suffix><ARTGs><ARTG>210579</ARTG></ARTGs><MinimumBenefit>5363</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ004</BillingCode><PriorBillingCodes><PriorBillingCode>AT074</PriorBillingCode></PriorBillingCodes><Name>Anatomics Cranial Patient Specific Implant - One Piece</Name><Description>Cranial patient specific implant constructed of Titanium, Acrylic or Porous Polyethylene</Description><Size>Custom</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>4343</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>288564</ARTG></ARTGs><MinimumBenefit>9682</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ005</BillingCode><PriorBillingCodes><PriorBillingCode>AT075</PriorBillingCode></PriorBillingCodes><Name>Anatomics Cranial Patient Specific Implant - Two Piece</Name><Description>Patient Specific Cranial Implant constructed of Titanium, Acrylic or Porous Polyethylene</Description><Size>Custom</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>4343</SubGroupID><Suffix>Biomodelled Two Piece</Suffix><ARTGs><ARTG>288564</ARTG></ARTGs><MinimumBenefit>10169</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ014</BillingCode><PriorBillingCodes><PriorBillingCode>AT081</PriorBillingCode></PriorBillingCodes><Name>Anatomics Surgical Guide</Name><Description>Biomodelled surgical guides to support surgical decision making both pre and intra-operatively</Description><Size>The device is custom made so the size will vary</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>5496</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>288564</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1315</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ001</BillingCode><PriorBillingCodes><PriorBillingCode>AT076</PriorBillingCode></PriorBillingCodes><Name>Anatomics Biomodel</Name><Description>A patient-specific, 3D printed  biomodel intended to assist the surgeon during pre- and intraoperative procedural planning.</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1807</GroupID><ARTGs><ARTG>288564</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ012</BillingCode><PriorBillingCodes><PriorBillingCode>AT082</PriorBillingCode></PriorBillingCodes><Name>Anatomics Patient Specific Orbital Rim</Name><Description>Custom, 3D-printed orbital rim constructed of porous polyethylene.</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4370</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>288564</ARTG></ARTGs><MinimumBenefit>4095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ008</BillingCode><PriorBillingCodes><PriorBillingCode>AT085</PriorBillingCode></PriorBillingCodes><Name>Anatomics Patient Specifc Surgical Guide</Name><Description>Patient specific surgical guide created from patient CT scan data, used to assist surgeons to implant the device by assisting in clinical decision making both pre- and intraoperatively</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>288564</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ007</BillingCode><PriorBillingCodes><PriorBillingCode>AT078</PriorBillingCode></PriorBillingCodes><Name>Anatomics Fixation Straight Plates</Name><Description>Titanium fixation straight plates</Description><Size>2 Holes
Thickness - 0.6mm
Length - 15mm</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4267</SubGroupID><ARTGs><ARTG>288564</ARTG></ARTGs><MinimumBenefit>76</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ003</BillingCode><PriorBillingCodes><PriorBillingCode>AT080</PriorBillingCode></PriorBillingCodes><Name>Anatomics Burr Hole Plates</Name><Description>Titanium burr hole plate</Description><Size>Thickness - 0.6mm
Diameter - 18-22mm</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Burr</Suffix><ARTGs><ARTG>288564</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ002</BillingCode><PriorBillingCodes><PriorBillingCode>AT077</PriorBillingCode></PriorBillingCodes><Name>Anatomics Bone Screws</Name><Description>Titanium bone screws for patient specific implants</Description><Size>Diameter - 1.6-2.0 mm
Length - 5mm</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>288564</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ006</BillingCode><PriorBillingCodes><PriorBillingCode>AT079</PriorBillingCode></PriorBillingCodes><Name>Anatomics Fixation Double-Y Plates</Name><Description>Titanium craniofacial fixation plates</Description><Size>6 Holes
Thickness - 0.6mm
Length - 17mm</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>288564</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ011</BillingCode><PriorBillingCodes><PriorBillingCode>AT087</PriorBillingCode></PriorBillingCodes><Name>Anatomics Patient Specific Orbital Floor Implant</Name><Description>A custom, patient specific implant intended for the reconstruction of the patient's orbital floor manufactured with titanium or porous polyethylene.</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4367</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>288564</ARTG></ARTGs><MinimumBenefit>4095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ009</BillingCode><PriorBillingCodes><PriorBillingCode>AT083</PriorBillingCode></PriorBillingCodes><Name>Anatomics Patient Specific Malar Implant</Name><Description>A customised patient specific implant constucted of porous polyethelene</Description><Size>The device is customised so sizes will vary</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1595</GroupID><SubGroupID>4352</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>288564</ARTG></ARTGs><MinimumBenefit>4095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ013</BillingCode><PriorBillingCodes><PriorBillingCode>AT088</PriorBillingCode></PriorBillingCodes><Name>Anatomics Patient Specific Surgical Guide</Name><Description>The Surgical Guide component of the system is created from the patient's CT scan data to assist the surgeon with pre- and intraoperative planning.</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>6023</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>288564</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>2584</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ010</BillingCode><PriorBillingCodes><PriorBillingCode>AT084</PriorBillingCode></PriorBillingCodes><Name>Anatomics Patient Specific Mandible</Name><Description>Custom mandible implant constructed of porous polyethylene</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>KU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>6741</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>288564</ARTG></ARTGs><MinimumBenefit>3493</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FQ002</BillingCode><Name>FlexDex Gastric Bypass and Gastrectomy Kit</Name><Description>Kit includes a single-use articulating laparoscopic needle driver with seven degrees of motion and sutures</Description><Size>One size only</Size><SupplierCode>FQ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>7361</SubGroupID><ARTGs><ARTG>315333</ARTG></ARTGs><MinimumBenefit>680</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MH015</BillingCode><Name>Epix™ Disposable Laparoscopic Clip Applier w/ TiGold M/L titanium clips</Name><Description>Epix™ Disposable Laparoscopic Clip Applier w/ TiGold M/L titanium clips 5mm</Description><Size>5mm</Size><SupplierCode>MH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Laparoscopic</Suffix><ARTGs><ARTG>116980</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MH013</BillingCode><Name>Paediatric Silhouette System Set</Name><Description>Coil reinforced body.  SL-6 hydrophilic coating.  UroWire 0.035" 3-in-1 guidewire with kink resistant nitinol core.  Design divided into 3 sections: silver section (front end) floppy SL - 6 hydrophilic coating; Blue section (mid) super stiff PTFE (not hydrophilicaly coated); and Green section (back) flexible</Description><Size>4F, 8 - 12cm</Size><SupplierCode>MH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>P</Suffix><ARTGs><ARTG>116727</ARTG><ARTG>116728</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MH010</BillingCode><Name>Silhouette Ureteral Stent</Name><Description>The Silhouette Ureteric Stent is manufactured with a soft material that provides superior comfort.  It has superior column strength through a coil-reinforced body providing effortless placement.  The tight coils prevent migration.  The smaller outside dia</Description><Size>Multiple French Sizes &amp; Lengths</Size><SupplierCode>MH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5321</SubGroupID><ARTGs><ARTG>116728</ARTG></ARTGs><MinimumBenefit>95</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JF002</BillingCode><Name>HealthPORT  Venous Access Port</Name><Description>HEALTHPORT Venous   Polysufone/Titanium Implantable Venous Access Systems, for mid and long term intermittent or continuous central venous infusion. Come with Silicon or Polyurethane catheter in multiple French sizes. Kits include Port chamber, Catheter, Connector, Huber needle 22G, Luer connector, Peel-away dilator-introducer, Introducer needle 18G, J-Guidewire 0.89mm, Stainless Steel Tunneler</Description><Size>5-8 Fr</Size><SupplierCode>JF</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><ARTGs><ARTG>385351</ARTG></ARTGs><MinimumBenefit>399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JF001</BillingCode><Name>HealthPORT Power Venous Access Port</Name><Description>HealthPORT Power Venous Polysufone/Titanium Implantable Venous Access Systems, for mid and long term intermittent or continuous central venous infusion. Come with Silicon or Polyurethane catheter in multiple French sizes. Kits include Port chamber, Catheter, Connector, Huber needle 22G, Luer connector, Peel-away dilator-introducer, Introducer needle 18G, J-Guidewire 0.89mm, Stainless Steel Tunneler  For Power Injection</Description><Size>5-8 Fr</Size><SupplierCode>JF</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>385351</ARTG></ARTGs><MinimumBenefit>510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ692</BillingCode><Name>Knotless Hip SutureTak</Name><Description>Knotless PEEK anchor suture for arthroscopic hip labral repair</Description><Size>2.4mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU239</BillingCode><PriorBillingCodes><PriorBillingCode>DE271</PriorBillingCode></PriorBillingCodes><Name>RetroButton</Name><Description>Femoral Fixation Device</Description><Size>12mm Button with 15-60mm loops, 15mm Button with 15-60mm loops</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>353493</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU182</BillingCode><PriorBillingCodes><PriorBillingCode>DE443</PriorBillingCode></PriorBillingCodes><Name>Low Profile T-Plate</Name><Description>Plate for fusion</Description><Size>5-6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU281</BillingCode><Name>Straight Plate</Name><Description>Plate for fracture fixation</Description><Size>6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU287</BillingCode><Name>Bridge Plate</Name><Description>Plate for fracture fixation</Description><Size>6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU135</BillingCode><PriorBillingCodes><PriorBillingCode>DE547</PriorBillingCode></PriorBillingCodes><Name>Medial Distal Tibia Plate</Name><Description>Plate for Fracture Fixation</Description><Size>≥ 16 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU221</BillingCode><PriorBillingCodes><PriorBillingCode>DE707</PriorBillingCode></PriorBillingCodes><Name>TightRope Implant with FiberTag Suture</Name><Description>TightRope implant pre-loaded with FiberTag suture</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>353493</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU286</BillingCode><Name>Rotation Correction Plate</Name><Description>Plate for arthrodesis</Description><Size>5 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU266</BillingCode><PriorBillingCodes><PriorBillingCode>DE215</PriorBillingCode></PriorBillingCodes><Name>Titanium Metatarsal Opening Wedge Osteotomy Plate </Name><Description>Titanium Metatarsal Opening Wedge Osteotomy Plate with 4 non locking holes and square wedge </Description><Size>2mm - 8mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU293</BillingCode><Name>T-Plate, Reinforced</Name><Description>Plate for fracture fixation</Description><Size>6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU227</BillingCode><PriorBillingCodes><PriorBillingCode>DE503</PriorBillingCode></PriorBillingCodes><Name>Dx Swivelock</Name><Description>A knotless screw in anchor used for soft tissue fixation to bone</Description><Size>2.4 - 3.9mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU203</BillingCode><PriorBillingCodes><PriorBillingCode>DE469</PriorBillingCode></PriorBillingCodes><Name>Ankle Fusion Plating System</Name><Description>Fusion Plate for Ankle Joint Arthritis</Description><Size>Anterior, Posterior, Lateral</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>508</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU148</BillingCode><PriorBillingCodes><PriorBillingCode>DE528</PriorBillingCode></PriorBillingCodes><Name>Ankle Fusion Plating System</Name><Description>Fusion Plate</Description><Size>8-10 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1295</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU334</BillingCode><Name>Knotless BicepsButton</Name><Description>Button suture construct</Description><Size>2.6 mm x 12 mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>385940</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU329</BillingCode><Name>Knotless AC Open Repair Implant  </Name><Description>Titanium or stainless steel fixation device, with nonabsorbable suture material  </Description><Size>2.6mm – 3.2mm, adjustable length suture</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>385940</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU222</BillingCode><PriorBillingCodes><PriorBillingCode>DE252</PriorBillingCode></PriorBillingCodes><Name>Tightrope Syndesmosis Repair Kit</Name><Description>Titanium or stainless steel, with non absorbable Fiberwire suture material</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>353493</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU125</BillingCode><PriorBillingCodes><PriorBillingCode>DE575</PriorBillingCode></PriorBillingCodes><Name>Straight Plate</Name><Description>Plate for Fracture Fixation</Description><Size>2-5 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>417</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU291</BillingCode><Name>Straight Plate, Reinforced</Name><Description>Plate for fracture fixation</Description><Size>6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU294</BillingCode><Name>Y-Plate</Name><Description>Plate for Arthrodesis</Description><Size>6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU173</BillingCode><PriorBillingCodes><PriorBillingCode>DE442</PriorBillingCode></PriorBillingCodes><Name>X Plate</Name><Description>Plate for fusion</Description><Size>Small</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU359</BillingCode><Name>Mini Fragment System - Straight Plates</Name><Description>Plates for Fracture Fixation</Description><Size>&lt;6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU290</BillingCode><Name>T-Plate, Wide</Name><Description>Plate for fracture fixation</Description><Size>6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU303</BillingCode><Name>Posterior Pilon Fusion Plate</Name><Description>Plate for Arthrodesis</Description><Size>13-15 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>508</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU176</BillingCode><PriorBillingCodes><PriorBillingCode>DE502</PriorBillingCode></PriorBillingCodes><Name>Arthrex Clavicle Plating System</Name><Description>Locking clavicle plate and screw system for fixation of clavicle fractures.</Description><Size>7-10 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>645</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU351</BillingCode><Name>Mini Fragment System - Tine Plate</Name><Description>Plate for Fracture Fixation</Description><Size>2.7mm, 6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU276</BillingCode><Name>V-Plate</Name><Description>Plate for fracture fixation</Description><Size>6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU289</BillingCode><Name>T- Plate</Name><Description>Plate for fracture fixation</Description><Size>6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU244</BillingCode><PriorBillingCodes><PriorBillingCode>DE755</PriorBillingCode></PriorBillingCodes><Name>Hook Plate</Name><Description>Plate for Fracture Fixation</Description><Size>6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU103</BillingCode><PriorBillingCodes><PriorBillingCode>DE293</PriorBillingCode></PriorBillingCodes><Name>Prostop</Name><Description>Arthroereisis Subtalar implant</Description><Size>7x12mm 8x12mm 9x14mm 10x14mm 11x16mm 12x16mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1219</GroupID><SubGroupID>3261</SubGroupID><ARTGs><ARTG>350870</ARTG></ARTGs><MinimumBenefit>1321</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU388</BillingCode><Name>Arthrex Univers Revers Modular Glenoid System - Modular Baseplate</Name><Description>Modular Baseplate</Description><Size>Size: 24-28mm Offset: +0 mm, +2 mm, +4 mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4078</SubGroupID><ARTGs><ARTG>481533</ARTG></ARTGs><MinimumBenefit>1991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU397</BillingCode><Name> Arthrex Universal Glenoid Baseplate</Name><Description>Baseplate</Description><Size>Small, Medium and Large</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4078</SubGroupID><ARTGs><ARTG>481530</ARTG></ARTGs><Note>Prescribed List reimbursement for the billing code is restricted to the use of the devices in reverse shoulder replacement procedures only.</Note><MinimumBenefit>1991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU396</BillingCode><Name>Arthrex Univers Revers Modular Glenoid System, Monoblock Post Baseplate</Name><Description>Monoblock Post Baseplate</Description><Size>24mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4078</SubGroupID><ARTGs><ARTG>481525</ARTG></ARTGs><MinimumBenefit>1991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU131</BillingCode><PriorBillingCodes><PriorBillingCode>DE529</PriorBillingCode></PriorBillingCodes><Name>Anterior Distal Tibia Plate</Name><Description>Plate for Fracture Fixation</Description><Size>16 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU269</BillingCode><PriorBillingCodes><PriorBillingCode>DE435</PriorBillingCode><PriorBillingCode>DE305</PriorBillingCode></PriorBillingCodes><Name>BioComposite PushLock</Name><Description>BioComposite Pushlock Knotless Suture Anchor</Description><Size>2.4 - 3.5 mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>354973</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU368</BillingCode><Name>Knotless FiberTak Biceps Implant</Name><Description>soft tissue fixation anchor </Description><Size>3mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU157</BillingCode><PriorBillingCodes><PriorBillingCode>DE550</PriorBillingCode></PriorBillingCodes><Name>RetroFusion</Name><Description>Implant for PIP Arthrodesis for Hammertoe and Clawtoe Deformity</Description><Size>20mm Length  24mm Length</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5474</SubGroupID><ARTGs><ARTG>350672</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ620</BillingCode><Name>FiberTag Tightrope II button and suture</Name><Description>TightRope implant pre-loaded with FiberTag suture</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>383904</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU161</BillingCode><PriorBillingCodes><PriorBillingCode>DE071</PriorBillingCode></PriorBillingCodes><Name>Washer</Name><Description>Screw Washer</Description><Size>6mm - 18mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>350851</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU406</BillingCode><Name>Metatarsal hook plate </Name><Description>Titanium locking complex plate </Description><Size>6 hole or less</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU162</BillingCode><PriorBillingCodes><PriorBillingCode>DE507</PriorBillingCode></PriorBillingCodes><Name>Mini Tightrope CMC</Name><Description>CMC fixation device</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>350631</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU335</BillingCode><Name>Knotless Distal Clavicle Plate Button Assembly</Name><Description>Knotless TightRope pre-loaded on Clavicle Button for use with DogBone. Titanium button with nonabsorbable UHMWPE suture material.</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>350871</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ234</BillingCode><Name>Mini Comprehensive Fixation System Plates</Name><Description>VAL Plate Mini Comprehensive Fixation System (CFS)</Description><Size>6 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU181</BillingCode><PriorBillingCodes><PriorBillingCode>DE444</PriorBillingCode></PriorBillingCodes><Name>Low Profile Straight Plate</Name><Description>Plate for Fusion</Description><Size>4-6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU172</BillingCode><PriorBillingCodes><PriorBillingCode>DE554</PriorBillingCode></PriorBillingCodes><Name>LPS Cotton Osteotomy Plates</Name><Description>Wedged Fusion Plate</Description><Size>Flat, 2mm - 8mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU337</BillingCode><Name>Low-Profile AC Implant</Name><Description>Knotless AC Implant (Button with Non-Absorbable Suture)  </Description><Size>One Size Only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>353493</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU326</BillingCode><Name>Knotless Distal Clavicle Plate Button TightRope® Implant</Name><Description>Knotless Distal Clavicle Plate Button attached to a large Pec Button pre-loaded on an inserter. Titanium or stainless steel button, with nonabsorbable UHMWPE suture material.</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>350871</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU331</BillingCode><Name>Knotless Mini Tightrope Implant System, 2.7mm, Titanium</Name><Description>Button fixation for ligament repair</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>350631</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU339</BillingCode><Name>Knotless Mini Tightrope Implant System, 1.1mm Titanium</Name><Description>1.1mm Knotless Tightrope Implant System includes the Knotless Mini Tightrope Construct, 2 Buttons, Suture, Passing wires and pins, and Kite Handle.</Description><Size>one size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>350631</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU323</BillingCode><Name>BTB TightRope II</Name><Description>Suture construct with button for soft tissue to bone fixation for ACL/PCL repair and reconstruction</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>383904</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU213</BillingCode><PriorBillingCodes><PriorBillingCode>DE654</PriorBillingCode></PriorBillingCodes><Name>Nano Corkscrew FT Suture Anchor</Name><Description>Suture Anchor</Description><Size>1.7mm x 5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU405</BillingCode><Name>Knotless 1.8 Hip FiberTak Anchor preloaded with suture</Name><Description>Suture Anchor, Ultra-high molecular weight polyethylene (UHMWPE), Polyester </Description><Size>1.8mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>384730</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ305</BillingCode><Name>Fiberstitch RC</Name><Description>Fiberstitch All Suture Anchor</Description><Size>1.5mm, 1.9mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>328289</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU325</BillingCode><Name>DX Knotless FiberTak</Name><Description>Soft Tissue Fixation Anchor</Description><Size>2.4-3.9mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>384730</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU322</BillingCode><Name>TightRope II ABS (Attachable Button System)</Name><Description>Adjustable FiberLoop for Attachable Button System constructs combined with a button</Description><Size>Round Button- Diameter: 11mm to 20mm  Standard Button: Length: 12mm, Width: 8mm; Oblong Button- Length: 13mm, Width: 3.4mm;    Button Shapes: standard, round, oblong; UHMWPE loop without button</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>353493</ARTG><ARTG>383904</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU214</BillingCode><PriorBillingCodes><PriorBillingCode>DE697</PriorBillingCode></PriorBillingCodes><Name>Mini Hip SutureTak</Name><Description>Suture anchor</Description><Size>Diameter: 2mm  Length: 8.6mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU211</BillingCode><PriorBillingCodes><PriorBillingCode>DE430</PriorBillingCode><PriorBillingCode>DE196</PriorBillingCode></PriorBillingCodes><Name>Corkscrew Suture Anchor</Name><Description>Titanium alloy with Fibrewire suture</Description><Size>2.2mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ688</BillingCode><Name>FiberStitch II</Name><Description>Double anchor, self tying device for all-inside meniscal repair</Description><Size>One size</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>328289</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU253</BillingCode><PriorBillingCodes><PriorBillingCode>DE273</PriorBillingCode></PriorBillingCodes><Name>Trim-IT Spin Pin</Name><Description>Trim-IT  Pin Fixation</Description><Size>1.5 - 2.0mm x 100mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>360375</ARTG></ARTGs><MinimumBenefit>257</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU324</BillingCode><Name>TightRope II RT Implant</Name><Description>Suture construct with button for soft tissue to bone fixation for ACL/PCL repair and reconstruction. </Description><Size>One Size Only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>383904</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU163</BillingCode><PriorBillingCodes><PriorBillingCode>DE509</PriorBillingCode></PriorBillingCodes><Name>Mini Tightrope</Name><Description>CMC Fixation Device</Description><Size>One Size fits all</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>350631</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU212</BillingCode><PriorBillingCodes><PriorBillingCode>DE483</PriorBillingCode></PriorBillingCodes><Name>FiberTak Suture Anchor</Name><Description>Suture anchor with 2 x #2 FibreWire CL or 1.3mm SutureTape</Description><Size>1.3mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU387</BillingCode><Name>KreuLock Compression Screw System - BB Tak Pins</Name><Description>Olive wire pin, threaded or smooth </Description><Size>2.4mm - 3.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><Suffix>OL</Suffix><ARTGs><ARTG>210499</ARTG><ARTG>351031</ARTG></ARTGs><MinimumBenefit>117</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU223</BillingCode><PriorBillingCodes><PriorBillingCode>DE548</PriorBillingCode></PriorBillingCodes><Name>Tightrope</Name><Description>Titanium or stainless steel fixation device, with non absorbable suture material</Description><Size>2.6mm - 13mm, various shapes, adjustable length suture</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>353493</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU136</BillingCode><PriorBillingCodes><PriorBillingCode>DE562</PriorBillingCode></PriorBillingCodes><Name>Anterolateral Distal Tibia Plate</Name><Description>Plate for Fracture Fixation</Description><Size>≥ 16 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU381</BillingCode><Name>Arthrex Univers Revers Glenosphere</Name><Description>Reverse Glenosphere</Description><Size>Size: 36-42  Lateral: +4mm  Inferior: +2.5mm  </Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>481540</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU393</BillingCode><Name>Arthrex Univers Revers Modular Glenoid System Glenosphere</Name><Description>Glenosphere</Description><Size>Size: 33-42mm Offset: neutral, +4LAT/24, +4LAT/28, +2.5INF/24, +2.5INF/28</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>481526</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU399</BillingCode><Name>Arthrex Univers Revers CaP Coated Revision Stem</Name><Description>Revision Stem</Description><Size>Size: 6-12</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4057</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>481539</ARTG></ARTGs><MinimumBenefit>6301</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU145</BillingCode><PriorBillingCodes><PriorBillingCode>DE412</PriorBillingCode></PriorBillingCodes><Name>Low Profile Locking Screws</Name><Description>Locking screws for Arthrex Fracture Plate Fixation</Description><Size>2.01mm to 2.7mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU369</BillingCode><Name>Snap-Off Compression FT Pins 1.9mm</Name><Description>Snap-Off Compression pins for fusion and fracture fixation</Description><Size>1.9mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>350672</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU132</BillingCode><PriorBillingCodes><PriorBillingCode>DE549</PriorBillingCode></PriorBillingCodes><Name>Posterior Distal Tibia Plate</Name><Description>Plate for Fracture Fixation</Description><Size>16 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU207</BillingCode><PriorBillingCodes><PriorBillingCode>DE364</PriorBillingCode><PriorBillingCode>DE291</PriorBillingCode></PriorBillingCodes><Name>QuickFix Screw Micro</Name><Description>Titanium Snap-off Small Bone Screw</Description><Size>2.0mm Diameter x 10-14mm lengths</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU133</BillingCode><PriorBillingCodes><PriorBillingCode>DE552</PriorBillingCode></PriorBillingCodes><Name>Anterolateral Distal Tibia Plate</Name><Description>Plate for Fracture Fixation</Description><Size>13-15 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1182</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU234</BillingCode><PriorBillingCodes><PriorBillingCode>DE433</PriorBillingCode><PriorBillingCode>DE261</PriorBillingCode></PriorBillingCodes><Name>Pushlock Suture Anchor</Name><Description>Knotless Suture Anchor</Description><Size>2.5 - 3.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU138</BillingCode><PriorBillingCodes><PriorBillingCode>DE571</PriorBillingCode></PriorBillingCodes><Name>Anterior Distal Tibia Plate</Name><Description>Plate for Fracture Fixation</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1182</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ641</BillingCode><Name>Knotless FiberTak Soft Anchor</Name><Description>Suture Anchor, Polyester </Description><Size>2.6mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU137</BillingCode><PriorBillingCodes><PriorBillingCode>DE569</PriorBillingCode></PriorBillingCodes><Name>Posterior Distal Tibia Plate</Name><Description>Plate for Fracture Fixation</Description><Size>≥ 7 to ≤ 15 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1182</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU248</BillingCode><PriorBillingCodes><PriorBillingCode>DE304</PriorBillingCode></PriorBillingCodes><Name>BioComposite SutureTak</Name><Description>Suture Anchor</Description><Size>2.4 – 3mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>354970</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU401</BillingCode><Name>Titanium Ankle and Fracture System</Name><Description>Posterolateral Distal Tibia Plate and Vertical Sheer Distal Tibia Plate</Description><Size>7-15 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG><ARTG>355042</ARTG></ARTGs><MinimumBenefit>1489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU270</BillingCode><PriorBillingCodes><PriorBillingCode>DE475</PriorBillingCode></PriorBillingCodes><Name>Biocomposite Swivelock Anchor</Name><Description>Knotless Suture Anchor</Description><Size>3.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>354972</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU225</BillingCode><PriorBillingCodes><PriorBillingCode>DE576</PriorBillingCode></PriorBillingCodes><Name>FiberTak DR/ FiberTak RC/FiberTak Knotless</Name><Description>Suture Anchor</Description><Size>2.6mm&gt;</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU231</BillingCode><PriorBillingCodes><PriorBillingCode>DE461</PriorBillingCode><PriorBillingCode>DE220</PriorBillingCode></PriorBillingCodes><Name>SutureTak</Name><Description>Suture Anchor</Description><Size>2.4mm - 3.9mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU134</BillingCode><PriorBillingCodes><PriorBillingCode>DE557</PriorBillingCode></PriorBillingCodes><Name>Medial Distal Tibia Plate</Name><Description>Plate for Fracture Fixation</Description><Size>12-14 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1182</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU306</BillingCode><Name>Anterolateral Pilon Fusion Plate</Name><Description>Plate for Arthrodesis</Description><Size>&gt;16 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5257</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1378</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU262</BillingCode><PriorBillingCodes><PriorBillingCode>DE172</PriorBillingCode></PriorBillingCodes><Name>Univers Glenoid Shoulder Prostheses</Name><Description>Cemented glenoid</Description><Size>Small, Medium, Large, Extra-Large</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>3701</SubGroupID><ARTGs><ARTG>308803</ARTG><ARTG>308804</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU240</BillingCode><PriorBillingCodes><PriorBillingCode>DE062</PriorBillingCode></PriorBillingCodes><Name>Ligament Staples</Name><Description>Cobalt Chromium Molybdenium Alloy</Description><Size>6mm - 16mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><ARTGs><ARTG>354063</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU263</BillingCode><PriorBillingCodes><PriorBillingCode>DE292</PriorBillingCode></PriorBillingCodes><Name>QuickFix Staple System</Name><Description>Compression Staple for Fusion</Description><Size>8mm 10mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><ARTGs><ARTG>367491</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU304</BillingCode><Name>Posterior Pilon Fusion Plate</Name><Description>Plate for Arthrodesis</Description><Size>≥ 16 Holes  </Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5257</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU362</BillingCode><Name>FiberLock Suspensionplasty</Name><Description>The FiberLock Suspension Implant Kit contains the FiberTak Anchor and devices for insertion for CMC arthritis.</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU160</BillingCode><PriorBillingCodes><PriorBillingCode>DE646</PriorBillingCode></PriorBillingCodes><Name>DynaNite</Name><Description>Nitinol Staple for Osteotomy Fixation</Description><Size>Width (9mm-25mm)    Length (7mm-20mm)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><Suffix>MM</Suffix><ARTGs><ARTG>350734</ARTG></ARTGs><MinimumBenefit>507</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU241</BillingCode><PriorBillingCodes><PriorBillingCode>DE577</PriorBillingCode></PriorBillingCodes><Name>BioSync Anatomic Reconstruction Wedge</Name><Description>Titanium metal scaffold for angular correction in ankle and foot</Description><Size>Cotton Wedges 16mm-20mm Depth x 4.5mm-7.5mm Thickness  Evans Wedges  18mm-22mm Width &amp; Depth x 6.5mm-12mm Thickness</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1777</GroupID><SubGroupID>5399</SubGroupID><Suffix>3D anatomical</Suffix><ARTGs><ARTG>355042</ARTG></ARTGs><MinimumBenefit>1219</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU249</BillingCode><PriorBillingCodes><PriorBillingCode>DE478</PriorBillingCode></PriorBillingCodes><Name>Quickset</Name><Description>Injectable Macroporous Calcium Phosphate</Description><Size>16cc</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><Suffix>CDS</Suffix><ARTGs><ARTG>267632</ARTG></ARTGs><MinimumBenefit>2043</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU127</BillingCode><PriorBillingCodes><PriorBillingCode>DE563</PriorBillingCode></PriorBillingCodes><Name>Volar Hook PLate</Name><Description>Plate for Fracture Fixation</Description><Size>4 Holes  6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1372</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ301</BillingCode><Name>Knee FiberTak Anchor, Hybrid preloaded with sutures</Name><Description>All Suture Anchor preloaded with sutures</Description><Size>2.6mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ300</BillingCode><Name>Knee FiberTak Anchor Internal Brace preloaded with sutures</Name><Description>All Suture Anchor preloaded with sutures</Description><Size>2.6mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU197</BillingCode><PriorBillingCodes><PriorBillingCode>DE078</PriorBillingCode></PriorBillingCodes><Name>Osteotomy Plates</Name><Description>Osteotomy, Femoral - Stainless Steel</Description><Size>7.5mm - 17.5 mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5287</SubGroupID><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>864</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU307</BillingCode><Name>Dx FiberTak double loaded with 0.9mm SutureTape</Name><Description>Soft Tissue Fixation Device</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU228</BillingCode><PriorBillingCodes><PriorBillingCode>DE500</PriorBillingCode></PriorBillingCodes><Name>TightRope Button</Name><Description>Titanium or stainless steel button</Description><Size>5mm-20mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>353493</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU215</BillingCode><PriorBillingCodes><PriorBillingCode>DE198</PriorBillingCode></PriorBillingCodes><Name>Fastak Suture Anchor (Small Bone)</Name><Description>With Fibrewire Suture</Description><Size>Dia. 2.4mm x Length 7.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU332</BillingCode><Name>SutureLoc Implant</Name><Description>Meniscal suture anchor</Description><Size>2.6mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>384730</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU327</BillingCode><Name>Knotless Tension Tight Button</Name><Description>Biceps Suture Button</Description><Size>2.6mm - 7.5mm  </Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>353493</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU260</BillingCode><PriorBillingCodes><PriorBillingCode>DE174</PriorBillingCode></PriorBillingCodes><Name>Univers Fracture Prostheses</Name><Description>Metal head</Description><Size>43/15 - 51/22</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><ARTGs><ARTG>308824</ARTG><ARTG>308825</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU370</BillingCode><Name>Arthrex® UNIVERS™ II Humeral Head</Name><Description>Humeral Head</Description><Size>40/17 - 56/24</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><ARTGs><ARTG>308821</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU261</BillingCode><PriorBillingCodes><PriorBillingCode>DE257</PriorBillingCode></PriorBillingCodes><Name>Eclipse Humeral Head Prosthesis</Name><Description>Eclipse Humeral Head Prosthesis Head</Description><Size>37/16 - 55/23</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><ARTGs><ARTG>308800</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU158</BillingCode><PriorBillingCodes><PriorBillingCode>DE466</PriorBillingCode></PriorBillingCodes><Name>Compression FT</Name><Description>Headless Compression Screw for bone fixation</Description><Size>3.5mm/4.0mm x 12-60mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU237</BillingCode><PriorBillingCodes><PriorBillingCode>DE301</PriorBillingCode></PriorBillingCodes><Name>Suture Button</Name><Description>Multiple hole button for fixation of bone to bone or soft tissue to bone, and are intended as fixation posts, a distribution bridge, or for distributing suture tension over areas of ligament or tendon repair. A button implant system is supplied with suture.</Description><Size>2.6mm - 7.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>385940</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ303</BillingCode><Name>Tightrope ABS Button Round Concave</Name><Description>Tibial buttons to accommodate various tunnel sizes</Description><Size>11-17mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>353493</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ241</BillingCode><Name>Low Profile Locking Screw</Name><Description>Low Profile Locking Screw </Description><Size>3-3.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU247</BillingCode><PriorBillingCodes><PriorBillingCode>DE126</PriorBillingCode></PriorBillingCodes><Name>Chondral Dart</Name><Description>Polylactide Compositition</Description><Size>Length 18mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5382</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>360372</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU144</BillingCode><PriorBillingCodes><PriorBillingCode>DE407</PriorBillingCode></PriorBillingCodes><Name>Non-Locking Cortical and Cancellous Screws, Small</Name><Description>Non-Locking Cortical and Cancellous Screws, Small</Description><Size>3-3.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>355042</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ298</BillingCode><Name>Knee FiberTak Anchor Button preloaded with sutures</Name><Description>All suture Anchor preloaded with sutures</Description><Size>2.6</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU143</BillingCode><PriorBillingCodes><PriorBillingCode>DE368</PriorBillingCode><PriorBillingCode>DE128</PriorBillingCode></PriorBillingCodes><Name>Locking Cortical land Cancellous Screws, Small</Name><Description>Locking Cortical and Cancellous Screws, Small</Description><Size>3-3.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ615</BillingCode><Name>Titanium Ankle and Fracture System – Screws</Name><Description>Low Profile Locking Screw </Description><Size>3mm </Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU274</BillingCode><Name>Nano Swivelock Anchor</Name><Description>Soft Tissue Fixation Anchor</Description><Size>2.5mm x 7mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ237</BillingCode><Name>Low Profile Screw, Cortical</Name><Description>Low Profile Screw, Cortical</Description><Size>3-3.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU338</BillingCode><Name>Double Loaded Knotless Knee FiberTak  </Name><Description>Self-Punching non-bioabsorbable soft anchor</Description><Size>2.6mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>384730</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU218</BillingCode><PriorBillingCodes><PriorBillingCode>DE370</PriorBillingCode><PriorBillingCode>DE286</PriorBillingCode></PriorBillingCodes><Name>Cannulated Low Profile Screws, Small</Name><Description>Cannulated Low Profile Screws, Small</Description><Size>3-4mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU250</BillingCode><PriorBillingCodes><PriorBillingCode>DE706</PriorBillingCode></PriorBillingCodes><Name>FiberStitch</Name><Description>Meniscal suture anchor</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>328289</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU216</BillingCode><PriorBillingCodes><PriorBillingCode>DE225</PriorBillingCode></PriorBillingCodes><Name>Fastak Anchor</Name><Description>Titanium with fibrewire suture</Description><Size>2.8mm x 11.7mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ299</BillingCode><Name>Knee FiberTak Anchor Double Loaded preloaded with sutures</Name><Description>All Suture Anchor preloaded with sutures</Description><Size>2.6mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU373</BillingCode><Name>2.4mm Sterile Distal Radius Plate    </Name><Description>2.4 Volar Distal Radius Kit Convenience Packs include the Volar plate, screws, and other accessories for insertion </Description><Size>2.4mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350871</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU230</BillingCode><PriorBillingCodes><PriorBillingCode>DE463</PriorBillingCode></PriorBillingCodes><Name>SwiveLock Suture Anchor</Name><Description>Suture Anchor</Description><Size>3.5mm - 3.9mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU153</BillingCode><PriorBillingCodes><PriorBillingCode>DE471</PriorBillingCode></PriorBillingCodes><Name>Titanium Volar Radius Plating System</Name><Description>Fixation Plate for Distal Radius Fractures</Description><Size>9-15 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU336</BillingCode><Name>Knotless FiberTak® Biceps</Name><Description>Non-Absorbable Soft Anchor</Description><Size>2.6mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ614</BillingCode><Name>Congruent-Arc Latarjet - 3.75 Cannulated Screws</Name><Description>Cannulated Low Profile Screws, Small</Description><Size>3.75mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU254</BillingCode><PriorBillingCodes><PriorBillingCode>DE272</PriorBillingCode></PriorBillingCodes><Name>Bio-Compression Screw System</Name><Description>Fixation Device</Description><Size>16mm, 18mm, 20mm, 22mm, 24mm, 26mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>DT</Suffix><ARTGs><ARTG>140794</ARTG><ARTG>360378</ARTG></ARTGs><MinimumBenefit>245</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU313</BillingCode><Name>Low Profile Cancellous Screws, SS</Name><Description>Cancellous Screws</Description><Size>2.71mm-4.49mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU226</BillingCode><PriorBillingCodes><PriorBillingCode>DE559</PriorBillingCode></PriorBillingCodes><Name>Dx Swivelock SL</Name><Description>A knotless screw in Anchor used for Soft Tissue Fixation</Description><Size>3.5mm Diameter x 8.5mm length</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU358</BillingCode><Name>Titanium Volar Distal Radius Plating System</Name><Description>Plate for fracture fixation</Description><Size>10 and 13 holes, Narrow, Standard and Wide, Left and Right</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ295</BillingCode><Name>Cannulated Low Profile Screws, Small</Name><Description>Cannulated Low Profile Screws, Small</Description><Size>4mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU205</BillingCode><PriorBillingCodes><PriorBillingCode>DE365</PriorBillingCode><PriorBillingCode>DE291</PriorBillingCode></PriorBillingCodes><Name>QuickFix Screw, Small</Name><Description>Titanium Snapp-off Small Bone Screw, small</Description><Size>3.0mm Diameter x 13-19mm Lengths</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU224</BillingCode><PriorBillingCodes><PriorBillingCode>DE687</PriorBillingCode></PriorBillingCodes><Name>Knotless Hip SutureTak</Name><Description>Knotless suture anchor for hip labral fixation</Description><Size>Diameter: 3mm  Length: 12.7mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU297</BillingCode><Name>KreuLock Locking Compression Screw, Ti</Name><Description>Locking Compression Screws Titanium</Description><Size>3.0mm-3.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350999</ARTG><ARTG>355042</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU296</BillingCode><Name>Beveled FT Screw</Name><Description>Screw for osteotomy</Description><Size>3.5mm and 4.0mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU206</BillingCode><PriorBillingCodes><PriorBillingCode>DE366</PriorBillingCode><PriorBillingCode>DE077</PriorBillingCode></PriorBillingCodes><Name>Low Profile Cancellous Bone Screws</Name><Description>Low Profile Cancellous Bone Screws</Description><Size>4mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ600</BillingCode><Name>Titanium Ankle Fracture System 3.5mm cortical screw</Name><Description>Low profile screw, Cortical</Description><Size>3.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU151</BillingCode><PriorBillingCodes><PriorBillingCode>DE480</PriorBillingCode></PriorBillingCodes><Name>Headless Compression Screw System</Name><Description>Headless Compression Screw for bone fixation</Description><Size>3mm Diameter ( 10-36mm Lengths)  4.3mm Diameter (14-80mm Lengths)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>350672</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU142</BillingCode><PriorBillingCodes><PriorBillingCode>DE696</PriorBillingCode></PriorBillingCodes><Name>Patella Fracture Screw</Name><Description>4mm Blunt Tip Cannulated Lag Screw</Description><Size>4mm x 24mm - 4mm x 60mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU403</BillingCode><Name>KreuLock Locking Compression Screws </Name><Description>Compression Screws Titanium and Stainless Steel </Description><Size>2.71mm - 4.49mm </Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>DT</Suffix><ARTGs><ARTG>350999</ARTG><ARTG>355042</ARTG></ARTGs><MinimumBenefit>245</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU316</BillingCode><Name>KrueLock Locking Compression Screws SS</Name><Description>locking compression screw </Description><Size>3.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350999</ARTG><ARTG>355042</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU178</BillingCode><PriorBillingCodes><PriorBillingCode>DE470</PriorBillingCode></PriorBillingCodes><Name>Titanium Volar Distal Radius Plating System</Name><Description>Fixation Plate for Distal Radius Fractures</Description><Size>16 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5278</SubGroupID><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1121</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU318</BillingCode><Name>FiberTak </Name><Description>Self-Bunching Soft Anchor</Description><Size>2.6</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU305</BillingCode><Name>Anterolateral Pilon Fusion Plate</Name><Description>Plate for Arthrodesis</Description><Size>7-15 Holes  </Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1295</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU402</BillingCode><Name>FiberTape Sternal Closure System Median Sternotomy Closure</Name><Description>FiberTape Closure (white/blue) and TigerTape Closure (white/black), w/Cutting Needles, or w/Blunt Needles; and Radiopaque FiberTape Closure w/conventional cutting needle, or w/tapered cutting needle, or w/TigerLink shuttle suture (no needles)</Description><Size>One Diameter Size (2mm)</Size><SupplierCode>HU</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>252</SubCategoryID><GroupID>1791</GroupID><ARTGs><ARTG>354057</ARTG></ARTGs><Note>The Prescribed List reimbursement is restricted to use of the devices in Median Sternotomy Closure in connection with the Medicare Services described by at least one of the MBS items: 38477, 38484, 38487, 38499, 38516, 38517, 38502, 38508, 38509, 38512, 38515, 38550, 38553, 38554, 38555, 38556, 38557, 38653, 38764, 38670, 38673, 38677, 38680, 38742.</Note><MinimumBenefit>119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU346</BillingCode><Name>Mini Fragment System - Straight Plates</Name><Description>Plate for Fracture Fixation</Description><Size>2.7mm; 20 holes and 20 holes reinforced</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU354</BillingCode><Name>Mini Fragment System - Straight Plates 2.4mm</Name><Description>Plates for Fracture Fixation</Description><Size>2.4mm; 20 holes and 20 holes reinforced</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU353</BillingCode><Name>Mini Fragment System - Wide T-Plate</Name><Description>Plate for Fracture Fixation</Description><Size>2.7mm; 24 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ656</BillingCode><Name>Mini Fragment Plate 2.7mm </Name><Description>Mini Fragment Plate, greater or equal to 16-hole, Variable angle locking</Description><Size>2.7mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU114</BillingCode><PriorBillingCodes><PriorBillingCode>DE342</PriorBillingCode></PriorBillingCodes><Name>PEEKPower HTO Plate</Name><Description>Medial High Tibial Osteotomy Implant Device System</Description><Size>One Universal Size</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><ARTGs><ARTG>350871</ARTG></ARTGs><MinimumBenefit>645</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU217</BillingCode><PriorBillingCodes><PriorBillingCode>DE428</PriorBillingCode><PriorBillingCode>DE196</PriorBillingCode></PriorBillingCodes><Name>Corkscrew Suture Anchor</Name><Description>Titanium alloy with Fibrewire suture</Description><Size>3.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU149</BillingCode><PriorBillingCodes><PriorBillingCode>DE684</PriorBillingCode></PriorBillingCodes><Name>Fibulock, Fibular Nail System</Name><Description>Fibular Nail for Fibular Fracture Fixation</Description><Size>4 Sizes (Left &amp; Right Side Specific)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3329</SubGroupID><ARTGs><ARTG>350831</ARTG></ARTGs><MinimumBenefit>963</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU271</BillingCode><PriorBillingCodes><PriorBillingCode>DE477</PriorBillingCode></PriorBillingCodes><Name>Quickset</Name><Description>Injectable Macropourous Calcium Phosphate</Description><Size>8cc</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>267632</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU390</BillingCode><Name>Arthrex Univers Revers Modular Glenoid System - Modular Central Post</Name><Description>Modular Central Post</Description><Size>20-35mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4083</SubGroupID><ARTGs><ARTG>481529</ARTG></ARTGs><MinimumBenefit>991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU187</BillingCode><PriorBillingCodes><PriorBillingCode>DE415</PriorBillingCode></PriorBillingCodes><Name>Locking Third Tubular Plate</Name><Description>Plate for fracture of the Fibula</Description><Size>7-12 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU123</BillingCode><PriorBillingCodes><PriorBillingCode>DE531</PriorBillingCode></PriorBillingCodes><Name>Wrist Spanning Plate</Name><Description>Plate for Fracture Fixation</Description><Size>9 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU202</BillingCode><PriorBillingCodes><PriorBillingCode>DE464</PriorBillingCode></PriorBillingCodes><Name>Calcaneal Fracture Plate</Name><Description>Calcaneal Fracture Plate for fixation of Calcaneal fractures</Description><Size>7-15 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5296</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1373</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU109</BillingCode><PriorBillingCodes><PriorBillingCode>DE533</PriorBillingCode></PriorBillingCodes><Name>Posterolateral Distal Fibula Plate</Name><Description>Plate for fracture fixation</Description><Size>8-12 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU191</BillingCode><PriorBillingCodes><PriorBillingCode>DE420</PriorBillingCode></PriorBillingCodes><Name>Locking Lateral Hook Plate</Name><Description>Locking Lateral Hook Plate for Fixation of Lateral Malleolus</Description><Size>7 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>916</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ650</BillingCode><Name>Forearm Fracture Fixation System – Plates</Name><Description>Locking Compression Plate</Description><Size> 7 - 14 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU310</BillingCode><Name>Anatomic Posterolateral Distal Fibula Plate</Name><Description>Plate for fracture fixation</Description><Size>4-6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU312</BillingCode><Name>Locking Medial Hook Plate</Name><Description>Plate for fracture fixation</Description><Size>7-15 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU321</BillingCode><Name>Locking Distal Fibular Plate</Name><Description>Plate for Fracture Fixation</Description><Size>7-15 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU343</BillingCode><Name>Postero-Lateral Distal Tibial Plate</Name><Description>Plate for Fracture Fixation</Description><Size>9-13 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ238</BillingCode><Name>Posterolateral distal fibula plate, locking </Name><Description>Distal fibula locking plate used for open reduction and internal fixation for fractures of the fibula. </Description><Size>10 hole plate</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU188</BillingCode><PriorBillingCodes><PriorBillingCode>DE414</PriorBillingCode></PriorBillingCodes><Name>Locking Reconstruction Plate</Name><Description>Reconstruction Plate for communited Fibula Shaft Fractures</Description><Size>7-12 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU365</BillingCode><Name>Patella SuturePlate II Arrow Plate</Name><Description>Titanium Plate for Patella Fracture Fixation</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>355042</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU341</BillingCode><Name>Postero-Medial Distal Tibial Plate</Name><Description>Plate for Fracture Fixation</Description><Size>8 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU183</BillingCode><PriorBillingCodes><PriorBillingCode>DE441</PriorBillingCode></PriorBillingCodes><Name>Medial Column Plate</Name><Description>Plate for fusion</Description><Size>Small, Medium, Large (Left and Right)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU258</BillingCode><PriorBillingCodes><PriorBillingCode>DE256</PriorBillingCode></PriorBillingCodes><Name>Eclipse Humeral Head Prosthesis</Name><Description>Eclipse Humeral Head Prosthesis Trunnion</Description><Size>41 - 53mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><ARTGs><ARTG>308802</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU243</BillingCode><PriorBillingCodes><PriorBillingCode>DE760</PriorBillingCode></PriorBillingCodes><Name>MaxForce MTP</Name><Description>Plate for Arthrodesis</Description><Size>7-8 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU192</BillingCode><PriorBillingCodes><PriorBillingCode>DE419</PriorBillingCode></PriorBillingCodes><Name>Locking Lateral Hook Plate</Name><Description>Locking Lateral Hook Plate for Fracture Fixation of the Lateral Malleolus</Description><Size>3-5 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>916</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU376</BillingCode><Name>Arthrex Univers Revers SutureCup CaP-Coated</Name><Description>SutureCup</Description><Size>Size: 36-42 Size: +2mm left hand side, +2mm right hand side, neutral</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>481541</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU309</BillingCode><Name>Posterolateral Fibula Plate</Name><Description>Plate for fracture fixation</Description><Size>8 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU392</BillingCode><Name>Arthrex Eclipse Slotted Trunion </Name><Description>Humeral Head Slotted trunion</Description><Size>37-55mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><ARTGs><ARTG>489985</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU190</BillingCode><PriorBillingCodes><PriorBillingCode>DE421</PriorBillingCode></PriorBillingCodes><Name>Locking distal Fibula plate</Name><Description>Locking Distal Fibula Plate For Fracture Fixation</Description><Size>≥ 7 to ≤ 15 holes, for left and right specific</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU195</BillingCode><PriorBillingCodes><PriorBillingCode>DE373</PriorBillingCode><PriorBillingCode>DE287</PriorBillingCode></PriorBillingCodes><Name>Low Profile MTP Plate</Name><Description>Arthodesis Plate - 8 Hole plate</Description><Size>8 Hole plate</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU193</BillingCode><PriorBillingCodes><PriorBillingCode>DE418</PriorBillingCode></PriorBillingCodes><Name>Locking Medial Hook Plate</Name><Description>Locking Medial Hook Plate for fixation of Medial malleolus fractures</Description><Size>7-9 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>916</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU311</BillingCode><Name>Anatomic Posterolateral Distal Fibula Plate</Name><Description>Plate for fracture fixation</Description><Size>7-15 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU342</BillingCode><Name>Vertical Shear Distal Tibial Plate</Name><Description>Plate for Fracture Fixation</Description><Size>9 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU299</BillingCode><Name>Locking Distal Fibula Plate</Name><Description>Plate for Fracture Fixation</Description><Size>7-15 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU308</BillingCode><Name>Posterolateral Fibula Plate</Name><Description>Plate for Fracture fixation</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU209</BillingCode><PriorBillingCodes><PriorBillingCode>DE345</PriorBillingCode></PriorBillingCodes><Name>iBalance HTO System</Name><Description>Medial High Tibial Osteotomy Implant Device System</Description><Size>Small (6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm)  Medium (5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm)  Large (5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5457</SubGroupID><ARTGs><ARTG>350871</ARTG></ARTGs><MinimumBenefit>1468</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU382</BillingCode><Name>Arthrex Univers Revers Spacer</Name><Description>Spacer</Description><Size>Size: 36-42 Height: 6-15</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4081</SubGroupID><ARTGs><ARTG>481545</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU177</BillingCode><PriorBillingCodes><PriorBillingCode>DE505</PriorBillingCode></PriorBillingCodes><Name>MTP Plate, Straight , Long</Name><Description>1st MTP Arthrodesis Plate , Straight, Long - 8 Holes</Description><Size>8 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU320</BillingCode><Name>Wedged Profile Plate</Name><Description>Wedged Profile Plate</Description><Size>2 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><ARTGs><ARTG>350871</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU130</BillingCode><PriorBillingCodes><PriorBillingCode>DE578</PriorBillingCode></PriorBillingCodes><Name>Posterolateral Anatomic Distal Fibula Plate</Name><Description>Plate for fracture fixation</Description><Size>≥ 7 to ≤ 15 holes, for left and right specific</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU186</BillingCode><PriorBillingCodes><PriorBillingCode>DE290</PriorBillingCode></PriorBillingCodes><Name>Titanium Plate with Wedge</Name><Description>Titanium Plate with Wedge. Left and right side specific.</Description><Size>6-10mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU171</BillingCode><PriorBillingCodes><PriorBillingCode>DE501</PriorBillingCode></PriorBillingCodes><Name>MTP Plate, Straight</Name><Description>Metatarso-Phalangeal Fusion plate for 1st MTP</Description><Size>Small and Standard, ≤ 6 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU169</BillingCode><PriorBillingCodes><PriorBillingCode>DE504</PriorBillingCode></PriorBillingCodes><Name>Double Compression Plate System</Name><Description>Fixation plates for surgical compression across fusion sites.</Description><Size>Double Compression Plate, 2 Hole, 20 mm   Double Compression Plate, 2 Hole, 25 mm   Double Compression Plate, 2 Hole, 30 mm   Double Compression Plate, 3 Hole, 20 mm   Double Compression Plate, 3 Hole, 25 mm   Double Compression Plate, 3 Hole, 30 mm   Double Compression Plate, 4 Hole, Straight, 20 mm   Double Compression Plate, 4 Hole, Straight, 25 mm   Double Compression Plate, 4 Hole, Straight, 30 mm   Double Compression Plate, 4 Hole, Square, 20 mm   Double Compression Plate, 4 Hole, Square, 25 mm   Double Compression Plate, 4 Hole, Square, 30 mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU219</BillingCode><PriorBillingCodes><PriorBillingCode>DE715</PriorBillingCode></PriorBillingCodes><Name>Dynanite PIP Hammertoe Implant</Name><Description>PIP Arthrodesis Implant</Description><Size>12mm, 14mm, 16mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>6561</SubGroupID><Suffix>Interphalangeal</Suffix><ARTGs><ARTG>354292</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU111</BillingCode><PriorBillingCodes><PriorBillingCode>DE525</PriorBillingCode></PriorBillingCodes><Name>Dorsal Distal Radius Plate</Name><Description>Plate for Fracture Fixation</Description><Size>4 Holes Standard (Left &amp; Right)  4 Holes Narrow (Left &amp;  Right)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU242</BillingCode><PriorBillingCodes><PriorBillingCode>DE763</PriorBillingCode></PriorBillingCodes><Name>MaxForce MTP</Name><Description>Plate for Arthrodesis</Description><Size>6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU170</BillingCode><PriorBillingCodes><PriorBillingCode>DE508</PriorBillingCode></PriorBillingCodes><Name>MTP Plate</Name><Description>1st MTP Arthrodesis Plate</Description><Size>≤ 6 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU301</BillingCode><Name>Lateral Hook Plate</Name><Description>Plate for fracture fixation</Description><Size>3-5 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU201</BillingCode><PriorBillingCodes><PriorBillingCode>DE285</PriorBillingCode></PriorBillingCodes><Name> Titanium Lapidus Arthrodesis Plate </Name><Description>Titanium Lapidus Arthrodesis Plate with locking holes and compresion slot</Description><Size>Small, Large</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ635</BillingCode><Name>Forearm Fracture Fixation System – Plates</Name><Description>Locking Compression Plate</Description><Size>5-hole, 6-hole</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU273</BillingCode><PriorBillingCodes><PriorBillingCode>DE302</PriorBillingCode></PriorBillingCodes><Name>BioComposite Corkscrew Suture Anchor</Name><Description>Suture Anchor</Description><Size>&gt;4mm-6.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>354971</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU302</BillingCode><Name>Lateral Hook Plate</Name><Description>Plate for fracture fixation</Description><Size>7-15 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU166</BillingCode><PriorBillingCodes><PriorBillingCode>DE416</PriorBillingCode></PriorBillingCodes><Name>Locking Third Tubular Plate</Name><Description>Plate for fracture fixation of the Fibula</Description><Size>4-6 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU356</BillingCode><Name>DualCompression Hindfoot Nail</Name><Description>Hindfoot Nail for Arthrodesis</Description><Size>Diameters: 10.5mm, 11.5mm, 12.5mm      Lengths: 180mm, 210mm, 240mm, 300mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3332</SubGroupID><ARTGs><ARTG>409312</ARTG></ARTGs><MinimumBenefit>3300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU268</BillingCode><PriorBillingCodes><PriorBillingCode>DE367</PriorBillingCode><PriorBillingCode>DE077</PriorBillingCode></PriorBillingCodes><Name>Cancellous Bone Screws</Name><Description>Cancellous Bone Screws</Description><Size>25-50mm x 6.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>350871</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU208</BillingCode><PriorBillingCodes><PriorBillingCode>DE369</PriorBillingCode><PriorBillingCode>DE128</PriorBillingCode></PriorBillingCodes><Name>Titanium Locking Cortical and Cancellous Screws, Large</Name><Description>Titanium Locking Cortical and Cancellous Screws, Large</Description><Size>4.5-6.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU156</BillingCode><PriorBillingCodes><PriorBillingCode>DE423</PriorBillingCode></PriorBillingCodes><Name>PEEKPower HTO Plate</Name><Description>Medial High Tibial Osteotomy Implant Device System</Description><Size>4.5mm Titanium compression Screws</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU155</BillingCode><PriorBillingCodes><PriorBillingCode>DE537</PriorBillingCode></PriorBillingCodes><Name>Arthrex Jones Fracture Screw</Name><Description>Partially Threaded Screw to fixate fractures of the 5th Metatarsal</Description><Size>4.5mm (40-65mm Lengths)  5.5mm (40-65mm Lengths)  6.0mm (40-65mm Lengths)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>350672</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU394</BillingCode><Name>Arthrex Univers Revers Modular Glenoid System Non-Locking Peripheral Screw</Name><Description>Non-Locking Peripheral Screw</Description><Size>Diameter: 4.5mm Length: 16-48mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>481528</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU377</BillingCode><Name>Arthrex Univers Revers Non-Locking Peripheral Screw</Name><Description>Glenoid Non-Locking Peripheral Screw</Description><Size>Diameter: 4.5mm Length: 24-48mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>481543</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU375</BillingCode><Name>Arthrex Univers Revers Modular Glenoid System - Glenosphere Screw</Name><Description>Glenosphere Screw</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>481534</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU391</BillingCode><Name>Arthrex Univers Revers Modular Glenoid System Locking Peripheral Screw</Name><Description>Locking Peripheral Screw</Description><Size>Diameter: 5.5mm Length: 16-48mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>481527</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU384</BillingCode><Name>Arthrex Universal Glenoid Central Screw</Name><Description>Central Locking Screw</Description><Size>15-25mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>481531</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU245</BillingCode><PriorBillingCodes><PriorBillingCode>DE753</PriorBillingCode></PriorBillingCodes><Name>Reinforced T-Plate</Name><Description>Plate for Fracture Fixation</Description><Size>8 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU284</BillingCode><Name>Cage Plate</Name><Description>Plate for fracture fixation</Description><Size>10 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU204</BillingCode><PriorBillingCodes><PriorBillingCode>DE371</PriorBillingCode><PriorBillingCode>DE286</PriorBillingCode></PriorBillingCodes><Name>Cannulated Titanium Low Profile Screws, Large</Name><Description>Cannulated titanium Low Profile Screws, Large</Description><Size>4.5-6.7mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU180</BillingCode><PriorBillingCodes><PriorBillingCode>DE454</PriorBillingCode></PriorBillingCodes><Name>Low Profile T-Plate</Name><Description> Plate for fusion</Description><Size>7-11 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU115</BillingCode><PriorBillingCodes><PriorBillingCode>DE343</PriorBillingCode></PriorBillingCodes><Name>PEEKPower HTO Plate</Name><Description>Medial High Tibial Osteotomy Implant Device System</Description><Size>5.0mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU352</BillingCode><Name>Mini Fragment System - Tine Plate</Name><Description>Plate for Fracture Fixation</Description><Size>2.7mm, 10 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU361</BillingCode><Name>Mini Fragment System - Straight Plates</Name><Description>Plate for Fracture Fixation</Description><Size>2.7mm; 8 holes, 8 holes reinforced, 10 holes, 10 holes reinforced</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU379</BillingCode><Name>Arthrex Univers Revers Non-Locking Central Screw</Name><Description>Non-Locking Central Screw</Description><Size>Diameter: 6.5mm Length: 15-35mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>481542</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU141</BillingCode><PriorBillingCodes><PriorBillingCode>DE588</PriorBillingCode></PriorBillingCodes><Name>Compression FT</Name><Description>Compression Screw</Description><Size>5.0mm &amp; 7.0mm Diameters</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU360</BillingCode><Name>Mini Fragment System - Triangular Plate</Name><Description>Plate for Fracture Fixation</Description><Size>&gt;7-15 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ294</BillingCode><Name>Y-Plate, 2.4mm, 11 hole</Name><Description>Plate used for fracture fixation or fusion</Description><Size>2.4mm plate 11 hole plate</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU282</BillingCode><Name>Straight Plate</Name><Description>Plate for fracture fixation</Description><Size>10 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU154</BillingCode><PriorBillingCodes><PriorBillingCode>DE481</PriorBillingCode></PriorBillingCodes><Name>Headless Compression Screw System</Name><Description>Headless Compression Screw for bone fixation</Description><Size>6.5mm Diameter (30-120mm Diameter)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>350672</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU210</BillingCode><PriorBillingCodes><PriorBillingCode>DE551</PriorBillingCode></PriorBillingCodes><Name>Low Profile Screw</Name><Description>Low Profile Screw</Description><Size>4.5mm - 5.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU126</BillingCode><PriorBillingCodes><PriorBillingCode>DE587</PriorBillingCode></PriorBillingCodes><Name>5th Metatarsal Fracture Plate</Name><Description>Hook Plate for Fracture fixation</Description><Size>2 Sizes Side Specific  Long Left - 7 Holes  Long Right - 7 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU179</BillingCode><PriorBillingCodes><PriorBillingCode>DE456</PriorBillingCode></PriorBillingCodes><Name>Low Profile Straight Plate</Name><Description>Plate for fusion</Description><Size>7-8 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU380</BillingCode><Name>Arthrex Universal Glenoid Peripheral Locking Screw</Name><Description>Peripheral Locking Screw</Description><Size>24mm-48mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>481532</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU116</BillingCode><PriorBillingCodes><PriorBillingCode>DE344</PriorBillingCode></PriorBillingCodes><Name>iBalance HTO System</Name><Description>PEEK Screws for iBalance HTO Implant</Description><Size>4.5mm Cortical and 6.5mm Cancellous</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU292</BillingCode><Name>Straight Plate, Reinforced</Name><Description>Plate for fracture fixation</Description><Size>8 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU275</BillingCode><Name>Triangle Plate</Name><Description>Plate for fracture fixation</Description><Size>8 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU345</BillingCode><Name>Mini Fragment System - Wide T-Plate</Name><Description>Plate for Fracture Fixation</Description><Size>2.7mm; 11 and 15 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU283</BillingCode><Name>Z-Plate</Name><Description>Plate for fracture fixation</Description><Size>10 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU288</BillingCode><Name>T- Plate</Name><Description>Plate for fracture fixation</Description><Size>8 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU350</BillingCode><Name>Mini Fragment System - T-Plate</Name><Description>Plate for Fracture Fixation</Description><Size>&gt;7-15 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU246</BillingCode><PriorBillingCodes><PriorBillingCode>DE754</PriorBillingCode></PriorBillingCodes><Name>Wide T-Plate</Name><Description>Plate for Fracture Fixation</Description><Size>10 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU367</BillingCode><Name>Dual Compression Hindfoot Nail - End Cap</Name><Description>End Cap for DualCompression Hindfoot Nail</Description><Size>Standard, 2.5mm, 5mm, 10mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>5363</SubGroupID><ARTGs><ARTG>409311</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU295</BillingCode><Name>Y-Plate</Name><Description>Plate for Arthrodesis</Description><Size>8 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU267</BillingCode><PriorBillingCodes><PriorBillingCode>DE649</PriorBillingCode></PriorBillingCodes><Name> Cerclage System</Name><Description>Pre-tied Cerclage System (FiberTape/TigerTape)</Description><Size>One Size Only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5367</SubGroupID><ARTGs><ARTG>354057</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted for use of the devices in surgical procedures described in Medicare Benefits Schedule (MBS) item 47450 or 47528 or 47565 in Group T8 of the Regulations.</Note><MinimumBenefit>470</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU277</BillingCode><Name>V-Plate</Name><Description>Plate for fracture fixation</Description><Size>10 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU378</BillingCode><Name>Arthrex Univers Revers Humeral Insert</Name><Description>Humeral Insert</Description><Size>Size: 36-42mm Height: +3mm to +6mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>481546</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU389</BillingCode><Name>Arthrex Univers Revers Modular Glenoid System Constrained Combination Humeral Insert</Name><Description>Constrained Combination Humeral Insert</Description><Size>Size: 33 Offset: 36 +3C, 36 +6C</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>481536</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU395</BillingCode><Name>Arthrex Univers Revers Modular Glenoid System, Combination Humeral Insert</Name><Description>Combination Humeral Insert</Description><Size>Size:33 Offset:36 +3, 36 +6</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>481536</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU272</BillingCode><PriorBillingCodes><PriorBillingCode>DE476</PriorBillingCode></PriorBillingCodes><Name>Quickset</Name><Description>Injectable Macroporous Calcium Phospahte</Description><Size>5cc</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>267632</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU200</BillingCode><PriorBillingCodes><PriorBillingCode>DE217</PriorBillingCode></PriorBillingCodes><Name>Titanium Femoral Osteotomy Plate </Name><Description>Titanium Femoral Osteotomy Plate with 7 Variable Angle Locking Holes </Description><Size>5mm - 17.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>Com,VAL</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1473</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU199</BillingCode><PriorBillingCodes><PriorBillingCode>DE216</PriorBillingCode></PriorBillingCodes><Name>Titanium Anterior Posterior Sloped Tibial Osteotomy Plate</Name><Description>Titanium Anterior Posterior Sloped Tibial Osteotomy Plate with 4 variable angle locking holes and 6 variable angle locking holes </Description><Size>0-17.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>Com,VAL</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1473</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU198</BillingCode><PriorBillingCodes><PriorBillingCode>DE094</PriorBillingCode></PriorBillingCodes><Name> Anterior Posterior Sloped Stainless Steel Tibial Osteotomy Plate</Name><Description>Anterior Posterior Sloped Stainless Steel Tibial Osteotomy Plate with 4 non locking holes</Description><Size>5 - 17.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>Com</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>487</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU105</BillingCode><PriorBillingCodes><PriorBillingCode>DE651</PriorBillingCode></PriorBillingCodes><Name>Mesh Plate</Name><Description>Plate for Fracture fixation and Arthrodesis</Description><Size>Short  Long</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU104</BillingCode><PriorBillingCodes><PriorBillingCode>DE708</PriorBillingCode></PriorBillingCodes><Name>Ankle Fusion Plate</Name><Description>Plate for Arthrodesis</Description><Size>One Universal Size</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU196</BillingCode><PriorBillingCodes><PriorBillingCode>DE055</PriorBillingCode></PriorBillingCodes><Name>Stainless Steel Square Wedge Tibial Osteotomy Plate</Name><Description>Steel Square Wedge Tibial Osteotomy Plate with 4 non locking holes </Description><Size>3mm - 17.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>Com</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>487</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU150</BillingCode><PriorBillingCodes><PriorBillingCode>DE643</PriorBillingCode></PriorBillingCodes><Name>Dual Syndesmosis Tightrope Plate</Name><Description>Buttress plate for syndesmosis repair</Description><Size>1 size (2 Hole Plate)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU344</BillingCode><Name>Snap-Off Compression FT Pins 2.4mm</Name><Description>Snap-Off Compression pins for fusion and fracture fixation</Description><Size>2.4mm Diameters</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>350672</ARTG></ARTGs><MinimumBenefit>295</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU167</BillingCode><PriorBillingCodes><PriorBillingCode>DE453</PriorBillingCode></PriorBillingCodes><Name>X Plate</Name><Description>Plate for fusion</Description><Size>Medium, Large</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU315</BillingCode><Name>KreuLock Locking Compression Screws SS</Name><Description>Locking Compression Screw</Description><Size>2.7mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350999</ARTG><ARTG>355042</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU256</BillingCode><PriorBillingCodes><PriorBillingCode>DE127</PriorBillingCode></PriorBillingCodes><Name>Bio-Transfix</Name><Description>Composition Poly (L-lactide)</Description><Size>Diameter 5mm, length 50mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5394</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>360377</ARTG></ARTGs><MinimumBenefit>462</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU147</BillingCode><PriorBillingCodes><PriorBillingCode>DE543</PriorBillingCode></PriorBillingCodes><Name>Mini Fragment System – Cortical Screws</Name><Description>Cortical Screw</Description><Size>2.4mm x (06-80mm)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>284416</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU366</BillingCode><Name>Patella SuturePlate II Star Plate</Name><Description>Titanium Plate for Patellar Fracture Fixation</Description><Size>Small, Medium, Large</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>355042</ARTG></ARTGs><MinimumBenefit>810</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ624</BillingCode><Name>3.5 mm Locking Compression Plate, Sterile </Name><Description>Locking Compression Plate, Sterile </Description><Size>More than or equal to 16 holes </Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>355042</ARTG></ARTGs><MinimumBenefit>591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU112</BillingCode><PriorBillingCodes><PriorBillingCode>DE535</PriorBillingCode></PriorBillingCodes><Name>Dorsal L Plate</Name><Description>Plate for Fracture Fixation</Description><Size>5 Holes (Left &amp; Right)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU107</BillingCode><PriorBillingCodes><PriorBillingCode>DE644</PriorBillingCode></PriorBillingCodes><Name>Proximal 1st Metatarsal Osteotomy Plate</Name><Description>1st Metatarsal Osteotomy Plate</Description><Size>Petite - Left and Right Side Specific  Standard - Left and Right Side Specific</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU347</BillingCode><Name>Mini Fragment System - 2.7mm Cortical Screws</Name><Description>Cortical Screws for Plate Fixation of Fracture</Description><Size>2.7mm x 6.0mm-15mm (1mm) Increments      2.7mm x 16mm-50mm (2mm) Increments      2.7mm x 55-80mm (5mm) Increments</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU174</BillingCode><PriorBillingCodes><PriorBillingCode>DE565</PriorBillingCode></PriorBillingCodes><Name>Lisfranc Plates</Name><Description>Arthrodesis Plate</Description><Size>Small, Medium, Large  Plates come in Left &amp; Right</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU259</BillingCode><PriorBillingCodes><PriorBillingCode>DE258</PriorBillingCode></PriorBillingCodes><Name>Eclipse Humeral Head Prosthesis</Name><Description>Eclipse Humeral Head Prosthesis Cage Screw</Description><Size>Small - X-Large</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4064</SubGroupID><ARTGs><ARTG>308799</ARTG></ARTGs><MinimumBenefit>2660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU285</BillingCode><Name>Dynanite Compression Plates</Name><Description>Plate for Arthrodesis</Description><Size>2-4 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>355042</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU300</BillingCode><Name>Locking Distal Fibula Plate</Name><Description>Plate for Fracture Fixation</Description><Size>&gt;16 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>810</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU124</BillingCode><PriorBillingCodes><PriorBillingCode>DE642</PriorBillingCode></PriorBillingCodes><Name>Dorsal Midfoot Fusion Plate</Name><Description>Plate for fusion</Description><Size>Small, Medium, Large</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>810</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU113</BillingCode><PriorBillingCodes><PriorBillingCode>DE348</PriorBillingCode></PriorBillingCodes><Name>Calcaneal Step Plate</Name><Description>Calcaneal Step Plate</Description><Size>5mm, 7.5mm, 10mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU189</BillingCode><PriorBillingCodes><PriorBillingCode>DE422</PriorBillingCode></PriorBillingCodes><Name>Locking Distal Fibula Plate</Name><Description>Locking Distal Fibula Plate for Fracture Fixation</Description><Size>≥ 16 holes, for left and right specific</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU372</BillingCode><Name>Arthrex® UNIVERS™ II Humeral Stem</Name><Description>Uncoated Humeral Stem</Description><Size>6-15mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><ARTGs><ARTG>308820</ARTG></ARTGs><MinimumBenefit>3325</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU164</BillingCode><PriorBillingCodes><PriorBillingCode>DE372</PriorBillingCode><PriorBillingCode>DE287</PriorBillingCode></PriorBillingCodes><Name>Low Profile MTP Plate</Name><Description>Athrodesis Plate - 6 hole plates</Description><Size>Contoured small left,contoured small right, contoured standard right,contoured standard left</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU386</BillingCode><Name>Arthrex Univers Revers CaP Coated Stem</Name><Description>Humeral Stem</Description><Size>6mm-15mm x 95mm-147mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>481538</ARTG></ARTGs><MinimumBenefit>6013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU383</BillingCode><Name>Arthrex Univers Revers Humeral Stem Modular</Name><Description>Modular Humeral Stem</Description><Size>Size 5</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>481544</ARTG></ARTGs><MinimumBenefit>6013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU363</BillingCode><Name>Dual Compression Hindfoot Nail - Headless Screws</Name><Description>Titanium Headless Cortical Screws</Description><Size>Diameter: 5mm   Length: 50mm-120mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>350672</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU348</BillingCode><Name>Mini Fragment System - VAL Screws</Name><Description>Variable Angle Locking Screws for Plate Fixation of Fracture</Description><Size>2.7mm x 6.0mm-15mm (1mm) Increments      2.7mm x 16mm-50mm (2mm) Increments      2.7mm x 55mm-80mm (5mm) Increments</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU298</BillingCode><Name>KreuLock Locking Compression Screws, Ti</Name><Description>Locking Compression Screws,Ti</Description><Size>2.4 mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350999</ARTG><ARTG>355042</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU404</BillingCode><Name>KreuLock Locking Compression Screws </Name><Description>Compression Screws Titanium and Stainless Steel </Description><Size>2.01mm - 2.7mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>DT</Suffix><ARTGs><ARTG>350999</ARTG><ARTG>355042</ARTG></ARTGs><MinimumBenefit>247</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU108</BillingCode><PriorBillingCodes><PriorBillingCode>DE455</PriorBillingCode></PriorBillingCodes><Name>Low Profile T-Plate</Name><Description>Plate for fusion</Description><Size>4-6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU357</BillingCode><Name>Dual Compression Hindfoot Nail - Low Profile Screws</Name><Description>Low Profile Cortical Screws </Description><Size>5mm Diamater  20mm-32mm  35mm-60mm  </Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>350672</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU371</BillingCode><Name>Arthrex® UNIVERS™ II Monoblock Stem</Name><Description>Uncoated Monoblock Stem</Description><Size>5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><ARTGs><ARTG>308819</ARTG></ARTGs><MinimumBenefit>3325</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU257</BillingCode><PriorBillingCodes><PriorBillingCode>DE173</PriorBillingCode></PriorBillingCodes><Name>Univers Fracture Prostheses</Name><Description>Shaft</Description><Size>8-13mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><ARTGs><ARTG>308823</ARTG></ARTGs><MinimumBenefit>3325</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU364</BillingCode><Name>Patella Suture Plate II Star Plate Pole Fracture</Name><Description>Titanium Plate for Fracture Fixation</Description><Size>Small, Medium, Large</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>355042</ARTG></ARTGs><MinimumBenefit>810</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU236</BillingCode><PriorBillingCodes><PriorBillingCode>DE429</PriorBillingCode><PriorBillingCode>DE196</PriorBillingCode></PriorBillingCodes><Name>Corkscrew Suture Anchor</Name><Description>Non Absorbable Suture Anchor</Description><Size>&gt;4mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU385</BillingCode><Name>Arthrex Univers Revers Humeral Stem</Name><Description>Press-Fit Humeral Stem</Description><Size>6mm-15mm x 95mm-147mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>481537</ARTG></ARTGs><MinimumBenefit>6013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU255</BillingCode><PriorBillingCodes><PriorBillingCode>DE297</PriorBillingCode></PriorBillingCodes><Name>BioComposite Interference Screw</Name><Description>Soft Tissue Fixation Device</Description><Size>6-12mm x 23-35mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>360376</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU355</BillingCode><Name>Mini Fragment System - 2.4mm VAL Screws</Name><Description>2.4mm Variable Angle Locking Screws for Bone Fixation</Description><Size>2.4mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU278</BillingCode><Name>Low Profile Screws, Cortical</Name><Description>Cortical Screws</Description><Size>1.0mm - 2.0mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU194</BillingCode><PriorBillingCodes><PriorBillingCode>DE417</PriorBillingCode></PriorBillingCodes><Name>Locking Medial Hook Plate</Name><Description>Locking Medial Hook Plate for Fixation of medial malleolus fractures</Description><Size>5 holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU220</BillingCode><PriorBillingCodes><PriorBillingCode>DE688</PriorBillingCode></PriorBillingCodes><Name>Cinch II</Name><Description>Meniscal anchor</Description><Size>L: 5.3mm   D: 1.1 mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>353493</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU106</BillingCode><PriorBillingCodes><PriorBillingCode>DE572</PriorBillingCode></PriorBillingCodes><Name>Plantar Lapidus Plates</Name><Description>Arthrodesis Plate</Description><Size>Short and Standard  Left &amp; Right side specific</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU279</BillingCode><Name>Variable Angle Locking Screw</Name><Description>VAL Screw</Description><Size>1.4mm - 2.0mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU317</BillingCode><Name>H-Plates</Name><Description>Plate for Arthrodesis</Description><Size>Small, Medium, Large</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU400</BillingCode><Name>Corkscrew FT Suture Anchors </Name><Description>Corkscrew FT suture anchor with and without needles, Titanium or PEEK</Description><Size>5.5mm </Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU168</BillingCode><PriorBillingCodes><PriorBillingCode>DE457</PriorBillingCode></PriorBillingCodes><Name>Low Profile Straight Plate</Name><Description>Plate for fusion</Description><Size>2-5 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU374</BillingCode><Name>SwiveLock SP</Name><Description>SwiveLock SP PEEK Suture Anchor</Description><Size>4.75mm &amp; 5.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU235</BillingCode><PriorBillingCodes><PriorBillingCode>DE432</PriorBillingCode><PriorBillingCode>DE195</PriorBillingCode></PriorBillingCodes><Name>Corkscrew FT</Name><Description>Suture Anchor with Fiberwire</Description><Size>4mm - 6.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU146</BillingCode><PriorBillingCodes><PriorBillingCode>DE214</PriorBillingCode></PriorBillingCodes><Name>Cortical Screw</Name><Description>Screw for Bone fixation</Description><Size>2.01-2.7mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>350999</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU229</BillingCode><PriorBillingCodes><PriorBillingCode>DE474</PriorBillingCode></PriorBillingCodes><Name>Achilles Speedbridge Convenience Pack</Name><Description>Disposable convenience pack for Achilles Insertional Tendonopathy</Description><Size>one size</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU233</BillingCode><PriorBillingCodes><PriorBillingCode>DE434</PriorBillingCode><PriorBillingCode>DE261</PriorBillingCode></PriorBillingCodes><Name>Pushlock Suture Anchor</Name><Description>Knotless Suture Anchor</Description><Size>4.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU252</BillingCode><PriorBillingCodes><PriorBillingCode>DE436</PriorBillingCode><PriorBillingCode>DE305</PriorBillingCode></PriorBillingCodes><Name>BioComposite PushLock</Name><Description>Knotless Suture Anchor</Description><Size>4.5mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>354973</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU159</BillingCode><PriorBillingCodes><PriorBillingCode>DE465</PriorBillingCode></PriorBillingCodes><Name>Compression FT</Name><Description>Headless Compression Screw for bone fixation</Description><Size>2.5mm x 8-50mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU265</BillingCode><PriorBillingCodes><PriorBillingCode>DE166</PriorBillingCode></PriorBillingCodes><Name>BioComposite Tenodesis Screw</Name><Description>Soft Tissue Fixation</Description><Size>3mm-9mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>360373</ARTG><ARTG>360374</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU330</BillingCode><Name>FastThread</Name><Description>BioComposite Interference Screw</Description><Size>Length: 20mm-30mm  Diameter: 6mm- 12mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>398151</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU117</BillingCode><PriorBillingCodes><PriorBillingCode>DE374</PriorBillingCode></PriorBillingCodes><Name>GraftBolt</Name><Description>Interference Screw and Sheath</Description><Size>7mm, 8mm, 9mm and 10mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>350870</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU175</BillingCode><PriorBillingCodes><PriorBillingCode>DE555</PriorBillingCode></PriorBillingCodes><Name>Locking POW Plate</Name><Description>Wedged Fusion Plate</Description><Size>0-7mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>351000</ARTG><ARTG>350871</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU280</BillingCode><Name>DX Swivelock Anchor</Name><Description>Soft Tissue Fixation Anchor</Description><Size>4.75mm x 12mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU121</BillingCode><PriorBillingCodes><PriorBillingCode>DE710</PriorBillingCode></PriorBillingCodes><Name>PEEK Tenodesis Screw</Name><Description>Interference Screw (2.5mm x 6mm)</Description><Size>2.5mm x 6mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>350870</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU251</BillingCode><PriorBillingCodes><PriorBillingCode>DE306</PriorBillingCode></PriorBillingCodes><Name>BioComposite SwiveLock</Name><Description>BC SwiveLock</Description><Size>&gt;4mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>354972</ARTG><ARTG>354974</ARTG><ARTG>354975</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU333</BillingCode><Name>FastThread PEEK Interference Screw</Name><Description>PEEK Interference Screw</Description><Size>Diameters: 6 - 12mm   Length: 20 - 30mm  </Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>350870</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU165</BillingCode><PriorBillingCodes><PriorBillingCode>DE413</PriorBillingCode></PriorBillingCodes><Name>Locking Reconstruction Plate</Name><Description>Reconstruction Plate for communited Fibula Shaft Fractures</Description><Size>4-6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>350871</ARTG><ARTG>351000</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU120</BillingCode><PriorBillingCodes><PriorBillingCode>DE510</PriorBillingCode></PriorBillingCodes><Name>Tenodesis Screw</Name><Description>Non Absorbable Tenodesis Screw</Description><Size>2.5mm-9mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>350870</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU152</BillingCode><PriorBillingCodes><PriorBillingCode>DE479</PriorBillingCode></PriorBillingCodes><Name>Headless Compression Screw System</Name><Description>Headless Compression Screw for bone fixation</Description><Size>2.5mm Diameter x (8-34mm Length)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>350672</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU319</BillingCode><Name>ACL Repair TightRope</Name><Description>Knotless tensionable system pre-loaded with FiberTape for ACL Repair. The kit includes the button/ anchor with the construct.</Description><Size>One size only</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>383904</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU349</BillingCode><Name>BioComposite Tenodesis Screw 4mm x 10mm, with Disposable Driver</Name><Description>Interference Screw for Soft tissue fixation</Description><Size>Diameter: 4mm  Length - 10mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>398150</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU264</BillingCode><PriorBillingCodes><PriorBillingCode>DE068</PriorBillingCode></PriorBillingCodes><Name>Interference Screws</Name><Description>ARTHREX Non-sheathed</Description><Size>7 x 28mm - 12 x 28mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>350870</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU314</BillingCode><Name>Locking Medial Hook Plate</Name><Description>Plate for fracture fixation</Description><Size>6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>351000</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU119</BillingCode><PriorBillingCodes><PriorBillingCode>DE440</PriorBillingCode></PriorBillingCodes><Name>Interference Screws</Name><Description>Interference screw for Soft Tissue Fixation</Description><Size>7-10mm x (15-35mm)</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>350870</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU232</BillingCode><PriorBillingCodes><PriorBillingCode>DE458</PriorBillingCode><PriorBillingCode>DE288</PriorBillingCode></PriorBillingCodes><Name>Swivelock</Name><Description>Twist-in knotless suture anchor</Description><Size>≥4mm</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>353482</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU340</BillingCode><Name>Postero-Medial Distal Tibial Plate</Name><Description>Plate for fracture fixation</Description><Size>4-6 Holes</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>284416</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HU118</BillingCode><PriorBillingCodes><PriorBillingCode>DE439</PriorBillingCode></PriorBillingCodes><Name>Peek Delta Screws</Name><Description>Interference screw for soft tissue Fixation</Description><Size>6-12mm Diameter x (23mm-35m) Length</Size><SupplierCode>HU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>350870</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN002</BillingCode><Name>Vivinex Gemetric Toric</Name><Description>Preloaded trifocal toric IOL</Description><Size> +10.00D to +30.00D in 0.50D increments, Cylinder (D) 1.00 - 3.75</Size><SupplierCode>XN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>464253</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN018</BillingCode><Name>Intramesh T1</Name><Description>Parietal reinforcement implant</Description><Size>30cm x 30cm</Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>516305</ARTG></ARTGs><MinimumBenefit>1013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN013</BillingCode><PriorBillingCodes><PriorBillingCode>AA021</PriorBillingCode></PriorBillingCodes><Name>4D VENTRAL COMPOSITE MESH </Name><Description>4D VENTRAL COMPOSITE MESH</Description><Size>30 X 30 </Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>354550</ARTG></ARTGs><MinimumBenefit>1013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN008</BillingCode><PriorBillingCodes><PriorBillingCode>AA016</PriorBillingCode></PriorBillingCodes><Name>4D - DOME SEMI ABSORBABLE HERNIA MESH</Name><Description>4D DOME semi absorbable bio mesh for abdominal reinforcement inguinal, femoral and incisional hernias</Description><Size>2.4, 9 x 5 cm 
3.0, 9 x 5 cm 
3.8, 9 x 5 cm</Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5434</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>222740</ARTG></ARTGs><MinimumBenefit>316</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN009</BillingCode><PriorBillingCodes><PriorBillingCode>AA017</PriorBillingCode></PriorBillingCodes><Name>4D - SEMI ABSORBABLE HERNIA MESH</Name><Description>4DMESH semi absorbable bio mesh for abdominal reinforcement inguinal, femoral and incisional hernias</Description><Size>6 x 13.5 cm 
10.5 x 14 cm 
12 x 15 cm</Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5434</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>283655</ARTG></ARTGs><MinimumBenefit>316</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN001</BillingCode><Name>Vivinex Gemetric</Name><Description>Preloaded Trifocal IOL</Description><Size> +10.00D to +30.00D in 0.50D increments. </Size><SupplierCode>XN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>464253</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN012</BillingCode><PriorBillingCodes><PriorBillingCode>AA020</PriorBillingCode></PriorBillingCodes><Name>4D VENTRAL COMPOSITE MESH</Name><Description>4D VENTRAL COMPOSITE MESH</Description><Size>15 X 30 CM, 20 X 25 CM.</Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>354550</ARTG></ARTGs><MinimumBenefit>966</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN017</BillingCode><Name>Intramesh T1</Name><Description>Parietal reinforcement implant</Description><Size>20cm x 25cm</Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>516305</ARTG></ARTGs><MinimumBenefit>966</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN014</BillingCode><PriorBillingCodes><PriorBillingCode>AA022</PriorBillingCode></PriorBillingCodes><Name>4D VENTRAL COMPOSITE MESH</Name><Description>4D VENTRAL COMPOSITE MESH</Description><Size>30 X 50 CM</Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5505</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>354550</ARTG></ARTGs><MinimumBenefit>2875</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN003</BillingCode><Name>Vivinex Gemetric Plus Toric</Name><Description>Preloaded trifocal toric IOL</Description><Size>+10.00D to +30.00D in 0.50D increments, Cylinder (D) 1.00 - 3.75</Size><SupplierCode>XN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>464253</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN019</BillingCode><Name>Intramesh T1</Name><Description>Parietal reinforcement implant</Description><Size>30cm X 50cm</Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5505</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>516305</ARTG></ARTGs><MinimumBenefit>2875</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN010</BillingCode><PriorBillingCodes><PriorBillingCode>AA018</PriorBillingCode></PriorBillingCodes><Name>4D - Semi Absorbable Hernia Mesh</Name><Description>4DMESH semi absorbable bio mesh for abdominal reinforcement inguinal, femoral and incisional hernias.</Description><Size>12 x 17 cm
17 x 17 cm</Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5435</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>283655</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN005</BillingCode><Name>Vivinex Gemetric Plus</Name><Description>Preloaded Trifocal IOL</Description><Size>+10.00D to +30.00D in 0.50D increments. </Size><SupplierCode>XN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>464253</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN011</BillingCode><PriorBillingCodes><PriorBillingCode>AA019</PriorBillingCode></PriorBillingCodes><Name>4D VENTRAL COMPOSITE MESH</Name><Description>4D VENTRAL COMPOSITE MESH</Description><Size>15 X 15 CM</Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>354550</ARTG></ARTGs><MinimumBenefit>721</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN016</BillingCode><Name>Intramesh T1</Name><Description>Parietal reinforcement implants</Description><Size>15cm X 15cm, 20cm x 20cm, 15 x 20cm, </Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>516305</ARTG></ARTGs><MinimumBenefit>721</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN022</BillingCode><Name>HOYA-PS AF-1 (UY) PY-60AD</Name><Description>Pre-loaded in a single use injector, Aspheric, blue light filter, Foldable, Single-Piece, Hydrophobic Acrylic IOL
 
</Description><Size>+6.0D to +30.0D (0.5D steps)</Size><SupplierCode>XN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>464253</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN006</BillingCode><Name>HOYA Vivinex multiSert XY1-SP</Name><Description>Aspheric monofocal hydrophobic acrylic preloaded IOL with multiSert injector</Description><Size>+6.0D to +30.0D in the steps of 0.5D</Size><SupplierCode>XN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>464253</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN023</BillingCode><Name>HOYA Vivinex iSert preloaded IOL (Model XY1)</Name><Description>Pre-loaded on iSert injector, aspheric, Foldable, Single-Piece, blue light filter, hydrophobic acrylic IOL </Description><Size>+6.0 to 30.0 D (in 0.5D steps)</Size><SupplierCode>XN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>464253</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN020</BillingCode><Name>CA.B.S' AIR Composite</Name><Description>Parietal prothesis with two or four fixation threads crimped with stainless steel needles.</Description><Size>5cm, 6.8cm, 9cm</Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>516306</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN004</BillingCode><Name>HOYA Vivinex Toric multiSert</Name><Description>Toric aspheric monfocal hydrophobic acrylic preloaded IOL with multiSert injector</Description><Size>Power (D) +10.00 - +30.00 Cylinder (D) 1.00 - 6.00</Size><SupplierCode>XN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, t1, vblf</Suffix><ARTGs><ARTG>464253</ARTG></ARTGs><MinimumBenefit>585</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN021</BillingCode><Name>HOYA Vivinex iSert preloaded IOL (Model XC1)</Name><Description>Pre-loaded on iSert injector, aspheric, Foldable, Single-Piece, hydrophobic acrylic IOL
</Description><Size>+6.0 to 30.0 D (in 0.5D steps)</Size><SupplierCode>XN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>464253</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN015</BillingCode><Name>Intramesh T1</Name><Description>Parietal reinforcement implant</Description><Size>12cm Diameter and 10cm x 15cm</Size><SupplierCode>XN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>516305</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN024</BillingCode><Name>HOYA Vivinex Toric XY1A</Name><Description>Pre-loaded in a single use injector, aspheric, blue light filter, Foldable, Single-Piece, Hydrophobic Acrylic, toric IOL
 
</Description><Size>IOL Power: + 10.0 to 30.0D (0.5D steps), IOL Cylinder power: 1.00D (XY1AT2), 1.50D (XY1AT3), 2.25D (XY1AT4), 3.00D (XY1AT5), 3.75D (XY1AT6), 4.50D (XY1AT7), 5.25D (XY1AT8), 6.00D (XY1AT9)</Size><SupplierCode>XN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, t1, vblf</Suffix><ARTGs><ARTG>464253</ARTG></ARTGs><MinimumBenefit>585</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XN007</BillingCode><Name>HOYA Vivinex multiSert</Name><Description>Aspheric monofocal hydrophobic acrylic preloaded IOL with multiSert injector</Description><Size>+6.0D to +30.0D in the steps of 0.5D</Size><SupplierCode>XN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>464253</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BQ004</BillingCode><PriorBillingCodes><PriorBillingCode>TX048</PriorBillingCode><PriorBillingCode>PM065</PriorBillingCode></PriorBillingCodes><Name>Ventilation Tubes / Grommet</Name><Description>a) Tubingen Gold Type 
b) Tubingen Titanium Type 
c) T Tube 
d) Reuter Bobbin Type 
e) Paparella Type
f) Collar Button Type 
g) Star Tube 
h) Bevel Buttton Tube
i) Straight Tube 
j) Armstrong Type 
k) Shepard Type 
l) Donaldson Type
m) Angular Type
n) Myringotomy Tube with Trocar
o) Ventilation Tubes with Eyelets
p) Minimal Type</Description><Size>a) I.D.  1.25mm w/w, I.D.1.25mm wo/w, I.D. 1.5mm wo/w 
b) one size only 
c) L- 6, 7.5, 12 
d) I.F.O.D 2.5mm, 2.7mm 
e) one size only  
f) one side only 
g) one size only 
h) one size only 
i) i.d.-0.9mm,1.1mm,1.15mm 
j) L-3.8mm, 3.7mm, 10mm 
k) L- 2.2mm w/t, 2.2mm wo/t,2.4mm w/t 
l) S- one size only, F one size only
m) one size only
n) Silver or Titanium
o) one or two
p) one size only</Size><SupplierCode>BQ</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>120972</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BQ008</BillingCode><Name>ProTrach DualCare Speaking Valve</Name><Description>ProTrach DualCare System is attached to a tracheostomy tube and is designed to eliminate the necessity of finger occlusion, enabling the tracheostomised patient to speak easily and more clearly. It combines a speaking valve with a HME and in this way enabling speaking and supporing your lungs with important heating and moisturising. The Set includes: 1pc Speaking Valve, 1pc ProTrach HME DigiTop, 1 Removal Aid and 1 connection strap.ProTrach DualCare Speaking Valve, 1 HME DigiTop, 1 removal aid and 1pc Connection Strap</Description><Size>15mm
22mm</Size><SupplierCode>BQ</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1569</GroupID><ARTGs><ARTG>275618</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BQ007</BillingCode><Name>ProTrach DualCare Set</Name><Description>ProTrach DualCare is attached to a tracheostomy tube and is designed to eliminate the necessity of finger occlusion, enabling the tracheostomised patient to speak easily and more clearly. It combines a speaking valve with an HME, and this way both enabling hands-free speech and helping to keep the lungs healthy by providing the important humidification of the inhaled air. The Set includes: 180pc HME Regular, 1pc Speaking Valve, 1pc ProTrach HME DigiTop, 1 Removal Aid and 1 connection strap.</Description><Size>15mm  22mm</Size><SupplierCode>BQ</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1569</GroupID><ARTGs><ARTG>275618</ARTG></ARTGs><MinimumBenefit>628</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BQ010</BillingCode><PriorBillingCodes><PriorBillingCode>BQ002</PriorBillingCode><PriorBillingCode>TX049</PriorBillingCode></PriorBillingCodes><Name>Tracheal Speaking Valve</Name><Description>Provox a) Two b) Vega c) Vega Puncture Set</Description><Size>a) 4.5, 6, 8, 10, 12.5, 15mm
b) 17, 20, 22.5fr in 4, 6, 8, 10, 12.5, 15mm
c) 17, 20, 22.5fr in 4, 6, 8, 10, 12.5, 15mm</Size><SupplierCode>BQ</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1569</GroupID><ARTGs><ARTG>120197</ARTG><ARTG>236026</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OI032</BillingCode><Name>Ponto 3 Sound Processor</Name><Description>A wireless enabled - fully programmable head worn sound processor for bone conduction hearing systems with full smart phone capabilities. Optional Superpower model, delivering higher output across the entire bandwidth.</Description><Size>Ponto 3: 34x21x11mm
Ponto 3 Power: 34x21x14mm
Ponto 3 SuperPower: 34x21x14mm</Size><SupplierCode>OI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4150</SubGroupID><Suffix>Programmable, Wireless-enabled</Suffix><ARTGs><ARTG>198104</ARTG></ARTGs><MinimumBenefit>6484</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OI039</BillingCode><Name>Ponto 5 Mini &amp; SuperPower</Name><Description>A wireless enabled - fully programmable head worn sound processor for bone conduction hearing systems with directionality paradigm offering analysis, balancing &amp; noise removal, IFTTT; together with programmable &amp; direct to smart phone capacity and remote care possibilities. Has the ability to detect, and prevent feedback from occurring. Ponto 5 Mini &amp; Ponto 5 SuperPower have the ability to be programmed using DSL (Desired Sensation Level) which is particularly beneficial to the paediatric population.  </Description><Size>26 x 19 x 11 mm - Ponto 5 Mini  31 x 21 x 15 mm - Ponto 5 SuperPower</Size><SupplierCode>OI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4150</SubGroupID><Suffix>Programmable, Wireless-enabled</Suffix><ARTGs><ARTG>198860</ARTG></ARTGs><MinimumBenefit>6484</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OI038</BillingCode><Name>Ponto 4 </Name><Description>A wireless enabled - fully programmable head worn sound processor for bone conduction hearing systems with directionality paradigm offering analysis, balancing &amp; noise removal, IFTTT; together with programmable &amp; direct to smart phone capacity.</Description><Size>One size (26 x 19 x 11 mm)</Size><SupplierCode>OI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4150</SubGroupID><Suffix>Programmable, Wireless-enabled</Suffix><ARTGs><ARTG>198860</ARTG></ARTGs><MinimumBenefit>6484</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OI027</BillingCode><Name>Ponto Healing Cap</Name><Description>Cover screw</Description><Size>One size only</Size><SupplierCode>OI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4152</SubGroupID><ARTGs><ARTG>198868</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OI031</BillingCode><Name>Ponto BHX Implant and Abutment</Name><Description>A laser-ablated titanium surface implant using Biohelix™ (BHX) and abutment
with connection screw.</Description><Size>Diameter: 3.75 - 4.5mm
Length: Fixture 3 - 4mm
Abutment: 6 -14mm</Size><SupplierCode>OI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>Abutment, Fixture &amp; Concave</Suffix><ARTGs><ARTG>198759</ARTG></ARTGs><MinimumBenefit>1916</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OI025</BillingCode><Name>Ponto Abutment</Name><Description>Bone anchor abutment with connection screw</Description><Size>Length: 6 - 14mm
Straight and angled</Size><SupplierCode>OI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>Abutment</Suffix><ARTGs><ARTG>198759</ARTG></ARTGs><MinimumBenefit>850</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OI028</BillingCode><Name>Ponto Cover Screw</Name><Description>Cover screw</Description><Size>One size only</Size><SupplierCode>OI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4152</SubGroupID><ARTGs><ARTG>198759</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OI030</BillingCode><Name>Ponto BHX Implant</Name><Description>A laser-ablated titanium surface implant using Biohelix™ (BHX).</Description><Size>Length: 3mm, 4mm</Size><SupplierCode>OI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>Fixture &amp; Concave</Suffix><ARTGs><ARTG>198759</ARTG></ARTGs><MinimumBenefit>1028</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OI024</BillingCode><Name>Ponto Implant</Name><Description>Bone anchor implant</Description><Size>Diameter: 3.75 - 4.5mm
Length: 3 - 4mm</Size><SupplierCode>OI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>Fixture</Suffix><ARTGs><ARTG>198759</ARTG></ARTGs><MinimumBenefit>983</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OI026</BillingCode><Name>Ponto Abutment and Implant</Name><Description>Bone anchor implant and abutment with connection screw</Description><Size>Diameter: 3.75 - 4.5mm
Length: Fixture 3 - 4mm, Abutment 6 -14mm</Size><SupplierCode>OI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>Abutment &amp; Fixture</Suffix><ARTGs><ARTG>198759</ARTG></ARTGs><MinimumBenefit>1833</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AP003</BillingCode><Name>Mira: Scleral Implants</Name><Description>Solid Silicone-Tire/Meridional/Wedge/Pad. Retinal Implant used in Scleral Buckling (Dimethylmethylvinyl Siloxane Copolymer)</Description><Size>Tires-Mira 286 Wendel Symmetrical Oval Tire 6mm, Mira Symmetrical Oval Tire 7mm, Mira 287WG Murray wide (3.5mm) grooved symmetrical tire, 10mm wide, Mira 288 ross symmetrical grooved tire, low profile 10mm wide by 2.5mm, Mira 289 Symmetrical oval tire 10mm, Mira 277Symmetrical tire 7mm, Mira 279 Symmetrical tire 9mm, Mira 78G Grooved symmetrical tire 10mm, Mira 281 Symmetrical tire 12.5mm, Mira 275 Munsen Asymmetrical tire 6mm, Mira 276 Asymmetrical tire 7mm, Mira 278 Brockhurst asymmetrical tire 8.5mm, Mira 280LG Large grooved asymmetrical tire 10mm, Mira 77G Grooved hemisphere 26mm. Meridional- Mira 106 Meridional Implant 6mm by 10.5mm, Mira 112 Curved Meridional implant 12mm by 12mm, Mira 103 Meridional implant 4mm by 15mm. Wedge- Mira 135 Pruett maxi wedge 14mm, Mira Pruett midi wedge 12mm, Mira 190 Spencer sub-implant 5mm by 10mm. Pad- Mira 80 Pad 4mm by 8mm, Mira 22 Button 5mm by 5mm</Size><SupplierCode>AP</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1342</GroupID><ARTGs><ARTG>143682</ARTG></ARTGs><MinimumBenefit>41</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AN017</BillingCode><Name>t:slim X2 Insulin Pump with Basal-IQ Technology</Name><Description>Ambulatory insulin infusion pump with real-time continuous glucose monitoring (CGM) capability and incorporating Basal-IQ Predictive Low Glucose Suspend (PLGS) Technology.</Description><Size>One size only.</Size><SupplierCode>AN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4187</SubGroupID><Suffix>DE, SS</Suffix><ARTGs><ARTG>304681</ARTG></ARTGs><MinimumBenefit>8574</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AN018</BillingCode><Name>t:slim X2 Insulin Pump with Control-IQ Technology</Name><Description>Ambulatory insulin infusion pump with real-time continuous glucose monitoring (CGM) capability and incorporating Control-IQ Technology.</Description><Size>One size only</Size><SupplierCode>AN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4187</SubGroupID><Suffix>DE, SS</Suffix><ARTGs><ARTG>304681</ARTG></ARTGs><MinimumBenefit>8574</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AN014</BillingCode><Name>t:slim X2 Insulin Pump</Name><Description>Ambulatory insulin infusion pump with real-time continuous glucose monitoring (CGM) capability</Description><Size>One size only.</Size><SupplierCode>AN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4183</SubGroupID><Suffix>DE, SS</Suffix><ARTGs><ARTG>304861</ARTG></ARTGs><MinimumBenefit>8077</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AN016</BillingCode><Name>t:slim Cartridge</Name><Description>Cartridge for use with the t:slim X2 System</Description><Size>Pack of 10</Size><SupplierCode>AN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1541</GroupID><SubGroupID>4192</SubGroupID><ARTGs><ARTG>304681</ARTG></ARTGs><MinimumBenefit>8</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW038</BillingCode><Name>Normmed ESA Alif PEEK Cage</Name><Description>ALIF PEEK Cage with screws/revision screws</Description><Size>Cage: 10-20 mm (height); 25-29 mm (length); 35-40 mm (width); available with 4, 9, and 14 degree angle. Screws: 4.0-4.3 mm (diameter); 20-30 mm (length)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>512805</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW016</BillingCode><Name>Normmed Thoracolumbar Rapidfix, Quatro, and Ares (MIS) Polyaxial Cannulated screws</Name><Description>Polyaxial Cannulated Screws, Rapidfix Dual Lead Fenestrated, Quatro Quad Lead Fenestrated, Ares (MIS) Dual Lead, Ares (MIS) Dual Lead Fenestrated, Ares (MIS) Quad Lead, Ares (MIS) Quad Lead Fenestrated</Description><Size>5.5-7.7 mm (diameter), 30-60mm (length)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>502271</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW006</BillingCode><Name>Normmed Oxis PLUS Rod</Name><Description>Titanium Rod Straight</Description><Size>3.5 X (120-240) mm</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>502270</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW004</BillingCode><Name>Normmed Oxis PLUS Occipitocervical Rod</Name><Description>Titanium Occipitocervical Rod 45 degree angled</Description><Size>Length 150 mm; 45 degree angled</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>502270</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW024</BillingCode><Name>Normmed Pedifix Polyaxial Screws</Name><Description>Polyaxial and polyaxial reduction screw </Description><Size>4.0-6.0 mm (diameter); 20-60 mm (length)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>502277</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW021</BillingCode><Name>Normmed Pedifix Hooks</Name><Description>Various hooks comprising:
Laminar Hook; Laminar Hook Angled Blade; Laminar Hook Extended Body; Thoracic Laminar Hook Ramped; Pedicle Hook; Supralaminar Thoracic Hook; Transverse Proses Hook; Thoracic Hook Offset;  all hooks are supplied with corresponding set screw in one package.
</Description><Size>Pedicle Large (17.6 mm);   Pedicle Small (16.6 mm);   Laminar Large (17.5 mm);   Laminar Medium (16.0 mm);   Laminar Small (14.5 mm);   Offset hooks: Left and right side </Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>502280</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW012</BillingCode><Name>Normmed Thoracolumbar Rapidfix Hooks</Name><Description>Laminar, Laminar-flexible, Pedicular, Pedicle Flexible, Laminar Angled (20 degrees; left and right) Hooks; Hooks are supplied with set screw in one package</Description><Size>5-11mm (length) x 5-8mm (width)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>502274</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW007</BillingCode><Name>Normmed Oxis PLUS Titanium Screw </Name><Description>Titanium Polyaxial Screw 

</Description><Size>(3.5-4.0mm) x (8-32mm)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>490505</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW010</BillingCode><Name>Normmed Thoracolumbar Rapidfix and ARES (MIS) Rods</Name><Description>Straight, Curved, Plexus, Dynamic, and Cr-Co Rods</Description><Size>40-600 mm (length), 5.5-6.0 mm (diameter)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>502275</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW039</BillingCode><Name>Normmed Carsten Trabecular Titanium Cervical Cage</Name><Description>Carsten Trabecular Titanium Cervical Cage including screws/revision screws</Description><Size>Cages: 5-8 mm (height), 12-14 mm (length), 14-16 mm (width); Screw: 3.5 mm (diameter), 12-20 mm (length); Screw-Revision: 4 mm (diameter), 12-20 mm (length)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>512828</ARTG><ARTG>513565</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ579</BillingCode><Name>adbone BCP </Name><Description>Bone Graft Substitute. Block, Wedge, Granules (0.1-0.5mm, 0.5-1mm, 1-2mm, 3-4mm) or Crunch (4-7mm)</Description><Size>5-10cc</Size><SupplierCode>KW</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>451205</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW008</BillingCode><Name>Normmed ARES MIS Locking Nut</Name><Description>ARES (MIS) Locking Nut, to be used with ARES (MIS) Pedicle Screws</Description><Size>10 mm (diameter), 5 mm (height)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>502276</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW011</BillingCode><Name>Normmed Thoracolumbar Rapidfix and Quatro Polyaxial Screws</Name><Description>Polyaxial Screws, Rapidfix Dual lead, Rapidfix Dual lead Reduction Fenestrated, Quatro Quad Lead, Quatro Quad lead Reduction, Quatro Quad Lead Reduction Fenestrated</Description><Size>4.0mm – 8.0mm (diameter), 20-100mm (length)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>502271</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW032</BillingCode><Name>Normmed Trimi Anterior Cervical Plate System</Name><Description>Trimi Anterior Cervical Plate &gt;55 mm</Description><Size>8-10 mm (hole); 60-90mm (length) x 2-2.1mm (thickness)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>512829</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW033</BillingCode><Name>Normmed Trimi Anterior Cervical Plate System</Name><Description>Trimi Anterior Cervical Plate</Description><Size>4-6 mm (hole); 17-55mm (length) x 2mm (thickness)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>512829</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW009</BillingCode><Name>Normmed Thoracolumbar Interspinous Fixation U-Device</Name><Description>U-Device Interspinous System Stabilisation Device</Description><Size>(8-16) mm </Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>177</SubCategoryID><GroupID>1496</GroupID><ARTGs><ARTG>502272</ARTG></ARTGs><MinimumBenefit>1321</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW018</BillingCode><Name>Normmed Pedifix Connectors and set screws</Name><Description>Rod to Rod Connector (small-medium-large), pre-assembled with set screws; Parallel Connector; Iliac Connector; Extended Connector Parallel, Iliac, and extended connectors are supplied with the corresponding set screw in one package  
</Description><Size>Diameter 3.5-6.0 mm (Rod-to-Rod);   Angle 15-45 degrees (Iliac);   Length 30-60 mm (Extended)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>502279</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW002</BillingCode><Name>Normmed Oxis PLUS Hybrid Rod </Name><Description>Normmed Hybrid Rod</Description><Size>Diameter 3.5/6.0 mm; Length 150-500 mm</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>502270</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW025</BillingCode><Name>Normmed Pedifix Rods</Name><Description>Titanium Alloy Rods</Description><Size>Titanium: 4.5mm x (30-480mm)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>502281</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW001</BillingCode><Name>Normmed Oxis PLUS Hook </Name><Description>Laminar Hooks, supplied with set screw in one package</Description><Size>Width 4.0 mm; length 5-7 mm</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>502268</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW022</BillingCode><Name>Normmed Pedifix Monoaxial Screws </Name><Description>Monoaxial Screw 
Monoaxial screws are single body- with the shaft fixed to the head. There is no movement between head and shaft.</Description><Size>4.0-6.0mm(diameter), 20-60mm (length)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>502277</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW013</BillingCode><Name>Normmed Thoracolumbar Rapidfix Monoaxial screws</Name><Description>Monoaxial Screws, Self Tapping, Dual lead, Reduction, Fenestrated</Description><Size>4.0-8.0 mm (diameter), 20-100 mm (length)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>502271</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ577</BillingCode><Name>adbone BCP</Name><Description>Bone Graft Substitute.  Granules (0.1-0.5mm, 0.5-1mm, 1-2mm, 3-4mm) or Crunch (4-7mm)</Description><Size>10-20cc</Size><SupplierCode>KW</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><ARTGs><ARTG>451205</ARTG></ARTGs><MinimumBenefit>1425</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW026</BillingCode><Name>Normmed Pedifix Single Staples</Name><Description>Single Staple</Description><Size>Diameter 12 mm; Height 9.5 mm</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>502278</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABH07</BillingCode><PriorBillingCodes><PriorBillingCode>SYN12</PriorBillingCode></PriorBillingCodes><Name>Bone, Cancellous Chips - 30cc</Name><SupplierCode>ABH</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>254592</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4000</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW019</BillingCode><Name>Normmed Pedifix Dual Staples</Name><Description>Caudal and Rostral Dual Staples</Description><Size>Small and Large</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>502278</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW030</BillingCode><Name>Normmed Oxis PLUS Transverse Link Connector</Name><Description> Posterior Cervical Transverse Link, Two Transverse Link Hooks, and the required set screws</Description><Size>Link Length 40-70mm</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>490507</ARTG><ARTG>502268</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW041</BillingCode><Name>Normmed Tra-Ti Trabecular Titanium TLIF Cage</Name><Description>Tra-Ti Trabecular Titanium TLIF Cage and Trabecular Titanium TLIF Cage angled</Description><Size>7-13 mm (height); 24-32 mm (Length); 10 mm (width); available with a 0, 4, and 8 degree angle</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>512828</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW020</BillingCode><Name>Normmed Pedifix Fixed Cross Connector</Name><Description>Monoblock Cross Connector pre-assembled with set screws</Description><Size>Length 12mm - 24mm (length), connects 4.5mm rods.</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>502279</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW037</BillingCode><Name>Normmed Trimi Anterior Cervical Plate System</Name><Description>Plate Screw and Plate Screw Revision to be used with the Trimi Anterior Cervical Plates</Description><Size>3.5-4.0mm (diameter), 12-20mm (length) </Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>513565</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW003</BillingCode><Name>Normmed Oxis PLUS Occipital Plate Screw</Name><Description>Titanium Posterior Occipital Plate Screw</Description><Size>(3.5-4.0) X (6.0-20) mm</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>490505</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW031</BillingCode><Name>Normmed Thoracolumbar Rapidfix Transverse Fixed Connector</Name><Description>Thoracolumbar Rapidfix Transverse Link, 2 x Transverse Link Hooks, and the required set screws</Description><Size>Link length: 40-80 mm; Hook (height x length x width): 15x12x8 mm</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>502273</ARTG><ARTG>502274</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABH05</BillingCode><PriorBillingCodes><PriorBillingCode>SYN10</PriorBillingCode></PriorBillingCodes><Name>Bone, Cancellous Chips - 15cc</Name><SupplierCode>ABH</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>254592</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3000</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW035</BillingCode><Name>Normmed Tra-Ti Trabecular Titanium PLIF Cage</Name><Description>Tra-Ti Trabecular Titanium PLIF Cage</Description><Size>7-13 mm (Height); 24-32 mm (Length); 10 mm (Width)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>512828</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABH08</BillingCode><PriorBillingCodes><PriorBillingCode>SYN13</PriorBillingCode></PriorBillingCodes><Name>Bone, Cancellous Granules - 30cc</Name><SupplierCode>ABH</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>254592</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4000</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW036</BillingCode><Name>Normmed Alligator PLIF PEEK Cage</Name><Description>Interbody Fusion Lumbar PEEK Cage</Description><Size>6-12 mm (height); 22-24 mm (length); 10 mm (width); </Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>512805</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABH06</BillingCode><PriorBillingCodes><PriorBillingCode>SYN11</PriorBillingCode></PriorBillingCodes><Name>Bone, Cancellous Granules - 15cc</Name><SupplierCode>ABH</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>254592</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3000</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW040</BillingCode><Name>Normmed Twisty TLIF PEEK Cage</Name><Description>Twisty TLIF PEEK Cage; Twisty TLIF PEEK Cage Angled</Description><Size>7-13 mm (height); 24-32 mm (length); 10 mm (width); available with 0, 4, and 8 degree angle</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>512805</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW028</BillingCode><Name>NeuroFlex Flexible Collagen Nerve Conduit </Name><Description>Resorbable collagen tubular matrix intended for use in peripheral nerve repair. </Description><Size>2.0-6.0 mm (ID) x 2.5 cm (L)</Size><SupplierCode>KW</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1564</GroupID><ARTGs><ARTG>513005</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW014</BillingCode><Name>Normmed Thoracolumbar Rapidfix Offset Connector</Name><Description>Lateral-Extension (Offset) Connector supplied with set screw in one package</Description><Size>15-40 mm</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>502273</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW029</BillingCode><Name>NeuroMatrix Standard Collagen Nerve Conduit</Name><Description>Resorbable collagen tubular matrix intended for use in peripheral nerve repair. </Description><Size>2.0-6.0 mm (ID) x 2.5 cm (L)</Size><SupplierCode>KW</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1564</GroupID><ARTGs><ARTG>510606</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW034</BillingCode><Name>Normmed Polar Cervical PEEK Cage</Name><Description>Cervical PEEK Cage with titanium pins; </Description><Size>4-8 mm (height); 12-14 mm (length); 14-16 mm(width)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>512805</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW027</BillingCode><Name>NeuroMend Collagen Nerve Wrap </Name><Description>Resorbable collagen matrix intended for use in peripheral nerve repair. </Description><Size>4.0-12.0 mm (ID) x 2.5-5.0 cm (L)</Size><SupplierCode>KW</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1564</GroupID><ARTGs><ARTG>510605</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW023</BillingCode><Name>Normmed Pedifix Offset Connectors</Name><Description>Lateral Connector, open, supplied with corresponding set screw</Description><Size>30mm - 70mm</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>502279</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW005</BillingCode><Name>Normmed Oxis PLUS Plate </Name><Description>Titanium Occipital Plate</Description><Size>S-M-L (length of 45, 50, and 55 mm)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>490506</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ578</BillingCode><Name>adbone BCP </Name><Description>Bone Graft Substitute - Block, Wedge, Granules (0.1-0.5mm, 0.5 - 1mm, 1-2mm, 3-4mm) Crunch (4-7mm), Cylinder (8 x20mm)</Description><Size>0-5gms</Size><SupplierCode>KW</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>451205</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW017</BillingCode><Name>Normmed Pedifix Adjustable Cross Connector</Name><Description>Polyaxial Cross Connector, pre assembled with set screw</Description><Size>S (24-30 mm length); M (30-36 mm); L (36-45 mm); XL (45-60 mm)</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>502279</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KW015</BillingCode><Name>Normmed Thoracolumbar Rapidfix Transverse Adjustable Connector</Name><Description>Transverse Link Multiaxial, supplied with set screws in one package</Description><Size>(20-80) X (40-100) mm</Size><SupplierCode>KW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>502273</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AUB03</BillingCode><Name>Femoral Head</Name><SupplierCode>AUB</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2354</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AUB08</BillingCode><Name>Bone – Cortico-Cancellous Crunch &lt;20g Sterile</Name><SupplierCode>AUB</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2215</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AUB05</BillingCode><Name>Cortical Strut</Name><SupplierCode>AUB</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2451</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AUB06</BillingCode><Name>Tibia – Proximal third</Name><SupplierCode>AUB</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2562</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AUB02</BillingCode><Name>Bone - Milled Femoral Head</Name><SupplierCode>AUB</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2457</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AUB09</BillingCode><Name>Tendon - Achilles with bone plug</Name><SupplierCode>AUB</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2228</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AUB07</BillingCode><Name>Spinal Ring</Name><SupplierCode>AUB</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1854</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AUB04</BillingCode><Name>Bone – Cortico-Cancellous Crunch &lt;30g</Name><SupplierCode>AUB</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2070</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AUB10</BillingCode><Name>Tendon</Name><SupplierCode>AUB</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2184</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GZ002</BillingCode><Name>JDEvolution Plus, JDEvolution S, JDIcon Plus, JDIcon Ultra S, JDNasal, JDPterygo Dental Implants</Name><Description>Titanium Dental Implants</Description><Size>2.75mm to 6.0mm (diameter), 6 to 30mm (height)</Size><SupplierCode>GZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4392</SubGroupID><ARTGs><ARTG>334160</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GZ001</BillingCode><Name>JD Zygoma Dental Implants</Name><Description>Titanium Dental Implants</Description><Size>3.9mm to 4.3mm (diameter), 30mm to 60mm (height)</Size><SupplierCode>GZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1601</GroupID><ARTGs><ARTG>334160</ARTG></ARTGs><MinimumBenefit>780</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GZ004</BillingCode><Name>JD Temporary Abutments</Name><Description>Titanium Abutments</Description><Size>3.2mm to 7.5mm (diameter), 1.0mm to 9.0mm (height)</Size><SupplierCode>GZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4386</SubGroupID><ARTGs><ARTG>334161</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GZ003</BillingCode><Name>JD Permanent Abutments</Name><Description>Titanium Abutments</Description><Size>1.5mm to 9.0mm (height)</Size><SupplierCode>GZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4385</SubGroupID><ARTGs><ARTG>334161</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ090</BillingCode><Name>Headless Compression Cannulated Screw System</Name><Description>Fully-threaded headless cannulated screws</Description><Size>3.0mm, 3.5mm, 4.0mm diameter   14-30mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>276915</ARTG><ARTG>284755</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ045</BillingCode><Name>Valens Hand - Screws</Name><Description>Cannulated Screws</Description><Size>3.0mm, 3.5mm, 4.0mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ076</BillingCode><Name>Cannulated Humeral Nail</Name><Description>Nail Locking Screw</Description><Size>3.5mm Width  20mm-30mm Length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ101</BillingCode><Name>Austofix Clavicle L&amp;C Plates</Name><Description>Hook Clavicle Locking Plates</Description><Size>7-15 Holes</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5271</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>1260</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ067</BillingCode><Name>F1 Proximal Femoral Nail</Name><Description>F1 Femoral Nail - Long</Description><Size>340mm - 460mm
120deg, 125deg, 130deg</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3327</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>1188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ012</BillingCode><PriorBillingCodes><PriorBillingCode>AX022</PriorBillingCode></PriorBillingCodes><Name>Austofix Femoral and Tibial Nailing System</Name><Description>Universal Tibial Nail (UTN) 4.0/4.8, stainless steel or titanium</Description><Size>Diameter 8 – 11mm, Lengths 260mm – 420mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3329</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>963</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ077</BillingCode><Name>Cannulated Humeral Nail</Name><Description>Nail Locking Screw</Description><Size>4.0mm diameter  20mm to 50mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ025</BillingCode><PriorBillingCodes><PriorBillingCode>AX088</PriorBillingCode></PriorBillingCodes><Name>Austofix PHP - Proximal Humeral Plating System</Name><Description>Anatomic Periarticular Humeral Variable Angle Locking Plate, Titanium</Description><Size>7-15 Hole</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ007</BillingCode><PriorBillingCodes><PriorBillingCode>AX107</PriorBillingCode></PriorBillingCodes><Name>F3 Femoral Nail</Name><Description>F3 Femoral Nail Titanium</Description><Size>Length 320mm to 440mm, left and right</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3327</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>1188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ002</BillingCode><Name>Austofix Small Fragment System </Name><Description>Humeral Plates – Dorsal, Distal, Distal Medial, Distal Lateral, Proximal</Description><Size>7-15 Holes</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ047</BillingCode><Name>Valetis Screws</Name><Description>Titanium Locking Screws</Description><Size>3.5mm width, 10-65mm length
4.0mm width, 10-75mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ001</BillingCode><Name>Austofix Small Fragment System</Name><Description>Humeral Plates - Distal Lateral Dorsal and Distal Medial</Description><Size>7-15 Holes</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ015</BillingCode><PriorBillingCodes><PriorBillingCode>AX087</PriorBillingCode></PriorBillingCodes><Name>Austofix Proximal Humeral Plating System - Austofix Cortical Screw</Name><Description>Cortical Screw, Titanium</Description><Size>3.5mm, 20-40mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ021</BillingCode><PriorBillingCodes><PriorBillingCode>AX029</PriorBillingCode></PriorBillingCodes><Name>Austofix Femoral and Tibial Nailing System</Name><Description>M8 End Cap, Intramedullary Nails, stainless steel or titanium</Description><Size>1mm-20mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>5363</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ055</BillingCode><Name>Valens Shoulder and Elbow - Screws</Name><Description>Cortex/Cancellous Screws</Description><Size>3.5mm, 4.0mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ061</BillingCode><Name>F1 Proximal Femoral Nail</Name><Description>F1 Helical End Cap</Description><Size>5mm, 10mm, 15mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>5363</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ062</BillingCode><Name>F1 Proximal Femoral Nail</Name><Description>Screw End Cap</Description><Size>5mm, 10mm, 15mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>5363</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ049</BillingCode><Name>Valetis Screws</Name><Description>Titanium Cortical Screws</Description><Size>3.5mm width, 10-80mm length
4.0mm width, 10-80mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ003</BillingCode><Name>Valens Shoulder and Elbow - Elbow</Name><Description>Locking Compression Plate Proximal Radius</Description><Size>1-6 Holes</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>1372</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ040</BillingCode><Name>Mini Fragment Plates</Name><Description>Locking Compression Plates</Description><Size>1.5mm, 2.0mm, 2.5mm, 2.7mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ022</BillingCode><PriorBillingCodes><PriorBillingCode>AX040</PriorBillingCode></PriorBillingCodes><Name>VRP Distal Radius Fixation System</Name><Description>Volar Distal Radius Plate</Description><Size>Standard, wide, narrow, long, short - left, right and universal</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>149433</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ004</BillingCode><Name>Valens Shoulder and Elbow - Elbow</Name><Description>Ulna Hook Locking Compression Plate</Description><Size>7 Holes</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5280</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>1198</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ056</BillingCode><Name>Valens Shoulder and Elbow - Screws</Name><Description>Cortex/Cancellous Screws</Description><Size>4.5mm, 6.5mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ052</BillingCode><Name>Valetis Screws</Name><Description>Titanium Cancellous Screws</Description><Size>4.5mm width, 10-80mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ098</BillingCode><Name>Austofix L&amp;C Large Fragment Plate and Screw System</Name><Description>Cortex, Cancellous Screws</Description><Size>4.5mm, 6.5mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ057</BillingCode><Name>Valens Shoulder and Elbow - Screws</Name><Description>Cannulated Screws</Description><Size>4.5mm, 5.0mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ037</BillingCode><Name>Valens - Cannulated Screws</Name><Description>Countersunk Cannulated Partial-Thread Screw</Description><Size>5.0mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ036</BillingCode><Name>Austofix Cannulated Screws</Name><Description>Cannulated Compression Screw</Description><Size>4.5mm, 6.5mm, 7.3mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ051</BillingCode><Name>Valetis Screws</Name><Description>Titanium Cortical Screws</Description><Size>4.5mm width, 10-80mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ048</BillingCode><Name>Austofix Locking Screws</Name><Description>Titanium Locking Screws</Description><Size>5.0 mm, 6.5 mm, and 7.5 mm width; 10–100 mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ078</BillingCode><Name>Cannulated Humeral Nail</Name><Description>Humeral Head Screw</Description><Size>4.3mm diameter  25mm to 45mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ058</BillingCode><Name>F1 Proximal Femoral Nail</Name><Description>F1 Femoral Nail, Titanium</Description><Size>170mm, 200mm
120deg, 125deg, 130deg</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3326</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>910</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ050</BillingCode><Name>Valetis Screws</Name><Description>Titanium Cancellous Screws</Description><Size>3.5mm width, 10-80mm length
4.0mm width, 10-80mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ064</BillingCode><PriorBillingCodes><PriorBillingCode>AX020</PriorBillingCode></PriorBillingCodes><Name>S2 Nail System</Name><Description>Cannulated supracondylar nail, stainless steel</Description><Size>11/13mm x 160-380mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3328</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>995</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ038</BillingCode><Name>Valens - Cannulated Screw Washer</Name><Description>Washer</Description><Size>8mm, 10mm, 12mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ023</BillingCode><PriorBillingCodes><PriorBillingCode>AX027</PriorBillingCode></PriorBillingCodes><Name>Austofix Femoral &amp; Tibial Nailing System</Name><Description>Washer for screws; s-s</Description><Size>Dia 11mm &amp; 13mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ013</BillingCode><PriorBillingCodes><PriorBillingCode>AX090</PriorBillingCode></PriorBillingCodes><Name>Austofix Proximal Humeral Plating System - Austofix PHP Cancellous Screw</Name><Description>Cancellous Screw, Titanium</Description><Size>4mm 20-40mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ102</BillingCode><Name>Austofix Distal Fibula L&amp;C Plates</Name><Description>Distal Fibula Anatomical Locking Plates</Description><Size>7 to 15 holes, left and right</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ006</BillingCode><Name>Austofix Clavicle Plates</Name><Description>Anterior, Anterior Lateral Extension, Reconstruction, and Anterior Reconstruction Locking Plates</Description><Size>7-15 Holes</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ095</BillingCode><Name>Small Fragment Screws</Name><Description>Locking Screws</Description><Size>3.5mm diameter,   10mm-90mm length </Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ106</BillingCode><Name>Austofix K-Wires</Name><Description>K-Wires</Description><Size>0.8 - 1.6 mm diameter ; 100-150 mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5364</SubGroupID><ARTGs><ARTG>303322</ARTG></ARTGs><MinimumBenefit>11</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ032</BillingCode><Name>Valetis Ankle - Plates</Name><Description>1/3 Tubular Plate</Description><Size>7 to 12 hole</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ075</BillingCode><Name>Cannulated Humeral Nail</Name><Description>Humeral Nail</Description><Size>Diameter: 7mm to 9mm  Length: 170mm to 280mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3330</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>878</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ005</BillingCode><Name>Austofix Clavicle Plates</Name><Description>Clavicle lateral extension plates</Description><Size>7 - 15 holes</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ034</BillingCode><Name>Valens Shoulder and Elbow - Plates</Name><Description>Locking Compression Plates</Description><Size>3.5mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ100</BillingCode><Name>Austofix Small Fragment L&amp;C Plates</Name><Description>Locking Compression Plates</Description><Size>3.5mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ616</BillingCode><Name>Austofix K-Wires</Name><Description>K-Wires</Description><Size>2.0 - 2.5 mm diameter ; 150-300 mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>298332</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ068</BillingCode><Name>Titan Headless Cannulated Screws</Name><Description>Headless Cannulated Compression Screws</Description><Size>3-4mm x 10-60mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ079</BillingCode><Name>Austofix Orthofuse</Name><Description>Titanium Intramedullary Fusion Devices</Description><Size>3.3mm Prox, 4.3mm Mid  2.8mm Prox, 3.8mm Mid  </Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>6561</SubGroupID><Suffix>Interphalangeal</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ024</BillingCode><PriorBillingCodes><PriorBillingCode>AX023</PriorBillingCode></PriorBillingCodes><Name>Austofix Femoral and Tibial Nailing System</Name><Description>4.0/4.8 Screws, Locking, stainless steel or titanium</Description><Size>Diameter 4.0-4.8mm, Lengths 20-90mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ063</BillingCode><Name>F1 Proximal Femoral Nail</Name><Description>Set Screws</Description><Size>Single Size; Angles: 120, 125, 130 degrees</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ081</BillingCode><Name>PEEK Suture Anchor</Name><Description>PEEK Suture Anchor</Description><Size>2.9mm, 3.5mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>325207</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ041</BillingCode><Name>Austofix Mini Fragment - Cortex Screws</Name><Description>Cortex Screws</Description><Size>1.5mm, 2.0mm diameters</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ010</BillingCode><PriorBillingCodes><PriorBillingCode>AX043</PriorBillingCode></PriorBillingCodes><Name>VRP Distal Radius Fixation System</Name><Description>VRP Distal Radius Fixation System, Variable Angle, Threaded, non-threaded, partially threaded locking, non-locking screw, peg, titanium</Description><Size>2.5-2.7mm diameter, 10-34mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>149433</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ054</BillingCode><Name>Valens Shoulder and Elbow - Screws</Name><Description>Self-Tapping Locking Screws</Description><Size>2.4mm, 2.7mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ042</BillingCode><Name>Valens Hand - Screws</Name><Description>Locking Screws</Description><Size>1.5mm, 2.0mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ043</BillingCode><Name>Austofix Mini Fragment - Locking screws</Name><Description>Locking Screws</Description><Size>2.4mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ096</BillingCode><Name>Mini Fragment Screws</Name><Description>Cortex/Cancellous Screws</Description><Size>2.4mm diameter,   6mm-60mm length </Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ085</BillingCode><Name>PEEK Suture Anchor</Name><Description>PEEK Suture Anchor</Description><Size>2.9mm, 3.5mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>352376</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ070</BillingCode><Name>Austofix Cannulated Compression Screws</Name><Description>2.4mm Headless Cannulated Compression Screws</Description><Size>2.4mm diameter
10-30mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ074</BillingCode><Name>Austofix PHP - Proximal Humeral Plating System</Name><Description>Locking Screws</Description><Size>2.7mm diameter, 16-70mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ069</BillingCode><Name>Austofix Cannulated Compression Screws</Name><Description>1.7mm Cannulated Headless Compression Screws</Description><Size>1.7mm diameter
6mm to 14mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>346</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ066</BillingCode><Name>VRP Distal Radius Fixation System</Name><Description>VRP Distal Radius Fixation System, Locking Peg</Description><Size>2.0mm width, 14-30mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>149433</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ053</BillingCode><Name>Valens Shoulder and Elbow - Screws</Name><Description>Self-Tapping Locking Screws</Description><Size>2.0mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ097</BillingCode><Name>Patient Specific Biomodelled Plate</Name><Description>Patient Specific Biomodelled Plate</Description><Size>Patient Specific</Size><SupplierCode>DZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>366767</ARTG></ARTGs><MinimumBenefit>2952</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ011</BillingCode><PriorBillingCodes><PriorBillingCode>AX025</PriorBillingCode></PriorBillingCodes><Name>Austofix Femoral and Tibial Nailing System</Name><Description>6.2/6.5 Hip Screw, stainless steel or titanium</Description><Size>Diameter 6.2-6.5mm, Lengths 70-120mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3341</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ059</BillingCode><Name>F1 Proximal Femoral Nail</Name><Description>F1 10.4mm Helical Blade</Description><Size>10.4mm width, 60-120mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3341</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ060</BillingCode><Name>F1 Proximal Femoral Nail</Name><Description>10.4mm Hip Screw</Description><Size>10.4mm width, 60-120mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3341</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ089</BillingCode><Name>PEEK Suture Anchor</Name><Description>PEEK Suture Anchor</Description><Size>1.5mm, 2.3mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>352376</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ080</BillingCode><Name>PEEK Suture Anchor</Name><Description>PEEK Suture Anchor</Description><Size>1.5mm, 2.3mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>325207</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ031</BillingCode><Name>Valetis Ankle - Plates</Name><Description>1/3 Tubular Plate</Description><Size>4 to 6 hole</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ107</BillingCode><Name>Austofix L&amp;C Olecranon Plates</Name><Description>Olecranon Locking Plates </Description><Size>17, 19 and 21 holes (8, 10, 12 screw holes in the shaft and 9 holes at the curved end)</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5281</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ035</BillingCode><Name>Valens Shoulder and Elbow - Plates</Name><Description>LCP, Right/Oblique Angled, T-Plate</Description><Size>1-6 Holes</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ033</BillingCode><Name>Valens Shoulder and Elbow - Plates</Name><Description>Locking Compression Plates</Description><Size>3.5mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ039</BillingCode><Name>Mini-Fragment Plates</Name><Description>Locking Compression Plates</Description><Size>1.5mm, 2.0mm, 2.5mm, 2.7mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ065</BillingCode><PriorBillingCodes><PriorBillingCode>AX021</PriorBillingCode></PriorBillingCodes><Name>S2 Nail System</Name><Description>6.2mm condylar screws</Description><Size>6.5mm x 60-85mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3712</SubGroupID><ARTGs><ARTG>111818</ARTG></ARTGs><MinimumBenefit>222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ104</BillingCode><Name>Austofix Small Fragment System</Name><Description>Anterolateral Distal, Distal Medial, Distal Lateral, Proximal, Proximal Lateral Tibial Plates </Description><Size>greater than or equal to 16 Holes</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>1338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ073</BillingCode><Name>Austofix Proximal Humeral Plating System - Austofix Proximal Humeral Plate</Name><Description>Anatomic Periarticular Humeral Variable Angle Locking Plate, Titanium</Description><Size>3-5 holes</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5273</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>1488</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ027</BillingCode><Name>Valetis Ankle - Tibial</Name><Description>Distal Tibial Anatomical Locking Plates</Description><Size>3 to 6 hole, left and right</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>1182</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ103</BillingCode><Name>Austofix Proximal Tibia L&amp;C Plates</Name><Description>Posterior, Lateral, Medial Proximal Tibial Plates</Description><Size>7 to 15 holes </Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>1182</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ028</BillingCode><Name>Austofix Tibial Plates</Name><Description>Anterolateral Distal, Distal Medial, Distal Lateral, Proximal, Proximal Lateral, Proximal Medial</Description><Size>7-15 holes</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>1182</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ099</BillingCode><Name>Austofix Small Fragment System</Name><Description>Cortex/Cancellous Screws</Description><Size>3.5mm width, 12-50mm length 4.0mm width, 12-60mm length</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>284755</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DZ014</BillingCode><PriorBillingCodes><PriorBillingCode>AX086</PriorBillingCode></PriorBillingCodes><Name>Austofix Proximal Humeral Plating System - Austofix PHP Locking Screw</Name><Description>Locking Screw Titanium</Description><Size>3.5mm, 16-100mm</Size><SupplierCode>DZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276915</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB023</BillingCode><Name>Mallet Finger Plate</Name><Description>Finger Plates</Description><Size>1 &amp; 2 Holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>229660</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB095</BillingCode><Name>Marathon Ankle Fracture Plating System, Distal Tibia &amp; Fibula plates VAL</Name><Description>MARATHON VAL Distal Posteromedial Tibial Plate, Left and right 
MARATHON VAL Distal Posterolateral Tibial Plate, left and right 
MARATHON VAL Distal Fibula Locking Plate, Anatomical, left and right 
MARATHON VAL Distal Tibial Medial Malleolus, Anatomic
MARATHON VAL Distal Tibial Anterolateral Tibial Plate, left and right 
MARATHON VAL Distal Anterior Locking Tibial Plate
MARATHON VAL Distal Medial Tibial Plate</Description><Size>7,8,9,10,11,12,13,14,15 holes </Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB056</BillingCode><Name>Marathon VA System</Name><Description>Variable Angle Bone Plates</Description><Size>&lt;6 Holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB068</BillingCode><Name>G Loop</Name><Description>Titanium or Stainless Steel fixation device with non-absorbable suture material</Description><Size>Adjustable Length</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>323905</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB077</BillingCode><Name>Marathon variable angle Fibula plates</Name><Description>Marathon variable angle Fibula plates</Description><Size>7 - 15 holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB076</BillingCode><Name>Marathon variable angle Fibula Plate</Name><Description>Marathon variable angle Fibula Plate</Description><Size>1 - 6 holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB094</BillingCode><Name>Marathon Ankle Fracture Plating System, Distal Anatomical Fibula Hook plates</Name><Description>MARATHON VAL Distal Fibula Lateral Malleolus, Hook Plate, Anatomical, left and right </Description><Size>7 holes </Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB039</BillingCode><PriorBillingCodes><PriorBillingCode>PB010</PriorBillingCode></PriorBillingCodes><Name>DPS Spine System  Double Locking Cap and Nut</Name><Description>Locking Cap and Nut</Description><Size>One size only</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1468</GroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>560</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB052</BillingCode><Name>The HN Intramedullary Nail locking screw</Name><Description>The HN Intramedullary Nail locking screw, cannulated, dual-threaded</Description><Size>Length 16mm - 60mm, Diameter 3.0mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB092</BillingCode><Name>Mini Bunion Nail Plate</Name><Description>Mini Bunion Nail Plate 5 holes</Description><Size>6 holes or less</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB085</BillingCode><Name>Marathon Mini VAL System</Name><Description>Marathon Mini VAL System</Description><Size>6 holes or less</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB073</BillingCode><Name>Hammer Fusion System</Name><Description>Interphalangeal Arthrodesis Implant</Description><Size>2.0mm - 4.0mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>6561</SubGroupID><Suffix>Interphalangeal</Suffix><ARTGs><ARTG>229660</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB017</BillingCode><Name>Ankle Fusion Locking Plate</Name><Description>Ankle Fusion Locking Plate</Description><Size>7 holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>916</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB013</BillingCode><Name>DPS Spine System - Hook</Name><Description>Hook for spinal fixation system.</Description><Size>Laminar and Pedicle; Diameter 5.5/6.0mm, Width - Broad, narrow; Left and Right</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB029</BillingCode><Name>Mini Locking System - Condylar Plates ≤ 6 holes</Name><Description>Condylar Plates</Description><Size>≤ 6 holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>417</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB045</BillingCode><Name>Subtalar Implant</Name><Description>Conical tapered titanium implant to treat flat foot and stabilise subtalar joint</Description><Size>7 – 12mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1219</GroupID><SubGroupID>3261</SubGroupID><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>1321</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB072</BillingCode><Name>Peek Suture Anchor</Name><Description>Peek suture anchor</Description><Size>Great than 4mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>323905</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB063</BillingCode><Name>MCS</Name><Description>MCS System</Description><Size>2.71mm - 4.49mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB067</BillingCode><Name>Full Thread Suture Anchor</Name><Description>Suture Anchor</Description><Size>&gt; 4mm </Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>323905</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB082</BillingCode><Name>VA Clavicle Plate</Name><Description>VA Clavicle Plating System</Description><Size>less than 6 holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5270</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB035</BillingCode><Name>Mini Locking System - Headless Compression Screw</Name><Description>Compression Screws</Description><Size>1.5mm &amp; 2mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>346</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB042</BillingCode><Name>Compression Screws</Name><Description>Headless Compression Screws</Description><Size>less than 2.4mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB096</BillingCode><Name>Marathon Ankle Fracture Plating System, Distal Tibia &amp; Fibula plates VAL</Name><Description>MARATHON VAL Distal Fibula Locking Plate, Anatomical, left and right 
MARATHON VAL Distal Tibial Anterolateral Tibial Plate, left and right 
MARATHON VAL Distal Medial Tibial Plate</Description><Size>16, 17,18,19,21,23,25 holes </Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>810</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB049</BillingCode><Name>Break-Off Screws</Name><Description>A self-breaking, self-drilling screw used for the fixation of small bone osteotomies and fractures</Description><Size>Diameter 2.7mm, Length 10-20mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>295</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB075</BillingCode><Name>Intramedullary Nailing System Locking Screw </Name><Description>Intramedullary Nailing System Locking Screw </Description><Size>5.0mm - 6.0mm </Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB046</BillingCode><Name>Laminoplasty Mini Plate</Name><Description>Laminoplasty Plate</Description><Size>10/12/14mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4131</SubGroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB036</BillingCode><Name>Headless Compression Screw System</Name><Description>Headless Compression Screw</Description><Size>2.71 - 4.49mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB043</BillingCode><Name>Cannulated Screws 3mm</Name><Description>Cannulated Screws</Description><Size>3mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB055</BillingCode><Name>Titanium Spinal Mesh</Name><Description>End rings</Description><Size>10 - 24 mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1495</GroupID><ARTGs><ARTG>215887</ARTG></ARTGs><MinimumBenefit>1030</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB080</BillingCode><Name>Marathon VAL Calcaneal Plate</Name><Description>Variable Angle Calcaneal Plates</Description><Size>7 - 15 Holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5296</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>1373</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB078</BillingCode><Name>Mini Nailing System</Name><Description>Mini Nailing System</Description><Size>Diameter 3mm - 4mm, Length 130mm - 230mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3329</SubGroupID><ARTGs><ARTG>229660</ARTG></ARTGs><MinimumBenefit>963</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB022</BillingCode><Name>Calcaneal Locking Plate MIPO System - Locking Screw</Name><Description>Locking Screws</Description><Size>2.71mm - 4.49mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB064</BillingCode><Name>C Nail</Name><Description>Intramedullary Nail</Description><Size>60mm - 100mm </Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>7362</SubGroupID><ARTGs><ARTG>229660</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB087</BillingCode><Name>BR Subtalar Compression Nail </Name><Description>BR Subtalar Compression Nail </Description><Size>Diameter : 8.0 - 9.5 mm ; Length : 70 - 95 mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>7362</SubGroupID><ARTGs><ARTG>229660</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB060</BillingCode><Name>TINA Minimally Invasive Spine System</Name><Description>Polyaxial Cannulated Screw</Description><Size>All sizes</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB079</BillingCode><Name>Mini Nailing System Reconstruction Screw</Name><Description>Mini Nailing System Reconstruction Screw</Description><Size>10mm - 40mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3712</SubGroupID><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB088</BillingCode><Name>ACP IV Bone Screws </Name><Description>ACP IV Bone Screws </Description><Size>Diameter : 3.5 - 4.0 mm, Length : 10 - 20 mm </Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB009</BillingCode><Name>DPS Spine System - Polyaxial Pedicle Screw</Name><Description>Polyaxial pedicle screws</Description><Size>Diameter 4/5/6/7mm; Length 25 - 55mm  Wide Angle 5.5/6.0/6.5/7.0/7.5/8.0 mm; Length 25 - 135 mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB003</BillingCode><Name>Delta Plate</Name><Description>Anterior cervical plate</Description><Size>Length: 16-22mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB015</BillingCode><Name>Anterior Cervical Plate System</Name><Description>Anterior cervical plate. Various size plates, Titanium</Description><Size>20-55mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB090</BillingCode><Name>Anterior Cervical Plate IV 15-55 mm </Name><Description>Anterior Cervical Plate IV 15-55 mm</Description><Size>15-55 mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB089</BillingCode><Name>Anterior Cervical Plate IV &gt; 55 mm</Name><Description>Anterior Cervical Plate IV - 57 mm - 86 mm</Description><Size>57 mm -86 mm </Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB016</BillingCode><Name>Anterior Cervical Plate System</Name><Description>Anterior cervical plate. Various size plates, Titanium</Description><Size>&gt;55mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB021</BillingCode><Name>Cortex, Cancellous and Non Locking Screw</Name><Description>Cortex, Cancellous, Non locking Screws</Description><Size>2.71mm - 4.49mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB001</BillingCode><Name>Anterior Cervical PEEK Cage</Name><Description>Interbody fusion cage</Description><Size>Height: 5 -10 mm in 1 mm increments  Foot Print 13 x 16 mm / 13 x 19 mm / 12.5 x 15 mm / 11 mm x 14 mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>215887</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB014</BillingCode><Name>ATP Cage</Name><Description>Lateral Interbody Spacer</Description><Size>Width 22mm x Length 40-60mm x Height 8 - 20mm
Angles 8, 15 &amp; 23 degree lordotic angle</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>215887</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB002</BillingCode><Name>Thoracic-lumbar PEEK cage</Name><Description>Interbody fusion cage</Description><Size>Height: 6 - 15mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>215887</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB065</BillingCode><Name>End Cap</Name><Description>Nail End Cap</Description><Size>One size</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>5363</SubGroupID><ARTGs><ARTG>229660</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB005</BillingCode><Name>TLIF (D-REX) Cage</Name><Description>Interbody fusion cage.</Description><Size>Height: 7-15 mm.</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>215887</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB093</BillingCode><Name>Marathon Ankle Fracture Plating System, Distal Fibula &amp; Tibial Hook plates </Name><Description>MARATHON VAL Distal Fibula Straight Hook Plate
MARATHON VAL Distal Fibula Lateral Malleolus, Hook Plate, Anatomical, left and right 
MARATHON VAL Distal Tibial Medial Malleolus, Hook Plate
MARATHON VAL Distal Medial Tibial Peg Hook Plate</Description><Size>2,3,4,5,6 holes </Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB040</BillingCode><Name>Cannulated Screws 4mm</Name><Description>Cannulated 4mm</Description><Size>4mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ216</BillingCode><Name>Ankle Fusion Locking Plate</Name><Description>Mini and ANTT Ankle Fusion Locking Plates, Left/ Right, or Universal with different angles. </Description><Size>6 Holes or less</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB004</BillingCode><Name>Bone Screws</Name><Description>Bone Screws</Description><Size>Diameter:2.0-4.35mm, Length: 6-18mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB030</BillingCode><Name>Mini Locking System - Condylar Plates ≥ 7 to ≤ 15 holes</Name><Description>Condylar Plates</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB097</BillingCode><Name>Marathon Ankle Fracture Plating System; Distal Tibia &amp; Fibula plates VAL</Name><Description>MARATHON VAL Distal Posteromedial Tibia Plate, left and right 
MARATHON VAL Distal fibula Locking Plate, Straight
MARATHON VAL Distal Tibial Trimalleolar Fracture Plate</Description><Size>3,4,5,6 holes </Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB058</BillingCode><Name>Marathon VA System</Name><Description>Variable Angle Bone plates</Description><Size>&gt;7 - &lt;15 holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB033</BillingCode><Name>Mini Locking System - Cortex Screw</Name><Description>Non locking screw</Description><Size>2.01mm - 2.7mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB027</BillingCode><Name>Mini Locking System - Locking Plates ≥ 7 to ≤ 15 holes</Name><Description>Foot &amp; hand plates - steel - titanium multiple hole</Description><Size>2-2.7 mm, ≥ 7 to ≤ 15 holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB084</BillingCode><Name>Marathon Mini VAL System</Name><Description>Marathon Mini VAL System</Description><Size>7 - 15 Holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB091</BillingCode><Name>Mini Bunion Nail (MBN) Locking Screws</Name><Description>2.4mm and 2.7mm MBN Locking Screws</Description><Size>2.4mm/ 2.7mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB032</BillingCode><Name>Mini Locking System - Cortex Screw</Name><Description>Cortex Screws</Description><Size>≤ 2.0mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB031</BillingCode><Name>Mini Locking System - Non Locking Plates</Name><Description>Non Locking Plate</Description><Size>screw size ≤ 2.7mm, ≥ 7 to ≤ 15 holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB037</BillingCode><Name>Headless Compression Screw System</Name><Description>Headless Compression Screw</Description><Size>≥4.5mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB020</BillingCode><Name>Calcaneal Locking Plate MIPO System - Locking Screw</Name><Description>Locking Screws</Description><Size>Mini (2.01mm-2.7mm)</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB074</BillingCode><Name>Ankle Arthrodesis Nail</Name><Description>Ankle Arthrodesis Nail</Description><Size>10mm - 12mm diameter</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3332</SubGroupID><ARTGs><ARTG>229660</ARTG></ARTGs><MinimumBenefit>3300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB062</BillingCode><Name>MCS</Name><Description>MCS System</Description><Size>&gt; 4.5mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB054</BillingCode><Name>Titanium Spinal Mesh</Name><Description>Mesh, Round</Description><Size>18 - 90 mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1494</GroupID><ARTGs><ARTG>215887</ARTG></ARTGs><MinimumBenefit>2616</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB034</BillingCode><Name>Mini Locking System - Locking Screw, Stardrive, Self Tapping</Name><Description>Locking Screws</Description><Size>1.5mm &amp; 2mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB044</BillingCode><Name>Cannulated Screws 6.5 &amp; 7.3mm</Name><Description>Cannulated Screws</Description><Size>6.5mm &amp; 7.3mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB061</BillingCode><Name>Compression Staple</Name><Description>Compression Staple</Description><Size>Multiple Sizes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><Suffix>COMP</Suffix><ARTGs><ARTG>319175</ARTG></ARTGs><MinimumBenefit>396</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB059</BillingCode><Name>TINA Minimally Invasive Spine System</Name><Description>Monoaxial Cannulated Screw</Description><Size>All sizes</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB008</BillingCode><Name>DPS Spine System - Monoaxial Pedicle Screw</Name><Description>Mono-axial pedicle screws</Description><Size>Diameter 4/5/6/7mm; Length 25 - 55mm.</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB070</BillingCode><Name>Static Staple</Name><Description>Static Staple</Description><Size>8mm - 10mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><ARTGs><ARTG>332960</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB038</BillingCode><PriorBillingCodes><PriorBillingCode>PB010</PriorBillingCode></PriorBillingCodes><Name>DPS Spine System  Single Locking Nut</Name><Description>Locking nut for pedicle screw.</Description><Size>One size</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB081</BillingCode><Name>Marathon VAL Tibia Plates</Name><Description>Variable angle periarticular tibia plates </Description><Size>7 - 15 Holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>1489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB007</BillingCode><Name>DPS Spine System - Rod</Name><Description>Rods for posterior pedicle screw fixation system.</Description><Size>Diameter 5/5.5/6mm; Length 40-500mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB041</BillingCode><Name>Washers</Name><Description>Washers</Description><Size>Thickness 1- 5.5mm
Width 7 - 13mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB083</BillingCode><Name>VA Clavicle Plate</Name><Description>VA Clavicle Plating System</Description><Size>7 - 15 holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5271</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>1320</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB006</BillingCode><Name>DCS System</Name><Description>Anterior cervical interbody fusion system with screws</Description><Size>Cage Height: 5/6/7/8/9/10/11/12 mm</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB012</BillingCode><Name>DPS Spine System - Transconnector Adjustable</Name><Description>Adjustable transconnector for spinal fixation system.</Description><Size>Diameter 5.5/6.0mm; Adjustable lengths: 34-39mm, 38-49mm, 48-68mm.</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB057</BillingCode><Name>Distal Radius Plate</Name><Description>Distal Radius Plating System</Description><Size>7 - 15 holes</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>261562</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB011</BillingCode><Name>DPS Spine System - Transconnector Fixed</Name><Description>Fixed transconnector for spinal fixation system.</Description><Size>Diameter 5.5/6.0mm; Length 50 - 80mm.</Size><SupplierCode>PB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>214788</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB069</BillingCode><Name>BFix Bone Pins</Name><Description>Bone Pins </Description><Size>0.6mm - 5.0mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>322423</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB051</BillingCode><Name>HN Intramedullary Nail</Name><Description>The HN Intramedullary Nail</Description><Size>Length 10mm - 26mm, Diameter 5.5mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5474</SubGroupID><ARTGs><ARTG>229660</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB071</BillingCode><Name>Peek Suture Anchor</Name><Description>Non-absorbable suture anchor</Description><Size>2.4mm - 3.9mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>323905</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB066</BillingCode><Name>Full Thread Suture Anchor</Name><Description>Suture Anchor</Description><Size>2.4mm - 3.9mm </Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>323905</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PB086</BillingCode><Name>Radfix Distal Radius System - Cannulated Peg / Post</Name><Description>Radfix Distal Radius System - Cannulated Peg / Post</Description><Size>14 mm - 28 mm</Size><SupplierCode>PB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>4521</SubGroupID><ARTGs><ARTG>223188</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA14</BillingCode><Name>Morsellised Bone (10-20 cc/g)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2707</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB93</BillingCode><Name>Gracilis Tendon</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2398</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA29</BillingCode><Name>Humerus – Proximal Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4061</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB12</BillingCode><Name>Patella Tendon with Bone Blocks - Whole</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3804</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD17</BillingCode><Name>Spinal Anterior Longitudonal Ligament Patch</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4023</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB38</BillingCode><Name>Achilles Tendon with Pre-Shaped Bone Block</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3923</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB96</BillingCode><Name>Hemipelvis – Whole</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>9452</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD30</BillingCode><Name>Freeze Dried Cortico-Cancellous Bone Granules 5-9cc</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2800</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB91</BillingCode><Name>Fascia Lata Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4001</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA92</BillingCode><Name>Bone Dowel / Plug (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1562</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD23</BillingCode><Name>Cortical – Demineralized Bone Matrix 1-4g/1-4cc</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2676</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB14</BillingCode><Name>HTO Wedge</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1694</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD29</BillingCode><Name>Freeze Dried Cortico-Cancellous Bone Granules 2-4cc</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2450</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA73</BillingCode><Name>Tricortical Cancellous Wedge</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1674</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA62</BillingCode><Name>Humeral Head – Whole</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2188</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD44</BillingCode><Name>Meniscus</Name><Size>one unit</Size><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2895</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB26</BillingCode><Name>Cortical Plate</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1522</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA05</BillingCode><Name>Tendon Patch Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4000</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD32</BillingCode><Name>Bone allograft kit (Demineralized and Mineralized Bone Matrix) 1-4g / 1-4cc</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4376</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB09</BillingCode><Name>Cervical Spacers - Lordotic (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1840</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD20</BillingCode><Name>Bone allograft kit (Demineralized and Mineralized Bone Matrix) 5-10g / 5-10cc</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6193</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA15</BillingCode><Name>Cortical Cancellous Block</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1674</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA40</BillingCode><Name>Patella Tendon with Bone Block – Whole Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3879</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA24</BillingCode><Name>Unicortical Cancellous Block Super Critical Fluid CO2 Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1553</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA23</BillingCode><Name>Femur – Whole</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>9013</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA32</BillingCode><Name>Cervical Spacers - Parrallel</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1840</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD26</BillingCode><Name>Moulded Demineralized Fibres (Large)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3750</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB68</BillingCode><Name>Femur – Proximal</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3996</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA87</BillingCode><Name>Femoral Condyle Whole</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3743</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB02</BillingCode><Name>Malleable Bone Segments Super Critical Fluid CO2Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2400</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB05</BillingCode><Name>Fibula – Whole</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>8780</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB52</BillingCode><Name>Femur – Distal</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3743</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB56</BillingCode><Name>Morsellised Bone (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2211</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA36</BillingCode><Name>Cortical Ring</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1840</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB45</BillingCode><Name>Patella Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3526</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA27</BillingCode><Name>Achilles Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4001</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB39</BillingCode><Name>HTO Wedge – Super Critical Fluid CO2  Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1571</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB08</BillingCode><Name>Femoral Condyle Half</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3253</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB28</BillingCode><Name>Cervical Spacers – Lordotic Super Critical Fluid CO2Treated 5mm-9mm</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2065</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA89</BillingCode><Name>Humerus – Distal Segment</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3075</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB32</BillingCode><Name>Unicortical Cancellous Wedge (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1522</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA09</BillingCode><Name>Femoral Condyle Half – Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3016</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB18</BillingCode><Name>Humerus – Strut Super Critical Fluid CO2 Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2504</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB60</BillingCode><Name>Femoral Head – Hemi</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3773</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA75</BillingCode><Name>Anterior Tibialis Tendon</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3125</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB07</BillingCode><Name>Tibial Strut</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3515</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB20</BillingCode><Name>Posterior Tibialis Tendon</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3125</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB78</BillingCode><Name>Femoral Ring Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2112</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD15</BillingCode><Name>Compressible Cancellous Strip (FZ)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3500</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA06</BillingCode><Name>Peroneus Longus Tendon</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3125</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA28</BillingCode><Name>Morsellised Bone (Freeze Dried) (6-10cc)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2707</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB87</BillingCode><Name>Hemipelvis – Segment Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1708</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB64</BillingCode><Name>Anterior Tibialis Tendon Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3187</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD18</BillingCode><Name>Pre-Shaped Cancellous/Cortical Block (Various Sizes)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3200</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB57</BillingCode><Name>Femoral Shaft</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3598</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA72</BillingCode><Name>Cortical Strut</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2700</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB94</BillingCode><Name>Morsellised Bone Super Critical Fluid CO2 Treated (5-9g)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2482</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD16</BillingCode><Name>Patella Quadriceps Tendon with Patellar Bone</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3902</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD01</BillingCode><Name>Demineralized Bone Fibres (FZ) 5-9g</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3800</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB79</BillingCode><Name>Tibia – Whole</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>7921</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB63</BillingCode><Name>Patella Tendon with Pre-Shaped Bone Block Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3879</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB11</BillingCode><Name>Posterior Tibialis Tendon Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3187</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA59</BillingCode><Name>Patella Tendon with Bone Block – Whole with Quads – Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3879</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA19</BillingCode><Name>Cortical Sheet</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1522</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA85</BillingCode><Name>Cortical Segment</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3449</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA57</BillingCode><Name>Gracilis Tendon Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2445</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA35</BillingCode><Name>Cancellous Plug Super Critical Fluid CO2 Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1593</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA79</BillingCode><Name>Humeral Head – Whole Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2029</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA97</BillingCode><Name>Cortical Cancellous Block Super Critical Fluid CO2Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1553</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA51</BillingCode><Name>Cortical Plate Super Critical Fluid CO2 Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1553</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA86</BillingCode><Name>Morsellised Bone – Super Critical Fluid CO2 Treated (1-4g)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2314</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD03</BillingCode><Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FZ) 1-4g</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2750</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB34</BillingCode><Name>Femoral Head – Whole</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3773</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD34</BillingCode><Name>Acellular Dermal Matrix &lt;25cm² Thickness &lt;2.5mm</Name><Size>&lt;25cm² Thickness &lt;2.5mm</Size><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>408663</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2036</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA70</BillingCode><Name>Hemi Patella Tendon with Bone Block Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3879</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD07</BillingCode><Name>Demineralized Bone Fibres (FD) 5-9cc</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3800</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD35</BillingCode><Name>Acellular Dermal Matrix &gt;26cm², Thickness &lt;2.5mm</Name><Size>&gt;26cm², Thickness &lt;2.5mm</Size><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>408663</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3257</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA16</BillingCode><Name>Peroneus Longus Tendon Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3187</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB88</BillingCode><Name>Cancellous Block Super Critical Fluid CO2 Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1593</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB69</BillingCode><Name>Cortical Sheet Super Critical Fluid CO2 Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1553</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB10</BillingCode><Name>Fibular Ring Super Critical Fluid CO2 Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1877</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB44</BillingCode><Name>Humerus – Shaft</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4453</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA54</BillingCode><Name>Cancellous Cube</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1718</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB74</BillingCode><Name>Patella Tendon with Pre-Shaped Bone Blocks</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3804</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA50</BillingCode><Name>Ulna – Whole</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4008</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA66</BillingCode><Name>Morsellised Bone (Freeze Dried) (1-5cc)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2432</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB15</BillingCode><Name>Humerus – Proximal</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3620</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD04</BillingCode><Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FZ) 5-9g</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3800</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD38</BillingCode><Name>Acellular Dermal Matrix 26 to 60cm²</Name><Size> 26 to 60cm²</Size><SupplierCode>ADD</SupplierCode><CategoryID>28</CategoryID><ARTGs><ARTG>408663</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3257</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD37</BillingCode><Name>Acellular Dermal Matrix &lt;25cm²</Name><Size>&lt;25cm²</Size><SupplierCode>ADD</SupplierCode><CategoryID>28</CategoryID><ARTGs><ARTG>408663</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2036</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA21</BillingCode><Name>Femoral Strut</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3996</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD36</BillingCode><Name>Acelluar Dermal Matrix &lt;25cm², Thickness &gt;2.5mm</Name><Size>&lt;25cm², Thickness &gt;2.5mm</Size><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>408663</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2505</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA83</BillingCode><Name>Tibial Shaft</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>5416</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD14</BillingCode><Name>Compressible Cancellous Strip (FD)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3500</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD22</BillingCode><Name>Pre-Shaped Hyaline Cartilage Segment</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2750</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD42</BillingCode><Name>Acellular Dermal Matrix 61 to 120cm² Dermal Matrix 61 to 120cm²</Name><Size>61cm² to 120cm²</Size><SupplierCode>ADD</SupplierCode><CategoryID>28</CategoryID><ARTGs><ARTG>408663</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>5428</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD25</BillingCode><Name>Moulded Demineralized Fibres (Small)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3000</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD40</BillingCode><Name>Acellular Dermal Matrix &gt;26cm² Thickness &gt;2.5mm</Name><Size>&gt;26cm² Thickness &gt;2.5mm</Size><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>408663</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6514</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB19</BillingCode><Name>Cancellous Block</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1718</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD06</BillingCode><Name>Demineralized Bone Fibres (FD) 2-4cc</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2750</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA88</BillingCode><Name>Tendon Patch</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3923</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD39</BillingCode><Name>Acellular Dermal Matrix &gt; 300cm²</Name><Size>&gt; 300cm²</Size><SupplierCode>ADD</SupplierCode><CategoryID>28</CategoryID><ARTGs><ARTG>408663</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>23569</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB80</BillingCode><Name>Cortical Ring Super Critical Fluid CO2 Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1877</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB99</BillingCode><Name>Demineralized Bone Fibres (FZ) 1-4g</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2750</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA78</BillingCode><Name>Cervical Spacers - Parallel Super Critical Fluid CO2Treated 5mm-9mm</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2065</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD13</BillingCode><Name>Compressible Cancellous Block (FZ)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3500</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA22</BillingCode><Name>Cancellous Cube – Super Critical Fluid CO2 Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1593</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB97</BillingCode><Name>Achilles Tendon with Bone Block Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4001</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD41</BillingCode><Name>Acellular Dermal Matrix 121 to 180cm²</Name><Size>121 to 180cm²</Size><SupplierCode>ADD</SupplierCode><CategoryID>28</CategoryID><ARTGs><ARTG>408663</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>8142</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD10</BillingCode><Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FD) 5-9cc</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3800</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB27</BillingCode><Name>Achilles Tendon Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4001</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA02</BillingCode><Name>Femoral Ring</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2277</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB89</BillingCode><Name>Cervical Spacers - Parrallel (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1840</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA08</BillingCode><Name>Radius – Whole</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3541</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA77</BillingCode><Name>Cancellous Plug</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1718</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD19</BillingCode><Name>Engineered Cancellous Block with DBM Component (Various Sizes)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3200</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB43</BillingCode><Name>Malleable Bone Segments</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2587</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA81</BillingCode><Name>Tricortical Cancellous Wedge Super Critical Fluid CO2 Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1553</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA43</BillingCode><Name>Femoral Ring Super Critical CO2 Treated (Freeze Dried)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2112</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA71</BillingCode><Name>Semitendonosis Tendon Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3188</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD43</BillingCode><Name>Acellular Dermal Matrix 181 to 300cm²</Name><Size>181 to 300cm²</Size><SupplierCode>ADD</SupplierCode><CategoryID>28</CategoryID><ARTGs><ARTG>408663</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>13028</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB50</BillingCode><Name>Unicortical Cancellous Block</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1674</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB59</BillingCode><Name>Fascia Lata</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3923</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB98</BillingCode><Name>Hemi Patella Tendon with Bone Block</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3804</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB83</BillingCode><Name>Humerus – Whole</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4530</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA25</BillingCode><Name>Patella Tendon with Bone Block – Whole with Quads</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3804</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD33</BillingCode><Name>Demineralized Bone Matrix/Cortico-Cancellous Granules 1-4cc</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2700</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA52</BillingCode><Name>Semitendonosis Tendon</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3126</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB92</BillingCode><Name>Achilles Tendon</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3923</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA90</BillingCode><Name>Morsellised Bone (1-4 cc/g)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2268</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA95</BillingCode><Name>Achilles Tendon with Bone Block</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3923</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB86</BillingCode><Name>Morsellised Bone (5-9 cc/g)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2432</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB35</BillingCode><Name>Fibular Ring</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2024</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA37</BillingCode><Name>Humerus – Strut</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2700</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA84</BillingCode><Name>Tibia – Distal</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3743</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD12</BillingCode><Name>Compressible Cancellous Block (FD)</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3500</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD27</BillingCode><Name>Demineralized Bone Matrix/Cortico-Cancellous Granules 5-9cc</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3800</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA68</BillingCode><Name>Malleable Bone Segments Super Critical Fluid CO2Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2400</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA58</BillingCode><Name>Cervical Spacers - Lordotic</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1840</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ADD09</BillingCode><Name>Demineralized Bone Fibres / Cortico-Cancellous Granules (FD) 2-4cc</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2750</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>AAA63</BillingCode><Name>Bone Dowel / Plug Super Critical Fluid CO2 Treated</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1752</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>ABB37</BillingCode><Name>Tibia – Proximal</Name><SupplierCode>ADD</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>277310</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3663</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FC012</BillingCode><Name>GL-DTRAX Bone Screw</Name><Description>Cortical screw</Description><Size>One Size</Size><SupplierCode>FC</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>290978</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FC008</BillingCode><Name>GL-DTRAX Expandable Cage System</Name><Description>Expandable titanium cage</Description><Size>One Size</Size><SupplierCode>FC</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1487</GroupID><ARTGs><ARTG>290977</ARTG></ARTGs><MinimumBenefit>1317</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FC009</BillingCode><Name>GL -DTRAX Cervical Cage- B</Name><Description>Cervical Cage with integral fixation.</Description><Size>One Size</Size><SupplierCode>FC</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1487</GroupID><ARTGs><ARTG>293579</ARTG></ARTGs><MinimumBenefit>1317</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FC011</BillingCode><Name>Ally Bone Screw</Name><Description>For use with DTRAX Cages</Description><Size>One size</Size><SupplierCode>FC</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>290978</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FC010</BillingCode><Name>GL-DTRAX Cervical Cage- T</Name><Description>Titanium Cervical Cage</Description><Size>One Size</Size><SupplierCode>FC</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1487</GroupID><ARTGs><ARTG>293579</ARTG></ARTGs><MinimumBenefit>1317</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KI005</BillingCode><Name>MIC-KEY Low Profile Balloon Feeding Accessories</Name><Description>MIC-KEY Extension Sets, ENFit, available in a variety of sizes and options including, bolus and y-port with straight or right-angle connectors.     MIC-KEY Medication Set is also available, ENFit. </Description><Size>30.5cm, 60.9cm, 5.1cm</Size><SupplierCode>KI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4198</SubGroupID><ARTGs><ARTG>261430</ARTG></ARTGs><MinimumBenefit>82</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KI010</BillingCode><PriorBillingCodes><PriorBillingCode>FT004</PriorBillingCode><PriorBillingCode>PO004</PriorBillingCode></PriorBillingCodes><Name>Corflo Max 20fg PEG Kit "Pull Type"</Name><Description>Sterile enteral feeding tube with  accessories</Description><Size>20fg</Size><SupplierCode>KI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1544</GroupID><ARTGs><ARTG>196774</ARTG></ARTGs><MinimumBenefit>161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KI007</BillingCode><Name>MIC* Gastrostomy Feeding Tube; MIC* Bolus Gastrostomy Feeding Tube, ENFit</Name><Description>Medical Grade Silicone Construction. Inflatable Silicone Internal Retention Balloon, SECUR-LOK* External Retention Ring, ENFit Feeding Port Connector, Tapered Distal Tip, Radiopaque Stripe along length of Tube</Description><Size>12Fr - 2-3ml balloon, 14Fr - 3-5ml balloon, 16Fr - 3-5ml balloon, 18Fr - 7-10ml balloon, 20Fr - 7-10ml balloon, 22Fr - 7-10ml balloon, 24Fr - 7-10ml balloon, 26Fr - 7-10ml balloon, 28Fr - 7-10ml balloon, 30Fr - 7-10ml balloon</Size><SupplierCode>KI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4198</SubGroupID><ARTGs><ARTG>248293</ARTG></ARTGs><MinimumBenefit>82</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KI001</BillingCode><Name>HALYARD* MIC*Percutaneous Endoscopic Gastrostomy (P.E.G) Feeding Tubes / Kits, Enfit and Non-Enfit</Name><Description>Sterile enteral feeding tube with accessories</Description><Size>14Fr, 20Fr, 24Fr</Size><SupplierCode>KI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>248293</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KI016</BillingCode><PriorBillingCodes><PriorBillingCode>KI006</PriorBillingCode><PriorBillingCode>KI015</PriorBillingCode></PriorBillingCodes><Name>MIC* &amp; MIC-KEY* Gastric-Jejunal Feeding Tubes, ENFit</Name><Description>MIC* Standard Gastric-Jejunal Feeding Tube: Medical Grade Silicone Construction, Inflatable Internal Retention Balloon, Gastric Decompression/Drainage Port, Multiple Gastric &amp; Jejunal Exit Ports, Tungsten Weighted Jejunal Portion, SECUR-LOK* External Retention Ring.    MIC-KEY* Low-Profile Gastric-Jejunal Feeding Tube: Low-profile Design, Medical Grade Silicone Construction, Inflatable Internal Retention Balloon, Gastric Decompression/Drainage Port, Multiple Gastric &amp; Jejunal Exit Ports, Tungsten Weighted Jejunal Portion, SECUR-LOK* Connection Mechanism for Extension Sets</Description><Size>MIC*: 16 - 22 French, 15cm - 45cm Jejunal Length  MIC-KEY*: 14 - 22 French, 15cm - 45cm Jejunal Length, 1cm - 7cm Stoma Length</Size><SupplierCode>KI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1546</GroupID><Suffix>Port</Suffix><ARTGs><ARTG>248294</ARTG></ARTGs><MinimumBenefit>451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KI002</BillingCode><Name>Halyard* MIC* Percutaneous Endoscopic Gastrostomy (P.E.G) Feeding BASIC Tubes/Kits Enfit and Non-Enf</Name><Description>Sterile enteral feeding tube with accessories</Description><Size>14 Fr, 20 Fr, 24 Fr</Size><SupplierCode>KI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>248293</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KI014</BillingCode><Name>MIC* Jejunostomy Feeding Tube</Name><Description>Sterile Jejunal Enteral Feeding Tube with Suture Wings (2 eaches per case)</Description><Size>14fg / 9fg</Size><SupplierCode>KI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1546</GroupID><Suffix>Port</Suffix><ARTGs><ARTG>248294</ARTG></ARTGs><MinimumBenefit>451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KI004</BillingCode><Name>MIC-KEY Low Profile Balloon Gastrostomy Feeding Tubes/Kits, ENFit</Name><Description>Sterile Low Profile Enteral Feeding Tube with Accessories</Description><Size>14FR to 24 Fr ; 0.8cm to 5.0cm</Size><SupplierCode>KI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>260222</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KI017</BillingCode><PriorBillingCodes><PriorBillingCode>KI009</PriorBillingCode><PriorBillingCode>KI008</PriorBillingCode></PriorBillingCodes><Name>MIC* &amp; MIC-KEY* Balloon Jejunal Feeding Tubes</Name><Description>MIC* Standard Balloon Jejunal Feeding Tube and MIC-KEY* Low-Profile Balloon Feeding Tube are designed for the delivery of enteral nutrition and medication into the distal duodenum or proximal jejunum. They have a medical grade silicone construction with a single access port labeled 'Jejunal'. Wide range of sizes available.</Description><Size>MIC*: 12 - 24 French, 2-3ml Balloon (12Fr) 7-10ml Balloon volume (14-24Fr)  MIC-KEY*: 14 &amp; 18 French, 0.8cm - 4.5cm stoma length, 5ml balloon (max fill volume 10ml)</Size><SupplierCode>KI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1546</GroupID><Suffix>Port</Suffix><ARTGs><ARTG>248294</ARTG></ARTGs><MinimumBenefit>451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HJ001</BillingCode><Name>Surgifeet Weil Screw</Name><Description>Snap off screw , self drilling, self tapping.</Description><Size>Diameter 2mm  Length 11-15mm</Size><SupplierCode>HJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>336654</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HJ003</BillingCode><Name>HBS Self-Drilled High Compression Screw</Name><Description>Headless compression screw, cannulated, dual thread, self-drilling, self-tapping, </Description><Size>Distal thread Diameter 3mm, Length 12-40mm</Size><SupplierCode>HJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>340314</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HJ002</BillingCode><Name>Surgifeet Cannulated Compression Screw</Name><Description>Compression screw. Cannulated, Dual thread, self drilling/tapping, Headless</Description><Size>Diameter 2.55mm. Length 10-34mm, Left or Right thread.</Size><SupplierCode>HJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>336654</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HJ006</BillingCode><Name>MEMODYN Hot Shape Memory Bipode Staple</Name><Description>Nitinol Memory Staple</Description><Size>6mm - 30mm </Size><SupplierCode>HJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><Suffix>MM</Suffix><ARTGs><ARTG>340094</ARTG></ARTGs><MinimumBenefit>507</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HJ005</BillingCode><Name>MICRO HBS Self-Drilled High Compression Screw</Name><Description>Micro headless compression screw, cannulated, dual threads, self-drilling, self- tapping, </Description><Size>Distal thread Diameter 2.5mm, Length 10-30mm</Size><SupplierCode>HJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>340314</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB417</BillingCode><Name>CoreHip Cementless Femoral Stem</Name><Description>Titanium alloy femoral stem with coating</Description><Size>0-11, Stem Length: 119.5mm - 194.5mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1406</GroupID><SubGroupID>3948</SubGroupID><ARTGs><ARTG>405251</ARTG></ARTGs><MinimumBenefit>3100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB367</BillingCode><Name>Aesculap Spinal System</Name><Description>Monoaxial Cannulated Screw</Description><Size>All sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB325</BillingCode><Name>Aesculap-Miethke DualSwitch shunt</Name><Description>Non-adjustable valve with preset values for treatment of patients susceptible to complication due to tumour cells or high protein levels. Treats patients in both supine and upright position. Titanium construction MRI compatible to 3 tesla</Description><Size>28mm diameter, 5.7mm profile, 510-50cmH2O pressure setting</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><ARTGs><ARTG>181718</ARTG></ARTGs><MinimumBenefit>1001</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB329</BillingCode><Name>Miethke Peritoneal Catheter</Name><Description>Peritoneal catheter, barium impregnated, radio-opaque silicon
2) Peritoneal catheter with integrated barium strip</Description><Size>d 1.2mm od =2.5mm; 600,900 1200mm long</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>181747</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB336</BillingCode><Name>Miethke Ventricular Catheter with stylet</Name><Description>Ventricluar catheters (with stylet) are used to drain CSF out of the ventricle. All catheters are made of radiopaque silicone.</Description><Size>Inside diameter 1.2mm, Outside diameter 2.5mm.
FV074P: 180mm, graduated.
FV077P: 250mm, graduated.</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal</Suffix><ARTGs><ARTG>196110</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB324</BillingCode><Name>Aesculap-Miethke gravitational shunt</Name><Description>Single valve, anti-siphon gravitational shunt, titanium construction (MRI safe to 3 tesla)</Description><Size>24mm and 27mm long, 4.0mm and 4.6mm diameter, 4cmH2O and 5cmH2O-40cmH2O</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Antisyphon function</Suffix><ARTGs><ARTG>181718</ARTG><ARTG>375141</ARTG><ARTG>375142</ARTG></ARTGs><MinimumBenefit>1083</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB403</BillingCode><Name>Aesculap-Miethke GAV Shunt System  </Name><Description>Single valve, (anti-siphon) gravitational shunt, titanium construction (MRI safe to 3 tesla), with incorporated reservoir, distal catheter and ventricular catheter.      </Description><Size>Valve: do=4.2 mm, Connector: do=1.9 mm  Catheter: di=1.2 mm, do=2.5 mm,  5cmH2O-30cmH2O</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>181718</ARTG><ARTG>375142</ARTG></ARTGs><MinimumBenefit>1697</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB321</BillingCode><Name>Pneumatic Challenger Multifire Clips</Name><Description>Challenger TI-P SM-Ligat. Clips 12 Cartridge (PL574T)  Challenger TI-P ML-Ligat. Clips 12 Cartridge (PL579T)</Description><Size>small-medium, medium-large</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4259</SubGroupID><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB026</BillingCode><Name>Vascular Uni - Graft - Tapered</Name><Description>Vascular graft</Description><Size>12x6 to 24x12</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1639</GroupID><ARTGs><ARTG>142665</ARTG></ARTGs><MinimumBenefit>770</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB335</BillingCode><Name>Miethke proGAV with distal catheter</Name><Description>Adjustable valve with a gravitational unit and a distal catheter</Description><Size>Adjustable valve: diameter 18mm, opening pressure 0-20 cmH2O, height 4.5mm  Gravitational unit: length 14.9mm, height 4.6mm, opening pressure 0-35 cm H2O  Distal catheter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Distal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>181718</ARTG></ARTGs><MinimumBenefit>2757</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB021</BillingCode><Name>Vascular Uni - Graft</Name><Description>Vascular graft</Description><Size>40cm</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4456</SubGroupID><ARTGs><ARTG>142665</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB022</BillingCode><Name>Vascular Uni - Graft</Name><Description>Vascular graft</Description><Size>30cm</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4456</SubGroupID><ARTGs><ARTG>142665</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB393</BillingCode><Name>Excia T Hip Stem</Name><Description>Cementless CoCr Plasma Femoral Stem</Description><Size>8 - 20 mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1406</GroupID><SubGroupID>3948</SubGroupID><ARTGs><ARTG>321609</ARTG></ARTGs><MinimumBenefit>3100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB371</BillingCode><PriorBillingCodes><PriorBillingCode>BB222</PriorBillingCode><PriorBillingCode>BB223</PriorBillingCode></PriorBillingCodes><Name>Aesculap Spinal System</Name><Description>Pre-bent Rods - Titanium Alloy</Description><Size>All Sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB278</BillingCode><Name>Aesculap Interbody Cage</Name><Description>ACDF Interbody cage</Description><Size>All sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>122641</ARTG><ARTG>273761</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB390</BillingCode><Name>AS Columbus Revision Femoral Component Cemented</Name><Description>Revision Femoral Component AS (Advanced Surface)</Description><Size>1 - 7</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Revision</Suffix><ARTGs><ARTG>312584</ARTG></ARTGs><MinimumBenefit>5450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB302</BillingCode><Name>Biolox Delta Ceramic Hip Prosthesis Head</Name><Description>Biolox Delta Ceramic Head</Description><Size>36 &amp; 40mm diameter</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>291964</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB288</BillingCode><Name>Aesculap Vertebral Body System</Name><Description>Vertebral Body System, Titanium Alloy</Description><Size>All sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>132297</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB338</BillingCode><Name>Miethke proGAV with pre-attached reservoir</Name><Description>Shunt system containing an adjustable valve with a gravitational unit and a reservoir.</Description><Size>Adjustable valve: diameter 18mm, opening pressure 0-20 cmH20, height 4.5mm.  Gravitational unit: length 14.9mm, height 4.6mm, opening pressure 0-35 cmH2O  Reservoir: diameter 14/20mm.</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Distal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>181718</ARTG><ARTG>375143</ARTG></ARTGs><MinimumBenefit>2757</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB350</BillingCode><Name>EnduRo Rotating Hinge Knee Femoral Component</Name><Description>The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to treat complex revision knee arthroplasty as well as unstable knees.</Description><Size>1-3 Right  1-3 Left</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>303701</ARTG></ARTGs><MinimumBenefit>5887</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB383</BillingCode><Name>Histoacryl</Name><Description>Topical and Surgical Adhesive</Description><Size>0.5ml per ampoule</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>206441</ARTG></ARTGs><MinimumBenefit>23</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB382</BillingCode><Name>Histoacryl Flexible</Name><Description>Topical Skin Adhesive</Description><Size>0.5ml per ampoule</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>221444</ARTG></ARTGs><MinimumBenefit>23</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB332</BillingCode><Name>Miethke proGAV</Name><Description>Adjustable valve with intergrated gravitational unit.  Titanium, MR safe up to 3 tesla.</Description><Size>Adjustable valve: Diameter 18mm, Opening pressure 0-20 cmH2O, Height 4.5mm.  Gravitational unit: Length 14.9mm, Height 4.6mm.</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Reservoir/Priming function</Suffix><ARTGs><ARTG>181718</ARTG></ARTGs><MinimumBenefit>2591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB339</BillingCode><Name>Miethke adjustable gratitational unit with differential pressure unit (miniNAV) and distal catheter</Name><Description>proSA and M.blue adjustable gravitational units for the treatment of hydracephalus. The valve can be combined with any differential pressure valve. miniNAV is a very small differential pressure unit, which is often used. The valves are made from titanium and are MR safe up to 3 tesla. The distal catheter is made of silicone.</Description><Size>Adjustable gravitational unit: height 4.5mm, diameter 18mm, opening pressure 0-40 cmH2O.  Differential pressure unit (miniNAV): length 14.7mm, diameter 2.8mm.  Distal catheter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm.</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Distal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>181718</ARTG></ARTGs><MinimumBenefit>2757</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB323</BillingCode><Name>Aesculap-Miethke SHUNTASSISTANT</Name><Description>Anti-siphon gravitational unit to treat standing pressure over drainage in conjunction with existing shunts in children and adults, titanium construction (MRI safe to 3 tesla).</Description><Size>19.5mm long and 23.7mm long , 4.0mm diameter and 4.6mm diameter, 10cmH2O and 15-35cmH2O. Straight and u-shaped.</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>2961</GroupID><ARTGs><ARTG>181718</ARTG><ARTG>375141</ARTG></ARTGs><MinimumBenefit>794</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB228</BillingCode><Name>Aesculap Spinal System</Name><Description>Cross Connector</Description><Size>All Sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB337</BillingCode><Name>Miethke proGAV Shunt System</Name><Description>Shunt system containing an adjustable valve with a gravitational unit, a distal catheter, a ventricular catheter and a reservoir.</Description><Size>Adjustable valve: diameter 18mm, opening pressure 0-20 cmH2O, height 4.5mm.  Gravitational unit: length 14.9mm, height 4.6mm, opening pressure 0-35 cmH2O.  Distal catheter: length 1200mm, inside diameter 1200mm, inside diameter 1.2mm, outside diameter 2.5mm.  Reservoir: diameter 14/20mm.  Ventricular catheter: 180/250mm.</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>181718</ARTG><ARTG>375143</ARTG></ARTGs><MinimumBenefit>2888</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB387</BillingCode><Name>AS EnduRo Femoral Component Cemented</Name><Description>EnduRo Rotating Hinge Knee Femoral Component AS (Advanced Surface)</Description><Size>1 - 3 R
1 - 3 L</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>312500</ARTG></ARTGs><MinimumBenefit>5887</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB301</BillingCode><Name>Challenger Ligating Clips</Name><Description>Challenger Ligating Clips Titanium Multifire</Description><Size>PL572T - small/medium</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4259</SubGroupID><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB243</BillingCode><Name>Plasmacup</Name><Description>Titanium, plasma, HA</Description><Size>44mm-68mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1427</GroupID><SubGroupID>4018</SubGroupID><ARTGs><ARTG>297211</ARTG></ARTGs><MinimumBenefit>2079</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB024</BillingCode><Name>Vascular Uni - Graft</Name><Description>Vascular graft</Description><Size>15cm</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4455</SubGroupID><ARTGs><ARTG>142665</ARTG></ARTGs><MinimumBenefit>508</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB023</BillingCode><Name>Vascular Uni - Graft</Name><Description>Vascular graft</Description><Size>20cm</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4455</SubGroupID><ARTGs><ARTG>142665</ARTG></ARTGs><MinimumBenefit>508</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB415</BillingCode><Name>Aesculap Neuro Plating System</Name><Description>Cranial fixation system</Description><Size>Screw Dimensions: 1.5mm x 3mm, 4mm &amp; 5mm; 1.8mm x 4mm &amp; 6mm</Size><SupplierCode>BB</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>388669</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB016</BillingCode><Name>Challenger Ligating Clips</Name><Description>Challenger Ligating Clips Titanium Multifire</Description><Size>Medium-large</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4259</SubGroupID><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB385</BillingCode><PriorBillingCodes><PriorBillingCode>BB082</PriorBillingCode><PriorBillingCode>BB084</PriorBillingCode></PriorBillingCodes><Name>Celsite Access Port</Name><Description>Single Access Port</Description><Size>Standard 32 x 27 x 12.2mm  Small  26 x 22 x 9.7mm  Baby/Brachial 22 x 18 x 8.7mm  </Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1522</GroupID><SubGroupID>4164</SubGroupID><ARTGs><ARTG>133738</ARTG><ARTG>137735</ARTG></ARTGs><MinimumBenefit>424</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB086</BillingCode><Name>Celsite Epoxy Peritoneal Port</Name><Description>Epoxy/titanium</Description><Size>32x27x13mm</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1522</GroupID><SubGroupID>4164</SubGroupID><ARTGs><ARTG>133738</ARTG></ARTGs><MinimumBenefit>424</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB230</BillingCode><Name>Aesculap Spinal System</Name><Description>Set Screw - titanium</Description><Size>All sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB356</BillingCode><Name>Lyoplant Onlay</Name><Description>Biological Onlay &amp; Suturable Dura Substitute</Description><Size>2.5 x 2.5cm</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1657</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>264832</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>320</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB238</BillingCode><Name>Acetabular Fixation Screws</Name><Description>Isotan</Description><Size>16mm-68mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>98978</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB421</BillingCode><Name>AESCULAP Lyoplant</Name><Description>Lyoplant is an implant made of purified collagen obtained from bovine pericardium. After implantation, the colonization of the implant by connective tissue cells begins after only a few days. The collagen will be converted into human connective tissue. The complete revitalization takes place within a period of one to three months</Description><Size>1.5 x 3cm (Packs of two pieces)</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1657</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>488671</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>320</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB365</BillingCode><Name>Aesculap Interbody Cage</Name><Description>PLIF Interbody Cage</Description><Size>All sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>122641</ARTG><ARTG>273761</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB070</BillingCode><Name>Prospace Block</Name><Description>Titanium</Description><Size>9mm-11mm</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>101789</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB275</BillingCode><Name>Excia Hip Stem</Name><Description>Cemented CoCr Femoral Stem</Description><Size>9mm-18mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3939</SubGroupID><ARTGs><ARTG>321607</ARTG></ARTGs><MinimumBenefit>1312</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB386</BillingCode><Name>Excia T Hip Stem</Name><Description>Cemented CoCr Femoral Stem</Description><Size>10 - 20 mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3939</SubGroupID><ARTGs><ARTG>321608</ARTG></ARTGs><MinimumBenefit>1312</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB404</BillingCode><Name>Aesculap Knee System Insert Bolt</Name><Description>Tibial insert locking bolt</Description><Size>10mm - 24mm</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1392</GroupID><ARTGs><ARTG>277357</ARTG><ARTG>277359</ARTG></ARTGs><MinimumBenefit>212</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB378</BillingCode><Name>Plasmafit Acetabular Cup</Name><Description>Acetabular Shell with Plasmapore Coating</Description><Size>40mm - 70mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4013</SubGroupID><ARTGs><ARTG>297206</ARTG><ARTG>297207</ARTG></ARTGs><MinimumBenefit>1856</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB252</BillingCode><Name>Aesculap Interbody Cage</Name><Description>TLIF Interbody Cage</Description><Size>All sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>122641</ARTG><ARTG>273761</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB017</BillingCode><Name>Vascular Patch</Name><Description>Vascular patch</Description><Size>12x9 to 3x4</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>209</SubCategoryID><GroupID>1640</GroupID><SubGroupID>4458</SubGroupID><ARTGs><ARTG>142664</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB331</BillingCode><Name>Miethke Ventricular catheter with deflector</Name><Description>Ventricular catheters (with deflector) are used to drain CSF out of the ventricle. All catheters are made of radiopaque silicone. The deflectors allow 90 degree deflection of the ventricular catheter in the burrhole without kinking the catheter. All deflectors are made of titanium. The deflectors are adjustable on the catheter, have suture fixation holes and are radiopaque.</Description><Size>Ventricular catheter with deflector:
Inside diameter 1.2mm, Outside diameter 2.5mm.
FV075P: Ventricular catheter 180mm, graduated.
Deflector: Large.
FV078P: Ventricular catheter 250mm, graduated.
Deflector: Large.
Ventricular catheter with deflector (for pediatric application):
Inside diameter 1.2mm, Outside diameter 2.5mm.
FV076P: Ventricular catheter 180mm, graduated.
Deflector: Small.</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal</Suffix><ARTGs><ARTG>196110</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB414</BillingCode><Name>Aesculap Neuro Plating System</Name><Description>Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates.</Description><Size>Plate Neuro, 8 - 10 hole, 28mm - 43.9mm x 3.4mm - 14mm.  </Size><SupplierCode>BB</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4265</SubGroupID><ARTGs><ARTG>388668</ARTG></ARTGs><MinimumBenefit>193</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB360</BillingCode><Name>AS Columbus Knee System Femur CR cemented</Name><Description>Columbus cemented AS coated CR Fixed bearing femoral component for total knee arthroplasty</Description><Size>1-8 Left and Right</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><Suffix>Ceramic Surface</Suffix><ARTGs><ARTG>279466</ARTG></ARTGs><MinimumBenefit>3009</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB411</BillingCode><Name>Aesculap Neuro Plating System</Name><Description>Cranial fixation system, internal fracture, non biodegradable. Consists of screws, plates.</Description><Size>Plate Neuro, 2 hole, 12.4 - 15.4mm</Size><SupplierCode>BB</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4261</SubGroupID><ARTGs><ARTG>388668</ARTG></ARTGs><MinimumBenefit>63</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB351</BillingCode><Name>Enduro Rotating Hinge Knee Femoral Stem locking nut neutral</Name><Description>The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to treat complex revision knee arthroplasty as well as unstable knees.</Description><Size>1 size neutral (for all femoral stems)</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><ARTGs><ARTG>96481</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB353</BillingCode><Name>EnduRo Rotating Hinge Knee Tibial and Femoral Extension Stems cementless and cemented</Name><Description>The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to  treat complex revision knee arthoplasty as well as unstable knees</Description><Size>Length Tibial: 52,92&amp;172mm Length Femoral: 77,117,157&amp;177mm - Tibial Cemented: x 12,15,18mm - Tibial Cementless: x 11-20cm - Femoral Cemented: x 12,15,18mm - Femoral Cementless: x 13-20mm</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>277356</ARTG><ARTG>277359</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB205</BillingCode><Name>Columbus Total Knee System (TKS) Femoral Component</Name><Description>Femoral component, cemented, CR, CoCr</Description><Size>F1 - F8, Left and Right</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>279465</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB348</BillingCode><Name>e.motion Total Knee System FP/UC Femoral Component cemented</Name><Description>e.motion mobile bearing FP/UC Femoral Component cemented</Description><Size>2-8, Left and right</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>293930</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB083</BillingCode><Name>Celsite Epoxy Dual Access Port</Name><Description>Dual lumen power injectable implanted port</Description><Size>Standard/small/baby</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1522</GroupID><SubGroupID>4437</SubGroupID><ARTGs><ARTG>133738</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB002</BillingCode><Name>Aesculap Hook System</Name><Description>Pedicle, Lamina, Thoracic and Offset Hooks</Description><Size>All Sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB379</BillingCode><Name>Aesculap AS Tibial and Femoral Stems</Name><Description>Tibial and Femoral Stems, cemented or uncemented, CoCr with ZrN coating</Description><Size>All Sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>277356</ARTG><ARTG>277357</ARTG><ARTG>277359</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB277</BillingCode><Name>Excia Hip System</Name><Description>Cement plug</Description><Size>8mm-18mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1446</GroupID><ARTGs><ARTG>123313</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB366</BillingCode><Name>Celsite Safety Venous Access Port</Name><Description>Celsite Safety is a venous access port that is implanted and is intended to be used for any condition that requires mid to long-term intermittent or continuous central venous infusions.</Description><Size>Standard: 33 x 26mm x 13.7mm: Septum 13.0mm
Small: 29 x 22mm x 11.3mm: Septum 10.8mm</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>285508</ARTG><ARTG>286710</ARTG></ARTGs><MinimumBenefit>510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB319</BillingCode><Name>Emotion Total Knee System Femoral Stem Extension</Name><Description>Revision nut for Femur Extension Stem</Description><Size>One size only</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><ARTGs><ARTG>96481</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ633</BillingCode><Name>PlasmaFit Closing Cap</Name><Description>Acetabulum prosthesis apical hole plug - A sterile, implantable cap screw intended to close the screw holes of an acetabulum cup.</Description><Size>ONE SIZE</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1446</GroupID><ARTGs><ARTG>413726</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB274</BillingCode><Name>Excia Hip System</Name><Description>plasma titanium, HA</Description><Size>8mm-18mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>123313</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB118</BillingCode><Name>Neuropatch Dura Substitute</Name><Description>Polyurethane</Description><Size>1.5 x 3cm</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1657</GroupID><ARTGs><ARTG>138310</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>64</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB170</BillingCode><Name>Celsite Access Port for pain relief</Name><Description>Composition - polysulphone.  Kit includes tunnelling rod, filter, connectors, needles, syringe, tuohy needle</Description><Size>Diameter of septum:11.7mm.  Height: 11.5mm.  Dimension: 25.8 x 37.8mm</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><ARTGs><ARTG>133738</ARTG></ARTGs><MinimumBenefit>399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB295</BillingCode><Name>Metha - modular short stem</Name><Description>Short stem, plasma, HA</Description><Size>1 -6</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><Suffix>Removable Neck</Suffix><ARTGs><ARTG>126457</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB242</BillingCode><Name>Columbus Total Knee System (TKS) Tibial Stem</Name><Description>Tibial Stem, cemented or uncemented, CoCr</Description><Size>12mm &amp; 14mm,  in uncemented, 12mm &amp; 14mm in cemented. </Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>277359</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB200</BillingCode><Name>Emotion Total Knee System (TKS) Tibial and Femoral Stems</Name><Description>Tibial and femoral stems, CoCr, cemented or uncemented</Description><Size>Short, D: 10mm to 20mm , Medium, D: 10mm to 20mm, Long, D: 10mm to 20mm</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>277356</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB381</BillingCode><Name>Aesculap AS Femoral Stem Locking Nut</Name><Description>Femoral Stem Locking Nut, CoCr with ZrN coating</Description><Size>One size</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><ARTGs><ARTG>277359</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB419</BillingCode><Name>AESCULAP DS Appendectomy titanium ligation-clip</Name><Description>The device is a DS clip cartridge with latch. The double shank (DS) and bars stabilise the clip against axial dislodgement. A latch at the distal end of the clip additionally prevents the clip from slipping the clip closes from the tip; a diamond-shaped inner clip profile leads to an enlarged contact surface with the tissue. The DS appendectomy clip consists of four clips in a disposable clip applier.</Description><Size>X-LARGE </Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><Suffix>Polymeric Non-resorbable</Suffix><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>40</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB300</BillingCode><Name>Aesculap Ligating Clips</Name><Description>Aesculap Ligating Clips Titanium</Description><Size>PL568T - medium/large; 6 clips/cartridge</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>10</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB204</BillingCode><Name>Columbus Total Knee System (TKS) Tibial Baseplate </Name><Description>Tibial baseplate, cemented, CoCr for fixed insert</Description><Size>T0 to T5    T0+ to T4+</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>298271</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB372</BillingCode><PriorBillingCodes><PriorBillingCode>BB219</PriorBillingCode><PriorBillingCode>BB220</PriorBillingCode><PriorBillingCode>BB221</PriorBillingCode></PriorBillingCodes><Name>Aesculap Spinal System</Name><Description>Straight Rods - Titanium Alloy</Description><Size>All Sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB374</BillingCode><PriorBillingCodes><PriorBillingCode>BB135</PriorBillingCode><PriorBillingCode>BB153</PriorBillingCode></PriorBillingCodes><Name>Aesculap Cervical Systen</Name><Description>Titanium Alloy</Description><Size>All Sizes &lt; 55 mm</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB229</BillingCode><Name>Aesculap Spinal System</Name><Description>Cross, Domino, Axial, Lateral Connector</Description><Size>All Sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB207</BillingCode><Name>Columbus Total Knee System (TKS) Tibial Insert  </Name><Description>Tibial Insert, UHMWPE, fixed </Description><Size>T0/0+ - T4/4+, T5  10mm -20mm</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>279900</ARTG><ARTG>298115</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB140</BillingCode><Name>Aesculap Cervical System</Name><Description>Titanium Alloy</Description><Size>All Sizes &gt;55mm</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB412</BillingCode><Name>Aesculap Neuro Plating System</Name><Description>Cranial fixation system, internal fracture, non biodegradable.  Consists of screws, plates.</Description><Size>Plate Neuro, 4 - 7 hole,   Dimensions: 11.0 - 30.3mm x 3.4 - 24.3mm  Diameters: 18.4 - 30.9mm</Size><SupplierCode>BB</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4263</SubGroupID><ARTGs><ARTG>388668</ARTG></ARTGs><MinimumBenefit>137</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB235</BillingCode><Name>Biolox Delta Ceramic Liner</Name><Description>Biolox Delta Liner</Description><Size>28, 32, 36 &amp; 40mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4025</SubGroupID><ARTGs><ARTG>296141</ARTG><ARTG>296145</ARTG></ARTGs><MinimumBenefit>1690</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB405</BillingCode><Name>Trend Hip Cementless Femoral Stem</Name><Description>Trend Hip Cementless Femoral Stem</Description><Size>1 - 8, Stem Length 134mm - 169mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>392930</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB400</BillingCode><Name>Columbus AS CR PS Tibial Plateau</Name><Description>Tibial baseplate, cemented, for fixed insert</Description><Size>T0 - T5</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>279473</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB391</BillingCode><Name>AS Columbus Revision Tibial Component Cemented</Name><Description>Revision Tibial Component AS (Advanced Surface)</Description><Size>T0+ - T5</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><Suffix>Revision</Suffix><ARTGs><ARTG>312586</ARTG></ARTGs><MinimumBenefit>2647</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB358</BillingCode><Name>Lyoplant Onlay</Name><Description>Biological Onlay &amp; Suturable Dura Substitute</Description><Size>7.5 x 7.5cm</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1659</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>264832</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>944</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB407</BillingCode><Name>Aesculap Neuro Plating System</Name><Description>Cranial Fixation Mesh Plate</Description><Size>28.8 - 48.8 mm x 14.5 - 25.2.2 mm    Thickness 0.3mm to 0.4mm</Size><SupplierCode>BB</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4203</SubGroupID><ARTGs><ARTG>388668</ARTG></ARTGs><MinimumBenefit>341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB237</BillingCode><Name>Plasmacup PE insert</Name><Description>UMHPE unmodified liner</Description><Size>44mm-68mm diameters, 22.2mm-32mm articulations</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4020</SubGroupID><ARTGs><ARTG>296146</ARTG></ARTGs><MinimumBenefit>688</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB113</BillingCode><Name>Neuropatch Dura Substitute</Name><Description>Polyurethane</Description><Size>Large</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1659</GroupID><ARTGs><ARTG>138310</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>709</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB422</BillingCode><Name>AESCULAP Lyoplant </Name><Description>Lyoplant is an implant made of purified collagen obtained from bovine pericardium. After implantation, the colonization of the implant by connective tissue cells begins after only a few days. The collagen will be converted into human connective tissue. The complete revitalization takes place within a period of one to three months</Description><Size>6x14cm and 8x9cm (Packs of one piece)</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1659</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>488671</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>944</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB410</BillingCode><Name>Aesculap Neuro Plating System</Name><Description>Cranial Fixation Mesh Plate</Description><Size>40.2mm x 50.2mm    Thickness 0.3mm</Size><SupplierCode>BB</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4204</SubGroupID><ARTGs><ARTG>388668</ARTG></ARTGs><MinimumBenefit>584</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB396</BillingCode><Name>Columbus Tibial Baseplate</Name><Description>Tibial baseplate CRA/PSA, cemented, for fixed insert</Description><Size>T0+ - T4+ and T0 - T5</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>298186</ARTG><ARTG>298272</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB346</BillingCode><Name>Arcadius L Stand-Alone Interbody Device with screws</Name><Description>Titanium Coated PEEK ALIF CAGE with screws</Description><Size>4 degree, 9 degree &amp; 14 degree lordosis with width 35mm x Depth 25mm X Height 10/12/14/16/18/20mm.4 degree, 9 degree &amp; 14 degree lordosis with Width 40mm x Depth 29mm x Height 10/12/14/16/18/20mm.  Bone screws either 4.5mm x 25mm or 4.5mm x 30mm.</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>221528</ARTG><ARTG>273761</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB380</BillingCode><Name>Aesculap AS Tibial and Femoral Augments</Name><Description>Tibial and Femoral Augments/Spacers CoCr with ZrN coating</Description><Size>All Sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>247596</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB388</BillingCode><Name>AS EnduRo Tibial Component Cemented</Name><Description>EnduRo Rotating Hinge Knee Tibial Component AS (Advanced Surface)</Description><Size>1-3</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>312501</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB354</BillingCode><Name>EnduRo Rotating Hinge Knee Tibial Component</Name><Description>The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to  treat complex revision knee arthoplasty as well as unstable knees</Description><Size>1-3</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>303700</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB198</BillingCode><Name>Emotion Total Knee System (TKS) Tibial Insert </Name><Description>Tibial Insert, UHMWPE, mobile</Description><Size>T1 to T8 Size: 10 to 24mm</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>96482</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB341</BillingCode><Name>Miethke adjustable gravitational unit with proGAV and distal catheter</Name><Description>proSA and M.blue are adjustable gravitational units. proGAV is an adjustable differential pressure unit. They are combined to treat pediatric and adult hydrocephalus. The valves are made from titanium and are MR safe up to 3 tesla. The distal catheters are made of silicone.</Description><Size>Adjustable gravitational unit: diameter 18mm  Adjustable differential pressure unit (proGAV): diameter 18mm  Distal catheter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm  Distal catheter (connection between both valves): inside diameter 1.2mm, outside diameter 2.5mm  FV783T:   proSA adjustable between 0-40 cmH2O, proGAV adjustable between 0-20 cmH2O</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>5978</SubGroupID><Suffix>Distal Catheter</Suffix><ARTGs><ARTG>181718</ARTG></ARTGs><MinimumBenefit>3813</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB375</BillingCode><Name>Aesculap Patella 3-Pegs</Name><Description>All poly patellar, UHMWPE cemented, 3 pegs</Description><Size>P1 - P5</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>293939</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB363</BillingCode><PriorBillingCodes><PriorBillingCode>BB114</PriorBillingCode><PriorBillingCode>BB115</PriorBillingCode><PriorBillingCode>BB116</PriorBillingCode><PriorBillingCode>BB117</PriorBillingCode></PriorBillingCodes><Name>Neuropatch Dura Substitute</Name><Description>Polyurethane</Description><Size>Medium</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1658</GroupID><ARTGs><ARTG>138310</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>426</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB201</BillingCode><Name>e.MOTION Total Knee</Name><Description>Tibial baseplate, cemented, CoCr with polished surface for mobile insert</Description><Size>T1-T8, left and right</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><ARTGs><ARTG>293935</ARTG><ARTG>296715</ARTG></ARTGs><MinimumBenefit>2005</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB342</BillingCode><Name>Miethke adjustable gravitational unit with proGAV</Name><Description>proSA and M.blue are adjustable gravitational units. proGAV is an adjustable differential pressure unit. They are combined to treat pediatric and adult hydrocephalus. The valves are made from titanium and are MR safe up to 3 tesla. They are connected by a distal catheter, which is made of silicone.</Description><Size>Adjustable gravitational unit: diameter 18mm Adjustable differential pressure unit (proGAV): diameter 18mm Distal catheter: inside diameter 1.2mm, outside diameter 2.5mm  FV782T: gravitational unit adjustable between 0-40 cmH2O  proGAV adjustable between 0-20 cmH2O</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>5978</SubGroupID><ARTGs><ARTG>181718</ARTG></ARTGs><MinimumBenefit>3646</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB377</BillingCode><Name>Vitelene PE Cup Insert</Name><Description>Highly cross-linked polyethylene liner stabilised with vitamin E</Description><Size>22.2mm - 40mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>297205</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB232</BillingCode><Name>Emotion Total Knee System (TKS) Femoral Component </Name><Description>Femoral Component, uncemented, CoCr Titanium plasma spray (Plasmapore), HA coated</Description><Size>F2 - F8, Left and Right</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1352</GroupID><SubGroupID>3917</SubGroupID><ARTGs><ARTG>293929</ARTG></ARTGs><MinimumBenefit>3575</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB296</BillingCode><Name>Metha - Modular neck adaptors</Name><Description>Modular neck adaptors made from CoCr</Description><Size>CCD - 130°, 135 °, 140°; Offset  - 0mm, -5mm ,+5mm; Version - 7.5° left ante/right retro, 0 °, 7.5 ° left retro/right ante</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1417</GroupID><ARTGs><ARTG>126457</ARTG></ARTGs><MinimumBenefit>1029</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB069</BillingCode><Name>Aesculap Bone Screws</Name><Description>Titanium alloy</Description><Size>All sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB293</BillingCode><Name>T-Bar Yasargil Aneurysm Clip</Name><Description>T-Bar Yarsargil Aneurysm Clip, Pyhnox Cobalt Alloy, Permanent Standard Fenestrated</Description><Size>5mm-13mm, 90 Deg</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>218</SubCategoryID><GroupID>1655</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>123979</ARTG></ARTGs><MinimumBenefit>341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB027</BillingCode><Name>Vascular Uni - Graft - Bifurcated</Name><Description>Vascular graft</Description><Size>12x7 to 12x12</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1637</GroupID><ARTGs><ARTG>142665</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB290</BillingCode><Name>T-Bar Yasargil Aneurysm Clip</Name><Description>T-Bar Yarsargil Aneurysm Clip, Titanium, Permanent Standard Fenestrated</Description><Size>5mm-9mm, 45 Deg</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>218</SubCategoryID><GroupID>1655</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>123979</ARTG></ARTGs><MinimumBenefit>341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB420</BillingCode><Name>AESCULAP Lyoplant</Name><Description>Lyoplant is an implant of purified collagen obtained from bovine pericardium. </Description><Size>6cm x 8cm, 4cm x 10cm, 5cm x 6cm Packs of one); 4cm x 5cm; 2cm x 10cm (Packs of two pieces)</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1658</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>488671</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>477</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB326</BillingCode><Name>Aesculap-Miethke Shunt inline Flushing reservoir</Name><Description>Titanium, (MRI safe 3 tesla), radio- opaque with low overall height for easy and safe positioning of ventricular catheter. Allows CSF extraction and drug injection by syringe through silicone dome. Solid Titanium base ensures syringes will not penetrate.</Description><Size>Radio-opaque titanium. 14mm diameter,4.8mmheight; 20mm diameter, 5.65mm height. For catheters - id = 1.2mm,od = 2.5mm</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1670</GroupID><ARTGs><ARTG>181719</ARTG></ARTGs><MinimumBenefit>338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB333</BillingCode><Name>Miethke Port / Reservoir</Name><Description>The ports / reservoirs are all made of titanium and are radiopaque. They have a low overall height for easy and safe positioning and fixation of the ventricular catheter. They allow CSF extraction and drug injection by inserting a syringe through the silicone dome. The solid titanium base prevents penetration with a syringe needle. There are 6 different types: Burrhole port, CSF port, Burrhole reservoir, Sprung reservoir, Flushing reservoir, Control reservoir.</Description><Size>Burrhole port:FV030T: Diameter 20mm, Height 5.65mm.FV040T: Diameter 14mm, Height 4.8mm (for pediatric application).CSF port:FV060T: Diameter 20mm, Height 5.65mm.Burrhole reservoir:FV028T: Diameter 20mm, Height 5.65mm.FV029T: Diameter 20mm, Height 5.65mm with adjustable connector.FV039T: Diameter 14mm, Height 4.8mm (for pediatric application).Sprung reservoir:FV043T: Diameter 20mm, Height 5.65mm.Flushing reservoir:FV033T: Diameter 20mm, Height 5.65mm.FV035T: Diameter 14mm, Height 4.8mm (for pediatric application).Control reservoir:FV047T: Diameter 20mm, Height 5.65mm. FV063T: Diameter 14mm, Height 4.8mm (Paediatric Sprung Reservoir)</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1670</GroupID><ARTGs><ARTG>181719</ARTG></ARTGs><MinimumBenefit>338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB108</BillingCode><Name>Aneurysm Clip</Name><Description>Aneurysm clip</Description><Size>All sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>218</SubCategoryID><GroupID>1655</GroupID><ARTGs><ARTG>138333</ARTG></ARTGs><MinimumBenefit>233</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB357</BillingCode><Name>Lyoplant Onlay</Name><Description>Biological Onlay &amp; Suturable Dura Substitute</Description><Size>5 x 5cm and 2.5 x 7.5cm</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1658</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>264832</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>477</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB343</BillingCode><Name>Miethke shunt system with reservoir and distal catheter</Name><Description>Shunt system containing an adjustable gravitational unit and an adjustable differential pressure unit with distal catheters and a ventircular catheter, combined with a deflector, a pediatric prechamber or a reservoir.  There are two types of reservoirs: Control reservoir and pediatric Burrhole reservoir. The shunt system is used for the treatment of pediatric and adult hydrocephalus. The valves, the prechamber, the deflector and the reservoirs are made from titanium. The catheters are made from silicone. The shunt system is MR safe up to 3 tesla.</Description><Size>Adjustable gravitational unit: height 4.5mm, diameter 18mm  Adjustable differential pressure unit: diameter 18mm  Distal catheter: length 1200mm, inside diameter 1.2mm, outside diameter 2.5mm  Distal catheter for connections: inside diameter 1.2mm, outside diameter 2.5mm, adjustable between 0-40 cmH2O, 0-20 cmH2O.</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>5978</SubGroupID><Suffix>Distal Catheter, Reservoir/Priming Function</Suffix><ARTGs><ARTG>181718</ARTG><ARTG>375150</ARTG></ARTGs><MinimumBenefit>4129</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB327</BillingCode><Name>Aesculap-Miethke Shunt Burr hole port</Name><Description>Titanium, (MRI safe 3 tesla), radio-opaque with low overall height for easy and safe positioning of ventricular catheter. Allows CSF extraction and drug injection by syringe through silicone dome. Solid Titanium base ensures syringes will not penetrate, supplied sterile.</Description><Size>Radio- opaque titanium. 14mm diameter, 4.8mm height; 20/9.5mm diameter, 5.65mm height. For catheters - id =1.2mm, od =2.5mm</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1670</GroupID><ARTGs><ARTG>181719</ARTG></ARTGs><MinimumBenefit>338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB330</BillingCode><Name>Miethke Reservoir with integrated catheter</Name><Description>The reservoirs are all made of titanium and are radiopaque. They have a low overall height for easy and safe positioning and fixation of the ventricular catheter. They allow CSF extraction and drug injection by inserting a syringe through the silicone dome. The solid titanium base prevents penetration with a syringe needle.
The reservoirs come with integrated catheters. There are 4 different types of reservoirs with integrated catheters: Burrhole reservoir, sprung reservoir, flushing reservoir and control reservoir.</Description><Size>Burrhole reservoir: 
FV027T - Diameter 20mm, Height 5.65mm, with integrated catheter 600mm. 
FV054T - Diameter 14mm, Height 4.8mm, with integrated catheter 200mm (pediatric).
Sprung reservoir: 
FV044T - Diameter 20mm, Height 5.65mm, with integrated catheter 600mm.
Flushing reservoir: 
FV034T - Diameter 20mm, Height 5.65mm, with integrated 600mm.
FV081T - Diameter 14mm, Height 4.8mm, with integrated catheter 600mm (pediatric).
Control reservoir: 
FV048T - Diameter 20mm, Height 5.65mm, with integrated catheter 600mm.</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1670</GroupID><Suffix>Integrated Catheter</Suffix><ARTGs><ARTG>181719</ARTG></ARTGs><MinimumBenefit>451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB355</BillingCode><Name>EnduRo Rotating Hinge Knee Tibial and Femoral Augments/Spacers</Name><Description>The EnduRo is a Rotating Hinge Knee prosthesis that enables the Orthopaedic Surgeon to
treat complex revision knee arthoplasty as well as unstable knees</Description><Size>Tibial Spacer(augment) to match Tibial component 4, 8, 12 &amp; 16mm Femoral Spacer distal (augment) to match femoral component 4, 8 &amp; 12mm
Femoral Spacer posterior/distal (augment) to match femoral component
4x4,4x8,4x12,8x4,8x8,8x12, 12x4, 12x8 and 12x12</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>247596</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB292</BillingCode><Name>T-Bar Yasargil Aneurysm Clip</Name><Description>T-Bar Yarsargil Aneurysm Clip, Pyhnox Cobalt Alloy, Permanent Standard Fenestrated</Description><Size>5mm-9mm, 45 Deg</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>218</SubCategoryID><GroupID>1655</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>123979</ARTG></ARTGs><MinimumBenefit>341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB322</BillingCode><Name>Aesculap-Miethke gravitational shunt (with catheter)</Name><Description>Single valve, (anti-siphon) gravitational shunt, titanium construction (MRI safe to 3 tesla), with incorporated distal catheter, supplied sterile</Description><Size>23mm long , 4.6mm diameter, 5cmH2O - 40cmH2O, Catheter - di=1.2mm, do=2.5mm, 1200mm long</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1667</GroupID><Suffix>Antisyphon function</Suffix><ARTGs><ARTG>181718</ARTG><ARTG>375142</ARTG></ARTGs><MinimumBenefit>1221</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB320</BillingCode><Name>Emotion Total Knee System Tibial and Femoral Augments</Name><Description>Medial/Lateral Tibial, Distal Femoral and Postero-Distal Augments</Description><Size>4mm to 12mm</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>96481</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB291</BillingCode><Name>T-Bar Yasargil Aneurysm Clip</Name><Description>T-Bar Yarsargil Aneurysm Clip, Titanium, Permanent Standard Fenestrated</Description><Size>5mm-13mm, 90 Deg</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>218</SubCategoryID><GroupID>1655</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>123979</ARTG></ARTGs><MinimumBenefit>341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB408</BillingCode><Name>Aesculap Neuro Plating System</Name><Description>Cranial fixation system, internal fracture, non biodegradable.</Description><Size>50 x 50mm and 100 x 100mm, 0.6mm Mesh</Size><SupplierCode>BB</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4209</SubGroupID><ARTGs><ARTG>388668</ARTG></ARTGs><MinimumBenefit>1146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB250</BillingCode><Name>Biolox Delta Ceramic Hip Prosthesis Head</Name><Description>Biolox Delta Ceramic Head</Description><Size>28 &amp; 32mm diameter</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>291964</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB370</BillingCode><Name>Aesculap Spinal System</Name><Description>Offset Connector</Description><Size>All Sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB384</BillingCode><PriorBillingCodes><PriorBillingCode>BB072</PriorBillingCode><PriorBillingCode>BB073</PriorBillingCode><PriorBillingCode>BB168</PriorBillingCode></PriorBillingCodes><Name>CranioFix</Name><Description>Titanium Skull Fixation Clamp</Description><Size>11mm - 20mm</Size><SupplierCode>BB</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1591</GroupID><SubGroupID>4337</SubGroupID><ARTGs><ARTG>138311</ARTG></ARTGs><MinimumBenefit>93</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB328</BillingCode><Name>Miethke Titanium connectors &amp; deflectors</Name><Description>Titanium, (MRI safe 3 tesla), deflector allows 90 degree deflection of the ventricular catheter in the burr hole without kinking, adjustable on length of catheter, suture fixture hole</Description><Size>Radio-opaque titanium, connector diameter: 1,9mm for use with catheters of id = 1.2mm; of id 1.2mm; od = 2.5mm</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1671</GroupID><SubGroupID>4470</SubGroupID><ARTGs><ARTG>181719</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB334</BillingCode><Name>Miethke Titanium connectors - right angled / shaped</Name><Description>In general, titanium connectors are preferably used with catheters of internal diameter 1.2m and external diameter 2.5mm.  Step-down connectors are designed for connecting standard catheters to lumbar catheters.  L-P connectors are designed for connecting two lumbar catheters to each other.</Description><Size>1.9mm</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1671</GroupID><SubGroupID>4470</SubGroupID><ARTGs><ARTG>194850</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB289</BillingCode><Name>CranioFix Absorbable</Name><Description>Double sided Cranial clamp, absorbable polyester</Description><Size>11mm, 16mm</Size><SupplierCode>BB</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1591</GroupID><SubGroupID>4337</SubGroupID><ARTGs><ARTG>125104</ARTG></ARTGs><MinimumBenefit>93</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB233</BillingCode><Name>Emotion Total Knee System (TKS) Tibial Baseplate</Name><Description>Tibial baseplate, uncemented, CoCr, Titanium plasma spray (Plasmapore) with polished insert surface, HA coated for mobile insert</Description><Size>T1 - T8</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1362</GroupID><SubGroupID>3924</SubGroupID><ARTGs><ARTG>293933</ARTG></ARTGs><MinimumBenefit>2409</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB369</BillingCode><Name>Aesculap Spinal System</Name><Description>In-Line Connector</Description><Size>All Sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB209</BillingCode><Name>Columbus Total Knee System (TKS) Tibial Insert  </Name><Description>Tibial Insert, UHMWPE, fixed, posterior stabilised with included screw for fixation to baseplate</Description><Size>T0/0+ - T4/4+, T5  10mm - 20mm</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>279901</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB413</BillingCode><Name>Aesculap Neuro Plating System</Name><Description>Cranial fixation system, internal fracture, non biodegradable.  </Description><Size>One size</Size><SupplierCode>BB</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4266</SubGroupID><ARTGs><ARTG>388668</ARTG></ARTGs><MinimumBenefit>283</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB019</BillingCode><Name>Vascular Uni - Graft</Name><Description>Vascular graft</Description><Size>60cm</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><ARTGs><ARTG>142665</ARTG></ARTGs><MinimumBenefit>663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB416</BillingCode><Name>Aesculap Neuro Plating System</Name><Description>Cranial fixation system, internal fracture, non biodegradable</Description><Size>150x 150 mm, 200 x 200 mm, 0.6mm Mesh</Size><SupplierCode>BB</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4210</SubGroupID><ARTGs><ARTG>388668</ARTG></ARTGs><MinimumBenefit>2072</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB018</BillingCode><Name>Vascular Uni - Graft</Name><Description>Vascular graft</Description><Size>100cm</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><ARTGs><ARTG>142665</ARTG></ARTGs><MinimumBenefit>663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB409</BillingCode><Name>SeQuent Please/SeQuent Please NEO</Name><Description>Drug eluting balloon catheter for percutaneous transluminal coronary angioplasty (PTCA)</Description><Size>SeQuent Please:  Diameter (mm) 2.0 to 4.0  Length (mm) 10.0 to 30.0      SeQuent Please NEO:  Diameter (mm) 2.0 to 4.0  Length (mm) 10.0 to 40.0  </Size><SupplierCode>BB</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>297</SubCategoryID><GroupID>2970</GroupID><ARTGs><ARTG>181392</ARTG></ARTGs><MinimumBenefit>854</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB224</BillingCode><Name>Aesculap Spinal System</Name><Description>Polyaxial Screw - titanium alloy</Description><Size>All sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB349</BillingCode><Name>Easypump</Name><Description>Disposable Elastomeric infusion pump system</Description><Size>LT: Filling Volume: 60ml - 400ml, Flow Rate: 0.5ml/h - 10ml/h
ST: Filling Volume: 50ml - 500ml, Flow Rate: 50ml/h - 500ml/h</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><ARTGs><ARTG>221448</ARTG></ARTGs><MinimumBenefit>28</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB392</BillingCode><Name>Columbus Revision Tibial Insert</Name><Description>Columbus Revision Gliding Surface</Description><Size>10mm - 32mm</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1371</GroupID><ARTGs><ARTG>312587</ARTG><ARTG>312588</ARTG></ARTGs><MinimumBenefit>1090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB206</BillingCode><Name>Columbus Total Knee System (TKS) Femoral Component</Name><Description>Femoral component, cemented, CoCr, posterior stabilised</Description><Size>F1 - F8, Left and Right</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>279467</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB020</BillingCode><Name>Vascular Uni - Graft</Name><Description>Vascular graft</Description><Size>50cm</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><ARTGs><ARTG>142665</ARTG></ARTGs><MinimumBenefit>663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB373</BillingCode><PriorBillingCodes><PriorBillingCode>BB226</PriorBillingCode><PriorBillingCode>BB227</PriorBillingCode></PriorBillingCodes><Name>Aesculap Spinal System</Name><Description>Monoaxial Screw - titanium alloy</Description><Size>All Sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB025</BillingCode><Name>Vascular Uni - Graft</Name><Description>Vascular graft</Description><Size>10cm</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4454</SubGroupID><ARTGs><ARTG>142665</ARTG></ARTGs><MinimumBenefit>221</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB199</BillingCode><Name>Emotion Total Knee System (TKS) Tibial Insert </Name><Description>Tibial Insert, UHMWPE, mobile, posterior stabilised with peg</Description><Size>T1 to T8 Sizes: 10 to 24mm</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>96482</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB236</BillingCode><Name>Polyethylene Acetabular Cup</Name><Description>Unmodified Polyethylene</Description><Size>22.2mm-32mm articulations; 40mm-64mm diameters</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4006</SubGroupID><ARTGs><ARTG>297032</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ751</BillingCode><Name>Histoacryl LapFix Procedure Pack (Delivery System with Adhesive)</Name><Description>Histoacryl LapFix Surgical Procedure Kit is a laproscopic, single-use, non-medicated Class III medical device. It contains the delivery system and the adhesive.</Description><Size>Single Procedure Kit (Delivery System with Adhesive)</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>6004</SubGroupID><Suffix>Synthetic, Endoscopic</Suffix><ARTGs><ARTG>430877</ARTG></ARTGs><MinimumBenefit>463</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB246</BillingCode><Name>Aesculap 12/14 Metal Femoral Head</Name><Description>Isodur CoCr Femoral Head</Description><Size>28mm, 32mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>279750</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB406</BillingCode><PriorBillingCodes><PriorBillingCode>BB352</PriorBillingCode><PriorBillingCode>BB389</PriorBillingCode></PriorBillingCodes><Name>EnduRo Meniscal Component</Name><Description>EnduRo Rotating Hinge Knee Meniscal Component</Description><Size>Sizes 1-3 10mm-24mm includes rotation axle, PEEK bushing and Tibial locking nut</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1371</GroupID><Suffix>Axle included</Suffix><ARTGs><ARTG>303702</ARTG><ARTG>312502</ARTG></ARTGs><MinimumBenefit>1726</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB364</BillingCode><Name>Aesculap Spinal System</Name><Description>Polyaxial Cannulated Screw</Description><Size>All Sizes</Size><SupplierCode>BB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>134538</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB210</BillingCode><Name>Columbus Total Knee System (TKS) Tibial Stems</Name><Description>Tibial Stem (cap), cemented or uncemented, short (mini) (obturator stem) CoCr, usually required when stem not used</Description><Size>Small &amp; Large D: 12mm &amp; D: 14mm</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1395</GroupID><ARTGs><ARTG>96481</ARTG></ARTGs><MinimumBenefit>633</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB359</BillingCode><Name>Lyoplant Onlay</Name><Description>Biological Onlay &amp; Suturable Dura Substitute</Description><Size>10 x 12.5cm</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1660</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>264832</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>1592</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB196</BillingCode><Name>E.motion Total Knee System</Name><Description>Posterior Stabilised Knee Component cemented</Description><Size>F2 - F8 Right Left</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>293932</ARTG><ARTG>293934</ARTG><ARTG>296713</ARTG><ARTG>296714</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB241</BillingCode><Name>Emotion Total Knee System (TKS) Tibial Stem</Name><Description>Tibial Stem (cap), cemented or uncemented, short (mini) (obturator stem) CoCr, usually required when stem not used</Description><Size>12mm, 14mm &amp; 16mm in cemented and uncemented</Size><SupplierCode>BB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1395</GroupID><ARTGs><ARTG>96481</ARTG></ARTGs><MinimumBenefit>633</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB015</BillingCode><Name>Neuro-Patch</Name><Description>Polyesterurethane</Description><Size>12 x 14cm</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1660</GroupID><ARTGs><ARTG>138310</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB340</BillingCode><Name>Miethke adjustable gratitational unit with differential pressure unit (miniNAV)</Name><Description>proSA and M.blue are adjustable gravitational units for the treatment of hydrocephalus. They can be combined with any differential pressure valve. miniNAV is a very small differential pressure unit, which is often used. The valves are made from titanium and are MR safe up to 3 tesla.</Description><Size>Adjustable gravitational unit: height 4.5mm, diameter 18mm, opening pressure 0-40 cmH2O.  Differential pressure unit (miniNAV): length 14.7mm, diameter 2.8mm.</Size><SupplierCode>BB</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Reservoir/Priming function</Suffix><ARTGs><ARTG>181718</ARTG></ARTGs><MinimumBenefit>2591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB362</BillingCode><Name>Nanogel</Name><Description>Synthetic, Biomimetic Bone Substitute Material</Description><Size>Syringe 0.5ml, 1.0ml, 2.5ml, 5.0ml</Size><SupplierCode>BB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>282244</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB245</BillingCode><Name>Distal centraliser</Name><Description>PMMA</Description><Size>7mm - 18mm</Size><SupplierCode>BB</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1438</GroupID><ARTGs><ARTG>123313</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB299</BillingCode><Name>Aesculap Ligating Clips</Name><Description>Aesculap Ligating Clips Titanium</Description><Size>PL567T - medium; 6 clips/cartridge</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>10</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB294</BillingCode><Name>Aesculap Ligating Clips</Name><Description>Aesculap Ligating Clips- Ligation Clips Titanium;</Description><Size>PL561T- Large; 6 clips/cartridge</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>10</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB297</BillingCode><Name>Aesculap Ligating Clips</Name><Description>Aesculap Ligating Clips Titanium</Description><Size>PL565T - Small; 6 clips/cartridge</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>10</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ619</BillingCode><Name>DS Titanium Ligation-Clip without latch - Multipack</Name><Description>The DS titanium ligation-clips are used for the ligation of vessels and hollow organs 
and for marking anatomical structures.</Description><Size>Small</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>2</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB418</BillingCode><Name>Histoacryl GI</Name><Description>Histoacryl GI is a sterile liquid which polymerises into a solid substance when in contact with body fluids, living tissues or blood.
Histoacryl GI is indicated as embolic agent in sclerotherapy of large oesophageal or fundal varices.</Description><Size>ONE SIZE - Histoacryl GI 0.5mL Ampoules (Box 5)</Size><SupplierCode>BB</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1692</GroupID><SubGroupID>7041</SubGroupID><ARTGs><ARTG>431394</ARTG></ARTGs><MinimumBenefit>713</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ618</BillingCode><Name>DS Titanium Ligation-Clip with or without latch</Name><Description>The DS titanium ligation-clips are used for the ligation of vessels and hollow organs and for marking anatomical structures.</Description><Size>Small, Small-Medium, Medium, Medium-Large</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>2</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BB298</BillingCode><Name>Aesculap Ligating Clips</Name><Description>Aesculap Ligating Clips Titanium</Description><Size>PL566T - small cardiopack of 24</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>41</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ617</BillingCode><Name>DS Titanium Ligation-Clip with or without latch</Name><Description>The DS titanium ligation-clips are used for the ligation of vessels and hollow organs and for marking anatomical structures.</Description><Size>Large</Size><SupplierCode>BB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>136103</ARTG></ARTGs><MinimumBenefit>2</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XX002</BillingCode><PriorBillingCodes><PriorBillingCode>ME215</PriorBillingCode><PriorBillingCode>NG071</PriorBillingCode></PriorBillingCodes><Name>Copernic RC</Name><Description>Venous remodelling balloon</Description><Size>Diameter:  8.0 - 10mm
Balloon Length:  80mm
Catheter Length:  160mm</Size><SupplierCode>XX</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1689</GroupID><SubGroupID>6022</SubGroupID><ARTGs><ARTG>170159</ARTG></ARTGs><MinimumBenefit>1500</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XX003</BillingCode><PriorBillingCodes><PriorBillingCode>ME226</PriorBillingCode></PriorBillingCodes><Name>Optima Coil System</Name><Description>Implantable embolization Coil comprised of platinum-tungsten alloy attached to a proximal stainless steel hypo-tube and distal body coil delivery pusher with a radiopaque distal positioning marker and a proximal fluorosafe marker.</Description><Size>Various sizes as attached.</Size><SupplierCode>XX</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1688</GroupID><ARTGs><ARTG>302253</ARTG></ARTGs><MinimumBenefit>1043</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XX005</BillingCode><PriorBillingCodes><PriorBillingCode>ME229</PriorBillingCode></PriorBillingCodes><Name>SQUID LIQUID EMBOLIC AGENT</Name><Description>SQUID is a non-adhesive, liquid embolic agent consisting of an ethylene vinyl alcohol (EVOH ) copolymer dissolved in DMSO (dimethyl sulfoxide), and suspended micronized tantalum powder to provide contrast for visualisation under fluoroscopy.  The SQUID Liquid Embolic System consists of a vial of SQUID, a vial of DMSO, two SQUID delivery syringes, one DMSO delivery syringe, two syringe adapters and 8 stickers to identify the vials of SQUID.  A SQUID-compatible delivery micro-catheter, the use of which is indicated for the neurovascular system (Sonic, Balt catheters) is used to access the embolization site.  The adapter is an interface between the SQUID delivery syringe and the delivery catheter.</Description><Size>12, 12LD, 18, 18LD formulations</Size><SupplierCode>XX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1692</GroupID><ARTGs><ARTG>262852</ARTG><ARTG>262853</ARTG></ARTGs><MinimumBenefit>2076</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XX004</BillingCode><PriorBillingCodes><PriorBillingCode>ME227</PriorBillingCode></PriorBillingCodes><Name>Optima XCEL Detachment Controller</Name><Description>The EXCEL Detachment Controller is used to detach the Pusher from the Coil after the coil is deployed, it is compatible with all Optima Coil configurations and is used to detach all coils needed for a single patient.</Description><Size>one size</Size><SupplierCode>XX</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1689</GroupID><SubGroupID>4495</SubGroupID><ARTGs><ARTG>312282</ARTG></ARTGs><MinimumBenefit>211</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XX001</BillingCode><PriorBillingCodes><PriorBillingCode>ME209</PriorBillingCode><PriorBillingCode>NG053</PriorBillingCode></PriorBillingCodes><Name>Leo+</Name><Description>Leo+ Stent</Description><Size>D 2.0mm L 12mm, 18mm, 25mm.
D 2.5mm L 12mm, 18mm, 25mm, 30mm, 35mm.
D 3.0mm L 12mm, 18mm, 25mm, 35mm 
D 3.5mm L 12mm, 18mm, 25mm, 30mm, 35mm, 50mm.
D 4.5mm L 15mm, 20mm, 25mm, 30mm, 40mm, 50mm, 75mm.
D 5.5mm L 25mm, 30mm, 35mm, 50mm, 60mm, 75mm.</Size><SupplierCode>XX</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1687</GroupID><ARTGs><ARTG>197947</ARTG></ARTGs><MinimumBenefit>6769</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA125</BillingCode><Name>Groshong Central Venous Catheter</Name><Description>Closed-Ended CVC, Single Lumen</Description><Size>5.5Fr - 9.5Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>cu (cuffed)</Suffix><ARTGs><ARTG>42589</ARTG></ARTGs><MinimumBenefit>146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA285</BillingCode><PriorBillingCodes><PriorBillingCode>BA263</PriorBillingCode></PriorBillingCodes><Name>Arista AH Flextip and Flextip XL</Name><Description>Extender tip for delivery of Arista AH powder</Description><Size>14cm  38cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><SubGroupID>5985</SubGroupID><ARTGs><ARTG>258012</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA284</BillingCode><PriorBillingCodes><PriorBillingCode>BA263</PriorBillingCode></PriorBillingCodes><Name>Arista AH FlexiTip XL-R Applicator</Name><Description>Rigid Dual lumen applicator for Arista AH, 38cm long specifically designe for Robotic surgery</Description><Size>38 cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><SubGroupID>5985</SubGroupID><ARTGs><ARTG>258012</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA269</BillingCode><Name>Bard Absorbable Fixation System</Name><Description>Open or Laparoscopic Absorbable Fixation System</Description><Size>30 Absorbable Fastners, 15 Absorbale Fastners</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4331</SubGroupID><Suffix>Absorbable</Suffix><ARTGs><ARTG>278914</ARTG></ARTGs><MinimumBenefit>473</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA212</BillingCode><Name>Peripherally Inserted Central Catheter</Name><Description>Valved, Power Injectable PICC, Single Lumen</Description><Size>4Fr - 6Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>191603</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA252</BillingCode><Name>BrachySource® I-125 Implant</Name><Description>BrachySource® Seeds supplied either loose, in Cartridges or needles or as a calibration source.  Up to 120 seeds per patient.</Description><Size>Seeds are a 4.5mm x 0.8mm welded titanium capsule.</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>187</SubCategoryID><GroupID>1521</GroupID><SubGroupID>4162</SubGroupID><ARTGs><ARTG>225229</ARTG><ARTG>225230</ARTG><ARTG>225231</ARTG><ARTG>225237</ARTG><ARTG>225238</ARTG></ARTGs><MinimumBenefit>5766</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA299</BillingCode><Name>PowerPICC SOLO²™ HF 5 French Triple Lumen 3CG</Name><Description>PowerPICC SOLO²™ HF 5-Fr Triple Lumen 3CG comes with a Sherlock 3CG stylet which is made of specifically formulated materials designed to aid in the placement of peripherally inserted central catheters. The stylet material provides internal reinforcement to aid in catheter placement. The Sherlock 3CG stylet may be used with the Sherlock 3CG Tip Confirmation System (TCS) to provide catheter tip placement information during the procedure.    The Sherlock 3CG stylet, Sherlock 3CG TCS system, and the Site~Rite 8 Ultrasound System, include a comprehensive, integrated set of PICC placement tools such as vein location, lumen size visualisation, needle guided vein access, catheter tip orientation, catheter tip depth, catheter tip placement using ECG, and ECG placement documentation. In most instances, this removes the need for confirming PICC tip placement through radiological methods.   </Description><Size>5 French Triple Lumen</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>325434</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA044</BillingCode><Name>Ureteral Stent</Name><Description>Hydrophilic coated ureteral stent</Description><Size>Fr 4.7 – 8.0, Length 22-32cm</Size><SupplierCode>BA</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1702</GroupID><SubGroupID>5324</SubGroupID><ARTGs><ARTG>235658</ARTG></ARTGs><MinimumBenefit>189</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA253</BillingCode><Name>ReadyLink® Implant</Name><Description>BrachySource® Seed Implants in the ReadyLink® Delivery System.  Up to 120 seeds per patient.</Description><Size>Seeds are 4.5mm x 0.8mm welded titanium capsule preconnected in user defined trains.</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>187</SubCategoryID><GroupID>1521</GroupID><SubGroupID>4162</SubGroupID><ARTGs><ARTG>225229</ARTG><ARTG>225230</ARTG><ARTG>225231</ARTG><ARTG>225237</ARTG><ARTG>225238</ARTG></ARTGs><MinimumBenefit>5766</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA298</BillingCode><Name>PowerPICC SOLO²™ HF 5 French Triple Lumen Basic</Name><Description>A peripherally inserted central catheter made from specially formulated and processed medical grade materials. Each PowerPICC SOLO²™ catheter has a kink resistant, reverse tapered design. PowerPICC SOLO²™ is packaged in a tray with accessories for reliable long (greater than 30 days) or short (less than 30 days) term vascular access.    The PowerPICC SOLO²™ catheter valve controls the flow of fluids to provide clamp-free infusion therapy. Positive pressure into the catheter (gravity, pump, syringe) will open the valve, allowing fluid infusion. When negative pressure (aspiration) is applied, the valve opens allowing for the withdrawal of blood into a syringe.</Description><Size>5 French Triple Lumen</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>325434</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA268</BillingCode><Name>PowerGlide Pro</Name><Description>Single lumen, power injectable percutaneous catheter</Description><Size>18 - 22 Gauge</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>228968</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA289</BillingCode><Name>PowerHickman, 9.5 Fr Dual Lumen, Intermediate Kit with SureCuff (5 cm) &amp; Airguard</Name><Description>PowerHickman, 9.5 Fr Dual Lumen, Intermediate Kit with SureCuff (5 cm) &amp; Airguard</Description><Size>9.5 Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>cu, pi</Suffix><ARTGs><ARTG>309586</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA294</BillingCode><Name>PowerLine Multi Lumen without Airguard Intermediate Kit</Name><Description>PowerLine 6 Fr Multi Lumen, Polyurethane Catheter with Surecuff, Intermediate Kit</Description><Size>6 Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>cu, pi</Suffix><ARTGs><ARTG>309589</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA293</BillingCode><Name>PowerLine Multi Lumen MicroIntroducer Kit</Name><Description>PowerLine 5-6 Fr Multi Lumen, Polyurethane Catheter with Surecuff, MicroIntroducer Kit</Description><Size>5-6Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>cu, pi</Suffix><ARTGs><ARTG>309588</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA302</BillingCode><Name>Provena™ Midline Catheter</Name><Description>The Provena™ Midline Catheters are intended to be inserted into a patient's vascular system to sample blood, administer fluids and power injection of contrast media. The unique feature of Provena™ Midline Catheters is that they are configured with a smaller outer diameter with minimal reduction to the intraluminal area assisting in providing the optimal catheter to vein ratio, whilst still enabling good flow rates to ensure the therapy delivery is uncompromised.</Description><Size>3Fr single lumen</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>317521</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA221</BillingCode><Name>Implanted infusion Port</Name><Description>Titanium or MRI Implanted Port, Open-Ended Catheter, Single Chamber</Description><Size>6Fr - 9.6Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><ARTGs><ARTG>156249</ARTG><ARTG>157392</ARTG><ARTG>157394</ARTG><ARTG>157395</ARTG><ARTG>157397</ARTG><ARTG>157398</ARTG><ARTG>157400</ARTG><ARTG>157401</ARTG><ARTG>157402</ARTG><ARTG>157403</ARTG></ARTGs><MinimumBenefit>399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA130</BillingCode><Name>Groshong Peripherally Inserted Central Catheter</Name><Description>Closed-Ended PICC, Multiple Lumen</Description><Size>3Fr - 5Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><ARTGs><ARTG>42589</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA126</BillingCode><Name>Groshong Central Venous Catheter</Name><Description>Closed-Ended CVC, Multiple Lumen</Description><Size>5.5Fr - 9.5 Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>cu (cuffed)</Suffix><ARTGs><ARTG>42589</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA209</BillingCode><Name>HemoStar Long Term Haemodialysis Catheter</Name><Description>Dialysis Catheter, Multiple Lumen</Description><Size>14.5Fr - 16Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>cu (cuffed)</Suffix><ARTGs><ARTG>170529</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA283</BillingCode><Name>PowerHohn 6 Fr Multi Lumen, Basic Kit</Name><Description>PowerHohn 6 Fr Dual Lumen, Basic Kit</Description><Size>6 Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>309587</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA256</BillingCode><Name>Bard Vascular Graft</Name><Description>PTFE graft</Description><Size>6-10mm diameter, 40 - 80cm length
4mm - 8mm diameter, 10cm - 50cm length
7 &amp; 8mm diameter. 50, 60, 70, 80cm lengths</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1639</GroupID><ARTGs><ARTG>134452</ARTG></ARTGs><MinimumBenefit>770</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA290</BillingCode><Name>PowerLine Multi Lumen Airguard Intermediate Kit</Name><Description>PowerLine 6 Fr Multi Lumen, Polyurethane Catheter with Surecuff, AirGuard, Intermediate Kit</Description><Size>6 Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>cu, pi</Suffix><ARTGs><ARTG>309590</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA295</BillingCode><Name>PowerHickman, 9.5 Fr Multi Lumen, MicroIntroducer Kit with SureCuff (2 &amp;5 cm)</Name><Description>PowerHickman, 9.5 Fr Dual Lumen, MicroIntroducer Kit with SureCuff (2 &amp; 5 cm)</Description><Size>9.5 Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>cu, pi</Suffix><ARTGs><ARTG>309584</ARTG><ARTG>309585</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA303</BillingCode><Name>Provena™ Midline Catheter</Name><Description>The Provena™ Midline Catheters are intended to be inserted into a patient's vascular system to sample blood, administer fluids and power injection of contrast media. The unique feature of Provena™ Midline Catheters is that they are configured with a smaller outer diameter with minimal reduction to the intraluminal area assisting in providing the optimal catheter to vein ratio, whilst still enabling good flow rates to ensure the therapy delivery is uncompromised.</Description><Size>4Fr dual lumen  </Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>317521</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA140</BillingCode><Name>Haemodialysis Catheters</Name><Description>Dialysis Catheter, Multiple Lumen</Description><Size>12.5Fr - 16FR</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1651</GroupID><Suffix>cu (cuffed)</Suffix><ARTGs><ARTG>107195</ARTG><ARTG>117986</ARTG><ARTG>145482</ARTG><ARTG>156250</ARTG><ARTG>170529</ARTG><ARTG>277925</ARTG></ARTGs><MinimumBenefit>267</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA257</BillingCode><Name>Bard Vascular Graft</Name><Description>Vascular Graft Patch</Description><Size>3x6cm, 2.5x15cm, 2x9cm, 5x7.5cm, 2.5x2.5cm, 10x10cm, 5.1x10.2cm, 6x5.1cm, 1.2x10cm, 5x5cm</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>209</SubCategoryID><GroupID>1640</GroupID><SubGroupID>4458</SubGroupID><ARTGs><ARTG>150355</ARTG><ARTG>150359</ARTG><ARTG>150360</ARTG><ARTG>150361</ARTG><ARTG>150376</ARTG><ARTG>150352</ARTG><ARTG>150353</ARTG><ARTG>150354</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA178</BillingCode><Name>Peripheral Vascular Bare Metal Stent</Name><Description>Nitonol self expanding stent</Description><Size>4mm - 14mm diameters,
2cm - 12cm lengths</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>52136</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA300</BillingCode><Name>PowerPICC SOLO²™ HF 5 French Triple Lumen Radiology</Name><Description>A peripherally inserted central catheter made from specially formulated and processed medical grade materials. Each PowerPICC SOLO²™ catheter has a kink resistant, reverse tapered design. PowerPICC SOLO²™ is packaged in a tray with accessories for reliable long (greater than 30 days) or short (less than 30 days) term vascular access.    The PowerPICC SOLO²™ catheter valve controls the flow of fluids to provide clamp-free infusion therapy. Positive pressure into the catheter (gravity, pump, syringe) will open the valve, allowing fluid infusion. When negative pressure (aspiration) is applied, the valve opens allowing for the withdrawal of blood into a syringe.  </Description><Size>5 French Triple Lumen with 70cm Nitinol Guidewire  5 French Triple Lumen with 135cm Nitinol Guidewire</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>325434</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA309</BillingCode><Name>InLay Optima® Ureteral Stent</Name><Description>The ureteral stent is intended to relieve obstruction in a variety of benign, malignant and post-traumatic conditions in the ureter in order to pass fluids to or from the ureter.</Description><Size>4.7Fr, with length 14cm, 20cm, 22cm, 24cm, 26cm, 28cm and 30cm  6Fr, with length 14cm, 20cm, 22cm, 24cm, 26cm, 28cm and 30cm   7Fr, with length 14cm, 20cm, 22cm, 24cm, 26cm, 28cm and 30cm   8Fr, with length 14cm, 20cm, 22cm, 24cm, 26cm, 28cm and 30cm</Size><SupplierCode>BA</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>235658</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA259</BillingCode><Name>Bard Vascular Graft</Name><Description>Vascular Graft Patch</Description><Size>15 x 15cm</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>209</SubCategoryID><GroupID>1640</GroupID><SubGroupID>4460</SubGroupID><ARTGs><ARTG>150352</ARTG><ARTG>150354</ARTG><ARTG>150355</ARTG><ARTG>150357</ARTG><ARTG>150359</ARTG><ARTG>150360</ARTG><ARTG>150361</ARTG><ARTG>150376</ARTG></ARTGs><MinimumBenefit>324</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA297</BillingCode><Name>Bard COVERA Vascular Covered Stent</Name><Description>The Covera™ Vascular Covered Stent is a flexible, self-expanding endoprosthesis comprised of expanded ePTFE encapsulating a nitinol stent framework. The inner lumen of the covered stent is carbon impregnated. Available in flared and straight end configurations allow for optimal sizing and adaption to the venous vessel wall. Straight device configurations are intended for use in anatomies where the diameter of the outflow vessel is equal to or smaller than the diameter of the inflow vessel. Flared device configurations are intended for use in anatomies where the diameter of the outflow vessel segment is larger than the inflow segment. The Covera™ Vascular Covered Stent device is an over-the-wire delivery system. The delivery system is compatible with 0.035 inch guidewires and 8F or 9F introducer sheaths. The delivery system is available in working lengths of 80 cm and 120 cm. Triaxial delivery system thumb wheel delivery facilitates accurate placement control.</Description><Size>Implant diameter: 6mm, 7mm, 8mm, 9mm,10 mm    Implant lengths: 30mm*, 40 mm, 60 mm, 80 mm, 100 mm      *30 mm length available in straight configurations</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1635</GroupID><SubGroupID>4451</SubGroupID><ARTGs><ARTG>321442</ARTG></ARTGs><MinimumBenefit>3064</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA219</BillingCode><Name>Encapsulated Carbon Lined Stent Graft</Name><Description>PTFE covered nitinol self-expanding stent</Description><Size>4mm - 13.5mm diameter, 2cm - 12cm length</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1635</GroupID><SubGroupID>4451</SubGroupID><ARTGs><ARTG>143665</ARTG></ARTGs><MinimumBenefit>3064</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA280</BillingCode><Name>Phasix ST</Name><Description>Fully resorbable mesh with a resorbable hydrogel coating (adhesion barrier)</Description><Size>PHASIX ST 30X35CM</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5495</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>318512</ARTG></ARTGs><MinimumBenefit>4964</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA264</BillingCode><Name>LifeStream Balloon Expandable Covered Stent</Name><Description>The LifeStream Balloon Expandable Vascular Covered Stent is comprised of an ectropolished balloon-expandable stent made from 316L stainless steel, encapsulated between two layers of ePTFE.</Description><Size>Implant Length: 16mm, 26mm, 37/38mm*,58mm
Implant Diameter: 5mm, 6mm, 7mm, 8mm, 9mm, 10mm, 12mm
* Diameters 5-8mm are offered in 37mm length, and diameters 9-12 are offered in 38mm length</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1634</GroupID><SubGroupID>4449</SubGroupID><ARTGs><ARTG>265593</ARTG></ARTGs><MinimumBenefit>3258</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA215</BillingCode><Name>Haemodialysis Catheter</Name><Description>Power Injectable, Triple Lumen Haemodialysis Catheter</Description><Size>13Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1651</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>141187</ARTG></ARTGs><MinimumBenefit>169</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA277</BillingCode><Name>Phasix</Name><Description>Fully resorbable synthetic mesh</Description><Size>Phasix™ Mesh – 12 x 12 in. Square (30 x 30 cm.)  Phasix™ Mesh – 10 x 16 in. Rectangle (10 x 16 cm.)  Phasix™ Mesh – 14 x 14 in. Square (35 x 35 cm.)  Phasix™ Mesh – 12 x 18 in. Rectangle (30 x 45 cm.)  Phasix™ Mesh – 16 x 16 in. Square (40 x 40 cm.)  Phasix™ Mesh – 18 x 18 in. Square (45 x 45 cm.)  Phasix™ Mesh – 19.5 x 19.5 in. Square (50 x 50 cm.)</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5495</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>318473</ARTG></ARTGs><MinimumBenefit>4964</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA211</BillingCode><Name>Haemodialysis Catheters</Name><Description>Haemodialysis Catheters, multiple lumen</Description><Size>11Fr - 13.5Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1651</GroupID><ARTGs><ARTG>141187</ARTG></ARTGs><MinimumBenefit>103</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA059</BillingCode><Name>Dual Lumen Subcutaneous Ports</Name><Description>Silicone, Polyurethane or ChronoFlex Open-ended Catheter</Description><Size>7 - 10 French Catheter</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1653</GroupID><ARTGs><ARTG>156247</ARTG><ARTG>157389</ARTG><ARTG>157390</ARTG></ARTGs><MinimumBenefit>636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA216</BillingCode><Name>Lifestent</Name><Description>Lifestent cut nitinol self expanding stent</Description><Size>6-10mm diameter 20mm-120mm length</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>160453</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA061</BillingCode><Name>Bard Mesh </Name><Description>PerFix Plug, PerFix Light Plug </Description><Size>Small, Medium, Large, Extra Large</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1691</GroupID><ARTGs><ARTG>394752</ARTG><ARTG>400494</ARTG></ARTGs><MinimumBenefit>238</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA274</BillingCode><Name>PowerMidline</Name><Description>Multiple lumen, power injectable percutaneous catheter</Description><Size>4Fr - 5Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>228968</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA213</BillingCode><Name>Peripherally Inserted Central Catheter</Name><Description>Valved, Power Injectable PICC, Multiple Lumen</Description><Size>4Fr-6Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>191603</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA250</BillingCode><Name>Navarre Drainage Catheter</Name><Description>A drainage catheter intended for use for Nephrostomy applications either by direct stick or modified seldinger technique.</Description><Size>6-12 French, Length: 15-40cm</Size><SupplierCode>BA</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>234</SubCategoryID><GroupID>1718</GroupID><ARTGs><ARTG>180316</ARTG><ARTG>180317</ARTG></ARTGs><MinimumBenefit>91</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA051</BillingCode><Name>Hickman/Leonard Catheters</Name><Description>Open-Ended CVC, Multiple Lumen</Description><Size>7Fr - 12.5Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>cu (cuffed)</Suffix><ARTGs><ARTG>145468</ARTG><ARTG>145469</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA183</BillingCode><Name>Peripherally Inserted Central Catheter</Name><Description>Power Injectable PICC, Multiple Lumen</Description><Size>4Fr - 6Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>155226</ARTG><ARTG>286034</ARTG><ARTG>286035</ARTG><ARTG>286036</ARTG><ARTG>286037</ARTG><ARTG>286038</ARTG><ARTG>286039</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA218</BillingCode><Name>Lifestent Valeo</Name><Description>Stainless Steel Balloon Expandable Peripheral Stent</Description><Size>6-10mm diameter 17-56mm length</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4439</SubGroupID><ARTGs><ARTG>161500</ARTG></ARTGs><MinimumBenefit>1053</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA238</BillingCode><Name>Ventralight ST</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>15.2 x 20.3cm oval, 15.2 x 25.4cm oval</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>219332</ARTG></ARTGs><MinimumBenefit>721</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA247</BillingCode><Name>Ventrio ST</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>13.8 x 17.8cm oval, 15.5 x 25.7cm oval</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>219324</ARTG></ARTGs><MinimumBenefit>721</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA242</BillingCode><Name>Ventralight ST with ECHO PS Positioning System</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>201-400cm2</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><Suffix>Coated, Complex delivery System</Suffix><ARTGs><ARTG>219333</ARTG></ARTGs><MinimumBenefit>911</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA304</BillingCode><Name>Ventralight™ ST Mesh with Echo 2™ Positioning System </Name><Description>Ventralight™ ST Mesh is an abdominal hernia surgical mesh of composite-polymer, indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of hernias. The Echo 2™ Positioning System is intended to facilitate the delivery and positioning of the soft tissue prosthesis during laparoscopic hernia repair.</Description><Size>11cm  10cm x 15cm  15cm  15cm x 20cm  15cm x 25cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><Suffix>Coated, Complex delivery System</Suffix><ARTGs><ARTG>365351</ARTG></ARTGs><MinimumBenefit>911</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA267</BillingCode><Name>Progel Platinum Surgical Sealant Spray Tip</Name><Description>Spray tip to be used in conjunction with Progel Platinum Surgical Sealant</Description><Size>5cm (packs of 2)</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Applicator Tip</Suffix><ARTGs><ARTG>260665</ARTG></ARTGs><MinimumBenefit>22</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA239</BillingCode><Name>Ventralight ST</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>17.8 x 22.9cm oval, 20.3 x 25.4cm oval</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>219332</ARTG></ARTGs><MinimumBenefit>966</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA266</BillingCode><Name>Progel Platinum Surgical Sealant Extender Spray Tip</Name><Description>Extender Spray tip to be used in conjunction with Progel Platinum Surgical Sealant</Description><Size>16cm, 29cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Rigid Delivery System</Suffix><ARTGs><ARTG>260665</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA243</BillingCode><Name>Ventralight ST with ECHO PS Positioning System</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>401-600cm2</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated, Integrated Delivery System</Suffix><ARTGs><ARTG>219333</ARTG></ARTGs><MinimumBenefit>1074</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA248</BillingCode><Name>Ventrio ST</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>19.6 x 24.6cm oval, 22.1 x 27.1cm oval</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>219324</ARTG></ARTGs><MinimumBenefit>966</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA047</BillingCode><Name>Gastrostomy Tube</Name><Description>Silicone Tubes and Replacement Tubes</Description><Size>12Fr - 28Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>141582</ARTG><ARTG>141583</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA306</BillingCode><Name>Ventralight™ ST Mesh with Echo 2™ Positioning System</Name><Description>Ventralight™ ST Mesh is an abdominal hernia surgical mesh of composite-polymer, indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of hernias. The Echo 2™ Positioning System is intended to facilitate the delivery and positioning of the soft tissue prosthesis during laparoscopic hernia repair.</Description><Size>18cm x 23cm  20cm  20cm x 25cm  </Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated, Integrated Delivery System</Suffix><ARTGs><ARTG>365351</ARTG></ARTGs><MinimumBenefit>1074</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA310</BillingCode><PriorBillingCodes><PriorBillingCode>QQ767</PriorBillingCode></PriorBillingCodes><Name>TissuePatchDural</Name><Description>Self adhesive dural sealant</Description><Size>50 x 25-100mm</Size><SupplierCode>BA</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1664</GroupID><ARTGs><ARTG>404630</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>446</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA258</BillingCode><Name>Bard Vascular Graft</Name><Description>Vascular Graft Patch</Description><Size>101 - 150sq cm</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>209</SubCategoryID><GroupID>1640</GroupID><SubGroupID>4459</SubGroupID><ARTGs><ARTG>150354</ARTG><ARTG>150355</ARTG><ARTG>150357</ARTG><ARTG>150359</ARTG><ARTG>150361</ARTG><ARTG>150376</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ268</BillingCode><Name>Lutonix Drug Coated Balloon PTA Catheter</Name><Description>The Lutonix Drug Coated Balloon PTA Catheter consists of an over the wire catheter with a drug coated balloon fixed at the distal tip. The balloon is coated with a specialized formulation that includes the drug, paclitaxel. There are three different Models available depending on guidewire compatibility.</Description><Size>Balloon Length (mm)*: 20-300 Catheter Length (cm)*: 75-150 Balloon Diameter (mm)*: 2-12   (*Range across all three models)</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>296</SubCategoryID><GroupID>2967</GroupID><ARTGs><ARTG>231258</ARTG><ARTG>231530</ARTG><ARTG>364691</ARTG></ARTGs><MinimumBenefit>1245</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA251</BillingCode><Name>BrachySource® I-125 seeds</Name><Description>Single BrachySource® Seeds supplied either loose, in Cartridges or needles or as a calibration source.  To be used only if more than 120 seeds are used per patient.</Description><Size>Seeds are a 4.5mm x 0.8mm welded titanium capsule.</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>187</SubCategoryID><GroupID>1521</GroupID><SubGroupID>4163</SubGroupID><ARTGs><ARTG>225229</ARTG><ARTG>225230</ARTG><ARTG>225231</ARTG><ARTG>225237</ARTG><ARTG>225238</ARTG></ARTGs><MinimumBenefit>73</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA287</BillingCode><Name>Phasix Mesh</Name><Description>Synthesised biologic, resorbable Hernia mesh</Description><Size>25.4 cm x 30.5 cm rectangle</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5494</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>318473</ARTG></ARTGs><MinimumBenefit>4061</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA279</BillingCode><Name>Phasix ST</Name><Description>Fully resorbable mesh with a resorbable hydrogel coating (adhesion barrier)</Description><Size>PHASIX ST 25X30CM</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5494</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>318512</ARTG></ARTGs><MinimumBenefit>4061</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA255</BillingCode><Name>Bard Vascular Grafts</Name><Description>PFTE Graft - radial support</Description><Size>50cm or &gt; 50cm</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><Suffix>R (ringed)</Suffix><ARTGs><ARTG>134552</ARTG></ARTGs><MinimumBenefit>1440</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA254</BillingCode><Name>Bard Vascular Graft</Name><Description>PTFE graft</Description><Size>50 cm or &gt; 50cm</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><ARTGs><ARTG>134452</ARTG></ARTGs><MinimumBenefit>663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA265</BillingCode><Name>Progel Platinum Surgical Sealant</Name><Description>Progel Pleural Air Leak Sealant is a single use device intended for application to visceral pleura.</Description><Size>4ml</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>5768</SubGroupID><ARTGs><ARTG>262979</ARTG></ARTGs><MinimumBenefit>718</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA019</BillingCode><Name>Impra PTFE Vascular Grafts</Name><Description>ePTFE graft - radially supported, thin wall, 10 - 50cm long</Description><Size>4mm - 8mm diameter</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4455</SubGroupID><Suffix>R (ringed)</Suffix><ARTGs><ARTG>23171</ARTG></ARTGs><MinimumBenefit>964</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA022</BillingCode><Name>Impra PTFE Vascular Grafts</Name><Description>ePTFE graft - radially supported, regular wall, 10-50cm long</Description><Size>4 - 19mm diameter</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4455</SubGroupID><Suffix>R (ringed)</Suffix><ARTGs><ARTG>23171</ARTG></ARTGs><MinimumBenefit>964</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA025</BillingCode><Name>Impra PTFE Vascular Grafts</Name><Description>ePTFE graft - regular wall, 10-50cm long</Description><Size>3 - 19mm diameter</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4455</SubGroupID><ARTGs><ARTG>23171</ARTG></ARTGs><MinimumBenefit>508</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA020</BillingCode><Name>Impra PTFE Vascular Grafts</Name><Description>ePTFE graft - thin wall, 10 - 50cm long</Description><Size>3mm - 10mm diameter</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4455</SubGroupID><ARTGs><ARTG>23171</ARTG></ARTGs><MinimumBenefit>508</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA222</BillingCode><Name>Bard 3DMAX Mesh, Bard 3DMAX Light Mesh, and 3DMAX MID</Name><Description>The 3DMAX family is anatomically shaped polypropylene mesh indicated for the use in Inguinal Hernia repair. Adding 3DMAX MID to the existing billing code</Description><Size> Medium left, Medium Right, Large Left, Large Right; 3.1 - 10.8cm x 5.3 - 16.0cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5434</SubGroupID><Suffix>Contoured, Without Fixation</Suffix><ARTGs><ARTG>376471</ARTG><ARTG>398770</ARTG><ARTG>490385</ARTG></ARTGs><MinimumBenefit>238</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA070</BillingCode><Name>Bard Mesh and Bard Soft Mesh</Name><Description>Bard Mesh - monofilament polypropylene for the reconstruction of tissue defects 
Bard Soft Mesh - large pore monofilament polypropylene for the reconstruction of tissue defects</Description><Size>2.5x10cm, 4.5x10cm, 5x10cm, 6x13.7cm, 7.5x15cm, 10x15cm, 5x30.5cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5434</SubGroupID><ARTGs><ARTG>404318</ARTG><ARTG>410979</ARTG></ARTGs><MinimumBenefit>72</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA157</BillingCode><Name>Bard Mesh</Name><Description>Flat Mesh</Description><Size>15X15cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5435</SubGroupID><ARTGs><ARTG>404318</ARTG><ARTG>410979</ARTG></ARTGs><MinimumBenefit>77</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA223</BillingCode><Name>Bard 3DMAX Mesh, Bard 3DMAX Light Mesh and 3DMAX MID Mesh</Name><Description>The 3DMAX family is anatomically shaped polypropylene mesh indicated for the use in Inguinal Hernia repair. Adding 3DMAX MID to the existing billing code</Description><Size>Extra Large Left, Extra Large Right; 12 - 12.4cm x 17 - 17.3cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5435</SubGroupID><Suffix>Contoured, Without Fixation</Suffix><ARTGs><ARTG>376471</ARTG><ARTG>398770</ARTG><ARTG>490385</ARTG></ARTGs><MinimumBenefit>261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA270</BillingCode><Name>Bard Venous Stent</Name><Description>Self Expanding Venous Stent</Description><Size>Length ≥150mm</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>409902</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA217</BillingCode><Name>Lifestent</Name><Description>Laser cut nitinol self expanding stent</Description><Size>Diameter 5mm to 10mm; length 150mm - 200mm</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>160453</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA305</BillingCode><Name>Ventralight™ ST Mesh with Echo 2™ Positioning System </Name><Description>Ventralight™ ST Mesh is an abdominal hernia surgical mesh of composite-polymer, indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of hernias. The Echo 2™ Positioning System is intended to facilitate the delivery and positioning of the soft tissue prosthesis during laparoscopic hernia repair</Description><Size>30cm x 35cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5505</SubGroupID><Suffix>Coated, Integrated Delivery System</Suffix><ARTGs><ARTG>365351</ARTG></ARTGs><MinimumBenefit>2996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA241</BillingCode><Name>Ventralight ST</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>30.5 x 35.6cm oval</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5505</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>219332</ARTG></ARTGs><MinimumBenefit>2875</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA245</BillingCode><Name>Ventralight ST with ECHO PS positioning System</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>30.5 x 35.6cm oval</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5505</SubGroupID><Suffix>Coated, Integrated Delivery System</Suffix><ARTGs><ARTG>219333</ARTG></ARTGs><MinimumBenefit>2996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA237</BillingCode><Name>Ventralight ST</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>11.4cm circle, 10.2 x 15.2cm oval</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>219332</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA307</BillingCode><Name>Ventralight™ ST Mesh with Echo 2™ Positioning System </Name><Description>Ventralight™ ST Mesh is an abdominal hernia surgical mesh of composite-polymer, indicated for use in the reconstruction of soft tissue deficiencies, such as for the repair of hernias. The Echo 2™ Positioning System is intended to facilitate the delivery and positioning of the soft tissue prosthesis during laparoscopic hernia repair.</Description><Size>25cm x 33cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><Suffix>Coated, Integrated Delivery System</Suffix><ARTGs><ARTG>365351</ARTG></ARTGs><MinimumBenefit>1121</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA246</BillingCode><Name>Ventrio ST</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>7.6cm circle, 11.4cm circle, 8 x 12cm oval, 11 x 14cm oval</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>219324</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA208</BillingCode><Name>PowerPort with Groshong Catheter</Name><Description>Titanium or MRI implantable Port, Closed-Ended Catheter, Single Chamber</Description><Size>8Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>170345</ARTG><ARTG>170346</ARTG></ARTGs><MinimumBenefit>510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA291</BillingCode><Name>PowerHickman Single Lumen Microinducer with SureCuff (2cm &amp; 5 cm) with AirGuard</Name><Description>PowerHickman, 8 Fr Single Lumen, MicroIntroducer Kit with SureCuff (2 cm &amp; 5 cm)</Description><Size>8 Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>cu, pi</Suffix><ARTGs><ARTG>309584</ARTG><ARTG>309585</ARTG></ARTGs><MinimumBenefit>146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA308</BillingCode><Name>PowerGlide Pro™ Midline Cannula with Cue™ Needle Tracking</Name><Description>Single lumen, power injectable percutaneous catheter </Description><Size>Basic kits: 22G x 8 cm, 20G x 8 cm, 22G x 10 cm, 18G x 8 cm, 18G x 10 cm   </Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>317521</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA184</BillingCode><Name>Peripherally Inserted Central Catheter</Name><Description>Power Injectable PICC, Single Lumen</Description><Size>3Fr - 5Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>155226</ARTG><ARTG>286034</ARTG><ARTG>286035</ARTG><ARTG>286036</ARTG><ARTG>301652</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA057</BillingCode><Name>Groshong Subcutaneous Ports</Name><Description>Titanium or MRI Implatable Port, Closed-Ended Catheter, Single Chamber</Description><Size>7Fr - 8 Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><ARTGs><ARTG>156248</ARTG><ARTG>157391</ARTG><ARTG>157393</ARTG><ARTG>157396</ARTG><ARTG>157399</ARTG></ARTGs><MinimumBenefit>399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA181</BillingCode><Name>PowerPort</Name><Description>Titanium or MRI implantable port, Open-ended Catheter, Single Chamber</Description><Size>6Fr - 8Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>149028</ARTG><ARTG>170347</ARTG></ARTGs><MinimumBenefit>510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA203</BillingCode><Name>Fixation Anchor Set</Name><Description>Open or Laparoscopic Permanent Fixation System.</Description><Size>15 Fasteners; 30 Fasteners</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4331</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>137898</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA286</BillingCode><Name>Phasix ST</Name><Description>Fully resorbable, synthetically derived biologic hernia mesh with added barrier to assist adhesion prevention</Description><Size>13 cm x 25 cm  15 cm x 20 cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5492</SubGroupID><Suffix>Contoured</Suffix><ARTGs><ARTG>318512</ARTG></ARTGs><MinimumBenefit>1399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA273</BillingCode><Name>PowerMidline</Name><Description>Single lumen, power injectable percutaneous catheter</Description><Size>3Fr-4Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>228968</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA292</BillingCode><Name>PowerLine Single Lumen MicroIntroducer Kit</Name><Description>PowerLine 5 Fr Single Lumen, Polyurethane Catheter with Surecuff, MicroIntroducer Kit</Description><Size>5 Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>cu, pi</Suffix><ARTGs><ARTG>309588</ARTG></ARTGs><MinimumBenefit>146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA288</BillingCode><Name>Phasix Mesh</Name><Description>Synthetic Bioresorbable Mesh</Description><Size>15.2 cm x 20.3 cm rectangle  10 cm x 25 cm rectangle  15 cm x 25 cm rectangle</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5492</SubGroupID><Suffix>Contoured</Suffix><ARTGs><ARTG>318473</ARTG></ARTGs><MinimumBenefit>1399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA311</BillingCode><Name>Avitene MCH</Name><Description>Avitene MCH Flour is a Microfibrillar 100% bovine collagen, topical haemostat which does not contain Thrombin. Flour is defined as a loose fibrous which can be manipulated to conform to any shape or surface. Avitene (MCH), in contact with a bleeding surface, attracts platelets which adhere to the fibrils  and undergo the release phenomenon to trigger aggregation of platelets into thrombi in the interstices of the fibrous mass.</Description><Size>0.5 gram  1.0 gram  </Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>332522</ARTG></ARTGs><MinimumBenefit>45</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA220</BillingCode><Name>Groshong Peripherally Inserted Central Catheter</Name><Description>Closed-Ended, Power Injectable PICC, Single Lumen</Description><Size>5Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>198806</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA260</BillingCode><Name>Arista AH</Name><Description>Arista Absorbable Haemostatic Particles</Description><Size>1g</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>233611</ARTG></ARTGs><MinimumBenefit>45</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA262</BillingCode><Name>Arista AH</Name><Description>Arista Absorbable Haemostatic Particles</Description><Size>5g</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>276133</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA204</BillingCode><Name>SorbaFix</Name><Description>Open of Laparoscopic Absorbable Fixation System.</Description><Size>15 Fasteners; 30 Fasteners</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4331</SubGroupID><Suffix>Absorbable</Suffix><ARTGs><ARTG>170112</ARTG></ARTGs><MinimumBenefit>473</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA282</BillingCode><Name>PowerHohn 5 Fr Single Lumen, Basic Kit</Name><Description>PowerHohn 5 Fr Single Lumen, Basic Kit</Description><Size>5 Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>309587</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA312</BillingCode><Name>Avitene MCH</Name><Description>Avitene MCH Flour is a Microfibrillar 100% bovine collagen, topical haemostat which does not contain Thrombin. Flour is defined as a loose fibrous which can be manipulated to conform to any shape or surface. Avitene (MCH), in contact with a bleeding surface, attracts platelets which adhere to the fibrils  and undergo the release phenomenon to trigger aggregation of platelets into thrombi in the interstices of the fibrous mass.</Description><Size>5.0 gram</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>332522</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA296</BillingCode><Name>PowerHickman, 8 Fr Single Lumen, Intermediate Kit with SureCuff  Airguard(5 cm)</Name><Description>PowerHickman, 8 Fr Single Lumen, Intermediate Kit with SureCuff Airguard(5 cm)</Description><Size>8Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>cu, pi</Suffix><ARTGs><ARTG>309586</ARTG></ARTGs><MinimumBenefit>146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA129</BillingCode><Name>Groshong Peripherally Inserted Central Catheter</Name><Description>Closed-Ended PICC, Single Lumen</Description><Size>3Fr - 5Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>cu (cuffed)</Suffix><ARTGs><ARTG>42589</ARTG></ARTGs><MinimumBenefit>146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA049</BillingCode><Name>Hickman/Broviac Catheters</Name><Description>Open-Ended CVC, Single Lumen</Description><Size>2.7Fr - 9.6Fr</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>cu (cuffed)</Suffix><ARTGs><ARTG>145466</ARTG><ARTG>145469</ARTG></ARTGs><MinimumBenefit>146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA281</BillingCode><Name>Phasix ST</Name><Description>Fully resorbable mesh with a resorbable hydrogel coating (adhesion barrier)</Description><Size>PHASIX ST 7.6CM ROUND   PHASIX ST 7CMX10CM   PHASIX ST 11CM ROUND   PHASIX ST 10CMX10CM   PHASIX ST 10X15CM   PHASIX ST 15CM ROUND   PHASIX ST 10CMX20CM</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5491</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>318512</ARTG></ARTGs><MinimumBenefit>710</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA271</BillingCode><Name>Bard Venous Stent</Name><Description>Self Expanding Venous Stent</Description><Size>Length: &lt;150mm</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>409902</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA261</BillingCode><Name>Arista AH</Name><Description>Arista Absorbable Haemostatic Particles</Description><Size>3g</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>233611</ARTG></ARTGs><MinimumBenefit>132</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA275</BillingCode><Name>Phasix</Name><Description>Fully resorbable synthetic mesh</Description><Size>Phasix™ Mesh – 3 in. Diameter Circle (7.6 cm.)  Phasix™ Mesh – 4.5 in. Diameter Circle (11 cm.)  Phasix™ Mesh – 2.4 x 6.3 in. Rectangle (6 x 16 cm)  Phasix™ Mesh – 3 x 3 in. Square (8 x 8 cm.)  Phasix™ Mesh – 3 x 6.3 in. Rectangle (8 x 16 cm.)  Phasix™ Mesh – 4 x 4 in. Square (10 x 10 cm.)  Phasix™ Mesh – 4 x 6 in. Rectangle (10.2 x 15.2 cm.)  Phasix™ Mesh – 3 x 8 in. Rectangle (8 x 20 cm.)  Phasix™ Mesh – 4 x 8 in. Rectangle (10 x 20 cm.)</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5491</SubGroupID><Suffix>Contoured</Suffix><ARTGs><ARTG>318473</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA313</BillingCode><PriorBillingCodes><PriorBillingCode>LH722</PriorBillingCode></PriorBillingCodes><Name>TissuePatchDural 100*100</Name><Description>Self adhesive dural sealant</Description><Size>100*100mm</Size><SupplierCode>BA</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1695</GroupID><ARTGs><ARTG>404630</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>921</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA278</BillingCode><Name>Phasix ST</Name><Description>Fully resorbable mesh with a resorbable hydrogel coating (adhesion barrier)</Description><Size>PHASIX ST 20X25CM</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5493</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>318512</ARTG></ARTGs><MinimumBenefit>3114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA276</BillingCode><Name>Phasix</Name><Description>Fully resorbable synthetic mesh</Description><Size>Phasix™ Mesh – 6 x 12 in. Rectangle (15 x 30 cm.)  Phasix™ Mesh – 8 x 10 in. Rectangle (20.3 x 25.4 cm.)  Phasix™ Mesh – 8 x 12 in. Rectangle (20 x 30 cm.)</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5493</SubGroupID><Suffix>Contoured</Suffix><ARTGs><ARTG>318473</ARTG></ARTGs><MinimumBenefit>3204</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA010</BillingCode><Name>Bard Inferior Vena Cava Filter</Name><Description>Nitinol self expanding vena cava filter</Description><Size>For IVC with a diameter less than or equal to 28mm diameter</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>211</SubCategoryID><GroupID>1642</GroupID><ARTGs><ARTG>150739</ARTG><ARTG>150742</ARTG><ARTG>198865</ARTG><ARTG>198866</ARTG></ARTGs><MinimumBenefit>2059</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA158</BillingCode><Name>Bard Mesh</Name><Description>Flat Mesh</Description><Size>25x35.5cm</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5437</SubGroupID><ARTGs><ARTG>404318</ARTG></ARTGs><MinimumBenefit>247</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA249</BillingCode><Name>Ventrio ST</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>27.4 x 34.9cm oval</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>219324</ARTG></ARTGs><MinimumBenefit>1013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA039</BillingCode><Name>Grafts Vascular</Name><Description>Polyester pledgets</Description><Size>Rectangle, Oval, Circle, Square 2.9mm-8mm x 6mm - 9.5mm</Size><SupplierCode>BA</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>209</SubCategoryID><GroupID>1640</GroupID><SubGroupID>4461</SubGroupID><ARTGs><ARTG>24168</ARTG></ARTGs><MinimumBenefit>22</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA244</BillingCode><Name>Ventralight ST with ECHO PS Positioning System</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>25.4 x 33.0cm oval</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><Suffix>Coated, Integrated Delivery System</Suffix><ARTGs><ARTG>219333</ARTG></ARTGs><MinimumBenefit>1121</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA236</BillingCode><Name>Ventralex ST</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>4.3cm circle, 6.4cm circle, 8.0cm circle</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>219323</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA240</BillingCode><Name>Ventralight ST</Name><Description>Bioresorbable Barrier/Permanent Mesh</Description><Size>22.4 x 33.0cm oval</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>219332</ARTG></ARTGs><MinimumBenefit>1013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA226</BillingCode><Name>Bard Mesh</Name><Description>Ventralex Patch</Description><Size>4.3cm circle, 6.4cm circle, 8cm circle</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>400716</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BA272</BillingCode><Name>Bard Onflex Mesh</Name><Description>Multi-layer, contoured polypropylene hernia repair system incorporating positioning pockets and an absorbable ring.</Description><Size>≤200cm²</Size><SupplierCode>BA</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Contoured</Suffix><ARTGs><ARTG>398775</ARTG></ARTGs><MinimumBenefit>271</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>DHR01</BillingCode><Name>Femoral Head</Name><SupplierCode>DHR</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>260540</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4616</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL024</BillingCode><Name>Oxane HD</Name><Description>Silicone oil - RMN3 mixture</Description><Size>10ml</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1347</GroupID><ARTGs><ARTG>108429</ARTG></ARTGs><MinimumBenefit>176</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL016</BillingCode><Name>Oxane LMWC Fractioned Silicone Oil</Name><Description>Purified fractioned silicone oil</Description><Size>10mL</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1347</GroupID><ARTGs><ARTG>108429</ARTG></ARTGs><MinimumBenefit>176</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LL006</BillingCode><Name>BLutein DYE200</Name><Description>Phaco Lutein Anterior Capsule Staining Dye (lutein + trypan blue)</Description><Size>0.5mL</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1330</GroupID><ARTGs><ARTG>458847</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL005</BillingCode><Name>Storz (Coburn) Intraocular Lens  121UV; L122UV PMMA Anterior Chamber Lens</Name><Description>PMMA Anterior Chamber Intraocular lens 1 piece</Description><Size>13.75mm length. 6.0mm optic size, diopter range 3-30d. L122UV: 6.0mm optic, 13.75mm length, power range; 5.0 to 30.0 Diopters</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>140</SubCategoryID><GroupID>1324</GroupID><SubGroupID>3887</SubGroupID><ARTGs><ARTG>97880</ARTG></ARTGs><MinimumBenefit>126</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LL004</BillingCode><Name>Loop Guardian PMMA AC IOL Model B60130S</Name><Description>PMMA, 1-piece, anterior chamber IOL</Description><Size>+6.0 D to +30.0 D (0.5 D increments)</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>140</SubCategoryID><GroupID>1324</GroupID><SubGroupID>3887</SubGroupID><ARTGs><ARTG>460868</ARTG></ARTGs><MinimumBenefit>126</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL022</BillingCode><Name>SofPort Advanced Optic (AO)</Name><Description>Posterior chamber, foldable silicone IOL with anterior optic-haptic square edge, posterior optic-haptic square edge, 360-degree optic square edge and asperic optic for aberration control</Description><Size>0 D to 30.0 D</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>98915</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL043</BillingCode><Name>Enhanced enVista Toric with Bausch + Lomb SimplifEYE preloaded delivery system</Name><Description>The enVista Family of Intraocular Lenses (IOLs) are ultraviolet-absorbing, posterior chamber, hydrophobic acrylic IOLs. They have an aspheric lens optic, square posterior edge, and modified C haptics. The lenses can be folded for insertion into the eye. The MX60PTC combines the preloaded IOL with the enVista SimplifEYE Preloaded Injector System inserter and is sold in a common package. This alternate packaging configuration allows for a simpler loading of the injector.</Description><Size>Specification: Optic Body Diameter 6.0 ± 0.1 mm Overall Diameter 12.5 ± 0.2 mm  Haptic Thickness 0.35 ± 0.04 mm Haptic Angulations Planar Haptic Lens Power Range +0.0 to +30.0D (in 0.5D increments) +0.90D to +5.75D (in 0.75D increments from +1.25D).</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>98915</ARTG></ARTGs><MinimumBenefit>530</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL040</BillingCode><Name>Enhanced enVista IOL with Bausch + Lomb SimplifEYE Preloaded Delivery System</Name><Description>The enVista Family of Intraocular Lenses (IOLs) are ultraviolet-absorbing, posterior chamber, hydrophobic acrylic IOLs. They have an aspheric lens optic, square posterior edge, and modified C haptics. The lenses can be folded for insertion into the eye.  The MXPLC combines the preloaded IOL with an inserter and is sold in a common package. This alternate packaging configuration allows for a simpler loading of the injector.  </Description><Size>Specification  Optic Body Diameter                 6.0 ± 0.1 mm     Overall Diameter                        12.5 ± 0.2 mm        Haptic Thickness                       0.35 ± 0.04 mm     Haptic Angulations                         Planar Haptic  Lens       Power Range                    +0.0 to +34.0D                                                     (+0.0 to +9.0D in 1D increments)                                                         (+10.0 to +30.0D in 0.5D increments)    (+31.0 to +34.0D in 1D increments)  </Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>98915</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LL002</BillingCode><Name>enVista IOL</Name><Description>The enVista IOL Model EE: UV -absorbing, posterior chamber, hydrophobic acrylic IOL. Aspheric lens optic, square posterior edge,  modified C haptics. Can be folded for insertion into the eye.</Description><Size>0.0 D to +34.0 D   0.0 D to +9.0 D in 1.0 D increments;  +10.0 D to +30.0 D in 0.5 D increments;  +31.0 D to +34.0 D in 1.0 D increments</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>98915</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL051</BillingCode><Name>enVista Toric IOL</Name><Description>The enVista Toric IOL Model: MXET / ETE. iUV-absorbing, posterior chamber, hydrophobic acrylic toric IOL. Aspheric lens optic, square posterior edge, and modified C haptics. Can be folded for insertion into the eye.</Description><Size>+6.0 D to +34.0 D (0.5 D increments); Cylinder powers 0.90D, 1.25D, 1.50D, 2.00D, 2.50D, 2.75D, 3.00D, 3.50D, 4.25D, 5.00D &amp; 5.75D</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>98915</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL008</BillingCode><Name>Ocucoat Intraocular Fluid</Name><Description>20mg/mL hydroxypropylmethyl cellulose for intraocular use</Description><Size>1ml and 2ml Sterile</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>140513</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL018</BillingCode><Name>DK Line 100% purified perfluorodecalin</Name><Description>Perfluorodecalin</Description><Size>7ml</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1346</GroupID><ARTGs><ARTG>108429</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LL010</BillingCode><Name>Luxlife Full Range of Field IOL, model YLIFE</Name><Description>The LuxLife intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL, with blue light filtering. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxLife lens is supplied with an Accuject Dual Injection System to provide a touch-free method of delivery of the lens into the capsular bag.</Description><Size>Body diameter: 6.0 mm, overall diameter: 11.00 mm.  Power range: +5.00 D to +32.00 D</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>342175</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL015</BillingCode><Name>Amvisc Plus injection</Name><Description>15mg/mL Sodium Hyaluronate for intraocular use</Description><Size>0.5mL and 0.8mL</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>161187</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LL001</BillingCode><Name>enVista IOL</Name><Description>The enhanced enVista (Model MX60E) is an ultraviolet-absorbing, posterior chamber, hydrophobic acrylic intraocular lens (IOL). They have an aspheric lens optic, square posterior edge, and modified C haptics. The lenses can be folded for insertion into the eye.</Description><Size>Specification:   Optic Body Diameter 6.0   Overall Diameter 12.5 Haptic Angulations Planar Haptic   Lens Power Range +0.0 to +34.0 Diopters (0.0 to +10.0 in 1.0 Diopter increments, +10.0 to +30.0 in 0.5 Diopter increments, and +30.0 to +34.0 in 1.0 Diopter increments)</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>98915</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LL003</BillingCode><Name>enVista Envy Model EN</Name><Description>The enVista Envy Model EN. Trifocal, UV-absorbing, posterior chamber, hydrophobic acrylic IOL. Aspheric lens optic, square posterior edge, modified C haptics. Can be folded for insertion into the eye.</Description><Size>+6.0 D to +34.0 D (0.5 D increments),   +1.6 D intermediate add power, +3.1  D near add power</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>98915</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL048</BillingCode><Name>LuxSmart Preloaded</Name><Description>The LuxSmart intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior  chamber, hydrophobic acrylic IOL, blue light filtering and has aspheric optics. The lens is  provided sterile and is designed to be folded prior to insertion into the eye. The preloaded  intraocular LuxSmart lens is supplied with an Delivery System to provide a  touch-free method of delivery of the lens into the capsular bag.</Description><Size>Body Diameter: 6.0 mm +/- 0.1 mm, Overall Diameter: 11.00 mm +/- 0.2 mm. Power Range: +0.00 D to +34.00 D.</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>342175</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL017</BillingCode><Name>Perfluo-octane (Oktaline) Okta-Line</Name><Description>Perfluorocarbon Liquid  for use as a retinal surgery additive</Description><Size>5mL</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1346</GroupID><ARTGs><ARTG>108429</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LL007</BillingCode><Name>enVista Aspire Toric Monofocal Intraocular Lens Non Preloaded Model ETA</Name><Description>The enVista Aspire Toric Model ETA. UV - absorbing, posterior chamber, hydrophobic acrylic toric IOL. Aspheric lens optic, square posterior
edge, modified C haptics. Can be folded for insertion into the eye.</Description><Size>+6.0 D to +34.0 D (0.5 D increments). Cylinder Powers: 0.9D, 1.25D, 1.50D, 2.00D, 2.50D, 2.75D, 3.00D, 3.50D, 4.25D, 5.00D &amp; 5.75D</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>98915</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL053</BillingCode><PriorBillingCodes><PriorBillingCode>ER281</PriorBillingCode></PriorBillingCodes><Name>IC-8, Hydrophobic Small Aperture Intraocular Lens</Name><Description>A hydrophobic posterior chamber intraocular lens (IOL), embedded with a central circular mask, which operates under the principle of small aperture optics to reduce near vision blur and provide seamless extended range vision from distance to near.</Description><Size>The overall diameter is 12.5 millimetres with a 6 millimetre diameter aspheric optic.</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>236210</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL049</BillingCode><Name>LuxSmart Toric Preloaded</Name><Description>The LuxSmart Toric intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL, with blue light filtering and has aspheric and toric optics. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxSmart lens is supplied with an  Delivery System to provide a touch-free method of delivery of the lens into the capsular bag.</Description><Size>Body Diameter: 6.0 mm; Overall Diameter: 11 mm; Haptic Angle: 0deg ; Powers: +6.00 to +34.00 Diopters; Cylindrical Powers: +0.75 to +6.00 Diopters </Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>342175</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL036</BillingCode><Name>FineVision Toric POD FT</Name><Description>Posterior chamber, toric, trifocal diffractive (aspheric), UV and blue light blocker, single piece acrylic IOL.</Description><Size>An overall diameter of 11.40mm and optic diameter of 6.00mm. From 0 to +35 Diopters with 0.5 diopter increments.</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>211587</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LL009</BillingCode><Name>Luxlife Full Range of Field Toric IOL, model YLIFET</Name><Description>The LuxLife Toric intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL, with blue light filtering. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxLife lens is supplied with an Accuject Dual Injection System to provide a touch-free method of delivery of the lens into the capsular bag.</Description><Size>Body diameter: 6.0 mm, overall diameter: 11.00 mm.  Power range: +6.00 D to +34.00 D sphere, +0.75 to +6.00D cylinder</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>342175</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL038</BillingCode><PriorBillingCodes><PriorBillingCode>IL004</PriorBillingCode></PriorBillingCodes><Name>B+L FINEVISION HP (POD F GF)</Name><Description>POD F GF test intraocular lens (IOL) is a foldable IOL with a quadripode “POD” open-loop design intended for capsular bag implantation. The IOL is made of the proprietary hydrophobic glistening-free (GFree®) material containing a UV-blocker and additional blue blocker. The material is a hydrophobic acrylic copolymer of medical quality which includes a UV (wavelength &lt; 400 nm) absorbing filter and a blue light-filtering chromophore which is covalently bounded to the hydrophobic material.
The optical part of the test POD F GF lens is biconvex and aspherical partially compensating the positive spherical aberration of the cornea. The optic bears a diffractive TRIFOCAL element on its anterior side (toward patient pupil), allowing for presbyopia correction and spectacle independence for near and intermediate visions. The add-power at the IOL plane for the near vision is + 3.5 diopters and for the intermediate vision + 1.75 diopters.
POD F GF is intended for implantation in the capsular bag after  human lens extraction after cataract. The IOL material is capable of being folded prior to insertion, allowing placement through an incision (2.0-2.2 mm) smaller than the optic diameter of the lens. After surgical insertion into the eye, the lens unfolds to ReSTOR the optical performance. The supporting haptics provide for proper positioning and fixation of the IOL optic within the eye.</Description><Size>Optic diameter: 6.00mm
Total diameter: 11.40mm
From Ø to +35 Diopters, with 0.5 Diopter increments</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>211587</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL042</BillingCode><Name>LuxGood Preloaded</Name><Description>The LuxGood intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL, blue light filtering and has aspheric optics. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxGood lens is supplied with a Delivery System to provide a touch-free method of delivery of the lens into the capsular bag.</Description><Size>Body Diameter: 6.0 mm +/- 0.1 mm, Overall Diameter: 11.00 mm +/- 0.2 mm.  Power Range: +0.00 D to +34.00 D</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>342175</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BL044</BillingCode><Name>LuxGood Toric Preloaded</Name><Description>The LuxGood Toric intraocular lens (IOL) is a single-piece ultraviolet (UV) absorbing, posterior chamber, hydrophobic acrylic IOL, with blue light filtering and has aspheric and toric optics. The lens is provided sterile and is designed to be folded prior to insertion into the eye. The preloaded intraocular LuxGood Toric lens is supplied with an Accuject Pro Delivery System to provide a touch-free method of delivery of the lens into the capsular bag.</Description><Size>Body Diameter: 6.0 mm; Overall Diameter: 11 mm Haptic Angle: 0°  Powers: +6.00 to +34.00 Diopters Cylindrical Powers: +0.75 to +6.00 Diopters  </Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, t1, vblf</Suffix><ARTGs><ARTG>342175</ARTG></ARTGs><MinimumBenefit>585</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LL008</BillingCode><Name>enVista Aspire Monofocal IOL Non Preloaded Model EA</Name><Description>The enVista Aspire Monofocal Model EA. enhance the depth of focus (DOF), UVabsorbing, posterior chamber, hydrophobic acrylic IOL. Aspheric lens optic, square posterior edge, modified C haptics. The lenses can be folded for insertion into the eye.</Description><Size>+6.0 D to +34.0 D (0.5 D increments)</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>98915</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LL005</BillingCode><Name>enVista Envy Toric Trifocal IOL</Name><Description>The enVista Envy toric IOL Model: ETN, trifocal, UV-absorbing, posterior chamber, hydrophobic acrylic IOL. Aspheric lens optic, square posterior edge, modified C haptics. Can be folded for insertion into the eye.</Description><Size>+6.0 to +34.0D (0.5D increments), +1.6D intermediate add power, +3.1D near add power, Cylinder powers: 0.75D, 0.90D, 1.25D, 1.50D, 2.00D, 2.50D, 3.00D, 3.50D, 4.25D, 5.00D, 5.75D</Size><SupplierCode>LL</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>98915</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ543</BillingCode><Name>Seprafilm 4-Section</Name><Description>Seprafilm Adhesion Barrier is a sodium hyaluronate carbomethylcellulose membrane . Seprafilm4-section  contains a sheet pre-cut into  4 sheets with sizes 6.5cm x 7.5cm each  to be used per patient</Description><Size>4 X (6.5cm x 7.5cm) sheets in a pouch</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5432</SubGroupID><ARTGs><ARTG>387710</ARTG></ARTGs><MinimumBenefit>312</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX328</BillingCode><PriorBillingCodes><PriorBillingCode>BX248</PriorBillingCode></PriorBillingCodes><Name>Infusor</Name><Description>Sterile Infusor Devices, Elastomeric Driven</Description><Size>LV 2, 2ml/hr, 275 ml vol;  LV 1.5, 1.5ml/hr, 275 ml vol.</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>168893</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX342</BillingCode><PriorBillingCodes><PriorBillingCode>GE006</PriorBillingCode></PriorBillingCodes><Name>Seprafilm Adhesion Barrier</Name><Description>Sodium hyaluronate carbomethylcellulose membrane</Description><Size>13cm x 15cm</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5432</SubGroupID><ARTGs><ARTG>387710</ARTG></ARTGs><MinimumBenefit>312</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX349</BillingCode><Name>INDUCTIGRAFT</Name><Description>Silicate Substituted Calcium Phosphate Bone Graft Substitute, 82.5%  Porosity</Description><Size>20ML</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>402036</ARTG></ARTGs><MinimumBenefit>4370</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX247</BillingCode><Name>Intermate</Name><Description>Sterile infusor devices, elastomeric driven</Description><Size>SV 200 - 200ml/hr, nominal 100ml vol. max 105 mL. SV 100 - 100ml/hr, nominal 100ml vol. max 105 mL. LV 250, 250ml/hr, 275ml vol. SV 50 - 50ml/hr, nominal 100ml vol. max 105mL.  LV 100  - 100ml/hr, 275ml vol. LV 50, 50ml/hr, 275ml vol</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>168893</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX287</BillingCode><Name>Intermate XLV 250</Name><Description>Sterile infusor devices, elastomeric driven.  The Intermate XLV 250 is an ambulatory device utilising elastomeric technology to deliver continuous infusion of parenteral therapy to patients in an ambulatory setting. The device is specifically suitable for patients requiring intravenous immunoglobulin therapy. The nominal flow rate of the Intermate XLV 250 is 250mL/hr, however when used for the administration of IVIG the flow rate is reduced to approximately 120mL/hr.</Description><Size>Volume 500mL. Approximate infusion time for IVIG solutions is 4.2 hrs.</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>168893</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX311</BillingCode><PriorBillingCodes><PriorBillingCode>GO177</PriorBillingCode></PriorBillingCodes><Name>ACTIFUSE ABX Putty</Name><Description>Actifuse AVX Putty - A silicated substituted synthetic bone graft.</Description><Size>20ml</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>188736</ARTG></ARTGs><MinimumBenefit>4370</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX281</BillingCode><Name>Baxter Folfusor</Name><Description>Sterile infusor devices, elastomeric driven.  Folfusor SV 0.5mL/hr 120mL (Baxter Code 2C4700K), Folfusor SV 2.5mL/hr 120mL (Baxter Code 2C4711K), Folfusor SV 5mL/hr 120mL (Baxter Code 2C4705K). The Baxter Folfusor is a disposable infusion pump used in an ambulatory setting for the continuous infusion of intravenous medications. The codes listed above represent three separate flow rates specific to Chemotherapy protocols.</Description><Size>120mL Maximum Volume</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>168893</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX327</BillingCode><PriorBillingCodes><PriorBillingCode>BX246</PriorBillingCode></PriorBillingCodes><Name>Infusor</Name><Description>Sterile Infusor Devices, Elastomeric Driven</Description><Size>LV 10, 10ml/hr, 240ml vol  LV 5, 5ml/hr, 240ml vol</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>168893</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX318</BillingCode><Name>ACTIFUSE SHAPE15.8mL –BONE MATRIX IMPLANT ARTIFICIAL</Name><Description>A silicate substituted synthetic bone graft</Description><Size>15.8mL</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>203922</ARTG></ARTGs><MinimumBenefit>4370</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX292</BillingCode><PriorBillingCodes><PriorBillingCode>AB069</PriorBillingCode></PriorBillingCodes><Name>Supple Peri-Guard (4 x 4cm)</Name><Description>Model No SPC0404CE  - 4 x 4cm Bovine pericardium patch</Description><Size>4 x 4cm</Size><SupplierCode>BX</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>182</SubCategoryID><GroupID>1507</GroupID><SubGroupID>5452</SubGroupID><ARTGs><ARTG>385632</ARTG></ARTGs><MinimumBenefit>333</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX314</BillingCode><Name>ACTIFUSE SHAPE 1.6mL–BONE MATRIX IMPLANT ARTIFICIAL</Name><Description>A silicate substituted synthetic bone graft</Description><Size>1.6mL</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>203922</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX315</BillingCode><Name>ACTIFUSE SHAPE 2.6mL–BONE MATRIX IMPLANT ARTIFICIAL</Name><Description>A silicate substituted synthetic bone graft</Description><Size>2.6mL</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>203922</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX282</BillingCode><Name>Floseal Special Applicator Tips</Name><Description>Floseal Malleable and Trimmable Applicator with Tips specifically designed for use with Floseal Haemostatic Matrix</Description><Size>14cm</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Extender</Suffix><ARTGs><ARTG>167776</ARTG></ARTGs><MinimumBenefit>25</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX279</BillingCode><Name>Coseal Duplospray Applicator 30cm</Name><Description>COSEAL, which is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts.  COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking.</Description><Size>30cm</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Laparoscopic Extender</Suffix><ARTGs><ARTG>115590</ARTG></ARTGs><MinimumBenefit>53</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX335</BillingCode><PriorBillingCodes><PriorBillingCode>FC006</PriorBillingCode></PriorBillingCodes><Name>Peri-Strips dry with Veritas Collagen Matrix Linear Single Firing</Name><Description>Peri-Strips Dry with Veritas is a remodeable material designed to increase staple line strength for surgical repair of soft tissue deficiencies</Description><Size> 30-130mm</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4251</SubGroupID><ARTGs><ARTG>385671</ARTG></ARTGs><MinimumBenefit>301</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX275</BillingCode><Name>COSEAL Extended Applicator 22 cm</Name><Description>22cm extended applicator for COSEAL. Coseal, is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts.  COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking.</Description><Size>A 22 cm long malleable applicator</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Extender</Suffix><ARTGs><ARTG>180922</ARTG></ARTGs><MinimumBenefit>25</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX263</BillingCode><Name>COSEAL Spray Accessory Kit</Name><Description>Spray Accessory kit for Coseal: A hydrogel that acts as a sealant by adhering to itself and the tissues it contacts.  COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking.</Description><Size>One size available</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Extender</Suffix><ARTGs><ARTG>299913</ARTG></ARTGs><MinimumBenefit>25</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ716</BillingCode><Name>Floseal -13 cm Malleable applicator tip </Name><Description>Floseal Malleable Applicator with Tips specifically designed for use with
Floseal Haemostatic Matrix</Description><Size>13cm</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Applicator Tip</Suffix><ARTGs><ARTG>115590</ARTG></ARTGs><MinimumBenefit>22</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX286</BillingCode><Name>Painfusor Catheter</Name><Description>The Painfusor Catheter is an extended fenestration catheter for the administration of analgesic drugs into surgical wounds to manage acute post-operative pain. Pack contains fenestrated catheter, peel away introducer needle accommodating 19Ga (100 mm length), 3M Tegaderm IV Transparent Film Dressing with border 1633, and GripLok catheter securement device</Description><Size>Catheters are 35cm + Fenestrated section:     (35cm + 2.5cm) - total length 37.5cm, (35cm + 7.5cm) - total length 42.5cm, (35cm + 15cm) - total length 50cm, (35cm + 22.5cm) - total length 57.5cm, (35cm + 30 cm) - total length 65cm</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1541</GroupID><SubGroupID>4190</SubGroupID><ARTGs><ARTG>177499</ARTG></ARTGs><MinimumBenefit>72</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX341</BillingCode><Name>EASYGRIP FLO-41</Name><Description>sterile, single-use endoscopic applicator device designed for single handed application, particularly  during laparoscopic and robotic procedures through an easy, precise, and controlled delivery of Floseal.</Description><Size>41cm</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Rigid Delivery System</Suffix><ARTGs><ARTG>115590</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX308</BillingCode><PriorBillingCodes><PriorBillingCode>GO184</PriorBillingCode></PriorBillingCodes><Name>Actifuse ABX MIS</Name><Description>Actifuse ABX MIS, Refill Cartridge, 7.5ml</Description><Size>7.5ml</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>193684</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX350</BillingCode><Name>INDUCTIGRAFT</Name><Description>Silicate Substituted Calcium Phosphate Bone Graft   Substitute, 82.5% Porosity</Description><Size>10ML</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>402036</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX312</BillingCode><PriorBillingCodes><PriorBillingCode>GO163</PriorBillingCode></PriorBillingCodes><Name>Actifuse ABX Easyfill Putty</Name><Description>Actifuse ABX Easyfill Putty - A silicate substituted synthetic bone graft</Description><Size>10ml</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>188736</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX317</BillingCode><Name>ACTIFUSE SHAPE 8.0mL –BONE MATRIX IMPLANT ARTIFICIAL</Name><Description>A silicate substituted synthetic bone graft</Description><Size>8.0mL</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>203922</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX309</BillingCode><PriorBillingCodes><PriorBillingCode>GO183</PriorBillingCode></PriorBillingCodes><Name>Actifuse ABX MIS</Name><Description>Actifuse ABX MIS, Applicator and Cartridge, 7.5ml</Description><Size>7.5ml</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>193684</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX280</BillingCode><Name>Coseal Duplospray Applicator 20cm</Name><Description>COSEAL, which is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts. COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking. This a</Description><Size>20 cm</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Laparoscopic Extender</Suffix><ARTGs><ARTG>115590</ARTG></ARTGs><MinimumBenefit>53</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX337</BillingCode><Name>Ostene 3.5g Bone Haemostasis material</Name><Description>OSTENE is a water soluble polymer which provides immediate bone haemostasis, ie a bone haemostasis material, in surgical procedures</Description><Size>3.5g</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>229426</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX252</BillingCode><Name>CoSeal Surgical Sealant</Name><Description>Composition: two synthetic polyethelene glycols (PEG's), COH102 and COH206, premixed and filled into one syringe, a dilute hydrogen chloride solution and a sodium phosphate/sodium carbonate solution</Description><Size>2ml</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>181132</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX346</BillingCode><PriorBillingCodes><PriorBillingCode>AB080</PriorBillingCode><PriorBillingCode>TM047</PriorBillingCode></PriorBillingCodes><Name>PerClot Standard &amp; XL - 1 gram</Name><Description>PerClot Polysaccharide Hemostatic System</Description><Size>1 gram</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>162991</ARTG><ARTG>275318</ARTG></ARTGs><MinimumBenefit>45</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX347</BillingCode><PriorBillingCodes><PriorBillingCode>AB081</PriorBillingCode><PriorBillingCode>TM048</PriorBillingCode></PriorBillingCodes><Name>PerClot Standard &amp; XL - 3 grams</Name><Description>PerClot Polysaccharide Hemostatic System</Description><Size>3 grams</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>162991</ARTG><ARTG>275318</ARTG></ARTGs><MinimumBenefit>132</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX345</BillingCode><PriorBillingCodes><PriorBillingCode>AB079</PriorBillingCode></PriorBillingCodes><Name>PerClot Laparascopic</Name><Description>PerClot Polysaccharide Hemostatic System</Description><Size>3 grams</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>164507</ARTG></ARTGs><MinimumBenefit>132</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX336</BillingCode><Name>OSTENE Bone Haemostasis material 2.5g</Name><Description>OSTENE is a water soluble polymer which provides immediate bone haemostasis, ie a bone haemostasis material, in surgical procedures</Description><Size>2.5g per stick</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>229426</ARTG></ARTGs><MinimumBenefit>107</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX348</BillingCode><PriorBillingCodes><PriorBillingCode>AB082</PriorBillingCode></PriorBillingCodes><Name>PerClot Standard</Name><Description>PerClot Polysaccharide Hemostatic System</Description><Size>5 gram</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>162991</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX295</BillingCode><PriorBillingCodes><PriorBillingCode>AB067</PriorBillingCode></PriorBillingCodes><Name>Supple Peri-Guard (8 x 14cm)</Name><Description>SPG0814CE - 8 x 14 Bovine pericardium patch</Description><Size>8 x 14cm</Size><SupplierCode>BX</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>182</SubCategoryID><GroupID>1507</GroupID><SubGroupID>5454</SubGroupID><ARTGs><ARTG>385632</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX294</BillingCode><PriorBillingCodes><PriorBillingCode>AB066</PriorBillingCode></PriorBillingCodes><Name>Supple Peri-Guard (10 x 16cm)</Name><Description>Model No SPC1016CE - 10 x 16 Bovine pericardium patch</Description><Size>10 x 16cm</Size><SupplierCode>BX</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>182</SubCategoryID><GroupID>1507</GroupID><SubGroupID>5454</SubGroupID><ARTGs><ARTG>385632</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX249</BillingCode><Name>Multirate with PCM</Name><Description>Sterile infusor devices, elastomeric driven</Description><Size>Multirate 5, 7 or 12 ml/hr with PCM</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5359</SubGroupID><Suffix>Bolus</Suffix><ARTGs><ARTG>168893</ARTG></ARTGs><MinimumBenefit>367</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX330</BillingCode><PriorBillingCodes><PriorBillingCode>BX250</PriorBillingCode></PriorBillingCodes><Name>Basal Bolus Infusor</Name><Description>Sterile Infusor Devices, Balloon based</Description><Size>Basal/Bolus 60, Basal 0.5ml/hr, Bolus 0.5 x 65ml
Basal/Bolus 15, Basal 0.5ml/hr, Bolus 2ml/hr x 65ml
Basal/Bolus infusor, Basal 2ml/hr, Bolus 2ml/hr x 65ml</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5359</SubGroupID><Suffix>Bolus</Suffix><ARTGs><ARTG>168893</ARTG></ARTGs><MinimumBenefit>367</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX259</BillingCode><Name>FloSeal Hemostatic Matrix</Name><Description>FloSeal is a proprietary combination of collagen-derived particles and topical thrombin. Comes with a syringe with needle or needle free  vial adapter. It is not sponge, but is a high viscosity gel for haemostasis.  Clinically proven to control bleeding from capillary oozing to arterial spurting.</Description><Size>10ml</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4214</SubGroupID><Suffix>Complete Biomaterial</Suffix><ARTGs><ARTG>192294</ARTG></ARTGs><MinimumBenefit>640</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ539</BillingCode><Name>HEMOPATCH SEALING HAEMOSTAT</Name><Description>HEMOPATCH is indicated as a hemostatic device and surgical  sealant for procedures in which control of bleeding or leakage 
of other body fluids by conventional surgical techniques is either  ineffective or impractical</Description><Size> Large 4.5cm X 9cm (3 pads per box)</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>5426</SubGroupID><ARTGs><ARTG>360130</ARTG></ARTGs><MinimumBenefit>412</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX293</BillingCode><PriorBillingCodes><PriorBillingCode>AB068</PriorBillingCode></PriorBillingCodes><Name>Supple Peri-Guard (6 x 8cm)</Name><Description>Model No SPG0608CE  -6 x 8cm Bovine pericardium patch</Description><Size>6 x 8cm</Size><SupplierCode>BX</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>182</SubCategoryID><GroupID>1507</GroupID><SubGroupID>5453</SubGroupID><ARTGs><ARTG>385632</ARTG></ARTGs><MinimumBenefit>523</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX354</BillingCode><Name>Hemopatch RT  -  Hemopatch Sealing Haemostat-Large</Name><Description>HEMOPATCH RT  ( RT=Room Temperature) is  an absorbable collagen pad (PCC)  coated with NHS-PEG intended to be used as a hemostatic device and surgical sealant for procedures in which control of bleeding or leakage of other body fluids by conventional surgical techniques is either ineffective or impractical.</Description><Size>Large 4.5cm X 9cm (3 pads per box)</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>5426</SubGroupID><ARTGs><ARTG>477685</ARTG></ARTGs><MinimumBenefit>412</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX313</BillingCode><PriorBillingCodes><PriorBillingCode>GO162</PriorBillingCode></PriorBillingCodes><Name>Actifuse ABX Easyfill Putty</Name><Description>Actifuse ABX Easyfill Putty - A silicate substituted synthetic bone graft</Description><Size>5ml</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>188736</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX351</BillingCode><Name>INDUCTIGRAFT</Name><Description>Silicate Substituted Calcium Phosphate Bone Graft   Substitute, 82.5% Porosity</Description><Size>0-5ML  </Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>402036</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ540</BillingCode><Name>HEMOPATCH SEALING HAEMOSTAT</Name><Description>HEMOPATCH is indicated as a hemostatic device and surgical sealant for procedures in which control of bleeding or 
leakage of other body fluids by conventional surgical techniques is either ineffective or impractical.
</Description><Size>Medium 4.5cm X 4.5cm ( 3 pads per box) </Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>5425</SubGroupID><ARTGs><ARTG>360130</ARTG></ARTGs><MinimumBenefit>208</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX326</BillingCode><PriorBillingCodes><PriorBillingCode>BX246</PriorBillingCode></PriorBillingCodes><Name>Infusor</Name><Description>Sterile Infusor Devices, Spring Powered</Description><Size>SV Half, 5ml/hr, nominal 60ml vol, max 65ml.
SV Single day, 2ml/hr, nominal 48ml vol, max 65ml</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1540</GroupID><SubGroupID>4188</SubGroupID><ARTGs><ARTG>168893</ARTG></ARTGs><MinimumBenefit>76</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX254</BillingCode><Name>CoSeal Surgical Sealant</Name><Description>Composition: two synthetic polyethelene glycols (PEG's), COH102 and COH206, premixed and filled into a syringe, a dilute hydrogen chloride solution and a sodium phosphate sodium carbonate solution</Description><Size>8ml</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4249</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>181132</ARTG></ARTGs><MinimumBenefit>963</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX258</BillingCode><Name>FloSeal Hemostatic Matrix</Name><Description>FloSeal is a proprietary combination of collagen-derived particles and topical thrombin. Comes with a syringe with needle or needle free  vial adapter.  It is not sponge, but is a high viscosity gel for haemostasis.  Clinical proven to control bleeding from capillary oozing to arterial spurting.</Description><Size>5ml</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4213</SubGroupID><Suffix>Complete Biomaterial</Suffix><ARTGs><ARTG>192294</ARTG></ARTGs><MinimumBenefit>394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX260</BillingCode><Name>ADEPT Adhesion Reduction Solution</Name><Description>ADEPT Adhesion Reduction Solution is a single use, sterile fluid for intraperitoneal administration. ADEPT is intended to be used as an instillate for the reduction of adhesions following gynaecologicalpelvic laparoscopic surgery of the abdominalpelvic cavity in adults</Description><Size>1500ml</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>4246</SubGroupID><ARTGs><ARTG>299826</ARTG></ARTGs><MinimumBenefit>226</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ544</BillingCode><Name>Seprafilm Adhesion Barrier - Single site and Mini site</Name><Description>Sodium hyaluronate carbomethylcellulose membrane
</Description><Size>13cm X7.5cm 6.5cm X7.5cm</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5431</SubGroupID><ARTGs><ARTG>387710</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX353</BillingCode><Name>Hemopatch RT - Hemopatch Sealing Haemostat - Medium</Name><Description>HEMOPATCH RT  ( RT=Room Temperature) is  an absorbable collagen pad (PCC)  coated with NHS-PEG intended to be used as a hemostatic device and surgical sealant for procedures in which control of bleeding or leakage of other body fluids by conventional surgical techniques is either ineffective or impractical.</Description><Size>Medium  4.5cm X 4.5cm ( 3 pads per box)</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>5425</SubGroupID><ARTGs><ARTG>477685</ARTG></ARTGs><MinimumBenefit>208</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX270</BillingCode><Name>COSEAL Applicator Tips 7 cm</Name><Description>Applicator tips for COSEAL. Coseal which is listed on the Prostheses List, is a hydrogel that acts as a sealant by adhering to itself and the tissues it contacts.  COSEAL is designed to completely seal suture lines along vascular reconstructions to prevent fluids from leaking.</Description><Size>A 7cm long applicator tip</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Applicator Tip</Suffix><ARTGs><ARTG>180922</ARTG></ARTGs><MinimumBenefit>22</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX273</BillingCode><Name>Floseal Endoscopic Applicator</Name><Description>Used as an adjunct to haemostasis when control of bleeding by ligature or conventional surgical procedures is ineffective or impractical.</Description><Size>A 41cm - 47cm long disposable cannulated applicator, with or without malleable tip.</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Rigid Delivery System</Suffix><ARTGs><ARTG>115590</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX253</BillingCode><Name>CoSeal Surgical Sealant</Name><Description>Composition: two synthetic polyethelene glycols (PEG's), COH102 and COH206, premixed and filled into a syringe, a dilute hydrogen chloride solution and a sodium phosphate sodium carbonate solution</Description><Size>4ml</Size><SupplierCode>BX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4248</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>181132</ARTG></ARTGs><MinimumBenefit>516</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BX310</BillingCode><PriorBillingCodes><PriorBillingCode>GO161</PriorBillingCode></PriorBillingCodes><Name>Actifuse ABX Easyfill</Name><Description>Actifuse ABX Easyfill - A silicate substituted synthetic bone graft</Description><Size>1.5mL to 4mL</Size><SupplierCode>BX</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>188736</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IW004</BillingCode><PriorBillingCodes><PriorBillingCode>BL038</PriorBillingCode><PriorBillingCode>IL004</PriorBillingCode></PriorBillingCodes><Name>B+L FINEVISION HP (POD F GF)</Name><Description>POD F GF test intraocular lens (IOL) is a foldable IOL with a quadripode “POD” open-loop design intended for capsular bag implantation. The IOL is made of the proprietary hydrophobic glistening-free(GFree®) material containing a UV-blocker and additional blue blocker. The material is a hydrophobic acrylic copolymer of medical quality which includes a UV(wavelength less than 400 nm) absorbing filter and a blue light-filtering chromophore which is covalently bounded to the hydrophobic material.  The optical part of the test POD F GF lens is biconvex and aspherical partially compensating the positive spherical aberration of the cornea. The optic bears a diffractive TRIFOCAL element on its anterior side (toward patient pupil), allowing for presbyopia correction and spectacle independence for near and intermediate visions. The add-power at the IOL plane for the near vision is + 3.5 diopters and for the intermediate vision + 1.75 diopters. POD F GF is intended for implantation in the capsular bag after human lens extraction after cataract. The IOL material is capable of being folded prior to insertion, allowing placement through an incision (2.0-2.2 mm) smaller than the optic diameter of the lens. After surgical insertion into the eye, the lens unfolds to ReSTOR the optical performance. The supporting haptics provide for proper positioning and fixation of the IOL optic within the eye</Description><Size>Optic diameter: 6.00mm  Total diameter: 11.40mm  From Ø to +35 Diopters, with 0.5 Diopter increments</Size><SupplierCode>IW</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>363012</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IW005</BillingCode><PriorBillingCodes><PriorBillingCode>DE702</PriorBillingCode></PriorBillingCodes><Name>ARCIOLANE 1300</Name><Description>Silicone Oil for Vitreoretinal Surgery</Description><Size>10ml</Size><SupplierCode>IW</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1347</GroupID><ARTGs><ARTG>171840</ARTG></ARTGs><MinimumBenefit>176</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IW002</BillingCode><PriorBillingCodes><PriorBillingCode>BL036</PriorBillingCode></PriorBillingCodes><Name>FineVision Toric POD FT</Name><Description>Posterior chamber, toric, trifocal diffractive (aspheric), UV and blue light blocker, single piece acrylic IOL.</Description><Size>An overall diameter of 11.40mm and optic diameter of 6.00mm. From 0 to +35 Diopters with 0.5 diopter increments.</Size><SupplierCode>IW</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>363012</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IW003</BillingCode><PriorBillingCodes><PriorBillingCode>BL034</PriorBillingCode></PriorBillingCodes><Name>FineVision Micro F</Name><Description>Posterior chamber, UV absorbing, foldable, aspheric, acrylic, single piece lens with apodised diffractive , trifocal optic and blue light protection</Description><Size>An overall diameter of 10.75mm and optic diameter of 6.15mm. From 0 to +35 dopters with 0.5 diopter increments.</Size><SupplierCode>IW</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>363012</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IW001</BillingCode><PriorBillingCodes><PriorBillingCode>BL037</PriorBillingCode></PriorBillingCodes><Name>MicroPure 123</Name><Description>Preloaded, posterior chamber, UV absorbing, foldable, aspheric, acrylic, single piece hydrophobic glistening-free Intra Ocular Lens.</Description><Size>Overall diameter of 10D to 24.5D: 11.00mm  25D to 30D: 10.75mm    Optic diameter of 10D to 24.5D: 6.00mm  25D to 30 D: 5.75mm    Power from 10D to 30D with 0.5 diopter increments.</Size><SupplierCode>IW</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>363012</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IW006</BillingCode><PriorBillingCodes><PriorBillingCode>DE701</PriorBillingCode></PriorBillingCodes><Name>ARCIOLANE 5500</Name><Description>Silicone Oil for Vitreoretinal Surgery</Description><Size>10ml</Size><SupplierCode>IW</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1347</GroupID><ARTGs><ARTG>171840</ARTG></ARTGs><MinimumBenefit>176</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IW008</BillingCode><PriorBillingCodes><PriorBillingCode>DE204</PriorBillingCode></PriorBillingCodes><Name>Arcaline (Perfluorodecaline)</Name><Description>Liquid perfluorocarbon aid for retinal surgery, operative device for retinal surgery, in particular retinal detachment (RD), RD with giant tear etc.</Description><Size>3ml, 5ml, 7ml</Size><SupplierCode>IW</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1346</GroupID><ARTGs><ARTG>140539</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IW010</BillingCode><Name>MONOBLUE SafR</Name><Description>MONOBLUE SafR is a sterile ophthalmic dye for temporary staining of ocular tissues in the background of cataract surgery. MONOBLUE SafR is a solution of Trypan Blue in a buffered isotonic vehicle at the concentration of 0.055%. At this concentration, Trypan Blue does not penetrate healthy cells but only dead cells. It allows the differentiation of cells with altered function and disturbed membrane exchanges.</Description><Size>&gt;=  0.75 mL solution in a 1mL glass syringe; 5 individually pouched syringes per box</Size><SupplierCode>IW</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1330</GroupID><ARTGs><ARTG>466266</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IW009</BillingCode><PriorBillingCodes><PriorBillingCode>DE205</PriorBillingCode></PriorBillingCodes><Name>Arcotane (Perfloro-N-Octane)</Name><Description>Liquid perfluoro-N-Octane aid for retinal surgery, pre-operative device for retinal surgery, in particular retinal detachment (RD), RD with giant tear, RD with proliferative vitreal retinopathy (PVR) etc.</Description><Size>5ml, 7ml</Size><SupplierCode>IW</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1346</GroupID><ARTGs><ARTG>140539</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IW007</BillingCode><PriorBillingCodes><PriorBillingCode>DE284</PriorBillingCode></PriorBillingCodes><Name>Single Dose Ophthalmic Gases</Name><Description>Single dose tamponading gas for retinal surgery</Description><Size>30ml</Size><SupplierCode>IW</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1345</GroupID><ARTGs><ARTG>99568</ARTG></ARTGs><MinimumBenefit>67</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FN009</BillingCode><Name>Bodyguard Pump (Single patient use only)</Name><Description>Ambulatory Infusion Pump, Battery Powered (Single patient use only)</Description><Size>Only one size</Size><SupplierCode>FN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4185</SubGroupID><ARTGs><ARTG>325821</ARTG></ARTGs><MinimumBenefit>2805</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FN007</BillingCode><Name>BD Bodyguard T (Single patient use only)</Name><Description>Ambulatory infusion pump, syringe (Single patient use only)</Description><Size>One size only</Size><SupplierCode>FN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4185</SubGroupID><ARTGs><ARTG>325943</ARTG></ARTGs><MinimumBenefit>2805</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FN001</BillingCode><PriorBillingCodes><PriorBillingCode>ZQ004</PriorBillingCode><PriorBillingCode>CI004</PriorBillingCode></PriorBillingCodes><Name>Pleurx</Name><Description>Pleurx Peritoneal Catheter Mini Kit</Description><Size>Catheter 71.0cm x 15.5 Fr</Size><SupplierCode>FN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>4243</SubGroupID><ARTGs><ARTG>321900</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FN003</BillingCode><PriorBillingCodes><PriorBillingCode>ZQ008</PriorBillingCode></PriorBillingCodes><Name>Denver Ascites Shunt, (PAK), Double-valved</Name><Description>Ascite Shunt - Double Valved Percutaneous Access Kit (PAK). A fenestrated peritoneal catheter, a venous catheter, and a flexible pump chamber containing two miter valves, provided with a Percutaneous Access Kit.</Description><Size>Double-valved, 42-2050</Size><SupplierCode>FN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1793</GroupID><ARTGs><ARTG>163267</ARTG></ARTGs><MinimumBenefit>1986</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FN004</BillingCode><PriorBillingCodes><PriorBillingCode>ZQ009</PriorBillingCode></PriorBillingCodes><Name>Denver Ascites Shunt, (PAK), Single-valved</Name><Description>Ascites Shunt - Single Valved Percutaneous Access Kit (PAK). A fenestrated peritoneal catheter, a veneous catheter, and a flexible pump chamber containing one miter valve, provided with a Percutaneous Access Kit (PAK).</Description><Size>Single valved, 42-2055</Size><SupplierCode>FN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1793</GroupID><ARTGs><ARTG>163266</ARTG></ARTGs><MinimumBenefit>1986</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FN002</BillingCode><PriorBillingCodes><PriorBillingCode>ZQ005</PriorBillingCode><PriorBillingCode>CI005</PriorBillingCode></PriorBillingCodes><Name>Pleurx</Name><Description>Pleurx Pleural Catheter Mini Kit</Description><Size>Catheter 24cm x 15.5Fr</Size><SupplierCode>FN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>4242</SubGroupID><ARTGs><ARTG>321900</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FN005</BillingCode><PriorBillingCodes><PriorBillingCode>ZQ010</PriorBillingCode></PriorBillingCodes><Name>Safe-T-Centesis Drainage system</Name><Description>Safe-T-Centesis drainage for para/thoracentesis</Description><Size>6FR and 8FR pigtail catheter with Veress technology</Size><SupplierCode>FN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>6000</SubGroupID><ARTGs><ARTG>120894</ARTG></ARTGs><MinimumBenefit>125</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FN006</BillingCode><PriorBillingCodes><PriorBillingCode>ZQ011</PriorBillingCode></PriorBillingCodes><Name>Paracentesis/Thoracentesis Catheter Drainage</Name><Description>Thora/Paracentesis kit</Description><Size>8FR, 12cm polyurethane catheter</Size><SupplierCode>FN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>6000</SubGroupID><ARTGs><ARTG>120894</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FN008</BillingCode><Name>Bodyguard infusion pump sets</Name><Description>Single use sterile disposble infusion set for use with Bodyguard Infusion Pump</Description><Size>Various</Size><SupplierCode>FN</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1541</GroupID><SubGroupID>4191</SubGroupID><ARTGs><ARTG>325889</ARTG><ARTG>326110</ARTG></ARTGs><MinimumBenefit>26</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GQ003</BillingCode><PriorBillingCodes><PriorBillingCode>RS002</PriorBillingCode><PriorBillingCode>SH004</PriorBillingCode></PriorBillingCodes><Name>MiniMizer gastric band.</Name><Description>Adjustable Silicone band which is placed around the upper part of the stomach to reduce the volume and speed of intake of food.</Description><Size>The gastric band comes in two sizes: Regular and Large</Size><SupplierCode>GQ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1548</GroupID><ARTGs><ARTG>203396</ARTG></ARTGs><MinimumBenefit>2791</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GQ001</BillingCode><PriorBillingCodes><PriorBillingCode>RS001</PriorBillingCode><PriorBillingCode>SH009</PriorBillingCode></PriorBillingCodes><Name>Minimizer Ring</Name><Description>Adjustable Gastric Ring</Description><Size>One size ranging from 6.5cm to a 8.0cm diameter</Size><SupplierCode>GQ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1781</GroupID><ARTGs><ARTG>203396</ARTG></ARTGs><MinimumBenefit>2073</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GQ007</BillingCode><Name>Microline Surgical Disposable 10 Titanium K2 Clip Cartridge</Name><Description>Disposable cartridge containing 10 surgical grade titanium clips delivered using a reusable handpiece applier</Description><Size>10 Clips per cartridge</Size><SupplierCode>GQ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4259</SubGroupID><ARTGs><ARTG>326239</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GQ006</BillingCode><Name>Microline Surgical Disposable 19 Titanium K2 Clip Cartridge</Name><Description>Disposable cartridge containing 19 surgical grade titanium clips delivered using a reusable handpiece applier</Description><Size>19 Clips per cartridge</Size><SupplierCode>GQ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4259</SubGroupID><ARTGs><ARTG>326239</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GQ002</BillingCode><PriorBillingCodes><PriorBillingCode>RS003</PriorBillingCode><PriorBillingCode>SH005</PriorBillingCode></PriorBillingCodes><Name>MiniMizer gastric band (injection port)</Name><Description>Adjustable Silicone band which is placed around the upper part of the stomach to reduce the volume and speed of intake of food. The injection port is used to inflate or deflate the gastric band therefore adjusting the diameter of the band.</Description><Size>Small or medium sized port.</Size><SupplierCode>GQ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1779</GroupID><ARTGs><ARTG>205914</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BE003</BillingCode><Name>CRE8 EVO</Name><Description>Coronary Artery Drug Eluting Stent </Description><Size>Stent Diameter (mm) 2.00, 2.25, 2.50, 2.75, 3.00, 3.50, 4.00, 4.50                           Stent Length(mm): 9, 13, 16, 20, 26, 33, 40, 46</Size><SupplierCode>BE</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>347171</ARTG><ARTG>347172</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BN020</BillingCode><Name>Omniflow II Vascular Prostheses - Straight</Name><Description>Vascular Patch</Description><Size>1.5cm x 5cm (less than 8 sq. Cm)</Size><SupplierCode>BN</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>209</SubCategoryID><GroupID>1640</GroupID><SubGroupID>4458</SubGroupID><ARTGs><ARTG>155500</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BN021</BillingCode><Name>Omniflow II Vascular Prostheses - Straight</Name><Description>Vascular Patch</Description><Size>2.5cm x 10cm (more than 8 sq. cm</Size><SupplierCode>BN</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>209</SubCategoryID><GroupID>1640</GroupID><SubGroupID>4458</SubGroupID><ARTGs><ARTG>155500</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BN028</BillingCode><Name>Omniflow II Vascular Prosthesis</Name><Description>Biosynthetic vascular prosthesis for peripheral revascularisation and vascular access</Description><Size>9 and 10mm internal diameter; 45 to 85cm length</Size><SupplierCode>BN</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4456</SubGroupID><ARTGs><ARTG>155500</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BN026</BillingCode><Name>Omniflow II Vascular Prosthesis</Name><Description>Biosynthetic vascular prosthesis for peripheral revascularisation and vascular access</Description><Size>9 and 10mm internal diameter, 20 to 40cm length</Size><SupplierCode>BN</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4456</SubGroupID><ARTGs><ARTG>155500</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HQ002</BillingCode><Name>SURGITIME PTFE</Name><Description>Surgitime PTFE is a synthetic non-absorbable membrane that is 100% biocompatible and not derived from animal source. This Membrane is considered to be a barrier for tissue regeneration. polytetraflouroethylene membranes or mechanical barriers for guided bone regeneration are used to prevent migration of cells from epithelial and connective tissues, thus providing a proper space for the formation of a natural fibrin structure which is the bone tissue precursor. Surgitime PTFE  are a high-density sheet with a surface structure and porosity suitable to prevent intergration and passage of bacteria within the interstices of the material, and simultaneously facilitate adhesion of the host cells and the material.</Description><Size>30x20mm- Thickness 0,10mm  30x20mm- Thickness 0,25mm</Size><SupplierCode>HQ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1901</GroupID><SubGroupID>6201</SubGroupID><ARTGs><ARTG>247014</ARTG></ARTGs><MinimumBenefit>159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HQ003</BillingCode><Name>SURGITIME Titanium Mesh</Name><Description>Titanium Surgitime is a non absorbable titanium mesh made of pure titanium (ASTM F-67). It comes in many different lengths, widths, thicknesses and hole diameters. It assist bone neoformation, acting as a barrier hindering the migration of epithelial cells and of the conjunctive tissues, thus avoiding competition with the bone graft.</Description><Size>34x25mm- Thickness 0.04mm/Round hole 0,15mm  34x25mm- Thickness 0.04mm/Round hole 0,85mm  34x25mm- Thickness 0,08mm/Round hole 0,85mm</Size><SupplierCode>HQ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4201</SubGroupID><ARTGs><ARTG>247013</ARTG></ARTGs><MinimumBenefit>161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HQ001</BillingCode><Name>Bionnovation Fixation Screws</Name><Description>Craniofacial Bone Screw, non-biodegradable    These are bone screws that are intended to be used to be surgically inserted for the use in bone graft surgery, fixation of grafts and membranes in the maxilla and mandible. </Description><Size>Diameter 1.2mm, Length 4,6,8,10,12,14mm   Diameter 1.4mm, Length 4,6,8,10,12,14mm  Diameter 1.6mm, Length 4,6,8,10,12, 14mm  Diameter 1.8mm, Length 4,6,8,10,12,14mm  </Size><SupplierCode>HQ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>247012</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HQ004</BillingCode><Name>Rex PiezoImplant (Piezoimplant, Retention Screw, Fixture Mount/Temp &amp; cover screw)</Name><Description>The PiezoImplant System is intended for use in Dental Implant applications for oral rehabilitation of edentoulous and partially dentate Patients in the Maxilla and Mandible.The Rex PiezoImplant was designed to manage reduced Crestal Width. Its rectangular section mimics the anatomy of the reduced Crestal bone. This level of bone preservation is not possible with traditional, screw-form implants because their circular section poses a geometrical discrepancy with the anatomy.</Description><Size>1.8mm x 5.0mm (rectangle)in lengths of 9,11,13 &amp; 15mm   2.9mm x 5.0mm (rectangle)in lengths of 9,11,13 &amp; 15mm</Size><SupplierCode>HQ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4392</SubGroupID><ARTGs><ARTG>389951</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HQ005</BillingCode><Name>Rex PiezoImplants Permanent Abutments (No Screw included) </Name><Description>The PiezoImplant System permanent restorations may consist of single crowns or bridges as well as complete or partial dentures. The prosthetic components are connected to the implants by corresponding abutments. The PiezoImplant System is intended for delayed loading. </Description><Size>1.8mm &amp; 2.9mm     </Size><SupplierCode>HQ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4385</SubGroupID><ARTGs><ARTG>389981</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DQ002</BillingCode><Name>Weight Dose Dispensor</Name><Description>Programmable Infusion Pump</Description><Size>50ml</Size><SupplierCode>DQ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4186</SubGroupID><ARTGs><ARTG>321942</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DQ001</BillingCode><Name>BioQ Pharma ReadyfusOR</Name><Description>Non-electric pre-filled infusion pain kit</Description><Size>250 ml</Size><SupplierCode>DQ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1540</GroupID><SubGroupID>4188</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>292140</ARTG></ARTGs><MinimumBenefit>233</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT231</BillingCode><Name>Intica Neo 7 DR-T</Name><Description>Dual Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, DF-1, IS-1 connector</Description><Size>65mm x 55mm x 11mm, 33cm3, 82grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>396265</ARTG></ARTGs><MinimumBenefit>24510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT261</BillingCode><Name>Pamira ProMRI SD </Name><Description>Quadripolar MR conditional ICD lead  with active fixation</Description><Size>Diameter 8.4F , Length/Dist prox. shock coil to tip  61/16cm, 65/16cm, 65/18cm, 75/18cm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><Suffix>e</Suffix><ARTGs><ARTG>412611</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT262</BillingCode><Name>Pamira ProMRI S DX</Name><Description>Pentapolar MR conditional ICD lead  with active fixation  </Description><Size>Diameter 8.4F; Length/Dist Dipole to Tip  65/15 cm , 65/17 cm.  </Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><Suffix>e</Suffix><ARTGs><ARTG>412612</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT227</BillingCode><Name>Rivacor 7 DR-T</Name><Description>Dual Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, ComfortDesign DF4, IS-1 connector</Description><Size>66.5mm x 60mm x 10mm, 32cm3, 77grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>396045</ARTG></ARTGs><MinimumBenefit>24954</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT209</BillingCode><Name>Plexa ProMRI DF-1 S</Name><Description>Tripolar MR conditional ICD lead
with active fixation</Description><Size>Diameter 7.8 F ; Length 65cm ,75cm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><ARTGs><ARTG>298206</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT245</BillingCode><Name>Plexa ProMRI DF4 S DX</Name><Description>Pentapolar MR conditional ICD lead  with active fixation  </Description><Size>Diameter 7.8F; Length/Dist Dipole to Tip  65/15 cm , 65/17 cm.  </Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><ARTGs><ARTG>329340</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT211</BillingCode><Name>Plexa ProMRI DF-1 S DX</Name><Description>Pentapolar MR conditional ICD lead
with active fixation</Description><Size>Diameter 7.8F; Length/Dist Dipole to Tip  65/15 cm , 65/17 cm.</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><ARTGs><ARTG>298208</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT254</BillingCode><Name>ORSIRO Mission</Name><Description>Sirolimus Coronary Artery Stent, Drug Eluting Co/Cr Alloy coated in PLLA</Description><Size>Stent diameters ø 2.25 - 4.0mm Lengths: 9-40mm  </Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>352490</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ151</BillingCode><Name>Amvia Sky DR-T </Name><Description>Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption, atrial anti-tachycardia pacing,  Quick/Early Check, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI Guard 24/7, Closed Loop Stimulation, IS-1 connector</Description><Size>48 x 44 x 6.5 mm, 11 cm3,  23.2 grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>g</Suffix><ARTGs><ARTG>443695</ARTG></ARTGs><MinimumBenefit>6573</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ135</BillingCode><Name>Solvia Rise DR-T</Name><Description>Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption,
EarlyCheck, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry,
Home Monitoring, MRI Guard 24/7, Closed Loop Stimulation, IS-1 connector</Description><Size>48 x 44  x 6.5 mm,  11cm3   23.2g </Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>g</Suffix><ARTGs><ARTG>443693</ARTG></ARTGs><MinimumBenefit>6573</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT212</BillingCode><Name>Plexa ProMRI S</Name><Description>Tripolar MR conditional ICD lead  with active fixation</Description><Size>Diameter 7.8F ; Length 61cm, 65cm , 75cm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><Suffix>e</Suffix><ARTGs><ARTG>298187</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT249</BillingCode><Name>Dynetic-35 Peripheral Balloon-Expandable Stent System</Name><Description> Dynetic-35 is a balloon-expandable  cobalt chromium alloy (L-605) stent pre-mounted on an over-the-wire PTA balloon catheter delivery system.</Description><Size>Diameter: 5-10mm; Length: 18-78mm; Catheter length: 90-170 cm</Size><SupplierCode>BT</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4439</SubGroupID><ARTGs><ARTG>209440</ARTG></ARTGs><MinimumBenefit>1053</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT193</BillingCode><Name>Edora 8 DR-T</Name><Description>Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector</Description><Size>48 x 44 x 6.5 mm, 11 cm3,  23.2 grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>g</Suffix><ARTGs><ARTG>396049</ARTG></ARTGs><MinimumBenefit>6573</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT242</BillingCode><Name>Enitra 8 DR-T</Name><Description>Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption,automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector</Description><Size>11 cm3/ 23.2 g        48 mm × 44 mm × 6.5 mm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>g</Suffix><ARTGs><ARTG>396044</ARTG></ARTGs><MinimumBenefit>6573</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT259</BillingCode><Name>Pamira ProMRI S </Name><Description>Tripolar MR conditional ICD lead  with active fixation</Description><Size>Diameter 8.4F ; Length 61cm, 65cm , 75cm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><Suffix>e</Suffix><ARTGs><ARTG>412610</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT213</BillingCode><Name>Plexa ProMRI SD</Name><Description>Quadripolar MR conditional ICD lead  with active fixation</Description><Size>Diamter 7.8F , Length/Dist prox. shock coil to tip  61/16cm, 65/16cm, 65/18cm, 75/18cm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><Suffix>e</Suffix><ARTGs><ARTG>298343</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT214</BillingCode><Name>Evity 8 DR-T</Name><Description>Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector</Description><Size>IS-1 (2x) 11 cm3/ 23.2 g     48 mm × 44 mm × 6.5 mm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>g</Suffix><ARTGs><ARTG>396051</ARTG></ARTGs><MinimumBenefit>6573</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT224</BillingCode><Name>AlCath Flutter Flux G eXtra</Name><Description>Mapping and Ablation Cardiac Catheter, Gold Tip(G) High Thermal Conduction Ablation, Advanced 3D irrigation (eXtra), FullCircle Deflection, Optimised stability,control &amp; length for flutter</Description><Size>7F ,95cm , 3.5mm Gold tip</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>Biotronik</Suffix><ARTGs><ARTG>221411</ARTG></ARTGs><MinimumBenefit>3280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT203</BillingCode><Name>Edora 8 SR-T</Name><Description>Single Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDect, MRI conditional, IS-1 connector</Description><Size>48 x 40 x 6.5 mm, 10 cm3 , 20.8 grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><Suffix>i</Suffix><ARTGs><ARTG>396052</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT223</BillingCode><Name>AlCath Flux G eXtra</Name><Description>Mapping and Ablation Cardiac Catheter, Advanced 3D irrigation (eXtra), Gold Tip(G) High Thermal Conduction Ablation, FullCircle Deflection</Description><Size>7F , 110cm , 3.5mm irrigated gold tip</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>Biotronik</Suffix><ARTGs><ARTG>193331</ARTG></ARTGs><MinimumBenefit>3280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ134</BillingCode><Name>Amvia Sky SR-T </Name><Description>Single Chamber Pacemaker, ventricular capture control, physiological rate adaption, Quick/Early Check, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI Guard 24/7, Closed Loop Stimulation, IS-1 connector</Description><Size>48 x 40 x 6.5 mm, 10 cm3 , 20.8 grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><Suffix>i</Suffix><ARTGs><ARTG>443694</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT178</BillingCode><Name>Orsiro</Name><Description>Sirolimus Coronary Artery Stent, Drug Eluting Co/Cr Alloy coated in PLLA</Description><Size>Stent diameters ø 2.25 -4.0mm Lengths: 9-40mm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>220414</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT215</BillingCode><Name>Evity 8 SR-T</Name><Description>Single Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDect, MRI conditional, IS-1 connector</Description><Size>IS-1 (1x)   10 cm3/ 20.8g     48 mm × 40 mm × 6.5 mm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><Suffix>i</Suffix><ARTGs><ARTG>396034</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ139</BillingCode><Name>Solvia Rise SR-T</Name><Description>Single Chamber Pacemaker, ventricular capture control, physiological rate adaption,
automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home
Monitoring, MRI Guard 24/7, Closed Loop Stimulation, IS-1 connector</Description><Size>48 x 40  x 6.5 mm,  10cm3   20.8g </Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><Suffix>i</Suffix><ARTGs><ARTG>443692</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT246</BillingCode><Name>CardioMessenger Smart 4G</Name><Description>Bedside/Remote transmitter w/ pacemaker/ICD device life network access to Biotronik standard home monitoring data management service.</Description><Size>Length - 130mm, Width - 65mm,  Height - 13mm        Weight - 75g</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>266</SubCategoryID><GroupID>1832</GroupID><ARTGs><ARTG>352258</ARTG></ARTGs><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT247</BillingCode><Name>BIOMONITOR III m  </Name><Description>Injectable cardiac monitor for continuous remote monitoring of patients with extended AF Detection</Description><Size>77.5 mm x 8.6 mm x 4.6 mm; 4 g; 1.9 cm3</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>293</SubCategoryID><GroupID>2962</GroupID><Suffix>i</Suffix><ARTGs><ARTG>396023</ARTG></ARTGs><MinimumBenefit>2886</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ621</BillingCode><Name>BIOMONITOR IV</Name><Description>Injectable cardiac monitor for continuous remote monitoring of patients </Description><Size>Dimensions (WxHxL) (overall) 77.5 mm x 8.6 mm x 4.6 mm Weight 4 g Volume (overall) 1.9 cm3</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>293</SubCategoryID><GroupID>2962</GroupID><Suffix>i</Suffix><ARTGs><ARTG>445773</ARTG></ARTGs><MinimumBenefit>2886</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT250</BillingCode><Name>ViaCath  20- Pole</Name><Description>Steerable Diagnostic Catheter</Description><Size>6F , 90cm, 2,8,2mm electrode spacing's, 2mm tip , Curve - Extra Large</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Biotronik - 20 pole</Suffix><ARTGs><ARTG>281001</ARTG></ARTGs><MinimumBenefit>1265</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT222</BillingCode><Name>AlCath G FullCircle</Name><Description>Mapping and Ablation Cardiac Catheter, Gold Tip(G) High Thermal Conduction Ablation, FullCircle Deflection, Standard or Long Tip.</Description><Size>7F, 110cm , 4 mm Tip Gold (G) and 8mm (LT) Long Tip Gold(G)</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>281003</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT248</BillingCode><Name>ViaCath 4 &amp; 10 Pole</Name><Description>Steerable Diagnostic Catheter</Description><Size>6F , 110cm , 2mm Electrode tip , Electrode spacing's - various, Curve- standard, large, Extra large</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Biotronik - 4 &amp; 10 pole</Suffix><ARTGs><ARTG>281000</ARTG></ARTGs><MinimumBenefit>885</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT251</BillingCode><Name>MultiCath 4 ,5 &amp; 10 Pole</Name><Description>Steerable Diagnostic Catheter</Description><Size>4,5, 6F ;  80,100,110cm length :  Various Types ; Various Electrode Spacing's ; Curve - Standard or Soft Tipped.</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Biotronik - MultiCath</Suffix><ARTGs><ARTG>280999</ARTG></ARTGs><MinimumBenefit>675</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT225</BillingCode><Name>AlCath Flutter LT G</Name><Description>Mapping and Ablation Cardiac Catheter, Gold Tip(G) High Thermal Conduction Ablation, FullCircle Deflection, Long 8mm Tip (LT), Optimised stability,control &amp; length for flutter</Description><Size>7F , 95cm , 8mm(LT) gold tip</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>221412</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT240</BillingCode><Name>Rivacor 7 HF-T QP</Name><Description>Triple  Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, LV Multipole pacing, Home Monitoring w/ Quickcheck, MRI conditional and AutoDetect, ComfortDesign, DF4,IS-1, IS-4 quadripolar connector,</Description><Size>75mm x 60mm x 10mm, 35cm3, 82grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>396013</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT228</BillingCode><Name>Rivacor 7 HF-T</Name><Description>Triple Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring, MRI conditional and AutoDetect, ComfortDesign DF4, IS-1 connector</Description><Size>71.5mm x 60mm x 10 mm, 33cm3, 78grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>396012</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT232</BillingCode><Name>Intica Neo 7 HF-T</Name><Description>Triple Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, DF-1, IS-1 connector</Description><Size>65mm x 58.5mm x 11mm, 34cm3, 83grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>396008</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT233</BillingCode><Name>Intica Neo 7 HF-T QP</Name><Description>Triple  Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, LV Multipolar pacing, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, DF-1,IS-1, IS4 quadripolar connectors</Description><Size>65mm x 60.5mm x 11mm, 36cm3, 86grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>396009</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT241</BillingCode><Name>Enitra 8 HF-T QP</Name><Description>Triple Chamber CRT-Pacemaker, capture management all chambers, physiological rate adaption, quadripolar LV pacing, atrial overdrive pacing, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional,  IS-4  IS-1 connectors</Description><Size>15 cm3/ 31.2g          53 mm × 53 mm × 6.5 mm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>i</Suffix><ARTGs><ARTG>396000</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT164</BillingCode><Name>Solia S</Name><Description>Sub 6F, steroid-eluting, transvenous, endocardial, bipolar active fixation lead with an extendable/retractable, electrically active screw. MRI conditional</Description><Size>Lengths: 45, 53, 60cm; Diameter: 5.6Fr</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1756</GroupID><ARTGs><ARTG>224786</ARTG></ARTGs><MinimumBenefit>441</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT217</BillingCode><Name>Biotronik Lead Fixation Sleeves</Name><Description>EFH Lead Fixation Sleeves</Description><Size>EFH-7F,8F,16,20,22,25,27</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1765</GroupID><ARTGs><ARTG>250355</ARTG></ARTGs><MinimumBenefit>54</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT185</BillingCode><Name>Sentus ProMRI OTW QP L &amp; S</Name><Description>Quadripolar, steroid eluting left ventricular lead with standard/short pole spacing's and fractal coating. IS4 Connector &amp; MRI Conditional for CRT</Description><Size>Lengths: 77cm, 87 cm, 97cm 4.8F</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1759</GroupID><ARTGs><ARTG>272573</ARTG><ARTG>272574</ARTG><ARTG>312682</ARTG><ARTG>312683</ARTG></ARTGs><MinimumBenefit>2028</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT126</BillingCode><PriorBillingCodes><PriorBillingCode>BT122</PriorBillingCode></PriorBillingCodes><Name>Pulsar 18 Peripheral self expanding Nitinol stent system</Name><Description>Pulsar 18  self expanding Nitinol stent system</Description><Size>Stent: Ø 4- 7mm length: 20-120mm Catheter length: 90-135mm</Size><SupplierCode>BT</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>169368</ARTG><ARTG>313356</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT190</BillingCode><Name>Biotronik BK &amp; BS Sealing Caps &amp; Blind Plugs</Name><Description>BK BS Lead Sealing Caps  BS Device Blind Plugs</Description><Size>BK-IS: IS1/DF1 Caps  BK-IS4/DF4:IS4/DF4 Caps  BS-IS4: BS-IS4 Blind Plugs  BS- IS1 Blind Plugs  BS- DF1 Blind Plugs</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1765</GroupID><ARTGs><ARTG>302014</ARTG><ARTG>302015</ARTG></ARTGs><MinimumBenefit>54</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT243</BillingCode><Name>Enitra 8 HF-T</Name><Description>Triple Chamber CRT Pacemaker, capture management all chambers, physiological rate adaption, atrial overdrive pacing, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional,  IS-1 connector</Description><Size>14 cm3/ 26.9g                    53 mm × 52 mm × 6.5 mm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>i</Suffix><ARTGs><ARTG>395999</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT127</BillingCode><PriorBillingCodes><PriorBillingCode>BT122</PriorBillingCode></PriorBillingCodes><Name>Pulsar 18 Peripheral self expanding Nitinol stent system</Name><Description>Pulsar 18  self expanding Nitinol stent system</Description><Size>Stent: 4-7mm Stent length: 150-200mm Catheter length: 90-135mm</Size><SupplierCode>BT</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>169368</ARTG><ARTG>313356</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT239</BillingCode><Name>Rivacor 7 VR-T</Name><Description>Single Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI Conditional and AutoDetect, ComfortDesign, DF4, IS-1 connector</Description><Size>W x H x D (mm) 61.5 x 60 x 10, Volume: 30cc, Mass: 75g</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d, e</Suffix><ARTGs><ARTG>396233</ARTG></ARTGs><MinimumBenefit>22650</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT216</BillingCode><Name>Solia JT</Name><Description>Sub 6F, steroid-eluting, transvenous, endocardial, bipolar passive fixation lead. MRI conditional</Description><Size>Lengths: 45, 53 cm; Diameter: 5.6Fr</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1753</GroupID><ARTGs><ARTG>294253</ARTG></ARTGs><MinimumBenefit>420</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT163</BillingCode><Name>Solia T</Name><Description>Sub 6F, steoid-eluting transvenous, endocardial, bipolar passive-fixation lead MRI conditional</Description><Size>Lengths: 53, 60cm; Diameter: 5.6Fr</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1753</GroupID><ARTGs><ARTG>224798</ARTG></ARTGs><MinimumBenefit>420</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT255</BillingCode><Name>Passeo-18 Lux</Name><Description>Paclitaxel releasing PTA Balloon Catheter</Description><Size>Catheter length 90-130cm; Balloon diameter 2.0 – 7.0 mm; Balloon Length 40-200 mm; 4F-5F</Size><SupplierCode>BT</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>296</SubCategoryID><GroupID>2967</GroupID><ARTGs><ARTG>275026</ARTG></ARTGs><MinimumBenefit>1245</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ143</BillingCode><Name>Amvia Sky HF-T QP</Name><Description>Triple Chamber CRT Pacemaker, capture management all chambers, physiological rate adaption, quadripolar LV pacing, atrial overdrive pacing, Quick/Early Checks, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI Guard 24/7, MRI AutoDetect, MRI conditional,  IS-1  IS4 connectors</Description><Size>53 x 53 x 6.5 mm, 15cm3,  31.2 grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>i</Suffix><ARTGs><ARTG>443691</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT230</BillingCode><Name>Intica Neo 7 VR-T DX</Name><Description>Single Chamber ICD, ventricular capture control, physiological rate adaption, additional atrial detection (DX),automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, DF-1, IS-1 connector</Description><Size>65mm x 55mm x 11mm, 33cm3, 82grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>396018</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT191</BillingCode><Name>Edora 8 HF-T</Name><Description>Triple Chamber CRT Pacemaker, capture management all chambers, physiological rate adaption, atrial overdrive pacing, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional,  IS-1 connector</Description><Size>53 x 52 x 6.5 mm, 14 cm3,  26.9 grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>i</Suffix><ARTGs><ARTG>396002</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT256</BillingCode><Name>Pantera Lux</Name><Description>Coronary Drug-Coated Balloon Catheter</Description><Size>Diameter (mm) - 2.0 to 4.0  Length (mm) -10 to 30</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>297</SubCategoryID><GroupID>2970</GroupID><ARTGs><ARTG>422261</ARTG></ARTGs><MinimumBenefit>854</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT229</BillingCode><Name>Intica Neo 7 VR-T</Name><Description>Single Chamber ICD, ventricular capture control, physiological rate adaption, automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, DF-1, IS-1 connector</Description><Size>W x H x D (mm) 65 x 55 x 11, Volume: 33cc, Mass: 82g</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>396014</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT220</BillingCode><Name>PK Papyrus Covered Coronary Stent System</Name><Description>Highly flexible, low profile , polyurethane/CoCr Covered Coronary Stent System</Description><Size>Length – 15,20,26mm     Diameter – 5F:2.5,3,3.5,4mm   6F:4.5,5mm</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1767</GroupID><SubGroupID>5349</SubGroupID><Suffix>l, m</Suffix><ARTGs><ARTG>307104</ARTG></ARTGs><MinimumBenefit>2146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT226</BillingCode><Name>Rivacor 7 VR-T DX</Name><Description>Single Chamber ICD, ventricular capture control, physiological rate adaption, additional atrial detection (DX),automatic event (IEGM) &amp; trend triggered transmission. Wandless telemetry, Home Monitoring w/ QuickCheck, MRI conditional and AutoDetect, ComfortDesign DF4, IS-1 connector</Description><Size>66.5mm x 60mm x 10mm, 32cm3, 77grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d, e</Suffix><ARTGs><ARTG>396258</ARTG></ARTGs><MinimumBenefit>22650</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BT199</BillingCode><Name>Edora 8 HF-T QP</Name><Description>Triple Chamber CRT-Pacemaker, capture management all chambers, physiological rate adaption, quadripolar LV pacing, atrial overdrive pacing, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional,  IS-4  IS-1 connectors</Description><Size>53 x 53 x 6.5 mm, 15cm3,  31.2 grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>i</Suffix><ARTGs><ARTG>396005</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ133</BillingCode><Name>Amvia Sky HF-T</Name><Description>Triple Chamber CRT Pacemaker, capture management all chambers, physiological rate adaption, atrial overdrive pacing, Quick/Early Check, event triggered IEMG transmission, Wandless telemetry, Home Monitoring, MRI Guard 24/7, MRI AutoDetect, MRI conditional,  IS-1 connector</Description><Size>53 x 52 x 6.5 mm, 14 cm3,  26.9 grams</Size><SupplierCode>BT</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>i</Suffix><ARTGs><ARTG>443690</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ293</BillingCode><Name>Variable Angle Locking Screw</Name><Description>Stainless steel screw</Description><Size>Diameter 3.5mm, Length 10mm to 90mm</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>433151</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ291</BillingCode><Name>CASCELLA 3.5mm Superior Clavicle Plate</Name><Description>Superior Clavicle Plate</Description><Size>7 and 9 holes</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ281</BillingCode><Name>TAMINA 3.5mm Proximal Humerus Plate</Name><Description>Proximal Humerus Plate</Description><Size>Standard and TF Plates, 3 to 5 holes</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LQ002</BillingCode><Name>SALTI 2.5/3.5MM Ankle System</Name><Description>Distal Fibular Plates</Description><Size>9 or 14 holes, Left and Right, Length 97mm to 172mm</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>468027</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LQ007</BillingCode><Name>SITTER 3.5mm Versatile Plate</Name><Description>Versatile Plate</Description><Size>7 to 15 holes, Length 98mm to 202mm.</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LQ005</BillingCode><Name>CASCELLA 3.5mm Superior Clavicle Plate Lateral</Name><Description>Superior Clavicle Plate Lateral</Description><Size>9, 12 and 15 holes, Left and Right, Length 75mm to 143mm.</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ260</BillingCode><Name>LORRAINE 3.5mm Distal Humerus Plate</Name><Description>Distal Humerus Plate</Description><Size>Medial and Posterolateral, 4 and 5 holes</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ261</BillingCode><Name>LORRAINE 3.5mm Distal Humerus Plate</Name><Description>Distal Humerus Plate</Description><Size>Posterolateral and Extraarticular, 8 to 13 holes</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LQ004</BillingCode><Name>SALGINA 2.5mm Wrist Spanning Plate</Name><Description>Wrist Spanning Plate</Description><Size>10mm wide, 195mm long</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>468027</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ262</BillingCode><Name>DALVAZZA 2.5mm Distal Ulna Plate</Name><Description>Distal Ulna Plate</Description><Size>One size only</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LQ003</BillingCode><Name>SALTI 2.5/3.5MM Ankle System</Name><Description>Distal Tibia Plate</Description><Size>7-15 holes, Left and Right, Length 65mm to 293mm</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>468027</ARTG></ARTGs><MinimumBenefit>1489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ264</BillingCode><Name>POYA 3.5mm Lateral Proximal Tibia Plate</Name><Description>Lateral Proximal Tibia Plate</Description><Size>4 to 9 holes</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>1489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ292</BillingCode><Name>Cortical Bone Screw</Name><Description>Stainless steel bone screw</Description><Size>Diameter 3.5mm, Length 10mm to 90mm</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>433151</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ284</BillingCode><Name>Variable Angle Locking Screw Diameter 2.5mm</Name><Description>Variable Angle Locking Screw</Description><Size>10mm to 30mm</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>433151</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ283</BillingCode><Name>Cortical Screw Diameter 2.5mm</Name><Description>Cortical Screw</Description><Size>10mm to 30mm</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>433151</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ265</BillingCode><Name>POYA 3.5mm Medial and Posteromedial Tibia Plate</Name><Description>Medial and Posteromedial Tibia Plate</Description><Size>Left and Right, 3 to 10 holes, Length 80mm to 215mm</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>1489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ297</BillingCode><Name>TAMINA 3.5mm Proximal Humerus Plate</Name><Description>Proximal Humerus Plate</Description><Size>Standard and TF Plates 5, 9 to 13 holes, long</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5275</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>1643</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ280</BillingCode><Name>SALGINA 2.5mm Distal Radius Plate</Name><Description>Volar and Dorsal Distal Radius Plate</Description><Size>Narrow, wide, long narrow, long wide, standard, distal narrow, and distal wide, Left and Right</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG><ARTG>468027</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LQ006</BillingCode><Name>SITTER 3.5mm Versatile Plate</Name><Description>Versatile Plate</Description><Size>19 to 23 holes, Length 254mm to 305mm.</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>810</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ263</BillingCode><Name>POYA 3.5mm Lateral and Posteromedial Proximal Tibia Plate</Name><Description>Lateral and Posteromedial Proximal Tibia Plate</Description><Size>13 to 18 holes</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>1636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ257</BillingCode><Name>LEPORELLO 3.5mm Olecranon Plate</Name><Description>3.5mm Olecranon Plate</Description><Size>7, 9 and 11 holes</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5280</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>433150</ARTG></ARTGs><MinimumBenefit>1198</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LQ001</BillingCode><Name>SALTI 2.5/3.5MM Ankle System</Name><Description>Medial Distal Tibia Plate</Description><Size>16 or 19 holes, Left and Right, Length 233mm to 293mm</Size><SupplierCode>LQ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>468027</ARTG></ARTGs><MinimumBenefit>1636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS389</BillingCode><Name>WaveWriter Alpha</Name><Description>16 or 32-output, multi-channel, zero-volt rechargeable neurostimulation system IPG with Combination Therapy, Sub-Perception Algorithms and Waveform Automation</Description><Size>One Size Only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1677</GroupID><SubGroupID>4481</SubGroupID><Suffix>Adaptive Stimulation, Unlimited Deep Discharge Battery</Suffix><ARTGs><ARTG>400374</ARTG><ARTG>400392</ARTG></ARTGs><MinimumBenefit>23465</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS324</BillingCode><Name>Vercise M8 and S8 Adapter</Name><Description>1 x 8 in-line connector designed to connect another manufacturer's previously implanted lead extensions to the Vercise Stimulator</Description><Size>15, 55cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4477</SubGroupID><ARTGs><ARTG>281579</ARTG><ARTG>462220</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS370</BillingCode><PriorBillingCodes><PriorBillingCode>MB025</PriorBillingCode></PriorBillingCodes><Name>TraceIT Gel System</Name><Description>TraceIT System is intended to create a temporary space within soft tissue during radiation therapy.</Description><Size>3mL</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>187</SubCategoryID><GroupID>1792</GroupID><SubGroupID>6061</SubGroupID><ARTGs><ARTG>268092</ARTG></ARTGs><MinimumBenefit>843</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS446</BillingCode><PriorBillingCodes><PriorBillingCode>XP004</PriorBillingCode><PriorBillingCode>UW004</PriorBillingCode></PriorBillingCodes><Name>Axonics Patient Remote Control</Name><Description>Remote patient controller for Axonics Sacral Neurmodulation System</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1713</GroupID><SubGroupID>5337</SubGroupID><ARTGs><ARTG>325941</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS408</BillingCode><Name>AMS 800 Urinary Control System with InhibiZone - cuff</Name><Description>Occlusive Cuff with InhibiZone Antibiotic Surface Treatment</Description><Size>13 Cuff sizes from 3.5 to 11.0 cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1696</GroupID><SubGroupID>5307</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>165326</ARTG><ARTG>352830</ARTG></ARTGs><MinimumBenefit>2708</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS461</BillingCode><Name>AMS 700 Series Inflatable Penile Prosthesis with TENACIO Pump Accessory Kit</Name><Description>AMS 700 Pump Accessory Kit (blunt needles; Keith needles, tubing, connectors, plugs).</Description><Size>One Size</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5334</SubGroupID><ARTGs><ARTG>390412</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS328</BillingCode><Name>Eluvia</Name><Description>Drug Eluting Vascular Stent System</Description><Size>Diameter 6-7mm, Stent Length 150mm</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1624</GroupID><SubGroupID>6562</SubGroupID><Suffix>≥150mm</Suffix><ARTGs><ARTG>285061</ARTG><ARTG>459345</ARTG></ARTGs><MinimumBenefit>2643</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS425</BillingCode><Name>AMS 800 Artificial Urinary Sphincter Cuff</Name><Description>Occlusive Cuff</Description><Size>13 Cuff sizes from 3.5 to 11.0 cm: Size: 3.5, 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 9, 10, 11cm  </Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1696</GroupID><SubGroupID>5307</SubGroupID><ARTGs><ARTG>390349</ARTG></ARTGs><MinimumBenefit>2483</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS327</BillingCode><Name>Eluvia</Name><Description>Drug Eluting Vascular Stent System</Description><Size>Diameter 6-7mm, Length 40-120mm</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1624</GroupID><SubGroupID>6562</SubGroupID><Suffix>&lt;150mm</Suffix><ARTGs><ARTG>285061</ARTG><ARTG>459345</ARTG></ARTGs><MinimumBenefit>2033</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS422</BillingCode><Name>AMS 700 Series Inflatable Penile Prostheses Reservoir non Inhibizone  </Name><Description>700 Series (Non InhibiZone)  </Description><Size>100ml  </Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5331</SubGroupID><ARTGs><ARTG>390412</ARTG></ARTGs><MinimumBenefit>1705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS445</BillingCode><PriorBillingCodes><PriorBillingCode>XP003</PriorBillingCode><PriorBillingCode>UW003</PriorBillingCode></PriorBillingCodes><Name>Axonics Neurostimulator</Name><Description>Rechargeable neurostimulator for sacral nerve stimulation</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>2950</GroupID><ARTGs><ARTG>390437</ARTG></ARTGs><MinimumBenefit>9606</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS434</BillingCode><Name>Axonics R20 Sacral Neurostimulator System model 5101</Name><Description>Rechargeable sacral neurostimulator</Description><Size>5cc</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>2950</GroupID><ARTGs><ARTG>462565</ARTG></ARTGs><MinimumBenefit>9606</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS423</BillingCode><Name>AMS 700 Series Inflatable Penile Prostheses Accessory Kit  </Name><Description>700 Series (Non InhibiZone)  </Description><Size>One Size  </Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5334</SubGroupID><ARTGs><ARTG>390412</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS317</BillingCode><Name>HOT AXIOS</Name><Description>Stent with Electrocautery Enhanced Delivery System for use in pseudocyst drainage. Self-expanding nitinol stent</Description><Size>Length 8-15mm, Lumen Diameter 6-20mm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1561</GroupID><SubGroupID>6011</SubGroupID><Suffix>Electrocautery</Suffix><ARTGs><ARTG>282177</ARTG></ARTGs><MinimumBenefit>4345</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS333</BillingCode><Name>Bipolar Lead Extender Model 6987</Name><Description>Bipolar 3.2mm to IS-1 lead extender</Description><Size>45cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>245</SubCategoryID><GroupID>1764</GroupID><ARTGs><ARTG>218790</ARTG></ARTGs><MinimumBenefit>208</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AM048</BillingCode><Name>AdVance XP Male Sling System</Name><Description>Sub-urethral sling implant for treatment of male stress urinary incontinence. Made from polypropylene monofilament mesh</Description><Size>Arm width: 1.2cm, Centre width: 3.55cm, Total Length: 35.5cm, 43.5cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1698</GroupID><SubGroupID>5314</SubGroupID><ARTGs><ARTG>388078</ARTG><ARTG>388082</ARTG></ARTGs><MinimumBenefit>5432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS451</BillingCode><PriorBillingCodes><PriorBillingCode>XP009</PriorBillingCode><PriorBillingCode>UW009</PriorBillingCode></PriorBillingCodes><Name>Axonics Foramen Needles</Name><Description>6 Foramen needles</Description><Size>Short and Long</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1715</GroupID><SubGroupID>5343</SubGroupID><ARTGs><ARTG>298140</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS276</BillingCode><Name>AUTOGEN ICD VR DF-4</Name><Description>Single Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector</Description><Size>26.5cc - 29.5cc, 60.0g - 68.9g, 9.9mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d, e</Suffix><ARTGs><ARTG>400122</ARTG><ARTG>400181</ARTG></ARTGs><MinimumBenefit>22650</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS428</BillingCode><Name>AMS 800 Artificial Urinary Sphincter Accessory Kit  </Name><Description>Accessory Kit  </Description><Size>One Size  </Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1696</GroupID><SubGroupID>5310</SubGroupID><ARTGs><ARTG>390349</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS392</BillingCode><Name>Blazer Dx-20</Name><Description>Steerable Diagnostic Catheter </Description><Size>Various</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Boston Scientific. Deflecting, 20-pole</Suffix><ARTGs><ARTG>170631</ARTG></ARTGs><MinimumBenefit>1265</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS278</BillingCode><Name>AUTOGEN ICD VR DF-1</Name><Description>Single Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector</Description><Size>28.5cc -31.5cc, 61.9g - 70.7g, 9.9mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>400123</ARTG><ARTG>400437</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS338</BillingCode><Name>RESONATE EL VR DF-4</Name><Description>Single Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector. ENDURALIFE Battery Technology and IMAGEREADY MR-Conditional</Description><Size>29.5cc, 68.9g, 5.37 x 7.36 x 0.99 (cm)</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d, e</Suffix><ARTGs><ARTG>399063</ARTG></ARTGs><MinimumBenefit>22650</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS340</BillingCode><Name>MOMENTUM EL VR DF-1</Name><Description>Single Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector. ENDURALIFE Battery Technology</Description><Size>29.5cc, 68.9g, 5.37 x 7.79 x 0.99 cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>399064</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS396</BillingCode><Name>Dynamic XT</Name><Description>Steerable Diagnostic Catheters</Description><Size>Various</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Boston Scientific, Deflecting, 10-pole</Suffix><ARTGs><ARTG>281428</ARTG></ARTGs><MinimumBenefit>750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS121</BillingCode><Name>Precision SCS IPG Port</Name><Description>IPG Port Plug</Description><Size>One Size Only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4500</SubGroupID><ARTGs><ARTG>156761</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS398</BillingCode><Name>Woven, WovenFlexi</Name><Description>Fixed Curve Diagnostic Catheter </Description><Size>Various</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Boston Scientific, Fixed</Suffix><ARTGs><ARTG>281436</ARTG><ARTG>281442</ARTG></ARTGs><MinimumBenefit>225</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS436</BillingCode><Name>Vercise Dual Lead Extension</Name><Description>2 lead extensions braided together to form a single lead extension which connects to 2 DBS brain leads</Description><Size>55 &amp; 95 cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4477</SubGroupID><Suffix>Dual Lead Extensions</Suffix><ARTGs><ARTG>363575</ARTG></ARTGs><MinimumBenefit>2558</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS437</BillingCode><Name>Vercise 16 Contact Dual Lead Extension</Name><Description>2 lead extensions braided together to form a single lead extension which connects to 16 DBS contacts</Description><Size>55 &amp; 95 cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4477</SubGroupID><Suffix>Dual Lead Extensions</Suffix><ARTGs><ARTG>487247</ARTG></ARTGs><MinimumBenefit>2558</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS393</BillingCode><Name>Polaris X</Name><Description>Steerable Diagnostic Catheters</Description><Size>Various</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Boston Scientific, Deflecting, 10-pole</Suffix><ARTGs><ARTG>164184</ARTG></ARTGs><MinimumBenefit>750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS247</BillingCode><Name>Stylet Kit</Name><Description>Stylet Kit with steering cap and stiffer stylet</Description><Size>Stiffer stylet length: Up to 74cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>156759</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS401</BillingCode><Name>Viking, Viking Soft Tip</Name><Description>Fixed Curve Diagnostic Catheters</Description><Size>Various</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Boston Scientific, Fixed</Suffix><ARTGs><ARTG>281431</ARTG><ARTG>285279</ARTG></ARTGs><MinimumBenefit>225</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS212</BillingCode><Name>Pacemaker/Defibrillator port safety plug</Name><Description>Pacemaker/Defibrillator Plug that seals unused IS-1/DF-1 or IS-4/DF-4 port</Description><Size>3.2mm x 38mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1765</GroupID><ARTGs><ARTG>190242</ARTG></ARTGs><MinimumBenefit>54</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS399</BillingCode><Name>Dynamic </Name><Description>Steerable Diagnostic Catheter</Description><Size>110 cm, 6F</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Boston Scientific, Deflecting</Suffix><ARTGs><ARTG>281427</ARTG></ARTGs><MinimumBenefit>400</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS359</BillingCode><Name>IntellaMap Orion High Resolution Mapping Catheter</Name><Description>High resolution 64-electrode steerable mapping catheter</Description><Size>8.5F, 115cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Boston Scientific</Suffix><ARTGs><ARTG>271032</ARTG></ARTGs><MinimumBenefit>1900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS444</BillingCode><PriorBillingCodes><PriorBillingCode>XP002</PriorBillingCode><PriorBillingCode>UW002</PriorBillingCode></PriorBillingCodes><Name>Axonics PNE Lead Implant Kit</Name><Description>Peripheral Nerve Evaluation Kit including lead, cables and implant tools</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1714</GroupID><SubGroupID>6036</SubGroupID><ARTGs><ARTG>298140</ARTG><ARTG>312912</ARTG></ARTGs><MinimumBenefit>753</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS341</BillingCode><Name>MOMENTUM EL DR DF-1</Name><Description>Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector. ENDURALIFE Battery Technology</Description><Size>31.5cc, 71.0g, 5.37 x 7.79 x 0.99cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>399571</ARTG></ARTGs><MinimumBenefit>24510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS443</BillingCode><PriorBillingCodes><PriorBillingCode>XP001</PriorBillingCode><PriorBillingCode>UW001</PriorBillingCode></PriorBillingCodes><Name>Axonics Tined Lead Extension</Name><Description>Percutaneous extension</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1714</GroupID><SubGroupID>5341</SubGroupID><ARTGs><ARTG>312913</ARTG><ARTG>325940</ARTG></ARTGs><MinimumBenefit>1434</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS279</BillingCode><Name>AUTOGEN ICD DR DF-1</Name><Description>Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-1 RV connector</Description><Size>28.5cc - 31.5cc, 62.3g - 71g, 9.9mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>400129</ARTG><ARTG>400131</ARTG></ARTGs><MinimumBenefit>24510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS435</BillingCode><Name>Axonics F15 Sacral Neuromodulation System model 4101</Name><Description>Implantable pulse generator for sacral nerve stimulation</Description><Size>10cc</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1712</GroupID><SubGroupID>7380</SubGroupID><ARTGs><ARTG>448867</ARTG></ARTGs><MinimumBenefit>9606</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS094</BillingCode><Name>Contour VL; Stretch VL Flexima; Ureteral Stents</Name><Description>Ureteral stent with attached suture</Description><Size>Diameters up to 14Fr &amp; lengths up to 40cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1702</GroupID><SubGroupID>5325</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>129376</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS091</BillingCode><Name>Percuflex; Percuflex Plus; Percuflex Plus SureDrive</Name><Description>Ureteral stent with attached suture</Description><Size>Diameters up to 14Fr &amp; lengths up to 40cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>104324</ARTG><ARTG>132306</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS277</BillingCode><Name>AUTOGEN ICD DR DF-4</Name><Description>Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector</Description><Size>28.0cc - 31.0cc, 62.5g - 71.4g, 9.9mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>400130</ARTG><ARTG>400259</ARTG></ARTGs><MinimumBenefit>24954</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS092</BillingCode><Name>Contour Ureteral Stent, Contour SureDrive Ureteral Stent</Name><Description>Ureteral stent with attached suture</Description><Size>Diameters up to 14Fr &amp; lengths up to 40cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>104324</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS363</BillingCode><Name>Tria Ureteral Stent</Name><Description>Tria Firm or Tria Soft ureteral stent. Tria Firm or Tria Soft ureteral stent kit with Sensor or ZIPwire Guidewire</Description><Size>Diameters up to 8Fr &amp; lengths up to 30cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>129376</ARTG><ARTG>410924</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS442</BillingCode><PriorBillingCodes><PriorBillingCode>SC001</PriorBillingCode><PriorBillingCode>JJ802</PriorBillingCode></PriorBillingCodes><Name>BULKAMID Urethral Bulking System</Name><Description>Transparent polyacrylamide gel for female urinary incontinence. Kit comprises 2 syringe, 2 needles, 1 applicator</Description><Size>2 x 1ml syringes, 2 x BULKAMID 23G needles, 1 x disposable sheath</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1699</GroupID><SubGroupID>5318</SubGroupID><ARTGs><ARTG>150554</ARTG></ARTGs><MinimumBenefit>1009</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS086</BillingCode><Name>Polaris Ultra Ureteral Stent</Name><Description>Dual durometer ureteral stent with attached suture</Description><Size>Diameters up to 14Fr &amp; lengths up to 40cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>104324</ARTG><ARTG>129379</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS116</BillingCode><Name>Polaris Loop Ureteral Stent</Name><Description>Dual durometer ureteral stent with attached suture</Description><Size>Diameters up to 14Fr &amp; lengths up to 40cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>104324</ARTG><ARTG>129376</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS196</BillingCode><Name>Innova Self-Expanding Stent</Name><Description>Nitinol, self expanding stent</Description><Size>Diameters up to 8mm, lengths less than 150mm</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>104281</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ179</BillingCode><Name>SYNERGY SHIELD</Name><Description>Everolimus-Eluting Platinum Chromium Coronary Stent System with Bioabsorbable Polymer
</Description><Size>8mm to 48mm in length, diameter of 2.25 mm - 5.0 mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>424111</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS427</BillingCode><Name>AMS 800 Artificial Urinary Sphincter Pump</Name><Description>Control Pump</Description><Size>One size</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1696</GroupID><SubGroupID>5306</SubGroupID><ARTGs><ARTG>390349</ARTG></ARTGs><MinimumBenefit>4700</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS409</BillingCode><Name>AMS 800 Urinary Control System Pump</Name><Description>Pump with InhibiZone Antibiotic Surface Treatment</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1696</GroupID><SubGroupID>5306</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>165326</ARTG><ARTG>352830</ARTG></ARTGs><MinimumBenefit>5076</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS452</BillingCode><PriorBillingCodes><PriorBillingCode>XP010</PriorBillingCode><PriorBillingCode>UW010</PriorBillingCode></PriorBillingCodes><Name>Axonics Stimulation Cable</Name><Description>Cable for trial and implant</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1715</GroupID><SubGroupID>5517</SubGroupID><ARTGs><ARTG>314969</ARTG></ARTGs><MinimumBenefit>190</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ319</BillingCode><PriorBillingCodes><PriorBillingCode>ER650</PriorBillingCode></PriorBillingCodes><Name>Apollo Endosurgery X-Tack™ Endoscopic HeliX Tacking System</Name><Description>The X-Tack™ System is intended for approximation of soft tissue in minimally invasive gastroenterology procedures (e.g. closure and healing of ESD/EMR sites, and closing of fistula, perforation or leaks).using tensioned helical tacks.     The X-Tack system comprises respective delivery systems for tacking and cinching; tethered stainless steel HeliX tacks; and a PEEK cinch system.    1. The delivery system is composed of biocompatible plastic and drives the HeliX tacks into the tissue. This is replaced with the PEEK cinching system when the defect is ready for compression.  2. The stainless steel HeliX tacks are placed around the defect with the tether providing compression when tensioned and so enabling closure.  Compression is maintained using a PEEK cinch which terminates the closing construct.  3. The PEEK cinching system is a delivery system that deploys a PEEK plug/collar to the tethering system to ensure the tissue in the defect area remains compressed.</Description><Size>160 and 235 cm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic, OTS</Suffix><ARTGs><ARTG>376194</ARTG></ARTGs><MinimumBenefit>2002</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS395</BillingCode><Name>Synergy Megatron</Name><Description>Everolimus-Eluting Platinum Chromium Coronary Stent System with Bioabsorbable Polymer</Description><Size>8 mm to 32 mm in length, diameter of 3.50 mm - 5.00 mm (over expansion capability to 6.00 mm)</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>380476</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS366</BillingCode><Name>Promus ELITE</Name><Description>Everolimus-Eluting Platinum Chromium Coronary Stent System</Description><Size>8mm - 38mm in length, diameter of 2.25mm - 4.0mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>327735</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS397</BillingCode><Name>SYNERGY XD</Name><Description>Everolimus-Eluting Platinum Chromium Coronary Stent System with Bioabsorbable Polymer</Description><Size>8mm to 48mm in length, diameter of 2.25 mm - 5.0 mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>365215</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS059</BillingCode><Name>Express Vascular LD Stent; Express Vascular SD Stent</Name><Description>Stainless Steel, Balloon Expanding Stent</Description><Size>Stent Diameters up to 10mm and lengths up to 60mm</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4439</SubGroupID><ARTGs><ARTG>153169</ARTG></ARTGs><MinimumBenefit>1053</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS387</BillingCode><Name>Vercise Genus</Name><Description>Dual Channel,16 &amp; 32 Contact, Zero Volt Rechargeable Deep Brain Stimulation IPG with anodic stimulation</Description><Size>52 mm x 46 mm x 11 mm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1672</GroupID><SubGroupID>4473</SubGroupID><Suffix>Unlimited Deep Discharge Battery</Suffix><ARTGs><ARTG>400411</ARTG><ARTG>400423</ARTG></ARTGs><MinimumBenefit>19855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS415</BillingCode><Name>FARAPULSE Pulsed Field Ablation System</Name><Description>Pulsed Field Ablation (PFA) System - FARAWAVE PFA Catheter</Description><Size>Distal Diameter 31 - 35 mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2966</GroupID><SubGroupID>7379</SubGroupID><Suffix>Boston Scientific</Suffix><ARTGs><ARTG>443310</ARTG><ARTG>485052</ARTG></ARTGs><MinimumBenefit>6399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS454</BillingCode><Name>FARAPOINT Pulsed Field Ablation Catheter</Name><Description>The FARAPOINT Pulsed Field Ablation Catheter is a single-use, bi-directional, steerable catheter with magnetic tracking, intended for the delivery of pulsed field energy for cardiac ablation and mapping. </Description><Size>8F, usable length 115 cm, number of electrodes: 4, electrode spacing: 1.5 mm – 6.0 mm – 1.5 mm, tip diameter: 2.5 mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2966</GroupID><SubGroupID>7379</SubGroupID><Suffix>Boston Scientific</Suffix><ARTGs><ARTG>522268</ARTG></ARTGs><MinimumBenefit>4299</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS431</BillingCode><Name>FARAWAVE NAV</Name><Description>Navigation enabled FARAWAVE Pulsed Field Ablation catheter</Description><Size>Distal Diameter 31 - 35 mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2966</GroupID><SubGroupID>7379</SubGroupID><Suffix>Boston Scientific</Suffix><ARTGs><ARTG>469731</ARTG></ARTGs><MinimumBenefit>6399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS137</BillingCode><Name>EPIC Nitinol Stent</Name><Description>Nitinol self expanding stent</Description><Size>Stent diameters up to 14mm and lengths up to 120mm</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>231681</ARTG><ARTG>468825</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS056</BillingCode><Name>Carotid WALLSTENT</Name><Description>Elgiloy self expanding stent</Description><Size>Stent diameters up to 10mm and lengths up to 40mm</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>166856</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS261</BillingCode><Name>RELIANCE 4-FRONT</Name><Description>Passive, single/dual coil, defibrillation lead</Description><Size>Length: 59cm - 70cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1741</GroupID><Suffix>e</Suffix><ARTGs><ARTG>217433</ARTG><ARTG>217434</ARTG><ARTG>217435</ARTG><ARTG>303417</ARTG></ARTGs><MinimumBenefit>2012</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS299</BillingCode><Name>Resolution 360</Name><Description>Radiopaque, single-use clip pre-loaded on a flexible, rotatable delivery system</Description><Size>11mm jaw opening</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>271874</ARTG></ARTGs><MinimumBenefit>125</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS405</BillingCode><Name>INTELLANAV STABLEPOINT</Name><Description>Open Irrigated Ablation bidirectional catheter with Total Tip Cooling Design technology; Contact Force Sensing</Description><Size>110cm, shaft size 7.5F</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>Boston Scientific</Suffix><ARTGs><ARTG>354210</ARTG></ARTGs><MinimumBenefit>3549</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS361</BillingCode><Name>IntellaNav™ MiFi™ Open-Irrigated Ablation Catheter</Name><Description>IntellaNav™ Open-Irrigated, MiFi™ Mini-electrode Technology, Nav-abled</Description><Size>110cm, shaft size 7.5F</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>Boston Scientific</Suffix><ARTGs><ARTG>300198</ARTG></ARTGs><MinimumBenefit>3549</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS433</BillingCode><Name>Mantis</Name><Description>Mantis clip with TrueGrip anchor </Description><Size>11 mm jaw opening</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic, Dual Action</Suffix><ARTGs><ARTG>271874</ARTG></ARTGs><MinimumBenefit>350</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS380</BillingCode><Name>Blazer™ Open Irrigated Ablation Catheter </Name><Description>Open Irrigated Ablation bidirectional catheter with Total Tip Cooling™ Design technology</Description><Size>110cm, shaft size 7.5F</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>Boston Scientific</Suffix><ARTGs><ARTG>186659</ARTG></ARTGs><MinimumBenefit>3549</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS379</BillingCode><Name>Resolution 360 Ultra Clip</Name><Description>Radiopaque, single-use clip pre-loaded on a flexible, rotatable delivery system</Description><Size>17mm jaw opening</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>271874</ARTG></ARTGs><MinimumBenefit>125</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS385</BillingCode><Name>IntellaTip MiFi™ Open Irrigated Ablation Catheter</Name><Description>Intella MiFi™ Mini- electrode Technology; Open-Irrigated</Description><Size>110cm, shaft size 7.5F</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>Boston Scientific</Suffix><ARTGs><ARTG>231654</ARTG></ARTGs><MinimumBenefit>3549</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS242</BillingCode><Name>Boston Scientific DBS OR Cable &amp; Extension</Name><Description>OR cable and extension for DBS</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4479</SubGroupID><ARTGs><ARTG>157994</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS448</BillingCode><PriorBillingCodes><PriorBillingCode>XP006</PriorBillingCode><PriorBillingCode>UW006</PriorBillingCode></PriorBillingCodes><Name>Axonics Trial Stimulator</Name><Description>External neurostimulator with belt</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1713</GroupID><SubGroupID>5518</SubGroupID><ARTGs><ARTG>313220</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS248</BillingCode><Name>OR Cable</Name><Description>OR Cable</Description><Size>Lengths up to 65cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>5484</SubGroupID><ARTGs><ARTG>157994</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS400</BillingCode><Name>EMBOLD Fully Retractable Coils</Name><Description>Platinum-tungsten, Fibered Occlusion System </Description><Size>Coil diameters up to 32mm and lengths up to 60cm, Delivery system lengths up to 200 cm</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5472</SubGroupID><Suffix>P, repositionable (Platinum, repositionable)</Suffix><ARTGs><ARTG>322240</ARTG></ARTGs><MinimumBenefit>825</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS450</BillingCode><PriorBillingCodes><PriorBillingCode>XP008</PriorBillingCode><PriorBillingCode>UW008</PriorBillingCode></PriorBillingCodes><Name>Axonics Lead Implant Kit</Name><Description>Lead introducer kit including needles, sheath and tools</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1715</GroupID><SubGroupID>5342</SubGroupID><ARTGs><ARTG>298140</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS021</BillingCode><Name>Interlock Detachable Coils</Name><Description>Platinum-tungsten, Fibered Occlusion System</Description><Size>Coil diameters up to 30mm and lengths up to 100cm. Delivery system lengths up 200cm</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5472</SubGroupID><Suffix>P, ids (Platinum, integral delivery system)</Suffix><ARTGs><ARTG>293646</ARTG><ARTG>322240</ARTG></ARTGs><MinimumBenefit>825</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS026</BillingCode><Name>VortX and Pushable Coils</Name><Description>Pushable coils</Description><Size>Diameters up to 30mm and lengths up to 60mm</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5472</SubGroupID><Suffix>P (Platinum)</Suffix><ARTGs><ARTG>293646</ARTG></ARTGs><MinimumBenefit>116</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS184</BillingCode><Name>Advanix Plastic Stent</Name><Description>Plastic stent manufactured individually</Description><Size>5-18cm length, 7-10 FR diameter</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><SubGroupID>4218</SubGroupID><ARTGs><ARTG>127387</ARTG></ARTGs><MinimumBenefit>74</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS173</BillingCode><Name>Advanix Plastic Stent with Naviflex Delivery System</Name><Description>Plastic stent manufactured pre loaded on a delivery catheter</Description><Size>5-18cm length, 7-10 FR diameter</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><SubGroupID>4218</SubGroupID><Suffix>Delivery System</Suffix><ARTGs><ARTG>127387</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS225</BillingCode><Name>Speedband Superview Super 7</Name><Description>Multiple Band Ligator</Description><Size>7 bands per unit, compatible with scopes with outer diameter of 8.6mm - 11.5mm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>5490</SubGroupID><ARTGs><ARTG>443901</ARTG></ARTGs><MinimumBenefit>236</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS447</BillingCode><PriorBillingCodes><PriorBillingCode>XP005</PriorBillingCode><PriorBillingCode>UW005</PriorBillingCode></PriorBillingCodes><Name>Axonics Charging System</Name><Description>Charger and dock with belt and adhesive carriers for Axonics Sacral Neuromodulation System</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1713</GroupID><SubGroupID>7367</SubGroupID><ARTGs><ARTG>297956</ARTG></ARTGs><MinimumBenefit>1215</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS414</BillingCode><Name>AMS 700 Series Inflatable Penile Prostheses InhibiZone Reservoir</Name><Description>700 Series InhibiZone</Description><Size>50, 65, 100ml</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5331</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>125444</ARTG><ARTG>352831</ARTG></ARTGs><MinimumBenefit>1881</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS457</BillingCode><Name>AMS 700 Series Inflatable Penile Prosthesis with TENACIO Pump</Name><Description>AMS 700 series Inflatable Penile implant with TENACIO Pump</Description><Size>One Size</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5332</SubGroupID><ARTGs><ARTG>390412</ARTG></ARTGs><MinimumBenefit>4076</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS412</BillingCode><Name>AMS 700 Series Inflatable Penile Prostheses with InhibiZone Pump</Name><Description>700 Series with InhibiZone</Description><Size>One Size</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5332</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>125444</ARTG><ARTG>352831</ARTG></ARTGs><MinimumBenefit>4432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS253</BillingCode><Name>Precision Spectra Patient Remote Programmer</Name><Description>Hand held remote control External Patient Programmer</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4483</SubGroupID><ARTGs><ARTG>206305</ARTG><ARTG>206306</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AM042</BillingCode><Name>AMS700 Series Inflatable Penile Prosthesis Pump</Name><Description>700 Series (Non InhibiZone)</Description><Size>One Size</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5332</SubGroupID><ARTGs><ARTG>390412</ARTG></ARTGs><MinimumBenefit>4076</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS367</BillingCode><Name>Tactra</Name><Description>Malleable Penile Prosthesis</Description><Size>9.5mm - 13mm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1721</GroupID><ARTGs><ARTG>329551</ARTG></ARTGs><MinimumBenefit>776</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS229</BillingCode><Name>Flexima vanSonnenburg Sump Catheter</Name><Description>Dual lumen catheters that drain cavity contents by application of suction</Description><Size>Length up to 35cm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>4243</SubGroupID><ARTGs><ARTG>132027</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS227</BillingCode><Name>Flexima All-Purpose Drainage Catheter</Name><Description>All-purpose drainage catheters for abscesses and fluid collections.</Description><Size>Length up to 25cm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>4243</SubGroupID><ARTGs><ARTG>132027</ARTG></ARTGs><MinimumBenefit>90</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS034</BillingCode><Name>Contour PVA</Name><Description>Polyvinyl Alcohol (PVA) embolization particles spherical-shaped PVA</Description><Size>Up to 1200 micron, volume up to 2ml.</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1645</GroupID><ARTGs><ARTG>392004</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS420</BillingCode><Name>AMS 700 Series Inflatable Penile Prostheses with InhibiZone Deactivation Package</Name><Description>700 Series with InhibiZone</Description><Size>One Size</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5333</SubGroupID><ARTGs><ARTG>390412</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS426</BillingCode><Name>AMS 800 Artificial urinary sphincter Pressure Regulating Balloon</Name><Description>Pressure Regulating Balloon</Description><Size>51 - 60cm, 61 -70cm, 71 - 80cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1696</GroupID><SubGroupID>5308</SubGroupID><ARTGs><ARTG>390349</ARTG></ARTGs><MinimumBenefit>1954</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS394</BillingCode><Name>Ultra ICE </Name><Description>Intracardiac Electrophysiology Catheter</Description><Size>One size </Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7375</SubGroupID><Suffix>Boston Scientific</Suffix><ARTGs><ARTG>284615</ARTG></ARTGs><MinimumBenefit>1550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ015</BillingCode><PriorBillingCodes><PriorBillingCode>ER279</PriorBillingCode></PriorBillingCodes><Name>OverStitchTM Endoscopic Suturing System</Name><Description>Needle Driver, Anchor Exchange and Tissue Helix Device</Description><Size>1 size only</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>5769</SubGroupID><Suffix>Endoscopic System</Suffix><ARTGs><ARTG>237773</ARTG><ARTG>237774</ARTG></ARTGs><MinimumBenefit>1473</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS294</BillingCode><Name>Latitude Communicator</Name><Description>Remote patient management system for implanted cardiac devices </Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>266</SubCategoryID><GroupID>1832</GroupID><ARTGs><ARTG>201875</ARTG><ARTG>230414</ARTG></ARTGs><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS197</BillingCode><Name>Innova Self-Expanding Stent</Name><Description>Nitinol, self expanding stent</Description><Size>Diameters up to 8mm, Lengths greater than 150mm</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>104281</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS244</BillingCode><Name>SureTek Burr Hole Cover</Name><Description>Burr hole cover</Description><Size>14mm compatability</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4478</SubGroupID><ARTGs><ARTG>203999</ARTG></ARTGs><MinimumBenefit>497</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS250</BillingCode><Name>Flexima Biliary Drainage Catheter</Name><Description>Biliary drainage catheters for drainage of the biliary tree</Description><Size>Length up to 35cm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>5489</SubGroupID><ARTGs><ARTG>132027</ARTG></ARTGs><MinimumBenefit>97</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS046</BillingCode><Name>Ultraflex Oesophageal Stent; Ultraflex Oesophageal NG Stent</Name><Description>Nitinol, self expanding stent</Description><Size>Diameters up to 30mm &amp; lengths up to 150mm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1558</GroupID><SubGroupID>4237</SubGroupID><ARTGs><ARTG>120176</ARTG></ARTGs><MinimumBenefit>2256</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS245</BillingCode><Name>Vercise Charging System</Name><Description>Recharging system for DBS</Description><Size>N/A</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4475</SubGroupID><ARTGs><ARTG>202018</ARTG><ARTG>203085</ARTG><ARTG>308576</ARTG><ARTG>363579</ARTG></ARTGs><MinimumBenefit>1782</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS321</BillingCode><Name>ACCOLADE MRI DR SL and EL</Name><Description>Dual Chamber Pacemaker, MRI Conditional</Description><Size>ACCOLADE MRI DR SL 4.45 x 5.02 x 0.75cm and ACCOLADE MRI DR EL 4.45 x 5.88 x 0.75cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>i</Suffix><ARTGs><ARTG>400396</ARTG><ARTG>400399</ARTG></ARTGs><MinimumBenefit>5448</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS418</BillingCode><Name>POLARx FIT Cryoablation Balloon Catheter</Name><Description>Flexible, over-the-wire balloon catheter used to ablate cardiac tissue</Description><Size>31mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2947</GroupID><SubGroupID>7352</SubGroupID><ARTGs><ARTG>409910</ARTG></ARTGs><MinimumBenefit>5100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS449</BillingCode><PriorBillingCodes><PriorBillingCode>XP007</PriorBillingCode><PriorBillingCode>UW007</PriorBillingCode></PriorBillingCodes><Name>Axonics Tined Lead</Name><Description>Tined lead for sacral neuromodulation</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1714</GroupID><SubGroupID>5339</SubGroupID><Suffix>tined</Suffix><ARTGs><ARTG>297953</ARTG></ARTGs><MinimumBenefit>4199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS214</BillingCode><PriorBillingCodes><PriorBillingCode>BS117</PriorBillingCode></PriorBillingCodes><Name>WallFlex Biliary Stent</Name><Description>Stent with permalume covering</Description><Size>6 - 10 x 40 - 120mm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><SubGroupID>4235</SubGroupID><ARTGs><ARTG>136261</ARTG><ARTG>177661</ARTG><ARTG>226864</ARTG></ARTGs><MinimumBenefit>2730</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS319</BillingCode><Name>Cartesia Directional Lead</Name><Description>Deep brain stimulation lead with 8 in-line contact electrodes. Independent 19-filar platinum-core. Contacts are separated circumferentially allowing for both axial and
rotational stimulation selectivity.</Description><Size>30cm - 45cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4476</SubGroupID><Suffix>Current steering</Suffix><ARTGs><ARTG>279186</ARTG></ARTGs><MinimumBenefit>4120</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS335</BillingCode><Name>Unipolar Lead Adaptor Models 6161, 6162</Name><Description>Model 6161: 6mm Unipolar to IS-1; Model 6162: Split 5mm Unipolar to IS-1</Description><Size>10cm-15cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>244</SubCategoryID><GroupID>1763</GroupID><ARTGs><ARTG>189952</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS334</BillingCode><Name>Bipolar Lead Adaptor Models 6986, 4402, 4403</Name><Description>Model 6986: Bipolar 3.2mm to IS-1; Model 4402: Bipolar IS-1 to Bipolar LV-1; Model 4403: Bipolar or Unipolar LV-1 to Bipolar or Unipolar IS-1</Description><Size>14cm-17cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>244</SubCategoryID><GroupID>1763</GroupID><ARTGs><ARTG>189952</ARTG><ARTG>218790</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS460</BillingCode><Name>AMS 700 Series Inflatable Penile Prosthesis with TENACIO Pump &amp; Cylinders Preconnected - InhibiZone</Name><Description>AMS 700 series Inflatable Penile implant with TENACIO Pump InhibiZone</Description><Size>10, 12, 14, 15, 16, 18, 21, 24cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5335</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>352831</ARTG></ARTGs><MinimumBenefit>8070</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS413</BillingCode><Name>AMS 700 Series Inflatable Penile Prostheses with InhibiZone Pump &amp; Cylinders  Preconnected</Name><Description>700 Series with InhibiZone</Description><Size>12-24cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5335</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>125444</ARTG><ARTG>352831</ARTG></ARTGs><MinimumBenefit>8070</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS410</BillingCode><Name>AMS 700 Series Inflatable Penile Prostheses Pump &amp; Cylinders Preconnected</Name><Description>700 Series (Non InhibiZone)</Description><Size>12, 14, 15, 16, 18, 21, 24cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5335</SubGroupID><ARTGs><ARTG>106606</ARTG><ARTG>390412</ARTG></ARTGs><MinimumBenefit>7419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS440</BillingCode><Name>Physician spare kit - 16 contact</Name><Description>Boots accessory kit for DBS</Description><Size>N/A</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4498</SubGroupID><ARTGs><ARTG>203998</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS240</BillingCode><Name>Vercise Physician's Spare Kit</Name><Description>Boots accessory kit for DBS</Description><Size>N/A</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4498</SubGroupID><ARTGs><ARTG>203998</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS241</BillingCode><Name>Boston Scientific DBS Tunneling Tool</Name><Description>Tunneling tool for DBS - straw, long</Description><Size>N/A</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4498</SubGroupID><ARTGs><ARTG>156757</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS459</BillingCode><Name>AMS 700 Series Inflatable Penile Prosthesis with TENACIO Pump &amp; Cylinders Preconnected</Name><Description>TENACIO Pump</Description><Size>12, 15, 18, 21, 24cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5335</SubGroupID><ARTGs><ARTG>390412</ARTG></ARTGs><MinimumBenefit>7419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS089</BillingCode><Name>WallFlex Oesophageal Stent, WallFlex RMV Oesophageal Stent</Name><Description>Nitinol, self expanding stent</Description><Size>Diameters up to 30mm &amp; lengths up to 155mm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1558</GroupID><SubGroupID>4238</SubGroupID><ARTGs><ARTG>120176</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS381</BillingCode><Name>Agile Esophageal Stent</Name><Description>Nitinol, Self-expanding</Description><Size>Diameters up to 23mm &amp; lengths up to 15cm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1558</GroupID><SubGroupID>4238</SubGroupID><ARTGs><ARTG>339843</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS298</BillingCode><Name>Ultraflex Oesophageal NG Covered Stent</Name><Description>Translucent polyurethane covered nitinol, self expanding stent</Description><Size>Diameters up to 30mm &amp; lengths up to 150mm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1558</GroupID><SubGroupID>4238</SubGroupID><ARTGs><ARTG>120176</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS369</BillingCode><PriorBillingCodes><PriorBillingCode>MB024</PriorBillingCode></PriorBillingCodes><Name>TraceIT Gel System</Name><Description>TraceIT System is intended to create a temporary space within soft tissue during radiation therapy.</Description><Size>10mL</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>187</SubCategoryID><GroupID>1792</GroupID><SubGroupID>6281</SubGroupID><ARTGs><ARTG>268092</ARTG></ARTGs><MinimumBenefit>1730</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS238</BillingCode><Name>Boston Scientific DBS Lead Kit</Name><Description>Deep brain stimulation lead with 8 in-line contact electrodes. Independent 19-filar platinum-core.</Description><Size>30cm - 45cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4476</SubGroupID><ARTGs><ARTG>202017</ARTG></ARTGs><MinimumBenefit>3746</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS388</BillingCode><Name>SpaceOAR VUE System</Name><Description>The SpaceOAR VUE System is a radiotherapy protection spacer consisting of components for preparation of synthetic absorbable hydrogel spacer and a delivery mechanism packaged in a single kit. The hydrogel spacer creates a temporary space between the prostate and rectum during radiation therapy. The hydrogel is radiopaque for visibility under computed tomography (CT) and cone beam CT.</Description><Size>10CC</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>187</SubCategoryID><GroupID>1792</GroupID><SubGroupID>6281</SubGroupID><ARTGs><ARTG>373630</ARTG></ARTGs><MinimumBenefit>1730</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS292</BillingCode><Name>ACUITY X4</Name><Description>Left ventricular family of quad leads with four pacing and sensing electrodes. Three lead configurations offered to assist in LV lead placement and avoid phrenic nerve stimulation and high thresholds.</Description><Size>86cm, 95cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1759</GroupID><Suffix>j</Suffix><ARTGs><ARTG>235035</ARTG><ARTG>235036</ARTG><ARTG>235037</ARTG></ARTGs><MinimumBenefit>2028</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS439</BillingCode><Name>Cartesia X/HX Directional Lead</Name><Description>Deep brain stimulation lead with 16 distal contacts electrodes. Contacts are separated circumferentially allowing for both axial and
rotational stimulation selectivity.</Description><Size>30-45cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4476</SubGroupID><Suffix>Current steering</Suffix><ARTGs><ARTG>476409</ARTG><ARTG>476410</ARTG></ARTGs><MinimumBenefit>4120</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS368</BillingCode><PriorBillingCodes><PriorBillingCode>MB017</PriorBillingCode></PriorBillingCodes><Name>SpaceOAR System</Name><Description>The SpaceOAR System consists of components for preparation of a synthetic, absorbable hydrogel spacer and a delivery mechanism packaged in a single kit. The hydrogel spacer creates a temporary space between the prostate and rectum during radiation therapy.</Description><Size>10CC</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>187</SubCategoryID><GroupID>1792</GroupID><SubGroupID>6281</SubGroupID><ARTGs><ARTG>354010</ARTG></ARTGs><MinimumBenefit>1730</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS383</BillingCode><Name>WaveWriter Alpha</Name><Description>16 &amp; 32 output, multi-channel, neurostimulation system IPG with 3D Algorythmic Programming, Combination Therapy and Multi Waveform capability </Description><Size>One Size Only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1677</GroupID><SubGroupID>4480</SubGroupID><Suffix>Multi waveforms</Suffix><ARTGs><ARTG>400292</ARTG><ARTG>400373</ARTG></ARTGs><MinimumBenefit>21660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS255</BillingCode><Name> CoverEdge 32 Contact Surgical Leads</Name><Description>CoverEdge, CoverEdge MRI, CoverEdge X, CoverEdge X MRI - 4x8 spaced electrodes.    </Description><Size>Up to 70cm in length</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>≥32 electrodes</Suffix><ARTGs><ARTG>218230</ARTG></ARTGs><MinimumBenefit>11011</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS331</BillingCode><Name>Avista MRI 8 Contact Lead</Name><Description>Eight contact percutaneous leads, MRI Conditional</Description><Size>56cm - 74cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>8 electrodes</Suffix><ARTGs><ARTG>287236</ARTG></ARTGs><MinimumBenefit>3817</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS357</BillingCode><PriorBillingCodes><PriorBillingCode>BS110</PriorBillingCode></PriorBillingCodes><Name>ARTISAN, ARTISAN MRI Lead</Name><Description>16 contact point leads with multiple independent current control</Description><Size>50cm - 70cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>greater than 8 and less than 32 electrodes</Suffix><ARTGs><ARTG>163471</ARTG><ARTG>308180</ARTG></ARTGs><MinimumBenefit>6895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS356</BillingCode><PriorBillingCodes><PriorBillingCode>BS110</PriorBillingCode></PriorBillingCodes><Name>INFINION Lead</Name><Description>16 contact point leads with multiple independent current control</Description><Size>50cm - 70cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>greater than 8 and less than 32 electrodes</Suffix><ARTGs><ARTG>197909</ARTG></ARTGs><MinimumBenefit>6895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS312</BillingCode><Name>Infinion CX Lead</Name><Description>1 x 16 lead with two 8 contact tails</Description><Size>50 - 70cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>greater than 8 and less than 32 electrodes, Bifurcated proximal tail</Suffix><ARTGs><ARTG>275241</ARTG></ARTGs><MinimumBenefit>8123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS441</BillingCode><Name>Infinion Pro Lead</Name><Description>1 x 16 lead with two 8 contact tails</Description><Size>50 - 70cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>greater than 8 and less than 32 electrodes, Bifurcated proximal tail</Suffix><ARTGs><ARTG>508385</ARTG></ARTGs><MinimumBenefit>8123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS109</BillingCode><Name>Precision SCS Eight Contact Leads</Name><Description>Eight contact percutaneous leads.</Description><Size>30cm to 70cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>8 electrodes</Suffix><ARTGs><ARTG>128775</ARTG></ARTGs><MinimumBenefit>3817</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS239</BillingCode><Name>Boston Scientific DBS Extension Kit</Name><Description>Deep brain stimulation extension kit</Description><Size>55 &amp; 95 cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4477</SubGroupID><ARTGs><ARTG>202034</ARTG><ARTG>363575</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS336</BillingCode><Name>Pacing Lead Suture Sleeve Models 6773, 6403, 4603</Name><Description>Suture sleeves are used to secure and immobilise Pacing/ICD Leads</Description><Size>One Size Only</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1765</GroupID><ARTGs><ARTG>132495</ARTG></ARTGs><MinimumBenefit>54</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS257</BillingCode><Name>Wrenches</Name><Description>Used to secure leads and anchors.</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>157487</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS213</BillingCode><Name>Lead Cap Kit</Name><Description>Caps used to protect lead terminal connector pin</Description><Size>4.75mm and 3.2mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1765</GroupID><ARTGs><ARTG>133934</ARTG><ARTG>133935</ARTG></ARTGs><MinimumBenefit>54</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS286</BillingCode><Name>AUTOGEN CRT-D DF-1</Name><Description>High energy CRT-D with DF-1 RV connector &amp; lS-1 (G173) or LV-1 (G175) LV connector. PaceSafe RV, RA, and LV auto threshold.</Description><Size>32.0cc, 72.8g, 9.9mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>400119</ARTG><ARTG>400120</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS430</BillingCode><Name>Ranger/Ranger SL Paclitaxel Coated Balloon Catheter</Name><Description>Peripheral angioplasty balloon catheter, drug-eluting  </Description><Size>Balloon Length: 30-200 mm; Diameter: 2.00 - 8.00 mm; </Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>296</SubCategoryID><GroupID>2967</GroupID><ARTGs><ARTG>300172</ARTG><ARTG>300173</ARTG></ARTGs><MinimumBenefit>1245</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS429</BillingCode><Name>Ranger OVER THE WIRE Paclitaxel Coated PTA Balloon Catheter</Name><Description>Peripheral angioplasty balloon catheter, drug-eluting  </Description><Size>Balloon Length: 30-200 mm; Diameter: 2.00 - 8.00 mm; </Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>296</SubCategoryID><GroupID>2967</GroupID><ARTGs><ARTG>453745</ARTG></ARTGs><MinimumBenefit>1245</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS345</BillingCode><Name>MOMENTUM CRT-D DF-1</Name><Description>High energy CRT-D with DF-1 RV connector &amp; lS-1/LV-1 LV connector. SmartCRT, Heart Failure Sensor Suite, ENDURALIFE Battery Technology</Description><Size>32cc, 72.8-72.9g, 5.37 x 8.08 x 0.99cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>399060</ARTG><ARTG>399061</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS285</BillingCode><Name>AUTOGEN X4 CRT-D DF-4</Name><Description>ICD with cardiac resynchronization therapy.</Description><Size>32.5cc, 73.8g, 9.9mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>400264</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS249</BillingCode><Name>Medical Adhesive</Name><Description>Medical adhesive is used to assist in fixing the lead to the suture sleeve.</Description><Size>One size</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>156755</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS284</BillingCode><Name>AUTOGEN CRT-D DF-4</Name><Description>ICD with cardiac resynchronization therapy. PaceSafe RV, RA, and LV auto threshold.</Description><Size>32.5cc, 73.6g, 9.9mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>398271</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS256</BillingCode><Name>Tunnelling Tools</Name><Description>Aid in placement of leads.</Description><Size>Various</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>156757</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS342</BillingCode><Name>RESONATE X4 CRT-D DF-4</Name><Description>High energy CRT-D with DF-4 RV connector &amp; lS4 LV connector. SmartCRT, Heart Failure Sensor Suite, ENDURALIFE Battery Technology, IMAGEREADY MR-Conditional</Description><Size>32.5cc, 73.8g, 5.37 x 8.18 x 0.99cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>399058</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS344</BillingCode><Name>MOMENTUM CRT-D DF-4</Name><Description>High energy CRT-D with DF-4 RV connector &amp; IS-1 LV connector. SmartCRT, Heart Failure Sensor Suite, ENDURALIFE Battery Technology</Description><Size>32.5cc, 73.6g, 5.37 x 8.18 x 0.99cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>399059</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS456</BillingCode><Name>OverStitchTM Endoscopic Suturing System - 2.0 Suture</Name><Description>Endoscopic Polypropylene Suture with Cinch</Description><Size>2-0 suture</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>6101</SubGroupID><Suffix>Endoscopic System</Suffix><ARTGs><ARTG>236906</ARTG><ARTG>357430</ARTG></ARTGs><MinimumBenefit>211</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS287</BillingCode><Name>AUTOGEN X4 CRT-D DF-1</Name><Description>High energy CRT-D with DF-1 RV connector &amp; lS4 LV connector</Description><Size>32.0cc, 73.4g, 9.9mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>400121</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS419</BillingCode><Name>Agent Paclitaxel-Coated Balloon Catheter</Name><Description>Coronary angioplasty balloon catheter, drug-eluting</Description><Size>Length (mm) 12-30; Diameter (mm) 2.00-4.00</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>297</SubCategoryID><GroupID>2970</GroupID><ARTGs><ARTG>445863</ARTG></ARTGs><MinimumBenefit>854</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS455</BillingCode><Name>OverStitchTM Endoscopic Suturing System - 2.0 Suture</Name><Description>Endoscopic Polypropylene Suture with Cinch</Description><Size>2-0 suture</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>6101</SubGroupID><Suffix>Endoscopic System</Suffix><ARTGs><ARTG>483506</ARTG><ARTG>485995</ARTG></ARTGs><MinimumBenefit>211</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS411</BillingCode><Name>AMS 700 Series Inflatable Penile Prostheses with Inhibizone Cylinders</Name><Description>700 Series with InhibiZone</Description><Size>12, 14, 15, 16, 18, 21, 24cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5330</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>125444</ARTG><ARTG>352831</ARTG></ARTGs><MinimumBenefit>3638</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS120</BillingCode><Name>Clik Anchor Kit</Name><Description>Clik, Clik X, Clik X MRI Anchors</Description><Size>Two anchors</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>156760</ARTG></ARTGs><MinimumBenefit>303</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS343</BillingCode><Name>MOMENTUM X4 CRT-D DF-1</Name><Description>High energy CRT-D with DF-1 RV connector &amp; lS4 LV connector. ENDURALIFE Battery Technology</Description><Size>32cc, 73.4g, 5.37 x 8.08 x 0.99cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>399592</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS421</BillingCode><Name>AMS 700 Series Inflatable Penile Prostheses Cylinders  </Name><Description>700 Series (Non InhibiZone)  </Description><Size>10, 12, 14, 15, 16, 18, 21, 24cm  </Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5330</SubGroupID><ARTGs><ARTG>390412</ARTG></ARTGs><MinimumBenefit>3344</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS118</BillingCode><Name>Precision SCS Lead Blanks</Name><Description>Lead Blank</Description><Size>One Size Only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4487</SubGroupID><ARTGs><ARTG>218730</ARTG></ARTGs><MinimumBenefit>438</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS215</BillingCode><PriorBillingCodes><PriorBillingCode>BS117</PriorBillingCode></PriorBillingCodes><Name>WallFlex Biliary Stent</Name><Description>Bare Metal Stent</Description><Size>6 - 10 x 40 - 120mm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><SubGroupID>4234</SubGroupID><ARTGs><ARTG>136261</ARTG><ARTG>226864</ARTG></ARTGs><MinimumBenefit>2008</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS354</BillingCode><Name>Epic Biliary Endoscopic Stent System</Name><Description>Uncovered self-expanding nitinol biliary stent</Description><Size>Diameter 6-10mm, Length 40-100mm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><SubGroupID>4234</SubGroupID><ARTGs><ARTG>299016</ARTG></ARTGs><MinimumBenefit>2008</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS246</BillingCode><Name>Introducer Kit</Name><Description>Introducer intended for the percutaneous introduction and placement of leads.</Description><Size>Length: 13cm; 23cm.</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>166195</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS258</BillingCode><Name>Insertion Needles</Name><Description>Aid in placement of leads.</Description><Size>Various</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>156758</ARTG><ARTG>254954</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS371</BillingCode><PriorBillingCodes><PriorBillingCode>DE275</PriorBillingCode></PriorBillingCodes><Name>DC Bead</Name><Description>Drug delivery embolisation system</Description><Size>100-500 (microns)</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1542</GroupID><SubGroupID>4195</SubGroupID><ARTGs><ARTG>392646</ARTG></ARTGs><MinimumBenefit>1760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS360</BillingCode><Name>Rhythmia Location Reference Patch Kit</Name><Description>Rhythmia Location Reference Patch Kit - Box of 1</Description><Size>50mm diameter</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7350</SubGroupID><Suffix>Boston Scientific</Suffix><ARTGs><ARTG>282996</ARTG></ARTGs><MinimumBenefit>200</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS372</BillingCode><PriorBillingCodes><PriorBillingCode>DE580</PriorBillingCode></PriorBillingCodes><Name>DC Bead M1</Name><Description>Drug delivery embolization system</Description><Size>70-150um</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1542</GroupID><SubGroupID>4195</SubGroupID><ARTGs><ARTG>392647</ARTG></ARTGs><MinimumBenefit>1760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS373</BillingCode><PriorBillingCodes><PriorBillingCode>DE647</PriorBillingCode></PriorBillingCodes><Name>DC Bead LUMI</Name><Description>Drug delivery embolisation system</Description><Size>70-150 microns (black)</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1542</GroupID><SubGroupID>4195</SubGroupID><ARTGs><ARTG>421310</ARTG></ARTGs><MinimumBenefit>1760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS143</BillingCode><Name>Precision SCS External Patient Recharger System</Name><Description>External Patient Recharging System: Base Station, Charger, Cradle power supply, charger base station.</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4497</SubGroupID><ARTGs><ARTG>149462</ARTG><ARTG>155857</ARTG><ARTG>155859</ARTG><ARTG>155924</ARTG></ARTGs><MinimumBenefit>1215</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS290</BillingCode><Name>Advanix Plastic Stent and Pusher Kit</Name><Description>Plastic stent manufactured, indicated for the treatment of pancreatic strictures.
Delivery System in form of a pusher (short wire or long wire system specific).
</Description><Size>2 - 18cm length / 3 - 10 FR diameter</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1561</GroupID><Suffix>Pusher</Suffix><ARTGs><ARTG>226891</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS289</BillingCode><Name>Advanix Plastic Stent</Name><Description>Plastic stent manufactured individually, indicated for the treatment of pancreatic strictures.</Description><Size>2 - 18cm length / 3 - 10 FR diameter</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1561</GroupID><ARTGs><ARTG>226891</ARTG></ARTGs><MinimumBenefit>77</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS453</BillingCode><PriorBillingCodes><PriorBillingCode>XP011</PriorBillingCode><PriorBillingCode>UW011</PriorBillingCode></PriorBillingCodes><Name>Axonics PNE Lead</Name><Description>Trial Lead</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1714</GroupID><SubGroupID>5340</SubGroupID><ARTGs><ARTG>312912</ARTG></ARTGs><MinimumBenefit>373</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS259</BillingCode><Name>Passing Elevators and Paddle Blanks</Name><Description>Aid in placement of leads, helps verify that the epidural space is cleared.</Description><Size>Various</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>156762</ARTG><ARTG>218730</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS382</BillingCode><Name>Vercise Genus </Name><Description>8, 16 &amp; 32 Contact Dual channel primary cell pulse generator with anodic stimulation</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1672</GroupID><SubGroupID>4472</SubGroupID><Suffix>Dual Channel</Suffix><ARTGs><ARTG>400380</ARTG><ARTG>400410</ARTG><ARTG>400422</ARTG></ARTGs><MinimumBenefit>13592</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS407</BillingCode><Name>POLARMAP Circular Mapping Catheter</Name><Description>Multi-electrode catheter designed to record intracardiac electrograms and provide pacing stimulation during electrophysiology procedures.</Description><Size>One size</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2947</GroupID><SubGroupID>7353</SubGroupID><ARTGs><ARTG>367271</ARTG></ARTGs><MinimumBenefit>1299</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS325</BillingCode><Name>FreeLink Remote Control Kit</Name><Description>Hand held remote control/external patient programmer</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4483</SubGroupID><ARTGs><ARTG>283694</ARTG><ARTG>287237</ARTG><ARTG>287738</ARTG><ARTG>318330</ARTG><ARTG>318331</ARTG><ARTG>362974</ARTG><ARTG>362991</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS378</BillingCode><Name>Blazer II XP</Name><Description>Non-irrigated ablation catheters</Description><Size>104-115 cm, 8F</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>164229</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS106</BillingCode><Name>Precision Plus Remote Patient Programmer; Precision Plus with MultiwaveTechnology Remote Patient Programmer</Name><Description>Hand held remote control External Patient Programmer</Description><Size>One Size Only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4483</SubGroupID><ARTGs><ARTG>128681</ARTG><ARTG>166929</ARTG><ARTG>231196</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS376</BillingCode><Name>IntellaTip MiFi™ XP</Name><Description>Non-irrigated ablation catheter with 3 mini-electrodes (MiFi) for more accurate mapping</Description><Size>110 cm, shaft size 7F</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>232994</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS377</BillingCode><Name>Blazer Prime </Name><Description>Non-irrigated ablation catheter</Description><Size>104-115 cm, 7F     </Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>179887</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS228</BillingCode><Name>Flexima Nephrostomy Catheter</Name><Description>Urinary drainage catheters for internal and external drainage of the urinary tract.</Description><Size>Length up to 25cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>234</SubCategoryID><GroupID>1718</GroupID><ARTGs><ARTG>132027</ARTG></ARTGs><MinimumBenefit>91</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS375</BillingCode><Name>Blazer II</Name><Description>Non-irrigated temperature ablation catheters </Description><Size>104-115 cm, shaft size 6-7F</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>164506</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS391</BillingCode><Name>IntellaNav ST</Name><Description>Non-irrigated temperature ablation catheters; navigation enabled</Description><Size>110 cm, 7F</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>354210</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS386</BillingCode><Name>IntellaNav MiFi XP</Name><Description>Non-irrigated ablation catheter with 3 mini-electrodes (MiFi), navigation enabled</Description><Size>110 cm, shaft size 7F</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>289500</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS243</BillingCode><Name>Vercise Remote Control, Vercise Remote Control 2, Vercise Remote Control 3, Vercise Remote Control 4</Name><Description>Remote patient control for DBS, remote patient control kit for DBS</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4474</SubGroupID><ARTGs><ARTG>202019</ARTG><ARTG>279188</ARTG><ARTG>308575</ARTG><ARTG>308577</ARTG><ARTG>363576</ARTG></ARTGs><MinimumBenefit>1264</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS326</BillingCode><Name>VISIONIST X4 CRT-P, VISIONIST CRT-P</Name><Description>Cardiac Resynchronization Therapy Pacemaker</Description><Size>U228: 4.45 x 6.17 x 0.75cm. U225 and U226: 4.45 x 6.13 x 0.75cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>i</Suffix><ARTGs><ARTG>400403</ARTG><ARTG>400404</ARTG><ARTG>400405</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS458</BillingCode><Name>AMS 700 Series Inflatable Penile Prosthesis with TENACIO Pump - InhibiZone</Name><Description>TENACIO Pump InhibiZone</Description><Size>One Size</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5332</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>352831</ARTG></ARTGs><MinimumBenefit>4432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS320</BillingCode><Name>ACCOLADE MRI SR</Name><Description>Single Chamber Pacemaker, MRI Conditional</Description><Size>ACCOLADE MRI SR 4.45 x 4.81 x 0.75cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><Suffix>i</Suffix><ARTGs><ARTG>400400</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS329</BillingCode><Name>Emblem MRI S-ICD Pulse Generator System</Name><Description>Subcutaneous Implantable Cardioverter Defibrillator, Subcutaneous Electrode, Subcutaneous Electrode Insertion Tool, with AF Monitor, SMART Pass and MRI Conditional</Description><Size>59.5cc: (W) 83.1mm x (H) 69.1mm x (D)12.7mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1812</GroupID><ARTGs><ARTG>291908</ARTG><ARTG>399599</ARTG></ARTGs><MinimumBenefit>28398</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ154</BillingCode><Name>LUX-Dx Mobile Monitor</Name><Description>Mobile applications for patient monitoring and remote programming that run on a handheld mobile/smart device. LUX-Dx Clinic Assistant application is for healthcare professionals while myLUX patient application is intended for patients to interact with the system and
their clinic and stay connected. The applications communicate with the LUX-Dx ICM via Bluetooth Low Energy (BLE) and the LATITUDE Server via cellular or Wi-Fi for collection and transmission of event, patient, and device data.</Description><Size>One size</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>266</SubCategoryID><GroupID>20001</GroupID><ARTGs><ARTG>413400</ARTG></ARTGs><MinimumBenefit>502</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS158</BillingCode><Name>Precision Connector M1</Name><Description>Lead extension for Precision SCS System</Description><Size>35. 55. 70 cm length</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1680</GroupID><ARTGs><ARTG>162422</ARTG></ARTGs><MinimumBenefit>1362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS095</BillingCode><Name>Urinary Diversion Stents</Name><Description>Percuflex urinary diversion stent</Description><Size>Diameters up to 14Fr &amp; lengths up to 95cm</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1703</GroupID><ARTGs><ARTG>104324</ARTG><ARTG>129379</ARTG></ARTGs><MinimumBenefit>125</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS337</BillingCode><Name>WallFlex Soft Enteral Stent (Duodenal/Colonic)</Name><Description>Nitinol, self expanding stent with Anchor Lock Delivery System</Description><Size>Diameters up to 27mm &amp; lengths up to 120mm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1562</GroupID><ARTGs><ARTG>119517</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS153</BillingCode><Name>Myopore</Name><Description>Bipolar sutureless myocardial pacing lead</Description><Size>25-54cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1746</GroupID><ARTGs><ARTG>161123</ARTG></ARTGs><MinimumBenefit>876</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS417</BillingCode><Name>LUX-Dx™ </Name><Description>Insertable Cardiac Monitor</Description><Size>7.2 mm x 44.8 mm x 4.0 mm, 1.2 cm3</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>293</SubCategoryID><GroupID>2962</GroupID><ARTGs><ARTG>411051</ARTG></ARTGs><MinimumBenefit>2886</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS111</BillingCode><Name>Precision SCS Lead Extensions</Name><Description>Lead Extensions</Description><Size>25cm to 55cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1680</GroupID><ARTGs><ARTG>128679</ARTG></ARTGs><MinimumBenefit>1362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS432</BillingCode><Name>LUX-Dx II, LUX-Dx II+</Name><Description>Insertable Cardiac Monitor with mobile remote monitoring </Description><Size>7.2 mm x 44.8 mm x 4.0 mm, 1.2 cm3</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>293</SubCategoryID><GroupID>2962</GroupID><Suffix>Remote Monitoring Service for ICM</Suffix><ARTGs><ARTG>466927</ARTG><ARTG>466928</ARTG></ARTGs><Note>The benefit payable for the billing code includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. When the benefit is claimable in respect to this billing code, no additional or separate claims are allowed in respect to any billing codes listed in Part C group 08.16.02 –Remote Monitoring System - Implantable Cardiac Event Recorders.</Note><MinimumBenefit>3388</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS384</BillingCode><Name>WATCHMAN FLX</Name><Description>Left Atrial Appendage Closure Device</Description><Size>20mm to 35mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>248</SubCategoryID><GroupID>2181</GroupID><ARTGs><ARTG>340173</ARTG></ARTGs><MinimumBenefit>11268</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS438</BillingCode><Name>WATCHMAN FLX PRO</Name><Description>Left Atrial Appendage Device</Description><Size>20mm to 35mm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>248</SubCategoryID><GroupID>2181</GroupID><ARTGs><ARTG>508386</ARTG></ARTGs><MinimumBenefit>11268</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS260</BillingCode><Name>RELIANCE 4-FRONT</Name><Description>Active, Single/Dual coil, defibrillation lead</Description><Size>Length: 59cm -70cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1743</GroupID><Suffix>e</Suffix><ARTGs><ARTG>217430</ARTG><ARTG>217431</ARTG><ARTG>217432</ARTG><ARTG>303416</ARTG></ARTGs><MinimumBenefit>2355</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS169</BillingCode><Name>Precision SCS Splitter</Name><Description>Lead extension for connection of multiple leads</Description><Size>Multiple Configurations</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1680</GroupID><ARTGs><ARTG>167101</ARTG><ARTG>167102</ARTG><ARTG>197908</ARTG></ARTGs><MinimumBenefit>1362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS295</BillingCode><Name>Ingevity</Name><Description>Passive MR conditional pacing lead</Description><Size>45cm to 59cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1753</GroupID><ARTGs><ARTG>263512</ARTG><ARTG>263513</ARTG></ARTGs><MinimumBenefit>420</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS416</BillingCode><Name>Rezum</Name><Description>Single-use radiofrequency delivery device kit for treatment of BPH</Description><Size>One size only</Size><SupplierCode>BS</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>256</SubCategoryID><GroupID>2971</GroupID><ARTGs><ARTG>329141</ARTG></ARTGs><MinimumBenefit>1950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS347</BillingCode><PriorBillingCodes><PriorBillingCode>GU012</PriorBillingCode></PriorBillingCodes><Name>Fineline II Sterox IROX Lead</Name><Description>Bipolar, passive fixation</Description><Size>45cm, 52cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1753</GroupID><ARTGs><ARTG>128060</ARTG></ARTGs><MinimumBenefit>420</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS346</BillingCode><PriorBillingCodes><PriorBillingCode>GU011</PriorBillingCode></PriorBillingCodes><Name>Fineline II Sterox IROX Lead</Name><Description>Bipolar passive fixation</Description><Size>52cm, 58cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1753</GroupID><ARTGs><ARTG>299176</ARTG></ARTGs><MinimumBenefit>420</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS323</BillingCode><Name>Precision M8 Adaptor and S8 adaptor</Name><Description>The Boston Scientific Precision S8 Adapter is compatible with a range of Abbott leads and lead extensions and the Boston Scientific Precision M8 Adapter is compatible with a range of Medtronic leads and lead extensions</Description><Size>15cm - 55cm</Size><SupplierCode>BS</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1680</GroupID><ARTGs><ARTG>281250</ARTG><ARTG>491585</ARTG></ARTGs><MinimumBenefit>1362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS390</BillingCode><Name>Ingevity+</Name><Description>Active MR conditional pacing lead</Description><Size>45cm to 59cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1756</GroupID><ARTGs><ARTG>374841</ARTG></ARTGs><MinimumBenefit>441</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS348</BillingCode><PriorBillingCodes><PriorBillingCode>GU016</PriorBillingCode></PriorBillingCodes><Name>Fineline II EZ Sterox IROX Lead</Name><Description>Bipolar, active fixation</Description><Size>45cm, 52cm, 58cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1756</GroupID><ARTGs><ARTG>299177</ARTG></ARTGs><MinimumBenefit>441</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS085</BillingCode><Name>Filterwire EZ</Name><Description>Embolic Protection Device</Description><Size>Vessel compatibility 3.5mm - 5.5mm and delivery system lengths up to 300cm.</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>211</SubCategoryID><GroupID>1643</GroupID><ARTGs><ARTG>167933</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS364</BillingCode><Name>Sentinel Cerebral Protection System</Name><Description>The device Sentinel Cerebral Protection System (Sentinel) is percutaneously delivered to capture and remove debris dislodged during endovascular procedures. The system utilises an embolic filter delivered to the brachiocephalic artery (Proximal Filter), and a second embolic filter delivered to the left common carotid artery (Distal Filter). The Sentinel Cerebral Protection System consists of 6 French catheter, with deployable proximal and distal filters, articulating sheath and integral handle assembly.</Description><Size>Proximal filter 15mm, Distal filter 7-10mm</Size><SupplierCode>BS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>211</SubCategoryID><GroupID>1643</GroupID><Suffix>Multi filter</Suffix><ARTGs><ARTG>346230</ARTG></ARTGs><MinimumBenefit>3288</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS296</BillingCode><Name>Ingevity</Name><Description>Active MR conditional pacing lead</Description><Size>45cm to 59cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1756</GroupID><ARTGs><ARTG>263514</ARTG></ARTGs><MinimumBenefit>441</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS090</BillingCode><Name>WallFlex Enteral Stent (Duodenal/Colonic)</Name><Description>Nitinol, self expanding stent</Description><Size>Diameters up to 30mm &amp; lengths up to 150mm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1562</GroupID><ARTGs><ARTG>119517</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS339</BillingCode><Name>RESONATE EL DR DF-4</Name><Description>Dual Chamber implantable cardioverter defibrillation, 4IJ, DF-4 RV connector. ENDURALIFE Battery Technology and IMAGEREADY MR-Conditional</Description><Size>71.4g, 31.0cc, 5.37 x 7.68 x 0.99cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>399570</ARTG></ARTGs><MinimumBenefit>24954</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS133</BillingCode><Name>Acuity Spiral</Name><Description>Unipolar passive fixation</Description><Size>80, 90 &amp; 100cm</Size><SupplierCode>BS</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1751</GroupID><ARTGs><ARTG>155274</ARTG></ARTGs><MinimumBenefit>931</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BS047</BillingCode><Name>Ultraflex Tracheobronchial Stent</Name><Description>Nitinol, self expanding stent</Description><Size>Diameters up to 25mm &amp; lengths up to 80mm</Size><SupplierCode>BS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1563</GroupID><ARTGs><ARTG>149594</ARTG></ARTGs><MinimumBenefit>2708</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XQ004</BillingCode><PriorBillingCodes><PriorBillingCode>JS004</PriorBillingCode></PriorBillingCodes><Name>Carbomedics Standard Mitral M700 - Prosthesis,  internal, valve, cardiac, artificial</Name><Description>Prosthesis, internal, valve, cardiac, artificial</Description><Size>16.2  18.8  21.8  23.8  25.8  27.8  29.8  31.8</Size><SupplierCode>XQ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>178</SubCategoryID><GroupID>1497</GroupID><ARTGs><ARTG>147290</ARTG></ARTGs><MinimumBenefit>4962</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XQ001</BillingCode><PriorBillingCodes><PriorBillingCode>AB083</PriorBillingCode><PriorBillingCode>DE604</PriorBillingCode><PriorBillingCode>RH027</PriorBillingCode></PriorBillingCodes><Name>HaemoCer Haemostatic Powder</Name><Description>Absorbable Polysaccharide Haemostat</Description><Size>5gms</Size><SupplierCode>XQ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>205062</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XQ002</BillingCode><PriorBillingCodes><PriorBillingCode>AB084</PriorBillingCode><PriorBillingCode>DE605</PriorBillingCode><PriorBillingCode>RH026</PriorBillingCode></PriorBillingCodes><Name>HaemoCer Haemostatic Powder</Name><Description>Absorbable Polysaccharide Haemostat</Description><Size>2gms</Size><SupplierCode>XQ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>205062</ARTG></ARTGs><MinimumBenefit>90</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XQ003</BillingCode><PriorBillingCodes><PriorBillingCode>JS003</PriorBillingCode><PriorBillingCode>SA150</PriorBillingCode></PriorBillingCodes><Name>Memo 3D Mitral Semirigid Annuloplasty Ring</Name><Description>Memo 3D Semirigid Mitral Annuloplasty Ring with 3D flexibility and coated with Carbofilm with or without Rechord system</Description><Size>24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm, 38mm</Size><SupplierCode>XQ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1842</GroupID><ARTGs><ARTG>176450</ARTG></ARTGs><MinimumBenefit>2280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XQ005</BillingCode><PriorBillingCodes><PriorBillingCode>QQ290</PriorBillingCode></PriorBillingCodes><Name>Perceval PLUS sutureless aortic heart valve - Aortic heart valve bioprosthesis</Name><Description>PERCEVAL PLUS prosthesis is intended to replace a damaged native 
aortic heart valve or a malfunctioning aortic prosthesis via open heart 
surgery. It is indicated for use in adult patients:
- suffering from aortic valve stenosis or steno-insufficiency;
- with a previously implanted aortic valve prosthesis that is no longer functioning adequately and requires replacement</Description><Size>S (19-21), M (21-23), L (23-25), XL (25-27)</Size><SupplierCode>XQ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1815</GroupID><Suffix>b (bovine)</Suffix><ARTGs><ARTG>427401</ARTG></ARTGs><MinimumBenefit>8978</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XQ006</BillingCode><PriorBillingCodes><PriorBillingCode>JS002</PriorBillingCode><PriorBillingCode>SA189</PriorBillingCode></PriorBillingCodes><Name>Memo 4D Mitral/tricuspid annuloplasty ring</Name><Description>Memo 4D Mitral/tricuspid annuloplasty ring device is intended for correction of mitral insufficiencies or steno-insufficiencies. The use of the Memo 4D device is indicated for correction of congenital or acquired mitral insufficiencies with dilatation and deformation of the mitral annulus.</Description><Size>Sizes 24,26,28,30, 32,34, 36, 38, 40, 42 mm</Size><SupplierCode>XQ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1842</GroupID><ARTGs><ARTG>332851</ARTG></ARTGs><MinimumBenefit>2280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FX003</BillingCode><PriorBillingCodes><PriorBillingCode>AH008</PriorBillingCode></PriorBillingCodes><Name>ambIT Single Use Regional Kit</Name><Description>The ambIT Single Use Regional Kit contains: a single use ambIT pump, single use administration cassette with male luer lock fitting, 420ml Medibag, the choice of 75mm, 127mm or 154mm fenestrated nerve/wound catheter, a peel away introducer sheath, button guard and patient carry bag.</Description><Size>ambIT Single Use Pump - 55mm x 36mm x 175mm  Ambit Single use administration cassette - 20mm x 10mm x 15mm   </Size><SupplierCode>FX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4186</SubGroupID><ARTGs><ARTG>190922</ARTG><ARTG>190933</ARTG><ARTG>190934</ARTG><ARTG>228804</ARTG><ARTG>228805</ARTG><ARTG>243381</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FX004</BillingCode><PriorBillingCodes><PriorBillingCode>AH013</PriorBillingCode></PriorBillingCodes><Name>ambIT Single Use</Name><Description>Kit contains: a single use ambIT infusion pump, single use administration cassette with spike fitting, Button Guard, 2 x AA batteries, and patient carry bag</Description><Size>AmbIT Single use Pump  - 55mm X 36mm X 175mm  AmbIT Single use administration cassette - 20mm X 10mm X 15mm</Size><SupplierCode>FX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4186</SubGroupID><ARTGs><ARTG>228804</ARTG><ARTG>228805</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FX002</BillingCode><PriorBillingCodes><PriorBillingCode>AH004</PriorBillingCode></PriorBillingCodes><Name>ambIT Infusion Pump</Name><Description>The ambIT Reusable Infusion Pump is an external programmable electronic ambulatory infusion pump used for the delivery of fluid and medications via intravenous, epidural, subcutaneous or regional routes.  It can be programmed with different delivery profiles which include basal rate/continuous only, basal rate with PCA (Patient Controlled Analgesia), PCA Bolus Only or Intermittent Bolus Dose (PIB). It is operated in conjunction with a ambIT disposable administration cassette</Description><Size>AmbIT Single use Pump - 55mm x 36mm x 175mm  AmbIT Single use administration cassette - 20mm x 10mm x 15mm</Size><SupplierCode>FX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4185</SubGroupID><ARTGs><ARTG>228804</ARTG></ARTGs><MinimumBenefit>2805</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ749</BillingCode><Name>Rythmic Evolution</Name><Description>Ambulatory infusion pump system intended to support intravenous, intra-arterial, subcutaneous, or intraperitoneal administration of medicine, and may be used in close proximity to nerves, into an intraoperative site (soft tissue, body cavity /surgical wound site), epidural space, or subarachnoid space. This is a reusable device.</Description><Size>Rythmic Evolution Pump 130mm x 133mm x 46mm (including 160 ml/200 ml bag); Rythmic Evolution Mini - 130mm x 75mm x 46mm (including 100 ml bag)</Size><SupplierCode>FX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4185</SubGroupID><ARTGs><ARTG>428078</ARTG></ARTGs><MinimumBenefit>2805</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ700</BillingCode><Name>Rythmic Evolution Administration Set</Name><Description>This administration set is intended for the administration of medicines or other liquid substances to the body through a catheter, by positive pressure of a Rythmic infusion pump, through intravenous, intraarterial, central neural block/regional neural block, subcutaneous, intraperitoneal and intraoperative sites (soft tissue, body cavity/surgical wound site). This is a sterile, single-use device.</Description><Size>Full set: 150cm +- 5cm; Spike set: 150cm +- 5cm; Luer set: 150cm +- 5cm; Y-extension line: 19cm +- 0.5cm</Size><SupplierCode>FX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1541</GroupID><SubGroupID>4191</SubGroupID><ARTGs><ARTG>427711</ARTG></ARTGs><MinimumBenefit>26</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ714</BillingCode><Name>Elasto-Q Infusion Pump and consumables (Strap, Silicon liquid storage device, Single-way filling port, Tubing, Clamp, Vent filter, Self-control device (PCA), Multiple regulator device, Transparent three way stopcock, Luer lock, Protective cap)</Name><Description>Elastomeric Infusion Pump System</Description><Size>200ml, 275ml, 500ml</Size><SupplierCode>FX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>409240</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FX001</BillingCode><PriorBillingCodes><PriorBillingCode>AH005</PriorBillingCode></PriorBillingCodes><Name>ambIT Infusion Pump Cassette</Name><Description>Single use sterile disposable administration set for use with the ambIT Infusion Pump.  The cassette contains a rotary mechanism that pumps the infusion solution at an accurate and controlled rate.  The cassette includes an administration line with either a spike fitting or a luer lock fitting depending on the solution bag used. The line has an inline air filter.</Description><Size>20mm x 10mm x 15mm</Size><SupplierCode>FX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1541</GroupID><SubGroupID>4191</SubGroupID><ARTGs><ARTG>228805</ARTG></ARTGs><MinimumBenefit>26</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ676</BillingCode><Name>Heliclip Endoscopic Hemoclip</Name><Description>Hemoclip for endoscopic marking and hemostasis.</Description><Size>9mm, 12mm or 16mm Opening Span</Size><SupplierCode>CK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>371015</ARTG></ARTGs><MinimumBenefit>125</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CK006</BillingCode><PriorBillingCodes><PriorBillingCode>EC019</PriorBillingCode></PriorBillingCodes><Name>Exmoor Plastics Ear Vent Drains -  Collar Button</Name><Description>Teflon </Description><Size>1.14 mm lumen dia x 2.24 mm inner flange dia x 2.24 mm outer flange dia x 1.27 inter flange. 1.78 mm total length</Size><SupplierCode>CK</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>133977</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CK008</BillingCode><PriorBillingCodes><PriorBillingCode>EC021</PriorBillingCode></PriorBillingCodes><Name>Exmoor Plastics Ear Vent Drains  -  Collar Button</Name><Description>Teflon </Description><Size>1.4 mm lumen dia x 2.55 mm inner flange dia x 2.55 mm outer flange dia x 0.85 inter flange. 1.35 mm total length</Size><SupplierCode>CK</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>133977</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CK009</BillingCode><PriorBillingCodes><PriorBillingCode>EC022</PriorBillingCode></PriorBillingCodes><Name>Exmoor Plastics Ear Vent Drains - Collar Button </Name><Description>Teflon </Description><Size>1.75 mm lumen dia x 2.85 mm inner flange dia x 2.85 mm outer flange dia x 0.95 inter flange. 1.46 mm total length</Size><SupplierCode>CK</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>133977</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CK005</BillingCode><PriorBillingCodes><PriorBillingCode>EC018</PriorBillingCode></PriorBillingCodes><Name>Exmoor Plastics Ear Vent Drains -  Reuter Bobbin </Name><Description>Without hole, teflon</Description><Size>1.14 mm lumen dia x 2.54 mm inner flange dia x 2.54 mm outer flange dia x 0.76 inter flange. 1.52mm total length</Size><SupplierCode>CK</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>133977</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CK012</BillingCode><PriorBillingCodes><PriorBillingCode>EC031</PriorBillingCode></PriorBillingCodes><Name>Exmoor Plastics Ear Vent Drains - Donaldson Grommet</Name><Description>With tab, silicone rubber</Description><Size>1.1 mm lumen dia x 2.25 mm inner flange dia x 2.25 mm outer flange dia x 0.76 inter flange. 2.25 mm total length</Size><SupplierCode>CK</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>133977</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CK007</BillingCode><PriorBillingCodes><PriorBillingCode>EC020</PriorBillingCode></PriorBillingCodes><Name>Exmoor Plastics Ear Vent Drains  -  Collar Button</Name><Description>Teflon </Description><Size>1.14 mm lumen dia x 3.0 mm inner flange dia x 3.0 mm outer flange dia x 1.27 inter flange. 1.78 mm total length</Size><SupplierCode>CK</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>133977</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CK013</BillingCode><Name>Exmoor Plastics Ventilation Tube - Shah </Name><Description>Teflon ventilation tube, w/o wire</Description><Size>Total Length: 2.41mm; Lumen Diameter: 1.14mm; Inner Flange Diameter: 3.61mm; Outer Flange Diameter: 2.59mm; Inter Flange Diameter: 1.42mm</Size><SupplierCode>CK</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>133977</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CK010</BillingCode><PriorBillingCodes><PriorBillingCode>EC024</PriorBillingCode></PriorBillingCodes><Name>Exmoor Plastics Ear Vent Drains - Shepards Drain</Name><Description>Teflon Shephards Drain</Description><Size>1.14 mm lumen dia x 2.36 mm inner flange dia x 2.36 mm outer flange dia x 1.42 inter flange. 2.41 mm total length</Size><SupplierCode>CK</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>133977</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CK011</BillingCode><PriorBillingCodes><PriorBillingCode>EC026</PriorBillingCode></PriorBillingCodes><Name>Exmoor Plastics Ear Vent Drains - Teflon Shephards Drain with wire grasping feature</Name><Description>Teflon Shephards Drain with wire</Description><Size>0.97 mm lumen dia x 2.08 mm inner flange dia x 2.08 mm outer flange dia x 1.42 inter flange. 2.41 mm total length</Size><SupplierCode>CK</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>133977</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU028</BillingCode><Name>Centrolock Plating System</Name><Description>CENTROLOCK Implant</Description><Size>Right and left 2, 4 and 6mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>235766</ARTG></ARTGs><MinimumBenefit>993</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU025</BillingCode><Name>Tuoren Infusion Pump</Name><Description>Non electronic, elastomeric balloon driven, ambulatory infusion pump, which can be supplied in a variety of volumes and flow rates to meet different clinical applications.  Its primary purpose is for continuous delivery of fluids/medications.</Description><Size>60ml - 300ml</Size><SupplierCode>BU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5359</SubGroupID><Suffix>Bolus</Suffix><ARTGs><ARTG>323586</ARTG></ARTGs><MinimumBenefit>367</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU013</BillingCode><PriorBillingCodes><PriorBillingCode>LI083</PriorBillingCode></PriorBillingCodes><Name>Lync Intramedullary Implant</Name><Description>Lync is a titanium intramedullary implant</Description><Size>12mm to 20mm Length, Angled 0 degrees and 10 degrees</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5474</SubGroupID><ARTGs><ARTG>235763</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU031</BillingCode><Name>Panda Hand Plating System</Name><Description>Straight and basic shaped plates</Description><Size>4 to 6 holes</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>428490</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU030</BillingCode><Name>Panda Hand Plating System</Name><Description>Complex form, hook  and gentian hand plates </Description><Size>1 to 6 holes</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>428490</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU023</BillingCode><Name>Airlock Plating System</Name><Description>MTP, MT wedge Lapidus, utility and Lisfranc T plate</Description><Size>MTP plates short and Wedge 0 to 5, Lapidus 0 to 3, Utility 0 to 6 holes and Lisfranc short to long.</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>235766</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU022</BillingCode><Name>Memofix</Name><Description>Threaded Titanium Suture Anchor</Description><Size>Diameter 4mm to 5mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>288706</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU037</BillingCode><Name>Varization Staples</Name><Description>Varization Staples 90 and 26 degrees</Description><Size>8mm, 10mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><ARTGs><ARTG>478348</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU035</BillingCode><Name>Panda Hand Plating System</Name><Description>Multidirectional locking screws</Description><Size>2.3mm x 5 to 30mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>429400</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU021</BillingCode><Name>Memofix</Name><Description>Threaded Titanium Suture Anchor</Description><Size>Diameter 3mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>288706</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU012</BillingCode><PriorBillingCodes><PriorBillingCode>LI087</PriorBillingCode></PriorBillingCodes><Name>Nexis osteosynthesis screws</Name><Description>Bone screw titanium alloy (compressive)</Description><Size>Diameter 5-7 mm, Length 26-120mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>235765</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU008</BillingCode><PriorBillingCodes><PriorBillingCode>LI077</PriorBillingCode></PriorBillingCodes><Name>Arcad osteosynthesis memory staples</Name><Description>Memory metal implants</Description><Size>8 to 25mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><Suffix>MM</Suffix><ARTGs><ARTG>235764</ARTG></ARTGs><MinimumBenefit>507</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU033</BillingCode><Name>Panda Hand Plating System</Name><Description>Straight and simple shaped plates</Description><Size>7 to 14 holes</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>428490</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU003</BillingCode><Name>Nexis osteosynthesis screws</Name><Description>Bone screw titanium alloy (headed)</Description><Size>Diameter 2.9-4mm, Length 10-60mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>235765</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU015</BillingCode><PriorBillingCodes><PriorBillingCode>LI091</PriorBillingCode></PriorBillingCodes><Name>Arcad osteosynthesis memory staples</Name><Description>Stainless steel static staples</Description><Size>8 to 10 mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><ARTGs><ARTG>235764</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ158</BillingCode><Name>Agomed Washers</Name><Description>Agomed Washers</Description><Size>Multiple</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>429400</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU026</BillingCode><PriorBillingCodes><PriorBillingCode>PF030</PriorBillingCode></PriorBillingCodes><Name>ARC Anchors</Name><Description>All Suture Anchor, multiple suture options</Description><Size>Small, Medium</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>336706</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU036</BillingCode><Name>Panda Hand Plating System</Name><Description>Double threaded screws</Description><Size>2.3mm x 5 to 30mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>429400</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU024</BillingCode><Name>Tuoren Infusion Pump</Name><Description>Non electronic, elastomeric balloon driven, ambulatory infusion pump, which can be supplied in a variety of volumes and flow rates to meet different clinical applications.  Its primary purpose is for continuous delivery of fluids/medications.</Description><Size>60ml - 300ml</Size><SupplierCode>BU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>323586</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU010</BillingCode><PriorBillingCodes><PriorBillingCode>LI084</PriorBillingCode></PriorBillingCodes><Name>Nexis osteosynthesis screws</Name><Description>Bone screw titanium alloy (compressive)</Description><Size>Diameter 2.3mm, Length 10-30mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>235765</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU029</BillingCode><Name>CentroLock Screws</Name><Description>CentroLock Screw System</Description><Size>smaller than 2.7mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>235767</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ174</BillingCode><Name>VAL Locking Screw</Name><Description>VAL Locking Screw</Description><Size>2.0mm or Less</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>429400</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU001</BillingCode><Name>Nexis osteosynthesis screws</Name><Description>Bone screw titanium alloy snap off</Description><Size>Diameter 2mm, Length 11-16mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>235767</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU014</BillingCode><PriorBillingCodes><PriorBillingCode>LI082</PriorBillingCode></PriorBillingCodes><Name>Airlock Plating System</Name><Description>Lisfranc H and Utility plates</Description><Size>8 hole Small, Medium, Large H plates and 7-hole Utility plate</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>235766</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU027</BillingCode><PriorBillingCodes><PriorBillingCode>PF029</PriorBillingCode></PriorBillingCodes><Name>ARC Anchors</Name><Description>All suture soft tissue anchor</Description><Size>Large</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>336706</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU007</BillingCode><PriorBillingCodes><PriorBillingCode>LI081</PriorBillingCode></PriorBillingCodes><Name>Airlock Bone screw</Name><Description>Bone Screws Titanium Alloy (non locking screws)</Description><Size>Diameter 3-3.5mm, Length 8-30mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>235767</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU009</BillingCode><PriorBillingCodes><PriorBillingCode>LI085</PriorBillingCode></PriorBillingCodes><Name>Nexis osteosynthesis screws</Name><Description>Bone screw titanium alloy (compressive)</Description><Size>Diameter 2.9-4 mm, Length 10-60mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>235765</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU032</BillingCode><Name>Panda Hand Plating System</Name><Description>Gentian plates</Description><Size>7 to 8 holes</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>428490</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ649</BillingCode><Name>Exofin Fusion Skin Closure System</Name><Description>Mesh and adhesive</Description><Size>Mesh 6-60cm and adhesive 0.5ml</Size><SupplierCode>BU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>386117</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ648</BillingCode><Name>Exofin Topical Skin Adhesive</Name><Description>Polymerising 2-octyl topical adhesive - tube and pen</Description><Size>0.5 - 1ml</Size><SupplierCode>BU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>386117</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU004</BillingCode><PriorBillingCodes><PriorBillingCode>LI080</PriorBillingCode></PriorBillingCodes><Name>Airlock Bone screw</Name><Description>Bone Screws Titanium Alloy (Locking screws)</Description><Size>Diameter 3-3.5mm, Length 8-30mm</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>235767</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BU034</BillingCode><Name>Panda Hand Plating System</Name><Description>Straight and simple shaped plates</Description><Size>16 -23 holes</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>428490</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ173</BillingCode><Name>Non-Locking Screw</Name><Description>Non-Locking Screw</Description><Size>2.0mm or Less</Size><SupplierCode>BU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>429400</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ013</BillingCode><Name>Z-HYALIN Plus Viscoelastic</Name><Description>Cohesive Viscoelastic Solution - sodium hyaluronate 15mg/ml.  (previously called Opthalin Plus)</Description><Size>Volume 1.0ml</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>150017</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ022</BillingCode><Name>VISTHESIA 1.5%</Name><Description>VISCOANAESTHETIC syringe contains sodium hyaluronate (NaHA, 1.5%) and lidocaine hydrochloride (1%). Also contains two topical ampoules with NaHA (0.3%) and lidocaine (2%)</Description><Size>0.8ml syringe &amp; 2x0.3ml ampoules</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>198088</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ012</BillingCode><Name>Z-HYALIN Viscoelastic</Name><Description>Cohesive Viscoelastic Solution - sodium hyaluronate 10mg/ml.  (previously called Ophthalin)</Description><Size>Volume 1.0ml</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>150016</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ048</BillingCode><Name>CT LUCIA 621P</Name><Description>One ZEISS UV light-absorbing Heparin Surface Hydrophobic Acrylic Posterior Chamber Intra-ocular Lens. This lens is intended to correct aphakia. It is made from an optically clear hydrophobic acrylic material which incorporates an UV-absorbing component and has a Heparin coating.</Description><Size>Dioptre Range: 00.0 to +34.0 with increments of 0.5  Optic Size: 6.0mm  Overall Length: 13.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>389794</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ043</BillingCode><Name>COMBIVISC</Name><Description>COMBIVISC consists of two ophthalmic viscoelastic devices. One prefilled syringe of dispersive viscoelastic 3% (0.85ml) and one prefilled syringe of cohesive viscoleastic 1.5% (1.0ml),  along with one 25 gauge Viscoflow cannula and one 27 gauge Viscoflow cannula, that can be used jointly or independently in surgical interventions to remove cataracts and implant a prosthetic lens.</Description><Size>COMBIVISC dispersive 3% 0.85ml 25G cannula
COMBIVISC cohesive 1.5% 1ml 27G cannula
Supplied as a single unit pack, comprising a single syringe of the COMBIVISC Dispersive and a single syringe of the COMBIVISC Cohesive 
Also supplied as a multipack containing five sealed pouched units</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><SubGroupID>3897</SubGroupID><ARTGs><ARTG>293592</ARTG></ARTGs><MinimumBenefit>66</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ019</BillingCode><Name>TWINVISC Viscoelastic</Name><Description>TWINVISC includes a cohesive and a dispersive viscoelastic in one syringe, separated by a valve.  Dispersive: sodium hyaluronate (2.2%).  Cohesive: sodium hyaluronate (1%)</Description><Size>Total volume 1.4 ml</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><SubGroupID>3897</SubGroupID><ARTGs><ARTG>160685</ARTG></ARTGs><MinimumBenefit>66</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ031</BillingCode><Name>AT TORBI 709MP (Standard Range)</Name><Description>Bitoric, preloaded, micro incision, aspheric (aberration neutral), foldable, square-edged, single-piece IOL for capsular bag fixation</Description><Size>Diopter range: Sph -10.0 to 32.0, Cyl +1.0 to 6.5
Optic size: 6.0mm, Overall length: 11.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3890</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>549</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ051</BillingCode><PriorBillingCodes><PriorBillingCode>DV244</PriorBillingCode></PriorBillingCodes><Name>D.O.R.C. Eftiar</Name><Description>Eftiar Decaline and Octane</Description><Size>5ml, 7ml</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1346</GroupID><ARTGs><ARTG>408574</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ042</BillingCode><Name>AT LARA 829MP</Name><Description>Extended depth of focus (EDoF), micro incision, single-piece IOL for capsular bag fixation, implantable with preloaded injector system, aberration neutral aspheric optical design</Description><Size>Diopter range: -10.0 D to +32.0 D, 0.5 increments
Optic size: 6mm
Overall length: 11mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ040</BillingCode><Name>CT SPHERIS 209M</Name><Description>Micro incision, Spherical aberrated, foldable square-edged single-piece intraocular lens for capsular bag fixation.</Description><Size>Diopter range :0.00 to + 32.0. Optic Size : 6mm  Overall Length  : 11mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3890</SubGroupID><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ020</BillingCode><Name>AT TORBI 709M</Name><Description>STANDARD RANGE BITORIC - ZEISS Micro Incision Aspheric (abberation neutral) IOL: Foldable, square-edged, single piece IOL for capsular bag fixation</Description><Size>6mm optic, 11mm overall diameter. Diopter range: Sph -10.0 to +32.0D, Cyl +1.0 to 6.5D (all 0.5D steps)</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3890</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>534</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ049</BillingCode><PriorBillingCodes><PriorBillingCode>DV231</PriorBillingCode></PriorBillingCodes><Name>Vision Blue</Name><Description>Trypan blue dye for ophthalmic applications</Description><Size>0.5ml syringe</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1330</GroupID><ARTGs><ARTG>193085</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ288</BillingCode><Name>AT TORBI 719M (Standard Range)</Name><Description>STANDARD RANGE BITORIC - ZEISS Micro Incision Aspheric (aberration neutral) IOL: Foldable, square-edged, single piece IOL for capsular bag fixation</Description><Size>Spherical Equivalent (SE) Diopter range: Sph -4.0 to +32.0D, 0.5D increments, Cylinder (cyl) +1.0 to 6.5D, 0.5 D increments, Optic size: 6.0mm, Overall length: 11.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3890</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>534</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ052</BillingCode><PriorBillingCodes><PriorBillingCode>DV270</PriorBillingCode></PriorBillingCodes><Name>OcuGas </Name><Description>Tamponade gas for retinal surgery</Description><Size>OCUGAS SF6 (15 ml)  OCUGAS C2F6 (12 ml)  OCUGAS C3F8 (9 ml)</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1345</GroupID><ARTGs><ARTG>408427</ARTG></ARTGs><MinimumBenefit>67</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ039</BillingCode><Name>AT LISA tri toric 939M high powered cylinder</Name><Description>Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation. The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and +1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision.</Description><Size>Diopter range: -10.00 to + 32.0 DS and +7 to +12 DC
Optic Size: 6.0mm. Overall Length: 11.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t2</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>1130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ016</BillingCode><Name>CT ASPHINA 409M</Name><Description>ZEISS Micro Incision Aspheric (aberration neutral) IOL: Foldable, square-edged, single piece IOL for capsular bag fixation</Description><Size>6mm optic, 11mm overall diameter. Diopter range 0.0 to +32.0D (0.5D steps from 10.0 to 30.0D, 1.0D outside this range)</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3890</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ046</BillingCode><Name>AT LARA toric 929MP</Name><Description>Bitoric Extended depth of focus (EDoF), micro incision, single-piece IOL for capsular bag fixation implantable with preloaded injector system, aberration neutral aspheric optical design</Description><Size>Diopter range SE: - 8.0 D to + 32.0 D in 0.5 increments
Cylinder: + 1.0 D to + 4.0 D in 0.5 increments
Further preselected SE/cylinder combinations are available above and below the stated SE range.
Optic size: 6mm, total diameter: 11mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>918</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ044</BillingCode><Name>AT LARA toric 929M high cylinder</Name><Description>Bitoric Extended depth of focus (EDoF), micro incision, single-piece IOL for capsular bag fixation implantable with injector system, aberration neutral aspheric optical design</Description><Size>Diopter range SE: - 4.0 D to + 32.0 D in 0.5 increments
Cylinder: + 7.0 D to + 12.0 D increments
Further preselected SE/cylinder combinations are available above and below the stated SE range.
Optic size: 6mm, total diameter: 11mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t2</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>1130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ027</BillingCode><Name>AT TORBI 709M</Name><Description>HIGH CYLINDER BITORIC - ZEISS Micro Incision Aspheric (aberration neutral) IOL: Foldable square edged, single piece IOL for capsular bag fixation</Description><Size>6mm optic, 11mm overall diameter.  Diopter range: Sph -10.0 to +32.0D, +7.0 to 12.0D (all 0.5D steps)</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3890</SubGroupID><Suffix>at, t2</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>751</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ028</BillingCode><Name>CT ASPHINA 409MP</Name><Description>Preloaded, micro incision, aspheric (aberration neutral), foldable square-edged single piece intraocular lens for capsular bag fixation.</Description><Size>Diopter range: 0.0 to 32.0D; Optic size: 6.0mm; Overall length: 11.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3890</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>270</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ017</BillingCode><Name>CT ASPHINA 509M</Name><Description>ZEISS Micro Incision Aspheric (aberration correcting) IOL: Foldable, square-edged, single piece IOL for capsular bag fixation</Description><Size>6mm Optic, 11mm overall diameter. Diopter range 0.0 to +32.0D (0.5D steps from 10.0 to 30.0D, 1.0D outside this range)</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3890</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ045</BillingCode><Name>AT LARA toric 929M low cylinder</Name><Description>Bitoric Extended depth of focus (EDoF), micro incision, single-piece IOL for capsular bag fixation implantable with injector system, aberration neutral aspheric optical design</Description><Size>Diopter range SE: - 4.0 D to + 32.0 D in 0.5 increments
Cylinder: + 4.5 D to + 6.5 D increments
Further preselected SE/cylinder combinations are available above and below the stated SE range.
Optic size: 6mm, total diameter: 11mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ286</BillingCode><Name>AT TORBI 719M High Cyl</Name><Description>HIGH CYLINDER BITORIC - ZEISS Micro Incision Aspheric (aberration neutral) IOL: Foldable square edged, single piece IOL for capsular bag fixation</Description><Size>Spherical Equivalent (SE) -4.0 to +32.0 D, 0.5 D increments Cylinder +7.0 to +12.0 D, 0.5 D increments Optic size: 6.0mm, Overall length: 11.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3890</SubGroupID><Suffix>at, t2</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>751</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ036</BillingCode><Name>AT LISA tri Toric 939MP</Name><Description>Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation, implantable with preloaded injector system. The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and + 1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision,</Description><Size>Diopter range -10.00 to +28.0 and +1 to +4.0 DC Optic size: 6..00mml; Overall length: 11.mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>918</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ273</BillingCode><Name>AT LISA TRI TORIC 949M - Low Cyl</Name><Description>Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation. The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and +1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate /30% near vision.</Description><Size>Spherical Equivalent (SE): -5.0 to +35.0 D, 0.5 D increments Low Cylinder +4.5 to +6.5 D, 0.5 D increments. Optic size: 6.0 mm Overall length: 11.mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ282</BillingCode><Name>AT LISA TRI TORIC 949MP</Name><Description>Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation, implantable with preloaded injector system. The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and + 1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision.</Description><Size>Spherical Equivalent (SE): -5.0 to +32.0 D, 0.5 D increments Cylinder +1.0 to +4.0 D, 0.5 D increments, Optic size: 6.0 mm Overall length: 11.mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>918</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ050</BillingCode><PriorBillingCodes><PriorBillingCode>DV243</PriorBillingCode></PriorBillingCodes><Name>D.O.R.C. Silicon Oil</Name><Description>D.O.R.C. Silicon Oil 1000/2000/5000-S</Description><Size>10ml</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1347</GroupID><ARTGs><ARTG>408427</ARTG></ARTGs><MinimumBenefit>176</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ041</BillingCode><Name>CT LUCIA 202</Name><Description>Foldable, 3-piece, monofocal, square-edged, hydrophobic acrylic intraocular lens.</Description><Size>Diopter size: 4.0 to 34.0 DS.  Optic size: 6mm.  Overall length: 13mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>214</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ038</BillingCode><Name>AT LISA tri toric 939M low cylinder</Name><Description>Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation.  The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and +1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision.</Description><Size>Diopter range: -10.00 to + 32.0 DS and +1 to +6.5DC
Optic Size: 6.0mm. Overall Length: 11.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ272</BillingCode><Name>AT LISA TRI TORIC 949M - High Cyl</Name><Description>Trifocal (aspheric), bitoric, micro incision, single-piece IOL for capsular bag fixation. The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and +1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision.</Description><Size>Spherical Equivalent (SE): -5.0 to +35.0 D, 0.5 D increments, High Cylinder +7.0 to 12.0 D, 0.5D increments. Optic size: 6.0 mm Overall length: 11.mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t2</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>1130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ034</BillingCode><Name>AT LISA tri 839MP</Name><Description>Trifocal (aspheric) micro incision, single-piece IOL for capsular bag fixation, implantable with preloaded injector system.  The trifocal (anterior) optic provides two diffractive focal points (+3.33D near focus and +1.66D intermediate focus) with asymmetric light distribution 50% distance / 20% intermediate / 30% near vision.</Description><Size>Diopter range: 0.0 to +32.0D (0.5D increments). Optic size: 6.0mm. Overall Length: 11.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>134490</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ047</BillingCode><Name>CT LUCIA 621PY</Name><Description>One ZEISS UV light-absorbing Heparin Surface Hydrophobic Acrylic Posterior Chamber Intra-ocular Lens. This lens is intended to correct aphakia. It is made from an optically clear hydrophobic acrylic with yellow dye additive (Acrylmex Yellow) [Optically clear blue-light blocking]</Description><Size>Dioptre Range: 00.0 to +34.0 with increments of 0.5   Optic Size: 6.0mm   Overall Length: 13.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>389793</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ030</BillingCode><Name>CT ASPHINA 404</Name><Description>Small incision, foldable, single piece, monofocal, aspheric (aberration neutral), square-edged, hydrophilic acrylic (with hydrophobic surface properties) intraocular lens for capsular bag fixation. (Monofocal lens for powers outside standard 409MP MICS range).</Description><Size>Diopter range: -10.0 to 42.0, Optic size: 6.0mm, Overall length: 11.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ287</BillingCode><Name>AT TORBI 719MP (Standard Range)</Name><Description>Bitoric, preloaded, micro incision, aspheric (aberration neutral), foldable, square-edged,
single-piece IOL for capsular bag fixation</Description><Size>Spherical Equivalent (SE) -8.0 to +28.0 D, 0.5 D increments Cylinder +1.0 to +4.0 D, 0.5 D increments Optic size: 6.0mm, Overall length: 11.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3890</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>151348</ARTG></ARTGs><MinimumBenefit>549</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CZ037</BillingCode><Name>CT ASPHINA 509MP</Name><Description>Preloaded, micro incision, aspheric (aberration correcting), foldable square-edged single-piece intraocular lens for capsular bag fixation</Description><Size>Diopter range: 0.0 to + 32.0D; Optic Size: 6.0mm; Overall length: 11.0mm</Size><SupplierCode>CZ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3890</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>134490</ARTG></ARTGs><MinimumBenefit>270</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XR003</BillingCode><Name>Khelix Steerable Electrophysiology Catheter 10 Pole</Name><Description>The Khelix Steerable Electrophysiology Catheters are designed to facilitate electrophysiological mapping of the heart. Each unit consists of a catheter shaft equipped with an array of platinum-iridium electrodes for both stimulation and recording. The catheters are available in various electrode configurations and curve types.
The distal tip can be deflected in one direction by pushing the deflection knob. The tip is straightened by returning the knob to the original position.
Khelix Steerable Electrophysiology Catheter interfaces with standard electrophysiological recording equipment, such as ECG monitoring equipment, impedance based navigational equipment and cardiac stimulation equipment, via the Khelix Diagnostic Extension Cable (supplied separately).</Description><Size>Shaft diameter 6F, Length 115cm, various number of electrodes (4 - 10), connector 10 poles and featuring either active tip or passive tip</Size><SupplierCode>XR</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Khelix, Steerable 10 pole</Suffix><ARTGs><ARTG>278921</ARTG></ARTGs><MinimumBenefit>730</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XR001</BillingCode><Name>Khelix Loop Steerable Electrophysiology Catheter</Name><Description>Steerable Loop PV Mapping Catheter 7F</Description><Size>Various</Size><SupplierCode>XR</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Khelix Loop</Suffix><ARTGs><ARTG>278923</ARTG></ARTGs><MinimumBenefit>2500</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XR004</BillingCode><Name>Khelix Steerable Electrophysiology Catheter 20 Pole</Name><Description>The Khelix Steerable Electrophysiology Catheters are designed to facilitate electrophysiological mapping of the heart. Each unit consists of a catheter shaft equipped with an array of platinum-iridium electrodes for both stimulation and recording. The catheters are available in various electrode configurations and curve types.
They are compatible with standard electrophysiological recording equipment, including ECG monitoring systems, impedance-based navigation systems, and cardiac stimulation equipment, via the Khelix Diagnostic Extension Cable (sold separately).</Description><Size>Shaft diameter 6F, Length 115cm, various number of electrodes (10 - 20), connector 20 poles, and featuring either active tip or passive tip</Size><SupplierCode>XR</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Khelix Steerable 20 pole</Suffix><ARTGs><ARTG>278921</ARTG></ARTGs><MinimumBenefit>1250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XR002</BillingCode><Name>Khelix Fixed Electrophysiology Catheter</Name><Description>The Khelix Fixed Electrophysiology Catheters are designed to facilitate electrophysiological mapping of the heart. It consists of a catheter shaft containing an array of platinum-iridium electrodes for stimulation and recording. The device is available in a number of different electrode configurations and curve types.
The Khelix Fixed Electrophysiology Catheter interfaces with standard electrophysiological recording equipment, such as ECG monitoring equipment, impedance based navigational equipment and cardiac stimulation equipment, via the Khelix Diagnostic Extension Cable (supplied separately).
Khelix Fixed Electrophysiology Catheter is intended to be used with the extension cable (supplied separately).</Description><Size>Diameter 6F, Length 115cm, various number of electrodes, and featuring active tip</Size><SupplierCode>XR</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>Khelix, fix</Suffix><ARTGs><ARTG>278920</ARTG></ARTGs><MinimumBenefit>225</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JP003</BillingCode><PriorBillingCodes><PriorBillingCode>JA023</PriorBillingCode></PriorBillingCodes><Name>Pro-Disc L - Core Component - Polyethylene Inlay</Name><Description>Pro-Disc L - Core Component - Polyethylene Inlay</Description><Size>10, 12, 14mm, Medium, Large</Size><SupplierCode>JP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1490</GroupID><ARTGs><ARTG>323814</ARTG></ARTGs><MinimumBenefit>1065</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JP004</BillingCode><PriorBillingCodes><PriorBillingCode>JA024</PriorBillingCode></PriorBillingCodes><Name>Pro-Disc C (Vivo)</Name><Description>Prosthesis used to replace a cervical inter-vertebral disc and to restore disc height and segmental motion.</Description><Size>5-7mm Hright  15-19 mm Width  12-18mm Depth</Size><SupplierCode>JP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5487</SubGroupID><ARTGs><ARTG>323813</ARTG></ARTGs><MinimumBenefit>6021</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JP011</BillingCode><PriorBillingCodes><PriorBillingCode>JA032</PriorBillingCode><PriorBillingCode>OH630</PriorBillingCode></PriorBillingCodes><Name>Prodisc-C</Name><Description>Cervical Intervertebral Disc</Description><Size>5-7mm Height; 15-19mm Width; 12-18mm Depth</Size><SupplierCode>JP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5487</SubGroupID><ARTGs><ARTG>196068</ARTG></ARTGs><MinimumBenefit>6021</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JP001</BillingCode><PriorBillingCodes><PriorBillingCode>JA021</PriorBillingCode></PriorBillingCodes><Name>Pro-Disc L Superior Plate Component</Name><Description>Pro-Disc L Superior Plate Component</Description><Size>3 Degree, 6 Degree, 11 Degree, Medium, Large</Size><SupplierCode>JP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1489</GroupID><ARTGs><ARTG>323814</ARTG></ARTGs><MinimumBenefit>3891</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JP002</BillingCode><PriorBillingCodes><PriorBillingCode>JA022</PriorBillingCode></PriorBillingCodes><Name>Pro-Disc L Inferior Plate Component</Name><Description>Pro-Disc L Inferior Plate Component</Description><Size>0 Degree, 6 Degree, 8 Degree, Medium, Large</Size><SupplierCode>JP</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1489</GroupID><ARTGs><ARTG>323814</ARTG></ARTGs><MinimumBenefit>3891</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO098</BillingCode><Name>Cochlear Nucleus 8 Nexa (Nucleus 8 Nexa) Sound Processor - Hybrid Mode (Initial)</Name><Description>Nucleus 8 Nexa Sound Processor - Hybrid Mode (Nucleus 8 Nexa) is a behind-the-ear (BTE) sound processor and exclusively compatible with Nucleus Nexa cochlear implants. It has similar features to the Nucleus 8, including SmartSound iQ 2 with SCAN 2 directional noise reduction algorithm, Bluetooth LE Audio Ready technology and automate function. The sound processor consists of the processing unit, Slimline coil, magnet and battery module. The Nucleus 8 Nexa in hybrid mode facilitates acoustic stimulation in the cochlea.
</Description><Size>There is one size of the sound processor unit with 4 battery options and 6 different magnet strengths</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4145</SubGroupID><Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>394470</ARTG><ARTG>475911</ARTG></ARTGs><MinimumBenefit>12796</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO074</BillingCode><Name>Cochlear Nucleus CI522 Cochlear Implant with Slim Straight Electrode</Name><Description>Model CI522, 5th generation cochlear implant with straight electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal.</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>389477</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO078</BillingCode><Name>Cochlear™ Nucleus® CI532 Cochlear Implant with Slim Modiolar Electrode</Name><Description>Model CI532, 5th generation cochlear implant with slim modiolar electrode array. Sheath, titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal. Compatible with 1.5T static magnetic field.</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>389476</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO092</BillingCode><Name>Cochlear Nucleus Nexa (CI1032) Cochlear Implant with Slim Modiolar Electrode</Name><Description>Nucleus Nexa series (CI1032), cochlear implant with Slim Modiolar electrode array. Sheath, titanium casing, removable magnet, 22 half banded platinum-iridium electrodes, moulded in a durable tapered silicone seal, and compatible with 1.5T and 3T static magnetic field. The CI1032 implant is designed to function in a similar manner to the Profile Plus Series (CI632) implant.</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>475908</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO095</BillingCode><Name>Cochlear Nucleus Kanso 3 (CP1170) Sound Processor (Replacement)</Name><Description>Nucleus Kanso 3 (Kanso 3) is Cochlear’s next generation off-the-ear (OTE) style sound processor. Kanso 3 has the benefits of the latest sound processing technologies of the behind-the-ear (BTE) Cochlear Nucleus 8 (Nucleus 8). Compared to Kanso 2, Kanso 3 provides improved features such as SmartSound iQ 2 with SCAN 2 directional noise reduction algorithm, Bluetooth LE Audio Ready technology and automate function.</Description><Size>One size, single magnet and battery charging option  </Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>475909</ARTG></ARTGs><MinimumBenefit>8114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO081</BillingCode><Name>Cochlear™ Nucleus® CP1000 Sound Processor - Hybrid™ Mode (initial)</Name><Description>The CP1000 (Nucleus 7, N7) - Hybrid Mode is a behind-the-ear (BTE) sound processor that is designed to function in a similar manner to the CP900 series (CP910/920) (Nucleus 6, N6) sound processor but with new architectural design, which provides improved battery life and MFi wireless connectivity directly with iOS devices via Smart App. The CP1000 in hybrid mode facilitates acoustic stimulation in the cochlea.</Description><Size>There is one size of the sound processor unit with 3 battery options and 7 different magnet strengths.</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4145</SubGroupID><Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>292000</ARTG></ARTGs><MinimumBenefit>12796</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO088</BillingCode><Name>Kanso® 2, Cochlear™ Nucleus® CP1150 Sound Processor (Initial)</Name><Description>The CP1150 Sound Processor (Kanso 2) is Cochlear’s next generation off-the-ear (OTE) style sound processor. Kanso 2 has the benefits of the latest sound processing technologies of the behind-the-ear (BTE) Cochlear™ Nucleus® 7  (N7). Compared to Kanso 1, Kanso 2 provides improved hearing performance in noise due to Spatial NR, and improved hearing experience and reduced user cost through buttonless interface, iOs and Android smartphone direct streaming and a rechargeable battery.  The initial Kanso 2 Kit provides multiple magnet strengths and range of battery charging options.</Description><Size>One size, multiple magnet strengths and range of battery charging options</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4145</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>351996</ARTG></ARTGs><MinimumBenefit>11392</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ642</BillingCode><Name>Osia System</Name><Description>Piezoelectric bone conduction implant system consisting of: the OSI300 implant with piezoelectric transducer, osseointegrated titanium self-tapping BI300, the Osia 2(I) sound processor with 2-way digital link, surgical components and software, for hearing loss up to 55dB.
The improved Osia System features a magnet technology allowing magnetic resonance imaging at 1.5 and 3.0 Tesla without the use of a splint kit or magnet removal.</Description><Size>OSI300 implant: One size, BI300: 3mm and 4mm, Osia 2(I) sound processor: One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>2960</GroupID><ARTGs><ARTG>123984</ARTG><ARTG>124177</ARTG><ARTG>292265</ARTG><ARTG>304387</ARTG><ARTG>305019</ARTG><ARTG>305024</ARTG><ARTG>355711</ARTG><ARTG>358293</ARTG><ARTG>375451</ARTG><ARTG>375452</ARTG><ARTG>444958</ARTG><ARTG>444959</ARTG></ARTGs><MinimumBenefit>14369</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ722</BillingCode><Name>Osia 2 Sound Processor Kit</Name><Description>Osia 2 replacement sound processor with 2-way digital link, compatible with the OSI200 implant of the Osia System.</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>2960</GroupID><Suffix>2-way digital link</Suffix><ARTGs><ARTG>375450</ARTG></ARTGs><MinimumBenefit>6808</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO087</BillingCode><Name>Cochlear Baha 6 Max Sound Processor </Name><Description>The Baha 6 Max is Cochlear’s next generation off-the-ear (OTE) sound processor for use with Cochlear Baha ‘Connect’ and ‘Attract’ Implantable Bone Conduction Hearing Systems with a fitting range up to 55dB HL. Baha 6 Max has broader bandwidth at higher frequencies, SmartSound iQ automatic noise reduction technology, iOS and Android smartphone direct streaming, and smaller, lighter, and more discreet OTE technology.</Description><Size>1 x SP size with 2 options of the snap coupling sizes</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4150</SubGroupID><Suffix>Programmable, Wireless-enabled, Autoscan</Suffix><ARTGs><ARTG>123987</ARTG></ARTGs><MinimumBenefit>6808</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO089</BillingCode><Name>Osia System</Name><Description>Piezoelectric bone conduction implant system consisting of: the Osia implant with piezoelectric transducer, osseointegrated titanium self-tapping BI300, the Osia sound processor with 2-way digital link, surgical components and software, for hearing loss up to 55dB.</Description><Size>Osia implant: One size  BI300: 3mm and 4mm  Osia sound processor: One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>2960</GroupID><ARTGs><ARTG>123984</ARTG><ARTG>124177</ARTG><ARTG>304387</ARTG><ARTG>305019</ARTG><ARTG>305024</ARTG><ARTG>355711</ARTG><ARTG>358293</ARTG><ARTG>375450</ARTG><ARTG>375451</ARTG><ARTG>389472</ARTG></ARTGs><MinimumBenefit>14369</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO103</BillingCode><Name>Cochlear Baha 7 Sound Processor </Name><Description>Baha 7 is Cochlear’s next-generation off-the-ear (OTE) sound processor for use with Cochlear Baha ‘Connect’ and ‘Attract’ Implantable Bone Conduction Hearing Systems, with a fitting range up to 55dB HL. Baha 7 features Bluetooth Low Energy (LE) Audio and Auracast broadcast-ready technology and is compatible with the new TV-Streamer+ and Multi-Mic+ wireless accessories.</Description><Size>1 x SP size with 2 options of the snap coupling sizes</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4150</SubGroupID><Suffix>Programmable, Wireless-enabled, Autoscan</Suffix><ARTGs><ARTG>123987</ARTG></ARTGs><MinimumBenefit>6808</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO097</BillingCode><Name>Cochlear Nucleus Nexa (CI1022) Cochlear Implant with Slim Straight Electrode</Name><Description>Nucleus Nexa series (CI1022) cochlear implant with Slim Straight electrode array. Titanium casing, removable magnet, 22 half banded platinum electrodes, moulded in a durable tapered silicone seal, and compatible with 1.5T and 3T static magnetic field. The CI1022 implant is designed to function in a similar manner to the Profile Plus Series (CI622) implant.</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>475907</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO096</BillingCode><Name>Cochlear Nucleus Nexa (CI1012) Cochlear Implant with Contour Advance Electrode</Name><Description>Nucleus Nexa series (CI1012) cochlear implant with Contour Advance electrode array. Titanium casing, removable magnet, 22 half banded platinum electrodes, moulded in a durable tapered silicone seal, and compatible with 1.5T and 3T static magnetic field. The CI1012 implant is designed to function in a similar manner to the Profile Plus Series (CI612) implant.</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>475906</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO091</BillingCode><Name>Cochlear™ Nucleus® 8 (CP1110) Sound Processor - Hybrid™ Mode (replacement)</Name><Description>The Nucleus 8 (CP1110) - Hybrid Mode is a behind-the-ear (BTE) sound processor that is designed to function in a similar manner to the Nucleus 7 (CP1000) Sound Processor but with improved features such as smaller size, new directional noise reduction algorithm (SmartSound® iQ 2 with SCAN 2), Bluetooth® LE Audio Ready technology and automate function. The sound processor consists of the processing unit, Slimline™ coil, magnet and battery module. The Nucleus 8 in hybrid mode facilitates acoustic stimulation in the cochlea.</Description><Size>There is one size of the sound processor unit with 3 battery options and 7 different magnet strengths.</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>394470</ARTG><ARTG>394471</ARTG><ARTG>394472</ARTG></ARTGs><MinimumBenefit>9078</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO099</BillingCode><Name>Cochlear Nucleus 8 Nexa (Nucleus 8 Nexa) Sound Processor - Hybrid Mode (Replacement)</Name><Description>Nucleus 8 Nexa Sound Processor - Hybrid Mode (Nucleus 8 Nexa) is a behind-the-ear (BTE) sound processor and exclusively compatible with Nucleus Nexa cochlear implants. It has similar features to the Nucleus 8, including SmartSound iQ 2 with SCAN 2 directional noise reduction algorithm, Bluetooth LE Audio Ready technology and automate function. The sound processor consists of the processing unit, Slimline coil, magnet and battery module. The Nucleus 8 Nexa in hybrid mode facilitates acoustic stimulation in the cochlea.
</Description><Size>There is one size of the sound processor unit with 4 battery options and 6 different magnet strengths</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>394470</ARTG><ARTG>475911</ARTG></ARTGs><MinimumBenefit>9078</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO085</BillingCode><Name>Cochlear™ Nucleus® Profile Plus Series (CI622) Cochlear Implant with Slim Straight Electrode</Name><Description>Profile Plus Series CI622, 6th generation cochlear implant with Slim Straight electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal, compatible with 1.5T and 3T static magnetic field.</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>389668</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO083</BillingCode><Name>Cochlear™ Nucleus® Profile Plus Series (CI632) Cochlear Implant with Slim Modiolar Electrode</Name><Description>Profile Plus Series CI632, 6th generation cochlear implant with Slim Modiolar electrode array. Sheath, titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal, compatible with 1.5T and 3T static magnetic field.</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>389693</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO094</BillingCode><Name>Cochlear Nucleus Kanso 3 Nexa (CP1175) Sound Processor (Initial)</Name><Description>Nucleus Kanso 3 Nexa (Kanso 3 Nexa) is Cochlear’s next generation off-the-ear (OTE) style sound processor and is exclusively compatible with Nucleus Nexa cochlear implants. Kanso 3 Nexa has the benefits of the latest sound processing technologies of the behind-the-ear (BTE) Cochlear Nucleus Nexa 8 (Nucleus 8 Nexa). Compared to Kanso 2, Kanso 3 Nexa provides improved features such as SmartSound iQ 2 with SCAN 2 directional noise reduction algorithm, Bluetooth LE Audio Ready technology and automate function.</Description><Size>One size, multiple magnet strengths and range of battery charging options</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4145</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>475910</ARTG></ARTGs><MinimumBenefit>11392</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO046</BillingCode><Name>Cochlear™ Nucleus® CI512 Cochlear Implants with Contour Advance Electrode</Name><Description>Model CI512, 5th generation cochlear implant with perimodiloar electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable silicone seal.</Description><Size>One Size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>389667</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO054</BillingCode><Name>Baha Cover Screw conical</Name><Description>Titanium cover screw of the Baha BI300 implant system used in the two-stage surgery.</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4152</SubGroupID><ARTGs><ARTG>123984</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO086</BillingCode><Name>Kanso® 2, Cochlear™ Nucleus® CP1150 Sound Processor (Replacement)</Name><Description>The CP1150 Sound Processor (Kanso 2) is Cochlear’s next generation off-the-ear (OTE) style sound processor. Kanso 2 has the benefits of the latest sound processing technologies of the behind-the-ear (BTE) Cochlear™ Nucleus® 7. Compared to Kanso 1, Kanso 2 provides improved hearing performance in noise due to Spatial NR, and improved hearing experience and reduced user cost through buttonless interface, iOs and Android smartphone direct streaming and a rechargeable battery. The Replacement Kanso 2 Kit provides a single magnet and battery charging option.</Description><Size>One size, single magnet and battery charging option  </Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>351996</ARTG></ARTGs><MinimumBenefit>8114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO100</BillingCode><Name>Cochlear Nucleus Kanso 3 (CP1170) Sound Processor (Initial)</Name><Description>Nucleus Kanso 3 (Kanso 3) is Cochlear’s next generation off-the-ear (OTE) style sound processor. Kanso 3 has the benefits of the latest sound processing technologies of the behind-the-ear (BTE) Cochlear Nucleus 8 (Nucleus 8). Compared to Kanso 2, Kanso 3 provides improved features such as SmartSound iQ 2 with SCAN 2 directional noise reduction algorithm, Bluetooth LE Audio Ready technology and automate function.</Description><Size>One size, multiple magnet strengths and range of battery charging options</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4145</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>475909</ARTG></ARTGs><MinimumBenefit>11392</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO051</BillingCode><Name>Baha® BI300 Implant</Name><Description>Titanium self-tapping implant with TiOblast surface of the Baha 3 system</Description><Size>3mm and 4 mm</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>Fixture &amp; Concave</Suffix><ARTGs><ARTG>123984</ARTG></ARTGs><MinimumBenefit>1028</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO093</BillingCode><Name>Cochlear Nucleus Kanso 3 Nexa (CP1175) Sound Processor (Replacement)</Name><Description>Nucleus Kanso 3 Nexa (Kanso 3 Nexa) is Cochlear’s next generation off-the-ear (OTE) style sound processor and is exclusively compatible with Nucleus Nexa cochlear implants. Kanso 3 Nexa has the benefits of the latest sound processing technologies of the behind-the-ear (BTE) Cochlear Nucleus Nexa 8 (Nucleus 8 Nexa). Compared to Kanso 2, Kanso 3 Nexa provides improved features such as SmartSound iQ 2 with SCAN 2 directional noise reduction algorithm, Bluetooth LE Audio Ready technology and automate function.</Description><Size>One size, single magnet and battery charging option  </Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>475910</ARTG></ARTGs><MinimumBenefit>8114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO084</BillingCode><Name>Cochlear™ Nucleus® Plus Series (CI612) Cochlear Implant with Contour Advance Electrode</Name><Description>Profile Plus Series CI612, 6th generation cochlear implant with Contour Advance electrode array. Titanium casing, removable magnet, 22 half-banded platinum electrodes, moulded in a durable tapered silicone seal, compatible with 1.5T and 3T static magnetic field.</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>389471</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO102</BillingCode><PriorBillingCodes><PriorBillingCode>OI037</PriorBillingCode></PriorBillingCodes><Name>Neuro 2 Sound Processor Replacement</Name><Description>The behind the ear Neuro 2 sound processor performs with the Neuro Zti cochlear implants. It consists of two microphones allowing for three automatic adaptive directionality modes, voice tracker and wind noise reduction features.     Its benefits include: smaller and more cosmetically appealing design and rechargeable batteries.    The processor is placed on the auricle of the either one of the patient's ears and an external antenna transmits the acoustic signal processed by the processor, by means of electromagnetic induction, to the internal component implanted beneath the skin and secured onto the mastoid.</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>Generation 4</Suffix><ARTGs><ARTG>316140</ARTG></ARTGs><MinimumBenefit>7648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO082</BillingCode><Name>Cochlear™ Nucleus® CP1000 Sound Processor - Hybrid™ Mode (replacement)</Name><Description>The CP1000 (Nucleus 7, N7) - Hybrid Model is a behind-the-ear (BTE) sound processor that is designed to function in a similar manner to the CP900 series (CP910/920) (Nucleus 6, N6) sound processor but with new architectural design, which provides improved battery life and MFi wireless connectivity directly with iOS devices via Smart App. The CP1000 in hybrid mode facilitates acoustic stimulation in the cochlea.</Description><Size>There is one size of the sound processor unit with 3 battery options and 7 different magnet strengths.</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>292000</ARTG></ARTGs><MinimumBenefit>9078</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO090</BillingCode><Name>Cochlear™ Nucleus® 8 (CP1110) Sound Processor - Hybrid™ Mode (initial)</Name><Description>The Nucleus 8 (CP1110) - Hybrid Mode is a behind-the-ear (BTE) sound processor that is designed to function in a similar manner to the Nucleus 7 (CP1000) Sound Processor but with improved features such as smaller size, new directional noise reduction algorithm (SmartSound® iQ 2 with SCAN 2), Bluetooth® LE Audio Ready technology and automate function. The sound processor consists of the processing unit, Slimline™ coil, magnet and battery module. The Nucleus 8 in hybrid mode facilitates acoustic stimulation in the cochlea.</Description><Size>There is one size of the sound processor unit with 3 battery options and 7 different magnet strengths.</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4145</SubGroupID><Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>394470</ARTG><ARTG>394471</ARTG><ARTG>394472</ARTG></ARTGs><MinimumBenefit>12796</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO050</BillingCode><Name>Baha BA210 Abutment</Name><Description>Titanium abutments compatible with hexagonal coupling Baha implants</Description><Size>5.5mm and 8.5mm</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>Abutment</Suffix><ARTGs><ARTG>123984</ARTG></ARTGs><MinimumBenefit>850</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO068</BillingCode><Name>Cochlear™ Baha® BIM400 Implant Magnet</Name><Description>The Cochlear Baha BIM400 is an implantable magnet that lies completely under the skin</Description><Size>One size</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>Magnetic Coupling</Suffix><ARTGs><ARTG>123984</ARTG></ARTGs><MinimumBenefit>1059</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO062</BillingCode><Name>Cochlear™ Baha®  BA400 DermaLock™ Abutment</Name><Description>Titanium abutment with hydroxyapatite (HA) coating</Description><Size>6mm, 8mm, 10mm, 12mm, 14mm</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>HA</Suffix><ARTGs><ARTG>123984</ARTG></ARTGs><MinimumBenefit>1059</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CO063</BillingCode><Name>Cochlear ™ Baha® BIA400 Implant with Abutment</Name><Description>Pre-mounted self-tapping titanium implant with TiOblast™ surface and coated Abutment with hydroxyapatite (HA) coating for Baha FAST surgery</Description><Size>4mm implant with pre-mounted 6mm, 8mm, 10mm, or 12mm , or 14mm abutment</Size><SupplierCode>CO</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>Abutment &amp; Fixture, HA</Suffix><ARTGs><ARTG>123984</ARTG></ARTGs><MinimumBenefit>2087</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT030</BillingCode><Name>Biosoft Minute Stent</Name><Description>Biosoft minute double loop ureteral stent. Ready to use; the stent is in place over the guidewire and connected to the steerable pusher. Duration of implantation: 6 months.</Description><Size>6 - 8 Fr
24 - 30 cm length</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><ARTGs><ARTG>142925</ARTG><ARTG>224219</ARTG></ARTGs><MinimumBenefit>153</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT023</BillingCode><Name>Biosoft Duo Multi Length Hydro-Coated Ureteral Stents</Name><Description>Biosoft Duo Multi Length Hydro-Coated Stents for drainage of upper urinary tract.</Description><Size>4.8, 6. 7 Fr</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1702</GroupID><SubGroupID>5325</SubGroupID><ARTGs><ARTG>142925</ARTG></ARTGs><MinimumBenefit>154</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT025</BillingCode><Name>Stenostent Double Loop Ureteral Stents</Name><Description>STENOSTENT® Double loop ureteral stent in silicone open/open, total reinforcement with connectable pusher and fixed core guidewire</Description><Size>16 - 30cm</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>SP</Suffix><ARTGs><ARTG>142923</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT029</BillingCode><Name>Vortek Double Loop Ureteral Stents</Name><Description>Vortek Double Loop Ureteral Stents have a double layered structure which make them easy to insert over guidewire, the stiffness of each size has been adapted in order to keep the mechanical properties.</Description><Size>4.8, 6, 7 &amp; 8 Fr
with steerable or simple pusher
with or without guidewire
O/O or O/C</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><ARTGs><ARTG>142924</ARTG><ARTG>224254</ARTG></ARTGs><MinimumBenefit>153</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT035</BillingCode><Name>Vortek Hydro-Coated Double Loop Ureteral Stents</Name><Description>Vortek Hydro-Coated Double Loop Ureteral Stents with simple or steerable pusher and with or without guidewire</Description><Size>4.8 - 7Fr
22 - 30cm lengths</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><ARTGs><ARTG>224254</ARTG></ARTGs><MinimumBenefit>153</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT012</BillingCode><Name>Titan Inflatable Penile Prosthesis (Resist Coated) - True-lock Plug</Name><Description>True Lock Plug for deactivation of three component penile prosthesis (Resist Coated)</Description><Size>One Size</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5333</SubGroupID><ARTGs><ARTG>140111</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT027</BillingCode><Name>Vortek Single Loop Ureteral Stents</Name><Description>Vortek Single Loop Ureteral Stents for drainage and urine collection</Description><Size>6, 7, 8 Fr
90cm length</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><ARTGs><ARTG>142924</ARTG><ARTG>224254</ARTG></ARTGs><MinimumBenefit>153</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT028</BillingCode><Name>Pyelostent Double Loop Ureteral Stent</Name><Description>Pyelostent, Silicone stent for long-term implantation (up to 12 months)</Description><Size>26 - 30cm</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>SP</Suffix><ARTGs><ARTG>142923</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT032</BillingCode><Name>Silicone Double Loop Ureteral Stent</Name><Description>Silicone Double Loop Ureteral Stent with guidewire and pusher</Description><Size>6 - 8Fr
16cm - 30cm</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><ARTGs><ARTG>142923</ARTG></ARTGs><MinimumBenefit>153</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT011</BillingCode><Name>Titan Inflatable Penile Prosthesis (Resist Coated) - Pump</Name><Description>Pump for three component penile prosthesis (Resist Coated)</Description><Size>One Size</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5332</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>140111</ARTG></ARTGs><MinimumBenefit>4432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT010</BillingCode><Name>Titan Inflatable Penile Prosthesis (Resist Coated) - Lock-out Valve Reservoir</Name><Description>Reservoir for three component penile prosthesis (Resist Coated)</Description><Size>60, 75, 100ml</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5331</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>140111</ARTG></ARTGs><MinimumBenefit>1881</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT005</BillingCode><PriorBillingCodes><PriorBillingCode>MN027</PriorBillingCode></PriorBillingCodes><Name>Titan Inflatable Penile Prosthesis (Resist Coated) - Assembly Kit</Name><Description>Assembly kit for three component penile prosthesis (Resist Coated)</Description><Size>Standard &amp; Narrow -base</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5334</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>140111</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT031</BillingCode><Name>Vortek TUMOR STENT Double loop ureteral stent</Name><Description>Vortek Tumor Stent is reinforced with stiffness of material offering excellent resistance to compression.</Description><Size>7-8Fr
26-30cm in length</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><ARTGs><ARTG>224254</ARTG></ARTGs><MinimumBenefit>153</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT008</BillingCode><Name>Titan Inflatable Penile Prosthesis (Resist Coated) - Cylinders</Name><Description>Cylinders for three component penile prosthesis (Resist Coated)</Description><Size>10, 12, 14,  16, 18, 20, 22cm</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5330</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>140111</ARTG></ARTGs><MinimumBenefit>3638</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT009</BillingCode><Name>Titan Inflatable Penile Prosthesis (Resist Coated) - Cylinders &amp; Pump Preconnected</Name><Description>Preconnected Cylinders &amp; pump for three component penile prosthesis (Resist Coated)</Description><Size>10, 12, 14, 16, 18, 20, 22cm (in both infrapubic &amp; scrotal models)</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1710</GroupID><SubGroupID>5335</SubGroupID><Suffix>A</Suffix><ARTGs><ARTG>140111</ARTG></ARTGs><MinimumBenefit>8070</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT026</BillingCode><Name>Biosoft Duo Double Loop Ureteral Stents</Name><Description>Biosoft Duo double loop ureteral stents supplied with simple or steerable pusher, with or without guidewire and with or without flush catheter depending on the model. Duration of Implantation: 12 months</Description><Size>6 - 9 Fr
20 - 30 cm
Either O/O or O/C</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><ARTGs><ARTG>142925</ARTG><ARTG>224254</ARTG></ARTGs><MinimumBenefit>153</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT007</BillingCode><PriorBillingCodes><PriorBillingCode>MN025</PriorBillingCode></PriorBillingCodes><Name>Genesis Penile Prosthesis (Resist Coated)</Name><Description>Malleable Penile Prosthesis (Resist Coated)</Description><Size>Dia: 9.5 mm (14 - 23cm lengths), Dia: 11mm (16 - 25cm lengths), Dia: 13mm (18 - 27cm lengths)</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>230</SubCategoryID><GroupID>1721</GroupID><Suffix>A</Suffix><ARTGs><ARTG>140302</ARTG></ARTGs><MinimumBenefit>828</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CT003</BillingCode><PriorBillingCodes><PriorBillingCode>MN007</PriorBillingCode></PriorBillingCodes><Name>Saline Filled Testicular Prosthesis</Name><Description> Testicular Prosthesis</Description><Size>Extra Small, Small, Medium, Large</Size><SupplierCode>CT</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>231</SubCategoryID><GroupID>1711</GroupID><ARTGs><ARTG>140205</ARTG></ARTGs><MinimumBenefit>620</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ683</BillingCode><Name>Colink Cfx Calcaneal Z Plate</Name><Description>Titanium Calcaneal Plate.</Description><Size>less than 6 Hole.</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV149</BillingCode><Name>Infinity  Tibial Button</Name><Description>The tibial buttons are available in two (2) sizes to accommodate various tunnel sizes and is meant to be used with the adjustable free loop for suspensory fixation of soft tissue grafts to bone in ligament reconstruction procedures.</Description><Size>Standard and Large</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ027</BillingCode><PriorBillingCodes><PriorBillingCode>LM285</PriorBillingCode></PriorBillingCodes><Name>IBS Screw</Name><Description>Compression Screw</Description><Size>3.00 &amp; 3.5mm diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ254</BillingCode><Name>Colink 4.5 locking Screws</Name><Description>Locking Titanium Alloy Screws 4.5 mm</Description><Size>20mm - 50 mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ682</BillingCode><Name>IBS - B Compression Screws</Name><Description>Titanium Headless Compression Screws</Description><Size>3.3, 4.0 mm Compression Screws, 16 - 60 mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>348714</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV010</BillingCode><Name>Mini-Revo Screw</Name><Description>Soft Tissue Re-attachment - Titanium</Description><Size>2.7mm diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ040</BillingCode><PriorBillingCodes><PriorBillingCode>LM351</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic locking Screws</Name><Description>Orthopaedic locking Screws</Description><Size>2.71 to 4.49 mm diameter, all lengths</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV151</BillingCode><Name>Argo Knotless PEEK NSP Anchor</Name><Description>The CONMED Argo KnotlessTM Anchors are manufactured from PolyEtherEtherKetone (PEEK). Non-self-punching products include tips manufactured from PEEK. The anchors are provided sterile, preloaded on a single-use driver and pre-threaded with one Hi-Fi® Ribbon. It may be used in either arthroscopic or open surgical procedures. After the suture is anchored to the bone, it may be used to reattach soft tissue, such as ligaments, tendons, or joint capsules to the bone. The suture anchor system thereby stabilizes the damaged soft tissue, in conjunction with appropriate postoperative immobilization throughout the healing period.</Description><Size>4.75mm, 5.5mm PEEK NSP suture anchors</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>376571</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ256</BillingCode><Name>Colink 4.5 Variable Angle locking Screws</Name><Description>Variable Angle Locking Titanium Alloy Screws 4.5 mm</Description><Size>20mm - 50mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ279</BillingCode><Name>Colink 3.0mm Low-Pro Cortical Screws</Name><Description>Low-profile 3.0mm Cortical Screws Titanium Type II Anodised </Description><Size>8 - 30 mm </Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV117</BillingCode><Name>CrossFT Suture Anchor Polyester</Name><Description>PEEK Optima Suture Anchor with Multiple Polyester Sutures</Description><Size>4.5mm, 5.5mm and 6.5mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ229</BillingCode><Name>Colink 3.5 Low-Pro Locking Screws</Name><Description>Low-profile Locking Titanium Type II Anodised Screws 3.5 mm</Description><Size>3.5 mm Diam x Length (10 - 60 mm)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA01</BillingCode><Name>Semitendinosis, Tendon, Frozen, Non-Irradiated</Name><Size>Various</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3591</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ020</BillingCode><PriorBillingCodes><PriorBillingCode>LM340</PriorBillingCode></PriorBillingCodes><Name>Bone Screws</Name><Description>Plate Fixation Bone Screws</Description><Size>2.71 to 4.49mm diameter  All lengths</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ037</BillingCode><PriorBillingCodes><PriorBillingCode>LM350</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic Fixation Screw</Name><Description>Fixation Screw</Description><Size>4.5mm and larger diameter, all lengths</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ678</BillingCode><Name>Colink Afx One Third Tubular Plates Small</Name><Description>One-third Tubular Plates</Description><Size>3, 4, 5, 6 Hole Plates</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ202</BillingCode><Name>IBS - B Neutralization Screws</Name><Description>Titanium Headless Neutralisation Screws</Description><Size>3.3, 4.0 mm Neutralisation Screws, 16 - 60 mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>348714</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ033</BillingCode><PriorBillingCodes><PriorBillingCode>LM290</PriorBillingCode></PriorBillingCodes><Name>NEOFIT - Screws</Name><Description>NEOFIT screws</Description><Size>2.7 &amp; 3.0mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ130</BillingCode><PriorBillingCodes><PriorBillingCode>LM371</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic Fixation Screw</Name><Description>Fixation Screw</Description><Size>2.0mm or less diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>346</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV084</BillingCode><Name>SmartNail</Name><Description>Self-reinforced 96L / 4D PLA Bone Fixation Nail</Description><Size>2.4mm O.D x 16, 25, 35 &amp; 45mm L</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>139690</ARTG></ARTGs><MinimumBenefit>257</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA40</BillingCode><Name>Patella Bone-Tendon-Bone, Whole (Special) with Quadriceps, Frozen, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6150</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV123</BillingCode><Name>Press FT PEEK Suture Anchor</Name><Description>Press FT PEEK Suture Anchor - preloaded on a single driver</Description><Size>2.6mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA46</BillingCode><Name>MPJ Arthrodesis Lengthening Graft Segment, Frozen, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2721</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ021</BillingCode><PriorBillingCodes><PriorBillingCode>LM341</PriorBillingCode></PriorBillingCodes><Name>Bone Screws - Locking</Name><Description>Locking</Description><Size>2.71mm - 4.49mm diameter
All lengths</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA17</BillingCode><Name>ENHANCE® Demineralized Cortical Fiber, 2.5cc, Dehydrated, Non-Irradiated</Name><Size>2.5cc</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3087</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ066</BillingCode><PriorBillingCodes><PriorBillingCode>LM377</PriorBillingCode></PriorBillingCodes><Name>Fibular Osteotomy Plates</Name><Description>Fibular Osteotomy Plates</Description><Size>Sizes to suit patient anatomy</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>113</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA06</BillingCode><Name>Anterior Tibialis Tendon, Frozen, Non-Irradiated</Name><Size>Various</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3624</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV113</BillingCode><Name>PopLok Suture Anchor</Name><Description>PEEK Optima Suture Anchor with or without sutures</Description><Size>2.8mm, 3.3mm, 3.5mm &amp; 4.5mm diameters</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA20</BillingCode><Name>Patella Bone-Tendon-Bone, Hemi with Quadriceps, Frozen, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3540</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA38</BillingCode><Name>Quadriceps Tendon, with 10.0mm Shaped Bone Blocks, Frozen, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2900</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV091</BillingCode><Name>ThRevo Suture Anchor</Name><Description>Titanium screw-in suture anchor</Description><Size>5.0mm OD x 14.2mm L</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ278</BillingCode><Name>Colink 3.0mm Locking Screws</Name><Description>Locking Screws 3.0mm Titanium Type II Anodised </Description><Size>8 - 30 mm </Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA13</BillingCode><Name>High Tibial Osteotomy Wedge Cortical Bone Wedges, (2-Piece), Freeze Dried, Non-Irradiated</Name><Size>Various diameters and lengths:  6-8mm x 3-6cm Length  10-18 x 5.5cm Length</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2950</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV142</BillingCode><Name>Knee Preservation System - GraftMax</Name><Description>Adjustable loop button for soft tissue fixation</Description><Size>KS-ALB and KS BTB (LxWxH):  14mm x 4.5mm x 2mm
KS-BCA (Cradle) (LxWxH): 21mm x 6mm x 2.8mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA30</BillingCode><Name>AlloPatchHD Acellular Human Dermis, ≥ 25cm² ≥ 1.8mm, Hydrated, Non-Irradiated</Name><Size>≥ 25cm²  ≥ 1.8mm Thick</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299299</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3479</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV144</BillingCode><Name>DuraClip™ Repositionable Hemostasis Clip</Name><Description>A single use repositionable hemostasis clip which is intended to be used for placement within the gastrointestinal tract.</Description><Size>165cm Length and 235cm Length</Size><SupplierCode>LV</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>274973</ARTG></ARTGs><MinimumBenefit>125</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA27</BillingCode><Name>AlloPatchHD Acellular Human Dermis, ≤ 25cm²  ≥ 1.8mm, Dehydrated, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2733</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV076</BillingCode><Name>Reflex ELC 530 Automatic Clip Applier</Name><Description>Titanium Endoscopic Clip Applier</Description><Size>Medium/Large, 10mm, 20 Clips</Size><SupplierCode>LV</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Laparoscopic</Suffix><ARTGs><ARTG>131194</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV147</BillingCode><Name>MicroLink All-Suture Button</Name><Description>The MicroLink™ All-Suture Button (Radiopaque) is an all-suture suspension device with one strand of #2 (5  metric) Hi-Fi® suture, a radiopaque flat braid Hi-Fi® Suture Button and a radiopaque flat braid Hi-Fi® suture  Backstop</Description><Size>N/A</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA10</BillingCode><Name>Achillies Tendon, Frozen, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2971</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ259</BillingCode><Name>Hercules Syndesmosis Implant Kit</Name><Description>Implant and Instrument Kit containing Two Titanium Alloy buttons tensioned with UHMWPE suture and guidewires and drill bits for stabilisation of the ankle.</Description><Size>1 Size</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>431330</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA52</BillingCode><Name>Demineralized 80%Cortical/20%Cancellous Granules, Freeze dried, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2597</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV109</BillingCode><Name>XO Button with Continuous Loop</Name><Description>Titanium suspensor, fixation device for femoral fixation in ACT and PCL repairs</Description><Size>4.5mm x 13.5mm with Continuous Loop lengths 15-60mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ044</BillingCode><PriorBillingCodes><PriorBillingCode>LM374</PriorBillingCode></PriorBillingCodes><Name>Plate Screw</Name><Description>Plate Screw</Description><Size>4.5mm diameter and greater</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA16</BillingCode><Name>Demineralized Cancellous Chips, Freeze dried, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2396</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA43</BillingCode><Name>Quadriceps Tendon, without Bone Block, Frozen, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3172</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV086</BillingCode><Name>Reflex 5mm Automatic Clip Applier</Name><Description>Autofeeding disposable clip applier. Contains 15 non absorbable polymer locking clips</Description><Size>medium/large</Size><SupplierCode>LV</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Laparoscopic</Suffix><ARTGs><ARTG>212478</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA23</BillingCode><Name>ENHANCE® Demineralized Cortical Fiber, 10cc, Dehydrated, Non-Irradiated</Name><Size>10cc</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>5316</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ131</BillingCode><PriorBillingCodes><PriorBillingCode>LM380</PriorBillingCode></PriorBillingCodes><Name>Screw and Locking Cap</Name><Description>Screw and Locking Cap</Description><Size>2.71 to 4.49 mm diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ018</BillingCode><PriorBillingCodes><PriorBillingCode>LM286</PriorBillingCode></PriorBillingCodes><Name>Bone Screw</Name><Description>Bone Screw</Description><Size>2.71 to 4.49mm diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ232</BillingCode><Name>Colink 4.0 Cancellous Screws</Name><Description>Cancellous Titanium Type II Anodised Screws 4.0 mm</Description><Size>4.0 mm Diam x Length (10 - 60 mm)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ065</BillingCode><PriorBillingCodes><PriorBillingCode>LM376</PriorBillingCode></PriorBillingCodes><Name>Fibular Osteotomy Plates</Name><Description>Fibular Osteotomy Plates</Description><Size>Multiple sizes to suit patient anatomy</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>113</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA54</BillingCode><Name>Fascia Lata, ≤ 60cm², Freeze Dried, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1821</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV118</BillingCode><Name>Genesys CrossFT</Name><Description>Micro TCP Soft Tissue Suture Anchor with multiple sutures with or without needles</Description><Size>4.5mm, 5.5mm, 6.5mm diameters</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>194022</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ047</BillingCode><PriorBillingCodes><PriorBillingCode>LM372</PriorBillingCode></PriorBillingCodes><Name>Tibial Osteotomy Plates</Name><Description>Tibial Osteotomy Plates</Description><Size>Multiple sizes to suit patient anatomy</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>113</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ016</BillingCode><PriorBillingCodes><PriorBillingCode>LM369</PriorBillingCode></PriorBillingCodes><Name>Ankle Arthrodesis Nail</Name><Description>Ankle Arthrodesis Nail</Description><Size>Multiple sizes to suit patient anatomy</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3332</SubGroupID><ARTGs><ARTG>308941</ARTG></ARTGs><MinimumBenefit>3300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA11</BillingCode><Name>Revision Core, Various Sizes, Freeze Dried, Non-Irradiated</Name><Size>10-16mm Diameter  ≤36mm Length</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2960</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ231</BillingCode><Name>Colink 3.5 Variable Angle Locking Screws</Name><Description>Variable Angle Locking Titanium Type II Anodised Screws 3.5 mm</Description><Size>3.5 mm Diam x Length (10 - 60 mm)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ038</BillingCode><PriorBillingCodes><PriorBillingCode>LM349</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic Fixation Screw</Name><Description>Fixation Screw</Description><Size>2.71 to 4.49mm diameter all lengths</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV148</BillingCode><Name>Infinity Femoral Adjustable Loop Button</Name><Description>The Infinity Fixation System is a metal buttons and non-absorbable Hi-Fi suture for suspensory fixation of soft tissue grafts to bone used in ligament reconstruction procedures.The cradle is an adaptor for the adjustable loop button, used for wide tunnels.</Description><Size>N/A</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ017</BillingCode><PriorBillingCodes><PriorBillingCode>LM288</PriorBillingCode></PriorBillingCodes><Name>Bone Screw</Name><Description>Bone Screw</Description><Size>4.5mm diameter and larger</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ072</BillingCode><PriorBillingCodes><PriorBillingCode>LM381</PriorBillingCode></PriorBillingCodes><Name>Screw and Locking Cap</Name><Description>Screw and Locking Cap</Description><Size>4.5 mm and larger diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA47</BillingCode><Name>Bone-Tendon-Bone, Hemi with Quadriceps, Freeze Dried, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3832</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV063</BillingCode><Name>SmartNail</Name><Description>Self-Reinforced 96L/4D PLA Bone Fixation Nail</Description><Size>1.5mm O.D x 16, 20 &amp; 25mm L</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>139690</ARTG></ARTGs><MinimumBenefit>257</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV112</BillingCode><Name>CrossFT Suture Anchor</Name><Description>PEEK Optima Suture Anchor with multiple sutures with or without needles</Description><Size>4.5mm, 5.5mm &amp; 6.5mm diameters</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA42</BillingCode><Name>Quadriceps Tendon, with Bone Block, Frozen, Non-Irradiated</Name><Size>various</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3791</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ029</BillingCode><PriorBillingCodes><PriorBillingCode>LM282</PriorBillingCode></PriorBillingCodes><Name>IBS Screw</Name><Description>Compression Screw</Description><Size>2mm diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>346</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV027</BillingCode><Name>Pre-Loaded Ultrafix RC Anchor</Name><Description>Surgical Grade Stainless Steel, preloaded with 2 #2 sutures</Description><Size>Dia 2.9mm, length 6.5mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ129</BillingCode><PriorBillingCodes><PriorBillingCode>LM343</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic Fixation Plate</Name><Description>Orthopaedic Fixation Plate</Description><Size>Screw size 2.7mm or less
7 to 15 holes</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA48</BillingCode><Name>Bone-Tendon-Bone, Hemi with 10.0mm Shaped Bone Blocks, Freeze Dried, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3680</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ026</BillingCode><PriorBillingCodes><PriorBillingCode>LM287</PriorBillingCode></PriorBillingCodes><Name>IBS Screw</Name><Description>Compression Screw</Description><Size>4.5, 6.5 &amp; 8.0mm diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ206</BillingCode><Name>5MS Titanium Locking Plates greather than and equal to 7 Hole</Name><Description>Anatomic curved titanium 8-hole plates for 5th metatarsal fractures and osteotomies</Description><Size>7 -15 Hole Plate</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA44</BillingCode><Name>Fascia Lata, ≥ 60cm² - ≤100cm² ≥, Freeze Dried, Non-Irradiated</Name><Size>2.5cm x 25cm  5cm x 15cm</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2714</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA45</BillingCode><Name>Fascia Lata, ≤ 60cm², Frozen, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2110</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ064</BillingCode><PriorBillingCodes><PriorBillingCode>LM379</PriorBillingCode></PriorBillingCodes><Name>Ankle Fusion Plate</Name><Description>Ankle Fusion Plate</Description><Size>Suitable for patient anatomy</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>113</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA05</BillingCode><Name>Fascia Lata, ≥ 120cm²  ≤ 180cm², Frozen, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2400</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ230</BillingCode><Name>Colink 3.5 Low-Pro Non-Locking Screws</Name><Description>Low-profile Non-Locking Titanium Type II Anodised Screws 3.5 mm</Description><Size>3.5 mm Diam x Length (10 - 60 mm)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA21</BillingCode><Name>Patella Bone-Tendon-Bone, Whole with Quadriceps, Frozen, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>5917</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ069</BillingCode><PriorBillingCodes><PriorBillingCode>LM490</PriorBillingCode></PriorBillingCodes><Name>Fully Threaded Suture Anchor </Name><Description>Fully Threaded Suture Anchor </Description><Size>≥4mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>364759</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV081</BillingCode><Name>Open Clip Applier</Name><Description>Titanium</Description><Size>25 medium size titanium clips</Size><SupplierCode>LV</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4257</SubGroupID><ARTGs><ARTG>131194</ARTG></ARTGs><MinimumBenefit>125</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ204</BillingCode><Name>5MS 2.4 / 2.7 mm Non-Locking Screws</Name><Description>2.4 / 2.7 mm Cortical Bone Screws Non-Locking Titanium Type II Anodised </Description><Size>2.4 / 2.7 mm Diam x Length (8mm - 30 mm)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV139</BillingCode><Name>Y-Knot RC &amp; Y-Knot Pro RC Suture Anchor</Name><Description>The Y-Knot RC All-Suture Anchor is constructed from High Strength Flat Braided Suture.</Description><Size>2.8mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV119</BillingCode><Name>Y-Knot Suture Anchor</Name><Description>Y-Knot All Suture Anchor</Description><Size>1.3mm to 2.1mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ226</BillingCode><Name>Colink 2.7 Low-Pro Locking Screws</Name><Description>Low-profile Locking Titanium Type II Anodised Screws 2.7 mm</Description><Size>2.7 mm Diam x Length (8 - 50 mm)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ213</BillingCode><Name>Colink Cfx Calcaneal Plates</Name><Description>Titanium Locking Calcaneal Plates Various Designs </Description><Size>Small, Medium, Large 9-13 Holes</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5296</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>1149</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ068</BillingCode><PriorBillingCodes><PriorBillingCode>LM489</PriorBillingCode></PriorBillingCodes><Name>Fully Threaded Suture Anchor </Name><Description>Fully Threaded Suture Anchor </Description><Size>2.4-3.9mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>364759</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ227</BillingCode><Name>Colink 2.7 Low-Pro Non-Locking Screws</Name><Description>Low-profile Non-Locking Titanium Type II Anodised Screws 2.7 mm</Description><Size>2.7 mm Diam x Length (8 - 50 mm)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV120</BillingCode><Name>GENESYS Matryx Interference Screw, diameter 7 - 11mm</Name><Description>GENESYS Matryx Interference Screw  - cannulated bioabsorbable</Description><Size>7.0x20mm,7.0x25mm,7.0x30mm,8.0x20mm,8.0x25mm,8.0x30mm,8.0x35mm,9.0x20mm,9.025mm,9.0x30mm,9.0x35mm,10x20mm,10x25mm,10x30mm,10x35mm,11x20mm,11x25mm,11x25mm,11x25mm,11x25mm,11x30mm,11x35mm,11x40mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>194179</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ039</BillingCode><PriorBillingCodes><PriorBillingCode>LM348</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic Fixation Screw</Name><Description>Fixation Screw</Description><Size>2.01 to 2.7mm all lengths</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV150</BillingCode><Name>Paradigm ClickLok Anchor</Name><Description> The Paradigm ClickLok Anchor (UHMWPE) is a High Strength Flat Braided Suture Anchor with Hi-Fi (UHMWPE) Braided Suture preloaded on Stainless Steel driver. It may be used in either arthroscopic or open surgical procedures. After the suture is anchored to the bone, it may be used to reattach soft tissue, such as ligaments, tendons, or joint capsules to the bone. The suture anchor system thereby stabilizes the damaged soft tissue, in conjunction with appropriate postoperative immobilization throughout the healing period.   </Description><Size>1.8 mm all suture anchor</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ203</BillingCode><Name>5MS 2.4 / 2.7 mm Locking Screws</Name><Description>2.4 / 2.7 mm Cortical Bone Screws Locking Titanium Type II Anodised </Description><Size>2.4 / 2.7 mm Diam x Length (8mm - 30mm)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ023</BillingCode><PriorBillingCodes><PriorBillingCode>LM247</PriorBillingCode></PriorBillingCodes><Name>Compression Staples</Name><Description>Compression Staples</Description><Size>Multiple sizes</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><Suffix>COMP</Suffix><ARTGs><ARTG>236772</ARTG></ARTGs><MinimumBenefit>396</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ022</BillingCode><PriorBillingCodes><PriorBillingCode>LM355</PriorBillingCode></PriorBillingCodes><Name>Compression Staple</Name><Description>Memory Metal Compression Staple</Description><Size>Multiple Sizes</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><Suffix>MM</Suffix><ARTGs><ARTG>338955</ARTG></ARTGs><MinimumBenefit>507</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA24</BillingCode><Name>Cotton Wedge, Freeze dried, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3011</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV018</BillingCode><Name>Cannulated Interference Screws</Name><Description>ACL Fixation - Titanium</Description><Size>Diameter 7.0 - 9.0mm, Length 20 - 40mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>129072</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA19</BillingCode><Name>Achilles Tendon, with Shaped Bone Blocks, Frozen, Non-Irradiated</Name><Size>Various</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4080</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV017</BillingCode><Name>Guardsman Femoral Interference Screws</Name><Description>ACL Fixation - Titanium</Description><Size>Diameter 7.0 - 9.0mm, Length 20 - 30mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>129072</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ067</BillingCode><PriorBillingCodes><PriorBillingCode>LM488</PriorBillingCode></PriorBillingCodes><Name>Fully Threaded Suture Anchor</Name><Description>Fully Threaded Suture Anchor</Description><Size>≤2.3mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>364759</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV114</BillingCode><Name>Super Revo-FT,ThRevo-FT</Name><Description>Fully Threaded Suture Anchor pre-threaded with two or three sutures with or without needles</Description><Size>5mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV153</BillingCode><Name>Infinity AIM</Name><Description>The Infinity AIM™ is an implantable suture retention device which facilitates percutaneous or endoscopic repair of meniscal tears. The Infinity AIM™ is composed of two (2) polyetheretherketone (PEEK) implants and a strand of #2-0 ultra-high molecular weight polyethylene (UHMWPE) Hi-Fi® suture, blue in color, from solid blue DSM fiber (Cr-Co-Al Oxidecolorant).  </Description><Size>Infinity AIM™, KMR2R - 15° Reverse with two 5mm polyetheretherketone (PEEK) implants and a strand of #2-0 ultra-high molecular weight polyethylene (UHMWPE) Hi-Fi® suture between them        Infinity AIM™ KMR2S 25° Curved with two 5mm polyetheretherketone (PEEK) implants and a strand of #2-0 ultra-high molecular weight polyethylene (UHMWPE) Hi-Fi® suture between them  </Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV121</BillingCode><Name>GENESYS Matrix Interference Screw, diameter 5-6.5mm.</Name><Description>GENESYS Matrix Interference Screw - Cannulated,bioabsorbable</Description><Size>5.0mm diameter x15,20,25,30mm lengths
5.5mm diameter x15,20,25,30mm lengths
6.0mm diameter x15,20,25,30mm lengths
6.5mm diameter x15,20,25,30mm lengths</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>101275</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ045</BillingCode><PriorBillingCodes><PriorBillingCode>LM352</PriorBillingCode></PriorBillingCodes><Name>Snap Off Screws</Name><Description>Snap Off Screws</Description><Size>2.01 to 2.7mm diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>295</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV146</BillingCode><Name>EZStart Screw</Name><Description>The EZStart™ Interference Screw is a dual threaded titanium interference screw with a tapered tip for easy insertion into  bone</Description><Size>6-10mm width x 15 - 30mm long</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>129072</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV145</BillingCode><Name>CrossFt Knotless DT</Name><Description>Screw in knotless anchor</Description><Size>4.0mm CrossFT Knotless Anchor  4.0mm CrossFT Knotless Anchor (w/ 1 blue Hi-Fi tape)  4.0mm CrossFT Knotless Anchor (w/ 1 white/black Hi-Fi tape)  4.75mm CrossFT Knotless Anchor   4.75mm CrossFT Knotless Anchor (w/ 1 blue Hi-Fi tape)  4.75mm CrossFT Knotless Anchor (w/ 1 white/black Hi-Fi tape)  5.5mm CrossFT Knotless Anchor   5.5mm CrossFT Knotless Anchor (w/ 1 blue Hi-Fi tape)  5.5mm CrossFT Knotless Anchor (w/ 1 white/black Hi-Fi tape)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ034</BillingCode><PriorBillingCodes><PriorBillingCode>LM354</PriorBillingCode></PriorBillingCodes><Name>Non-Locking Screws</Name><Description>Non-Locking Screws</Description><Size>2.7mm diameter, multiple lengths</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ025</BillingCode><PriorBillingCodes><PriorBillingCode>LM246</PriorBillingCode></PriorBillingCodes><Name>Duafit</Name><Description>Interphalangeal implant</Description><Size>11 - 20 mm implant length, zero, 10.0 or 17.0 degrees of plantarflexion</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5474</SubGroupID><ARTGs><ARTG>236773</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ205</BillingCode><Name>5MS Plantar Plates </Name><Description>Anatomic contoured titanium 4, 5-hole plates for proximal 5th metatarsal fractures.</Description><Size>4, 5 Hole Plates</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ036</BillingCode><PriorBillingCodes><PriorBillingCode>LM339</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic Fixation Plate</Name><Description>Orthopaedic Fixation Plates</Description><Size>2 - 8 holes and/or Small, Medium, Large</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5298</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>1007</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV090</BillingCode><Name>Super Revo Suture Anchor with Hi-Fi Suture</Name><Description>Titanium Suture Anchor</Description><Size>5.0mm O.D x 14.2mm L</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV143</BillingCode><Name>TenoLok</Name><Description>Soft tissue anchor with or without suture</Description><Size>5.0mm and 6.0mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA37</BillingCode><Name>Patella Bone-Tendon-Bone, Hemi with 10.0mm Shaped Bone Blocks, Frozen, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4237</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ042</BillingCode><PriorBillingCodes><PriorBillingCode>LM345</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic Plate Fixation Screw</Name><Description>Orthopaedic Plate Fixation Screw</Description><Size>2.01 to 2.7 mm diameter
all lengths</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ251</BillingCode><Name>Colink 2.4 mm Low-Pro Non-Locking Screws</Name><Description>Low-profile Non-Locking Titanium Type II Anodised Screws 2.4 mm</Description><Size>2.4 mm Diam x Length (8mm - 24 mm)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV016</BillingCode><Name>Propel Interference Screws</Name><Description>ACL Fixation - Titanium</Description><Size>Diameter 7.0 - 9.0mm, Length 20 - 30mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>129072</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA08</BillingCode><Name>Gracilis Tendon, Frozen, Non-Irradiated</Name><Size>Various</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3281</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ024</BillingCode><PriorBillingCodes><PriorBillingCode>LM365</PriorBillingCode></PriorBillingCodes><Name>Distal Radius Plates</Name><Description>Distal Radius Plates</Description><Size>Multiple Sizes</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV125</BillingCode><Name>GENESYS PressFT Suture Anchor 2.1mm</Name><Description>The ConMed Linvatec GENESYS PressFT (biocomposite) Suture Anchors are manufactured from polylactide copolymer (96L/4D PLA co-polymer) and beta-tricalcium phosphate (B-TCp), and are provided sterile, preloaded on a single-use driver and pre-threaded with either one or two Hi-Fi Sutures</Description><Size>2.1mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>208881</ARTG></ARTGs><MinimumBenefit>503</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ030</BillingCode><PriorBillingCodes><PriorBillingCode>LM370</PriorBillingCode></PriorBillingCodes><Name>Intramedullary Nail Screw</Name><Description>Intramedullary Nail Screw</Description><Size>Multiple sizes to suit patient anatomy</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3341</SubGroupID><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ253</BillingCode><Name>Colink Mini Plates VAL up to 6 Hole</Name><Description>Foot and Ankle Mini Plates Titanium, Various designs straight, L, and T Plates.</Description><Size>2 - 6 Hole</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ028</BillingCode><PriorBillingCodes><PriorBillingCode>LM283</PriorBillingCode></PriorBillingCodes><Name>IBS Screw</Name><Description>Compression Screw</Description><Size>2.5mm diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ207</BillingCode><Name>5MS Titanium Locking Plates less than equal to 6 Hole</Name><Description>Anatomic curved titanium 4 - 6 -hole plates for 5th metatarsal fractures.</Description><Size>4, 5, 6, Hole</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ031</BillingCode><PriorBillingCodes><PriorBillingCode>LM361</PriorBillingCode></PriorBillingCodes><Name>Jones Fracture Plate</Name><Description>Jones Fracture Plate</Description><Size>6 holes or less</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA36</BillingCode><Name>Patella Bone-Tendon-Bone, Hemi without Quadriceps, Frozen, Non-irradiated</Name><Size>Various</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4233</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ035</BillingCode><PriorBillingCodes><PriorBillingCode>LM342</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic Fixation Plate</Name><Description>Orthopaedic Fixation Plates</Description><Size>Screw size 2.7mm or less
6 holes or less</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ258</BillingCode><Name>Colink Vallux Plate</Name><Description>MIS Plate for Tri planar Hallux Valgus Correction</Description><Size>4 - Hole</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA12</BillingCode><Name>Evans Wedge, Freeze dried, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3250</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA41</BillingCode><Name>Posterior Tibialis Tendon, Frozen, Non-Irradiated</Name><Size>Various</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3499</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ071</BillingCode><PriorBillingCodes><PriorBillingCode>LM378</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic screw cap</Name><Description>Orthopaedic screw cap</Description><Size>All sizes</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3732</SubGroupID><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA55</BillingCode><Name>Fascia Lata,  ≥ 120cm² ≤ 180cm², Freeze-Dried, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2259</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV152</BillingCode><Name>Argo Knotless PEEK SP Anchor</Name><Description>The CONMED Argo KnotlessTM Anchors are manufactured from PolyEtherEtherKetone (PEEK). Self-punching products include tips manufactured from Titanium. The anchors are provided sterile, preloaded on a single-use driver and pre-threaded with one Hi-Fi® Ribbon. It may be used in either arthroscopic or open surgical procedures. After the suture is anchored to the bone, it may be used to reattach soft tissue, such as ligaments, tendons, or joint capsules to the bone. The suture anchor system thereby stabilizes the damaged soft tissue, in conjunction with appropriate postoperative immobilization throughout the healing period.</Description><Size>4.75mm, 5.5mm PEEK suture anchors with Ti self-punching tip  </Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>376571</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA22</BillingCode><Name>ENHANCE® Demineralized Cortical Fiber, 5cc, Dehydrated, Non-Irradiated</Name><Size>5cc</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4374</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ019</BillingCode><PriorBillingCodes><PriorBillingCode>LM284</PriorBillingCode></PriorBillingCodes><Name>Bone Screw</Name><Description>Bone Screw</Description><Size>2.01-2.7mm diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>266217</ARTG></ARTGs><MinimumBenefit>156</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ128</BillingCode><PriorBillingCodes><PriorBillingCode>LM353</PriorBillingCode></PriorBillingCodes><Name>Locking Screws</Name><Description>Locking Screws</Description><Size>2.7mm diameter, multiple lengths</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ041</BillingCode><PriorBillingCodes><PriorBillingCode>LM344</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic Plate Fixation Screw</Name><Description>Orthopaedic Plate Fixation Screw</Description><Size>2.01 to 2.7mm diameter
All lengths</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV126</BillingCode><Name>GENESYS PressFT Suture Anchor 2.6mm</Name><Description>The ConMed Linvatec GENESYS PressFT (biocomposite) Suture Anchors are manufactured from polylactide copolymer (96L/4D PLA co-polymer) and beta-tricalcium phosphate (B-TCp), and are provided sterile, preloaded on a single-use driver and pre-threaded with either one or two Hi-Fi Sutures</Description><Size>2.6mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>208881</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA34</BillingCode><Name>AlloPatchHD Acellular Human Dermis, ≤25cm² ≥1.8mm, Hydrated, Non-Irradiated</Name><Size>≤25cm²   ≥1.8mm Thick</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299299</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3578</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV025</BillingCode><Name>Staplizer Bone Staple Cartridge</Name><Description>5 Titanium staples per cartridge</Description><Size>7 x 7mm, 7 x 10mm, 10 x 7mm, 10 x 10mm, 10 x 15mm, 13 x 7mm, 13 x 10mm, 13 x 15mm, 13 x 20mm, 16 x 10mm, 16 x 15mm, 16 x 20mm, 16 x 25mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><Suffix>MI</Suffix><ARTGs><ARTG>93500</ARTG></ARTGs><MinimumBenefit>255</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA03</BillingCode><Name>Peroneus Longus Tendon, Frozen, Non-Irradiated</Name><Size>Various</Size><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>299298</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3152</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ250</BillingCode><Name>Colink 2.4 mm Locking Screws</Name><Description>Low-profile Locking Titanium Type II Anodised Screws 2.4 mm</Description><Size>2.4 mm Diam x Length (8mm - 24 mm)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV005</BillingCode><Name>Ultrafix MiniMite StitchPak Suture Anchor</Name><Description>Soft Tissue Re-attachment - Stainless Steel</Description><Size>2.3mm predeployed diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ228</BillingCode><Name>Colink 2.7 Variable Angle Locking Screws</Name><Description>Variable Angle Locking Titanium Type II Anodised Screws 2.7 mm</Description><Size>2.7 mm Diam x Length (8 - 60 mm)</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ252</BillingCode><Name>Colink Mini Plates VAL from 7 Hole to 15 Hole</Name><Description>Foot and Ankle Mini Plates Titanium, Various designs straight, L, and T Plates.</Description><Size>7 - 8 Hole</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ043</BillingCode><PriorBillingCodes><PriorBillingCode>LM248</PriorBillingCode></PriorBillingCodes><Name>OS2®-V Varisation Staple</Name><Description>Varisation Staple</Description><Size>8 &amp; 10mm, 26 degrees &amp; 90 degrees</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><ARTGs><ARTG>236772</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ032</BillingCode><PriorBillingCodes><PriorBillingCode>LM360</PriorBillingCode></PriorBillingCodes><Name>MTP Plate</Name><Description>MTP Plate</Description><Size>7 to 15 holes</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>266216</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ233</BillingCode><Name>Colink Afx Posterior Tibia Plates</Name><Description>Periarticular VAL Posterior Tibia Plates</Description><Size>3, 5 Hole</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5292</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>1474</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA26</BillingCode><Name>Proximal Metatarsal Lengthening Graft Segment, Freeze Dried, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2374</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV024</BillingCode><Name>Ultrafix MicroMite Small Joint Anchor</Name><Description>Suture Anchoring Device - Titanium</Description><Size>1.5mm predeployed diameter</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA15</BillingCode><Name>Milled Cancellous Chips, Freeze dried, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2357</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>CAA14</BillingCode><Name>Brachymetatarsal Lengthening Graft Segment, Freeze Dried, Non-Irradiated</Name><SupplierCode>CAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2404</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV124</BillingCode><Name>PressFT PEEK Suture Anchor 2.1mm</Name><Description>The ConMed Linvatec PressFT Suture Anchors are manufactured from PEEK and are provided, preloaded on a single use driver and pre-threaded with either one or two Hi-Fi Sutures.</Description><Size>2.1mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>136631</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ677</BillingCode><Name>Colink Afx One Third Tubular Plates Large</Name><Description>One-Third Tubular Plates</Description><Size>7, 8, 10, 12 Hole </Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ046</BillingCode><PriorBillingCodes><PriorBillingCode>LM373</PriorBillingCode></PriorBillingCodes><Name>Subtalar Implants</Name><Description>Subtalar Implants</Description><Size>All sizes</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1219</GroupID><SubGroupID>3261</SubGroupID><ARTGs><ARTG>308018</ARTG></ARTGs><MinimumBenefit>1321</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ255</BillingCode><Name>Colink 4.5 Non-locking Screws</Name><Description>Non-Locking Titanium Alloy Screws 4.5 mm</Description><Size>20mm - 95 mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>338649</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ070</BillingCode><PriorBillingCodes><PriorBillingCode>LM491</PriorBillingCode></PriorBillingCodes><Name>Knotless Suture Anchors</Name><Description>Knotless Suture Anchors</Description><Size>Various sizes </Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5382</SubGroupID><ARTGs><ARTG>364759</ARTG></ARTGs><MinimumBenefit>234</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LV103</BillingCode><Name>Matryx Interference Screw</Name><Description>Matryx (SR-96L/4D PLA with ß-TCP) Inteference Screw</Description><Size>7.3 x 20mm; 7.3 x 25mm; 7.3 x 30mm; 8 x 20mm; 8 x 25mm; 8 x 30mm; 9 x 20mm; 9 x 25mm; 9 x 30mm; 9 x 38mm; 10 x 25mm; 10 x 33mm; 10 x 38mm; 11 x 25mm; 11 x 33mm; 11 x 38mm</Size><SupplierCode>LV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>139664</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ100</BillingCode><PriorBillingCodes><PriorBillingCode>SQ159</PriorBillingCode></PriorBillingCodes><Name>Neo Cage System </Name><Description>Cage anatomical, straight, curved</Description><Size>22-36mm length, 7-14mm width, 0-8 degrees</Size><SupplierCode>LR</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>316221</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ099</BillingCode><PriorBillingCodes><PriorBillingCode>SQ155</PriorBillingCode></PriorBillingCodes><Name>Neo Cage System</Name><Description>Cage Kit  PLIF, TLIF  Straight, Lordotic</Description><Size>22-26mm Length  7-14mm Width  7-14mm Height</Size><SupplierCode>LR</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>316221</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ106</BillingCode><PriorBillingCodes><PriorBillingCode>SQ127</PriorBillingCode></PriorBillingCodes><Name>NEO Pedicle Screw System - Set Screw</Name><Description>Titanium Alloy</Description><Size>Diameter: 5.0mm - 7.0mm</Size><SupplierCode>LR</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>289017</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ102</BillingCode><PriorBillingCodes><PriorBillingCode>SQ141</PriorBillingCode></PriorBillingCodes><Name>NEO Pedicle Screw System - K-wire</Name><Description>Stainless steel</Description><Size>1.5mm</Size><SupplierCode>LR</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5364</SubGroupID><ARTGs><ARTG>289290</ARTG></ARTGs><MinimumBenefit>11</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ104</BillingCode><PriorBillingCodes><PriorBillingCode>SQ126</PriorBillingCode></PriorBillingCodes><Name>NEO Pedicle Screw System - Rod</Name><Description>Straight, Titanium Alloy, CoCr</Description><Size>30mm - 500mm length</Size><SupplierCode>LR</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>289017</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ103</BillingCode><PriorBillingCodes><PriorBillingCode>SQ125</PriorBillingCode></PriorBillingCodes><Name>NEO Pedicle Screw System - Polyaxial Screw</Name><Description>Pedicle Screw, Iliac Screw, Titanium Alloy</Description><Size>Diameter: 4.5mm - 8.0mm  Length: 25mm - 100mm</Size><SupplierCode>LR</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>289017</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ101</BillingCode><PriorBillingCodes><PriorBillingCode>SQ193</PriorBillingCode></PriorBillingCodes><Name>NEO Pedicle Screw System - Inline Connector</Name><Description>Parallel connector, Iliac connector</Description><Size>40-70mm</Size><SupplierCode>LR</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>289017</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ105</BillingCode><PriorBillingCodes><PriorBillingCode>SQ128</PriorBillingCode></PriorBillingCodes><Name>NEO Pedicle Screw System - Rod</Name><Description>Shaped, Titanium Alloy</Description><Size>30mm - 100mm length</Size><SupplierCode>LR</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>289017</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JS001</BillingCode><PriorBillingCodes><PriorBillingCode>SA170</PriorBillingCode></PriorBillingCodes><Name>Perceval S Sutureless Aortic Heart Valve</Name><Description>Sutureless Aortic Pericardial Heart Valve</Description><Size>S (19-21mm), M (21-23mm), L(23-25mm), XL (25-27mm)</Size><SupplierCode>JS</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1815</GroupID><Suffix>b (bovine)</Suffix><ARTGs><ARTG>232485</ARTG></ARTGs><MinimumBenefit>8978</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW006</BillingCode><PriorBillingCodes><PriorBillingCode>DO010</PriorBillingCode><PriorBillingCode>JJ646</PriorBillingCode></PriorBillingCodes><Name>Precise Pro Rx Nitinol Stent System</Name><Description>Nitinol self expanding stent</Description><Size>Diameter:  5, 6, 7, 8, 9, 10mm;  Length:  20, 30, 40mm</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>149399</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW018</BillingCode><PriorBillingCodes><PriorBillingCode>DO003</PriorBillingCode><PriorBillingCode>JJ567</PriorBillingCode></PriorBillingCodes><Name>PALMAZ® BLUE™ .018 Peripheral Stent System</Name><Description>L605 Cobalt Chromium Alloy Balloon Expandable Stent</Description><Size>12, 15, 18, 24mm length 4, 5, 6, 7mm diameter</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4439</SubGroupID><ARTGs><ARTG>187122</ARTG></ARTGs><MinimumBenefit>1053</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW011</BillingCode><PriorBillingCodes><PriorBillingCode>DO015</PriorBillingCode><PriorBillingCode>JJ592</PriorBillingCode></PriorBillingCodes><Name>SMART Nitinol Stent System</Name><Description>Long 120mm Stent, 6F compatible</Description><Size>6-8mm diameter, 120mm stent length, 120cm delivery system</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>151011</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW005</BillingCode><PriorBillingCodes><PriorBillingCode>DO009</PriorBillingCode><PriorBillingCode>MB008</PriorBillingCode></PriorBillingCodes><Name>Mynx Vascular Closure Device</Name><Description>Water-soluble synthetic sealant made of a polyethylene glycol (PEG) The sealant is resorbed by the body within 30 days</Description><Size>5F, 6/7F</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>212</SubCategoryID><GroupID>1644</GroupID><ARTGs><ARTG>201265</ARTG></ARTGs><MinimumBenefit>290</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW003</BillingCode><PriorBillingCodes><PriorBillingCode>DO006</PriorBillingCode><PriorBillingCode>MN178</PriorBillingCode></PriorBillingCodes><Name>InCraft AAA Stent-Graft System - Aortic Bifurcate</Name><Description>Bifurcated main body</Description><Size>22-34mm diameter, 86-94mm length</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1628</GroupID><SubGroupID>4446</SubGroupID><ARTGs><ARTG>231895</ARTG></ARTGs><MinimumBenefit>5229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW008</BillingCode><PriorBillingCodes><PriorBillingCode>DO012</PriorBillingCode><PriorBillingCode>JJ823</PriorBillingCode></PriorBillingCodes><Name>EXOSEAL (TM) Vascular Closure Device</Name><Description>Vascular Closure Device</Description><Size>5 - 7F</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>212</SubCategoryID><GroupID>1644</GroupID><ARTGs><ARTG>176723</ARTG></ARTGs><MinimumBenefit>290</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW001</BillingCode><PriorBillingCodes><PriorBillingCode>DO002</PriorBillingCode><PriorBillingCode>MN173</PriorBillingCode></PriorBillingCodes><Name>S.M.A.R.T. Flex Vascular Stent System</Name><Description>A fully connected, laser cut nitinol stent </Description><Size>5-8mm diameter, 30-120mm length</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>223910</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW016</BillingCode><PriorBillingCodes><PriorBillingCode>DO007</PriorBillingCode><PriorBillingCode>JJ306</PriorBillingCode></PriorBillingCodes><Name>Palmaz Genesis Peripheral Stent on Opta Pro (Large)</Name><Description>Stainless steel balloon expandable stent mounted on an Opta Pro Balloon.</Description><Size>Diameter 4-12mm, length 11-79mm</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4439</SubGroupID><ARTGs><ARTG>188675</ARTG></ARTGs><MinimumBenefit>1053</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW007</BillingCode><PriorBillingCodes><PriorBillingCode>DO011</PriorBillingCode><PriorBillingCode>JJ419</PriorBillingCode></PriorBillingCodes><Name>SMART Control Peripheral Stent System</Name><Description>SMART Control is a laser cut nitinol self expanding stent, used to treat peripheral vessel disease.</Description><Size>Dia 6 – 14mm; Length 20 – 100mm</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>151010</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW004</BillingCode><PriorBillingCodes><PriorBillingCode>DO008</PriorBillingCode><PriorBillingCode>JJ480</PriorBillingCode></PriorBillingCodes><Name>Angioguard RX Emboli Capture Guidewire System</Name><Description>Distal protection device and delivery system</Description><Size>Length 180cm, Diameter 0.014"; basket sizes 4mm, 5mm, 6mm, 7mm and 8mm</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>211</SubCategoryID><GroupID>1643</GroupID><ARTGs><ARTG>116900</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW012</BillingCode><PriorBillingCodes><PriorBillingCode>DO016</PriorBillingCode><PriorBillingCode>JJ305</PriorBillingCode></PriorBillingCodes><Name>Palmaz Genesis Peripheral Stent on Opta Pro (Medium)</Name><Description>Stainless steel balloon expandable stent mounted on an Opta Pro Balloon</Description><Size>Diameter 4-8mm, length 12-39mm</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4439</SubGroupID><ARTGs><ARTG>188675</ARTG></ARTGs><MinimumBenefit>1053</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW009</BillingCode><PriorBillingCodes><PriorBillingCode>DO013</PriorBillingCode><PriorBillingCode>JJ617</PriorBillingCode></PriorBillingCodes><Name>SMART Nitinol Stent System</Name><Description>Long 150mm stent, 6F compatible</Description><Size>6-8mm diameter, 150mm length, 120cm delivery system</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>151011</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW002</BillingCode><PriorBillingCodes><PriorBillingCode>DO004</PriorBillingCode><PriorBillingCode>MN174</PriorBillingCode></PriorBillingCodes><Name>S.M.A.R.T. Flex Vascular Stent System</Name><Description>A fully connected, laser cut nitinol stent </Description><Size>5-8mm diameter, 150-200mm length</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>223910</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW010</BillingCode><PriorBillingCodes><PriorBillingCode>DO014</PriorBillingCode><PriorBillingCode>MN179</PriorBillingCode></PriorBillingCodes><Name>InCraft AAA Stent-Graft System - Iliac Limb/Extension</Name><Description>Contralateral/Ipsilateral lliac limbs and extensions</Description><Size>10-24mm diameter, 80-140mm length</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1632</GroupID><ARTGs><ARTG>231895</ARTG></ARTGs><MinimumBenefit>2986</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW015</BillingCode><PriorBillingCodes><PriorBillingCode>DO025</PriorBillingCode></PriorBillingCodes><Name>MYNX Control Vascular Closure Device</Name><Description>The MYNX CONTROL Vascular Closure Device is designed to achieve femoral artery hemostasis via delivery of an extravascular, water-soluble synthetic  hydrogel sealant, using a balloon catheter in conjunction with a standard procedural sheath. The sealant is made of a polyethylene glycol (PEG) material which expands upon contact with subcutaneous fluids to seal the  arteriotomy. The sealant is resorbed by the body within 30 days. A 10 ml locking syringe is used for balloon inflation and deflation.</Description><Size>5F, 6/7F</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>212</SubCategoryID><GroupID>1644</GroupID><ARTGs><ARTG>333853</ARTG></ARTGs><MinimumBenefit>290</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW017</BillingCode><PriorBillingCodes><PriorBillingCode>DO019</PriorBillingCode></PriorBillingCodes><Name>Incraft AAA Stent Graft System - Aortic Extension</Name><Description>Aortic Extension</Description><Size>Aortic Extension Diameter (mm): 22, 26, 30, 34</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1631</GroupID><SubGroupID>4448</SubGroupID><ARTGs><ARTG>231895</ARTG></ARTGs><MinimumBenefit>2306</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW014</BillingCode><PriorBillingCodes><PriorBillingCode>DO018</PriorBillingCode><PriorBillingCode>JJ688</PriorBillingCode></PriorBillingCodes><Name>Palmaz Blue .014 Renal Stent System (on Aviator Plus)</Name><Description>CoCr balloon expandable stent</Description><Size>12, 15, 18, 24mm Lengths  40, 50, 60, 70mm diameters  80, 142cm shaft lengths</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4439</SubGroupID><ARTGs><ARTG>190149</ARTG></ARTGs><MinimumBenefit>1053</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JW013</BillingCode><PriorBillingCodes><PriorBillingCode>DO017</PriorBillingCode><PriorBillingCode>JJ423</PriorBillingCode></PriorBillingCodes><Name>OPTEASE retrievable vena cava filter</Name><Description>OPTEASE is a laser cut nitinol vena cava filter, used to treat patients at high risk of pulmonary embolisation</Description><Size>Suitable for vessels up to 30mm</Size><SupplierCode>JW</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>211</SubCategoryID><GroupID>1642</GroupID><ARTGs><ARTG>186230</ARTG></ARTGs><MinimumBenefit>2059</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR084</BillingCode><Name>CoCr Femoral Head</Name><Description>CoCr Modular Head</Description><Size>Dia 36-62</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>224980</ARTG><ARTG>269352</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR310</BillingCode><PriorBillingCodes><PriorBillingCode>GO308</PriorBillingCode><PriorBillingCode>GM166</PriorBillingCode></PriorBillingCodes><Name>BioBall Delta Femoral Head, 32mm or less</Name><Description>Femoral Head Biolox Delta Ceramic, 28mm and 32mm</Description><Size>28mm, 32mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>276307</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR041</BillingCode><Name>Canal Occluder</Name><Description>Cement plug, UHMWPE, multi-layered</Description><Size>08/10mm, 12/14mm, 16/18mm,20/22mm and universal.</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1437</GroupID><ARTGs><ARTG>106747</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR292</BillingCode><PriorBillingCodes><PriorBillingCode>GO283</PriorBillingCode></PriorBillingCodes><Name>Apex Revision Knee Stems</Name><Description>Apex Revision Knee Femoral and Tibial Stems</Description><Size>Modular Stem - 9-25mm x 75-150mm Offset - 9-25mm x 75-15mm x 2-4mm Angled Stem - 9-25mm x 75x150mm Revision Fluted Stem - 10-24mm x 100-150mm Revision Fluted Offset Stem - 10-24mm x 100-150mm x 4mm Modular Tibial Keels 1-16</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>276775</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR287</BillingCode><PriorBillingCodes><PriorBillingCode>GO195</PriorBillingCode></PriorBillingCodes><Name>Apex Knee, Femoral Component Porous Coated</Name><Description>Femoral Component Porous Coated Size 1 to 6 left &amp; Right.</Description><Size>Sizes 1-6, 1+, 2+, 3+, 4+, 5+, 6+ in Left &amp; Right</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1351</GroupID><SubGroupID>3914</SubGroupID><ARTGs><ARTG>286880</ARTG></ARTGs><MinimumBenefit>3226</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR317</BillingCode><PriorBillingCodes><PriorBillingCode>GO314</PriorBillingCode><PriorBillingCode>GO262</PriorBillingCode></PriorBillingCodes><Name>Apex Revision Knee - Tibial Insert Locking Peg/Bolt</Name><Description>Tibial Insert Locking Peg/Bolt</Description><Size>10; 11; 12; 14; 16; 18; 20; 24 and 28mm</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1397</GroupID><ARTGs><ARTG>276775</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR216</BillingCode><Name>Trinity ECiMA Liner</Name><Description>Cross linked polyethylene with vitamin E</Description><Size>Size 1-5, 28mm, 32mm, 36mm, 40mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>210774</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR029</BillingCode><Name>CoCr Femoral Head</Name><Description>CoCr femoral head</Description><Size>Dia 22,26,28,32mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>220077</ARTG><ARTG>224980</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR289</BillingCode><PriorBillingCodes><PriorBillingCode>GO256</PriorBillingCode></PriorBillingCodes><Name>Apex Revision Knee System</Name><Description>Modular and revision tibial baseplate</Description><Size>sizes 1-6</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><Suffix>Revision</Suffix><ARTGs><ARTG>311061</ARTG><ARTG>398790</ARTG></ARTGs><MinimumBenefit>2647</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR288</BillingCode><PriorBillingCodes><PriorBillingCode>GO196</PriorBillingCode></PriorBillingCodes><Name>Apex Knee - Cemented Femoral Component</Name><Description>CR Cemented Femoral Component, Non-Porous, Size 1 to 6</Description><Size>Size 1-6, 1+, 2+, 3+, 4+, 5+, 6+ in Left &amp; Right</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>273814</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR249</BillingCode><Name>Unity Knee - Cruciate Retaining Femur Cemented</Name><Description>Femoral Component Cemented - Cruciate Retaining</Description><Size>Size 1 – 9, Left and Right</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>223554</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR117</BillingCode><Name>Metafix Femoral Stem</Name><Description>Titanium femoral stem striated and fully coated with HA</Description><Size>standard, lateralised, short neck and 125 and 135 degree</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>207831</ARTG><ARTG>281110</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR253</BillingCode><Name>Unity Knee - Augments</Name><Description>Tibial Full and Half block Augments, Femoral distal and posterior augments</Description><Size>All components available in Size: 1-9;
Thickness: 5 and 10mm

Tibia: Full, LM-RL, RM-LL,</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>274559</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR293</BillingCode><PriorBillingCodes><PriorBillingCode>GO284</PriorBillingCode><PriorBillingCode>GO258</PriorBillingCode></PriorBillingCodes><Name>Apex Revision Knee Modular Tibia Cup</Name><Description>Modular Tibia Cup</Description><Size>Only One size</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1395</GroupID><ARTGs><ARTG>276775</ARTG></ARTGs><MinimumBenefit>633</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR157</BillingCode><Name>MiniHip Stem</Name><Description>Short stem, Titanium, Plasma Spray with HA</Description><Size>9 sizes</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>106747</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR180</BillingCode><PriorBillingCodes><PriorBillingCode>CR154</PriorBillingCode></PriorBillingCodes><Name>Ceramic modular head</Name><Description>Biolox Delta Ceramic heads 32mm or less</Description><Size>28 and 32mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>157505</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR300</BillingCode><PriorBillingCodes><PriorBillingCode>GO292</PriorBillingCode><PriorBillingCode>GM042</PriorBillingCode></PriorBillingCodes><Name>BioBall - Revision Neck Adaptor</Name><Description>Titanium, varying tapers &amp; lengths, for ceramic &amp; metal heads</Description><Size>Types: 12/14, 14/16, V40, PCA, ABG, 11/13, SROM, 10/12, 8/10  Sizes:  S, M, L, XL, 2XL, 3XL, 4XL, 5XL  Options: Standard, Offset</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1443</GroupID><ARTGs><ARTG>276306</ARTG></ARTGs><MinimumBenefit>436</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR024</BillingCode><Name>Taperfit Femoral Stem</Name><Description>Double taper stainless steel femoral stem</Description><Size>sizes 0-4 with 4 different offsets</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>106747</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR318</BillingCode><PriorBillingCodes><PriorBillingCode>GO257</PriorBillingCode></PriorBillingCodes><Name>Apex Knee, Tibial insert</Name><Description>Tibial Insert, PS, PS-R, PS ECiMa &amp; PS-C</Description><Size>size 1 to 6mm x 10 to 28mm UHMWPE &amp; ECiMa</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>282757</ARTG><ARTG>282762</ARTG><ARTG>311062</ARTG><ARTG>388576</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR250</BillingCode><Name>Unity Knee - Cruciate Retaining Insert</Name><Description>Tibial Insert Cruciate Retaining</Description><Size>Size 1 – 9, Thickness 9-20MM</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>223556</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR290</BillingCode><PriorBillingCodes><PriorBillingCode>GO259</PriorBillingCode></PriorBillingCodes><Name>Apex Revision Knee - Femoral and Tibial Augment Locking Screw/Bolt</Name><Description>Femoral and Tibial Locking Screw/Bolt</Description><Size>Femoral Augment Locking Screw/Bolt - one size only  Tibial Augment Locking Screw/Bolt - 4mm, 8mm, 12mm</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1398</GroupID><ARTGs><ARTG>252312</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR296</BillingCode><PriorBillingCodes><PriorBillingCode>GO287</PriorBillingCode><PriorBillingCode>GO255</PriorBillingCode></PriorBillingCodes><Name>Apex PS Cemented Femoral Component</Name><Description>The femoral component of a total knee system that incorporates a proportionally sized box.</Description><Size>Sizes 1-6, plus Sizes 1+ to 6+ Left and Right</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>278616</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR301</BillingCode><PriorBillingCodes><PriorBillingCode>GO293</PriorBillingCode><PriorBillingCode>GM066</PriorBillingCode></PriorBillingCodes><Name>BioBall Femoral Head</Name><Description>Femoral Head Vivium &gt; 32mm</Description><Size>36mm to 58mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3994</SubGroupID><ARTGs><ARTG>266538</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR314</BillingCode><PriorBillingCodes><PriorBillingCode>GO312</PriorBillingCode><PriorBillingCode>LC191</PriorBillingCode></PriorBillingCodes><Name>BioBall Femoral Head</Name><Description>Femoral DuoHead Vivium &gt; 32mm</Description><Size>36mm to 58mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3994</SubGroupID><ARTGs><ARTG>266540</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR259</BillingCode><Name>Unity Knee – Posterior Stabilised Femur Cemented</Name><Description>Femoral Component Cemented - Posterior Stabilised</Description><Size>Size 1 – 9, Left and Right</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>223555</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR285</BillingCode><PriorBillingCodes><PriorBillingCode>GO192</PriorBillingCode></PriorBillingCodes><Name>Apex Knee, Bone Screw</Name><Description>6.5mm Bone Screw</Description><Size>15mm, 20mm, 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm, 60mm, 65mm, 70mm.</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1398</GroupID><ARTGs><ARTG>242554</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR295</BillingCode><PriorBillingCodes><PriorBillingCode>GO286</PriorBillingCode><PriorBillingCode>GO255</PriorBillingCode></PriorBillingCodes><Name>Apex PS Cemented Revision Femoral Component</Name><Description>The femoral component of a total knee revision system that incorporates a proportionally sized box.</Description><Size>Sizes 1-6, plus Sizes 1+ to 5+ Left and Right</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><Suffix>Revision</Suffix><ARTGs><ARTG>311060</ARTG></ARTGs><MinimumBenefit>5363</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ687</BillingCode><Name>Unity Knee CS Tibial Insert</Name><Description>Unity Knee - Condylar Stabilized tibial insert, UHMWPE</Description><Size>Size: 1- 9 Thickness: 9 - 16mm</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>460706</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR163</BillingCode><Name>Trinity polyethylene liner</Name><Description>Highly cross linked Polyethylene liner in neutral +4mm offset +4mm oblique and 4mm elevated wall variants for use with the Trinity acetabular multi-bearing shell</Description><Size>28mm, 32mm, 36mm, 40mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>106747</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR309</BillingCode><PriorBillingCodes><PriorBillingCode>GO307</PriorBillingCode><PriorBillingCode>GM165</PriorBillingCode></PriorBillingCodes><Name>BioBall Delta Femoral Head, &gt;32mm</Name><Description>Femoral Head Biolox Delta Ceramic, &gt;32mm</Description><Size>36mm, 40mm, 44mm, 48mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>276307</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR179</BillingCode><PriorBillingCodes><PriorBillingCode>CR154</PriorBillingCode></PriorBillingCodes><Name>Ceramic Modular head</Name><Description>Biolox Delta Ceramic heads  &gt; 32mm</Description><Size>36, 40 and 44mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>157505</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR284</BillingCode><PriorBillingCodes><PriorBillingCode>GO191</PriorBillingCode></PriorBillingCodes><Name>Apex Knee, Tibial Insert</Name><Description>Tibial Insert, Standard, Ultra &amp; Congruent, UHMWPE &amp; ECiMa, Size 1-6, 10mm to 20mm</Description><Size>Size 1, 10mm to 20mm, size 2, 10mm to 20mm, size 3, 10mm to 20mm, size 4, 10mm to 20mm, size 5, 10mm to 20mm, size 6, 10mm to 20mm.</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>271614</ARTG><ARTG>278615</ARTG><ARTG>388574</ARTG><ARTG>388575</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR242</BillingCode><PriorBillingCodes><PriorBillingCode>TO085</PriorBillingCode></PriorBillingCodes><Name>Dual Mobility Cup, shell uncemented</Name><Description>Acetabular shell titanium Plasma spray + HA, flanges and/or hook.</Description><Size>42 to 68mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1427</GroupID><SubGroupID>4018</SubGroupID><Suffix>Flange</Suffix><ARTGs><ARTG>210208</ARTG><ARTG>210209</ARTG><ARTG>210210</ARTG></ARTGs><MinimumBenefit>2600</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR164</BillingCode><Name>Trinity Metal Liner</Name><Description>Metal liner for use with the Trinity acetabular shell</Description><Size>35mm,40mm,42.5mm, 45mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4023</SubGroupID><ARTGs><ARTG>312411</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR291</BillingCode><PriorBillingCodes><PriorBillingCode>GO260</PriorBillingCode></PriorBillingCodes><Name>Apex Revision Knee</Name><Description>Apex Revision Knee Femoral and Tibial Augments</Description><Size>Femoral, Size 0-6+, 5mm/10mm/15mm  Tibial, Size 0-6, 4mm</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>252312</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR228</BillingCode><PriorBillingCodes><PriorBillingCode>TO087</PriorBillingCode></PriorBillingCodes><Name>Dual Mobility Cup, Liner</Name><Description>Acetabular Liner UHMWPE</Description><Size>Head 22.2mm or 28mm, Diameter 42 mm to 68mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4020</SubGroupID><ARTGs><ARTG>312410</ARTG><ARTG>383312</ARTG></ARTGs><MinimumBenefit>688</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR165</BillingCode><Name>Trinity Acetabular Cup</Name><Description>Tri-liner hemispherical shell. Titanium (Ti6A14V) material with Titanium and HA coated plasma spray</Description><Size>44 - 68 mm in 2mm increments</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1427</GroupID><SubGroupID>4018</SubGroupID><ARTGs><ARTG>106747</ARTG></ARTGs><MinimumBenefit>2079</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR267</BillingCode><Name>Dual Mobility Cup (MobiliT), Liner</Name><Description>Acetabular Liner ECiMa</Description><Size>Head 22.2mm or 28mm, Diameter 42 mm to 68mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>383768</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR283</BillingCode><PriorBillingCodes><PriorBillingCode>GO190</PriorBillingCode></PriorBillingCodes><Name>Apex Knee, Locking Bolt</Name><Description>Tibial Insert Locking Bolt</Description><Size>One size</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1392</GroupID><ARTGs><ARTG>309120</ARTG></ARTGs><MinimumBenefit>212</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR252</BillingCode><Name>Unity Knee – Patella</Name><Description>Patella Cemented</Description><Size>Sizes 1 – 5</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>223558</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR086</BillingCode><Name>TriFit  System</Name><Description>Titanium stem proximally coated with plasma spray and HA</Description><Size>Sizes 1- 11</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>207830</ARTG><ARTG>342332</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ184</BillingCode><Name>Bioball </Name><Description>Bioball Vivium Femoral Head </Description><Size>28mm and 32mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3988</SubGroupID><ARTGs><ARTG>266538</ARTG></ARTGs><MinimumBenefit>671</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR282</BillingCode><PriorBillingCodes><PriorBillingCode>GO189</PriorBillingCode></PriorBillingCodes><Name>Apex Knee, All-Poly Patella</Name><Description>All-Poly Dome 3 Peg Patella, ECiMa or UHMWPE</Description><Size>26mm x 10mm &amp; 8mm, 29mm x 10mm &amp; 8mm, 32mm x 10mm &amp; 8mm, 35mm x 10mm &amp; 8mm, 38mm x 10mm &amp; 8mm, 41mm x 10mm</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>278529</ARTG><ARTG>388573</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR294</BillingCode><PriorBillingCodes><PriorBillingCode>GO285</PriorBillingCode></PriorBillingCodes><Name>Paragon Hip Stem PCHA</Name><Description>Paragon Femoral Stem, Porous and HA coated</Description><Size>1-12, STD, High Offset, Coxa Vara, Collared</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>296134</ARTG><ARTG>296139</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR273</BillingCode><PriorBillingCodes><PriorBillingCode>GO193</PriorBillingCode></PriorBillingCodes><Name>Apex Knee, Tibial Base Plate - Porous</Name><Description>Tibial Baseplate, Cementless</Description><Size>Size 1 Left &amp; Right, Size 2 Left &amp; Right, Size 3 Left &amp; Right, Size 4 Left &amp; Right, Size 5 Left &amp; Right, Size 6 Left &amp; Right</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1360</GroupID><SubGroupID>3923</SubGroupID><ARTGs><ARTG>287595</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR286</BillingCode><PriorBillingCodes><PriorBillingCode>GO194</PriorBillingCode></PriorBillingCodes><Name>Apex Knee, Tibial Base Plate - Cemented</Name><Description>Tibial Baseplate, Cemented, Non-Porous, Size 1 - 7 Left &amp; Right</Description><Size>Size 1 Left &amp; Right, size 2 Left &amp; Right, size 3 Left &amp; Right, size 4 Left &amp; Right, size 5 Left &amp; Right, size 6 Left &amp; Right, size 7 Left &amp; Right.</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>278528</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR070</BillingCode><Name>Titanium Counter Sunk Screw</Name><Description>Titanium Counter Sunk Screw</Description><Size>Lengths 15-70mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>106747</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR261</BillingCode><Name>Unity Knee – Posterior Stabilised Insert</Name><Description>Tibial Insert Posterior Stabilised</Description><Size>Size 1 – 9, Thickness 9-20MM</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>223557</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR251</BillingCode><Name>Unity Knee – Tibial Tray</Name><Description>Tibial Tray Cemented</Description><Size>Sizes 1 – 9</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>223558</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR232</BillingCode><PriorBillingCodes><PriorBillingCode>TO086</PriorBillingCode></PriorBillingCodes><Name>Dual Mobility Cup (MobiliT), Shell Cemented</Name><Description>Acetabular Shell, Cemented stainless steel with groove, internal mirror polished</Description><Size>42mm to 60mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4009</SubGroupID><ARTGs><ARTG>383311</ARTG></ARTGs><MinimumBenefit>1511</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR158</BillingCode><Name>Biolox Delta Acetabular Liner</Name><Description>Biolox Delta ceramic acetabular liner</Description><Size>28mm, 32mm, 36mm, 40mm</Size><SupplierCode>CR</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4025</SubGroupID><ARTGs><ARTG>157687</ARTG></ARTGs><MinimumBenefit>1690</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR265</BillingCode><Name>Unity Knee – Stem Extenders</Name><Description>Tibial Stem extenders and offset couplings -cemented</Description><Size>3mm, 6mm  Diameter Ø10-18  Length 60 , 30 and 100mm  Offset and straight</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><ARTGs><ARTG>274747</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CR315</BillingCode><PriorBillingCodes><PriorBillingCode>GO313</PriorBillingCode></PriorBillingCodes><Name>APEX knee Retaining Bolt</Name><Description>Tibial insert, Retaining Bolt, Uncoated knee tibia prosthesis, metallic  for PS, PS-C, PS-R, Congruent, Ultra inserts/ Tibial Baseplates</Description><Size>10-32 mm</Size><SupplierCode>CR</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1392</GroupID><ARTGs><ARTG>309120</ARTG></ARTGs><MinimumBenefit>212</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ710</BillingCode><Name>CareVis Vario Pump and Catheter</Name><Description>Variable flow rate ambulatory and disposable silicone balloon infusion pump kit</Description><Size>100 ml, 275 ml, 450 ml, 600 ml</Size><SupplierCode>CU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5359</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>443279</ARTG></ARTGs><MinimumBenefit>319</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CU001</BillingCode><Name>BeeLINE MotIV Infusion Pump (275ml)</Name><Description>External infusion pump, spring powered, fixed flow rate, 275ml set: set includes reservoir, introducer needle, tubing set, priming/flushing syringes, saturation catheter, dressing, syringes.  30min - 7 day infusion</Description><Size>275ml infuser reservoir = 19cm (7.5") x 7cm (2.8")</Size><SupplierCode>CU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1540</GroupID><SubGroupID>4188</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>167182</ARTG></ARTGs><MinimumBenefit>233</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ708</BillingCode><Name>CareVis Single-Use Pump and Catheter</Name><Description>Standard and OncO continuous flow rate ambulatory and disposable silicone balloon infusion pump kit - single use. Includes pump, catheter, syringe, carry bag and optional consumables.</Description><Size>Volume 100 ml, 180ml, 275 ml, 450 ml, 600 ml</Size><SupplierCode>CU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>443279</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>CU002</BillingCode><Name>BeeLINE MotIV Infusion Pump (100ml)</Name><Description>External infusion pump, spring powered, fixed flow rate, 100ml set: set includes reservoir, introducer needle, tubing set, priming/flushing syringes, saturation catheter, dressing, syringes.  30min - 7 day infusion</Description><Size>100ml infusor reservoir = 13cm (5.1") x 7cm (2.8")</Size><SupplierCode>CU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1540</GroupID><SubGroupID>4188</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>167182</ARTG></ARTGs><MinimumBenefit>233</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ707</BillingCode><Name>CareVis Vario Plus Pump</Name><Description>Ambulatory and disposable silicone balloon infusion pump with bolus function</Description><Size>Volume 100 ml, 275 ml, 450 ml, 600 ml</Size><SupplierCode>CU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5359</SubGroupID><Suffix>Bolus</Suffix><ARTGs><ARTG>443279</ARTG></ARTGs><MinimumBenefit>367</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ057</BillingCode><PriorBillingCodes><PriorBillingCode>AB075</PriorBillingCode></PriorBillingCodes><Name>BioGlue Surgical Adhesive - 2ml Syringe System</Name><Description>Model No BG3502-5-A (BioGlue Surgical Adhesive)</Description><Size>2ml</Size><SupplierCode>JY</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Biological</Suffix><ARTGs><ARTG>137751</ARTG></ARTGs><MinimumBenefit>323</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JY008</BillingCode><Name>E-liac Stent Graft System</Name><Description>The E-liac Stent Graft is intended for the endovascular treatment of patients with aorto-iliac or iliac aneurysm allowing preservation of flow perfusion to the internal iliac artery. The implant is a self-expanding stent graft with side branch, which is pre-loaded into a delivery system.</Description><Size>Proximal Diameters (mm) 14, 16, 18 Distal Diameters (mm) 10, 12, 14 Proximal Lengths (mm) 53, 65 Distal Length (mm) 44, 56</Size><SupplierCode>JY</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1629</GroupID><ARTGs><ARTG>489626</ARTG></ARTGs><MinimumBenefit>6769</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JY002</BillingCode><PriorBillingCodes><PriorBillingCode>IU001</PriorBillingCode></PriorBillingCodes><Name>E-vita OPEN NEO</Name><Description>The E-vita OPEN NEO is a hybrid aortic arch device for the repair and replacement of the thoracic aorta using the frozen elephant trunk procedure which provides an alternative for conventional open surgery. The device is a one-piece polyester fabric tube which combines a conventional vascular graft part and an endovascular stent graft part that allows the open surgical treatment of aneurysms or dissections in the aortic arch and the descending thoracic aorta with or without involvement of the ascending aorta. It is available in a range of sizes with varying diameters and lengths and comes in three different configurations for individual supra-aortic vessel management. One-piece polyester fabric tube which combines a conventional vascular graft part and an endovascular stent graft part, including a delivery system. The E-vita OPEN NEO implant consists of a self expanding stent graft part, a conventional vascular graft part, and the delivery system.</Description><Size>Stent graft, 20-40mm diameter, 120-180mm length : Vascular graft, 26-30mm diameter, 100mm length : Perfusion branch, 10mm diameter, 100mm length : Collar, 15mm width : Brachiocephalic trunk, 12 mm diameter, 100 mm length : Left common carotid artery, 8mm diameter, 100mm length : Left subclavian artery, 10mm diameter, 100mm length.</Size><SupplierCode>JY</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>186</SubCategoryID><GroupID>2601</GroupID><ARTGs><ARTG>374560</ARTG></ARTGs><MinimumBenefit>19430</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JY004</BillingCode><Name>E-tegra Iliac Extension</Name><Description>E-tegra Stent Graft System - Iliac Extension</Description><Size>Diameter (distal): 10-27mm    Diameter (proximal): 13-27    Length (usable): 50mm    Length (total): 80mm</Size><SupplierCode>JY</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1632</GroupID><ARTGs><ARTG>388373</ARTG></ARTGs><MinimumBenefit>2986</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JY003</BillingCode><Name>E-tegra Contralateral Leg</Name><Description>E-tegra Stent Graft System - Contralateral Leg</Description><Size>Diameter (Proximal): 15mm    Diameter (Distal): 10-25mm    Length (Useable): 50-105mm    Length (Total): 80-135mm</Size><SupplierCode>JY</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1632</GroupID><ARTGs><ARTG>388370</ARTG></ARTGs><MinimumBenefit>2986</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JY006</BillingCode><Name>E-tegra Aorto-Uni-Iliac</Name><Description>E-tegra Stent Graft System - AUI</Description><Size>Length (covered): 105mm  Diameter (proximal): 23-36mm  Diameter (distal): 13mm</Size><SupplierCode>JY</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1627</GroupID><ARTGs><ARTG>388371</ARTG></ARTGs><MinimumBenefit>9206</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ059</BillingCode><PriorBillingCodes><PriorBillingCode>AB076</PriorBillingCode></PriorBillingCodes><Name>BioGlue Surgical Adhesive - Spreader Tips</Name><Description>Spreader (extender) Tips (various sizes), (Pack of 3)</Description><Size>12mm, 16mm</Size><SupplierCode>JY</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Extender</Suffix><ARTGs><ARTG>137420</ARTG></ARTGs><MinimumBenefit>25</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ062</BillingCode><PriorBillingCodes><PriorBillingCode>AB008</PriorBillingCode></PriorBillingCodes><Name>BioGlue Surgical Adhesive - Syringe Standard Applicator Tip</Name><Description>Model No BGAT-SY (BioGlue Surgical Adhesive)</Description><Size>Standard Applicator Tip</Size><SupplierCode>JY</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Applicator Tip</Suffix><ARTGs><ARTG>137420</ARTG></ARTGs><MinimumBenefit>22</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ060</BillingCode><PriorBillingCodes><PriorBillingCode>AB009</PriorBillingCode></PriorBillingCodes><Name>BioGlue Surgical Adhesive - Syringe 10cm Extender</Name><Description>Model No BGAT-10-SY (BioGlue Surgical Adhesive)</Description><Size>10cm Extender</Size><SupplierCode>JY</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Extender</Suffix><ARTGs><ARTG>137420</ARTG></ARTGs><MinimumBenefit>25</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ055</BillingCode><PriorBillingCodes><PriorBillingCode>AB065</PriorBillingCode></PriorBillingCodes><Name>BioGlue Delivery Tip Extension (various sizes)</Name><Description>Rigid Extender Tip (BGDTE range)</Description><Size>10cm, 27cm, 35cm</Size><SupplierCode>JY</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Laparoscopic Extender</Suffix><ARTGs><ARTG>137420</ARTG></ARTGs><MinimumBenefit>53</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JY001</BillingCode><PriorBillingCodes><PriorBillingCode>IU002</PriorBillingCode></PriorBillingCodes><Name>E-vita OPEN NEO</Name><Description>The E-vita OPEN NEO straight graft configuration is a hybrid aortic arch device for the repair and replacement of the thoracic aorta using the frozen elephant trunk procedure which provides an alternative for conventional open surgery. The device is a one-piece polyester fabric tube which combines a conventional vascular graft part and an endovascular stent graft part that allows the open surgical treatment of aneurysms or dissections in the aortic arch and the descending thoracic aorta with or without involvement of the ascending aorta. One-piece polyester fabric tube which combines a conventional vascular graft part and an endovascular stent graft part, including a delivery system. The E-vita OPEN NEO implant consists of a self-expanding stent graft part, a conventional vascular graft part, and the delivery system.</Description><Size>Stent graft, 20-40mm diameter, 120-180mm length : Vascular graft, 26-30mm diameter, 100mm length : Perfusion branch, 10mm diameter, 100mm length : Collar, 30mm width</Size><SupplierCode>JY</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>186</SubCategoryID><GroupID>1811</GroupID><ARTGs><ARTG>374560</ARTG></ARTGs><MinimumBenefit>19000</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ061</BillingCode><PriorBillingCodes><PriorBillingCode>AB010</PriorBillingCode></PriorBillingCodes><Name>BioGlue Surgical Adhesive - Syringe 27CM Extender</Name><Description>Model No BGAT-27-SY (BioGlue Surgical Adhesive)</Description><Size>27cm Extender</Size><SupplierCode>JY</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Extender</Suffix><ARTGs><ARTG>137420</ARTG></ARTGs><MinimumBenefit>25</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ058</BillingCode><PriorBillingCodes><PriorBillingCode>AB003</PriorBillingCode></PriorBillingCodes><Name>BioGlue Surgical Adhesive - 5ml Syringe System</Name><Description>Model No BG3515-5-A (BioGlue Surgical Adhesive)</Description><Size>One size only</Size><SupplierCode>JY</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4248</SubGroupID><Suffix>Biological</Suffix><ARTGs><ARTG>137751</ARTG></ARTGs><MinimumBenefit>588</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JY005</BillingCode><Name>E-tegra Aortic Extension</Name><Description>E-tegra Stent Graft System - Aortic Extension</Description><Size>Length: 50mm    Diameter (proximal): 23-38mm    Diameter (distal): 23-38mm</Size><SupplierCode>JY</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1631</GroupID><SubGroupID>4448</SubGroupID><ARTGs><ARTG>388372</ARTG></ARTGs><MinimumBenefit>2306</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ056</BillingCode><PriorBillingCodes><PriorBillingCode>AB004</PriorBillingCode></PriorBillingCodes><Name>BioGlue Surgical Adhesive - 10ml Syringe System</Name><Description>Model No BG3510-5-A (BioGlue Surgical Adhesive)</Description><Size>One size only</Size><SupplierCode>JY</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4249</SubGroupID><Suffix>Biological</Suffix><ARTGs><ARTG>137751</ARTG></ARTGs><MinimumBenefit>1177</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JY007</BillingCode><Name>E-tegra Main Body</Name><Description>E-tegra Stent Graft system - Bifurcated Graft Main Body</Description><Size>Diameters 23-36mm (proximal)    Length: 100-160mm (covered)    Length: 85, 100mm (trunk),   Diameter : 13,16,19mm (distal)</Size><SupplierCode>JY</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1628</GroupID><SubGroupID>4445</SubGroupID><ARTGs><ARTG>388374</ARTG></ARTGs><MinimumBenefit>8082</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FB001</BillingCode><Name>K-Wire</Name><Description>K-Wire, stainless steel, sterile</Description><Size>0.6mm – 2.8mm   x   75mm – 230mm</Size><SupplierCode>FB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>226653</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FB002</BillingCode><Name>K-Wire</Name><Description>K-Wire, threaded, stainless steel, sterile</Description><Size>1.2mm – 2.8mm   x   100mm – 230mm</Size><SupplierCode>FB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>226653</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ312</BillingCode><Name>AI Guide</Name><Description>Custom made patient specific guide for use with the ARDS Dental System (JN001)</Description><Size>size will vary as patent specific</Size><SupplierCode>JN</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>443915</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JN004</BillingCode><Name>ARDS Anatomic Biomodel</Name><Description>Anatomic patient specific model for use with ARDS Implants JN001</Description><Size>Patient Specific</Size><SupplierCode>JN</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1807</GroupID><ARTGs><ARTG>443915</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JN001</BillingCode><Name>ARDS Implants</Name><Description>Titanium implants (SMART, CIT, Classic, PSI, Premium, One Piece)  </Description><Size>(3 - 6)mm diameter x (6-60)mm length</Size><SupplierCode>JN</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4392</SubGroupID><ARTGs><ARTG>375050</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JN002</BillingCode><Name>ARDS Cover Screws and Healing Caps</Name><Description>Cover Screws and Healing Caps </Description><Size>(4-6.3)mm diameter  x (2 - 5)mm height,</Size><SupplierCode>JN</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4387</SubGroupID><ARTGs><ARTG>375050</ARTG></ARTGs><MinimumBenefit>47</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JN003</BillingCode><Name>ARDS Abutments</Name><Description>Permanent - ball,  conical,  straight, angled, anatomic</Description><Size>(4.2 - 6)mm width x (2.5 - 1)mm height</Size><SupplierCode>JN</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4385</SubGroupID><ARTGs><ARTG>375050</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV015</BillingCode><Name>Simplant Surgical Guides</Name><Description>Custom made patient specific surgical guide for use with the Dentsply Sirona Implants Systems (FV002).


</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>476045</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV013</BillingCode><Name>OSSIX Bone</Name><Description>OSSIX Bone is an osteoconductive bone grafting material aimed to fill, augment, or reconstruct periodontal and bony defects of the maxillo-facial complex.</Description><Size>5 x 10 x 10mm (0.5 cc)</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4394</SubGroupID><ARTGs><ARTG>380303</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV005</BillingCode><PriorBillingCodes><PriorBillingCode>DH005</PriorBillingCode></PriorBillingCodes><Name>Ankylos C/X Implants</Name><Description>Screw implant with cover screw (included) and pre-mounted placement head</Description><Size>Diameter range 3.5 - 7.0 mm, Length 8-17mm</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4392</SubGroupID><ARTGs><ARTG>212688</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV011</BillingCode><Name>Ossix Plus</Name><Description>Ossix Plus is a resorbable collagen membrane intended for use during the process of guided bone regeneration (GBR) and guided tissue regeneration (GTR) as a biodegradable barrier.     </Description><Size>15 x 25mm, 25 x 30mm, 30 x 40mm</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4253</SubGroupID><ARTGs><ARTG>380301</ARTG></ARTGs><MinimumBenefit>224</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV007</BillingCode><PriorBillingCodes><PriorBillingCode>DH007</PriorBillingCode></PriorBillingCodes><Name>Ankylos / DS EV Permanent Abutments</Name><Description>Permanent Abutments</Description><Size>Diameter range: 3.3mm - 5.7mm, height range: 7.5mm - 11.1mm</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4385</SubGroupID><ARTGs><ARTG>153161</ARTG><ARTG>224096</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV014</BillingCode><Name>OSSIX Agile</Name><Description>OSSIX Agile is a resorbable collagen membrane intended for use during the process of guided bone regeneration (GBR) and guided tissue regeneration (GTR) as a biodegradable barrier.   
</Description><Size>10 x 12mm, 15 x 25mm, 25 x 30mm, 30 x 40mm</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4253</SubGroupID><ARTGs><ARTG>473445</ARTG></ARTGs><MinimumBenefit>224</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV001</BillingCode><PriorBillingCodes><PriorBillingCode>DH001</PriorBillingCode><PriorBillingCode>AZ001</PriorBillingCode></PriorBillingCodes><Name>Astra Tech Implant System/ DS EV Cover Screws &amp; healing cap</Name><Description>Cover Screw and healing cap</Description><Size>Diameter range 3.0 - 5.4</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4387</SubGroupID><ARTGs><ARTG>153161</ARTG><ARTG>212100</ARTG></ARTGs><MinimumBenefit>47</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV012</BillingCode><Name>OSSIX Volumax</Name><Description>A resorbable collagen membrane intended for use during the process of guided bone regeneration (GBR) and guided tissue regeneration (GTR) as a biodegradable barrier.</Description><Size>10 x 12.5mm  15 x 25mm  25 x 30mm  10 x 40mm</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4253</SubGroupID><ARTGs><ARTG>380302</ARTG></ARTGs><MinimumBenefit>224</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV006</BillingCode><PriorBillingCodes><PriorBillingCode>DH006</PriorBillingCode></PriorBillingCodes><Name>Ankylos Temporary Abutments</Name><Description>Temporary and healing abutments</Description><Size>Diameter 3.3mm - 7mm</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4386</SubGroupID><ARTGs><ARTG>212101</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV004</BillingCode><PriorBillingCodes><PriorBillingCode>DH004</PriorBillingCode><PriorBillingCode>AZ004</PriorBillingCode></PriorBillingCodes><Name>Astra Tech Implant System / DS EV Abutments</Name><Description>Temporary Abutment</Description><Size>Diameter range: 3.3 - 7.0 mm</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4386</SubGroupID><ARTGs><ARTG>212101</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV002</BillingCode><PriorBillingCodes><PriorBillingCode>DH002</PriorBillingCode><PriorBillingCode>AZ002</PriorBillingCode></PriorBillingCodes><Name>Dentsply Sirona Implants (Astra Tech implant EV/Tx, PrimeTaper EV and OmniTaper EV)</Name><Description>Titanium fixture with microthreaded cervical neck</Description><Size>Diameter 3.0 - 5.5mm, Length 6-18mm</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4392</SubGroupID><ARTGs><ARTG>212688</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FV003</BillingCode><PriorBillingCodes><PriorBillingCode>DH003</PriorBillingCode><PriorBillingCode>AZ003</PriorBillingCode></PriorBillingCodes><Name>Astra Tech Implant System/ DS EV Healing Abutments</Name><Description>Healing Abutments</Description><Size>Healing Abutment  Diameter: Range 3.5 - 7.5 mm,  Height Range from 2.0 - 10mm</Size><SupplierCode>FV</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4386</SubGroupID><ARTGs><ARTG>212101</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DV273</BillingCode><Name>Oasis Visco Shield HPMC Viscoelastic</Name><Description>A sterile,  high molecular weight HPMC solution for use as a surgical aid in maintaining a deep anterior chamber during ophthalmic surgical procedures</Description><Size>2 ml syringe</Size><SupplierCode>DV</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>373573</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DV268</BillingCode><Name>Hoya Vivinex iSert preloaded IOL (Model XC1)</Name><Description>Preloaded injector system, micro incision, aspheric, UV filtering, single piece, hydrophobic acrylic</Description><Size>+6.0 to 30.0 D (in 0.5D steps)</Size><SupplierCode>DV</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>287542</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DV029</BillingCode><Name>Morcher Eyejet Capsular Tension Ring</Name><Description>PMMA implant on disposable injector</Description><Size>10-12mm</Size><SupplierCode>DV</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>143</SubCategoryID><GroupID>1331</GroupID><Suffix>pl</Suffix><ARTGs><ARTG>325435</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DV009</BillingCode><Name>Morcher Capsular Tension Ring</Name><Description>PMMA Implant</Description><Size>9 -12mm</Size><SupplierCode>DV</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>143</SubCategoryID><GroupID>1331</GroupID><ARTGs><ARTG>325435</ARTG></ARTGs><MinimumBenefit>99</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DV250</BillingCode><PriorBillingCodes><PriorBillingCode>AQ003</PriorBillingCode></PriorBillingCodes><Name>Hoya-PS AF-1 (UY) PY-60AD</Name><Description>Preloaded in cartridge, Aspheric, Blue blocker, Foldable, Single-Piece, Hydrophobic Acrylic</Description><Size>+6.0D to +30.0D (0.5D steps)</Size><SupplierCode>DV</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>287542</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DV267</BillingCode><Name>Hoya Vivinex XY1AT Toric</Name><Description>Preloaded injector system, toric / corrects corneal astigmatism, micro-incision, aspheric, blue blocker, single piece hydrophobic</Description><Size>IOL Power: + 10.0 to 30.0 (0.5 steps), IOL Cylinder power: 1.0D (XY1AT2), 1.50D (XY1AT3), 2.25D (XY1AT4), 3.00D (XY1AT5), 3.75D (XY1AT6), 4.50D (XY1AT7), 5.25D (XY1AT8), 6.00D (XY1AT9)</Size><SupplierCode>DV</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, t1, vblf</Suffix><ARTGs><ARTG>287542</ARTG></ARTGs><MinimumBenefit>585</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DV264</BillingCode><Name>Hoya Vivinex iSert  Preloaded IOL (Model XY1)</Name><Description>Intra Ocular Lens</Description><Size>Power +6 dioptres  - +30 dioptres</Size><SupplierCode>DV</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>287542</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DV010</BillingCode><Name>Morcher Complex CTR, Cionni Rings for Scleral Fixation, and Capsular Segments for Scleral Fixation</Name><Description>Complex PMMA Implant</Description><Size>8.5-11mm</Size><SupplierCode>DV</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>143</SubCategoryID><GroupID>1332</GroupID><ARTGs><ARTG>325435</ARTG></ARTGs><MinimumBenefit>209</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE796</BillingCode><Name>Meridian No Profile Cage with Faceplate, Locking Cover and Screws</Name><Description>No Profile ALIF cage with Titanium faceplate - two or three hole, locking cover and screws</Description><Size>Cage 31x24, 35x27, 39x30, 43x30; 10-20mm Heights; 10,15,20 &amp; 25 Degree Lordosis; Screws: 5.5 &amp; 6.0mm,20mm-35mm. Faceplate Locking cover: 2 &amp; 3 holes, 10-20mm. Locking cover: one size</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE853</BillingCode><PriorBillingCodes><PriorBillingCode>PY036</PriorBillingCode></PriorBillingCodes><Name>Sinus-Venous and Sinus-Obliquus Stents</Name><Description>Sinus-Venous and Sinus-Obliquus Stents used for treating venous insufficiency, occlusion and stenosis</Description><Size>Diameter: 10, 12, 14, 16, 18mm 
Length: 60, 80, 100, 120mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>201852</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE793</BillingCode><Name>Admiral Cervical Plate</Name><Description>Admiral Cervical Plate Screws</Description><Size>4.0 &amp; 4.3mm Diameter, 10-18mm Lengths</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>275780</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE771</BillingCode><Name>NorthStar OCT  </Name><Description>NorthStar OCT Occipital Plate</Description><Size>Extra Small - Small - Large</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE768</BillingCode><Name>NorthStar OCT</Name><Description>NorthStar OCT Crossbar - Screw to Screw,  Screw to Rod Connector, Rod to Rod</Description><Size>3.5 &amp; 4mm  SM: 21-26mm  MD: 24-32mm  LG: 34-44mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE866</BillingCode><Name>Teleon Visiotis Progressive+ IOL (PCM81NY)</Name><Description>Foldable one-piece hydrophillic multifocal C-loop IOL with aspherical surface</Description><Size>Overall Length 12.0mm and Optic Size 6.0mm. Available dioptres +10.0D to +30.0D (0.5D)</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE840</BillingCode><PriorBillingCodes><PriorBillingCode>AK011</PriorBillingCode></PriorBillingCodes><Name>Band Ligator</Name><Description>A surgical instrument used to apply a ligature to haemorrhoids. A ligator typically consists of a long shaft or cannula with a clamp or grip at the distal end for holding the ligature. The proximal end consists of a handle with moving parts that mechanically operate the distal clamp or grip.</Description><Size>Barrel with 5 bands</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>5490</SubGroupID><ARTGs><ARTG>308836</ARTG></ARTGs><MinimumBenefit>236</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE472</BillingCode><Name>Endowrist Stapler 45</Name><Description>Endowrist Stapler 45 White Reload, 45 Blue Reload, 45 Green Reload</Description><Size>Length of reload: 45mm
Staple height: 2.5mm, 3.5mm, 4.3mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>239813</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE850</BillingCode><PriorBillingCodes><PriorBillingCode>PY029</PriorBillingCode></PriorBillingCodes><Name>Sinus-XL Stent ≥25mm Ø</Name><Description>Self-expanding Nitinol stent</Description><Size>Diameter: 25mm to 36mm  Length: 30 to 100mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><Suffix>LD (large diameter, &gt;25mm)</Suffix><ARTGs><ARTG>187326</ARTG></ARTGs><MinimumBenefit>2434</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE560</BillingCode><Name>EndoWrist/SureForm Stapler Reloads (used with IS Endowrist/SureForm Stapler)</Name><Description>Endowrist/SureForm Stapler Reload.</Description><Size>SureForm 30, 45 &amp; 60mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>239813</ARTG><ARTG>452485</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE852</BillingCode><PriorBillingCodes><PriorBillingCode>PY031</PriorBillingCode></PriorBillingCodes><Name>Optimed Sinus Stents</Name><Description>Sinus-wave nitinol stent</Description><Size>Diameter: 3mm to 14mm   Length:  20mm to 130mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>178915</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE648</BillingCode><Name>FEMTIS FB-313</Name><Description>Foldable one-piece monofocal acrylic plate haptic IOL for fixation in the capsulorhexis</Description><Size>Optic Size 5.7mm, Overall length 10.5mm. Available Diopters: +-15.0D to 30.0D (0.5D steps)</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE867</BillingCode><Name>Visiotis Progressive+ Toric PCM81NYT0-T3</Name><Description>Foldable one-piece hydrophillic multifocal-toric c loop IOL with aspherical and toric
surface.</Description><Size>Overall Length 12.00, Optic Size 6.0mm. Available Diopters SE +10.0D to +30.0D (0.5D increments), CYL: T0 +0.75D, T1 +1.50D, T2 +2.25D, T3 +3.00D</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE699</BillingCode><Name>NorthStar / Sierra OCT Occipital Clamp</Name><Description>Occipital Clip / Eyelet</Description><Size>One Size</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1466</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE859</BillingCode><PriorBillingCodes><PriorBillingCode>PY043</PriorBillingCode><PriorBillingCode>PY028</PriorBillingCode></PriorBillingCodes><Name>sinus-XL Stent</Name><Description>Self expanding Nitinol Stents</Description><Size>Diameter:  14mm to 24mm
Length:  30mm to &lt;150mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>187326</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE672</BillingCode><Name>icotec Pedicle System Cross Link</Name><Description>Adjustable cross link</Description><Size>30-34mm  33-42mm  40-53mm  50-70mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>283853</ARTG><ARTG>283854</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE683</BillingCode><Name>SureForm</Name><Description>The Curved Tip anvil fits through a smaller dissection window allowing for easy access around vessels, and a 120 degree cone of articulation.</Description><Size>SureForm 30, 45 &amp; 60mm Straight and Curved Tip</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix><ARTGs><ARTG>309263</ARTG></ARTGs><MinimumBenefit>447</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE673</BillingCode><Name>LENTIS LU-814VR</Name><Description>Foldable one-piece acrylic posterior chamber aspheric IOL for capsular bag, sulcus and sulcus-sclera fixation.</Description><Size>Optic size: 6.2mm 0.0D to +23.0D, 5.5mm +23.01D to +35.0D , Overall length: 13.0mm, Available Dioptres: 0.0D to +35.0D (1.0D steps), +15.5D to +26.5D (0.5D steps).</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE712</BillingCode><Name>Mariner Outrigger</Name><Description>Mariner Outrigger Offset Connectors</Description><Size>Parallel/Closed, Parallel/Side Loading, Parallel/Top Loading, Parallel/Closed/Side Loading, Parallel/Top/Side Loading, Parallel/Top/Offset, Side Loading with Rod  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE843</BillingCode><PriorBillingCodes><PriorBillingCode>PY001</PriorBillingCode></PriorBillingCodes><Name>Optimed Ureteral Stents</Name><Description>Soft-Polyurethane. Ureteral. Paediatric Ureteral. Renal Transplantation. Urinary Diversion.</Description><Size>Ureteral -
Diameter: 4.5Fr-8Fr
Length: 22cm-36cm
Paediatric Ureteral - Diameter: 3Fr-4Fr 
Length: 10cm-16cm
Renal Transplantation -  
Diameter: 6Fr-8Fr
Length:8cm-18cm
Urinary Diversion -
Diameter: 4.5Fr-9Fr 
Length: 70cm</Size><SupplierCode>DE</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5322</SubGroupID><Suffix>SP</Suffix><ARTGs><ARTG>171564</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE668</BillingCode><Name>Mariner CrossBar</Name><Description>Adjustable Cross link</Description><Size>Small 33-41mm  Medium  39-52mm  Large 50-75mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE711</BillingCode><Name>REEF TO TLIF</Name><Description>REEF TO NanoMetalene TLIF</Description><Size>9&amp;11mm Widths  28, 32, 36mm Lengths  7-18mm Heights  0-22 Degree Lordosis</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE842</BillingCode><PriorBillingCodes><PriorBillingCode>AK013</PriorBillingCode></PriorBillingCodes><Name>Biliary Nitinol Stents</Name><Description>Biliary Nitinol Stents, self expandable</Description><Size>6mm - 10mm wide  40mm - 120mm long</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><SubGroupID>4234</SubGroupID><ARTGs><ARTG>365092</ARTG></ARTGs><MinimumBenefit>2008</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE665</BillingCode><Name>Mariner Pedicle Screw Modular Head</Name><Description>Polyaxial, Extended, Deformity and Trauma Heads and MIS open polyaxial </Description><Size>One size each</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE689</BillingCode><PriorBillingCodes><PriorBillingCode>PY017</PriorBillingCode><PriorBillingCode>LV094</PriorBillingCode></PriorBillingCodes><Name>Niti-S Pyloric/Duodenal Stent</Name><Description>Niti-S Pyloric self-expanding stent, covered and uncovered, OTW or TTS</Description><Size>Diameter:  16 to 28mm   Length: 40 to 160mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1562</GroupID><ARTGs><ARTG>130746</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE858</BillingCode><PriorBillingCodes><PriorBillingCode>PY042</PriorBillingCode><PriorBillingCode>PY028</PriorBillingCode></PriorBillingCodes><Name>sinus-XL Flex Stent</Name><Description>Self expanding Nitinol Stents</Description><Size>Diameter:  14mm to 24mm
Length:  30mm to &lt;150mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>281019</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE761</BillingCode><Name>NorthStar OCT</Name><Description>NorthStar OCT Offset Connector</Description><Size>Parallel, Top Loading; Dual, Parallel, Top Loading; Parallel, Side Loading/Variable; Open Lateral Offset</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE860</BillingCode><PriorBillingCodes><PriorBillingCode>PY044</PriorBillingCode><PriorBillingCode>PY028</PriorBillingCode></PriorBillingCodes><Name>sinus-XL 6F Stents</Name><Description>Self expanding Nitinol Stents</Description><Size>Diameter:  14mm to 24mm
Length:  30mm to &lt;150mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>281020</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE716</BillingCode><Name>REEF TO PLIF</Name><Description>REEF TO NanoMetalene PLIF</Description><Size>9 &amp; 11mm Widths  20 &amp; 24mm Lengths  7-18mm Heights  0-22 Degree Lordosis  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE772</BillingCode><Name>NorthStar OCT</Name><Description>NorthStar OCT Rod</Description><Size>3.5, 4.0mm Diameter  30mm-500mm Lengths</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE765</BillingCode><Name>LENTIS Mplus Toric LU-814MF15T</Name><Description>Foldable one-piece acrylic posterior chamber aspheric multifocal toric IOL for capsular bag,sulcus and sulcus-sclera fixation</Description><Size>Optic size: 6.2mm,Overall length:13.0mm, Available Dioptres: sph. 0.0D to +36.0D (0.01D increments), cyl. +0.25D to +12.0D (0.01D increments), axis 1 deg. increments</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE811</BillingCode><PriorBillingCodes><PriorBillingCode>VL008</PriorBillingCode><PriorBillingCode>RJ011</PriorBillingCode></PriorBillingCodes><Name>Biopore Nasal Dorsum Shape</Name><Description>An implantable device intended to support, contour, and provide structure for the nose and zygoma. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description><Size>53 x 5mm, 66 x 6 mm, 76 x 15mm, 40 x 9mm</Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1597</GroupID><SubGroupID>4360</SubGroupID><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>272</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE709</BillingCode><Name>Hot Spaxus</Name><Description>Hot Spaxus is a self-expanding nitinol stent that maintains an anastomotic conduit between two adjacent organs. It has an Electrocautery Enhanced Delivery System.</Description><Size>Length 20mm, Lumen Diameter 8 - 16mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1561</GroupID><SubGroupID>6011</SubGroupID><Suffix>Electrocautery</Suffix><ARTGs><ARTG>226438</ARTG></ARTGs><MinimumBenefit>4345</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE718</BillingCode><Name>FEMTIS Comfort Toric FB-313MF15T0-T3</Name><Description>Foldable one-piece toric multifocal acrylic plate haptic IOL for fixation in the capsulorhexis</Description><Size>Optic Size 5.7mm, Overall length 10.5mm. Available Dioptres: SE +15.0D to 30.0D (0.5Dsteps), cyl  T0 +0.75D | T1 +1.5D | T2 +2.25D | T3 +3.0D</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE662</BillingCode><Name>Shoreline ACS NoProfile Cage and screws</Name><Description>Cervical cage with no anterior profile constructed of cage and bone screws</Description><Size>Footprints: 16 x 14mm and 18 x 15mm
Heights: 6 -12 mm
7 Degrees Lordosis</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE713</BillingCode><Name>Mariner Outrigger</Name><Description>Mariner Outrigger Inline Connectors</Description><Size>Axial, Closed  Closed, Axial with Rod (40-500mm)</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE774</BillingCode><Name>Acunex Vario AN6V</Name><Description>Foldable one-piece acrylic EDOF C loop IOL with aspheric surface and violet blue light filter.</Description><Size>Overall Length 12.5mm and Optic Size 6.0mm, SE +10.0D to +30.0D (0.5D steps), ADD +1.5D.</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE764</BillingCode><Name>LENTIS Comfort LU-814MF15</Name><Description>Foldable one-piece acrylic posterior chamber aspheric multifocal IOL for capsular bag, sulcus and sulcus-sclera fixation.</Description><Size>Optic size: 6.2mm, Overall length: 13.0mm, Available Dioptres: 0.0D to +36.0D (0.5D increments).</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE784</BillingCode><Name>FlareHawk Expandable TLIF Cage</Name><Description>Expandable PEEK &amp; titanium alloy lumbar interbody fusion device that enables significant graft delivery. FlareHawk is made up of an expandable shell and titanium shim.</Description><Size>0,6,9,15 degree lordosis. Unexpanded: 7mm height x 9mm width  or 7mm height x 7mm width. Expanded: 8mm - 14mm height x 14mm or 11mm widths; 29mm or 30mm lengths </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>380419</ARTG><ARTG>380420</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE808</BillingCode><PriorBillingCodes><PriorBillingCode>VL005</PriorBillingCode><PriorBillingCode>RJ008</PriorBillingCode></PriorBillingCodes><Name>Su-Por Orbital Rim, Extended</Name><Description>An implantable device intended to support, contour, and provide structure for the face including the cheeks and eye socket. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description><Size>Left and Right (44mm x 38mm)</Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4370</SubGroupID><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>385</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE694</BillingCode><PriorBillingCodes><PriorBillingCode>PY040</PriorBillingCode></PriorBillingCodes><Name>Niti-S Nagi and Spaxus Pancreatic, Pseudocyst and Gall Bladder Drainage Stent</Name><Description>Fully Covered, self-expanding metal pancreatic pseudocyst intra-luminal drainage stent</Description><Size>Diameter: 8, 10,12,14,16mm  Length: 1,2,3cm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1561</GroupID><SubGroupID>6011</SubGroupID><ARTGs><ARTG>226438</ARTG></ARTGs><MinimumBenefit>3124</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE637</BillingCode><PriorBillingCodes><PriorBillingCode>TV006</PriorBillingCode><PriorBillingCode>PJ012</PriorBillingCode></PriorBillingCodes><Name>Malibu Spinal System ESS CoNiCr Rods</Name><Description>Rod CoNiCr Precontored</Description><Size>5.5mm x 100mm - 600mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE492</BillingCode><PriorBillingCodes><PriorBillingCode>DE400</PriorBillingCode></PriorBillingCodes><Name>LENTIS L-313</Name><Description>Foldable one-piece monofocal acrylic plate haptic IOL</Description><Size>Optic Size 6.0mm, Overall length 11.0mm. Available Diopters: +-10.0D to 36.0D (1.0D steps) +10.5D to 29.5D (0.5D steps)</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-09-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE809</BillingCode><PriorBillingCodes><PriorBillingCode>VL006</PriorBillingCode><PriorBillingCode>RJ009</PriorBillingCode></PriorBillingCodes><Name>Su-Por Custom Made Implant</Name><Description>An implantable device made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is custom made/biomodelled from individual patient's CT scan, on doctors prescription, used for correction and reconstruction of any facial, head or any non-weight bearing bone structure.</Description><Size>Custom designed and biomodelled from patient's CT scan image.</Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>4346</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>9682</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE815</BillingCode><PriorBillingCodes><PriorBillingCode>VL012</PriorBillingCode></PriorBillingCodes><Name>Su-Por Pterional, Mastoid, Temporal</Name><Description>Mastoid, Pterional, Contourable Porous Polyethylene.</Description><Size>Various sizes, left, right</Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>4346</SubGroupID><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>1267</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE624</BillingCode><PriorBillingCodes><PriorBillingCode>RH024</PriorBillingCode></PriorBillingCodes><Name>Chord-X</Name><Description>ePTFE chordal repair</Description><Size>Five (5) loop lengths -(0mm/adjustable, 12mm, 16mm, 20mm and 24mm),
Two (2) sutures (2-0 ePTFE or 3-0 ePTFE),
Two (2) needle shapes (1/2 circle and 3/8 circle),
Two (2) needle lengths (18mm and 22mm).</Size><SupplierCode>DE</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>265</SubCategoryID><GroupID>1828</GroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>262630</ARTG></ARTGs><MinimumBenefit>256</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE494</BillingCode><PriorBillingCodes><PriorBillingCode>DE388</PriorBillingCode></PriorBillingCodes><Name>LENTIS Mplus Toric LU-313MFT</Name><Description>Patient specific one-piece multifocal-toric plate haptic acrylic IOL</Description><Size>Overall Length 11.0mm and Optic Size 6.0 + 0.0D to +36.0D inclusive in 0.01D increments. Cyl +0.50 to +12.00D inclusive in 0.01D increments  sph + cyl &lt;40.0D  axis 1 degree scaling</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-09-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE789</BillingCode><Name>Acunex Variomax Toric AN6VMT</Name><Description>Foldable one-piece acrylic Multifocal C loop IOL with aspheric surface and violet blue light filter.</Description><Size>Overall Length 12.5mm and Optic Size 6.0mm, SE: +10.0D to +30.0D (0.5D steps), cyl: T0 +0.75D T1 +1.5D T2 +2.25D T3 +3.0D, ADD +3.0D.</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE678</BillingCode><Name>icotec Anterior Cervical Plate System - Screw</Name><Description>Self-tapping bone screws</Description><Size>Diameter: 4mm and 4.25mm  Length: 13mm and 15mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>283853</ARTG></ARTGs><Note>Prescribed List reimbursement is only payable for the billing code when the device is used in patients with spinal tumours requiring regular magnetic resonance imaging (MRI) and/or computerised tomography (CT) imaging and or adjuvant radiotherapy and/or proton therapy.</Note><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE767</BillingCode><Name>NorthStar OCT</Name><Description>NorthStar OCT Hook</Description><Size>4.5 &amp; 6.0mm  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE526</BillingCode><Name>LENTIS Comfort Toric LS-313MF15T0-T6</Name><Description>Foldable one piece multifocal toric plate haptic acrylic IOL</Description><Size>Overall Length 11.0mm and Optic Size 6.0mm, SE: +10.0D to +30.0D (0.5D steps), Cyl: +0.75D to +5.25D (0.75D steps).</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ695</BillingCode><Name>Regatta Screws </Name><Description>The SeaSpine Regatta screws are indicated for use with the Regatta plate system to secure the plate to the spine as additional support during fusion via a lateral or anterolateral surgical approach in the treatment of thoracic and thoracolumbar (T1-S1) spine instability, as the result of fracture, tumour, DDD, scoliosis, kyphosis, lordosis, stenosis or failed previous surgery. </Description><Size>Variable screws 5.5mm &amp; 6.0mm Diameter and Lengths 35, 40, 45, 50, 55, 60 &amp; 65</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE675</BillingCode><Name>LENTIS Mplus LU-814MF30</Name><Description>Foldable one-piece acrylic posterior chamber aspheric multifocal IOL for capsular bag, sulcus and sulcus-sclera fixation.</Description><Size>Optic size: 6.2mm , 0.0D to +23.0D,  5.5mm +23.01D to +36.0D Overall length: 13.0mm, Available Dioptres: 0.0D to +36.0D (0.5D increments).</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE795</BillingCode><Name>Micromed Microgas</Name><Description>Single dose high molecular weight gases for replacement of vitreous humor during retinal surgery  </Description><Size>50cc aluminium canister with dispenser</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1345</GroupID><ARTGs><ARTG>382032</ARTG></ARTGs><MinimumBenefit>67</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE758</BillingCode><Name>KONG-C</Name><Description>KONG-C VBR Body</Description><Size>13mm Diameter  16-66mm, Height</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1814</GroupID><ARTGs><ARTG>345871</ARTG></ARTGs><MinimumBenefit>3340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE790</BillingCode><Name>Mariner Hooks</Name><Description>Lamina, Pedicle, Angled &amp; Offset Hooks</Description><Size>5.5-10.5 Heights  4.5-9.0 Widths  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE797</BillingCode><Name>Meridian TruProfile ALIF Cage, Plate, Locking Cover, Screws</Name><Description>Anterior lumbar cage with plate, locking cover and screws</Description><Size>Cage: 31x24, 35x27, 39x30, 43 x 30 ;10-20mm Heights;10, 15, 20 &amp; 25 Degree Lordosis    Plate: 2 &amp; 4 Hole, Size 10mm-20mm   Locking Cover: 10mm-20mm  Screws: 5.5 &amp; 6.0mm, 20mm-35mm  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE805</BillingCode><PriorBillingCodes><PriorBillingCode>VL001</PriorBillingCode><PriorBillingCode>RJ005</PriorBillingCode></PriorBillingCodes><Name>Su-Por Flexible Block</Name><Description>An implantable device intended to support, contour, and provide structure for the craniofacial anatomy during reconstructive and plastic surgery procedures. Made of high density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description><Size>13 x 38 x 3mm, 25 x 50 x 6mm, 13 x 38 x 9.5mm  25 x 50 x 3mm, 25 x 50 x 6mm, 25 x 50 x 9.5mm  38 x 63 x 3mm, 38 x 63 x 6mm, 38 x 63 x 9.5mm</Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4255</SubGroupID><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>804</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE786</BillingCode><Name>FEMTIS Mplus Toric FB313MF30T0-T3</Name><Description>Foldable one-piece toric multifocal acrylic plate haptic IOL for fixation in the capsulorhexis</Description><Size>Optic Size 5.7mm, Overall length 10.5mm. Available Dioptres: SE +15.0D to +30.0D (0.5Dsteps), cyl T0 +0.75D | T1 +1.5D | T2 +2.25D | T3 +3.0D</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE785</BillingCode><Name>FEMTIS Mplus FB-313MF30</Name><Description>Foldable one-piece multifocal acrylic plate haptic IOL for fixation in the capsulorhexis</Description><Size>Optic Size 5.7mm, Overall length 10.5mm. Available Dioptres: +15.0D to 30.0D (0.5Dsteps)</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE496</BillingCode><PriorBillingCodes><PriorBillingCode>DE396</PriorBillingCode></PriorBillingCodes><Name>LENTIS Mplus   LENTIS Comfort</Name><Description>Foldable one-piece multifocal plate haptic acrylic IOL</Description><Size>Overall Length 11.0mm and Optic Size 6.0mm.  Available diopters -10.0D to -1.0D (1.0D), 0.0D to +36.0D (0.5D)</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-09-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE855</BillingCode><PriorBillingCodes><PriorBillingCode>PY038</PriorBillingCode></PriorBillingCodes><Name>Niti-S Biliary Uncovered Stents</Name><Description>Niti-S Biliary Uncovered Stents.</Description><Size>Diameter:  6mm to 10mm   Length:  40mm to 120mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><SubGroupID>4234</SubGroupID><ARTGs><ARTG>130531</ARTG></ARTGs><MinimumBenefit>2008</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE862</BillingCode><PriorBillingCodes><PriorBillingCode>PY049</PriorBillingCode><PriorBillingCode>PY027</PriorBillingCode><PriorBillingCode>LV106</PriorBillingCode></PriorBillingCodes><Name>Niti-S Biliary Covered and Partially Covered Stents</Name><Description>Niti-S Biliary Covered and Partially Covered Stents</Description><Size>Diameter:  4mm to 16mm  Length:  10mm to 120mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><SubGroupID>4235</SubGroupID><ARTGs><ARTG>130531</ARTG></ARTGs><MinimumBenefit>2730</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE759</BillingCode><Name>KONG-C</Name><Description>KONG-C VBR Endplates</Description><Size>14x13mm, 16x13mm, 18x14mm  5.5mm Height  0,3 &amp; 6 Degree Angles</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1814</GroupID><ARTGs><ARTG>345871</ARTG></ARTGs><MinimumBenefit>3340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE851</BillingCode><PriorBillingCodes><PriorBillingCode>PY030</PriorBillingCode></PriorBillingCodes><Name>Taewoong ePTFE covered dual nitinol ureteral/urethral stent</Name><Description>Taewoong ePTFE covered dual nitinol ureteral/urethral stent</Description><Size>Diameter: 6mm to 16mm
Length: 4cm to 20cm</Size><SupplierCode>DE</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5323</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>130532</ARTG><ARTG>220258</ARTG></ARTGs><MinimumBenefit>2996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE638</BillingCode><PriorBillingCodes><PriorBillingCode>TV008</PriorBillingCode><PriorBillingCode>PJ014</PriorBillingCode></PriorBillingCodes><Name>Malibu Spinal System Rods</Name><Description>Rod</Description><Size>5.5mm x 30mm - 600mm  6.35mm x 100mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE670</BillingCode><Name>icotec Pedicle System Rod</Name><Description>Pre-bent and straight rods</Description><Size>5.5, 5.7, mm &amp; 6.0mm diameter   30-500 mm Length</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>283853</ARTG><ARTG>283854</ARTG></ARTGs><Note>Prescribed List reimbursement is only payable for the billing code when the device is used in patients with spinal tumours requiring regular magnetic resonance imaging (MRI) and/or computerised tomography (CT) imaging and or adjuvant radiotherapy and/or proton therapy.</Note><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE674</BillingCode><Name>LENTIS Tplus LU-814T</Name><Description>Foldable one-piece acrylic posterior chamber aspheric toric IOL for capsular bag, sulcus and sulcus-sclera fixation.</Description><Size>Optic size: 6.2mm ,-10.0D to +23.0D (SEQ), 5.5mm +23.01D to +35.0D (SEQ) Overall length: 13.0mm, Available Dioptres: sph. -10.0D to +35.0D (0.01D increments), cyl. +0.25D to +12.0D (0.01D increments), axis. 1 degree increments.</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE695</BillingCode><PriorBillingCodes><PriorBillingCode>PY048</PriorBillingCode><PriorBillingCode>PY025</PriorBillingCode><PriorBillingCode>PY026</PriorBillingCode></PriorBillingCodes><Name>Niti-S Tracheal and Bronchial Stents</Name><Description>Niti-S Tracheal and Bronchial Stents</Description><Size>Diameter:  10mm to 24mm  Length:  30mm to 100mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1563</GroupID><ARTGs><ARTG>130533</ARTG><ARTG>130534</ARTG></ARTGs><MinimumBenefit>2708</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE666</BillingCode><Name>Mariner Set Screw</Name><Description>Set Screw</Description><Size>1 size</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE778</BillingCode><Name>Acunex Vario Toric AN6VT</Name><Description>Foldable one-piece acrylic EDOF C loop IOL with aspheric surface and violet blue light filter.</Description><Size>Overall Length 12.5mm and Optic Size 6.0mm, SE: +10.0D to +30.0D (0.5D steps), cyl: T0 +0.75D  T1 +1.5D  T2 +2.25D  T3 +3.0D, ADD +1.5D.</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE823</BillingCode><PriorBillingCodes><PriorBillingCode>CR118</PriorBillingCode></PriorBillingCodes><Name>LARS Ligament Staple</Name><Description>CoCr synthetic ligament anchor</Description><Size>Width 8mm &amp; length 20mm</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><ARTGs><ARTG>138574</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ533</BillingCode><Name>Disposable Dual Action Tissue Closure Device</Name><Description>The Disposable Dual Action Tissue Closure Device is mainly composed of a clip component and a release device. The clip component is mainly composed of a clip and a clip pedestal.  The release device is mainly composed of a spring tube and a handle, and the handle is mainly composed
of a core bar, slide block and handle ring.</Description><Size>Opening width 15mm, Working Length 1650-2350mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic, Dual Action</Suffix><ARTGs><ARTG>418087</ARTG></ARTGs><MinimumBenefit>350</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE847</BillingCode><PriorBillingCodes><PriorBillingCode>PY011</PriorBillingCode></PriorBillingCodes><Name>Optimed Opti-J Stents</Name><Description>Dual Use directional Double J stent and delivery system. Can also be used as urinary diversion stent.</Description><Size>4.5Fr to 8Fr
Length:  22cm to 36cm</Size><SupplierCode>DE</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5321</SubGroupID><ARTGs><ARTG>171564</ARTG></ARTGs><MinimumBenefit>95</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE848</BillingCode><PriorBillingCodes><PriorBillingCode>PY012</PriorBillingCode></PriorBillingCodes><Name>Ex-Stent Tumour Ureteral Stent Set</Name><Description>Open end stent with guide wire and pusher</Description><Size>Diameter: 6Fr-8Fr
Length: 26cm-36cm</Size><SupplierCode>DE</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5321</SubGroupID><Suffix>T</Suffix><ARTGs><ARTG>171564</ARTG></ARTGs><MinimumBenefit>187</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE838</BillingCode><PriorBillingCodes><PriorBillingCode>AK009</PriorBillingCode><PriorBillingCode>AK002</PriorBillingCode></PriorBillingCodes><Name>Oesophageal Tracheal Stents</Name><Description>Nitinol wire expandable stents, covered and non covered, Y shaped</Description><Size>multiple sizes</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1563</GroupID><ARTGs><ARTG>173875</ARTG></ARTGs><MinimumBenefit>1805</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE622</BillingCode><PriorBillingCodes><PriorBillingCode>RH018</PriorBillingCode></PriorBillingCodes><Name>Park Bridge Stabiliser</Name><Description>Stablisation of Pectus Bar - optional use for multiple bar placement</Description><Size>3 sizes: 6 hole - 60mm, 8 hole 80mm, 10 hole - 100mm</Size><SupplierCode>DE</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>264</SubCategoryID><GroupID>1825</GroupID><ARTGs><ARTG>224584</ARTG><ARTG>317581</ARTG></ARTGs><MinimumBenefit>480</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE686</BillingCode><Name>Regatta</Name><Description>Regatta Lateral Interbody System</Description><Size>Height: 8 -16mm  Width: 18 and 23mm  Length: 40,45,50,55 and 60mm  Lordosis: 0, 10 and 15 degrees</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE567</BillingCode><Name>Hemoclip</Name><Description>Pre-loaded Endoscopically  applied clip for the GI tract.</Description><Size>Jaw openings: 9 - 16mm;
Applicator length: 165 - 230cm.</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>284272</ARTG></ARTGs><MinimumBenefit>125</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE868</BillingCode><Name>STAR Clip</Name><Description>Long Term Hemostatic Clip</Description><Size> Working Channel 1950 mm, endoscopic dia. (9.5-12)mm,  Working Channel 2350 mm, endoscopic dia. (11.5-14)mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic, OTS</Suffix><ARTGs><ARTG>418087</ARTG></ARTGs><MinimumBenefit>884</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE806</BillingCode><PriorBillingCodes><PriorBillingCode>VL003</PriorBillingCode><PriorBillingCode>RJ004</PriorBillingCode></PriorBillingCodes><Name>Su-Por Chin Two Piece Anatomical contour.</Name><Description>An implantable device intended to support, contour, and provide structure for the chin. Made of high density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description><Size>3mm, 5mm, 7mm, 9mm</Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1592</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>626</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE621</BillingCode><PriorBillingCodes><PriorBillingCode>RH017</PriorBillingCode></PriorBillingCodes><Name>Park Pectus Hinge Plate Stabiliser</Name><Description>Stabilisation of Pectus Bar - optional use in asymmetric or adult pectus excavatum to prevent bar displacement stripping of intercostal muscles</Description><Size>65mm</Size><SupplierCode>DE</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>264</SubCategoryID><GroupID>1825</GroupID><ARTGs><ARTG>317581</ARTG></ARTGs><MinimumBenefit>480</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE837</BillingCode><PriorBillingCodes><PriorBillingCode>AK008</PriorBillingCode></PriorBillingCodes><Name>Ligation Loop</Name><Description>A device used in combination with a dedicated endoscope. It is intended to ligate a polyp using loop wire for haemostasis or necrosis during endoscopy. It consist of an insertion sheath, a loop wire attached at the distal end of the sheath, and a control handle and operation wire connected to both the loop wire and control handle.</Description><Size>Introducer up to 240cm long
Loop sizes 15mm-40mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>279077</ARTG></ARTGs><MinimumBenefit>125</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE798</BillingCode><Name>Meridian ALIF Plate</Name><Description>Titanium ALIF Plate </Description><Size>2 &amp; 4 Hole, Size 10mm-20mm </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4128</SubGroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE623</BillingCode><PriorBillingCodes><PriorBillingCode>RH019</PriorBillingCode></PriorBillingCodes><Name>Park Claw Fixator, Clip and Nut Stabiliser</Name><Description>Stabilisation of Pectus Bar</Description><Size>Park Claw Fixator - Small (20mm x 12mm), Medium (23mm x 15mm), Large (25mm x 18mm), Extra Large (30mm x 18mm).Fixator Clip - 15mm.Nut - 7mm.</Size><SupplierCode>DE</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>264</SubCategoryID><GroupID>1825</GroupID><ARTGs><ARTG>224584</ARTG><ARTG>317581</ARTG></ARTGs><MinimumBenefit>480</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE671</BillingCode><Name>icotec Pedicle System Set Screw</Name><Description>Set screw</Description><Size>one size only</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>283853</ARTG><ARTG>283854</ARTG></ARTGs><Note>Prescribed List reimbursement is only payable for the billing code when the device is used in patients with spinal tumours requiring regular magnetic resonance imaging (MRI) and/or computerised tomography (CT) imaging and or adjuvant radiotherapy and/or proton therapy.</Note><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE705</BillingCode><Name>Mariner MIS Rods</Name><Description>Mariner MIS Rods</Description><Size>5.5mm - 6.0mm Diameter.  20-450mm Length.</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE609</BillingCode><PriorBillingCodes><PriorBillingCode>RH021</PriorBillingCode></PriorBillingCodes><Name>Cor-Knot Mini Device Kit</Name><Description>The Cor-Knot Mini Device Kit contains two Cor-Knot Mini Devices which deliver and crimp a titanium fastener around a suture placed using routine suture placement techniques, trimming any excess suture tails.</Description><Size>2 x Cor-Knot Mini Sterile Devices (14cm length shaft) in each kit</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4257</SubGroupID><ARTGs><ARTG>219812</ARTG></ARTGs><MinimumBenefit>249</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE606</BillingCode><PriorBillingCodes><PriorBillingCode>RH012</PriorBillingCode></PriorBillingCodes><Name>Cor-Knot® Device Kit</Name><Description>The Cor-Knot Device kit contains two Cor Knot devices which deliver and crimp a titanium fastener around a suture placed using routine suture placement techniques, trimming any excess suture tails</Description><Size>Each kit contains two Cor- Knot sterile devices</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4257</SubGroupID><ARTGs><ARTG>219812</ARTG></ARTGs><MinimumBenefit>249</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE841</BillingCode><PriorBillingCodes><PriorBillingCode>AK012</PriorBillingCode></PriorBillingCodes><Name>Lockado Clip and SureClip  </Name><Description>An endotherapy device used in combination with a compatible flexible  endoscope for the application of haemostatic clips to the mucosal lining  of the gastrointestinal (GI) tract for endoscopic marking, haemostasis,  tissue approximation, closure of luminal perforations, and/or for treating  mucosal/submucosal defects during an endoscopic procedure.</Description><Size>8mm, 11mm, 16mm, 20mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>261692</ARTG></ARTGs><MinimumBenefit>125</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE827</BillingCode><PriorBillingCodes><PriorBillingCode>CR204</PriorBillingCode></PriorBillingCodes><Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament - MCL 32</Name><Description>Woven polyester prosthetic ligament</Description><Size>32 fibres</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1776</GroupID><SubGroupID>5398</SubGroupID><ARTGs><ARTG>138573</ARTG></ARTGs><Note>Prescribed List reimbursement  for the billing code is restricted to the use of Artificial Ligaments for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note><MinimumBenefit>4217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE826</BillingCode><PriorBillingCodes><PriorBillingCode>CR203</PriorBillingCode></PriorBillingCodes><Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament - LAC 30</Name><Description>Woven polyester prosthetic ligament</Description><Size>30 fibres</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1776</GroupID><SubGroupID>5398</SubGroupID><ARTGs><ARTG>138573</ARTG></ARTGs><Note>Prescribed List reimbursement  for the billing code is restricted to the use of Artificial Ligaments for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note><MinimumBenefit>4217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE829</BillingCode><PriorBillingCodes><PriorBillingCode>CR206</PriorBillingCode></PriorBillingCodes><Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament  - Rotator Cuff CR 30</Name><Description>Woven polyester prosthetic ligament</Description><Size>48 fibres</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1776</GroupID><SubGroupID>5398</SubGroupID><ARTGs><ARTG>138573</ARTG></ARTGs><Note>Prescribed List reimbursement  for the billing code is restricted to the use of Artificial Ligaments for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note><MinimumBenefit>4217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE828</BillingCode><PriorBillingCodes><PriorBillingCode>CR205</PriorBillingCode></PriorBillingCodes><Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament  - Rotator Cuff CR 25</Name><Description>Woven polyester prosthetic ligament</Description><Size>40 fibres</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1776</GroupID><SubGroupID>5398</SubGroupID><ARTGs><ARTG>138573</ARTG></ARTGs><Note>Prescribed List reimbursement  for the billing code is restricted to the use of Artificial Ligaments for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note><MinimumBenefit>4217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE830</BillingCode><PriorBillingCodes><PriorBillingCode>CR214</PriorBillingCode></PriorBillingCodes><Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament</Name><Description>Woven polyester prosthetic ligaments</Description><Size>8 fibres</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1776</GroupID><SubGroupID>5398</SubGroupID><ARTGs><ARTG>138573</ARTG></ARTGs><Note>Prescribed List reimbursement  for the billing code is restricted to the use of Artificial Ligaments for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note><MinimumBenefit>4217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE679</BillingCode><Name>icotec Anterior Cervical Plate</Name><Description>Cervical Plate</Description><Size>18mm Width, 58mm - 94mm Length</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>283853</ARTG></ARTGs><Note>Prescribed List reimbursement is only payable for the billing code when the device is used in patients with spinal tumours requiring regular magnetic resonance imaging (MRI) and/or computerised tomography (CT) imaging and or adjuvant radiotherapy and/or proton therapy.</Note><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE822</BillingCode><PriorBillingCodes><PriorBillingCode>CR032</PriorBillingCode></PriorBillingCodes><Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament</Name><Description>Woven polyester prosthetic ligaments</Description><Size>60,80,100,120,160 &amp; Y shaped fibres</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1776</GroupID><SubGroupID>5398</SubGroupID><ARTGs><ARTG>138573</ARTG></ARTGs><Note>Prescribed List reimbursement  for the billing code is restricted to the use of Artificial Ligaments for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note><MinimumBenefit>4217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE762</BillingCode><Name>NorthStar OCT</Name><Description>NorthStar OCT Set Screw</Description><Size>One Size</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE757</BillingCode><Name>KONG-TL</Name><Description>KONG-TL VBR Endplates with Screw</Description><Size>26-52mm Lengths  20-29mm Widths  0,4, 8 &amp; 12 Degree Angles</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4138</SubGroupID><ARTGs><ARTG>345871</ARTG></ARTGs><MinimumBenefit>928</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE825</BillingCode><PriorBillingCodes><PriorBillingCode>CR202</PriorBillingCode></PriorBillingCodes><Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament – LAC 20</Name><Description>Woven polyester prosthetic ligament</Description><Size>20 fibres</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1776</GroupID><SubGroupID>5398</SubGroupID><ARTGs><ARTG>138573</ARTG></ARTGs><Note>Prescribed List reimbursement  for the billing code is restricted to the use of Artificial Ligaments for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note><MinimumBenefit>4217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE824</BillingCode><PriorBillingCodes><PriorBillingCode>CR201</PriorBillingCode></PriorBillingCodes><Name>Ligament Advanced Reinforcement System (LARS) Artificial Ligament -  AC30RA </Name><Description>Woven polyester prosthesic ligament</Description><Size>30 fibres</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1776</GroupID><SubGroupID>5398</SubGroupID><ARTGs><ARTG>138573</ARTG></ARTGs><Note>Prescribed List reimbursement  for the billing code is restricted to the use of Artificial Ligaments for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note><MinimumBenefit>4217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE835</BillingCode><Name>GENTA-PROTEC </Name><Description>Absorbable, implantable haemostatic matrix collagen sponge for surgical use; containing Gentamicin</Description><Size>5CM x 5CM</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4215</SubGroupID><Suffix>Antibiotic</Suffix><ARTGs><ARTG>467807</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE832</BillingCode><Name>GENTA-COLL</Name><Description>Absorbable, implantable, haemostatic collagen sponge for surgical use; containing Gentamicin</Description><Size>5cm x 5cm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4215</SubGroupID><Suffix>Antibiotic</Suffix><ARTGs><ARTG>467809</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE680</BillingCode><Name>icotec Anterior Cervical Plate</Name><Description>Cervical Plate</Description><Size>18mm width, 21mm - 55mm length</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>283853</ARTG></ARTGs><Note>Prescribed List reimbursement is only payable for the billing code when the device is used in patients with spinal tumours requiring regular magnetic resonance imaging (MRI) and/or computerised tomography (CT) imaging and or adjuvant radiotherapy and/or proton therapy.</Note><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE810</BillingCode><PriorBillingCodes><PriorBillingCode>VL007</PriorBillingCode><PriorBillingCode>RJ010</PriorBillingCode></PriorBillingCodes><Name>Su-Por Mandible (Left / Right)</Name><Description>An implantable device intended to support, contour, and provide structure for the mandible. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device can be cut by the surgeon to meet the patient's specific needs.</Description><Size>74 x 33 x5mm</Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4355</SubGroupID><Suffix>Polymer</Suffix><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>1448</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE846</BillingCode><PriorBillingCodes><PriorBillingCode>PY010</PriorBillingCode></PriorBillingCodes><Name>Platinum Spirale and Cirrus embolisation coils 200-450mm</Name><Description>Embolisation coils with and without fibers</Description><Size>Spiral diameter: 5mm to 16mm
Length: 200mm to 450mm
Coil diameter: 0.82mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5473</SubGroupID><Suffix>P (Platinum)</Suffix><ARTGs><ARTG>175423</ARTG><ARTG>175567</ARTG></ARTGs><MinimumBenefit>231</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE584</BillingCode><Name>ALOS Eyelid Implants - Platinum</Name><Description>Platinum Eyelid Implants</Description><Size>0.6, 0.8, 1.0, 1.2, 1.4, 1.6, 1.8 grams</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>145</SubCategoryID><GroupID>1336</GroupID><SubGroupID>3902</SubGroupID><ARTGs><ARTG>290117</ARTG></ARTGs><MinimumBenefit>1173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE801</BillingCode><Name>Mariner Uniaxial Screw</Name><Description>Uniaxial Screw</Description><Size>4.5-7.5mm Diameter, 20-110mm Lengths    </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE799</BillingCode><Name>Olie Medical (Sidapharm) Lacrimal Intubation Set</Name><Description>This disposable device consists of two stainless steel malleable probes (with or without olive tip) attached to a silicon tube.</Description><Size>23G, 17.5 cm, Straight tip    23G, 11.0 cm, Olive tip</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>146</SubCategoryID><GroupID>1337</GroupID><ARTGs><ARTG>370527</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE191</BillingCode><Name>Canaliculus Intubation Sets </Name><Description>Silicone, SS &amp; Nylon</Description><Size>17.7 x .064 x 29cm, 15.5 x .051 x 33cm</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>146</SubCategoryID><GroupID>1337</GroupID><ARTGs><ARTG>182623</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE660</BillingCode><Name>Shoreline ACS Bone Screws</Name><Description>Self drilling and self tapping bone screws</Description><Size>3.5 and 4.0mm diameters
10-18mm length</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE756</BillingCode><Name>KONG-TL</Name><Description>KONG-TL VBR Extension with Screw</Description><Size>19mm Diameter, 20 &amp; 35mm Heights</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>345871</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE856</BillingCode><PriorBillingCodes><PriorBillingCode>PY039</PriorBillingCode></PriorBillingCodes><Name>BeGraft Peripheral Stent Graft System</Name><Description>Balloon Expandable "One layer" Biocompatible CoCr Alloy and Micro-porous ePTFE Peripheral Vascular Stent</Description><Size>Diameter: 5mm to 12mm
Length: 18mm to 58mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1634</GroupID><SubGroupID>4449</SubGroupID><ARTGs><ARTG>280061</ARTG></ARTGs><MinimumBenefit>3258</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE620</BillingCode><PriorBillingCodes><PriorBillingCode>RH016</PriorBillingCode></PriorBillingCodes><Name>Park Modified Pectus Bar</Name><Description>Park Modified Pectus bar available in titanium alloy and stainless steel</Description><Size>6" - 152mm, 7" - 178mm, 8" - 203mm, 9" - 228mm, 10" - 254mm, 11" - 279mm, 12" - 305mm, 13" - 330mm, 14" - 356mm, 15" = 381mm, 16" - 406mm, 17" - 432mm</Size><SupplierCode>DE</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>264</SubCategoryID><GroupID>1824</GroupID><ARTGs><ARTG>317581</ARTG></ARTGs><MinimumBenefit>1193</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE813</BillingCode><PriorBillingCodes><PriorBillingCode>VL010</PriorBillingCode></PriorBillingCodes><Name>Su-Por Orbital Floor</Name><Description>An implantable device intended to support, contour, and provide structure for the face including the cheeks and eye socket. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various size and can be cut by the surgeon to meet the patient's specific needs.</Description><Size>24mm, 30mm, 34mm, 35mm, 40mm</Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4367</SubGroupID><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>868</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE664</BillingCode><Name>Mariner Pedicle Screw Shank</Name><Description>Posterior Fixation System</Description><Size>4.5, 5.5, 6.5, 7.5, 8.5, 9.5 and 10.5mm Diameters  25-110mm Length</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE773</BillingCode><Name>KONG-TL</Name><Description>KONG-TL VBR Bodies</Description><Size>19mm Diameter:  19-23mm, 20-24mm, 22-29mm, 23-30mm, 27-37mm &amp; 33-49mm Heights  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>345871</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE667</BillingCode><Name>Mariner Rod</Name><Description>Pre-contoured and straight rods</Description><Size>5.5 &amp; 6.0mm diameter   20mm - 600mm Length</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE812</BillingCode><PriorBillingCodes><PriorBillingCode>VL009</PriorBillingCode><PriorBillingCode>RJ012</PriorBillingCode></PriorBillingCodes><Name>Su-Por Ultra Thin, Membrane, Flor-Tec, Channel Sheet</Name><Description>An implantable device intended to support, contour, and provide structure for the craniofacial anatomy during reconstructive and plastic surgery procedures. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description><Size>2.5mm, 3.5mm. 4.0mm, 0.85mm, 1.5mm, 3.0mm</Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4254</SubGroupID><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>234</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE794</BillingCode><Name>Mariner Connectors</Name><Description>Mariner Offset Connectors</Description><Size>5.5mm  15mm-200mm Lengths  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE657</BillingCode><Name>NovaBone BioGlass</Name><Description>Bioactive synthetic bone graft - calcium phospho-silicate</Description><Size>15cc </Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>302475</ARTG></ARTGs><MinimumBenefit>4370</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE800</BillingCode><Name>NorthStar Transition Rod</Name><Description>Transition Rod</Description><Size>3.5mm, 4.0mm – 5.5mm, 6.0mm Diameters  500mm Length  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE844</BillingCode><PriorBillingCodes><PriorBillingCode>PY008</PriorBillingCode></PriorBillingCodes><Name>Platinum Spirale and Cirrus embolisation coils &lt;100mm</Name><Description>Embolisation coils with or without fibers</Description><Size>Spiral diameter 2mm to 16mm
Length: 25mm to 80mm
Coil diameter: 0.27mm to 0.82mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5472</SubGroupID><Suffix>P (Platinum)</Suffix><ARTGs><ARTG>175423</ARTG><ARTG>175567</ARTG></ARTGs><MinimumBenefit>116</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE845</BillingCode><PriorBillingCodes><PriorBillingCode>PY009</PriorBillingCode></PriorBillingCodes><Name>Platinum Spirale and Cirrus embolisation coils 100-150mm</Name><Description>Embolisation coils with or without fibers</Description><Size>Spiral diameter: 4mm to 11mm
Length: 100mm to 150mm
Coil diameter:  0.27mm to 0.82mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5472</SubGroupID><Suffix>P (Platinum)</Suffix><ARTGs><ARTG>175423</ARTG><ARTG>175567</ARTG></ARTGs><MinimumBenefit>116</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE864</BillingCode><PriorBillingCodes><PriorBillingCode>PY051</PriorBillingCode></PriorBillingCodes><Name>Prestige Plus Detachable Coil</Name><Description>Implantable embolization Coil comprised of platinum-tungsten alloy attached to a proximal stainless steel hypo-tube and distal body coil delivery pusher with a radiopaque distal positioning marker and a proximal fluorosafe marker.  </Description><Size>Diameter 2mm-24mm  Length 2cm-65cm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5472</SubGroupID><Suffix>P, repositionable (Platinum, repositionable)</Suffix><ARTGs><ARTG>377475</ARTG></ARTGs><MinimumBenefit>825</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE807</BillingCode><PriorBillingCodes><PriorBillingCode>VL004</PriorBillingCode><PriorBillingCode>RJ006</PriorBillingCode></PriorBillingCodes><Name>Su-Por Malar, Paranasal, Midface Implant</Name><Description>An implantable device intended to support, contour and provide structure for the face including the cheeks and eye sockets. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in various shapes and can be cut by the surgeon to meet the patient's specific needs.</Description><Size>Left and Right (47mm x 24mm x 4mm)</Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1595</GroupID><SubGroupID>4351</SubGroupID><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>1121</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE770</BillingCode><Name>NorthStar OCT</Name><Description>NorthStar OCT Occipital Screw  </Description><Size>4.0, 4.5mm Diameter  7-16mm Lengths  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE541</BillingCode><Name>Balloon G-Tube</Name><Description>Conventional Length Balloon Gastrostomy tube</Description><Size>12F-24F; 
Length: 10cm;
Balloon fill volumes from 2 -15ml depending on French size.</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>181742</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE564</BillingCode><Name>Mini ONE Balloon Button</Name><Description>Low Profile Balloon Gastrostomy Tube</Description><Size>12F to 24F and length 0.8 - 6.5cms; Balloon Fill Volumes: 2-15ml</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>181741</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE818</BillingCode><Name>BlackArmor Carbon Fibre/PEEK Curved / Multicurved Rods</Name><Description>The BlackArmor material is a combination of continuous, high-strength carbon-  fiber-reinforced PEEK and a procedure developed by icotec – Injection Moulding CFM (Composite Flow Moulding). The result is a non-metallic implant component with an interwoven 3D fibre architecture that provides unmatched  strength and endurance. BlackArmor® is radiolucent in all diagnostic imaging modes (MRI, CT and X-ray) and will therefore not create imaging artifacts; a significant clinical benefit in the postoperative monitoring of anatomical structures and other forms of treatment.</Description><Size>Curved and Multicurved rods,    Diameter: 6.0mm  Radius: 120mm, 450mm  Length: 40mm-300mm  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>283853</ARTG></ARTGs><Note>Prescribed List reimbursement is only payable for the billing code when the device is used in patients with spinal tumours requiring regular magnetic resonance imaging (MRI) and/or computerised tomography (CT) imaging and or adjuvant radiotherapy and/or proton therapy.</Note><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE788</BillingCode><Name>Mariner Screw</Name><Description>Polyaxial and Extended Tab Uni-Planar Screws  </Description><Size>4.5mm. 5.5mm, 6.5mm &amp; 7.5mm Diameters, 20mm to 110mm Lengths  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE691</BillingCode><PriorBillingCodes><PriorBillingCode>PY022</PriorBillingCode><PriorBillingCode>LV100</PriorBillingCode></PriorBillingCodes><Name>Niti-S Oesophageal Double Stent &amp; Beta Double &amp; D-Double Stent</Name><Description>Niti-S Oesophageal covered Double Stent &amp; Beta Double and D-Double self-expanding metal stent made from Nitinol, with an anti-migration outer uncovered wire construction to allow the mesh to embed in the oesophageal wall. Also with anti reflux valve inner polyurethane layer, PTFE &amp; silicone covering to prevent tumor ingrowth.  String for retrieval or re-positioning.</Description><Size>Diameter: 10mm to 28mm  Length: 40mm to 200mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1558</GroupID><SubGroupID>4238</SubGroupID><ARTGs><ARTG>130535</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE593</BillingCode><Name>Newport MIS Extended Tab Polyaxial Screw</Name><Description>Cannulated Polaxial Pedicle Screw</Description><Size>4.75, 5.5, 6.5, 7.5, 8.5 and 9.5mm diameter
Lengths 30 - 60mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE546</BillingCode><Name>Capsule Dome G-Tube</Name><Description>Conventional Length Dome Gastrostomy Tube</Description><Size>20Fr, 10cm length, available with or without guidewire.</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>181742</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE536</BillingCode><Name>Capsule Monarch G Tube</Name><Description>Conventional Length Non Balloon Gastronomy Tube.</Description><Size>12F, 14F, 18F, 20F, 10cm length, available with or without guidewire.</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>181742</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE690</BillingCode><PriorBillingCodes><PriorBillingCode>PY021</PriorBillingCode><PriorBillingCode>LV099</PriorBillingCode></PriorBillingCodes><Name>Niti-S Oesophageal Fully Covered Stent</Name><Description>Niti-S Oesophageal fully covered self expanding nitinol stent with covering of PTFE, silicone, a polyurethane layer. Nylon drawstring for removal or repositiong</Description><Size>Diameter: 10mm to 36mm  Length: 60mm to 230mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1558</GroupID><SubGroupID>4238</SubGroupID><ARTGs><ARTG>130535</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE515</BillingCode><PriorBillingCodes><PriorBillingCode>DE390</PriorBillingCode></PriorBillingCodes><Name>LENTIS TplusX LU-313T</Name><Description>Foldable one-piece monofocal  toric IOL for capsular bag fixation</Description><Size>Optic Size 6.0mm, overall length 11.0mm. Sph -10.0D to +36.0D (in 0.01D increments) Cyl +0.50 to +10.0D cyl (in 0.01D increments), sph  + cyl &lt;40.0D,  axis 1 degree scaling</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE658</BillingCode><Name>Shoreline ACS TruProfile Cage</Name><Description>Cervical ACDF Cage</Description><Size>Footprints: 14 x 13mm, 16 x 14mm, 18 x 15mm and 20 x 15mm  Lordosis: 7, 10 and 15 degrees  Heights: 5,6,7,8,9,10,11 and 12mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE676</BillingCode><Name>LENTIS Mplus toric LU-814MF30T</Name><Description>Foldable one-piece acrylic posterior chamber aspheric multifocal toric IOL for capsular bag, sulcus and sulcus-sclera fixation.</Description><Size>Optic size: 6.2mm, Overall length: 13.0mm, Available Dioptres: sph. 0.0D to +36.0D (0.01D increments), cyl. +0.50D to +12.0D (0.01D increments), axis 1 deg. increments.</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE616</BillingCode><PriorBillingCodes><PriorBillingCode>RH006</PriorBillingCode><PriorBillingCode>RH005</PriorBillingCode></PriorBillingCodes><Name>Vitalitec Titanium Hemostatic Clips</Name><Description>The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically.</Description><Size>Micro, Small, Small/Medium, Medium, Medium/Large and Large. 6 clips per cartridge</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>194411</ARTG></ARTGs><MinimumBenefit>11</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE720</BillingCode><PriorBillingCodes><PriorBillingCode>MG038</PriorBillingCode></PriorBillingCodes><Name>Glubran 2</Name><Description>Synthetic cyanoacrylic surgical glue: N-Butyl (2) cyanoacrylate and methacryloxysulfolane co-monomer</Description><Size>0.25 ml, 0.5 ml, 1 ml</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>158438</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE724</BillingCode><PriorBillingCodes><PriorBillingCode>MG045</PriorBillingCode></PriorBillingCodes><Name>Everest Ligating Clip</Name><Description>Titanium clip</Description><Size>Small, Medium, Medium-Large, Large (6 per cartridge)</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>235137</ARTG></ARTGs><MinimumBenefit>10</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE618</BillingCode><PriorBillingCodes><PriorBillingCode>RH008</PriorBillingCode><PriorBillingCode>RH005</PriorBillingCode></PriorBillingCodes><Name>Vitalitec Titanium Hemostatic Clips</Name><Description>The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically.</Description><Size>Micro, Small, Small/Medium, Medium (9 clips per cartridge)</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>194411</ARTG></ARTGs><MinimumBenefit>9</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE721</BillingCode><PriorBillingCodes><PriorBillingCode>MG047</PriorBillingCode></PriorBillingCodes><Name>Glubran Tiss2</Name><Description>Tissue adhesive</Description><Size>0.25 ml, 0.35 ml, 0.50 ml</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>158442</ARTG></ARTGs><MinimumBenefit>23</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE725</BillingCode><PriorBillingCodes><PriorBillingCode>MG046</PriorBillingCode></PriorBillingCodes><Name>Everest Ligating Clip</Name><Description>Titanium clip</Description><Size>Small, Medium (24 per cartridge)</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>235137</ARTG></ARTGs><MinimumBenefit>41</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE619</BillingCode><PriorBillingCodes><PriorBillingCode>RH009</PriorBillingCode><PriorBillingCode>RH005</PriorBillingCode></PriorBillingCodes><Name>Vitalitec Titanium Hemostatic Clips</Name><Description>The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically.</Description><Size>Small and Medium (27 clips per pouch - 9 clips per cartridge, 3 cartridges per pouch)</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>194411</ARTG></ARTGs><MinimumBenefit>25</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE857</BillingCode><PriorBillingCodes><PriorBillingCode>PY041</PriorBillingCode><PriorBillingCode>PY028</PriorBillingCode></PriorBillingCodes><Name>sinus-XL Flex Stent</Name><Description>Flexible Nitinol Stent with diameters up to 24mm</Description><Size>Diameter:  14mm to 24mm
Length:  &gt;150mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>281019</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE617</BillingCode><PriorBillingCodes><PriorBillingCode>RH007</PriorBillingCode><PriorBillingCode>RH005</PriorBillingCode></PriorBillingCodes><Name>Vitalitec Titanium Hemostatic Clips</Name><Description>The SLS titanium (grade 1) hemostatic clips are designed to securely grip the vessel in order to provide a complete and final occlusion atraumatically.</Description><Size>Small &amp; Medium Clips (24 clips per pouch - 6 clips per cartridge, 4 cartridges per pouch)</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>194411</ARTG></ARTGs><MinimumBenefit>41</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE849</BillingCode><PriorBillingCodes><PriorBillingCode>PY016</PriorBillingCode><PriorBillingCode>PY005</PriorBillingCode></PriorBillingCodes><Name>Optimed Iliac Sinus Stent - extra long</Name><Description>Sinus-wave nitinol stent - extra long</Description><Size>Diameter: 3mm to 8 mm
Length:  150mm to 200mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>178915</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE523</BillingCode><PriorBillingCodes><PriorBillingCode>DE394</PriorBillingCode></PriorBillingCodes><Name>LENTIS Mplus LU-313MFTY</Name><Description>Patient specific one-piece multifocal toric plate haptic acrylic IOL. Violet light filter.</Description><Size>Overall Length 11.0mm and Optic Size 6.0mm, +-0.0D to +36.0D inclusive in 0.01D increments. Cyl +0.50D to +12.0D inclusive in 0.01D increments, axis 1 degree increments</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE854</BillingCode><PriorBillingCodes><PriorBillingCode>PY037</PriorBillingCode></PriorBillingCodes><Name>Sinus-Venous and Sinus-Obliquus Stents</Name><Description>Sinus-Venous and Sinus-Obliquus Stents used for treating venous insufficiency, occlusion and stenosis</Description><Size>Diameter: 10, 12, 14, 16, 18mm
Length: 150mm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>201852</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE814</BillingCode><PriorBillingCodes><PriorBillingCode>VL011</PriorBillingCode></PriorBillingCodes><Name>Su-Por Inferior 2/3 Orbit, Complete Orbit, 3D Orbital Floor</Name><Description>An implantable device intended to support, contour, and provide structure for the face including the cheeks and eye socket. Made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. Includes Inferior 2/3 Orbit (left, right); left complete orbit (left, right)</Description><Size>various sizes, left, right</Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4366</SubGroupID><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>1892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ694</BillingCode><Name>Regatta Lateral Plate and locking cover</Name><Description>The SeaSpine Regatta Lateral Plate is indicated as additional support during fusion via a lateral or anterolateral surgical approach in the treatment of thoracic and thoracolumbar (T1-S1) spine instability, as the result of fracture, tumour, DDD, scoliosis, kyphosis, lordosis, stenosis or failed previous surgery. The Regatta Plate must be used with a locking cover. </Description><Size>1 hole plate size 8mm - 18mm in 2mm increments. 2 Hole Plate size 8mm - 18mm in 2mm increments, 4 Hole Plate size 8mm - 18mm in 2mm increments, Plate locking cover 8mm-18mm and 1 hole locking plate 8mm-18mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4128</SubGroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE783</BillingCode><Name>FlareHawk Expandable PLIF Cage</Name><Description>Expandable PEEK &amp; Titanium alloy lumbar interbody fusion device that enables significant graft delivery. FlareHawk is made up of an expandable shell and titanium shim.</Description><Size>0,6,9,15 degree lordosis. Unexpanded: 7mm height x 9mm width or 7mm Height x 7mm width. Expanded: 8mm - 14mm height x 14mm or 11mm width. 25mm or 26mm Lengths</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>380419</ARTG><ARTG>380420</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE821</BillingCode><PriorBillingCodes><PriorBillingCode>CR031</PriorBillingCode></PriorBillingCodes><Name>LARS Interference Screw</Name><Description>Titanium Interference screw</Description><Size>5.2 - 10mm diameter, 
15 - 30mm</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>138574</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE816</BillingCode><PriorBillingCodes><PriorBillingCode>VL013</PriorBillingCode></PriorBillingCodes><Name>Su-Por Enophthalmos Wedge</Name><Description>The Su-Por Enophthalmos Wedge is contoured in the shape of the orbital floor and provides volume to restore the orbit to its normal shape and size. </Description><Size>24mm x 33.5mm x 7mm (left,right)  28mm x 40mm x 7.5mm (left, right)    </Size><SupplierCode>DE</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4371</SubGroupID><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>325</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE655</BillingCode><Name>NovaBone BioGlass</Name><Description>Bioactive synthetic bone graft - calcium phospo-silicate</Description><Size>0.25 - 5cc</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>302472</ARTG><ARTG>302473</ARTG><ARTG>320170</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE693</BillingCode><PriorBillingCodes><PriorBillingCode>PY024</PriorBillingCode><PriorBillingCode>LV102</PriorBillingCode></PriorBillingCodes><Name>Niti-S Colorectal Stent</Name><Description>Niti-S Colorectal self-expanding metal stent made from Nitinol.  Stent PTFE covered and uncovered OTW or TTS with string for ease of removal.</Description><Size>Diameter:  18mm to 30mm  Length: 30mm to 160mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1557</GroupID><Suffix>Self Expanding</Suffix><ARTGs><ARTG>130747</ARTG></ARTGs><MinimumBenefit>2762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE704</BillingCode><Name>Mariner Cannulated Pedicle Screw Shanks</Name><Description>Posterior Fixation System</Description><Size>4.5-10.5mm Diameters.  20-110mm Lengths.</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ171</BillingCode><Name>Coral Fixed Cross Connector</Name><Description>The Coral Spinal System offers a full range of implants for adaptation to most surgical needs. Coral Spinal System is a spinal fixation device intended for use as a posterior pedicle screw fixation system, a posterior non-pedicle screw fixation system, or as an anterolateral fixation system. Cross-links allow for greater strength of construct.</Description><Size>10mm-40mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE659</BillingCode><Name>Shoreline ACS TruProfile Cervical Plate</Name><Description>Anterior cervical plating system</Description><Size>Holes: 2, 3 and 4 
Length: 5-12mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE820</BillingCode><Name>Vygon Seesite</Name><Description>SEESITE is a high-pressure implantable port with accessories dedicated to percutaneous echo guided placement. The maximum injection rate claimed is written on the device in the form of the radiopaque marking (marking RX) affixed to the back of the case.</Description><Size>7Fr - 8Fr</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>444200</ARTG><ARTG>444201</ARTG></ARTGs><MinimumBenefit>510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE611</BillingCode><PriorBillingCodes><PriorBillingCode>RH014</PriorBillingCode></PriorBillingCodes><Name>Cor-Knot®Quick Load 6 Pouch</Name><Description>The Cor-Knot®Quick load 6 contains six single sterile Cor-Knot® Titanium Fasteners for use with the Cor-Knot® device kit</Description><Size>One size</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>5988</SubGroupID><ARTGs><ARTG>219813</ARTG></ARTGs><MinimumBenefit>308</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE865</BillingCode><PriorBillingCodes><PriorBillingCode>PY052</PriorBillingCode></PriorBillingCodes><Name>Ultra, Prestige Plus Coil Detachment Controller</Name><Description>Handheld battery powered coil detachment controller  </Description><Size>One Size only</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1693</GroupID><SubGroupID>5507</SubGroupID><ARTGs><ARTG>376881</ARTG></ARTGs><MinimumBenefit>206</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE831</BillingCode><Name>GENTA-COLL</Name><Description>Absorbable, implantable, haemostatic collagen sponge for surgical use; containing Gentamicin</Description><Size>10cm x 10cm, 20cm x 5cm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4216</SubGroupID><Suffix>Antibiotic</Suffix><ARTGs><ARTG>467809</ARTG></ARTGs><MinimumBenefit>277</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE610</BillingCode><PriorBillingCodes><PriorBillingCode>RH013</PriorBillingCode></PriorBillingCodes><Name>Cor-Knot®Quick Load single</Name><Description>The Cor-Knot®Quick Load houses one sterile Cor-Knot®Titanium Fastener for use with the Cor-Knot®device kit</Description><Size>One size</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>5988</SubGroupID><ARTGs><ARTG>219813</ARTG></ARTGs><MinimumBenefit>50</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ315</BillingCode><PriorBillingCodes><PriorBillingCode>RJ007</PriorBillingCode><PriorBillingCode>VL002</PriorBillingCode></PriorBillingCodes><Name>Su-Por Sphere</Name><Description>An implantable device made of high-density polyethylene material with an interconnecting pore structure that supports tissue ingrowth. The device is available in sizes to meet the patient's specific needs.  Used for orbital reconstruction following enucleation and evisceration procedure.</Description><Size>14mm, 16mm, 18mm, 20mm, 22mm, 24mm (diameter)</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>147</SubCategoryID><GroupID>1340</GroupID><SubGroupID>3903</SubGroupID><Suffix>vp</Suffix><ARTGs><ARTG>335454</ARTG></ARTGs><MinimumBenefit>1741</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE836</BillingCode><Name>GENTA-PROTEC </Name><Description>Absorbable, implantable haemostatic matrix collagen sponge for surgical use; containing Gentamicin</Description><Size>10CM x 10CM, 5CM x 20 CM</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4216</SubGroupID><Suffix>Antibiotic</Suffix><ARTGs><ARTG>467807</ARTG></ARTGs><MinimumBenefit>277</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE717</BillingCode><Name>REEF TA</Name><Description>REEF TA NanoMetalene TLIF</Description><Size>9&amp;11mm Widths    28, 32, 36, 40mm Lengths    7-18mm Heights    0 - 20 Degrees Lordosis</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE819</BillingCode><Name>Vygon Polysite Echo</Name><Description>Polysite Echo is a Power injectable single chamber implantable hybrid Titanium and Polyoxymethylene port.  </Description><Size>6.5Fr - 9Fr</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>444198</ARTG><ARTG>444199</ARTG></ARTGs><MinimumBenefit>510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE585</BillingCode><Name>OCULFIT Orbital Implant</Name><Description>Porous polyethylene spherical orbital implant</Description><Size>14, 16, 18, 19, 20, 21, 22, 23 mm</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>147</SubCategoryID><GroupID>1340</GroupID><SubGroupID>3903</SubGroupID><Suffix>vp</Suffix><ARTGs><ARTG>290198</ARTG></ARTGs><MinimumBenefit>1741</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE661</BillingCode><Name>Shoreline ACS Locking Cover</Name><Description>Locking cover for fixation of bone screws</Description><Size>5-12mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>298002</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE727</BillingCode><PriorBillingCodes><PriorBillingCode>MG044</PriorBillingCode></PriorBillingCodes><Name>Glubran 2 Spray Device</Name><Description>Spray device for nebulized application of Glubran 2</Description><Size>Cannula length: 5cm, 40cm, 30cm, 33cm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Rigid Delivery System</Suffix><ARTGs><ARTG>321253</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE594</BillingCode><Name>Newport MIS Rod</Name><Description>MIS bulleted pre-contoured rod</Description><Size>35-80 (5mm incr.)
90-110 (10mm incr.)</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE714</BillingCode><Name>Mariner Outrigger</Name><Description>Mariner Outrigger Variable Connectors</Description><Size>8 &amp; 10mm</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE817</BillingCode><Name>NorthStar OCT Hinged Rod</Name><Description>NorthStar OCT Hinged Rod allows for optimal rod angulation in occipito-cervical fusions.</Description><Size>Ti Hinged Rod, 3.5mm and 4.0mm Left and Right.  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE517</BillingCode><PriorBillingCodes><PriorBillingCode>DE397</PriorBillingCode></PriorBillingCodes><Name>LENTIS LS-313T0-T6</Name><Description>Foldable one-piece monofocal toric acrylic IOL.</Description><Size>Optic Size 6.0mm, Overall Length 11.00mm. Available diopters: +10.0D to +30.0D (0.5D). Cyl: (T0 +0.75D) (T1 +1.5D) (T2 +2.25D) (T3 +3.0D) (T4 + 3.75D) (T5 + 4.5D) (T6 +5.25D)</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE723</BillingCode><PriorBillingCodes><PriorBillingCode>MG035</PriorBillingCode></PriorBillingCodes><Name>Glubran 2 Catheter for Laparoscopy</Name><Description>Catheter for laparoscopic application of Glubran 2.</Description><Size>One size only</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Extender</Suffix><ARTGs><ARTG>162589</ARTG></ARTGs><MinimumBenefit>25</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE722</BillingCode><PriorBillingCodes><PriorBillingCode>MG034</PriorBillingCode></PriorBillingCodes><Name>Glubran 2 Applicators</Name><Description>Dispensing tip/Drop control device for applying Glubran 2.</Description><Size>5-6 and 7-8 French</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Applicator Tip</Suffix><ARTGs><ARTG>162589</ARTG></ARTGs><MinimumBenefit>22</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE839</BillingCode><PriorBillingCodes><PriorBillingCode>AK010</PriorBillingCode><PriorBillingCode>AK002</PriorBillingCode></PriorBillingCodes><Name>Oesophageal Tracheal Stents</Name><Description>self expanding nitinol stent, covered and uncovered, straight and J shape</Description><Size>multiple sizes</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1563</GroupID><ARTGs><ARTG>173875</ARTG></ARTGs><MinimumBenefit>1805</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE726</BillingCode><PriorBillingCodes><PriorBillingCode>MG048</PriorBillingCode></PriorBillingCodes><Name>Glutack</Name><Description>Catheter for controlled application of surgical adhesive.</Description><Size>25, 40, 50 drops</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>6004</SubGroupID><Suffix>Synthetic, Endoscopic</Suffix><ARTGs><ARTG>313580</ARTG></ARTGs><MinimumBenefit>211</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE603</BillingCode><PriorBillingCodes><PriorBillingCode>RH025</PriorBillingCode></PriorBillingCodes><Name>PleuraFlow® Active Clearance Technology® (ACT)</Name><Description>Pleural drainage catheter</Description><Size>20; 24; 28;32FR</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>4242</SubGroupID><ARTGs><ARTG>218317</ARTG><ARTG>324895</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE769</BillingCode><Name>NorthStar OCT  </Name><Description>NorthStar OCT Polyaxial Screw  </Description><Size>3.5, 4.0, 4.5, 5.5mm Diameter  8-40mm Lengths  </Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>275794</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE669</BillingCode><Name>icotec Pedicle System Polyaxial Screw</Name><Description>Polyaxial Pedicle Screw</Description><Size>Size(s):4.5, 5.5, 6.5 and 7.5mm diameter   25-60mm length</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>283853</ARTG></ARTGs><Note>Prescribed List reimbursement is only payable for the billing code when the device is used in patients with spinal tumours requiring regular magnetic resonance imaging (MRI) and/or computerised tomography (CT) imaging and or adjuvant radiotherapy and/or proton therapy.</Note><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE650</BillingCode><Name>FEMTIS Comfort FB-313MF15</Name><Description>Foldable one-piece multifocal acrylic plate haptic IOL for fixation in the capsulorhexis</Description><Size>Optic Size 5.7mm, Overall length 10.5mm. Available Dioptres: +15.0D to 30.0D (0.5D steps)</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE607</BillingCode><PriorBillingCodes><PriorBillingCode>RH001</PriorBillingCode></PriorBillingCodes><Name>On-X Prosthetic Heart Valve</Name><Description>Bileaflet Mechanical Heart Valve</Description><Size>19-33mm</Size><SupplierCode>DE</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>178</SubCategoryID><GroupID>1497</GroupID><ARTGs><ARTG>123500</ARTG><ARTG>123501</ARTG><ARTG>123502</ARTG><ARTG>123503</ARTG></ARTGs><MinimumBenefit>4962</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE792</BillingCode><Name>Admiral Cervical Plate</Name><Description>Admiral Cervical Plate &gt;55mm</Description><Size>57mm-100mm Lengths</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>275780</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE863</BillingCode><PriorBillingCodes><PriorBillingCode>PY050</PriorBillingCode></PriorBillingCodes><Name>BeGraft Coronary Stent Graft System</Name><Description>Coronary Stent Graft System</Description><Size>Diameter: 2.50mm, 2.75mm, 3.00mm, 3.50mm, 4.00mm, 4.50mm, 5.00m  Length: 8mm, 12mm, 16mm, 18mm, 21mm, 24mm</Size><SupplierCode>DE</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1767</GroupID><SubGroupID>5349</SubGroupID><Suffix>l, m</Suffix><ARTGs><ARTG>278654</ARTG></ARTGs><MinimumBenefit>2146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE791</BillingCode><Name>Admiral Cervical Plate</Name><Description>Admiral Cervical Plate &lt;55mm</Description><Size>7mm-54mm Length</Size><SupplierCode>DE</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>275780</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE692</BillingCode><PriorBillingCodes><PriorBillingCode>PY023</PriorBillingCode><PriorBillingCode>LV101</PriorBillingCode></PriorBillingCodes><Name>Niti-S Colorectal D-Type Stent</Name><Description>Niti-S Colorectal D-Type self-expanding Stent</Description><Size>Diameters: 18 to 30mm   Lengths: 60 to 150mm</Size><SupplierCode>DE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1557</GroupID><Suffix>Self Expanding</Suffix><ARTGs><ARTG>130747</ARTG></ARTGs><MinimumBenefit>2762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE861</BillingCode><PriorBillingCodes><PriorBillingCode>PY045</PriorBillingCode></PriorBillingCodes><Name>BeGraft Aortic Stent Graft System</Name><Description>Aortic Stent Graft System</Description><Size>Expanded Diameter: 12mm to 30mm
Stent Length:  19mm to 59mm
Catheter Length: 75cm and 120cm</Size><SupplierCode>DE</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1634</GroupID><SubGroupID>4450</SubGroupID><ARTGs><ARTG>286040</ARTG></ARTGs><MinimumBenefit>5140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE766</BillingCode><Name>Acunex Variomax AN6VM</Name><Description>Foldable one-piece acrylic multifocal C loop IOL with aspheric surface and violet blue light filter.</Description><Size>Overall Length 12.5mm and Optic Size 6.0mm, SE +10.0D to +30.0D (0.5D steps), ADD +3.0D.</Size><SupplierCode>DE</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>328681</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DE656</BillingCode><Name>NovaBone BioGlass</Name><Description>Bioactive synthetic bone graft - calcium phospho-silicate</Description><Size>8cc-10cc</Size><SupplierCode>DE</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>302472</ARTG><ARTG>302473</ARTG><ARTG>302474</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HI002</BillingCode><Name>DDN Biomodel</Name><Description>Custom made biomodel for use with the Neoss Implant System (NJ001)</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>HI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1807</GroupID><ARTGs><ARTG>336209</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HI001</BillingCode><Name>DDN Guide</Name><Description>Custom made patient specific guide for use with the Neoss Implant System (NJ001)</Description><Size>The device is custom made so the size will vary</Size><SupplierCode>HI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>336209</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1495</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HI005</BillingCode><Name>DDN Biomodel</Name><Description>Custom made biomodel for use with the STRAUMANN Implant System (SB024), (SB009), (SB015), (SB023), (SB008), (SB012), (SB018), (SB029), (SB030), (SB035)</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>HI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1807</GroupID><ARTGs><ARTG>336209</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HI006</BillingCode><Name>DDN Guide</Name><Description>Custom made patient specific guide for use with the STRAUMANN Implant System (SB024), (SB009), (SB015), (SB023), (SB008), (SB012), (SB018), (SB029), (SB030) and (SB035).</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>HI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>336209</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DL004</BillingCode><Name>VenaBlock Venous Closure System</Name><Description>VenaBlock is an n-Butyy Cyanoacrylate-polymer structure which was modified by adding a monomer synthesized by the producing company. It is a ready for use, blue colored, transparent liquid. The product exhibits a polymerization effect with embolization. When in contact with living tissue and in humid environments, it rapidly polymerises  by forming a thin, flexible membrane with high tension resistance that adheres firmly to the tissues.</Description><Size>One size</Size><SupplierCode>DL</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1692</GroupID><SubGroupID>7041</SubGroupID><ARTGs><ARTG>283020</ARTG></ARTGs><MinimumBenefit>713</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DL005</BillingCode><Name>CGuard</Name><Description>Carotid Stent System</Description><Size>Diameters: 6-10mm
Lengths: 20mm-60mm</Size><SupplierCode>DL</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>311660</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DL003</BillingCode><PriorBillingCodes><PriorBillingCode>MB026</PriorBillingCode></PriorBillingCodes><Name>WIRION Embolic Protection System</Name><Description>Temporary arterial embolic protection system</Description><Size>Blood vessel diameter: 3.5 - 6.0mm
Filter unit length: 22.5mm
Pore size: 120μ
Crossing profile: 3.2F
Guide catheter/Sheath: 6F
Delivery catheter length: 145cm
Retrieval catheter length: 146cm</Size><SupplierCode>DL</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>211</SubCategoryID><GroupID>1643</GroupID><ARTGs><ARTG>280883</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DL002</BillingCode><Name>iVolution  ≥150mm</Name><Description>Self-expanding nitinol stent system</Description><Size>Diameters: 5-8mm   Lengths: 150-200mm  Catheter Length: 80-140cm</Size><SupplierCode>DL</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>281201</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DL006</BillingCode><Name>IMPEDE Embolization Plug</Name><Description>The IMPEDE Embolization Plug is a pushable embolization device comprised of a self-expanding porous Shape Memory Polymer (SMP) Plug and a proximal platinum/iridium markerband or distal pre-shaped helical Anchor Coil comprised of nitinol and platinum, and a proximal platinum marker band..  The device is supplied pre-loaded in an Introducer with the SMP Plug in a crimped state. It is designed to be delivered to the target vessel using a guidewire through a standard catheter/sheath. Upon deployment in the target vessel and exposure to an aqueous environment and body temperature, the SMP Plug will self-expand to embolize the target vessel.  The IMPEDE Embolization Plug System is packaged as a single unit and is provided sterile, non-pyrogenic, and is intended for single use only.  </Description><Size>5mm, 6 mm, 7mm, 8 mm, 10mm, 12 mm</Size><SupplierCode>DL</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1648</GroupID><Suffix>Microcatheter</Suffix><ARTGs><ARTG>386855</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DL001</BillingCode><Name>iVolution</Name><Description>Self-expanding nitinol stent system</Description><Size>Diameters: 5-10mm 
Lengths: 40-100mm
Catheter Length: 80-140cm</Size><SupplierCode>DL</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>281201</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XY001</BillingCode><Name>FFX IMPLANT</Name><Description>FFX IMPLANTS are titanium devices to be fixed in the facet joint in adult patients. They are implanted between the two facets to be stabilized and can contain bone graft or bone substitute. </Description><Size>Width: 11-13mm Length: 10mm Height: 2.5-3.5mm</Size><SupplierCode>XY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1487</GroupID><ARTGs><ARTG>460406</ARTG></ARTGs><MinimumBenefit>1317</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV28</BillingCode><Name>Fibula - Segment (6cm)</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2596</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV08</BillingCode><Name>Cancellous Wedge</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2741</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV62</BillingCode><Name>Bone – Cancellous Bone Matrix Lyophilised 20cc</Name><Size>20cc</Size><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3611</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV31</BillingCode><Name>Hemipelvis - Acetabulum</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>8169</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV39</BillingCode><Name>Meniscus with Ligaments</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6124</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV42</BillingCode><Name>Tendon - Patellar with bone plugs</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4966</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV30</BillingCode><Name>Fibular Shaft</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6238</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV19</BillingCode><Name>Radius</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>8467</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV58</BillingCode><Name>Tendon - Semitendinosus</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4867</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV09</BillingCode><Name>Bone - Chips/cubes 40cc</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2721</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV33</BillingCode><Name>Hemipelvis - iliac crest</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>7476</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV52</BillingCode><Name>Bone - Cancellous Bone Matrix, Lyophilised 40cc</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>5256</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV49</BillingCode><Name>Humerus - Distal</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6349</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV10</BillingCode><Name>Bone - Chips/cubes 80cc</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4721</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV18</BillingCode><Name>Elbow - joint</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>13631</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV22</BillingCode><Name>Femur - Distal (Shaft &amp; Condyles)</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>10258</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV43</BillingCode><Name>Rib (5cm)</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2101</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV36</BillingCode><Name>Humerus - Proximal</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>7628</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV37</BillingCode><Name>Humeral Head</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4927</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV12</BillingCode><Name>Bone - Milled 80cc</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6852</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV47</BillingCode><Name>Tibia - Condyles only</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4945</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV01</BillingCode><Name>Valve - Aortic</Name><SupplierCode>TBV</SupplierCode><CategoryID>6</CategoryID><ARTGs><ARTG>236613</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>13271</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV56</BillingCode><Name>Conduit - Aortic</Name><SupplierCode>TBV</SupplierCode><CategoryID>6</CategoryID><ARTGs><ARTG>236613</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2865</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV34</BillingCode><Name>Hemipelvis - Tricortical iliac wedge</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3445</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV03</BillingCode><Name>Conduit - Pulmonary</Name><SupplierCode>TBV</SupplierCode><CategoryID>6</CategoryID><ARTGs><ARTG>236613</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2865</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV61</BillingCode><Name>Tendon - Tibialis Posterior</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4867</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV65</BillingCode><Name>Tendon - Patella with Quadriceps</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4982</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV21</BillingCode><Name>Fascia Lata</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2874</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV02</BillingCode><Name>Valve - Pulmonary</Name><SupplierCode>TBV</SupplierCode><CategoryID>6</CategoryID><ARTGs><ARTG>236613</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>13271</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV55</BillingCode><Name>Bone - Demineralised Bone Matrix, Lyophilised 10cc</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4419</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV48</BillingCode><Name>Tibia - Distal</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6195</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV46</BillingCode><Name>Femoral Hemi-condyle</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3844</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV50</BillingCode><Name>Pericardium</Name><SupplierCode>TBV</SupplierCode><CategoryID>6</CategoryID><ARTGs><ARTG>236613</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3487</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV44</BillingCode><Name>Tibia - Proximal 7-15cm</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>7128</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV05</BillingCode><Name>Tendon - Achilles</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2936</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV14</BillingCode><Name>Cortical Strut</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2771</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV20</BillingCode><Name>Ulna</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>7878</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV26</BillingCode><Name>Femoral head</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6744</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV07</BillingCode><Name>Bone Plug/Dowel - Cancellous</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2596</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV11</BillingCode><Name>Bone - Milled 40cc</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4412</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV32</BillingCode><Name>Hemipelvis - Complete</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>17364</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV40</BillingCode><Name>Meniscus</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3791</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV24</BillingCode><Name>Femoral Shaft - Middle Third</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6098</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV63</BillingCode><Name>Bone - Cancellous Bone Matrix Lyophilised 10cc</Name><Size>10cc</Size><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2961</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV29</BillingCode><Name>Fibula - Segment (12cm)</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3480</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV41</BillingCode><Name>Patella</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3395</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV38</BillingCode><Name>Ligament - Medial</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>5236</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV54</BillingCode><Name>Bone - Demineralised Bone Matrix, Lyophilised 1-5cc</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2788</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV64</BillingCode><Name>Bone - Cancellous Bone Matrix Lyophilised 1 - 5cc</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2246</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV59</BillingCode><Name>Tendon - Peroneus Longus</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4867</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV57</BillingCode><Name>Tendon - Tibialis Anterior</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4867</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV45</BillingCode><Name>Tibia - Proximal 16-25cm</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6901</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV23</BillingCode><Name>Femur - Entire</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>16560</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV27</BillingCode><Name>Fibula - Entire</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>7652</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV06</BillingCode><Name>Tendon - Achilles with bone block</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4885</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV25</BillingCode><Name>Femur - Proximal (shaft, trochanter, neck)</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>10189</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV51</BillingCode><Name>Femur - Proximal with femoral head</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>9917</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV35</BillingCode><Name>Humerus - Proximal with rotator cuff</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>7334</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV60</BillingCode><Name>Tendon - EHL</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>6327</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>TBV17</BillingCode><Name>Cartilage - costal segments</Name><SupplierCode>TBV</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>238244</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1866</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY018</BillingCode><Name>Precision ShurFit ACDF</Name><Description>Anterior Cervical Interbody Fusion System</Description><Size>14 to 18mm wide  12 to 15mm deep  5 to 12mm height  5 and 10 Degree Lordotic Options</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>317596</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY054</BillingCode><Name>CHARSPINE VBR expandable implant system (Body and Extension)</Name><Description>Expandable body and extension made of PEEK optima</Description><Size>25mm-64mm (Body)      9mm and 18mm (Extension) </Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>523091</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY020</BillingCode><Name>Slimplicity HP Screws</Name><Description>Screws</Description><Size>12mm - 18mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>287906</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY011</BillingCode><Name>Reform POCT Cross Connector</Name><Description>Cross Connector</Description><Size>Diameter 3.5mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>287906</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY052</BillingCode><Name>BMD Titanium ACIF Standalone System</Name><Description>Cervical cage construct including fixation screws. Biomaterial: titanium. Design variants:
1. BMD Titanium ACIF SA (stand-alone), 
2. BMD Titanium ACIF SA GW (graft window), 
3. BMD Titanium ACIF ZP (zero profile), 
4. BMD Titanium ACIF ZP GW Implants.
</Description><Size>Cages - Height: 4-12mm, Length: 12-16mm, Width: 14-18mm, Screws - Diameter: 3.5-4mm, Length: 12-18mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>323561</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY008</BillingCode><Name>Reform Modular Polyaxial Screws</Name><Description>Module Polyaxial Screws</Description><Size>Diameter 4.5mm to 10.5mm  Length 25mm to 120mm  Cannulated and Non-Cannulated</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY051</BillingCode><Name>Reform Fenestrated Modular Screw</Name><Description>Fenestrated modular screw made of titanium</Description><Size>Diameter: 4.5-10.5mm, Length: 30-80mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY019</BillingCode><Name>Slimplicity HP Plates</Name><Description>Plates</Description><Size>10mm - 105mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>287906</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY017</BillingCode><Name>BMD Titanium TLIF Cage</Name><Description>Lumbar Interbody Cage</Description><Size>Height 7mm to 17mm </Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>323520</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY035</BillingCode><Name>Reform MIS Set Screw</Name><Description>Set Screw</Description><Size>5.5</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY037</BillingCode><Name>Reform POCT </Name><Description>Occipital Rod</Description><Size>3.5mm Diameter</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>287906</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY002</BillingCode><Name>Reform Tulip Head</Name><Description>Tulip Head</Description><Size>12.5mm/17mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY012</BillingCode><Name>Reform POCT Cap Screw</Name><Description>Cap Screw</Description><Size>One size only</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>287906</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY036</BillingCode><Name>Reform MIS Tulip</Name><Description>Tulip</Description><Size>5.5mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY034</BillingCode><Name>Dakota ACDF System</Name><Description>Dakota ACDF System comprising of ACDF cage, ACDF plate, locking screw, bone screw</Description><Size>5mm to 12mm heights</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>317596</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY010</BillingCode><Name>Reform POCT Rod</Name><Description>Rod - Straight and Curved</Description><Size>Length 20mm to 350mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>287906</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY003</BillingCode><Name>Reform Locking Cap</Name><Description>Locking Cap</Description><Size>3.5mm to 5.5mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY038</BillingCode><Name>Reform POCT Occipital Plate</Name><Description>Occipital Plate</Description><Size>25mm to 50mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>287906</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY049</BillingCode><Name>BMD Titanium ALIF Standalone System</Name><Description>ALIF cage made of titanium with fixation screws </Description><Size>Cage - Height 10-21mm, Length: 26-34mm, Width: 33-45mm, Screws - Diameter: 5-5.85mm, Length: 20-60mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>323520</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY006</BillingCode><Name>Reform Hooks</Name><Description>Hooks and Reduction Hooks</Description><Size>Various</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY055</BillingCode><Name>CHARSPINE VBR expandable implant system Endplate</Name><Description>Endplate made of PEEK optima</Description><Size>18-30mm  </Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4138</SubGroupID><ARTGs><ARTG>523091</ARTG></ARTGs><MinimumBenefit>928</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY027</BillingCode><Name>BMD Titanium ALIF Cage</Name><Description>Lumbar Interbody Cage</Description><Size>Heights: 9mm to 19mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>323520</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY004</BillingCode><Name>Reform Rods</Name><Description>Straight and Lordotic Curved Rods</Description><Size>Length 20mm to 600mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY050</BillingCode><Name>BMD Titanium LLIF Standalone System</Name><Description>LLIF cage made of titanium with fixation screws </Description><Size>Cage - Height 7-17mm, Length: 40-60mm, Width: 18-22mm, Screws - Diameter: 5-5.85mm, Length: 20-60mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>323520</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY029</BillingCode><Name>Slim HP Plates</Name><Description>Plates</Description><Size>55 -105mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>287906</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY039</BillingCode><Name>Dakota ALIF construct</Name><Description>Anterior lumbar fusion device:  construct containing Dakota ALIF Cage, integrated faceplate and screw</Description><Size>11mm to 19mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>317596</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY016</BillingCode><Name>BMD Titanium ACIF Implant</Name><Description>ACIF Cage</Description><Size>Height 4mm height to 10mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>323561</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY009</BillingCode><Name>Reform POCT Polyaxial Screw</Name><Description>Polyaxial Screw</Description><Size>Length 8mm to 50mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>287906</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY030</BillingCode><Name>Reform POCT Rod</Name><Description>Transition Rod</Description><Size>Lengths 250mm - 650mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY053</BillingCode><Name>Dakota LP Cervical Cage </Name><Description>Low-profile anterior cervical cage</Description><Size>Footprints: 14x12, 16x14, 18x15, 20x16.5, 22x18,  Lordosis: 0, 7, 12, 17 degrees, Height: 5-12mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>317596</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY007</BillingCode><Name>Reform Crosslinks</Name><Description>Crosslinks Adjustable</Description><Size>Length 20mm to 100mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY005</BillingCode><Name>Reform Dominoes</Name><Description>Dominoes - Axial and Parallel</Description><Size>Diameter 3.5mm to 6.0mm</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY001</BillingCode><Name>Reform Polyaxial Screw</Name><Description>Polyaxial Screw</Description><Size>Diameter 4.5mm to 10.5mm  Length 25mm to 120mm  Cannulated and Non-Cannulated</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>287905</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EY031</BillingCode><Name>BMD Titanium XLIF Cage</Name><Description>Lumbar Interbody Fusion Cage</Description><Size>9mm to 17mm Heights</Size><SupplierCode>EY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>323520</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL071</BillingCode><Name>Edwards SAPIEN 3 Ultra RESILIA Transcatheter Heart Valve System</Name><Description>The Edwards SAPIEN 3 Ultra RESILIA (S3UR) transcatheter heart valve (THV) system consists of the S3UR THV and Delivery System (DS). The THV is comprised of a balloon-expandable, radiopaque, cobaltchromium frame, trileaflet RESILIA bovine pericardial tissue valve, and polyethylene terephthalate (PET) inner and outer fabric skirts. The DS and accessories are intended to facilitate the placement of the bioprosthesis via the transfemoral, transseptal, subclavian/axillary access approaches.</Description><Size>20, 23, 26 and 29 mm</Size><SupplierCode>EL</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>267</SubCategoryID><GroupID>2641</GroupID><ARTGs><ARTG>471906</ARTG></ARTGs><MinimumBenefit>22932</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL063</BillingCode><Name>Edwards SAPIEN 3 Transcatheter Heart Valve</Name><Description>Transcatheter, balloon expanded aortic heart valve with Commander Delivery System</Description><Size>20mm, 23mm, 26mm and 29mm</Size><SupplierCode>EL</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>267</SubCategoryID><GroupID>2641</GroupID><ARTGs><ARTG>284496</ARTG></ARTGs><MinimumBenefit>22932</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL067</BillingCode><Name>Edwards SAPIEN 3 Ultra Transcatheter Heart Valve System </Name><Description>The Edwards SAPIEN 3 Ultra Transcatheter Heart Valve (THV) system is an Aortic transcatheter heart valve bioprosthesis, with stent-like framework. It  consists of the Edwards SAPIEN 3 Ultra transcatheter heart valves and delivery systems. The Edwards SAPIEN 3 Ultra Valve is comprised of a balloon-expandable, radiopaque, cobalt-chromium frame, trileaflet bovine pericardial tissue valve, and polyethylene terephthalate inner and outer fabric skirts. </Description><Size> (mm) 20, 23, 26</Size><SupplierCode>EL</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>267</SubCategoryID><GroupID>2641</GroupID><ARTGs><ARTG>343715</ARTG></ARTGs><MinimumBenefit>22932</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL031</BillingCode><Name>Carpentier-Edwards Perimount Pericardial Bioprosthesis - Models 2900/6900  Carpentier-Edwards Perimount Plus Pericardial Bioprosthesis Mitral - Model 6900P</Name><Description>Carpentier-Edwards Pericardial Bioprosthesis. Composition: Bovine Pericardium; Elgiloy Alloy; Silicone Rubber, Polytetrafluoroethylene</Description><Size>Models 2900/6900 19-33mm, Model 6900P 25, 27, 29, 31, 33mm</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1500</GroupID><ARTGs><ARTG>154064</ARTG><ARTG>154073</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL060</BillingCode><Name>Carpentier-Edwards PERIMOUNT Magna Mitral Ease Tissue Valve</Name><Description>The Carpentenier-Edwards PERIMOUNT Magna Mitral Ease Tissue is comprised of Bovine Pericardial Tissue and is bioengineered to withstand the higher pressures encountered in the mitral position, whilst maximising implantation ease.</Description><Size>25, 27, 29, 31, 33mm</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1500</GroupID><ARTGs><ARTG>196126</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL069</BillingCode><Name>PASCAL Precision System (PASCAL Implant and PASCAL ACE Implant) </Name><Description>The PASCAL Precision system is intended to repair an insufficient mitral valve via percutaneous reconstruction through tissue approximation. The PASCAL Precision System is comprised of the Implant System and Guide 
Sheath. The Implant System consists of the Loader, Steerable Catheter, Implant Catheter and Implant which comes in two sizes: 10 mm and 6 mm. The 10 mm Implant is referred to as PASCAL Implant and the 6 mm Implant is referred to as PASCAL Ace Implant. The Guide Sheath consists of the Guide Sheath, Introducer and an additional Loader for user convenience.
</Description><Size>10 mm PASCAL and 6mm PASCAL ACE Implant </Size><SupplierCode>EL</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>267</SubCategoryID><GroupID>2952</GroupID><SubGroupID>7365</SubGroupID><Suffix>DMR only</Suffix><ARTGs><ARTG>329150</ARTG><ARTG>329680</ARTG><ARTG>342270</ARTG><ARTG>342271</ARTG><ARTG>371670</ARTG><ARTG>410288</ARTG><ARTG>410289</ARTG><ARTG>410290</ARTG><ARTG>421719</ARTG></ARTGs><Note>The Prescribed List reimbursement for the devices listed under the billing code (listed item) is restricted to the use of the devices in the procedure described under the Medicare Benefits Schedule (MBS) item 38461, meaning transcatheter mitral valve repair (TMVr)  in patients with degenerative (primary) mitral valve regurgitation (DMR).</Note><MinimumBenefit>23104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL061</BillingCode><Name>Carpentier-Edwards Physio Tricuspid Annuloplasty Ring</Name><Description>The Carpentier-Edwards Physio Tricuspid annuloplasty ring, model 6200 is intended for use in patients with tricuspid valvular insufficiency. Designed with selective flexibility and 3D waveform shape.</Description><Size>24,  26, 28, 30, 32, 34, 36mm</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1842</GroupID><ARTGs><ARTG>196111</ARTG></ARTGs><MinimumBenefit>2280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL059</BillingCode><Name>Carpentier-Edwards PHYSIO ll Mitral Annuloplasty Ring</Name><Description>PHYSIO II is a semi rigid mitral annuloplasty ring, with an improved saddle shape and global disease based design</Description><Size>24, 26, 28, 30, 32, 34, 36, 38, 40mm</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1842</GroupID><ARTGs><ARTG>170274</ARTG></ARTGs><MinimumBenefit>2280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL028</BillingCode><Name>Baxter Sterile Grafts, Implants &amp; Prostheses, Non-Animal Origin Annuloplasty: Ring-Mitral Ring with Holder; Mitral Cosgrove-Edwards Annuloplasty System Model 4600; Classic Annuloplasty Ring-Tricuspid</Name><Description>Carpentier-Edwards Classic Annuloplasty Ring. Composition: Titanium Alloy; Silicone Rubber; Polyester Fabric Carpentier-Edwards Physio Annuloplasty Ring. Composition: Elgiloy Bands; Polyester Film Strips; Silicone Rubber; Polyester Cloth, Cosgrove-Edwards Annuloplasty Band. Composition: Silicone Rubber; Polyester Cloth. Carpentier-Edwards Tricuspid Ring. Composition: Titanium Alloy; Silicone Rubber; Polyester Fabric</Description><Size>24mm-40mm</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1841</GroupID><ARTGs><ARTG>158660</ARTG><ARTG>158661</ARTG><ARTG>158662</ARTG><ARTG>158663</ARTG></ARTGs><MinimumBenefit>2090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL033</BillingCode><Name>Baxter Augmentation / Substitution Material, Human or Animal Origin, Sterile Pericardial Patch.</Name><Description>Edwards Pericardial Patch. Bovine Pericardium.</Description><Size>10cm x 15cm</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>182</SubCategoryID><GroupID>1507</GroupID><SubGroupID>5454</SubGroupID><ARTGs><ARTG>154067</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL050</BillingCode><Name>Edwards MC3 Tricuspid Ring Annuloplalsty System (Model: 4900)</Name><Description>3D rigid annuloplasty ring with a tricuspid specific design</Description><Size>26mm, 28mm, 30mm, 32mm, 34mm, 36mm</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1842</GroupID><ARTGs><ARTG>118648</ARTG></ARTGs><MinimumBenefit>2280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL070</BillingCode><Name>Edwards MITRIS RESILIA Mitral Valve</Name><Description>The Edwards MITRIS RESILIA Mitral Valve is a stented tri-leaflet prosthetic heart valve comprised of RESILIA bovine pericardial tissue. This low-profile valve is based on the Edwards PERIMOUNT valve design with a nitinol wire form. This valve is mounted on a retainer with a holder system attached to the valve.</Description><Size> 25mm, 27mm, 29mm, 31mm and 33mm</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>401374</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL068</BillingCode><Name>KONECT RESILIA Aortic Valved Conduit</Name><Description>KONECT RESILIA Aortic Valved Conduit is developed specifically for  bio-Bentall procedures. Edwards Lifesciences’ integrity preservation technology  transforms bovine pericardial tissue into RESILIA tissue, effectively eliminating free aldehydes, while protecting and preserving the tissue.  RESILIA tissue is the first to deliver the combination of Improved anti-calcification properties, Improved sustained hemodynamic performance and  Stored dry and ready to use.</Description><Size>KONECT Valve   11060A 21 mm – 29 mm      Model Accessories  TRAY1190   Accessory tray  1190 Individual sizers 19 mm* – 29 mm  1190SET Sizer set  19 mm* – 29 mm  </Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>180</SubCategoryID><GroupID>1503</GroupID><Suffix>valve and conduit</Suffix><ARTGs><ARTG>387297</ARTG></ARTGs><MinimumBenefit>7642</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL049</BillingCode><Name>McCarthy-Edwards IMR Etlogix Annuloplasty Ring (Model: 4100)</Name><Description>Rigid mitral annuloplasty ring with an assymetric design</Description><Size>24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1842</GroupID><ARTGs><ARTG>114193</ARTG></ARTGs><MinimumBenefit>2280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL062</BillingCode><Name>EDWARDS INTUITY Elite Aortic Valve System</Name><Description>Rapid Deployment Aortic Valve System</Description><Size>19mm - 27mm</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1815</GroupID><Suffix>b (bovine)</Suffix><ARTGs><ARTG>261673</ARTG></ARTGs><MinimumBenefit>8978</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL058</BillingCode><Name>Carpentier-Edwards PERIMOUNT Magna Ease Aortic Bioprosthesis (Model: 3300TFX)</Name><Description>Stented Bovine Pericardial Aortic Tissue Valve with a reduced profile height</Description><Size>19mm, 21mm, 23mm, 25mm, 27mm and 29mm</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>156355</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EL064</BillingCode><Name>Edwards INSPIRIS RESILIA Aortic Valve, Model 11500A</Name><Description>A stented, trileaflet aortic valve, with leaflets comprised of RESILIA bovine pericardial tissue mounted on a flexible cobalt-chromium alloy frame</Description><Size>INSPIRIS RESILIA is available in tissue annulus/stent diameter sizes 19, 21, 23, 25, 27, and 29 mm.</Size><SupplierCode>EL</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>308830</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HV001</BillingCode><Name>OzScrew</Name><Description>PEEK Screw</Description><Size>Diameter 8mm to 12mm  Lengths 25mm and 30mm</Size><SupplierCode>HV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>351410</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HV003</BillingCode><Name>OzAnchor All Suture</Name><Description>Anchor with suture</Description><Size>1.4mm</Size><SupplierCode>HV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>351431</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HV005</BillingCode><Name>OzAnchor Knotless PEEK</Name><Description>PEEK Suture Anchor</Description><Size>4.5mm</Size><SupplierCode>HV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>351629</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HV004</BillingCode><Name>OzAnchor All Suture</Name><Description>Anchor with suture</Description><Size>2.5mm</Size><SupplierCode>HV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>351431</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HV002</BillingCode><Name>OzLoop</Name><Description>Fixation Button</Description><Size>15mm to 60mm</Size><SupplierCode>HV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>351392</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EG023</BillingCode><Name>RS-OIL</Name><Description>Highly purified Silicone Oil</Description><Size>10ml</Size><SupplierCode>EG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1347</GroupID><ARTGs><ARTG>297730</ARTG></ARTGs><MinimumBenefit>176</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EG022</BillingCode><Name>Perfluorocarbons</Name><Description>HPF8 Perfluoro-n-octane and HPF10 Perfluorodecalin</Description><Size>5ml and 7ml</Size><SupplierCode>EG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1346</GroupID><ARTGs><ARTG>252153</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EG021</BillingCode><Name>GOT Multi</Name><Description>Tamponade gas for retinal surgery</Description><Size>75ml</Size><SupplierCode>EG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1345</GroupID><ARTGs><ARTG>297730</ARTG></ARTGs><MinimumBenefit>67</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EG024</BillingCode><Name>RS-Blue</Name><Description>Trypan Blue for the reversible staining of human tissue during surgery</Description><Size>0.7ml Syringe</Size><SupplierCode>EG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1330</GroupID><ARTGs><ARTG>252154</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EG028</BillingCode><Name>Bluerhexis</Name><Description>Selectively stains connective tissue structures in the human eye for visualisation</Description><Size>1ml</Size><SupplierCode>EG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1330</GroupID><ARTGs><ARTG>317632</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER597</BillingCode><PriorBillingCodes><PriorBillingCode>OF075</PriorBillingCode><PriorBillingCode>OF021</PriorBillingCode><PriorBillingCode>OF044</PriorBillingCode></PriorBillingCodes><Name>PILLAR SA</Name><Description>ALIF Cage constructed of PEEK with titanium cover plate and bone screws</Description><Size>Cage: 33-43mm x 28-32mm x 12.5-18mm, Lordosis - 7 -12 degrees; Cover plate - 33mm-43mm; Bone screw; dia 5-5.5 mm x length 20-35mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER311</BillingCode><Name>Ulrich posterior OCT System (neon3)-Pedicle Screws, cannulated</Name><Description>Ulrich posterior OCT System (neon3)-Pedicle Screws, cannulated</Description><Size>dia (4-5.5 mm) x length (20-55 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER356</BillingCode><Name>Ulrich Fusion Cages-ALIF</Name><Description>Ulrich Fusion Cages pezo/tezo-ALIF (various shapes), PEEK or Titanium</Description><Size>height (8-26mm) x width (22-28mm) x length (28-34mm) x angle (0-12°)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>279703</ARTG><ARTG>279705</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER656</BillingCode><Name>Biocomposites Stimulan kit 10 cc</Name><Description>Calcium Sulfate synthetic bone void filler kit  </Description><Size>10 cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>391242</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER598</BillingCode><PriorBillingCodes><PriorBillingCode>OF001</PriorBillingCode></PriorBillingCodes><Name>Construx Mini PTC</Name><Description>Anterior  cervical cage</Description><Size>12x12mm, 15x12mm, 15x15mm, 5-14mm height, parallel or 5 degree lordotic</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER655</BillingCode><Name>Biocomposites Stimulan kit 5 cc</Name><Description>Calcium Sulfate synthetic bone void filler kit   </Description><Size>5cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>391242</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ149</BillingCode><Name>Evolution Spine E3D-A Interbody System-Integrated Fusion Cage</Name><Description>E3D-A Interbody-ALIF integrated sterile fusion cage with screws and optional cover plate, non-sterile.</Description><Size>Footprint: (32-40mm) x (24-28mm) Height: 11-21 mm Lordosis: 8-30 degrees</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>445950</ARTG><ARTG>445955</ARTG><ARTG>445956</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER601</BillingCode><PriorBillingCodes><PriorBillingCode>OF046</PriorBillingCode><PriorBillingCode>AE151</PriorBillingCode></PriorBillingCodes><Name>Forza PLIF</Name><Description>PEEK PLIF cages in various sizes</Description><Size>9x23/27mm  11x23/27mm  0 and 8 degree  6-16mm height in 1mm increments</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER777</BillingCode><PriorBillingCodes><PriorBillingCode>HW724</PriorBillingCode><PriorBillingCode>ER014</PriorBillingCode><PriorBillingCode>AJ016</PriorBillingCode></PriorBillingCodes><Name>Denali Spinal System / Polyaxial Pedicle Screw</Name><Description>Polyaxial Pedicle Screw</Description><Size>Diameter: 3.5 - 8.5mm, Length: 10 - 100mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>154442</ARTG><ARTG>159828</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER728</BillingCode><Name>SIGNUS CYLOX ST Cervical Plate</Name><Description>CYLOX ST Cervical plate 2 and 4 holes (for use with No Integral Fixation SIGNUS CYLOX ST Cervical Cages)</Description><Size>14-21 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>493705</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER312</BillingCode><Name>Ulrich posterior OCT System (neon3)-Occipital Screws</Name><Description>Ulrich posterior OCT System (neon3)-Occipital screws, self tapping</Description><Size>dia (5-5.5 mm) x length (6-16 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER721</BillingCode><PriorBillingCodes><PriorBillingCode>IJ028</PriorBillingCode><PriorBillingCode>CR298</PriorBillingCode><PriorBillingCode>GO290</PriorBillingCode></PriorBillingCodes><Name>NanoBone - Putty</Name><Description>Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute putty</Description><Size>0.5ml, 1.0ml, 2.5ml, 5ml</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>292263</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER163</BillingCode><PriorBillingCodes><PriorBillingCode>LH382</PriorBillingCode><PriorBillingCode>TB382</PriorBillingCode></PriorBillingCodes><Name>Signus Anterior Cervical Plate - Bone Screws</Name><Description>Provides stability in patients undergoing anterior cervical spine fusion procedures. It consists of a pre-contoured titanium plate, secured onto the spinal vertebrae by either fixed or variable angle colour coded screws. These screws have an integral lock</Description><Size>4.0-4.5mm diameter x 12-22mm length</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Expansion Screw / Expansion Head Screw</Suffix><ARTGs><ARTG>216749</ARTG></ARTGs><MinimumBenefit>274</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER776</BillingCode><PriorBillingCodes><PriorBillingCode>HW723</PriorBillingCode><PriorBillingCode>ER013</PriorBillingCode><PriorBillingCode>AJ014</PriorBillingCode></PriorBillingCodes><Name>K2M Spinal Systems</Name><Description>Lumbar Thoracic or Cervical Hooks; open or closed</Description><Size>Various blade and throat sizes</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>154442</ARTG><ARTG>159828</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER544</BillingCode><Name>Biedermann Motech MOSS Spinal Fixation System-Ti Pedicle Screw</Name><Description>Polyaxial Screw shank-solid and cannulated/fenestrated</Description><Size>Ø4.3mm - Ø10.0 mm diameter, 20-120mm length</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>337238</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER836</BillingCode><PriorBillingCodes><PriorBillingCode>SK188</PriorBillingCode></PriorBillingCodes><Name>VITOSS - Synthetic cancellous bone void filler</Name><Description>Beta-tricalcium phosphate</Description><Size>10cc morsels and 10cc dowels</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>140557</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER796</BillingCode><PriorBillingCodes><PriorBillingCode>HW743</PriorBillingCode><PriorBillingCode>ER046</PriorBillingCode><PriorBillingCode>LH468</PriorBillingCode></PriorBillingCodes><Name>Chesapeake Thoracolumbar Spinal System</Name><Description>Thoracolumbar Peek Cage with Ti Screws</Description><Size>Cages: Footprint: 24mm - 30mm x 30mm - 40mm Height: 11mm - 21mm, Screws: Diameter 5.5mm Lengths: 20-30mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>159146</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER167</BillingCode><PriorBillingCodes><PriorBillingCode>LH432</PriorBillingCode></PriorBillingCodes><Name>Signus Anterior Cervical Plate - L3-L4</Name><Description>Pre-contoured titanium plate, secured onto the spinal vertebrae by either fixed or variable angle colour coded screws.</Description><Size>56mm - 100mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>122274</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER551</BillingCode><Name>Biedermann Motech MOSS Spinal Fixation System-Ti Offset Connector</Name><Description>Offset Connector  </Description><Size>dia 5.5-6.0mm  </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>337238</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER819</BillingCode><PriorBillingCodes><PriorBillingCode>HW768</PriorBillingCode><PriorBillingCode>ER409</PriorBillingCode></PriorBillingCodes><Name>Capri Small Solid Corpectomy Cage System</Name><Description>Non Stackable vertebral body replacement</Description><Size>(12 x14)mm or (13x16)mm footprint</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1814</GroupID><ARTGs><ARTG>291618</ARTG></ARTGs><MinimumBenefit>3340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER653</BillingCode><Name>Biocomposites Stimulan Rapid Cure 10 cc</Name><Description>Calcium Sulfate synthetic rapid setting bone void filler kit.  </Description><Size>10 cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>391243</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER103</BillingCode><PriorBillingCodes><PriorBillingCode>OH373</PriorBillingCode></PriorBillingCodes><Name>GeneX</Name><Description>GeneX paste</Description><Size>10cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>158711</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER317</BillingCode><Name>Ulrich posterior OCT System (neon3)-Hooks</Name><Description>Ulrich posterior OCT System (neon3)-Hooks, counter hooks, right/left, short/long</Description><Size>short to long</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER812</BillingCode><PriorBillingCodes><PriorBillingCode>HW761</PriorBillingCode><PriorBillingCode>ER215</PriorBillingCode><PriorBillingCode>ER183</PriorBillingCode></PriorBillingCodes><Name>Everest Spinal System-Fenestrated Screw</Name><Description>Polyaxial Screw, Fenestrated</Description><Size>(4.5 -9.5)mm diam x (20-110)mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER105</BillingCode><PriorBillingCodes><PriorBillingCode>OH375</PriorBillingCode></PriorBillingCodes><Name>GeneX</Name><Description>GeneX putty</Description><Size>10cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>155298</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ137</BillingCode><Name>Evolution Spine EMERGE Plate System- Plates-&gt;55mm</Name><Description>Evolution Spine EMERGE Plate System- Plates-&gt;55mm, Level 2-5</Description><Size>56-110 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>445230</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER560</BillingCode><Name>Osteomed ExtremiLock Screw, Mini (2.01 – 2.7 mm), variable angle locking</Name><Description>Variable angle locking screws, fully or partially threaded</Description><Size>dia (2.4-2.7 mm) x length (8-40 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>337240</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER288</BillingCode><Name>Premia Spine Versalink Fixation System-Polyaxial Pedicle Screw</Name><Description>Premia Spine Versalink Fixation System-Cannulated Polyaxial Pedicle Screw</Description><Size>dia (5.5-8.5)mm x length (25-60)mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>267145</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER800</BillingCode><PriorBillingCodes><PriorBillingCode>HW748</PriorBillingCode><PriorBillingCode>ER138</PriorBillingCode></PriorBillingCodes><Name>Santorini Solid Corpectomy Cage System</Name><Description>Cage, fixed height, Peek</Description><Size>(12x14) or (16x20) mm footprint x (18-62) mm height</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1814</GroupID><ARTGs><ARTG>204117</ARTG></ARTGs><MinimumBenefit>3340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER840</BillingCode><PriorBillingCodes><PriorBillingCode>SK225</PriorBillingCode></PriorBillingCodes><Name>Oasys-Occipito Cervico Thoracic System</Name><Description>Polyaxial Screw</Description><Size>Dia: 3.5mm x Length: 10mm - 40mm  Dia: 4.0mm x Length: 10mm - 50mm  Dia: 4.5mm x Length: 20mm - 52mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>279144</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER824</BillingCode><PriorBillingCodes><PriorBillingCode>HW775</PriorBillingCode><PriorBillingCode>ER476</PriorBillingCode></PriorBillingCodes><Name>Yukon OCT System</Name><Description>Polyaxial Posterior Cervical Screws</Description><Size>3.5-5.0 diameter, length 10-50mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>159828</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER648</BillingCode><Name>SIGNUS INTROX HighV Cement</Name><Description>The INTROX® HighV cement is a radiopaque bone cement.</Description><Size>Powder 20 g; Liquid 8.6 g</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4089</SubGroupID><ARTGs><ARTG>354819</ARTG></ARTGs><MinimumBenefit>437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ745</BillingCode><Name>SIGNUS DIPLOMAT Pedicle Screw System-Polyaxial Screw-Shank</Name><Description>SIGNUS DIPLOMAT Pedicle Screw System-Polyaxial Screw-Shank, sterile and non-sterile</Description><Size>dia (4.5-9.5 mm) x length (25-100 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER581</BillingCode><PriorBillingCodes><PriorBillingCode>OF082</PriorBillingCode></PriorBillingCodes><Name>Orthofix In-Line Connector</Name><Description>Axial In-Line Connector with Rod</Description><Size>One size only</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER390</BillingCode><Name>Signus Introx Bone Cement-Cement plus mixer/delivery system</Name><Description>Signus Introx low viscosity bone cement plus preparation/delivery kit for mixing and delivering the bone cement.</Description><Size>20 grams</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4089</SubGroupID><ARTGs><ARTG>287168</ARTG></ARTGs><MinimumBenefit>437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER763</BillingCode><PriorBillingCodes><PriorBillingCode>HW594</PriorBillingCode></PriorBillingCodes><Name>Xia 4.5 CT Cannulated Polyaxial Screw</Name><Description>Cannulated Cortical Thread Polyaxial Screw</Description><Size>Dia 4.5mm to 6.5mm, length 20mm to 45mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>279160</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER757</BillingCode><PriorBillingCodes><PriorBillingCode>HW484</PriorBillingCode></PriorBillingCodes><Name>ES2 Spinal System, Screw</Name><Description>Polyaxial cannulated screw with integrated blades</Description><Size>Diam 4.5mm to 8.5mm, Length 25mm to 90mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>278581</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER723</BillingCode><Name>Ulrich uCentum comprehensive posterior system – Rods</Name><Description>Ulrich uCentum Z-Rod sterile</Description><Size> Dia 5.5mm &amp; 6.0mm, Length 300mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>442550</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER817</BillingCode><PriorBillingCodes><PriorBillingCode>HW766</PriorBillingCode><PriorBillingCode>ER282</PriorBillingCode></PriorBillingCodes><Name>Cascadia Lateral</Name><Description>Interbody spacer, Porous Ti</Description><Size>8-20mm high</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>293886</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER546</BillingCode><Name>Biedermann Motech MOSS Spinal Fixation System-Ti In-line Connector</Name><Description>Side by side / end to end connectors  </Description><Size>Various sizes</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>337238</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER838</BillingCode><PriorBillingCodes><PriorBillingCode>SK222</PriorBillingCode></PriorBillingCodes><Name>Oasys-Occipito Cervico Thoracic System</Name><Description>Hook</Description><Size>Standard, Standard Short, Standard Tall, Offset Right, Offset Left</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>279144</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER556</BillingCode><Name>Biedermann Motech MOSS Spinal Fixation System-Multiple diameter rod  </Name><Description>Dual Diameter Transition Rods, Ti or CoCr  </Description><Size>Ø 3.0 - Ø6.0mm range in various sizes  </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>337238</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER603</BillingCode><PriorBillingCodes><PriorBillingCode>OF057</PriorBillingCode></PriorBillingCodes><Name>FORZA PTC</Name><Description>PEEK/Titanium spacer with porous titanium endplates</Description><Size>9mm X 27mm, Height 7mm-14mm  11mm X 27mm, Height 7mm-14mm  11mm X 31mm, Height 7mm-14mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ733</BillingCode><Name> SIGNUS DIPLOMAT Deformity – Clip</Name><Description>SIGNUS DIPLOMAT Deformity System-Clip, non-sterile. Note: Sterile clip is packed as part of a sterile multicomponent pack (hook, shear nut, lamina screw).</Description><Size>N/A</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1471</GroupID><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>349</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER633</BillingCode><PriorBillingCodes><PriorBillingCode>OF027</PriorBillingCode><PriorBillingCode>AE168</PriorBillingCode></PriorBillingCodes><Name>Blackstone - Posterior Hook</Name><Description>Titanium</Description><Size>Large/Angled/Offset/Left/Right/Narrow/Wide/ThoracicLaminar/Lumbar Laminar</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER413</BillingCode><Name>Bicon Dental Implant System-Implant</Name><Description>Bicon Dental Implants for mandible or maxilla, endosseous, hydroxyapatite coated, with well</Description><Size>Dia (3-6mm) x length (5-11mm); well (2-3mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4392</SubGroupID><ARTGs><ARTG>158187</ARTG><ARTG>160010</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER811</BillingCode><PriorBillingCodes><PriorBillingCode>HW760</PriorBillingCode><PriorBillingCode>ER214</PriorBillingCode><PriorBillingCode>ER183</PriorBillingCode></PriorBillingCodes><Name>Everest Spinal System -Cannulated Screw</Name><Description>Polyaxial Screw, Cannulated</Description><Size>(4.5 -10.5)mm diam x (20-110)mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER171</BillingCode><Name>LifeSpan ePTFE vascular grafts-straight-supported-regular or thin wall, 50-80 cm</Name><Description>LifeSpan ePTFE vascular grafts-straight-supported; regular and thin wall; 6-10 mm dia x 50-80 cm length; 10-80 cm external spiral support length</Description><Size>6-10 mm dia x 50-80 cm length; 10-80 cm external spiral support length</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><Suffix>R (ringed)</Suffix><ARTGs><ARTG>216528</ARTG></ARTGs><MinimumBenefit>1440</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER600</BillingCode><PriorBillingCodes><PriorBillingCode>OF058</PriorBillingCode></PriorBillingCodes><Name>FORZA PTC</Name><Description>PEEK/Titanium spacer with porous titanium endplates</Description><Size>9mm X 23mm, Height 7mm-14mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER414</BillingCode><Name>Bicon Dental Implant System-Abutment (temporary)</Name><Description>Bicon Dental Implant System temporary abutments</Description><Size>dia (4-7.5mm) x length (2.5-6.5mm) x post (2-3mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4386</SubGroupID><ARTGs><ARTG>158187</ARTG><ARTG>160010</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER517</BillingCode><PriorBillingCodes><PriorBillingCode>EU003</PriorBillingCode></PriorBillingCodes><Name>e.Spine Hook</Name><Description>Titanium Spine hook</Description><Size>Transverse process. Pedicular, Lumbar laminar, Thoracic laminar, Right offset lumbar laminar, Left offset lumbar laminar and raised body lumbar laminar hook, Progressive blade (small, medium, large), Pedicle (small, medium, large), Reduced blade (small, medium, large), Large blade (small, medium, large), and Laminar (Left offset - Reduced, Right offset - Reduced)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>171952</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER765</BillingCode><PriorBillingCodes><PriorBillingCode>HW632</PriorBillingCode></PriorBillingCodes><Name>Xia Serrato Cannulated Polyaxial Screw</Name><Description>Cannulated Polyaxial Screw</Description><Size>Dia 4.5mm-7.5mm; Length 20mm-60mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>279159</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER740</BillingCode><PriorBillingCodes><PriorBillingCode>MI241</PriorBillingCode></PriorBillingCodes><Name>Mahurkar Elite Subclavian Dual Lumen Catheter Kit</Name><Description>Acute haemodialysus, short term vascular access. Catheters constructed of radiopaque polyurethane. Tips are made of polyvinyl chloride and are more radiopaque than the rest of the catheter.</Description><Size>10 Fr-12Fr, 13cm-30 cm, Straight/Curved/PreCurved Exten.</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1651</GroupID><ARTGs><ARTG>180135</ARTG></ARTGs><MinimumBenefit>103</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER170</BillingCode><Name>LifeSpan ePTFE vascular grafts-straight-regular or thin wall, 50-100 cm</Name><Description>LifeSpan ePTFE vascular grafts-straight-regular or thin wall, 5-10 mm dia x length 50-100 cm</Description><Size>5-10 mm dia x length 50-100 cm</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><ARTGs><ARTG>216528</ARTG></ARTGs><MinimumBenefit>663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER843</BillingCode><PriorBillingCodes><PriorBillingCode>SK424</PriorBillingCode></PriorBillingCodes><Name>VBOSS / VLIFT</Name><Description>End cap</Description><Size>Sizes 10 to 25mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1495</GroupID><ARTGs><ARTG>315105</ARTG></ARTGs><MinimumBenefit>1030</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER643</BillingCode><PriorBillingCodes><PriorBillingCode>OF068</PriorBillingCode></PriorBillingCodes><Name>SKYHAWK Interbody Fusion Device</Name><Description>PEEK Interbody Fusion Device</Description><Size>Width - 16mm, 18mm and 20mm, 22mm, 26mm  Length - 35mm, 40mm, 45mm, 50mm, 55mm, 60mm  Height - 8mm, 10mm, 11mm, 12mm, 13mm, 14mm, 15mm, 16mm, 17mm, 18mm, 19mm, 20mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER784</BillingCode><PriorBillingCodes><PriorBillingCode>HW731</PriorBillingCode><PriorBillingCode>ER022</PriorBillingCode><PriorBillingCode>AJ030</PriorBillingCode></PriorBillingCodes><Name>Aleutian TLIF</Name><Description>Transforaminal lumbar interbody spacer</Description><Size>(8.5-12)mm wide x (22-36)mm long x (4-17)mm height x (6-18) degree lordotic angle</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>159146</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER809</BillingCode><PriorBillingCodes><PriorBillingCode>HW758</PriorBillingCode><PriorBillingCode>ER211</PriorBillingCode></PriorBillingCodes><Name>Mesa Hooks</Name><Description>Thoracic and Lumbar hooks</Description><Size>Various blade and throat sizes</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><Suffix>Integrated Locking Mechanism</Suffix><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>913</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER351</BillingCode><Name>Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium, cancellous</Name><Description>Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium,cancellous</Description><Size>dia (4-4.5mm) x length (12-26mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>279702</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER719</BillingCode><Name>SIGNUS TETRIS ST Fusion Cage</Name><Description>SIGNUS TETRIS ST Lumbar fusion cage</Description><Size>Length 20-32 mm     Width 10 mm      Height 6-18 mm    Lordosis Angle 0-20 degrees</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>464252</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER669</BillingCode><Name>FORZA Spacer System-TLIF</Name><Description>FORZA Spacer System-TLIF, Ti, straight or curved</Description><Size>Profile: (9-11) mm x (&gt;27-31) mm  Height: 6-14 mm  Lordosis: 0 or 8 degrees</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER315</BillingCode><Name>Ulrich posterior OCT System (neon3)-Connector, offset</Name><Description>Ulrich posterior OCT System (neon3)-Connector, offset, square or parallel, left or right</Description><Size>length (7-20 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER532</BillingCode><PriorBillingCodes><PriorBillingCode>SQ153</PriorBillingCode></PriorBillingCodes><Name>E.SPINE System</Name><Description>TANIT SI Connector, sterile or non-sterile</Description><Size>one size</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>171952</ARTG></ARTGs><MinimumBenefit>913</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER646</BillingCode><PriorBillingCodes><PriorBillingCode>HZ001</PriorBillingCode></PriorBillingCodes><Name>Forza XP Expandable Spacer System</Name><Description>The Forza XP Expandable Spacer System is comprised of an assortment of non-sterile as well as sterile, single use, titanium alloy and polyetheretherketone (PEEK) polymer spacers with height expansion capability. The expandable interbody spacer is inserted into the lumbar disc space and expanded to fit the patient anatomy. The implants are offered in parallel, lordotic, and hyperlordotic configurations to help restore the natural curvature of the spine. The implants can be used in single placement or pairs with typical approaches being transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF). The implants feature a bulleted nose for ease of insertion and anti-migration ripples on both the inferior and superior surfaces to provide increased stability and help prevent anterior/posterior movement of the device.</Description><Size>Length: 24 mm - 28 mm  Width: 10 mm  Starting height: 6.5 mm - 12.5 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER333</BillingCode><Name>Ulrich Pedicle Screw System-Pedicle Screw, Polyaxial</Name><Description>Ulrich Pedicle Screw System (uCentum)-Pedicle Screw, Polyaxial, standard or long arm, sterile or non-sterile</Description><Size>dia (4.5-10 mm) x length (25-60 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>279706</ARTG><ARTG>442550</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ146</BillingCode><Name>Evolution Spine Whistler Modular Pedicle Screw System-Pedicle Screw</Name><Description>Evolution Spine Whistler Modular Pedicle Screw System-Pedicle Screw Shank, solid or cannulated, sterile or non-sterile, HA coated or uncoated.</Description><Size>Diameter: 4.75-10.50 mm Length: 25-120 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>445292</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER760</BillingCode><PriorBillingCodes><PriorBillingCode>HW560</PriorBillingCode></PriorBillingCodes><Name>Tritanium PL Posterior Lumbar Cage</Name><Description>Porous Titanium Alloy Interbody Cage</Description><Size>6-16mm height, 23-32mm length, 9-11mm width, 0, 6 and 12 degrees</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>265560</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER149</BillingCode><PriorBillingCodes><PriorBillingCode>LH182</PriorBillingCode><PriorBillingCode>TB182</PriorBillingCode></PriorBillingCodes><Name>Tetris / Tasmin Family of Lumbar fusion cages</Name><Description>Titanium or peek, Interbody fusion device</Description><Size>(6-24)mm x (20-28) mm x (9-11) mm; lordosis 0-22 degrees</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>129772</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER764</BillingCode><PriorBillingCodes><PriorBillingCode>HW631</PriorBillingCode></PriorBillingCodes><Name>Xia Serrato Polyaxial Screw</Name><Description>Polyaxial Screw, Reduction Polyaxial Screw, Medial Biased Angle Screw</Description><Size>Dia 4mm-10.5mm, Length 20mm-130mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>279159</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER143</BillingCode><Name>Signus Pedicle Screw System-Pedicle Screw Polyaxial</Name><Description>Signus Pedicle Screw</Description><Size>4.5 - 7.5mm x 30 - 70mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>216751</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER744</BillingCode><Name>Evolution Spine E3D-C Static cervical fusion cage </Name><Description>Evolution Spine E3D-C Static cervical fusion cage </Description><Size>(12-16) mm x (14-18) MM; height 5-12 mm; lordosis 7-15 degrees</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>489965</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER845</BillingCode><PriorBillingCodes><PriorBillingCode>SR050</PriorBillingCode></PriorBillingCodes><Name>AVS TL Peek Spacer System</Name><Description>Transforaminal Lumbar Interbody Fusion cage, PEEK</Description><Size>7-18mm x 25--30mm. 0-4 degree</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>315081</ARTG><ARTG>315106</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER570</BillingCode><Name>Biedermann Motech TELIX K Interbody Fusion Cage Implant System</Name><Description>Biedermann Motech TELIX K Interbody Fusion Cage (TLIF), curved profile, Titanium  </Description><Size>(7-17mm) x (28-36mm); lordosis 0/5°  </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>354050</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER537</BillingCode><Name>Signus JASPIS</Name><Description>Cervical porous titanium fusion cage </Description><Size>width (14-18mm) x length (12-14 mm) x height (4-10 mm); lordosis (0-8°)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>129772</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER622</BillingCode><PriorBillingCodes><PriorBillingCode>OF015</PriorBillingCode><PriorBillingCode>AE200</PriorBillingCode></PriorBillingCodes><Name>Blackstone Medical ACP Bone Screw</Name><Description>Titanium Alloy Bone Screw</Description><Size>4.1mm x 10mm - 18mm. 4.5mm x 10mm - 18mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER712</BillingCode><Name>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Offset Connector</Name><Description>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Offset Connector, sterile, incl. set screws (sterile or non-sterile).</Description><Size>dia 3.5 x 12-15 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>464685</ARTG><ARTG>464686</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER844</BillingCode><PriorBillingCodes><PriorBillingCode>SR042</PriorBillingCode></PriorBillingCodes><Name>MANTIS</Name><Description>Screw, Cannulated, Multiaxial, Ti</Description><Size>4.5mm - 7.5mm x 25mm - 60mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>278581</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER801</BillingCode><PriorBillingCodes><PriorBillingCode>HW749</PriorBillingCode><PriorBillingCode>ER142</PriorBillingCode></PriorBillingCodes><Name>Aleutian Cervical Interbody System</Name><Description>Cage, Convex, or Lordotic. PEEK</Description><Size>Height: 5 -15mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>159146</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER314</BillingCode><Name>Ulrich posterior OCT System (neon3)-Connector, axial/parallel</Name><Description>Ulrich posterior OCT System (neon3)-Connector, axial/parallel</Description><Size>one size</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER810</BillingCode><PriorBillingCodes><PriorBillingCode>HW759</PriorBillingCode><PriorBillingCode>ER212</PriorBillingCode></PriorBillingCodes><Name>Mesa Polyaxial Cannulated Screw</Name><Description>Cannulated Pedicle Screw, polyaxial </Description><Size>Diameter: 5.5-6.5mm Length: 30-45mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Integrated Locking Mechanism, Cannulated</Suffix><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>1105</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER762</BillingCode><PriorBillingCodes><PriorBillingCode>HW593</PriorBillingCode></PriorBillingCodes><Name>Xia 4.5 CT Polyaxial  Screw</Name><Description>Cortical Thread Polyaxial Screw</Description><Size>Dia 4mm to 6.5mm, length 20mm to 45mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>279160</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER389</BillingCode><Name>Signus Introx Bone Cement System-Cement, low viscosity</Name><Description>Signus Introx cement is a radiopaque bone cement for Percutaneous Vertebral Augmentation (PVA) procedures</Description><Size>20 grams</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4087</SubGroupID><ARTGs><ARTG>287169</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER837</BillingCode><PriorBillingCodes><PriorBillingCode>SK191</PriorBillingCode></PriorBillingCodes><Name>VITOSS - Synthetic Cancellous bone void filler</Name><Description>Beta-tricalcium phosphate</Description><Size>5cc morsels</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>140557</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER779</BillingCode><PriorBillingCodes><PriorBillingCode>HW726</PriorBillingCode><PriorBillingCode>ER017</PriorBillingCode><PriorBillingCode>AJ025</PriorBillingCode></PriorBillingCodes><Name>Mesa Spinal System / Polyaxial Pedicle Screw</Name><Description>Polyaxial Pedicle Screw, Titanium</Description><Size>4.0-9.5mm, Length 20-110mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Integrated Locking Mechanism</Suffix><ARTGs><ARTG>154442</ARTG><ARTG>159828</ARTG></ARTGs><MinimumBenefit>1257</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER807</BillingCode><PriorBillingCodes><PriorBillingCode>HW755</PriorBillingCode><PriorBillingCode>ER201</PriorBillingCode></PriorBillingCodes><Name>K2M Spinal Systems-Transitional Rod</Name><Description>Transitional Rod</Description><Size>3.5-(4.5 /5.5)mm x (300-600)mm length or 5.5/5.5mm x 495 rod/rail</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>154442</ARTG><ARTG>159828</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER321</BillingCode><Name>Ulrich posterior OCT System (neon3)-Toggle</Name><Description>Ulrich posterior OCT System (neon3)-Toggle, incl. nut and washer</Description><Size>N/A</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>241</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER190</BillingCode><Name>Signus Mobis II TLIF Implant</Name><Description>Signus Mobis II Thoracolumbar Fusion Cage-Peek or Ti</Description><Size>Height (6-14 mm)xWidth 9 mm x Length 29 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>129772</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER630</BillingCode><PriorBillingCodes><PriorBillingCode>OF024</PriorBillingCode><PriorBillingCode>AE142</PriorBillingCode></PriorBillingCodes><Name>Firebird lateral offsets</Name><Description>lateral offsets in lengths from 8mm-80mm. Titanium.</Description><Size>15, 20, 25, 30, 35, 80mm; 8mm-35mm in 3mm increments</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER722</BillingCode><PriorBillingCodes><PriorBillingCode>IJ029</PriorBillingCode><PriorBillingCode>CR297</PriorBillingCode><PriorBillingCode>GO288</PriorBillingCode></PriorBillingCodes><Name>NanoBone - Granules</Name><Description>Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute granules</Description><Size>0.6ml, 1.2ml, 2.4ml, 5ml</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>281303</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER286</BillingCode><Name>Premia Spine Versalink Fixation System-Cross Bar</Name><Description>Premia Spine Versalink Fixation System-Cross Bar</Description><Size>one size</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>267145</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER833</BillingCode><PriorBillingCodes><PriorBillingCode>SK184</PriorBillingCode></PriorBillingCodes><Name>VITOSS - Synthetic cancellous bone void filler</Name><Description>Beta-tricalcium phosphate</Description><Size>1.2cc dowel</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>140557</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER629</BillingCode><PriorBillingCodes><PriorBillingCode>OF066</PriorBillingCode></PriorBillingCodes><Name>Centurion Rod Connectors</Name><Description>Parallel Rod Connector, Axial Rod Connector and Lateral Offset Adaptor</Description><Size>3.5mm by 5.5mm and 10mm offset (Lateral Adaptor)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER104</BillingCode><PriorBillingCodes><PriorBillingCode>OH374</PriorBillingCode></PriorBillingCodes><Name>GeneX</Name><Description>GeneX/GeneX DS paste</Description><Size>2.5 and 5cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>158711</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER106</BillingCode><PriorBillingCodes><PriorBillingCode>OH376</PriorBillingCode></PriorBillingCodes><Name>GeneX</Name><Description>GeneX putty</Description><Size>5cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>155298</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER652</BillingCode><Name>Biocomposites Stimulan Rapid Cure 5 cc</Name><Description>Calcium Sulfate synthetic rapid setting bone void filler kit.  </Description><Size>5cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>391243</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER107</BillingCode><PriorBillingCodes><PriorBillingCode>OH377</PriorBillingCode></PriorBillingCodes><Name>GeneX</Name><Description>GeneX putty</Description><Size>2.5cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>155298</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ735</BillingCode><Name>SIGNUS DIPLOMAT Deformity– Lamina Screw</Name><Description>SIGNUS DIPLOMAT Deformity– Lamina Screw, non-sterile and sterile supplied as part of multipack (with hook; clip; shear nut) </Description><Size>5.0-10.0 mm </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER352</BillingCode><Name>Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium, expansion</Name><Description>Ulrich Anterior Distraction Device (ADDplus)-Screws, Osmium, expansion,  include bolt.</Description><Size>dia (4-5 mm) x length (12-18 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Expansion Screw / Expansion Head Screw</Suffix><ARTGs><ARTG>279702</ARTG></ARTGs><MinimumBenefit>274</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER815</BillingCode><PriorBillingCodes><PriorBillingCode>HW764</PriorBillingCode><PriorBillingCode>ER242</PriorBillingCode></PriorBillingCodes><Name>Cascadia Interbody Spacer</Name><Description>Cascadia interbody spacer, porous Ti</Description><Size>8.5 -14mm wide</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>293886</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER681</BillingCode><Name>LeMaitre Omniflow II Vascular Prosthesis-≥50cm</Name><Description>Omniflow II Vascular Prosthesis-≥50cm. biologically engineered, straight</Description><Size>diameter:5-8 mm  length: 50-65 cm</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><Suffix>Biologically engineered</Suffix><ARTGs><ARTG>399614</ARTG></ARTGs><MinimumBenefit>2736</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER830</BillingCode><PriorBillingCodes><PriorBillingCode>HW781</PriorBillingCode><PriorBillingCode>ER495</PriorBillingCode></PriorBillingCodes><Name>Ozark Cervical Plate System Screw</Name><Description>Screw, fixed or variable angle</Description><Size>(4-4.5)mm diameter x (10-26)mm length</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ150</BillingCode><Name>Evolution Spine E3D-A Interbody System-Static Fusion Cage</Name><Description>Evolution Spine E3D-A Interbody System-Static Fusion Cage, sterile</Description><Size>Footprint: (32-40 mm) x (24-28 mm) Height:9-21 mm Lordosis: 8-30 degrees</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>445955</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER144</BillingCode><Name>Signus Pedicle Screw System-Pedicle Screw Polyaxial Cannulated</Name><Description>Signus Pedicle Screw System-Pedicle Screw Polyaxial Cannulated</Description><Size>4.5 - 7.5mm x 30 - 70mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>216751</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER327</BillingCode><Name>Ulrich Anterior Cervical Cage</Name><Description>Ulrich cerv-X Anterior Cervical Cage-PEEK, convex and lordotic</Description><Size>height (4-10mm) x width (12-16mm) x length (12-14mm) x angle (0-5°)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>279703</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER850</BillingCode><PriorBillingCodes><PriorBillingCode>ST914</PriorBillingCode><PriorBillingCode>ST912</PriorBillingCode><PriorBillingCode>ST915</PriorBillingCode><PriorBillingCode>ST916</PriorBillingCode></PriorBillingCodes><Name>REFLEX  Anterior Cervical Plating System</Name><Description>Screw</Description><Size>Diameter 4 - 4.5mm lengths 10mm - 20mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>278368</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER785</BillingCode><PriorBillingCodes><PriorBillingCode>HW732</PriorBillingCode><PriorBillingCode>ER023</PriorBillingCode><PriorBillingCode>AJ031</PriorBillingCode></PriorBillingCodes><Name>Cayman Thoracolumbar Plate System / Bone Screw</Name><Description>Self tapping screw, Ti</Description><Size>Length: 20mm to 60mm  Diameter:  5mm and 7mm, titanium</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER209</BillingCode><Name>SIGNUS  Cervical Plating Implant System-Bone Screw</Name><Description>SIGNUS  Cervical Plating Implant System-Cervical Bone Screw, fixed or variable angle; self drilling or self tapping</Description><Size>dia (2.7-4.3 mm)x length (12-22 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>216749</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER162</BillingCode><PriorBillingCodes><PriorBillingCode>LH370</PriorBillingCode><PriorBillingCode>TB370</PriorBillingCode></PriorBillingCodes><Name>Signus Mobis Lumbar TLIF Cage</Name><Description>Peek-Optima Lumbar intervertebral TLIF cage</Description><Size>6, 7, 8, 9, 10, 11, 12, 13, 14, 16, 18mm heights</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>129772</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER284</BillingCode><Name>Premia Spine Versalink Fixation System-Rods (straight or bent)</Name><Description>Premia Spine Versalink Rods (straight or bent)</Description><Size>dia 6 mm, length (40-180) mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>267145</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER726</BillingCode><Name>SIGNUS CYLOX ST Cervical Cage </Name><Description>CYLOX ST Cervical cage (non-integral use only)-straight or angled

</Description><Size>(4-11 mm) x (15-20 mm) x  (12-16 mm); 0-12 degrees</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>493705</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER596</BillingCode><PriorBillingCodes><PriorBillingCode>OF074</PriorBillingCode></PriorBillingCodes><Name>PILLAR SA PTC</Name><Description>ALIF Cage constructed of PEEK Titanium composite (PTC) with cover plate and bone screws.</Description><Size>Width - 33mm to 43mm Depth/Length - 28mm Height - 12mm to 18 mm, Lordosis - 7 to 12 degrees; Cover Plate - 33mm to 43mm; Bone Screw: dia 5-5.5 mm x length 20-35 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER720</BillingCode><PriorBillingCodes><PriorBillingCode>IJ027</PriorBillingCode><PriorBillingCode>CR299</PriorBillingCode><PriorBillingCode>GO291</PriorBillingCode></PriorBillingCodes><Name>NanoBone - Putty</Name><Description>Nanocrystalline HA in a porous silica matrix, synthetic bone graft substitute putty</Description><Size>10ml</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>292263</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER336</BillingCode><Name>Ulrich Pedicle Screw System-Hooks</Name><Description>Ulrich Pedicle Screw System (uCentum)-Hooks, pedicle, lamina, offset (left or right), incl. set screws, non-sterile or sterile (packed together with set screws)</Description><Size>width (5-8 mm) x length (7-11 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>279706</ARTG><ARTG>442550</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER775</BillingCode><PriorBillingCodes><PriorBillingCode>HW722</PriorBillingCode><PriorBillingCode>ER011</PriorBillingCode><PriorBillingCode>AJ012</PriorBillingCode></PriorBillingCodes><Name>K2M Spinal Systems</Name><Description>Axial connectors, in-line, parallel, open and closed face</Description><Size>3.5 – 6.5mm rods</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>154442</ARTG><ARTG>159828</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER206</BillingCode><Name>Signus TLIF Implant </Name><Description>Signus TLIF Implant (Peek or Titanium)</Description><Size>Height (6-18 mm) x Width 11 mm x Length (28-40) mm x 0 or 6 degree angle</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>129772</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER717</BillingCode><Name>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System-Rods</Name><Description>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System-Rods, straight or curved, Titanium or CoCr; non-sterile or sterile</Description><Size>dia 3.5 mm; length 30-360 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>464685</ARTG><ARTG>464686</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER828</BillingCode><PriorBillingCodes><PriorBillingCode>HW779</PriorBillingCode><PriorBillingCode>ER493</PriorBillingCode></PriorBillingCodes><Name>Ozark Plate Level 1-5, ≤55 mm</Name><Description>Plate level 1 -5, ≤55 mm</Description><Size>16-55 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER172</BillingCode><Name>LifeSpan ePTFE vascular grafts-tapered or end modified-regular or thin wall, 40-70 cm</Name><Description>LifeSpan ePTFE vascular grafts-unsupported, tapered or end modified, 4-7 mm dia x 40-70 cm long  </Description><Size>4-7 mm dia x 40-70 cm long; </Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1639</GroupID><ARTGs><ARTG>216528</ARTG></ARTGs><MinimumBenefit>770</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ739</BillingCode><Name>SIGNUS DIPLOMAT Pedicle Screw System - Parallel Connector, incl set screws</Name><Description>SIGNUS DIPLOMAT Pedicle Screw System - Parallel Connector, non-sterile and sterile; incl set screws</Description><Size>(5.5-6.5) mm x (4.5-15.0) mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER782</BillingCode><PriorBillingCodes><PriorBillingCode>HW729</PriorBillingCode><PriorBillingCode>ER020</PriorBillingCode><PriorBillingCode>AJ028</PriorBillingCode></PriorBillingCodes><Name>Aleutian PLIF</Name><Description>Posterior lumbar spacer, PEEK</Description><Size>(22-28)mm long x (8.5-10)mm wide x (4-17)mm high x (0-18) degree lordosis</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>159146</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER773</BillingCode><PriorBillingCodes><PriorBillingCode>HW680</PriorBillingCode></PriorBillingCodes><Name>Monterey AL, Cage </Name><Description>ALIF Cage </Description><Size>Height 8mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>356926</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ136</BillingCode><Name>Evolution Spine EMERGE Plate System- Plates</Name><Description>Evolution Spine EMERGE Plate System- Plates, Level 1-4</Description><Size>18-55 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>445230</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER789</BillingCode><PriorBillingCodes><PriorBillingCode>HW736</PriorBillingCode><PriorBillingCode>ER030</PriorBillingCode><PriorBillingCode>AJ039</PriorBillingCode></PriorBillingCodes><Name>Pyrenees Cervical Plate System</Name><Description>Cervical Plate</Description><Size>18mm to 54mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER735</BillingCode><PriorBillingCodes><PriorBillingCode>MC764</PriorBillingCode></PriorBillingCodes><Name>Microelectrode Cable</Name><Description>Cable used for intracranial recording of neural activity prior to DBS</Description><Size>One size</Size><SupplierCode>ER</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4479</SubGroupID><ARTGs><ARTG>177947</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER778</BillingCode><PriorBillingCodes><PriorBillingCode>HW725</PriorBillingCode><PriorBillingCode>ER016</PriorBillingCode><PriorBillingCode>AJ018</PriorBillingCode></PriorBillingCodes><Name>Pyrenees Cervical Plate System - Screw</Name><Description>Self-drilling, self-tapping and bone reduction screws</Description><Size>(3.5 - 4.7)mm diam x (10-20)mm length</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER814</BillingCode><PriorBillingCodes><PriorBillingCode>HW763</PriorBillingCode><PriorBillingCode>ER241</PriorBillingCode></PriorBillingCodes><Name>Pyrenees Cervical Plate System-Monoplate, Short</Name><Description>Pyrenees MonoPlate, Short</Description><Size>18-55mm length</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER590</BillingCode><PriorBillingCodes><PriorBillingCode>OF077</PriorBillingCode></PriorBillingCodes><Name>Cetra Anterior Cervical Plate</Name><Description>Low profile anterior cervical plate</Description><Size>16mm-54mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>195018</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER587</BillingCode><PriorBillingCodes><PriorBillingCode>OF078</PriorBillingCode></PriorBillingCodes><Name>Cetra Anterior Cervical Plate &gt; 55mm</Name><Description>Low profile anterior cervical plate</Description><Size>56mm-94mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>195018</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER355</BillingCode><Name>Ulrich thoracolumbar body replacement system (ObeliscPRO)-End plates</Name><Description>Ulrich thoracolumbar body replacement system (ObeliscPRO)-End plates, various shapes</Description><Size>dia (20-32 mm) x angle (0-15°); oval (32x26 mm) x angle (0-15°); lateral length (35-55 mm) x angle (0-15°)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4138</SubGroupID><ARTGs><ARTG>279702</ARTG></ARTGs><MinimumBenefit>928</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER309</BillingCode><Name>Ulrich Anterior Distraction Device</Name><Description>Ulrich Anterior Distraction Device (ADD)-telescoping cage,  thoracolumbar</Description><Size>dia (12-16 mm) x height collapsed (10-39 mm) x height extended (13-65 mm) x angle (0-6°)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>279702</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER737</BillingCode><PriorBillingCodes><PriorBillingCode>MI119</PriorBillingCode></PriorBillingCodes><Name>Electrode Insertion Tube set</Name><Description>Electrode Insertion Tube Set for DBS</Description><Size>One size only</Size><SupplierCode>ER</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4498</SubGroupID><ARTGs><ARTG>203992</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER752</BillingCode><PriorBillingCodes><PriorBillingCode>HW407</PriorBillingCode></PriorBillingCodes><Name>Aviator Anterior Cervical Plating System - Plate longer than 55mm</Name><Description>Anterior Cervical Plate - Integral Locking</Description><Size>Three and four level greater than 55mm in length</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>278368</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER835</BillingCode><PriorBillingCodes><PriorBillingCode>SK187</PriorBillingCode></PriorBillingCodes><Name>VITOSS - Synthetic cancellous bone void filler</Name><Description>Beta-tricalcium phosphate</Description><Size>30cc morsels and 30cc dowels</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4095</SubGroupID><ARTGs><ARTG>140557</ARTG></ARTGs><MinimumBenefit>1482</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER512</BillingCode><PriorBillingCodes><PriorBillingCode>EU001</PriorBillingCode></PriorBillingCodes><Name>e.Spine PEDICULAR SCREW</Name><Description>spine Pedicular Screw for sacral-thoraco-lumbar osteosynthesis</Description><Size>Pedicle or Reduction pedicle;
Diameter 4.35 Length 25 to 55 mm,
Diameter 5 Length 25 to 60 mm,
Diameter 6 Length 25 to 65 mm,
Diameter 6.5 Length 25 to 70 mm,
Diameter 7 Length 30 to 80 mm.</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>171952</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER787</BillingCode><PriorBillingCodes><PriorBillingCode>HW734</PriorBillingCode><PriorBillingCode>ER025</PriorBillingCode><PriorBillingCode>AJ033</PriorBillingCode></PriorBillingCodes><Name>Denali cannulated polyaxial screw</Name><Description>Cannulated polyaxial pedicle screw</Description><Size>Diameter:  5.5mm, 6.5mm and 7.5mm  Length:  35 to 55mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER849</BillingCode><PriorBillingCodes><PriorBillingCode>SR085</PriorBillingCode></PriorBillingCodes><Name>Reflex Anterior Cervical Plate System</Name><Description>Plate</Description><Size>≤55mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>278368</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER786</BillingCode><PriorBillingCodes><PriorBillingCode>HW733</PriorBillingCode><PriorBillingCode>ER024</PriorBillingCode><PriorBillingCode>AJ032</PriorBillingCode></PriorBillingCodes><Name>Cayman Thoracolumbar Plate System / Plate</Name><Description>Thoracolumbar Plate, Titanium</Description><Size>21mm to 109mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER208</BillingCode><Name>SIGNUS  Cervical Plating Implant System-Plate (&gt;55 mm)</Name><Description>SIGNUS  Cervical Plating Implant System-Plate (&gt;55 mm)</Description><Size>56-100 mm, in 3-5 mm increments</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>216749</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER713</BillingCode><Name>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Pedicle Screws</Name><Description>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Pedicle Screws, cannulated; non-sterile or sterile (packed together with set screw)</Description><Size>dia (3.5 - 4.5mm) x length (8 - 50mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>464685</ARTG><ARTG>464686</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER374</BillingCode><Name>Ulrich Sacroiliac Joint Fixation Device</Name><Description>Ulrich Sacroiliac Joint Fixation Device-Bone Screw</Description><Size>dia (7.5-10 mm) x length (40-140 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>241</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER825</BillingCode><PriorBillingCodes><PriorBillingCode>HW776</PriorBillingCode><PriorBillingCode>ER489</PriorBillingCode></PriorBillingCodes><Name>Cayman United Plate</Name><Description>Thoracolumbar Plate</Description><Size>16-24</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>293886</ARTG></ARTGs><Note>Prescribed List reimbursement of the billing code is restricted to the use of the device with posterior supplemental fixation with other implants</Note><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER693</BillingCode><Name> IntoCare Circular Stapler including handle, powered</Name><Description>Endoscopic Circular Stapler inclusive of handle, powered</Description><Size>21-33 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Endoscopic, Circular</Suffix><ARTGs><ARTG>390947</ARTG></ARTGs><MinimumBenefit>671</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER827</BillingCode><PriorBillingCodes><PriorBillingCode>HW778</PriorBillingCode><PriorBillingCode>ER491</PriorBillingCode></PriorBillingCodes><Name>Yukon OCT Spinal System</Name><Description>Occipital Screw</Description><Size>(4.5-5.75)mm dia  x (6-16)mm length</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>159828</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER818</BillingCode><PriorBillingCodes><PriorBillingCode>HW767</PriorBillingCode><PriorBillingCode>ER289</PriorBillingCode></PriorBillingCodes><Name>Pyrenees Segmental Plate</Name><Description>Single level fusion plate with shelf.</Description><Size>5-10mm shelf</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER545</BillingCode><Name>Osteomed ExtremiLock K-Wire</Name><Description>K-Wire</Description><Size>0.9-1.6 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>337153</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER750</BillingCode><PriorBillingCodes><PriorBillingCode>HW393</PriorBillingCode></PriorBillingCodes><Name>Xia Spine System</Name><Description>Bone Screw</Description><Size>One size only</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>279150</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER682</BillingCode><Name>ReShape Lap-Band AP with RapidPort EZ</Name><Description>Lap-Band AP with RapidPort EZ-small or large, inclusive of accessories, i.e.: needle for band priming; needle for access port flushing (5”); moulded end plug- Lap-Band; connector tubing; access port needle (3.5”).  </Description><Size>small/large</Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1548</GroupID><ARTGs><ARTG>375520</ARTG></ARTGs><MinimumBenefit>2791</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER169</BillingCode><Name>LifeSpan ePTFE vascular grafts-straight-regular or thin wall-20cm</Name><Description>LifeSpan ePTFE vascular grafts-straight-regular or thin wall; 5-8mm dia x 20 cm long</Description><Size>5-8 mm dia x 20 cm long</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4455</SubGroupID><ARTGs><ARTG>216528</ARTG></ARTGs><MinimumBenefit>508</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER797</BillingCode><PriorBillingCodes><PriorBillingCode>HW745</PriorBillingCode><PriorBillingCode>ER049</PriorBillingCode></PriorBillingCodes><Name>Everest Spinal System -Pedicle Screw</Name><Description>Polyaxial Pedicle Screw, Ti</Description><Size>Diameter: 4.5mm-10.5mm,  Length: 25mm - 110mm (open or closed)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>154442</ARTG><ARTG>293862</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER377</BillingCode><Name>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 0.25 g</Name><Description>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 0.25 g, synthetic</Description><Size>0.25 g, granule size 50-500μm or 500-1000μm</Size><SupplierCode>ER</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4393</SubGroupID><ARTGs><ARTG>230860</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER602</BillingCode><PriorBillingCodes><PriorBillingCode>OF047</PriorBillingCode><PriorBillingCode>AE152</PriorBillingCode></PriorBillingCodes><Name>FORZA TLIF</Name><Description>PEEK TLIF cages in various sizes</Description><Size>Width - 9mm to 11mm  Length - 27mm to 33mm  Height - 6mm to 16mm   0 - 8 degree</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER310</BillingCode><Name>Ulrich posterior OCT System (neon3)-Pedicle Screws</Name><Description>Ulrich posterior OCT System (neon3)-Pedicle Screws, non-cannulated, lateral mass screws</Description><Size>dia (3.5-4 mm) x length (10-28 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER718</BillingCode><Name>SIGNUS TETRIS R ST Fusion Cage</Name><Description>SIGNUS TETRIS R ST Lumbar fusion cage, rotatable</Description><Size>Length 20-32 mm  Width 9 mm   Height 6-18 mm    Lordosis Angle 0-20 degrees</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>464252</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER711</BillingCode><Name>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Occipital Screws</Name><Description>COSY Cervicothoracic Occipital Rod-Screw System - Occipital Screws, self-tapping; non-sterile or sterile</Description><Size>dia (4.5 - 5.0 mm) x length  (6 -16 mm) </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>464685</ARTG><ARTG>464686</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER820</BillingCode><PriorBillingCodes><PriorBillingCode>HW769</PriorBillingCode><PriorBillingCode>ER455</PriorBillingCode></PriorBillingCodes><Name>Cascadia Cervical Interbody System</Name><Description>Cascadia Interbody spacer, Porous Ti</Description><Size>5-13mm heights</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>293886</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER612</BillingCode><Name>Alpha Omega Microelectrodes</Name><Description>Alpha Omega Neuroprobe family of microtargeting electrodes; shielded, Sonus shielded or unshielded, AlphaProbe, various configurations, sterile; supplied as a single unit or a pack of 3 or 10.</Description><Size>Length: 219-282 mm; Microtip length: 2.5-27 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1675</GroupID><ARTGs><ARTG>346530</ARTG></ARTGs><MinimumBenefit>1145</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER783</BillingCode><PriorBillingCodes><PriorBillingCode>HW730</PriorBillingCode><PriorBillingCode>ER021</PriorBillingCode><PriorBillingCode>AJ029</PriorBillingCode></PriorBillingCodes><Name>Aleutian Anterior</Name><Description>Anterior/lateral lumbar interbody spacer</Description><Size>(30-60)mm wide x (18-28)mm long x (8-21)mm height</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>159146</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER647</BillingCode><PriorBillingCodes><PriorBillingCode>SJ198</PriorBillingCode></PriorBillingCodes><Name>MicroTargeting Electrodes</Name><Description>Microtargeting mono- and bipolar- electrodes</Description><Size>100-300mm</Size><SupplierCode>ER</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1675</GroupID><ARTGs><ARTG>161735</ARTG></ARTGs><MinimumBenefit>1145</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER620</BillingCode><PriorBillingCodes><PriorBillingCode>OF059</PriorBillingCode></PriorBillingCodes><Name>Centurion Multi-Axial Screws</Name><Description>Multi-Axial and Smooth Shank Multi-Axial Screws</Description><Size>3.5mm Diameter – 10mm - 52mm in 2mm increments  4.0mm Diameter – 10mm - 52mm in 2mm increments  4.5mm Diameter – 10mm – 50mm in 5mm increments  5.0mm Diameter – 10mm – 50mm in 5mm increments</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER766</BillingCode><PriorBillingCodes><PriorBillingCode>HW636</PriorBillingCode></PriorBillingCodes><Name>Tritanium C</Name><Description>Porous Titanium ACDF Cage</Description><Size>H 5mm-9mm, Base 12mm x 14mm to 14mm x 17mm, 6deg to 10deg angle</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>297569</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER679</BillingCode><Name>LeMaitre Omniflow II Vascular Prosthesis-20 cm</Name><Description>Omniflow II Vascular Prosthesis 20 cm, bioengineered, straight</Description><Size>diameter:5-8 mm  length: 20 cm</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4455</SubGroupID><Suffix>Biologically Engineered</Suffix><ARTGs><ARTG>399614</ARTG></ARTGs><MinimumBenefit>1104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER736</BillingCode><PriorBillingCodes><PriorBillingCode>MI073</PriorBillingCode></PriorBillingCodes><Name>Medtronic MicroTargeting Electrodes</Name><Description>Microelectrodes used for intra-operative recording of neuronal activity for DBS</Description><Size>Various</Size><SupplierCode>ER</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1675</GroupID><ARTGs><ARTG>161735</ARTG></ARTGs><MinimumBenefit>1145</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER572</BillingCode><PriorBillingCodes><PriorBillingCode>OF002</PriorBillingCode></PriorBillingCodes><Name>Azure Anterior Cervical Plate System</Name><Description>Bone Screws</Description><Size>4.0 &amp; 4.5mm diameter  12, 14, 16, 18mm length</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>195018</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ761</BillingCode><Name>SIGNUS DIPLOMAT Deformity System – Lamina Hook    </Name><Description>DIPLOMAT Deformity System with lamina hook, non-sterile</Description><Size>5.0-10.0 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>458188</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER151</BillingCode><PriorBillingCodes><PriorBillingCode>LH303</PriorBillingCode><PriorBillingCode>TB303</PriorBillingCode></PriorBillingCodes><Name>Nubic</Name><Description>Cervical Fusion Implant in interbody fusion of the Cervical Spine</Description><Size>(4-12)x13x(14-17) mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>129772</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER184</BillingCode><Name>SIGNUS Poseidon/POSEIDON ST Vertebral Body Replacement System-Vertebral Body</Name><Description>SIGNUS POSIDON/POSEIDON ST Vertebral Body, porous titanium</Description><Size>Dia 16/20mm x (Height 12-89mm)    </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>216750</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER808</BillingCode><PriorBillingCodes><PriorBillingCode>HW757</PriorBillingCode><PriorBillingCode>ER210</PriorBillingCode></PriorBillingCodes><Name>Capri Vertebral Body Replacement System-Cage</Name><Description>Cage, Internal or External Component</Description><Size>23 - 122mm height, multiple footprints</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>204117</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER378</BillingCode><Name>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 0.5 g</Name><Description>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 0.5 gram, synthetic</Description><Size>0.5 gram; granule size 50-500μm or 500-1000μm</Size><SupplierCode>ER</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4394</SubGroupID><ARTGs><ARTG>230860</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ763</BillingCode><Name>SIGNUS DIPLOMAT FT Pedicle Screw System-Polyaxial Screw-Shank</Name><Description>SIGNUS DIPLOMAT FT Pedicle Screw System-Polyaxial Screw-Shank, non-sterile and
sterile</Description><Size>Diameter: 5.5-9.5 mm Length: 25-100 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER354</BillingCode><Name>Ulrich thoracolumbar body replacement system (ObeliscPro)-Telescoping cage</Name><Description>Ulrich thoracolumbar body replacement system (ObeliscPro)-Telescoping cage, thoracolumbar</Description><Size>dia 20 mm x collapsed height (17-76 mm) x expanded height (23-132 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>279702</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER826</BillingCode><PriorBillingCodes><PriorBillingCode>HW777</PriorBillingCode><PriorBillingCode>ER490</PriorBillingCode></PriorBillingCodes><Name>Cayman United Bone Screw</Name><Description>Bone Screw</Description><Size>Length 20-60mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER350</BillingCode><Name>Ulrich Anterior Distraction Device System (ADDplus)-Telescopic cage</Name><Description>Ulrich Anterior Distraction System (ADDplus) telescopic cage, integral end plate, cervical.</Description><Size>dia 12 mm x collapsed height (13-40 mm) x expanded height (18-65 mm) x angle (0-18°)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>279702</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER821</BillingCode><PriorBillingCodes><PriorBillingCode>HW770</PriorBillingCode><PriorBillingCode>ER471</PriorBillingCode></PriorBillingCodes><Name>CAPRI Small  Expandable Corpectomy Cage System</Name><Description>Vertebral Body Replacement</Description><Size>(13-16) x (16-20) mm – height 18-74mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>291618</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER716</BillingCode><Name>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System- Hooks</Name><Description>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System- Hooks, various, left and right, sterile, incl. set screws (sterile or non-sterile).</Description><Size>short or long </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>464685</ARTG><ARTG>464686</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER515</BillingCode><PriorBillingCodes><PriorBillingCode>EU006</PriorBillingCode></PriorBillingCodes><Name>e.Spine connector</Name><Description>Titanium connector for rods of diameter 5.5 mm</Description><Size>Straight (axial connexion), Open domino (parallel connexion), Closed domino (parallel connexion)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>171952</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER508</BillingCode><Name>LeMaitre Xenosure Biologic Patch-Medium, 25-75cm²</Name><Description>The XenoSure Biologic Patch is a high-quality bovine pericardium patch used for vascular and cardiovascular reconstructions.</Description><Size>6 x 8 cm Rectangular Patch
  5 x 10 cm Rectangular Patch</Size><SupplierCode>ER</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>182</SubCategoryID><GroupID>1507</GroupID><SubGroupID>5453</SubGroupID><ARTGs><ARTG>310096</ARTG></ARTGs><MinimumBenefit>523</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER569</BillingCode><Name>SIGNUS VERTACONNECT expandable lumbar cage TLIF Implant</Name><Description>SIGNUS expandable TLIF cage, Titanium alloy</Description><Size>width (12 mm) x length (31 mm / 34 mm / 37 mm);     height:  posterior (8 mm /10mm / 12 mm),    anterior unexpanded (9 mm - 14 mm);  anterior expanded     (13 mm -19 mm)    angle:  anterior unexpanded (3°-7°),  anterior expanded  (11°-19°)           </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>129772</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER759</BillingCode><PriorBillingCodes><PriorBillingCode>HW520</PriorBillingCode></PriorBillingCodes><Name>AVS Navigator</Name><Description>Steerable TLIF Cage</Description><Size>L 26-31mm, H6-15mm, 0 and 4 degree anglulation</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>278569</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER795</BillingCode><PriorBillingCodes><PriorBillingCode>HW742</PriorBillingCode><PriorBillingCode>ER045</PriorBillingCode></PriorBillingCodes><Name>Aleutian Lateral</Name><Description>Lateral Interbody Spacer</Description><Size>(16-22)mm width x (25-60)mm length x (6-20)mm height, (0-15) degreee  lordotic angle</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>159146</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ743</BillingCode><Name>SIGNUS DIPLOMAT Pedicle Screw System - Sleeve</Name><Description>SIGNUS DIPLOMAT Pedicle Screw System – Sleeve, sterile, incl. set screws</Description><Size>Diameter 5.5 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>458187</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER847</BillingCode><PriorBillingCodes><PriorBillingCode>SR082</PriorBillingCode></PriorBillingCodes><Name>UniLIF</Name><Description>PEEK Unilateral Lumbar Interbody Fusion Cage</Description><Size>Width 11mm, Height 6mm to 13mm, Length 30mm - 33mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>315086</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER623</BillingCode><PriorBillingCodes><PriorBillingCode>OF060</PriorBillingCode></PriorBillingCodes><Name>Centurion Occipital Bone Screws and Rescue Screws</Name><Description>Occipital Bone screws with non-anodized heads</Description><Size>6mm – 14mm in 2mm increments</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER767</BillingCode><PriorBillingCodes><PriorBillingCode>HW649</PriorBillingCode></PriorBillingCodes><Name>Tritanium TL</Name><Description>Steerable Posterior Lumbar Cage</Description><Size>Footprints: 27mm x 10mm, 31mm x 10mm, 35mm x 10mm; Height 7mm to 14mm; Angulation 0, 6 and 12 degree</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>265560</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER357</BillingCode><Name>Ulrich Fusion Cages-TLIF</Name><Description>Ulrich Fusion Cages pezo/tezo-TLIF (various shapes), PEEK or Titanium</Description><Size>height (7-14mm) x width (11-16mm) x length (29-34mm) x angle 5°</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>279703</ARTG><ARTG>279705</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER185</BillingCode><Name>SIGNUS POSEIDON/POSEIDON ST Vertebral Body Replacement System-End Plate</Name><Description>SIGNUS POSEIDON/POSEIDON ST End Plate; porous titanium; </Description><Size>Dia (16mm) x (18 mm - 20mm) x (18 mm – 59 mm); lordosis 0°/ 5°/10°/15°/20°</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4138</SubGroupID><ARTGs><ARTG>216750</ARTG></ARTGs><MinimumBenefit>928</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER634</BillingCode><PriorBillingCodes><PriorBillingCode>OF064</PriorBillingCode></PriorBillingCodes><Name>Centurion Cervical Hooks</Name><Description>Cervical Hooks</Description><Size>4.5mm and 6.0mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER542</BillingCode><Name>Tack Endovascular System</Name><Description>The Tack Endovascular System is a dissection repair device that is purpose-built to provide precision treatment of peripheral arterial dissections following balloon angioplasty. </Description><Size>Diameter: 5.7-9.8mm (unconstrained); Diameter treatment range: 1.5-8.0 mm;  Length: ~6-8mm</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>7364</SubGroupID><ARTGs><ARTG>352394</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER338</BillingCode><Name>Ulrich Pedicle Screw System-inline connector</Name><Description>Ulrich Pedicle Screw System (uCentum)-inline connectors, axial or parallel (UU, UC and OC), sterile, pre-assembled with grub screws/corresponding locking set screws. </Description><Size>connecting rods of various diameters in the range of 4.0-6.0 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>442550</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER583</BillingCode><PriorBillingCodes><PriorBillingCode>OF081</PriorBillingCode></PriorBillingCodes><Name>Orthofix Bypass Connector</Name><Description>Offset Connector with Integrated Rod</Description><Size>16mm - 34mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER599</BillingCode><PriorBillingCodes><PriorBillingCode>OF045</PriorBillingCode><PriorBillingCode>AE191</PriorBillingCode></PriorBillingCodes><Name>Construx Mini PEEK VBR System</Name><Description>The Construx Mini is an anterior Cervical Interbody PEEK or Titanium Cage</Description><Size>12mm x 12mm 5 degrees lordotic. 5mm-12mm in 1mm increments. 12mm x 12mm, Parallel. 5mm - 12mm in 1mm increments. 15mm x 12mm, 5/10/15 degrees lordotic. 5mm - 12mm in 1mm increments. 15mm x 12mm, Parallel. 5mm-12mm in 1mm increments        Width 12-17 mm; Length 12-15 mm, Height 5-12 mm, lordosis 0-15 degrees  </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER547</BillingCode><Name>Osteomed ExtremiLock Screw, Mini (2.01 – 2.7 mm), variable angle locking, cannulated, dual thread</Name><Description>variable angle locking screw, cannulated, dual thread</Description><Size>dia 2.4 mm x lenght (12-40 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>337240</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER846</BillingCode><PriorBillingCodes><PriorBillingCode>SR066</PriorBillingCode></PriorBillingCodes><Name>AVS AL PEEK Spacer System</Name><Description>Anterior Lumbar Interbody Fusion Cage</Description><Size>22mm deep x 28mm wide x 10mm - 50mm height and 28mm deep x 33mm wide x 10mm-50mm height.  Both base sizes come in 4 degree and 8 degree angulations</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>315080</ARTG><ARTG>315081</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER746</BillingCode><PriorBillingCodes><PriorBillingCode>HW386</PriorBillingCode></PriorBillingCodes><Name>Xia Spine System</Name><Description>Rod Clamp - Parallel, Axial</Description><Size>One size only</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>279150</ARTG><ARTG>279159</ARTG><ARTG>279160</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER550</BillingCode><Name>Biedermann Motech MOSS Spinal Fixation System-Ti Hooks </Name><Description>Pedicle Hook, Laminar Hook</Description><Size>Various sizes</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>337238</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER332</BillingCode><Name>Ulrich Pedicle Screw System-Pedicle Screw, polyaxial, cannulated</Name><Description>Ulrich Pedicle Screw System (uCentum)-Pedicle Screws (reduction/prefixation/with extended Tabs for MIS)-polyaxial, cannulated, with or without fenestrations, non-sterile or sterile.</Description><Size>dia (4.5-11.5 mm) x length (25-60 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>279706</ARTG><ARTG>442550</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER576</BillingCode><PriorBillingCodes><PriorBillingCode>OF079</PriorBillingCode></PriorBillingCodes><Name>Cetra Bone Scews</Name><Description>Self tapping and self drilling bone screws</Description><Size>Diameter: 4mm-4.5mm  Length:10mm-20mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>195018</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER751</BillingCode><PriorBillingCodes><PriorBillingCode>HW405</PriorBillingCode></PriorBillingCodes><Name>Xia Spine System</Name><Description>Hooks</Description><Size>Laminar and Pedicle Hooks</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>279150</ARTG><ARTG>279159</ARTG><ARTG>279160</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER749</BillingCode><PriorBillingCodes><PriorBillingCode>HW392</PriorBillingCode></PriorBillingCodes><Name>Xia Spine System</Name><Description>Sacral Block</Description><Size>One size only</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>279150</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER725</BillingCode><Name>Microelectrode Cable</Name><Description>Cable used for intracranial recording of neural activity prior to DBS</Description><Size>1.5-3m</Size><SupplierCode>ER</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4479</SubGroupID><ARTGs><ARTG>177947</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER229</BillingCode><Name>SIGNUS Noval Interbody Fusion Cage </Name><Description>SIGNUS Noval Interbody Fusion Cage </Description><Size>height (8-18 mm) x width (40-48 mm)x lordosis (5-15 degrees)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>129772</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER559</BillingCode><Name>Osteomed ExtremiLock Screw, Mini (2.01 – 2.7 mm), standard </Name><Description>Cortex screw</Description><Size>dia (2.4-2.7 mm) x lenth (8-40 mm) </Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>337240</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER624</BillingCode><PriorBillingCodes><PriorBillingCode>OF070</PriorBillingCode></PriorBillingCodes><Name>SKYHAWK Bone Screws</Name><Description>Primary and Rescue Screws</Description><Size>Primary Screw: 5.5 mm diameter,  30mm- 60mm length (in 5mm increments)  Rescue Screw: 6.5 mm diameter, 30mm - 60mm length (in 5mm increments)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER668</BillingCode><Name>FORZA Spacer System-PLIF</Name><Description>FORZA Ti straight or curved spacers, PLIF, paired in various sizes</Description><Size>Profile: (9-11) mm x (23-27) mm  Height:6-14 mm  Lordosis: 0 and 8 degrees</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER561</BillingCode><Name>Osteomed ExtremiLock Screw, Mini (2.01 – 2.7 mm), screw washer</Name><Description>Screw washer</Description><Size>2.4/2.7 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>337240</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER680</BillingCode><Name>LeMaitre Omniflow II Vascular Prosthesis-30-40cm</Name><Description>Omniflow II Vascular Prosthesis, biologically engineered, 30-40 cm, straight </Description><Size>diameter: 5-8 mm  Length: 30-40 cm</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4456</SubGroupID><Suffix>Biologically engineered</Suffix><ARTGs><ARTG>399614</ARTG></ARTGs><MinimumBenefit>1976</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER772</BillingCode><PriorBillingCodes><PriorBillingCode>HW678</PriorBillingCode></PriorBillingCodes><Name>Monterey AL, Cage with integral fixation including screws</Name><Description>ALIF cage with screws for integral fixation</Description><Size>Cage: 10-24mm, Screws: 17.5-30mm Length, 5-6mm Diameter</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>356926</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER538</BillingCode><Name>Signus BIG ST – Lumbar Cage and fixation screws system</Name><Description>ALIF Lumbar Cage and fixation screws</Description><Size>10 – 20mm : 8 deg 12 deg 16deg &amp; 20deg</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>129772</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER509</BillingCode><Name>LeMaitre Xenosure Biologic Patch-Large, &gt;75cm²</Name><Description>The XenoSure Biologic Patch is a high-quality bovine pericardium patch used for vascular and cardiovascular reconstructions.</Description><Size>8 x 14 cm Rectangular Patch
10 x 16 cm Rectangular Patch
12 x 25 cm Rectangular Patch</Size><SupplierCode>ER</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>182</SubCategoryID><GroupID>1507</GroupID><SubGroupID>5454</SubGroupID><ARTGs><ARTG>310096</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER748</BillingCode><PriorBillingCodes><PriorBillingCode>HW391</PriorBillingCode></PriorBillingCodes><Name>Xia Spine System</Name><Description>Connector - Axial, Dual, Offset</Description><Size>4.5mm - 6mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>279150</ARTG><ARTG>279151</ARTG><ARTG>279159</ARTG><ARTG>279160</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER708</BillingCode><Name>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System  - Connector in-line</Name><Description> SIGNUS COSY Cervicothoracic Occipital Rod-Screw System- Connector in-line, parallel, sterile, incl. set screws.</Description><Size>to accomodate 3.5-6.0 mm dia rods</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>464685</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER688</BillingCode><Name>EziSurg easyEndo  staple reloads for linear cutting stapler-straight</Name><Description>easyEndo staple reload cartridges for universal and Lite linear stapler-straight </Description><Size>30, 45, 60 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>431192</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER691</BillingCode><Name>Ezisurg easyEndo powered endoscopic single use stapler- staple reload cartridges</Name><Description>Staple reload cartridges</Description><Size>Anastomosis length 45, 60 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>431192</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER692</BillingCode><Name>EziSurg easyEndo staple reloads for linear cutting stapler-articulating</Name><Description>easyEndo staple reloads for linear cutting stapler-articulating</Description><Size>30, 45, 60 mm </Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>431192</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ738</BillingCode><Name>SIGNUS DIPLOMAT Pedicle Screw System - Offset Connector, incl. set screws</Name><Description>SIGNUS DIPLOMAT Pedicle Screw System - Offset Connector, non-sterile and sterile incl. set screws</Description><Size>dia 5.5 mm x length (15-90 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER790</BillingCode><PriorBillingCodes><PriorBillingCode>HW737</PriorBillingCode><PriorBillingCode>ER031</PriorBillingCode><PriorBillingCode>AJ040</PriorBillingCode></PriorBillingCodes><Name>Pyrenees Cervical Plate System</Name><Description>Cervical Plate</Description><Size>57mm to 110mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER813</BillingCode><PriorBillingCodes><PriorBillingCode>HW762</PriorBillingCode><PriorBillingCode>ER240</PriorBillingCode></PriorBillingCodes><Name>Pyrenees Cervical Plate System-MonoPlate, Long</Name><Description>Pyrenees Cervical Plate System-MonoPlate, Long</Description><Size>Length 56-78 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ138</BillingCode><Name>Evolution Spine EMERGE Plate System- Screws</Name><Description>Evolution Spine EMERGE Plate System- Screws, self-starting and self-drilling</Description><Size>diameter: 3.75-4.25 mm length: 10-26 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>445231</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER694</BillingCode><Name>IntoCare Endoscopic reload</Name><Description>Staple reload, straight or curved for versatility of use. </Description><Size>Staple line length- 30mm/45mm/60mm</Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>389093</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER794</BillingCode><PriorBillingCodes><PriorBillingCode>HW741</PriorBillingCode><PriorBillingCode>ER035</PriorBillingCode><PriorBillingCode>LH465</PriorBillingCode></PriorBillingCodes><Name>Caspian OC screw</Name><Description>The Caspian OC screw is used to fixate the Caspian OC plate to the occiput</Description><Size>4.5mm diameter. 6-16mm length in 1mm increments 5.25mm diameter. 6-16mm length in 1mm increments</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>159828</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER614</BillingCode><Name>Alpha Omega Electrode cable</Name><Description>Alpha Omega Electrode cable, including Input Cable and LeadConfirm cable, sterile; supplied as a single unit or a pack of 3 or 10.</Description><Size>Length: 15-50 cm</Size><SupplierCode>ER</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4479</SubGroupID><ARTGs><ARTG>321642</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER573</BillingCode><PriorBillingCodes><PriorBillingCode>OF013</PriorBillingCode><PriorBillingCode>AE189</PriorBillingCode></PriorBillingCodes><Name>Unity Lumbar Plate</Name><Description>Unity Bone Screw</Description><Size>6-7mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>195018</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER739</BillingCode><PriorBillingCodes><PriorBillingCode>MI238</PriorBillingCode></PriorBillingCodes><Name>Palindrome™ Precision Catheter</Name><Description>Haemodialysis catheter presented in a kit assembly including insertion stylets</Description><Size>14.5 Fr; 19cm-55cm (implant length); 36-72cm overall length with side slots,  symmetric tip</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1651</GroupID><Suffix>cu (cuffed)</Suffix><ARTGs><ARTG>270192</ARTG><ARTG>270194</ARTG></ARTGs><MinimumBenefit>267</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER839</BillingCode><PriorBillingCodes><PriorBillingCode>SK223</PriorBillingCode></PriorBillingCodes><Name>Oasys-Occipito Cervico Thoracic System</Name><Description>Cortical Screws</Description><Size>Dia: 3.5mm x Length: 6mm - 24mm  Dia: 4.0mm x Length: 6mm - 54mm  Dia: 4.5mm x Length: 6mm - 16mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>279144</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER341</BillingCode><Name>Ulrich Pedicle Screw System-Rod, dual diameter</Name><Description>Ulrich Pedicle Screw System (neon3/uCentum)-Rod, hybrid, non-sterile or sterile  </Description><Size>dia 4.0mm/(5.5 mm-6.0) mm, length 200-400 mm;</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>279706</ARTG><ARTG>442550</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER548</BillingCode><Name>Biedermann Motech MOSS Spinal Fixation System-Ti hook bone screw</Name><Description>Bone screw for hook</Description><Size>10.5mm - 13.5mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>337238</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER848</BillingCode><PriorBillingCodes><PriorBillingCode>SR084</PriorBillingCode></PriorBillingCodes><Name>Reflex Anterior Cervical Plate System</Name><Description>Plate</Description><Size>&gt;55mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>278368</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER829</BillingCode><PriorBillingCodes><PriorBillingCode>HW780</PriorBillingCode><PriorBillingCode>ER494</PriorBillingCode></PriorBillingCodes><Name>Ozark Plate Level 1-5 , &gt;55mm</Name><Description>Plate Level 1-5 , &gt;55mm</Description><Size>56-110 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER753</BillingCode><PriorBillingCodes><PriorBillingCode>HW408</PriorBillingCode></PriorBillingCodes><Name>Aviator Anterior Cervical Plating System - Plate</Name><Description>Anterior Cervical Plate - Integral Locking</Description><Size>One, two and three level up to 55mm in length</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>278368</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER798</BillingCode><PriorBillingCodes><PriorBillingCode>HW746</PriorBillingCode><PriorBillingCode>ER052</PriorBillingCode></PriorBillingCodes><Name>Blue Ridge Hybrid Cervical Plate System - Plate</Name><Description>Low profile, anterior cervical plate. Locking,  titanium.</Description><Size>56-92mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>290395</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER613</BillingCode><Name>Alpha Omega Cannula</Name><Description>Alpha Omega Cannula, standard or tapered used for microelectrodes recording (MER) and for lead insertion; stylet, sterile, packed singly or a pack of 10. </Description><Size>Length: 130-216.5 mm  Inner diameter: 0.83-1.6 mm  Outer diameter: 1.23-1.81 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4498</SubGroupID><ARTGs><ARTG>346590</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER358</BillingCode><Name>Ulrich Fusion Cages-PLIF (paired)</Name><Description>Ulrich Fusion Cages pezo/tezo-PLIF, paired, various, PEEK or Titanium</Description><Size>height (7-14mm) x length (24-29mm) x angle (5-12°)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>279703</ARTG><ARTG>279705</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER724</BillingCode><Name>Electrode Insertion Tube Set</Name><Description>Electrode Insertion Tube Set for DBS</Description><Size>15 and 20mm</Size><SupplierCode>ER</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4498</SubGroupID><ARTGs><ARTG>203992</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER207</BillingCode><Name>SIGNUS  Cervical Plating Implant System-Plate</Name><Description>SIGNUS Cervical Plating Implant System-Plate</Description><Size>20-54 mm, in 2-3 mm increments</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>216749</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER173</BillingCode><Name>LifeSpan ePTFE vascular grafts-supported, tapered or end modified 50-80 cm</Name><Description>LifeSpan ePTFE vascular grafts-supported, end modified or tapered, regular or thin wall, 4-7 mm dia x 50-80 cm length; spiral length 5-70 cm</Description><Size>4-7 mm dia x 50-80 cm length; spiral length 5-70 cm</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1639</GroupID><Suffix>R (ringed)</Suffix><ARTGs><ARTG>216528</ARTG></ARTGs><MinimumBenefit>770</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER571</BillingCode><PriorBillingCodes><PriorBillingCode>OF076</PriorBillingCode><PriorBillingCode>OF010</PriorBillingCode><PriorBillingCode>OF023</PriorBillingCode></PriorBillingCodes><Name>Firebird Modular Screws</Name><Description>Modular pedicle screws - shank</Description><Size>Diameter - 4mm -11.5mm   Length - 25mm - 110mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER287</BillingCode><Name>Premia Spine Versalink Fixation System-Ring Nut/set screws</Name><Description>Premia Spine Versalink Fixation System-Nut/set screws</Description><Size>N/A</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>267145</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER141</BillingCode><Name>Signus Pedicle Screw System-Set Screw</Name><Description>Set Screw - as part of Signus Pedicle Screw System Construct</Description><Size>N/A</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>216751</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ742</BillingCode><Name>SIGNUS DIPLOMAT Pedicle Screw System - Set Screw</Name><Description>SIGNUS DIPLOMAT Pedicle Screw System - Set Screw, non-sterile and sterile (x5) </Description><Size>dia 9.7mm x height 4.2mm </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER379</BillingCode><Name>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 1-2 g</Name><Description>Bicon SynthoGraft Pure Phase Beta-Tricalcium Phosphate, 1-2 gram, synthetic</Description><Size>1 and 2 grams, granule size 50-500μm and  500-1000μm</Size><SupplierCode>ER</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4395</SubGroupID><ARTGs><ARTG>230860</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ737</BillingCode><Name>SIGNUS DIPLOMAT Pedicle Screw System - Monoaxial Screw</Name><Description>SIGNUS DIPLOMAT Pedicle Screw System - Monoaxial Screw, non-sterile and sterile (packed with set screw)</Description><Size>dia (5.5-9.5 mm) x length (30-100 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ147</BillingCode><Name>Evolution Spine Whistler Modular Pedicle Screw System-Pedicle Screw Tulip</Name><Description>Evolution Spine Whistler Modular Pedicle Screw System-Pedicle Screw Tulip, polyaxial, standard/MI/reduction</Description><Size>5.5 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>445290</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER745</BillingCode><PriorBillingCodes><PriorBillingCode>HW385</PriorBillingCode></PriorBillingCodes><Name>Xia Spine System</Name><Description>Monoaxial Screw</Description><Size>Dia 4.5 - 8.5mm Length 25 - 60mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>279150</ARTG><ARTG>279159</ARTG><ARTG>279160</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER678</BillingCode><Name>Orthofix Firebird SI Fusion System</Name><Description>Firebird SI Fusion System, cannulated, fenestrated, Ti, sterile</Description><Size>Diameter: 9-12 mm, Length 25-70 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>261</SubCategoryID><GroupID>1821</GroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>405333</ARTG><ARTG>405334</ARTG></ARTGs><MinimumBenefit>1853</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ744</BillingCode><Name>SIGNUS DIPLOMAT Pedicle Screw System –Transverse Connector, adjustable, preassembled with set screws</Name><Description>SIGNUS DIPLOMAT Pedicle Screw System – Cross Connector, adjustable, non-sterile and sterile, preassembled with set screws</Description><Size>extra small, small, medium, large, extra large, (25-61mm x 31-99mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER553</BillingCode><Name>Biedermann Motech MOSS Spinal Fixation System-Ti Polyaxial head</Name><Description>Tulip Screw Head, standard,/reduction,modular</Description><Size>Various sizes  </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>337238</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER714</BillingCode><Name>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Transition Rod</Name><Description>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Transition Rod-straight; non-sterile or sterile</Description><Size>dia (3.5 - 6.0mm) x length (420 - 600mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>464685</ARTG><ARTG>464686</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ741</BillingCode><Name>SIGNUS DIPLOMAT Pedicle Screw System - Screw Head (Tulip)</Name><Description>
SIGNUS DIPLOMAT Pedicle Screw System - Screw Head (Tulip); standard, reduction, percutaneous and lateral; non-sterile and sterile packed with set screw. </Description><Size>dia 12.5 mm x height 14.9-150 mm; lateral tulip width 25 mm x height 15 mm (accommodates 5.5 mm rods)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER727</BillingCode><Name>SIGNUS CYLOX ST Cervical Cage Screws</Name><Description>CYLOX ST dual thread screws (for use with non-integral cage only)-variable or fixed angle, self-tapping or self-drilling</Description><Size>dia: 3.5-4.0 mm; length: 10-18 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>493705</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER580</BillingCode><PriorBillingCodes><PriorBillingCode>OF022</PriorBillingCode><PriorBillingCode>AE145</PriorBillingCode></PriorBillingCodes><Name>Firebird Phoenix screw heads</Name><Description>Modular screw heads; various sizes including reduction heads</Description><Size>Body Top Loading, NXG Body Top Loading, Top loaded Body-Slotted, Body Closed, Body Reduction - All one size only  Body Offset - 8mm, 11mm, 14mm  Short, standard and tall (open and closed)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER318</BillingCode><Name>Ulrich posterior OCT System (neon3)-Rods, occipital</Name><Description>Ulrich posterior OCT System (neon3)-Rods, occipital, various shapes</Description><Size>dia 4 mm x length (240-300 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1480</GroupID><SubGroupID>4133</SubGroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>1350</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER345</BillingCode><Name>Signus Diana SI Joint Fusion Device</Name><Description>The DIANA® sacroiliac fusion device is a titanium alloy, tapered hollow cylindrical implant with radial fenestrations to encourage bony in-growth and a threaded outer surface for fixation and stabilisation of the sacroiliac joint.</Description><Size>Tapered design: dia at wide point (13-21 mm) x dia at narrow point (12-20mm) x length 30mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>261</SubCategoryID><GroupID>1821</GroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>216752</ARTG></ARTGs><MinimumBenefit>1853</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER534</BillingCode><PriorBillingCodes><PriorBillingCode>NW008</PriorBillingCode></PriorBillingCodes><Name>NovaBone Dental Putty</Name><Description>NovaBone® Dental Putty is 100% synthetic and fully resorbable.</Description><Size>CARTRIDGES 2 UNITS X 0.5CC  CARTRIDGES 4 UNITS X 0.25CC  CARTRIDGES 4 UNITS X 0.5CC  SYRINGE, 1 UNIT X  0.5CC</Size><SupplierCode>ER</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4395</SubGroupID><ARTGs><ARTG>242772</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER710</BillingCode><Name>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Occipital Rod</Name><Description>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Occipital Rod-various shapes, non-sterile and sterile, incl. set screws.</Description><Size>dia 3,5 mm; 85 - 300mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1480</GroupID><SubGroupID>4133</SubGroupID><ARTGs><ARTG>464685</ARTG><ARTG>464686</ARTG></ARTGs><MinimumBenefit>1350</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER305</BillingCode><PriorBillingCodes><PriorBillingCode>GO274</PriorBillingCode></PriorBillingCodes><Name>Barricaid</Name><Description>Annular replacement prosthesis</Description><Size>Height: 14mm; Width 8mm, 10mm, 12mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>263</SubCategoryID><GroupID>1823</GroupID><ARTGs><ARTG>273822</ARTG></ARTGs><MinimumBenefit>4954</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER806</BillingCode><PriorBillingCodes><PriorBillingCode>HW754</PriorBillingCode><PriorBillingCode>ER200</PriorBillingCode></PriorBillingCodes><Name>K2M Spinal Systems – Fixed Cross Connector</Name><Description>Fixed Cross Connector</Description><Size>14-60mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>154442</ARTG><ARTG>159828</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER164</BillingCode><PriorBillingCodes><PriorBillingCode>LH389</PriorBillingCode><PriorBillingCode>TB389</PriorBillingCode></PriorBillingCodes><Name>Signus Athlet VBR System - Main Body</Name><Description>Peek Vertebral Body Replacement System (Main body)</Description><Size>12, 18, 24, 30, 36 and 42mm lengths</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1493</GroupID><ARTGs><ARTG>216750</ARTG></ARTGs><MinimumBenefit>3529</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER632</BillingCode><PriorBillingCodes><PriorBillingCode>OF065</PriorBillingCode></PriorBillingCodes><Name>Centurion Cross Connectors</Name><Description>Adjustable Cross Connector</Description><Size>20mm – 50mm in 5mm increments</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER531</BillingCode><PriorBillingCodes><PriorBillingCode>SQ152</PriorBillingCode></PriorBillingCodes><Name>E.SPINE System</Name><Description>TANIT SI Screw, non-sterile or sterile</Description><Size>Diameter: 7mm  Length: 40mm - 120mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>171952</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER791</BillingCode><PriorBillingCodes><PriorBillingCode>HW738</PriorBillingCode><PriorBillingCode>ER032</PriorBillingCode><PriorBillingCode>AJ045</PriorBillingCode></PriorBillingCodes><Name>ARI Anterior Staple System - Staple</Name><Description>A non-cervical anterolateral thoracolumbar screw stabilization as an adjunct to fusion.</Description><Size>Single Hole Design and Dual Hole Design: 13mm, Left &amp; Right; 16mm, Left &amp; Right; 18mm, Left &amp; Right.</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER770</BillingCode><PriorBillingCodes><PriorBillingCode>HW664</PriorBillingCode><PriorBillingCode>SK466</PriorBillingCode><PriorBillingCode>SK476</PriorBillingCode><PriorBillingCode>SK477</PriorBillingCode><PriorBillingCode>SK478</PriorBillingCode></PriorBillingCodes><Name>VITOSS Foam - Compression Resistant Synthetic Cancellous Bone Void Filler</Name><Description>Highly porous bone graft material made from beta-tricalcium phosphate (β-TCP) and Type I bovine collagen</Description><Size>0-5cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4114</SubGroupID><ARTGs><ARTG>322495</ARTG></ARTGs><MinimumBenefit>808</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER519</BillingCode><PriorBillingCodes><PriorBillingCode>EU002</PriorBillingCode></PriorBillingCodes><Name>e.Spine Rod</Name><Description>Spine straight or pre-bend rods</Description><Size>Diameter 5.5mm; Lengths:
Titanium or CoCr Straight rods 40, 50, 60, 70, 80, 90, 110, 130, 160, 220, 440, 500, 600mm;
Titanium Pre-bend rods: 40, 50, 60, 70, 80, 90mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>171952</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER516</BillingCode><PriorBillingCodes><PriorBillingCode>EU004</PriorBillingCode></PriorBillingCodes><Name>e.Spine Transverse Link</Name><Description>Titanium spine transverse link</Description><Size>Lengths 35, 46, 60, 70, 80 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>171952</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ736</BillingCode><Name>SIGNUS DIPLOMAT Deformity System– Transverse connector</Name><Description>SIGNUS DIPLOMAT Deformity System – Transverse connector comprising a cross bar and 2 cross bar clamps incl. grub screws, non-sterile and sterile </Description><Size>4.0x50 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>458188</ARTG><ARTG>458187</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER654</BillingCode><Name>Biocomposites Stimulan Rapid Cure 20 cc</Name><Description>  Calcium Sulfate synthetic rapid setting bone void filler kit  </Description><Size>20 cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><ARTGs><ARTG>391243</ARTG></ARTGs><MinimumBenefit>1425</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER834</BillingCode><PriorBillingCodes><PriorBillingCode>SK185</PriorBillingCode></PriorBillingCodes><Name>VITOSS - Synthetic cancellous bone void filler</Name><Description>Beta-tricalcium phosphate</Description><Size>15cc morsels</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><ARTGs><ARTG>140557</ARTG></ARTGs><MinimumBenefit>1425</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER283</BillingCode><Name>AnastoClip GC</Name><Description>AnastoClip GC</Description><Size>Medium
Large
Extra Large
Medium, with long applier
Large, with long applier
Extra Large, with long applier</Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1771</GroupID><ARTGs><ARTG>278601</ARTG></ARTGs><MinimumBenefit>402</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER558</BillingCode><Name>Osteomed ExtremiLock Plate (≥ 7 to ≤ 15 holes)</Name><Description>VDR Narrow, standard, PQ sparing plates, left or right    </Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>337239</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER197</BillingCode><PriorBillingCodes><PriorBillingCode>TM049</PriorBillingCode></PriorBillingCodes><Name>Anastoclips</Name><Description>Vessel Closure System (VCS) (8 and 15 cm shaft)</Description><Size>Small, Medium, Large, Extra Large</Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1771</GroupID><ARTGs><ARTG>120976</ARTG></ARTGs><MinimumBenefit>402</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER640</BillingCode><PriorBillingCodes><PriorBillingCode>OF062</PriorBillingCode></PriorBillingCodes><Name>Centurion Rods</Name><Description>Titanium or Cobalt Chrome Rods and Transition Rods</Description><Size>3.5mm diameter and 70mm, 120mm, and 200mm in length (Rods)  3.5mm – 5.5mm and 200/200mm, 200/300mm and 300/300mm in length (Transition Rods)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ740</BillingCode><Name>SIGNUS DIPLOMAT Pedicle Screw System - Rod-Straight or Curved</Name><Description>SIGNUS DIPLOMAT Pedicle Screw System - Rod-Straight or Curved, non-sterile or sterile  </Description><Size>dia 5.5 mm x length (30-150 mm)  dia 5.5 mm x length (150/200/250/300/500 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER543</BillingCode><Name>Osteomed ExtremiLock Plate (≤ 6 holes)</Name><Description>VDR Radial/Intermediate Column; Standard; Left or Right and Styloid Plates; 6 hole  </Description><Size>6 holes</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>337239</ARTG></ARTGs><MinimumBenefit>1372</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER340</BillingCode><Name>Ulrich Pedicle Screw System-Locking cap</Name><Description>Ulrich Pedicle Screw System (uCentum/uBase)-Locking cap assembly (dual innie screw, nut, washer)</Description><Size>one size</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1468</GroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>560</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER675</BillingCode><Name>SIGNUS ROTAIO</Name><Description>Cervical Disc Prosthesis</Description><Size>Footprint: width × depth (mm): 15×13; 17×13; 17×15, 19×15  Height: 5-6 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5487</SubGroupID><ARTGs><ARTG>216748</ARTG></ARTGs><MinimumBenefit>6021</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER816</BillingCode><PriorBillingCodes><PriorBillingCode>HW765</PriorBillingCode><PriorBillingCode>ER243</PriorBillingCode></PriorBillingCodes><Name>MESA Rail</Name><Description>CoCr and Ti shaped beam rail rods</Description><Size>Diameter: 4.5-5.5mm Length: 375-500mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER841</BillingCode><PriorBillingCodes><PriorBillingCode>SK227</PriorBillingCode></PriorBillingCodes><Name>Oasys-Occipito Cervico Thoracic System</Name><Description>Connector - Transverse; Offset; Cross; Rod to Rod; Axial</Description><Size>For rod diameters from 3.5mm to 6mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>279144</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER554</BillingCode><Name>Biedermann Motech MOSS Spinal Fixation System-Ti Cross Connector  </Name><Description>Adjustable Cross Connector, compatible with dia 5.5 mm and 6.0 mm MOSS Rods  </Description><Size>70mm - 110mm  </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>337238</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ145</BillingCode><Name>Evolution Spine Whistler Modular Pedicle Screw System-Locking Cap</Name><Description>Evolution Spine Whistler Modular Pedicle Screw System-Locking Cap, solid or cannulated</Description><Size>for 5.5 or 6.0 mm rods</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>445290</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER334</BillingCode><Name>Ulrich Pedicle Screw System-Rods</Name><Description>Ulrich Pedicle Screw System (uCentum)-Rods, straight, curved , open or percutaneous, sterile or non-sterile. Rods 200-500 mm in length can be used for scoliosis correction.</Description><Size>dia 5.5-6.0 mm x length (30-500 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>279706</ARTG><ARTG>442550</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER831</BillingCode><PriorBillingCodes><PriorBillingCode>JV001</PriorBillingCode></PriorBillingCodes><Name>Everest</Name><Description>Breakoff Set Screw</Description><Size>One size only</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER707</BillingCode><Name>COSY Cervicothoracic Occipital Rod-Screw System  - Set Screw for use with pedicle screws</Name><Description>SIGNUS COSY cervical occipital screw System - Set Screw; non-sterile or sterile.</Description><Size>dia 6.1 mm x 2.8 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>464685</ARTG><ARTG>464686</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER577</BillingCode><PriorBillingCodes><PriorBillingCode>OF016</PriorBillingCode><PriorBillingCode>AE163</PriorBillingCode></PriorBillingCodes><Name>Spinal Fixation System</Name><Description>Set Screw Spinal System</Description><Size>One size only</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER339</BillingCode><Name>Ulrich Pedicle Screw System-Offset connector</Name><Description>Ulrich Pedicle Screw System (uCentum)-Offset connector, incl. set screws, non-sterile or sterile (packed with set screws)</Description><Size>for dia 6mm x length (15-100 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>279706</ARTG><ARTG>442550</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER514</BillingCode><PriorBillingCodes><PriorBillingCode>EU017</PriorBillingCode></PriorBillingCodes><Name>e.Spine locking screw</Name><Description>Titanium locking screw for e.Spine hooks and e.Spine pedicular screws</Description><Size>One size</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>171952</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER832</BillingCode><PriorBillingCodes><PriorBillingCode>SK112</PriorBillingCode></PriorBillingCodes><Name>XIA/Oasys Spine System</Name><Description>Buttress thread locking nut</Description><Size>3.5mm - 6mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>278581</ARTG><ARTG>279144</ARTG><ARTG>279159</ARTG><ARTG>279160</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER627</BillingCode><PriorBillingCodes><PriorBillingCode>OF061</PriorBillingCode></PriorBillingCodes><Name>Centurion Set Screw</Name><Description>Universal set screw</Description><Size>One size only</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER628</BillingCode><PriorBillingCodes><PriorBillingCode>OF071</PriorBillingCode></PriorBillingCodes><Name>SKYHAWK Set Screw</Name><Description>Set Screw for SKYHAWK Lateral Interbody Fusion System</Description><Size>One size only</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ760</BillingCode><Name>SIGNUS DIPLOMAT Deformity – Shear Nut</Name><Description>SIGNUS DIPLOMAT Deformity – Shear nut, non-sterile</Description><Size>N/A</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>458188</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER690</BillingCode><Name>Ezisurg easyEndo endoscopic linear cutting staplers for single use</Name><Description>Ezisurg easyEndo endoscopic universal and lite disposable linear cutting staplers. </Description><Size>70-440 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>355633</ARTG></ARTGs><MinimumBenefit>357</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER552</BillingCode><Name>Biedermann Motech MOSS Spinal Fixation System-Ti Lock Screw</Name><Description>Lock Screw  </Description><Size>Various sizes</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>337238</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER756</BillingCode><PriorBillingCodes><PriorBillingCode>HW483</PriorBillingCode></PriorBillingCodes><Name>ES2 Spinal System, Rod</Name><Description>Hex end rods</Description><Size>5.5mm x 20 - 600mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>278581</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER823</BillingCode><PriorBillingCodes><PriorBillingCode>HW774</PriorBillingCode><PriorBillingCode>ER475</PriorBillingCode></PriorBillingCodes><Name>KEYS Anterior Staple</Name><Description>Staple</Description><Size>13-18mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER803</BillingCode><PriorBillingCodes><PriorBillingCode>HW751</PriorBillingCode><PriorBillingCode>ER213</PriorBillingCode></PriorBillingCodes><Name>K2M Spinal Systems Set Screws</Name><Description>Set Screw</Description><Size>Diameter: 5-9mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>154442</ARTG><ARTG>159828</ARTG><ARTG>293862</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER805</BillingCode><PriorBillingCodes><PriorBillingCode>HW753</PriorBillingCode><PriorBillingCode>ER176</PriorBillingCode></PriorBillingCodes><Name>Santorini Stackable Corpectomy Cage-Medium/Large</Name><Description>Corpectomy Cage, Peek </Description><Size>(16x20) or (21x25)mm footprint x (2-98)mm height</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1493</GroupID><ARTGs><ARTG>204117</ARTG></ARTGs><MinimumBenefit>3529</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER353</BillingCode><Name>Ulrich Anterior Distraction Device System (ADDplus)-Locking Screw</Name><Description>Ulrich Anterior Distraction Device System (ADDplus)-Locking Screw</Description><Size>one size</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>279702</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER168</BillingCode><Name>LifeSpan ePTFE vascular grafts-straight, regular or thin wall-10cm</Name><Description>LifeSpan ePTFE vascular grafts-straight, regular or thin wall-5-8 mm dia x length 10cm</Description><Size>5-8 mm dia x 10 cm long</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4454</SubGroupID><ARTGs><ARTG>216528</ARTG></ARTGs><MinimumBenefit>221</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER319</BillingCode><Name>Ulrich posterior OCT System (neon3)-Rods</Name><Description>Ulrich posterior OCT System (neon3)-Rods, Titanium or Co-CR, straight or curved</Description><Size>dia 4 mm x length (20-400 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER593</BillingCode><PriorBillingCodes><PriorBillingCode>OF083</PriorBillingCode></PriorBillingCodes><Name>Orthofix Z Rod</Name><Description>Pre-bent Z Rod</Description><Size>Standard, 16mm, 18mm Offset  150mm X150mm, 150mm X 300mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER331</BillingCode><Name>Ulrich Pedicle Screw System-Pedicle Screw, monoaxial</Name><Description>Ulrich Pedicle Screw System (uCentum)-Pedicle Screw, monoaxial, standard or long arm, sterile and non-sterile</Description><Size>dia (4.5-10 mm) x length (25-60 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>442550</ARTG><ARTG>279706</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER615</BillingCode><PriorBillingCodes><PriorBillingCode>OF005</PriorBillingCode><PriorBillingCode>AE141</PriorBillingCode></PriorBillingCodes><Name>Firebird mono axial screws</Name><Description>Firebird mono axial pedicle screws in various diameters and lengths. Titanium.</Description><Size>4.0, 4.5, 5.5, 6.5, 7.5. 8.5; 25mm-100mm in 5mm increments</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER774</BillingCode><PriorBillingCodes><PriorBillingCode>HW721</PriorBillingCode><PriorBillingCode>ER010</PriorBillingCode><PriorBillingCode>AJ011</PriorBillingCode></PriorBillingCodes><Name>K2M Spinal Systems</Name><Description>Offset connectors, Open or Closed</Description><Size>Length: 10mm - 100mm, Degree connector angle: -15 - +15</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>154442</ARTG><ARTG>159828</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER330</BillingCode><Name>Ulrich Pedicle Screw System-Pedicle Screw, monoaxial, cannulated</Name><Description>Ulrich Pedicle Screw System (cosmicMIA, uCentum)-Pedicle Screw, monoaxial, cannulated, with or without HA coating or fenestrations, sterile or non-sterile</Description><Size>dia (4.5-10 mm) x length (25-60 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>279706</ARTG><ARTG>442550</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ762</BillingCode><Name>SIGNUS DIPLOMAT FT Pedicle Screw System-Monoaxial Screw</Name><Description>SIGNUS DIPLOMAT FT Pedicle Screw System-Monoaxial Screw- cannulated, non-sterile and sterile</Description><Size>Diameter 5.5-9.5 mm Length 30-100 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER730</BillingCode><Name>SIGNUS CYLOX ST locking screw </Name><Description>CYLOX ST locking screw for non-integral fixation cage plate</Description><Size>dia 3.0 mm, length 4.5/9.0 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>493705</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER804</BillingCode><PriorBillingCodes><PriorBillingCode>HW752</PriorBillingCode><PriorBillingCode>ER175</PriorBillingCode></PriorBillingCodes><Name>Santorini Stackable Corpectomy Cage-Small</Name><Description>Corpectomy Cage, Peek  </Description><Size>(12x17)mm footprint x (2-62)mm height</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1493</GroupID><ARTGs><ARTG>204117</ARTG></ARTGs><MinimumBenefit>3529</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER139</BillingCode><Name>Signus Pedicles Screw System - Rod</Name><Description>Titanium Rod- as part of the Signus Pedicle Screw System Construct</Description><Size>6.0mm x 30mm - 100mm in 5mm increments 6.0mm x 108mm - 204mm in 12 mm increments</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>216751</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER695</BillingCode><Name>IntoCare Endostapler, including handle </Name><Description>Endoscopic articulated stapler, inclusive of handle</Description><Size>65-250 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix><ARTGs><ARTG>389093</ARTG><ARTG>389152</ARTG></ARTGs><MinimumBenefit>447</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER641</BillingCode><PriorBillingCodes><PriorBillingCode>OF063</PriorBillingCode></PriorBillingCodes><Name>Centurion Occipital Rods</Name><Description>Titanium or Cobalt Chrome Occipital Rod</Description><Size>3.5mm, 110°, 120°, 135°</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER313</BillingCode><Name>Ulrich posterior OCT System (neon3)-Locking Screw</Name><Description>Ulrich posterior OCT System (neon3)-Locking Screw, nut</Description><Size>N/A</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER731</BillingCode><PriorBillingCodes><PriorBillingCode>JZ001</PriorBillingCode></PriorBillingCodes><Name>Wallaby Avenir Coil System</Name><Description>Platinum alloy coils attached to an implant delivery pusher which delivers the coil to the treatment site.  The pusher has a platinum iridium marker band to visualise coil position within a standard microcatheter which also has a radiopaque marker.</Description><Size>Diameter: 1mm - 25mm  Length: 1cm - 60cm</Size><SupplierCode>ER</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1688</GroupID><ARTGs><ARTG>389092</ARTG></ARTGs><MinimumBenefit>1043</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER732</BillingCode><PriorBillingCodes><PriorBillingCode>KA001</PriorBillingCode></PriorBillingCodes><Name>Tenckhoff Peritoneal Catheters</Name><Description>Tenckhoff Peritoneal Dialysis Catheters - includes a variety of catheter lengths and cuff placements </Description><Size>41cm to 47cm length</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>215</SubCategoryID><GroupID>1654</GroupID><ARTGs><ARTG>178936</ARTG><ARTG>179006</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER335</BillingCode><Name>Ulrich Pedicle Screw System-Locking screws</Name><Description>Ulrich Pedicle Screw System (uCentum)-Locking screws, sterile and non-sterile</Description><Size>Diameter 9.9 mm, height 4.6 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>279706</ARTG><ARTG>442550</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER742</BillingCode><PriorBillingCodes><PriorBillingCode>MI319</PriorBillingCode><PriorBillingCode>KA004</PriorBillingCode><PriorBillingCode>KA005</PriorBillingCode></PriorBillingCodes><Name>Swan Neck Peritoneal Catheter</Name><Description>Swan Neck Peritoneal Dialysis Catheters - includes catheter options: Tenckhoff, Curl Cath and Presternal</Description><Size>43cm to 113cm length</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>215</SubCategoryID><GroupID>1654</GroupID><ARTGs><ARTG>179006</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER734</BillingCode><PriorBillingCodes><PriorBillingCode>KA006</PriorBillingCode></PriorBillingCodes><Name>Curl Cath Peritoneal Catheter</Name><Description>Curl Cath Peritoneal Dialysis Catheters - includes a variety of catheter lengths and cuff placements </Description><Size>57cm to 62cm length</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>215</SubCategoryID><GroupID>1654</GroupID><ARTGs><ARTG>178936</ARTG><ARTG>179006</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER761</BillingCode><PriorBillingCodes><PriorBillingCode>HW581</PriorBillingCode></PriorBillingCodes><Name>ES2 Augmentable Monoaxial Screw</Name><Description>Fenestrated Cannulated Monoaxial Screw</Description><Size>Dia 5.5mm to 7.5mm, length 30mm to 90mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>315418</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER733</BillingCode><PriorBillingCodes><PriorBillingCode>KA002</PriorBillingCode></PriorBillingCodes><Name>Paediatric Peritoneal Catheter</Name><Description>Paediatric Peritoneal Dialysis Catheters - includes catheter options: Tenckhoff, Curl Cath, Swan Neck</Description><Size>31cm to 42cm length</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>215</SubCategoryID><GroupID>1654</GroupID><ARTGs><ARTG>179006</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER755</BillingCode><PriorBillingCodes><PriorBillingCode>HW445</PriorBillingCode></PriorBillingCodes><Name>Oasys-Occipito Cervico Thoracic System (Saddle)</Name><Description>Saddle Connector</Description><Size>one size only</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1466</GroupID><ARTGs><ARTG>279144</ARTG></ARTGs><MinimumBenefit>179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER689</BillingCode><Name>Ezisurg easyEndo E-lite single use powered endoscopic linear stapler</Name><Description>Ezisurg easyEndo E-lite powered endoscopic linear stapler, single use</Description><Size>Anastomosis length 45, 60 mm       Shaft length 160-340mm (overall length 260-440mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix><ARTGs><ARTG>431191</ARTG></ARTGs><MinimumBenefit>447</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER769</BillingCode><PriorBillingCodes><PriorBillingCode>HW655</PriorBillingCode></PriorBillingCodes><Name>Xia Spine System</Name><Description>Transition Rods</Description><Size>4.5 mm transitioning to 5.5mm and 6.0mm.   Titanium Alloy and Vitallium</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>279160</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER799</BillingCode><PriorBillingCodes><PriorBillingCode>HW747</PriorBillingCode><PriorBillingCode>ER137</PriorBillingCode></PriorBillingCodes><Name>Chesapeake Cervical</Name><Description>Cage Ti with integral fixation with screws</Description><Size>Cages: Height: 5mm - 10mm, Screws: Diameter: 3.5mm - 3.85mm. Lengths: 12mm to 18mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>159146</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER743</BillingCode><Name>Evolution Spine E3D-C integrated cervical fusion cage </Name><Description> Evolution Spine E3D-C integrated cervical fusion cage with two screws or two anchors and an optional cover plate.</Description><Size>Cage: (12-16) mm x (14-18) mm; height 5-12 mm; lordosis 7-15 degrees; Screw: dia: 3.5-4.0 mm; ; length: 10-20 mm; Anchor: 10-18 mm.</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>489965</ARTG><ARTG>490206</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER320</BillingCode><Name>Ulrich posterior OCT System (neon3)-Plate-rod</Name><Description>Ulrich posterior OCT System (neon3)-Occipital plate, lateral, with rod</Description><Size>One size</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>171</SubCategoryID><GroupID>1481</GroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>1905</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER802</BillingCode><PriorBillingCodes><PriorBillingCode>HW750</PriorBillingCode><PriorBillingCode>ER174</PriorBillingCode></PriorBillingCodes><Name>Nile Alternative Fixation System - Tether, Connector, Set Screws</Name><Description>Woven Braid, polyester; Clamp, Titanium; Set Screw, Titanium</Description><Size>(3-4)mm width, 60cm strap length, (50-110)mm leader, Size 20 </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1816</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>757</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER793</BillingCode><PriorBillingCodes><PriorBillingCode>HW740</PriorBillingCode><PriorBillingCode>ER034</PriorBillingCode><PriorBillingCode>LH464</PriorBillingCode></PriorBillingCodes><Name>K2M Spinal Systems- Occipital Plate</Name><Description>Occipital Plate for posterior occipital/cervical/thoracic fixation</Description><Size>24-50mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>159828</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER738</BillingCode><PriorBillingCodes><PriorBillingCode>MI229</PriorBillingCode></PriorBillingCodes><Name>Mahurkar Elite Triple Lumen Catheter Kit</Name><Description>Triple Lumen Catheter  Straight/Curved/Pre-Curved Exten.</Description><Size>12Fr, 12.5Fr; 13-30 cm</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1651</GroupID><ARTGs><ARTG>180135</ARTG></ARTGs><MinimumBenefit>103</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER729</BillingCode><Name>SIGNUS CYLOX ST Integrated Cervical Cage </Name><Description>CYLOX ST Integrated cage, stand-alone straight or angled; with screws (single/double thread, self-drilling/self- tapping, fixed and variable angle)
 </Description><Size>Cage: (5-11 mm) x (15-20 mm) x (12-16 mm); 0-12 degrees; Screws: Dia: 3.5-4.0 mm; Length: 10-18 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>493705</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER715</BillingCode><Name>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System- Cross Connector</Name><Description>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System- Cross Connector, adjustable; sterile, incl. set screws (non-sterile or sterile)</Description><Size>dia 3.5 mm; length adjustable from (22-44) mm to (30-52) mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>464685</ARTG><ARTG>464686</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER822</BillingCode><PriorBillingCodes><PriorBillingCode>HW773</PriorBillingCode><PriorBillingCode>ER474</PriorBillingCode></PriorBillingCodes><Name>KEYS Supplemental Screw</Name><Description>Dual lead thread bone screw</Description><Size>5.5 - 6.0mm diameter, length 20-40mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER683</BillingCode><Name>RapidPort EZ Access Port Kit (replacement port)</Name><Description>Access Port Kit for LAP-BAND RapidPort EZ system, inclusive of accessories, i.e: needle-Band priming; needle- access port flushing (5”); molded end plug- Lap-Band; connector, tubing; tubin-silicone, 6% BaSO4; access port needle (3.5”).  </Description><Size>one size</Size><SupplierCode>ER</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1779</GroupID><ARTGs><ARTG>375519</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER165</BillingCode><PriorBillingCodes><PriorBillingCode>LH397</PriorBillingCode><PriorBillingCode>TB397</PriorBillingCode></PriorBillingCodes><Name>Signus Athlet VBR System - End Body</Name><Description>Peek Vertebral Body Replacement System (End body)</Description><Size>4, 6, 8mm heights</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1493</GroupID><ARTGs><ARTG>216750</ARTG></ARTGs><MinimumBenefit>3529</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER771</BillingCode><PriorBillingCodes><PriorBillingCode>HW665</PriorBillingCode><PriorBillingCode>SK467</PriorBillingCode><PriorBillingCode>SK479</PriorBillingCode></PriorBillingCodes><Name>VITOSS Foam - Compression Resistant Synthetic Cancellous Bone Void Filler</Name><Description>Highly porous bone graft material made from beta-tricalcium phosphate (β-TCP) and Type I bovine collagen.</Description><Size>&gt;5cc - 10cc</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4115</SubGroupID><ARTGs><ARTG>322495</ARTG></ARTGs><MinimumBenefit>1889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER386</BillingCode><Name>Hintermann Series H3™ Total Ankle Prosthesis-Screw</Name><Description>Hintermann Series H3™ Total Ankle Prosthesis-Screw, cortical, stainless steel</Description><Size>dia 3.5 mm x length (12-42 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>289320</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER792</BillingCode><PriorBillingCodes><PriorBillingCode>HW739</PriorBillingCode><PriorBillingCode>ER033</PriorBillingCode><PriorBillingCode>AJ046</PriorBillingCode></PriorBillingCodes><Name>ARI Anterior Staple System - Washer</Name><Description>The ARI Anterior Staple System - washer</Description><Size>One size only</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1482</GroupID><ARTGs><ARTG>154442</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER337</BillingCode><Name>Ulrich Pedicle Screw System-Transverse connectors, adjustable</Name><Description>Ulrich Pedicle Screw System (uCentum)-crosslink connectors, adjustable, with or without hook, supplied pre-assembled with grub screws, sterile or non-sterile</Description><Size>closed (35-92) mm x open (43-107 mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>279706</ARTG><ARTG>442550</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER595</BillingCode><PriorBillingCodes><PriorBillingCode>OF054</PriorBillingCode></PriorBillingCodes><Name>Lonestar Cervical Stand Alone System Cage</Name><Description>The Lonestar Cervical Stand Alone device is a stand-alone cervical cage system consisting of cages, screws and a anti-backout cover plate. The Lonestar is manufactured from PEEK and Titanium with Titanium Bone Screws.</Description><Size>Cage: 15-17mm x 13-15mmx6-9 mm; 7 degrees; Cover Plate: 9.9x5.1 mm; Bone Screw: dia 3.6-4.0mmx Length 12-16 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>206571</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER578</BillingCode><PriorBillingCodes><PriorBillingCode>OF020</PriorBillingCode><PriorBillingCode>AE190</PriorBillingCode></PriorBillingCodes><Name>Unity Lumbar Plate</Name><Description>Unity Cover Plate</Description><Size>17-28mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1467</GroupID><ARTGs><ARTG>195018</ARTG></ARTGs><MinimumBenefit>391</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER594</BillingCode><PriorBillingCodes><PriorBillingCode>OF072</PriorBillingCode><PriorBillingCode>OF041</PriorBillingCode><PriorBillingCode>OF042</PriorBillingCode></PriorBillingCodes><Name>Blackstone Washers</Name><Description>Titanium</Description><Size>2mm, 3mm, 4mm, 5mm, 6mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1482</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER285</BillingCode><Name>Premia Spine Versalink Fixation System-Rods (shaped)</Name><Description>Premia Spine Versalink Fixation System-Rods (shaped)</Description><Size>offset and angle (0-30 degrees), length (40-90) mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>267145</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER758</BillingCode><PriorBillingCodes><PriorBillingCode>HW518</PriorBillingCode></PriorBillingCodes><Name>AVS Anchor C Cervical Cage System</Name><Description>Cervical Cage with integrated screws</Description><Size>Cages: 12 x 14mm, 14 x 16mm, height range ; 6mm-12 mm.) 0, 4 and 8 degree angulation, Screws: Diameter 3.5-4mm Length 8-14mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>315081</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER316</BillingCode><Name>Ulrich posterior OCT System (neon3)-Connector, transverse</Name><Description>Ulrich posterior OCT System (neon3)- Crosslink, adjustable, screw to screw and rod to rod</Description><Size>length adjustable within range of 34-50 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER709</BillingCode><Name>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Occipital Plate</Name><Description>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Occipital Plate; non-sterile or sterile, incl. set screws</Description><Size>32x56 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>464685</ARTG><ARTG>464686</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER592</BillingCode><PriorBillingCodes><PriorBillingCode>OF073</PriorBillingCode><PriorBillingCode>OF034</PriorBillingCode><PriorBillingCode>OF035</PriorBillingCode><PriorBillingCode>OF036</PriorBillingCode><PriorBillingCode>OF039</PriorBillingCode></PriorBillingCodes><Name>Firebird Rods</Name><Description>Firebird Rods - straight and pre-lordosed, titanium and CoCr</Description><Size>35mm-600mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER781</BillingCode><PriorBillingCodes><PriorBillingCode>HW728</PriorBillingCode><PriorBillingCode>ER019</PriorBillingCode><PriorBillingCode>AJ027</PriorBillingCode></PriorBillingCodes><Name>K2M Spinal Systems</Name><Description>Transverse Connector</Description><Size>3.5 – 5.5mm rod /rail diameter 14 - 93mm width</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>154442</ARTG><ARTG>159828</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER842</BillingCode><PriorBillingCodes><PriorBillingCode>SK241</PriorBillingCode></PriorBillingCodes><Name>Xia Spinal System</Name><Description>Titanium or Stainless Steel Cross Connector</Description><Size>15-20mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>279150</ARTG><ARTG>279151</ARTG><ARTG>279160</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER415</BillingCode><Name>Bicon Dental Implant System-Abutment, Permanent</Name><Description>Bicon Dental Implant System permanent abutment, universal, Ti, various profiles</Description><Size>diameter (4-7.5mm) (post (2-3mm), angle 0˚ and 15˚, height (1-12mm)</Size><SupplierCode>ER</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4385</SubGroupID><ARTGs><ARTG>158187</ARTG><ARTG>160010</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER788</BillingCode><PriorBillingCodes><PriorBillingCode>HW735</PriorBillingCode><PriorBillingCode>ER027</PriorBillingCode><PriorBillingCode>AJ036</PriorBillingCode></PriorBillingCodes><Name>Caspian OCT Spinal System - Rod</Name><Description>cervico-thoracic posterior rigid fixation system - Rod</Description><Size>Diameter: 3.5mm Length: 1.80mm - 240mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>159828</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER582</BillingCode><PriorBillingCodes><PriorBillingCode>OF080</PriorBillingCode></PriorBillingCodes><Name>Orthofix Offset Connectors</Name><Description>Side/Top Loading, Side/Side Loading, Side/Front Loading, Front/Front Loading, Small Side/Front Loading</Description><Size>Standard, 16mm and 18mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER747</BillingCode><PriorBillingCodes><PriorBillingCode>HW390</PriorBillingCode></PriorBillingCodes><Name>XIA Spine System</Name><Description>Cross Link</Description><Size>Length 20mm - 99mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>279150</ARTG><ARTG>279151</ARTG><ARTG>279159</ARTG><ARTG>279160</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ148</BillingCode><Name>Evolution Spine Whistler Modular Pedicle Screw System-Rods</Name><Description>Evolution Spine Whistler Modular Pedicle Screw System-Rods, straight, bent, bullet-nosed, Ti or CoCr</Description><Size>Diameter: 5.5 or 6.0 mm Length: 30-500 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>445291</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER657</BillingCode><Name>Biedermann Motech MOSS Spinal Fixation System-Ti Cross Connector-adjustable    </Name><Description>Biedermann Motech MOSS Spinal Fixation System-Ti Cross Connector-adjustable, compatible with dia 5.5 mm and 6.0 mm MOSS Rods   </Description><Size>35-100 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>337238</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER780</BillingCode><PriorBillingCodes><PriorBillingCode>HW727</PriorBillingCode><PriorBillingCode>ER018</PriorBillingCode><PriorBillingCode>AJ026</PriorBillingCode></PriorBillingCodes><Name>Mesa/Denali/Everest Rod</Name><Description>Straight and Contoured, CoCr, Ti Rods</Description><Size>Length: 25mm - 600 mm; Diameter: 3.5mm - 6.5 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>154442</ARTG><ARTG>159828</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER584</BillingCode><PriorBillingCodes><PriorBillingCode>OF025</PriorBillingCode><PriorBillingCode>AE159</PriorBillingCode></PriorBillingCodes><Name>Spinal Fixation System</Name><Description>Multi Axial Cross Connector Assembly – Titanium/Lateral Offset</Description><Size>5.5mm-80mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER706</BillingCode><Name>SIGNUS COSY Cervicothoracic Occipital Rod-Screw System - Rod, shaped</Name><Description>Occiput rod, shaped, sterile and non-sterile</Description><Size>dia3.5x300mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>464685</ARTG><ARTG>464686</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER741</BillingCode><PriorBillingCodes><PriorBillingCode>MI242</PriorBillingCode></PriorBillingCodes><Name>Mahurkar Elite High Flow Dual Lumen Catheter Kit</Name><Description>Mahurkar Elite High Flow Dual Lumen Catheter Kit</Description><Size>13.5 Fr, 13cm-30cm, Straight/Curved/PreCurved Exten.</Size><SupplierCode>ER</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1651</GroupID><ARTGs><ARTG>180135</ARTG></ARTGs><MinimumBenefit>103</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER637</BillingCode><PriorBillingCodes><PriorBillingCode>OF067</PriorBillingCode></PriorBillingCodes><Name>Centurion Occipital Plate</Name><Description>Occipital Plate</Description><Size>20-30mm Rod Spacing  30- 40mm Rod Spacing  40-50mm Rod Spacing</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>195012</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER768</BillingCode><PriorBillingCodes><PriorBillingCode>HW654</PriorBillingCode></PriorBillingCodes><Name>OASYS Spine System</Name><Description>Transition Rods</Description><Size>3.5mm transitioning to 4.5mm, 5.5mm and 6.0mm.  Ti Alloy and Vitallium</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>279144</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER549</BillingCode><Name>Biedermann Motech MOSS Spinal Fixation System-Rod </Name><Description>Rod, Ti or CoCr, straight or curved, bullet or hexagonal end </Description><Size>Ø4.5mm -Ø6.0mm diameter, 30 - 600mm length, Ti and CoCr  </Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>337238</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ734</BillingCode><Name>SIGNUS DIPLOMAT Deformity – Rod</Name><Description>SIGNUS DIPLOMAT Deformity System – Rod, non-sterile and sterile  </Description><Size>5.5x500 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>458187</ARTG><ARTG>458188</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER322</BillingCode><Name>Ulrich posterior OCT System (neon3)-Plate</Name><Description>Ulrich posterior OCT System (neon3)-Plate, occipital, midline for occipital and standard rod (4 mm).</Description><Size>47,57 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>279706</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER754</BillingCode><PriorBillingCodes><PriorBillingCode>HW409</PriorBillingCode></PriorBillingCodes><Name>Aviator Anterior Cervical Plating System - Screw</Name><Description>Anterior Cervical Plate System - Screw</Description><Size>4 - 4.35mm diameter, 10 - 18mm length</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>278368</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER140</BillingCode><Name>Signus Pedical Screw System-Cross Link</Name><Description>Cross Link-as part of Signus Pedicle Screw System Construct</Description><Size>MP 0150-0038-38 mm; MP-0150-0042-42 mm;MP-0150-0050-50 mm</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>216751</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER851</BillingCode><PriorBillingCodes><PriorBillingCode>HW783</PriorBillingCode><PriorBillingCode>ER555</PriorBillingCode></PriorBillingCodes><Name>Yukon Head to Head Connectors</Name><Description>Head to Head Transverse Connector, with Nut and Set Screw</Description><Size>Small, Medium, Large and Extra Large</Size><SupplierCode>ER</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>159828</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ER507</BillingCode><Name>LeMaitre Xenosure Biologic Patch-Small, &lt; 25cm²</Name><Description>The XenoSure Biologic Patch is a high-quality bovine pericardium
patch used for vascular and cardiovascular reconstructions.</Description><Size>0.8 x 8 cm Tapered Patch
  1 x 6 cm   Rounded Patch
  1 x 10 cm Tapered Patch
  1.5 x 10 cm Tapered Patch
  1 x 14 cm Tapered Patch
  2 x 9 cm Rounded Patch
  4 x 4 cm Square Patch
  4 x 6 cm Rectangular Patch</Size><SupplierCode>ER</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>182</SubCategoryID><GroupID>1507</GroupID><SubGroupID>5452</SubGroupID><ARTGs><ARTG>310096</ARTG></ARTGs><MinimumBenefit>333</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET055</BillingCode><PriorBillingCodes><PriorBillingCode>ED006</PriorBillingCode></PriorBillingCodes><Name>Memokath Ureteric Stent</Name><Description>Memokath Model 051CW.</Description><Size>30mm - 200mm</Size><SupplierCode>ET</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5323</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>141654</ARTG></ARTGs><MinimumBenefit>2996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET066</BillingCode><Name>Insorb Subcuticular Stapler</Name><Description>A subcuticular (dermal) surgical delivery system loaded with resorbable staples/prostheses</Description><Size>Each staple is 5mm x 3mm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><ARTGs><ARTG>178665</ARTG></ARTGs><MinimumBenefit>292</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET065</BillingCode><Name>HAL-RAR</Name><Description>HAL-Ligating Suture, AMI HAL-Ligating suture, prosthetic component of AMI HAL-RAR Doppler System</Description><Size>One size</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4260</SubGroupID><ARTGs><ARTG>180973</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET073</BillingCode><Name>Eclipse Malleus Piston</Name><Description>Malleus &amp; Stapes: Nitinol, Fluoroplastic</Description><Size>Diamater 0.6mm: 5.5mm-8.00mm</Size><SupplierCode>ET</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4156</SubGroupID><ARTGs><ARTG>170281</ARTG></ARTGs><MinimumBenefit>227</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET097</BillingCode><PriorBillingCodes><PriorBillingCode>WC251</PriorBillingCode></PriorBillingCodes><Name>Biodesign Surgisis  Hernia Graft</Name><Description>Biodesign Hernia Graft is 8-layer perforated and quilted porcine sis collagen matrix, non cross-linked, remodelable and resorbable tissue graft</Description><Size>20cm x 30cm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5493</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>153052</ARTG></ARTGs><MinimumBenefit>3114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET056</BillingCode><Name>Soft Basket Band. INFUSION PORT.</Name><Description>TITANIUM PORT</Description><Size>9.8CMS/13.3CMS</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1779</GroupID><ARTGs><ARTG>148776</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET053</BillingCode><Name>Macroplastique</Name><Description>Sterile, textured, highly cross linked polydimethylsiloxane elastomer implants suspended in a bio-excretable carrier gel.</Description><Size>2.5ml Implants</Size><SupplierCode>ET</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1699</GroupID><SubGroupID>5319</SubGroupID><ARTGs><ARTG>146732</ARTG></ARTGs><MinimumBenefit>1262</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET091</BillingCode><PriorBillingCodes><PriorBillingCode>WC242</PriorBillingCode></PriorBillingCodes><Name>Biodesign Surgisis Hernia Graft</Name><Description>Biodesign Hernia Graft is 8-layer perforated and quilted porcine sis collagen matrix, non cross-linked, remodelable and resorbable tissue graft</Description><Size>13cm x 15cm, 10cm x 10cm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5491</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>153052</ARTG></ARTGs><MinimumBenefit>710</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET092</BillingCode><PriorBillingCodes><PriorBillingCode>WC243</PriorBillingCode></PriorBillingCodes><Name>Surgisis Biodesign Anal Fistula Plug</Name><Description>Surgisis Biodesign Anal Fistula Plug is a small intestine submucosal porcine derived, rolled and shaped collagen matrix, non cross-linked, that signals the body and provides support for native tissue remodeling, healing and closure of anal fistulas</Description><Size>0.6cm Width Tapering to 0.2cm Width x 9.5cm Length. Conical Shape</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1691</GroupID><SubGroupID>4519</SubGroupID><ARTGs><ARTG>153045</ARTG></ARTGs><MinimumBenefit>903</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET050</BillingCode><Name>ARGUS</Name><Description>Adjustable Male Sling made of silicone adjustable self fixating columns and urethral cushion</Description><Size>One size only</Size><SupplierCode>ET</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1698</GroupID><SubGroupID>5314</SubGroupID><ARTGs><ARTG>118082</ARTG></ARTGs><MinimumBenefit>5432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET054</BillingCode><PriorBillingCodes><PriorBillingCode>ED004</PriorBillingCode></PriorBillingCodes><Name>Memokath Prostatic - Urethral Stents</Name><Description>Memokath Models: 028S, 028SW, 028T, 028TW, 044T, 044TW, 045T, 045TW, 045TTW</Description><Size> 5mm - 90mm</Size><SupplierCode>ET</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>256</SubCategoryID><GroupID>1800</GroupID><SubGroupID>5501</SubGroupID><ARTGs><ARTG>141653</ARTG></ARTGs><MinimumBenefit>2351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET096</BillingCode><PriorBillingCodes><PriorBillingCode>WC250</PriorBillingCode></PriorBillingCodes><Name>Biodesign Surgisis Hernia Graft</Name><Description>Biodesign Hernia Graft is 8-layer perforated and quilted porcine sis collagen matrix, non cross-linked, remodelable and resorbable tissue graft</Description><Size>20cm x 20cm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5492</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>153052</ARTG></ARTGs><MinimumBenefit>1341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET039</BillingCode><Name>SX-Ella Tips Stent</Name><Description>Uncovered, self-expanding nitinol stent</Description><Size>Dia 10-14mm, length 52-77mm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><SubGroupID>4234</SubGroupID><ARTGs><ARTG>144490</ARTG></ARTGs><MinimumBenefit>2008</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET098</BillingCode><PriorBillingCodes><PriorBillingCode>WC255</PriorBillingCode></PriorBillingCodes><Name>Surgisis Biodesign 4-layer Tissue Graft</Name><Description>Surgisis Soft Tissue Graft</Description><Size>Length 20cm, Width 7cm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5491</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>153047</ARTG></ARTGs><MinimumBenefit>710</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET051</BillingCode><Name>Surgiwrap</Name><Description>Bio Absorbable Antiadhesion Barrier</Description><Size>All sizes with and without suture holes</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5432</SubGroupID><Suffix>Complex, Bioresorbable</Suffix><ARTGs><ARTG>91233</ARTG></ARTGs><MinimumBenefit>1173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET067</BillingCode><Name>OTSC Clip</Name><Description>The OTSC Clip is a superelastic Nitinol clip which compresses the tissue between its teeth. Therefore it enables hemostasis as well as closing of perforations</Description><Size>OTSC Clip is available in three sizes: 9mm, 10mm and 11mm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic, OTS</Suffix><ARTGs><ARTG>185054</ARTG><ARTG>185057</ARTG></ARTGs><MinimumBenefit>738</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET064</BillingCode><Name>AMI HAL-RAR Flexi Procedure Kit</Name><Description>Doppler guided Haemorrhoidal Arterial Ligation and Recto-Anal Repair System.
HAL Haemorrhoidal Ligating sutures, doppler/ultrasound proctoscope, flexiprobe, knot pusher</Description><Size>One size, several components</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Doppler Guided, Endoscopic</Suffix><ARTGs><ARTG>144489</ARTG></ARTGs><MinimumBenefit>844</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET077</BillingCode><Name>ELLA BD Stent</Name><Description>The ELLA BD Stent is a self-expanding biodegradable stent made of polydiaxanone designed to slowly degrade when in contact with living tissue. Full degradation of stent occurs within 11-12 weeks of implantation. It is designed for dilation and treatment of benign oesophageal lesions.</Description><Size>Stent body diameters = 18mm - 25mm;   Stent flares diameters = 23mm - 31mm;   Stent nominal length = 60/80/100/135mm.</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1558</GroupID><SubGroupID>6025</SubGroupID><ARTGs><ARTG>232514</ARTG></ARTGs><MinimumBenefit>4513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET100</BillingCode><PriorBillingCodes><PriorBillingCode>WA010</PriorBillingCode></PriorBillingCodes><Name>Biodesign Rectopexy Graft</Name><Description>The Biodesign Rectopexy Graft is a dried multi-layered small intestinal submucosa (SIS) sheet. The graft is used to reinforce soft tissue for the repair of rectal prolapse and rectal intussusception.</Description><Size>7cm x 20cm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5491</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>317940</ARTG></ARTGs><MinimumBenefit>710</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET083</BillingCode><Name>Full-Thickness Resection Device (FTRD)</Name><Description>The FTRD System Set is used for diagnostic and therapeutic full-thickness resection via flexible endoscopy in the colon and rectum. The FTRD System Set is designed to ensure that the transection of tissue happens only after the defect has been completely closed.</Description><Size>The FTRD clip is and 11mm nitinol clip.
Also supplied with the FTRD marking probe (220cm) and FTRD Grasper (220cm).</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic, OTS</Suffix><ARTGs><ARTG>235539</ARTG></ARTGs><MinimumBenefit>2002</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET072</BillingCode><Name>Eclipse Piston</Name><Description>Stapes: Nitinol, Fluroplastic</Description><Size>Diameter 0.4mm: 3.75mm - 6.00mm; Diameter 0.5mm: 3.75mm - 6.00mm;  Diameter 0.6mm: 3.75mm - 6.00mm</Size><SupplierCode>ET</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4154</SubGroupID><ARTGs><ARTG>170281</ARTG></ARTGs><MinimumBenefit>94</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET028</BillingCode><Name>Promedon Testicular Prosthesis</Name><Description>Silicone Elastomer</Description><Size>Small - 31 x 23 mm,  Medium - 37 x 28 mm,  Large - 42 x 32 mm,  Xlarge</Size><SupplierCode>ET</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>231</SubCategoryID><GroupID>1711</GroupID><ARTGs><ARTG>136709</ARTG></ARTGs><MinimumBenefit>620</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET101</BillingCode><Name>ARCHIMEDES Biodegradable Pancreaticobiliary Stent</Name><Description>A polymeric stent with a fluted, cross-sectional profile and containing two channels which spiral in a double helix down the length of the stent. The Archimedes BPS is designed to fit the natural curvature of the common bile duct and pancreatic duct. The ends of the Archimedes are tapered to allow insertion through the papilla. The Archimedes comes in three degradation profiles of slow, medium, and fast. The minimal strength retention time of the Archimedes BPS is 11 weeks, 20 days, and 12 days respectively.</Description><Size>Stent Diameters: 2.0mm, 2.6mm, 3.4mm. Stent Length: 40mm, 60mm, 80mm, 100mm, 125mm, 150mm, 175mm, 200mm, 225mm.</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><Suffix>Biodegradable</Suffix><ARTGs><ARTG>335504</ARTG><ARTG>335505</ARTG><ARTG>335506</ARTG></ARTGs><MinimumBenefit>1500</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET068</BillingCode><Name>OTSC System</Name><Description>Has two components:
1. The OTSC Clip is a superelastic Nitinol clip which compresses the tissue between its teeth; enables hemostasis as well as closing performations.

2. Grasping and Anchoring Tool. Ovesco Twin Graspers – to approximate wound edges.. Ovesco Anchor- to grasp fibrous tissue or fistulas</Description><Size>OTSC Clip is available in three sizes: 9mm, 10mm and 11 mm.
Ovesco Twin Graspers : 165mm or 220mm
Ovesco Anchor: 165mm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Endoscopic, OTS</Suffix><ARTGs><ARTG>18057</ARTG><ARTG>185054</ARTG><ARTG>185056</ARTG><ARTG>185058</ARTG></ARTGs><MinimumBenefit>2002</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET075</BillingCode><PriorBillingCodes><PriorBillingCode>ET071</PriorBillingCode></PriorBillingCodes><Name>AMI ATOMS Infusion Port</Name><Description>Hydraulic Infusion port for use with AMI ATOMS System - seperate</Description><Size>22mm Diameter, 9.8mm High</Size><SupplierCode>ET</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1786</GroupID><SubGroupID>5987</SubGroupID><ARTGs><ARTG>148776</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET090</BillingCode><PriorBillingCodes><PriorBillingCode>WC177</PriorBillingCode></PriorBillingCodes><Name>Biodesign Tissue Graft</Name><Description>Surgical Mesh composed of Sub-Intestinal Submucosa (SIS)</Description><Size>Length - 10cm, Width - 7cm; Length - 7cm, Width - 4cm; Length - 3cm, Width - 2cm.</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5491</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>153047</ARTG></ARTGs><MinimumBenefit>710</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET074</BillingCode><PriorBillingCodes><PriorBillingCode>ET071</PriorBillingCode></PriorBillingCodes><Name>ATOMS System</Name><Description>The ATOMS System is a long term, adjustable prostheses that substitutes urinary sphincter function in incontinent males. It is a hydraulic system comprising of a suburethral sphincter cushion/cuff which can be adjusted hydraulically intra-operatively or post-operatively through an implanted titanium port. Fixation arms and attachment sutures hold the implant in situ.</Description><Size>1 size only - ATS 5011 (Length of Implant 560mm, width of tape 12mm, dimensions of cushion 40x45mm, max. filling volume of cushion 25mL). Titanium port-reservoir with hydraulic tubing, one size.</Size><SupplierCode>ET</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1786</GroupID><SubGroupID>5451</SubGroupID><ARTGs><ARTG>154803</ARTG></ARTGs><MinimumBenefit>7876</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET099</BillingCode><PriorBillingCodes><PriorBillingCode>WC284</PriorBillingCode></PriorBillingCodes><Name>Surgisis Biodesign Hiatal Hernia Graft</Name><Description>Surgisis Biodesign Hiatal Hernia Graft is an extracellular collagen matrix, non cross-linked sterile graft material, that provides support for damaged tissues and assists in host tissue regeneration and remodelling of the diaphragmatic wall following surgical repair for paraoesophageal and hiatal hernia.</Description><Size>7 x 10cm rectangular and U-shaped</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5491</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>153051</ARTG></ARTGs><MinimumBenefit>710</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET088</BillingCode><Name>Comfort Drain</Name><Description>The Comfort Drain is a silicone anorectal fistula drainage catheter, that is designed to provide a knotless closure of the drain.</Description><Size>Inner Diameter: 0.3mm, Outer Diameter: 1.5mm, Length: 180mm.</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>7363</SubGroupID><ARTGs><ARTG>220607</ARTG></ARTGs><MinimumBenefit>114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET076</BillingCode><Name>Triune Vent Tube</Name><Description>A tympanostomy (myringotomy) tube</Description><Size>Lumen size 0.76mm - 1.35mm</Size><SupplierCode>ET</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>170820</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET040</BillingCode><Name>Vox Implants</Name><Description>Vox Implants are solid, irregularly textured, medical grade Polydimethylsiloxane Elastomer implants suspended in a hydrogel carrier</Description><Size>One size only</Size><SupplierCode>ET</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1576</GroupID><ARTGs><ARTG>146733</ARTG></ARTGs><MinimumBenefit>7401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET084</BillingCode><Name>ATOMS with Integrated Scrotal Port</Name><Description>The ATOMS with Integrated Scrotal Port is a long-term hydraulically adjustable substitute urinary sphincter. The implant is supplied as a single piece system which includes a hydraulically adjusted urethral cuff and a silicone coated adjustment port which rests in the patient's scrotum. The pressure applied by the cuff is evenly distributed over the bulbar urethra, providing ventral closure in order to achieve continence. The adjustment port is designed to allow for non-surgical postoperative adjustment of cuff pressure.</Description><Size>1 size only  Width of tape: 12mm  Dimensions of cushion: 40 x 45mm  Port Diameter: 11mm</Size><SupplierCode>ET</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1696</GroupID><SubGroupID>5311</SubGroupID><ARTGs><ARTG>154803</ARTG></ARTGs><MinimumBenefit>9500</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET038</BillingCode><Name>SX-Ella Biliary Stent</Name><Description>Self-expanding nitinol stent</Description><Size>Diameter 8 - 10mm, Length 40 - 100mm.</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><SubGroupID>4234</SubGroupID><ARTGs><ARTG>144490</ARTG></ARTGs><MinimumBenefit>2008</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET069</BillingCode><Name>SX - ELLA Stent Esophageal HV (HV Stent Plus)</Name><Description>The SX-ELLA Atent Esophageal HV (HV Stent Plus) is a self-expandable, fully covered nitinol stent, pre-loaded on a delivery system. The stent is designed to provide relief from malignant or benign strictures in the oesophagus, or treating anastomic leaks. HV Stent Plus includes an anti-migration collar &amp; is also available with an anti-reflux valve</Description><Size>Stent Body Diameter = 18 - 20mm  Stent Flare Diameter = 24 - 25mm  Stent nominal length = 85/110/135/150mm  </Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1558</GroupID><SubGroupID>4238</SubGroupID><ARTGs><ARTG>95573</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ752</BillingCode><Name>HyaRegen Gel</Name><Description>HyaRegen Gel is a highly viscous gel adhesion barrier comprised of cross-linked molecules of hyaluronan (HA). The coss-linking process makes HA more viscous and persist longer in vivo. HyaRegen Gel is supplied in a pre-filled sterile syringe. HyaRegen Gel is indicated for the prevention or reduction of post-surgical adhesion formation in abdominal and/or intrauterine surgery.</Description><Size>Pre-filled sterile syringe in volumes: 3mL, 5mL, 10mL, and 20mL</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5433</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>389550</ARTG></ARTGs><MinimumBenefit>1173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET001</BillingCode><Name>Ferx Ella Esophageal Stent</Name><Description>Kit includes esophageal stent, introducer, balloon catheter</Description><Size>Diam 20mm, Length 80 - 160mm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1558</GroupID><SubGroupID>4238</SubGroupID><ARTGs><ARTG>95573</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET070</BillingCode><Name>SX- ELLA Stent Danis</Name><Description>The Danis Procedure Pack Basic contains the SX-ELLA Stent Danis, a nitinol wire that is compressed &amp; preloaded within a delivery system, along with various instruments necessary for the stent implantation. The Stent Denis is a removable stent system for the treatment of bleeding esophageal varices. It is intended to be implanted and then removed within seven days of the date of implantation in order to avoid the risk of in-growth into the stent mesh</Description><Size>One size: Stent flares diameter 30mm; Stent body diameter 25mm; Nominal length 135mm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1558</GroupID><SubGroupID>4238</SubGroupID><ARTGs><ARTG>95573</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET095</BillingCode><PriorBillingCodes><PriorBillingCode>WC249</PriorBillingCode></PriorBillingCodes><Name>Biodesign Surgisis Hernia Graft</Name><Description>Biodesign Hernia Graft is 8-layer perforated and quilted porcine sis collagen matrix, non cross-linked, remodelable and resorbable tissue graft</Description><Size>13cm x 22cm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5492</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>153052</ARTG></ARTGs><MinimumBenefit>1341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET045</BillingCode><Name>Boubella Esophageal Stent</Name><Description>Self expandable stainless steel wire stent with anti-reflux valve</Description><Size>Length 90 - 210mm</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1558</GroupID><SubGroupID>4238</SubGroupID><ARTGs><ARTG>95573</ARTG></ARTGs><MinimumBenefit>3159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ET082</BillingCode><Name>PureRegen Gel Sinus</Name><Description>PureRegen Gel Sinus is a gel adhesion barrier comprised of a hyaluronic acid based hydrogel. The product does not contain any medicinal, human or animal components. It is removed from the application site by natural elimination.</Description><Size>2ml, 5ml, 6ml, 8ml, 10ml, 20ml.</Size><SupplierCode>ET</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5433</SubGroupID><Suffix>Sinus</Suffix><ARTGs><ARTG>264407</ARTG></ARTGs><MinimumBenefit>94</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA572</BillingCode><PriorBillingCodes><PriorBillingCode>LC030</PriorBillingCode></PriorBillingCodes><Name>Revision Modular Femoral Stem</Name><Description>Revision Modular Femoral Stem Ti6A4I</Description><Size>14-26mm Diameter x 140mm Length</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>210670</ARTG></ARTGs><MinimumBenefit>2619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA018</BillingCode><Name>Intramedullary Plug</Name><Description>Cement Restricter</Description><Size>Small to Extra Large</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1437</GroupID><ARTGs><ARTG>241997</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA024</BillingCode><Name>CCE Acetabular Reinforcing Ring</Name><Description>Titanium, grit blast, acetabular reconstruction cage with proximal rim</Description><Size>Dia 42 - 58mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1432</GroupID><SubGroupID>4035</SubGroupID><ARTGs><ARTG>211196</ARTG></ARTGs><MinimumBenefit>1197</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA452</BillingCode><Name>BalanSys UNI tibial baseplate </Name><Description>Uni tibial baseplate for fixed bearing insert, cemented, CoCr</Description><Size>1,2,3,4,5</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>152</SubCategoryID><GroupID>1364</GroupID><ARTGs><ARTG>212824</ARTG></ARTGs><MinimumBenefit>1352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ794</BillingCode><PriorBillingCodes><PriorBillingCode>DD002</PriorBillingCode></PriorBillingCodes><Name>Turon Shoulder System - Humeral Neck</Name><Description>Turon - Humeral Neck</Description><Size>Neutral and 7.5 Degree</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4076</SubGroupID><ARTGs><ARTG>216043</ARTG></ARTGs><MinimumBenefit>998</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA593</BillingCode><PriorBillingCodes><PriorBillingCode>LC160</PriorBillingCode><PriorBillingCode>LC031</PriorBillingCode></PriorBillingCodes><Name>C2 Revision Stem</Name><Description>C2 Revision Stem</Description><Size>Size 7-9 x 202 to 213mm Length</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1408</GroupID><SubGroupID>3953</SubGroupID><ARTGs><ARTG>210716</ARTG></ARTGs><MinimumBenefit>4540</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA631</BillingCode><PriorBillingCodes><PriorBillingCode>LC203</PriorBillingCode></PriorBillingCodes><Name>SpaceFlex Hip</Name><Description>Modular Hip Spacer Mold</Description><Size>10mm  13mm  15mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1452</GroupID><ARTGs><ARTG>329464</ARTG></ARTGs><MinimumBenefit>1309</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ778</BillingCode><PriorBillingCodes><PriorBillingCode>DD032</PriorBillingCode></PriorBillingCodes><Name>Reverse Shoulder System</Name><Description>Humeral Stem, Ti</Description><Size>6mm to 12mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><ARTGs><ARTG>210915</ARTG><ARTG>210917</ARTG></ARTGs><MinimumBenefit>3325</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ777</BillingCode><PriorBillingCodes><PriorBillingCode>DD058</PriorBillingCode></PriorBillingCodes><Name>Reverse Shoulder – Glenosphere Head</Name><Description>Glenosphere</Description><Size>32mm to 44mm, neutral or -4mm offset</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>210932</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA522</BillingCode><PriorBillingCodes><PriorBillingCode>MA449</PriorBillingCode></PriorBillingCodes><Name>Affinis Shoulder System</Name><Description>Stem Cementless - Titanium, adjustable cone</Description><Size>6, 7.5, 9, 10.5, 12, 13.5 and 15mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><ARTGs><ARTG>219395</ARTG></ARTGs><MinimumBenefit>3325</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA556</BillingCode><PriorBillingCodes><PriorBillingCode>DD066</PriorBillingCode></PriorBillingCodes><Name>Altivate Reverse Humeral Stem</Name><Description>Altivate Reverse Humeral Stem</Description><Size>Standard and Small Shell, 108, 175 &amp; 220mm Length</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>297842</ARTG><ARTG>297843</ARTG></ARTGs><MinimumBenefit>6013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA529</BillingCode><Name>Affinis Inverse Revision stem, uncemented</Name><Description>Monoblock Revision Humeral Stem</Description><Size>6 to 12 x180 to 230mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>238292</ARTG></ARTGs><MinimumBenefit>6013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA527</BillingCode><Name>Affinis Inverse Stem, uncemented</Name><Description>Monoblock Humeral Stem</Description><Size>6 to 15 mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>215274</ARTG></ARTGs><MinimumBenefit>6013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA530</BillingCode><Name>Affinis Inverse locking screw</Name><Description>Locking Metaglene screw</Description><Size>24x4.0mm to 48x4.0mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>241996</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA541</BillingCode><Name>optimys Stem</Name><Description>Ti with Ti Plasma spray and CaP coating</Description><Size>XS, 0 to 12, standard and lateral</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>287920</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA543</BillingCode><Name>Affinis Shoulder System – Humeral Stem</Name><Description>Humeral stem and trunion, uncemented, Ti with Ti Plasma Spray and CaP coating</Description><Size>1-6</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><ARTGs><ARTG>215479</ARTG></ARTGs><MinimumBenefit>3325</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA536</BillingCode><Name>Affinis Fracture Inverse</Name><Description>Metaphyseal body with Ti plama spray plus CaPcoating- includes humeralcup with CoCr bearing surface</Description><Size>39 to 42</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><ARTGs><ARTG>224971</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA533</BillingCode><Name>Affinis Inverse glenosphere</Name><Description>Glenosphere</Description><Size>36 to 42mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>215499</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA481</BillingCode><Name>Affinis Shoulder System</Name><Description>Affinis Fracture Stem - metaphyseal, uncemented</Description><Size>15.5, Part 2- 18</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><ARTGs><ARTG>219732</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA513</BillingCode><Name>RM Acetabular Cup, Polyethylene</Name><Description>Titanium bonded UHMWPE Cup, with and without lugs</Description><Size>46 to 64mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1429</GroupID><SubGroupID>4026</SubGroupID><ARTGs><ARTG>209312</ARTG><ARTG>212648</ARTG><ARTG>212649</ARTG></ARTGs><MinimumBenefit>2517</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA617</BillingCode><PriorBillingCodes><PriorBillingCode>LC188</PriorBillingCode><PriorBillingCode>LC041</PriorBillingCode></PriorBillingCodes><Name>SMR Humeral Body with Locking Screw</Name><Description>Humeral Body Ti6aI4V - Finned - Trauma</Description><Size>Short/Medium/Long</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><ARTGs><ARTG>234232</ARTG><ARTG>235005</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA618</BillingCode><PriorBillingCodes><PriorBillingCode>LC189</PriorBillingCode><PriorBillingCode>LC041</PriorBillingCode></PriorBillingCodes><Name>SMR Reverse Humeral Body with Locking Screw</Name><Description>SMR  Humeral Body -Reverse</Description><Size>Reverse Humeral body - short;  Reverse humeral body - finned;  Reverse humeral body - Standard HA Coated; 140° Reverse Humeral body - short; 140° Reverse humeral body - finned;  140°Reverse humeral body - Standard HA Coated</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>225315</ARTG><ARTG>234748</ARTG><ARTG>234749</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA025</BillingCode><Name>Mathys Bipolar Femoral Head</Name><Description>Stainless steel with fixed UHMWPE insert</Description><Size>28mm Inner diameter, 42-58mm outer diameter</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1424</GroupID><SubGroupID>4004</SubGroupID><ARTGs><ARTG>212427</ARTG></ARTGs><MinimumBenefit>654</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ785</BillingCode><PriorBillingCodes><PriorBillingCode>DD060</PriorBillingCode></PriorBillingCodes><Name>RSP Monoblock Humeral Stem Uncemented</Name><Description>RSP Monoblock Humeral Stem Uncemented</Description><Size>6 x 101mm, 7 x 101mm, 8 x 101mm, 10 x 101mm,12 x 101mm
6 x 175mm, 8 x 175mm, 10 x 175mm, 12 x 175mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>283578</ARTG><ARTG>283579</ARTG></ARTGs><MinimumBenefit>6013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA517</BillingCode><Name>Bionit Ceramic Femoral Head</Name><Description>Femoral Head, Ceramic</Description><Size>36 to 54mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3996</SubGroupID><ARTGs><ARTG>210564</ARTG></ARTGs><MinimumBenefit>1357</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA509</BillingCode><Name>Balansys Revision Knee, Tibial Plateau</Name><Description>Revision Tibial Baseplate, modular</Description><Size>64 to 85</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><Suffix>Revision</Suffix><ARTGs><ARTG>209537</ARTG></ARTGs><MinimumBenefit>2647</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ788</BillingCode><PriorBillingCodes><PriorBillingCode>HW565</PriorBillingCode><PriorBillingCode>DD067</PriorBillingCode></PriorBillingCodes><Name>SR Hand Implant System</Name><Description>SR Hand MCP Proximal, CoCr - Titanium Alloy, UHMWPE</Description><Size>XS/S/M/L/XL</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6044</SubGroupID><ARTGs><ARTG>237799</ARTG></ARTGs><MinimumBenefit>665</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ796</BillingCode><PriorBillingCodes><PriorBillingCode>DD064</PriorBillingCode></PriorBillingCodes><Name>Turon to RSP Conversion Module</Name><Description>Conversion Module</Description><Size>Neutral and Offset</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4086</SubGroupID><ARTGs><ARTG>302688</ARTG></ARTGs><MinimumBenefit>829</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA583</BillingCode><PriorBillingCodes><PriorBillingCode>LC150</PriorBillingCode><PriorBillingCode>LC006</PriorBillingCode><PriorBillingCode>OH102</PriorBillingCode></PriorBillingCodes><Name>Proximal Centraliser PMMA</Name><Description>Proximal Centraliser PMMA</Description><Size>Left &amp; Right Size 0-3</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1438</GroupID><ARTGs><ARTG>186627</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA616</BillingCode><PriorBillingCodes><PriorBillingCode>LC187</PriorBillingCode><PriorBillingCode>LC045</PriorBillingCode></PriorBillingCodes><Name>SMR Revision Modular Locking Ring</Name><Description>Modular Locking Collar (Ring) Ti6AI4V</Description><Size>One Size</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>247559</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ793</BillingCode><PriorBillingCodes><PriorBillingCode>DD003</PriorBillingCode></PriorBillingCodes><Name>Turon Shoulder System - Humeral Head</Name><Description>Turon Standard Humeral Head, Standard and Offset</Description><Size>38-54mm x 14-26mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><ARTGs><ARTG>215957</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA448</BillingCode><Name>Affinis Total Shoulder</Name><Description>Humeral Head - CoCr</Description><Size>Diameter 39, 41, 43, 45, 47, 49, 51, 53mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><ARTGs><ARTG>220762</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA610</BillingCode><PriorBillingCodes><PriorBillingCode>LC181</PriorBillingCode><PriorBillingCode>LC045</PriorBillingCode></PriorBillingCodes><Name>SMR CTA Humeral Head</Name><Description>CTA Humeral Head CoCRMo</Description><Size>42 - 54mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><Suffix>EL</Suffix><ARTGs><ARTG>211950</ARTG></ARTGs><MinimumBenefit>3941</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA609</BillingCode><PriorBillingCodes><PriorBillingCode>LC180</PriorBillingCode><PriorBillingCode>LC045</PriorBillingCode></PriorBillingCodes><Name>SMR Humeral Head</Name><Description>Humeral Head CoCrMo</Description><Size>Diameter (mm) 38 to 54  Offset 2 - 7 mm Eccentric  Shape Standard or Flattened</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><ARTGs><ARTG>221715</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA546</BillingCode><Name>Ligamys Monoblock</Name><Description>Dynamic spring system with clamping cone</Description><Size>One size</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5394</SubGroupID><ARTGs><ARTG>230046</ARTG></ARTGs><MinimumBenefit>451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA480</BillingCode><Name>Affinis Humeral Head</Name><Description>Affinis Humeral Head - Ceramic</Description><Size>39 to 53</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><Suffix>Cer</Suffix><ARTGs><ARTG>215480</ARTG><ARTG>215501</ARTG></ARTGs><MinimumBenefit>1449</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA311</BillingCode><Name>balanSys Tibial Mobile Insert</Name><Description>Tibial Insert, Mobile bearing, UHMWPE,</Description><Size>XS/8mm to F/20.5mm</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>211084</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA516</BillingCode><Name>BalanSys Tibial Insert</Name><Description>Tibial Insert, ultra congruent and minimally stabilised, UHMWPE</Description><Size>59/8mm to 85/20.5mm</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>211081</ARTG><ARTG>211087</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA531</BillingCode><Name>Affinis Fixation Screw</Name><Description>Fixation Screw Long</Description><Size>one size only</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>5428</SubGroupID><ARTGs><ARTG>257052</ARTG></ARTGs><MinimumBenefit>1132</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ772</BillingCode><PriorBillingCodes><PriorBillingCode>DD055</PriorBillingCode></PriorBillingCodes><Name>Glenoid Baseplate Non Locking Bone Screw</Name><Description>Glenoid Baseplate Non Locking Bone Screw</Description><Size>3.5mm diameter, length 14-34mm in 2mm increments</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>212470</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA463</BillingCode><Name>twinSys Cemented Femoral Stem</Name><Description>stainless steel, highly polished, triple tapered</Description><Size>8 sizes in standard and lateral version (Size 9, 10, 11, 12, 13, 14, 15, 16)</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>274206</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA506</BillingCode><Name>Balansys Revision Knee</Name><Description>Femoral component, contrained</Description><Size>A to E, right to left</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><Suffix>Revision</Suffix><ARTGs><ARTG>209536</ARTG></ARTGs><MinimumBenefit>5363</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA559</BillingCode><PriorBillingCodes><PriorBillingCode>LC010</PriorBillingCode><PriorBillingCode>OH201</PriorBillingCode></PriorBillingCodes><Name>Modulus Modular Femoral Stem</Name><Description>Modulus Modular Femoral Stem</Description><Size>Size A &amp; B x 13 to 26mm diameter</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>210668</ARTG></ARTGs><MinimumBenefit>2619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA597</BillingCode><PriorBillingCodes><PriorBillingCode>LC166</PriorBillingCode><PriorBillingCode>LC016</PriorBillingCode></PriorBillingCodes><Name>Delta PF Acetabular Cup</Name><Description>Delta PF Acetabular Cup Ti6AI4V + Poro + HA</Description><Size>44 - 76mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1427</GroupID><SubGroupID>4018</SubGroupID><ARTGs><ARTG>210795</ARTG></ARTGs><MinimumBenefit>2079</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ790</BillingCode><PriorBillingCodes><PriorBillingCode>HW676</PriorBillingCode><PriorBillingCode>DD074</PriorBillingCode></PriorBillingCodes><Name>Tactys PIP - Distal System </Name><Description>Distal Surface and Stem</Description><Size>XS, S, M &amp; L</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6145</SubGroupID><ARTGs><ARTG>237793</ARTG></ARTGs><MinimumBenefit>760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA500</BillingCode><Name>Modular Revision Stem</Name><Description>Titanium, grit blast, non HA</Description><Size>14mm x 140mm - 24mm x 140mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>274204</ARTG></ARTGs><MinimumBenefit>2619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ775</BillingCode><PriorBillingCodes><PriorBillingCode>DD054</PriorBillingCode></PriorBillingCodes><Name>Replacement retaining screw for glenoid head</Name><Description>Replacement retaining screw for glenoid head</Description><Size>6.5mm x 30mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>212521</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA550</BillingCode><Name>balanSys vitamys Inlay</Name><Description>Tibial insert - cruciate retaining, ultra congruent and rotating platform, minimally stabilised, vitamys</Description><Size>59/8mm to 85/20.5mm</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>312503</ARTG><ARTG>312504</ARTG><ARTG>312505</ARTG><ARTG>312506</ARTG><ARTG>312507</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA111</BillingCode><Name>Balansys Patella Component</Name><Description>All Polyethylene, UHMWPE, cemented </Description><Size>Dia 25, 26, 28, 31, 34, 37mm</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>211442</ARTG><ARTG>211443</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ774</BillingCode><PriorBillingCodes><PriorBillingCode>SK603</PriorBillingCode><PriorBillingCode>DD072</PriorBillingCode></PriorBillingCodes><Name>PIP Finger Prosthesis</Name><Description>Distal part PIP joint</Description><Size>0-5</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6145</SubGroupID><ARTGs><ARTG>237793</ARTG></ARTGs><MinimumBenefit>760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ771</BillingCode><PriorBillingCodes><PriorBillingCode>DD056</PriorBillingCode></PriorBillingCodes><Name>Glenoid Baseplate Locking Bone Screws</Name><Description>Glenoid Baseplate Locking Bone Screws</Description><Size>5.0mm diameter, length 14-38mm in 4mm increments</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>212469</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA598</BillingCode><PriorBillingCodes><PriorBillingCode>LC167</PriorBillingCode><PriorBillingCode>LC016</PriorBillingCode></PriorBillingCodes><Name>Met Acetabular Cup</Name><Description>Met Acetabular Cup CoCrMo + Poro + HA</Description><Size>42 - 64mm OD x 38 - 58mm ID</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1427</GroupID><SubGroupID>4018</SubGroupID><ARTGs><ARTG>222644</ARTG></ARTGs><MinimumBenefit>2079</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA487</BillingCode><Name>balanSys Femoral Component</Name><Description>Femoral component, cemented, CoCr, posterior stabilised </Description><Size>XS to F, Left and Right</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>206047</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA493</BillingCode><Name>Balansys Knee System / Femoral Component, PS, cemented, TiNbN coated</Name><Description>Balansys Femoral Component/PS cemented, TiNbN coated, CoCrMo, TiNbN</Description><Size>XS to F, Left and Right</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>206174</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA485</BillingCode><Name>Ceramys Large Ceramic Revision Femoral Head</Name><Description>Ceramic, zirconia alumina combination, large diameters, supplied with titanium taper sleeve</Description><Size>36 L, 36 M, 36 S, 36 XL, 36</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><Suffix>Sleeve</Suffix><ARTGs><ARTG>274113</ARTG></ARTGs><MinimumBenefit>2097</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA566</BillingCode><PriorBillingCodes><PriorBillingCode>LC022</PriorBillingCode></PriorBillingCodes><Name>Delta Revision TT Acetabular Cup</Name><Description>Delta Revision TT Acetabular Cup Ti</Description><Size>50 - 66mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1432</GroupID><SubGroupID>4034</SubGroupID><ARTGs><ARTG>210779</ARTG></ARTGs><MinimumBenefit>2658</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA508</BillingCode><Name>Balansys Revision Knee, Augments</Name><Description>Revision Femoral/Tibial Augments, complete with screws</Description><Size>5 and 10mm</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>257053</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA622</BillingCode><PriorBillingCodes><PriorBillingCode>LC193</PriorBillingCode></PriorBillingCodes><Name>BioBall Femoral Head</Name><Description>Femoral Head Vivium &gt; 32mm</Description><Size>36mm to 58mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3994</SubGroupID><ARTGs><ARTG>227095</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA620</BillingCode><PriorBillingCodes><PriorBillingCode>LC191</PriorBillingCode><PriorBillingCode>GM066</PriorBillingCode></PriorBillingCodes><Name>BioBall Femoral Head</Name><Description>Femoral Head Vivium &gt; 32mm</Description><Size>36mm to 58mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3994</SubGroupID><ARTGs><ARTG>227096</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA558</BillingCode><PriorBillingCodes><PriorBillingCode>LC009</PriorBillingCode><PriorBillingCode>OH200</PriorBillingCode></PriorBillingCodes><Name>Modulus Femoral Body</Name><Description>Femoral Body 12/14 Taper CCD 125* to 130* - Ti6AI4V</Description><Size>A &amp; B x Small to Large</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Body</Suffix><ARTGs><ARTG>210669</ARTG></ARTGs><MinimumBenefit>2401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA539</BillingCode><Name>Affinis Inverse Lag Screw</Name><Description>Metaglene Lag screw</Description><Size>18x4.5mm to 38 x 4.5 mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>241996</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA621</BillingCode><PriorBillingCodes><PriorBillingCode>LC192</PriorBillingCode><PriorBillingCode>GM108</PriorBillingCode></PriorBillingCodes><Name>BioBall Delta Femoral Head</Name><Description>Femoral Head Biolox Delta</Description><Size>28mm, 32mm, 36mm, 40mm, 44mm, 48mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>227095</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA467</BillingCode><Name>Mathys Unipolar Femoral Head</Name><Description>Stainless steel, unipolar head</Description><Size>42 mm - 58mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3994</SubGroupID><ARTGs><ARTG>212967</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA589</BillingCode><PriorBillingCodes><PriorBillingCode>LC156</PriorBillingCode><PriorBillingCode>LC033</PriorBillingCode></PriorBillingCodes><Name>Cephalic Head</Name><Description>Cephalic Head AISI 316L</Description><Size>41 - 57mm Diameter</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3994</SubGroupID><ARTGs><ARTG>210761</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA624</BillingCode><PriorBillingCodes><PriorBillingCode>LC196</PriorBillingCode><PriorBillingCode>LC194</PriorBillingCode><PriorBillingCode>GM146</PriorBillingCode></PriorBillingCodes><Name>BioBall Femoral Head</Name><Description>Femoral Head Vivium &gt; 32mm</Description><Size>36mm, 38mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3994</SubGroupID><ARTGs><ARTG>227096</ARTG></ARTGs><MinimumBenefit>681</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA587</BillingCode><PriorBillingCodes><PriorBillingCode>LC154</PriorBillingCode><PriorBillingCode>LC035</PriorBillingCode></PriorBillingCodes><Name>Modular Biolox Delta Head</Name><Description>Modular Biolox Delta Head</Description><Size>36 - 40mm Small to Large</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>210721</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA553</BillingCode><Name>Affinis Inverse Screw with Locking Cap</Name><Description>Titanium Screw with Locking Cap</Description><Size>Length 15mm to 51mm  Diameter 4.5mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>241996</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA483</BillingCode><Name>Ceramys Large Ceramic Femoral Head</Name><Description>Ceramic, zirconia alumina combination, large diameters</Description><Size>36 XL, 36 L, 36 M, 36 S</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>236457</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA515</BillingCode><Name>Balansys Tibial Baseplate</Name><Description>Tibial Baseplate cemented, CoCr</Description><Size>59mm to 85mm</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>211082</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA608</BillingCode><PriorBillingCodes><PriorBillingCode>LC179</PriorBillingCode><PriorBillingCode>LC043</PriorBillingCode></PriorBillingCodes><Name>SMR Resurfacing Humeral Stem</Name><Description>Resurfacing Humeral Stem Ti6AI4V - Uncemented</Description><Size>Dia 11-13mm x length 32-36mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4064</SubGroupID><ARTGs><ARTG>211983</ARTG></ARTGs><MinimumBenefit>2660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ289</BillingCode><Name>Affinis Glenoid vitamys uncemented</Name><Description>RM titanium coated vitamin-E glenoid component </Description><Size>Size 1 to 4</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>3702</SubGroupID><ARTGs><ARTG>238289</ARTG></ARTGs><MinimumBenefit>2109</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA588</BillingCode><PriorBillingCodes><PriorBillingCode>LC155</PriorBillingCode><PriorBillingCode>LC035</PriorBillingCode></PriorBillingCodes><Name>Revision Modular Biolox Delta Head</Name><Description>Revision Modular Biolox Delta Head Ti6AI4V 12/14 Taper</Description><Size>36 - 40mm Small to Xlarge</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><Suffix>Sleeve</Suffix><ARTGs><ARTG>210872</ARTG></ARTGs><MinimumBenefit>2097</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA557</BillingCode><PriorBillingCodes><PriorBillingCode>LC005</PriorBillingCode><PriorBillingCode>OH100</PriorBillingCode></PriorBillingCodes><Name>Friendly Femoral Stem</Name><Description>Femoral Stem Cemented Tapered Polished FeCrNiMnMoNbN</Description><Size>0, 1, 2, 3</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>210666</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA574</BillingCode><PriorBillingCodes><PriorBillingCode>LC036</PriorBillingCode></PriorBillingCodes><Name>SMR Shoulder - Modular Augment</Name><Description>Modular Augment Ti6AI4V</Description><Size>20 - 50mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4081</SubGroupID><ARTGs><ARTG>225458</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA576</BillingCode><PriorBillingCodes><PriorBillingCode>LC038</PriorBillingCode></PriorBillingCodes><Name>SMR Shoulder System</Name><Description>Metal Back Glenoid</Description><Size> Small, Small R, Standard, Large</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>3702</SubGroupID><ARTGs><ARTG>218703</ARTG></ARTGs><MinimumBenefit>2109</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA524</BillingCode><PriorBillingCodes><PriorBillingCode>MA499</PriorBillingCode></PriorBillingCodes><Name>Modular Revision Stem</Name><Description>Proximal body, grit Blasted Titanium</Description><Size>50-70mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Body</Suffix><ARTGs><ARTG>274207</ARTG></ARTGs><MinimumBenefit>2401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA451</BillingCode><Name>BalanSys UNI femoral component </Name><Description>Uni Femoral component, cemented CoCr</Description><Size>A, B,C,D,E</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>150</SubCategoryID><GroupID>1353</GroupID><ARTGs><ARTG>212827</ARTG></ARTGs><MinimumBenefit>2007</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA563</BillingCode><PriorBillingCodes><PriorBillingCode>LC015</PriorBillingCode><PriorBillingCode>OH342</PriorBillingCode></PriorBillingCodes><Name>Sam-Fit modular stem</Name><Description>Modular stem</Description><Size>1 - 7</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>210760</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA565</BillingCode><PriorBillingCodes><PriorBillingCode>LC021</PriorBillingCode></PriorBillingCodes><Name>Acetabular Plate</Name><Description>Acetabular Reconstruction Plate Ti</Description><Size>50 - 66mm x Standard or Long</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1432</GroupID><SubGroupID>4035</SubGroupID><ARTGs><ARTG>210762</ARTG></ARTGs><MinimumBenefit>1197</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA020</BillingCode><Name>Mathys Ceramic Femoral Head</Name><Description>Ceramic, Bionit (alumina)</Description><Size>diameter 28-32mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3990</SubGroupID><ARTGs><ARTG>210564</ARTG></ARTGs><MinimumBenefit>1568</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA594</BillingCode><PriorBillingCodes><PriorBillingCode>LC161</PriorBillingCode><PriorBillingCode>LC031</PriorBillingCode></PriorBillingCodes><Name>Revision Modular Stem</Name><Description>Revision Modular Stem Ti6AI4V</Description><Size>14 - 26mm Diameter x 200mm Length</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1412</GroupID><SubGroupID>3971</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>210670</ARTG></ARTGs><MinimumBenefit>3877</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA627</BillingCode><PriorBillingCodes><PriorBillingCode>LC199</PriorBillingCode><PriorBillingCode>LC165</PriorBillingCode><PriorBillingCode>LC016</PriorBillingCode></PriorBillingCodes><Name>Delta Multihole TT Cup</Name><Description>Delta Multihole TT Acetabular Cup (Ti6AI4V)</Description><Size>Diameter (mm) 44 to 76</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4014</SubGroupID><ARTGs><ARTG>292687</ARTG></ARTGs><MinimumBenefit>2812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA581</BillingCode><PriorBillingCodes><PriorBillingCode>LC144</PriorBillingCode></PriorBillingCodes><Name>ColloMis Femoral Stem</Name><Description>The COLLO-MIS Femoral Stem</Description><Size>Sizes 1 to 9</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>219427</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA462</BillingCode><Name>twinSys Non Cemented Femoral Stem</Name><Description>Titanium, grit blast, fully HA</Description><Size>Various offsets and sizes under 200mm length</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>274437</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ782</BillingCode><PriorBillingCodes><PriorBillingCode>DD061</PriorBillingCode></PriorBillingCodes><Name>RSP Hemi Adaptor</Name><Description>Adaptor for conversion of Reverse Shoulder Prostheses (RSP) to a hemi arthroplasty prosthesis</Description><Size>One size only</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4084</SubGroupID><ARTGs><ARTG>302695</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA577</BillingCode><PriorBillingCodes><PriorBillingCode>LC042</PriorBillingCode></PriorBillingCodes><Name>SMR Shoulder System</Name><Description>Short and Revision Cemented Stem</Description><Size>Dia 12-20mm x length 80-210mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4063</SubGroupID><ARTGs><ARTG>218715</ARTG><ARTG>218783</ARTG></ARTGs><MinimumBenefit>3755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA538</BillingCode><Name>Affinis Inverse inlay spacer</Name><Description>Humeral offset spacer. Supplied with screw</Description><Size>+9mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4084</SubGroupID><ARTGs><ARTG>224412</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA479</BillingCode><Name>Affinis Shoulder System</Name><Description>Affinis Fracture Stem - diaphyseal, cemented, short</Description><Size>6/125, 9/125, 12/125, 12/125, 9/200, 12/200</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4063</SubGroupID><ARTGs><ARTG>219731</ARTG></ARTGs><MinimumBenefit>3755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA575</BillingCode><PriorBillingCodes><PriorBillingCode>LC037</PriorBillingCode></PriorBillingCodes><Name>SMR Adaptor</Name><Description>Adaptor Eccentric / Neutral / CTA</Description><Size>Standard &amp; long 0 to +8mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4084</SubGroupID><ARTGs><ARTG>221473</ARTG><ARTG>221712</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA537</BillingCode><Name>Affinis Inverse head adaptor</Name><Description>Adaptor for conversion tohemi prostheses, includes fixation screw</Description><Size>One size only</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4084</SubGroupID><ARTGs><ARTG>224965</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ783</BillingCode><PriorBillingCodes><PriorBillingCode>DD062</PriorBillingCode></PriorBillingCodes><Name>RSP Humeral Stem Adapter</Name><Description>RSP Humeral Stem Adapter for conversion to hemiarthroplasty prostheses</Description><Size>6 &amp; 12mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4084</SubGroupID><ARTGs><ARTG>302694</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA555</BillingCode><PriorBillingCodes><PriorBillingCode>DD063</PriorBillingCode></PriorBillingCodes><Name>Altivate Reverse - Metal Spacer</Name><Description>Small and Standard Metal Spacer</Description><Size>+8 and +12 </Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4084</SubGroupID><ARTGs><ARTG>284539</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA604</BillingCode><PriorBillingCodes><PriorBillingCode>LC175</PriorBillingCode><PriorBillingCode>LC039</PriorBillingCode></PriorBillingCodes><Name>SMR Reverse Modular Humeral Body Extension</Name><Description>Reverse Modular Mumeral Body Extension Ti6AI4V</Description><Size>+9mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4084</SubGroupID><ARTGs><ARTG>265126</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA562</BillingCode><PriorBillingCodes><PriorBillingCode>LC013</PriorBillingCode><PriorBillingCode>OH328</PriorBillingCode></PriorBillingCodes><Name>FIT Femoral Stem</Name><Description>FIT Femoral Stem 12/14 Taper Ti6AI4V HA Coated</Description><Size>Size 1-7, Left &amp; Right</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>210717</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA632</BillingCode><Name>ArTT Acetabular Augments and Buttresses</Name><Description>3D Augments and Buttresses - compatible with DELTA Multihole TT and DELTA Revision TT acetabular cups.</Description><Size>Augments: 50mm to 66mm diameter, 10mm to 20mm thickness. Buttresses: 50mm to 60mm diameter, 15mm to 60mm height, neutral, left and right..</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1433</GroupID><ARTGs><ARTG>510206</ARTG></ARTGs><MinimumBenefit>1175</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA592</BillingCode><PriorBillingCodes><PriorBillingCode>LC159</PriorBillingCode><PriorBillingCode>LC028</PriorBillingCode></PriorBillingCodes><Name>H-Max S Femoral Stem</Name><Description>H-Max S Femoral Stem HA Coated Ti6AI4V</Description><Size>9 - 18</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>218784</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA569</BillingCode><PriorBillingCodes><PriorBillingCode>LC025</PriorBillingCode></PriorBillingCodes><Name>Delta Hemispheric Acetabular Cup</Name><Description>Delta Hemispheric Acetabular Cup Ti6AI4V</Description><Size>50 - 62mm &amp; Eccentricity 12-18mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1433</GroupID><ARTGs><ARTG>210763</ARTG></ARTGs><MinimumBenefit>1175</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA629</BillingCode><PriorBillingCodes><PriorBillingCode>LC201</PriorBillingCode><PriorBillingCode>OH525</PriorBillingCode><PriorBillingCode>OH505</PriorBillingCode></PriorBillingCodes><Name>G21 Bone Cement + Delivery System</Name><Description>Bone Cement – low &amp; std viscosity</Description><Size>20-60g</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4089</SubGroupID><ARTGs><ARTG>329063</ARTG></ARTGs><MinimumBenefit>437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA552</BillingCode><Name>Affinis Inverse inlay ceramys</Name><Description>Ceramic Humeral Cup</Description><Size>Size 36, 39, 42. Height 0mm, 3mm, 6mm.</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>238291</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA507</BillingCode><Name>Balansys Revision Knee, Stems</Name><Description>Ti uncemented Stem, straight and offset, complete with locking screw</Description><Size>80 to 200mm, straight and offset 4mm</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>257054</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA567</BillingCode><PriorBillingCodes><PriorBillingCode>LC023</PriorBillingCode></PriorBillingCodes><Name>DELTA Coupling / Spacer / Liner</Name><Description>DELTA Coupling / Spacer / Adaptor / Liner</Description><Size>Size Small to Extra Large  Angle (In degrees) 0 to 20  Offset +5</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1806</GroupID><ARTGs><ARTG>210771</ARTG></ARTGs><MinimumBenefit>1309</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA532</BillingCode><Name>Affinis Inverse inlay</Name><Description>Humeral Cup</Description><Size>36+0 to 42+6mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>215500</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA606</BillingCode><PriorBillingCodes><PriorBillingCode>LC177</PriorBillingCode><PriorBillingCode>LC039</PriorBillingCode></PriorBillingCodes><Name>SMR Reverse Liner (Cup) CoCrMo</Name><Description>Reverse Liner Standard &amp; Excentric CoCrMo</Description><Size>Dia 40 - 44mm x Short to Long</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>212775</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA502</BillingCode><Name>RM Pressfit Acetabular Cup</Name><Description>Acetabular component - Bonded Shell / Liner - polyethylene modified. Ti coated monoblock, bearing surface is Vit E stabilised highly cross linked polyethylene</Description><Size>28, 32, 36mm (Articulation); 42 to 70mm (Cup size)</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1429</GroupID><SubGroupID>4027</SubGroupID><ARTGs><ARTG>274133</ARTG></ARTGs><MinimumBenefit>2854</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA605</BillingCode><PriorBillingCodes><PriorBillingCode>LC176</PriorBillingCode><PriorBillingCode>LC039</PriorBillingCode></PriorBillingCodes><Name>SMR Reverse Liner (Cup) UHMWPE X-Lima</Name><Description>Reverse Liner UHMWPE X-Lima</Description><Size>36mm x +3/+6mm Standard &amp; Retentive</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>212774</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA549</BillingCode><Name>balanSys vitamys Inlay</Name><Description>Tibial insert, posterior stabilised, vitamys</Description><Size>59/8 to 85/20.5</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>312503</ARTG><ARTG>312504</ARTG><ARTG>312505</ARTG><ARTG>312506</ARTG><ARTG>312507</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA580</BillingCode><PriorBillingCodes><PriorBillingCode>LC117</PriorBillingCode></PriorBillingCodes><Name>SMR Shoulder Accessories</Name><Description>SMR Connector and Screw</Description><Size>Small R / Small STD</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4083</SubGroupID><ARTGs><ARTG>210861</ARTG></ARTGs><MinimumBenefit>991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ779</BillingCode><PriorBillingCodes><PriorBillingCode>DD035</PriorBillingCode></PriorBillingCodes><Name>Reverse Shoulder System</Name><Description>Humeral Socket Insert - UHMWPE</Description><Size>32mm to 44mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>210914</ARTG><ARTG>210933</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ781</BillingCode><PriorBillingCodes><PriorBillingCode>DD080</PriorBillingCode></PriorBillingCodes><Name>Reverse Socket Insert e+</Name><Description>Socket Inserts e+ Poly</Description><Size>Size - 32mm, 36mm, 40mm, 44mm, Standard and Small, Thickness - Standard and +4</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>400333</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA457</BillingCode><Name>Balansys Femoral Component</Name><Description>Femur, CoCr with Ti vacuum plasma spray coating</Description><Size>XS TO F Left and Right</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1351</GroupID><SubGroupID>3914</SubGroupID><ARTGs><ARTG>206063</ARTG></ARTGs><MinimumBenefit>3226</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA469</BillingCode><Name>Mathys CoCr Femoral Head </Name><Description>Hip Prosthesis Femoral Head CoCrMo ≤32mm</Description><Size>22.2mm, 28 mm &amp; 32mm, (S,M,L,XL,XXL)</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>274272</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA554</BillingCode><Name>Affinis Inverse cap</Name><Description>Titanium screw locking cap</Description><Size>one size</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3732</SubGroupID><ARTGs><ARTG>241996</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA573</BillingCode><PriorBillingCodes><PriorBillingCode>LC032</PriorBillingCode></PriorBillingCodes><Name>Modular Head</Name><Description>Modular Head CoCrMo</Description><Size>28-32mm Diameter Small to XXXLarge</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>210718</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA510</BillingCode><Name>Balansys Revision Knee, Tibial Insert</Name><Description>Tibial insert, contrained, with stabilising screw for reinforcement</Description><Size>64/10.5 to 85/23</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>210625</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA564</BillingCode><PriorBillingCodes><PriorBillingCode>LC020</PriorBillingCode></PriorBillingCodes><Name>Lima Cemented Cup</Name><Description>UHMWPE Cemented Cup Unmodified</Description><Size>28-36mm OD x 44-58mm OD 20*</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4006</SubGroupID><ARTGs><ARTG>213029</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ787</BillingCode><PriorBillingCodes><PriorBillingCode>SK589</PriorBillingCode><PriorBillingCode>DD070</PriorBillingCode></PriorBillingCodes><Name>Sbi Silicone MCP Implant System</Name><Description>Silicon finger joint</Description><Size>Various</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6146</SubGroupID><Suffix>Total</Suffix><ARTGs><ARTG>237799</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ786</BillingCode><PriorBillingCodes><PriorBillingCode>SK588</PriorBillingCode><PriorBillingCode>DD069</PriorBillingCode></PriorBillingCodes><Name>Sbi PIP Silicone Implant System</Name><Description>Silicone finger joint</Description><Size>Various</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6146</SubGroupID><Suffix>Total</Suffix><ARTGs><ARTG>237800</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ795</BillingCode><PriorBillingCodes><PriorBillingCode>DD005</PriorBillingCode></PriorBillingCodes><Name>Turon Shoulder System - Humeral Stems</Name><Description>Turon Humeral Stem, Primary and Revision</Description><Size>6-16mm x 115mm and 6-16mm x 200mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4057</SubGroupID><ARTGs><ARTG>210938</ARTG><ARTG>215958</ARTG></ARTGs><MinimumBenefit>3771</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA528</BillingCode><Name>Affinis Inverse revision stem, cemented</Name><Description>Monoblock Revision Humeral Stem</Description><Size>6x180 to 12x230mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4057</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>224955</ARTG></ARTGs><MinimumBenefit>6301</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA542</BillingCode><Name>Mathys CoCr Femoral Head</Name><Description>CoCr Femoral Head</Description><Size>36mm, S to XXL</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>274272</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ784</BillingCode><PriorBillingCodes><PriorBillingCode>DD059</PriorBillingCode></PriorBillingCodes><Name>RSP Monoblock Humeral Stem Cemented</Name><Description>RSP Monoblock Humeral Stem cemented</Description><Size>6 x 101mm, 7 x 101mm, 8 x 101mm, 10 x 101mm, 12 x 101mm
6 x 175mm, 8 x 175mm,10 x 175mm, 12 x 175mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4057</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>283578</ARTG><ARTG>283579</ARTG></ARTGs><MinimumBenefit>6301</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA578</BillingCode><PriorBillingCodes><PriorBillingCode>LC044</PriorBillingCode></PriorBillingCodes><Name>SMR Large Resection Stem</Name><Description>Resection Stem Large Ti6AI4V</Description><Size>7-10mm Dia x 50-80 Height</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4057</SubGroupID><ARTGs><ARTG>211984</ARTG></ARTGs><MinimumBenefit>3771</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA523</BillingCode><PriorBillingCodes><PriorBillingCode>MA449</PriorBillingCode></PriorBillingCodes><Name>Affinis Shoulder System</Name><Description>Stem Cemented - adjustable cone</Description><Size>6, 9, 12 and 15mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4057</SubGroupID><ARTGs><ARTG>215496</ARTG><ARTG>219396</ARTG></ARTGs><MinimumBenefit>3771</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA526</BillingCode><Name>Affinis Inverse Stem, cemented</Name><Description>Humeral component - cemented. Monoblock primary stem for reverse inlay</Description><Size>6,9,12,15mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4057</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>215275</ARTG></ARTGs><MinimumBenefit>6301</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA634</BillingCode><PriorBillingCodes><PriorBillingCode>LC204</PriorBillingCode></PriorBillingCodes><Name>SMR TT Augmented 360 Baseplate</Name><Description>Reverse glenoid baseplate</Description><Size>Angle 7 to 19, Height 0 to 4mm, Size Standard and X</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>20004</SubGroupID><ARTGs><ARTG>490452</ARTG></ARTGs><MinimumBenefit>1777</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA635</BillingCode><PriorBillingCodes><PriorBillingCode>LC205</PriorBillingCode></PriorBillingCodes><Name>SMR System Glenoid Peg TT</Name><Description>Trabecular metal glenoid peg</Description><Size>Short to X-Long, S-R and S/STD</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>20003</SubGroupID><ARTGs><ARTG>285238</ARTG></ARTGs><MinimumBenefit>214</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA582</BillingCode><PriorBillingCodes><PriorBillingCode>LC149</PriorBillingCode><PriorBillingCode>LC006</PriorBillingCode><PriorBillingCode>OH102</PriorBillingCode></PriorBillingCodes><Name>Lima Plug and hood </Name><Description>UHMWPE Cement Plug with distal femoral stem hood</Description><Size>10mm - 20mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1447</GroupID><ARTGs><ARTG>186627</ARTG></ARTGs><MinimumBenefit>236</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA584</BillingCode><PriorBillingCodes><PriorBillingCode>LC151</PriorBillingCode><PriorBillingCode>LC006</PriorBillingCode><PriorBillingCode>OH102</PriorBillingCode></PriorBillingCodes><Name>Cement Plug UHMWPE</Name><Description>UHMWPE Cement Restrictor / Plug</Description><Size>Size 1 - 3</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1447</GroupID><ARTGs><ARTG>186627</ARTG></ARTGs><MinimumBenefit>236</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA591</BillingCode><PriorBillingCodes><PriorBillingCode>LC158</PriorBillingCode><PriorBillingCode>LC028</PriorBillingCode></PriorBillingCodes><Name>H-Max M Femoral Stem Ti6AI4V</Name><Description>H-Max M Femoral Stem HA Coated Ti6AI4V</Description><Size>9 - 18</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1411</GroupID><SubGroupID>3966</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>210634</ARTG></ARTGs><MinimumBenefit>2376</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA486</BillingCode><Name>SeleXys Acetabular Ceramys Ceramic Liner</Name><Description>Ceramys ceramic (zirconia &amp; alumina combination)</Description><Size>28/AA, 28/BB, 28/CC, 28/DD, 32/CC, 32DD, 32/EE, 32/FF,36/EE, 36/FF, 36/GG, 386HH,36/II, 36/JJ, 36/KK, /36/LL</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4025</SubGroupID><ARTGs><ARTG>274136</ARTG></ARTGs><MinimumBenefit>1690</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA599</BillingCode><PriorBillingCodes><PriorBillingCode>LC168</PriorBillingCode><PriorBillingCode>LC017</PriorBillingCode></PriorBillingCodes><Name>Delta Ceramic Liner Biolox Delta</Name><Description>Delta Ceramic Liner Biolox Delta</Description><Size>28 - 40mm ID x Small to Large</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4025</SubGroupID><ARTGs><ARTG>210724</ARTG></ARTGs><MinimumBenefit>1690</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA489</BillingCode><Name>balanSys Tibial Insert</Name><Description>Tibial insert, posterior stabilised UHMWPE</Description><Size>59/8mm to 85/23mm</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>211054</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ780</BillingCode><PriorBillingCodes><PriorBillingCode>DD036</PriorBillingCode></PriorBillingCodes><Name>Reverse Shoulder System</Name><Description>Humeral Socket Shell - Ti</Description><Size>Neutral, +4mm, +8mm offset</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4059</SubGroupID><ARTGs><ARTG>210937</ARTG></ARTGs><MinimumBenefit>2314</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA590</BillingCode><PriorBillingCodes><PriorBillingCode>LC157</PriorBillingCode><PriorBillingCode>LC033</PriorBillingCode></PriorBillingCodes><Name>Modular Head</Name><Description>Modular Head CoCrMo</Description><Size>36mm Diameter Small to XXXLarge</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>210718</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA482</BillingCode><Name>Ceramys Ceramic Femoral Head</Name><Description>Ceramic, zirconia alumina combination</Description><Size>28 L,  28 M, 28 S, 32 XL, 32 L, 32 M, 32 S</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>236457</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA568</BillingCode><PriorBillingCodes><PriorBillingCode>LC024</PriorBillingCode></PriorBillingCodes><Name>Lima Bone Screw</Name><Description>Titanium  Bone Screw</Description><Size>Dia. 4.5mm to 6.5mm
Length 15mm - 90mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>168711</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA612</BillingCode><PriorBillingCodes><PriorBillingCode>LC183</PriorBillingCode><PriorBillingCode>LC045</PriorBillingCode></PriorBillingCodes><Name>SMR Resurfacing CTA Humeral Head</Name><Description>CTA Resurfacing Humeral Head CoCrMo +Poro+Ti+Ha Coated</Description><Size>42 - 54mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4068</SubGroupID><Suffix>EL</Suffix><ARTGs><ARTG>211951</ARTG></ARTGs><MinimumBenefit>5220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ791</BillingCode><PriorBillingCodes><PriorBillingCode>HW675</PriorBillingCode><PriorBillingCode>DD073</PriorBillingCode></PriorBillingCodes><Name>Tactys PIP - Proximal System</Name><Description>Proximal Surface and Stem</Description><Size>XS, S, M &amp; L</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6144</SubGroupID><ARTGs><ARTG>237793</ARTG></ARTGs><MinimumBenefit>760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA623</BillingCode><PriorBillingCodes><PriorBillingCode>LC195</PriorBillingCode><PriorBillingCode>LC194</PriorBillingCode><PriorBillingCode>GM146</PriorBillingCode></PriorBillingCodes><Name>BioBall Femoral Head</Name><Description>Femoral Head Vivium ≤ 32mm</Description><Size>28mm,  32mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3988</SubGroupID><ARTGs><ARTG>227096</ARTG></ARTGs><MinimumBenefit>671</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ773</BillingCode><PriorBillingCodes><PriorBillingCode>SK597</PriorBillingCode><PriorBillingCode>DD071</PriorBillingCode></PriorBillingCodes><Name>PIP Finger Prosthesis</Name><Description>Proximal part PIP joint</Description><Size>0-5</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6144</SubGroupID><ARTGs><ARTG>237793</ARTG></ARTGs><MinimumBenefit>760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA514</BillingCode><Name>Acetabular Screws</Name><Description>Titanium cancellous bone screws</Description><Size>varying lengths and sizes</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>241996</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA611</BillingCode><PriorBillingCodes><PriorBillingCode>LC182</PriorBillingCode><PriorBillingCode>LC045</PriorBillingCode></PriorBillingCodes><Name>SMR Resurfacing Humeral Head</Name><Description>Resurfacing Humeral Head CoCrMo + Poro+Ti+HA coated</Description><Size>42 - 54mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4068</SubGroupID><ARTGs><ARTG>211982</ARTG></ARTGs><MinimumBenefit>3040</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA633</BillingCode><Name>ArTT Bone Screws</Name><Description>Titanium standard and locking bone screws, compatible with ArTT Augments and Buttresses</Description><Size>4mm and 6.5mm diameter, standard and locking screws, lengths 15mm to 40mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>510145</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA016</BillingCode><Name>CCA Cemented Femoral Stem</Name><Description>SS, straight, not polished</Description><Size>7.50mm -17.5mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3939</SubGroupID><ARTGs><ARTG>274203</ARTG></ARTGs><MinimumBenefit>1312</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA028</BillingCode><Name>Mathys Stainless Steel Femoral Heads</Name><Description>Stainless Steel, </Description><Size>22-32mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3988</SubGroupID><ARTGs><ARTG>210158</ARTG></ARTGs><MinimumBenefit>671</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA475</BillingCode><Name>twinSys Non Cemented Long Femoral Stem</Name><Description>Titanium, grit blast, fully HA, long</Description><Size>Various offsets and sizes &gt; 200mm length (12-15)</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1409</GroupID><SubGroupID>3957</SubGroupID><ARTGs><ARTG>287895</ARTG></ARTGs><MinimumBenefit>4826</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA585</BillingCode><PriorBillingCodes><PriorBillingCode>LC152</PriorBillingCode><PriorBillingCode>LC034</PriorBillingCode></PriorBillingCodes><Name>Modular Biolox Delta Head</Name><Description>Modular Biolox Delta Head</Description><Size>28 - 32mm Small to Large</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>210721</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA571</BillingCode><PriorBillingCodes><PriorBillingCode>LC029</PriorBillingCode></PriorBillingCodes><Name>Modular Neck</Name><Description>Modular Neck Segment - CoCrMo</Description><Size>Size 1-6, Sm &amp; Lg in STD, LAT, AVR/RVL, AVL/RVR</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1417</GroupID><ARTGs><ARTG>210671</ARTG></ARTGs><MinimumBenefit>1029</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA619</BillingCode><PriorBillingCodes><PriorBillingCode>LC190</PriorBillingCode><PriorBillingCode>GM042</PriorBillingCode></PriorBillingCodes><Name>BioBall - Revision Neck Adaptor</Name><Description>Titanium, varying tapers &amp; lengths, for ceramic &amp; metal heads</Description><Size>8/10 standard, 8/10 offset
10/12 standard, 10/12 offset
12/14 standard, 12/14 offset
14/16 standard,14/16 offset
V40 standard, V40 offset,
PCA standard, PCA offset
Type 1 standard 
11/13 standard, 11/13 offset
S - 5XL standard
M-5XL offset</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1443</GroupID><ARTGs><ARTG>227099</ARTG></ARTGs><MinimumBenefit>436</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA503</BillingCode><Name>Selexys Acetabular Cup Liner</Name><Description>Insert / Liner, modified polyethylene.  Highly crossed link polyethylene, stabilised with Vit E.</Description><Size>Articulation 28, 32, 36mm; Cup size AA to LL (42 to 70mm)</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>274134</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA518</BillingCode><Name>Balansys Tibial Baseplate</Name><Description>Tibial Baseplate cemented, CoCr, TiNbN coated</Description><Size>59mm to 85mm</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>211083</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA630</BillingCode><PriorBillingCodes><PriorBillingCode>LC202</PriorBillingCode><PriorBillingCode>OH526</PriorBillingCode><PriorBillingCode>OH505</PriorBillingCode></PriorBillingCodes><Name>G21 Bone Cement</Name><Description>Bone Cement - std and low viscosity</Description><Size>20-60g</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4087</SubGroupID><ARTGs><ARTG>329063</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA496</BillingCode><Name>SeleXys Acetabular PC Shell</Name><Description>Uncemented Ti acetabular shell, beaded, non HA</Description><Size>42mm - 72mm in 2mm increments</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4011</SubGroupID><ARTGs><ARTG>274135</ARTG></ARTGs><MinimumBenefit>1802</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA600</BillingCode><PriorBillingCodes><PriorBillingCode>LC170</PriorBillingCode><PriorBillingCode>LC018</PriorBillingCode></PriorBillingCodes><Name>Delta Non Constrained Liner</Name><Description>Delta Non Constrained Liner UHMWPE X Lima Ti6AI4V Neutral and Protruded</Description><Size>Diameter (mm) 28 to 40  Size Small to Extra Large  Shape Neutral  Shape Protruded</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>218819</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA586</BillingCode><PriorBillingCodes><PriorBillingCode>LC153</PriorBillingCode><PriorBillingCode>LC034</PriorBillingCode></PriorBillingCodes><Name>Revision Modular Biolox Delta Head</Name><Description>Revision Modular Biolox Delta Head Ti6AI4V 12/14 Taper</Description><Size>28 - 32mm Small to Xlarge</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><Suffix>Sleeve</Suffix><ARTGs><ARTG>210872</ARTG></ARTGs><MinimumBenefit>1931</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA601</BillingCode><PriorBillingCodes><PriorBillingCode>LC171</PriorBillingCode><PriorBillingCode>LC018</PriorBillingCode></PriorBillingCodes><Name>SPH Constrained Poly Liner</Name><Description>SPH Constrained Poly Liner UHMWPE protruded 20*</Description><Size>Protruded Liners
ID 28mm X Size XXA, A, B, C, D, E
ID 32mm x Size B, C, D, E

Neutral Liners
ID 28mm X Size XXA, A, B, C, D, E
ID 32mm x Size B, C, D, E</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>222629</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA484</BillingCode><Name>Ceramys Ceramic Revision Femoral Head</Name><Description>Ceramic, zirconia alumina combination, supplied with titanium taper sleeve</Description><Size>28 L, 28 M, 28 S, 28 XL, 32 L, 32 M, 32 S, 32 XL, 28, 32</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><Suffix>Sleeve</Suffix><ARTGs><ARTG>274113</ARTG></ARTGs><MinimumBenefit>1931</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA615</BillingCode><PriorBillingCodes><PriorBillingCode>LC186</PriorBillingCode><PriorBillingCode>LC045</PriorBillingCode></PriorBillingCodes><Name>SMR Reverse Glenoid Base Plate</Name><Description>Reverse Glenoid Base Plate</Description><Size>Small-R or Small/Standard</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4078</SubGroupID><ARTGs><ARTG>210956</ARTG></ARTGs><MinimumBenefit>1991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA534</BillingCode><Name>Affinis Inverse Metaglene, DP</Name><Description>Metaglene, uncemented. Ti plasma plus CaP coating</Description><Size>One size only</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4078</SubGroupID><ARTGs><ARTG>215497</ARTG></ARTGs><MinimumBenefit>1991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA535</BillingCode><Name>Affinis Inverse revision metaglene</Name><Description>Revision Metaglene, Ti plasma plus CaP Coating</Description><Size>one size only</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4078</SubGroupID><ARTGs><ARTG>224964</ARTG></ARTGs><MinimumBenefit>1991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA548</BillingCode><Name>balanSys Uni vitamys Inlay</Name><Description>Uni tibial insert, vitamys</Description><Size>5,6,7,9</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>154</SubCategoryID><GroupID>1372</GroupID><ARTGs><ARTG>312503</ARTG></ARTGs><MinimumBenefit>689</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA419</BillingCode><Name>SeleXys Acetabular UHMWPE Liner</Name><Description>UHMWPE</Description><Size>44mm-72mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4020</SubGroupID><ARTGs><ARTG>274137</ARTG></ARTGs><MinimumBenefit>688</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA027</BillingCode><Name>CCB Cemented UHMWPE Cup</Name><Description>UHMWPE, low &amp; full profile</Description><Size>28/32 ID - 42/64 OD</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4006</SubGroupID><ARTGs><ARTG>211096</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ789</BillingCode><PriorBillingCodes><PriorBillingCode>HW566</PriorBillingCode><PriorBillingCode>DD068</PriorBillingCode></PriorBillingCodes><Name>SR Hand Implant System</Name><Description>SR Hand MCP Distal CoCr - Titanium Alloy, UHMWPE</Description><Size>XS/S/M/L/XL</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6143</SubGroupID><ARTGs><ARTG>237799</ARTG></ARTGs><MinimumBenefit>665</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ776</BillingCode><PriorBillingCodes><PriorBillingCode>DD057</PriorBillingCode></PriorBillingCodes><Name>Reverse Shoulder - Glenoid Baseplate</Name><Description>Reverse Glenoid Component, Baseplate</Description><Size>6.5mm x 30mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4078</SubGroupID><ARTGs><ARTG>210932</ARTG></ARTGs><MinimumBenefit>1991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA561</BillingCode><PriorBillingCodes><PriorBillingCode>LC012</PriorBillingCode><PriorBillingCode>OH229</PriorBillingCode></PriorBillingCodes><Name>Lima Cup </Name><Description>Metal Liner</Description><Size>28mm, 32mm and 36mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4023</SubGroupID><ARTGs><ARTG>216035</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ792</BillingCode><PriorBillingCodes><PriorBillingCode>DD004</PriorBillingCode></PriorBillingCodes><Name>Turon Shoulder System - All-Poly Glenoid</Name><Description>Turon - All-Poly Glenoid, Keeled and Pegged</Description><Size>38mm, 42mm, 46mm, 50mm, 54mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>3701</SubGroupID><ARTGs><ARTG>210954</ARTG><ARTG>210955</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA454</BillingCode><Name>BalanSys UNI tibial Insert </Name><Description>Uni tibial insert, UHMWPE, fixed </Description><Size>5,6,7,9</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>154</SubCategoryID><GroupID>1372</GroupID><ARTGs><ARTG>212830</ARTG></ARTGs><MinimumBenefit>689</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA560</BillingCode><PriorBillingCodes><PriorBillingCode>LC011</PriorBillingCode><PriorBillingCode>OH227</PriorBillingCode></PriorBillingCodes><Name>C2 Femoral Stem</Name><Description>C2 Femoral Stem Standard / Lateralised / Revision 12/14 Taper Ti6AI4V</Description><Size>02 to 12</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1406</GroupID><SubGroupID>3945</SubGroupID><ARTGs><ARTG>210716</ARTG><ARTG>210720</ARTG></ARTGs><MinimumBenefit>2883</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA570</BillingCode><PriorBillingCodes><PriorBillingCode>LC027</PriorBillingCode></PriorBillingCodes><Name>Revision Modular Femoral Body</Name><Description>Revision Modular Femoral Body 12/14 Taper with Locking Screw Ti6AI4V</Description><Size>Std &amp; Lat x 50-70mm - Body Height</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Body</Suffix><ARTGs><ARTG>210642</ARTG></ARTGs><MinimumBenefit>2401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA626</BillingCode><PriorBillingCodes><PriorBillingCode>LC198</PriorBillingCode><PriorBillingCode>LC163</PriorBillingCode><PriorBillingCode>LC019</PriorBillingCode></PriorBillingCodes><Name>2M Cups Double Mobility System Mobile Liners (UHMWPE)</Name><Description>The liner functions as part of a double mobility system. The liner articulates with an acetabular cup and femoral head as part of a total hip arthroplasty. The liner has an inner clearance of 0.3 mm with respect to the femoral head. The outer clearance has been increased to 0.6 mm to avoid locking of the outer joint due to the interposition of fibrous tissue. The centre of the inner head is cranialized with respect to the centre of the liner (1,5 mm), to permit the self-centring of the system.</Description><Size>Diameter (mm)
Outer 42 to 58
Diameter (mm)
Inner 22 to 28</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1424</GroupID><SubGroupID>4005</SubGroupID><ARTGs><ARTG>294065</ARTG></ARTGs><MinimumBenefit>868</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA625</BillingCode><PriorBillingCodes><PriorBillingCode>LC197</PriorBillingCode><PriorBillingCode>LC163</PriorBillingCode><PriorBillingCode>LC019</PriorBillingCode></PriorBillingCodes><Name>Delta Mobile Liner UHMWPE</Name><Description>The Mobile Liner UHMWPE functions as part of a double mobility system. It is coupled with an outer liner before being fitted onto the head of a femoral stem. The inner liner provides the articulating surface within the outer liner and the coupled liner provides the articulating surface with the acetabular shell after insertion into the acetabular shell/Cup as part of a total hip arthroplasty.</Description><Size>Diameter (mm) 40 - 42 Outer</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1424</GroupID><SubGroupID>4005</SubGroupID><ARTGs><ARTG>294077</ARTG></ARTGs><MinimumBenefit>868</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA595</BillingCode><PriorBillingCodes><PriorBillingCode>LC162</PriorBillingCode><PriorBillingCode>LC019</PriorBillingCode></PriorBillingCodes><Name>Lock Bipolar Head and Liner</Name><Description>Self Centering Head CoCrMo and UHMWPE Liner</Description><Size>Diameter x 28mm x OD 41-57mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1424</GroupID><SubGroupID>4005</SubGroupID><ARTGs><ARTG>216354</ARTG></ARTGs><MinimumBenefit>868</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA312</BillingCode><Name>balanSys Tibial Baseplate</Name><Description>Tibial Baseplate for Mobile Bearing Insert, cemented, CoCr</Description><Size>59mm to 85mm</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><ARTGs><ARTG>211085</ARTG></ARTGs><MinimumBenefit>2005</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA545</BillingCode><Name>Ligamys DIS Suture with button</Name><Description>UHMWPE braid with Ti alloy button</Description><Size>One size</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1776</GroupID><SubGroupID>5398</SubGroupID><ARTGs><ARTG>232098</ARTG></ARTGs><Note>Prescribed List reimbursement  for the billing code is restricted to the use of Artificial Ligaments for intra-articular cases where no non-synthetic graft sources (allografts and autografts) are available.</Note><MinimumBenefit>4217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA603</BillingCode><PriorBillingCodes><PriorBillingCode>LC173</PriorBillingCode><PriorBillingCode>LC008</PriorBillingCode><PriorBillingCode>OH113</PriorBillingCode></PriorBillingCodes><Name>SMR - Glenoid 3 Peg UHMWPE</Name><Description>Glenoid 3 Peg UHMWPE X-Lima</Description><Size>Extra small, Standard, Small, and Large</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>3701</SubGroupID><ARTGs><ARTG>210963</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA547</BillingCode><Name>Affinis Glenoid cemented vitamys</Name><Description>Cemented glenoid - vitamys UHMWPE</Description><Size>Sizes 1 - 4</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>3701</SubGroupID><ARTGs><ARTG>238288</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA108</BillingCode><Name>balanSys Femoral Component</Name><Description>Femoral component, cemented, CoCr</Description><Size>XS TO F Left and Right</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>206062</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA551</BillingCode><Name>Affinis Inverse Glenosphere</Name><Description>Glenosphere vitamys</Description><Size>36mm, 39mm, 42mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>238290</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA596</BillingCode><PriorBillingCodes><PriorBillingCode>LC164</PriorBillingCode><PriorBillingCode>LC016</PriorBillingCode></PriorBillingCodes><Name>Delta TT Acetabular Cup</Name><Description>Delta TT Acetabular Cup Ti6AI4V</Description><Size>44 - 76mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4014</SubGroupID><ARTGs><ARTG>210796</ARTG></ARTGs><MinimumBenefit>2812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA525</BillingCode><PriorBillingCodes><PriorBillingCode>MA499</PriorBillingCode></PriorBillingCodes><Name>Modular Revision Stem</Name><Description>Proximal Body, Long, Grit Blasted Titanium</Description><Size>80mm-110mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1412</GroupID><SubGroupID>3971</SubGroupID><Suffix>Body</Suffix><ARTGs><ARTG>274207</ARTG></ARTGs><MinimumBenefit>3239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA450</BillingCode><Name>Affinis Total Shoulder</Name><Description>Glenoid - UHMWPE</Description><Size>Size 1 to 4</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>3701</SubGroupID><ARTGs><ARTG>219394</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA490</BillingCode><Name>balanSys Knee System / Femoral Component, CR, cemented, TiNbN coated</Name><Description>Balansys Femoral Component/ CR cemented, TiNbN coated</Description><Size>XS to F, left and right</Size><SupplierCode>MA</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>206173</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA501</BillingCode><Name>Modular Revision Stem - Long</Name><Description>Titanium, grit blast, non HA</Description><Size>14mm x 200mm - 24 x 200mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1412</GroupID><SubGroupID>3971</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>274204</ARTG></ARTGs><MinimumBenefit>3877</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA613</BillingCode><PriorBillingCodes><PriorBillingCode>LC184</PriorBillingCode><PriorBillingCode>LC045</PriorBillingCode></PriorBillingCodes><Name>SMR Reverse Poly Gleonsphere</Name><Description>Reverse Glenophere UHMWPE X-Lima Ti6AI4V</Description><Size>40 - 44 Standard &amp; Exxentric</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>211987</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA628</BillingCode><PriorBillingCodes><PriorBillingCode>LC200</PriorBillingCode><PriorBillingCode>LC165</PriorBillingCode><PriorBillingCode>LC016</PriorBillingCode></PriorBillingCodes><Name>Delta ONE TT cup</Name><Description>Delta One TT Acetabular Cup Ti6AI4V</Description><Size>Diameter (mm) 44 - 66mm</Size><SupplierCode>MA</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4014</SubGroupID><ARTGs><ARTG>216036</ARTG></ARTGs><MinimumBenefit>2812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA602</BillingCode><PriorBillingCodes><PriorBillingCode>LC172</PriorBillingCode><PriorBillingCode>LC008</PriorBillingCode><PriorBillingCode>OH113</PriorBillingCode></PriorBillingCodes><Name>SMR Cemented Glenoid</Name><Description>All Poly Glenoid Cemented UHMWPE</Description><Size>Small - Large</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>3701</SubGroupID><ARTGs><ARTG>211974</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA579</BillingCode><PriorBillingCodes><PriorBillingCode>LC062</PriorBillingCode></PriorBillingCodes><Name>HVS BONE SCREW</Name><Description>Self drilling, self threading double threaded cannulated screw</Description><Size>Length 10-34mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>168711</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA607</BillingCode><PriorBillingCodes><PriorBillingCode>LC178</PriorBillingCode><PriorBillingCode>LC043</PriorBillingCode></PriorBillingCodes><Name>SMR System - Finned &amp; Revision Humeral Stem</Name><Description>Finned Humeral Stem Ti6AI4V</Description><Size>Dia 11-26mm x Length 45 - 80mm, Dia 13-16mm x H 150 - 180mm</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4064</SubGroupID><ARTGs><ARTG>218726</ARTG><ARTG>274360</ARTG></ARTGs><MinimumBenefit>2660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MA614</BillingCode><PriorBillingCodes><PriorBillingCode>LC185</PriorBillingCode><PriorBillingCode>LC045</PriorBillingCode></PriorBillingCodes><Name>SMR Reverse Glenosphere</Name><Description>Reverse Glenosphere CoCrMo</Description><Size>36mm Standard and Eccentric</Size><SupplierCode>MA</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>211985</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ831</BillingCode><Name>SMARTeZ Rigid Shell Single Use Elastomeric Infusion Pump - Chemotherapy</Name><Description>SMARTeZ Rigid Shell Single use Elastomeric Infusion Pump - Chemotherapy-rated pumps are available with and without a bonded closed system transfer device attachment. (CSTD) providing a true closed system for the safety of both the patient and caregivers. Product is used for a single patient only.</Description><Size>Size, 60ml - 275ml. Flow rates: 0.5mL/hr to 100mL/hr</Size><SupplierCode>LU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><ARTGs><ARTG>396632</ARTG></ARTGs><MinimumBenefit>28</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ828</BillingCode><Name>SMARTeZ Plus Painbloc Single Use Elastomeric Infusion pump - Fixed Flow rate - Single patient use</Name><Description>The SMARTeZ Plus PainBloc pump is a single use soft-shell elastomeric pump, for single patient use only. The Painbloc pump provides continuous delivery of medication (local anesthetics &amp; analgesics) to or around surgical wound sites and/or close proximity to nerves for preoperative, perioperative and postoperative regional anesthesia and/or pain management.
Route of administration include: intraoperative site, peripheral nerve block, percutaneous and epidural.</Description><Size>270ml, 400ml and 600ml sizes. Fixed flow rates at 2ml /hr and 5ml/hr</Size><SupplierCode>LU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><ARTGs><ARTG>396632</ARTG></ARTGs><MinimumBenefit>28</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ826</BillingCode><Name>eZPush Infusion administration set, controller - single use only</Name><Description>The infusion controller administration sets for Non-electrically Driven Portable Infusion Devices are intended to regulate the flow rate of 
mechanical infusion pumps are single use only</Description><Size>Many flow rates - 1ml per hour up to 120 ml per hour</Size><SupplierCode>LU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1541</GroupID><SubGroupID>4193</SubGroupID><ARTGs><ARTG>401812</ARTG></ARTGs><MinimumBenefit>7</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ827</BillingCode><Name>eZPush IV Spring Infusion Pump - Single Use only</Name><Description>The eZPush IV Spring Infusion Pump is a SINGLE USE mechanical infusion pump that works independently from main power supplies or batteries, 
providing constant intravenous (IV) or subcutaneous (SC) infusions in either a 10ml, 30ml or 50ml configuration. The pump works with any Luer Lock tip syringe regardless of the manufacturer whilst the flow rates are managed by either precision tubing (simiular to Springfusor flow controlled tubing) or Flobot Flow Regulator with attached tubing. The Epic Medical tubing is compatible with the GO Medical Springfusor pumps.</Description><Size>5ml, 10ml, 20ml and 60ml Spring Infusion Pump systems. </Size><SupplierCode>LU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1540</GroupID><SubGroupID>4188</SubGroupID><ARTGs><ARTG>406013</ARTG></ARTGs><MinimumBenefit>76</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ830</BillingCode><Name>SMARTeZ Plus Single Use Painbloc Elastomeric Infusion pump - Variable Flow Rate controller</Name><Description>SMARTeZ Plus Single Use Painbloc Elastomeric Infusion pump with Variable Flow Rate controller is intended to provide delivery of medication (local anesthetics &amp; analgesics) to or around surgical wound sites and/or close proximity to nerves for preoperative, perioperative and postoperative regional anesthesia and/or pain management, for single patient use The variable flow controllers allow for the delivery rate to be adjusted in 2ml increments from 2ml-14ml hour, or in 1 ml increments from 1ml-7ml per hour.
Route of administration include: intraoperative site, peripheral nerve block, percutaneous and epidural.
</Description><Size>Sizes: 270ml, 400ml and 600ml.   Variable flow rates: 0-14ml/hr with 2 ml/hour increments,  1-7ml/hr with 1ml/hour increments.</Size><SupplierCode>LU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5359</SubGroupID><ARTGs><ARTG>396632</ARTG></ARTGs><MinimumBenefit>142</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ832</BillingCode><Name>SMARTeZ RS Rigid Shell Single Use Elastomeric Infusion Pump</Name><Description>DESCRIPTION
The SMARTeZ RS Rigid Shell Elastomeric Infusion Pump (SINGLE USE for a Single patient),  elastomeric pump with rigid shell on the fluid reservoir. The device works independently of main power supplies or batteries, enabling patient to be treated in an ambulatory manner.
Fluid is delivered to patient by positive pressure applied by the elastomeric membranes on the fluid reservoir. The flow rate is determined by the combination of the flow restrictor (capillary tube) and positive pressure of the elastomeric membrane. This pressure delivers the fluid against the back pressure of the catheters and  infusion site. Suitable for short term and long term infusion.</Description><Size>Long Term Infusion: 60ml - 300ml, 0.5ml/hr to 11.5ml/hr flow rate.     Short Time Infusion: 50ml - 250ml, 50ml/hr to 250ml/hr flow rate.  </Size><SupplierCode>LU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><ARTGs><ARTG>396632</ARTG></ARTGs><MinimumBenefit>28</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ829</BillingCode><Name>SMARTeZ Plus Single Use Painbloc Elastomeric Infusion pump - Variable Flow Rate and PCA Bolus</Name><Description>SMARTeZ Plus Single Use Painbloc Elastomeric Infusion pump - Variable Flow Rate and PCA Bolus is intended to provide adjustable flow rate delivery of medication (local anesthetics &amp; analgesics) to or around surgical wound sites and/or close proximity to nerves for preoperative, perioperative and postoperative regional anesthesia and/or pain management, with the additional option of PCA Bolus administration.
Route of administration include: intraoperative site, peripheral nerve block, percutaneous and epidural. For single patient use only
</Description><Size>Sizes: 270ml, 400ml and 600ml. Variable Flow rate options 0-7ml/hr and 0-14ml/hr. PCA Bolus options: 2ml -5ml / 30 minute PCA Bolus options</Size><SupplierCode>LU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5359</SubGroupID><Suffix>Bolus</Suffix><ARTGs><ARTG>396632</ARTG></ARTGs><MinimumBenefit>367</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ825</BillingCode><Name>SMARTeZ Soft Shell Elastomeric Infusion Pump</Name><Description>The SMARTeZ Soft Shell Elastomeric Infusion Pump pump has a specially designed multi-layered balloon-like reservoir to be filled with the drug or fluid intended for infusion. It exerts mechanical pressure to administer the contents at a predetermined flow rate. The entire unit is sterile and is intended for single use only.</Description><Size>Long Infusion: Filling Volume: 60ml - 400ml, Flow Rate: 0.5ml/h - 10ml/h  Short Infusion: Filling Volume: 50ml - 500ml, Flow Rate: 50ml/h - 500ml/h</Size><SupplierCode>LU</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><ARTGs><ARTG>396632</ARTG></ARTGs><MinimumBenefit>28</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW104</BillingCode><Name>MaxAn Anterior Cervical Plate System - Fixed and Variable Screws</Name><Description>Anterior Cervical Plate System - Fixed and Variable Screws
</Description><Size>Diameter: 4.0mm - 4.5mm; Length 8mm to 26mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>287243</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW089</BillingCode><PriorBillingCodes><PriorBillingCode>NW018</PriorBillingCode><PriorBillingCode>ZI995</PriorBillingCode></PriorBillingCodes><Name>Vitality Spine System - Set Screw</Name><Description>SET SCREW</Description><Size>One size only</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW077</BillingCode><PriorBillingCodes><PriorBillingCode>NW041</PriorBillingCode><PriorBillingCode>ZA057</PriorBillingCode><PriorBillingCode>DE411</PriorBillingCode></PriorBillingCodes><Name>Mobi-C Cervical Disc Prosthesis</Name><Description>A cervical intervertebral disc replacement consisting of superior and inferior spinal plates and a mobile bearing insert.</Description><Size>Depth (13-19mm) x width (15-19mm) x height (4.5-7mm)</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5487</SubGroupID><ARTGs><ARTG>297897</ARTG></ARTGs><MinimumBenefit>6021</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW097</BillingCode><PriorBillingCodes><PriorBillingCode>NW026</PriorBillingCode><PriorBillingCode>ZI908</PriorBillingCode></PriorBillingCodes><Name>Virage Rod to Rod Transverse Connector</Name><Description>Rod to Rod Transverse Connector (supplied pre-assembled with hex nuts)</Description><Size>XS, S, M, L, XL</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW073</BillingCode><PriorBillingCodes><PriorBillingCode>NW035</PriorBillingCode><PriorBillingCode>ZI914</PriorBillingCode></PriorBillingCodes><Name>Virage Rods</Name><Description>Virage OCT Straight, Curved and Pre-Contoured Rods</Description><Size>3.5mm x 25-400mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW019</BillingCode><Name>WEGO Spinal Systems</Name><Description>Hooks - various</Description><Size>Small, medium, large</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW084</BillingCode><PriorBillingCodes><PriorBillingCode>NW013</PriorBillingCode><PriorBillingCode>ZI993</PriorBillingCode></PriorBillingCodes><Name>Vitality Spine System - Monoaxial Pedicle Screws</Name><Description>Monoaxial pedicle Screws Titanium</Description><Size>Diameter = 4.0mm-7.5mm  Length= 20mm-55mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW078</BillingCode><PriorBillingCodes><PriorBillingCode>NW042</PriorBillingCode><PriorBillingCode>BH108</PriorBillingCode></PriorBillingCodes><Name>Anterior Cervical Plate System</Name><Description>Titanium Cancellous Bone Screw</Description><Size>4 - 20mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW096</BillingCode><PriorBillingCodes><PriorBillingCode>NW025</PriorBillingCode><PriorBillingCode>ZA001</PriorBillingCode></PriorBillingCodes><Name>Vitality Spine System - Fixed Cross Connector</Name><Description>Fixed length cross connector, titanium</Description><Size>21mm X 5.5mm - 31mm X 5.5mm &amp; 21mm Wide X 6.0mm - 31mm Wide X 6.0mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW045</BillingCode><Name>WEGO Spinal Systems </Name><Description>Cannulated polyaxial screws </Description><Size>All sizes</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW091</BillingCode><PriorBillingCodes><PriorBillingCode>NW020</PriorBillingCode><PriorBillingCode>ZI910</PriorBillingCode></PriorBillingCodes><Name>Virage Closed Rod Connector</Name><Description>Closed Rod Connector (supplied pre-assembled with set screws)</Description><Size>3.5 to 5.5mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW099</BillingCode><PriorBillingCodes><PriorBillingCode>NW028</PriorBillingCode><PriorBillingCode>ZI999</PriorBillingCode></PriorBillingCodes><Name>Vitality Spine System - Multi-Span Cross Connector</Name><Description>Adjustable length cross connector, titanium</Description><Size>33-36mm Wide X 5.5mm - 70-90mm Wide X 6.0mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW028</BillingCode><Name>WEGO Spinal Systems </Name><Description>Set screws </Description><Size>All sizes</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW032</BillingCode><Name>Equinox Spinal Systems</Name><Description>In Line Connectors</Description><Size>3 mm to 6.5 mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW102</BillingCode><PriorBillingCodes><PriorBillingCode>NW031</PriorBillingCode><PriorBillingCode>ZA014</PriorBillingCode></PriorBillingCodes><Name>MaxAn Anterior Cervical Plating System</Name><Description>Titanium plate for anterior cervical spine</Description><Size>≤55mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>287243</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW093</BillingCode><PriorBillingCodes><PriorBillingCode>NW022</PriorBillingCode><PriorBillingCode>ZI907</PriorBillingCode></PriorBillingCodes><Name>Virage Lateral Offset Connector</Name><Description>Virage Lateral Offset Connectors and Occipital Eyelet supplied pre-assembled with set screws</Description><Size>10mm and 25mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW079</BillingCode><PriorBillingCodes><PriorBillingCode>NW043</PriorBillingCode><PriorBillingCode>ZI950</PriorBillingCode></PriorBillingCodes><Name>Timberline Lateral Fusion System</Name><Description>Bone Screws</Description><Size>30-60mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW075</BillingCode><PriorBillingCodes><PriorBillingCode>NW039</PriorBillingCode><PriorBillingCode>ZA052</PriorBillingCode><PriorBillingCode>DE350</PriorBillingCode></PriorBillingCodes><Name>ROI-C Cervical Cage</Name><Description>A cervical cage for anterior approaches to cervical spine with screws</Description><Size>Footprints 12x14, 12x15.5, 14x14, 14x15.5; 14x17mm; Heights 4.5mm to 10mm; Anchors: Short, Long</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>188175</ARTG><ARTG>188176</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW071</BillingCode><PriorBillingCodes><PriorBillingCode>NW033</PriorBillingCode><PriorBillingCode>ZI916</PriorBillingCode></PriorBillingCodes><Name>Virage Rods</Name><Description>Virage OCT Transition Rods</Description><Size>3.5/5.5mm x 450mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW050</BillingCode><Name>WEGO Spinal Systems</Name><Description>Connectors</Description><Size>All Sizes</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW092</BillingCode><PriorBillingCodes><PriorBillingCode>NW021</PriorBillingCode><PriorBillingCode>ZI996</PriorBillingCode></PriorBillingCodes><Name>Vitality Spine system - Rod Connectors</Name><Description>Tandem rod connectors</Description><Size>5.5/6.0mm &amp; 3.5mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW081</BillingCode><PriorBillingCodes><PriorBillingCode>NW045</PriorBillingCode><PriorBillingCode>ZI951</PriorBillingCode></PriorBillingCodes><Name>Timberline Lateral Fusion System</Name><Description>Lateral Plate</Description><Size>6-16mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4128</SubGroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW082</BillingCode><PriorBillingCodes><PriorBillingCode>NW046</PriorBillingCode><PriorBillingCode>BH170</PriorBillingCode></PriorBillingCodes><Name>Zyston Straight Interbody Spacer</Name><Description>Posterior Lumbar Interbody Spacer, PEEK</Description><Size>(7mm x 20mm) to (18mm x 30mm), Convex, Lordotic</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>287188</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW098</BillingCode><PriorBillingCodes><PriorBillingCode>NW027</PriorBillingCode><PriorBillingCode>ZI909</PriorBillingCode></PriorBillingCodes><Name>Virage Head to Head Transverse Connector</Name><Description>Transverse Connector Adjustable</Description><Size>XS, S, M, L, XL</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>111775</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW083</BillingCode><PriorBillingCodes><PriorBillingCode>NW047</PriorBillingCode><PriorBillingCode>BH143</PriorBillingCode></PriorBillingCodes><Name>Zyston Curved Interbody Spacer</Name><Description>Transformaminal Lumbar Interbody Spacer, PEEK</Description><Size>(7 to 18)mm height to (27x32)mm length, Parallel, Lordotic</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>287188</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW024</BillingCode><Name>WEGO Spinal Systems</Name><Description>Washer</Description><Size>Various</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1482</GroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW080</BillingCode><PriorBillingCodes><PriorBillingCode>NW044</PriorBillingCode><PriorBillingCode>ZI952</PriorBillingCode></PriorBillingCodes><Name>Timberline Lateral Fusion System</Name><Description>Cover Plate</Description><Size>2 and 4 hole</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1467</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>391</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW001</BillingCode><Name>WEGO Spinal Systems </Name><Description>Break off set screw </Description><Size>5.5 mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW101</BillingCode><PriorBillingCodes><PriorBillingCode>NW030</PriorBillingCode><PriorBillingCode>ZA015</PriorBillingCode></PriorBillingCodes><Name>MaxAn Anterior Cervical Plating System</Name><Description>Titanium plate for anterior cervical spine</Description><Size>&gt;55mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>287243</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW088</BillingCode><PriorBillingCodes><PriorBillingCode>NW017</PriorBillingCode><PriorBillingCode>ZI906</PriorBillingCode></PriorBillingCodes><Name>Virage Closure Top</Name><Description>Closure Top and dome nut</Description><Size>One Size</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>111775</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW070</BillingCode><PriorBillingCodes><PriorBillingCode>NW032</PriorBillingCode><PriorBillingCode>ZI913</PriorBillingCode></PriorBillingCodes><Name>Virage Occiptial Plates</Name><Description>Virage Occipital Plates and an Occipital Strap</Description><Size>small, medium, large</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW095</BillingCode><PriorBillingCodes><PriorBillingCode>NW024</PriorBillingCode><PriorBillingCode>ZI998</PriorBillingCode></PriorBillingCodes><Name>Vitality Spine System - Tandem rod connectors</Name><Description>Tandem rod connectors</Description><Size>5.5/6.0mm &amp; 3.5mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW086</BillingCode><PriorBillingCodes><PriorBillingCode>NW015</PriorBillingCode><PriorBillingCode>ZI994</PriorBillingCode></PriorBillingCodes><Name>Vitality Spine System - Polyaxial Pedicle Screws</Name><Description>Polyaxial Pedicle Screws Titanium</Description><Size>Diameter = 4.0mm-10.5mm  Length= 20mm-120mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW087</BillingCode><PriorBillingCodes><PriorBillingCode>NW016</PriorBillingCode><PriorBillingCode>ZI904</PriorBillingCode></PriorBillingCodes><Name>Virage Occipital Screws</Name><Description>Occipital Screws</Description><Size>4.5mm x 6-16mm, 5.25mm x 6-16mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW044</BillingCode><Name>WEGO Spinal Systems </Name><Description>Lateral Connectors</Description><Size>20 mm to 65 mm long</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW103</BillingCode><Name>Vitalign S-Rods</Name><Description>S Rod / Titanium alloy and Cobalt Chrome</Description><Size>(5.5 - 6.0)mm diameter x (400-510)mm length, CoCr Ti Alloy</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW072</BillingCode><PriorBillingCodes><PriorBillingCode>NW034</PriorBillingCode><PriorBillingCode>ZA002</PriorBillingCode></PriorBillingCodes><Name>Vitality Spine System - Rods</Name><Description>Straight and contoured rods titanium and CoCR</Description><Size>5.5 x 25mm - 5.5 x 510mm &amp; 6 x 25mm - 6 x 510mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW090</BillingCode><PriorBillingCodes><PriorBillingCode>NW019</PriorBillingCode><PriorBillingCode>ZI911</PriorBillingCode></PriorBillingCodes><Name>Virage Cable Connector</Name><Description>Cable Connector</Description><Size>One Size</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW021</BillingCode><Name>WEGO Spinal Systems </Name><Description>Plates</Description><Size>All sizes &amp;lt;55 mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW031</BillingCode><Name>WEGO Spinal Systems </Name><Description>Rods</Description><Size>All sizes</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW100</BillingCode><PriorBillingCodes><PriorBillingCode>NW029</PriorBillingCode><PriorBillingCode>ZI912</PriorBillingCode></PriorBillingCodes><Name>Virage Hooks</Name><Description>Virage Laminar and Offset Laminar Hooks</Description><Size>6mm and 8mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW029</BillingCode><Name>WEGO Spinal Systems</Name><Description>Staple</Description><Size>Various</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW020</BillingCode><Name>WEGO Spinal Systems </Name><Description>Monoaxial screws </Description><Size>All sizes</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW027</BillingCode><Name>WEGO Spinal Systems </Name><Description>Polyaxial screws </Description><Size>All sizes</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW085</BillingCode><PriorBillingCodes><PriorBillingCode>NW014</PriorBillingCode><PriorBillingCode>ZI905</PriorBillingCode></PriorBillingCodes><Name>Virage Pedicle Polyaxial Screws</Name><Description>Polyaxial and Polyaxial Smooth Shank Pedicle screws</Description><Size>3.5mm-5.0mm x 10-45mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW043</BillingCode><Name>WEGO Spinal Systems</Name><Description>Bone screws</Description><Size>All sizes</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>330363</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW094</BillingCode><PriorBillingCodes><PriorBillingCode>NW023</PriorBillingCode><PriorBillingCode>ZI997</PriorBillingCode></PriorBillingCodes><Name>Vitality Spine System - Iliac Lateral Connector</Name><Description>Open and Closed Iliac Lateral Connector</Description><Size>20mm - 50mm</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW074</BillingCode><PriorBillingCodes><PriorBillingCode>NW036</PriorBillingCode><PriorBillingCode>ZI915</PriorBillingCode></PriorBillingCodes><Name>Virage Occipital Rod</Name><Description>Occipital Hinged Rod</Description><Size>One size</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1480</GroupID><SubGroupID>4133</SubGroupID><ARTGs><ARTG>287242</ARTG></ARTGs><MinimumBenefit>1350</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GW076</BillingCode><PriorBillingCodes><PriorBillingCode>NW040</PriorBillingCode><PriorBillingCode>ZA053</PriorBillingCode><PriorBillingCode>DE349</PriorBillingCode></PriorBillingCodes><Name>ROI-A ALIF Cage</Name><Description>The ROI-A implant is an ALIF interbody/fusion cage manufactured from PEEK-Optima.  If the surgeon so chooses, additional stability can be added to the construct by inserting optional self-guided, locking anchoring plates into the cage and the adjacent vertebral bodies (plates are included, and no screws are required).</Description><Size>Footprints 23x26mm, 30x33mm, 33x36m, 27x36mm, 30x39mm. Lordosis angles 2, 6, 10, 14 degrees. Heights 9-19mm. 1 cage per pack.</Size><SupplierCode>GW</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>188175</ARTG><ARTG>188176</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XZ002</BillingCode><PriorBillingCodes><PriorBillingCode>JT004</PriorBillingCode></PriorBillingCodes><Name>Sublime Line Mammary Implant</Name><Description>Smooth, Microthane or textured surface. Round or oval based with anatomical or central projection</Description><Size>Low Profile, Moderate Profile, High Profile and Extra High Profile. Sizes 500-1035cc.</Size><SupplierCode>XZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>171783</ARTG></ARTGs><MinimumBenefit>1170</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XZ003</BillingCode><PriorBillingCodes><PriorBillingCode>JT005</PriorBillingCode></PriorBillingCodes><Name>Polytech Smooth Tissue Expander with integrated or remote magnetic valve</Name><Description>Smooth with integrated or remote valve</Description><Size>The  tissue expanders vary in maximum volume from 100 - 960mls</Size><SupplierCode>XZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1606</GroupID><SubGroupID>4414</SubGroupID><ARTGs><ARTG>168188</ARTG></ARTGs><MinimumBenefit>653</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XZ006</BillingCode><PriorBillingCodes><PriorBillingCode>JT008</PriorBillingCode></PriorBillingCodes><Name>Testicular Implants</Name><Description>Testicular Implants with needle guide or reinforced cap for fixation</Description><Size>The Testicular Implants with needle guide or reinforced cap are available in 5 different sizes ranging from 5, 12, 21, 27 and 36 grams.</Size><SupplierCode>XZ</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>231</SubCategoryID><GroupID>1711</GroupID><ARTGs><ARTG>168141</ARTG></ARTGs><MinimumBenefit>620</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XZ001</BillingCode><PriorBillingCodes><PriorBillingCode>JT003</PriorBillingCode></PriorBillingCodes><Name>Sublime Line Mammary Implant</Name><Description>Smooth, Microthane or textured surface. Round or oval based with anatomical or central projection.</Description><Size>Low Profile, Moderate Profile, High Profile and Extra High Profile. Sizes 45-495cc.</Size><SupplierCode>XZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>171783</ARTG></ARTGs><MinimumBenefit>975</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XZ005</BillingCode><PriorBillingCodes><PriorBillingCode>JT007</PriorBillingCode></PriorBillingCodes><Name>Polytech Textured Mammary Expander with integrated or remote magnetic valve</Name><Description>Textured  with integrated or remote magnetic valve. Anatomically shaped with reinforced inner base</Description><Size>The mammary expanders vary in maximum volume from 200 - 960mls</Size><SupplierCode>XZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1606</GroupID><SubGroupID>4414</SubGroupID><ARTGs><ARTG>168188</ARTG></ARTGs><MinimumBenefit>653</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XZ004</BillingCode><PriorBillingCodes><PriorBillingCode>JT006</PriorBillingCode></PriorBillingCodes><Name>Polytech Textured Mammary or  Tissue Expander with integrated or remote magnetic valve</Name><Description>Textured with integrated or remote valve.</Description><Size>The tissue expanders vary in maximum volume from 100 - 960mls</Size><SupplierCode>XZ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1606</GroupID><SubGroupID>4414</SubGroupID><ARTGs><ARTG>168188</ARTG></ARTGs><MinimumBenefit>653</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY036</BillingCode><PriorBillingCodes><PriorBillingCode>EV017</PriorBillingCode></PriorBillingCodes><Name>Shuriken Cage</Name><Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description><Size>7-13mm height; 30-35mm length; 6-18 degrees lordosis</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>393044</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY059</BillingCode><PriorBillingCodes><PriorBillingCode>DR023</PriorBillingCode></PriorBillingCodes><Name>Hygro-L PLIF/TLIF (single)</Name><Description>Titanium lumbar interbody fusion cage PLIF/TLIF (single) </Description><Size>length (30-36mm) x width (11.5-13.5mm) heights (7-14mm); lordosis (0-12) degrees</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>330365</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ558</BillingCode><Name>Artus/uNion</Name><Description>Anterior Cervical Fusion Plate</Description><Size>12-84mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>464109</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY003</BillingCode><PriorBillingCodes><PriorBillingCode>EV004</PriorBillingCode></PriorBillingCodes><Name>Katana Monoaxial/Uniplanar Screw</Name><Description>Monoaxial/Uniplanar Pedicle Screw</Description><Size>4.5 - 7.5mm diameter   20 - 55mm length</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY115</BillingCode><PriorBillingCodes><PriorBillingCode>LH746</PriorBillingCode><PriorBillingCode>LM499</PriorBillingCode></PriorBillingCodes><Name>Inline Connectors</Name><Description>Inline Connectors</Description><Size>7.5 to 17 mm </Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>362890</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY018</BillingCode><PriorBillingCodes><PriorBillingCode>EV003</PriorBillingCode></PriorBillingCodes><Name>Katana Cross-Connector</Name><Description>Adjustable Cross-Connector</Description><Size>Extra Small to Extra Large, 22-60 x 28-75</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY039</BillingCode><PriorBillingCodes><PriorBillingCode>DE538</PriorBillingCode></PriorBillingCodes><Name>Jazz Claw Posterior Fixation System (Set Screw)</Name><Description>Set Screw</Description><Size>one size</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>200830</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY026</BillingCode><PriorBillingCodes><PriorBillingCode>EV029</PriorBillingCode></PriorBillingCodes><Name>Katana Rods</Name><Description>Deformity, Straight and MIS Rods - Ti or CoCr</Description><Size>Small - Extra Large (200-500mm)</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1480</GroupID><SubGroupID>4132</SubGroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>1352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY135</BillingCode><Name>Evolution Surgical Set Screw</Name><Description>Set Screw (for use with Pedicle Screws)</Description><Size>One Size</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY132</BillingCode><Name>Evolution Surgical Monoaxial/Uniplanar Screw</Name><Description>Monoaxial/Uniplanar Pedicle Screw</Description><Size>4.5-9.5mm, 25-120mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY012</BillingCode><PriorBillingCodes><PriorBillingCode>EV027</PriorBillingCode></PriorBillingCodes><Name>Revolution Standalone ACDF bone screw</Name><Description>Anterior cervical fusion cage system Standalone screw</Description><Size>Diameter 4 - 4.5mm  Length 12 -17mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>236041</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY119</BillingCode><PriorBillingCodes><PriorBillingCode>LH750</PriorBillingCode><PriorBillingCode>LM495</PriorBillingCode></PriorBillingCodes><Name>Curved Rod</Name><Description>Curved Rod</Description><Size>Diameter 5.5 or 6 mm  Length 150 to 450 mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>362890</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY107</BillingCode><PriorBillingCodes><PriorBillingCode>JG004</PriorBillingCode></PriorBillingCodes><Name>Stromboli</Name><Description>ACX - Direct Lateral Interbody Fusion Cage 'XLIF'</Description><Size>0, 5, 8, 14 degree angle  42mm to 58mm length  7mm to 13mm height</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>370517</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY108</BillingCode><PriorBillingCodes><PriorBillingCode>JG005</PriorBillingCode></PriorBillingCodes><Name>Salina</Name><Description>ACL - Lateral Oblique Cage</Description><Size>5 degree angle  26mm to 33mm length  7mm to 14mm height</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>370517</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY103</BillingCode><PriorBillingCodes><PriorBillingCode>JG006</PriorBillingCode></PriorBillingCodes><Name>Capri ACIF Cage</Name><Description>Cervical Interbody Fusion Cage</Description><Size>Angle 0, 5 and 10 degrees      Height 4mm to 9mm      Length 12, 14, 16, 18mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>370516</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY019</BillingCode><PriorBillingCodes><PriorBillingCode>EV043</PriorBillingCode><PriorBillingCode>SF179</PriorBillingCode></PriorBillingCodes><Name>BA Posterior Screw Rod to Rod Connector</Name><Description>Rod to Rod Connector</Description><Size>25-66mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>329318</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY131</BillingCode><Name>Evolution Surgical Monoaxial Screw Cann.</Name><Description>Cannulated Monoaxial/Uniaxial Pedicle Screw</Description><Size>4.5-7.5mm, 20-55mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY142</BillingCode><PriorBillingCodes><PriorBillingCode>OH526</PriorBillingCode><PriorBillingCode>OH505</PriorBillingCode></PriorBillingCodes><Name>G21 Bone Cement</Name><Description>Bone Cement - std and low viscosity</Description><Size>20-60g</Size><SupplierCode>IY</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4087</SubGroupID><ARTGs><ARTG>235604</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY028</BillingCode><PriorBillingCodes><PriorBillingCode>EV026</PriorBillingCode></PriorBillingCodes><Name>Revolution Standalone ACDF cage with screws</Name><Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description><Size>Standard – 6 and 9 degrees, height 4-10mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>236042</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY010</BillingCode><PriorBillingCodes><PriorBillingCode>EV005</PriorBillingCode></PriorBillingCodes><Name>Katana Setscrew</Name><Description>The Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine.</Description><Size>standard</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY022</BillingCode><PriorBillingCodes><PriorBillingCode>EV009</PriorBillingCode></PriorBillingCodes><Name>Evolution ACDF Plate</Name><Description>Anterior Cervical Plate</Description><Size>1 level Plate (20mm-32mm), 2 level plate (34mm – 50mm)</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>247573</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY128</BillingCode><Name>Evolution Surgical Hooks</Name><Description>Laminar/Transverse Process/Pedicle - Hooks (with Set Screw to Lock) </Description><Size>S/M/L</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY023</BillingCode><PriorBillingCodes><PriorBillingCode>EV021</PriorBillingCode></PriorBillingCodes><Name>Revolution ACDF Plate</Name><Description>Anterior Cervical Plate</Description><Size>Double and Mini Plates, 18 - 50mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>273279</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY034</BillingCode><PriorBillingCodes><PriorBillingCode>EV012</PriorBillingCode></PriorBillingCodes><Name>Evolution ACDF Contoured Cage</Name><Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description><Size>small, large - contoured</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>248234</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY124</BillingCode><Name>Katana Polyaxial Screw (Solid)</Name><Description>Polyaxial Pedicle Screw (Non Cannulated)</Description><Size>4.5-9.5mm, 20-100mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY100</BillingCode><PriorBillingCodes><PriorBillingCode>JG012</PriorBillingCode></PriorBillingCodes><Name>VENTOTENE Set Screw</Name><Description>Standard Cannulated</Description><Size>9.8mm diameter</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>397231</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY098</BillingCode><PriorBillingCodes><PriorBillingCode>JG009</PriorBillingCode></PriorBillingCodes><Name>VENTOTENE Modular Screw</Name><Description>Standard Solid</Description><Size>4.5/5.5/6.5/7.5mm diameter  25-100mm length</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>397231</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY063</BillingCode><PriorBillingCodes><PriorBillingCode>DR031</PriorBillingCode></PriorBillingCodes><Name>Hygro-C Integrated ACDF with screws</Name><Description>Integrated ACDF Cage with screws for Integral Fixation</Description><Size>14mm-16mm x 16mm-19mm x 4mm-9mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>330365</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY133</BillingCode><Name>Evolution Surgical Polyaxial Screw</Name><Description>Polyaxial Pedicle Screw</Description><Size>4.5-10.5mm, 20-120mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY066</BillingCode><PriorBillingCodes><PriorBillingCode>DR048</PriorBillingCode></PriorBillingCodes><Name>Ulrich Medical Pedicle Screw System - Pedicle Screws, polyaxial, cannulated</Name><Description>Ulrich Medical Pedicle Screw System - Pedicle Screws, polyaxial, cannulated</Description><Size>4.5-10.0mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>365230</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY007</BillingCode><PriorBillingCodes><PriorBillingCode>EV008</PriorBillingCode></PriorBillingCodes><Name>Evolution ACDF Plate Bone Screw</Name><Description>Bone screw</Description><Size>4.0mm diameter 10-20mm, 4.5mm diameter 10-20mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>248233</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY046</BillingCode><PriorBillingCodes><PriorBillingCode>DE570</PriorBillingCode></PriorBillingCodes><Name>Jazz Claw Posterior Fixation System (Hook)</Name><Description>Left and Right Hook</Description><Size>Standard and large hook</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>200830</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY052</BillingCode><Name>Mako ACDF Cage</Name><Description>ACDF Locking Cage</Description><Size>Small, Medium, Large, Extra-Large 6 and 9 degrees 5mm to 10mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>393044</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY089</BillingCode><PriorBillingCodes><PriorBillingCode>DR034</PriorBillingCode></PriorBillingCodes><Name>Z-Medical Pedicle Screw System - Pedicle Screws, Cannulated</Name><Description>Z-Medical Pedicle Screw - Cannulated (polyaxial and uniplanar)</Description><Size>Dia. (5-8)mm x Length (35-55)mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>343676</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ177</BillingCode><Name>GlassBONE Granules</Name><Description>Bioglass granules for bone graft</Description><Size>6cc-10cc</Size><SupplierCode>IY</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>433832</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY058</BillingCode><PriorBillingCodes><PriorBillingCode>DR024</PriorBillingCode></PriorBillingCodes><Name>Hygro-L PLIF</Name><Description>Titanium lumbar interbody fusion cage PLIF (paired)</Description><Size>Length (22-26mm) x width (11.5mm); heights (7-14mm); lordotic angle (0-12) </Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>330365</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY129</BillingCode><Name>Evolution Surgical Inline Connectors</Name><Description>Inline Rod Connectors (Axial, Dominoes, Wedding Band, Clamshell locking screw included, W - Set Screw to lock)</Description><Size>3.5-6.0mm Rod Compatibility, 11-16mm, 40-50mm - (W, Inline, Single, Double, Domino, Hybrid) Variants</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY002</BillingCode><PriorBillingCodes><PriorBillingCode>EV037</PriorBillingCode></PriorBillingCodes><Name>GlassBONE Injectable Putty</Name><Description>Injectable putty for bone grafting</Description><Size>10cc</Size><SupplierCode>IY</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>341771</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY053</BillingCode><PriorBillingCodes><PriorBillingCode>DR004</PriorBillingCode></PriorBillingCodes><Name>Freedom Cervical Disc</Name><Description>Cervical disc replacement prosthesis.</Description><Size>Footprints: 13x16mm, 15x18mm, 17x20mm   Heights: 5, 6mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5487</SubGroupID><ARTGs><ARTG>280296</ARTG></ARTGs><MinimumBenefit>6021</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY008</BillingCode><PriorBillingCodes><PriorBillingCode>EV011</PriorBillingCode></PriorBillingCodes><Name>Evolution ACDF Cage Bone Screw</Name><Description>Bone screw for fusion cages</Description><Size>4.0 diameter, 12-16mm; 4.5 diameter, 12-16mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>248233</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY043</BillingCode><PriorBillingCodes><PriorBillingCode>DE553</PriorBillingCode></PriorBillingCodes><Name>Jazz Claw Posterior Fixation System - Connector</Name><Description>Connector with dual locking screws for Jazz Claw Connector</Description><Size>One size</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>200830</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY068</BillingCode><PriorBillingCodes><PriorBillingCode>DR050</PriorBillingCode></PriorBillingCodes><Name>Ulrich Medical Pedicle Screw System - Locking Screw</Name><Description>Ulrich Medical Pedicle Screw System - Locking Screw</Description><Size>One Size</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>365230</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY016</BillingCode><PriorBillingCodes><PriorBillingCode>EV045</PriorBillingCode><PriorBillingCode>SF181</PriorBillingCode></PriorBillingCodes><Name>BA Posterior Screw Domino Connector</Name><Description>BA Posterior Screw Domino Connector</Description><Size>Various Sizes</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>329318</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY005</BillingCode><PriorBillingCodes><PriorBillingCode>EV042</PriorBillingCode><PriorBillingCode>SF177</PriorBillingCode></PriorBillingCodes><Name>BA Posterior Screw</Name><Description>Polyaxial Screw</Description><Size>Ø3.5, Ø4.0, Ø4.5  8mm to 50mm in length.</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>329318</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY140</BillingCode><PriorBillingCodes><PriorBillingCode>OH521</PriorBillingCode></PriorBillingCodes><Name>CP-ESP Cervical disc prosthesis</Name><Description>Cervical disc prosthesis</Description><Size>AP 13mm-15mm x ML 15mm-20mm, Height 5, 6, 7mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5487</SubGroupID><ARTGs><ARTG>434732</ARTG></ARTGs><MinimumBenefit>6021</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY111</BillingCode><Name>Additive Surgical Lateral Expandable Cage - Giannutri</Name><Description>Lateral Titanium Expandable Cage</Description><Size>46-52mm x 18-22mm, 0-14 Degrees Lordosis</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>370517</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY113</BillingCode><Name>Additive Surgical Posterior Expandable Cage - Procida</Name><Description>TLIF/PLIF Titanium Expandable Fusion Cage</Description><Size>26-32mm, 0-20 degrees Lordosis</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>370517</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY001</BillingCode><PriorBillingCodes><PriorBillingCode>EV038</PriorBillingCode></PriorBillingCodes><Name>GlassBONE Injectable Putty</Name><Description>Injectable putty for bone grafting</Description><Size>0.1cc to 5cc</Size><SupplierCode>IY</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>341771</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY056</BillingCode><PriorBillingCodes><PriorBillingCode>DR039</PriorBillingCode></PriorBillingCodes><Name>Tesera Screws</Name><Description>Tesera Fusion Cage Screws</Description><Size>Dia. (3.5 - 5.0mm) x (12-35mm) Length </Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>354092</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY015</BillingCode><PriorBillingCodes><PriorBillingCode>EV032</PriorBillingCode></PriorBillingCodes><Name>Katana Connectors</Name><Description>In-Line Connectors</Description><Size>5.5mm to 6.35mm  5.5mm to 5.5mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY092</BillingCode><PriorBillingCodes><PriorBillingCode>EV034</PriorBillingCode><PriorBillingCode>SF105</PriorBillingCode></PriorBillingCodes><Name>ACDF cage screw</Name><Description>ACDF cage screw</Description><Size>12-17mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>248233</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY009</BillingCode><PriorBillingCodes><PriorBillingCode>EV015</PriorBillingCode></PriorBillingCodes><Name>Evolution ALIF Cage Screw</Name><Description>ThoracoLumbar Cage Bone Screw</Description><Size>5.5mm Diameter, 20-35mm; 6.5mm Diameter, 20-35mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>248233</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY060</BillingCode><PriorBillingCodes><PriorBillingCode>DR001</PriorBillingCode></PriorBillingCodes><Name>Freedom Lumbar Disc</Name><Description>Lumbar Disc Replacement Prosthesis</Description><Size>26mmx36mm, 28mmx38mm, 30mmx40mm, 12-16mm, 4-12 degrees.</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5488</SubGroupID><ARTGs><ARTG>279935</ARTG></ARTGs><MinimumBenefit>8847</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY070</BillingCode><PriorBillingCodes><PriorBillingCode>DR052</PriorBillingCode></PriorBillingCodes><Name>Ulrich Medical Pedicle Screw System - Connectors</Name><Description>Ulrich Medical Pedicle Screw System - Connectors</Description><Size>4.0mm-6.0mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>365230</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY130</BillingCode><Name>Evolution Surgical Lateral Connector</Name><Description>Lateral/Offset Connector (with Set Screw to lock)</Description><Size>35-70mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ118</BillingCode><PriorBillingCodes><PriorBillingCode>DR025</PriorBillingCode></PriorBillingCodes><Name>Hygro-C ACDF Cage</Name><Description>Hygro-C Titanium ACDF Cage</Description><Size>Length (13.7mm) x Width (16.5-19.1mm) x Height (4-9mm); Lordotic angle 6 Degrees</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>330365</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ665</BillingCode><Name>Katana Crosslinks</Name><Description>Fixed Crosslinks, Tri-Rod Connector - includes set screw (pre-assembled with grub screw)</Description><Size>19mm-27mm, Small - Extra Large</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY024</BillingCode><PriorBillingCodes><PriorBillingCode>EV007</PriorBillingCode></PriorBillingCodes><Name>Katana Rods</Name><Description>Pre-Lordosed, Straight and MIS Rods</Description><Size>Length: 25mm - 200mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY025</BillingCode><PriorBillingCodes><PriorBillingCode>EV039</PriorBillingCode><PriorBillingCode>SF171</PriorBillingCode></PriorBillingCodes><Name>BA Posterior Screw Rod</Name><Description>BA Posterior Screw Rod  Straight/PreBent  CrCo/Titanium</Description><Size>Ø3.5 to 5.5  20-500mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>329318</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY138</BillingCode><PriorBillingCodes><PriorBillingCode>OH467</PriorBillingCode></PriorBillingCodes><Name>LP-ESP Intervertebral Disc Prosthesis</Name><Description>Lumbar disc prosthesis</Description><Size>Height 10-12mm, Inclination 7/9/11 degrees</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5488</SubGroupID><ARTGs><ARTG>434733</ARTG></ARTGs><MinimumBenefit>8847</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY037</BillingCode><PriorBillingCodes><PriorBillingCode>EV023</PriorBillingCode></PriorBillingCodes><Name>Shinto PLIF Cage</Name><Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description><Size>Angle 8 - 22 degrees  Length 21 - 26mm   Height 5 - 13mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>393044</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ176</BillingCode><Name>GlassBONE Granules</Name><Description>Bioglass granules for bone grafting</Description><Size>10cc-20cc</Size><SupplierCode>IY</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>433832</ARTG></ARTGs><MinimumBenefit>4370</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY134</BillingCode><Name>Evolution Surgical Polyaxial Screw Cann.</Name><Description>Cannulated Polyaxial Pedicle Screw</Description><Size>4.5-10.5mm, 20-120mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY096</BillingCode><PriorBillingCodes><PriorBillingCode>JG007</PriorBillingCode></PriorBillingCodes><Name>VENTOTENE Fixed Screw</Name><Description>Standard Cannulated</Description><Size>5.5/6.5/7.5mm Diameter  25-80mm Length</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>397231</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY074</BillingCode><PriorBillingCodes><PriorBillingCode>DR003</PriorBillingCode></PriorBillingCodes><Name>BioSphere Putty</Name><Description>Bone Graft Substrate - Bioactive Glass</Description><Size>6cc-10cc</Size><SupplierCode>IY</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>297474</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY116</BillingCode><PriorBillingCodes><PriorBillingCode>LH747</PriorBillingCode><PriorBillingCode>LM498</PriorBillingCode></PriorBillingCodes><Name>Sacral Screw</Name><Description>Sacral Screw</Description><Size>Diameter 6.5 &amp; 7.5mm  Length 30 - 70 mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>362890</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY099</BillingCode><PriorBillingCodes><PriorBillingCode>JG010</PriorBillingCode></PriorBillingCodes><Name>VENTOTENE Modular Screw</Name><Description>Standard Cannulated</Description><Size>5.5/6.5/7.5mm diameter  30-70mm length</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>397231</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY033</BillingCode><PriorBillingCodes><PriorBillingCode>EV010</PriorBillingCode></PriorBillingCodes><Name>Evolution ACDF Cage</Name><Description>Interbody Fusion Cage</Description><Size>5-10mm   small, medium, large, extra large</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>248234</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY044</BillingCode><PriorBillingCodes><PriorBillingCode>DE586</PriorBillingCode></PriorBillingCodes><Name>Jazz Frame T-Bar</Name><Description>Fixed transverse rod-to-rod connector</Description><Size>25mm, 30mm, 35mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>200830</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY027</BillingCode><PriorBillingCodes><PriorBillingCode>EV019</PriorBillingCode></PriorBillingCodes><Name>Katana Staple</Name><Description>The Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine.</Description><Size>13-25mm, Caudal, Rostral, Single</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY061</BillingCode><PriorBillingCodes><PriorBillingCode>DR047</PriorBillingCode></PriorBillingCodes><Name>Kyocera Lateral Lumbar Interbody System</Name><Description>Lateral Lumbar Interbody Cage</Description><Size>18-22mm W, 30-60mm L, 8-20mm H</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>354092</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ178</BillingCode><Name>GlassBONE Granules</Name><Description>Bioglass granules for bone grafting</Description><Size>0.5-5cc</Size><SupplierCode>IY</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>433832</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY090</BillingCode><PriorBillingCodes><PriorBillingCode>DR035</PriorBillingCode></PriorBillingCodes><Name>Z-Medicle Pedicle Screw System - Locking Screw</Name><Description>Z-Medicle Pedicle Screw System - Locking Screw</Description><Size>One Size</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>343676</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY121</BillingCode><PriorBillingCodes><PriorBillingCode>LH752</PriorBillingCode><PriorBillingCode>LM493</PriorBillingCode></PriorBillingCodes><Name>Pedicle Screw</Name><Description>Pedicle Screw</Description><Size>Diameter 4.5 - 9.5 mm  Length 25 - 110 mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>362890</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY097</BillingCode><PriorBillingCodes><PriorBillingCode>JG008</PriorBillingCode></PriorBillingCodes><Name>VENTOTENE Fixed Screw</Name><Description>Standard Solid</Description><Size>4.5/5.5/6.5/7.5mm Diameter  25-110mm Length</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>397231</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY011</BillingCode><PriorBillingCodes><PriorBillingCode>EV040</PriorBillingCode><PriorBillingCode>SF172</PriorBillingCode></PriorBillingCodes><Name>BA Posterior Set Screw</Name><Description>BA Posterior Set Screw</Description><Size>Various</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>329318</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY073</BillingCode><PriorBillingCodes><PriorBillingCode>DR002</PriorBillingCode></PriorBillingCodes><Name>BioSphere Putty</Name><Description>Bone Graft Substitue - Bioactive Glass Putty</Description><Size>1cc, 2.5cc, 5cc</Size><SupplierCode>IY</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>297474</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY139</BillingCode><PriorBillingCodes><PriorBillingCode>OH503</PriorBillingCode></PriorBillingCodes><Name>G-21 Radiopaque Bone cement for Vertebral Consolidation + V-Kit 06</Name><Description>Radiopaque Bone Cement for Vertebroplasty – high and low viscosity</Description><Size>10-20g</Size><SupplierCode>IY</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4089</SubGroupID><ARTGs><ARTG>235604</ARTG></ARTGs><MinimumBenefit>437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY004</BillingCode><PriorBillingCodes><PriorBillingCode>EV006</PriorBillingCode></PriorBillingCodes><Name>Katana Polyaxial Screw</Name><Description>Polyaxial Pedicle Screw</Description><Size>4.5 - 9.5mm diameter, 20 - 100mm length</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY118</BillingCode><PriorBillingCodes><PriorBillingCode>LH749</PriorBillingCode><PriorBillingCode>LM496</PriorBillingCode></PriorBillingCodes><Name>Nut for Screw or connector</Name><Description>Nut for screw or connector</Description><Size>one size for each type</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>362890</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY091</BillingCode><PriorBillingCodes><PriorBillingCode>DR036</PriorBillingCode></PriorBillingCodes><Name>Z-Medical Pedicle Screw System - Pedicle Screws, Monoaxial</Name><Description>Z-Medical Pedicle Screw System - Pedicle Screws, Monoaxial, Cannulated</Description><Size>Dia (5-8)mm x Length (35-55)mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>343676</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ680</BillingCode><Name>Skyway Plate</Name><Description>Skyway ACDF Plate</Description><Size>12-16mm, (2,3&amp;4 Hole configurations)</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>462407</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY035</BillingCode><PriorBillingCodes><PriorBillingCode>EV020</PriorBillingCode></PriorBillingCodes><Name>Fukiya ACDF Cage</Name><Description>Fukiya Fusion Cages are used to restore disc height and support loading during intervertebral body fusion. Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description><Size>6-9 degrees, 5-10mm. Small, Medium, Large, Extra large</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>236042</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY141</BillingCode><PriorBillingCodes><PriorBillingCode>OH525</PriorBillingCode><PriorBillingCode>OH505</PriorBillingCode></PriorBillingCodes><Name>G21 Bone Cement + Delivery System</Name><Description>Bone Cement – low &amp; std viscosity</Description><Size>20-60g</Size><SupplierCode>IY</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4089</SubGroupID><ARTGs><ARTG>235604</ARTG></ARTGs><MinimumBenefit>437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY064</BillingCode><PriorBillingCodes><PriorBillingCode>DR041</PriorBillingCode><PriorBillingCode>DR026</PriorBillingCode></PriorBillingCodes><Name>Bone Screw </Name><Description>Bone screw, Dual Thread</Description><Size>Diameter (4.0mm); Length (20-35mm)</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>330365</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY102</BillingCode><PriorBillingCodes><PriorBillingCode>JG011</PriorBillingCode></PriorBillingCodes><Name>VENTOTENE Rods</Name><Description>Straight and Pre-Bended</Description><Size>5.5mm diameter  35-450mm length</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>397231</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY071</BillingCode><PriorBillingCodes><PriorBillingCode>DR045</PriorBillingCode></PriorBillingCodes><Name>Tesera P</Name><Description>Titanium PLIF Cage</Description><Size>Length (22-27mm) x Width (9mm) x Height (7-16mm); Lordotic angle (5-7) Degrees</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>354092</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY125</BillingCode><Name>Evolution Surgical Cross-Connector</Name><Description>Adjustable Cross-Connectors (Locking Screw Included)</Description><Size>31-77mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY104</BillingCode><PriorBillingCodes><PriorBillingCode>JG003</PriorBillingCode></PriorBillingCodes><Name>Panarea</Name><Description>ACP: Posterior Lumbar Cage 'PLIF'</Description><Size>0, 5, 8, 14, 20 degree angle  24mm to 29mm width  7mm to 16mm height</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>370517</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ559</BillingCode><Name>Artus/uNion Screws</Name><Description>Fixation Screws for the uNion/Artus Plates</Description><Size>12-18mm Length, 4.0-4.5mm Dia</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>464109</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY057</BillingCode><PriorBillingCodes><PriorBillingCode>DR038</PriorBillingCode></PriorBillingCodes><Name>Tesera Locking Devices</Name><Description>Locking Cap/Locking Plate for Tesera Cage Systems</Description><Size>Single size per locking mechanism</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1467</GroupID><ARTGs><ARTG>354092</ARTG></ARTGs><MinimumBenefit>391</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY112</BillingCode><Name>Additive Surgical Posterior Expandable Cage - Ustica</Name><Description>TLIF Titanium Expandable Cage</Description><Size>29-40mm x 9mm, 2-14 Degree Lordosis</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>370517</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY088</BillingCode><PriorBillingCodes><PriorBillingCode>DR033</PriorBillingCode></PriorBillingCodes><Name>Z-Medical Pedicle Screw System - Rods</Name><Description>Z-Medical Pedicle Screw System - Rods 5.5mm, Straight &amp; Curved (Open or Percutaneous)</Description><Size>dia (5.5)mm x length (20-500)mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>343676</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY032</BillingCode><PriorBillingCodes><PriorBillingCode>EV030</PriorBillingCode></PriorBillingCodes><Name>Evolution Altus ALIF Cage with screws</Name><Description>ThoracoLumbar ALIF Cage with screws</Description><Size>Small (34x25mm) 8 - 18 degrees, 10 - 18mm  Medium (38x30mm) 8 - 18 degrees, 10 -  18mm  Medium Long (38x34mm) 8 - 18 degrees, 10 -  18mm  Large (42x30mm) 8 - 18 degrees, 10 - 18mm  X Large (42x34mm) 8 - 18 degrees, 10 - 22mm  XX Large (42x38mm) 13 degrees, 12 - 18mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>236042</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY030</BillingCode><PriorBillingCodes><PriorBillingCode>EV014</PriorBillingCode></PriorBillingCodes><Name>Evolution ALIF Cage with screws</Name><Description>ThoracoLumbar ALIF Cage with screws</Description><Size>Small (34x25mm) 8 - 18 degrees, 10 - 18mm  Medium (38x29mm) 8 - 18 degrees, 10 - 18mm  Medium Long (38x34mm) 8 - 18 degrees, 10 - 18mm  Large (42x30mm) 8 - 18 degrees, 10 - 18mm  X Large (42x34mm) 8 - 18 degrees, 10 - 22mm  XX Large (42x38mm) 13 degrees, 12 - 18mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>248234</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY122</BillingCode><PriorBillingCodes><PriorBillingCode>QQ249</PriorBillingCode></PriorBillingCodes><Name>KHEIRON Spinal Fixation System</Name><Description>K-ROD patient specific shaped rods</Description><Size>5.5 and 6mm diameter</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>362890</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY106</BillingCode><PriorBillingCodes><PriorBillingCode>JG002</PriorBillingCode></PriorBillingCodes><Name>Alicudi</Name><Description>ACA - Anterior Lumbar Fusion Cage</Description><Size>5, 8, 14, 20 degree angle  9mm to 15mm height  30mm to 38mm width</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>370517</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY137</BillingCode><Name>Tesera k XL</Name><Description>Integrated Lateral Lumbar Interbody System (Including Screws and locking plate)
</Description><Size>18-22mm W, 30-60mm L, 8-20mm H, 0-28D; 4.5-5.00mm diameter, 20-35mm length</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>354092</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY062</BillingCode><PriorBillingCodes><PriorBillingCode>DR027</PriorBillingCode></PriorBillingCodes><Name>Hygro-L Stand-alone ALIF with screws</Name><Description>Integrated Titanium ALIF cage with Screws for Integral Fixation</Description><Size>Length (32-38mm) x width (24.5-29mm); heights (12-24mm); lordotic angle (9-27) degrees</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>330365</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY045</BillingCode><PriorBillingCodes><PriorBillingCode>DE539</PriorBillingCode></PriorBillingCodes><Name>Jazz Claw Posterior Fixation System (Hook)</Name><Description>Left and Right Hook</Description><Size>Standard and large hook</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>200830</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY054</BillingCode><PriorBillingCodes><PriorBillingCode>DR037</PriorBillingCode></PriorBillingCodes><Name>Tesera SA / Tesera-k SA</Name><Description>Integrated Fusion Cage –  Construct achieves integral fixation with screws and locking mechanism</Description><Size>Footprint (30-42mm)x(26-32mm); Height 11-21mm, Lordosis 7-28 Degrees</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>354092</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY123</BillingCode><Name>Kheiron Hooks</Name><Description>Pedicle Hook, Laminar Hook, Pedicle hook, Counterhook (with locking screws)</Description><Size>Small, Medium, Large (Left/Right, Short/Long)</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>362890</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ666</BillingCode><Name>Katana Offset Connectors</Name><Description>Offset Connector</Description><Size>20mm-40mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY094</BillingCode><PriorBillingCodes><PriorBillingCode>EV028</PriorBillingCode></PriorBillingCodes><Name>Katana Rod</Name><Description>The Katana Rod, part of the Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine. These are specialty rods for use in procedures such as the treatment for scoliosis.</Description><Size>Titanium or CrCo straight rods.  300 and 500mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>236041</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY120</BillingCode><PriorBillingCodes><PriorBillingCode>LH751</PriorBillingCode><PriorBillingCode>LM494</PriorBillingCode></PriorBillingCodes><Name>Straight Rod</Name><Description>Straight Rod</Description><Size>Diameter 5.5 or 6 mm  Length 35 - 505 mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>362890</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY065</BillingCode><PriorBillingCodes><PriorBillingCode>DR042</PriorBillingCode><PriorBillingCode>DR030</PriorBillingCode></PriorBillingCodes><Name>Bone Screws</Name><Description>Bone Screws</Description><Size>3-4mm, 12-14mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>330365</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY110</BillingCode><PriorBillingCodes><PriorBillingCode>EV013</PriorBillingCode></PriorBillingCodes><Name>Cato ACDF Standalone Cage with screws</Name><Description>Interbody Fusion Cages are used to restore disc height and support loading during intervertebral body fusion.</Description><Size>Medium, Large – 6°, 9° and 12°, height 4-10mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>248234</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY029</BillingCode><PriorBillingCodes><PriorBillingCode>EV033</PriorBillingCode></PriorBillingCodes><Name>HRCc Cervical Locking Cage</Name><Description>Cervical Locking Cage - no screws required for fixation</Description><Size>Size 4 to 9  Standard and Large</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>322672</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY006</BillingCode><PriorBillingCodes><PriorBillingCode>EV031</PriorBillingCode></PriorBillingCodes><Name>Evolution Altus Dual Thread Screw</Name><Description>Thoraco Lumbar Cage Dual Thread Bone Screw</Description><Size>diameter: 5.5 - 6mm  Length: 20 - 35mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>236041</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY020</BillingCode><PriorBillingCodes><PriorBillingCode>EV044</PriorBillingCode><PriorBillingCode>SF180</PriorBillingCode></PriorBillingCodes><Name>BA Posterior Screw Head to Head Connector</Name><Description>BA Posterior Screw Head to Head Connector</Description><Size>25-66mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>329318</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY127</BillingCode><Name>Evolution Surgical Deformity Rods</Name><Description>Deformity Rods</Description><Size>5.5/6.0, 300-500mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ681</BillingCode><Name>Skyway Screws</Name><Description>Self Drilling Bone Screws</Description><Size>12-18mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>462407</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY126</BillingCode><Name>Evolution Surgical Curved Rod</Name><Description>Prebent Rods Ti/CoCr</Description><Size>5.5/6.0, 30-500mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY114</BillingCode><PriorBillingCodes><PriorBillingCode>LH745</PriorBillingCode><PriorBillingCode>LM500</PriorBillingCode></PriorBillingCodes><Name>Rod or Post Connector</Name><Description>Rod or Post Connector and set screws</Description><Size>Rod Connectors for 5.5 &amp; 6mm rods  Sacral Connectors for 5.5 &amp; 6mm rods  Post connector - one size  </Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>362890</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY021</BillingCode><PriorBillingCodes><PriorBillingCode>EV018</PriorBillingCode></PriorBillingCodes><Name>Katana Hook</Name><Description>The Katana Pedicle Screw System is intended to provide immobilization and stabilisation of spinal segments in skeletally mature patients, as an adjunct to fusion in the thoracic, lumbar and sacral spine.</Description><Size>Small, Medium, Large, Wide, Narrow, Pedicle</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY031</BillingCode><PriorBillingCodes><PriorBillingCode>EV016</PriorBillingCode></PriorBillingCodes><Name>Evolution TM2 Cage</Name><Description>Thoraco Lumbar ALIF cage - no screws required for fixation</Description><Size>standard</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>248234</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY017</BillingCode><PriorBillingCodes><PriorBillingCode>EV041</PriorBillingCode><PriorBillingCode>SF173</PriorBillingCode></PriorBillingCodes><Name>BA Posterior Screw Lateral Offset Connector</Name><Description>BA Posterior Screw Lateral Offset Connector</Description><Size>10-25mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>329318</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY047</BillingCode><PriorBillingCodes><PriorBillingCode>DE527</PriorBillingCode></PriorBillingCodes><Name>Jazz Posterior Fixation System Rod</Name><Description>Straight, contoured and transition rods, titanium and cobalt chrome</Description><Size>4mm - 6mm diameter, 70mm - 600mm length</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>200830</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY105</BillingCode><PriorBillingCodes><PriorBillingCode>JG001</PriorBillingCode></PriorBillingCodes><Name>Elba</Name><Description>ACT - Transforaminal Lumbar Interbody Fusion Cage 'TLIF'</Description><Size>Height 7mm to 15mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>370517</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY042</BillingCode><PriorBillingCodes><PriorBillingCode>DE574</PriorBillingCode><PriorBillingCode>LH496</PriorBillingCode></PriorBillingCodes><Name>Jazz Posterior Fixation System - Multipurpose Connector</Name><Description>Polyester braid, connector and set screw</Description><Size>5.5mm diameter</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1816</GroupID><ARTGs><ARTG>200830</ARTG></ARTGs><MinimumBenefit>757</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY093</BillingCode><PriorBillingCodes><PriorBillingCode>EV035</PriorBillingCode><PriorBillingCode>SF156</PriorBillingCode></PriorBillingCodes><Name>ALIF cage screw</Name><Description>ALIF cage screw</Description><Size>Diameter 5.5 and 6mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>248233</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY041</BillingCode><PriorBillingCodes><PriorBillingCode>DE573</PriorBillingCode><PriorBillingCode>LH535</PriorBillingCode></PriorBillingCodes><Name>Jazz Posterior Fixation System</Name><Description>System of Polyester Braid, connector and locking screw</Description><Size>4mm braid, 3.5-6mm connector</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1816</GroupID><ARTGs><ARTG>200830</ARTG></ARTGs><MinimumBenefit>757</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY109</BillingCode><PriorBillingCodes><PriorBillingCode>EV036</PriorBillingCode><PriorBillingCode>SF157</PriorBillingCode></PriorBillingCodes><Name>Tora Cage and screw</Name><Description>Anterior Lumbar Cage with integral fixation (PEEK, HA PEEK, Titanium, Porous Titanium) and screws</Description><Size>Angle 0 - 12 degrees, Length 40 - 60mm, Height 8 - 16mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>248234</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY072</BillingCode><PriorBillingCodes><PriorBillingCode>DR046</PriorBillingCode></PriorBillingCodes><Name>Tesera-k PL</Name><Description>Titanium Posterior Lumbar Cages</Description><Size>Length (22-34mm) x Width (09-11mm) x Height (7-16mm) Lordotic angle (0-17) Degrees</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>354092</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY136</BillingCode><Name>Evolution Surgical Straight Rod</Name><Description>Straight Rod Ti/CoCr</Description><Size>5.5/6.0, 30-500mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>396083</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY101</BillingCode><PriorBillingCodes><PriorBillingCode>JG013</PriorBillingCode></PriorBillingCodes><Name>VENTOTENE Modular Tulip</Name><Description>Standard Polyaxial Short</Description><Size>13.9mm diameter</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>397231</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY117</BillingCode><PriorBillingCodes><PriorBillingCode>LH748</PriorBillingCode><PriorBillingCode>LM497</PriorBillingCode></PriorBillingCodes><Name>Sacral Plates</Name><Description>Sacral Plates</Description><Size>Left and Right 60° and 90°</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>362890</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY067</BillingCode><PriorBillingCodes><PriorBillingCode>DR049</PriorBillingCode></PriorBillingCodes><Name>Ulrich Medical Pedicle Screw System - Rods</Name><Description>Ulrich Medical Pedicle Screw System - Rods</Description><Size>5.5/6.0 - 35mm-500mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>365230</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY055</BillingCode><PriorBillingCodes><PriorBillingCode>DR040</PriorBillingCode></PriorBillingCodes><Name>Tesera SC / Tesera-k SC</Name><Description>Integrated Fusion Cage – Construct achieves integral fixation with screws and a locking mechanism</Description><Size>Foot Print (14.5-19mm) Wide x (12.5 - 16mm) Deep x (5-12mm) Height,  2-12 Degrees Lordosis</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>354092</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY013</BillingCode><PriorBillingCodes><PriorBillingCode>EV022</PriorBillingCode></PriorBillingCodes><Name>Revolution ACDF Plate Screw</Name><Description>Anterior Cervical Bone Screws</Description><Size>Fixed and Variable Angle. Diameter 4 - 4.5mm. Length 10 - 20mm</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>236041</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY040</BillingCode><PriorBillingCodes><PriorBillingCode>DE532</PriorBillingCode></PriorBillingCodes><Name>Jazz Sublaminar Band</Name><Description>Sublaminar Band for use with Jazz Claw Connector</Description><Size>1 size</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1816</GroupID><ARTGs><ARTG>200830</ARTG></ARTGs><MinimumBenefit>757</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IY069</BillingCode><PriorBillingCodes><PriorBillingCode>DR051</PriorBillingCode></PriorBillingCodes><Name>Ulrich Medical Momentum Pedicle Screw System - Crosslinks integrated with grub screws</Name><Description>Ulrich Medical Pedicle Screw System - Rod to rod drop on and rod to rod crosslinks for use with 5.5 and 6.0mm rods with integrated grub screws. </Description><Size>XXS-XL</Size><SupplierCode>IY</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>365230</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FD002</BillingCode><Name>Evolutis CoCr Femoral Head</Name><Description>CoCr Femoral Heads</Description><Size>36mm diamater</Size><SupplierCode>FD</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>268273</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FD001</BillingCode><Name>Evolutis CoCr Femoral Head</Name><Description>CoCr Femoral Head</Description><Size>22mm, 28mm and 32mm diameter</Size><SupplierCode>FD</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>268273</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FD003</BillingCode><Name>Delta Ceramic Femoral Head</Name><Description>Delta Ceramic Head</Description><Size>28mm to 32mm diameter</Size><SupplierCode>FD</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>273049</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FD007</BillingCode><PriorBillingCodes><PriorBillingCode>LI118</PriorBillingCode></PriorBillingCodes><Name>Evolutis CoCr Femoral Heads</Name><Description>Large Diameter CoCr Femoral Heads</Description><Size>36mm  Short, Medium, Long, Extra Long  12/14 Taper</Size><SupplierCode>FD</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>268273</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FD005</BillingCode><Name>Stemsys Cementless HA Coated Stems</Name><Description>Uncemented Femoral Stem with HA Coating - Collared and Collarless</Description><Size>Sizes 7 to 20 - Standard and Laterlised</Size><SupplierCode>FD</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>356300</ARTG><ARTG>356301</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FD006</BillingCode><PriorBillingCodes><PriorBillingCode>LI108</PriorBillingCode><PriorBillingCode>AX044</PriorBillingCode></PriorBillingCodes><Name>HACTIV Uncemented Stem</Name><Description>Titanium, gritblast, HA coated, collared, collarless and high offset</Description><Size>Sizes 7 to 20</Size><SupplierCode>FD</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>232289</ARTG><ARTG>268272</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FD004</BillingCode><Name>Delta Ceramic Femoral Head</Name><Description>Delta Femoral Head</Description><Size>36mm to 40mm</Size><SupplierCode>FD</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>273049</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YJ001</BillingCode><PriorBillingCodes><PriorBillingCode>DE775</PriorBillingCode></PriorBillingCodes><Name>CAPSULBlue</Name><Description>Trypan blue solution for use in anterior segment ophthalmic surgery. </Description><Size>0.15ml prefilled glass syringe</Size><SupplierCode>YJ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1330</GroupID><ARTGs><ARTG>343322</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YJ002</BillingCode><PriorBillingCodes><PriorBillingCode>DE787</PriorBillingCode></PriorBillingCodes><Name>CAPSULGel</Name><Description>Isotonic, clear, viscoelastic and  sterile HPMC solution for intraocular application</Description><Size>2.0ml prefilled, single-use, glass syringe.</Size><SupplierCode>YJ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>383098</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FE003</BillingCode><Name>Filshie Clips - Sterishot</Name><Description>With Disposable Applicator</Description><Size>One Size</Size><SupplierCode>FE</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>233</SubCategoryID><GroupID>1716</GroupID><SubGroupID>5344</SubGroupID><Suffix>With applicator</Suffix><ARTGs><ARTG>157661</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FE001</BillingCode><Name>Filshie Clip</Name><Description>Titanium</Description><Size>One size only</Size><SupplierCode>FE</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>233</SubCategoryID><GroupID>1716</GroupID><SubGroupID>5344</SubGroupID><ARTGs><ARTG>153023</ARTG></ARTGs><MinimumBenefit>147</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO005</BillingCode><PriorBillingCodes><PriorBillingCode>LM392</PriorBillingCode></PriorBillingCodes><Name>Cannulated Screws</Name><Description>Cannulated Screws</Description><Size>2.01 mm – 2.70 mm diameter</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>329613</ARTG></ARTGs><MinimumBenefit>156</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO009</BillingCode><PriorBillingCodes><PriorBillingCode>LM394</PriorBillingCode></PriorBillingCodes><Name>Headless Compression Screw</Name><Description>Headless Compression Screw</Description><Size>2.71mm – 4.49mm diameter</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>329613</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO001</BillingCode><PriorBillingCodes><PriorBillingCode>LM395</PriorBillingCode></PriorBillingCodes><Name>Cannulated Screws</Name><Description>Cannulated Screws</Description><Size>4.50 mm or larger diameter</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>329613</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO012</BillingCode><PriorBillingCodes><PriorBillingCode>LM478</PriorBillingCode></PriorBillingCodes><Name>Locking Screws</Name><Description>Locking Screws</Description><Size>≤ 2.0mm</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>337193</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO006</BillingCode><PriorBillingCodes><PriorBillingCode>LM481</PriorBillingCode></PriorBillingCodes><Name>Complex Variable Locking Hand Plates</Name><Description>Complex Variable Locking Hand Plates</Description><Size>6 holes or less</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>337193</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO008</BillingCode><PriorBillingCodes><PriorBillingCode>LM483</PriorBillingCode></PriorBillingCodes><Name>Complex Variable Locking Hand Plates</Name><Description>Complex Variable Locking Hand Plates</Description><Size>16 holes or more</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>337193</ARTG></ARTGs><MinimumBenefit>1180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO004</BillingCode><PriorBillingCodes><PriorBillingCode>LM399</PriorBillingCode></PriorBillingCodes><Name>Cannulated Screws</Name><Description>Cannulated Screws</Description><Size>2.71mm – 4.49mm diameter</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>329613</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO010</BillingCode><PriorBillingCodes><PriorBillingCode>LM396</PriorBillingCode></PriorBillingCodes><Name>Headless Compression Screw</Name><Description>Headless Compression Screw</Description><Size>2.01 – 2.7 mm</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>329613</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO003</BillingCode><PriorBillingCodes><PriorBillingCode>LM480</PriorBillingCode></PriorBillingCodes><Name>Variable Locking Hand Plates</Name><Description>Variable Locking Hand Plates</Description><Size>7 to 15 holes</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>337193</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO014</BillingCode><PriorBillingCodes><PriorBillingCode>LM479</PriorBillingCode></PriorBillingCodes><Name>Variable Locking Hand Plates</Name><Description>Variable Locking Hand Plates</Description><Size>6 holes or less</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>337193</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO002</BillingCode><PriorBillingCodes><PriorBillingCode>LM397</PriorBillingCode></PriorBillingCodes><Name>Headless Compression Screws</Name><Description>Headless Compression Screws</Description><Size>4.50mm or larger diameter</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>329613</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO015</BillingCode><PriorBillingCodes><PriorBillingCode>LM398</PriorBillingCode></PriorBillingCodes><Name>Cannulated Screws</Name><Description>Cannulated Screws</Description><Size>2.0mm diameter and smaller</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>329613</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO011</BillingCode><PriorBillingCodes><PriorBillingCode>LM393</PriorBillingCode></PriorBillingCodes><Name>Headless Compression Screws</Name><Description>Headless Compression Screws</Description><Size>2.0mm or smaller diameter</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>329613</ARTG></ARTGs><MinimumBenefit>346</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO007</BillingCode><PriorBillingCodes><PriorBillingCode>LM482</PriorBillingCode></PriorBillingCodes><Name>Complex Variable Locking Hand Plates</Name><Description>Complex Variable Locking Hand Plates</Description><Size>7 to 15 holes</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>337193</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KO013</BillingCode><PriorBillingCodes><PriorBillingCode>LM484</PriorBillingCode></PriorBillingCodes><Name>Periarticular Hand Plates</Name><Description>Periarticular Hand Plates</Description><Size>Multiple sizes to suit patient anatomy</Size><SupplierCode>KO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5282</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>337193</ARTG></ARTGs><MinimumBenefit>2238</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK009</BillingCode><Name>Freka Intestinal Tube, ENFit</Name><Description>Intestinal extension tube for the gastric Freka PEG FR 15 or FR 20. Made with integrated Teflon-coated wire with fitted Y-Connector and blue fixation screw, radio-opaque strip, interval markings every 10 cm, distal pigtail bend tip, 4 lateral outlet ports, straight open flexible tube with small antenna end</Description><Size>9 Fr x 120 cm 
12 Fr x 120 cm</Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1546</GroupID><Suffix>Port</Suffix><ARTGs><ARTG>126461</ARTG></ARTGs><MinimumBenefit>451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK007</BillingCode><Name>Ambix Intraport CP Powerflow &amp; Ambix Intraport T Powerflow</Name><Description>Ambix Intraport® systems are completely implantable catheter systems.  They consist of a casing, a medicine compartment with a silicone membrane and a catheter which can be connected to the port casing.</Description><Size>Port: 8086012 Ambix Intraport CP Powerflow
Material: PEEK casing with aluminium oxide ceramic medicine compartment
Diameter of port base: 30mm
Port Weight: 7.8/7.6g
Port filling volume: 0.21/0.25ml
Port: 8086442
Material: Titanium
Diameter of port: 30mm
Port Height: 13.8mm
Port weight: 12.6g
Port filling volume: 0.56ml</Size><SupplierCode>FK</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>222676</ARTG><ARTG>222677</ARTG></ARTGs><MinimumBenefit>510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK020</BillingCode><Name>Freka Intestinal Tube For Freka PEG</Name><Description>Freka intestinal tube for PEG is intended as intestinal extension for the gastric Freka PEG for long term- intestinal feeding and gastric decompression, for patients at risk of aspiration or motility disorders, intestinal tube is made of polyurethane with, integrated Teflon-coated guidewire, 118 cm long, radio-opaque strip, interval markings every 10 cm,  four lateral outlet ports, plastic antenna end with distal opening and flexible tube extension which can be gripped. 
Accessories
Freka Y-Connectors for simultaneous gastric and  intestinal access consisting of 2 parts (either Freka Y-Connector ENFit - ENFit + Fixation Screw for Y-Connector) or (Freka Y-Connector ENFit - Funnel+ Fixation Screw for Y-Connector), Freka Y-Connector ENFit - ENFit, Freka Y-Connector ENFit - Funnel, Fixation Screw for Y-Connector , Freka Click Adaptor, ENFit consisting of click connector (to attach the gastric PEG), ENFit connector (to connect the giving set)



</Description><Size>Freka Intestinal Tube FR 9 for PEG FR 15, ENFit 120cm length product code M90800351 , Freka Intestinal Tube FR 9 for PEG FR 16 ENFit 120cm length product code M90800373, Freka Intestinal Tube FR 12 for PEG FR 20 , ENFit 120cm length product code M90800350.</Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1546</GroupID><Suffix>Port</Suffix><ARTGs><ARTG>126461</ARTG></ARTGs><MinimumBenefit>451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK015</BillingCode><Name>Freka EasyIn, ENFit</Name><Description>Double lumen feeding and decompression tube for the early jejunal feeding and gastric decompression for ICU patients</Description><Size>Intestinal tube: 8 Fr, 270 cm  Gastric tube: 16 Fr, 100 cm</Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1546</GroupID><Suffix>Port</Suffix><ARTGs><ARTG>405292</ARTG></ARTGs><MinimumBenefit>451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK010</BillingCode><Name>Freka FCJ Set FR 9, ENFit</Name><Description>System consisting of Freka polyurethrane tube, Freka ENfit Connector, Freka fixation plate, Freka tube clamp, long cannula with blunt steel mandrin for catheterisation of the jejenum, and short cannula for puncturing the abdominal wall</Description><Size>9 Fr, length 75 cm</Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1546</GroupID><Suffix>Port</Suffix><ARTGs><ARTG>126461</ARTG></ARTGs><MinimumBenefit>451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK016</BillingCode><Name>Freka Trelumina, ENFit</Name><Description>Transanasal, 3-lumen polyurethane tube for early jejunal feeding and gastric decompression in ICU patients</Description><Size>Intestinal feeding lumen: 9 Fr, length 150 cm   Gastric decompression lumen: 16 Fr, length 95 cm  Gastric ventilation valve: internal diameter 1.2 mm, length 95 cm</Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1546</GroupID><Suffix>Port</Suffix><ARTGs><ARTG>405292</ARTG></ARTGs><MinimumBenefit>451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK017</BillingCode><Name>Agilia SP PCA Infusion System</Name><Description>Agilia SP PCA is a programmable electronic medical system dedicated to administering a pre-determined volume of a syringe at a programmed rate. This syringe pump ensures a fluid delivery, by pushing the syringe plunger and advancing the liquid to the patient through an extension set. The Agilia SP PCA syringe pump can also be used for general infusions on adults, pediatrics, and neonatal patients for the intermittent or continuous delivery of parenteral fluids (such as solutions, colloids, parenteral nutrition), medications (such as diluted drugs, chemotherapy, anesthesia drugs), blood and blood derivatives, and medications through clinically accepted routes of administration.  It is intended for use by trained healthcare professionals in clinical healthcare facilities. In PCA therapy, it is also intended for use by the patient in order to self administer doses of analgesic agent, after receiving appropriate training and instructions from the clinical staff. Agilia SP PCA is a transportable and reusable device that can be used every day. </Description><Size>The size of a syringe can be 5, 10, 20, 30 or 50/60 mL.  </Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4185</SubGroupID><ARTGs><ARTG>267873</ARTG></ARTGs><MinimumBenefit>2805</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK014</BillingCode><Name>Freka Endolumina, ENFit</Name><Description>Single lumen feeding tube for the early jejunal feeding for ICU patients</Description><Size>8 Fr, length 270 cm</Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1546</GroupID><Suffix>Port</Suffix><ARTGs><ARTG>125846</ARTG></ARTGs><MinimumBenefit>451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK011</BillingCode><Name>Freka Pexact, FR 15 set II, ENFit</Name><Description>Kit consisting of a gastropexy device (Loop Fixture II), trocar with peel-away sheath, and silicone balloon tube for direct puncture gastrostomy</Description><Size>Trocar with peel-away sheath:16 Fr, length 17.5 cm
Silicone balloon tube:15 Fr, shaft length 23 ± 1 cm</Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>285517</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK019</BillingCode><Name>Freka PEG Pro Set </Name><Description>Freka Percutaneous Endoscopic Gastrostomy (PEG) Pro set is intended for percutaneous intragastric long-term feeding and gastric decompression / drainage by gravity, consisting of PEG tube made from polyurethane + 60% barium sulphate, proximal cone and integrated fixation loop, radio-opaque strip, measuring marks over a length of 2-16 cm at 2 cm intervals, silicone inner retention plate, radio-opaque, rounded distal opening
Accessories 
Pen blade scalpel, puncture cannula with air valve and safety trocar, reel of thread with double thread, introducer device, silicone external fixation plate, radio-opaque, tube clamp
M90800346 (PEG PRO 12FR) Includes ENFit fixing screw and ENFit connector 
M90800347 (PEG PRO 14FR) Includes ENFit fixing screw and ENFit connector 
M90800349 (PEG PRO 16FR) Includes ENFit fixing screw and ENFit connector 
M90800348 (PEG PRO 20FR) Includes ENFit fixing screw, ENFit connector, and funnel connector 
ENFit connector:
Connection of the PEG tube to: 
Enteral Giving Sets for pump-assisted enteral feeding
Gravity Enteral Giving Sets connected to a nutrition/hydration container
ENFit syringes
Decompression / drainage bags
The ENFit connector is an internationally standardized enteral feeding connector that increases patient safety by preventing misconnections with other medical systems.

Fixing Screw:
To fix the ENFit connector to the PEG tube

Funnel Connector:
Provided (in addition to the ENFit connector) for gastric decompression, gastric access for instruments or bolus/gravity tube feeding. 
Use of a wide-lumen gastric PEG (PEG FR 20) is particularly recommended for:
use of the gastric port for instrument insertion for therapeutic/diagnostic purposes
positioning of an intestinal tube for gastric decompression and intestinal feeding

Drawings of the components are available on page 6 of the IFU:


</Description><Size> Freka PEG Pro Set FR 12 35 cm length product code M90800346,   Freka PEG Pro Set FR 14 35 cm length product code M90800347, Freka PEG Pro Set FR 16 35 cm length product code M90800349,   Freka PEG Pro Set FR 20 35 cm length product code M90800348,</Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>126460</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK008</BillingCode><Name>Freka PEG, ENFit</Name><Description>PEG polyurethane tube with a proximal cone and integrated fixation loop, radio-opaque strip, measuring marks over a length of l-16 cm at 2 cm intervals, radio-opaque silicone retention plate, and a rounded distal opening</Description><Size>9 Fr x 30 cm 
15 Fr x 35 cm
20 Fr x 35 cm</Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>126460</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK013</BillingCode><Name>Freka Belly Button Comfort Kit, ENFit</Name><Description>Gastric replacement system consisting of Freka Belly Button, insertion introducer, 2 compresses, syringe for filling balloon, lubricant gel, Seldinger wire, Freka Button Extension Sets 1 and 2, and Freka Connect. An Initial Placement System (PEG) would have been placed at least 4 weeks prior.</Description><Size>12 Fr x 1.0cm ,12 Fr x 1.5cm, 12 Fr x 2.0cm, 12 Fr x 2.5cm, 12 Fr x 3.0cm, 12 Fr x 3.5cm, 12 Fr x 4.0cm, 12 Fr x 4.5cm,12 Fr x 5.0cm 

14 Fr x 1.0cm, 14 Fr x 1.5cm, 14 Fr x 2.0cm, 14 Fr x 2.5cm, 14 Fr x 3.0cm, 14 Fr x 3.5cm,14 Fr x 4.0cm,14 Fr x 4.5cm, 14 Fr x 5.0cm

16 Fr x 1.0cm, 16 Fr x 1.5cm, 16 Fr x 2.0cm, 16 Fr x 2.5cm, 16 Fr x 3.0cm, 16 Fr x 3.5cm,16 Fr x 4.0cm,16 Fr x 4.5cm, 16 Fr x 5.0cm

18 Fr x 1.0cm, 18 Fr x 1.5cm, 18 Fr x 2.0cm, 18 Fr x 2.5cm, 18 Fr x 3.0cm, 18 Fr x 3.5cm,18 Fr x 4.0cm,18 Fr x 4.5cm, 18 Fr x 5.0cm

20 Fr x 1.0cm, 20 Fr x 1.5cm, 20 Fr x 2.0cm, 20 Fr x 2.5cm, 20 Fr x 3.0cm, 20 Fr x 3.5cm,20 Fr x 4.0cm, 20 Fr x 4.5cm, 20 Fr x 5.0cm

24 Fr x 1.0cm, 24 Fr x 1.5cm, 24 Fr x 2.0cm, 24 Fr x 2.5cm, 24 Fr x 3.0cm, 24 Fr x 3.5cm, 24 Fr x 4.0cm, 24 Fr x 4.5cm, 24 Fr x 5.0cm</Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>126462</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK018</BillingCode><Name>Freka Belly Button  Basic Kit, ENFit</Name><Description>Gastric replacement system consisting of 1 Freka Belly Button, 1 insertion introducer, 2 compresses, 1 Luer syringe for filling balloon, 1 lubricant gel, 1 X10 ml ampoule of sterile water. An Initial Placement System (PEG) would have been placed at least 4 weeks prior.</Description><Size>12 Fr x 1.0cm ,12 Fr x 1.5cm, 12 Fr x 2.0cm, 12 Fr x 2.5cm, 12 Fr x 3.0cm, 12 Fr x 3.5cm, 12 Fr x 4.0cm, 12 Fr x 4.5cm,12 Fr x 5.0cm              14 Fr x 1.0cm, 14 Fr x 1.5cm, 14 Fr x 2.0cm, 14 Fr x 2.5cm, 14 Fr x 3.0cm, 14 Fr x 3.5cm,14 Fr x 4.0cm,14 Fr x 4.5cm, 14 Fr x 5.0cm              16 Fr x 1.0cm, 16 Fr x 1.5cm, 16 Fr x 2.0cm, 16 Fr x 2.5cm, 16 Fr x 3.0cm, 16 Fr x 3.5cm,16 Fr x 4.0cm,16 Fr x 4.5cm, 16 Fr x 5.0cm              18 Fr x 1.0cm, 18 Fr x 1.5cm, 18 Fr x 2.0cm, 18 Fr x 2.5cm, 18 Fr x 3.0cm, 18 Fr x 3.5cm,18 Fr x 4.0cm,18 Fr x 4.5cm, 18 Fr x 5.0cm              20 Fr x 1.0cm, 20 Fr x 1.5cm, 20 Fr x 2.0cm, 20 Fr x 2.5cm, 20 Fr x 3.0cm, 20 Fr x 3.5cm,20 Fr x 4.0cm, 20 Fr x 4.5cm, 20 Fr x 5.0cm              24 Fr x 1.0cm, 24 Fr x 1.5cm, 24 Fr x 2.0cm, 24 Fr x 2.5cm, 24 Fr x 3.0cm, 24 Fr x 3.5cm, 24 Fr x 4.0cm, 24 Fr x 4.5cm, 24 Fr x 5.0cm  </Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4197</SubGroupID><ARTGs><ARTG>126462</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FK012</BillingCode><Name>Freka Gastrotube, FR 15, ENFit</Name><Description>Gastric replacement system intended for use for long-term intragastric feeding within a fully formed and healed stoma. An Initial Placement System (PEG) would have been placed at least 4 weeks prior. Made of silicone rubber.</Description><Size>Fits 15 Fr</Size><SupplierCode>FK</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>189</SubCategoryID><GroupID>1545</GroupID><SubGroupID>4198</SubGroupID><ARTGs><ARTG>126462</ARTG></ARTGs><MinimumBenefit>82</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FJ003</BillingCode><PriorBillingCodes><PriorBillingCode>LM196</PriorBillingCode></PriorBillingCodes><Name>Dynavisc</Name><Description>Absorbable adhesion barrier gel</Description><Size>1 ml</Size><SupplierCode>FJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5433</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>208839</ARTG></ARTGs><MinimumBenefit>411</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FJ001</BillingCode><PriorBillingCodes><PriorBillingCode>LH534</PriorBillingCode></PriorBillingCodes><Name>Oxiplex/AP Absorbable Adhesion Barrier Gel</Name><Description>Combination of Polyethylene Oxide (PEO) and Sodium Carboxylmethylcellulose stabilised with Calcium and made isotonic with Sodium Chloride.  Kit contains 2 x 20ml Sterile syringes , 1 x Applicator</Description><Size>2 x 20ml Sterile Syringes, 1 x Applicator</Size><SupplierCode>FJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5433</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>152224</ARTG></ARTGs><MinimumBenefit>1173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FJ002</BillingCode><PriorBillingCodes><PriorBillingCode>LH001</PriorBillingCode></PriorBillingCodes><Name>Oxiplex Absorbable Adhesion Barrier Gel</Name><Description>Oxiplex Absorbable Adhesion Barrier gel (Oxiplex is a co-polymer gel composed of carboxymethylcellulose and polyethylene.)</Description><Size>3ml in sterile 3ml syringe</Size><SupplierCode>FJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5433</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>149294</ARTG></ARTGs><MinimumBenefit>1173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>FJ004</BillingCode><Name>Oxiplex/IU</Name><Description>Oxiplex/IU® is a clear, single use flowable gel. The gel is a sterile, absorbable  combination of sodium carboxymethylcellulose (CMC) and polyethylene oxide (PEO) with calcium chloride and sodium chloride in water. Oxiplex/IU is intended for use as a mechanical barrier to adhesion formation. Oxiplex/IU is intended to be used as an adjunct to intrauterine procedures for reducing the incidence, extent, and severity of adhesions.</Description><Size>1 x 10ml pre-filled syringe and vaginal applicator.</Size><SupplierCode>FJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5433</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>313985</ARTG></ARTGs><MinimumBenefit>1173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI033</BillingCode><Name>Stoma Osteosynthesis Screws</Name><Description>Screw Titanium</Description><Size>Diameter 1.3-1.6mm; Length 4-14mm</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>351730</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI017</BillingCode><PriorBillingCodes><PriorBillingCode>HD014</PriorBillingCode></PriorBillingCodes><Name>Bio-Oss Collagen</Name><Description>The product consists of Bio-Oss granules, embedded in 10% porcine collagen.  The collagen component is resorbed within a few weeks.  The properties of the Bio-Oss granules remain unchanged. Facilitates handling. </Description><Size>1 preformed block of cancellous-bone granulate and collagen, block size 100mg</Size><SupplierCode>GI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4114</SubGroupID><ARTGs><ARTG>229994</ARTG></ARTGs><MinimumBenefit>808</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI004</BillingCode><PriorBillingCodes><PriorBillingCode>HD009</PriorBillingCode></PriorBillingCodes><Name>Bio-Oss</Name><Description>This bone block consists of anorganic bovine bone matrix sterilised by gamma-irradiation.  Bio-Oss is a natural bone mineral for filling of bone defects in maxillofacial surgery, implantology, and periodontology.</Description><Size>approx 1.4-1.6g, 2cc</Size><SupplierCode>GI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4111</SubGroupID><ARTGs><ARTG>229987</ARTG></ARTGs><MinimumBenefit>503</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI016</BillingCode><PriorBillingCodes><PriorBillingCode>HD008</PriorBillingCode></PriorBillingCodes><Name>Bio-Oss Collagen</Name><Description>The product consists of Bio-Oss granules, embedded in 10% porcine collagen.  The collagen component is resorbed within a few weeks.  The properties of the Bio-Oss granules remain unchanged. Facilitates handling. </Description><Size>1 preformed block of cancellous-bone granulate and collagen, block size 250mg</Size><SupplierCode>GI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4114</SubGroupID><ARTGs><ARTG>229994</ARTG></ARTGs><MinimumBenefit>808</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI003</BillingCode><PriorBillingCodes><PriorBillingCode>HD003</PriorBillingCode></PriorBillingCodes><Name>Bio-Oss Bone Natural Bone Mineral</Name><Description>Derived from bovine bone</Description><Size>Granule size 1 - 2mm, 1.0gm (3cc)  Granule size 0.25 - 1mm, 2.0gm (4cc)</Size><SupplierCode>GI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4111</SubGroupID><ARTGs><ARTG>229987</ARTG></ARTGs><MinimumBenefit>503</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI009</BillingCode><PriorBillingCodes><PriorBillingCode>HD021</PriorBillingCode></PriorBillingCodes><Name>Bio-Oss Pen</Name><Description>Pen applicator with natural bone mineral derived from bovine bone</Description><Size>1 to 2mm; 0.5g (1.5cc)</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4395</SubGroupID><ARTGs><ARTG>229990</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI006</BillingCode><PriorBillingCodes><PriorBillingCode>HD018</PriorBillingCode></PriorBillingCodes><Name>Bio-Oss</Name><Description>Natural bone mineral derived from bovine bone</Description><Size>1 to 2mm: 0.5g (1.5cc)</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4395</SubGroupID><ARTGs><ARTG>229987</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI005</BillingCode><PriorBillingCodes><PriorBillingCode>HD017</PriorBillingCode></PriorBillingCodes><Name>Bio-Oss</Name><Description>Natural bone mineral derived from bovine bone</Description><Size>1 to 2mm; 2.0g (6cc)</Size><SupplierCode>GI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4112</SubGroupID><ARTGs><ARTG>229987</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI015</BillingCode><PriorBillingCodes><PriorBillingCode>HD007</PriorBillingCode></PriorBillingCodes><Name>Bio-Oss Collagen</Name><Description>The product consists of Bio-Oss granules, embedded in 10% porcine collagen.  The collagen component is resorbed within a few weeks.  The properties of the Bio-Oss granules remain unchanged. Facilitates handling. </Description><Size>1 preformed block of cancellous-bone granulate and collagen, block sizes 500mg</Size><SupplierCode>GI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4114</SubGroupID><ARTGs><ARTG>229994</ARTG></ARTGs><MinimumBenefit>808</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI008</BillingCode><PriorBillingCodes><PriorBillingCode>HD020</PriorBillingCode></PriorBillingCodes><Name>Bio-Oss Pen</Name><Description>Pen applicator with natural bone mineral derived from bovine bone</Description><Size>0.25 to 1mm; 0.5g (1.025cc)</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4395</SubGroupID><ARTGs><ARTG>229990</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI030</BillingCode><Name>Yxoss CBR</Name><Description>Yxoss CBR is a customized 3-D printed pure titanium or titanium alloys (certified medical grade 4) scaffold for use in craniofacial surgery, to regenerate complex alveolar bone in craniofacial bone rejuvenation and augmentation (Attachments 1 &amp; 2).</Description><Size>Patient specific - size matches individual patient.</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>280805</ARTG></ARTGs><MinimumBenefit>2952</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI020</BillingCode><PriorBillingCodes><PriorBillingCode>GI013</PriorBillingCode><PriorBillingCode>HD013</PriorBillingCode></PriorBillingCodes><Name>Geistlich Bio-Gide Shape</Name><Description>Geistlich Bio-Gide Shape is intended to be used as a barrier membrane in the regeneration of bone defects and used after bone grafting procedures in extraction sockets.
Because of its elasticity, Geistlich Bio-Gide Shape should be used in combination with void-filling bone graft materials such as autologous bone or bone substitutes (e.g. Geistlich Bio-Oss / Geistlich Bio-Oss Collagen) whenever possible.
The porous surface, facing the bone, allows the ingrowth of bone-forming cells. The dense surface, facing the soft tissue, prevents the ingrowth of fibrous tissue into the bone defect.</Description><Size>14 x 24 mm</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4253</SubGroupID><ARTGs><ARTG>287902</ARTG></ARTGs><MinimumBenefit>224</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI007</BillingCode><PriorBillingCodes><PriorBillingCode>HD019</PriorBillingCode></PriorBillingCodes><Name>Bio-Oss Pen</Name><Description>Pen applicator with natural bone mineral derived from bovine bone</Description><Size>0.25 to 1mm; 0.25g (0.5125cc)</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4394</SubGroupID><ARTGs><ARTG>229990</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI032</BillingCode><Name>Bio-Oss</Name><Description>Natural bone mineral derived from bovine bone</Description><Size>0.25 to 1mm; 0.25g (0.5125cc)</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4394</SubGroupID><ARTGs><ARTG>229987</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI019</BillingCode><PriorBillingCodes><PriorBillingCode>GI013</PriorBillingCode><PriorBillingCode>HD013</PriorBillingCode></PriorBillingCodes><Name>Geistlich Bio-Gide Perio / Geistlich Bio-Gide Compressed</Name><Description>Geistlich Bio-Gide Perio and Geistlich Bio-Gide Compressed are collagen membranes containing porcine collagen in a bilayer structure. Geistlich Bio-Gide Perio is used for guided bone regeneration and is especially indicated for periodontal bone defects in oral and maxillofacial surgery.
Geistlich Bio-Gide Compressed is intended to be used as a barrier membrane in the regeneration of bone defects.</Description><Size>16 x 22 mm, 13 x 25 mm, 20 x 30 mm</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4253</SubGroupID><ARTGs><ARTG>230085</ARTG><ARTG>294333</ARTG></ARTGs><MinimumBenefit>224</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI014</BillingCode><PriorBillingCodes><PriorBillingCode>HD022</PriorBillingCode></PriorBillingCodes><Name>Geistlich Mucograft,  Geistlich Mucograft Seal</Name><Description>Collagen Matrix</Description><Size>15mm x 20mm, 20mm x 30mm, diameter 8mm, diameter 12mm</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4253</SubGroupID><ARTGs><ARTG>229991</ARTG><ARTG>229995</ARTG></ARTGs><MinimumBenefit>224</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI018</BillingCode><Name>Master Pin</Name><Description>Pins used in dental surgery for the fixation of membranes (absorbable, non-absorbable and titanium membranes) in order to avoid micro-mobility of the graft. With sharp tips and the stable construction, the pins can be precisely inserted into cortical bones. The pins have an additional minithread and are a hybrid composed of a screw and pin. The thread makes easy and safe removal possible after a healing period has taken place. This thread enlarges the surface of the shaft at the same time and therefore offers more stability.</Description><Size>3.5mm</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4389</SubGroupID><ARTGs><ARTG>280879</ARTG></ARTGs><MinimumBenefit>76</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GI021</BillingCode><PriorBillingCodes><PriorBillingCode>GI010</PriorBillingCode><PriorBillingCode>HD010</PriorBillingCode></PriorBillingCodes><Name>Geistlich Bio-Gide</Name><Description>Geistlich Bio-Gide is a collagen membrane containing porcine collagen in a bilayer structure. It is used for guided bone regeneration and peridontal tissue regeneration in oral and maxillofacial surgery.</Description><Size>13 x 25 mm, 25 x 25 mm, 30 x 40 mm</Size><SupplierCode>GI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4253</SubGroupID><ARTGs><ARTG>230084</ARTG></ARTGs><MinimumBenefit>224</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX012</BillingCode><PriorBillingCodes><PriorBillingCode>MQ029</PriorBillingCode><PriorBillingCode>AC079</PriorBillingCode></PriorBillingCodes><Name>Intergard W - Woven Straight</Name><Description>Woven Straight</Description><Size>15cm</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4455</SubGroupID><ARTGs><ARTG>145512</ARTG></ARTGs><MinimumBenefit>508</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX026</BillingCode><PriorBillingCodes><PriorBillingCode>MQ020</PriorBillingCode><PriorBillingCode>AC056</PriorBillingCode></PriorBillingCodes><Name>Advanta PTFE Vascular Graft</Name><Description>Trilaminate PTFE Graft with Graft Deployment System</Description><Size>4mm - 8mm  11cm - 20cm length</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4455</SubGroupID><Suffix>R (ringed)</Suffix><ARTGs><ARTG>279716</ARTG></ARTGs><MinimumBenefit>964</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX010</BillingCode><PriorBillingCodes><PriorBillingCode>MQ035</PriorBillingCode><PriorBillingCode>AC088</PriorBillingCode></PriorBillingCodes><Name>Advanta V12 Stent Graft System</Name><Description>Balloon Expandable PTFE Encapsulated Stainless Steel Vascular Stent</Description><Size>Large Diameter 12 -16mm. 80 and 120cm catheter lengths</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1634</GroupID><SubGroupID>4450</SubGroupID><ARTGs><ARTG>156635</ARTG></ARTGs><MinimumBenefit>5140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX011</BillingCode><PriorBillingCodes><PriorBillingCode>MQ018</PriorBillingCode><PriorBillingCode>AC054</PriorBillingCode></PriorBillingCodes><Name>Advanta PTFE Vascular Graft with Graft Deployment System</Name><Description>Trilaminate PTFE. Vascular Access PTFE</Description><Size>4mm - 8mm diameter  11cm - 20cm length</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4455</SubGroupID><Suffix>R, ID</Suffix><ARTGs><ARTG>279716</ARTG></ARTGs><MinimumBenefit>1091</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX016</BillingCode><PriorBillingCodes><PriorBillingCode>MQ032</PriorBillingCode><PriorBillingCode>AC085</PriorBillingCode></PriorBillingCodes><Name>InterVascular Radially Supported Vascular Grafts</Name><Description>Radially Supported Vascular Grafts</Description><Size>6mm - 8mm diameter, 70cm - 85cm length</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><Suffix>R (ringed)</Suffix><ARTGs><ARTG>145506</ARTG><ARTG>145511</ARTG></ARTGs><MinimumBenefit>1440</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX009</BillingCode><PriorBillingCodes><PriorBillingCode>MQ006</PriorBillingCode><PriorBillingCode>AC023</PriorBillingCode></PriorBillingCodes><Name>Advant PTFE V12 Stent Graft System</Name><Description>Balloon Expandable PTFE Encapsulated Stainless Steel Peripheral Vascular Stent</Description><Size>5mm - 12mm Diameter</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1634</GroupID><SubGroupID>4449</SubGroupID><ARTGs><ARTG>156635</ARTG><ARTG>200244</ARTG></ARTGs><MinimumBenefit>3258</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX023</BillingCode><PriorBillingCodes><PriorBillingCode>MQ013</PriorBillingCode><PriorBillingCode>AC049</PriorBillingCode></PriorBillingCodes><Name>Advantra PTFE Vascular Graft with Graft Deployment System</Name><Description>Trilaminate PTFE. Vascular Access Graft</Description><Size>4mm - 8mm diameter. 50 - 80cm length</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1639</GroupID><Suffix>ID (immediate dialysis)</Suffix><ARTGs><ARTG>279716</ARTG></ARTGs><MinimumBenefit>1878</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX020</BillingCode><PriorBillingCodes><PriorBillingCode>MQ033</PriorBillingCode><PriorBillingCode>AC086</PriorBillingCode></PriorBillingCodes><Name>Maquet InterVascular Bifurcated Vascular Grafts</Name><Description>Bifurcated Vascular Grafts</Description><Size>Diameter – 12mmx6mm – 24mmx12mm  Length - 50cm </Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1637</GroupID><ARTGs><ARTG>145507</ARTG><ARTG>145515</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX017</BillingCode><PriorBillingCodes><PriorBillingCode>MQ016</PriorBillingCode><PriorBillingCode>AC052</PriorBillingCode></PriorBillingCodes><Name>Advanta PTFE Vascular Graft</Name><Description>Straight PTFE Vascular Graft</Description><Size>6mm - 10mm; 50cm - 90cm</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><ARTGs><ARTG>279716</ARTG></ARTGs><MinimumBenefit>663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX021</BillingCode><PriorBillingCodes><PriorBillingCode>MQ027</PriorBillingCode><PriorBillingCode>AC064</PriorBillingCode></PriorBillingCodes><Name>Intergard W</Name><Description>Woven Aortic Arch</Description><Size>Body Diameter 20mm - 36mm  Limbs Diameter 8 - 10mm</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1638</GroupID><ARTGs><ARTG>145513</ARTG><ARTG>145514</ARTG></ARTGs><MinimumBenefit>1760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX022</BillingCode><PriorBillingCodes><PriorBillingCode>MQ028</PriorBillingCode><PriorBillingCode>AC067</PriorBillingCode></PriorBillingCodes><Name>Intergard Knitted</Name><Description>Knitted Axillobifemoral Radially Supported</Description><Size>Diameter - 8x6x6mm - 10x8x8mm  Total body/branch length 100cm - 55cm   Radially Supported length 20-60cm  </Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1638</GroupID><ARTGs><ARTG>145509</ARTG></ARTGs><MinimumBenefit>1760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX028</BillingCode><PriorBillingCodes><PriorBillingCode>MQ041</PriorBillingCode></PriorBillingCodes><Name>Cardioroot</Name><Description>Woven polyester vascular prosthesis, gelatin sealed</Description><Size>Diameter 24mm - 34mm Length 15cm</Size><SupplierCode>GX</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>186</SubCategoryID><GroupID>1517</GroupID><ARTGs><ARTG>343016</ARTG></ARTGs><MinimumBenefit>2673</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX024</BillingCode><PriorBillingCodes><PriorBillingCode>MQ012</PriorBillingCode><PriorBillingCode>AC047</PriorBillingCode></PriorBillingCodes><Name>Advantra PTFE Vascular Graft</Name><Description>Tapered Trilaminate PTFE Graft with Graft Deployment System</Description><Size>4mm - 8mm diameter, 10 - 40cm lengths</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1639</GroupID><ARTGs><ARTG>279716</ARTG></ARTGs><MinimumBenefit>770</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX019</BillingCode><PriorBillingCodes><PriorBillingCode>MQ031</PriorBillingCode><PriorBillingCode>AC084</PriorBillingCode></PriorBillingCodes><Name>Maquet InterVascular Straight Vascular Grafts</Name><Description>Straight Vascular Grafts</Description><Size>6mm - 32mm Diameter, 60cm -100cm length</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><ARTGs><ARTG>145380</ARTG><ARTG>145510</ARTG><ARTG>145512</ARTG></ARTGs><MinimumBenefit>663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX014</BillingCode><PriorBillingCodes><PriorBillingCode>MQ030</PriorBillingCode><PriorBillingCode>AC083</PriorBillingCode></PriorBillingCodes><Name>Maquet InterVascular Straight vascular Grafts</Name><Description>Straight Vascular Grafts</Description><Size>6mm - 38mm diameter, Length 30cm - 40cm</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4456</SubGroupID><ARTGs><ARTG>145380</ARTG><ARTG>145510</ARTG><ARTG>145512</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX013</BillingCode><PriorBillingCodes><PriorBillingCode>MQ019</PriorBillingCode><PriorBillingCode>AC055</PriorBillingCode></PriorBillingCodes><Name>Advanta PTFE Vascular Graft with Graft Deployment System</Name><Description>Trilaminate PTFE. Vascular Access PTFE</Description><Size>4mm - 8mm diameter  21cm - 49cm length</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4456</SubGroupID><Suffix>R, ID</Suffix><ARTGs><ARTG>279716</ARTG></ARTGs><MinimumBenefit>1552</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX015</BillingCode><PriorBillingCodes><PriorBillingCode>MQ017</PriorBillingCode><PriorBillingCode>AC053</PriorBillingCode></PriorBillingCodes><Name>Atrium PTFE Vascular Graft</Name><Description>Ringed PTFE</Description><Size>4mm - 10mm; 50cm - 100cm</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4457</SubGroupID><Suffix>R (ringed)</Suffix><ARTGs><ARTG>279716</ARTG></ARTGs><MinimumBenefit>1440</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GX025</BillingCode><PriorBillingCodes><PriorBillingCode>MQ021</PriorBillingCode><PriorBillingCode>AC057</PriorBillingCode></PriorBillingCodes><Name>Advanta PTFE Vascular Graft</Name><Description>Trilaminate PTFE Graft with Graft Deployment System</Description><Size>4mm - 8mm diameter 21cm - 49cm length</Size><SupplierCode>GX</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>208</SubCategoryID><GroupID>1636</GroupID><SubGroupID>4456</SubGroupID><Suffix>R (ringed)</Suffix><ARTGs><ARTG>279716</ARTG></ARTGs><MinimumBenefit>1351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ053</BillingCode><PriorBillingCodes><PriorBillingCode>LM486</PriorBillingCode></PriorBillingCodes><Name>Haemostatic Gauze </Name><Description>Haemostatic Gauze </Description><Size>&gt;75cm²</Size><SupplierCode>ME</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6010</SubGroupID><ARTGs><ARTG>332360</ARTG></ARTGs><MinimumBenefit>26</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ME223</BillingCode><PriorBillingCodes><PriorBillingCode>NG075</PriorBillingCode></PriorBillingCodes><Name>General Purpose Drainage Catheter</Name><Description>Abscess Drainage Catheters</Description><Size>6FR x 12CM through to 28FR x 50CM</Size><SupplierCode>ME</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>4243</SubGroupID><ARTGs><ARTG>98030</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ME230</BillingCode><Name>NexPak X</Name><Description>Intranasal splint</Description><Size>8cms</Size><SupplierCode>ME</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1797</GroupID><ARTGs><ARTG>328036</ARTG></ARTGs><MinimumBenefit>93</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ME216</BillingCode><PriorBillingCodes><PriorBillingCode>NG058</PriorBillingCode></PriorBillingCodes><Name>NEPHRO-CATH Nephrostomy Drainage Catheter</Name><Description>Nephrostomy Drainage Catheter</Description><Size>Diameters: 8fr to 14fr sizes; Lengths 27cm through to 29cm</Size><SupplierCode>ME</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>234</SubCategoryID><GroupID>1718</GroupID><ARTGs><ARTG>98030</ARTG></ARTGs><MinimumBenefit>91</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>ME207</BillingCode><PriorBillingCodes><PriorBillingCode>NG065</PriorBillingCode></PriorBillingCodes><Name>TRU-CLOSE THORACIC VENT</Name><Description>Device for the treatment of spontanious, traumatic or iatrogenic simple pneumothorax.Allowing for amubulation during resolution and the aspiration of small amount of fluids</Description><Size>Catheter outer diameter = 11 French, catheter length = 10cm
Catheter outer diameter = 11 French, catheter length = 13cm
Catheter outer diameter = 13 French, catheter length = 10cm
Catheter outer diameter = 13 French, catheter length = 13cm</Size><SupplierCode>ME</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>4242</SubGroupID><ARTGs><ARTG>181784</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ054</BillingCode><PriorBillingCodes><PriorBillingCode>LM487</PriorBillingCode></PriorBillingCodes><Name>Haemostatic Gauze  </Name><Description>Haemostatic Gauze</Description><Size>≤50cm²</Size><SupplierCode>ME</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6008</SubGroupID><ARTGs><ARTG>332360</ARTG></ARTGs><MinimumBenefit>8</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV008</BillingCode><Name>VIPLOK PLDLA BTCP PEEK Tip Screw Anchor with suture</Name><Description>The Knotless PLDLA BTCP Anchor with PEEK Tip consists of Screw Anchor design. The anchor and tip is pre-mounted on an inserter. The tip has an eyelet intended for fixation of suture(s)/tape(s) to bone tendon fixation. The device is designed for insertion of the tip and anchor into bone by using instrumentation for creation of a pilot hole. A suture threader is included with the inserter to facilitate loading of suture through the eyelet.</Description><Size>4.8, 5.5 mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>510946</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV002</BillingCode><Name>Helysis PLDLA Interference Screw</Name><Description>The PLDLA Interference screw is absorbable. These Interference screw products are threaded and cannulated.</Description><Size>6mm x 20mm, 6mm x 25mm, 7mm x 20mm, 7mm x 25mm, 7mm x 30mm, 8mm x 25mm, 8mm x 30mm, 9mm x 25mm, 9mm, 9mm x 30mm, 9mm x 35mm, 10mm x 25mm, 10mm, 10mm x 35mm, 11mm x 30mm.</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>510880</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV020</BillingCode><Name>Helysis Peek</Name><Description>The PEEK Interference screw is in PEEK material.
These PEEK Interference Screw products are threaded and cannulated.</Description><Size>6mm x 20mm, 6mm x 25mm, 7mm x 20mm, 7mm x 25mm, 7mm x 30mm, 8mm x 25mm, 8mm x 30mm, 9mm x 25mm, 9mm x 30mm, 9mm x 35mm, 10mm x 25mm, 10mm x 30mm, 10mm x 35mm, 11mm x 30mm.</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>501746</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV019</BillingCode><Name>Viplok Titanium</Name><Description>The Knotless PEEK Anchor with single preloaded suture and Titanium Tip consists of Screw/Wedge Anchor design. The anchor and tip is premounted on an inserter. The tip has an eyelet intended for fixation of suture(s)/tape(s) to bone tendon fixation. The device is designed for insertion of the tip and anchor into bone by using instrumentation for creation of a pilot hole. A suture threader is included with the inserter to facilitate loading of suture through the eyelet.</Description><Size>4.8mm, 5.5 mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>501769</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV011</BillingCode><Name>Ceptre Knotted UHMWPE Suture PLDLA BTCP Screw Anchor</Name><Description>The Knotted UHMWPE Suture PLDLA Anchors is made up from RESOMER Composite LR 706 S BTCP (mixture of 70 % RESOMER LR 706 S and 30 % BTCP) which are available as a Screw Anchor and are preloaded with suture(s), tape(s) or suture–tape combinations on a disposable inserter assembly. The implant is supplied sterile and ready to use.</Description><Size>4.8mm, 5.5mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>510945</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV014</BillingCode><Name>Ceptre PEEK</Name><Description>The Knotted UHMWPE Suture PEEK Anchors are available as Screw Anchor which are preloaded with suture(s), tape(s) or suture-tape combinations on a disposable inserter assembly. The implant is supplied sterile and ready to use.</Description><Size>4.8 - 5.5 mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>501767</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV001</BillingCode><Name>Surestitch</Name><Description>The UHMWPE Suture PEEK Button Meniscus Repair Implant is an all-inside meniscal repair device with two PEEK non-absorbable polymer implants, preloaded with UHMWPE sutures. The UHMWPE Suture PEEK Button Meniscus Repair Implant is preloaded with USP #3-0 UHMWPE suture whereas UHMWPE Suture PEEK Button Meniscus Repair Implant XL is preloaded with USP #2-0 suture. The adjustable depth control knob is used to define the needle piercing length in the meniscus prior to deployment of the implant. These meniscal repair devices are available in various needle curvature.</Description><Size>Up, Left, Right, Down, XL-Up, XL-Down, XL-Right, XL-Left</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>501766</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV006</BillingCode><Name>Proloop</Name><Description>The Adjustable Loop UHMWPE Suture Titanium Button consists of one metal button and sutures strands used for accurate fixation in lower limb ligament reconstructive surgery. </Description><Size>14 x 60 mm, 14 x 90 mm, 20 x 90 mm, 8 x 100 mm.</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>501745</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV005</BillingCode><Name>Infiloop</Name><Description>The fixed loop UHMWPE suture titanium is composed of a titanium button and a fixed loop made of Ultra-High-Molecular-Weight Polyethylene (UHMWPE) suture, for accurate fixation in ligament reconstructive surgeries.</Description><Size>12 x 10 mm, 12 x 15 mm, 12 x 20 mm, 12 x 25 mm, 12 x 30 mm, 12 x 35 mm, 14 x 15 mm, 14 x 20 mm, 14 x 25 mm, 14 x 30 mm, 14 x 35 mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>501745</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV023</BillingCode><Name>STATIV suture anchors with sutures / tapes.</Name><Description>The Knotted UHMWPE suture anchor is a self-punching fixation device intended to provide secure fixation of soft tissue to bone. It consists of a soft suture anchor with attached nonabsorbable suture(s) to an inserter with handle. The anchors are available in various sizes, preloaded with suture, tape or suture-tape combinations. This device is provided sterile, for single use only.</Description><Size>1.5 mm, 1.8 mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>501768</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV015</BillingCode><Name>Ceptre Titanium</Name><Description>The Knotted UHMWPE suture Titanium anchor is available as Screw (threaded) knotted anchor which is preloaded with suture / tape on a disposable inserter assembly intended for fixation of suture/ tape to bone. The implant is supplied sterile ready to use.</Description><Size>4.8 mm, 5.5 mm, 6.5 mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>501767</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV021</BillingCode><Name>Helysis Titanium</Name><Description>The Titanium Interference screw is in TITANIUM material.
These Titanium Interference screw products are threaded and cannulated.</Description><Size>7mm x 20mm, 7mm x 25mm, 7mm x 30mm, 8mm x 25mm, 8mm x 30mm, 9mm x 25mm, 9mm x 30mm, 9mm x 35mm, 10mm x 25mm, 10mm x 30mm, 10mm x 35mm, 11mm x 30mm, 11mm x 35mm.</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>501746</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV017</BillingCode><Name>Viplok PEEK</Name><Description>The Knotless PEEK Anchor with single preloaded suture and PEEK Tip consists of Screw/Wedge Anchor design. The anchor and tip is premounted on an inserter. The tip has an eyelet intended for fixation of suture(s)/tape(s) to bone tendon fixation. The device is designed for insertion of the tip and anchor into bone by using instrumentation for creation of a pilot hole. A suture threader is included with the inserter to facilitate loading of suture through the eyelet.</Description><Size>4.8mm, 5.5 mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>501769</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV003</BillingCode><Name>VIPLOK PLDLA BTCP TI Wedge Anchor with suture</Name><Description>The Knotless PLDLA BTCP Anchor with Titanium Tip consists of Wedge Anchor design. The anchor and tip is pre-mounted on an inserter. The tip has an eyelet intended for fixation of suture(s)/tape(s) to bone tendon fixation. The device is designed for insertion of the tip and anchor into bone by using instrumentation for creation of a pilot hole. A suture threader is included with the inserter to facilitate loading of suture through the eyelet.</Description><Size>5.5</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>511741</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV010</BillingCode><Name>VIPLOK PLDLA BTCP PEEK Wedge with suture</Name><Description>The Knotless PLDLA BTCP Anchor with PEEK Tip consists of Wedge Anchor design. The anchor and tip is pre-mounted on an inserter. The tip has an eyelet intended for fixation of suture(s)/tape(s) to bone tendon fixation. The device is designed for insertion of the tip and anchor into bone by using instrumentation for creation of a pilot hole. A suture threader is included with the inserter to facilitate loading of suture through the eyelet.</Description><Size>2.8</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>511742</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV013</BillingCode><Name>Ceptre PEEK</Name><Description>The Knotted UHMWPE Suture PEEK Anchors are available as a Wedge Anchor (Tap in) which are preloaded with suture(s), tape(s) or suture-tape combinations on a disposable inserter assembly. The implant is supplied sterile and ready to use.</Description><Size>2.5 mm, 2.8mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>501767</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV012</BillingCode><Name>Ceptre Knotted UHMWPE Suture PLDLA+BTCP Wedge Anchor</Name><Description>The Knotted UHMWPE Suture PLDLA-BTCP Anchors is made up from RESOMER Composite LR 706 S BTCP (mixture of 70 % RESOMER LR 706 S and 30 % BTCP) available as Wedge Anchor (Tap in) which are preloaded with suture(s), tape(s) or suture–tape combinations on a disposable inserter assembly. The implant is supplied sterile and ready to use.</Description><Size>2.5, 2.8 mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>511743</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV009</BillingCode><Name>VIPLOK PLDLA BTCP PEEK Wedge 5.5 loaded with suture</Name><Description>The Knotless PLDLA BTCP Anchor with PEEK Tip consists of Wedge Anchor design. The anchor and tip is pre-mounted on an inserter. The tip has an eyelet intended for fixation of suture(s)/tape(s) to bone tendon fixation. The device is designed for insertion of the tip and anchor into bone by using instrumentation for creation of a pilot hole. A suture threader is included with the inserter to facilitate loading of suture through the eyelet.</Description><Size>5.5</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>511742</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV007</BillingCode><Name>T Button</Name><Description>The Adjustable loop UHMWPE suture PEEK button (close button &amp; open button) is a permanently implantable polyether ether ketone (PEEK) implant for ligament reconstructive surgeries. The closed button is preloaded with UHMWPE adjustable loop and in open button the UHMWPE adjustable loop is non preloaded.</Description><Size>16 mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>501745</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV004</BillingCode><Name>VIPLOK PLDLA BTCP Titanium Tip Screw Anchor with suture</Name><Description>The Knotless PLDLA BTCP Anchor with Titanium Tip consists of Screw Anchor design. The anchor and tip is pre-mounted on an inserter. The tip has an eyelet intended for fixation of suture(s)/tape(s) to bone tendon fixation. The device is designed for insertion of the tip and anchor into bone by using instrumentation for creation of a pilot hole. A suture threader is included with the inserter to facilitate loading of suture through the eyelet.</Description><Size>4.8, 5.5</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>511740</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV022</BillingCode><Name>STATIV suture anchors with sutures / tapes.</Name><Description>The Knotted UHMWPE suture anchor is a fixation device intended to provide secure fixation of soft tissue to bone and is available in self-tap/self-punching variant also. It consists of a soft suture anchor with attached nonabsorbable suture(s) to an inserter with handle. The anchors are available in various sizes, preloaded with suture, tape or suture-tape combinations. This device is provided sterile, for single use only.</Description><Size>2.5 mm, 2.9 mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>501768</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV018</BillingCode><Name>Viplok PEEK</Name><Description>The Knotless PEEK Anchor with single preloaded suture and PEEK Tip consists of Wedge Anchor design. The anchor and tip is premounted on an inserter. The tip has an eyelet intended for fixation of suture(s)/tape(s) to bone tendon fixation. The device is designed for insertion of the tip and anchor into bone by using instrumentation for creation of a pilot hole. A suture threader is included with the inserter to facilitate loading of suture through the eyelet.</Description><Size>2.8 mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>501769</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YV016</BillingCode><Name>Ceptre Titanium</Name><Description>The Knotted UHMWPE suture Titanium anchor is available as Screw (threaded) knotted anchor which is preloaded with suture / tape on a disposable inserter assembly intended for fixation of suture/ tape to bone. The implant is supplied sterile ready to use.</Description><Size>2.5 mm, 2.8mm</Size><SupplierCode>YV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>501767</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB029</BillingCode><Name>REVERE ADDITION Offset Rod Connectors with Integral Rod</Name><Description>Offset Connector with integral rod</Description><Size>5.5mm - 6.5 mm, 20mm - 200mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB216</BillingCode><Name>CREO® Cross Connector</Name><Description>Cross Connector</Description><Size>20-78mm to 22-91mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB034</BillingCode><Name>Colonial Spacers</Name><Description>Anterior Cervical Interbody Cage</Description><Size>12 x 11 mm, 14 x 12mm, 16 x 14mm, 18 x 15mm and 0, 7, 12, 15 and 20 degree lordosis</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>191532</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB100</BillingCode><Name>CREO AMP™ Modular Screw Shaft</Name><Description>Modular screw shaft</Description><Size>4.0mm - 10.5mm x 20mm - 120mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB095</BillingCode><Name>PLYMOUTH Thoracolumbar Plate System Plate</Name><Description>Thoracolumbar Plate</Description><Size>15 - 24mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>190063</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB149</BillingCode><Name>Canopy Radiolucent Spacer</Name><Description>Slide-on PEEK spacer with graft packing chamber</Description><Size>5-13mm in 2mm increments</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4131</SubGroupID><ARTGs><ARTG>219536</ARTG></ARTGs><MinimumBenefit>660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB185</BillingCode><Name>Independence MIS Anchor</Name><Description>Lumbar anchor for use with the Independence Spacer</Description><Size>Diameter: 5.5mm  Length, 25mm, 27mm and 30mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190071</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB043</BillingCode><Name>ELLIPSE Stabilization System, Polyaxial Screw</Name><Description>Polyaxial Bone Screw</Description><Size>3.5mm - 4.5mm diameter 8mm x 50mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB122</BillingCode><Name>CREO MIS Posterior Stabilization System - Bone Screws</Name><Description>Cannulated self-tapping polyaxial screws - Shank</Description><Size>Diameter 4.5-10.5mm, Length 25-120mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB112</BillingCode><Name>ASSURE® Anterior Plate System – Screws</Name><Description>Standard - Self-drilling or Self Tapping 
Rigid – Self Drilling or Self Tapping</Description><Size>Diameter - 4.0 -4.5mm
Length – 10-20mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB090</BillingCode><Name>CREO Stabilization System Preassembled Polyaxial Screw</Name><Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description><Size>4.0mm diameter to 10.5mm diameter
20mm to 120mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB130</BillingCode><Name>CREO MCS - Polyaxial Screw</Name><Description>Pre-assembled dual outer diameter polyaxial screw</Description><Size>Diameter: 5.0- 6.5 mm, Length 20-45mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB179</BillingCode><Name>CREO ADDITION - Offset Connectors</Name><Description>Offset connectors with various configurations</Description><Size>5.5-6.35 to 5.5-6.35mm, 12mm Wide
5.5-6.35 to 5.5-6.35mm, 9mm Wide
5.5-6.35mm
5.5mm Top Loading
5.5-6.0mm Head to 5.5mm Top Loading
5.5-6.0mm Head to 5.5-6.35mm Open, 12mm Wide
5.5-6.0mm to 5.5-6.0mm, 12mm Wide</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB102</BillingCode><Name>CREO AMP™ Sacral Plate</Name><Description>Sacral Plate</Description><Size>One size</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB062</BillingCode><Name>SI-LOK Stabilization System</Name><Description>Fusion Screw</Description><Size>8.0-12.0mm diameter x 25-60mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>261</SubCategoryID><GroupID>1821</GroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>199414</ARTG></ARTGs><MinimumBenefit>1853</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB018</BillingCode><Name>REVOLVE Stabilization System Poliaxial Screw</Name><Description>Polyaxial, cannulated pedicale screw</Description><Size>5.5mm - 8.5mm diameter 30mm - 90mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>190043</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB073</BillingCode><PriorBillingCodes><PriorBillingCode>LB047</PriorBillingCode></PriorBillingCodes><Name>ELLIPSE Stabilization System In-line Connector</Name><Description>Connector</Description><Size>3.5mm - 6.35mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB174</BillingCode><Name>Haven Dual Plates</Name><Description>Dual Laminoplasty plates</Description><Size>32mm - 39mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4131</SubGroupID><Suffix>Bilateral laminoplasty plate</Suffix><ARTGs><ARTG>219536</ARTG></ARTGs><MinimumBenefit>832</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB091</BillingCode><Name>CREO Stabilization Tapered Rod</Name><Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description><Size>4.75 and 5.5
600mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB124</BillingCode><Name>CREO MIS Posterior Stabilization System - Screw Head</Name><Description>Modular Polyaxial Screw Head</Description><Size>10mm and 30mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>196054</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB110</BillingCode><Name>ASSURE® Anterior Cervical Plate System – Plate</Name><Description>Titanium Alloy Anterior Cervical Plate</Description><Size>1.8 mm depth, 16mm width, 14- 54mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB146</BillingCode><Name>CAPITOL Polyaxial Screw</Name><Description>Self-tapping polyaxial screw</Description><Size>3.5 - 4.0mm diameter, 8-26mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB193</BillingCode><Name>PROVIDENCE Fixed Angle Screws</Name><Description>Fixed angled screws, self-drilling and self-tappiing</Description><Size>Length - 10mm to 26mm  Diameter - 4.2mm to 4.6mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB013</BillingCode><Name>CITADEL® Anterior Variable Angled Bone Screws</Name><Description>Variable Angle screw</Description><Size>22m - 57mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190969</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB069</BillingCode><Name>BEACON™ Stabilization System Posted Screw</Name><Description>Posted Screw and Reduction Screw</Description><Size>4.5mm - 9.5mm diameter 25mm - 90mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>219169</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB077</BillingCode><PriorBillingCodes><PriorBillingCode>LB024</PriorBillingCode></PriorBillingCodes><Name>REVERE Rods Preshaped</Name><Description>Pre-shaped Rods</Description><Size>4.5, 5.5 - 6.35mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB101</BillingCode><Name>CREO AMP™ Tulip</Name><Description>Tulip Head</Description><Size>4.75mm and 5.5mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB157</BillingCode><Name>QUARTEX Lateral Connectors</Name><Description>Lateral Connectors</Description><Size>standard, short, long, extra long for 3.5mm and 4.0mm rods</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB106</BillingCode><Name>InterContinental Plate</Name><Description>Lateral Plate</Description><Size>20mm x 8mm - 21mm.</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>190063</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB210</BillingCode><Name>CREO One</Name><Description>Monaxial pedicle screw  </Description><Size>Diameter: 5.5 -7.5mm  Length: 35-55mm  </Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB067</BillingCode><Name>BEACON™ Stabilization System Clamp</Name><Description>Clamp</Description><Size>5.5mm and 6.35mm small, medium, large</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>219169</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB123</BillingCode><Name>CREO MIS Posterior Stabilization System - Locking Cap</Name><Description>Threaded Locking Cap</Description><Size>9mm diameter</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB111</BillingCode><Name>ASSURE® Anterior Plate System – Plate</Name><Description>Titanium Alloy Anterior Cervical Plate</Description><Size>1.8 mm depth, 16mm width, 57-100mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB147</BillingCode><Name>CAPITOL Locking Cap</Name><Description>Non-threading locking cap</Description><Size>One size only</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB171</BillingCode><Name>ELSA Expandable Lateral Interbody Fusion Spacer</Name><Description>Expandable lateral interbody fusion spacer with integrated fixation and bone screws</Description><Size>Height (unexpanded): 7-11mmHeight (expanded): 14-20mmLength: 40-65mmWidth: 20mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>190968</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB138</BillingCode><Name>Fortify I Integrated Corpectomy Spacer System - Endplates</Name><Description>PEEK and Titanium endplates</Description><Size>Lateral – 22mm X 40-50mm, 14mm X 14-16mm, 12-14mmX 14-16mm, 21x23mm and 25 X 30mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4138</SubGroupID><ARTGs><ARTG>190055</ARTG></ARTGs><MinimumBenefit>928</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB009</BillingCode><Name>TRUSS® Thoracolumbar Plate</Name><Description>Thoracolumbar plate</Description><Size>22mm - 55mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>190063</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB015</BillingCode><Name>VIP Anterior Cervical Plate</Name><Description>Anterior Cervical Plate</Description><Size>13mm - 46mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>190972</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB116</BillingCode><Name>Unify Dynamic Anterior Cervical Plate System – Screws</Name><Description>Variable and fixed angle expanding titanium alloy screws</Description><Size>Diameter – 4.2mm and 4.6mm
Length – 10mm – 20mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Expansion Screw / Expansion Head Screw</Suffix><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>274</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB167</BillingCode><Name>REVERE Anterior Single Staple</Name><Description>Single anterior staple constructed of Titanium Alloy</Description><Size>small, medium, large</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB129</BillingCode><Name>CREO MCS - Screw Post</Name><Description>Double threaded, dual outer diameter screw post</Description><Size>Diameter 5.0-7.5mm, Length 20-45mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB189</BillingCode><Name>CREO DLX Rods</Name><Description>Curved, Straight and Hex-ended Rods</Description><Size>Diameter: 6.35mm  Length: 20mm-600mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB212</BillingCode><Name>CREO® Side Loading Rod</Name><Description>Curved, straight and offset rods</Description><Size>Length: 20mm- 600mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB160</BillingCode><Name>QUARTEX Occiptal Screws</Name><Description>Occipital Screws</Description><Size>Diameter 4.2mm-4.6mm and Length 6mm-16mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB066</BillingCode><Name>XP and R Corpectomy Spacer System</Name><Description>Expandable Corpectomy spacer</Description><Size>Small, Medium,15-88mm in varying lordotic/kyphotic angles</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>Cervical</Suffix><ARTGs><ARTG>190055</ARTG></ARTGs><MinimumBenefit>2755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB113</BillingCode><Name>SP-Fix™ Spinous Process Fixation</Name><Description>Posterior non-pedicle supplemental fixation device</Description><Size>35-55mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>177</SubCategoryID><GroupID>1496</GroupID><ARTGs><ARTG>237299</ARTG></ARTGs><MinimumBenefit>1321</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB181</BillingCode><Name>REFLECT Staple</Name><Description>Three prong threaded staple</Description><Size>5.0 mm - 7.5 mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><Note>The Prescribed List (PL) billing code does not cover the use of the device for vertebral body tethering (VBT) for the management of adolescent idiopathic scoliosis (AIS).</Note><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB058</BillingCode><Name>ZYFUSE Facet Fixation System Screw with washer</Name><Description>Facet Screw</Description><Size>5.0 - 6.0mm diameter x 30 - 60mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>196053</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB060</BillingCode><Name>REVLOK Fenestrated Screw System Screw</Name><Description>Fenestrated Screw</Description><Size>5.5mm -10.5mm x 30mm -120mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>196054</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB152</BillingCode><Name>QUARTEX Tapered Rods</Name><Description>Tapered rods which transition in diameter.</Description><Size>Diameter 3.5mm &amp; 4.0mm transitioning up to 6.5mm 
Length 350mm -500mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB215</BillingCode><Name>CREO® Side Loading Monoaxial Screw, Cannulated</Name><Description>Cannulated monoaxial pedicle screw</Description><Size>Diameter: 4.0 - 10.5mm  Length: 20 -120mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB080</BillingCode><PriorBillingCodes><PriorBillingCode>LB063</PriorBillingCode><PriorBillingCode>LB021</PriorBillingCode></PriorBillingCodes><Name>REVERE TRANSITION HA coated Pedicle Screw</Name><Description>Polyaxial Screw HA Coated, Dual Outer Diameter, Prefered Angle</Description><Size>5.5mm-8.5mm x 35mm - 100mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>196585</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB089</BillingCode><Name>CREO Stabilization System Preassembled Monoaxial Screw</Name><Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description><Size>4.75 and 5.5  4.0mm diameter to 8.5mm diameter  20mm to 90mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><Note>The Prescribed List (PL) billing code does not cover the use of the device for vertebral body tethering (VBT) for the management of adolescent idiopathic scoliosis (AIS).</Note><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB038</BillingCode><Name>XTEND Anterior Cervical Plate</Name><Description>Anterior Cervical Plate</Description><Size>10mm - 54mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB115</BillingCode><Name>Unify Dynamic Anterior Cervical Plate System – Plate</Name><Description>Titanium Alloy Dynamic Anterior Cervical Plate</Description><Size>Depth - 2.8mm
Width – 16.6mm
Length – 58 -70 mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB025</BillingCode><Name>REVERE Hooks</Name><Description>Hook - various</Description><Size>small, medium, large</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB163</BillingCode><Name>QUARTEX Occipital Jointed Rod</Name><Description>Occipital Jointed Rods</Description><Size>Left and Right, 4mm -Left and Right</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1480</GroupID><SubGroupID>4133</SubGroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>1350</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB055</BillingCode><Name>Xpand Corpectomy Spacer System</Name><Description>Expandable corpectomy spacer</Description><Size>small, Medium, Large. 15-120mm in varying lordotic/kyphotic angles</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>190055</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB097</BillingCode><Name>FORTIFY R Corpectomy Spacer Core</Name><Description>Expandable corpectomy spacer</Description><Size>14mm -20mm  15mm-120mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>190055</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB039</BillingCode><Name>XTEND Anterior Cervical Plate &gt;55mm</Name><Description>Anterior Cervical Plate &gt;55mm</Description><Size>57mm - 104mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB093</BillingCode><Name>FORTIFY Ti Corpectomy Spacer Core</Name><Description>Expandable corpectomy spacer</Description><Size>12mm, 16mm and 20mm x 15mm-135mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>190055</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB190</BillingCode><Name>CREO DLX Threaded Locking Cap</Name><Description>Threaded Locking Cap</Description><Size>One Size Only</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB158</BillingCode><Name>QUARTEX Inline Connectors</Name><Description>In-line connectors</Description><Size>4.0mm-4.0mm and 4.0mm-6.5mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB028</BillingCode><Name>REVERE ADDITION In-line Connectors</Name><Description>Connector, in-line</Description><Size>4.5mm, 5.5mm and 6.35mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB074</BillingCode><PriorBillingCodes><PriorBillingCode>LB044</PriorBillingCode></PriorBillingCodes><Name>ELLIPSE® Stabilization System Lateral Connector</Name><Description>Connector</Description><Size>Std, Short, medium, long</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB068</BillingCode><Name>BEACON™ Stabilizer System Connector</Name><Description>Connector</Description><Size>5.5mm and 6.35mm small, medium, large, offset</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>219169</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB040</BillingCode><Name>XTEND Anterior Cervical Extender Plate</Name><Description>Anterior Cervical Extender Plate</Description><Size>10mm - 46mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB094</BillingCode><Name>PLYMOUTH Thoracolumbar Plate System Screw</Name><Description>Bone Screw</Description><Size>5.5mm - 6.5mm
22mm - 57mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190063</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB016</BillingCode><Name>VIP Anterior Cervical Fixed Angle Screws</Name><Description>Anterior Cervical Fixed Angle Bone Screws</Description><Size>4.6mm - 5.1mm Diameter, 12mm - 20mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190972</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB042</BillingCode><Name>XTEND Fixed Angled Screws</Name><Description>Fixed Angled Bone Screws</Description><Size>4.2, 4.6 and 5.1mm diameter x 10mm - 20mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB087</BillingCode><Name>CREO Stabilization System Rod</Name><Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description><Size>4.75 and 5.5 diameter
15mm - 600mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB214</BillingCode><Name>CREO® Side Loading Locking Sleeve</Name><Description>Integrated nut and sleeve</Description><Size>5.5-6.0mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1466</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB084</BillingCode><PriorBillingCodes><PriorBillingCode>LB022</PriorBillingCode></PriorBillingCodes><Name>REVERE TRANSITION HA Coated Monoaxial Screw</Name><Description>Monoaxial Screw HA Coated</Description><Size>6.5mm - 8.5mm x 35mm - 65mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB137</BillingCode><Name>Fortify® I Integrated Corpectomy Spacer System - Core</Name><Description>PEEK and Titanium Cores with option of fixed lower endplate</Description><Size>12mm, 14mm and 20mm diameter Height 24-90mm to 32-120mm (expanded)</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4136</SubGroupID><ARTGs><ARTG>190055</ARTG></ARTGs><MinimumBenefit>2016</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB166</BillingCode><Name>REVERE Anterior Dual Staple</Name><Description>Dual Anterior Staple constructed of Titanium Alloy</Description><Size>small, medium, large, x-large</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB053</BillingCode><Name>CORRIDOR Fixation System Screw Cannulated Screws</Name><Description>Bone Screws</Description><Size>3.5mm - 4.5 diameter. 3
0mm - 60mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>190041</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB083</BillingCode><PriorBillingCodes><PriorBillingCode>LB022</PriorBillingCode></PriorBillingCodes><Name>REVERE Monoaxial Screw</Name><Description>Monoaxial Screw</Description><Size>4.0mm x 20-35mm in 5mm increments
4.5mm x 20-45mm in 5mm increments
5.0mm x 25-55mm in 5mm increments
5.5mm x 20 -50mm in 5mm increments
5.5 x 27mm in 5mm increments and 25mm-6mm increments in 5mm increments
6.5mm x 25-65mm in 5mm increments
6.5mm x 27mm -55mm in 5mm increments and 25mm - 65mm in 5mm increments
8.5mm x 25mm-65mm in 5mm increments
9.0mm x 25- 25mm-120mm in 5mm increments
10.0mm x 25mm-120mm in 5mm increments</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB180</BillingCode><Name>CREO ADDITION Headed Rods</Name><Description>Headed, shaped rods of various configurations</Description><Size>Diameter - 5.5mm
Length - 40mm - 230mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB154</BillingCode><Name>QUARTEX Locking Cap</Name><Description>Threaded locking cap</Description><Size>One size only</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB012</BillingCode><Name>CITADEL® Anterior Lumbar Plate</Name><Description>Anterior Lumbar plate</Description><Size>20mm - 99mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>190969</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB027</BillingCode><Name>REVERE ADDITION Offset Connectors</Name><Description>Connector, offset</Description><Size>4.5, 5.5 and 6.35mm Diameter, 15-150mm Length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB014</BillingCode><Name>CITADEL® Anterior Fixed Angles Bone Screws</Name><Description>Fixed Angle screw</Description><Size>22mm - 57mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190969</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB114</BillingCode><Name>Unify Dynamic Anterior Cervical Plate System – Plate</Name><Description>Titanium Alloy Dynamic Anterior Cervical Plate</Description><Size>Depth - 2.8mm
Width – 16.6mm
Length – 10- 55 mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB008</BillingCode><Name>TRUSS® Thoracolumbar Plate with slider</Name><Description>Thoracolumbar plate</Description><Size>45mm-99.5mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>190063</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB010</BillingCode><Name>TRUSS® Thoracolumbar Variable Angle Screws</Name><Description>Variable Angle screw</Description><Size>5.5m and 6.5mm diameter x 22mm - 57mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190063</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB213</BillingCode><Name>CREO® Side Loading Monoxial Screw</Name><Description>Monoaxial screw</Description><Size>Diameter: 4-10.5mm  Length: 20-120mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB139</BillingCode><Name>Fortify® I-R Corpectomy Spacer System - Screws</Name><Description>Bone Screws, fixed or variable angles, self-tapping or self-drilling</Description><Size>4.2, 3.6, and 5.5mm diameter, 12-60mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190055</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB023</BillingCode><Name>REVERE Locking Cap</Name><Description>Locking Cap</Description><Size>4.5, 5.5 and 6.35mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB092</BillingCode><Name>CANOPY Laminoplasty System Plate</Name><Description>Laminoplasty Plate</Description><Size>5 - 13mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4131</SubGroupID><ARTGs><ARTG>219536</ARTG></ARTGs><MinimumBenefit>660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB046</BillingCode><Name>ELLIPSE Stabilization System, Rod</Name><Description>Rod</Description><Size>3.5mm Diameter x 40mm - 240mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB162</BillingCode><Name>QUARTEX Occipital Clamp</Name><Description>Occipital Clamps</Description><Size>3.5mm to 4.0mm, short and long</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1471</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>349</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB187</BillingCode><Name>CREO DLX Hook</Name><Description>Hooks-Thoracic, Laminar, Transverse Process and Pedicle</Description><Size>Small,  Medium,  Large,  Right Large  Left Large  Right Medium  Left Medium  Offset Right  Offset Left  30 degree Offset Right  30 degree Offset Left</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB195</BillingCode><Name>PROVIDENCE Anterior Cervical Plates &gt; 55mm</Name><Description>Low profile anterior cervical plates</Description><Size>57mm to 104mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB145</BillingCode><Name>Coalition Anchor</Name><Description>Titanium Anchor for Coalition Spacer</Description><Size>12mm, 14mm and 15mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190040</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB208</BillingCode><Name>HEDRON A </Name><Description>3D Printed ALIF Spacer</Description><Size>Footprint: 22X 29mm, 24X 35mm, 28X39mm  Height 9-21mm  </Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>353398</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB192</BillingCode><Name>PROVIDENCE Variable Angle Screws</Name><Description>Variable angled screws, self drilling and self tapping</Description><Size>Length -10mm to 26mm  Diameter - 4.2mm to 4.6mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB207</BillingCode><Name>HEDRON IC</Name><Description>3D Printed Integrated ACDF Plate-Spacer including screws</Description><Size>Footprint: 12X14, 14X16, 15X18mm  Height: 5-12mm  Screws 3.6-4.2mm, 12-20mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>353400</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB103</BillingCode><Name>CREO AMP™ Lamina Clamp</Name><Description>Lamina clamp</Description><Size>Small, medium, large</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB071</BillingCode><PriorBillingCodes><PriorBillingCode>LB035</PriorBillingCode></PriorBillingCodes><Name>SUSTAIN Spacer</Name><Description>TLIF Cage</Description><Size>8mm-17mm height, 8mm-12mm width, 26-30mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>191534</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB133</BillingCode><Name>Sustain-IR and Sustain-IR Narrow - Paired</Name><Description>PEEK radiolucent interbody lumbar fusion device</Description><Size>Height 7-17mm, Length 18-22mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>191535</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB186</BillingCode><Name>CREO DLX Cross Connector</Name><Description>Adjustable Cross Connectors</Description><Size>20mm-78mm to 22mm-91mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB196</BillingCode><Name>COLOSSEUM Mesh Corpectomy Spacer</Name><Description>Titanium mesh corpectomy spacer</Description><Size>12-25mm X 14-30mm, 8-120mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1494</GroupID><ARTGs><ARTG>325140</ARTG></ARTGs><MinimumBenefit>2616</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB135</BillingCode><Name>Caliber Expandable Lumbar Fusion Device - Paired</Name><Description>Expandable titanium alloy and PEEK lumbar inter-body fusion device</Description><Size>Unexpanded Height 7-12mm, Expanded Height 11-17mm, Width 10-12mm, Length 22mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>190042</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB134</BillingCode><Name>Calber Expandable Lumbar Fusion Device</Name><Description>Expandable titanium alloy and PEEK lumbar interbody fusion device</Description><Size>Un-expanded Height -7-12mm, Expanded Height 11-17mm, Width 10-12mm, Length 26-30mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>190042</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB206</BillingCode><Name>HEDRON IA</Name><Description>3D Printed Integrated ALIF Spacer including screws/anchor</Description><Size>Spacer  Footprint: 24X30, 26X34, 29X39mm  Height: 11-21mm        Screws/Anchor: Diameter 5.5mm, Length 20-40mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>353398</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB070</BillingCode><PriorBillingCodes><PriorBillingCode>LB035</PriorBillingCode></PriorBillingCodes><Name>SUSTAIN spacer</Name><Description>PLIF cage</Description><Size>8mm-17mm height, 8mm-12mm width, 22mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>191531</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB057</BillingCode><Name>ELLIPSE Stabilization System, Top Loading T-Connector</Name><Description>T-Connector</Description><Size>21mm - 56mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB119</BillingCode><Name>Assure-X Anterior Cervical Plate System - Plates</Name><Description>Titanium Alloy Anterior Cervical Plate</Description><Size>1.8 mm profile, 16mm width, 10-54mm in length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB161</BillingCode><Name>QUARTEX Occipital Plate</Name><Description>Occipital Plate</Description><Size>Small to Large</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB019</BillingCode><Name>REVOLVE Stabilization Locking Cap</Name><Description>Locking Cap</Description><Size>One Size</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1468</GroupID><ARTGs><ARTG>190043</ARTG></ARTGs><MinimumBenefit>560</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB172</BillingCode><Name>Altera Articulating Expandable TLIF</Name><Description>Articulating Expandable Titanium TLIF Spacer</Description><Size>Length: 26-36mm
Height (non-expanded):8-12mm
Height (expanded): 12-16mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>214537</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB121</BillingCode><Name>Assure-X Anterior Cervical Plate System - Screws</Name><Description>Variable Angle and Fixed Angle Self-drilling and Self-tapping Expansion Bone Screws</Description><Size>Diameter 4.2-4.6 mm, Length 10-20mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Expansion Screw / Expansion Head Screw</Suffix><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>274</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB170</BillingCode><Name>REVERE Anterior Staple System - Cross Connector</Name><Description>Top Tightening Cross Connector</Description><Size>13mm -20mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB049</BillingCode><Name>ELLIPSE® Stabilization System Hooks</Name><Description>Hooks</Description><Size>5 - 7mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB151</BillingCode><Name>QUARTEX Rods</Name><Description>Ttianium alloy and cobalt chrome alloy curved and straight rods</Description><Size>3.5 and 4.0mm diameter, 25-500mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB143</BillingCode><Name>Rise IntraLIF</Name><Description>Intradiscal Lumbar Interbody Fusion Device</Description><Size>Width 8mm, Length 26mm, 30mm and 34mm
Height 7-14mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>214537</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB020</BillingCode><Name>REVOLVE Stabilization System Rods</Name><Description>Rod</Description><Size>5.5mm diameter 40mm - 300mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>190043</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB048</BillingCode><Name>ELLIPSE Stabilization System, Locking Cap</Name><Description>Locking Cap</Description><Size>One Size</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1468</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>560</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB178</BillingCode><Name>CREO ADDITION In-line Connectors with Integrated Rod</Name><Description>In-line Closed Connector with Integrated Rod</Description><Size>5.5 Rod, 5.5-6.35, 400mm
6.0 Rod, 5.5-6.35, 400mm
6.35 Rod, 5.5-6.35, 400mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB104</BillingCode><Name>SECURE Cervical Artificial Disc</Name><Description>Cervical Disc Replacement System</Description><Size>5mm - 9mm, 11x12 - 15x18mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5487</SubGroupID><ARTGs><ARTG>191978</ARTG></ARTGs><MinimumBenefit>6021</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB088</BillingCode><Name>CREO Stabilization System Locking Cap</Name><Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description><Size>4.75 and 5.5</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1468</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><Note>The Prescribed List (PL) billing code does not cover the use of the device for vertebral body tethering (VBT) for the management of adolescent idiopathic scoliosis (AIS).</Note><MinimumBenefit>560</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB006</BillingCode><Name>Signature Spacer</Name><Description>PEEK Interbody spacer</Description><Size>small, medium, large. 7mm - 17mm Height</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>190020</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB109</BillingCode><Name>SILC™ PET Band</Name><Description>PET Band</Description><Size>4 -6mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1816</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>757</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB041</BillingCode><Name>XTEND Variable Angled Screws</Name><Description>Variable Angled Bone Screws</Description><Size>4.2, 4.6 and 5.1mm diameter x 10mm - 20mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB191</BillingCode><Name>CREO DLX Polyaxial Screw</Name><Description>Polyaxial screws</Description><Size>Diameter: 4.0mm to 10.5mm  Length: 20mm to 120mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB218</BillingCode><Name>SABLE Expandable Spacer</Name><Description>Expandable lumbar interbody fusion device</Description><Size>Footprint: 8 x 22mm, 10 x 22mm. Starting height: 6-11mm.</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>408637</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB075</BillingCode><PriorBillingCodes><PriorBillingCode>LB044</PriorBillingCode></PriorBillingCodes><Name>ELLIPSE® Stabilization System Lateral Connector</Name><Description>Connector</Description><Size>3.5mm to 10.0mm - 3.5mm - 6.5mm Rod</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB056</BillingCode><Name>REVERE ADDITION In-line Rod Connectors with Integral Rod</Name><Description>IN-line Connector with integral rod</Description><Size>5.5mm-6.5mm 160-200mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB033</BillingCode><Name>REVERE Bone Screw, Anterior Plate</Name><Description>Bone Screw</Description><Size>5.5mm - 7.5mm Diameter x 25mm - 50mm Length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB153</BillingCode><Name>QUARTEX Polyaxial Screws</Name><Description>Polyaxial screws</Description><Size>3.5-5.5mm diameter
8-50mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB120</BillingCode><Name>Assure-X Anterior Cervical Plate System - Plates &gt; 55mm</Name><Description>Titanium Alloy Anterior Cervical Plate</Description><Size>1.8mm profile, 16mm width, 57-100 mm in length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB086</BillingCode><Name>CREO Stabilization System Cross Connector</Name><Description>The CREO Stabilization System implants are non-cervical spinal fixation intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description><Size>4.75 and 5.5, 30-91mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB177</BillingCode><Name>CREO ADDITION-Inline Connectors</Name><Description>In-line Closed Connector</Description><Size>5.5-6.35 to 5.5-6.35
5.5-6.0 to 5.5-6.0</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB169</BillingCode><Name>RISE-L Lateral Lumbar Interbody Fusion Device</Name><Description>Expandable titanium lumbar interbody fusion device</Description><Size>Width 18-22mm, Length 40-60mm, Height 7-10mm (unexpanded) - 14-17mm (expanded)</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>214537</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB007</BillingCode><Name>Continental Spacer</Name><Description>PEEK Interbody spacer</Description><Size>x-small, small, medium, large. 0deg, 8deg, 15deg. 9mm - 21mm Height</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>190020</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB051</BillingCode><Name>ELLIPSE Occipito Cervico Thoracic Stabilization System</Name><Description>T-Connector and Locking Nut</Description><Size>21mm - 63mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB045</BillingCode><Name>ELLIPSE Stabilization System, Tapered Rod</Name><Description>Dual Diameter Rod</Description><Size>3.5mm ti 4.0mm - 6.5mm x 350mm - 500mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB184</BillingCode><Name>SIGNIFY Bioactive</Name><Description>Osteostimulative and osteoconductive bioactive bone void filler</Description><Size>2cc and 5cc</Size><SupplierCode>LB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>317260</ARTG><ARTG>317427</ARTG><ARTG>317449</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB203</BillingCode><Name>HEDRON P</Name><Description>3D Printed Posterior Lumbar Interbody Spacer</Description><Size>Width: 8-10mm  Length: 22mm  Height: 7-17mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>353398</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB026</BillingCode><Name>REVERE Cross Connectors</Name><Description>Cross Connectors</Description><Size>4.5mm 20mm-78mm
5.5mm 29mm-91mm
6.35mm 29-90mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB085</BillingCode><Name>CREO Stabilization System Hook</Name><Description>The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.</Description><Size>4.75 and 5.5; small, medium and large</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB194</BillingCode><Name>PROVIDENCE Anterior Cervical Plates</Name><Description>Low profile anterior cervical plates</Description><Size>10mm to 54mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>190070</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB142</BillingCode><Name>RISE - paired</Name><Description>Expandable Lumbar Fusion Device</Description><Size>Width: 8mm, 10mm and 12mm 
Length: 22mm
Height 7-17mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>214537</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB205</BillingCode><Name>HEDRON T</Name><Description>3D Printed TLIF Spacer</Description><Size>Width: 10-11mm  Length: 28-33mm  Height: 7-17mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>353398</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB183</BillingCode><Name>SIGNIFY Bioactive</Name><Description>Osteostimulative and osteoconductive bioactive bone void filler</Description><Size>10cc</Size><SupplierCode>LB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>317260</ARTG><ARTG>317427</ARTG><ARTG>317449</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB217</BillingCode><Name>SABLE Expandable Spacer</Name><Description>Expandable lumbar interbody fusion device</Description><Size>Footprint: 10 x 26mm, 10 x 30mm, 12 x 26mm, 12 x 30mm. Starting Height 6-10mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>408637</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB188</BillingCode><Name>CREO DLX Offset Connectors</Name><Description>Head, Closed and Open Offset Connectors</Description><Size>15mm to 150mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB076</BillingCode><PriorBillingCodes><PriorBillingCode>LB024</PriorBillingCode></PriorBillingCodes><Name>REVERE Rods</Name><Description>Rod, precurved and straight</Description><Size>30mm-600mm in 4.5mm 5.5mm and 6.35mm diameter</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB159</BillingCode><Name>QUARTEX T-Connectors</Name><Description>Rod to Rod and Head to Head T-Connectors</Description><Size>21mm to 57mm - 27mm to 63mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB117</BillingCode><Name>Colonial - TPS ACDF System</Name><Description>ACDF spacer with Titanium Plasma Spray</Description><Size>Height : 5-12mm, Width 12-18mm, Length: 11-15mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>191532</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB079</BillingCode><PriorBillingCodes><PriorBillingCode>LB063</PriorBillingCode><PriorBillingCode>LB021</PriorBillingCode></PriorBillingCodes><Name>REVERE Polyaxial Screw</Name><Description>Polyaxial screw</Description><Size>5.5 Titanium, Alloy and Stainless Steel- 4.0-8.5mm x 20mm to 90mm in 5mm increments
5.5 Reduction screws - 5.5mm-7.5mm x 30mm-90mm in 5mm increments
6.35 Titanium Alloy and Stainless Steel - 5.5mm - 90mm x 25mm to 120mm in 5mm increments
5.5 Dual Diameter Screw Titanium Alloy and Stainless Steel - 5.5mm, 6.0mm 7.0mm, 7.5mm x 30mm to 100mm in 5mm increments
6.35 Dual Diameter Screws Titanium Alloy and Stainless Steel - 5.5mm, 6.0mm, 7.0mm, 7.5mm x 30mm to 65mm in 5mm increments
4.0-8.0mm diameter 20-90mm length
4.5 - 6.5mm diameter uniplanar fracture reduction screws, 25-55mm in 5mm increments</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB197</BillingCode><Name>COLLOSSEUM Mesh Endcap</Name><Description>Endcap</Description><Size>12-25mm X 14-30mm, 2-8mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1495</GroupID><ARTGs><ARTG>325140</ARTG></ARTGs><MinimumBenefit>1030</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB082</BillingCode><PriorBillingCodes><PriorBillingCode>LB064</PriorBillingCode><PriorBillingCode>LB021</PriorBillingCode></PriorBillingCodes><Name>REVERE TRANSITION HA Coated Cannulated Polyaxial Screw</Name><Description>Polyaxial Screw HA Coated, Cannulated</Description><Size>6.5mm - 8.5mm x 35mm - 6mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>196585</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB059</BillingCode><Name>ZYFUSE Facet Fixation System Screw</Name><Description>Facet Screw</Description><Size>5.0 - 6.0mm diameter x 30 - 60mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>196053</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB127</BillingCode><Name>Sustain - O TPS</Name><Description>TPS coated PEEK radiolucent lumbar interbody fusion device</Description><Size>Height 8-18mm,  Width 8-12mm, Length 22mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>191535</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB209</BillingCode><Name>HEDRON™ C</Name><Description>3D Printed ACDF Spacer</Description><Size>Footprints: 12X14mm, 14X16mm, 15X18mm  Height 5-12mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>353400</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB030</BillingCode><Name>REVERE H-LINK</Name><Description>Transverse Connector with integral Rods</Description><Size>5.5mm - 6.35mm Rod with 38mm - 71mm transverse connector and 40 - 45mm rod</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB126</BillingCode><Name>Sustain - O TPS</Name><Description>TPS coated PEEK radiolucent lumbar interbody fusion device</Description><Size>Height-8mm-18mm,  Width 8mm - 12mm, Length - 26mm-30mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>191535</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB148</BillingCode><Name>CAPITOL Curved Rod</Name><Description>Pre-lordosed Rods</Description><Size>3.5mm diameter 25-120mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB118</BillingCode><Name>Continental TPS Spacer</Name><Description>ALIF PEEK spacer with Titanium Plasma Spray</Description><Size>Width 25-39mm, Length 20-28mm, Height 9-21mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>191535</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB081</BillingCode><PriorBillingCodes><PriorBillingCode>LB064</PriorBillingCode><PriorBillingCode>LB021</PriorBillingCode></PriorBillingCodes><Name>REVERE Cannulated Polyaxial Screw</Name><Description>Cannulated Polyaxial Screw</Description><Size>5.5mm x 25 - 8.5 x 65mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB005</BillingCode><Name>TransContinental M Spacer</Name><Description>PEEK Interbody cages</Description><Size>0 degree, 6 degree, 20 degree and 25 degree, Height: 8mm - 21mm . Length: 35mm-60mm, Width: 20mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>191535</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB004</BillingCode><Name>TransContinental Spacer</Name><Description>PEEK Interbody cages</Description><Size>X-small, small, medium, large, x-large 0 deg, 6 deg and 10 degree 7 - 17mm Height</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>191535</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB175</BillingCode><Name>ELSA ATP</Name><Description>Anterior-to-Psoas Expandable Lumbar Spacer and bone screws</Description><Size>Width: 20mmLength - 40mm-65mmUnexpanded Height - 7-10mmExpanded Height - 14mm-17mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>190968</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB065</BillingCode><Name>COALITION Spacer</Name><Description>ACDF Spacer with screws</Description><Size>12mm x 14mm, 14mm x 16mm and 15mm x 18mm ,5mm - 12mm height</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>190040</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB032</BillingCode><Name>REVERE Blocking Plate, Anterior Screw</Name><Description>Blocking Plate</Description><Size>One Size</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1482</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB108</BillingCode><Name>SILC™ Clamp</Name><Description>Inline connector</Description><Size>4.5 -6.35mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB078</BillingCode><PriorBillingCodes><PriorBillingCode>LB024</PriorBillingCode></PriorBillingCodes><Name>REVERE Rods, Dual Unit</Name><Description>Scoliosis Rods</Description><Size>5.5mm - 6.35mm 450mm - 500mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1480</GroupID><SubGroupID>4132</SubGroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>1352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB168</BillingCode><Name>REVERE Anterior Staple System - Washer</Name><Description>Washers and Stackable Washers</Description><Size>5.5mm - 8.5mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1482</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB125</BillingCode><Name>CREO MIS Posterior Stabilization System</Name><Description>Titanium alloy and cobalt chrome straight and curved rods</Description><Size>30-500mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB211</BillingCode><Name>CREO® Side Loading Polyaxial Screw</Name><Description>Side Loading Polyaxial screw with CoCr head and Ti shank</Description><Size>Diameter: 4.0 - 10.5mm  Length: 20 -120mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB099</BillingCode><Name>CANOPY Laminoplasty System Screw</Name><Description>Bone and graft screw for Laminoplasty Plate</Description><Size>2.2mm - 3.0mm 
4mm - 12mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>219536</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB131</BillingCode><Name>Niko Corpectomy Spacer</Name><Description>PEEK Thoracolumbar pre-assembled corpectomy cage</Description><Size>Width 12 and 14mm, Length 14mm and 16mm, Height 15-33mm in 2mm increments</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1814</GroupID><ARTGs><ARTG>190055</ARTG></ARTGs><MinimumBenefit>3340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB199</BillingCode><Name>CREO S2AI Preferred Angle</Name><Description>Cannulated CoCr polyaxial screw</Description><Size>Diameter 6.0 -10.5mm  Length 60-120mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB204</BillingCode><Name>HEDRON P</Name><Description>3D Printed Posterior Lumbar Interbody Spacer</Description><Size>Width: 10-12mm  Length: 26-30mm  Height: 7-17mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>353398</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB072</BillingCode><PriorBillingCodes><PriorBillingCode>LB047</PriorBillingCode></PriorBillingCodes><Name>ELLIPSE Stabilization System Parallel Connector</Name><Description>Connector</Description><Size>3.5mm to 4.0 - 6.5mm Rod</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB011</BillingCode><Name>TRUSS® Thoracolumbar Fixed Angle Screws</Name><Description>Fixed Angle screw</Description><Size>5.5m and 6.5mm diameter x 22mm - 57mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190063</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB176</BillingCode><Name>CREO Offset Connectors</Name><Description>Threaded Head Offset Connectors</Description><Size>15mm-150mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB140</BillingCode><Name>Fortify® I-R Static Corpectomy Spacer System -Spacer</Name><Description>PEEK spacer with integrated titanium plates</Description><Size>Footprint - 12 X14mm   Heights 15-33mm (2mm increments)</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1814</GroupID><ARTGs><ARTG>190055</ARTG></ARTGs><MinimumBenefit>3340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB164</BillingCode><Name>AFFIRM Vertebral Compression Fracture System - Access Pack</Name><Description>Bone Cement and Delivery System</Description><Size>20g</Size><SupplierCode>LB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4087</SubGroupID><ARTGs><ARTG>192479</ARTG><ARTG>274306</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB096</BillingCode><Name>FORTIFY Ti Corpectomy Spacer Endplate</Name><Description>Expandable  corpectomy spacer endplate</Description><Size>12 and 20mm x 12-50mm 0-12deg.  13mm Round, 16mm, 16mm Round,16mm Footprint. 16mm,  18mm Round, 18mm Footprint.  20mm Round, 20mm, 20mm Footprint. 12 X 13mm. 12mm X 13mm Footprint.  16 X 30mm Footprint, 16 x35mm Footprint, 16 x 40mm Footprint, 16 x 45mm Footprint, 18 x30mm Footprint, 18X 35mm Footprint, 18X40mm Footprint, 18 X 45mm Footprint</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4138</SubGroupID><ARTGs><ARTG>190055</ARTG></ARTGs><MinimumBenefit>928</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB155</BillingCode><Name>QUARTEX Hooks</Name><Description>Left and Right Inline Hooks</Description><Size>One size only</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB061</BillingCode><Name>REVLOK Fenestrated Screw System Locking Cap</Name><Description>Locking Cap</Description><Size>One Size</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1468</GroupID><ARTGs><ARTG>196054</ARTG></ARTGs><MinimumBenefit>560</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB031</BillingCode><Name>REVERE Integrated Staple Head Plate</Name><Description>Integrated Staple Head Plate</Description><Size>small, medium, large, x-large</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB107</BillingCode><Name>InterContinental HA Screws</Name><Description>HA Coated Bone Screws</Description><Size>5.5mm x 30mm - 60mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190063</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB202</BillingCode><Name>HEDRON L</Name><Description>3D Printed Lateral Spacer</Description><Size>Width: 18-22mm  Lengths: 40-60mm  Heights: 7-15mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>353398</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB165</BillingCode><Name>Fortress and Fortress-Plus Bone Cement</Name><Description>Bone Cement</Description><Size>20g</Size><SupplierCode>LB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4087</SubGroupID><ARTGs><ARTG>274306</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB132</BillingCode><Name>Sustain-IR and Sustain-IR Narrow</Name><Description>PEEK radiolucent interbody lumbar fusion device</Description><Size>Height 7-17mm, Length 26-30mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>191535</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB001</BillingCode><Name>Independence Spacer</Name><Description>Spacer with integral plate and screws</Description><Size>small (24 X30mm), medium (26 X 34mm), large (29mm X 39mm) 8,15, 20, 25 and 30 deg 11mm - 25mm height</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>190071</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB050</BillingCode><Name>ELLIPSE® Stabilization System Occipital Plate</Name><Description>Occipital Plate</Description><Size>Small to Large</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB052</BillingCode><Name>ELLIPSE® Stabilization System Occipital Screw</Name><Description>Bone Screw</Description><Size>4.0mm to 4.5mm Diameter x 6mm - 16mm Length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB198</BillingCode><Name>SUSTAIN-RT</Name><Description>Insert and rotate lumbar fusion device</Description><Size>8-10mm X 22mm X 6-17mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>191535</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB144</BillingCode><Name>RISE IntraLIF - paired</Name><Description>Intradiscal Lumbar Interbody Fusion Device</Description><Size>8mm Width, 22mm Length 7-14mm Height</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>214537</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB017</BillingCode><Name>VIP Anterior Cervical Variable Angle Screws</Name><Description>Anterior Cervical Variable Bone Screws</Description><Size>4.6mm - 5.1mm Diameter, 12mm - 20mm length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190972</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB156</BillingCode><Name>QUARTEX Parallel Connectors</Name><Description>Parallel Connector</Description><Size>4.0mm Rod to 4.0-6.5mm Rod</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>190061</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB128</BillingCode><Name>Signature-R, Signature-R TPS &amp; Signature-Ti  TLIF System</Name><Description>PEEK or TPS Coated PEEK or Titanium lumbar interbody fusion device</Description><Size>Small - 10 x 28mm with heights from 7-17mm
Large - 11 x 33mm with heights from 7-17mm
PEEK TPS - 10-11mm x 32-37mm with heights from 7-17mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>191535</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB200</BillingCode><Name>SUSTAIN-RT</Name><Description>Insert and rotate lumbar fusion device</Description><Size>8-10mm x 26-30mm x 6-17mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>191535</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB098</BillingCode><Name>FORTIFY R Corpectomy Spacer Endplate</Name><Description>Expandable corpectomy spacer endplate</Description><Size>14-30mm X 14-25mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4138</SubGroupID><ARTGs><ARTG>190055</ARTG></ARTGs><MinimumBenefit>928</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB141</BillingCode><Name>RISE</Name><Description>Expandable Lumbar Fusion Device</Description><Size>Width:10mm, Length: 26mm, 30mm
Width:12mm, Length: 26mm and 30mm

Heights 7-17mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>214537</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB136</BillingCode><Name>TransContinental TPS</Name><Description>Lateral Lumbar Interbody Fusion (LLIF) Device</Description><Size>Length - 40-60mm in 5mm increments
Height - 7-17mm
Width - 18mm &amp; 22mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>191535</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB182</BillingCode><Name>CREO ADDITION - Z Rods</Name><Description>Z pre-shaped rods</Description><Size>Diameter 5.5-6.35mm
12mm Offset
100-200mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>190039</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB054</BillingCode><Name>CORRIDOR Fixation System Screw Non Cannulated Screws</Name><Description>Bone Screws</Description><Size>3.5mm - 4.5mm diameter, 30mm - 60mm Length</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>190041</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB201</BillingCode><Name>SUSTAIN Large</Name><Description>Anterior Lumbar Interbody Fusion Device in PEEK and Titanium</Description><Size>Footprint: 25 X 31mm  Height 9-21mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>191533</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LB150</BillingCode><Name>Caliber -L</Name><Description>Expandable Lateral Lumbar Interbody Fusion Device</Description><Size>Width -16mm, Length 25-40mm in 5mm increments
Width -18mm, Length 40-60mm in 5mm increments
Width -22mm, 40 - 60mm in 5mm increments 
Heights - 7-10mm, 8-11mm, 9-13mm, 10-13mm, 10mm-14mm, 11-15mm, 11-16mm, 12-16mm, 12-17mm</Size><SupplierCode>LB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>190042</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG008</BillingCode><Name>FIN XLPE Liner</Name><Description>A cup liner made from Cross-linked UHMWPE (Ultra High Molecular Weight Polyethylene) for use in hip prostheses systems.</Description><Size>Inner 28mm-5°, DIA 44/46
Inner 32mm-5°, DIA 48/50
Inner 32mm-5°, DIA 52/54
Inner 32mm-5°, DIA 56/58 
Inner 36mm-5°, DIA 52/54
Inner 36mm-5°, DIA 56/58
Inner 36mm-5°, DIA 60/72 
Inner 40mm-5°, DIA 60/72 
Inner 28mm-0°, DIA 44/46 
Inner 32mm-0°, DIA 48/50
Inner 32mm-0°, DIA 52/54 
Inner 32mm-0°, DIA 56/58
Inner 36mm-0°, DIA 52/54
Inner 36mm-0°, DIA 56/58
Inner 36mm-0°, DIA 60/72
Inner 40mm-0°, DIA 60/72</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>308933</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG010</BillingCode><PriorBillingCodes><PriorBillingCode>CR220</PriorBillingCode><PriorBillingCode>GM052</PriorBillingCode></PriorBillingCodes><Name>SMR Modular Femoral Stem Proximal Body</Name><Description>Titanium, grit blast, non HA,</Description><Size>40 to 70mm, Standard and Filling</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Body</Suffix><ARTGs><ARTG>277843</ARTG></ARTGs><MinimumBenefit>2401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG004</BillingCode><PriorBillingCodes><PriorBillingCode>GM130</PriorBillingCode></PriorBillingCodes><Name>Contile Fin II Acetabular Biolox Delta Ceramic Liners</Name><Description>Contile Fin II Acetabular Biolox Delta Ceramic Liner inserts 28mm,32mm, 36mm &amp; 46mm</Description><Size>Inserts 28mm 44mm to 46mm, Inserts 32mm 48mm to 66mm, Inserts 36mm 52mm to 66mm, Inserts 40mm 56mm to 66mm</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4025</SubGroupID><ARTGs><ARTG>281318</ARTG></ARTGs><MinimumBenefit>1690</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG014</BillingCode><Name>Korus Stem Cemented</Name><Description>A straight femoral stem for use in hip prostheses systems.</Description><Size>125 and 135 degrees; sizes 1 to 9; offset 37 to 50 mm</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>368330</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG013</BillingCode><PriorBillingCodes><PriorBillingCode>CR221</PriorBillingCode><PriorBillingCode>GM053</PriorBillingCode></PriorBillingCodes><Name>SMR Locking Screw</Name><Description>Locking Screw for Proximal Body to Stem</Description><Size>40 to 70mm</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1450</GroupID><ARTGs><ARTG>246519</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG006</BillingCode><PriorBillingCodes><PriorBillingCode>GM131</PriorBillingCode></PriorBillingCodes><Name>Biolox Delta Ceramic Femoral Heads</Name><Description>Biolox Delta Ceramic Femoral Heads 28mm 32mm</Description><Size>Biolox Delta Femoral Head 28mm - -3.5mm to +3.5mm and Biolox Delta Femoral Head 32mm - 3.5mm to +7mm</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>279805</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG007</BillingCode><Name>Biolox Delta Ceramic Femoral Head 36mm</Name><Description>A sterile implantable component of a hip prostheses system intended to replace the femoral head in total hip arthroplasty procedures.</Description><Size>Diameter: 36mm
Taper: 12/14
Neck: S, M, L, XL
Centre of rotation: -3.5, 0, +3.5, +7.0mm</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>279805</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG015</BillingCode><Name>DUALIS DM Cup with Plasma and HA</Name><Description>Uncemented Dual Mobility Shell - Plasma and HA Coating</Description><Size>44mm to 64mm</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4013</SubGroupID><ARTGs><ARTG>475836</ARTG></ARTGs><MinimumBenefit>1856</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG016</BillingCode><Name>DUALIS DM Insert XLPE</Name><Description>Dual Mobility Insert XLPE</Description><Size>Inner Diameter 28mm, 44mm to 64mm</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4024</SubGroupID><ARTGs><ARTG>475837</ARTG></ARTGs><MinimumBenefit>1540</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG002</BillingCode><PriorBillingCodes><PriorBillingCode>GM050</PriorBillingCode></PriorBillingCodes><Name>Contile Fin II</Name><Description>Bone Screw</Description><Size>20 to 50mm</Size><SupplierCode>GG</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>246519</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG003</BillingCode><PriorBillingCodes><PriorBillingCode>GM128</PriorBillingCode></PriorBillingCodes><Name>Contile Fin II Acetabular, Mueller Cup 28mm and 32mm</Name><Description>Mueller Cup</Description><Size>28mm Neutral and 10 Degree, 32mm Neutral and 10 Degree</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4006</SubGroupID><ARTGs><ARTG>284657</ARTG><ARTG>285462</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG009</BillingCode><Name>Cementless Korus Stem</Name><Description>A straight femoral stem, with or without collar, for use in hip prostheses systems.</Description><Size>125 and 135 degrees; sizes 1 to 9; ; offset 37 to 50 mm; with and without collar</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>312760</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG011</BillingCode><PriorBillingCodes><PriorBillingCode>CR223</PriorBillingCode><PriorBillingCode>GM144</PriorBillingCode></PriorBillingCodes><Name>SMR Femoral Stem</Name><Description>SMR Distal Component less than 200mm</Description><Size>SMR Distal Components:  14 x 100mm, 15 x 100mm, 16 x 100mm, 17 x 100mm, 18 x 100mm, 19 x 100mm, 20 x 100mm, 21 x 100mm, 22 x 100mm, 24 x 100mm, 14 x 160mm, 15 x 160mm, 16 x 160mm, 17 x 160mm, 18 x 160mm, 19 x 160mm,  20 x 160mm,  21 x 160mm, 22 x 160mm,  24 x 160mm</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>277980</ARTG></ARTGs><MinimumBenefit>2619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG001</BillingCode><PriorBillingCodes><PriorBillingCode>GM047</PriorBillingCode></PriorBillingCodes><Name>Fin II Acetabular Shell</Name><Description>titanium, Plasma sprayed, HA, with variable screw options</Description><Size>44 to 72mm</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1427</GroupID><SubGroupID>4018</SubGroupID><ARTGs><ARTG>279500</ARTG></ARTGs><MinimumBenefit>2079</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG005</BillingCode><PriorBillingCodes><PriorBillingCode>GM056</PriorBillingCode></PriorBillingCodes><Name>SMR Femoral Head</Name><Description>CoCr</Description><Size>22 to 40mm</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>280608</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>GG012</BillingCode><PriorBillingCodes><PriorBillingCode>CR224</PriorBillingCode><PriorBillingCode>GM143</PriorBillingCode></PriorBillingCodes><Name>SMR Femoral Stem</Name><Description>SMR Distal Component 200mm and greater.</Description><Size>SMR distal component 14 x 240mm, SMR distal component 15 x 240mm, SMR distal component 16 x 240mm, SMR distal component 17 x 240mm, SMR distal component 18 x 240mm, SMR distal component 19 x 240mm, SMR distal component 20 x 240mm,  SMR distal component 21 x 240mm, SMR distal component 22 x 240mm, SMR distal component 24 x 240mm  SMR distal component 14 x 200mm, SMR distal component 15 x 200mm, SMR distal component 16 x 200mm, SMR distal component 17 x200mm, SMR distal component 18 x 200mm, SMR distal component 19 x 200mm, SMR distal component 20 x 200mm, SMR distal component 21 x 200mm, SMR distal component 22 x 200mm, SMR distal component 24 x 200mm.</Size><SupplierCode>GG</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1412</GroupID><SubGroupID>3971</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>277980</ARTG></ARTGs><MinimumBenefit>3877</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HR005</BillingCode><Name>OTNI locking screw</Name><Description>Titanium screw for structural reinforcement of internal cone extension of proximal</Description><Size>One size M6x1 </Size><SupplierCode>HR</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5409</SubGroupID><ARTGs><ARTG>354839</ARTG></ARTGs><MinimumBenefit>5486</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HR006</BillingCode><Name>OTNi DC Adapter</Name><Description>The modular dual cone transcutaneous adapter, interconnects the femur at the stoma region to an external esoprosthesis by means of the OTN click safety adapter and OTN cannulated self-locking screw.</Description><Size>available in lengths of 60mm , 70mm, 80mm, 90mm, 100mm and 110mm of unique diameter of 18mm</Size><SupplierCode>HR</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5408</SubGroupID><ARTGs><ARTG>354839</ARTG></ARTGs><MinimumBenefit>18288</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HR004</BillingCode><Name>OTNI Osseointegration Femur Prosthesis</Name><Description>The medical device acts as an abutment and provides a fixed support for the connection of an artificial limb prosthesis to the residual femoral bone after transfemoral amputation.</Description><Size>OTNi Femur Stem Ø15x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø16x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø17x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø18x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø19x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø20x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø21x140 + OTNi Proximal Screw + OTNi Healing Plug  OTNi Femur Stem Ø22x140 + OTNi Proximal Screw + OTNi Healing Plug  </Size><SupplierCode>HR</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5407</SubGroupID><ARTGs><ARTG>354881</ARTG></ARTGs><MinimumBenefit>35055</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XS001</BillingCode><Name>VASCADE</Name><Description>Vascular closure system</Description><Size>5F and 6/7 F</Size><SupplierCode>XS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>212</SubCategoryID><GroupID>1644</GroupID><ARTGs><ARTG>427854</ARTG></ARTGs><MinimumBenefit>290</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HG001</BillingCode><Name>HSP K - Wire</Name><Description>Stainless Steel Wire with Trocar point, single, double.</Description><Size>Diameter - 0.7mm - 2.0mm  Length - 80mm - 250mm</Size><SupplierCode>HG</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>295191</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HD033</BillingCode><Name>BioHorizons PTG Implant</Name><Description>BioHorizons Tapered PTG implants support full-arch treatment in severely resorbed maxillae and provide an alternative to grafting, potentially expediting treatment. Tapered PTG Implant is narrow, dual tapered shape which is designed for precise placement. This approach maximizes AP spread for full arch restorations, while maintaining high implant stability. Cover screw included.  </Description><Size>Body diameter: 4.2mm.  Apex diameter: 2.2mm.  Platform diameter: 3.5mm.  Body length: 15-18mm.  </Size><SupplierCode>HD</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4392</SubGroupID><ARTGs><ARTG>126233</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HD028</BillingCode><Name>BioHorizons MinerOss XP</Name><Description>MinerOss XP is a highly porous anorganic porcine bone mineral matrix designed for hard tissue grafting applications. Xenograft for filling of bone defects in maxillofacial surgery,implantology, and periodontology.</Description><Size>Particle size ranges from 250-1000μm or 1000-2000μm Volume: 1.0cc, 2.0cc, and 4.0cc Jar or Syringe applicator</Size><SupplierCode>HD</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4395</SubGroupID><ARTGs><ARTG>299220</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HD030</BillingCode><Name>Camlog Conelog Progressive Line Implant</Name><Description>Bone-level CONELOG PROGRESSIVE conically tapered implant designed for high primary stability in all bone types. Other features include sand-blasted and acid etched surface and proven deep conical connection with integrated platform switching. </Description><Size>Diameters: 3.3, 3.8, 4.3, 5.0. Length: 7, 9, 11, 13, 16mm </Size><SupplierCode>HD</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4392</SubGroupID><ARTGs><ARTG>378610</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HD024</BillingCode><Name>BioHorizons Tapered Pro</Name><Description>Bone level tapered implant with Laser-Lok collar for immediate placement. Colour-coded internal hex conical connection. Cover screw included.</Description><Size>Body diameter: 3.8-5.2mm   Platform diameter: 3-4.5mm   Body length: 9-18mm  </Size><SupplierCode>HD</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4392</SubGroupID><ARTGs><ARTG>126233</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HD031</BillingCode><Name>CAMLOG Conelog Progressive Line - Multi Unit Abutment </Name><Description>Titanium abutments used for multiple-unit restorations. Includes straight, 17 and 30 degree abutments. Comes with a cover cap</Description><Size>Collar height: 1.0 - 5.0mm.  Angles: Straight,17 and 30 degrees </Size><SupplierCode>HD</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4385</SubGroupID><ARTGs><ARTG>343993</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HD023</BillingCode><Name>BioHorizons MinerOss XP</Name><Description>MinerOss XP is a highly porous anorganic porcine bone mineral matrix designed for hard tissue grafting applications. Xenograft for filling of bone defects in maxillofacial surgery, implantology, and periodontology.</Description><Size>Particle size ranges from 250-1000μm   Volume: 0.5cc,  Jar or Syringe applicator</Size><SupplierCode>HD</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4394</SubGroupID><ARTGs><ARTG>299220</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HD029</BillingCode><Name>BioHorions Mem-Lok RCM</Name><Description>Mem-Lok Resorbable Collagen Matrix is engineered from highly purified, Type I bovine collagen to provide a predictable resorption period and ensure optimal bone regeneration in periodontal, implantology or maxillofacial surgery.</Description><Size>15mm x 20mm  20mm x 30mm  30mm x 40mm</Size><SupplierCode>HD</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4253</SubGroupID><ARTGs><ARTG>196055</ARTG></ARTGs><MinimumBenefit>224</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HD026</BillingCode><Name>BioHorizons Multi-unit Abutments</Name><Description>Titanium abutments used for multiple-unit restorations. Includes straight, 17 and 30 degree abutments. Laser-lok technology optional. Comes with a cover cap. </Description><Size>Collar height: 1.0 - 5.0mm  Platforms: 3.0, 3.5, 4.5, 5.7mm  Angles: Straight,  17 and 30 degrees  </Size><SupplierCode>HD</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4385</SubGroupID><ARTGs><ARTG>133898</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HD027</BillingCode><Name>BioHorizons Mem-Lok Pliable </Name><Description>Mem-Lok Pliable is a strong, conformable collagen barrier membrane manufactured from highly purified porcine tissue. Predictable resorption time is 12-16 weeks. Used for guided bone regeneration and periodontal tissue regeneration in oral and maxillofacial surgery.</Description><Size>15mm x 20mm  20mm x 30mm  30mm x 40mm</Size><SupplierCode>HD</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4253</SubGroupID><ARTGs><ARTG>300312</ARTG></ARTGs><MinimumBenefit>224</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HD025</BillingCode><Name>BioHorizons Healing Abutment</Name><Description>Titanium healing abutment with or without laser-lok technology</Description><Size>Emergence profiles: Narrow - Wide     Diameter - 4.0-8.0mm     Height: 1.0 - 5.0mm   </Size><SupplierCode>HD</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4386</SubGroupID><ARTGs><ARTG>133898</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HD032</BillingCode><Name>CAMLOG Conelog Progressive Line - Healing Abutment </Name><Description>Temporary healing abutment for Camlog Conelog implant. Sterile. </Description><Size>Shape: Cylindrical, Wide body, Bottle neck  Height: 2-6mm</Size><SupplierCode>HD</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1600</GroupID><SubGroupID>4386</SubGroupID><ARTGs><ARTG>378911</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HK012</BillingCode><Name>PALACOS® fast R+G</Name><Description>Fast setting, high viscosity, radiopaque bone cement with gentamicin</Description><Size>40g</Size><SupplierCode>HK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4088</SubGroupID><ARTGs><ARTG>248254</ARTG></ARTGs><MinimumBenefit>161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HK005</BillingCode><PriorBillingCodes><PriorBillingCode>ZI232</PriorBillingCode></PriorBillingCodes><Name>Palacos or Palamed bone cement</Name><Description>Single mix PMMA</Description><Size>40g</Size><SupplierCode>HK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4087</SubGroupID><ARTGs><ARTG>152109</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HK008</BillingCode><Name>Copal G+C</Name><Description>High-viscosity, radiopaque bone cement with gentamicin and clindamycin</Description><Size>40g</Size><SupplierCode>HK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4088</SubGroupID><ARTGs><ARTG>176198</ARTG></ARTGs><MinimumBenefit>161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HK011</BillingCode><Name>Copal G + V</Name><Description>Specialised cement with gentamicin and vancomycin for use in septic revisions</Description><Size>40g</Size><SupplierCode>HK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4088</SubGroupID><ARTGs><ARTG>228234</ARTG></ARTGs><MinimumBenefit>161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HK013</BillingCode><Name>Palacos Bone Cement with Gentamicin</Name><Description>Single mix PMMA with Gentamicin supplied in regular viscosity, medium viscosity and low viscosity.</Description><Size>10, 20, 40, 60 gms</Size><SupplierCode>HK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4088</SubGroupID><ARTGs><ARTG>133411</ARTG><ARTG>133412</ARTG><ARTG>147285</ARTG></ARTGs><MinimumBenefit>161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HK014</BillingCode><PriorBillingCodes><PriorBillingCode>HK010</PriorBillingCode><PriorBillingCode>HK006</PriorBillingCode></PriorBillingCodes><Name>Palacos R+G Pro or Palacos MV+G Pro</Name><Description>Single Mix PMMA with Gentamicin and Complex Delivery System</Description><Size>40g, 55g, 60g, 75g, 80g</Size><SupplierCode>HK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4090</SubGroupID><ARTGs><ARTG>220925</ARTG><ARTG>309121</ARTG></ARTGs><MinimumBenefit>437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HK016</BillingCode><Name>Copal G+C pro</Name><Description>High-viscosity, radiopaque ready to mix bone cement containing gentamicin and clindamycin. The cement is supplied is supplied pre-packaged in a single-use ready to use mixing system with all the required components for mixing and delivery of the cement included.</Description><Size>40g, 80g</Size><SupplierCode>HK</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4090</SubGroupID><ARTGs><ARTG>455545</ARTG></ARTGs><MinimumBenefit>437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT036</BillingCode><PriorBillingCodes><PriorBillingCode>GW049</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Clavicle Plating System</Description><Size>7 - 15 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5271</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1260</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT050</BillingCode><PriorBillingCodes><PriorBillingCode>GW064</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Self-tapping Cannulated Screw</Description><Size>Small (2.71mm – 4.49mm)</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT006</BillingCode><PriorBillingCodes><PriorBillingCode>GW007</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Standard Bone Screw Systems</Description><Size>Standard ( ≥4.5mm) 10-130mm</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT008</BillingCode><PriorBillingCodes><PriorBillingCode>GW009</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems </Name><Description>Washers</Description><Size>10-13mm</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT046</BillingCode><PriorBillingCodes><PriorBillingCode>GW060</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Periarticular Fibula Plating System</Description><Size>7 - 15 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5290</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1194</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT020</BillingCode><PriorBillingCodes><PriorBillingCode>GW025</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Perarticular Ulna Plating Systems</Description><Size>7 - 15 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5280</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1126</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT052</BillingCode><PriorBillingCodes><PriorBillingCode>GW066</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>1/3 Tubular Plate</Description><Size>7-15 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>113</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT026</BillingCode><PriorBillingCodes><PriorBillingCode>GW036</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Humerus Plating Systems</Description><Size>7 - 15 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT017</BillingCode><PriorBillingCodes><PriorBillingCode>GW018</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Periarticular Tibia Plating Systems</Description><Size>≤ 6 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5292</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1365</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT007</BillingCode><PriorBillingCodes><PriorBillingCode>GW008</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Mini Bone Screw Systems</Description><Size>Mini (2.01 – 2.7 mm); lengths 5 - 70mm.</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT013</BillingCode><PriorBillingCodes><PriorBillingCode>GW014</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Supracondylar Femur Plates</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5268</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>850</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT015</BillingCode><PriorBillingCodes><PriorBillingCode>GW016</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Periarticular Femur Plates</Description><Size>≤ 6 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5286</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT053</BillingCode><PriorBillingCodes><PriorBillingCode>GW067</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems - Titanium Alloy</Name><Description>Clavicle Plating System - Titanium Alloy</Description><Size>≤ 6 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5270</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1208</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT010</BillingCode><PriorBillingCodes><PriorBillingCode>GW011</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Micro Bone Screw Systems</Description><Size>Micro (≤ 2.0mm)</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT009</BillingCode><PriorBillingCodes><PriorBillingCode>GW010</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Micro Bone Screw Systems</Description><Size>Micro (≤ 2.0mm)</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT040</BillingCode><PriorBillingCodes><PriorBillingCode>GW054</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Small Bone Screw Systems</Description><Size>Small (2.71mm – 4.49mm)</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT005</BillingCode><PriorBillingCodes><PriorBillingCode>GW006</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Cannulated Bone Screw Systems</Description><Size>Small (2.71mm – 4.49mm)</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT043</BillingCode><PriorBillingCodes><PriorBillingCode>GW057</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems </Name><Description>Periarticular Femur Plates</Description><Size>≥ 16 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5288</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1498</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT039</BillingCode><PriorBillingCodes><PriorBillingCode>GW053</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Standard Cannulated Screw Systems</Description><Size>Standard ( ≥4.5mm) 20-120mm</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT022</BillingCode><PriorBillingCodes><PriorBillingCode>GW030</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Periarticular Radius Plating Systems</Description><Size>≥ 16 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5278</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1234</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT004</BillingCode><PriorBillingCodes><PriorBillingCode>GW005</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Standard Locking Screw Systems</Description><Size>Standard ( ≥4.5mm) 10-120mm</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT044</BillingCode><PriorBillingCodes><PriorBillingCode>GW058</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Locking Compression Plates</Description><Size>≥16 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT028</BillingCode><PriorBillingCodes><PriorBillingCode>GW038</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Periarticular Radius Plating Systems</Description><Size>≤ 6 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1113</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT002</BillingCode><PriorBillingCodes><PriorBillingCode>GW003</PriorBillingCode></PriorBillingCodes><Name>WEGO Nailing Systems</Name><Description>Locking Screw for IM Nails</Description><Size>4.0-6.5mm x 18-130mm</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>324374</ARTG><ARTG>324375</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT038</BillingCode><PriorBillingCodes><PriorBillingCode>GW052</PriorBillingCode></PriorBillingCodes><Name>WEGO Nailing Systems</Name><Description>Femoral Nail</Description><Size>≥220mm</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3327</SubGroupID><ARTGs><ARTG>324374</ARTG></ARTGs><MinimumBenefit>1188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT029</BillingCode><PriorBillingCodes><PriorBillingCode>GW039</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Mini Bone Screw Systems</Description><Size>Mini (2.01 – 2.7 mm)</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT024</BillingCode><PriorBillingCodes><PriorBillingCode>GW034</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Small Fragment Plating System</Description><Size>≤ 6 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT027</BillingCode><PriorBillingCodes><PriorBillingCode>GW037</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Small Bone Screw Systems</Description><Size>Small (2.71mm – 4.49mm)</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT033</BillingCode><PriorBillingCodes><PriorBillingCode>GW046</PriorBillingCode></PriorBillingCodes><Name>WEGO Nailing Systems</Name><Description>Femoral Neck Lag Screw</Description><Size>75 - 120mm</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3341</SubGroupID><ARTGs><ARTG>324374</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT032</BillingCode><PriorBillingCodes><PriorBillingCode>GW042</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Periarticular Ulna Plating System</Description><Size>≤ 6 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5279</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>778</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT001</BillingCode><PriorBillingCodes><PriorBillingCode>GW002</PriorBillingCode></PriorBillingCodes><Name>WEGO Nailing Systems</Name><Description>Tibial Nail</Description><Size>&gt; 220mm</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3329</SubGroupID><ARTGs><ARTG>324375</ARTG></ARTGs><MinimumBenefit>963</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT023</BillingCode><PriorBillingCodes><PriorBillingCode>GW033</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Locking Compression Plate</Description><Size>7 - 15 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT019</BillingCode><PriorBillingCodes><PriorBillingCode>GW023</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Humerus Plating Systems</Description><Size>≥ 16 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5275</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT018</BillingCode><PriorBillingCodes><PriorBillingCode>GW022</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Periarticular Radius Plating Systems</Description><Size>7 - 15 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT051</BillingCode><PriorBillingCodes><PriorBillingCode>GW065</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Self-tapping Cannulated Screw</Description><Size>Standard ( ≥4.5mm)</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>324381</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT021</BillingCode><PriorBillingCodes><PriorBillingCode>GW026</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Non-Locking Plate Systems</Description><Size>≤ 6 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>417</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT011</BillingCode><PriorBillingCodes><PriorBillingCode>GW012</PriorBillingCode></PriorBillingCodes><Name>WEGO Nailing Systems</Name><Description>End Cap for Nails</Description><Size>0-20mm</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>5363</SubGroupID><ARTGs><ARTG>324374</ARTG><ARTG>324375</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT016</BillingCode><PriorBillingCodes><PriorBillingCode>GW017</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Locking Compression Plate</Description><Size>7 - 15 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT025</BillingCode><PriorBillingCodes><PriorBillingCode>GW035</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Distal Humerus Plating System</Description><Size>≤ 6 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5273</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1205</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT045</BillingCode><PriorBillingCodes><PriorBillingCode>GW059</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Periarticular Ulan Plating System</Description><Size>≥ 16 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5281</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT012</BillingCode><PriorBillingCodes><PriorBillingCode>GW013</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Locking Compression Plates</Description><Size>≤ 6 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>993</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT054</BillingCode><PriorBillingCodes><PriorBillingCode>GW068</PriorBillingCode></PriorBillingCodes><Name>Equinox Trauma Systems</Name><Description>Clavicle Midshaft Locking Compression Plate </Description><Size>6 holes left, 6 holes right</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT041</BillingCode><PriorBillingCodes><PriorBillingCode>GW055</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems </Name><Description>Supracondylar Femur Plates</Description><Size>≤ 6 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5267</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>850</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT034</BillingCode><PriorBillingCodes><PriorBillingCode>GW047</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Locking Plate Systems</Description><Size>≤ 6 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT042</BillingCode><PriorBillingCodes><PriorBillingCode>GW056</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems </Name><Description>Periarticular Femur Plates</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5287</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT055</BillingCode><PriorBillingCodes><PriorBillingCode>GW069</PriorBillingCode></PriorBillingCodes><Name>Equinox Trauma Systems </Name><Description>Clavicle Midhsaft Locking Plates </Description><Size>6 holes left, 6 holes right</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT014</BillingCode><PriorBillingCodes><PriorBillingCode>GW015</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Non-Locking Plate Systems</Description><Size>≥ 16 holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>431</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT047</BillingCode><PriorBillingCodes><PriorBillingCode>GW061</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Periarticular Fibula Plating Systems</Description><Size>≥ 16 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5291</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT030</BillingCode><PriorBillingCodes><PriorBillingCode>GW040</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Locking Compression Plates</Description><Size>≤ 6 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT049</BillingCode><PriorBillingCodes><PriorBillingCode>GW063</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Periarticular Tibia Plating Systems</Description><Size>≥ 16 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT037</BillingCode><PriorBillingCodes><PriorBillingCode>GW051</PriorBillingCode></PriorBillingCodes><Name>WEGO Nailing Systems</Name><Description>Femoral Nail</Description><Size>≤ 200mm</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3326</SubGroupID><ARTGs><ARTG>324374</ARTG></ARTGs><MinimumBenefit>910</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT003</BillingCode><PriorBillingCodes><PriorBillingCode>GW004</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Non-Locking Plate Systems</Description><Size>7-15 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT048</BillingCode><PriorBillingCodes><PriorBillingCode>GW062</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems </Name><Description>Periarticular Tibia Plating Systems</Description><Size>7 - 15 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1182</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT035</BillingCode><PriorBillingCodes><PriorBillingCode>GW048</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Locking Plate Systems</Description><Size>7-15 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XT031</BillingCode><PriorBillingCodes><PriorBillingCode>GW041</PriorBillingCode></PriorBillingCodes><Name>WEGO Trauma Systems</Name><Description>Periarticular Radius Plating Systems</Description><Size>7 - 15 Holes</Size><SupplierCode>XT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>324402</ARTG></ARTGs><MinimumBenefit>1126</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>HB001</BillingCode><Name>Haemoband</Name><Description>A preloaded, single use, 4 band ligator for haemorrhoids.</Description><Size>1 size, 4 bands</Size><SupplierCode>HB</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>5490</SubGroupID><ARTGs><ARTG>136643</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>RNB02</BillingCode><Name>Autologous Skull Flap</Name><SupplierCode>HAA</SupplierCode><CategoryID>3</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1470</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>RNB01</BillingCode><Name>Femoral Head</Name><SupplierCode>HAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229914</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3300</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IB007</BillingCode><Name>AIM-TEC PRIM PK</Name><Description>Peek screw type suture anchor system</Description><Size>5mm, 6.5mm</Size><SupplierCode>IB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>259865</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IB002</BillingCode><Name>Vertefix ll Locking screw</Name><Description>Transverse connector rod system</Description><Size>One size only</Size><SupplierCode>IB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>188902</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IB005</BillingCode><Name>Vertefix II Poly-Axial Screw</Name><Description>Multi/ Poly-Axial Pedicle Screw</Description><Size>Diameters: 5.5, 6.5, 7.5mm length: 35, 40, 45, 50mm</Size><SupplierCode>IB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>188902</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IB006</BillingCode><Name>STACC Cervical Screw</Name><Description>Cervical  Screw</Description><Size>4mm x 14,16 and 18mm</Size><SupplierCode>IB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>188902</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IB001</BillingCode><Name>STACC Cervical Cage</Name><Description>PEEK Stand alone interbody fusion cage</Description><Size>5.5, 6.5, 7.5, 8.5 (Height) x 14mm (Width)</Size><SupplierCode>IB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>188902</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IB004</BillingCode><Name>Vertefix II Alignment Rod</Name><Description>Alignment Rod</Description><Size>Diameters: 5.5 Length: 50, 75, 100, 125, 150, 200, 300mm</Size><SupplierCode>IB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>188902</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IB003</BillingCode><Name>Vertefix II Locking Screw</Name><Description>Set/Locking Screw</Description><Size>One size only</Size><SupplierCode>IB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>188902</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IB008</BillingCode><Name>AIM-TEC MINI PK</Name><Description>Peek screw type suture anchor system</Description><Size>3mm</Size><SupplierCode>IB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>259865</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IF001</BillingCode><Name>Implant Direct Oceania Implant Systems (InterActive, Legacy, Swish)</Name><Description>Dental implants, endosseous</Description><Size>Diameter 3.2 - 7.0mm; Length 6.0 - 16.0mm</Size><SupplierCode>IF</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4392</SubGroupID><ARTGs><ARTG>238870</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IF002</BillingCode><Name>Bioresorb Macro Pore</Name><Description>ß-Tricalcium Phosphate Bone Regeneration Material with Advanced Porosity</Description><Size>200 – 500 μm at 0.5 ml, 500 – 1000 μm at 0.5 ml, 500 – 1000 μm at 1.0 ml </Size><SupplierCode>IF</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4394</SubGroupID><ARTGs><ARTG>136546</ARTG></ARTGs><MinimumBenefit>293</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IF003</BillingCode><Name>Regaurde Resorbable Collagen Membrane</Name><Description>Collagen dental regeneration membrane</Description><Size>15x20mm, 20x30mm, 30x40mm</Size><SupplierCode>IF</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4253</SubGroupID><ARTGs><ARTG>216324</ARTG></ARTGs><MinimumBenefit>224</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ626</BillingCode><Name>iReach Magnum Endo Reach Stapler</Name><Description>Battery Powered Endoscopic Linear Stapler, single-use</Description><Size>(282 - 448) mm shaft length , (45-60) mm cartridge length </Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix><ARTGs><ARTG>381246</ARTG></ARTGs><MinimumBenefit>447</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ025</BillingCode><Name>Regenerative Dural Repair Patch (ReDuraTM)</Name><Description>Absorbable synthetic patch with biomimetic design.</Description><Size>Extra Large</Size><SupplierCode>IJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1660</GroupID><ARTGs><ARTG>363114</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ024</BillingCode><Name>Regenerative Dural Repair Patch (ReDuraTM)</Name><Description>Absorbable synthetic patch with biomimetic design</Description><Size>Large</Size><SupplierCode>IJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1659</GroupID><ARTGs><ARTG>363114</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>709</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ022</BillingCode><Name>Regenerative Dural Repair Patch (ReDuraTM)</Name><Description>Absorbable synthetic patch with biomimetic design.</Description><Size>Small</Size><SupplierCode>IJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1657</GroupID><ARTGs><ARTG>363114</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>64</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ541</BillingCode><Name>iReach Omnia Powered Articulating Stapler</Name><Description>Powered Articulating Stapler, single-use</Description><Size>85 to 255mm </Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix><ARTGs><ARTG>381246</ARTG></ARTGs><MinimumBenefit>447</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ026</BillingCode><PriorBillingCodes><PriorBillingCode>AT086</PriorBillingCode></PriorBillingCodes><Name>NEUROVENT-P catheter</Name><Description>RAUMEDIC NEUROVENT-P catheter for the continuous measurement of ICP (intracranial pressure) within the parenchyma.</Description><Size>5F</Size><SupplierCode>IJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>253</SubCategoryID><GroupID>1794</GroupID><Suffix>Catheter</Suffix><ARTGs><ARTG>282695</ARTG></ARTGs><MinimumBenefit>1173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ629</BillingCode><Name>Imedcare Plastic Clip Closure System</Name><Description>Plastic Ligating Clips, sterile, non-absorbable,  polyformaldehyde (POM),  (6 clips/cartridge)</Description><Size>Medium-Large, Large, Extra-Large </Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><Suffix>Polymeric Non-resorbable</Suffix><ARTGs><ARTG>374950</ARTG></ARTGs><MinimumBenefit>40</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ020</BillingCode><PriorBillingCodes><PriorBillingCode>ME224</PriorBillingCode></PriorBillingCodes><Name>Frankenman Endoscopic Linear Cutter</Name><Description>The Endoscopic Linear Cutter and Reloads have applications in resection, transection and/or anastomosis of tissue in open or laparoscopic procedures.</Description><Size>Stapler Unit - 280mm, 330mm, 380mm, 430mm, 480mm in 12.5mm shaft OD.  Reloadable Cartridges - 30mm, 45mm, 60mm staple lengths.</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>205331</ARTG></ARTGs><MinimumBenefit>357</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ035</BillingCode><Name>Frankenman Linear Cutter Reloads</Name><Description>Single use, linear cutter reload cartridge containing titanium staples
</Description><Size>Staple line length: 61 - 101mm</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>372951</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ625</BillingCode><Name>Endo Reach ENDO III </Name><Description>Staple Cartridge  PPA</Description><Size>(45-60) mm length x (2.0 - 4.4) mm leg length </Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>381247</ARTG><ARTG>446370</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ038</BillingCode><Name>Peek Skull Repair Systems</Name><Description>PEEK Patient Specific Implant PEEK-OPTIMA CAD/CAM/3D printed cranial implants</Description><Size>(4-10)mm thick x (40-200) outer radius x (15-120) degrees angulation</Size><SupplierCode>IJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>4343</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>471106</ARTG></ARTGs><MinimumBenefit>9682</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ034</BillingCode><Name>Frankenman Circular Stapler</Name><Description>Standard, Long Endosteer,  Cone Tip, Flip, Compact-Short, Compact Short Extended Anvil,  Intraluminal stapler preloaded with titanium staples.</Description><Size>Outer Diameter: 21 - 32mm</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Circular</Suffix><ARTGs><ARTG>410612</ARTG></ARTGs><MinimumBenefit>648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ032</BillingCode><Name>Frankenman Linear Stapler </Name><Description>Single use, linear cutter stapler containing titanium staples</Description><Size>31 - 101mm</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><ARTGs><ARTG>410791</ARTG></ARTGs><MinimumBenefit>292</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ037</BillingCode><Name>Frankenman Linear Stapler</Name><Description>Linear stapler preloaded with titanium staples
</Description><Size>30 - 90mm</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><ARTGs><ARTG>410791</ARTG></ARTGs><MinimumBenefit>292</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ031</BillingCode><Name>Frankenman Endoscopic Linear Cutter Reload</Name><Description>Endoscopic Applicator cartridge reload, std,  reversed stepped, reversed with curved tip cartridge </Description><Size>staple row length 32, 44, 60mm </Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>372951</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ542</BillingCode><Name>iReach Omnia Reload Units</Name><Description>Single Use Loading Units for Powered Articulating Staplers</Description><Size>30 to 60mm length</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>381247</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ033</BillingCode><Name>Suzhou Frankenman Haemorrhoidal (CPH) Staple</Name><Description>Circular stapler for rectal prolapse and haemorrhoids preloaded with titanium staples</Description><Size>Outside diameter: 32.5 - 36.5mm (White, Green, Lime Green) </Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Circular</Suffix><ARTGs><ARTG>410611</ARTG></ARTGs><MinimumBenefit>648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ018</BillingCode><PriorBillingCodes><PriorBillingCode>ME221</PriorBillingCode><PriorBillingCode>NG063</PriorBillingCode></PriorBillingCodes><Name>Frankenman Linear Stapler</Name><Description>Linear stapler preloaded with titanium staples</Description><Size>32mm; 46mm; 60mm; 90mm</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><ARTGs><ARTG>205319</ARTG><ARTG>205331</ARTG></ARTGs><MinimumBenefit>292</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ021</BillingCode><PriorBillingCodes><PriorBillingCode>ME225</PriorBillingCode></PriorBillingCodes><Name>Frankenman Endoscopic Linear Cutter Reload</Name><Description>The Endoscopic Linear Cutter Reload has applications in resection, transection and/or anastomosis of tissue in open or laparoscopic procedures.</Description><Size>Cartridge Reload - 30mm, 45mm, 60mm staple lengths. Open leg length: 2.0mm - 4.5mm, closed staple height: 0.75mm - 2.0mm.</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>207254</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ030</BillingCode><Name>Frankenman Endoscopic Linear</Name><Description>Endoscopic Linear Cutting Stapler , 45 degree  articulation 
</Description><Size>60, 160, 260mm </Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Articulating/Roticulating</Suffix><ARTGs><ARTG>410792</ARTG></ARTGs><MinimumBenefit>662</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ023</BillingCode><Name>Regenerative Dural Repair Patch (ReDuraTM)</Name><Description>Absorbable synthetic patch with biomimetic design.</Description><Size>Medium</Size><SupplierCode>IJ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1658</GroupID><ARTGs><ARTG>363114</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>426</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ014</BillingCode><PriorBillingCodes><PriorBillingCode>ME218</PriorBillingCode><PriorBillingCode>NG060</PriorBillingCode></PriorBillingCodes><Name>Frankenman Haemorrhoidal (CPH) Stapler</Name><Description>Circular stapler for rectal prolapse and haemorrhoids preloaded with titanium staples</Description><Size>Outside diameter: 32.5mm; 34.5mm</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Circular</Suffix><ARTGs><ARTG>205330</ARTG></ARTGs><MinimumBenefit>648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ017</BillingCode><PriorBillingCodes><PriorBillingCode>ME220</PriorBillingCode><PriorBillingCode>NG062</PriorBillingCode></PriorBillingCodes><Name>Frankenman Linear Stapler Reloads</Name><Description>Linear stapler single use reload with titanium staples</Description><Size>32mm; 46mm; 60mm; 90mm</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>207254</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ036</BillingCode><Name>Frankenman Linear Cutter Reloads</Name><Description>Linear stapler single use reload, titanium staples
</Description><Size>30 - 90mm</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>372951</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ015</BillingCode><PriorBillingCodes><PriorBillingCode>ME219</PriorBillingCode><PriorBillingCode>NG061</PriorBillingCode></PriorBillingCodes><Name>Frankenman Linear Cutter Stapler</Name><Description>Single use, reloadable, linear cutter stapler containing titanium staples</Description><Size>61mm; 81mm; 100mm</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><ARTGs><ARTG>205319</ARTG><ARTG>205331</ARTG></ARTGs><MinimumBenefit>292</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ019</BillingCode><PriorBillingCodes><PriorBillingCode>ME222</PriorBillingCode><PriorBillingCode>NG064</PriorBillingCode></PriorBillingCodes><Name>Frankenman Linear Cutter Reloads</Name><Description>Single use, linear cutter reload cartridge containing titanium staples</Description><Size>61mm; 81mm; 100mm</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>207254</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IJ016</BillingCode><PriorBillingCodes><PriorBillingCode>ME217</PriorBillingCode><PriorBillingCode>NG059</PriorBillingCode></PriorBillingCodes><Name>Frankenman Circular Stapler</Name><Description>Curved intraluminal stapler preloaded with titanium staples.</Description><Size>21mm; 25mm; 28mm; 32mm</Size><SupplierCode>IJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Circular</Suffix><ARTGs><ARTG>292060</ARTG></ARTGs><MinimumBenefit>648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IZ001</BillingCode><PriorBillingCodes><PriorBillingCode>IX004</PriorBillingCode></PriorBillingCodes><Name>ALN Vena Cava Filter</Name><Description>The ALN Vena Cava Filter is implanted into the SVC via the femoral, brachial and jugular vein to prevent pulmonary emboli (PEs).</Description><Size>One size, diameter up to 32mm</Size><SupplierCode>IZ</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>211</SubCategoryID><GroupID>1642</GroupID><ARTGs><ARTG>184695</ARTG><ARTG>184696</ARTG><ARTG>184697</ARTG><ARTG>184698</ARTG><ARTG>184699</ARTG><ARTG>184700</ARTG><ARTG>185255</ARTG></ARTGs><MinimumBenefit>2059</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ717</BillingCode><Name>Omnipod 5 Automated Insulin Delivery System</Name><Description>The Omnipod 5 (OP5) Automated Insulin Delivery (AID) System includes the tubeless insulin Pod, the Omnipod 5 App on the Insulet provided controller, and the chosen compatible glucose sensor. The glucose sensor sends CGM values and trends to the Pod. The Pod houses the insulin pump and a microprocessor which holds the SmartAdjustTM Technology that uses CGM values to make decisions and automatically adjust the insulin delivered. The Pod or the sensor also sends the CGM value to the Omnipod 5 App. This is used to display the data and to manually send commands to the Pod for bolusing and for basal insulin doses when not operating in automated mode.</Description><Size>One size only</Size><SupplierCode>II</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>294</SubCategoryID><GroupID>20002</GroupID><ARTGs><ARTG>455009</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is payable no more frequently than once every 4 years.</Note><MinimumBenefit>8574</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>II001</BillingCode><Name>Omnipod DASH® Insulin Management System - Personal Diabetes Manager (PDM) &amp; Software only</Name><Description>An insulin pump system for the continuous subcutaneous delivery of insulin at set and variable rates that receives and stores external glucose information via a rechargeable Personal Diabetes Manager (PDM). The PDM wirelessly activates/deactivates, controls, directs and monitors operation of a tubeless wearable waterproof Pod via secure Bluetooth Low Energy communication, as well as serves as a bolus calculator. The PDM provides audio alarms, alerts and reminders related to insulin delivery and the Pod. The PDM handles all processes for operation of the system and displays up to 90 days of information including basal rates, bolus doses, carbohydrates, alarms and blood glucose entries that are entered manually from any BGM meter. </Description><Size> The Personal Diabetes Manager (PDM)  is 6.3 cm wide x 13.0 cm long x 1.0 cm high) and weighs 106grams.                                                                                                                                                                                                                                           </Size><SupplierCode>II</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>294</SubCategoryID><GroupID>2964</GroupID><ARTGs><ARTG>344290</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is payable no more frequently than once every 4 years.</Note><MinimumBenefit>8077</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG033</BillingCode><PriorBillingCodes><PriorBillingCode>GS218</PriorBillingCode></PriorBillingCodes><Name>Reservoirs</Name><Description>Shunt component</Description><Size>9mm to 25mm, with or without convertible outlet port, burr hole or flat bottom style</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1670</GroupID><ARTGs><ARTG>163539</ARTG></ARTGs><MinimumBenefit>338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG030</BillingCode><PriorBillingCodes><PriorBillingCode>GS214</PriorBillingCode></PriorBillingCodes><Name>Cardiac/Peritoneal Catheters</Name><Description>SiliconDistal Catheter, ID 1.3mm, OD 2.5mm</Description><Size>90cm, barium impregnated silicone catheter, closed or open ended, with or without slits</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>150579</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG035</BillingCode><PriorBillingCodes><PriorBillingCode>GS286</PriorBillingCode></PriorBillingCodes><Name>Integra Artificial Skin (IDRT) Terminally Sterile</Name><Description>INTEGRA  Dermal Regeneration Template is a bilayer membrane system for skin replacement made of a porous matrix of fibers of cross-linked bovine tendon collagen and glycosaminoglycan and polysiloxane layer.</Description><Size>10cm x 12.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1607</GroupID><SubGroupID>4420</SubGroupID><ARTGs><ARTG>158795</ARTG></ARTGs><MinimumBenefit>1112</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG184</BillingCode><PriorBillingCodes><PriorBillingCode>JJ934</PriorBillingCode></PriorBillingCodes><Name>Codman Hydrocephalus Connectors</Name><Description>Metal and plastic connectors</Description><Size>8mm to 20mm length</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1671</GroupID><SubGroupID>4470</SubGroupID><ARTGs><ARTG>140901</ARTG><ARTG>150104</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG048</BillingCode><Name>DuraGen Suturable</Name><Description>Collagen dural graft matrix</Description><Size>7.5cm x 7.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1659</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158826</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>944</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG036</BillingCode><PriorBillingCodes><PriorBillingCode>GS287</PriorBillingCode></PriorBillingCodes><Name>Integra Artificial Skin (IDRT) Terminally Sterile</Name><Description>INTEGRA  Dermal Regeneration Template is a bilayer membrane system for skin replacement made of a porous matrix of fibers of cross-linked bovine tendon collagen and glycosaminoglycan and polysiloxane layer.</Description><Size>10cm x 25cm</Size><SupplierCode>IG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1607</GroupID><SubGroupID>4421</SubGroupID><ARTGs><ARTG>158795</ARTG></ARTGs><MinimumBenefit>1697</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG037</BillingCode><PriorBillingCodes><PriorBillingCode>GS288</PriorBillingCode></PriorBillingCodes><Name>Integra Artificial Skin (IDRT) Terminally Sterile</Name><Description>INTEGRA  Dermal Regeneration Template is a bilayer membrane system for skin replacement made of a porous matrix of fibers of cross-linked bovine tendon collagen and glycosaminoglycan and polysiloxane layer.</Description><Size>20cm x 25cm</Size><SupplierCode>IG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1607</GroupID><SubGroupID>4422</SubGroupID><ARTGs><ARTG>158795</ARTG></ARTGs><MinimumBenefit>3296</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG183</BillingCode><PriorBillingCodes><PriorBillingCode>JJ908</PriorBillingCode></PriorBillingCodes><Name>Codman Bactiseal External Ventricular Drain (EVD) Catheter</Name><Description>Antibiotic impregated External Ventricular Drain</Description><Size>1.5mm &amp; 1.9mm lumen diameter</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>255</SubCategoryID><GroupID>1796</GroupID><Suffix>Antibiotics</Suffix><ARTGs><ARTG>343680</ARTG><ARTG>343681</ARTG></ARTGs><MinimumBenefit>424</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG174</BillingCode><PriorBillingCodes><PriorBillingCode>JJ857</PriorBillingCode></PriorBillingCodes><Name>HOLTER Intracranial Pressure Shunt</Name><Description>HOLTER distal peritoneal catheter/Salmon, packaged sterile, silicone</Description><Size>90cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>384998</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG002</BillingCode><Name>NeuraGen</Name><Description>NeuraGen is a semi-permeable Type 1 collagen tube for peripheral nerve repair. It provides a protective environment and conduit for axonal regrowth across a nerve gap.  It is biocompatible and completely resorbed. The open collagen structure facilitates suture placement. It has a resilient structure that maintains an open lumen throughout the process of axonal growth.</Description><Size>2mm x 2cm, 3mm x 2cm, 4mm x 2cm, 5mm x 2cm, 6mm x 2cm, 7mm x 2cm, 1.5mm x 3cm, 2mm x 3cm, 3mm x 3cm, 4mm x 3cm, 5mm x 3cm, 6mm x 3cm, 7mm x 3cm</Size><SupplierCode>IG</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1564</GroupID><ARTGs><ARTG>158870</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG182</BillingCode><PriorBillingCodes><PriorBillingCode>JJ907</PriorBillingCode></PriorBillingCodes><Name>Codman External Ventricular Drain (EVD) Catheter</Name><Description>External Ventricular Drain</Description><Size>1.5mm &amp; 1.9mm diameter</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>255</SubCategoryID><GroupID>1796</GroupID><ARTGs><ARTG>123031</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG185</BillingCode><PriorBillingCodes><PriorBillingCode>MN108</PriorBillingCode></PriorBillingCodes><Name>Codman Certas Programmable Valve - with reservoir and catheter</Name><Description>Programmable valve with reservoir and catheters</Description><Size>30-210mmH2O</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Distal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>373431</ARTG></ARTGs><MinimumBenefit>2306</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG186</BillingCode><PriorBillingCodes><PriorBillingCode>MN109</PriorBillingCode></PriorBillingCodes><Name>Codman Certas Programmable Valve - with Reservoir and Siphonguard</Name><Description>Programmable valve with Reservoir and Siphonguard</Description><Size>30-210mmH2O</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Reservoir/Priming function</Suffix><ARTGs><ARTG>373428</ARTG></ARTGs><MinimumBenefit>2591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG038</BillingCode><Name>DuraGen</Name><Description>Collagen dural graft matrix</Description><Size>2.5cm x 2.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1657</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158829</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>320</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG142</BillingCode><PriorBillingCodes><PriorBillingCode>AS181</PriorBillingCode><PriorBillingCode>LH369</PriorBillingCode></PriorBillingCodes><Name>DuraSeal Xact Spinal Dural Sealant</Name><Description>Xact Dural Sealant for spine.  Packaged in sterile single use disposable tray.</Description><Size>3ml</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1661</GroupID><ARTGs><ARTG>233759</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG019</BillingCode><PriorBillingCodes><PriorBillingCode>GS149</PriorBillingCode></PriorBillingCodes><Name>Precision Flow-OSV II Valve System</Name><Description>Ventricular/Peritoneal OSV11-  Ventricular/Peritoneal Hydrocephalus Shunt</Description><Size>Drainage Cath 110 cm, F7. Ventricular Catheters 7,9,13 &amp; 15 cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><ARTGs><ARTG>151647</ARTG></ARTGs><MinimumBenefit>1001</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG160</BillingCode><PriorBillingCodes><PriorBillingCode>JJ221</PriorBillingCode></PriorBillingCodes><Name>Codman Hakim Precision System - Valves</Name><Description>Fixed Pressure Valve - Valve System Unitized – Without Rickham Reservoir - Without SiphonGuard  -with connectors/adaptors, stylet, ventricular catheter, distal catheter</Description><Size>Very Low - high pressure</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>375410</ARTG></ARTGs><MinimumBenefit>1616</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG175</BillingCode><PriorBillingCodes><PriorBillingCode>JJ858</PriorBillingCode></PriorBillingCodes><Name>Codman Hakim Precision Valves</Name><Description>Regular and burr hole Valves with Siphonguard</Description><Size>Pressure 10-130mm H2O</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Antisyphon function, Reservoir/Priming function</Suffix><ARTGs><ARTG>375411</ARTG></ARTGs><MinimumBenefit>1399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG168</BillingCode><PriorBillingCodes><PriorBillingCode>JJ440</PriorBillingCode></PriorBillingCodes><Name>Codman Hakim Precision System - Valve only</Name><Description>features 5 operating pressures</Description><Size>10, 40, 70, 100, and 130mmH2O</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Reservoir/Priming function</Suffix><ARTGs><ARTG>375410</ARTG><ARTG>375411</ARTG></ARTGs><MinimumBenefit>898</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG152</BillingCode><PriorBillingCodes><PriorBillingCode>JJ157</PriorBillingCode></PriorBillingCodes><Name>Hakim Precision Valve System</Name><Description>Precision cylindrical, micro and regular valve system with 120cm distal silicone catheter and 14cm ventricular silicone catheter</Description><Size>10mm H2O - 130mm H2O (very low to high)</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>375410</ARTG><ARTG>375411</ARTG></ARTGs><MinimumBenefit>1616</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG060</BillingCode><Name>DURAGEN PLUS</Name><Description>Collagen Dural Graft Matrix</Description><Size>12.5cm x 17.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1660</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158825</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>1592</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG018</BillingCode><PriorBillingCodes><PriorBillingCode>GS148</PriorBillingCode></PriorBillingCodes><Name>Precision Flow-OSV II Valve System </Name><Description>Ventricular/Atrial OSV11-Ventricular /Atrial Hydrocephalus Shunt</Description><Size>Drainage Cath 110 cm, F7. Ventricular Catheters 7,9,13 &amp; 15 cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Distal catheter, Proximal catheter</Suffix><ARTGs><ARTG>151647</ARTG></ARTGs><MinimumBenefit>1300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG159</BillingCode><PriorBillingCodes><PriorBillingCode>JJ220</PriorBillingCode></PriorBillingCodes><Name>Codman Hakim Precision System - Valves</Name><Description>Fixed Pressure Valve - with/without Valve System Unitized – With SiphonGuard with connectors/adaptors, stylet, ventricular catheter, distal catheter</Description><Size>Very Low - High pressure</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>375410</ARTG></ARTGs><MinimumBenefit>1697</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG166</BillingCode><PriorBillingCodes><PriorBillingCode>JJ436</PriorBillingCode></PriorBillingCodes><Name>Codman Hakim Programmable Valves</Name><Description>Micro, regular and burr hole valves</Description><Size>30mm H2O - 200mm H2O</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Reservoir/Priming function</Suffix><ARTGs><ARTG>378355</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG017</BillingCode><PriorBillingCodes><PriorBillingCode>GS147</PriorBillingCode></PriorBillingCodes><Name>Precision Flow-OSV II Valve System</Name><Description>Lumbar peritoneal OSV11-Lumboperitoneal System Hydrocephalus Shunt</Description><Size>Lumber Catheter 80cm, F5  Peritoneal Catheter 110cm, F7</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Distal catheter, Lumboperitoneal</Suffix><ARTGs><ARTG>151647</ARTG></ARTGs><MinimumBenefit>1242</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG032</BillingCode><PriorBillingCodes><PriorBillingCode>GS216</PriorBillingCode></PriorBillingCodes><Name>Burr Hole Valve Shunt Assemblies</Name><Description>Shunt Assembly: silicone encased valve, silicone ventricular and peritoneal catheters</Description><Size>16mm or 12mm base; low, medium or high pressure, various kit configurations</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><ARTGs><ARTG>152728</ARTG></ARTGs><MinimumBenefit>1001</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG046</BillingCode><Name>DuraGen</Name><Description>Collagen dural graft matrix</Description><Size>7.5cm x 7.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1659</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158829</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>944</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG010</BillingCode><PriorBillingCodes><PriorBillingCode>GS133</PriorBillingCode></PriorBillingCodes><Name>Shunt</Name><Description>Components - catheter: Atrial</Description><Size>55cm - 60cm, Low - High pressure range</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>151659</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG047</BillingCode><Name>DuraGen Plus</Name><Description>Collagen dural graft matrix</Description><Size>7.5cm x 7.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1659</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158825</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>944</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG025</BillingCode><PriorBillingCodes><PriorBillingCode>GS207</PriorBillingCode></PriorBillingCodes><Name>Right Angle Ventricular Catheter</Name><Description>Silicone, integral right angle</Description><Size>3-11cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal</Suffix><ARTGs><ARTG>151660</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG161</BillingCode><PriorBillingCodes><PriorBillingCode>JJ227</PriorBillingCode></PriorBillingCodes><Name>Codman Medos Straight Ventricular Catheter</Name><Description>14cm, packaged sterile, silicone rubber</Description><Size>14cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal</Suffix><ARTGs><ARTG>384993</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG041</BillingCode><Name>DuraGen Plus</Name><Description>Collagen dural graft matrix</Description><Size>2.5cm x 7.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1658</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158825</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>477</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG162</BillingCode><PriorBillingCodes><PriorBillingCode>JJ229</PriorBillingCode></PriorBillingCodes><Name>Codman Medos Peritoneal Catheter</Name><Description>Peritoneal catheter for use in the treatment of hydrocephalus as a component of a shunt system.</Description><Size>120cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>384994</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG153</BillingCode><PriorBillingCodes><PriorBillingCode>JJ158</PriorBillingCode></PriorBillingCodes><Name>Hakim Programmable Valve System</Name><Description>Valve only &amp; Valve System (catheters included)</Description><Size> 30mm H2O - 200mm H2O</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><ARTGs><ARTG>378354</ARTG><ARTG>378355</ARTG></ARTGs><MinimumBenefit>1823</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG187</BillingCode><PriorBillingCodes><PriorBillingCode>MN110</PriorBillingCode></PriorBillingCodes><Name>Codman Certas Programmable Valve - with Reservoir, Siphonguard and catheter</Name><Description>Programmable valve with reservoir, siphonguard and catheters</Description><Size>30-210mmH2O</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Distal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>373429</ARTG><ARTG>373430</ARTG></ARTGs><MinimumBenefit>2757</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG188</BillingCode><PriorBillingCodes><PriorBillingCode>MN111</PriorBillingCode></PriorBillingCodes><Name>Codman Certas Programmable Valve - with reservoir</Name><Description>Programmable valve with reservoir</Description><Size>30-210mmH2O</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Reservoir/Priming function</Suffix><ARTGs><ARTG>373427</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG045</BillingCode><Name>DuraGen Suturable</Name><Description>Collagen dural graft matrix</Description><Size>5cm x 5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1658</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158826</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>477</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG021</BillingCode><PriorBillingCodes><PriorBillingCode>GS151</PriorBillingCode></PriorBillingCodes><Name>Peritoneal Catheter</Name><Description>Peritoneal Catheters</Description><Size>Length: 91cm, F7.  OD: 2.1mm; ID:1.1mm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>151659</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG189</BillingCode><PriorBillingCodes><PriorBillingCode>MN158</PriorBillingCode></PriorBillingCodes><Name>MicroSensor Monitoring System</Name><Description>Skull bolt with ICP transducer</Description><Size>0.7mm sensor lead diameter</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>253</SubCategoryID><GroupID>1794</GroupID><Suffix>Skull Bolt</Suffix><ARTGs><ARTG>363812</ARTG><ARTG>363813</ARTG><ARTG>363816</ARTG><ARTG>363817</ARTG></ARTGs><MinimumBenefit>948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG181</BillingCode><PriorBillingCodes><PriorBillingCode>JJ906</PriorBillingCode></PriorBillingCodes><Name>MicroSensor Monitoring System</Name><Description>Ventricular catheter with transducer</Description><Size>Catheter length 38cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>253</SubCategoryID><GroupID>1794</GroupID><Suffix>Catheter</Suffix><ARTGs><ARTG>363814</ARTG><ARTG>363819</ARTG></ARTGs><MinimumBenefit>1173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG155</BillingCode><PriorBillingCodes><PriorBillingCode>JJ160</PriorBillingCode></PriorBillingCodes><Name>Codman Ventricular Catheter and Codman Peritoneal Catheter with Bactiseal Silicone</Name><Description>Silicone antibiotic impregnated catheter kit</Description><Size>Kit</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Antibiotics, Distal, Proximal</Suffix><ARTGs><ARTG>343682</ARTG></ARTGs><MinimumBenefit>609</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG042</BillingCode><Name>DuraGen Suturable</Name><Description>Collagen dural graft matrix</Description><Size>2.5cm x 7.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1658</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158826</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>477</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG043</BillingCode><Name>DuraGen</Name><Description>Collagen dural graft matrix</Description><Size>5cm x 5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1658</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158829</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>477</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG014</BillingCode><PriorBillingCodes><PriorBillingCode>GS139</PriorBillingCode></PriorBillingCodes><Name>Heyer Schulte Portnoy Flanged Ventricular Catheter</Name><Description>Composition - silicone with tantalum markings</Description><Size>Length 18cm, outer diameter 8mm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal</Suffix><ARTGs><ARTG>163262</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG044</BillingCode><Name>DuraGen Plus</Name><Description>Collagen dural graft matrix</Description><Size>5cm x 5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1658</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158825</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>477</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG163</BillingCode><PriorBillingCodes><PriorBillingCode>JJ261</PriorBillingCode></PriorBillingCodes><Name>ACCU-FLO Intracranial Pressure shunt</Name><Description>ACCU-FLO catheter, packaged sterile, silicone rubber</Description><Size>91cm in length</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>150089</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG040</BillingCode><Name>DuraGen</Name><Description>Collagen dural graft matrix</Description><Size>2.5cm x 7.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1658</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158829</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>477</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG156</BillingCode><PriorBillingCodes><PriorBillingCode>JJ164</PriorBillingCode></PriorBillingCodes><Name>Siphonguard CSF Control Device</Name><Description>PET shell anti-siphon device for shunt</Description><Size>One size only</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>2961</GroupID><ARTGs><ARTG>384996</ARTG></ARTGs><MinimumBenefit>794</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG051</BillingCode><Name>DuraGen Suturable</Name><Description>Collagen dural graft matrix</Description><Size>10cm x 12.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1660</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158826</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>1592</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG020</BillingCode><PriorBillingCodes><PriorBillingCode>GS150</PriorBillingCode></PriorBillingCodes><Name>Atrial Catheter </Name><Description>Components - catheter: Atrial Atrial Catheters  Hydrocephalux Valve Accessories</Description><Size>Length: 46cm, F7.  OD: 2.1mm; ID:1.1mm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>151659</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG141</BillingCode><PriorBillingCodes><PriorBillingCode>AS180</PriorBillingCode><PriorBillingCode>LH296</PriorBillingCode></PriorBillingCodes><Name>Duraseal Dural Sealant</Name><Description>DuraSeal is a Synthetic, absorbable, Polyethylene Glycon, hydrogel sealant used as an adjunct to sutured dural repair to achieve watertight closure.</Description><Size>5ml of hydrogel sealant</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1662</GroupID><ARTGs><ARTG>233618</ARTG></ARTGs><MinimumBenefit>580</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG164</BillingCode><PriorBillingCodes><PriorBillingCode>JJ263</PriorBillingCode></PriorBillingCodes><Name>ACCU-FLO Intracranial Pressure shunt</Name><Description>ACCU-FLO barium ventricular catheter, packaged sterile, silicone rubber</Description><Size>One size only</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal</Suffix><ARTGs><ARTG>150088</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG172</BillingCode><PriorBillingCodes><PriorBillingCode>JJ855</PriorBillingCode></PriorBillingCodes><Name>Codman-Medos Non-programmable Valve System</Name><Description>Lumbar/peritoneal catheter, James and Holter designs</Description><Size>25-80cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1667</GroupID><ARTGs><ARTG>149300</ARTG><ARTG>150123</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG167</BillingCode><PriorBillingCodes><PriorBillingCode>JJ437</PriorBillingCode></PriorBillingCodes><Name>Codman Hakim Programmable Valves with Siphonguard</Name><Description>18 different pressure settings and SIPHONGUARD technology</Description><Size>30mm H2O - 200mm H2O</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Reservoir/Priming function</Suffix><ARTGs><ARTG>378355</ARTG></ARTGs><MinimumBenefit>2591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG049</BillingCode><Name>DuraGen</Name><Description>Collagen Dural graft matrix</Description><Size>10cm x 12.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1660</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158829</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>1592</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG022</BillingCode><PriorBillingCodes><PriorBillingCode>GS193</PriorBillingCode></PriorBillingCodes><Name>Connectors</Name><Description>Silicone and Stainless Steel</Description><Size>Straight, right angle, Y, T</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1671</GroupID><SubGroupID>4470</SubGroupID><ARTGs><ARTG>151592</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG158</BillingCode><PriorBillingCodes><PriorBillingCode>JJ219</PriorBillingCode></PriorBillingCodes><Name>Hakim Programmable Valve System</Name><Description>Burr hole and regular valve system with SiphonGuard, 120cm distal catheter and 14cm ventricular catheter</Description><Size>30mm H2O - 200mm H2O</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>378354</ARTG></ARTGs><MinimumBenefit>2888</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG059</BillingCode><Name>DURAGEN PLUS</Name><Description>Collagen Dural Graft Matrix</Description><Size>10cm x 12.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1660</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158825</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>1592</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG013</BillingCode><PriorBillingCodes><PriorBillingCode>GS138</PriorBillingCode></PriorBillingCodes><Name>Shunt</Name><Description>Reservoir</Description><Size>Standard, Large</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1670</GroupID><ARTGs><ARTG>151646</ARTG></ARTGs><MinimumBenefit>338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG173</BillingCode><PriorBillingCodes><PriorBillingCode>JJ856</PriorBillingCode></PriorBillingCodes><Name>Holter - Rickman - Salmon Rickman and Selker Ventriculostomy Reservoirs</Name><Description>Various ventriculostomy reservoirs</Description><Size>Standard/Large and Low Profile - Size 6-18mm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1670</GroupID><ARTGs><ARTG>379450</ARTG><ARTG>379451</ARTG><ARTG>379452</ARTG></ARTGs><MinimumBenefit>338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG012</BillingCode><PriorBillingCodes><PriorBillingCode>GS136</PriorBillingCode></PriorBillingCodes><Name>Shunt</Name><Description>Ventricular</Description><Size>14.5cm - 23cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal</Suffix><ARTGs><ARTG>163262</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG052</BillingCode><PriorBillingCodes><PriorBillingCode>GS194</PriorBillingCode></PriorBillingCodes><Name>Electa right angle guide</Name><Description>Silicone</Description><Size>One Size Only</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1671</GroupID><SubGroupID>4471</SubGroupID><ARTGs><ARTG>151661</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG031</BillingCode><PriorBillingCodes><PriorBillingCode>GS215</PriorBillingCode></PriorBillingCodes><Name>Ventricular Catheters</Name><Description>Silicon Ventricular Catheter</Description><Size>15cm - 25cm, optional flanges or right angle or endoscopic tip. ID 1.3mm, OD 2.5mm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal</Suffix><ARTGs><ARTG>150579</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG179</BillingCode><PriorBillingCodes><PriorBillingCode>JJ883</PriorBillingCode><PriorBillingCode>JJ163</PriorBillingCode></PriorBillingCodes><Name>Codman Ventricular Catheter with Bactiseal Silicone </Name><Description>Silicone ventricular catheter, antibiotic impregnated</Description><Size>14cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Antibiotics</Suffix><ARTGs><ARTG>343683</ARTG></ARTGs><MinimumBenefit>424</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG034</BillingCode><PriorBillingCodes><PriorBillingCode>GS285</PriorBillingCode></PriorBillingCodes><Name>Integra Artificial Skin (IDRT) Terminally Sterile</Name><Description>INTEGRA  Dermal Regeneration Template is a bilayer membrane system for skin replacement made of a porous matrix of fibers of cross-linked bovine tendon collagen and glycosaminoglycan and polysiloxane layer.</Description><Size>5cm x 5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1607</GroupID><SubGroupID>4419</SubGroupID><ARTGs><ARTG>158795</ARTG></ARTGs><MinimumBenefit>877</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG180</BillingCode><PriorBillingCodes><PriorBillingCode>JJ884</PriorBillingCode><PriorBillingCode>JJ163</PriorBillingCode></PriorBillingCodes><Name>Codman Peritoneal Catheter with Bactiseal Silicone</Name><Description>Silicone peritoneal catheter, antibiotic impregnated</Description><Size>120cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Antibiotics</Suffix><ARTGs><ARTG>343684</ARTG></ARTGs><MinimumBenefit>424</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG011</BillingCode><PriorBillingCodes><PriorBillingCode>GS135</PriorBillingCode></PriorBillingCodes><Name>Shunt</Name><Description>Peritoneal</Description><Size>90 - 120cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>151659</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG154</BillingCode><PriorBillingCodes><PriorBillingCode>JJ159</PriorBillingCode></PriorBillingCodes><Name>Hakim Programmable Valve System</Name><Description>Micro valve system with 120cm distal catheter and 14cm ventricular catheter</Description><Size>30mm H2O - 200mm H2O</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>378354</ARTG></ARTGs><MinimumBenefit>2437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG157</BillingCode><PriorBillingCodes><PriorBillingCode>JJ218</PriorBillingCode></PriorBillingCodes><Name>HOLTER Intracranial Pressure Shunt</Name><Description>HOLTER Ventricular Catheter, packaged sterile, silicone rubber</Description><Size>3 - 7cm and 15cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal</Suffix><ARTGs><ARTG>384997</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG003</BillingCode><Name>NeuraWrap</Name><Description>NeuraWrap nerve protector is designed to provide an interface between the nerve and the surrounding tissues. NeuraWrap remains in place during the active phase of tissue healing and is completely resorbed after tissue response has resolved. The porous outer layer of NeuraWrap comprises a tubular matrix that mechanically resists compression from surrounding tissue and excludes scar tissue ingrowth. The semi-permeable inner membrane allows passage of small molecules (ie water, ions, metabolites, nutrients) but prevents the escape of endogenous growth factors (Nerve Growth Factor). NeuraWrap provides a new alternative for the treatment of peripheral nerve injuries.</Description><Size>3mm x 2cm, 3mm x 4cm, 5mm x 2cm, 5mm x 4cm, 7mm x 2cm, 7mm x 4cm, 10mm x 2cm, 10mm x 4cm</Size><SupplierCode>IG</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1564</GroupID><ARTGs><ARTG>158924</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG023</BillingCode><PriorBillingCodes><PriorBillingCode>GS195</PriorBillingCode></PriorBillingCodes><Name>Cordis Omnishunt System</Name><Description>Silicone and Synthetic ruby</Description><Size>Very low to very high pressures</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1667</GroupID><ARTGs><ARTG>151644</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG039</BillingCode><Name>DuraGen Plus</Name><Description>Collagen dural graft matrix</Description><Size>2.5cm x 2.5cm</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1657</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>158825</ARTG></ARTGs><MinimumBenefit>320</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IG008</BillingCode><PriorBillingCodes><PriorBillingCode>GS012</PriorBillingCode></PriorBillingCodes><Name>Heyer-Schulte Ommaya CSF Reservoir</Name><Description>Standard, side-inlet, convertible, mini</Description><Size>1.5 - 2.5cm and mini</Size><SupplierCode>IG</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1670</GroupID><ARTGs><ARTG>161176</ARTG></ARTGs><MinimumBenefit>338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT001</BillingCode><PriorBillingCodes><PriorBillingCode>HA019</PriorBillingCode></PriorBillingCodes><Name>Hawk Anterior Ankle Fusion Set</Name><Description>Anatomically contoured 6 hole plate and screw set for anterior fixation of the ankle joint.</Description><Size>77mm in length
22mm in width
23mm depth</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>Com</Suffix><ARTGs><ARTG>177278</ARTG></ARTGs><MinimumBenefit>487</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT026</BillingCode><Name>Frame It Struts</Name><Description>Complex 3D Strut</Description><Size>Standard</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4505</SubGroupID><Suffix>3D</Suffix><ARTGs><ARTG>282764</ARTG></ARTGs><MinimumBenefit>1235</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT023</BillingCode><Name>Frame It Full Ring</Name><Description>Full Circular Ring</Description><Size>Diameter 80mm-220mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3405</SubGroupID><ARTGs><ARTG>282764</ARTG></ARTGs><MinimumBenefit>685</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT018</BillingCode><PriorBillingCodes><PriorBillingCode>LA010</PriorBillingCode></PriorBillingCodes><Name>Fuse It</Name><Description>Titanium alloy fusion cage - to use in situations such as anterior cervical fusion surgery</Description><Size>6mm x 1cm, 8mm x 1cm, 10mm x 1cm, 12mm x 1cm, 6mm x 1cm, 8mm x 2cm, 10mm x 2cm, 12mm x 2cm</Size><SupplierCode>IT</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>235024</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT007</BillingCode><PriorBillingCodes><PriorBillingCode>HA020</PriorBillingCode></PriorBillingCodes><Name>Hawk Anterior Ankle Fusion Set</Name><Description>4.5mm screw set with lengths ranging from 35mm to 110mm.</Description><Size>4.5mm x length (35mm to 110mm)</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>191738</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT013</BillingCode><PriorBillingCodes><PriorBillingCode>LA007</PriorBillingCode></PriorBillingCodes><Name>Hawk 2.0mm Twist off Screw</Name><Description>2.0mm Twist off Screw</Description><Size>2.0mm in diameter with lengths of 11mm to 20mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>230954</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT014</BillingCode><Name>Superior Fusion Plate System - Plate</Name><Description>Anatomically contoured 6 hole plate and screw set with locking screw hole option, for
anterior fixation of ankle joint. Used for Primary, Revision and Pantalar fusions.</Description><Size>The fixation plate is 77mm in length, 22mm in width and 23mm in depth. 6 hole plate</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>177278</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT022</BillingCode><Name>Loop It</Name><Description>Titanium or stainless steel fixation device with non-absorbable fibrewire suture material</Description><Size>One Size Only</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>297561</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT009</BillingCode><PriorBillingCodes><PriorBillingCode>HA022</PriorBillingCode></PriorBillingCodes><Name>Hawk Anterior Ankle Fusion Set</Name><Description>6.5mm screw set with lengths ranging from 35mm to 110 mm.</Description><Size>6.5mm length 35mm to 110mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>191738</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT030</BillingCode><Name>Frame It Wires - Olives</Name><Description>Wires with stopper</Description><Size>Diameter 1mm-3mm
Length 120mm-250mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><Suffix>OL</Suffix><ARTGs><ARTG>282764</ARTG></ARTGs><MinimumBenefit>117</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT003</BillingCode><PriorBillingCodes><PriorBillingCode>LA006</PriorBillingCode></PriorBillingCodes><Name>Hawk 4.0mm Cannulated Screw System - Washer</Name><Description>Titanium washer</Description><Size>internal diameter of 4.13mm and external diameter of 10mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>232499</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT029</BillingCode><Name>Frame It Rods</Name><Description>Threaded Rods</Description><Size>6mm Diameter
Lengths from 80mm-200mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4509</SubGroupID><Suffix>Standard</Suffix><ARTGs><ARTG>282764</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT011</BillingCode><PriorBillingCodes><PriorBillingCode>LA004</PriorBillingCode></PriorBillingCodes><Name>Hawk 4.0mm Cannulated Screw System</Name><Description>4.0mm Cannulated screw</Description><Size>4.0mm in diameter with lengths of 26mm to 70mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>230954</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT031</BillingCode><Name>Integrant 6.5mm Screws</Name><Description>6.5mm diameter screws with variable pitch/dynamic thread</Description><Size>6.5mm diameter, 45mm-120mm length</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>230954</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT004</BillingCode><PriorBillingCodes><PriorBillingCode>LA002</PriorBillingCode></PriorBillingCodes><Name>Hawk 6.5mm Cannulated Screw System - Guide Pin</Name><Description>Threaded, Stainless steel</Description><Size>2.5mm in diameter and 200 in length</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>230955</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT021</BillingCode><Name>Integrant Bone Graft Granules</Name><Description>Osteo Conductive Bone Substitute, that promotes bone growth</Description><Size>0.5cc - 5.0cc</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>282832</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT012</BillingCode><PriorBillingCodes><PriorBillingCode>LA008</PriorBillingCode></PriorBillingCodes><Name>Hawk 3.0mm Cannulated Screw system</Name><Description>3.0mm cannulated screw</Description><Size>3.0mm in diameter with lengths of 14mm to 50mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>230954</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT008</BillingCode><PriorBillingCodes><PriorBillingCode>HA021</PriorBillingCode></PriorBillingCodes><Name>Hawk Anterior Ankle Fusion Set</Name><Description>3.5mm diameter screw set lengths 35mm to 110mm</Description><Size>3.5mm x length 35mm to 110mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>191738</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT010</BillingCode><PriorBillingCodes><PriorBillingCode>LA001</PriorBillingCode></PriorBillingCodes><Name>Hawk 6.5mm Cannulated Screw System</Name><Description>6.5mm Cannulated Screw</Description><Size>6.5mm in diameter 45 to 115mm in length</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>230954</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT032</BillingCode><Name>Integrant 4.0mm Cannulated Screws</Name><Description>Cannulated screws with variable pitch/dynamic thread screw heads</Description><Size>4.0mm Diameter with lenghts from 26mm-70mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>230954</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT002</BillingCode><PriorBillingCodes><PriorBillingCode>LA003</PriorBillingCode></PriorBillingCodes><Name>Hawk 6.5mm Cannulated Screw System - Washer</Name><Description>Titanium Washer</Description><Size>Internal diameter 6.6mm and external diameter 14mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>232499</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT035</BillingCode><Name>Fuse It Healing Screw</Name><Description>Fenestrated conical fusion cage - intended to be used in situations where an aid is required to help facilitate bone fusion and alignment generally following an osteotomy but also in the instance of large bone deformities and complex fusion procedures.</Description><Size>Diameters from 6mm-16mm, lengths from 10mm-30mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1219</GroupID><SubGroupID>3261</SubGroupID><ARTGs><ARTG>308601</ARTG></ARTGs><MinimumBenefit>1321</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT017</BillingCode><Name>Arch It</Name><Description>Subtalar Arthroereisis Implant</Description><Size>8mm, 9mm, 10mm, 11mm &amp; 12mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1219</GroupID><SubGroupID>3261</SubGroupID><ARTGs><ARTG>266192</ARTG></ARTGs><MinimumBenefit>1321</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT024</BillingCode><Name>Frame It Partial Ring</Name><Description>Partial circular ring</Description><Size>2/3 rings and half rings

Diameter 80mm-220mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3406</SubGroupID><ARTGs><ARTG>282764</ARTG></ARTGs><MinimumBenefit>978</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT015</BillingCode><Name>Superior Fusion Plate System - Locking screws</Name><Description>4.5mm locking screw set with lengths ranging from 35mm to 110mm.Locking screws to hold and aid an anatomical contoured locking plate used for primary, revision and pantalar anterior ankle fusions.</Description><Size>4.5mm in diameter with lengths of 35mm,37mm, 39mm, 41mm, 43mm, 45mm, 47mm, 49mm,
50mm, 55mm, 60mm, 65mm, 70mm, 75mm, 80mm, 85mm, 90mm, 95mm, 100mm, 105mm,
110mm each</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>191738</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT025</BillingCode><Name>Frame It Coupling</Name><Description>Coupling devices; Posts, Basic Struts, Plates, Hinges and Extenders</Description><Size>Ranging from 1-12 holes</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3757</SubGroupID><ARTGs><ARTG>282764</ARTG></ARTGs><MinimumBenefit>225</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT020</BillingCode><Name>Frame IT - Pins</Name><Description>Fixation Pins used in conjunction with the external fixation frame to adjust the placement of frame to best suit individual patient</Description><Size>6mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4510</SubGroupID><ARTGs><ARTG>282833</ARTG></ARTGs><MinimumBenefit>134</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT019</BillingCode><Name>Frame IT - Pre-assembled Frame</Name><Description>Pre assembled Frame - used for the correction of deformities</Description><Size>120mm-180mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3401</SubGroupID><ARTGs><ARTG>282764</ARTG></ARTGs><MinimumBenefit>4035</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT034</BillingCode><PriorBillingCodes><PriorBillingCode>IT016</PriorBillingCode></PriorBillingCodes><Name>Anchor It</Name><Description>Fully threaded Titanium suture anchor with fibrewire suture</Description><Size>2.5mm - 3.5mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>271554</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT036</BillingCode><Name>Integrant 2.5 mm Screw</Name><Description>2.5 mm Cannulated Screw</Description><Size>8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30, 32, 34, 36 mm lengths</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>230954</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT037</BillingCode><Name>AnchorIT</Name><Description>Soft tissue anchor for reattachment of soft tissue to bone.</Description><Size>3.5 mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>405362</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT006</BillingCode><PriorBillingCodes><PriorBillingCode>LA009</PriorBillingCode></PriorBillingCodes><Name>Hawk 3.0mm Cannulated Screw System - guide pin</Name><Description>Threaded, stainless steel</Description><Size>1.0mm in diameter with a length of 200mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>230955</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT028</BillingCode><Name>Frame It Nuts &amp; Bolts</Name><Description>Nuts, Bolts and spacers</Description><Size>standard</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4507</SubGroupID><ARTGs><ARTG>282764</ARTG></ARTGs><MinimumBenefit>36</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT005</BillingCode><PriorBillingCodes><PriorBillingCode>LA005</PriorBillingCode></PriorBillingCodes><Name>Hawk 4.0mm Cannulated Screw system - Guide Pin</Name><Description>Threaded, Stainless steel</Description><Size>1.5mm in diameter and length of 200mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>230955</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT033</BillingCode><PriorBillingCodes><PriorBillingCode>IT016</PriorBillingCode></PriorBillingCodes><Name>Anchor It 5mm</Name><Description>Fully threaded suture anchor with fibrewire suture</Description><Size>5mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>271554</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IT027</BillingCode><Name>Frame It Foot Plate</Name><Description>Foot plate</Description><Size>Diameter 80mm-220mm</Size><SupplierCode>IT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4506</SubGroupID><ARTGs><ARTG>282764</ARTG></ARTGs><MinimumBenefit>1872</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ435</BillingCode><PriorBillingCodes><PriorBillingCode>RC006</PriorBillingCode></PriorBillingCodes><Name>Ventilation Tubes - Shepherd</Name><Description>Teflon, w or w/o wire</Description><Size>1.15mm lumen</Size><SupplierCode>LX</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>182921</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ432</BillingCode><PriorBillingCodes><PriorBillingCode>RC002</PriorBillingCode></PriorBillingCodes><Name>Ventilation tube</Name><Description>Ventilation tube - Silicone - T-tube, T-tube grommet</Description><Size>1.1mm; 1.27mm lumen</Size><SupplierCode>LX</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>182921</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ433</BillingCode><PriorBillingCodes><PriorBillingCode>RC003</PriorBillingCode></PriorBillingCodes><Name>Ventilation Tubes - Collar Button</Name><Description>Teflon, w/o wire</Description><Size>1.10mm, 1.25mm, 1.50mm lumen</Size><SupplierCode>LX</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>182921</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ437</BillingCode><PriorBillingCodes><PriorBillingCode>RC009</PriorBillingCode></PriorBillingCodes><Name>Ventilation Tubes - Silicone</Name><Description>Armstrong Grommet, Donaldson w &amp; w/o Tab, Paparella 1 and Paparella 2 (1.5mm)</Description><Size>1.1mm &amp; 1.5mm lumen</Size><SupplierCode>LX</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>182921</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ429</BillingCode><PriorBillingCodes><PriorBillingCode>AN008</PriorBillingCode></PriorBillingCodes><Name>Collatamp G</Name><Description>Biodegradable collagen implant with gentamicin</Description><Size>10cm x 10cm x 0.5cm, 20cm x 5cm x 0.5cm</Size><SupplierCode>LX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4216</SubGroupID><Suffix>Antibiotic</Suffix><ARTGs><ARTG>156287</ARTG></ARTGs><MinimumBenefit>277</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ430</BillingCode><PriorBillingCodes><PriorBillingCode>AN009</PriorBillingCode></PriorBillingCodes><Name>Collatamp G</Name><Description>Biodegradeable collagen implant with gentamicin</Description><Size>5cm x 5cm x 0.5cm</Size><SupplierCode>LX</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4215</SubGroupID><Suffix>Antibiotic</Suffix><ARTGs><ARTG>156287</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ434</BillingCode><PriorBillingCodes><PriorBillingCode>RC004</PriorBillingCode></PriorBillingCodes><Name>Ventilation Tubes - Collar Button</Name><Description>Teflon w/wire, and titanium w/o wire</Description><Size>0.76mm, 1.00mm, 1.25mm, 1.50mm lumen</Size><SupplierCode>LX</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>182921</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ431</BillingCode><PriorBillingCodes><PriorBillingCode>RC001</PriorBillingCode></PriorBillingCodes><Name>LIDCHAIN Platinum Eyelid Implant</Name><Description>Platinum</Description><Size>Weights - 0.8, 1.0, 1.2, 1.4, 1.6, 1.8 grams</Size><SupplierCode>LX</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>145</SubCategoryID><GroupID>1336</GroupID><SubGroupID>3902</SubGroupID><ARTGs><ARTG>182945</ARTG></ARTGs><MinimumBenefit>1173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ462</BillingCode><PriorBillingCodes><PriorBillingCode>RC013</PriorBillingCode></PriorBillingCodes><Name>Septal Button, silicone, sterile</Name><Description>For non-surgical closure of septal perforation  · Silicone prevents adhesion  · Soft material for easy insertion and removal  · No scabbing, epistaxis or other septal perforation symptoms  · Surface with Lotus leaf effect prevents adhesion of secretions / tissue</Description><Size>3.2cm - 1mm thick, one-piece  3.2cm - 1mm thick , two-piece</Size><SupplierCode>LX</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>197</SubCategoryID><GroupID>1568</GroupID><ARTGs><ARTG>338464</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ464</BillingCode><PriorBillingCodes><PriorBillingCode>RC011</PriorBillingCode></PriorBillingCodes><Name>TORP - Total Ossicular Replacement Prosthesis</Name><Description>Total implant made of titanium, for reconstructing a destroyed middle-air ossicular chain (chain of sound transmission) between the footplate of the stirrup bone and the plane of the eardrum.
The implants are available in fixed length and adjustable versions for shortening. The implant can be subdivided into three areas: 1.) the implant shoe; 2.) the implant shaft; 3.) the perforated implant plate. The implant plate can be arranged centrically (round) towards the implant shaft or eccentrically (oval). In the eccentric version (oval, fixed length only), an additional groove has been worked into the plate to improve receiving the malleus handle. The surface of the predefined contact points (upper side of implant plate and implant shoe) is roughened in order to facilitate better bonding to the eardrum resp. the stapes footplate. To improve the adaptation of the implant plate to the plane of the eardrum, the angle between the implant plate and shaft can be optimally adapted because the shaft below the implant plate tapers off (onwards from a total length of 3.5 mm). The product is available in different lengths. The length information is stated both on the outer package as well as on the product’s sterile packaging.</Description><Size>Fixed Length
Central Head shaft diam. 0.3 mm Length 3.00 mm
Central Head shaft diam. 0.3 mm Length 3.50 mm
Central Head shaft diam. 0.3 mm Length 4.00 mm
Central Head shaft diam. 0.3 mm Length 4.25 mm
Central Head shaft diam. 0.3 mm Length 4.50 mm
Central Head shaft diam. 0.3 mm Length 4.75 mm
Central Head shaft diam. 0.3 mm Length 5.00 mm
Central Head shaft diam. 0.3 mm Length 5.50 mm
Central Head shaft diam. 0.3 mm Length 6.00 mm
Central Head shaft diam. 0.3 mm Length 6.50 mm
Central Head shaft diam. 0.3 mm Length 7.00 mm
Offset Head shaft diam. 0.3 mm Length 3.00 mm
Offset Head shaft diam. 0.3 mm Length 3.50 mm
Offset Head shaft diam. 0.3 mm Length 4.00 mm
Offset Head shaft diam. 0.3 mm Length 4.25 mm
Offset Head shaft diam. 0.3 mm Length 4.50 mm
Offset Head shaft diam. 0.3 mm Length 4.75 mm
Offset Head shaft diam. 0.3 mm Length 5.00 mm
Offset Head shaft diam. 0.3 mm Length 5.50 mm
Offset Head shaft diam. 0.3 mm Length 6.00 mm
Offset Head shaft diam. 0.3 mm Length 6.50 mm
Offset Head shaft diam. 0.3 mm Length 7.00 mm
Shortenable
Total Titanium Implant with Separate Shoe shaft diam. 0.4 mm Length 7.8-2.8 
mm
Total Titanium Implant with Separate Shoe shaft diam. 0.4 mm Length 7.8-2.3 
mm
Total Titanium Implant with Separate Shoe shaft diam. 0.4 mm Length 7.8-3.5 
mm
Total Titanium Implant with Separate Shoe shaft diam. 0.4 mm Length 7.8-3.0 
mm
Adjustable Titanium Implant with Separate Shoe, shaft diam. 0.4 mm Length 7.8-2.8 mm
Adjustable Titanium Implant with Separate Shoe, shaft diam. 0.4 mm Length 7.8-2.3 mm</Size><SupplierCode>LX</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4157</SubGroupID><ARTGs><ARTG>290802</ARTG></ARTGs><MinimumBenefit>343</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ436</BillingCode><PriorBillingCodes><PriorBillingCode>RC007</PriorBillingCode></PriorBillingCodes><Name>Ventilation Tubes - Shepherd</Name><Description>Titanium, w/o wire</Description><Size>1.00mm, 1.25mm lumen</Size><SupplierCode>LX</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>182921</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ463</BillingCode><PriorBillingCodes><PriorBillingCode>RC010</PriorBillingCode></PriorBillingCodes><Name>Stapes Prosheses</Name><Description>For reconstruction of the sound conduction chain between middle ear and inner ear through replacement of the stapes. The body of the implant consists of a columella (which in some product versions can be shortened) and a flat band. The columella is inserted in the opened Vestibulum auris through the trepanated stapes foot-plate. The flat band is placed around the long process of the incus. The implants are available in various versions and materials:
• Titanium: Columella and flat band made of titanium;
• Platinum/PTFE: Columella made of polytetrafluoroethylene (PTFE), flat band made of platinum (Pt);
• Nitinol/PTFE: Columella made of polytetrafluoroethylene (PTFE), flat band made of nitinol.</Description><Size>Stapes Prostheses Nitinol/PTFE, 1 piece, sterile, Wire diam: 0.2 mm, PTFE shaft diam: 0.4 &amp; 0.6 mm, Incus diam. small standard, large; length 5.25, 5.50, 5.75, 7.00 (shortenable)
Stapes Prostheses Platinum/PTFE, 1 piece, sterile; piston diam. 0.4 &amp; 0.6 mm; length 5.25, 5.50, 5.75, 7.00 (shortenable), 10.00 (shortenable)
Stapes Prostheses Titanium, 1 piece, sterile; piston diam. 0.4 &amp; 0.6 mm; length 5.25, 5.50, 5.75, 8.00 (shortenable)</Size><SupplierCode>LX</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4156</SubGroupID><ARTGs><ARTG>290802</ARTG></ARTGs><MinimumBenefit>227</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ461</BillingCode><PriorBillingCodes><PriorBillingCode>RC012</PriorBillingCode></PriorBillingCodes><Name>PORP - Partial Ossicular Replacement Prosthesis</Name><Description>Partial implant made of titanium, for reconstructing a (partially) destroyed middle ear ossicular chain (chain of sound transmission) between the stapes and the tympanic membrane level in fixed and variable lengths. 
Fixed - The implant body is a single piece and was made from a single part only, i.e. it has no susceptible material bonding points such as weld seams. The implant can be subdivided into three areas: 1.) the implant bell that is offered in 2 embodiments: Unslitted and slitted; 2.) the implant shaft; 3.) the perforated implant plate. The implant plate can be arranged centrically (round) towards the implant shaft or eccentrically (oval). In the eccentric version (oval), an additional groove has been worked into the plate to improve receiving the malleus handle. 
Variable - The implant body consists of two parts, a shortenable shaft that is firmly bound to the prosthesis bell, and a prosthesis plate that has been provided with a borehole in its underside. The borehole has been dimensionally designed in such a way that it can receive the shaft after the latter has been adapted lengthwise to the respective situation in the middle ear. 
The surface of the predefined contact point (upper side of implant plate and inner side of the bell) is roughened in order to facilitate better bonding to the eardrum resp. the stapes head.</Description><Size>Central Head with slitted Bell - shaft diam. 0.3mm, Length 0.5 - 3.5mm
Offset Head with slitted Bell - shaft diam. 0.3mm, Length 0.5 - 3.5mm
Central Head with Complete Bell - shaft diam. 0.3mm, Length 0.5 - 3.5mm
Partial Titanium Implant with Separate Head, shaft 0 0.3 mm, Length 5.5-2.5mm (variable)
Partial Titanium Implant with Separate Head, shaft 0 0.3 mm, Length 5.5-2.0mm (variable)</Size><SupplierCode>LX</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4156</SubGroupID><ARTGs><ARTG>290802</ARTG></ARTGs><MinimumBenefit>227</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JI007</BillingCode><PriorBillingCodes><PriorBillingCode>LH595</PriorBillingCode></PriorBillingCodes><Name>Aerstent</Name><Description>Nitinol Self Expanding Tracheal and Bronchial Stent. Nitinol Mesh, Silicone </Description><Size>Straight, J or Y Shaped, (10-24) mm diameter</Size><SupplierCode>JI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1571</GroupID><Suffix>Nitinol</Suffix><ARTGs><ARTG>297568</ARTG></ARTGs><MinimumBenefit>1814</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JI003</BillingCode><PriorBillingCodes><PriorBillingCode>LH579</PriorBillingCode><PriorBillingCode>MY004</PriorBillingCode></PriorBillingCodes><Name>CP Stent</Name><Description>CP Stent Uncovered</Description><Size>16,22,28,34,39,&amp;45mm length</Size><SupplierCode>JI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>257</SubCategoryID><GroupID>1804</GroupID><ARTGs><ARTG>121892</ARTG></ARTGs><MinimumBenefit>1199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JI008</BillingCode><PriorBillingCodes><PriorBillingCode>LH574</PriorBillingCode><PriorBillingCode>My001</PriorBillingCode></PriorBillingCodes><Name>GSS &amp; Dumon</Name><Description>Silicone tracheal and bronchial stents, Straight and Y Shape</Description><Size>10 - 20mm diameter, 20 - 110mm length  </Size><SupplierCode>JI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1571</GroupID><Suffix>Silicone</Suffix><ARTGs><ARTG>143612</ARTG></ARTGs><MinimumBenefit>903</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JI005</BillingCode><PriorBillingCodes><PriorBillingCode>LH580</PriorBillingCode><PriorBillingCode>MY005</PriorBillingCode></PriorBillingCodes><Name>CP Stent</Name><Description>CP Stent Covered</Description><Size>16,22,28,34,39,&amp;45mm length</Size><SupplierCode>JI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>257</SubCategoryID><GroupID>1805</GroupID><ARTGs><ARTG>121892</ARTG></ARTGs><MinimumBenefit>1998</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JI004</BillingCode><PriorBillingCodes><PriorBillingCode>LH582</PriorBillingCode><PriorBillingCode>MY007</PriorBillingCode></PriorBillingCodes><Name>CP Stent</Name><Description>CP Stent Covered, mounted on BIB balloon</Description><Size>16,22,28,34,39,&amp;45mm length</Size><SupplierCode>JI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>257</SubCategoryID><GroupID>1805</GroupID><Suffix>Balloon-in-Balloon</Suffix><ARTGs><ARTG>121892</ARTG></ARTGs><MinimumBenefit>2923</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JI006</BillingCode><PriorBillingCodes><PriorBillingCode>LH572</PriorBillingCode><PriorBillingCode>My003</PriorBillingCode></PriorBillingCodes><Name>Steritalc</Name><Description>Sterile granules of talc implanted in pleural space to act as permanent adhesive</Description><Size>3 grams &amp; 4 grams</Size><SupplierCode>JI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4252</SubGroupID><ARTGs><ARTG>143613</ARTG></ARTGs><MinimumBenefit>129</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JI002</BillingCode><PriorBillingCodes><PriorBillingCode>LH581</PriorBillingCode><PriorBillingCode>MY006</PriorBillingCode></PriorBillingCodes><Name>CP Stent</Name><Description>CP Stent Uncovered, mounted on BIB balloon</Description><Size>16,22,28,34,39,&amp;45mm length</Size><SupplierCode>JI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>257</SubCategoryID><GroupID>1804</GroupID><Suffix>Balloon- in-Balloon</Suffix><ARTGs><ARTG>121892</ARTG></ARTGs><MinimumBenefit>2124</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ020</BillingCode><Name>PreciSAL EZ Toric 1-Piece Yellow Pre-loaded IOL (PT302A, PST302A)</Name><Description>Pre-loaded acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, toric correction on anterior surface with cylinder marks to indicate flat meridian plus the cylinder axis to allow alignment for astigmatic correction, and UV and blue light filters.</Description><Size>Available in spherical dioptric powers from 0.0 to +34.0D. 1D steps: 0.0D to +10.0D and 30.0D to 34.0D; 0.5D steps: +10.5 to +29.5; Cylinder powers from 1.0D to 6.0D in 0.5D steps.</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, t1, vblf</Suffix><ARTGs><ARTG>183558</ARTG></ARTGs><MinimumBenefit>585</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ042</BillingCode><Name>Precizon Presbyopic Toric Intraocular Lens</Name><Description>Hybrid acrylic toric intraocular lens with continual transitional focus</Description><Size>spherical range: +5.0 to +34.5D (0.5 D increments); cylindrical range: 1.0 to 6.0 D (0.5 D increments)</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>483005</ARTG></ARTGs><MinimumBenefit>902</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ019</BillingCode><Name>PreciSAL Toric T302A</Name><Description>Acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, toric correction on anterior surface with cylinder marks to indicate flat meridian plus the cylinder axis to allow alignment for astigmatic correction, and UV and blue light filters.</Description><Size>Available in spherical dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; Cylinder powers from 1.0D to 6.0D</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>183558</ARTG></ARTGs><MinimumBenefit>471</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ027</BillingCode><Name>Vioron</Name><Description>Trypan blue dye for ophthalmic applications</Description><Size>0.5ml syringe</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1330</GroupID><ARTGs><ARTG>150061</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ036</BillingCode><Name>Precizon Presbyopic NVA</Name><Description>Hybrid acrylic IOL with continuous transitional focus</Description><Size>+1.0 to +35.0 D (0.5 D increments)</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>483005</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ039</BillingCode><Name>Precizon Go Toric</Name><Description>One-piece toric intraocular lens</Description><Size>+1.5 to +34.5 D (0.5 D increments); cylindrical range: 1.0 D and 1.5 to 9.75 D (0.75 D increments)</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>483005</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ037</BillingCode><Name>Asqelio Trifocal IOL</Name><Description>Trifocal Intraocular Lens with VIVIS Technology
</Description><Size>Diopter power:+0.05D - +34.0D in 0.5D increments.</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>512662</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ022</BillingCode><Name>PresiSAL Multifocal M302A</Name><Description>Acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation. Aberration technology, pupil independent diffractive anterior surface with a near sight correction addition of up to +3.5D, and UV and blue light fliters.</Description><Size>Available in sperical dioptric powers from 0.0D to +30.0D. 1D steps: 0.0D to +10.0D; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers.</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>183558</ARTG></ARTGs><MinimumBenefit>651</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ030</BillingCode><PriorBillingCodes><PriorBillingCode>EG010</PriorBillingCode></PriorBillingCodes><Name>Artiflex Anterior Chamber Intraocular Lens</Name><Description>Optic: Hydrophobic Polysiloxane. Haptic: PMMA</Description><Size>6mm optic diameter x 8.5 in overall length</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>140</SubCategoryID><GroupID>1325</GroupID><SubGroupID>3889</SubGroupID><ARTGs><ARTG>92476</ARTG></ARTGs><MinimumBenefit>565</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ029</BillingCode><PriorBillingCodes><PriorBillingCode>EG009</PriorBillingCode></PriorBillingCodes><Name>Artisan Anterior Chamber Intraocular Lens</Name><Description>Aphakia Model
Composition: PMMA</Description><Size>5.00mm Optic Diameter x 8.5 in overall length</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>140</SubCategoryID><GroupID>1324</GroupID><SubGroupID>3887</SubGroupID><Suffix>ifc</Suffix><ARTGs><ARTG>92476</ARTG></ARTGs><MinimumBenefit>203</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ025</BillingCode><Name>PreciSAL Multifocal PM302A</Name><Description>Pre-loaded acrylic single piece, foldable intraocular lens with anterior and posterior optichaptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, pupil independent diffractive anterior surface with a near sight correction addition of up to +3.5D, and UV and blue filter powers.</Description><Size>Available in spherical dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers.</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>183558</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ038</BillingCode><Name>Asqelio EDOF Toric IOL</Name><Description>Preloaded extended Depth of Focus Toric IOL with Phase-Ring Technology</Description><Size>+5.0D to +34.0D in 0.5D increments, Cylinder +0.00 - 6.00D in 0.5D increments.</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>512662</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ032</BillingCode><PriorBillingCodes><PriorBillingCode>EG018</PriorBillingCode></PriorBillingCodes><Name>RINGJECT</Name><Description>Preloaded Capsular tension ring</Description><Size>12/10, 13/11</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>143</SubCategoryID><GroupID>1331</GroupID><Suffix>pl</Suffix><ARTGs><ARTG>145740</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ028</BillingCode><PriorBillingCodes><PriorBillingCode>EG001</PriorBillingCode></PriorBillingCodes><Name>Capsular Tension Rings Clear</Name><Description>PMMA Implant</Description><Size>10/08, 12/10, 13/11mm</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>143</SubCategoryID><GroupID>1331</GroupID><ARTGs><ARTG>145740</ARTG></ARTGs><MinimumBenefit>99</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ024</BillingCode><Name>PreciSAL Mulitfocal PM302AC</Name><Description>Pre-loaded acrylic single piece, foldable intraocular lens with anterior and posterior optichaptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology, pupil independent diffractive anterior surface with a near sight correction addition of up to +3.5D, and UV filter.</Description><Size>Available in spherical dioptric powers from 0.0 to +30.0.  1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers.</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>183558</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ040</BillingCode><Name>Asqelio Trifocal Toric IOL</Name><Description>Trifocal Toric Intraocular Lens with VIVIS Technology</Description><Size>Diopter Power; +5.00D - +34.00D, Cylinder Power: +0.0D - +6.0D</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1, vlbf</Suffix><ARTGs><ARTG>512662</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ005</BillingCode><Name>Densiron</Name><Description>Heavy Tamponade Liquid Medium, Postoperative</Description><Size>10 ml, Sterile</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1347</GroupID><Suffix>HO</Suffix><ARTGs><ARTG>152234</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ002</BillingCode><Name>Ocuvis and Ocumax 2% Hydroxypropylmethylcellulose</Name><Description>20mg/mL hydroxypropylmethyl cellulose for intraocular use. Pre-loaded in a sterile syringe with one cannula for injection, in a sterile Tyvek pouch</Description><Size>2mL sterile</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>104427</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ041</BillingCode><Name>Precizon Go</Name><Description>Enhanced monovision intraocular lens</Description><Size>-10.0 to +0.0D; +1.0 to +35D (0.5 D increments)</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>483005</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ015</BillingCode><PriorBillingCodes><PriorBillingCode>IQ011</PriorBillingCode></PriorBillingCodes><Name>PreciSAL 302A</Name><Description>Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and blue light filter.</Description><Size>Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>183558</ARTG></ARTGs><MinimumBenefit>221</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ033</BillingCode><PriorBillingCodes><PriorBillingCode>EG019</PriorBillingCode><PriorBillingCode>EG008</PriorBillingCode></PriorBillingCodes><Name>Artisan Toric (Custom) T1</Name><Description>AC Iris clip IOL Toric</Description><Size>5.00mm Optic Diameter x 7.5 Overall</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>140</SubCategoryID><GroupID>1325</GroupID><SubGroupID>3888</SubGroupID><Suffix>t1, ifc</Suffix><ARTGs><ARTG>92476</ARTG></ARTGs><MinimumBenefit>934</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ034</BillingCode><PriorBillingCodes><PriorBillingCode>EG020</PriorBillingCode><PriorBillingCode>EG008</PriorBillingCode></PriorBillingCodes><Name>Artisan Toric (Custom) T2</Name><Description>AC Iris clip IOL Toric</Description><Size>5.00mm Optic Diameter x 7.5 Overall</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>140</SubCategoryID><GroupID>1325</GroupID><SubGroupID>3888</SubGroupID><Suffix>t2, ifc</Suffix><ARTGs><ARTG>92476</ARTG></ARTGs><MinimumBenefit>1180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ031</BillingCode><PriorBillingCodes><PriorBillingCode>EG012</PriorBillingCode></PriorBillingCodes><Name>Artisan Anterior Chamber IOL</Name><Description>Phakic Intraocular Lens Myopic / Hyperopic</Description><Size>5.00mm Optic Diameter x 8.5 in overall length;</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>140</SubCategoryID><GroupID>1325</GroupID><SubGroupID>3888</SubGroupID><ARTGs><ARTG>92476</ARTG></ARTGs><MinimumBenefit>552</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ023</BillingCode><Name>PreciSAL Multifocal M302AC</Name><Description>Acrylic single piece, foldable intraocular lens with anterior and posterior optic-haptic edge, 360 degree optic square edge design, precision power calculation, abreration technology, pupil independent diffractive anterior surface with a near sigh correction addition of up to +3.5D, and UV Filter.</Description><Size>Available in spherical dioptric powers from 0.0D to +30.0D. 1D steps: 0.0D to+10.0D; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0; near sight correction addition up to +3.5D on all spherical dioptric powers.</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>183558</ARTG></ARTGs><MinimumBenefit>619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ008</BillingCode><Name>Octane &amp; Decalin</Name><Description>Perfluorocarbon retinal tamponade medium, intraoperative</Description><Size>5ml &amp; 7ml, Sterile</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1346</GroupID><ARTGs><ARTG>152235</ARTG></ARTGs><MinimumBenefit>217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ035</BillingCode><Name>Asqelio EDOF IOL </Name><Description>Pre-loaded extended depth of focus intraocular lens with Phase-Ring Technology</Description><Size>+5.0D - +34.0D in 0.5D increments</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>512662</ARTG></ARTGs><MinimumBenefit>666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ013</BillingCode><PriorBillingCodes><PriorBillingCode>IQ010</PriorBillingCode></PriorBillingCodes><Name>PreciSAL 302AC</Name><Description>Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and UV light filter.</Description><Size>Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to + 17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>183558</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ006</BillingCode><Name>Siluron 1000 &amp; Siluron 5000</Name><Description>Silicone Oils</Description><Size>10 ml, Sterile</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1347</GroupID><ARTGs><ARTG>152234</ARTG></ARTGs><MinimumBenefit>176</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ014</BillingCode><PriorBillingCodes><PriorBillingCode>IQ010</PriorBillingCode></PriorBillingCodes><Name>PreciSAL P302AC  PreciSAL PS302AC</Name><Description>Preloaded Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and UV light filter.</Description><Size>Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to + 17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>183558</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ012</BillingCode><Name>EasyGas</Name><Description>Endotamponade Gases for Retinal Surgery, EasyGas SF6, C2F6 or C3F8, each supplied in a 60ml syringe, sterile</Description><Size>60ml dispensed in a single dose, sterile syringe</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1345</GroupID><ARTGs><ARTG>197089</ARTG></ARTGs><MinimumBenefit>67</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>IQ016</BillingCode><PriorBillingCodes><PriorBillingCode>IQ011</PriorBillingCode></PriorBillingCodes><Name>PreciSAL P302A  PreciSAL PS302A</Name><Description>Preloaded Acrylic, single piece, foldable intraocular lens with anterior and posterior optic-haptic square edge, 360 degree optic square edge design, precision power calculation, aberration technology and blue light filter.</Description><Size>Available in dioptric powers from 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D steps: +10.5 to +17.5 and +28.5 to +30.0; 0.25D steps: +18.0 to +28.0</Size><SupplierCode>IQ</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>183558</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XW001</BillingCode><Name>derma+flex</Name><Description>Topical Skin Adhesive</Description><Size>0.7ml</Size><SupplierCode>XW</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>479186</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XW003</BillingCode><Name>Exofin Topical Skin Adhesive</Name><Description>Polymerising 2-octyl topical adhesive - tube and pen</Description><Size>0.5ml, 1ml</Size><SupplierCode>XW</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>479187</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XW002</BillingCode><Name>Exofin Fusion</Name><Description>Topical skin adhesive with self-adhering mesh</Description><Size>22, 30, 60cm</Size><SupplierCode>XW</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>479185</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ696</BillingCode><Name>Trochanteric Reattachment Device</Name><Description>Titanium alloy reattachment device with cables</Description><Size>Small</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5994</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>982</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY710</BillingCode><PriorBillingCodes><PriorBillingCode>SY684</PriorBillingCode><PriorBillingCode>SY376</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Femur Plates</Description><Size>7-15 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5287</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1710</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ558</BillingCode><Name>DELTA Xtend</Name><Description>Metaglene Screw Dia 4.5</Description><Size>4.5mm; 24, 30, 36, 42, 48</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>218567</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY140</BillingCode><Name>AO/ASIF Spinal Implants</Name><Description>Locking Screws</Description><Size>Length 12 - 55mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>293275</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY721</BillingCode><PriorBillingCodes><PriorBillingCode>SY115</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Non-Locking Fragment Plates</Description><Size>7-15 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>113</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN360</BillingCode><Name>VA-LCP Periprosthetic Proximal Femur Plating System</Name><Description>VAL compression plate, proximal femur hook plates, stainless steel</Description><Size>≥7 to ≤15 holes, left &amp; right profile</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>Com,VAL</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ277</BillingCode><Name>HEALIX ADVANCE Knotless Anchor System</Name><Description>PEEK anchor with ORTHOCORD suture</Description><Size>Anchor diameter: 4.75 mm; 5.5 mm; 6.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>330849</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY550</BillingCode><Name>Titanium Sternal Fixation System</Name><Description>Locking Plate - Star</Description><Size>Star: 6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4311</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>187295</ARTG></ARTGs><MinimumBenefit>1306</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ275</BillingCode><Name>Healix  Anchor System</Name><Description>PEEK anchor with ORTHOCORD suture</Description><Size>Anchor diameter: 4.5 mm; 5.5 mm; 6.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>205027</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY493</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium Mandibular locking plate, complex shape</Description><Size>16-32 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>854</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY556</BillingCode><PriorBillingCodes><PriorBillingCode>DY431</PriorBillingCode></PriorBillingCodes><Name>Expedium Spine System</Name><Description>Polyaxial Screws</Description><Size>4.35 - 8mm diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY722</BillingCode><PriorBillingCodes><PriorBillingCode>SY115</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>LCP T, L, Straight Plates, Stainless Steel, Titanium</Description><Size>7-15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ800</BillingCode><Name>Skyline Cervical Plate System</Name><Description>Skyline anterior cervical plate. Various size plates, Titanium</Description><Size>12-55mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>194058</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY589</BillingCode><Name>AO/ASIF Plate</Name><Description>Rapid resorbable reconstruction plate</Description><Size>16-32 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>167547</ARTG></ARTGs><MinimumBenefit>394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY762</BillingCode><PriorBillingCodes><PriorBillingCode>SY681</PriorBillingCode><PriorBillingCode>SY284</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plate</Name><Description>Locking Perarticular Anatomic Humerus plate</Description><Size>≥ 7 - ≤ 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY763</BillingCode><PriorBillingCodes><PriorBillingCode>SY681</PriorBillingCode><PriorBillingCode>SY284</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plate</Name><Description>Locking Perarticular Anatomic Humerus plate</Description><Size>≥ 7 - ≤ 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY148</BillingCode><Name>Universal Spine System (USS)</Name><Description>Pedicle Hook Screw</Description><Size>Length 20- 40mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Closed</Suffix><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY790</BillingCode><PriorBillingCodes><PriorBillingCode>SY262</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Intramedullary Nails</Name><Description>Femoral Nail</Description><Size>9-15mm D &lt;220mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3326</SubGroupID><ARTGs><ARTG>161140</ARTG></ARTGs><MinimumBenefit>910</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY147</BillingCode><Name>Universal Spine System (USS)</Name><Description>Connectors</Description><Size>Parallel, In-line, Transverse, SS, 15 - 25mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ271</BillingCode><Name>HEALIX ADVANCE Knotless Anchor System</Name><Description>Biocryl Rapid anchor with ORTHOCORD suture</Description><Size>Anchor diameter: 4.75 mm; 5.5 mm; 6.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>330848</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY194</BillingCode><Name>Limb Preservation System</Name><Description>LPS Diaphyseal Porous Straight Stem, with 2cm porous collar</Description><Size>Porocoat 10.5mm - 18.5mm diameter x 100mm - 125mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1386</GroupID><ARTGs><ARTG>227900</ARTG></ARTGs><MinimumBenefit>2648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ036</BillingCode><Name>Absolok* Extra Absorbable Ligating Clips </Name><Description>Polydioxanone clips contained in a plastic cartridge</Description><Size>Small to Extralarge</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>121372</ARTG></ARTGs><MinimumBenefit>81</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY645</BillingCode><PriorBillingCodes><PriorBillingCode>SY322</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Screws</Name><Description>HCS Countersinkable Compression Screw</Description><Size>4.5mm-6.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>157068</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY478</BillingCode><Name>Uniplate ACP System</Name><Description>Rescue Screw</Description><Size>12-18mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>128257</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY193</BillingCode><Name>Limb Preservation System</Name><Description>LPS Cemented Straight Stem with 2cm porous Collar</Description><Size>9mm - 17mm diameter, 100 - 125mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1386</GroupID><ARTGs><ARTG>228694</ARTG></ARTGs><MinimumBenefit>2648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ818</BillingCode><Name>DePuy Delta TS Heads</Name><Description>Delta ceramic femoral head with titanium sleeve</Description><Size>≤32mm, +1 to +12</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><Suffix>Sleeve</Suffix><ARTGs><ARTG>217543</ARTG></ARTGs><MinimumBenefit>1931</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN169</BillingCode><Name>VIPER Spinal System</Name><Description>Spinal Rods</Description><Size>30-480mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>128257</ARTG><ARTG>97391</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN325</BillingCode><Name>HEALIX Anchor System </Name><Description>Self-Punching Biocomposite Anchor</Description><Size>4.9 mm, 5.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>382170</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ160</BillingCode><Name>Delta Xtend Shoulder System</Name><Description>Modular humeral stem</Description><Size>10-16mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4064</SubGroupID><ARTGs><ARTG>307921</ARTG></ARTGs><MinimumBenefit>2660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY190</BillingCode><Name>Limb Preservation System</Name><Description>LPS Diaphyseal Porous Bowed Stem, with 2cm porous collar</Description><Size>Porocoat 12.5mm - 18.5mm diameter x 150mm - 200mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1386</GroupID><ARTGs><ARTG>225060</ARTG></ARTGs><MinimumBenefit>2648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY562</BillingCode><Name>Matrix</Name><Description>Micro X, Frame plates</Description><Size>4  - 7 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4263</SubGroupID><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>137</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN349</BillingCode><Name>BI-MENTUM Dual Mobility System</Name><Description>Cemented metal acetabular dual mobility cup designed to be used with a polyethylene liner</Description><Size>43-63 mm diameter in 2mm increments</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4009</SubGroupID><ARTGs><ARTG>363211</ARTG></ARTGs><MinimumBenefit>1511</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ752</BillingCode><Name>DePuy Delta Heads</Name><Description>Delta femoral head various tapers &amp; neck lengths</Description><Size>≤32mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>232415</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY189</BillingCode><Name>Limb Preservation System</Name><Description>LPS Cemented Bowed Stem with 2cm porous Collar</Description><Size>11mm - 17mm diameter x 150 - 200mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1386</GroupID><ARTGs><ARTG>225059</ARTG></ARTGs><MinimumBenefit>2648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN196</BillingCode><Name>Matrix Plate</Name><Description>Burr Hole Plates</Description><Size>12 to 24mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4263</SubGroupID><Suffix>Burr</Suffix><ARTGs><ARTG>298355</ARTG></ARTGs><MinimumBenefit>155</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ519</BillingCode><Name>AEGIS ALP</Name><Description>AEGIS ALP Bone Screws, Titanium</Description><Size>24-36mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>128257</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY662</BillingCode><PriorBillingCodes><PriorBillingCode>SY202</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic External Fixator Systems</Name><Description>Hybrid Ring Clamps; Combination, Rod, Rod/Wire, Adjustable, Tube/Tube RL MRI</Description><Size>11.0mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3757</SubGroupID><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>225</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ274</BillingCode><Name>Healix  Anchor System</Name><Description>PEEK anchor with PERMATAPE suture (Blue or While/Blue)</Description><Size>Anchor diameter: 4.5 mm; 5.5 mm; 6.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>215753</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY630</BillingCode><PriorBillingCodes><PriorBillingCode>SY074</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Screws</Name><Description>Cannulated Full, Partial Thread screw</Description><Size>≥4.50mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY705</BillingCode><PriorBillingCodes><PriorBillingCode>SY565</PriorBillingCode></PriorBillingCodes><Name>Spinal Fixation System</Name><Description>Matrix Preassembled Polyaxial Pedicle Screw</Description><Size>4.00mm - 9.00mm; 20mm  - 100mm Length</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN211</BillingCode><Name>Truespan meniscal repair system</Name><Description>Pre-loaded Peek backstops and ORTHOCORD suture</Description><Size>0 to 24 degree</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>292990</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY347</BillingCode><Name>Titanium Sternal Fixation System</Name><Description>Locking Plate - straight</Description><Size>20 or 30 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4314</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1630</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY228</BillingCode><Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name><Description>Connecting Plate / Spacer</Description><Size>1 - 5 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4507</SubGroupID><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>36</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ932</BillingCode><Name>SmartSet</Name><Description>PMMA bone cement</Description><Size>20 to 40g</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4087</SubGroupID><ARTGs><ARTG>96550</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY419</BillingCode><Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name><Description>Nuts, Washers &amp; Spacers, Bolts</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4507</SubGroupID><ARTGs><ARTG>289708</ARTG><ARTG>305577</ARTG><ARTG>326183</ARTG></ARTGs><MinimumBenefit>36</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ961</BillingCode><Name>BioIntrafix</Name><Description>Tibial soft tissue fastner screw/sheath</Description><Size>6-8mm-7-10mm x 30mm; Small and Large</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>136254</ARTG><ARTG>136255</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ984</BillingCode><Name>Dual Energy THERMOCOOL SMARTTOUCH SF</Name><Description>PFA/RF dual energy, irrigated, contact-force sensing catheter and mapping catheter</Description><Size>Unidirectional, bidirectional; 3.5 mm tip</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2966</GroupID><SubGroupID>7379</SubGroupID><Suffix>Johnson and Johnson</Suffix><ARTGs><ARTG>357290</ARTG><ARTG>444051</ARTG><ARTG>490706</ARTG><ARTG>490707</ARTG></ARTGs><MinimumBenefit>6399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY631</BillingCode><PriorBillingCodes><PriorBillingCode>SY074</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Screws</Name><Description>Cannulated Locking Screws</Description><Size>≥4.50mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,LK</Suffix><ARTGs><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>246</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY143</BillingCode><Name>Universal Spine System (USS)</Name><Description>Rods</Description><Size>Length 40 - 500mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY187</BillingCode><Name>Limb Preservation System</Name><Description>Beaded, 'Porocoat' Standard &amp; Trochanter Replacement</Description><Size>Neutral, 15deg Left &amp; Right in both styles</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3962</SubGroupID><Suffix>Body, Tumor</Suffix><ARTGs><ARTG>226872</ARTG><ARTG>226873</ARTG></ARTGs><MinimumBenefit>5867</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP982</BillingCode><Name>SROM ZTT Femoral Sleeve</Name><Description>Titanium, beaded without HA, proximal femoral cone</Description><Size>12A-24F</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3962</SubGroupID><Suffix>Cone</Suffix><ARTGs><ARTG>98085</ARTG><ARTG>98086</ARTG></ARTGs><MinimumBenefit>2619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN257</BillingCode><Name>HEALIX Anchor System</Name><Description>Biocryl Rapide anchor with Dynacord suture</Description><Size>4.5-6.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>330845</ARTG><ARTG>330847</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY184</BillingCode><Name>Monarch Spinal System</Name><Description>Dual Rod Connectors End to End or Side by Side</Description><Size>4.75 to 6.35mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>145010</ARTG><ARTG>97391</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP107</BillingCode><Name>CMW Bone Cement</Name><Description>CMW Bone Cement Various  without Antibiotic</Description><Size>20, 40 grams</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4087</SubGroupID><ARTGs><ARTG>304906</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY051</BillingCode><Name>AO/ASIF Pins</Name><Description>Seldrill, Schanz Screws, Steinmann Pins, Stainless Steel, Titanium Alloy</Description><Size>3mm - 6mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4510</SubGroupID><ARTGs><ARTG>133927</ARTG><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>134</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ786</BillingCode><Name>Corail Hip System Cemented Femoral Stem</Name><Description>Stainless steel cemented, polished femoral stem, standard and high offsets</Description><Size>Size 8 - 20</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>273725</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY691</BillingCode><Name>Midfoot Fusion Bolt</Name><Description>Solid intramedullary arthodesis implant</Description><Size>6.5mm diameter; 50-160mm Length</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>DT</Suffix><ARTGs><ARTG>182343</ARTG></ARTGs><MinimumBenefit>229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN265</BillingCode><Name>SYMPHONY OCT System</Name><Description>Axial and parallel connectors</Description><Size>3.5-6.35mm </Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ760</BillingCode><Name>Moss Miami (Titanium)</Name><Description>Swedge Rod</Description><Size>One Size</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>145010</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY317</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium Plate - straight</Description><Size>1.6mm Profile, 2-4 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4286</SubGroupID><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>107</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY512</BillingCode><Name>Pinnacle Acetabular Cup System</Name><Description>Pinnacle ceramic liner</Description><Size>44 - 66mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4025</SubGroupID><ARTGs><ARTG>223381</ARTG></ARTGs><MinimumBenefit>1690</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN239</BillingCode><Name>CARTO Reference</Name><Description>External Reference</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7350</SubGroupID><Suffix>JJM, nav</Suffix><ARTGs><ARTG>157549</ARTG></ARTGs><MinimumBenefit>499</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP546</BillingCode><Name>C-Stem AMT Femoral Stem</Name><Description>Stainless steel Ortron 90, highly polished, triple taper</Description><Size>Size 1-8 standard Offset, Size 1-8 High Offset, Long Size 2-3, Standard Offset; Long Size 2-3 High Offset; CDH and 1A to 3A sizes</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>312661</ARTG><ARTG>312663</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ678</BillingCode><Name>Versalok Bone Anchor System</Name><Description>Suture anchor</Description><Size>4.9-6.3mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>154329</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY380</BillingCode><Name>Occipito-Cervical Fusion System</Name><Description>Occipital Plate Medial / Lateral, Pure titanium</Description><Size>50mm / 60mm width, 3 or 4 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>293275</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP045</BillingCode><Name>Isola System (Stainless Steel)</Name><Description>Double Wire</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5364</SubGroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>11</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY752</BillingCode><Name>Zero-P</Name><Description>Anterior Cervical Interbody Fusion System with locking screws</Description><Size>5-12mm Height</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>231839</ARTG><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ977</BillingCode><Name>VARIPULSE Pulsed Field Ablation System</Name><Description>VARIPULSE variable-loop multielectrode bi-directional catheter</Description><Size>Variable loop diameter, 25- 35 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2966</GroupID><SubGroupID>7379</SubGroupID><Suffix>Johnson and Johnson</Suffix><ARTGs><ARTG>472885</ARTG></ARTGs><MinimumBenefit>6399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN359</BillingCode><Name>VA-LCP Periprosthetic Proximal Femur Plating System</Name><Description>VAL compression plate, proximal femur hook plates, stainless steel</Description><Size>≥16 holes, left &amp; right profile</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5257</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>1378</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY566</BillingCode><Name>Spinal Fixation System</Name><Description>Matrix Reduction Screw</Description><Size>4.0mm - 8.00mm; 20mm - 65mm Length</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ142</BillingCode><Name>AO/ASIF Wires</Name><Description>Smooth and reduction wires</Description><Size>1.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5364</SubGroupID><ARTGs><ARTG>133927</ARTG></ARTGs><MinimumBenefit>11</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN271</BillingCode><Name>HEALIX Anchor System</Name><Description>Self-Punching PEEK Anchor</Description><Size>4.9 mm, 5.5 mm , 6.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>215753</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY643</BillingCode><PriorBillingCodes><PriorBillingCode>SY107</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>DCS DHS plate</Description><Size>≥ 16 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5269</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1009</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY515</BillingCode><Name>Corail Revision Femoral Stem</Name><Description>Titanium, grit blast, full HA coating, fluted distally</Description><Size>Sizes 14 - 20, (length 200mm &amp; greater)</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1409</GroupID><SubGroupID>3957</SubGroupID><ARTGs><ARTG>307520</ARTG></ARTGs><MinimumBenefit>4826</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN114</BillingCode><Name>EXPEDIUM Spinal System</Name><Description>Pre-Shaped Rod</Description><Size>4.5 - 7.5mm Diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>128257</ARTG><ARTG>178040</ARTG><ARTG>205380</ARTG><ARTG>97391</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY824</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ025</PriorBillingCode></PriorBillingCodes><Name>OBL PorousiTi Patient Specific Implant - Mandible</Name><Description>Patient specific implant for mandible constructed of PourousiTi</Description><Size>The model is custom made so size will vary</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4353</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>276733</ARTG></ARTGs><MinimumBenefit>5119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-09-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY709</BillingCode><PriorBillingCodes><PriorBillingCode>SY684</PriorBillingCode><PriorBillingCode>SY376</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Femur Plates</Description><Size>7-15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5287</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN200</BillingCode><PriorBillingCodes><PriorBillingCode>MN040</PriorBillingCode></PriorBillingCodes><Name>Bristow-Latarjet Instability Shoulder Set - Screw</Name><Description>Cannulated locking screw</Description><Size>≥4.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>215753</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN113</BillingCode><Name>Mountaineer Spine System</Name><Description>OC Adjustable Rod</Description><Size>3.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>145010</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY637</BillingCode><PriorBillingCodes><PriorBillingCode>SY097</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>LC-LCP Plates</Description><Size>≥ 16 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5257</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY479</BillingCode><Name>Uniplate ACP System</Name><Description>Primary Screw</Description><Size>12-18mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>128257</ARTG><ARTG>97391</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY699</BillingCode><Name>SynPOR</Name><Description>Anatomical Porous Polyethylene with Titanium</Description><Size>08.mm - 1.5mm thick</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1587</GroupID><SubGroupID>4239</SubGroupID><ARTGs><ARTG>190454</ARTG></ARTGs><MinimumBenefit>775</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ801</BillingCode><Name>Skyline Cervical Plate System</Name><Description>Skyline anterior cervical plate. Various size plates. Titanium</Description><Size>56-105mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>194058</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY690</BillingCode><Name>MultiLoc Screw</Name><Description>Conical, Locking "Screw-in-Screw"</Description><Size>4.5mm; 20mm - 60mm Length</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>157068</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN333</BillingCode><Name>SOUNDSTAR</Name><Description>3D Ultrasound Diagnostic Catheter</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7375</SubGroupID><Suffix>JJM</Suffix><ARTGs><ARTG>221253</ARTG></ARTGs><MinimumBenefit>2200</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN356</BillingCode><Name>VA-LCP Periprosthetic Proximal Femur Plating System</Name><Description>VAL compression plate, proximal femur plates, stainless steel</Description><Size>≥16 holes, left &amp; right profile</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5257</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>1378</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN205</BillingCode><Name>Hammerlock</Name><Description>Intramedulary Nitinol Implant</Description><Size>Small to large</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>6561</SubGroupID><Suffix>Interphalangeal</Suffix><ARTGs><ARTG>95685</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY596</BillingCode><Name>AO/ASIF Screws</Name><Description>Cortex,Cancellous, Compression Screws</Description><Size>≥ 4.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ456</BillingCode><Name>PROCEED Surgical Mesh</Name><Description>PROCEED Surgical Mesh L1</Description><Size>12x12 inches</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>357230</ARTG></ARTGs><MinimumBenefit>1013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ654</BillingCode><Name>VA-LCP Periprosthetic Proximal Femur Plating System</Name><Description>Variable Angle Positioning Pin</Description><Size>5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5373</SubGroupID><ARTGs><ARTG>332243</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY725</BillingCode><PriorBillingCodes><PriorBillingCode>SY115</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Non-Locking Anatomical Pelvic Plates</Description><Size>≤6 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5283</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>679</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN185</BillingCode><Name>Ultrapro Advanced</Name><Description>Macroporous, Partially Absorbable Mesh</Description><Size>Size (cm) 30x30;,quantity/pack 1</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><ARTGs><ARTG>390526</ARTG></ARTGs><MinimumBenefit>271</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN304</BillingCode><Name>CARTO System Therapeutic Catheters, QDOT MICRO</Name><Description>Navigation, contact-force, irrigated, very high-power short-duration</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>JJM, nav, cf</Suffix><ARTGs><ARTG>345779</ARTG><ARTG>345780</ARTG></ARTGs><MinimumBenefit>3700</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN338</BillingCode><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Femur Plates Titanium</Description><Size>≥16 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5288</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1947</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ904</BillingCode><PriorBillingCodes><PriorBillingCode>JJ568</PriorBillingCode></PriorBillingCodes><Name>Echelon</Name><Description>Stapler</Description><Size>45 - 60mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>155639</ARTG></ARTGs><MinimumBenefit>357</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ470</BillingCode><Name>ULTRAPRO Mesh</Name><Description>ULTRAPRO Mesh L1</Description><Size>30x30cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><ARTGs><ARTG>390525</ARTG></ARTGs><MinimumBenefit>271</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ020</BillingCode><Name>Vicryl Mesh</Name><Description>1 sheet/box</Description><Size>Large - 30cm x 30cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><ARTGs><ARTG>143774</ARTG></ARTGs><MinimumBenefit>271</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY623</BillingCode><PriorBillingCodes><PriorBillingCode>SY059</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomical Pelvic Locking Plates</Description><Size>≤ 6 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5283</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>809</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN331</BillingCode><Name>HEALIX ADVANCE™ Anchor with DYNATAPE™ Suture</Name><Description>PEEK anchor with DYNATAPE suture and DYNACORD suture</Description><Size>4.5-6.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>215753</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY195</BillingCode><Name>Limb Preservation System</Name><Description>Tibial Replacement Component</Description><Size>X-small</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1381</GroupID><SubGroupID>3933</SubGroupID><ARTGs><ARTG>226874</ARTG></ARTGs><MinimumBenefit>7006</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN363</BillingCode><Name>Nitinol Implant System</Name><Description>Bone staples</Description><Size>Bridge size: 18-30</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><Suffix>MM</Suffix><ARTGs><ARTG>387415</ARTG></ARTGs><MinimumBenefit>507</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY377</BillingCode><Name>Orthopaedic Cable System</Name><Description>Cable with Crimp</Description><Size>1.0mm - 1.7mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5367</SubGroupID><ARTGs><ARTG>332243</ARTG><ARTG>332244</ARTG></ARTGs><MinimumBenefit>470</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN180</BillingCode><Name>PROLENE™ Soft Polypropylene Mesh</Name><Description>Non-absorbable Synthetic Surgical Mesh</Description><Size>Size (cm) 30.5x35.6, 25x25; quantity/pack 3  </Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5437</SubGroupID><ARTGs><ARTG>389989</ARTG></ARTGs><MinimumBenefit>247</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ176</BillingCode><Name>Prolene Mesh</Name><Description>Large polypropylene monofilament non absorbable mesh</Description><Size>30cm x 30cm, quantity/box 3</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5437</SubGroupID><ARTGs><ARTG>389990</ARTG></ARTGs><MinimumBenefit>247</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN206</BillingCode><PriorBillingCodes><PriorBillingCode>JJ892</PriorBillingCode><PriorBillingCode>JJ188</PriorBillingCode></PriorBillingCodes><Name>Endopath Cutter</Name><Description>Cutter and Stapler</Description><Size>45mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>155639</ARTG></ARTGs><MinimumBenefit>357</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ920</BillingCode><Name>Moss Miami Spinal System</Name><Description>Axial Connector</Description><Size>4/4mm to 5/7mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>145010</ARTG><ARTG>97391</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ912</BillingCode><Name>Intrafix Interference System</Name><Description>Non absorbable screw/sheath</Description><Size>7-12 mm x 23-30 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>215753</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ630</BillingCode><Name>CARTO System Diagnostic Catheters, OPTRELL</Name><Description>High Density Paddle Mapping Catheter</Description><Size>Catheter: 36 electrodes, 48 electrodes Shape: D-F curves, F-J curves</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>JJM, nav, defl, hd</Suffix><ARTGs><ARTG>444051</ARTG></ARTGs><MinimumBenefit>2200</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY756</BillingCode><PriorBillingCodes><PriorBillingCode>SY734</PriorBillingCode><PriorBillingCode>SY162</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Tibial Plates</Description><Size>≥16 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>1338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY799</BillingCode><PriorBillingCodes><PriorBillingCode>SY714</PriorBillingCode><PriorBillingCode>SY627</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>LCP, Condylar, Mini Fragment Plates - Various</Description><Size>7-15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ635</BillingCode><Name>Expedium Spine System – Dual Rod Connector</Name><Description>Dual Rod Connector</Description><Size>4.75, 5.5 &amp; 6.35mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY628</BillingCode><PriorBillingCodes><PriorBillingCode>SY059</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>LCP, Condylar , mini Fragment Plates - Various</Description><Size>7 - 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY768</BillingCode><PriorBillingCodes><PriorBillingCode>SY685</PriorBillingCode><PriorBillingCode>SY376</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Femur Plates</Description><Size>≥16 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5288</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1498</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN336</BillingCode><Name>AO/ASIF Plate</Name><Description>VA Locking Patella Plate Titanium</Description><Size>13 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ518</BillingCode><Name>AEGIS ALP</Name><Description>Curved anterior lumbar plate</Description><Size>4-25mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>148371</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ648</BillingCode><Name>Pre-cut rod - Expedium Anterior Spine System</Name><Description>Rod - Titanium</Description><Size>Diameter 5.5mm x lengths 45-150mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN301</BillingCode><Name>THERMOCOOL</Name><Description>Non-nav, irrigated</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>JJM, non-nav</Suffix><ARTGs><ARTG>149552</ARTG><ARTG>155131</ARTG><ARTG>178844</ARTG></ARTGs><MinimumBenefit>2000</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY515</BillingCode><Name>CMF Distraction System</Name><Description>Distractor System, Distractor Body</Description><Size>10-40mm distraction length</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4402</SubGroupID><ARTGs><ARTG>155806</ARTG><ARTG>183673</ARTG></ARTGs><MinimumBenefit>2145</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN258</BillingCode><Name>RIGIDLOOP Clip Cortical Button</Name><Description>Clip Cortical Button</Description><Size>Standard; XL</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>381183</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY818</BillingCode><PriorBillingCodes><PriorBillingCode>SY253</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Locking plates</Description><Size>7 to 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ982</BillingCode><Name>VA-LCP Periprosthetic Proximal Femur Plating System</Name><Description>Connecting screw for Greater Trochanter Ring Attachment Plate</Description><Size>5.9 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ644</BillingCode><Name>Extra long rod - Expendium Anterior Spine System</Name><Description>Rod - Titanium</Description><Size>5.5mm x 450mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN306</BillingCode><Name>AO/ASIF Plate</Name><Description>VA Locking Patella Plating System, Stainless Steel, Titanium</Description><Size>13 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP257</BillingCode><Name>SROM Noiles Knee System tibial insert</Name><Description>Tibial insert, rotating platform, hinged, with metal axis ring incorporated and polyethylene axis bearings</Description><Size>Sizes: XS, S, M; Thickness: 12mm - 31mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1371</GroupID><ARTGs><ARTG>219089</ARTG></ARTGs><MinimumBenefit>1090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY809</BillingCode><PriorBillingCodes><PriorBillingCode>SY718</PriorBillingCode><PriorBillingCode>SY625</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Locking Specialty Plate</Description><Size>≥16 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1397</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY401</BillingCode><Name>External Midface Distractor System</Name><Description>Head Frame Assembly, Carbon Fibre Rods</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1603</GroupID><SubGroupID>4396</SubGroupID><Suffix>Multivector</Suffix><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>7897</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY427</BillingCode><Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name><Description>Foot Rings, Foot Plates Short/Long, Footplate Support Kit - single unit with Left/Right Supports</Description><Size>Rings/Plates 100mm-210mm, Supports One Size - Left &amp; Right</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4506</SubGroupID><ARTGs><ARTG>155806</ARTG><ARTG>289708</ARTG></ARTGs><MinimumBenefit>1872</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP233</BillingCode><Name>Hardinge Cement Restrictor</Name><Description>Hardinge cement Restrictor (ea)</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1437</GroupID><ARTGs><ARTG>137671</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN240</BillingCode><Name>LASSO/ PENTARAY</Name><Description>Circular/High Density</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>JJM, nav, defl, hd</Suffix><ARTGs><ARTG>121901</ARTG><ARTG>122187</ARTG><ARTG>145997</ARTG><ARTG>203362</ARTG><ARTG>231772</ARTG><ARTG>278955</ARTG><ARTG>278956</ARTG></ARTGs><MinimumBenefit>2200</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY822</BillingCode><Name>AO/ASIF Plates</Name><Description>VA Locking Plates</Description><Size>7-12 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN215</BillingCode><PriorBillingCodes><PriorBillingCode>MN134</PriorBillingCode><PriorBillingCode>MN191</PriorBillingCode></PriorBillingCodes><Name>Echelon</Name><Description>Disposable powered stapling device</Description><Size>35 to 60mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix><ARTGs><ARTG>195695</ARTG></ARTGs><MinimumBenefit>447</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ163</BillingCode><Name>TRUESPAN Meniscal Repair System Absorbable</Name><Description>Preloaded PLGA backstops and ORTHOCORD suture</Description><Size>0, 12, 24 degree Needle</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>425610</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN302</BillingCode><Name>WEBSTER</Name><Description>Non-nav, deflectable, 10-pole CS diagnostic</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>JJM, deflect, 10-pole</Suffix><ARTGs><ARTG>145984</ARTG><ARTG>162172</ARTG><ARTG>219252</ARTG></ARTGs><MinimumBenefit>750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY735</BillingCode><PriorBillingCodes><PriorBillingCode>SY112</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Non-Locking Plates</Description><Size>7-15 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ963</BillingCode><Name>DePuy Hip Systems</Name><Description>Distal femoral centralisers</Description><Size>8 to 20mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1438</GroupID><ARTGs><ARTG>137671</ARTG><ARTG>97695</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN300</BillingCode><Name>WEBSTER</Name><Description>Non-nav, fixed HIS diagnostic</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>JJM, fix</Suffix><ARTGs><ARTG>145984</ARTG><ARTG>219254</ARTG></ARTGs><MinimumBenefit>225</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY446</BillingCode><Name>CerviFix Posterior Cervical System</Name><Description>Rod: Tapered</Description><Size>3.5/5.0 - 3.5/6.0 dual diameter, 300 -500mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ992</BillingCode><Name>VOLT Mini Fragment Plating System</Name><Description>Adaption Plate, Adaption Combi Plate, Compact Straight Plate, Condylar Plate, Straight Plate, Tine Plate, Triangle Plate, T Plate, Y Plate
</Description><Size>7 to 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY125</BillingCode><Name>AO/ASIF Intramedullary Nails</Name><Description>End caps - Femoral, Tibial, Nailing Systems - TFNA, TNA, FRNA, RFNA, ETN, PFNA</Description><Size>0 - 40mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>5363</SubGroupID><ARTGs><ARTG>182344</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN311</BillingCode><Name>CARTO System Diagnostic Catheters, DECANAV</Name><Description>Navigation, deflectable, 10-pole diagnostic</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>JJM, nav, defl, 10-pole</Suffix><ARTGs><ARTG>217338</ARTG></ARTGs><MinimumBenefit>799</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ754</BillingCode><Name>DePuy Femoral Cement Restrictor</Name><Description>UHMWPE cement restrictor</Description><Size>Size 0 to 10</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1437</GroupID><ARTGs><ARTG>138869</ARTG><ARTG>97695</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ771</BillingCode><Name>Expedium Spine System</Name><Description>Staple</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY110</BillingCode><Name>AO/ASIF Screws</Name><Description>Buttress Pin</Description><Size>Various lengths</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>4521</SubGroupID><ARTGs><ARTG>133927</ARTG><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN309</BillingCode><Name>AO/ASIF Plates</Name><Description>VA-LCP Clavicle Plates, Shaft</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY816</BillingCode><PriorBillingCodes><PriorBillingCode>SY761</PriorBillingCode><PriorBillingCode>SY687</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>LCP Lateral Distal Fibula</Description><Size>&gt;16 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5291</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY810</BillingCode><PriorBillingCodes><PriorBillingCode>SY718</PriorBillingCode><PriorBillingCode>SY625</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Locking Specialty Plate</Description><Size>≥16 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ557</BillingCode><Name>DELTA Xtend</Name><Description>Non Locking Canulated Metaglene Screw </Description><Size>4.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>218567</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN214</BillingCode><PriorBillingCodes><PriorBillingCode>DY541</PriorBillingCode><PriorBillingCode>DY542</PriorBillingCode></PriorBillingCodes><Name>EES Linear Cutter</Name><Description>Single use, reloadable stapler</Description><Size>55 to 75mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><ARTGs><ARTG>155639</ARTG></ARTGs><MinimumBenefit>69</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY757</BillingCode><PriorBillingCodes><PriorBillingCode>SY734</PriorBillingCode><PriorBillingCode>SY162</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Variable Locking Tibial Plates</Description><Size>≥16 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN307</BillingCode><Name>WEBSTER Fixed Catheter</Name><Description>Non-navigational, fixed curve diagnostic catheter</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>JJM, fix</Suffix><ARTGs><ARTG>145985</ARTG><ARTG>146266</ARTG></ARTGs><MinimumBenefit>225</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN268</BillingCode><Name>SYMPHONY OCT System</Name><Description>Straight, hinged, and pre-lordosed rods</Description><Size>3.5-4.0mm diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY577</BillingCode><PriorBillingCodes><PriorBillingCode>DY538</PriorBillingCode></PriorBillingCodes><Name>Healix Anchor System</Name><Description>Titanium anchor with suture</Description><Size>4.5 - 6.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>133430</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ967</BillingCode><Name>Delta Shoulder System</Name><Description>Glenosphere</Description><Size>38 to 42</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>217442</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN370</BillingCode><Name>CARTO System Diagnostic Catheters, OCTARAY</Name><Description>High Density Mapping Catheter</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>JJM, nav, defl, hd</Suffix><ARTGs><ARTG>357290</ARTG></ARTGs><MinimumBenefit>2200</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ983</BillingCode><Name>VOLT Mini Fragment Plating System</Name><Description>Hook Plate
</Description><Size>7 to 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY649</BillingCode><PriorBillingCodes><PriorBillingCode>SY173</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Screws</Name><Description>Self Drilling, self tapping, conical screws/pins/bar</Description><Size>≥ 3.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>4521</SubGroupID><ARTGs><ARTG>133927</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN335</BillingCode><Name>AO/ASIF Plates</Name><Description>Locking Specialty Plates, LCP Clavicle, MatrixRIB, Titanium</Description><Size>7-15 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY367</BillingCode><Name>PFC Sigma TC3 Knee System  Tibial Insert </Name><Description>Tibial Insert, totally constrained, mobile bearing, UHMWPE, with post</Description><Size>Size 1.5 to 5 thickness of 10mm to 30mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1371</GroupID><ARTGs><ARTG>270732</ARTG></ARTGs><MinimumBenefit>1090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN303</BillingCode><Name>WEBSTER</Name><Description>Non-nav, deflectable diagnostic, less than 10-pole</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7351</SubGroupID><Suffix>JJM, defl</Suffix><ARTGs><ARTG>145984</ARTG></ARTGs><MinimumBenefit>400</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN278</BillingCode><Name>Femoral Neck System, Bolt</Name><Description>Orthopaedic bone bolt</Description><Size>75 to 130 mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>4521</SubGroupID><ARTGs><ARTG>183900</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ978</BillingCode><Name>VA-LCP Periprosthetic Proximal Femur Plating System</Name><Description>Connecting Screw</Description><Size>One size</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>4521</SubGroupID><ARTGs><ARTG>157068</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN358</BillingCode><Name>Delta XTEND Revolution Lateralized Glenoid</Name><Description>Glenosphere</Description><Size>Standard and Eccentric diameter: 38 - 42 mm            Lateralization:  +0 mm  +2 mm      +4 mm       +6 mm      +8 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>217442</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY518</BillingCode><Name>Midface, CMF Distractor System</Name><Description>Distractor System , Body extensions</Description><Size>20-60 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4411</SubGroupID><ARTGs><ARTG>155806</ARTG><ARTG>213820</ARTG></ARTGs><MinimumBenefit>487</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN298</BillingCode><Name>AO/ASIF Plates</Name><Description>3.5 mm LCP Medial Anterior Clavicle Plate  </Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN337</BillingCode><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Femur Plates Titanium</Description><Size>7-15 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5287</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1710</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY785</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium Contourable Mesh, Cranial Neuro</Description><Size>0.5mm-0.8mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4210</SubGroupID><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>2072</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY653</BillingCode><PriorBillingCodes><PriorBillingCode>SY278</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Screws</Name><Description>Locking Screws</Description><Size>≥ 4.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY636</BillingCode><PriorBillingCodes><PriorBillingCode>SY097</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>LC-LCP Fragment Plates</Description><Size>7-15 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>508</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY641</BillingCode><PriorBillingCodes><PriorBillingCode>SY107</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>DCS DHS plate</Description><Size>≤ 6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5267</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>480</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP108</BillingCode><Name>CMW Antibiotic Bone Cement </Name><Description>CMW Bone Cement Various with Antibiotic</Description><Size>20, 40 grams</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4088</SubGroupID><ARTGs><ARTG>329863</ARTG><ARTG>329864</ARTG><ARTG>329865</ARTG></ARTGs><MinimumBenefit>161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ602</BillingCode><Name>ULTRAPRO Plug</Name><Description>Partially Absorbable Synthetic Surgical Mesh Device</Description><Size>Small- Onlay patch plug: 12cm x 7.5cm, 5cm rim diameter, 3cm anchor diameter; Medium- Onlay patch plug: 12cm x 7.5cm, 5cm rim diameter, 4cm anchor diameter; Large- Onlay patch plug: 12cm x 7.5cm, 5cm rim diameter, 5cm anchor diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1691</GroupID><ARTGs><ARTG>142608</ARTG></ARTGs><MinimumBenefit>238</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ981</BillingCode><Name>VA-LCP Periprosthetic Proximal Femur Plating System</Name><Description>VAL compression plate, proximal femur plates, stainless steel</Description><Size>14 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ933</BillingCode><Name>SmartSet</Name><Description>Bone cement with antibiotic</Description><Size>40g</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4088</SubGroupID><ARTGs><ARTG>329866</ARTG><ARTG>329867</ARTG></ARTGs><MinimumBenefit>161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ097</BillingCode><Name>Fastin Anchor System</Name><Description>Suture Anchor</Description><Size>5 - 6.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>133430</ARTG><ARTG>152661</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN296</BillingCode><Name>AO/ASIF Plates</Name><Description>VA-LCP Anterior Clavicle Plates</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY789</BillingCode><Name>AO/ASIF intramedullary Nails</Name><Description>Locking Screws/Bolts/Nuts, Titanium Alloy</Description><Size>4 mm (18-80 mm length), 5 mm (26-120 mm length)</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>133919</ARTG><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ979</BillingCode><Name>VA-LCP Periprosthetic Proximal Femur Plating System</Name><Description>Greater Trochanter Ring Attachment Plate, stainless steel</Description><Size>Small and large, 12 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1295</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY191</BillingCode><Name>Limb Preservation System</Name><Description>Total Femoral Segment Component (Male/Male)</Description><Size>55 mm Length</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3938</SubGroupID><ARTGs><ARTG>252532</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY798</BillingCode><Name>AO/ASIF Plates</Name><Description>Variable Angle Locking Specialty Plate</Description><Size>7-15 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY767</BillingCode><PriorBillingCodes><PriorBillingCode>SY741</PriorBillingCode><PriorBillingCode>SY283</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Locking Periarticular Ulna Plates</Description><Size>≥7 to ≤15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5280</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1126</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN369</BillingCode><Name>MILAGRO® Small Bioabsorbable Interference Screw</Name><Description>Biocryl Rapide Interference screw system</Description><Size>Diameter 5-8 mm; Length 12-30 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>122579</ARTG><ARTG>217763</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY299</BillingCode><Name>Spinal Fixation System – Screws</Name><Description>Vectra Screws - variable and fixed angle</Description><Size>Length 12-18 mm; Diameter 4.0, 4.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>293275</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY558</BillingCode><Name>Matrix</Name><Description>Micro Adaption, Strut Plates</Description><Size>18-20 hole</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4266</SubGroupID><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>283</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ276</BillingCode><Name>Healix  Anchor System</Name><Description>PEEK anchor with ORTHOCORD suture and needle</Description><Size>Anchor diameter: 5.5 mm; 6.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>205026</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY642</BillingCode><PriorBillingCodes><PriorBillingCode>SY107</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>DCS DHS plate</Description><Size>7- 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5268</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>386</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY786</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium Contourable mesh, Cranial Neuro</Description><Size>&lt;0.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4206</SubGroupID><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>1462</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY801</BillingCode><Name>SynFix Spinal System</Name><Description>Evolution, Interbody Fusion Spacer with locking screws</Description><Size>Size: Small; Small deep; Medium; Medium Deep; Large; Large Deep.   Height: 10.5 mm - 19 mm   Angle: 6°, 10°, 14°, 18°.  Locking screws: 20, 25, 30 mm; 4.0mm diameter;  Fine tip, Blunt tip</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>231840</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ270</BillingCode><Name>HEALIX ADVANCE Anchor System</Name><Description>Biocryl Rapide anchor with ORTHOCORD suture and needle</Description><Size>Anchor diameter: 5.5 mm; 6.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>205024</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY192</BillingCode><Name>Limb Preservation System</Name><Description>Segmental Component (Male/Female)</Description><Size>25 to 125mm Length</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3938</SubGroupID><ARTGs><ARTG>252532</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ512</BillingCode><Name>Skyline Cervical Plate System</Name><Description>Skyline anterior cervical screw, titanium</Description><Size>Self drilling 4.0 mm, 12-18mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY766</BillingCode><PriorBillingCodes><PriorBillingCode>SY741</PriorBillingCode><PriorBillingCode>SY283</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Variable Angle Locking Perarticular Ulna Plates</Description><Size>≥7 to ≤15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5280</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1198</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN246</BillingCode><Name>HEALIX Anchor System</Name><Description>PEEK anchor with Dynacord suture</Description><Size>4.5 - 6.5mm anchor diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>215753</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY514</BillingCode><Name>Corail Revision Femoral Stem</Name><Description>Titanium, grit blast, full HA coating, fluted distally</Description><Size>Size ≤13, (length less than 200mm)</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>173831</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN170</BillingCode><Name>Delta Xtend Reverse Shoulder System - Humeral Cup</Name><Description>High Mobility, Standard and Retentive polyethylene humeral cup</Description><Size>Diameter 38 – 42mm, +3 – +9 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>307889</ARTG><ARTG>307890</ARTG><ARTG>307891</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN256</BillingCode><Name>Corail Femoral Stem</Name><Description>Titanium, grit blast, full HA coating</Description><Size>Size 11 to 14; Offset Low, Standard; Angle (In degrees) 125-135</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>306751</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP943</BillingCode><Name>Corail Femoral Stem</Name><Description>Titanium, grit blast, full HA coating,</Description><Size>Size 8 to 18; Offset Standard, High; Angle (in degrees) 125-135</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>306751</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ269</BillingCode><Name>HEALIX ADVANCE Anchor System</Name><Description>Biocryl Rapide anchor with ORTHOCORD suture</Description><Size>Anchor diameter: 4.5 mm; 5.5 mm; 6.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>205025</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY428</BillingCode><Name>MAXFRAME, Distraction Osteogenesis &amp; External Fixation System</Name><Description>Hinge</Description><Size>One Size</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4513</SubGroupID><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>428</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN355</BillingCode><Name>TRUMATCH® CMF Orbital</Name><Description>Patient matched, orbital floor reconstruction implants, Titanium  </Description><Size>Custom sized</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4367</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>276733</ARTG></ARTGs><MinimumBenefit>4095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ903</BillingCode><PriorBillingCodes><PriorBillingCode>JJ568</PriorBillingCode></PriorBillingCodes><Name>Echelon</Name><Description>Disposable stapling device</Description><Size>45-60mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>155639</ARTG></ARTGs><MinimumBenefit>357</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN293</BillingCode><Name>SYMPHONY OCT System</Name><Description>Offset rods</Description><Size>3.5-5.5mm Diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY391</BillingCode><Name>Orbital Fixation System</Name><Description>Orbital Floor Plate</Description><Size>S, M, L</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4367</SubGroupID><ARTGs><ARTG>167547</ARTG></ARTGs><MinimumBenefit>868</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ513</BillingCode><Name>Skyline Cervical Plate System</Name><Description>Skyline anterior cervical screw. Titanium</Description><Size>Self tapping 3.8mm, 10-26mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>145290</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY698</BillingCode><Name>SynPOR</Name><Description>Anatomical Porous Polyethylene</Description><Size>0.8mm - 1.5mm thick</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4367</SubGroupID><ARTGs><ARTG>190454</ARTG></ARTGs><MinimumBenefit>868</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ078</BillingCode><Name>Rigidfix ACL Cross Pin</Name><Description>Polylactic acid pin</Description><Size>2.7 &amp; 3.3mm x 42mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5394</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>140561</ARTG></ARTGs><MinimumBenefit>462</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ980</BillingCode><Name>VA-LCP Periprosthetic Proximal Femur Plating System </Name><Description>Distal Spanning Attachment Plate</Description><Size>8 or 10 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY381</BillingCode><Name>Axon Occipital Fusion System</Name><Description>Occipital Screws 4.5mm / 5.0mm diameter
Titanium Alloy</Description><Size>Length 4 - 18mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN263</BillingCode><Name>SYMPHONY OCT System</Name><Description>Polyaxial screws</Description><Size>3.0-5.5mm diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN210</BillingCode><Name>AO/ASIF Plates</Name><Description>Variable Angle Locking  Plate</Description><Size>7-15 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ070</BillingCode><Name>GYNECARE TVT™: Device Tension Free Vaginal Tape / EXACT™ Continence System</Name><Description>Female stress urinary incontinence surgical mesh</Description><Size>Tape - 133 mm (W) x 190 mm (H); EXACT™ - Flat:460 mm (W) x 546 mm (H)</Size><SupplierCode>JJ</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1698</GroupID><SubGroupID>5315</SubGroupID><ARTGs><ARTG>351635</ARTG><ARTG>351636</ARTG></ARTGs><MinimumBenefit>822</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY609</BillingCode><PriorBillingCodes><PriorBillingCode>SY030</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>DHS Plates</Description><Size>2-6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5264</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>324</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN039</BillingCode><Name>GYNECARE TVT™ ABBREVO™ Continence System</Name><Description>Female stress urinary incontinence surgical mesh</Description><Size>459.91 mm X 545.9 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1698</GroupID><SubGroupID>5315</SubGroupID><ARTGs><ARTG>351638</ARTG></ARTGs><MinimumBenefit>822</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY564</BillingCode><Name>Spinal Fixation System</Name><Description>Matrix Rods</Description><Size>20mm - 500mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ573</BillingCode><Name>Echelon 3000 Stapler</Name><Description>Powered surgical stapling device</Description><Size>45-60mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix><ARTGs><ARTG>456246</ARTG></ARTGs><MinimumBenefit>447</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN238</BillingCode><Name>CARTO System Therapeutic Catheters, THERMOCOOL SMARTTOUCH</Name><Description>Navigation, contact-force, irrigated</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>JJM, nav, cf</Suffix><ARTGs><ARTG>184035</ARTG><ARTG>198574</ARTG><ARTG>233354</ARTG><ARTG>233355</ARTG></ARTGs><MinimumBenefit>3700</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ657</BillingCode><Name>Single Hole Staple - Expedium Anterior Spine System</Name><Description>Single Hole Staple - Titanium</Description><Size>One Size Only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY759</BillingCode><PriorBillingCodes><PriorBillingCode>SY733</PriorBillingCode><PriorBillingCode>SY162</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Variable Angle Locking Tibial Plates</Description><Size>7 to 15 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>1489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY783</BillingCode><Name>SynPOR</Name><Description>Porous Polyethylene Malar Implant</Description><Size>3-5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1595</GroupID><SubGroupID>4351</SubGroupID><ARTGs><ARTG>190454</ARTG></ARTGs><MinimumBenefit>1121</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ842</BillingCode><Name>Reclaim Revision Hip System - Long Distal Stem</Name><Description>Long distal stem</Description><Size>16-31mm x 240-290mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1412</GroupID><SubGroupID>3971</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>219278</ARTG></ARTGs><MinimumBenefit>3877</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ442</BillingCode><Name>GYNECARE TVT™ Obturator System</Name><Description>Female stress urinary incontinence surgical mesh</Description><Size>461.86 mm X 548.96 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1698</GroupID><SubGroupID>5315</SubGroupID><ARTGs><ARTG>351637</ARTG></ARTGs><MinimumBenefit>822</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ689</BillingCode><Name>MARATHON XLPE Cemented Cup</Name><Description>Cemented cross-linked polyethylene acetabular cup with flange</Description><Size>Inner diameter 22-36mm, outer diameter 38-53mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4007</SubGroupID><ARTGs><ARTG>210127</ARTG></ARTGs><MinimumBenefit>786</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY425</BillingCode><Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name><Description>Full Ring</Description><Size>90mm-270mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3405</SubGroupID><ARTGs><ARTG>289708</ARTG><ARTG>326183</ARTG></ARTGs><MinimumBenefit>685</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY758</BillingCode><PriorBillingCodes><PriorBillingCode>SY733</PriorBillingCode><PriorBillingCode>SY162</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Tibial Plates</Description><Size>7 to 15 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>1182</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ954</BillingCode><Name>Attune Knee System</Name><Description>Posterior Stabilised Cemented Femur</Description><Size>1-10 including narrow</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>220504</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ843</BillingCode><Name>reclaim Revision Hip System - Proximal Body</Name><Description>Proximal Body</Description><Size>20-28 x 75-105mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1412</GroupID><SubGroupID>3971</SubGroupID><Suffix>Body</Suffix><ARTGs><ARTG>219085</ARTG></ARTGs><MinimumBenefit>3239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN264</BillingCode><Name>SYMPHONY OCT System</Name><Description>Dual diameter rods</Description><Size>3.5-6.35mm diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY830</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ006</PriorBillingCode></PriorBillingCodes><Name>Surgical Guide for OBL PorousiTi® PSI System – Orbital Floor</Name><Description>Patient specific surgical guide for orbital floor implant</Description><Size>The model is custom made so size will vary</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>6023</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>276733</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>2584</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-09-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY130</BillingCode><Name>AO/ASIF Arthrodesis system</Name><Description>Arthrodesis</Description><Size>26 - 240mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3332</SubGroupID><ARTGs><ARTG>141931</ARTG></ARTGs><MinimumBenefit>3300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY578</BillingCode><Name>Expedium Spine System</Name><Description>Rods</Description><Size>Length 30–600 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY385</BillingCode><Name>Speciality Rods</Name><Description>Scoliosis / J/S Rod, Precontoured, Titanium / Stainless Steel</Description><Size>5mm, 6mm diameter. Left / Right 50mm - 500mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>133401</ARTG><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ643</BillingCode><Name>Dual Hole Staple - Expendium Anterior Spine System</Name><Description>Dual Hole Staple - Titanium</Description><Size>Small to Xlarge - 4 sizes</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN131</BillingCode><Name>Mentor Siltex Round Gel Implant</Name><Description>Textured, Round Cohesive Gel ll Implant</Description><Size>≥500cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><ARTGs><ARTG>110589</ARTG></ARTGs><MinimumBenefit>668</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN127</BillingCode><Name>Mentor Contour Profile Gel Implant</Name><Description>Textured, Contour Profile, Cohesive lll, Gel implant</Description><Size>≥500cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>130678</ARTG></ARTGs><MinimumBenefit>1170</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN125</BillingCode><Name>Mentor Siltex Round Gel Implant</Name><Description>Textured, Round Cohesive l Gel implant</Description><Size>≥500cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><ARTGs><ARTG>110588</ARTG><ARTG>326144</ARTG></ARTGs><MinimumBenefit>668</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY837</BillingCode><Name>Nitinol Implant System</Name><Description>Bone staples</Description><Size>Bridge size 9-30</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><Suffix>MM</Suffix><ARTGs><ARTG>95685</ARTG></ARTGs><MinimumBenefit>507</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN123</BillingCode><Name>Mentor Smooth MemoryGel™, MemoryGel™ XTRA Breast Implant</Name><Description>Round, smooth surface cohesive I silicone gel-filled breast implant. Available in two projections: MemoryGel™ and MemoryGel™ XTRA. MemoryGel™ has two options: Moderate Plus and High Profile. MemoryGel™ XTRA has two options: Moderate Plus XTRA and High Profile XTRA</Description><Size>≥500cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><ARTGs><ARTG>393728</ARTG><ARTG>393729</ARTG></ARTGs><MinimumBenefit>668</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY769</BillingCode><PriorBillingCodes><PriorBillingCode>SY685</PriorBillingCode><PriorBillingCode>SY376</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Femur Plates</Description><Size>≥16 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5288</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1947</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN172</BillingCode><Name>Surgiflo Haemostatic Matrix with Thrombin</Name><Description>Absorbable Porcine Gelatin Matrix pre-packaged in a syringe and with plasma derived Human Thrombin</Description><Size>8mls</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4214</SubGroupID><Suffix>Complete Biomaterial</Suffix><ARTGs><ARTG>226071</ARTG><ARTG>280654</ARTG></ARTGs><MinimumBenefit>640</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY577</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium contourable mesh; Orbital &amp; Pre-Shaped</Description><Size>&lt;0.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4203</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>707</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY815</BillingCode><PriorBillingCodes><PriorBillingCode>SY761</PriorBillingCode><PriorBillingCode>SY687</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>LCP Lateral Distal Fibula</Description><Size>7 to 15 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5290</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1238</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ636</BillingCode><Name>Spongostan Absorbable Haemostatic Gelatin Powder</Name><Description>1 g Porcine Absorbable Haemostatic Gelatin Powder</Description><Size>1 gram</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>144853</ARTG></ARTGs><MinimumBenefit>45</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN279</BillingCode><Name>Femoral Neck System, Antirotation Screw</Name><Description> Orthopaedic bone screw,  sterile  </Description><Size>75 to 130 mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3373</SubGroupID><ARTGs><ARTG>157068</ARTG></ARTGs><MinimumBenefit>155</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY702</BillingCode><Name>AO/ASIF Plates</Name><Description>DCS DHS Plate, Angled blade, Osteotomy</Description><Size>≤6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY054</BillingCode><Name>AO/ASIF Screws</Name><Description>DHS/DCS lag screw</Description><Size>50-145mm L</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3373</SubGroupID><ARTGs><ARTG>157068</ARTG><ARTG>183900</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>155</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY157</BillingCode><Name>MBT  Knee Systems tibial metaphyseal sleeve</Name><Description>Universal tibial metaphyseal sleeve, Porocoat, smaller size cemented or uncemented, larger sizes uncemented, titanium</Description><Size>29 - 61mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>237112</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ469</BillingCode><Name>ULTRAPRO Mesh</Name><Description>ULTRAPRO Mesh T1</Description><Size>15x30cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><ARTGs><ARTG>390525</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY156</BillingCode><Name>LCS, PFC and SROM  Knee Systems, femoral metaphyseal sleeve</Name><Description>Universal femoral metaphyseal sleeve, Porocoat, smaller size cemented, larger sizes uncemented, titanium</Description><Size>20 - 46mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>237112</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN259</BillingCode><Name>SYMPHONY OCT System</Name><Description>Rod to rod cross connectors</Description><Size>20-64mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN234</BillingCode><Name>Surgicel Powder</Name><Description>Absorbable Haemostatic Powder</Description><Size>3.0grams</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1552</GroupID><ARTGs><ARTG>296463</ARTG></ARTGs><MinimumBenefit>132</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY137</BillingCode><Name>Syncage</Name><Description>Interbody fusion cage</Description><Size>9-19mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>231840</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY569</BillingCode><Name>Spinal Fixation System</Name><Description>Matrix Snap-on Transconnector</Description><Size>21mm - 90mm Length</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN184</BillingCode><Name>Ultrapro Advanced</Name><Description>Macroporous, Partially Absorbable Mesh</Description><Size>Size (cm) 15x30;,quantity/pack 1</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><ARTGs><ARTG>390526</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ482</BillingCode><Name>LIGAMAX 5mm Endoscopic Clip Applier</Name><Description>LIGAMAX 5mm Endoscopic Clip Applier</Description><Size>Medium / Large</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Laparoscopic</Suffix><ARTGs><ARTG>122810</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ038</BillingCode><Name>Ligaclip* Multiple Clip Applier </Name><Description>Metal/plastic applier preloaded with titanium clips</Description><Size>3-12 mm; 30 clips per applier</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Open</Suffix><ARTGs><ARTG>122810</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY421</BillingCode><Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name><Description>Threaded Rod</Description><Size>60- 400mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4509</SubGroupID><Suffix>Standard</Suffix><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY151</BillingCode><Name>Universal Spine System (USS)</Name><Description>Sleeve</Description><Size>5 – 6 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1466</GroupID><ARTGs><ARTG>293275</ARTG></ARTGs><MinimumBenefit>179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ186</BillingCode><Name>Ligaclip Endoscopic Multiclip Applier</Name><Description>Metal/plastic stapler with titanium clips</Description><Size>10-12 mm shaft diameter, medium to large clip</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Laparoscopic</Suffix><ARTGs><ARTG>122810</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY224</BillingCode><Name>MAXFRAME, Distraction Osteogenesis &amp; External Fixation System</Name><Description>External fixator clamp components, angled piece</Description><Size>Oblique, 1.0 - 3.0mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4509</SubGroupID><Suffix>Small</Suffix><ARTGs><ARTG>289708</ARTG></ARTGs><MinimumBenefit>137</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN227</BillingCode><Name>Attune Knee System</Name><Description>Metaphyseal Sleeves, femoral and tibial</Description><Size>29 to 69mm plus cemented</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>298543</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN253</BillingCode><PriorBillingCodes><PriorBillingCode>LH585</PriorBillingCode></PriorBillingCodes><Name>CONDUIT EIT SMART PLIF</Name><Description>Cellular Titanium Cage with Graft Hole</Description><Size>8-16mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>319880</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ037</BillingCode><Name>Ligaclip* Multiple Clip Applier </Name><Description>Metal/plastic applier preloaded with titanium clips</Description><Size>3-12 mm; 20 clips per applier</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Open</Suffix><ARTGs><ARTG>122810</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN248</BillingCode><PriorBillingCodes><PriorBillingCode>LH571</PriorBillingCode><PriorBillingCode>EQ002</PriorBillingCode></PriorBillingCodes><Name>CONDUIT EIT PLIF Cage</Name><Description>Lumbar Cage with Titanium</Description><Size>7-16mm Heights</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>319880</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY196</BillingCode><Name>Orthopaedic External Fixator Systems</Name><Description>Rod/Bar</Description><Size>8 - 11 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4509</SubGroupID><Suffix>Standard</Suffix><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY578</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium contourable mesh; Mastoid, Cranial &amp; Pre-Shaped</Description><Size>0.2mm-0.49mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4204</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>725</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ706</BillingCode><Name>LCS, PFC &amp; SROM Knee System - Universal Fully Porous Femoral Metaphyseal Sleeve</Name><Description>Universal Fully Beaded (Porocoat) Femoral Metaphyseal Titanium Sleeve</Description><Size>31-46mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>237112</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY778</BillingCode><Name>ProPlan</Name><Description>Pateint specific Maxillofacial Surgical Guides, Implants</Description><Size>Custom</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>276733</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN260</BillingCode><Name>SYMPHONY OCT System</Name><Description>Cross connector head adapter</Description><Size>One size</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1466</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY193</BillingCode><Name>Orthopaedic External Fixator Systems</Name><Description>Rod / Bar</Description><Size>2.0mm - 15mm (diameter)</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4509</SubGroupID><Suffix>Small</Suffix><ARTGs><ARTG>155806</ARTG><ARTG>289708</ARTG><ARTG>326183</ARTG></ARTGs><MinimumBenefit>137</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ452</BillingCode><Name>PROCEED Surgical Mesh</Name><Description>PROCEED Surgical Mesh H1</Description><Size>8x10 inches oval</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>357230</ARTG></ARTGs><MinimumBenefit>966</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY829</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ010</PriorBillingCode></PriorBillingCodes><Name>Custom made plates (including Megaplates) – Surgical Guides</Name><Description>Surgical Guides for patient specific plates for the mandible and maxilla</Description><Size>The model is custom made so size will vary</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>276733</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-09-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP250</BillingCode><Name>Duraloc Dynamic Locking Ring</Name><Description>Titanium locking Ring for Duraloc insert, seperately listed, only for revision</Description><Size>Size 36-76mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1449</GroupID><ARTGs><ARTG>138292</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY472</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium mandible locking plate, complex shape</Description><Size>&gt;32 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4310</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>1414</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY398</BillingCode><Name>Axon Spinal System - Transconnector</Name><Description>Axon Transconnector</Description><Size>60mm - 75mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY650</BillingCode><PriorBillingCodes><PriorBillingCode>SY278</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Cortex Screws</Name><Description>Locking head screws</Description><Size>1.3-2.0mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY820</BillingCode><PriorBillingCodes><PriorBillingCode>SY621</PriorBillingCode><PriorBillingCode>SY059</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Pre-contoured Locking plate</Description><Size>≥16 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY667</BillingCode><PriorBillingCodes><PriorBillingCode>SY194</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic External Fixator Systems</Name><Description>Curved and straight rod, RL, MRI Carbon Fibre</Description><Size>8.0-11.0mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4509</SubGroupID><Suffix>Standard</Suffix><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY065</BillingCode><Name>AO/ASIF Screws</Name><Description>Cortex Screw</Description><Size>≤2.0mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>157068</ARTG><ARTG>157706</ARTG><ARTG>295238</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN339</BillingCode><Name>AO/ASIF Plates</Name><Description>VA Locking Patella Plating System Titanium</Description><Size>≥ 16 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ987</BillingCode><Name>VOLT Mini Fragment Plating System</Name><Description>Adaption Plate, Adaption Combi Plate, Straight plate</Description><Size>18 to 20 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY294</BillingCode><Name>Synmesh</Name><Description>Mesh, Round</Description><Size>6mm - 88mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1494</GroupID><ARTGs><ARTG>133398</ARTG></ARTGs><MinimumBenefit>2616</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN305</BillingCode><Name>AO/ASIF Plates</Name><Description>VA Locking Patella Plating System, Stainless Steel, Titanium</Description><Size>≥ 16 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY647</BillingCode><PriorBillingCodes><PriorBillingCode>SY322</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Screws</Name><Description>HCS Countersinkable Compression Screw</Description><Size>≤ 2.0mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>297881</ARTG></ARTGs><MinimumBenefit>346</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY293</BillingCode><Name>Synmesh</Name><Description>Mesh, Oblong</Description><Size>6mm - 88mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1494</GroupID><ARTGs><ARTG>133398</ARTG></ARTGs><MinimumBenefit>2616</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY111</BillingCode><Name>AO/ASIF Plates</Name><Description>Specially manufactured plate</Description><Size>1.0mm - 6.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ957</BillingCode><Name>Attune Knee System</Name><Description>Fixed Bearing Cemented Tibial Tray</Description><Size>1-10</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>220503</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN262</BillingCode><Name>AO/ASIF Screws</Name><Description>Quick Insertion Screws, Twist-Off</Description><Size>2.0mm x 11-18mm lengths</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY416</BillingCode><Name>AO/ASIF Intramedullary Nails ASLS</Name><Description>Intramedullary Angular Stable Locking System</Description><Size>4-6mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3330</SubGroupID><ARTGs><ARTG>168395</ARTG></ARTGs><MinimumBenefit>878</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN162</BillingCode><Name>PROLENE Soft Polypropylene Mesh</Name><Description>Nonabsorbable Synthetic Surgical Mesh</Description><Size>Size (cm) 15x15; quantity/pack 6</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5435</SubGroupID><ARTGs><ARTG>389989</ARTG></ARTGs><MinimumBenefit>77</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ780</BillingCode><Name>Sigma HP Unicompartmental Knee - Fixed bearing tibial tray</Name><Description>Unicompartmental tibial base plate, cemented, CoCr for fixed bearing insert</Description><Size>Size 1-6, LM/RL &amp; RM/LL</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>152</SubCategoryID><GroupID>1364</GroupID><ARTGs><ARTG>224039</ARTG></ARTGs><MinimumBenefit>1352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY287</BillingCode><Name>USS llio-Sacral Fixation system</Name><Description>Transconnecting bar</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ222</BillingCode><Name>Prolene Mesh - medium</Name><Description>Abdominal hernia surgical mesh, sterile device composed of non-absorbable undyed polypropylene fiber.</Description><Size>Size (cm) 15x15; quantity/pack 1 or 3</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5435</SubGroupID><ARTGs><ARTG>389990</ARTG></ARTGs><MinimumBenefit>77</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ804</BillingCode><Name>MBT Revision Thick Tibial Tray</Name><Description>Tibial Tray</Description><Size>Size range 2 to 5.  Tray Thickness of 25mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><Suffix>Revision, Extra Thick</Suffix><ARTGs><ARTG>230630</ARTG></ARTGs><MinimumBenefit>6497</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY196</BillingCode><Name>Limb Preservation System</Name><Description>Tibial Hinge Insert</Description><Size>XX-Small, X-Small, Small, Medium, Height (mm) 12 - 31</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1393</GroupID><ARTGs><ARTG>228695</ARTG><ARTG>314170</ARTG></ARTGs><MinimumBenefit>2454</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN270</BillingCode><Name>Attune Knee System</Name><Description>Revision mobile bearing tibial tray, also usable with specific hinged insert </Description><Size>2-10</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>298539</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ958</BillingCode><Name>Attune Knee System</Name><Description>Mobile Bearing Cemented Tibial Tray</Description><Size>1-10</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><ARTGs><ARTG>226651</ARTG></ARTGs><MinimumBenefit>2005</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ990</BillingCode><Name>VOLT Mini Fragment Plating System</Name><Description>Cortex screw</Description><Size>Diameter: 2.0 mm;</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>461930</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN254</BillingCode><PriorBillingCodes><PriorBillingCode>LH586</PriorBillingCode></PriorBillingCodes><Name>CONDUIT EIT SMART TLIF</Name><Description>Cellular Titanium Cage with Graft Hole</Description><Size>7-15mm heights</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>319880</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ010</BillingCode><Name>Interceed Absorbable Adhesion Barrier</Name><Description>Oxidized Regenerated Cellulose</Description><Size>7.6cm x 10.2cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5431</SubGroupID><ARTGs><ARTG>137081</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ986</BillingCode><Name>VOLT Mini Fragment Plating System</Name><Description>Locking screw</Description><Size>Diameter: 2.0 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>461930</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY689</BillingCode><Name>MultiLoc Humeral Nail</Name><Description>Humeral Nail</Description><Size>7.0mm-9.5mm D, 160mm-315mm L</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3330</SubGroupID><ARTGs><ARTG>161139</ARTG></ARTGs><MinimumBenefit>878</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY288</BillingCode><Name>USS llio-Sacral Fixation system</Name><Description>Sacral clamp</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ634</BillingCode><Name>LCS Complete Knee System - MBT Revision Thick Tray</Name><Description>Thick Tibial Tray</Description><Size>1 to 6</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><Suffix>Revision, Extra Thick</Suffix><ARTGs><ARTG>230630</ARTG></ARTGs><MinimumBenefit>6497</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY787</BillingCode><Name>AO/ASIF K-Wires</Name><Description>K-Wires</Description><Size>0.6 - 3.2mm, Length 70-500mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>153667</ARTG><ARTG>203637</ARTG><ARTG>203638</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY754</BillingCode><PriorBillingCodes><PriorBillingCode>SY674</PriorBillingCode><PriorBillingCode>SY166</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomical Locking Humerus Plate</Description><Size>≥ 16 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5275</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY794</BillingCode><Name>XRL</Name><Description>Expandable Vertebral Body</Description><Size>22 - 121mm Height</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>133398</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY700</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium Mandibular locking plate, complex shape</Description><Size>&gt;32 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4300</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>756</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY511</BillingCode><Name>AO/ASIF Plate</Name><Description>Rapid resorbable reconstruction plate</Description><Size>&gt;32 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4300</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>167547</ARTG></ARTGs><MinimumBenefit>378</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ687</BillingCode><Name>PDS Plates</Name><Description>Absorbable synthetic (poly-p-dioxanone) plate/foil</Description><Size>0.25 x 30 x 40mm
0.5 x 30 x 40mm
0.25 x 40 x 50mm
0.5 x 40 x 50mm
0.15 x 30 x 40mm
0.15 x 40 x 50mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4220</SubGroupID><ARTGs><ARTG>165926</ARTG></ARTGs><MinimumBenefit>502</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY598</BillingCode><Name>Spinal Fixation System</Name><Description>Pedicle: Screw, Head</Description><Size>4mm - 9mm D</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>133401</ARTG><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY834</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ001</PriorBillingCode></PriorBillingCodes><Name>OBL PorousiTi® Patient Specific Implant - Cranium</Name><Description>Patient specific implant for the cranium constructed of PourousTi®</Description><Size>The implant is custom made so the size is variable</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>4343</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>276733</ARTG></ARTGs><MinimumBenefit>9682</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-09-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN266</BillingCode><Name>SYMPHONY OCT System</Name><Description>Lateral offset and cable connectors</Description><Size>One size</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN353</BillingCode><Name>GLOBAL ICON Stemless Shoulder System</Name><Description>Humeral Head</Description><Size>40 to 56 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><ARTGs><ARTG>395271</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ970</BillingCode><Name>Global Shoulder System</Name><Description>CTA humeral head; Advantage, AP </Description><Size>Sizes 44-56mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><Suffix>EL</Suffix><ARTGs><ARTG>275072</ARTG><ARTG>275073</ARTG></ARTGs><MinimumBenefit>3941</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ141</BillingCode><Name>AO/ASIF Pins</Name><Description>Hybrid Pins – Spade Point, trocar point; Kirschner, smooth, compression and reduction wires.</Description><Size>1.6 - 3.2mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>203638</ARTG><ARTG>370937</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ554</BillingCode><Name>DELTA Xtend</Name><Description>Delta Xtend CTA Head Extended Lip</Description><Size>48 + 52; 21, 26mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><Suffix>EL</Suffix><ARTGs><ARTG>217443</ARTG></ARTGs><MinimumBenefit>3941</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ965</BillingCode><Name>Global Shoulder System</Name><Description>Humeral heads</Description><Size>40–56mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4067</SubGroupID><ARTGs><ARTG>222178</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ968</BillingCode><Name>Delta Shoulder System</Name><Description>Humeral Spacer</Description><Size>Diameter 36, 42; +9mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4081</SubGroupID><ARTGs><ARTG>310880</ARTG></ARTGs><MinimumBenefit>950</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ607</BillingCode><Name>Expedium Spine System</Name><Description>Lateral Connector, Open or Closed with/without rod</Description><Size>4.5-6.35mm x 20 -500mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>145290</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN225</BillingCode><Name>Attune Knee System</Name><Description>Femoral and tibial augments</Description><Size>Size 1 to 10</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>298543</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY071</BillingCode><Name>AO/ASIF Screws</Name><Description>Cannulated screws</Description><Size>&gt;2.7mm-4.49mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY600</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium mandible locking plate</Description><Size>16-32 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4307</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>1073</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ819</BillingCode><Name>DePuy Delta TS Heads</Name><Description>Delta ceramic femoral head with titanium sleeve</Description><Size>&gt;32mm, +1 to +12</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><Suffix>Sleeve</Suffix><ARTGs><ARTG>217543</ARTG></ARTGs><MinimumBenefit>2097</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP269</BillingCode><Name>SROM Noiles Knee System femoral augments </Name><Description>Distal femoral augmentation blocks</Description><Size>5 and 10 mm distal thickness, for use with femoral sizes XS/S/M</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>237112</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY780</BillingCode><Name>AO/ASIF Plate</Name><Description>Anatomical Preformed Complex Locking Reconstruction Plates</Description><Size>Small, Medium, Large</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4307</SubGroupID><Suffix>Complex, Locking</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>1287</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY464</BillingCode><Name>DePuy Delta Ceramic Femoral Head</Name><Description>Ceramic delta &gt;32mm</Description><Size>&gt;32mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>232415</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ767</BillingCode><Name>Expedium SFX Cross Connector System</Name><Description>Variable Length Cross Connector</Description><Size>26mm - 100 mm Length, 4.5, 5.5, 6.35mm rod diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY797</BillingCode><Name>AO/ASIF Screws</Name><Description>Philos Cannulated locking screw</Description><Size>3.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,LK</Suffix><ARTGs><ARTG>157068</ARTG></ARTGs><MinimumBenefit>183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY551</BillingCode><PriorBillingCodes><PriorBillingCode>SY344</PriorBillingCode></PriorBillingCodes><Name>Titanium Sternal Fixation System</Name><Description>Locking Plate - Straight , H or Star</Description><Size>Straight: 8-12holes, H: small &amp; large, Star: 12 holes, Xplate:10 holes, Double T;14 holes, Angled plate 12 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4312</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>1443</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY150</BillingCode><Name>Universal Spine System (USS)</Name><Description>Washers</Description><Size>Pointed, Flat, 4.2 - 7mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1482</GroupID><ARTGs><ARTG>133921</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ770</BillingCode><Name>Expedium Spine System</Name><Description>Washer</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1482</GroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ649</BillingCode><Name>Washer &amp; Single Hole Staple - Expedium Anterior Spine System</Name><Description>Washer and Single Hole Staple - Titanium</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1482</GroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN324</BillingCode><Name>SYMPHONY OCT System</Name><Description>Polyaxial cannulated screws</Description><Size>3.5-5.5mm diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY068</BillingCode><Name>AO/ASIF Screws</Name><Description>Cortex, Conical, Cancellous, Compression Screws</Description><Size>2.71mm-4.49mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ739</BillingCode><Name>Expedium Spine system</Name><Description>Open and closed Polyaxial connectors with or without end tab</Description><Size>5.5 x 6.35 x 20-200mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP255</BillingCode><Name>SROM Noiles Knee System bumper and hinge bearing replacements </Name><Description>Replacements for UHMWPE axis bearings and bumpers, for hinged prosthesis </Description><Size>Sizes xxsmall - medium.</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1397</GroupID><ARTGs><ARTG>131657</ARTG><ARTG>132151</ARTG><ARTG>97698</ARTG><ARTG>97981</ARTG><ARTG>98088</ARTG><ARTG>98092</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY701</BillingCode><Name>Spinal Fixation System</Name><Description>Cap</Description><Size>One size</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1467</GroupID><ARTGs><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>391</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY587</BillingCode><Name>MatrixMANDIBLE Mandible Plating System</Name><Description>Titanium mandible locking plates</Description><Size>4-7 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>298355</ARTG></ARTGs><MinimumBenefit>345</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY498</BillingCode><PriorBillingCodes><PriorBillingCode>SY324</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plate</Name><Description>Mandible plate</Description><Size>4-7 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><ARTGs><ARTG>298355</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY838</BillingCode><Name>Bengal System</Name><Description>Cervical Fusion Device</Description><Size>4 to 16mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>200396</ARTG><ARTG>98094</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ781</BillingCode><Name>Sigma HP Unicompartmental Knee - Unicondylar femoral component</Name><Description>Unicompartmental femoral component, cemented, CoCr</Description><Size>Size 1-6, LM/RL &amp; RM/LL</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>150</SubCategoryID><GroupID>1353</GroupID><ARTGs><ARTG>223246</ARTG></ARTGs><MinimumBenefit>2007</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN252</BillingCode><PriorBillingCodes><PriorBillingCode>LH584</PriorBillingCode></PriorBillingCodes><Name>CONDUIT EIT SMART ACDF</Name><Description>Cellular Titanium Cage with Graft Hole</Description><Size>4-12mm height</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>319880</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY644</BillingCode><PriorBillingCodes><PriorBillingCode>SY322</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Screws</Name><Description>HCS Countersinkable Compression Screw</Description><Size>2.71mm - 4.49mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY703</BillingCode><PriorBillingCodes><PriorBillingCode>SY016</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Specialty Locking Plate</Description><Size>≤ 6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY652</BillingCode><PriorBillingCodes><PriorBillingCode>SY278</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Screws</Name><Description>Locking Head Screws</Description><Size>&gt;2.7mm to &amp;lt; 4.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY445</BillingCode><Name>CerviFix Posterior Cervical System</Name><Description>Occipital Plate Rod</Description><Size>one size</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>171</SubCategoryID><GroupID>1481</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>1905</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY145</BillingCode><Name>Universal Spine System (USS)</Name><Description>Half Ring</Description><Size>SS, Standard, Self-Holding</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>173</SubCategoryID><GroupID>1484</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>306</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ640</BillingCode><Name>Surgiflo Haemostatic Matrix</Name><Description>Absorbable Porcine Gelatin Matrix Pre-packaged in a Syringe</Description><Size>6ml</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1555</GroupID><SubGroupID>4213</SubGroupID><ARTGs><ARTG>204900</ARTG></ARTGs><MinimumBenefit>343</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ574</BillingCode><Name>ECHELON ENDOPATH Staple Line Reinforcement</Name><Description>Staple line buttress with click and go applicator</Description><Size>60mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4319</SubGroupID><ARTGs><ARTG>448305</ARTG></ARTGs><MinimumBenefit>198</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN201</BillingCode><Name>AO/ASIF Plates</Name><Description>Anatomical  Radial Plates</Description><Size>≥ 16 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5278</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN276</BillingCode><Name>SYMPHONY OCT System</Name><Description>Multipoint System - Adapter Connector Plate and Screws</Description><Size>Standard, Angled, Left, Right, Long; 6-16mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1468</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>560</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN250</BillingCode><PriorBillingCodes><PriorBillingCode>LH575</PriorBillingCode><PriorBillingCode>EQ003</PriorBillingCode></PriorBillingCodes><Name>CONDUIT EIT Cervical Cage</Name><Description>Cervical Cage with Titanium</Description><Size>4-10mm heights</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>319880</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY696</BillingCode><Name>SynPOR</Name><Description>Porous Polyethylene</Description><Size>0.45mm - 3.0mm thick</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4254</SubGroupID><ARTGs><ARTG>190454</ARTG></ARTGs><MinimumBenefit>234</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY726</BillingCode><PriorBillingCodes><PriorBillingCode>SY115</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Non-Locking Fragment Plates</Description><Size>≤6 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY792</BillingCode><Name>ACIS</Name><Description>Anterior Cervical Interbody Spacer</Description><Size>Small to large</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>133400</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY795</BillingCode><Name>XRL</Name><Description>Endplate</Description><Size>-10˚/+15˚ Degrees</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4138</SubGroupID><ARTGs><ARTG>133398</ARTG></ARTGs><MinimumBenefit>928</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY448</BillingCode><Name>Spinal Fixation System</Name><Description>Locking Cap</Description><Size>One Size</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1468</GroupID><ARTGs><ARTG>133401</ARTG><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>560</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY723</BillingCode><PriorBillingCodes><PriorBillingCode>SY115</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>LCP Plates</Description><Size>less than or equal to 6 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ694</BillingCode><Name>Mountaineer OCT Spinal System -Lateral washer plate</Name><Description>Titanium Occipital - Lateral Washer Plate</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1468</GroupID><ARTGs><ARTG>194063</ARTG></ARTGs><MinimumBenefit>560</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN244</BillingCode><Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name><Description>ASSURE-STRUT™ Quick Adjust Strut - integral locking system, self-adjustment knob</Description><Size>XShort - Long</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4505</SubGroupID><Suffix>3D</Suffix><ARTGs><ARTG>326183</ARTG></ARTGs><MinimumBenefit>1235</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY793</BillingCode><Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name><Description>Circular frame struts</Description><Size>XX Short - Long</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4505</SubGroupID><Suffix>3D</Suffix><ARTGs><ARTG>326183</ARTG></ARTGs><MinimumBenefit>1235</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY250</BillingCode><Name>Universal Spine System</Name><Description>Low Profile Transconnector</Description><Size>18-83mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN297</BillingCode><Name>AO/ASIF Plates</Name><Description>3.5 mm LCP Medial Anterior Clavicle Plate  </Description><Size>≤ 6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY682</BillingCode><PriorBillingCodes><PriorBillingCode>SY376</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Non-Locking Femur Plates</Description><Size>≤ 6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5286</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>643</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY711</BillingCode><PriorBillingCodes><PriorBillingCode>SY683</PriorBillingCode><PriorBillingCode>SY376</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Femur Plates</Description><Size>≤6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5286</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ453</BillingCode><Name>PROCEED Surgical Mesh</Name><Description>PROCEED Surgical Mesh J1</Description><Size>8x12 inches</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>357230</ARTG></ARTGs><MinimumBenefit>966</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN357</BillingCode><Name>VA-LCP Periprosthetic Proximal Femur Plating System </Name><Description>VAL compression plate, locking attachment plate, stainless steel</Description><Size>≤6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY417</BillingCode><Name>Titanium Wire, Barb and Needle</Name><Description>Titanium wire surture and needle with titanium alloy barb fixation</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>139010</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN308</BillingCode><Name>AO/ASIF Plates</Name><Description>VA-LCP Clavicle Plates, Lateral &amp; Medial</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5271</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG><ARTG>286609</ARTG></ARTGs><MinimumBenefit>1320</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY828</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ026</PriorBillingCode></PriorBillingCodes><Name>OBL PorousiTi Patient Specific Implant - Maxilla</Name><Description>Patient specific implant for maxilla constructed of PorousiTi</Description><Size>The model is custom made so size will vary</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5782</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>276733</ARTG></ARTGs><MinimumBenefit>6337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-09-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ926</BillingCode><Name>MiniLok Anchor System</Name><Description>Suture Anchor</Description><Size>2.3mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>140353</ARTG><ARTG>154627</ARTG></ARTGs><MinimumBenefit>503</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN330</BillingCode><Name>VERSALOOP Anchor System</Name><Description>All-Suture Anchor</Description><Size>1.5 mm, 1.8 mm, 1.5 mm XL</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>379270</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY765</BillingCode><PriorBillingCodes><PriorBillingCode>SY742</PriorBillingCode><PriorBillingCode>SY283</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Ulna Plates</Description><Size>≥16 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5281</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1433</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY694</BillingCode><Name>Condylar Head Add-On System</Name><Description>Condylar Head - Left, Right</Description><Size>One Size</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4357</SubGroupID><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>1506</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ225</BillingCode><Name>RIGIDLOOP Cortical fixation system</Name><Description>Cortical Fixation System - Button and thread</Description><Size>Size: 15-60 mm Button: Standard, XL</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>215753</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ100</BillingCode><Name>Micro Quick Anchor </Name><Description>Titanium Suture Anchor</Description><Size>1.3 x 3.7mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>136374</ARTG><ARTG>161092</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY695</BillingCode><Name>Condylar Head Add-On System</Name><Description>Fixation Plate 0-6mm positions</Description><Size>2 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4357</SubGroupID><Suffix>Fixation Plate</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ091</BillingCode><Name>Mini Quick Anchor with Suture</Name><Description>Anchor with Suture</Description><Size>Anchor with Suture and Multiple size needles</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>136374</ARTG><ARTG>154626</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ224</BillingCode><Name>RIGIDLOOP BTB Adjustable Cortical system</Name><Description>Bone-Tendon-Bone Adjustable Cortical System - button and thread</Description><Size>Button: Standard, XL</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>381183</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ817</BillingCode><Name>Proceed™ Ventral Patch</Name><Description>3D, sterile, self expanding, partially absorbable, flexible laminate mesh for hernia or other abdominal, fascial defect repair that require addition of a reinforcing or bridging material to obtain the desired surgical result.</Description><Size>small (4.3cm x 4.3cm)</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>161186</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY285</BillingCode><Name>AO/ASIF Intramedullary nails</Name><Description>Helical blade</Description><Size>65-135mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3341</SubGroupID><Suffix>Com</Suffix><ARTGs><ARTG>227971</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ705</BillingCode><Name>LPS &amp; SROM Systems - Hinge Pin</Name><Description>Rotating Hinge Axle - uncemented, CoCr</Description><Size>xxsmall - medium</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1391</GroupID><ARTGs><ARTG>243112</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ565</BillingCode><Name>ULTRAPRO Mesh</Name><Description>Composite Mesh</Description><Size>7.6cm x 15cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><ARTGs><ARTG>390525</ARTG></ARTGs><MinimumBenefit>86</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY126</BillingCode><Name>AO/ASIF Intramedullary Nails</Name><Description>Spiral blade</Description><Size>Length 34 - 100mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3341</SubGroupID><ARTGs><ARTG>227971</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN218</BillingCode><PriorBillingCodes><PriorBillingCode>JJ190</PriorBillingCode><PriorBillingCode>JJ192</PriorBillingCode></PriorBillingCodes><Name>Endopath Linear Cutter</Name><Description>Staple reload</Description><Size>35-45mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>132171</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ816</BillingCode><Name>Proceed™ Ventral Patch</Name><Description>3D, sterile, self expanding, partially absorbable, flexible laminate mesh for hernia or other abdominal, fascial defect repair that require addition of a reinforcing or bridging material to obtain the desired surgical result.</Description><Size>medium (6.4cm x 6.4cm)</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>161186</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ585</BillingCode><Name>Ultrapro Hernia System</Name><Description>Ultrapro Hernia System. Mesh Made From Composite of Monocryl &amp; Prolene</Description><Size>Small to Large Oval</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Contoured</Suffix><ARTGs><ARTG>132509</ARTG></ARTGs><MinimumBenefit>271</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ448</BillingCode><Name>PROCEED Surgical Mesh</Name><Description>PROCEED Surgical Mesh N1</Description><Size>4x6 inches oval</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>357230</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN219</BillingCode><PriorBillingCodes><PriorBillingCode>JJ564</PriorBillingCode><PriorBillingCode>MN190</PriorBillingCode></PriorBillingCodes><Name>Echelon</Name><Description>Staple Reload</Description><Size>35 - 60mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>125609</ARTG><ARTG>234042</ARTG><ARTG>276233</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY803</BillingCode><Name>AO/ASIF Intramedullary Nails</Name><Description>Femoral Neck Screw Perforated</Description><Size>70mm - 130mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3341</SubGroupID><ARTGs><ARTG>227971</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY618</BillingCode><PriorBillingCodes><PriorBillingCode>SY059</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>LCP Clavicle - superior, anterior, hook</Description><Size>7-15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5271</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1260</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN220</BillingCode><PriorBillingCodes><PriorBillingCode>DY539</PriorBillingCode><PriorBillingCode>DY540</PriorBillingCode></PriorBillingCodes><Name>EES Linear Cutter</Name><Description>Staple reload</Description><Size>55-75mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>179411</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ587</BillingCode><Name>ECHELON CONTOUR GST Reload</Name><Description>ECHELON CONTOUR Gripping Surface Technology (GST) Reload, Blue and Green</Description><Size>Closed staple height, 1.5 - 2.0 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Curved</Suffix><ARTGs><ARTG>124512</ARTG></ARTGs><MinimumBenefit>226</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN327</BillingCode><Name>AO/ASIF Plates</Name><Description>VA-LCP Clavicle Plate 2.7 System - Short and Long Hook Plates</Description><Size>9, 11  holes; 9-, 12- and 15-mm hook depths</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5271</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1320</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN295</BillingCode><Name>AO/ASIF Plates</Name><Description>LCP Clavicle Hook Plates</Description><Size>≥7 to ≤ 15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5271</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1260</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY092</BillingCode><Name>AO/ASIF Washers</Name><Description>Washers</Description><Size>1.0mm - 18mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>133921</ARTG><ARTG>332026</ARTG><ARTG>332027</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN182</BillingCode><Name>Ultrapro Advanced</Name><Description>Macroporous, Partially Absorbable Mesh</Description><Size>Size (cm) 6x12, 7.6x15, 10x15;,quantity/pack 1 or 3</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><ARTGs><ARTG>390526</ARTG></ARTGs><MinimumBenefit>86</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY697</BillingCode><Name>SynPOR</Name><Description>Porous Polyethylene with Titanium</Description><Size>&gt; 08.mm thick</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1587</GroupID><SubGroupID>4241</SubGroupID><ARTGs><ARTG>190454</ARTG></ARTGs><MinimumBenefit>991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN213</BillingCode><PriorBillingCodes><PriorBillingCode>JJ046</PriorBillingCode><PriorBillingCode>JJ047</PriorBillingCode><PriorBillingCode>JJ048</PriorBillingCode><PriorBillingCode>JJ053</PriorBillingCode><PriorBillingCode>JJ054</PriorBillingCode><PriorBillingCode>JJ055</PriorBillingCode></PriorBillingCodes><Name>Proximate Linear Stapler</Name><Description>Staple reload</Description><Size>30 to 100mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>132170</ARTG><ARTG>133407</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ971</BillingCode><Name>DELTA Xtend</Name><Description>Monoblock Humeral Stem</Description><Size>8-14mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4057</SubGroupID><Suffix>Reverse</Suffix><ARTGs><ARTG>307886</ARTG></ARTGs><MinimumBenefit>6301</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ697</BillingCode><Name>Trochanteric Reattachment Device</Name><Description>Titanium alloy reattachment device with cables</Description><Size>Large</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5996</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1048</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ465</BillingCode><Name>ULTRAPRO Mesh</Name><Description>ULTRAPRO Mesh S3</Description><Size>6 x 11cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><ARTGs><ARTG>390525</ARTG></ARTGs><MinimumBenefit>86</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY508</BillingCode><Name>AO/ASIF Plate</Name><Description>Rapid resorbable reconstruction plate</Description><Size>8-15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4293</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>167547</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ467</BillingCode><Name>ULTRAPRO Mesh</Name><Description>ULTRAPRO Mesh N3</Description><Size>10 x 15cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><ARTGs><ARTG>390525</ARTG></ARTGs><MinimumBenefit>86</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ466</BillingCode><Name>ULTRAPRO Mesh</Name><Description>ULTRAPRO Mesh P3</Description><Size>10 x 12cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><ARTGs><ARTG>390525</ARTG></ARTGs><MinimumBenefit>86</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY610</BillingCode><PriorBillingCodes><PriorBillingCode>SY030</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>DHS Plates</Description><Size>8-14 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5265</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>360</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN362</BillingCode><Name>Bristow-Latarjet Instability Shoulder Set - Top Hat Screw Washer</Name><Description>Cannulated titanium top hat screw washer</Description><Size>One size</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>215753</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN354</BillingCode><Name>GLOBAL ICON Stemless Shoulder System</Name><Description>Anchor Plate</Description><Size>40 to 56 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4058</SubGroupID><ARTGs><ARTG>395270</ARTG></ARTGs><MinimumBenefit>3325</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY588</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium mandible locking plate, complex shape</Description><Size>8-15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4293</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY310</BillingCode><Name>Axon Spinal System</Name><Description>transverse bar</Description><Size>one size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ988</BillingCode><Name>VOLT Mini Fragment Plating System</Name><Description>Cortex screw</Description><Size>Diameter: 2.4 mm, 2.7 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>461930</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY688</BillingCode><Name>Sternal ZipFix System</Name><Description>Sternal Closure Tie with Needle</Description><Size>One Size</Size><SupplierCode>JJ</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>252</SubCategoryID><GroupID>1791</GroupID><ARTGs><ARTG>187295</ARTG></ARTGs><MinimumBenefit>119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN207</BillingCode><Name>Attune Knee System</Name><Description>Revision fixed bearing tibial tray.</Description><Size>1 to 10</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><Suffix>Revision</Suffix><ARTGs><ARTG>289595</ARTG></ARTGs><MinimumBenefit>2647</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ953</BillingCode><Name>Attune Knee System</Name><Description>Cruciate Retaining Cemented Femur</Description><Size>1-10 including narrow</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>220502</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY352</BillingCode><Name>A/ASIF Screw</Name><Description>Cortex, Cancellous, Compression Screws</Description><Size>2.01mm-2.7mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>157068</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY651</BillingCode><PriorBillingCodes><PriorBillingCode>SY278</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Cortex Screws</Name><Description>Locking Head Screws</Description><Size>2.4mm-2.7mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157068</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY263</BillingCode><Name>AO/ASIF Intramedullary Nails</Name><Description>Reconstruction Screw, Titanium Alloy</Description><Size>26-200mm Length</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3712</SubGroupID><ARTGs><ARTG>157068</ARTG><ARTG>227971</ARTG></ARTGs><MinimumBenefit>222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY547</BillingCode><Name>PolyMax Rapid-Resorbable Fixation System</Name><Description>Mesh Plate</Description><Size>0.5-0.8mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4228</SubGroupID><ARTGs><ARTG>167547</ARTG></ARTGs><MinimumBenefit>1865</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY257</BillingCode><Name>A/O/ASIF K-wires</Name><Description>Cerclage Wire - coils with and without eye</Description><Size>0.4-1.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5369</SubGroupID><ARTGs><ARTG>203638</ARTG><ARTG>332244</ARTG></ARTGs><MinimumBenefit>43</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ653</BillingCode><Name>Pinnacle Hip System - Gription Cup</Name><Description>Porous metal acetabular cup</Description><Size>38 - 80mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4014</SubGroupID><ARTGs><ARTG>222606</ARTG><ARTG>224199</ARTG><ARTG>224540</ARTG><ARTG>236733</ARTG></ARTGs><MinimumBenefit>2812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY646</BillingCode><PriorBillingCodes><PriorBillingCode>SY322</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Screws</Name><Description>HCS Countersinkable Compression Screw</Description><Size>2.01mm-2.7mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>157068</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN175</BillingCode><Name>SECURESTRAP Open</Name><Description>Open Absorbable Strap Fixation Device</Description><Size>Strap length 6.7mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4331</SubGroupID><Suffix>Absorbable</Suffix><ARTGs><ARTG>230205</ARTG></ARTGs><MinimumBenefit>473</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN294</BillingCode><Name>AO/ASIF Plates</Name><Description>LCP Clavicle Hook Plate</Description><Size>≤ 6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5270</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1208</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN323</BillingCode><Name>AO/ASIF Plates</Name><Description>VA-LCP Clavicle Plate 2.7 System - Button Hook Plate</Description><Size> ≤ 6 holes, 9-, 12- and 15-mm hook depth</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5270</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ989</BillingCode><Name>VOLT Mini Fragment Plating System</Name><Description>Locking screw</Description><Size>Diameter: 2.4 mm, 2.7 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>461930</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN115</BillingCode><Name>SECURESTRAP™</Name><Description>5mm Absorbable Strap Fixation Device</Description><Size>5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4331</SubGroupID><Suffix>Absorbable</Suffix><ARTGs><ARTG>193268</ARTG></ARTGs><MinimumBenefit>473</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ974</BillingCode><Name>Delta Shoulder System</Name><Description>Metaglene</Description><Size>Standard, Revision, +10 to +15mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4078</SubGroupID><ARTGs><ARTG>307920</ARTG></ARTGs><MinimumBenefit>1991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN299</BillingCode><Name>AO/ASIF Intramedullary Nails</Name><Description>Retrograde Femoral Nail</Description><Size>9-15mm / 160-420mm Length</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3328</SubGroupID><ARTGs><ARTG>161140</ARTG></ARTGs><MinimumBenefit>995</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY321</BillingCode><Name>AO/ASIF Screw</Name><Description>Cannulated screw</Description><Size>2.4mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>157068</ARTG></ARTGs><MinimumBenefit>156</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY188</BillingCode><Name>Limb Preservation System</Name><Description>Distal Femoral Replacement Component Left/Right</Description><Size>XX Small and X Small</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1380</GroupID><SubGroupID>3931</SubGroupID><ARTGs><ARTG>227901</ARTG></ARTGs><MinimumBenefit>6984</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ964</BillingCode><Name>Global Shoulder System</Name><Description>Glenoid component</Description><Size>40 to 56mm including XL</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>3701</SubGroupID><ARTGs><ARTG>224217</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY151</BillingCode><Name>MBT Knee System Revision Tibial base Plate </Name><Description>Tibial baseplate, cemented, CoCr, for rotating platform, also usable with specific hinged insert </Description><Size>Sizes: 1-6 ; Tray Thickness: 4.8</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>230630</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN222</BillingCode><Name>Attune Knee System</Name><Description>Cemented Revision Femur</Description><Size>Sizes 1 to 10</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Revision</Suffix><ARTGs><ARTG>298538</ARTG></ARTGs><MinimumBenefit>5450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN280</BillingCode><Name>SYMPHONY OCT System</Name><Description>Hook Left, Right, Centre</Description><Size>Short - Long</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ006</BillingCode><Name>Spongostan Absorbable Haemostat</Name><Description>Anal 20s (Box of 20)</Description><Size>80 x 30mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1553</GroupID><SubGroupID>4199</SubGroupID><Suffix>Anatomically Conforming</Suffix><ARTGs><ARTG>144852</ARTG></ARTGs><MinimumBenefit>15</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN322</BillingCode><Name>Attune Knee System</Name><Description>ATTUNE Revision LPS Insert</Description><Size>XX-Small, X-Small, Small and Medium; 12-32 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1393</GroupID><ARTGs><ARTG>375180</ARTG></ARTGs><MinimumBenefit>2454</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY439</BillingCode><Name>OPAL</Name><Description>Cage Spacer</Description><Size>7-17mm, 10 x 28-32mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>231840</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ007</BillingCode><Name>Spongostan Absorbable Haemostat</Name><Description>Anal 5s (Box of 5)</Description><Size>80 x 30mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1553</GroupID><SubGroupID>4199</SubGroupID><Suffix>Anatomically Conforming</Suffix><ARTGs><ARTG>144852</ARTG></ARTGs><MinimumBenefit>15</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ003</BillingCode><Name>Spongostan Absorbable Haemostat</Name><Description>Standard (Box of 20)</Description><Size>70 x 50 x 10mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1553</GroupID><SubGroupID>4199</SubGroupID><ARTGs><ARTG>144852</ARTG></ARTGs><MinimumBenefit>8</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP254</BillingCode><Name>SROM Noiles Knee System femoral component </Name><Description>Rotating Hinge, cemented, CoCr femoral component.</Description><Size>Sizes X-Small - Medium (M/L – 66-71mm; A/P – 58-66mm). </Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Hinged</Suffix><ARTGs><ARTG>219088</ARTG></ARTGs><MinimumBenefit>5887</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP150</BillingCode><Name>PFC Sigma Knee System TC3 femoral component</Name><Description>Femoral component, cemented, CoCr, totally constrained</Description><Size>Size 1.5-5</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Revision</Suffix><ARTGs><ARTG>227177</ARTG></ARTGs><MinimumBenefit>5450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY178</BillingCode><Name>Spinal Fixation System</Name><Description>Pedicle screw head</Description><Size>5 - 6mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY453</BillingCode><Name>Oracle</Name><Description>Lumbar Interbody Fusion Cage</Description><Size>40-55mm M/L x 22mm A/P, 9-17mm Height</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>231840</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ005</BillingCode><Name>Spongostan Absorbable Haemostat</Name><Description>Special (Box of 20)</Description><Size>70 x 50 x 1mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1553</GroupID><SubGroupID>4199</SubGroupID><ARTGs><ARTG>144852</ARTG></ARTGs><MinimumBenefit>8</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY514</BillingCode><Name>AO/ASIF Plate</Name><Description>Rapid resorbable reconstruction plate</Description><Size>&gt;32 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4284</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>167547</ARTG></ARTGs><MinimumBenefit>342</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ985</BillingCode><Name>VOLT Mini Fragment Plating System</Name><Description>Hook Plate</Description><Size>6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>993</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN236</BillingCode><Name>OPAL</Name><Description>Interbody Fusion Cage</Description><Size>10-15mm, 9-10 x 24mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>231840</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP188</BillingCode><Name>Self Centering Bipolar Head</Name><Description>Bipolar femoral head, CoCr with UHMWPE insert</Description><Size>39-65mm outer diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1424</GroupID><SubGroupID>4004</SubGroupID><ARTGs><ARTG>235557</ARTG></ARTGs><MinimumBenefit>654</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY561</BillingCode><Name>Matrix</Name><Description>Simple shaped plates</Description><Size>&lt; 4 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4261</SubGroupID><ARTGs><ARTG>298355</ARTG></ARTGs><MinimumBenefit>63</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ991</BillingCode><Name>VOLT Mini Fragment Plating System</Name><Description>Adaption Plate, Adaption Combi Plate, Compact Straight Plate, Straight Plate</Description><Size>4 to 6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN150</BillingCode><Name>Pinnacle Acetabular System</Name><Description>Gripton Ti-Foam Augments</Description><Size>Wedges 52-72, buttress 56-68 or shim 5 to 15 degrees</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1433</GroupID><Suffix>Bone Reconstruction</Suffix><ARTGs><ARTG>248252</ARTG></ARTGs><MinimumBenefit>2769</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ015</BillingCode><Name>Spongostan Absorbable Haemostat</Name><Description>Dental (Box of 24)</Description><Size>10 x 10 x 10mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1553</GroupID><SubGroupID>4199</SubGroupID><ARTGs><ARTG>144852</ARTG></ARTGs><MinimumBenefit>8</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY579</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium mesh</Description><Size>0.5mm-0.8mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4209</SubGroupID><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>1146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY832</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ011</PriorBillingCode></PriorBillingCodes><Name>SynpliciTi System - Plates</Name><Description>Patient specific plates for the mandible, maxilla and TMJ</Description><Size>The model is custom made so size will vary</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>276733</ARTG></ARTGs><MinimumBenefit>2952</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-09-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN243</BillingCode><Name>MatrixNEURO</Name><Description>Preformed mesh</Description><Size>0.6mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4209</SubGroupID><ARTGs><ARTG>313407</ARTG></ARTGs><MinimumBenefit>1146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY804</BillingCode><Name>AO/ASIF Plates</Name><Description>Locking Plates</Description><Size>≤6 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY064</BillingCode><Name>Elastic Nail</Name><Description>Elastic bone nail</Description><Size>1.5mm - 4.0mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5360</SubGroupID><ARTGs><ARTG>303666</ARTG><ARTG>303674</ARTG></ARTGs><MinimumBenefit>223</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY736</BillingCode><PriorBillingCodes><PriorBillingCode>SY112</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Non-Locking Plates</Description><Size>≤ 6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>417</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY808</BillingCode><PriorBillingCodes><PriorBillingCode>SY620</PriorBillingCode><PriorBillingCode>SY059</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Pre-contoured locking plates</Description><Size>≤6 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>993</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY821</BillingCode><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Hand Plates</Description><Size>2-6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ586</BillingCode><Name>ECHELON CONTOUR Curved Cutter Stapler</Name><Description>Curved cutter and stapler applier for gastrointestinal transection and resection</Description><Size>40 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Curved</Suffix><ARTGs><ARTG>118291</ARTG></ARTGs><MinimumBenefit>559</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ746</BillingCode><Name>ECHELON CIRCULAR Powered Stapler</Name><Description>Powered Endoscopic Circular Staplers</Description><Size>23-31mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Endoscopic, Circular</Suffix><ARTGs><ARTG>329572</ARTG></ARTGs><MinimumBenefit>671</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN217</BillingCode><PriorBillingCodes><PriorBillingCode>JJ043</PriorBillingCode><PriorBillingCode>JJ044</PriorBillingCode><PriorBillingCode>JJ045</PriorBillingCode><PriorBillingCode>JJ049</PriorBillingCode><PriorBillingCode>JJ051</PriorBillingCode><PriorBillingCode>JJ052</PriorBillingCode></PriorBillingCodes><Name>Proximate</Name><Description>Preloaded stapler</Description><Size>30-100mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><ARTGs><ARTG>132166</ARTG><ARTG>132167</ARTG><ARTG>133406</ARTG></ARTGs><MinimumBenefit>292</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY817</BillingCode><PriorBillingCodes><PriorBillingCode>SY253</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Locking plates</Description><Size>Less than 6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>993</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN216</BillingCode><PriorBillingCodes><PriorBillingCode>JJ041</PriorBillingCode><PriorBillingCode>JJ042</PriorBillingCode></PriorBillingCodes><Name>Ethicon Intraluminal Stapler</Name><Description>Proximate and  Endopath staplers</Description><Size>21 - 33mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Endoscopic, Circular</Suffix><ARTGs><ARTG>124512</ARTG><ARTG>99218</ARTG></ARTGs><MinimumBenefit>671</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ443</BillingCode><Name>Proximate Intraluminal Stapler PPH</Name><Description>Proximate Hemorrhoidal Circular Stapler PPH</Description><Size>One Size Only</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Circular</Suffix><ARTGs><ARTG>99218</ARTG></ARTGs><MinimumBenefit>648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ812</BillingCode><Name>CONTOUR Curved Cutter Stapler</Name><Description>Curved cutter and stapler for gastrointestinal transaction and resection.</Description><Size>40mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Curved</Suffix><ARTGs><ARTG>118291</ARTG></ARTGs><MinimumBenefit>559</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY737</BillingCode><PriorBillingCodes><PriorBillingCode>SY112</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Locking Plates</Description><Size>≤6 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ508</BillingCode><Name>PFC Sigma Knee System  tibial insert </Name><Description>Tibial insert, UHMWPE, moderately cross linked, with peg </Description><Size>Sizes  1 - 6.  8-30mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>97700</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ956</BillingCode><Name>Attune Knee System</Name><Description>Posterior Stabilised Insert</Description><Size>1-10</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>213019</ARTG><ARTG>220507</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN247</BillingCode><PriorBillingCodes><PriorBillingCode>LH570</PriorBillingCode></PriorBillingCodes><Name>CONDUIT EIT ALIF Cage</Name><Description>Lumbar Cage with Titanium</Description><Size>8-18mm heights</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>319880</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN130</BillingCode><Name>Mentor Siltex Round Gel Implant</Name><Description>Textured, Round Cohesive Gel ll Implant</Description><Size>&lt;500cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><ARTGs><ARTG>110589</ARTG></ARTGs><MinimumBenefit>595</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN124</BillingCode><Name>Mentor Siltex Round Gel Implant</Name><Description>Textured, Round Cohesive l Gel implant</Description><Size>less than 500cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><ARTGs><ARTG>110588</ARTG><ARTG>326144</ARTG></ARTGs><MinimumBenefit>595</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN126</BillingCode><Name>Mentor Contour Profile Gel Implant</Name><Description>Textured, Contour Profile, Cohesive lll, Gel implant</Description><Size>&lt;500cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>130678</ARTG></ARTGs><MinimumBenefit>975</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN122</BillingCode><Name>Mentor Smooth MemoryGel™, MemoryGel™ XTRA Breast Implant</Name><Description>Round, smooth surface cohesive I silicone gel-filled breast implant. Available in two projections: MemoryGel™ and MemoryGel™ XTRA. MemoryGel™ has two options: Moderate Plus and High Profile. MemoryGel™ XTRA has two options: Moderate Plus XTRA and High Profile XTRA</Description><Size>less than 500cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><ARTGs><ARTG>393728</ARTG><ARTG>393729</ARTG></ARTGs><MinimumBenefit>595</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY806</BillingCode><PriorBillingCodes><PriorBillingCode>SY620</PriorBillingCode><PriorBillingCode>SY059</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Pre-contoured locking plates</Description><Size>≤6 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY713</BillingCode><PriorBillingCodes><PriorBillingCode>SY627</PriorBillingCode><PriorBillingCode>SY059</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>LCP, Condylar, Mini Fragment Plates - Various</Description><Size>≤6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY405</BillingCode><Name>PFC Sigma Knee System RPF tibial insert</Name><Description>Tibial insert, UHMWPE, rotating platform for high flex with post </Description><Size>Size 1 - 6.  10-17.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>209459</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY057</BillingCode><Name>Cable system</Name><Description>Cerclage fix, cerclage eye, positioning pins, and spacers.</Description><Size>3.5mm - 5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5371</SubGroupID><ARTGs><ARTG>133923</ARTG><ARTG>332243</ARTG><ARTG>332244</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY563</BillingCode><Name>Matrix</Name><Description>Micor Orbital curved plate</Description><Size>12 hole</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4265</SubGroupID><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>193</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY568</BillingCode><Name>Spinal Fixation System</Name><Description>Pedicle and Lamina Hooks, straight, angled, off-set</Description><Size>Small, Medium, Large</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY012</BillingCode><Name>CerviFix Posterior Cervical System</Name><Description>Clamp</Description><Size>Left, Right, Medial, Lateral, Pedicle, Lamina</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY559</BillingCode><Name>AO/ASIF Screw</Name><Description>CMF screw; cortex, cortical, emergency, self-tapping,self-drilling</Description><Size>1.0mm-1.20mm various lengths</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4321</SubGroupID><ARTGs><ARTG>157706</ARTG><ARTG>297881</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY438</BillingCode><Name>Expedium Spine System</Name><Description>Hooks, Right, Left, Angled, Offset, Extended, Reduced Bladed</Description><Size>5 - 12 mm including narrow - wide</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN249</BillingCode><PriorBillingCodes><PriorBillingCode>LH573</PriorBillingCode><PriorBillingCode>EQ001</PriorBillingCode></PriorBillingCodes><Name>CONDUIT EIT TLIF Cage</Name><Description>Titanium Lumbar Cage</Description><Size>7-15mm heights</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>319880</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN251</BillingCode><PriorBillingCodes><PriorBillingCode>LH583</PriorBillingCode></PriorBillingCodes><Name>CONDUIT EIT SMART ALIF</Name><Description>Cellular Titanium Cage with Graft Hole</Description><Size>8-20mm height</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>319880</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY422</BillingCode><Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name><Description>Partial Circular Ring, Arch Plate</Description><Size>80-240mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3406</SubGroupID><ARTGs><ARTG>289708</ARTG><ARTG>326183</ARTG><ARTG>383992</ARTG></ARTGs><MinimumBenefit>978</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ761</BillingCode><Name>Moss Miami (Titanium)</Name><Description>Slotted Hook</Description><Size>One Size</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>145010</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY295</BillingCode><Name>Synmesh</Name><Description>End rings</Description><Size>round/oblong</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1495</GroupID><ARTGs><ARTG>133398</ARTG></ARTGs><MinimumBenefit>1030</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN326</BillingCode><Name>MatrixRIB Fixation System</Name><Description>Pre-Contoured Plates; Straight Plates; Universal Plates</Description><Size>7 - 30 holes </Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5938</SubGroupID><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1010</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN255</BillingCode><PriorBillingCodes><PriorBillingCode>LH599</PriorBillingCode></PriorBillingCodes><Name>CONDUIT EIT SMART LLIF system</Name><Description>Lateral Lumbar Interbody Cage</Description><Size>8-16mm Height</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>319880</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ240</BillingCode><Name>RIGIDLOOP T Adjustable Cortical system</Name><Description>Adjustable Cortical Fixation – adjustable button and thread system</Description><Size>Button size: Standard, XL</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>381183</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ239</BillingCode><Name>RIGIDLOOP Adjustable Cortical system</Name><Description>Adjustable Cortical Fixation – adjustable button and thread system</Description><Size>Size: Standard, Large, XL</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>215753</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY457</BillingCode><Name>PFC Sigma Knee System  tibial insert </Name><Description>Tibial insert, posterior stabilised, rotating platform UHMWPE</Description><Size>Sizes  2 - 6.  10-20mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>223651</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ421</BillingCode><Name>MicroFix Anchor with Suture</Name><Description>Anchor with suture</Description><Size>Anchor with Suture and Multiple size needles</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>140549</ARTG><ARTG>161091</ARTG></ARTGs><MinimumBenefit>503</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY418</BillingCode><Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name><Description>Bolt-connecting, clamp, eye, wire offset, wire slotted, MRI safe.</Description><Size>One size</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4511</SubGroupID><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>933</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN344</BillingCode><Name>FIBERGRAFT</Name><Description>Bioactive Glass (BG) Bone Graft Morsels</Description><Size>2cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>387006</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN231</BillingCode><PriorBillingCodes><PriorBillingCode>SY451</PriorBillingCode><PriorBillingCode>SY574</PriorBillingCode><PriorBillingCode>SY576</PriorBillingCode></PriorBillingCodes><Name>Chronos</Name><Description>Bone Graft Substitute</Description><Size>5 - 10cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>CDS</Suffix><ARTGs><ARTG>153247</ARTG></ARTGs><MinimumBenefit>1449</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN342</BillingCode><Name>FIBERGRAFT</Name><Description>Bioactive Glass Bone Graft - BG Putty and BG Putty GPS</Description><Size>6cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>387410</ARTG><ARTG>387411</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ975</BillingCode><Name>Attune Knee System</Name><Description>ATTUNE Cementless Posterior Stabilised Femoral Component</Description><Size>Left/Right Sizes 1-10 Standard Shape, Left/Right Sizes 3-6 Narrow Shape</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1351</GroupID><SubGroupID>3915</SubGroupID><ARTGs><ARTG>315525</ARTG></ARTGs><MinimumBenefit>3314</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY152</BillingCode><Name>Universal Spine System (USS)</Name><Description>Set Screw</Description><Size>Standard</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY200</BillingCode><Name>Orthopaedic External Fixator Systems</Name><Description>External fixator clamps, transverse clamp</Description><Size>1.25 - 6.0mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4511</SubGroupID><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>933</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY440</BillingCode><Name>Synapse</Name><Description>Locking Screw</Description><Size>One size</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>293275</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ942</BillingCode><Name>Moss Miami Spinal System</Name><Description>Inner and outer screw, nuts and set screws</Description><Size>3 - 6.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>128257</ARTG><ARTG>145010</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN345</BillingCode><Name>FIBERGRAFT</Name><Description>Bioactive Glass (BG) Bone Graft Morsels</Description><Size>6cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>387006</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY678</BillingCode><PriorBillingCodes><PriorBillingCode>SY280</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomical Variable Angle Locking Radial Plates</Description><Size>7-15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN119</BillingCode><Name>Mentor Smooth Round Saline Implant</Name><Description>Smooth Round implant with Anterior Diaphragm Valve</Description><Size>≥500cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1609</GroupID><SubGroupID>4426</SubGroupID><Suffix>Valved</Suffix><ARTGs><ARTG>119646</ARTG></ARTGs><MinimumBenefit>624</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ524</BillingCode><Name>VIPER Spine System</Name><Description>Viper Single Innie Set Screw</Description><Size>One size</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>SYN14</BillingCode><Name>Skin 121 to 180cm² - acellular dermal matrix allograft from human origin</Name><SupplierCode>JAA</SupplierCode><CategoryID>28</CategoryID><ARTGs><ARTG>211608</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>9900</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP124</BillingCode><Name>DePuy Femoral Head</Name><Description>CoCr Femoral Head Various Tapers &amp; Neck Lengths</Description><Size>22-32 mm </Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>211855</ARTG><ARTG>222991</ARTG><ARTG>224613</ARTG><ARTG>224755</ARTG><ARTG>231693</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN340</BillingCode><Name>GRYPHON BR Instability Anchor</Name><Description>Suture Anchor</Description><Size>3.0 x 10.7mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>388083</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ615</BillingCode><Name>Global AP Shoulder</Name><Description>Fixed 135 Degree Taper Assembly</Description><Size>135 Degree Angle</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>4083</SubGroupID><ARTGs><ARTG>224368</ARTG></ARTGs><MinimumBenefit>991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ944</BillingCode><Name>Expedium Spine System</Name><Description>Polyaxial screws</Description><Size>4.35 - 12mm diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN273</BillingCode><Name>Attune Knee System</Name><Description>Cruciate Retaining Cementless Component</Description><Size>Sizes 1-10 including narrow</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1351</GroupID><SubGroupID>3914</SubGroupID><ARTGs><ARTG>290326</ARTG></ARTGs><MinimumBenefit>3226</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY289</BillingCode><Name>USS llio-Sacral Fixation system</Name><Description>Polyaxial screw</Description><Size>20mm to 140mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY796</BillingCode><Name>Vertebral Body Replacement System</Name><Description>Endplate Screw</Description><Size>One Size</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>133398</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY429</BillingCode><Name>Traumacem</Name><Description>Cement with mixing and delivery system</Description><Size>10-20gm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4089</SubGroupID><ARTGs><ARTG>177835</ARTG></ARTGs><MinimumBenefit>437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ736</BillingCode><Name>Confidence Spinal cement system</Name><Description>Spinal Bone Cement PMMA and Percutaneous Administration Kit</Description><Size>11cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4089</SubGroupID><ARTGs><ARTG>211565</ARTG></ARTGs><MinimumBenefit>437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY286</BillingCode><Name>USS llio-Sacral Fixation system</Name><Description>Locking Screw</Description><Size>one size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>SYN06</BillingCode><Name>Skin 181 to 300cm² - acellular dermal matrix allograft from human origin</Name><SupplierCode>JAA</SupplierCode><CategoryID>28</CategoryID><ARTGs><ARTG>211608</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>14000</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY664</BillingCode><PriorBillingCodes><PriorBillingCode>SY202</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic External Fixator Systems</Name><Description>Mini Frame Holding Clamp</Description><Size>3.0-4.0mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3402</SubGroupID><Suffix>Mini</Suffix><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>312</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>SYN03</BillingCode><Name>Skin &lt; 25cm² - acellular dermal matrix allograft from human origin</Name><SupplierCode>JAA</SupplierCode><CategoryID>28</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>2200</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY384</BillingCode><Name>Speciality Rods</Name><Description>Unit Rod, Titanium / Stainless Steel</Description><Size>5mm, 6mm diameter
250mm - 500mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1480</GroupID><SubGroupID>4132</SubGroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>1352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>SYN04</BillingCode><Name>Skin 26 to 60cm² - acellular dermal matrix allograft from human origin</Name><SupplierCode>JAA</SupplierCode><CategoryID>28</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3500</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY186</BillingCode><Name>Posterior Cervical System</Name><Description>Nut</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>133919</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN372</BillingCode><Name>GRYPHON PEEK Instability Anchor</Name><Description>PEEK Anchor with PERMACORD suture</Description><Size>3.0 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>133430</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ656</BillingCode><Name>SI Set Screw - Expedium Anterior Spine System</Name><Description>Single Innie Set Screw - Titanium</Description><Size>one size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY116</BillingCode><Name>AO/ASIF Plates</Name><Description>LCP Large Fragement Plates</Description><Size>≤ 6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>325</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY107</BillingCode><Name>Carbon Fibre Cages</Name><Description>Stackable Cage Titanium Interface Screw Nuts</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>128255</ARTG><ARTG>128257</ARTG><ARTG>98094</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN267</BillingCode><Name>SYMPHONY OCT System</Name><Description>Set screws and locking nut</Description><Size>One size</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ095</BillingCode><Name>Mitek Super Quick Anchor Plus </Name><Description>Titanium  Anchor, with various sutures</Description><Size>2.8 x 11.4mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>140796</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>SYN07</BillingCode><Name>Skin &gt; 300cm² - acellular dermal matrix allograft from human origin</Name><SupplierCode>JAA</SupplierCode><CategoryID>28</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>27000</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>SYN05</BillingCode><Name>Skin 61 to 120cm² - acellular dermal matrix allograft from human origin</Name><SupplierCode>JAA</SupplierCode><CategoryID>28</CategoryID><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>5700</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN118</BillingCode><Name>Mentor Smooth Round Saline Implant</Name><Description>Smooth Round implant with Anterior Diaphragm Valve</Description><Size>&lt;500cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1609</GroupID><SubGroupID>4423</SubGroupID><Suffix>Valved</Suffix><ARTGs><ARTG>119646</ARTG></ARTGs><MinimumBenefit>697</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ161</BillingCode><Name>Global Unite Revision Stem</Name><Description>Long Humeral stem</Description><Size>6-12mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4063</SubGroupID><ARTGs><ARTG>220390</ARTG></ARTGs><MinimumBenefit>3755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ162</BillingCode><Name>Global Unite Standard Stem</Name><Description>Standard humeral stem</Description><Size>6-16mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4063</SubGroupID><ARTGs><ARTG>220179</ARTG></ARTGs><MinimumBenefit>3755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN198</BillingCode><PriorBillingCodes><PriorBillingCode>JJ835</PriorBillingCode><PriorBillingCode>JJ522</PriorBillingCode></PriorBillingCodes><Name>Viper Spine System</Name><Description>Polyaxial, uniplanar cannulated screws</Description><Size>4.35 to 10mm diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ468</BillingCode><Name>ULTRAPRO Mesh</Name><Description>ULTRAPRO Mesh M3</Description><Size>15 x 15cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><ARTGs><ARTG>390525</ARTG></ARTGs><MinimumBenefit>137</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY497</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium mandible plate</Description><Size>8-15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4303</SubGroupID><Suffix>Compression</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>761</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN334</BillingCode><Name>VERSALOOP Anchor System</Name><Description>All-Suture Anchor</Description><Size>2.5 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>379270</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY591</BillingCode><Name>External Midface Distractor System</Name><Description>Fixation; Set - Screws</Description><Size>1.25-3.24mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><Suffix>Distractor</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>83</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN183</BillingCode><Name>Ultrapro Advanced</Name><Description>Macroporous, Partially Absorbable Mesh</Description><Size>Size (cm) 15x15;,quantity/pack 1 or 3</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><ARTGs><ARTG>390526</ARTG></ARTGs><MinimumBenefit>137</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ173</BillingCode><Name>VICRYL Mesh</Name><Description>Polyglactin 910 - synthetic absorbable mesh.</Description><Size>15cm x 15cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><ARTGs><ARTG>143774</ARTG></ARTGs><MinimumBenefit>137</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY382</BillingCode><Name>Occipito-Cervical Fusion System</Name><Description>Occipital Clamp Titanium Alloy</Description><Size>1 or 2 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1471</GroupID><ARTGs><ARTG>293275</ARTG></ARTGs><MinimumBenefit>349</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ450</BillingCode><Name>PROCEED Surgical Mesh</Name><Description>PROCEED Surgical Mesh M1</Description><Size>6x6 inches</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>357230</ARTG></ARTGs><MinimumBenefit>721</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ451</BillingCode><Name>PROCEED Surgical Mesh</Name><Description>PROCEED Surgical Mesh G1</Description><Size>6x8 inches oval</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>357230</ARTG></ARTGs><MinimumBenefit>721</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY174</BillingCode><Name>Universal Spine System (USS)</Name><Description>Nut</Description><Size>Standard</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>293275</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY791</BillingCode><PriorBillingCodes><PriorBillingCode>SY262</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Intramedullary Nails</Name><Description>Femoral Nail</Description><Size>9-15mm D ≥ 220mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3327</SubGroupID><ARTGs><ARTG>161140</ARTG></ARTGs><MinimumBenefit>1188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN041</BillingCode><Name>Endoscopic Applicator</Name><Description>Rigid applicator</Description><Size>34cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Rigid Delivery System</Suffix><ARTGs><ARTG>174430</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY383</BillingCode><Name>Synmesh</Name><Description>Locking Screw, Low Profile, For Synmesh End Rings</Description><Size>Small, Large</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ928</BillingCode><Name>Bioknotless Anchor System</Name><Description>Suture Anchor</Description><Size>3.9mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>154629</ARTG><ARTG>154630</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ916</BillingCode><Name>Mountaineer Spinal System</Name><Description>Inner screws and out nuts</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>128255</ARTG><ARTG>128257</ARTG><ARTG>145290</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ820</BillingCode><Name>Viper Spinal System - monoaxial screw</Name><Description>Monoaxial screw</Description><Size>30 - 80mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>145290</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY708</BillingCode><PriorBillingCodes><PriorBillingCode>SY567</PriorBillingCode></PriorBillingCodes><Name>Spinal Fixation System</Name><Description>Matrix Preassembled Monoaxial Pedicle Screw, Cannulated</Description><Size>5.00mm - 9.00mm Diameter; 20mm - 65mm Length</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ267</BillingCode><Name>GRYPHON BR PROKNOT</Name><Description>Biocryl Rapide anchor with Permacord suture
</Description><Size>3.00</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>257872</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY597</BillingCode><Name>Universal Spinal system – USS &amp; USS II</Name><Description>Pedicle and Vertebral Screws</Description><Size>25mm - 110mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>133401</ARTG><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ976</BillingCode><Name>SURGICEL Endoscopic Applicator</Name><Description>2-in-1 endoscopic applicator for delivery of SURGICEL Powder.</Description><Size>38 cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4250</SubGroupID><Suffix>Rigid Delivery System</Suffix><ARTGs><ARTG>312494</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN171</BillingCode><Name>Lupine Anchor System</Name><Description>Suture Anchor</Description><Size>3.9mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>154628</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY499</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium mandible plate</Description><Size>4-7 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4301</SubGroupID><Suffix>Compression</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN176</BillingCode><Name>Mentor Siltex Contour Profile Breast Tissue Expander</Name><Description>Siltex Contour Profile Breast Tissue Expander (CPX4)</Description><Size>250-850cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1606</GroupID><SubGroupID>4414</SubGroupID><ARTGs><ARTG>226977</ARTG></ARTGs><MinimumBenefit>653</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN229</BillingCode><Name>Dermabond</Name><Description>Topical Skin Adhesive</Description><Size>Per 0.36 - 0.75ml vial</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>171563</ARTG></ARTGs><MinimumBenefit>23</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY210</BillingCode><Name>Pinnacle Acetabular Cross Linked UHMWPE Insert</Name><Description>UHMWPE, highly cross linked insert</Description><Size>22-48mm ID</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>225791</ARTG><ARTG>232174</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN348</BillingCode><Name>BI-MENTUM Dual Mobility System</Name><Description>Polyethylene liner </Description><Size>22.2mm heads: 41 - 69mm diameter in 2mm increments,   28mm heads: 47 - 69mm diameter in 2mm increments</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>363212</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ035</BillingCode><Name>Ligaclip* Ligating Clips - titanium</Name><Description>Titanium clips contained in a plastic cartridge</Description><Size>3-5 mm; 20 clips per cartridge</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>122810</ARTG></ARTGs><MinimumBenefit>30</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN230</BillingCode><Name>Dermabond Prineo</Name><Description>Topical skin adhesive with self-adhering mesh</Description><Size>22 - 60cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>185773</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ514</BillingCode><Name>Skyline Cervical Plate System</Name><Description>Skyline anterior cervical screw.  Titanium</Description><Size>Self Tapping 4.3mm, 10-18mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>145290</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ033</BillingCode><Name>Ligaclip* Ligating Clips - titanium</Name><Description>Titanium clips contained in a plastic cartridge</Description><Size>3-5mm; 6 clips per cartridge</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>122810</ARTG></ARTGs><MinimumBenefit>10</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY319</BillingCode><Name>AO/ASIF Plate</Name><Description>Low profile neurosurgical plate, burr hole</Description><Size>4-7 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Burr</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ827</BillingCode><Name>Limb Preservation System - Sleeve Adapter</Name><Description>Diaphyseal sleeve adapter</Description><Size>+0 to +10mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3937</SubGroupID><ARTGs><ARTG>252532</ARTG></ARTGs><MinimumBenefit>1482</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY420</BillingCode><Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name><Description>Wire Post MRI Safe</Description><Size>Short, Tall, Long and 1 to 5 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4512</SubGroupID><ARTGs><ARTG>289708</ARTG><ARTG>383992</ARTG></ARTGs><MinimumBenefit>89</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP944</BillingCode><Name>DePuy Hip Bone Screws</Name><Description>Titanium, cancellous screws</Description><Size>Size 3.5-6.5 diameter 5-120mm length</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>150913</ARTG><ARTG>171784</ARTG><ARTG>98086</ARTG><ARTG>99196</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN371</BillingCode><Name>MILAGRO® Advance BR interference screw</Name><Description>Biocryl Rapide Interference screw system</Description><Size>Diameter 7-12 mm; Length 23-35 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>218737</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY504</BillingCode><Name>AO/ASIF Plate</Name><Description>Rapid resorbable reconstruction plate</Description><Size>4-7 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>167547</ARTG></ARTGs><MinimumBenefit>195</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ034</BillingCode><Name>Ligaclip* Ligating Clips - titanium</Name><Description>Titanium clips contained in a plastic cartridge</Description><Size>9-12 mm; 6 clips per cartage</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4256</SubGroupID><ARTGs><ARTG>122810</ARTG></ARTGs><MinimumBenefit>10</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY732</BillingCode><PriorBillingCodes><PriorBillingCode>SY162</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Tibial Plates</Description><Size>≤ 6 Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5292</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1365</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY582</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium adaption plate</Description><Size>4-7 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY581</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium adaption plate</Description><Size>4-7 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Compression</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN373</BillingCode><Name>INTRAFIX™ Advance BR™</Name><Description>Tibial Sheath and Screw System</Description><Size>7-10mm X 23-30 mm; Small and Large</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>421230</ARTG></ARTGs><MinimumBenefit>457</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY521</BillingCode><Name>Pinnacle Acetabular Shell</Name><Description>Titanium, beaded (Porocoat), not HA, acetabular cups</Description><Size>38 - 80mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4011</SubGroupID><ARTGs><ARTG>221600</ARTG><ARTG>221679</ARTG><ARTG>223026</ARTG></ARTGs><MinimumBenefit>1802</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ030</BillingCode><Name>Surgicel Fibrillar Absorbable Haemostat</Name><Description>Fibrous fleece, oxidised regenerated cellulose, the material is biocompatible and also bactericidal</Description><Size>5.1 x 10.2cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6009</SubGroupID><Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix><ARTGs><ARTG>166221</ARTG></ARTGs><MinimumBenefit>69</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN116</BillingCode><Name>Surgicel Non-Woven (SNoW) Absorbable Haemostat</Name><Description>Absorbable haemostat, Structured Non-Woven</Description><Size>5 x 10.2cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6009</SubGroupID><Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix><ARTGs><ARTG>191054</ARTG></ARTGs><MinimumBenefit>69</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ844</BillingCode><Name>Reclaim Revision Hip System - Bolt</Name><Description>Locking Bolt</Description><Size>75-105mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1434</GroupID><ARTGs><ARTG>242912</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP155</BillingCode><Name>PFC Sigma Knee System femoral stem bolts</Name><Description>Bolts to connect femoral stem, straight and offset </Description><Size>Neutral +/- 2mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1392</GroupID><ARTGs><ARTG>131657</ARTG></ARTGs><MinimumBenefit>212</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ940</BillingCode><Name>Moss Miami Spinal System</Name><Description>Polyaxial Screw</Description><Size>4.35 to 8mm diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>128257</ARTG><ARTG>97391</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY512</BillingCode><Name>AO/ASIF Plate</Name><Description>Rapid resorbable reconstruction plate</Description><Size>&lt;4 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4267</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>167547</ARTG></ARTGs><MinimumBenefit>144</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN223</BillingCode><Name>Attune Knee System</Name><Description>Revision totally constrained tibial insert, fixed and mobile bearing</Description><Size>Size 1 - 10</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1371</GroupID><ARTGs><ARTG>298540</ARTG><ARTG>298541</ARTG></ARTGs><MinimumBenefit>1090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ156</BillingCode><Name>Modular M-Spec Metal Femoral Head</Name><Description> Metal Femoral Head - Modular M-Spec</Description><Size>36-40mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>264072</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ157</BillingCode><Name>Ultamet Metal Femoral Head</Name><Description> Metal Femoral Head - Ultamet</Description><Size>36mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>261993</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ155</BillingCode><Name>Modular Cathcart Fracture Head Hip Ball and Articul/eze M-Spec Metal Femoral Head</Name><Description> Metal Femoral Head - Articul/eze, M-Spec, Unipolar</Description><Size>36mm to 60mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>235556</ARTG><ARTG>261972</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ178</BillingCode><Name>Prolene Mesh</Name><Description>Large keyhole polypropylene monofilament non absorbable mesh</Description><Size>Size (cm) 6x13.7; quantity/pack 1 or 3</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5434</SubGroupID><ARTGs><ARTG>389990</ARTG></ARTGs><MinimumBenefit>72</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY545</BillingCode><PriorBillingCodes><PriorBillingCode>DY179</PriorBillingCode></PriorBillingCodes><Name>Monarch Spinal System</Name><Description>Threaded Connector</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ652</BillingCode><Name>Cross Connector - Expedium Anterior Spine System</Name><Description>Drop and Lock One Piece Connector-Titanium</Description><Size>13 to 20mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>97391</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN181</BillingCode><Name>PROLENE™ Soft Polypropylene Mesh</Name><Description>Nonabsorbable Synthetic Surigcal Mesh</Description><Size>Size (cm) 2.5x10, 7.6x15, 6.4x11.4; quantity/pack 6  </Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5434</SubGroupID><ARTGs><ARTG>389989</ARTG></ARTGs><MinimumBenefit>72</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ566</BillingCode><Name>PROLENE Mesh</Name><Description>Polypropylene Mesh</Description><Size>10 x 15cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5434</SubGroupID><ARTGs><ARTG>389990</ARTG></ARTGs><MinimumBenefit>72</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ177</BillingCode><Name>Prolene Mesh</Name><Description>Small keyhole polypropylene monofilament non absorbable mesh</Description><Size>Size (cm) 4.6x10; quantity/pack 1 or 3</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5434</SubGroupID><ARTGs><ARTG>389990</ARTG></ARTGs><MinimumBenefit>72</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN261</BillingCode><Name>SYMPHONY OCT System</Name><Description>Head to head cross connectors</Description><Size>20-70mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ532</BillingCode><Name>LCS Complete Knee System tibial insert </Name><Description>Tibial insert, UHMWPE, rotating platform, totally constrained, with reinforcing post  </Description><Size>Sizes small to large+. 10-25mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1371</GroupID><ARTGs><ARTG>259354</ARTG></ARTGs><MinimumBenefit>1090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ175</BillingCode><Name>Prolene Mesh</Name><Description>Medium polypropylene monofilament non absorbable mesh</Description><Size>Size (cm) 6x11, 7.5x15, quantity/pack 1 or 3</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5434</SubGroupID><ARTGs><ARTG>389990</ARTG></ARTGs><MinimumBenefit>72</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN208</BillingCode><Name>Attune Knee System</Name><Description>Revision Stems</Description><Size>14mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>288501</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY590</BillingCode><Name>AO/ASIF Screw</Name><Description>Cortex, Cortical, Emergency, Self-tapping, Self-drilling; Low Profile, Pure Titanium; Matrix Plating System Titanium Alloy, </Description><Size>1.25-3.24mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>295238</ARTG><ARTG>297881</ARTG><ARTG>298355</ARTG><ARTG>309862</ARTG><ARTG>157706</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY677</BillingCode><PriorBillingCodes><PriorBillingCode>SY280</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomical Locking Radial Plates</Description><Size>7-15 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1126</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP550</BillingCode><Name>C-Stem AMT Femoral Stem</Name><Description>Stainless steel Ortron 90, highly polished, triple taper, long stem</Description><Size>Size 3 x 205; 240mm; Standard Offset</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1405</GroupID><SubGroupID>3944</SubGroupID><ARTGs><ARTG>312663</ARTG></ARTGs><MinimumBenefit>2980</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN226</BillingCode><Name>Attune Knee System</Name><Description>Revision stems</Description><Size>10 to 24mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>288501</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ013</BillingCode><Name>Surgicel ORIGINAL Absorbable Haemostat</Name><Description>Oxidised regenerated cellulose gauze, the material is biocompatible and also bactericidal</Description><Size>5.1 cm x 7.6 cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6008</SubGroupID><Suffix>Antimicrobial, Low Antigenicity</Suffix><ARTGs><ARTG>177702</ARTG></ARTGs><MinimumBenefit>19</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY611</BillingCode><PriorBillingCodes><PriorBillingCode>SY030</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>DHS Plates</Description><Size>≥ 16-20 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5266</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>745</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ655</BillingCode><Name>PFC Knee System - Universal Slotted Stem</Name><Description>Tibial/Femoral Stem-Titanium</Description><Size>Lengths 75, 115, 150mm; widths 10 to 24mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>238732</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ012</BillingCode><Name>Surgicel ORIGINAL Absorbable Haemostat</Name><Description>Oxidised regenerated cellulose gauze, the material is biocompatible and also bactericidal</Description><Size>5.1 cm x 35.6 cm; 10.2 cm x 20.3 cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6010</SubGroupID><Suffix>Antimicrobial, Low Antigenicity</Suffix><ARTGs><ARTG>177702</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ023</BillingCode><Name>Surgicel Nu-Knit Absorbable Haemostat</Name><Description>High density, oxidised regenerated cellulose, the material is biocompatible and also bactericidal</Description><Size>2.5 cm x 2.5 cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6008</SubGroupID><Suffix>Antimicrobial, Low Antigenicity, Woven</Suffix><ARTGs><ARTG>177701</ARTG></ARTGs><MinimumBenefit>33</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN117</BillingCode><Name>Surgicel Non-Woven (SNoW) Absorbable Haemostat</Name><Description>Absorbable haemostat, Structured Non-Woven</Description><Size>10.2 x 10.2cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6010</SubGroupID><Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix><ARTGs><ARTG>191054</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY517</BillingCode><Name>Midface Distractor System</Name><Description>Distractor System, Screw</Description><Size>4-10mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4409</SubGroupID><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>73</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY592</BillingCode><Name>AO/ASIF Screw</Name><Description>Cortex, Cortical, Emergency, Self-tapping, Self-drilling; Locking Screws</Description><Size>1.25-3.24mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>88</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN112</BillingCode><Name>Surgicel Non-Woven (SNoW) Absorbable Haemostat</Name><Description>Absorbable haemostat, Structured Non-Woven</Description><Size>2.5 x 5cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6008</SubGroupID><Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix><ARTGs><ARTG>191054</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY788</BillingCode><Name>AO/ASIF Intramedullary Nails</Name><Description>Tibial Nail</Description><Size>7-19; 200-600mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3329</SubGroupID><ARTGs><ARTG>161138</ARTG></ARTGs><MinimumBenefit>963</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ008</BillingCode><Name>Surgicel Nu-Knit Absorbable Haemostat</Name><Description>High density, oxidised regenerated cellulose, the material is biocompatible and also bactericidal</Description><Size>7.6 cm x 10.2 cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6010</SubGroupID><Suffix>Antimicrobial, Low Antigenicity, Woven</Suffix><ARTGs><ARTG>177701</ARTG></ARTGs><MinimumBenefit>91</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ433</BillingCode><Name>SURGICEL Nu knit Absorbable Haemostat</Name><Description>High density , oxidised regenerated cellulose, the material is biocompatible and also bactericidal.</Description><Size>15.2 x 22.9cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6010</SubGroupID><Suffix>Antimicrobial, Low Antigenicity, Woven</Suffix><ARTGs><ARTG>177701</ARTG></ARTGs><MinimumBenefit>91</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN233</BillingCode><PriorBillingCodes><PriorBillingCode>SY003</PriorBillingCode><PriorBillingCode>SY004</PriorBillingCode><PriorBillingCode>SY005</PriorBillingCode><PriorBillingCode>SY333</PriorBillingCode><PriorBillingCode>SY358</PriorBillingCode></PriorBillingCodes><Name>Chronos</Name><Description>Bone Graft Substitute</Description><Size>0-5cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>153247</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ009</BillingCode><Name>Surgicel Fibrillar Absorbable Haemostat</Name><Description>Fibrous fleece, oxidised regenerated cellulose, the material is biocompatible and also bactericidal</Description><Size>2.5 x 5.1cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6008</SubGroupID><Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix><ARTGs><ARTG>166221</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY706</BillingCode><PriorBillingCodes><PriorBillingCode>SY565</PriorBillingCode></PriorBillingCodes><Name>Spinal Fixation System</Name><Description>Matrix Preassembled Pedicle Screw, Cannulated</Description><Size>5.00mm - 9.00mm; 20mm - 65mm Length</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>293275</ARTG><ARTG>293276</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ029</BillingCode><Name>Surgicel Fibrillar Absorbable Haemostat</Name><Description>Fibrous fleece, oxidised regenerated cellulose, the material is biocompatible and also bactericidal</Description><Size>10.2 x 10.2cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6010</SubGroupID><Suffix>Antimicrobial, Low Antigenicity, Micro-fibrous</Suffix><ARTGs><ARTG>166221</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN341</BillingCode><Name>FIBERGRAFT</Name><Description>Bioactive Glass Bone Graft - BG Putty and BG Putty GPS</Description><Size>1-4cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>387410</ARTG><ARTG>387411</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ014</BillingCode><Name>Surgicel ORIGINAL Absorbable Haemostat</Name><Description>Oxidised regenerated cellulose gauze, the material is biocompatible and also bactericidal</Description><Size>1.3 cm x 5.1 cm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1554</GroupID><SubGroupID>6008</SubGroupID><Suffix>Antimicrobial, Low Antigenicity</Suffix><ARTGs><ARTG>177702</ARTG></ARTGs><MinimumBenefit>19</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ647</BillingCode><Name>Expedium Spine System</Name><Description>EXPEDIUM Dual Innie Setscrew and Correction Key</Description><Size>5.5-6.35</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ915</BillingCode><Name>Expedium Spine System</Name><Description>Si and Unitised Screw Set</Description><Size>4.35 -7.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>178040</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN232</BillingCode><PriorBillingCodes><PriorBillingCode>SY189</PriorBillingCode><PriorBillingCode>SY450</PriorBillingCode><PriorBillingCode>SY573</PriorBillingCode><PriorBillingCode>SY575</PriorBillingCode></PriorBillingCodes><Name>Chronos</Name><Description>Bone Graft Substitute</Description><Size>0-5cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>CDS</Suffix><ARTGs><ARTG>153247</ARTG><ARTG>159907</ARTG></ARTGs><MinimumBenefit>1188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY002</BillingCode><Name>Chronos</Name><Description>Bone Graft Substitute</Description><Size>5 - 10cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>153247</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY308</BillingCode><Name>Axon Spinal System</Name><Description>Locking Set screw</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY399</BillingCode><Name>Alveolar Distractor</Name><Description>Vertical mandibular, maxilla alveolar ridge distractor</Description><Size>8-16mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1603</GroupID><SubGroupID>4399</SubGroupID><Suffix>Single Vector</Suffix><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>1906</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP166</BillingCode><Name>PFC Sigma Knee System  tibial insert </Name><Description>Tibial Insert, rotating platform UHMWPE</Description><Size>Sizes  2 - 6.  10-17.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>226935</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ509</BillingCode><Name>PFC Sigma Knee System  tibial insert </Name><Description>Tibial insert, UHMWPE, moderately cross linked</Description><Size>Sizes  1.5 - 6.  8-20mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>219401</ARTG><ARTG>224759</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY663</BillingCode><PriorBillingCodes><PriorBillingCode>SY202</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic External Fixator Systems</Name><Description>Medium Frame; Rod, Threaded, Adjustable Clamps RL MRI</Description><Size>5-11.0mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4508</SubGroupID><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>622</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN001</BillingCode><Name>Mentor Radovan Tissue Expander</Name><Description>Tissue Expander</Description><Size>Volume 25cc - 1000cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1606</GroupID><SubGroupID>4414</SubGroupID><ARTGs><ARTG>125097</ARTG></ARTGs><MinimumBenefit>653</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP026</BillingCode><Name>LCS Complete Knee System rotating platform tibial Insert </Name><Description>Tibial insert, for rotating platform, UHMWPE </Description><Size>Sizes small to large+</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>217376</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY146</BillingCode><Name>Universal Spine System (USS)</Name><Description>Cross Link Rod</Description><Size>40-80mm length </Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1470</GroupID><ARTGs><ARTG>133401</ARTG></ARTGs><MinimumBenefit>349</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY745</BillingCode><PriorBillingCodes><PriorBillingCode>SY198</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic External Fixator Systems</Name><Description>Distractors and lengthening apparatus</Description><Size>≥ 160mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4508</SubGroupID><Suffix>CDD</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>622</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN343</BillingCode><Name>FIBERGRAFT</Name><Description>Bioactive Glass Bone Graft - BG Putty and BG Putty GPS</Description><Size>11cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>387410</ARTG><ARTG>387411</ARTG></ARTGs><MinimumBenefit>4370</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP014</BillingCode><Name>Pinnacle Constrained Inserts</Name><Description>UHMWPE, constrained liner with titanium alloy locking ring</Description><Size>Inner diameter 28-44mm, 36-76mm outer diameter</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4024</SubGroupID><Suffix>Cup &amp; Ring</Suffix><ARTGs><ARTG>222179</ARTG></ARTGs><MinimumBenefit>1540</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP513</BillingCode><Name>Stackable Corpectomy CFRP Cage System</Name><Description>Stackable Cage</Description><Size>Xsmall-Xlarge</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1493</GroupID><ARTGs><ARTG>98094</ARTG></ARTGs><MinimumBenefit>3529</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN281</BillingCode><Name>CARTO System Therapeutic Catheters, NAVISTAR</Name><Description>4mm navigation, non-irrigated</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>135672</ARTG><ARTG>135731</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN177</BillingCode><Name>Mentor Siltex Contour Profile Breast Tissue Expander</Name><Description>Siltex Contour Profile Breast Tissue Expander (CPX4) with suture tabs</Description><Size>250-850cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1606</GroupID><SubGroupID>4414</SubGroupID><ARTGs><ARTG>226982</ARTG></ARTGs><MinimumBenefit>653</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY744</BillingCode><PriorBillingCodes><PriorBillingCode>SY198</PriorBillingCode></PriorBillingCodes><Name>MAXFRAME Distraction Osteogenesis External Fixation System</Name><Description>Distractors and lengthening apparatus</Description><Size>20mm-250mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4508</SubGroupID><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>622</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY753</BillingCode><Name>Curvilinear Distraction System</Name><Description>Curvilinear Distraction, Right Left</Description><Size>30mm - 100mm radius</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1603</GroupID><SubGroupID>4399</SubGroupID><Suffix>Multivector</Suffix><ARTGs><ARTG>183673</ARTG></ARTGs><MinimumBenefit>2608</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY077</BillingCode><Name>Apex Hole eliminator </Name><Description>Hole eliminator screw Titanium</Description><Size>48 - 66 mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1441</GroupID><ARTGs><ARTG>238812</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY743</BillingCode><PriorBillingCodes><PriorBillingCode>SY283</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomic Locking Ulna Plates</Description><Size>≤6  Holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5279</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>778</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ841</BillingCode><Name>Reclaim Revision Hip System - Standard Distal Stem</Name><Description>Standard distal stem</Description><Size>14-31mm x 140-190mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>219278</ARTG></ARTGs><MinimumBenefit>2619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN346</BillingCode><Name>FIBERGRAFT</Name><Description>Bioactive Glass (BG) Bone Graft Morsels</Description><Size>11cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>387006</ARTG></ARTGs><MinimumBenefit>4370</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP264</BillingCode><Name>SROM Noiles Knee System patella</Name><Description>All poly, cemented patella </Description><Size>Sizes 30 - 38mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>219087</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ959</BillingCode><Name>Attune Knee System</Name><Description>All Poly Cemented Patella</Description><Size>29-41mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>208794</ARTG><ARTG>220505</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ955</BillingCode><Name>Attune Knee System</Name><Description>Cruciate Retaining Insert</Description><Size>1-10</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>220506</ARTG><ARTG>226662</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN013</BillingCode><Name>Mentor Siltex Becker Expander/Mammary Implant</Name><Description>Textured Becker Expander/Mammary Implant</Description><Size>145 to 800cc</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>203</SubCategoryID><GroupID>1606</GroupID><SubGroupID>4414</SubGroupID><Suffix>Expander Implant</Suffix><ARTGs><ARTG>119809</ARTG></ARTGs><MinimumBenefit>1989</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN347</BillingCode><Name>BI-MENTUM Dual Mobility System</Name><Description>Press-Fit cementless metal acetabular dual mobility cup, designed to be used with a polyethylene liner.</Description><Size>43mm to 69mm diameter in 2mm increments</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1427</GroupID><SubGroupID>4018</SubGroupID><ARTGs><ARTG>363113</ARTG></ARTGs><MinimumBenefit>2079</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN275</BillingCode><Name>ACTIS Femoral Stem</Name><Description>Collared, proximal beaded with HA </Description><Size>Size 0-12</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3950</SubGroupID><ARTGs><ARTG>346130</ARTG></ARTGs><MinimumBenefit>2933</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP152</BillingCode><Name>PFC Sigma Knee System</Name><Description>Cemented, all poly, patella</Description><Size>32-41mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>271408</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP224</BillingCode><Name>Charnley &amp; Wroblewski Trochanteric Spring Wire</Name><Description>Stainless steel wire for trochanteric attachment</Description><Size>0.5-3.00mm, 18 to 20g</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1458</GroupID><ARTGs><ARTG>99178</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ779</BillingCode><Name>Sigma HP Unicompartmental Knee - Fixed bearing insert</Name><Description>Unicompartmental tibial insert, fixed bearing UHMWPE</Description><Size>Size 1-6, 7-11mm LM/RL &amp; RM/LL</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>154</SubCategoryID><GroupID>1372</GroupID><ARTGs><ARTG>233187</ARTG></ARTGs><MinimumBenefit>689</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ749</BillingCode><Name>SROM Femoral Stem</Name><Description>Titanium, fluted, distal polished femoral stem &amp; neck</Description><Size>Stem diameter: proximal 12 - 24mm, distal 6 - 19mm;   Size Standard, Stem Length: 115 - 175mm;   Neck Length: 30 - 42mm;   Offset: 0 - 12mm  </Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3965</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>225291</ARTG></ARTGs><MinimumBenefit>2954</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ004</BillingCode><Name>Spongostan Absorbable Haemostat</Name><Description>Film (Box of 20)</Description><Size>200 x 70 x 0.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>191</SubCategoryID><GroupID>1553</GroupID><SubGroupID>4200</SubGroupID><ARTGs><ARTG>144852</ARTG></ARTGs><MinimumBenefit>27</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN221</BillingCode><Name>Global Unite Shoulder System</Name><Description>Anatomic Proximal Body</Description><Size>6 to 16</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><ARTGs><ARTG>231183</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY782</BillingCode><Name>SynPOR</Name><Description>Porous Polyethylene Chin Implant</Description><Size>4-9mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1592</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>190454</ARTG></ARTGs><MinimumBenefit>626</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ973</BillingCode><Name>Delta Shoulder System</Name><Description>Epiphysis</Description><Size>Size 1 or 2; Offset Centred, Eccentric Left, Eccentric Right</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><ARTGs><ARTG>307922</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN277</BillingCode><Name>CELSIUS</Name><Description>4mm non-nav, non-irrigated</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>135671</ARTG><ARTG>135732</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY403</BillingCode><Name>Cathcart Taper Insert</Name><Description>CoCr head taper insert for use with Unipolar Head (DY402)</Description><Size>-3 to +10mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1442</GroupID><ARTGs><ARTG>255314</ARTG></ARTGs><MinimumBenefit>266</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ936</BillingCode><Name>Expedium Spine System</Name><Description>Monoaxial Screw</Description><Size>Diameter 4.35-10mm; Length 25-80mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>128257</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY402</BillingCode><Name>External Midface Distractor System</Name><Description>Horizontal Rod Assembly</Description><Size>One size only</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4406</SubGroupID><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>965</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ089</BillingCode><Name>Mitek GII QuickAnchor Plus </Name><Description>Titanium Anchor, with various sutures</Description><Size>2.4 x 8.8mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>133430</ARTG><ARTG>140795</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DP524</BillingCode><Name>LCS Complete Knee System patella component </Name><Description>All Poly patella, UHMWPE, cemented</Description><Size>Sizes small to large+</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>217375</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY676</BillingCode><PriorBillingCodes><PriorBillingCode>SY280</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Locking Distal Radius Ulna Column Plate System</Description><Size>≤ 6 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1372</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY779</BillingCode><Name>ProPlan</Name><Description>Patient Specific Craniofacial Anatomical Biomodel</Description><Size>Custom</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1807</GroupID><ARTGs><ARTG>276733</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ945</BillingCode><PriorBillingCodes><PriorBillingCode>JJ810</PriorBillingCode></PriorBillingCodes><Name>GRYPHON BR Instability Anchor</Name><Description>Suture Anchor</Description><Size>2.4-3.0mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>165434</ARTG><ARTG>165465</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN274</BillingCode><Name>Attune Knee System</Name><Description>Rotating Platform Cementless Components</Description><Size>Size 1-10</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1362</GroupID><ARTGs><ARTG>290324</ARTG></ARTGs><MinimumBenefit>2493</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY595</BillingCode><Name>Midface, CMF Distractor System</Name><Description>Distractor Footplate</Description><Size>Various</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4403</SubGroupID><Suffix>Dual Plate</Suffix><ARTGs><ARTG>155806</ARTG><ARTG>183673</ARTG></ARTGs><MinimumBenefit>1279</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY406</BillingCode><Name>External Midface Distractor System</Name><Description>Titanium Zygomatic, Maxxilary Footplate</Description><Size>3 holes, 40mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4403</SubGroupID><ARTGs><ARTG>155806</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY585</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium adaption plate</Description><Size>8-32 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JJ654</BillingCode><Name>PFC Sigma - Femoral Adaptor</Name><Description>Offset Adaptor</Description><Size>5 and 7 degree</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1396</GroupID><ARTGs><ARTG>131657</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY488</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium Contourable mesh plate</Description><Size>&lt;0.5mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4205</SubGroupID><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>1229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY583</BillingCode><Name>AO/ASIF Plate</Name><Description>Titanium adaption plate</Description><Size>8-32 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><Suffix>Compression</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>195</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY777</BillingCode><Name>ProPlan</Name><Description>Patient Specific Cranical Surgical Guides, Implants</Description><Size>Custom</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>5496</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>276733</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1315</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY520</BillingCode><Name>Vectra Anterior Spinal System</Name><Description>Cervical Plate</Description><Size>≤55</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>155808</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY544</BillingCode><Name>PolyMax Rapid-Resorbable Fixation System</Name><Description>Mesh Plate</Description><Size>0.5-0.8mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4226</SubGroupID><ARTGs><ARTG>167547</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY755</BillingCode><PriorBillingCodes><PriorBillingCode>SY674</PriorBillingCode><PriorBillingCode>SY166</PriorBillingCode></PriorBillingCodes><Name>AO/ASIF Plates</Name><Description>Anatomical Locking Humerus Plate</Description><Size>≥ 16 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5275</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>157069</ARTG></ARTGs><MinimumBenefit>1643</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN329</BillingCode><Name>GRYPHON PEEK Suture Anchor </Name><Description>Anchor with suture</Description><Size>3.0 x 10.7mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>215753</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN361</BillingCode><Name>Global Unite Reverse Fracture Epiphysis</Name><Description>Coated epiphysis, includes superior-lateral suture collar with suture holes. </Description><Size>Size 1. Centered, Left, and Right configurations</Size><SupplierCode>JJ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><ARTGs><ARTG>311439</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY467</BillingCode><Name>PFC Sigma Knee System tibial baseplate</Name><Description>Tibial baseplate, cemented, keeled, Titanium, standard and offset keels with capacity for augment and stem attachment </Description><Size>Size 1.5 - 5</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><Suffix>Revision</Suffix><ARTGs><ARTG>221774</ARTG></ARTGs><MinimumBenefit>2647</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SY584</BillingCode><Name>AO/ASIF Plate</Name><Description>Rapid resorbable reconstruction plate</Description><Size>8-32 holes</Size><SupplierCode>JJ</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>157706</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MN228</BillingCode><Name>Attune Knee System</Name><Description>Offset adaptor</Description><Size>2 to 6mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1396</GroupID><ARTGs><ARTG>288501</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DY524</BillingCode><Name>Uniplate Spinal System</Name><Description>Titanium Anterior Cervical Plate</Description><Size>13-55mm</Size><SupplierCode>JJ</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>148371</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD007</BillingCode><PriorBillingCodes><PriorBillingCode>AE256</PriorBillingCode></PriorBillingCodes><Name>CarboFix Piccolo Plate Systems – Locking Screws: Mini</Name><Description>Titanium alloy screws (locking) for fixation of CarboFix plate shaft and head.</Description><Size>Locking Proximal Screw 2.5mm x 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm

Locking Screw 2.7mm x 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>222648</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD015</BillingCode><Name>Proximal Femur Nails</Name><Description>Nails</Description><Size>Diameter 11mm
Proximal Diameter 17mm
&lt;220mm length</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3326</SubGroupID><ARTGs><ARTG>222647</ARTG></ARTGs><MinimumBenefit>910</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD019</BillingCode><Name>Femoral Nail</Name><Description>Femoral Nail</Description><Size>Diameter 10 - 12mm</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3328</SubGroupID><ARTGs><ARTG>222647</ARTG></ARTGs><MinimumBenefit>995</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD002</BillingCode><PriorBillingCodes><PriorBillingCode>AE257</PriorBillingCode></PriorBillingCodes><Name>CarboFix Piccolo Plate Systems – Non-Locking Screws: Mini</Name><Description>Titanium alloy screws (non-locking) for fixation of CarboFix plate shaft and head.</Description><Size>Non-Locking Proximal Screw 2.5mm x 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm

Non-Locking Screw 2.7mm x 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>222648</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD017</BillingCode><Name>Proximal Femur Lag Screws</Name><Description>Lag Screws</Description><Size>80-110mm Length</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3341</SubGroupID><ARTGs><ARTG>222647</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD022</BillingCode><Name>MTP Plate</Name><Description>Fusion Plates</Description><Size>Left and Right</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>222648</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD001</BillingCode><PriorBillingCodes><PriorBillingCode>AE258</PriorBillingCode></PriorBillingCodes><Name>CarboFix Piccolo Plate Systems – Locking Screws: Small</Name><Description>Titanium alloy screws (locking) for fixation of CarboFix plate shaft and head.</Description><Size>Locking Proximal Screw 4.0mm x 25.0mm, 30.0mm, 32.5mm, 35.0mm, 37.5mm, 40.0mm, 42.5mm, 45.0mm, 47.5mm, 50.0mm, 55.0mm, 60.0mm
Locking Distal Screw 3.5mm x 10mm, 12mm, 14mm, 16mm, 18mm, 22.5mm, 25.0mm, 27.5mm, 30.0mm, 32.5mm, 35.0mm, 40.0mm, 45.0mm
Locking Screw 3.5mm x 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>222648</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD023</BillingCode><Name>1/3 Tubular Plate</Name><Description>1/3 Tubular Plate</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>222648</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD018</BillingCode><Name>Nail Set Screw</Name><Description>Nail Set Screw</Description><Size>Static &amp; Dynamic</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>222647</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD014</BillingCode><Name>Screws - Locking</Name><Description>Locking</Description><Size>≥4.5mm</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>222648</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD011</BillingCode><Name>Screws - Reconstruction</Name><Description>Screws</Description><Size>3.5 - 5 mm diameter</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>222647</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD013</BillingCode><Name>Screws - Non Locking</Name><Description>≥4.5mm)</Description><Size>≥4.5mm</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>222648</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD012</BillingCode><Name>Nail Caps</Name><Description>Nail Cap</Description><Size>0, 5, 10 &amp; 11mm diameter</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>5363</SubGroupID><ARTGs><ARTG>222647</ARTG></ARTGs><MinimumBenefit>96</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD020</BillingCode><Name>Tibial Nail</Name><Description>Tibial Nail</Description><Size>10 - 11mm diameter</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3329</SubGroupID><ARTGs><ARTG>222647</ARTG></ARTGs><MinimumBenefit>963</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD016</BillingCode><Name>Proximal Femur Nail</Name><Description>Femoral Nail</Description><Size>Diameter 11mm
Proximal Diameter 17mm
Length ≥220mm</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3327</SubGroupID><ARTGs><ARTG>222647</ARTG></ARTGs><MinimumBenefit>1188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD010</BillingCode><Name>Ankle Arthrodesis Nail</Name><Description>Arthrodesis Nail</Description><Size>10 &amp; 12mm diameter</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3332</SubGroupID><ARTGs><ARTG>222647</ARTG></ARTGs><MinimumBenefit>3300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD003</BillingCode><PriorBillingCodes><PriorBillingCode>AE259</PriorBillingCode></PriorBillingCodes><Name>CarboFix Piccolo Plate Systems – Non-Locking Screws: Small</Name><Description>Titanium alloy screws (non-locking) for fixation of CarboFix plate shaft and head.</Description><Size>Non-Locking Distal Screw 3.5mm x 10mm, 12mm, 14mm, 16mm, 18mm, 22.5mm, 25.0mm, 27.5mm, 30.0mm, 32.5mm, 35.0mm, 40.0mm, 45.0mm
Non-Locking Screw 3.5mm x 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 24mm, 26mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>222648</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JD021</BillingCode><Name>1/3 Tubular Plate</Name><Description>1/3 Tubular Plates</Description><Size>≤ 6 holes</Size><SupplierCode>JD</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>222648</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JA018</BillingCode><PriorBillingCodes><PriorBillingCode>OH541</PriorBillingCode></PriorBillingCodes><Name>Spinal Plate - Cervical 55mm+</Name><Description>Anterior Cervical Plate 55mm+</Description><Size>56 - 92mm</Size><SupplierCode>JA</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>289731</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JA014</BillingCode><PriorBillingCodes><PriorBillingCode>OH353</PriorBillingCode></PriorBillingCodes><Name>Novel/Zenius Reduction Poly Screw</Name><Description>Polyaxial Reduction pedicle screw</Description><Size>5.5-8.5</Size><SupplierCode>JA</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>148858</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JA020</BillingCode><PriorBillingCodes><PriorBillingCode>OH538</PriorBillingCode></PriorBillingCodes><Name>Taurus-P</Name><Description>Taurus-P Fusion Cage</Description><Size>0-8°, H7-16mm, L25-40mm, W9-12mm</Size><SupplierCode>JA</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>289247</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JA019</BillingCode><PriorBillingCodes><PriorBillingCode>OH539</PriorBillingCode></PriorBillingCodes><Name>Spinal Plate Screws</Name><Description>Self-Drilling and Self-Tapping Plate Screws</Description><Size>Diam - 4.0 - 4.5mm
Length - 10 - 16mm</Size><SupplierCode>JA</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>289731</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JA017</BillingCode><PriorBillingCodes><PriorBillingCode>OH540</PriorBillingCode></PriorBillingCodes><Name>Spinal Plate - Cervical</Name><Description>Anterior Cervical Plate</Description><Size>20mm - 53mm</Size><SupplierCode>JA</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>289731</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JA036</BillingCode><PriorBillingCodes><PriorBillingCode>FY004</PriorBillingCode></PriorBillingCodes><Name>Novomax Fusion</Name><Description>Cervical Interbody Fusion Device, CaO-SiO2 based  glass ceramic</Description><Size>(15 x 13)mm footprint x (5-10)mm height, 3 degree lordosis</Size><SupplierCode>JA</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>376357</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JA015</BillingCode><PriorBillingCodes><PriorBillingCode>OH352</PriorBillingCode></PriorBillingCodes><Name>Novel/Zenius Rods</Name><Description>Rod</Description><Size>5.5, 6.0, 6.5</Size><SupplierCode>JA</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>148858</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>JA016</BillingCode><PriorBillingCodes><PriorBillingCode>OH351</PriorBillingCode></PriorBillingCodes><Name>Medyssey set screw</Name><Description>Set screw</Description><Size>9.5 - 10mm</Size><SupplierCode>JA</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>148858</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG028</BillingCode><Name>Labtician - Retinal Implants</Name><Description>Solid Silicone- Tire/Meridional/ Wedge/Pad. Retinal Implant used in Scleral Buckling (Dimethylmethylvinyl Siloxane Copolymer)</Description><Size>S 2965 Silicone Strip , S 2967 Silicone Strip , S 2968 Silicone Strip, S 2970 Silicone Strip , S 2971 Silicone Strip , S 2976 Silicone Button , S 2977 Silicone Tire 10mm , S 2986 Silicone Tire 7mm, S 2991 Silicone Tire 9mm, S 2994 Silicone Tire 6.0mm , S 2995 Silicone Tire 8.5mm , S 2996 Silicone Tire 10mm , S 2996 L Silicone Tire 10mm LG , S 2997 Silicone Tire 12.5mm, S 2999 Silicone Tire 7.0mm , S 2999 L Silicone Tire Wide Groove , S 3004 Silicone Tire 9mm , S 3010 Silicone Tire 6mm, S 3014 Silicone Tire 7mm , S 3014 L Silicone Tire 7mm WG , S 3016 Silicone Tire 10mm , S 3017 Silicone Tire , S 3018 Silicone Sleeve , S 3019 Silicone Sleeve, S 3025 Wong Meridional Implant , S 3071 Silicone Sleeve, S 5020 Silicone Lace™ 2mm , S 5025 Silicone Lace™ 2.5mm.</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1342</GroupID><ARTGs><ARTG>337137</ARTG></ARTGs><MinimumBenefit>41</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG020</BillingCode><Name>RayOne Hydrophobic IOL</Name><Description>Hydrophobic acrylic IOL, preloaded injector system, micro incision, aspheric, UV filtering, single piece.</Description><Size>Power range: 
-10.0 D to +7.0 D (1.0 D increments, including plano)
+8.0 D to +30.0 D (0.5 D increments)
+31.0 D to +32.0 D (1.0 D increments) 
Shapes:
Biconvex (positive powers), Plano, Concave (negative powers)</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>100926</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG030</BillingCode><Name>LSO Silicone Oil</Name><Description>Highly purified, sterile, transparent, silicone oil available in both a 1,000 cP and a 5,000 cP viscosity.</Description><Size>10mL vial, 10mL syringe</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1347</GroupID><ARTGs><ARTG>337138</ARTG></ARTGs><MinimumBenefit>176</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG042</BillingCode><Name>RayOne  Galaxy Toric</Name><Description>Single-piece IOL toric non-diffractive spiral optic for 0% light loss, that progressively elongates focus supplied pre-loaded in RayOne injector.</Description><Size>Spherical Equivalent: +6.0 D to +30.0 D (0.5 D increments), Cylinders: +0.75 D, +1.5 D, +2.25 D, +3.0 D, +3.75 D, +4.5 D, Trifocal, diffractive, +3.5 D near add and +1.75 D intermediate add at the IOL plane</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>220612</ARTG></ARTGs><MinimumBenefit>918</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG032</BillingCode><PriorBillingCodes><PriorBillingCode>DE183</PriorBillingCode></PriorBillingCodes><Name>Lid Load Gold Eyelid Weights;</Name><Description>Gold</Description><Size>0.6, 0.8, 1.0, 1.2, 1.4, 1.6 grams</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>145</SubCategoryID><GroupID>1336</GroupID><SubGroupID>3900</SubGroupID><ARTGs><ARTG>337652</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG037</BillingCode><Name>RayOne Hydrophobic Aspheric BLF IOL</Name><Description>Hydrophobic acrylic IOL, preloaded injector system, micro incision, aspheric, UV filtering, single piece, with blue light filtering.</Description><Size>Power range:   +0.0 D to +7.0 D (1.0 D increments)  +8.0 D to +30.0 D (0.5 D increments)  +31.0 D to +32.0 D (1.0 D increments)Shapes:  Biconvex (positive powers), Plano</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, vblf</Suffix><ARTGs><ARTG>100926</ARTG></ARTGs><MinimumBenefit>291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG017</BillingCode><PriorBillingCodes><PriorBillingCode>DV265</PriorBillingCode></PriorBillingCodes><Name>RayOne Ashperic preloaded</Name><Description>Preloaded aspheric intraocular lens, hydrophilic acrylic, UV absorbing, 360 square edge, anti-vaulting haptics</Description><Size>6mm optic, range sphere -10 to +34</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>220612</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG036</BillingCode><Name>Simedice Intraocular Lens</Name><Description>Foldable Acrylic Single-piece Lens with Blue Light Protection and Aspheric Correction</Description><Size>Spherical power: +10.0 to +30.0 D, in 0.5 increments</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, vblf</Suffix><ARTGs><ARTG>385551</ARTG></ARTGs><MinimumBenefit>221</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG016</BillingCode><PriorBillingCodes><PriorBillingCode>DV266</PriorBillingCode></PriorBillingCodes><Name>RayOne Toric (Model RAO610T)</Name><Description>Single piece preloaded aspheric toric acrylic IOL, UV absorbing, 360 square edge, anti-vaulting haptics</Description><Size>6mm optic, +8 ro +30 sphere, +1 to +6 cylinder in 0.5 steps</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>220612</ARTG></ARTGs><MinimumBenefit>530</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG022</BillingCode><Name>Sulcoflex Trifocal</Name><Description>Acrylic, aberration-neutral, trifocal pseudophakic secondary IOL; sulcus-fixated with undulating and rounded C-loop haptics.</Description><Size>Power range: -3.0 D to +3.0 D (increments 0.5 D). -1.0 D to +1.0 D (increments 0.25 D)
Trifocal, diffractive,
+3.5 D near add and +1.75 D intermediate add at the IOL plane</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1328</GroupID><SubGroupID>3896</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>100926</ARTG></ARTGs><MinimumBenefit>668</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG027</BillingCode><Name>RayOne Toric Aspheric preloaded - Premium/Made to Order</Name><Description>Single piece preloaded aspheric toric acrylic IOL, UV absorbing, 360 square edge, anti-vaulting haptics</Description><Size>-9.5 to +34.5 D SE (subject to sphere power)  +7 to +11 cylinder  Further pre-selected SE/cylinder combinations are available above and below the stated SE range.</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t2, pl</Suffix><ARTGs><ARTG>220612</ARTG></ARTGs><MinimumBenefit>793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG034</BillingCode><Name>RayOne EMV RAO200E Intraocular lens</Name><Description>RayOne EMV Model 200E is an extended vision, non-diffractive, UV-Absorbing, single-piece, foldable, hydrophilic, posterior chamber intraocular lens.  Provided preloaded in two-step injector.</Description><Size>6mm optic, Power range +10.0 to +30.0D (0.5D increments)</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>220612</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG029</BillingCode><Name>Labtician Retinal Implants</Name><Description>Band/Strip: solid silicone</Description><Size>S 2950 Circling Band, S 2969 Circling Band, S 2978 Meridional Implant - Flat, S 2987 Circling Band, S 2988 Meridional Implant, S 2989 Boat, S 2992 Silicone Strip, S 2993 Pad, S 2998 Silicone Strip, S 3012 Boat, S 3013 Silicone Strip, S 3020 Meridional Implant, S 3021 Wedge, S 3022 Wedge, S 3083 Labtician Oval Sleeve, S 3084 Labtician Oval Sleeve, S 3093 Labtician Buckling Sleeve, S 3094 Labtician Buckling Sleeve, S 4050 Silicone Strip, S 4055 Silicone Strip, S 4060 Silicone Strip, S 4065 Silicone Strip</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1342</GroupID><ARTGs><ARTG>337137</ARTG></ARTGs><MinimumBenefit>41</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ221</BillingCode><Name>Ophteis FR Pro</Name><Description>Viscoelastic solution for intraocular use - 2.0% sodium hyaluronate and 4.0% sorbitol</Description><Size>1.2 mL</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>366798</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG039</BillingCode><Name>Simedice Toric IOL</Name><Description>Posterior chamber, UV absorbing, foldable, acrylic, toric, single piece lens with blue light protection and aspheric correction.</Description><Size>Sperical diopter: +10.0 to +30.0 D, in 0.5 increments Cylinder power: 0.75 to 5.75</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>385551</ARTG></ARTGs><MinimumBenefit>471</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG023</BillingCode><Name>RayOne Trifocal Toric</Name><Description>Trifocal posterior chamber, toric, aberration-neutral technology, pre-loaded single piece acrylic IOL.</Description><Size>Spherical Equivalent: +6.0 D to +30.0 D (0.5 D increments), Cylinders: +0.75 D, +1.5 D, +2.25 D, +3.0 D, +3.75 D, +4.5 D, Trifocal, diffractive, +3.5 D near add and +1.75 D intermediate add at the IOL plane</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>220612</ARTG></ARTGs><MinimumBenefit>918</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ235</BillingCode><Name>OphteisBio 1.8</Name><Description>Viscoelastic solution for intraocular use - 1.8% sodium hyaluronate</Description><Size>1.1 mL</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>366798</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG038</BillingCode><Name>RayOne EMV Toric</Name><Description>Single piece preloaded monofocal toric aspheric acrylic IOL, enhanced monovision (EMV) UV absorbing, 360 degree square edge, anti vaulting haptics</Description><Size>6mm optic,   Power Range: SE: +10.0 D to +25.0 D (0.5 D increments), Cylinder: +0.75 D, +1.5 D, +2.25 D, +3.0 D, +3.75 D, +4.5 D</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl, t1</Suffix><ARTGs><ARTG>220612</ARTG></ARTGs><MinimumBenefit>918</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG035</BillingCode><Name>Methylvisc 2.0%</Name><Description>Hydroxypropyl Methylcellulose, viscoelastic solution for intraocular application. Pre-loaded in single-use sterile syringe with single-use injection cannula.</Description><Size>2mL</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>366798</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ247</BillingCode><Name>OphteisBio 1.6</Name><Description>Viscoelastic solution for intraocular use - 1.6% sodium hyaluronate</Description><Size>1.1 mL</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>366798</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ223</BillingCode><Name>OphteisBio 3.0</Name><Description>Viscoelastic solution for intraocular use - 3.0% sodium hyaluronate</Description><Size>1.1mL</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>366798</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG041</BillingCode><Name>Oasis Visco Shield HPMC Viscoelastic</Name><Description>A sterile high molecular weight HPMC solution for use as a surgical aid in maintaining a deep anterior chamber during ophthalmic surgical procedures.</Description><Size>2 mL syringe</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>512305</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG033</BillingCode><PriorBillingCodes><PriorBillingCode>DE182</PriorBillingCode></PriorBillingCodes><Name>Lid Load Gold Eyelid Weights;</Name><Description>Gold</Description><Size>1.8, 2.0, 2.2, 2.4, 2.6, 2.8 grams</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>145</SubCategoryID><GroupID>1336</GroupID><SubGroupID>3901</SubGroupID><ARTGs><ARTG>337652</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG040</BillingCode><Name>RayOne Galaxy</Name><Description>Single-piece IOL non-diffractive spiral optic for 0% light loss, that progressively elongates focus supplied pre-loaded in RayOne injector.</Description><Size>+5.0 D to +30.0D (increments 0.5D)</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>220612</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG007</BillingCode><Name>Rayner Sulcoflex Aspheric Toric Pseudophakic Secondary IOL (Premium)</Name><Description>Acrylic, Aspheric, Toric Pseudophakic Secondary IOL: Sulcus fixated with undulating Haptics and Posterior Haptic Angulation (Premium)</Description><Size>SE -7.00 to +7.00 in 0.5 D steps; Cyl +1.00 to +6.00 in 0.5D steps</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1328</GroupID><SubGroupID>3895</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>100926</ARTG></ARTGs><MinimumBenefit>567</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG014</BillingCode><PriorBillingCodes><PriorBillingCode>OS001</PriorBillingCode></PriorBillingCodes><Name>ALTO Prosthesis</Name><Description>Adjustable Length Titanium Ossicular Chain Reconstruction Prosthesis</Description><Size>Head Size: 1.5mm x 2.5mm / 2mm x 2.5mm / 2mm x 3.3mm / 2.5mm x 3.5mm / 4mm x 3.25mm.  Length: 0.75mm -  8.6mm.  Distal Diameter: 0.4mm - 1.45mm.</Size><SupplierCode>KG</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4157</SubGroupID><ARTGs><ARTG>170281</ARTG></ARTGs><MinimumBenefit>343</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG008</BillingCode><Name>Rayner "Sulcoflex" Pseudophakic I.O.L.</Name><Description>Sulcoflex Aspheric Pseudophakic I.O.L</Description><Size>-5D to +5D</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1328</GroupID><SubGroupID>3895</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>100926</ARTG></ARTGs><MinimumBenefit>296</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG031</BillingCode><Name>Labtician Retinal Implants - Sponges</Name><Description>Silicone Sponge- Retinal Implant Used in Scleral Buckling (Silicone Elastomer Sponge)</Description><Size>S 1981-4 Oval Sponge,  S 1981-5 Oval Sponge,  S 1981-7 Oval Sponge,  S 1981-7.5 Oval Sponge,  S 1982-1.5 Round Sponge 1.5mm,  S 1982-2 Round Sponge 2mm,  S 1982-2.5 Round Sponge 2.5mm,  S 1982-3 Round Sponge 3mm,  S 1982-4 Round Sponge 4mm,  S 1982-5 Round Sponge 5mm,  S 1982-5T Round Tunnel Sponge 5mm,  S 1982-7 Round Sponge 7mm,  S 1982-7.5 Round Sponge 7.5mm x 50mm,  S 1983-2.3 Grooved Sponge,  S 1983-2.5 Grooved Part Thickness Sponge,  S 1983-2.8 Grooved Part Thickness Sponge,  S 1983-3 Grooved Sponge,  S 1983-3.2 Grooved Sponge,  S 1983-3.5 Grooved Sponge,  S 1983-4 Grooved Sponge,  S 1983-5 Grooved Sponge,  S 1983-7.5 Grooved Sponge,  S 1984-2.5 Part Thickness Sponge,  S 1984-3 Partial Thickness Sponge,  S 1984-3.3 Partial Thickness Sponge,  S 1984-5 Partial Thickness Sponge,  S 1984-7.5 Partial Thickness Sponge,  S 1986-3.5 Oblong Sponge,  S 1986-4 Oblong Sponge,  S 1987-7 Accessory Sponge,  S 1987-8 Accessory Sponge</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>148</SubCategoryID><GroupID>1342</GroupID><SubGroupID>3905</SubGroupID><ARTGs><ARTG>337137</ARTG></ARTGs><MinimumBenefit>82</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG005</BillingCode><Name>Rayner Sulcoflex Aspheric Toric Pseudophakic Secondary I.O.L - Standard</Name><Description>Acrylic, Aspheric, Toric Pseudophakic Secondary IOL :  Sulcus fixated with undulating Haptics and Posterior Haptic Angulation (Standard)</Description><Size>SE -3 to +3 in 0.5 D steps
Cyl +1 to +3 in 1D steps</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1328</GroupID><SubGroupID>3895</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>100926</ARTG></ARTGs><MinimumBenefit>567</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG021</BillingCode><PriorBillingCodes><PriorBillingCode>DV271</PriorBillingCode></PriorBillingCodes><Name>RayOne Trifocal</Name><Description>Diffractive step trifocal with smooth transition and reduced light loss</Description><Size>0.0 D to +30.0D (increments 0.5D)</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3893</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>220612</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KG024</BillingCode><PriorBillingCodes><PriorBillingCode>DV246</PriorBillingCode></PriorBillingCodes><Name>Rayner Sulcoflex Ashperic (Premium) I.O.L.</Name><Description>Pseudophakic Supplementary I.O.L.O.L.</Description><Size>-10.0D to -5.50D in 0.5D increments.                +5.50D to 10.00D in 0.5D increments</Size><SupplierCode>KG</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1328</GroupID><SubGroupID>3895</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>100926</ARTG></ARTGs><MinimumBenefit>296</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH081</BillingCode><Name>ZINA MIS Monoaxial Screw </Name><Description>ZINA MIS Spine System - Cannulated Monoaxial Screw</Description><Size>Diameter x Length ( mm )   4.5×30   4.5×35  4.5×40  4.5×45  4.5×50  4.5×55  4.5×60  4.5×65  5.0×30  5.0×35  5.0×40  5.0×45  5.0×50  5.0×55  5.0×60  5.0×65  5.5×30  5.5×35  5.5×40  5.5×45  5.5×50  5.5×55  5.5×60  5.5×65  6.0×30  6.0×35  6.0×40  6.0×45  6.0×50  6.0×55  6.0×60  6.0×65  6.5×30  6.5×35  6.5×40  6.5×45  6.5×50  6.5×55  6.5×60  6.5×65  7.0×30  7.0×35  7.0×40  7.0×45  7.0×50  7.0×55  7.0×60  7.0×65  7.5×30  7.5×35  7.5×40  7.5×45  7.5×50  7.5×55  7.5×60  7.5×65  </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH059</BillingCode><Name>Monoaxial Screws</Name><Description>Monoaxial Screws</Description><Size>20-55mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>473725</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH047</BillingCode><Name>Connector</Name><Description>Lateral Connector / Dual Head Lateral Connector </Description><Size>10-60mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>473725</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH048</BillingCode><Name>Polyaxial Screws</Name><Description>Dual Head Screws</Description><Size>35-45mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH056</BillingCode><Name>Rod Plate</Name><Description>Plate</Description><Size>3.5 mm to single occipital screw</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH058</BillingCode><Name>Lateral Connector</Name><Description>Closed</Description><Size>10-20mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH044</BillingCode><Name>Rod</Name><Description>Rod</Description><Size>4.5 / 5.5 x 30-500mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>473725</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH050</BillingCode><Name>Monoaxial Screws</Name><Description>Dual Head Screws</Description><Size>35-45mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH061</BillingCode><Name>Crosslink</Name><Description>Crosslink Connector</Description><Size>20-80mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>473725</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH074</BillingCode><Name>Kumafix Connector with Nut </Name><Description>Connector with Nut </Description><Size>Connector Degree : 0;  7; 14   Left and Right    Nut Size : 6 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH049</BillingCode><Name>Domino Rod Connector</Name><Description>Rod connector</Description><Size>S, M &amp; L</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>473725</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH053</BillingCode><Name>Screw</Name><Description>Occipital Screw</Description><Size>6-12mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH043</BillingCode><Name>Lydia Cage</Name><Description>Interbody Fusion Cage</Description><Size>8 &amp; 15 degrees angle, 8-12mm height and 20-24mm length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>312519</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH080</BillingCode><Name>ZINA MIS Polyaxial Screw</Name><Description>ZINA MIS Spine System - Cannulated Polyaxial Screw</Description><Size> Diameter x Length ( mm )    4.5×25      4.5×30      4.5×35      4.5×40      4.5×45      4.5×50      4.5×55      4.5×60      4.5×65      5.0×30      5.0×35      5.0×40      5.0×45      5.0×50      5.0×55      5.0×60      5.0×65      5.5×30      5.5×35      5.5×40      5.5×45      5.5×50      5.5×55      5.5×60      5.5×65      6.0×30      6.0×35      6.0×40      6.0×45      6.0×50      6.0×55      6.0×60      6.0×65      6.5×30      6.5×35      6.5×40      6.5×45      6.5×50      6.5×55      6.5×60      6.5×65      7.0×30      7.0×35      7.0×40      7.0×45      7.0×50      7.0×55      7.0×60      7.0×65      7.5×30      7.5×35      7.5×40      7.5×45      7.5×50      7.5×55      7.5×60      7.5×65      8.0×30      8.0×35      8.0×40      8.0×45      8.0×50      8.0×55      8.0×60      8.0×65      8.5×30      8.5×35      8.5×40      8.5×45      8.5×50      8.5×55      8.5×60      8.5×65    </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH054</BillingCode><Name>Crosslink</Name><Description>Crosslink Adjustable Connector</Description><Size>28-52mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH097</BillingCode><Name>RS8 Long Rod </Name><Description>RS8 Long Rod </Description><Size>Straight &amp; Curved   Diameter : 5.5 mm &amp; 6.0 mm   Length : 30 - 500 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>380418</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH090</BillingCode><Name>Rod </Name><Description>Rod </Description><Size>Diameter ： 5.5 mm &amp; 6.0 mm  Length : 30 mm - 500 mm   </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>380418</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH079</BillingCode><Name>ZINA MIS Rod </Name><Description>ZINA MIS Spine System - Rod  </Description><Size>Diameter x Length ( mm )   5.5×30    5.5×35    5.5×40    5.5×45    5.5×50  5.5×55  5.5×60  5.5×65  5.5×70  5.5×75  5.5×80  5.5×85  5.5×90  5.5×95  5.5×100  5.5×110  5.5×120  5.5×130  5.5×140  5.5×150  5.5×160  5.5×170  5.5×180  5.5×190  5.5×200  5.5×210  5.5×220  5.5×230  5.5×240  5.5×250  5.5×300  5.5×350  5.5×400  5.5×450  5.5×500  </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH102</BillingCode><Name>Reach Scorpn 3D Printing ACDF Cage and Bone screws </Name><Description>Reach Scorpn 3D Printing ACDF Cage and Bone screws 
Lordotic : 3 &amp; 6 Degree
Cage Height: 5 -8 mm, Bone Screw Size : 3.5 - 4.0 mm, Length : 8 - 18 mm</Description><Size>Cage Height: 5 -8 mm, Bone Screw Size : 3.5 - 4.0 mm, Length : 8 - 18 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>457345</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH093</BillingCode><Name>Rod Connector </Name><Description>Rod Connector </Description><Size>Diameter : 5.5 mm - 5.5 mm / 5.5 mm - 6.0 mm / 6.0 mm - 6.0 mm   </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>380418</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH094</BillingCode><Name>Lateral Connector </Name><Description>Lateral Connector </Description><Size>Diameter ： 5.5 mm &amp; 6.0 mm   Length : 20 mm - 60 mm </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>380418</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH073</BillingCode><Name>CARMEN Anterior Cervical Cover Plate ( One plate with three screws ) </Name><Description>The CARMEN plate and bone screw components are intended for anterior inter-body screw fixation from C2-TI. The plate and bone screw components are indicated for use together with the Carmen Anterior Cage in the temporary stabilization of the anterior spine during the development of spinal fusions in patients with: 1) degenerative disc disease (as defined by neck pain of discogenic origin with degeneration of the disc confirmed by patient history and radio-graphic studies), 2) trauma (including fractures), 3) tumors, 4) deformity (defined as kyphosis, lordosis, or scoliosis), 5) pseudoarthrosis, and/or 6) failed previous fusions.</Description><Size>Plate Size : Length : 18 mm - 20 mm;  Width : 13.6 mm - 14.2 mm     Bone Screw Size : Diameter : 3.5 mm ; 4.0 mm;  Length :  12 mm - 17 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1467</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>391</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH075</BillingCode><Name>CARMEN Anterior Cervical Cage </Name><Description>The CARMEN anterior cervical cage component is intended to be used for anterior cervical inter-body fusion procedures in skeletally mature patients with cervical disc disease at one level from the C2-C3 disc to the C7-T1 disc. Cervical disc disease is defined as intractable radiculopathy and/or myelopathy with herniated disc and/or osteophyte formation on posterior vertebral end-plates producing symptomatic nerve root and/or spinal cord compression confirmed by radio-graphic studies. This cage is to be used in patients who have had six weeks of non-operative treatment. The CARMEN cage must be used with supplemental fixation. The Carmen  cage is also required to be used with autogenous bone graft comprised of cancellous and/or corticocancellous bone graft and is to be implanted via an open, anterior approach</Description><Size>Height       4 mm - 7 mm   Footprint :    12 mm x 14 mm ; 14 mm x 14 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>312519</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH055</BillingCode><Name>Connector</Name><Description>Rod to Rod</Description><Size>3.5mm to 5.5mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH051</BillingCode><Name>Rod</Name><Description>Rods</Description><Size>80 - 240mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH098</BillingCode><Name>RS8 Long Set Screw </Name><Description>RS8 Long Set Screw </Description><Size>Diameter : 9.5 mm / 10 mm   Length : 4.5 mm / 5.0 mm / 9.3 mm </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>380418</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH077</BillingCode><Name>Kumafix Pedicle Shank Screw </Name><Description>Shank Screw </Description><Size>Diameter : 5.5 mm - 6.6 mm   Length :     40 mm - 55 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH060</BillingCode><Name>Adena-Zina&amp;Illiac Break-off set screw, ZEUS Torsional Set Screw for use with rods and pedicle Screws</Name><Description>Adena-Zina Break-of set screw, Adena-Zina iliac Break-off set screw, and ZEUS Torsional Set Screw for use with rods and pedicle screws.</Description><Size>5.5 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>473725</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH078</BillingCode><Name>Kumafix Rod </Name><Description>Rod </Description><Size>Length : 30-500 mm </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH057</BillingCode><Name>Hook</Name><Description>Laminar</Description><Size>5.5 mm &amp; 7.0 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH100</BillingCode><Name>Zeus Modular Assembling screw seat</Name><Description>Zeus Modular Assembling screw seat ( Normal &amp; Reduction )</Description><Size>one size </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>473725</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH046</BillingCode><Name>Cannulated Polyaxial Screws</Name><Description>Cannulated</Description><Size>20-110mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>473725</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH089</BillingCode><Name>Polyaxial Pedicle Screw   </Name><Description>Polyaxial Pedicle Screw </Description><Size>Diameter : 4.5 mm - 9.5 mm   Length : 35 mm - 120 mm </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>380418</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH052</BillingCode><Name>Polyaxial Screws</Name><Description>Polyaxial Screws</Description><Size>10-52mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH087</BillingCode><Name>Ceplate Anterior Cervical System - Bone Screw </Name><Description>Screws - Self-Tapping / Self-Drilling and Fixed / Variable Angle</Description><Size>Diameter: 4.0mm - 4.5mm; Length 11mm - 17mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>366091</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH088</BillingCode><Name>Ceplate Anterior Cervical Plate </Name><Description>Anterior Cervical Plate - Single or Multi level plate </Description><Size>22.5 mm - 55 mm </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>366091</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH082</BillingCode><Name>Katia Anterior Cervical Plate - Long </Name><Description>Anterior Cervical Plate &gt; 55 mm</Description><Size>56 mm - 110 mm </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH086</BillingCode><Name>Ceplate Anterior Cervical Plate</Name><Description>Anterior Cervical Plate &gt;55mm</Description><Size>57.5 mm - 110 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>366091</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH101</BillingCode><Name>Zeus Modular Screw Shaft </Name><Description>Zeus Modular Screw Shaft (offset / Cannulated )</Description><Size>30-55mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>473725</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH096</BillingCode><Name>RS8 Long Cannulated Polyaxial Reduction Screw </Name><Description>Cannulated Polyaxial Reduction Screw </Description><Size>Diameter : 5.0 - 7.5 mm   Length : 25 - 120 mm </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>380418</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH099</BillingCode><Name>Cervical Thoracic Tapered Transition Rod 3.5 - 5.5 mm</Name><Description>Cervical Thoracic Tapered Transition Rod 3.5 - 5.5 mm</Description><Size>3.5 - 5.5 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>473725</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH083</BillingCode><Name>Katia Bone Screw</Name><Description>Cancellous Screw   Fixed or Variable Angle</Description><Size>4.0 mm &amp; 4.5 mm   10 mm - 17 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH085</BillingCode><Name>Caro Cervical Cage</Name><Description>Cervical interbody cage, PEEK</Description><Size> 4x14x12    4x14x14    5x14x12    5x14x14    6x14x12    6x14x14    7x14x12    7x14x14    8x14x12    8x14x14   </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>312519</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH084</BillingCode><Name>Katia Anterior Cervical Plate </Name><Description>Anterior Cervical Plate - Single or Multi level </Description><Size>20 mm - 53.5 mm</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH042</BillingCode><Name>DICA Lumbar Cage</Name><Description>Interbody Fusion Cage</Description><Size>7 degrees</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>312519</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH076</BillingCode><Name>Adena™ CBT Polyaxial Screw</Name><Description>Cortical Thread Polyaxial Screw</Description><Size>4.0 mm - 6.5 mm Diameter  20 mm - 45 mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>312520</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH041</BillingCode><Name>Halis Cages</Name><Description>Interbody Fusion Cage</Description><Size>6, 12 &amp; 18 Degrees Angle</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>312519</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH045</BillingCode><Name>Polyaxial Screws</Name><Description>Polyaxial &amp; Reduction Polyaxial Screws
Favored angle Screws &amp; Dual Head &amp; Iliac (S2Ai) screws</Description><Size>20-100mm Length</Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>473725</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH092</BillingCode><Name>Set Screw </Name><Description>Set Screw </Description><Size>Diameter : 9.5 mm &amp; 10 mm   Length : 4.5 mm - 9.3 mm </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>380418</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH095</BillingCode><Name>Reach Cervical Interbody Cage </Name><Description>Reach Cervical Interbody Cage </Description><Size>Cage Height : 4 mm - 10 mm   Bone Screw Diameter : 3.5 mm &amp; 4.0 mm   Bone Screw Length : 8 mm - 18 mm   </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>384821</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KH091</BillingCode><Name>Crosslink </Name><Description>Crosslink </Description><Size>Diameter : 5.5 mm &amp; 6.0 mm   Length : 32 mm - 75 mm </Size><SupplierCode>KH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>380418</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KB001</BillingCode><PriorBillingCodes><PriorBillingCode>SV070</PriorBillingCode></PriorBillingCodes><Name>STERISPINE™ sterile Multiaxial Pedicle Screws</Name><Description>Cannulated: Fenestrated/ Multi Axial Cannulated Extended Head/ Extended Head Max and Auto Adjust screw</Description><Size>Cannulated, Multi Axial Cannulated Extended Head, Extended Head Max and Auto Adjust  4.5mm x 25; 30; 35 mm  5.5mm x 25; 30; 35; 40; 45; 50; 55; 60 mm  6.5mm x 25; 30; 35; 40; 45; 50; 55; 60 mm  7.5mm x 25; 30; 35; 40; 45; 50; 55; 60 mm  Fenestrated  4.5mm x 30;35;40 mm  5.5mm x 30; 35; 40; 45; 50; 55; 60 mm  6.5mm x 30; 35; 40; 45; 50; 55; 60 mm  7.5mm x 30; 35; 40; 45; 50; 55; 60 mm  Fenestrated Extended Head Max  4.5mm x30; 35; 40 mm  5.5mm x 30; 35; 40; 45; 50; 55; 60 mm  6.5mm x 25; 30; 35; 40; 45; 50; 55; 60 mm  7.5mm x 25; 30; 35; 40; 45; 50; 55; 60 mm</Size><SupplierCode>KB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>273286</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KB010</BillingCode><PriorBillingCodes><PriorBillingCode>SV066</PriorBillingCode></PriorBillingCodes><Name>STERISPINE™ Lumbar Cage -Single</Name><Description>Curved and Straight Fusion Cage- Oblique/TLIF/PLIF PEEK (straight/curved/bullet nosed)</Description><Size>Straight:  Height 7-14mm  Width: 10-12mm  Length: 22-32mm  Curved   Height: 7-14mm  Length: 28-32mm</Size><SupplierCode>KB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>273286</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KB004</BillingCode><PriorBillingCodes><PriorBillingCode>SV067</PriorBillingCode></PriorBillingCodes><Name>STERISPINE™ Set Screw</Name><Description>Sterile nut set screw or locking screw</Description><Size>One Size</Size><SupplierCode>KB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>273286</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KB005</BillingCode><PriorBillingCodes><PriorBillingCode>SV072</PriorBillingCode></PriorBillingCodes><Name>Set Screw</Name><Description>Set screw with cross connector kit</Description><Size>One Size</Size><SupplierCode>KB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>273286</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KB006</BillingCode><PriorBillingCodes><PriorBillingCode>SV064</PriorBillingCode></PriorBillingCodes><Name>STERISPINE™ Cross Connector System (transverse rod to rod fixed)</Name><Description>STERISPINE™ Cross Connector System (tranverse rod to rod, fixed)</Description><Size>20-36 mm  34-50 mm  48 -64 mm</Size><SupplierCode>KB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>273286</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KB002</BillingCode><PriorBillingCodes><PriorBillingCode>SV068</PriorBillingCode></PriorBillingCodes><Name>STERISPINE™ sterile Multiaxial non cannulated Pedicle Screw</Name><Description>Non Cannulated pedicle screws</Description><Size>Multiaxial screws  Diameter: 5.5-7.5 mm   Length: 25-60 mm</Size><SupplierCode>KB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>273286</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KB007</BillingCode><PriorBillingCodes><PriorBillingCode>SV069</PriorBillingCode></PriorBillingCodes><Name>STERISPINE™ PS Sterile Connecting Rod</Name><Description>Sterile rod available in straight and prebent versions.</Description><Size>Pre bent rods-5.5mm   Lengths (mm): 30-100    Straight Rods-5.5mm  Lengths (mm): 100-380</Size><SupplierCode>KB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>273288</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KB008</BillingCode><PriorBillingCodes><PriorBillingCode>SV062</PriorBillingCode></PriorBillingCodes><Name>STERISPINE™ Cervical Cage</Name><Description>Sterile Cervical Interbody Fusion Device</Description><Size>H05- W.14.5 D12  H06- W.14.5 D12  H07- W.14.5 D12  H08- W.14.5 D12  H05- W.16 D14  H06- W.16 D14  H07- W.16 D14  H08- W.16 D14</Size><SupplierCode>KB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>273290</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KB009</BillingCode><PriorBillingCodes><PriorBillingCode>SV071</PriorBillingCode></PriorBillingCodes><Name>STERISPINE™ Lumbar Cage- Paired</Name><Description>Curved and Straight Fusion Cage- Oblique/TLIF/PLIF PEEK (straight/curved/bullet nosed)- Paired</Description><Size>7 – 14mm in height, 10 – 12mm in width, 22 and 28mm in length</Size><SupplierCode>KB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>273286</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KB003</BillingCode><PriorBillingCodes><PriorBillingCode>SV063</PriorBillingCode></PriorBillingCodes><Name>STERISPINE™ Bone Screws with dual thread</Name><Description>Standard with dual thread</Description><Size>12mm x 3.5mm; 4.0 mm  13mm x 3.5mm; 4.0 mm  15mm x 3.5mm; 4.0 mm</Size><SupplierCode>KB</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>273286</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT080</BillingCode><PriorBillingCodes><PriorBillingCode>OH515</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Hand fracture system - multidirectional screw</Name><Description>Multidirectional screw</Description><Size>2.3mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276650</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT076</BillingCode><PriorBillingCodes><PriorBillingCode>OH502</PriorBillingCode><PriorBillingCode>MO145</PriorBillingCode></PriorBillingCodes><Name>Martin Ulna Head prosthesis</Name><Description>Ulnar Stem Titanium</Description><Size>Small, medium and large,2mm,4mm and 17mm collar</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1273</GroupID><SubGroupID>3667</SubGroupID><ARTGs><ARTG>225176</ARTG></ARTGs><MinimumBenefit>1064</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT016</BillingCode><PriorBillingCodes><PriorBillingCode>MO233</PriorBillingCode></PriorBillingCodes><Name>Martin Distraction Osteogenesis</Name><Description>Distractor System, Complete, other, titanium</Description><Size>1.5mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1603</GroupID><SubGroupID>4396</SubGroupID><Suffix>Single Vector</Suffix><ARTGs><ARTG>113786</ARTG></ARTGs><MinimumBenefit>4114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT018</BillingCode><PriorBillingCodes><PriorBillingCode>MO236</PriorBillingCode></PriorBillingCodes><Name>Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II)</Name><Description>Distractor System, Complete, External, Midface, Aluminium, Carbon Fibre</Description><Size>one size only</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1603</GroupID><SubGroupID>4396</SubGroupID><Suffix>Multivector</Suffix><ARTGs><ARTG>113786</ARTG></ARTGs><MinimumBenefit>7897</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT090</BillingCode><PriorBillingCodes><PriorBillingCode>OH641</PriorBillingCode><PriorBillingCode>OH469</PriorBillingCode></PriorBillingCodes><Name>KLS Martin - Radial Plating System</Name><Description>smartDrive Screw</Description><Size>2.5 x 8-30mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>276650</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT053</BillingCode><PriorBillingCodes><PriorBillingCode>MO396</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Distractor</Name><Description>Zurich II distractor bodies</Description><Size>15mm - 30mm distraction length</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4402</SubGroupID><ARTGs><ARTG>113786</ARTG></ARTGs><MinimumBenefit>2145</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT057</BillingCode><PriorBillingCodes><PriorBillingCode>MO401</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Plate Titanium</Description><Size>0.5 to 0.99mm thick, 4 - 7 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT071</BillingCode><PriorBillingCodes><PriorBillingCode>OH471</PriorBillingCode></PriorBillingCodes><Name>IXOS Radius Plating System</Name><Description>Titanium Radial Plates</Description><Size>23mm - 32mm x 60mm - 95mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5278</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>236206</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT105</BillingCode><Name>Nexos Pelvis Plates</Name><Description>C-Plates, I-Plates, S-Plates</Description><Size>8-14 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><ARTGs><ARTG>236206</ARTG></ARTGs><MinimumBenefit>645</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT111</BillingCode><PriorBillingCodes><PriorBillingCode>LH507</PriorBillingCode></PriorBillingCodes><Name>Martin Osteosynthesis 1.5mm System Burr hole plate</Name><Description>Burr Hole Plate, Titanium</Description><Size>0.6mm thick, 4-7 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Burr</Suffix><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT082</BillingCode><PriorBillingCodes><PriorBillingCode>OH518</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Hand fracture system - standard screw</Name><Description>Standard screw</Description><Size>2.3mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>276650</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT029</BillingCode><Name>Martin Level One Fixation</Name><Description>Plate, titanium</Description><Size>1.0 to 1.99mm thick, 16 to 32 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><Suffix>3D</Suffix><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>798</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT087</BillingCode><PriorBillingCodes><PriorBillingCode>OH534</PriorBillingCode><PriorBillingCode>OH516</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Hand Fracture System - Plates</Name><Description>Various Size and Shapes plates</Description><Size>1 to 6 hole</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>236206</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT054</BillingCode><PriorBillingCodes><PriorBillingCode>MO397</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Distractors</Name><Description>Zurich II remote release activators</Description><Size>20mm - 50mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4411</SubGroupID><ARTGs><ARTG>113786</ARTG></ARTGs><MinimumBenefit>487</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT086</BillingCode><PriorBillingCodes><PriorBillingCode>OH533</PriorBillingCode><PriorBillingCode>OH516</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Hand Fracture System - Plates</Name><Description>Various Size and Shaped Plates</Description><Size>1 to 6 Hole</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>236206</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT113</BillingCode><PriorBillingCodes><PriorBillingCode>LH511</PriorBillingCode></PriorBillingCodes><Name>Martin Osteosynthesis 1.5mm System Mesh 200cm2</Name><Description>Mesh, Titanium</Description><Size>0.5-0.8mm thick, &gt;200cm2</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4210</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>2072</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT030</BillingCode><Name>Martin Level One Fixation</Name><Description>Plate Titanium</Description><Size>1.0 to 1.99mm thick, 16 to 32 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT017</BillingCode><PriorBillingCodes><PriorBillingCode>MO234</PriorBillingCode></PriorBillingCodes><Name>Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II)</Name><Description>Distractor System, Component, Screws/Pins (other than bone screws), titanium</Description><Size>45-55mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4408</SubGroupID><ARTGs><ARTG>113786</ARTG><ARTG>96619</ARTG></ARTGs><MinimumBenefit>144</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT088</BillingCode><PriorBillingCodes><PriorBillingCode>OH639</PriorBillingCode><PriorBillingCode>OH468</PriorBillingCode></PriorBillingCodes><Name>KLS Martin - Radial Plating Sysem</Name><Description>smartDrive Locking Screw</Description><Size>2.5 x 8-30mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276650</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT092</BillingCode><PriorBillingCodes><PriorBillingCode>OH655</PriorBillingCode></PriorBillingCodes><Name>Martin Endoprosthesis System CapFlex PIP</Name><Description>CapFlex PIP Proximal</Description><Size>S,M,L</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6144</SubGroupID><ARTGs><ARTG>266373</ARTG></ARTGs><MinimumBenefit>760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT028</BillingCode><Name>Martin Level One Fixation Resorb x &amp; SonicWeld Rx</Name><Description>Plate, PDLLA (resorbable)</Description><Size>1.0 to 1.99mm thick, 16 to 32 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT099</BillingCode><Name>Recos Radial Plating System</Name><Description>Titanium Volar Locking Radius Plates</Description><Size>21mm - 24mm (Width) x 70mm (Length): 7-15 Holes</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>236206</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT020</BillingCode><PriorBillingCodes><PriorBillingCode>MO240</PriorBillingCode></PriorBillingCodes><Name>Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II)</Name><Description>Distractor System, Component, Other, titanium, aluminium</Description><Size>1.5-1.58mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4410</SubGroupID><ARTGs><ARTG>113786</ARTG></ARTGs><MinimumBenefit>1424</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT104</BillingCode><Name>L1® Rib Screws</Name><Description>Rib Osteosynthesis Screws</Description><Size>2.3mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276650</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT025</BillingCode><PriorBillingCodes><PriorBillingCode>MO287</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Screw Titanium</Description><Size>diameter &lt;1.24mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4321</SubGroupID><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT056</BillingCode><PriorBillingCodes><PriorBillingCode>MO400</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Plate ,Titanium</Description><Size>1.0 to 1.99mm thick, 8 -15 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4293</SubGroupID><ARTGs><ARTG>99619</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT073</BillingCode><PriorBillingCodes><PriorBillingCode>OH480</PriorBillingCode></PriorBillingCodes><Name>HBS 2 midi</Name><Description>Self-compressive screws</Description><Size>3.0mm x 10-40mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>276650</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT063</BillingCode><PriorBillingCodes><PriorBillingCode>MO412</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Orthodontic skeletal anchorage plate</Description><Size>0.5 to 0.99mm thick, 2 to 7 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4390</SubGroupID><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT036</BillingCode><PriorBillingCodes><PriorBillingCode>MO326</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation Resorb x &amp; Sonic Weld</Name><Description>Plate PDLLA (resorbable)</Description><Size>1.0 to 1.99mm thick, 8 to 15 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4293</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT026</BillingCode><Name>Martin Level One Fixation</Name><Description>Mesh, Titanium</Description><Size>&lt;0.2mm, 51 to 100cm² area</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4202</SubGroupID><ARTGs><ARTG>109878</ARTG></ARTGs><MinimumBenefit>371</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT046</BillingCode><PriorBillingCodes><PriorBillingCode>MO346</PriorBillingCode><PriorBillingCode>MO305</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Mesh PDLLA resorbable</Description><Size>0.5-0.8mm thick, 26-50cm²</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4227</SubGroupID><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>1182</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT004</BillingCode><Name>UNIQOS Patient Specific Anatomical Biomodel</Name><Description>Patient specific antomical biomodel</Description><Size>Custom-Patient Specific</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1807</GroupID><ARTGs><ARTG>463471</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT107</BillingCode><PriorBillingCodes><PriorBillingCode>LH492</PriorBillingCode></PriorBillingCodes><Name>Standard Approach Mesh</Name><Description>Pre-contoured titanium mesh implants for 11 standard approaches.</Description><Size>0.6mm thick</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4210</SubGroupID><ARTGs><ARTG>202842</ARTG></ARTGs><MinimumBenefit>2072</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT110</BillingCode><PriorBillingCodes><PriorBillingCode>LH506</PriorBillingCode></PriorBillingCodes><Name>Martin Osteosynthesis 1.5mm System 16-32 hole plate</Name><Description>Plate, Titanium</Description><Size>&lt;0.5mm thick, 16-32 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4266</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>283</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT098</BillingCode><Name>Nexos Screw</Name><Description>3.5mm Screws</Description><Size>3.5mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>276650</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT091</BillingCode><PriorBillingCodes><PriorBillingCode>OH642</PriorBillingCode><PriorBillingCode>OH469</PriorBillingCode></PriorBillingCodes><Name>KLS Martin - Radial Plating System</Name><Description>smartDrive Screw</Description><Size>3.0 x 8-30mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>276650</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT014</BillingCode><PriorBillingCodes><PriorBillingCode>MO224</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Plate, titanium</Description><Size>0.5-0.99mm thick, 4-7 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>96619</ARTG><ARTG>96620</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT072</BillingCode><PriorBillingCodes><PriorBillingCode>OH472</PriorBillingCode></PriorBillingCodes><Name>IXOS Radius Plating System</Name><Description>Straight/L plate R&amp;L</Description><Size>7.5-15mm x 43-52mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>236206</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>1372</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT070</BillingCode><PriorBillingCodes><PriorBillingCode>OH470</PriorBillingCode></PriorBillingCodes><Name>IXOS Radius Plating System</Name><Description>Titanium Radial Plates</Description><Size>23-27mm x 43-71mm - &gt;7 to &amp;lt;15 Holes</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>236206</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT048</BillingCode><PriorBillingCodes><PriorBillingCode>MO358</PriorBillingCode><PriorBillingCode>MO204</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Mesh PDLLA resorbable</Description><Size>0.5-0.8mm thick, 101-200cm²</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4229</SubGroupID><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>2018</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT009</BillingCode><PriorBillingCodes><PriorBillingCode>MO054</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Plate, titanium</Description><Size>1 to 1.99mm thick, &lt;4 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4286</SubGroupID><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>107</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT097</BillingCode><Name>Nexos Screw</Name><Description>4.5mm Screws</Description><Size>4.5mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>276650</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT008</BillingCode><PriorBillingCodes><PriorBillingCode>MO024</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Temporary condylar impant, titanium</Description><Size>5cm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4357</SubGroupID><ARTGs><ARTG>304394</ARTG></ARTGs><MinimumBenefit>1506</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT103</BillingCode><Name>L1® Rib Plates</Name><Description>Rib Osteosynthesis Plates</Description><Size>10-32 hole </Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5938</SubGroupID><ARTGs><ARTG>236206</ARTG></ARTGs><MinimumBenefit>1010</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT106</BillingCode><Name>Nexos Pelvis Plates</Name><Description>C-Plates, I-Plates, S-Plates</Description><Size>3-6 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><ARTGs><ARTG>236206</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT047</BillingCode><PriorBillingCodes><PriorBillingCode>MO347</PriorBillingCode><PriorBillingCode>MO127</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Mesh, Titanium &amp; 3D</Description><Size>0.2-0.49mm thick, 51-200cm²</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4205</SubGroupID><ARTGs><ARTG>109878</ARTG></ARTGs><MinimumBenefit>1229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT021</BillingCode><PriorBillingCodes><PriorBillingCode>MO242</PriorBillingCode></PriorBillingCodes><Name>Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II)</Name><Description>Distractor System, Component, Footplate, titanium</Description><Size>1.5mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4403</SubGroupID><ARTGs><ARTG>113786</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT058</BillingCode><PriorBillingCodes><PriorBillingCode>MO402</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation Resorb X &amp; SonicWeld RX</Name><Description>Mesh, PDLLA (resorbable)</Description><Size>0.50 to 0.80mm thick, 1 to 10cm²</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4225</SubGroupID><ARTGs><ARTG>14336</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT065</BillingCode><Name>IPS Custom Distractor</Name><Description>Internal distractor with patient specific 3D Printed plates and/or standard implant parts that have been adjusted to patients anatomical structures and needs.</Description><Size>1mm – 2mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1603</GroupID><SubGroupID>4399</SubGroupID><Suffix>Multivector</Suffix><ARTGs><ARTG>113786</ARTG></ARTGs><MinimumBenefit>2608</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT001</BillingCode><Name>UNIQOS Biomodelled Customised Orbital Floor Mesh</Name><Description>UNIQOS Biomodelled Customised Orbital Floor Mesh</Description><Size>Customised - patient specific</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4367</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>109878</ARTG></ARTGs><MinimumBenefit>4095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT019</BillingCode><PriorBillingCodes><PriorBillingCode>MO239</PriorBillingCode></PriorBillingCodes><Name>Martin Distraction Osteogenesis</Name><Description>Distractor System, Complete, other, titanium</Description><Size>15-60 mm distraction length</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1603</GroupID><SubGroupID>4399</SubGroupID><Suffix>Multivector</Suffix><ARTGs><ARTG>113786</ARTG></ARTGs><MinimumBenefit>2608</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT100</BillingCode><Name>Nexos Anatomic Pelvic Plates</Name><Description>Nexos Anatomic Pelvic Plates</Description><Size>16 holes or more  </Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5285</SubGroupID><ARTGs><ARTG>236206</ARTG></ARTGs><MinimumBenefit>760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT039</BillingCode><PriorBillingCodes><PriorBillingCode>MO330</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Mesh Titanium</Description><Size>0.5-0.8mm thick, 1-10cm²</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4207</SubGroupID><ARTGs><ARTG>109878</ARTG></ARTGs><MinimumBenefit>307</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT079</BillingCode><PriorBillingCodes><PriorBillingCode>OH514</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Hand fracture system - multidirectional locking screw</Name><Description>Multidirectional locking screw</Description><Size>1.2 – 2.0mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276650</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT062</BillingCode><PriorBillingCodes><PriorBillingCode>MO411</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Mesh, Titanium</Description><Size>0.5-0.8mm thick, 11-50cm²</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4208</SubGroupID><ARTGs><ARTG>109878</ARTG></ARTGs><MinimumBenefit>388</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT006</BillingCode><Name>Zurich II Modular Distractors</Name><Description>Distractor System, Component, Dual fixation plates, pair</Description><Size>Mesh-large and small design; Cloverleaf design</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4403</SubGroupID><Suffix>Dual Plate</Suffix><ARTGs><ARTG>113786</ARTG></ARTGs><MinimumBenefit>1279</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT005</BillingCode><Name>UNIQOS Patient Specific Surgical guides</Name><Description>UNIQOS Patient Specific Surgical guides</Description><Size>Custom - Patient specific</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>387616</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT094</BillingCode><Name>RECOS Ulna </Name><Description>Ulna Plate</Description><Size>Short 80mm, Long 90mm x 10mm  </Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>236206</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT060</BillingCode><PriorBillingCodes><PriorBillingCode>MO409</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Mesh, Titanium</Description><Size>0.9-0.49mm thick, 11-50cm²</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4204</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>109878</ARTG></ARTGs><MinimumBenefit>725</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT011</BillingCode><PriorBillingCodes><PriorBillingCode>MO135</PriorBillingCode></PriorBillingCodes><Name>Martin Distraction Osteogenesis</Name><Description>Distractor System, Complete, internal/intraoral, titanium</Description><Size>10 to 20 mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1603</GroupID><SubGroupID>4399</SubGroupID><Suffix>Single Vector</Suffix><ARTGs><ARTG>113786</ARTG></ARTGs><MinimumBenefit>1906</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT084</BillingCode><PriorBillingCodes><PriorBillingCode>OH531</PriorBillingCode><PriorBillingCode>OH516</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Hand Fracture System - Plates</Name><Description>Various size and shaped plates</Description><Size>7 to 15 hole</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>236206</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT067</BillingCode><Name>Martin Level One Fixation</Name><Description>Plate, Titanium</Description><Size>2.0-2.99m thick, 8-15 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4303</SubGroupID><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>459</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT003</BillingCode><Name>IPS Implants® Cranium</Name><Description>IPS Implants® Cranium</Description><Size>Custom - Patient Specific</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>4343</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>96619</ARTG><ARTG>96620</ARTG></ARTGs><MinimumBenefit>9682</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT027</BillingCode><Name>Martin Level One Fixation</Name><Description>Mesh, Titanium</Description><Size>&lt;0.2mm thick, 1 to 10cm² area</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4201</SubGroupID><ARTGs><ARTG>109878</ARTG></ARTGs><MinimumBenefit>161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT040</BillingCode><PriorBillingCodes><PriorBillingCode>MO331</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation Resorb x &amp; Sonic Weld</Name><Description>Sonic Pin PDDLA (resorbable)</Description><Size>Diameter 1.25 - 3.24mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>143327</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT038</BillingCode><PriorBillingCodes><PriorBillingCode>MO329</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Screw Titanium</Description><Size>Diameter 1.25 to 3.24mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>96620</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT102</BillingCode><Name>Nexos Anatomic Pelvic Plates</Name><Description>Nexos Anatomic Pelvic Plates</Description><Size>7-15 Holes</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5284</SubGroupID><ARTGs><ARTG>236206</ARTG></ARTGs><MinimumBenefit>727</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT015</BillingCode><PriorBillingCodes><PriorBillingCode>MO231</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation Resorb x &amp; SonicWeld Rx</Name><Description>Mesh, PDLLA (resorbable)</Description><Size>&gt;0.80mm thick, 11 to 25cm² area</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4231</SubGroupID><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>617</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT002</BillingCode><Name>UNIQOS custom Threadlock TS Mandible Reconstruction Plates</Name><Description>UNIQOS Custom Threadlock TS Mandible Reconstruction Plates</Description><Size>Custom-Patient Specific</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>2952</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT013</BillingCode><PriorBillingCodes><PriorBillingCode>MO188</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation Resorb x &amp; SonicWeld Rx</Name><Description>Mesh, PDLLA (resorbable)</Description><Size>0.20 to 0.49mm thick, 26 to 50cm² area</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4223</SubGroupID><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT033</BillingCode><Name>Martin Level One Fixation Resorb x &amp; SonicWeld</Name><Description>Reconstruction sheet not mesh PDLLA (resorbable)</Description><Size>25x25mm-0.1mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1588</GroupID><SubGroupID>4253</SubGroupID><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>224</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT037</BillingCode><PriorBillingCodes><PriorBillingCode>MO328</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Plate Titanium</Description><Size>0.5-0.99mm thick, 8-32 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT095</BillingCode><Name>IPS Implants® – Patient-Specific Implants</Name><Description>IPS patient specific maxilla complex locking reconstruction plate</Description><Size>Custom made - patient specific</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>2952</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT024</BillingCode><PriorBillingCodes><PriorBillingCode>MO283</PriorBillingCode></PriorBillingCodes><Name>Martin Micro Plate Osteosynthesis System</Name><Description>1.5mm system Straight Plate Titanium</Description><Size>2 hole, 0.6mm profile</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4267</SubGroupID><ARTGs><ARTG>96620</ARTG></ARTGs><MinimumBenefit>76</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT066</BillingCode><Name>Martin Level One Fixation</Name><Description>Plate, Titanium</Description><Size>2.0-2.99m thick, 4-7 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4301</SubGroupID><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>604</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT012</BillingCode><PriorBillingCodes><PriorBillingCode>MO185</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation Resorb x &amp; SonicWeld Rx</Name><Description>Mesh, PDLLA (resorbable)</Description><Size>1.0 to 1.99mm thick, 4 to 7 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><Suffix>Resorbable</Suffix><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>245</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT093</BillingCode><PriorBillingCodes><PriorBillingCode>OH656</PriorBillingCode></PriorBillingCodes><Name>Martin Endoprosthesis System CapFlex PIP</Name><Description>CapFlex PIP Distal</Description><Size>S,M,L, Height: 2.1, 3.0 &amp; 4.4mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6145</SubGroupID><ARTGs><ARTG>266373</ARTG></ARTGs><MinimumBenefit>760</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT049</BillingCode><PriorBillingCodes><PriorBillingCode>MO359</PriorBillingCode><PriorBillingCode>MO204</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Mesh PDLLA resorbable</Description><Size>&gt;0.8mm thick, 101-200cm2</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4496</SubGroupID><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>1953</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT007</BillingCode><PriorBillingCodes><PriorBillingCode>MO002</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Plate, titanium</Description><Size>=&gt;3mm thick, 8 to 15 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4312</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>96620</ARTG></ARTGs><MinimumBenefit>562</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT032</BillingCode><Name>Martin Level One Fixation Resorb x &amp; SonicWeld</Name><Description>Mesh PDLLA (resorbable)</Description><Size>0.20 to 0.49mm thick, 1 to 10 cm2 area</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4221</SubGroupID><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT085</BillingCode><PriorBillingCodes><PriorBillingCode>OH532</PriorBillingCode><PriorBillingCode>OH516</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Hand Fracture System - Plates</Name><Description>Various size and shaped plates</Description><Size>7 to 15 hole</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>236206</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT064</BillingCode><Name>Martin Level 1 Fixation</Name><Description>Orthodontic Screw</Description><Size>1.5 - 2.0mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>1602</GroupID><SubGroupID>4389</SubGroupID><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>76</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT010</BillingCode><PriorBillingCodes><PriorBillingCode>MO121</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Plate, titanium</Description><Size>&lt;0.5mm thick, 4 to 7 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4263</SubGroupID><Suffix>Burr</Suffix><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>155</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT112</BillingCode><PriorBillingCodes><PriorBillingCode>LH508</PriorBillingCode></PriorBillingCodes><Name>Martin Osteosynthesis 1.5mm System Mesh thin 50cm2</Name><Description>Mesh, Titanium</Description><Size>0.2-0.49mm thick, 11-50cm2</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4204</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>584</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT044</BillingCode><PriorBillingCodes><PriorBillingCode>MO344</PriorBillingCode><PriorBillingCode>MO300</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Mesh PDLLA resorbable</Description><Size>&gt;0.8mm thick, 1-10cm²</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4230</SubGroupID><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>569</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT089</BillingCode><PriorBillingCodes><PriorBillingCode>OH640</PriorBillingCode><PriorBillingCode>OH468</PriorBillingCode></PriorBillingCodes><Name>KLS Martin - Radial Plating Sysem</Name><Description>smartDrive Locking Screws</Description><Size>3.0 x 8-30mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>276650</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT059</BillingCode><PriorBillingCodes><PriorBillingCode>MO403</PriorBillingCode></PriorBillingCodes><Name>Martin Level  One Fixation Plate</Name><Description>Martin Level One Fixation</Description><Size>1.0-1.99mm thick, 4-7 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT022</BillingCode><PriorBillingCodes><PriorBillingCode>MO246</PriorBillingCode></PriorBillingCodes><Name>Martin Distraction Osteogenesis Rigid External Distraction (Polley RED II)</Name><Description>Distractor System, Component, Cross Bar, aluminium.carbon fibre</Description><Size>one size only</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>202</SubCategoryID><GroupID>1604</GroupID><SubGroupID>4406</SubGroupID><ARTGs><ARTG>113786</ARTG></ARTGs><MinimumBenefit>965</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT075</BillingCode><PriorBillingCodes><PriorBillingCode>OH500</PriorBillingCode><PriorBillingCode>MO324</PriorBillingCode></PriorBillingCodes><Name>Martin Ulna Head prosthesis</Name><Description>UHP Ceramic Head</Description><Size>Small, medium and large</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1273</GroupID><SubGroupID>3668</SubGroupID><ARTGs><ARTG>225176</ARTG></ARTGs><MinimumBenefit>1064</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT101</BillingCode><Name>Nexos Anatomic Pelvic Plates</Name><Description>Nexos Anatomic Pelvic Plates</Description><Size>6 holes or less</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5283</SubGroupID><ARTGs><ARTG>236206</ARTG></ARTGs><MinimumBenefit>679</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT077</BillingCode><PriorBillingCodes><PriorBillingCode>OH501</PriorBillingCode><PriorBillingCode>MO325</PriorBillingCode></PriorBillingCodes><Name>Martin Ulna Head prosthesis</Name><Description>UHP Cobalt Chrome Head</Description><Size>Small, medium and large</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1273</GroupID><SubGroupID>3668</SubGroupID><ARTGs><ARTG>225176</ARTG></ARTGs><MinimumBenefit>1064</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT068</BillingCode><PriorBillingCodes><PriorBillingCode>KT055</PriorBillingCode><PriorBillingCode>MO399</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Plating System</Name><Description>Locking, Preshaped reconstruction plates, in left and right options</Description><Size>2.0mm to 2.5mm thickness with 26 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4307</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>1073</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT074</BillingCode><PriorBillingCodes><PriorBillingCode>OH481</PriorBillingCode></PriorBillingCodes><Name>HBS 2 mini</Name><Description>Self-compressive screws</Description><Size>Diam: 1.7 - 2.0mm  Length: 10 - 40mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>276650</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>346</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT109</BillingCode><PriorBillingCodes><PriorBillingCode>LH505</PriorBillingCode></PriorBillingCodes><Name>Martin Osteosynthesis 1.5mm System 8-32 hole plate</Name><Description>Plate, 0.6mm thick, Titanium</Description><Size>8-32 hole</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT045</BillingCode><PriorBillingCodes><PriorBillingCode>MO345</PriorBillingCode><PriorBillingCode>MO305</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Mesh PDLLA resorbable</Description><Size>&gt;0.8mm thick, 26-50cm²</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1586</GroupID><SubGroupID>4232</SubGroupID><ARTGs><ARTG>143326</ARTG></ARTGs><MinimumBenefit>987</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT023</BillingCode><PriorBillingCodes><PriorBillingCode>MO251</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Mesh, Titanium</Description><Size>0.50 to 0.80mm thick, 51 to 100cm² area</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4209</SubGroupID><ARTGs><ARTG>109878</ARTG></ARTGs><MinimumBenefit>1146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT061</BillingCode><PriorBillingCodes><PriorBillingCode>MO410</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Plate, Titanium</Description><Size>≥3mm thick, 16 to 32 Holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4314</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>554</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT069</BillingCode><PriorBillingCodes><PriorBillingCode>KT055</PriorBillingCode><PriorBillingCode>MO399</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Plating System</Name><Description>Preshaped reconstruction plates, in left and right options, Complex, locking</Description><Size>2.0mm to 2.5mm thickness with 26 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4307</SubGroupID><Suffix>Complex, Locking</Suffix><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>1287</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT031</BillingCode><Name>Martin Level One Fixation</Name><Description>Mesh, Titanium</Description><Size>0.2 to 0.49mm thick, 1 to 10cm² area</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4203</SubGroupID><ARTGs><ARTG>109878</ARTG></ARTGs><MinimumBenefit>341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT108</BillingCode><PriorBillingCodes><PriorBillingCode>LH504</PriorBillingCode></PriorBillingCodes><Name>Martin Osteosynthesis 1.5mm System 8-15 hole plate</Name><Description>Plate, Titanium</Description><Size>&lt;0.5mm thick, 8-15 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4265</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>193</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT081</BillingCode><PriorBillingCodes><PriorBillingCode>OH517</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Hand fracture system, standard screw</Name><Description>Bone screw</Description><Size>1.2 – 2.0mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>276650</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT034</BillingCode><Name>Martin Level One Fixation</Name><Description>Mesh, Titanium</Description><Size>0.2 to 0.49mm thick, 1 to 10cm² area</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4203</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>109878</ARTG></ARTGs><MinimumBenefit>707</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT114</BillingCode><PriorBillingCodes><PriorBillingCode>LH516</PriorBillingCode></PriorBillingCodes><Name>Martin Osteosynthesis 1.5mm System Screw</Name><Description>Self retaining, Titanium</Description><Size>3-7mm length, 1.5-1.8mm diam</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>212844</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT043</BillingCode><PriorBillingCodes><PriorBillingCode>MO342</PriorBillingCode><PriorBillingCode>MO282</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Plate Titanium locking</Description><Size>1.0 to 1.99 mm thick, 4 - 7 holes</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>345</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT083</BillingCode><PriorBillingCodes><PriorBillingCode>OH519</PriorBillingCode></PriorBillingCodes><Name>KLS Martin Hand fracture system - washer</Name><Description>Washer</Description><Size>4.5 – 5mm</Size><SupplierCode>KT</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>276650</ARTG><ARTG>276674</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>KT035</BillingCode><Name>Martin Level One Fixation</Name><Description>Screw, titanium</Description><Size>Diameter 2.25 - 2.74mm</Size><SupplierCode>KT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>96619</ARTG></ARTGs><MinimumBenefit>88</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>UL009</BillingCode><Name>Revolution Cage</Name><Description>Spinal Cage</Description><Size>9-17mm high, 21-27mm length, 12-22 degrees</Size><SupplierCode>UL</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>349790</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>UL011</BillingCode><Name>Revolution TC/TS lumbar interbody fusion implant</Name><Description>Revolution TC/TS lumbar interbody fusion implant</Description><Size>21, 24, 27 lengths; 9-17mm heights; 12, 16, 22 deg lordosis</Size><SupplierCode>UL</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>349790</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>UL010</BillingCode><Name>Revolution Spacer</Name><Description>Spinal Spacer</Description><Size>9-17mm high, 21-27mm length, 12-22 degrees</Size><SupplierCode>UL</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>349790</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YB002</BillingCode><Name>Synicem Evolution Knee Spacer</Name><Description>Hip, Knee and Shoulder Spacer use is indicated for a limited period, in
patients with an infection due to gentamicin-sensitive germs, who require a
Two-stage Revision Arthroplasty. Together with the spacer, the use of
systemic antibiotic therapy is recommended. The Spacer is placed as a
hermiarthroplasty after the original implant is removed.</Description><Size>RD-58, RI-79, RI-72, RI-65, RI-58, RD-79, RD-72, RD-65</Size><SupplierCode>YB</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1401</GroupID><ARTGs><ARTG>477745</ARTG></ARTGs><MinimumBenefit>1814</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YB001</BillingCode><Name>Synicem Spacer with Gentamicin</Name><Description>Hip, Knee and Shoulder Spacer use is indicated for a limited period, in patients with an infection due to gentamicin-sensitive germs, who require a Two-stage Revision Arthroplasty. Together with the spacer, the use of systemic antibiotic therapy is recommended. The Spacer is placed as a hermiarthroplasty after the original implant is removed.</Description><Size>H40, H48</Size><SupplierCode>YB</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1278</GroupID><SubGroupID>7378</SubGroupID><ARTGs><ARTG>491575</ARTG></ARTGs><MinimumBenefit>1309</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YD003</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ106</PriorBillingCode></PriorBillingCodes><Name>AEON Powered Endostapler</Name><Description>Endoscopic Powered Stapler</Description><Size>60mm, 160mm, 260mm</Size><SupplierCode>YD</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix><ARTGs><ARTG>453405</ARTG></ARTGs><MinimumBenefit>447</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YD001</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ068</PriorBillingCode></PriorBillingCodes><Name>AEON Endostapler</Name><Description>Endoscopic articulated stapler</Description><Size>Short (60mm)  Medium (160mm)  Long (260mm)</Size><SupplierCode>YD</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>329207</ARTG></ARTGs><MinimumBenefit>357</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>YD002</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ069</PriorBillingCode></PriorBillingCodes><Name>AEON Endostapler Reload</Name><Description>Reload Staples</Description><Size>30mm-60mm</Size><SupplierCode>YD</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>329235</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ345</BillingCode><PriorBillingCodes><PriorBillingCode>LM080</PriorBillingCode></PriorBillingCodes><Name>Neurolac</Name><Description>A bioresorbable tension-less Nerve repair guide</Description><Size>1.5mm x 3cm to 10.0mm x 3cm</Size><SupplierCode>LH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1564</GroupID><ARTGs><ARTG>139653</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH657</BillingCode><PriorBillingCodes><PriorBillingCode>OO117</PriorBillingCode><PriorBillingCode>OO039</PriorBillingCode></PriorBillingCodes><Name>Mutars Proximal Femur</Name><Description>Mutars Proximal Femur</Description><Size>50/70mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3965</SubGroupID><Suffix>Body, Tumour</Suffix><ARTGs><ARTG>227163</ARTG><ARTG>284591</ARTG><ARTG>319680</ARTG></ARTGs><MinimumBenefit>4322</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ344</BillingCode><PriorBillingCodes><PriorBillingCode>LM335</PriorBillingCode></PriorBillingCodes><Name>Nerve Capping Device</Name><Description>A peripheral bioresorbable nerve capping device</Description><Size>30mm</Size><SupplierCode>LH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1564</GroupID><ARTGs><ARTG>285368</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH770</BillingCode><Name>Reosrba Synthetic bone</Name><Description>Injectable Bone Substitute – Granules / Syringe</Description><Size>16 &amp; 20cc</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><ARTGs><ARTG>400446</ARTG></ARTGs><MinimumBenefit>1425</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ352</BillingCode><PriorBillingCodes><PriorBillingCode>LM307</PriorBillingCode></PriorBillingCodes><Name>Osteomed FPS</Name><Description>Anterior Lateral Plates</Description><Size>7 to 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>1489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH853</BillingCode><PriorBillingCodes><PriorBillingCode>LM337</PriorBillingCode><PriorBillingCode>LM183</PriorBillingCode><PriorBillingCode>LM292</PriorBillingCode><PriorBillingCode>LM064</PriorBillingCode></PriorBillingCodes><Name>Trimed Plates</Name><Description>Elbow, Forearm, clavicle and Wrist Plates</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>916</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH804</BillingCode><PriorBillingCodes><PriorBillingCode>LM014</PriorBillingCode></PriorBillingCodes><Name>Trimed Marked K-Wire</Name><Description>Stainless Steel</Description><Size>Diameter 0.9 - 1.1mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH632</BillingCode><PriorBillingCodes><PriorBillingCode>OO056</PriorBillingCode></PriorBillingCodes><Name>MUTARS - PE Inlay</Name><Description>MUTARS - PE Inlay</Description><Size>xsmall, Small, Standard, Large</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1384</GroupID><ARTGs><ARTG>227770</ARTG></ARTGs><MinimumBenefit>2007</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ405</BillingCode><PriorBillingCodes><PriorBillingCode>LM517</PriorBillingCode></PriorBillingCodes><Name>OMNI Plating System</Name><Description>Straight Plates</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH859</BillingCode><PriorBillingCodes><PriorBillingCode>LM471</PriorBillingCode></PriorBillingCodes><Name>TriMed ASET Foot Plating System</Name><Description>Lapidus Plate</Description><Size>≥ 7 Holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH644</BillingCode><PriorBillingCodes><PriorBillingCode>OO103</PriorBillingCode></PriorBillingCodes><Name>ACS Knee Minimmaly Stabilised Tibial Insert</Name><Description>ACS PE Insert</Description><Size>10, 12.5, 15, 17.5, 20mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>265624</ARTG><ARTG>265632</ARTG><ARTG>265640</ARTG><ARTG>265641</ARTG><ARTG>265643</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH904</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Frame coupling devices for pins, wires, hinges and distractors</Description><Size>Swivel, short to long, low to high profile, 8mm, universal and one size</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4508</SubGroupID><ARTGs><ARTG>177324</ARTG><ARTG>229624</ARTG></ARTGs><MinimumBenefit>622</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH918</BillingCode><PriorBillingCodes><PriorBillingCode>VK003</PriorBillingCode><PriorBillingCode>PM061</PriorBillingCode></PriorBillingCodes><Name>Orthofix External Fixation System Elbow Fixator</Name><Description>Anodised aluminium and stainless steel</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4508</SubGroupID><ARTGs><ARTG>117273</ARTG><ARTG>118320</ARTG><ARTG>123604</ARTG></ARTGs><MinimumBenefit>622</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH773</BillingCode><PriorBillingCodes><PriorBillingCode>MB003</PriorBillingCode></PriorBillingCodes><Name>Adjustable Continence Therapy for Women</Name><Description>ACT Device: Prosthesis designed for the treatment of female SUI comprising of a single silicone balloon attached via a conduit to titanium and rubber ports allowing for post operative adjustment.</Description><Size>6 - 14cm</Size><SupplierCode>LH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1786</GroupID><SubGroupID>5450</SubGroupID><ARTGs><ARTG>163939</ARTG></ARTGs><MinimumBenefit>3938</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ422</BillingCode><PriorBillingCodes><PriorBillingCode>LM537</PriorBillingCode></PriorBillingCodes><Name>Omni Stable AF Plating System</Name><Description>Tibia Plates</Description><Size>7 to 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>1489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH776</BillingCode><PriorBillingCodes><PriorBillingCode>MB006</PriorBillingCode></PriorBillingCodes><Name>Adjustable Continence Therapy for Men</Name><Description>ProACT Device: Prosthesis designed for the treatment of male SUI comprising of a single silicone balloon attached via a conduit to titanium and rubber ports allowing for post operative adjustment.</Description><Size>6 - 14cm</Size><SupplierCode>LH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1786</GroupID><SubGroupID>5450</SubGroupID><ARTGs><ARTG>163939</ARTG></ARTGs><MinimumBenefit>3938</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH898</BillingCode><Name> TrueLok External Fixation Systems- Dynamization modules and Radiolucent dynamizers</Name><Description>Dynamization modules and each Radiolucent dynamizers supplied in a pack of 4.</Description><Size>One Size</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4508</SubGroupID><Suffix>CDD</Suffix><ARTGs><ARTG>177324</ARTG><ARTG>229624</ARTG></ARTGs><MinimumBenefit>622</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH950</BillingCode><PriorBillingCodes><PriorBillingCode>VK050</PriorBillingCode></PriorBillingCodes><Name>TrueLok Wire, Pin Fixators</Name><Description>Wire, Pin Fixators.</Description><Size>4mm to 8mm.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4508</SubGroupID><ARTGs><ARTG>177324</ARTG></ARTGs><MinimumBenefit>622</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH818</BillingCode><PriorBillingCodes><PriorBillingCode>LM123</PriorBillingCode><PriorBillingCode>LM002</PriorBillingCode></PriorBillingCodes><Name>TriMed Periarticular Plate</Name><Description>Periarticular Plates</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH798</BillingCode><Name>Sophysa Polaris Catheter</Name><Description>Atrial/Peritoneal Catheters</Description><Size>1.1mm ID; 2.5mm OD; length 110cm</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>478065</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH956</BillingCode><PriorBillingCodes><PriorBillingCode>LM213</PriorBillingCode></PriorBillingCodes><Name>Fusion Cup</Name><Description>PEEK curved and round plate</Description><Size>7, 9, 10, 11 &amp; 12 hole</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH743</BillingCode><PriorBillingCodes><PriorBillingCode>LM527</PriorBillingCode></PriorBillingCodes><Name>Sophy Valves - hydrocephalic</Name><Description>Monopressure Valve with Antechamber or Burr-Hole Reservoir  </Description><Size>50 - 170mmH2O</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Reservoir/Priming function</Suffix><ARTGs><ARTG>143218</ARTG></ARTGs><MinimumBenefit>898</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH821</BillingCode><PriorBillingCodes><PriorBillingCode>LM126</PriorBillingCode><PriorBillingCode>LM099</PriorBillingCode></PriorBillingCodes><Name>TriMed Sidewinder</Name><Description>Ankle Fixation Plate</Description><Size>7 hole sidewinder plate</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>916</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH485</BillingCode><Name>Paradigm  Spinal System</Name><Description>DSS/ HPS Rod, Titanium alloy</Description><Size>5.5mm diameter rod  Length: 20mm to 300mm</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>186733</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH920</BillingCode><PriorBillingCodes><PriorBillingCode>VK005</PriorBillingCode><PriorBillingCode>PM063</PriorBillingCode></PriorBillingCodes><Name>Orthofix External Fixation System Knee Fixator</Name><Description>Anodised aluminium and stainless steel</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4508</SubGroupID><ARTGs><ARTG>117273</ARTG><ARTG>118320</ARTG><ARTG>123604</ARTG><ARTG>177324</ARTG></ARTGs><MinimumBenefit>622</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH668</BillingCode><PriorBillingCodes><PriorBillingCode>OO129</PriorBillingCode></PriorBillingCodes><Name>MUTARS extension piece</Name><Description>MUTARS humerus extension piece</Description><Size>20mm/40mm/60mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5412</SubGroupID><ARTGs><ARTG>244561</ARTG><ARTG>284403</ARTG></ARTGs><MinimumBenefit>4173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ338</BillingCode><PriorBillingCodes><PriorBillingCode>LM326</PriorBillingCode></PriorBillingCodes><Name>Extremilock Screws</Name><Description>Screws</Description><Size>2.7mm - 4.49mm x 8-70mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>149435</ARTG><ARTG>202319</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH914</BillingCode><PriorBillingCodes><PriorBillingCode>CB023</PriorBillingCode></PriorBillingCodes><Name>PHIL</Name><Description>Precipitating Hydrophobic injectable liquid</Description><Size>1ml PHIL liquid embolic, 1 sterile pre-filled syringe of DMSO and 1 Universal Adaptor</Size><SupplierCode>LH</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1692</GroupID><ARTGs><ARTG>375425</ARTG></ARTGs><MinimumBenefit>2076</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH887</BillingCode><PriorBillingCodes><PriorBillingCode>QQ584</PriorBillingCode></PriorBillingCodes><Name>Extremity Medical Screw System</Name><Description>Non locking Screws</Description><Size>3.0-4.0mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>164980</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ411</BillingCode><PriorBillingCodes><PriorBillingCode>LM523</PriorBillingCode></PriorBillingCodes><Name>OMNI Plating System</Name><Description>Cannulated Screws</Description><Size>3.5mm diameter; 20-70mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ361</BillingCode><PriorBillingCodes><PriorBillingCode>LM279</PriorBillingCode></PriorBillingCodes><Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Cortical Screw</Name><Description>Cortical Screw</Description><Size>3.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>182168</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH875</BillingCode><PriorBillingCodes><PriorBillingCode>LM553</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Bone Screw Locking  </Name><Description>Bone Screw Locking  </Description><Size>3.5mm diameter, 10 to 44mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH694</BillingCode><PriorBillingCodes><PriorBillingCode>OO146</PriorBillingCode></PriorBillingCodes><Name>MUTARS LUMiC Cup</Name><Description>Modular partial pelvic replacement and acetabular reconstruction device in case of large bone defects</Description><Size>50, 54 and 60mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1432</GroupID><SubGroupID>4034</SubGroupID><Suffix>Tumour</Suffix><ARTGs><ARTG>227162</ARTG><ARTG>284582</ARTG></ARTGs><MinimumBenefit>8351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH620</BillingCode><PriorBillingCodes><PriorBillingCode>OO033</PriorBillingCode></PriorBillingCodes><Name>IC-Head Biolox delta</Name><Description>Biolox delta ceramic head</Description><Size>36mm and 40 mm. S, M, L and XL.</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3999</SubGroupID><ARTGs><ARTG>288475</ARTG></ARTGs><MinimumBenefit>1626</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH675</BillingCode><PriorBillingCodes><PriorBillingCode>OO136</PriorBillingCode></PriorBillingCodes><Name>MUTARS Cancellous Screws</Name><Description>MUTARS Cancellous Screws</Description><Size>10-40mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>237075</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH614</BillingCode><PriorBillingCodes><PriorBillingCode>OO026</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System-ACS spacer (tibial and femoral)</Name><Description>ACS tibial and femoral augments for use with mobile bearing and Revision FB tibial base plates</Description><Size>Left and Right, medial, lateral, posterior and distal.</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>221737</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH830</BillingCode><PriorBillingCodes><PriorBillingCode>LM146</PriorBillingCode><PriorBillingCode>LM007</PriorBillingCode></PriorBillingCodes><Name>TriMed Bone Screws</Name><Description>Non-Locking cortical, hex, cancellous and lag screws for Wrist, Ankle and Ulnar Osteotomy plating systems</Description><Size>3.2 - 3.8mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH678</BillingCode><PriorBillingCodes><PriorBillingCode>OO160</PriorBillingCode></PriorBillingCodes><Name>MUTARS GenuX MK Augments</Name><Description>MUTARS GenuX MK Augments</Description><Size>1-6 Femoral distal,  Femoral posterior and 1-6 Tibial spacers. 5-20mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>221737</ARTG><ARTG>284264</ARTG><ARTG>284265</ARTG><ARTG>284266</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH882</BillingCode><PriorBillingCodes><PriorBillingCode>QQ181</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Bone Screw</Name><Description>Polyaxial locking cannulated screw</Description><Size>3.0mm x 10-70mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,LK</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH888</BillingCode><PriorBillingCodes><PriorBillingCode>QQ585</PriorBillingCode></PriorBillingCodes><Name>Extremity Medical Screw system</Name><Description>Cannulated Screws </Description><Size>3.0-4.3mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>164980</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ413</BillingCode><PriorBillingCodes><PriorBillingCode>LM536</PriorBillingCode></PriorBillingCodes><Name>Omni Stable AF Plating System</Name><Description>Cannulated Screws</Description><Size>4.0 x 20-70mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ395</BillingCode><PriorBillingCodes><PriorBillingCode>LM383</PriorBillingCode></PriorBillingCodes><Name>K-Wire</Name><Description>K-Wire</Description><Size>Multiple sizes to suit patient and surgeon requirements</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>317003</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH865</BillingCode><PriorBillingCodes><PriorBillingCode>LM477</PriorBillingCode></PriorBillingCodes><Name>TriMed ASET Foot Plating System</Name><Description>VA Locking Screws (small) </Description><Size>2.71mm – 4.49mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH880</BillingCode><PriorBillingCodes><PriorBillingCode>LM561</PriorBillingCode></PriorBillingCodes><Name>TriMed Headless Compression Screws</Name><Description>Dual thread, cannulated headless compression screws</Description><Size>3.0-3.5mm x 10-45mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>229704</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH886</BillingCode><PriorBillingCodes><PriorBillingCode>QQ583</PriorBillingCode></PriorBillingCodes><Name>Extremity Medical  Screw System</Name><Description> Small non locking crews</Description><Size>3.0-4.0mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>164980</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ397</BillingCode><PriorBillingCodes><PriorBillingCode>LM504</PriorBillingCode></PriorBillingCodes><Name>Locking Screws (Small)</Name><Description>Locking Screws (Small)</Description><Size>2.71mm – 4.49mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ116</BillingCode><PriorBillingCodes><PriorBillingCode>KH072</PriorBillingCode></PriorBillingCodes><Name>Rejoin Peek Suture Anchor</Name><Description>Suture Anchor System</Description><Size>Greater than 4.0mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>320191</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH627</BillingCode><PriorBillingCodes><PriorBillingCode>OO041</PriorBillingCode></PriorBillingCodes><Name>Mutars RS revision system - cementless stem HA</Name><Description>RS Cementless stem HA</Description><Size>12 - 22mm dia stems, 150 - 190mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>236460</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH895</BillingCode><Name>eight-Plate Plus  screw</Name><Description>Solid screw for the guided growth eight-plate and quad-plate</Description><Size>3.5mm x 12-16mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>289252</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ329</BillingCode><Name>Omni Stable AF Plating System</Name><Description>Lateral and straight variable angle locking plates</Description><Size>16 - 19 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>810</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-08-08</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ356</BillingCode><PriorBillingCodes><PriorBillingCode>LM262</PriorBillingCode></PriorBillingCodes><Name>Osteomed Plates</Name><Description>Low Profile plates</Description><Size>1.2/1.6/2.0/2.4mm 4-12 hole; straight, L, T</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH676</BillingCode><PriorBillingCodes><PriorBillingCode>OO137</PriorBillingCode></PriorBillingCodes><Name>IC Muller PE snap lock cup</Name><Description>PE acetabulum cup , constrained</Description><Size>44 – 64mm, 32mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4008</SubGroupID><ARTGs><ARTG>234880</ARTG></ARTGs><MinimumBenefit>699</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ355</BillingCode><PriorBillingCodes><PriorBillingCode>LM263</PriorBillingCode></PriorBillingCodes><Name>OsteoMed HPS</Name><Description>Low Profile hand plates</Description><Size>1.2/1.6/2.0/2.4mm 4-12 hole; Complex</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH835</BillingCode><PriorBillingCodes><PriorBillingCode>LM210</PriorBillingCode></PriorBillingCodes><Name>Jones Fracture Plate</Name><Description>Fracture Fixation Systems</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>308</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH515</BillingCode><Name>Martin Osteosynthesis 1.5mm System 1mm 16-32 hole plate</Name><Description>Plate, Titanium</Description><Size>1.0-1.99mm thick, 16-32 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH633</BillingCode><PriorBillingCodes><PriorBillingCode>OO057</PriorBillingCode></PriorBillingCodes><Name>MUTARS - Patella</Name><Description>Mutars PE Patella</Description><Size>Standard Large</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>227773</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH947</BillingCode><PriorBillingCodes><PriorBillingCode>VK047</PriorBillingCode></PriorBillingCodes><Name>Orthofix and CalcFix Plus Calcaneal External Fixator Sterile Kit</Name><Description>The Kits contain the Calcaneal Fixator, T-Wrench, Driver, Screws and Kirschner wire.</Description><Size>One size.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>5509</SubGroupID><ARTGs><ARTG>257368</ARTG></ARTGs><MinimumBenefit>5397</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH925</BillingCode><PriorBillingCodes><PriorBillingCode>VK010</PriorBillingCode><PriorBillingCode>PM099</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic External Fixation System - Xcaliber External Fixator</Name><Description>Articulated Ankle Fixator</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>5509</SubGroupID><ARTGs><ARTG>257368</ARTG></ARTGs><MinimumBenefit>5397</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH927</BillingCode><PriorBillingCodes><PriorBillingCode>VK012</PriorBillingCode><PriorBillingCode>PM108</PriorBillingCode></PriorBillingCodes><Name>Orthofix Limb Reconstruction System</Name><Description>Orthofix Limb Reconstruction System</Description><Size>Adult and paediatric - Short, Standard and Long</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>5509</SubGroupID><ARTGs><ARTG>197364</ARTG></ARTGs><MinimumBenefit>5397</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH531</BillingCode><Name>M6L Artificial Lumbar Disc</Name><Description>Intervertebral Artificial Disc – Lumbar</Description><Size>(Medium, Large, Xlarge) footprint, 3 - 16 degrees lordosis</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5488</SubGroupID><ARTGs><ARTG>177102</ARTG></ARTGs><MinimumBenefit>8847</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH756</BillingCode><PriorBillingCodes><PriorBillingCode>LM425</PriorBillingCode><PriorBillingCode>NK079</PriorBillingCode></PriorBillingCodes><Name>Synergy Disc</Name><Description>The Synergy Disc is a three-component system consisting of an Inferior titanium endplate, a UHMWPE core and a Superior titanium endplate.</Description><Size>Small (A-P: 14 mm, Lateral: 15 mm), Medium (A-P: 16 mm, Lateral: 17 mm) and Large (A-P: 16 mm, Lateral: 17 mm).</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5487</SubGroupID><ARTGs><ARTG>238877</ARTG></ARTGs><MinimumBenefit>6021</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH494</BillingCode><Name>Aneurism Clip - Elgiloy</Name><Description>Sugita Clips, Elgiloy. Cobalt Chrome alloy.</Description><Size>One size each</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>218</SubCategoryID><GroupID>1655</GroupID><ARTGs><ARTG>100108</ARTG></ARTGs><MinimumBenefit>233</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH860</BillingCode><PriorBillingCodes><PriorBillingCode>LM472</PriorBillingCode></PriorBillingCodes><Name>TriMed ASET Foot Plating System </Name><Description>MTP Plates</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH294</BillingCode><PriorBillingCodes><PriorBillingCode>TB294</PriorBillingCode></PriorBillingCodes><Name>Aneurism Clip - T2</Name><Description>Sugita Clips, Titanium 2, Fenestrated and Crankshaft.</Description><Size>One size each</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>218</SubCategoryID><GroupID>1655</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>100120</ARTG></ARTGs><MinimumBenefit>341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ364</BillingCode><PriorBillingCodes><PriorBillingCode>LM276</PriorBillingCode></PriorBillingCodes><Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Plate ≥ 16 holes</Name><Description>Proximal Humerus Plate</Description><Size>≥ 16 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5275</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>182168</ARTG></ARTGs><MinimumBenefit>1643</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH119</BillingCode><PriorBillingCodes><PriorBillingCode>TB119</PriorBillingCode></PriorBillingCodes><Name>Aneurism Clip - T2</Name><Description>Sugita Clips, Titanium2. Slim, mini, curved and L-shape.</Description><Size>One Size Each</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>218</SubCategoryID><GroupID>1655</GroupID><ARTGs><ARTG>100108</ARTG></ARTGs><MinimumBenefit>233</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH643</BillingCode><PriorBillingCodes><PriorBillingCode>OO102</PriorBillingCode></PriorBillingCodes><Name>IC Intramedullary Plug</Name><Description>Intramedullary Plug</Description><Size>9mm, 14mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1437</GroupID><ARTGs><ARTG>208322</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH147</BillingCode><PriorBillingCodes><PriorBillingCode>TB147</PriorBillingCode></PriorBillingCodes><Name>Aneurism Clip - T2</Name><Description>Sugita Clips, Titanium 2. L-shape, bayoneted, slightly curved, curved.</Description><Size>One Size Each</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>218</SubCategoryID><GroupID>1655</GroupID><ARTGs><ARTG>100108</ARTG></ARTGs><MinimumBenefit>233</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH148</BillingCode><PriorBillingCodes><PriorBillingCode>TB148</PriorBillingCode></PriorBillingCodes><Name>Aneurism Clip - T2</Name><Description>Sugita Clips, Titanium 2. Mini, temp, straight.</Description><Size>One Size Each</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>218</SubCategoryID><GroupID>1655</GroupID><ARTGs><ARTG>100108</ARTG></ARTGs><MinimumBenefit>233</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ347</BillingCode><PriorBillingCodes><PriorBillingCode>LM253</PriorBillingCode></PriorBillingCodes><Name>OsteoMed FPS</Name><Description>Titanium locking footplates</Description><Size>2mm and 2.7mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH512</BillingCode><Name>Martin Osteosynthesis 1.5mm System 3D Mesh 200cm2</Name><Description>3D Mesh, Titanium</Description><Size>0.2-0.49mm thick, 51-200cm2</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4205</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>1229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH615</BillingCode><PriorBillingCodes><PriorBillingCode>OO027</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System </Name><Description> ACS double taper adapter, ACS MB offset adapter, ACS Double Taper for MK stems, ACS MB offset adapter for MK stems</Description><Size>0, +2mm, +4mm, +6mm.</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1396</GroupID><ARTGs><ARTG>265635</ARTG><ARTG>265644</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH637</BillingCode><PriorBillingCodes><PriorBillingCode>OO093</PriorBillingCode></PriorBillingCodes><Name>MUTARS - Genux offset adapter</Name><Description>Offset Adapter</Description><Size>0, 2.5mm, 5mm, 7.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1396</GroupID><ARTGs><ARTG>250452</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH680</BillingCode><PriorBillingCodes><PriorBillingCode>OO162</PriorBillingCode></PriorBillingCodes><Name>MUTARS GenuX MK Offset Adapter</Name><Description>MUTARS GenuX MK Offset Adapter</Description><Size>Offset adapter 0mm, +2mm, +4mm, +6mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1396</GroupID><ARTGs><ARTG>245856</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH605</BillingCode><PriorBillingCodes><PriorBillingCode>OO012</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System - PE patella implant</Name><Description>ACS PE patella</Description><Size>26mm, 29mm, 32mm, 35mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>265637</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH706</BillingCode><Name>Ultio Laminoplasty Screw</Name><Description>Screw, self drilling, self tapping</Description><Size>4-20mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>275605</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH826</BillingCode><PriorBillingCodes><PriorBillingCode>LM140</PriorBillingCode><PriorBillingCode>LM037</PriorBillingCode></PriorBillingCodes><Name>TriMed Wrist Fixation System</Name><Description>TriMed Volar Bearing Plate</Description><Size>3 and 5 hole</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>1372</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH812</BillingCode><PriorBillingCodes><PriorBillingCode>LM117</PriorBillingCode><PriorBillingCode>LM002</PriorBillingCode></PriorBillingCodes><Name>TriMed Radial Column Plates</Name><Description>Radial Column Plate</Description><Size>3 &amp; 5 hole</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH847</BillingCode><PriorBillingCodes><PriorBillingCode>LM321</PriorBillingCode></PriorBillingCodes><Name>GEMINUS Volar Distal Radius Plates</Name><Description>Fixation Plate for Distal Radius Fractures</Description><Size>3 and 4 hole</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>1372</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH819</BillingCode><PriorBillingCodes><PriorBillingCode>LM124</PriorBillingCode><PriorBillingCode>LM002</PriorBillingCode></PriorBillingCodes><Name>TriMed Periarticular Plate</Name><Description>Periarticular Plates</Description><Size>≥ 16 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH792</BillingCode><PriorBillingCodes><PriorBillingCode>LM070</PriorBillingCode></PriorBillingCodes><Name>Lockdown Shoulder Stabilisation System </Name><Description>Woven Polyester Prosthetic Ligament</Description><Size>5 to 20cm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1776</GroupID><SubGroupID>5398</SubGroupID><ARTGs><ARTG>433851</ARTG></ARTGs><MinimumBenefit>4217</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH814</BillingCode><PriorBillingCodes><PriorBillingCode>LM119</PriorBillingCode><PriorBillingCode>LM002</PriorBillingCode></PriorBillingCodes><Name>TriMed Ulna Column Plates</Name><Description>Ulna Column Plate</Description><Size>3 &amp; 5 hole</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH836</BillingCode><PriorBillingCodes><PriorBillingCode>LM211</PriorBillingCode></PriorBillingCodes><Name>Trimed Volar &amp; Dorsal Hook Plate</Name><Description>Wrist Fixation System - Volar &amp; Dorsal Hook Plates</Description><Size>≤ 6 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>1113</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH791</BillingCode><PriorBillingCodes><PriorBillingCode>CB019</PriorBillingCode></PriorBillingCodes><Name>Option ELITE Vena Cava Filter</Name><Description>The Option ELITE Vena Cava Filter is designed for the prevention of recurrent pulmonary embolism via percutaneous delivery in the inferior vena cava.</Description><Size>Suitable for vessels up to 32mm</Size><SupplierCode>LH</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>211</SubCategoryID><GroupID>1642</GroupID><ARTGs><ARTG>283794</ARTG><ARTG>284696</ARTG></ARTGs><MinimumBenefit>2059</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH654</BillingCode><PriorBillingCodes><PriorBillingCode>OO113</PriorBillingCode></PriorBillingCodes><Name>Mutars – Proximal Tibia</Name><Description>Mutars – Proximal Tibia</Description><Size>100mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1381</GroupID><SubGroupID>3932</SubGroupID><ARTGs><ARTG>227164</ARTG><ARTG>284586</ARTG></ARTGs><MinimumBenefit>7066</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH650</BillingCode><PriorBillingCodes><PriorBillingCode>OO109</PriorBillingCode></PriorBillingCodes><Name>Mutars – tibial plateau</Name><Description>Tibial plateau for hinged knee</Description><Size>X small, small, standard, large</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1381</GroupID><SubGroupID>3932</SubGroupID><ARTGs><ARTG>225903</ARTG><ARTG>284585</ARTG></ARTGs><MinimumBenefit>7066</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH623</BillingCode><PriorBillingCodes><PriorBillingCode>OO036</PriorBillingCode></PriorBillingCodes><Name>IC Polaric head</Name><Description>IC Polaric head</Description><Size>38, 40, 42, 44, 46, 48, 50, 52, 54, 56, 58</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4024</SubGroupID><ARTGs><ARTG>281540</ARTG></ARTGs><MinimumBenefit>1540</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH616</BillingCode><PriorBillingCodes><PriorBillingCode>OO029</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System - ACS Screws</Name><Description>Screw for spacers and augments</Description><Size>2 sizes</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1398</GroupID><ARTGs><ARTG>221737</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH939</BillingCode><PriorBillingCodes><PriorBillingCode>VK038</PriorBillingCode></PriorBillingCodes><Name>Fusion Beaming System</Name><Description>The Fusion Beaming System has been designed to address the specific demands of advanced deformity and trauma reconstructions of foot and ankle applications. The system was developed for the treatment of neuropathic deformities, such as Charcot, requiring fusion of the medial and/or lateral columns, with or without corrective osteotomies as well as for joint fusions within the mid and hindfoot. The Fusion Beaming System consists of two different diameter implant ranges, designed for optimal implant selection for wide ranging patient anatomies, and an instrumentation including the dedicated Sterilization Tray. The Fusion Beaming System is designed with an instrumentation and technique that have been developed to simplify the surgery.</Description><Size>5.4mm diameter implants: Lengths - 50mm, 55mm, 60mm, 65mm, 70mm, 75mm, 80mm, 85mm, 90mm, 95mm, 100mm, 105mm, 110mm, 115mm, 120mm, 125mm, 130mm, 135mm, 140mm, 145mm, 150mm, 155mm, 160mm, 165mm, 170mm.  7.4mm diameter implants: Lengths - 50mm, 55mm, 60mm, 65mm, 70mm, 75mm, 80mm, 85mm, 90mm, 95mm, 100mm, 105mm, 110mm, 115mm, 120mm, 125mm, 130mm, 135mm, 140mm, 145mm, 150mm, 155mm, 160mm, 165mm, 170mm, 175mm, 180mm, 185mm, 190mm, 195mm, 200mm.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5474</SubGroupID><ARTGs><ARTG>295285</ARTG><ARTG>307583</ARTG><ARTG>307749</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ531</BillingCode><PriorBillingCodes><PriorBillingCode>DE608</PriorBillingCode></PriorBillingCodes><Name>IFUSE Implant System</Name><Description>Sacral fusion implants IFUSE &amp; IFUSE 3D</Description><Size>7-13.5mm x 30-90mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>261</SubCategoryID><GroupID>1821</GroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>212886</ARTG></ARTGs><MinimumBenefit>1853</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH945</BillingCode><PriorBillingCodes><PriorBillingCode>VK045</PriorBillingCode></PriorBillingCodes><Name>LRS Clamps</Name><Description>Monoplanar clamp - 3 dimensional.</Description><Size>Small.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3402</SubGroupID><ARTGs><ARTG>123604</ARTG><ARTG>172152</ARTG><ARTG>197638</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH954</BillingCode><Name>iFuse TORQ Implant System</Name><Description>Threaded fenestrated 3D printed sacroiliac fusion implant</Description><Size>10.0mm, 11.5mm, 13.5mm in lengths 30mm-90mm in 5mm increments</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>261</SubCategoryID><GroupID>1821</GroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>511368</ARTG></ARTGs><MinimumBenefit>1853</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH759</BillingCode><PriorBillingCodes><PriorBillingCode>LM422</PriorBillingCode><PriorBillingCode>NK045</PriorBillingCode></PriorBillingCodes><Name>Silex Joint Fixation Device</Name><Description>Single-Thread Sacroiliac Anchor Implant or Dual-Thread Sacroiliac Anchor Implant</Description><Size>12.5mm x 30-70mm</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>261</SubCategoryID><GroupID>1821</GroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>228758</ARTG></ARTGs><MinimumBenefit>1853</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH617</BillingCode><PriorBillingCodes><PriorBillingCode>OO030</PriorBillingCode></PriorBillingCodes><Name>Mutars RS revision system - bolt</Name><Description>RS bolt</Description><Size>40,50,65,75,90,100,115,125mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1434</GroupID><ARTGs><ARTG>250156</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH560</BillingCode><PriorBillingCodes><PriorBillingCode>AJ007</PriorBillingCode></PriorBillingCodes><Name>JectOS</Name><Description>Injectable synthetic bone graft substitute</Description><Size>5cc</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>141918</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH562</BillingCode><PriorBillingCodes><PriorBillingCode>AJ041</PriorBillingCode></PriorBillingCodes><Name>i-FACTOR Putty Peptide Enhanced Bone Graft</Name><Description>P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute</Description><Size>0 - 5.0mL</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>169831</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ333</BillingCode><PriorBillingCodes><PriorBillingCode>LM215</PriorBillingCode></PriorBillingCodes><Name>BonAlive Granules</Name><Description>Bone Graft Substitute - Bioactive Glass Granules</Description><Size>Range (1-5cc)
0.5-08mm (small) 1cc
0.5-08mm (small) 2.5cc
0.5-0.8mm (small) 5cc
1.0-2.0mm (medium) 5cc
2.0-3.15mm (large) 5cc</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>176953</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH766</BillingCode><Name>Reosrba Synthetic bone</Name><Description>Injectable Bone Substitute – Putty</Description><Size>0.5-5mL</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>400447</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH768</BillingCode><Name>Reosrba Synthetic bone</Name><Description>60/40 HA/TCP bone graft substitute</Description><Size>2cc, 5cc Granules</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>400446</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH679</BillingCode><PriorBillingCodes><PriorBillingCode>OO161</PriorBillingCode></PriorBillingCodes><Name>MUTARS GenuX MK Stems</Name><Description>MUTARS GenuX MK Stems</Description><Size>11/12/13/14/15/16/17/18/19/20/22/24/26/28mm dia. 125/150/200/250 length</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>241989</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH634</BillingCode><PriorBillingCodes><PriorBillingCode>OO082</PriorBillingCode></PriorBillingCodes><Name>MUTARS - Arthrodesis stems</Name><Description>Arthrodesis tibial and femoral stems, cvd, straight, cemented/cementless</Description><Size>11-20mm x 100 - 250mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5475</SubGroupID><ARTGs><ARTG>236019</ARTG></ARTGs><MinimumBenefit>3724</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH557</BillingCode><Name>IOS  Fixator Kit</Name><Description>Complete kit of fixator, 6x bone pins, 6 x set screws, 6 x collets, drill bit.</Description><Size>long, short</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>6401</SubGroupID><ARTGs><ARTG>266632</ARTG></ARTGs><MinimumBenefit>3042</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH765</BillingCode><Name>Neodura Dural Repair Patch ≤10cm²</Name><Description>absorbable dural repair patch made of degradable PLLA &amp; Gelatin</Description><Size>10cm² or less</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1657</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>419571</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>320</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH683</BillingCode><PriorBillingCodes><PriorBillingCode>OO173</PriorBillingCode></PriorBillingCodes><Name>MUTARS Femoral Stem Cemented with TiN and HA Collar</Name><Description>MUTARS Femoral Stem Cemented with TiN and HA Collar</Description><Size>11/13/15/17 
120/160/200/240mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1405</GroupID><SubGroupID>3944</SubGroupID><ARTGs><ARTG>244313</ARTG></ARTGs><MinimumBenefit>2980</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH844</BillingCode><PriorBillingCodes><PriorBillingCode>LM318</PriorBillingCode></PriorBillingCodes><Name>PROTEAN Plate</Name><Description>Plate</Description><Size>One size</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>1126</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH662</BillingCode><PriorBillingCodes><PriorBillingCode>OO122</PriorBillingCode></PriorBillingCodes><Name>ACS Knee system, ACS stems, straight and offset</Name><Description>ACS tibial and femoral stems</Description><Size>12/14/16/18/20/22mm dia stems, 25/50/75/100/150/200mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>241989</ARTG><ARTG>265633</ARTG><ARTG>265634</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ335</BillingCode><PriorBillingCodes><PriorBillingCode>LM207</PriorBillingCode></PriorBillingCodes><Name>BonAlive Putty</Name><Description>Bone Graft Substitute - Bioactive Glass Putty</Description><Size>1cc, 2.5cc, 5cc</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>231484</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH638</BillingCode><PriorBillingCodes><PriorBillingCode>OO094</PriorBillingCode></PriorBillingCodes><Name>MUTARS - Genux stems</Name><Description>Genux cemented. Press fit stems</Description><Size>130-240mm length, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20mm wide</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>241989</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH785</BillingCode><PriorBillingCodes><PriorBillingCode>CB012</PriorBillingCode></PriorBillingCodes><Name>LVIS Intraluminal Support Device</Name><Description>Self-expanding intracranial vascular stent</Description><Size>Diameters: 2.5, 3.0, 3.5, 4.0, 4.5, 5.5mm  Lengths: 8-67mm</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1687</GroupID><ARTGs><ARTG>194409</ARTG></ARTGs><MinimumBenefit>6769</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH905</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Full external fixator rings</Description><Size>80mm - 300mm full rings</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3405</SubGroupID><ARTGs><ARTG>177324</ARTG><ARTG>229624</ARTG></ARTGs><MinimumBenefit>685</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH827</BillingCode><PriorBillingCodes><PriorBillingCode>LM141</PriorBillingCode><PriorBillingCode>LM037</PriorBillingCode></PriorBillingCodes><Name>TriMed Wrist Fixation System</Name><Description>TriMed Volar Bearing Plate</Description><Size>Narrow, Standard, Wide; 3, 5, and 7 Holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH815</BillingCode><PriorBillingCodes><PriorBillingCode>LM120</PriorBillingCode><PriorBillingCode>LM002</PriorBillingCode></PriorBillingCodes><Name>TriMed Ulna Column Plates</Name><Description>Ulna Column Plate</Description><Size>7 hole</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH701</BillingCode><PriorBillingCodes><PriorBillingCode>OO158</PriorBillingCode></PriorBillingCodes><Name>MUTARS GenuX PE Insert</Name><Description>MUTARS GenuX PE Insert</Description><Size>Size: 2 - 6  Height : 12.5, 15, 17.5 mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1371</GroupID><ARTGs><ARTG>238794</ARTG><ARTG>250453</ARTG></ARTGs><MinimumBenefit>1090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH502</BillingCode><Name>Martin Osteosynthesis 1.5mm System 2 hole plate</Name><Description>Plate, 0.6mm thick, titanium</Description><Size>2-4 hole</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4267</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>76</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH705</BillingCode><Name>IC-Head</Name><Description>IC-Head, CoCrMo</Description><Size>36mm, S-XL</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>291215</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH848</BillingCode><PriorBillingCodes><PriorBillingCode>LM322</PriorBillingCode></PriorBillingCodes><Name>GEMINUS Volar Plating System</Name><Description>Plates</Description><Size>7 hole, Long (207mm) and Short (160mm)</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH805</BillingCode><PriorBillingCodes><PriorBillingCode>LM033</PriorBillingCode></PriorBillingCodes><Name>Trimed Wrist Fixation System,</Name><Description> Volar Fixed Angle Plates</Description><Size>Narrow, standard and wide plates, 10 to 14 hole</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH942</BillingCode><PriorBillingCodes><PriorBillingCode>VK042</PriorBillingCode></PriorBillingCodes><Name>TrueLok Ring Fixation System - Spacers, Washers, Nuts, Bolts</Name><Description>Nuts, Spacers, Washers and Bolts.</Description><Size>Length 12 - 30mm, 10mm Hex Heads, Thickness 2 - 4mm.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4507</SubGroupID><ARTGs><ARTG>177324</ARTG></ARTGs><MinimumBenefit>36</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH777</BillingCode><PriorBillingCodes><PriorBillingCode>MB013</PriorBillingCode></PriorBillingCodes><Name>Allium Bulbar Urethral Stent</Name><Description>Round Nitinol stent with co-polymer covering and supplied premounted on a delivery tool.</Description><Size>50, 55, 60, 80 mm</Size><SupplierCode>LH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>256</SubCategoryID><GroupID>1800</GroupID><SubGroupID>5501</SubGroupID><ARTGs><ARTG>205004</ARTG></ARTGs><MinimumBenefit>2351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH910</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Nuts, Spacers, Washers and Bolts.
</Description><Size>One Size, 2-30mm, slotted, conical and M6</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4507</SubGroupID><ARTGs><ARTG>177324</ARTG><ARTG>229624</ARTG></ARTGs><MinimumBenefit>36</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH413</BillingCode><Name>Miband Access Port (replacement)</Name><Description>A device, metallic or non- metallic, implanted in a patient for a short or long-term delivery of fluid or medications to the vascular system  or other anatomical region. The device consists of a housing, self-sealing septum and a catheter connection mechanism. The device may be implanted in a variety of anatomical locations.</Description><Size>Port Size - 10.6mm High, 24.7mm Base width- One Size only</Size><SupplierCode>LH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1779</GroupID><ARTGs><ARTG>153863</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH813</BillingCode><PriorBillingCodes><PriorBillingCode>LM118</PriorBillingCode><PriorBillingCode>LM002</PriorBillingCode></PriorBillingCodes><Name>TriMed Radial Column Plates</Name><Description>Radial Column Plate</Description><Size>7 hole</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH660</BillingCode><PriorBillingCodes><PriorBillingCode>OO120</PriorBillingCode></PriorBillingCodes><Name>MUTARS - Arthrodesis femoral component</Name><Description>MUTARS - Arthrodesis femoral component</Description><Size>45mm left and right</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5479</SubGroupID><ARTGs><ARTG>242292</ARTG><ARTG>284584</ARTG></ARTGs><MinimumBenefit>6242</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH779</BillingCode><PriorBillingCodes><PriorBillingCode>MB015</PriorBillingCode></PriorBillingCodes><Name>Allium Triangle Prostatic Urethral Stent</Name><Description>Round Nitinol stent with copolymer covering and supplied premounted on a delivery tool. For longer term temporary treatment of bladder outlet obstruction caused by enlarged prostate.</Description><Size>Body lengths 30, 40, 50, 60, 65mm
main body calibre 45Fr</Size><SupplierCode>LH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>256</SubCategoryID><GroupID>1800</GroupID><SubGroupID>5501</SubGroupID><ARTGs><ARTG>205004</ARTG></ARTGs><MinimumBenefit>2351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH503</BillingCode><Name>Martin Osteosynthesis 1.5mm System 4-7 hole plate</Name><Description>Plate, 0.6mm thick, Titanium</Description><Size>4-7 hole</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH778</BillingCode><PriorBillingCodes><PriorBillingCode>MB014</PriorBillingCode></PriorBillingCodes><Name>Allium Round Posterior Urethral Stent</Name><Description>Round Nitinol stent with copolymer covering and supplied premounted on a delivery tool. For longer term temporary treatment of bladder outlet obstruction caused by  male stenotic posterior urethra or  stenotic bladder-neck.</Description><Size>The RPS has a body length of 40mm and a main body calibre of 45Fr</Size><SupplierCode>LH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>256</SubCategoryID><GroupID>1800</GroupID><SubGroupID>5501</SubGroupID><ARTGs><ARTG>205004</ARTG></ARTGs><MinimumBenefit>2351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH636</BillingCode><PriorBillingCodes><PriorBillingCode>OO090</PriorBillingCode></PriorBillingCodes><Name>MUTARS - Genux Locking screws</Name><Description>Locking screws for augments</Description><Size>Various</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1392</GroupID><ARTGs><ARTG>221737</ARTG></ARTGs><MinimumBenefit>212</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH693</BillingCode><PriorBillingCodes><PriorBillingCode>OO145</PriorBillingCode><PriorBillingCode>OO081</PriorBillingCode></PriorBillingCodes><Name>MUTARS - KRI Screw M8</Name><Description>KRI Screw M8 - Tumour System and Arthrodesis Interlocking System</Description><Size>25mm - 50mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1392</GroupID><ARTGs><ARTG>250193</ARTG></ARTGs><MinimumBenefit>212</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH851</BillingCode><PriorBillingCodes><PriorBillingCode>LM334</PriorBillingCode></PriorBillingCodes><Name>Axis Pin</Name><Description>Axis Pin</Description><Size>2.5mm x 30mm-70mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4510</SubGroupID><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>134</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH484</BillingCode><Name>DSS HP Spinal System - Pedicle Screw</Name><Description>Cannulated Pedicle Screw, Titanium</Description><Size>(5 - 10)mm diam x (30 - 110(mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>186733</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH923</BillingCode><PriorBillingCodes><PriorBillingCode>VK008</PriorBillingCode><PriorBillingCode>PM097</PriorBillingCode></PriorBillingCodes><Name>Osteotite screw</Name><Description>HA coated screw used for fixation of an external frame</Description><Size>Shaft Dia 3.0 - 6.0mm, Thread Dia 6.0 - 2.0mm, Total Length 40 - 260mm, Thread Length 15 - 90mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4510</SubGroupID><ARTGs><ARTG>377918</ARTG></ARTGs><MinimumBenefit>134</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH909</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Frame pins and screws</Description><Size>Diameter - 1.6 to 6mm;  Lengths - 40 to 550mm </Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4510</SubGroupID><ARTGs><ARTG>177324</ARTG><ARTG>289252</ARTG></ARTGs><MinimumBenefit>134</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH922</BillingCode><PriorBillingCodes><PriorBillingCode>VK007</PriorBillingCode><PriorBillingCode>PM095</PriorBillingCode></PriorBillingCodes><Name>Screw</Name><Description>Frame Component - Pins</Description><Size>Shaft Dia 3.0 - 6.0mm
Thread Dia 6.0 - 2.00mm
Total Length 40 - 260mm
Thread Length 15 - 100mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4510</SubGroupID><ARTGs><ARTG>289252</ARTG><ARTG>377918</ARTG></ARTGs><MinimumBenefit>134</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH618</BillingCode><PriorBillingCodes><PriorBillingCode>OO031</PriorBillingCode></PriorBillingCodes><Name>Mutars RS revision system  - Bone Screw</Name><Description>4.5mm diameter implatan TiAI6V4 cortical bone screw</Description><Size>4.5mm x 25mm, 30mm, 35mm, 40mm, 42mm, 45mm, 50mm, 55mm, 60mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>237075</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ337</BillingCode><PriorBillingCodes><PriorBillingCode>LM305</PriorBillingCode></PriorBillingCodes><Name>Extremilock FPS</Name><Description>Ankle Plating System</Description><Size>3.5mm and 4mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5292</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>1474</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH445</BillingCode><Name>Hinge Pediatric Plating System - Hinge Plate</Name><Description>Articulated growth-correction fixation plate</Description><Size>12mm, 16mm, 20mm (distance between anchoring points)</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5292</SubGroupID><ARTGs><ARTG>161505</ARTG></ARTGs><MinimumBenefit>929</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH656</BillingCode><PriorBillingCodes><PriorBillingCode>OO115</PriorBillingCode></PriorBillingCodes><Name>Mutars – Proximal tibia connecting piece</Name><Description>Mutars – Proximal tibia connecting piece</Description><Size>105mm, 125mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3937</SubGroupID><ARTGs><ARTG>244316</ARTG><ARTG>284223</ARTG></ARTGs><MinimumBenefit>1482</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH949</BillingCode><PriorBillingCodes><PriorBillingCode>VK049</PriorBillingCode></PriorBillingCodes><Name>TrueLok</Name><Description>Coupling devices.</Description><Size>Standard.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3757</SubGroupID><ARTGs><ARTG>177324</ARTG></ARTGs><MinimumBenefit>225</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH697</BillingCode><PriorBillingCodes><PriorBillingCode>OO149</PriorBillingCode></PriorBillingCodes><Name>Implacross PE liner</Name><Description>PE Liner for LUMiC acetabula reconstruction system</Description><Size>0,15 and 15 with 4mm offset. 39 - 52 external diameter</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>277989</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ690</BillingCode><Name>EPORE Acetabular Augment System</Name><Description>Spongiosa and cancellous screw</Description><Size>6.5 x 15mm - 80mm and 8 x 40-100mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>237075</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH658</BillingCode><PriorBillingCodes><PriorBillingCode>OO118</PriorBillingCode></PriorBillingCodes><Name>Mutars RS revision system - Proximal component</Name><Description>RS proximal component</Description><Size>127 degrees, 32/42mm, 135 degrees, 32/42mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1417</GroupID><Suffix>Complex (Neck)</Suffix><ARTGs><ARTG>238834</ARTG><ARTG>284587</ARTG></ARTGs><MinimumBenefit>1449</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH495</BillingCode><PriorBillingCodes><PriorBillingCode>MO121</PriorBillingCode></PriorBillingCodes><Name>Martin Level One Fixation</Name><Description>Plate, titanium</Description><Size>&lt;0.5mm thick, 4 to 7 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4263</SubGroupID><Suffix>Burr</Suffix><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>155</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH789</BillingCode><PriorBillingCodes><PriorBillingCode>CB017</PriorBillingCode></PriorBillingCodes><Name>Skater Biliary Drainage Catheter</Name><Description>Used for biliary drainage applications</Description><Size>Biliary Drainage Catheter w/Locking Pigtail
8Fx40cm, 10Fx40cm, 12Fx40cm
Biliary Drainage Catheter w/Non-Locking Pigtail
8Fx40cm, 10Fx40cm, 12Fx40cm</Size><SupplierCode>LH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>5489</SubGroupID><ARTGs><ARTG>223261</ARTG></ARTGs><MinimumBenefit>97</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH641</BillingCode><PriorBillingCodes><PriorBillingCode>OO099</PriorBillingCode></PriorBillingCodes><Name>Mutars RS revision system- Metaphyseal component</Name><Description>RS metaphyseal component</Description><Size>25mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3964</SubGroupID><Suffix>Body</Suffix><ARTGs><ARTG>237292</ARTG></ARTGs><MinimumBenefit>2619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH646</BillingCode><PriorBillingCodes><PriorBillingCode>OO105</PriorBillingCode></PriorBillingCodes><Name>Mutars Diaphyseal connecting piece</Name><Description>Mutars Diaphyseal connecting piece</Description><Size>100mm -120mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3937</SubGroupID><ARTGs><ARTG>221740</ARTG><ARTG>284221</ARTG><ARTG>284224</ARTG></ARTGs><MinimumBenefit>1482</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH597</BillingCode><Name>LiquiBand Topical</Name><Description>Topical Skin Adhesive</Description><Size>0.5g and 0.8g</Size><SupplierCode>LH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>151324</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH596</BillingCode><Name>Liquiband Surgical</Name><Description>Surgical Adhesive</Description><Size>0.8gm ampoule</Size><SupplierCode>LH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>151324</ARTG></ARTGs><MinimumBenefit>23</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH690</BillingCode><PriorBillingCodes><PriorBillingCode>OO141</PriorBillingCode></PriorBillingCodes><Name>MUTARS RS Hip System. MUTARS RS coupling device</Name><Description>RS coupling device</Description><Size>30mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3937</SubGroupID><ARTGs><ARTG>237292</ARTG><ARTG>284583</ARTG></ARTGs><MinimumBenefit>1482</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH655</BillingCode><PriorBillingCodes><PriorBillingCode>OO114</PriorBillingCode></PriorBillingCodes><Name>Mutars – reducer</Name><Description>Mutars – reducer</Description><Size>20mm/30mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3937</SubGroupID><ARTGs><ARTG>237292</ARTG><ARTG>284271</ARTG></ARTGs><MinimumBenefit>1482</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH919</BillingCode><PriorBillingCodes><PriorBillingCode>VK004</PriorBillingCode><PriorBillingCode>PM062</PriorBillingCode></PriorBillingCodes><Name>Orthofix External Fixation System Hybrid Fixator</Name><Description>Anodised aluminium and stainless steel</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4508</SubGroupID><ARTGs><ARTG>117273</ARTG><ARTG>118320</ARTG><ARTG>123604</ARTG><ARTG>177324</ARTG></ARTGs><MinimumBenefit>622</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ351</BillingCode><PriorBillingCodes><PriorBillingCode>LM306</PriorBillingCode></PriorBillingCodes><Name>Osteomed FPS</Name><Description>Calcaneal Plates</Description><Size>7 to 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5296</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>1373</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH758</BillingCode><PriorBillingCodes><PriorBillingCode>LM423</PriorBillingCode><PriorBillingCode>NK046</PriorBillingCode></PriorBillingCodes><Name>Silex Bone Screw</Name><Description>Dual-Thread Sacroiliac Locking Screw</Description><Size>7mm x 30-70mm</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>228758</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH686</BillingCode><PriorBillingCodes><PriorBillingCode>OO178</PriorBillingCode><PriorBillingCode>OO005</PriorBillingCode><PriorBillingCode>OO009</PriorBillingCode></PriorBillingCodes><Name>ACS Knee Porous Coated Tibia Component Cementless</Name><Description>Tibial base plate porous coated for use with mobile bearing insert - TiN Coated</Description><Size>2-7</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1362</GroupID><ARTGs><ARTG>265617</ARTG><ARTG>265623</ARTG></ARTGs><MinimumBenefit>2493</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ115</BillingCode><PriorBillingCodes><PriorBillingCode>KH063</PriorBillingCode></PriorBillingCodes><Name>Rejoin Peek Anchor System</Name><Description>Suture Anchor System</Description><Size>2.4mm - 3.9mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>320191</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH869</BillingCode><PriorBillingCodes><PriorBillingCode>LM546</PriorBillingCode></PriorBillingCodes><Name>Midshaft Humerus Plates</Name><Description>Midshaft Humerus Plates</Description><Size>136-244mm, narrow and broad versions.   7 to 13 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ425</BillingCode><PriorBillingCodes><PriorBillingCode>LM540</PriorBillingCode></PriorBillingCodes><Name>Omni Stable AF Plating System</Name><Description>Simple Plates, Straight, L and T plates</Description><Size>7 to 14 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH868</BillingCode><PriorBillingCodes><PriorBillingCode>LM544</PriorBillingCode></PriorBillingCodes><Name>Ulnar Shortening Plates</Name><Description>Distal Ulnar Shortening Plates  Proximal Ulnar Shortening Plates</Description><Size>The Distal Ulnar Shortening Plates are available in two lengths, left and right configurations.    The Proximal Ulnar Shortening Plates are available in two  lengths.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH691</BillingCode><PriorBillingCodes><PriorBillingCode>OO142</PriorBillingCode></PriorBillingCodes><Name>MUTARS RS screw for coupling device</Name><Description>RS coupling device screw</Description><Size>60-140mm length M8</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1434</GroupID><ARTGs><ARTG>250353</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ407</BillingCode><PriorBillingCodes><PriorBillingCode>LM519</PriorBillingCode></PriorBillingCodes><Name>OMNI Plating System</Name><Description>Lisfranc Plates</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ110</BillingCode><PriorBillingCodes><PriorBillingCode>KH071</PriorBillingCode></PriorBillingCodes><Name>Rejoin HealFix Suture Anchor</Name><Description>Suture Anchor System</Description><Size>Greater than 4mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>320191</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH624</BillingCode><PriorBillingCodes><PriorBillingCode>OO037</PriorBillingCode></PriorBillingCodes><Name>IC Reinforcement cage</Name><Description>Acetabular Reinforcement cage</Description><Size>Left and Right. 44mm, 50mm, 56mm, 62mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1432</GroupID><SubGroupID>4035</SubGroupID><ARTGs><ARTG>169691</ARTG></ARTGs><MinimumBenefit>1197</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH726</BillingCode><PriorBillingCodes><PriorBillingCode>BY013</PriorBillingCode></PriorBillingCodes><Name>Motiva, Matrix Silk Surface PLUS</Name><Description>Sterile Silicone Breast Implants, Motiva Matrix, SilkSurface PLUS - prostheses, Internal, Mammary, gel filled</Description><Size>500cc to 1050cc</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><ARTGs><ARTG>282778</ARTG></ARTGs><MinimumBenefit>668</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH625</BillingCode><PriorBillingCodes><PriorBillingCode>OO038</PriorBillingCode></PriorBillingCodes><Name>IC titanium ring</Name><Description>Acetabular recontrusction ring</Description><Size>42mm, 44mm, 46mm, 48mm, 50mm, 52mm, 54mm, 56mm, 58mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1432</GroupID><SubGroupID>4035</SubGroupID><ARTGs><ARTG>169691</ARTG></ARTGs><MinimumBenefit>1197</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH727</BillingCode><PriorBillingCodes><PriorBillingCode>BY015</PriorBillingCode></PriorBillingCodes><Name>Motiva Ergonomix Implant Matrix, SilkSurface with QID</Name><Description>Sterile Silicone Breast Implants, Motiva Ergonomix Matrix, SilkSurface PLUS with QID  - prostheses, Internal, Mammary, gel filled</Description><Size>500cc TO 775cc</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>282777</ARTG></ARTGs><MinimumBenefit>1170</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ410</BillingCode><PriorBillingCodes><PriorBillingCode>LM522</PriorBillingCode></PriorBillingCodes><Name>Omni Plating System</Name><Description>Post</Description><Size>12 &amp; 16 mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>4521</SubGroupID><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH806</BillingCode><PriorBillingCodes><PriorBillingCode>LM041</PriorBillingCode></PriorBillingCodes><Name>Trimed Fixation Pegs</Name><Description>Plate fixation pegs</Description><Size>10-32mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>4521</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH801</BillingCode><Name>SiphonX</Name><Description>Gravitational anti-siphon device</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>2961</GroupID><ARTGs><ARTG>489669</ARTG></ARTGs><MinimumBenefit>794</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH912</BillingCode><Name>Motiva Ergonomix2 SmoothSilk</Name><Description>Gel filled silicone Motiva breast implant</Description><Size>500cc and greater</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>492425</ARTG></ARTGs><MinimumBenefit>1170</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH731</BillingCode><PriorBillingCodes><PriorBillingCode>BY014</PriorBillingCode></PriorBillingCodes><Name>Motiva, Matrix Silk Surface PLUS with QID</Name><Description>Sterile Silicone Breast Implants, Motiva Matrix, SilkSurface PLUS with QID  - prostheses, Internal, Mammary, gel filled</Description><Size>500cc TO 1050cc</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><ARTGs><ARTG>282776</ARTG></ARTGs><MinimumBenefit>668</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ354</BillingCode><PriorBillingCodes><PriorBillingCode>LM309</PriorBillingCode></PriorBillingCodes><Name>Osteomed FPS</Name><Description>Tubular Plates</Description><Size>7 to 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH840</BillingCode><PriorBillingCodes><PriorBillingCode>LM311</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Pegs</Name><Description>Smooth Pegs:Locking, Threaded Pegs: Locking &amp; Non Locking</Description><Size>2mm, 2.3mm &amp; 2.7mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>4521</SubGroupID><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH730</BillingCode><PriorBillingCodes><PriorBillingCode>BY018</PriorBillingCode></PriorBillingCodes><Name>MOTIVA IMPLANTS ANATOMICAL TRUEFIXATION</Name><Description>Sterile Silicone Breast Implants. Gel filled, pre-shaped. </Description><Size>500-600 cc</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>373251</ARTG></ARTGs><MinimumBenefit>1170</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH891</BillingCode><Name>Motiva Ergonomix Implant Matrix</Name><Description>SilkSurface without QID gel filled silicone breast implant</Description><Size>500cc to 1050cc</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4432</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>510445</ARTG></ARTGs><MinimumBenefit>1170</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ423</BillingCode><PriorBillingCodes><PriorBillingCode>LM538</PriorBillingCode></PriorBillingCodes><Name>Omni Stable AF Plating System</Name><Description>Tibia Plates</Description><Size>17 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>1636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH653</BillingCode><PriorBillingCodes><PriorBillingCode>OO112</PriorBillingCode></PriorBillingCodes><Name>Mutars – Metaphyseal component</Name><Description>Mutars – Genux metaphyseal tibial spacer</Description><Size>Right/Left 25mm, 35mm, 45mm, 50mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1385</GroupID><ARTGs><ARTG>221737</ARTG><ARTG>284267</ARTG><ARTG>284269</ARTG></ARTGs><MinimumBenefit>1864</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH652</BillingCode><PriorBillingCodes><PriorBillingCode>OO111</PriorBillingCode></PriorBillingCodes><Name>Mutars – Genux Augments</Name><Description>Mutars – Genux Augments</Description><Size>Size, small, 3,4,5, 5mm, 10mm, 15mm, 20mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1385</GroupID><ARTGs><ARTG>221737</ARTG><ARTG>284269</ARTG></ARTGs><MinimumBenefit>1864</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH692</BillingCode><PriorBillingCodes><PriorBillingCode>OO144</PriorBillingCode><PriorBillingCode>OO081</PriorBillingCode></PriorBillingCodes><Name>MUTARS - M10 Screw</Name><Description>M10 Screw - Tumour System and Arthrodesis Interlocking System</Description><Size>25mm - 245mm Length</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1434</GroupID><ARTGs><ARTG>250194</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH787</BillingCode><PriorBillingCodes><PriorBillingCode>CB015</PriorBillingCode></PriorBillingCodes><Name>V-Grip Detachment Controller</Name><Description>A battery powered device used to control detachment of an implantable embolisation coil from a delivery pusher.</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1689</GroupID><SubGroupID>4495</SubGroupID><ARTGs><ARTG>148674</ARTG></ARTGs><MinimumBenefit>211</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH601</BillingCode><PriorBillingCodes><PriorBillingCode>OO002</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System - Femoral component porous coated</Name><Description>Porous coated resurfacing femoral component</Description><Size>Left/Right 1-6</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1351</GroupID><SubGroupID>3914</SubGroupID><ARTGs><ARTG>265596</ARTG></ARTGs><MinimumBenefit>3226</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ113</BillingCode><PriorBillingCodes><PriorBillingCode>KH064</PriorBillingCode></PriorBillingCodes><Name>Rejoin JoinFix All-Suture Anchor</Name><Description>Suture Anchor System</Description><Size>2.4mm - 3.9mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>320191</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH931</BillingCode><PriorBillingCodes><PriorBillingCode>VK027</PriorBillingCode></PriorBillingCodes><Name>eight-Plate Plus</Name><Description>The guided growth plate system plus consists of different sizes of eight-Plate plus. The device is designed for the gradual correction of paediatric congenital as well as acquired deformities in both upper and lower extremities.</Description><Size>12mm  16mm  20mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><ARTGs><ARTG>289399</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH682</BillingCode><PriorBillingCodes><PriorBillingCode>OO171</PriorBillingCode></PriorBillingCodes><Name>ACCIS Insert (15 degrees)</Name><Description>ACCIS liner (15 degrees) for use with MUTARS RS and LUMIC Cup</Description><Size>38/39, 42/44, 46/48, 50/52mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4023</SubGroupID><Suffix>Revision/Tumour</Suffix><ARTGs><ARTG>281539</ARTG></ARTGs><MinimumBenefit>2140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH894</BillingCode><Name>eight-Plate Plus</Name><Description>Guided growth eight-plate and quad-plate</Description><Size>Length: 12 to 22mm; Holes 2-4</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><ARTGs><ARTG>289399</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ376</BillingCode><PriorBillingCodes><PriorBillingCode>LM367</PriorBillingCode></PriorBillingCodes><Name>Calcaneal Osteotomy Device</Name><Description>Calcaneal Osteotomy Device</Description><Size>All sizes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH854</BillingCode><PriorBillingCodes><PriorBillingCode>LM362</PriorBillingCode></PriorBillingCodes><Name>X-Clips</Name><Description>X-Clips</Description><Size>Multiple sizes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><ARTGs><ARTG>164980</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH809</BillingCode><PriorBillingCodes><PriorBillingCode>LM066</PriorBillingCode></PriorBillingCodes><Name>TriMed Olecranon Sled</Name><Description>Washer</Description><Size>one size</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH772</BillingCode><PriorBillingCodes><PriorBillingCode>KH062</PriorBillingCode></PriorBillingCodes><Name>Healfix Anchor System</Name><Description>Titanium Suture Anchor</Description><Size>2.4mm - 3.9mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>320191</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ426</BillingCode><PriorBillingCodes><PriorBillingCode>LM541</PriorBillingCode></PriorBillingCodes><Name>Omni Stable AF Plating System</Name><Description>Fibula Plates</Description><Size>5 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5255</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>826</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH533</BillingCode><Name>High V+ Cement with Delivery Kit</Name><Description>PMMA Cement including Delivery Kit</Description><Size>20gm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4089</SubGroupID><ARTGs><ARTG>239816</ARTG></ARTGs><MinimumBenefit>437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH621</BillingCode><PriorBillingCodes><PriorBillingCode>OO034</PriorBillingCode></PriorBillingCodes><Name>IC-Head CoCrMo</Name><Description>IC Head, CoCrMo</Description><Size>22,28,32mm - S-M-L-XL</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>291215</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH934</BillingCode><PriorBillingCodes><PriorBillingCode>VK030</PriorBillingCode></PriorBillingCodes><Name>Orthofix Circular Frame Full ring</Name><Description>The Orthofix circular frame is a surgeon designed, user friendly ring fixation system for trauma applications, limb lengthening and deformity correction. It is based on the science, methodology and principles of Prof Ilizarov. The circular frame is simple, offering preassembled functional components that are easy to connect and operate. The frame is stable with anti-rotational feature on connection elements that prevents any undesirable movement. Its unique wire and half pin fixation elements provide efficient bone segment stabilisation. A biomechanically superior metal-plastic interface is stable both during and between adjustments. The system is versatile, consisting of rings, half-rings, foot plates, 5/8 rings and arches. Full control of bone segments accomplished with Orthofix circular frame allows precise movement of segments without compromising stability.</Description><Size>80mm - 300mm full rings</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3405</SubGroupID><ARTGs><ARTG>177324</ARTG><ARTG>229624</ARTG></ARTGs><MinimumBenefit>685</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ167</BillingCode><Name>Neodura Dural Repair Patch</Name><Description>Absorbable dural repair patch made of degradable PLLA &amp; Gelatin</Description><Size>Greater than 100cm2</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1660</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>419571</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>1592</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH681</BillingCode><PriorBillingCodes><PriorBillingCode>OO170</PriorBillingCode></PriorBillingCodes><Name>MUTARS RS Cup</Name><Description>Acetabulum reconstruction cup, flange multiple screw holes</Description><Size>46, 50, 54, 58, 62mm
right &amp; left</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4012</SubGroupID><ARTGs><ARTG>238836</ARTG></ARTGs><MinimumBenefit>1897</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH704</BillingCode><Name>HPS 2.0 Pedicle Screw</Name><Description>Pedicle Screw with Reduction and Extended tabs - Cannulated &amp; Fenestrated</Description><Size>4.5-9.5mm diameters</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>186733</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ428</BillingCode><PriorBillingCodes><PriorBillingCode>LM545</PriorBillingCode></PriorBillingCodes><Name>Reduct Arthrodesis Screw System</Name><Description>The REDUCT® Arthrodesis Screw System is intended for fixation of osseous fragments or fractures, arthrodesis of small joints, and osteotomies, with the appropriately sized screw.</Description><Size>• 2.0mm non-cannulated screws: 20mm - 44mm in 2mm increments.  • 2.5mm cannulated screws: 26mm - 40mm in 2mm increments.  • 3.5mm cannulated screws: 32mm - 46mm in 2mm increments.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>6561</SubGroupID><Suffix>Interphalangeal</Suffix><ARTGs><ARTG>279795</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ111</BillingCode><PriorBillingCodes><PriorBillingCode>KH068</PriorBillingCode></PriorBillingCodes><Name>Rejoin Interference Screw</Name><Description>Interference Screw</Description><Size>6mm - 12mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>320191</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH786</BillingCode><PriorBillingCodes><PriorBillingCode>CB013</PriorBillingCode></PriorBillingCodes><Name>Scepter Occlusion Balloon Catheter</Name><Description>Intravascular occlusion balloon catheter</Description><Size>Balloon diameter: 4mm
Balloon lengths: 10 - 20mm</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1689</GroupID><SubGroupID>6022</SubGroupID><ARTGs><ARTG>194400</ARTG></ARTGs><MinimumBenefit>1500</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH769</BillingCode><Name>Reosrba Synthetic bone</Name><Description>Injectable Bone Substitute – Granules / Syringe</Description><Size>10cc Granules</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>400446</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ342</BillingCode><PriorBillingCodes><PriorBillingCode>LM214</PriorBillingCode></PriorBillingCodes><Name>Highly Elastic Staples</Name><Description>Nitinol Staples</Description><Size>8-25mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><Suffix>MM</Suffix><ARTGs><ARTG>229705</ARTG></ARTGs><MinimumBenefit>507</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH696</BillingCode><PriorBillingCodes><PriorBillingCode>OO148</PriorBillingCode></PriorBillingCodes><Name>MUTARS LUMiC Screw, M6</Name><Description>M6 Screw used to bolt the LUMiC Cup and LUMiC Stem together</Description><Size>28mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1434</GroupID><ARTGs><ARTG>250195</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH486</BillingCode><Name>DSS HP Spinal System - Set Screw</Name><Description>Set Screw</Description><Size>one size</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>186733</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH892</BillingCode><Name>APEX and XMCP Fusion device</Name><Description>X-Post</Description><Size>4.0 - 7.0 x 16-30mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>6561</SubGroupID><Suffix>Interphalangeal</Suffix><ARTGs><ARTG>164980</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ336</BillingCode><PriorBillingCodes><PriorBillingCode>LM208</PriorBillingCode></PriorBillingCodes><Name>BonAlive Putty</Name><Description>Bone Graft Substitute - Bioactive Glass Putty</Description><Size>10cc</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>231484</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH603</BillingCode><PriorBillingCodes><PriorBillingCode>OO004</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System - Posterior stabilised femoral component porous coated</Name><Description>Posterior stabilised, porous coated, femoral component for use in knee arthroplasty</Description><Size>Left/Right 1-6</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1351</GroupID><SubGroupID>3915</SubGroupID><ARTGs><ARTG>265604</ARTG></ARTGs><MinimumBenefit>3314</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ334</BillingCode><PriorBillingCodes><PriorBillingCode>LM216</PriorBillingCode></PriorBillingCodes><Name>BonAlive Granules</Name><Description>Bone Graft Substitute - Bioactive Glass Granules</Description><Size>(5.1-10cc)
13140 - 0.5-0.8mm small granules, 10cc syringe
13340 - 1.0-2.0mm medium granules, 10cc syringe
13440 - 2.0-3.15mm large granules, 10cc syringe</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>176953</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH838</BillingCode><PriorBillingCodes><PriorBillingCode>LM300</PriorBillingCode></PriorBillingCodes><Name>Hammerfix</Name><Description>Implant for small joint Arthrodesis</Description><Size>Small, Medium, Large  </Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5474</SubGroupID><ARTGs><ARTG>164980</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH871</BillingCode><PriorBillingCodes><PriorBillingCode>LM548</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Distal Humerus Plates</Name><Description>Medial Direct, Lateral Direct, Lateral Capitellar, Lateral Helical, Supracondylar plates</Description><Size>Medial Direct - 105 to 165mm,   Lateral Direct - 85 to 115mm  Lateral Capitellar - 70 to 160mm  Lateral Helical - 85 to 175mm  Supracondylar - 142 to 250mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ365</BillingCode><PriorBillingCodes><PriorBillingCode>LM275</PriorBillingCode></PriorBillingCodes><Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Plates</Name><Description>Proximal Humerus Plate</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>182168</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH566</BillingCode><PriorBillingCodes><PriorBillingCode>AJ042</PriorBillingCode></PriorBillingCodes><Name>i-FACTOR Putty Peptide Enhanced Bone Graft</Name><Description>P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute</Description><Size>5.0ml - 10ml</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>169831</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH767</BillingCode><Name>Reosrba Synthetic bone</Name><Description>Injectable Bone Substitute – Putty</Description><Size>10mL</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>400447</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH893</BillingCode><Name>IO Fix,  CarpalFix Intraosseous Fusion Device </Name><Description>X-Post </Description><Size>4.0 - 9.5 x 14-40mm, small -  large </Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5474</SubGroupID><ARTGs><ARTG>164980</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH610</BillingCode><PriorBillingCodes><PriorBillingCode>OO018</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System - PS Femoral component, cemented</Name><Description>ACS posterior stabilised femoral component, cemented</Description><Size>Size 1,2,2.5,3,4,5,6,7 left/right slim</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>265603</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH635</BillingCode><PriorBillingCodes><PriorBillingCode>OO089</PriorBillingCode></PriorBillingCodes><Name>MUTARS - Genux Locking screw for locking mechanism</Name><Description>Locking screw, axel, for Genux hinge locking mechanism</Description><Size>1 Size</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1391</GroupID><ARTGs><ARTG>250192</ARTG></ARTGs><MinimumBenefit>635</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH663</BillingCode><PriorBillingCodes><PriorBillingCode>OO123</PriorBillingCode></PriorBillingCodes><Name>MUTARS Distal Humerus</Name><Description>MUTARS Distal Humerus</Description><Size>50mm, 30mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1275</GroupID><SubGroupID>3673</SubGroupID><ARTGs><ARTG>221739</ARTG><ARTG>284227</ARTG></ARTGs><MinimumBenefit>4387</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH628</BillingCode><PriorBillingCodes><PriorBillingCode>OO042</PriorBillingCode></PriorBillingCodes><Name>Mutars RS revision system - cementless stem HA long</Name><Description>RS Cementless stem HA long</Description><Size>12 - 22mm dia stems, 200 to 250mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1409</GroupID><SubGroupID>3960</SubGroupID><ARTGs><ARTG>236460</ARTG></ARTGs><MinimumBenefit>5371</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ109</BillingCode><PriorBillingCodes><PriorBillingCode>KH065</PriorBillingCode></PriorBillingCodes><Name>Rejoin HealFix Preloaded Suture &amp; Anchor and HealFix Mini Preloaded Suture &amp; Anchor’</Name><Description>Anchor system with one or two sutures</Description><Size>1.3 to 2.0mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>320191</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ112</BillingCode><PriorBillingCodes><PriorBillingCode>KH070</PriorBillingCode></PriorBillingCodes><Name>Rejoin JoinFix All Suture Anchor</Name><Description>Suture Anchor System</Description><Size>less than 2.4mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>320191</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ399</BillingCode><PriorBillingCodes><PriorBillingCode>LM505</PriorBillingCode></PriorBillingCodes><Name>Non-Locking Screw (Standard)</Name><Description>Non-Locking Screw (Standard)</Description><Size> ≥4.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ114</BillingCode><PriorBillingCodes><PriorBillingCode>KH069</PriorBillingCode></PriorBillingCodes><Name>Rejoin Peek Anchor</Name><Description>Suture Anchor System</Description><Size>less than 2.4mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>320191</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ108</BillingCode><PriorBillingCodes><PriorBillingCode>KH067</PriorBillingCode></PriorBillingCodes><Name>Rejoin Button</Name><Description>Suture Button</Description><Size>Multiple</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>320191</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ117</BillingCode><PriorBillingCodes><PriorBillingCode>KH066</PriorBillingCode></PriorBillingCodes><Name> RapidLink, RapidLink Plus and RapidLink Ultra</Name><Description>Meniscal Repair PEEK implants with #2-0 UHMWPE Wilsuture</Description><Size>Straight 0 degree, Curved 27 and 17 degree and reverse curved -5 degree</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>320191</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH619</BillingCode><PriorBillingCodes><PriorBillingCode>OO032</PriorBillingCode></PriorBillingCodes><Name>IC- Head Biolox delta</Name><Description>Biolox delta ceramic head</Description><Size>28 and 32mm. Small, medium and large.</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>288475</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH926</BillingCode><PriorBillingCodes><PriorBillingCode>VK011</PriorBillingCode><PriorBillingCode>PM100</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic External Fixation System - Xcaliber External Fixator</Name><Description>Hybrid Fixator</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3406</SubGroupID><ARTGs><ARTG>117273</ARTG><ARTG>118320</ARTG><ARTG>123604</ARTG></ARTGs><MinimumBenefit>978</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH953</BillingCode><Name>Fitbone Intramedullary Lengthening System </Name><Description>Fitbone Partially Threaded IM nail Locking Screw </Description><Size>Diameter 4.0 - 4.5mm. Length 20 - 80mm. Short - Long Thread</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1229</GroupID><SubGroupID>3713</SubGroupID><ARTGs><ARTG>289252</ARTG></ARTGs><MinimumBenefit>139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH901</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Arch, half rings 5/8 and 3/8th rings,</Description><Size>80mm to 300mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3406</SubGroupID><ARTGs><ARTG>177324</ARTG><ARTG>229624</ARTG></ARTGs><MinimumBenefit>978</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH661</BillingCode><PriorBillingCodes><PriorBillingCode>OO121</PriorBillingCode></PriorBillingCodes><Name>MUTARS - Arthrodesis body</Name><Description>Arthrodesis Body</Description><Size>120mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5402</SubGroupID><ARTGs><ARTG>242292</ARTG><ARTG>284220</ARTG></ARTGs><MinimumBenefit>6242</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH933</BillingCode><PriorBillingCodes><PriorBillingCode>VK029</PriorBillingCode></PriorBillingCodes><Name>Orthofix Circular Frame Partial ring</Name><Description>The Orthofix circular frame is a surgeon designed, user-friendly ring fixation system for trauma applications, limb lengthening and deformity correction. It is based on the science, methodology and principles of Prof Ilizarov. The circular frame is simple offering pre-assembled functional components that are easy to connect and operate. The frame is stable with anti-rotational feature on connection elements that prevents any undesirable movement. It's unique wire and half pin fixation elements provide efficient bone segment stabilisation. A biomechanically superior metal-plastic interface is stable both during and between adjustments. The system is versatile, consisting of rings, half-rings, foot plates, 5/8 rings and arches. Full control of bone segments accomplished with orthodox circular frame allows precise movement of segments without compromising stability.</Description><Size>100mm - 300mm partial rings</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3406</SubGroupID><ARTGs><ARTG>177324</ARTG><ARTG>229624</ARTG></ARTGs><MinimumBenefit>978</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH823</BillingCode><PriorBillingCodes><PriorBillingCode>LM134</PriorBillingCode><PriorBillingCode>LM049</PriorBillingCode></PriorBillingCodes><Name>TriMed Compression Screws</Name><Description>Cannulated dual thread compression screws</Description><Size>4.5-7.3mm x 26-112mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>229704</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH946</BillingCode><PriorBillingCodes><PriorBillingCode>VK046</PriorBillingCode></PriorBillingCodes><Name>LRS Knee Hinge</Name><Description>Knee spanning and limb salvage external fixator - fully assembled.</Description><Size>One size.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3401</SubGroupID><ARTGs><ARTG>123604</ARTG><ARTG>172152</ARTG><ARTG>197638</ARTG></ARTGs><MinimumBenefit>4035</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH852</BillingCode><PriorBillingCodes><PriorBillingCode>LM336</PriorBillingCode></PriorBillingCodes><Name>Osteo-x External Mini Fixator</Name><Description>The Osteo-x® external fixator is a device used for the fixation and distraction of small bones, primarily in the hand. It incorporates four K-wires which are driven into the bone and placed to provide three-dimensional stability.</Description><Size>One Size Only</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3401</SubGroupID><Suffix>Small, CDD</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>1824</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH928</BillingCode><PriorBillingCodes><PriorBillingCode>VK013</PriorBillingCode><PriorBillingCode>PM109</PriorBillingCode></PriorBillingCodes><Name>Orthofix External Fixation Systems</Name><Description>MiniRail System</Description><Size>Short, Standard, Long and Articulated Horizontal and Vertical Axis</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3401</SubGroupID><Suffix>Mini</Suffix><ARTGs><ARTG>197364</ARTG></ARTGs><MinimumBenefit>1405</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH917</BillingCode><PriorBillingCodes><PriorBillingCode>VK002</PriorBillingCode><PriorBillingCode>PM013</PriorBillingCode></PriorBillingCodes><Name>Orthofix External Fixation System Pennig Wrist Fixator</Name><Description>Anodised aluminium and stainless steel</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3401</SubGroupID><Suffix>Small</Suffix><ARTGs><ARTG>118320</ARTG><ARTG>123604</ARTG></ARTGs><MinimumBenefit>1353</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH916</BillingCode><PriorBillingCodes><PriorBillingCode>VK001</PriorBillingCode><PriorBillingCode>PM012</PriorBillingCode></PriorBillingCodes><Name>Orthofix External Fixation System Ankle Fixator</Name><Description>Anodised aluminium and stainless steel</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3401</SubGroupID><ARTGs><ARTG>117273</ARTG><ARTG>118320</ARTG><ARTG>123604</ARTG><ARTG>177324</ARTG></ARTGs><MinimumBenefit>4035</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH924</BillingCode><PriorBillingCodes><PriorBillingCode>VK009</PriorBillingCode><PriorBillingCode>PM098</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic External Fixation System - Xcaliber External Fixator</Name><Description>Metadiaphyseal Fixator</Description><Size>One size</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3401</SubGroupID><ARTGs><ARTG>117273</ARTG><ARTG>118320</ARTG><ARTG>123604</ARTG></ARTGs><MinimumBenefit>4035</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH929</BillingCode><PriorBillingCodes><PriorBillingCode>VK014</PriorBillingCode><PriorBillingCode>PM110</PriorBillingCode></PriorBillingCodes><Name>Orthofix External Fixation Systems</Name><Description>Pennig Minifixator</Description><Size>Short, Standard, Long</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3401</SubGroupID><Suffix>Small, 3D, CDD</Suffix><ARTGs><ARTG>197364</ARTG></ARTGs><MinimumBenefit>1824</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH867</BillingCode><PriorBillingCodes><PriorBillingCode>LM543</PriorBillingCode></PriorBillingCodes><Name>TriMed RipCord® Syndesmosis Button Kit</Name><Description>The system consists of UHMWPE suture, a far button and a near button made from 316L medical grade implant quality stainless steel, and accompanying instrumentation</Description><Size>1 size</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>409845</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH915</BillingCode><PriorBillingCodes><PriorBillingCode>QQ465</PriorBillingCode></PriorBillingCodes><Name>Fitbone Intramedullary Limb Lengthening</Name><Description>Fitbone IM Lengthening Nail and Receiver.</Description><Size>Diameter 9mm - 13mm. Length 200 - 245mm.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>5362</SubGroupID><ARTGs><ARTG>457877</ARTG></ARTGs><MinimumBenefit>16741</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH729</BillingCode><PriorBillingCodes><PriorBillingCode>BY017</PriorBillingCode></PriorBillingCodes><Name>MOTIVA IMPLANTS ANATOMICAL TRUEFIXATION</Name><Description>Sterile Silicone Breast Implants. Gel filled, pre-shaped. </Description><Size>250- 495 cc</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>373251</ARTG></ARTGs><MinimumBenefit>975</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH724</BillingCode><PriorBillingCodes><PriorBillingCode>BY011</PriorBillingCode></PriorBillingCodes><Name>Motiva, Matrix Silk Surface PLUS</Name><Description>Sterile Silicone Breast Implants, Motiva Matrix SilkSurface PLUS - Prosthesis, internal, mammary, gel filled</Description><Size>105cc to 500cc</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><ARTGs><ARTG>282778</ARTG></ARTGs><MinimumBenefit>595</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH725</BillingCode><PriorBillingCodes><PriorBillingCode>BY012</PriorBillingCode></PriorBillingCodes><Name>Motiva Ergonomix Implant Matrix, SilkSurface with Qid</Name><Description>Sterile Silicone Breast Implants Motiva Implant  Matrix Ergonomix, SilkSurface with Qid - Prosthesis, internal,  mammary, gel filled</Description><Size>105cc to 500cc</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>282777</ARTG></ARTGs><MinimumBenefit>975</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ343</BillingCode><PriorBillingCodes><PriorBillingCode>LM243</PriorBillingCode></PriorBillingCodes><Name>HK2</Name><Description>Finger Mini Fixator System</Description><Size>1.2mm, 1.5mm, 1.8mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5371</SubGroupID><ARTGs><ARTG>235591</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH728</BillingCode><PriorBillingCodes><PriorBillingCode>BY016</PriorBillingCode></PriorBillingCodes><Name>Motiva, Matrix Silk Surface PLUS with QID</Name><Description>Sterile Silicone Breast Implants Motiva Implant Matrix SilkSurface PLUS with Qid - Prosthesis, internal, mammary,gel filled</Description><Size>105cc to 500cc</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><ARTGs><ARTG>282776</ARTG></ARTGs><MinimumBenefit>595</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH913</BillingCode><Name>Motiva Ergonomix2 SmoothSilk</Name><Description>Gel filled silicone Motiva breast implant </Description><Size>Less than 500cc</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>492425</ARTG></ARTGs><MinimumBenefit>975</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH890</BillingCode><Name>Motiva Ergonomix Implant Matrix</Name><Description>SilkSurface without QID gel filled silicone breast implant</Description><Size>105cc to 500cc</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>204</SubCategoryID><GroupID>1610</GroupID><SubGroupID>4429</SubGroupID><Suffix>Pre-shaped</Suffix><ARTGs><ARTG>510445</ARTG></ARTGs><MinimumBenefit>975</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH755</BillingCode><PriorBillingCodes><PriorBillingCode>LM449</PriorBillingCode><PriorBillingCode>NK101</PriorBillingCode></PriorBillingCodes><Name>Intracranial Pressure and Temperature Catheter</Name><Description>Intracranial Pressure and Temperature Catheter</Description><Size>Suitable for all patient anatomy</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>253</SubCategoryID><GroupID>1794</GroupID><Suffix>Catheter</Suffix><ARTGs><ARTG>308491</ARTG><ARTG>308492</ARTG></ARTGs><MinimumBenefit>1173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH948</BillingCode><PriorBillingCodes><PriorBillingCode>VK048</PriorBillingCode></PriorBillingCodes><Name>AHN Locking End Caps</Name><Description>AHN end cap.</Description><Size>0mm, 5mm, 10mm.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3732</SubGroupID><ARTGs><ARTG>377915</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH771</BillingCode><Name>Reosrba Synthetic bone</Name><Description>60/40 HA/TCP bone graft substitute</Description><Size>30cc Granules</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4095</SubGroupID><ARTGs><ARTG>400446</ARTG></ARTGs><MinimumBenefit>1482</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH780</BillingCode><PriorBillingCodes><PriorBillingCode>MB016</PriorBillingCode></PriorBillingCodes><Name>Allium Ureteral Stent</Name><Description>Round Nitinol stent with copolymer covering and supplied premounted on a delivery tool. Intended to be inserted into the lower ureter to allow free flow of urine from the kidney to the bladder.</Description><Size>8mm x 100mm, 8mm x 120mm, 10mm x 100mm, 10mm x 120mm</Size><SupplierCode>LH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5323</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>205005</ARTG></ARTGs><MinimumBenefit>2996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH876</BillingCode><PriorBillingCodes><PriorBillingCode>LM554</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Bone Screw Non-Locking</Name><Description>Bone Screw Non-Locking</Description><Size>4.5mm diameter, 14 to 40mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ374</BillingCode><PriorBillingCodes><PriorBillingCode>LM524</PriorBillingCode></PriorBillingCodes><Name>Ankle Fusion Plate</Name><Description>Ankle Fusion Plate</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH782</BillingCode><PriorBillingCodes><PriorBillingCode>MB028</PriorBillingCode></PriorBillingCodes><Name>Allium URS Long Ureteral stent</Name><Description>Fully covered, flexible, extra long ureteral stent</Description><Size>9 mm diameter
200 mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>227</SubCategoryID><GroupID>1701</GroupID><SubGroupID>5323</SubGroupID><Suffix>Therm</Suffix><ARTGs><ARTG>205005</ARTG></ARTGs><MinimumBenefit>2996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH510</BillingCode><Name>Martin Osteosynthesis 1.5mm System Mesh 64cm2</Name><Description>Mesh, Titanium</Description><Size>0.5-0.8mm thick, 51-200cm2</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4209</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>1146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH567</BillingCode><PriorBillingCodes><PriorBillingCode>AJ044</PriorBillingCode></PriorBillingCodes><Name>i-Factor Flex &amp; Flex FR Peptide Enhanced Bone Graft – 25mm</Name><Description>P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute</Description><Size>50mm x 25mm x 4mm, 100mm x 25mm x 4mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4095</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>176753</ARTG><ARTG>231653</ARTG></ARTGs><MinimumBenefit>5700</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH631</BillingCode><PriorBillingCodes><PriorBillingCode>OO048</PriorBillingCode></PriorBillingCodes><Name>MUTARS Stems</Name><Description>MUTARS Stems</Description><Size>120 -240 mm length, 11 - 23 mm diameter</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1386</GroupID><ARTGs><ARTG>236017</ARTG><ARTG>244312</ARTG><ARTG>244314</ARTG><ARTG>244315</ARTG><ARTG>245435</ARTG></ARTGs><MinimumBenefit>2648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH834</BillingCode><PriorBillingCodes><PriorBillingCode>LM209</PriorBillingCode></PriorBillingCodes><Name>Jones Fracture Plate</Name><Description>Fracture Fixation Systems</Description><Size>≤ 6 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH861</BillingCode><PriorBillingCodes><PriorBillingCode>LM473</PriorBillingCode></PriorBillingCodes><Name>TriMed ASET Foot Plating System</Name><Description>Straight and T Plates</Description><Size>≤ 6 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH564</BillingCode><PriorBillingCodes><PriorBillingCode>AJ043</PriorBillingCode></PriorBillingCodes><Name>i-Factor Flex &amp; Flex FR Peptide Enhanced Bone Graft – 25mm</Name><Description>P-15, ABM, Osteoinductive, Osteoconductive bone graft substitute</Description><Size>25mm x 25mm x 4mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4095</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>176753</ARTG><ARTG>231653</ARTG></ARTGs><MinimumBenefit>5700</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH444</BillingCode><Name>Hinge Pediatric Plating System - Screws</Name><Description>2 screws for articulated growth-correction fixation plate</Description><Size>4.5 x 35mm, 4.5 x 30mm, 4.5 x 25mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>161505</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH645</BillingCode><PriorBillingCodes><PriorBillingCode>OO104</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System</Name><Description>ACS Posterior Stabilised Tibial PE Insert</Description><Size>Sizes 2-6 x 10-20mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>265625</ARTG><ARTG>265626</ARTG><ARTG>265639</ARTG><ARTG>265642</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH781</BillingCode><PriorBillingCodes><PriorBillingCode>MB023</PriorBillingCode></PriorBillingCodes><Name>Allium Biliary Stent</Name><Description>Endoscopic or Transhepatic biliary stent made of nitinol with copolymer covering and unraveling technology for atraumatic removal</Description><Size>Stent length - 60, 80, 100, 120mm. Diameter  - 8, 10mm. Anchor optional</Size><SupplierCode>LH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>192</SubCategoryID><GroupID>1556</GroupID><SubGroupID>4235</SubGroupID><ARTGs><ARTG>205006</ARTG></ARTGs><MinimumBenefit>2730</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH858</BillingCode><PriorBillingCodes><PriorBillingCode>LM470</PriorBillingCode></PriorBillingCodes><Name>TriMed ASET Foot Plating System </Name><Description>Lapidus and Universal Plates</Description><Size>≤ 6 holes  </Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH543</BillingCode><Name>Posterior Spine Truss System Interbody Fusion Device</Name><Description>TLIF Cage</Description><Size>(9-12)mm x (22-40)mm</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>252733</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ348</BillingCode><PriorBillingCodes><PriorBillingCode>LM254</PriorBillingCode></PriorBillingCodes><Name>OsteoMed FPS</Name><Description>Titanium locking footplates</Description><Size>2mm and 2.7mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ689</BillingCode><Name>EPORE Acetabular Augment System</Name><Description>Highly porous titanium alloy acetabular spacer, buttress, shim and IC restrictor augments</Description><Size>8mm spacers 46/10  to 70/30 , buttress left posterior/right anterior , right posterior/left anterior, Straight 54-58mm. Shims 5-15 degrees, IC restrictor 26-38mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1433</GroupID><Suffix>Bone Reconstruction</Suffix><ARTGs><ARTG>389744</ARTG></ARTGs><MinimumBenefit>2769</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH648</BillingCode><PriorBillingCodes><PriorBillingCode>OO107</PriorBillingCode></PriorBillingCodes><Name>Mutars Modular Tumour and Revision System</Name><Description>Mutars Diaphyseal extension piece</Description><Size>30 to 100mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3938</SubGroupID><ARTGs><ARTG>237292</ARTG><ARTG>284224</ARTG><ARTG>284236</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ691</BillingCode><Name>MUTARS PRS</Name><Description>EPORE Reconstruction Full Acetabular Augment</Description><Size>52 to 72mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1433</GroupID><Suffix>Bone Reconstruction</Suffix><ARTGs><ARTG>389744</ARTG></ARTGs><MinimumBenefit>2769</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH546</BillingCode><Name>Lateral Spine Truss System</Name><Description>Interbody spacer, Porous Ti</Description><Size>8-16mm high</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>252733</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH672</BillingCode><PriorBillingCodes><PriorBillingCode>OO133</PriorBillingCode></PriorBillingCodes><Name>MUTARS humeral stem</Name><Description>MUTARS humeral stems</Description><Size>7-16mm diameter  75mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5410</SubGroupID><ARTGs><ARTG>238835</ARTG><ARTG>244655</ARTG><ARTG>250512</ARTG></ARTGs><MinimumBenefit>5486</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH938</BillingCode><PriorBillingCodes><PriorBillingCode>VK034</PriorBillingCode></PriorBillingCodes><Name>eight-Plate Plus Cannulated Screw</Name><Description>The guided growth plate system plus consists of different sizes of plates and cannulated screws. The device is designed for the gradual correction of paediatric congenital as well as acquired deformities in both upper and lower extremities.</Description><Size>4.5mm x 16mm  4.5mm x 24mm  4.5mm x 32mm  4.5mm x 36mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>289252</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH639</BillingCode><PriorBillingCodes><PriorBillingCode>OO097</PriorBillingCode></PriorBillingCodes><Name>MUTARS - Genux Hinged knee femoral component</Name><Description>Cemented Hinge Knee</Description><Size>Size 3,4,5 left and right</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>223514</ARTG></ARTGs><MinimumBenefit>5887</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH885</BillingCode><PriorBillingCodes><PriorBillingCode>QQ582</PriorBillingCode></PriorBillingCodes><Name>Extremity Medical  Screw System</Name><Description>Cannulated Screws</Description><Size>4.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>164980</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH666</BillingCode><PriorBillingCodes><PriorBillingCode>OO126</PriorBillingCode></PriorBillingCodes><Name>MUTARS Humerus Head</Name><Description>MUTARS Humerus Head</Description><Size>50mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5422</SubGroupID><ARTGs><ARTG>223513</ARTG><ARTG>284244</ARTG></ARTGs><MinimumBenefit>4047</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ168</BillingCode><Name>Neodura Dural Repair Patch</Name><Description>Absorbable dural repair patch made of degradable PLLA &amp; Gelatin</Description><Size>50 to 100cm2</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1659</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>419571</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>944</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ427</BillingCode><PriorBillingCodes><PriorBillingCode>LM542</PriorBillingCode></PriorBillingCodes><Name>Omni Stable AF Plating System</Name><Description>Fibula Plates</Description><Size>9 - 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5256</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>1244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH647</BillingCode><PriorBillingCodes><PriorBillingCode>OO106</PriorBillingCode></PriorBillingCodes><Name>Mutars Distal Femur</Name><Description>Mutars Distal Femur</Description><Size>Left/Right 90mm -110mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1380</GroupID><SubGroupID>3931</SubGroupID><ARTGs><ARTG>225901</ARTG><ARTG>227769</ARTG><ARTG>284225</ARTG><ARTG>284226</ARTG><ARTG>284581</ARTG></ARTGs><MinimumBenefit>6984</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH673</BillingCode><PriorBillingCodes><PriorBillingCode>OO134</PriorBillingCode></PriorBillingCodes><Name>MUTARS ulna anchorage</Name><Description>MUTARS ulna anchorage</Description><Size>left/right 70mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1275</GroupID><SubGroupID>3676</SubGroupID><ARTGs><ARTG>221739</ARTG></ARTGs><MinimumBenefit>3398</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH685</BillingCode><PriorBillingCodes><PriorBillingCode>OO177</PriorBillingCode></PriorBillingCodes><Name>MUTARS Ulna Anchorage</Name><Description>MUTARS Ulna Anchorage Component</Description><Size>Left/Right 70-100mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1275</GroupID><SubGroupID>3676</SubGroupID><ARTGs><ARTG>221739</ARTG></ARTGs><MinimumBenefit>3398</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH671</BillingCode><PriorBillingCodes><PriorBillingCode>OO132</PriorBillingCode></PriorBillingCodes><Name>MUTARS Proximal ulna</Name><Description>MUTARS Proximal ulna</Description><Size>60mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1275</GroupID><SubGroupID>3676</SubGroupID><ARTGs><ARTG>221739</ARTG><ARTG>284268</ARTG></ARTGs><MinimumBenefit>3398</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ396</BillingCode><PriorBillingCodes><PriorBillingCode>LM506</PriorBillingCode></PriorBillingCodes><Name>Locking Screw (Standard)</Name><Description>Locking Screw (Standard)</Description><Size>≥4.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH879</BillingCode><PriorBillingCodes><PriorBillingCode>LM560</PriorBillingCode></PriorBillingCodes><Name>TriMed Headless Compression Screws</Name><Description>Dual thread, cannulated headless compression screws</Description><Size>2.3 x 10 - 28mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>229704</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH897</BillingCode><Name>eight-Plate Plus Cannulated Screw</Name><Description>Cannulated screw for the guided growth eight-plate and quad-plate</Description><Size>4.5mm x 16 -36mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>289252</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH833</BillingCode><PriorBillingCodes><PriorBillingCode>LM185</PriorBillingCode></PriorBillingCodes><Name>Trimed Locking Cortical Screws</Name><Description>Locking cortical screw</Description><Size>2.01 to 2.7mm diameter</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH958</BillingCode><PriorBillingCodes><PriorBillingCode>LM562</PriorBillingCode></PriorBillingCodes><Name>TriMed Small Threaded IM Nails</Name><Description>Cannulated dual threaded Nails</Description><Size>2.1 - 2.7 x 20 - 65mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>229704</ARTG></ARTGs><MinimumBenefit>156</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH828</BillingCode><PriorBillingCodes><PriorBillingCode>LM144</PriorBillingCode><PriorBillingCode>LM007</PriorBillingCode></PriorBillingCodes><Name>TriMed Bone Screw</Name><Description>Non-Locking Cortical Bone Screws</Description><Size>2.3mm - 2.7mm x 7mm - 32mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH841</BillingCode><PriorBillingCodes><PriorBillingCode>LM312</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Peg High Compression Locking</Name><Description>High Compression Locking Peg</Description><Size>2.7mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH846</BillingCode><PriorBillingCodes><PriorBillingCode>LM320</PriorBillingCode></PriorBillingCodes><Name>Screws</Name><Description>Screws, Locking</Description><Size>2.01 to 2.7mm diameter</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ340</BillingCode><PriorBillingCodes><PriorBillingCode>LM314</PriorBillingCode></PriorBillingCodes><Name>Headless Compression Screws</Name><Description>Compression Screws</Description><Size>2.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>279795</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH604</BillingCode><PriorBillingCodes><PriorBillingCode>OO007</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System - TCP coated tibial component</Name><Description>Tibial base plate, TCP coated for use with mobile bearing insert, TiN coated</Description><Size>Sizes 2-7</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1362</GroupID><SubGroupID>3924</SubGroupID><ARTGs><ARTG>265621</ARTG></ARTGs><MinimumBenefit>2409</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ349</BillingCode><PriorBillingCodes><PriorBillingCode>LM255</PriorBillingCode></PriorBillingCodes><Name>OsteoMed FPS</Name><Description>Screw Washers</Description><Size>2/2.7/3.5/4.0mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ367</BillingCode><PriorBillingCodes><PriorBillingCode>LM277</PriorBillingCode></PriorBillingCodes><Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Post with Cross Element</Name><Description>Threaded Locking Screw</Description><Size>5.2mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,LK</Suffix><ARTGs><ARTG>182168</ARTG></ARTGs><MinimumBenefit>246</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH872</BillingCode><PriorBillingCodes><PriorBillingCode>LM550</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Bone Screw Locking  </Name><Description>Bone Screw Locking  </Description><Size>4.5mm diameter, 14 to 34mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH698</BillingCode><PriorBillingCodes><PriorBillingCode>OO155</PriorBillingCode></PriorBillingCodes><Name>PE Glenoid</Name><Description>PE glenoid</Description><Size>Small and Standard</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>3701</SubGroupID><ARTGs><ARTG>244654</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH873</BillingCode><PriorBillingCodes><PriorBillingCode>LM551</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Bone Screw Locking  </Name><Description>Bone Screw Locking  </Description><Size>2.7mm diameter, 10 to 70mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH849</BillingCode><PriorBillingCodes><PriorBillingCode>LM323</PriorBillingCode></PriorBillingCodes><Name>GEMINUS Hook Plate</Name><Description>GEMINUS Hook Plate</Description><Size>One size</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5369</SubGroupID><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>43</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH802</BillingCode><PriorBillingCodes><PriorBillingCode>LM001</PriorBillingCode></PriorBillingCodes><Name>TriMed Wrist Fixation System</Name><Description>Washer</Description><Size>One size</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5369</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>43</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH609</BillingCode><PriorBillingCodes><PriorBillingCode>OO017</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System - ACS LS Revision Femoral component, Cemented</Name><Description>Cemented femoral component, revision, for use with stems</Description><Size>Left/Right Sizes 2/3/4/5/6</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><Suffix>Revision</Suffix><ARTGs><ARTG>265605</ARTG></ARTGs><MinimumBenefit>5276</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH707</BillingCode><Name>Ultio Laminoplasty Plate</Name><Description>Plate</Description><Size>Small - 25,7mm  Med - 27,1mm  Lge - 28,9mm  X-Large - 30,3mm  Standard support plate - 15,35mm</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4131</SubGroupID><ARTGs><ARTG>330538</ARTG></ARTGs><MinimumBenefit>660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ360</BillingCode><PriorBillingCodes><PriorBillingCode>LM327</PriorBillingCode></PriorBillingCodes><Name>Osteomed Screws</Name><Description>Cannulated Compression Screws</Description><Size>Diameter 2.0mm, 2.4mm and 2.7mm. Length 6mm to 52mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH864</BillingCode><PriorBillingCodes><PriorBillingCode>LM476</PriorBillingCode></PriorBillingCodes><Name>TriMed ASET Foot Plating System </Name><Description>VA Locking Screw (Mini)</Description><Size>2.01 – 2.7 mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ358</BillingCode><PriorBillingCodes><PriorBillingCode>LM324</PriorBillingCode></PriorBillingCodes><Name>Osteomed Screws</Name><Description>Bone Screws</Description><Size>2- 2.7m x 6-38mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH712</BillingCode><Name>Athena Rod</Name><Description>titanium alloy rods in both straight and curved </Description><Size>Diameter 5.5mm  Lengths 25mm -700mm  </Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>337150</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH881</BillingCode><PriorBillingCodes><PriorBillingCode>QQ180</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Bone Screw</Name><Description>Polyaxial locking cannulated screw</Description><Size>2.5mm x 10-30mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,LK</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>177</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH842</BillingCode><PriorBillingCodes><PriorBillingCode>LM313</PriorBillingCode></PriorBillingCodes><Name>Volar Bearing Plate Screws</Name><Description>Volar Bearing Plate Screws</Description><Size>2.5mm x 10mm-30mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH874</BillingCode><PriorBillingCodes><PriorBillingCode>LM552</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Bone Screw Non-Locking  </Name><Description>Non-Locking Cortical Bone Screws  </Description><Size>2.7mm diameter, 10 to 70mm length</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ369</BillingCode><PriorBillingCodes><PriorBillingCode>LM081</PriorBillingCode></PriorBillingCodes><Name>Surgicraft Washers</Name><Description>Fixation Washers</Description><Size>All Sizes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>149434</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH600</BillingCode><PriorBillingCodes><PriorBillingCode>OO001</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System - Femoral component cemented</Name><Description>Cemented resurfacing femoral component for use in knee athroplasty</Description><Size>Left/Right 1-7</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>265601</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH955</BillingCode><Name>Polaris adjustable hydrocephalus valve </Name><Description>Externally adjustable valve with antisyphon device</Description><Size>Adjustable valve  with siphonX</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function</Suffix><ARTGs><ARTG>489667</ARTG></ARTGs><MinimumBenefit>1970</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH870</BillingCode><PriorBillingCodes><PriorBillingCode>LM547</PriorBillingCode></PriorBillingCodes><Name>Periarticular Distal Humerus Plates</Name><Description>Direct Medial Plates</Description><Size>75mm Left and Right  6 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5273</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>1488</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ359</BillingCode><PriorBillingCodes><PriorBillingCode>LM325</PriorBillingCode></PriorBillingCodes><Name>Osteomed Screws</Name><Description>Bone Screw standard and threaded/lag.</Description><Size>2.01-2.7mm x 4-50mm.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH794</BillingCode><Name>Polaris adjustable hydrocephalus valve </Name><Description>Externally adjustable valve</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><ARTGs><ARTG>478045</ARTG></ARTGs><MinimumBenefit>1823</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH796</BillingCode><Name>Polaris adjustable hydrocephalus valve </Name><Description>Externally adjustable valve with  reservoir/priming function, pre-attached distal catheter and separate ventricular catheter</Description><Size>Adjustable Valve Kit</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>478046</ARTG></ARTGs><MinimumBenefit>2437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH957</BillingCode><PriorBillingCodes><PriorBillingCode>LM346</PriorBillingCode></PriorBillingCodes><Name>Screw Washer</Name><Description>Screw Washer</Description><Size>All sizes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH862</BillingCode><PriorBillingCodes><PriorBillingCode>LM474</PriorBillingCode></PriorBillingCodes><Name>TriMed ASET Foot Plating System </Name><Description>Cortical Bone Screws (mini)</Description><Size>2.01 to 2.7mm diameter</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH800</BillingCode><Name>Polaris adjustable hydrocephalus valve </Name><Description>Externally adjustable valve with  burr hole reservoir/antechamber </Description><Size>Adjustable valve  with  burr hole reservoir/antechamber </Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Reservoir/Priming function</Suffix><ARTGs><ARTG>489668</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH799</BillingCode><Name>Polaris adjustable hydrocephalus valve </Name><Description>Externally adjustable valve with  antisyphon device and bur hole reservoir/antechamber </Description><Size>Adjustable valve with siphonX and  burr hole reservoir/antechamber </Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Reservoir/Priming function</Suffix><ARTGs><ARTG>489667</ARTG></ARTGs><MinimumBenefit>2591</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ373</BillingCode><PriorBillingCodes><PriorBillingCode>LM532</PriorBillingCode></PriorBillingCodes><Name>Align Radial Head System</Name><Description>Titanium alloy stems with titanium plasma spray coating   </Description><Size>7 - 11mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1275</GroupID><SubGroupID>3674</SubGroupID><ARTGs><ARTG>279801</ARTG></ARTGs><MinimumBenefit>1259</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH795</BillingCode><Name>Polaris adjustable hydrocephalus valve </Name><Description>Externally adjustable valve with  pre-attached distal catheter and separate ventricular catheter</Description><Size>Adjustable Valve Kit</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, distal catheter, proximal catheter</Suffix><ARTGs><ARTG>478046</ARTG></ARTGs><MinimumBenefit>2123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH775</BillingCode><PriorBillingCodes><PriorBillingCode>MB005</PriorBillingCode></PriorBillingCodes><Name>Adjustable Continence Therapy for Men</Name><Description>ProACT Device: prosthesis designed for the treatment of male SUI comprising of silicone balloons x2 attached via a conduit to titanium and rubber ports allowing for post operative adjustment.</Description><Size>6 - 14cm</Size><SupplierCode>LH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1786</GroupID><SubGroupID>5451</SubGroupID><ARTGs><ARTG>163939</ARTG></ARTGs><MinimumBenefit>7876</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH667</BillingCode><PriorBillingCodes><PriorBillingCode>OO128</PriorBillingCode></PriorBillingCodes><Name>MUTARS Humerus connecting part</Name><Description>MUTARS Humerus connecting part</Description><Size>80mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5414</SubGroupID><ARTGs><ARTG>244561</ARTG><ARTG>284241</ARTG></ARTGs><MinimumBenefit>4351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH774</BillingCode><PriorBillingCodes><PriorBillingCode>MB004</PriorBillingCode></PriorBillingCodes><Name>Adjustable Continence Therapy device for women</Name><Description>ACT Device: prosthesis designed for the treatment of female SUI comprising of silicone balloons x 2 attached via a conduit to titanium and rubber ports allowing for post operative adjustment.</Description><Size>6 - 14cm</Size><SupplierCode>LH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>226</SubCategoryID><GroupID>1786</GroupID><SubGroupID>5451</SubGroupID><ARTGs><ARTG>163939</ARTG></ARTGs><MinimumBenefit>7876</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH669</BillingCode><PriorBillingCodes><PriorBillingCode>OO130</PriorBillingCode></PriorBillingCodes><Name>MUTARS humerus reducer</Name><Description>MUTARS humerus reducer</Description><Size>10/100mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5414</SubGroupID><ARTGs><ARTG>244561</ARTG><ARTG>284590</ARTG></ARTGs><MinimumBenefit>4351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH808</BillingCode><PriorBillingCodes><PriorBillingCode>LM061</PriorBillingCode></PriorBillingCodes><Name>Xpode Screws</Name><Description>Xpode screws</Description><Size>2.4mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH715</BillingCode><Name>Integrated Anterior Lumbar Spine Truss Cage</Name><Description>Integral fixation ALIF cage with screws</Description><Size>8-20mm heights</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>252733</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH845</BillingCode><PriorBillingCodes><PriorBillingCode>LM319</PriorBillingCode></PriorBillingCodes><Name>Screws</Name><Description>Non Locking</Description><Size>2.01 - 2.7mm diameter
all lengths</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH811</BillingCode><PriorBillingCodes><PriorBillingCode>LM100</PriorBillingCode></PriorBillingCodes><Name>HyProCure</Name><Description>Sinus Tarsi Implant</Description><Size>05 to 10</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1219</GroupID><SubGroupID>3261</SubGroupID><ARTGs><ARTG>291288</ARTG></ARTGs><MinimumBenefit>1321</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH514</BillingCode><Name>Martin Osteosynthesis 1.5mm System 1mm 8-15 hole plate</Name><Description>Plate, Titanium</Description><Size>1.0-1.99mm thick, 8-15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4293</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH003</BillingCode><PriorBillingCodes><PriorBillingCode>OA003</PriorBillingCode></PriorBillingCodes><Name>Adjustable Peri Gastric Belt-Midband</Name><Description>Silicon moulded peri gastric band and implantable chamber</Description><Size>Peri gastric band - 2.2 x 17.5 x 0.8cm, Implantable chamber - one size only</Size><SupplierCode>LH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1548</GroupID><ARTGs><ARTG>145372</ARTG></ARTGs><MinimumBenefit>2791</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH896</BillingCode><Name>eight-Plate Plus  screw</Name><Description>Solid screw for the guided growth eight-plate and quad-plate
</Description><Size>4.5mm x 24-36mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>289252</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH843</BillingCode><PriorBillingCodes><PriorBillingCode>LM316</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Washer</Name><Description>Washer</Description><Size>One size</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH884</BillingCode><PriorBillingCodes><PriorBillingCode>QQ571</PriorBillingCode></PriorBillingCodes><Name>Extremity Medical Screw System</Name><Description>Cannulated Screws </Description><Size>greater than or equal to 4.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>164980</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ420</BillingCode><PriorBillingCodes><PriorBillingCode>LH232</PriorBillingCode><PriorBillingCode>LM363</PriorBillingCode></PriorBillingCodes><Name>Toe Joint</Name><Description>Metallic Hemiarthroplasty resurfacing prosthesis for the Metatarsophalangeal Joint</Description><Size>8mm - 23 mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>124</SubCategoryID><GroupID>1461</GroupID><SubGroupID>4048</SubGroupID><ARTGs><ARTG>141544</ARTG></ARTGs><MinimumBenefit>1145</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH952</BillingCode><PriorBillingCodes><PriorBillingCode>VK052</PriorBillingCode></PriorBillingCodes><Name>AHN Screw</Name><Description>Compression screw.</Description><Size>20 - 120mm length.  5mm diameter.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>377916</ARTG><ARTG>377918</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH883</BillingCode><PriorBillingCodes><PriorBillingCode>QQ570</PriorBillingCode></PriorBillingCodes><Name>Extremity Medical  Screw System</Name><Description>Non locking screws</Description><Size>greater than or equal to 4.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>164980</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH797</BillingCode><Name>Sophysa Catheter</Name><Description>Ventricular Catheters</Description><Size>1.3 mm ID ; 2.2 -2.5 mm OD ; length 150 -230 mm</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal</Suffix><ARTGs><ARTG>478066</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH921</BillingCode><PriorBillingCodes><PriorBillingCode>VK006</PriorBillingCode><PriorBillingCode>PM092</PriorBillingCode></PriorBillingCodes><Name>Orthopaedic External Fixation System - Radiolucent Wrist Fixator</Name><Description>Complete System Sterile</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>5508</SubGroupID><ARTGs><ARTG>257368</ARTG></ARTGs><MinimumBenefit>4969</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH899</BillingCode><Name>Orthofix External Fixation Systems</Name><Description>Wires with and without wires and bayonets</Description><Size>Diameter - 1.5mm x 300mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5364</SubGroupID><ARTGs><ARTG>117273</ARTG></ARTGs><MinimumBenefit>11</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ304</BillingCode><Name>OMNI Plating System</Name><Description>Screw Washer</Description><Size>4.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH689</BillingCode><PriorBillingCodes><PriorBillingCode>OO140</PriorBillingCode></PriorBillingCodes><Name>MUTARS intrameduallary connecting module</Name><Description>MUTARS intramedullary connecting module</Description><Size>100-440mm Length</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1382</GroupID><ARTGs><ARTG>244052</ARTG><ARTG>244656</ARTG></ARTGs><MinimumBenefit>3845</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH677</BillingCode><PriorBillingCodes><PriorBillingCode>OO138</PriorBillingCode></PriorBillingCodes><Name>IC Muller PE Cup</Name><Description>PE acetabulum cup with 0 and10 degree lip - cemented</Description><Size>44-62mm, 28-32mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4006</SubGroupID><ARTGs><ARTG>234879</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH649</BillingCode><PriorBillingCodes><PriorBillingCode>OO108</PriorBillingCode></PriorBillingCodes><Name>Mutars Tumour System</Name><Description>Mutars diaphyseal implant</Description><Size>100mm length x 11-19mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1382</GroupID><ARTGs><ARTG>221740</ARTG><ARTG>284222</ARTG></ARTGs><MinimumBenefit>3845</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ353</BillingCode><PriorBillingCodes><PriorBillingCode>LM308</PriorBillingCode></PriorBillingCodes><Name>Osteomed FPS</Name><Description>Fibular Fracture Plates</Description><Size>7 to 15 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5290</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>1238</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH907</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Articulating hinges, universal, inline, joint, ankle, knee
</Description><Size>100mm, universal, inline, outboard, phantom and spherical</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4513</SubGroupID><ARTGs><ARTG>177324</ARTG><ARTG>229624</ARTG></ARTGs><MinimumBenefit>428</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH837</BillingCode><PriorBillingCodes><PriorBillingCode>LM291</PriorBillingCode></PriorBillingCodes><Name>Forearm Locking Plate</Name><Description>Forearm plates</Description><Size>≤ 6 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH911</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Telescopic liner distractors, telescope hinge distractors and angular distractors</Description><Size>70mm to 200mm.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4505</SubGroupID><ARTGs><ARTG>177324</ARTG><ARTG>229624</ARTG></ARTGs><MinimumBenefit>836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ406</BillingCode><PriorBillingCodes><PriorBillingCode>LM518</PriorBillingCode></PriorBillingCodes><Name>OMNI Plating System</Name><Description>X and Dog Bone Plates</Description><Size>≤ 6 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH937</BillingCode><PriorBillingCodes><PriorBillingCode>VK033</PriorBillingCode></PriorBillingCodes><Name>3D Telescopic Strut</Name><Description>Struts consist of two telescopic aluminium tubes, outer tube and an inner tube, which can be locked together at various lengths using the side locking bolt and clamp washer. The inner tube is attached to a spring-loaded, black knurled adjustment knob. The adjustment knob mates with the threaded rod in a manner such that the rod translates relative to the inner tube when the knob is rotated. This will provide gradual changes of overall strut length in 0.5mm increments. A reference arrow with plus sign located on the base of the adjustment knob indicates the direction of turning to perform strut elongation - distraction. Each strut has two special joints and one at the base of the outer tube and the other at the end of the threaded rod. Each joint has a mounting stud, which can be inserted into the mounting holes on the ring tabs and held in place by the locking screw. The rapid adjustment of the strut length is achieved by untightening the side locking bolt, sliding the inner tube relative to the outer tube to the desired length. The rapid adjustment is indicated by the inner tube scale in 1mm increments relative to the orange line mark on the outer tube. The gradual adjustment is achieved by pulling and rotating the adjustment knob resulting in a noticeable detect click every 0.5mm of adjustment. Gradual adjustment is indicated by the scale relative to the green line mark.</Description><Size>Struts are available in four sizes - ultrashort, short, medium and long providing adjustment range from 45mm to 318mm.  Ultrashort strut  45 - 101mm range  Short strut 92 - 122mm range  Medium strut 114 - 184mm range  Long strut 158 - 318mm range</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4505</SubGroupID><Suffix>3D</Suffix><ARTGs><ARTG>177324</ARTG><ARTG>207662</ARTG></ARTGs><MinimumBenefit>1235</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH936</BillingCode><PriorBillingCodes><PriorBillingCode>VK032</PriorBillingCode></PriorBillingCodes><Name>3D Rapid Adjust Strut</Name><Description>The rapid adjust strut is made of two metal casings encapsulating a threaded rod. It has the ability to correct acutely or gradually. The rapid adjust strut ends have 45 degree locking angulation with 360 degree rotation. The rapid adjust struts have unique ball and claw universal lockable joint at both ends of the strut. Two rapid adjust struts are sufficient for fracture reduction and initial stabilisation, whereas three rapid adjust struts are necessary for walking and weight bearing. Loosening of the ball claw joints allows for verification of the amplitude of angular correction and horizontal translation, magnitude of rotational correction and stability of fixation in coronal, sagittal and horizontal planes.</Description><Size>Short 70 - 104mm range  Medium 98 - 188mm range  Long 163 - 300mm range</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4505</SubGroupID><Suffix>3D</Suffix><ARTGs><ARTG>177324</ARTG><ARTG>207662</ARTG></ARTGs><MinimumBenefit>1235</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH944</BillingCode><PriorBillingCodes><PriorBillingCode>VK044</PriorBillingCode></PriorBillingCodes><Name>LRS</Name><Description>Rails and Compression Distraction Unit.</Description><Size>100mm to 400mm.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>3756</SubGroupID><Suffix>CDD</Suffix><ARTGs><ARTG>123604</ARTG><ARTG>172152</ARTG><ARTG>197638</ARTG></ARTGs><MinimumBenefit>2410</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH943</BillingCode><PriorBillingCodes><PriorBillingCode>VK043</PriorBillingCode></PriorBillingCodes><Name>Linear Distractor</Name><Description>Linear Distractor.</Description><Size>70mm to 200mm.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4505</SubGroupID><ARTGs><ARTG>177324</ARTG></ARTGs><MinimumBenefit>836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH961</BillingCode><PriorBillingCodes><PriorBillingCode>LM565</PriorBillingCode></PriorBillingCodes><Name>TriMed Wrist Fixation System</Name><Description>Volar Bearing Plate</Description><Size>16-18 Hole</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5278</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ166</BillingCode><Name>Neodura Dural Repair Patch</Name><Description>absorbable dural repair patch made of degradable PLLA &amp; Gelatin</Description><Size>10 to 50cm2</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>219</SubCategoryID><GroupID>1658</GroupID><Suffix>Biological</Suffix><ARTGs><ARTG>419571</ARTG></ARTGs><Note>The Prescribed List reimbursement for the billing code is restricted to use of the device for procedures related to dura defect repair in spinal and neurosurgical procedures only.</Note><MinimumBenefit>477</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH930</BillingCode><PriorBillingCodes><PriorBillingCode>VK016</PriorBillingCode><PriorBillingCode>PM118</PriorBillingCode></PriorBillingCodes><Name>Orthofix eight-Plate</Name><Description>Guided growth plate for correction of angular deformities over an open growth plate. Titanium, two screw holes, wire guided.</Description><Size>12mm, 16mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><ARTGs><ARTG>289399</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ404</BillingCode><PriorBillingCodes><PriorBillingCode>LM516</PriorBillingCode></PriorBillingCodes><Name>OMNI plating system</Name><Description>MTP, Lapidus, Straight, T Plates</Description><Size>≤ 6 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH932</BillingCode><PriorBillingCodes><PriorBillingCode>VK028</PriorBillingCode></PriorBillingCodes><Name>Quad Plate Plus</Name><Description>The Guided Growth Plate System Plus consists of different sizes of quad- Plate plus, different cannulated and solid screw options. The device is designed for the gradual correction of paediatric congenital as well as acquired deformities in both the upper and lower extremities, provided that the physics are not fused. The plates feature a contoured waist and low profile for paediatric usage. There is a centre hole in the plates for a temporary guide pin to be implanted to aid application and removal of the plate. The plates are attached to the external surface of the bone over the growth plate by screws. These screws are not locked to the plate, but rather are allowed to swivel and diverge in their position as bone growth occurs. The implant acts like a flexible hinge, permitting growth at the growth plate to gradually straighten the limb.</Description><Size>16mm plate  22mm plate</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><ARTGs><ARTG>289399</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH857</BillingCode><PriorBillingCodes><PriorBillingCode>LM382</PriorBillingCode></PriorBillingCodes><Name>Volar Distal Radius Plates</Name><Description>Fixation Plate for Distal Radius Fractures</Description><Size>16 holes or more</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5278</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH602</BillingCode><PriorBillingCodes><PriorBillingCode>OO003</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System - Femoral component Ti/TCP coated</Name><Description>Tricalcium phosphate coated resurfacing femoral component for use in knee arthroplasty</Description><Size>Left/Right 1-7</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1352</GroupID><SubGroupID>3917</SubGroupID><ARTGs><ARTG>265602</ARTG></ARTGs><MinimumBenefit>3575</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH695</BillingCode><PriorBillingCodes><PriorBillingCode>OO147</PriorBillingCode></PriorBillingCodes><Name>MUTARS LUMiC Stem</Name><Description>Stems for use with a modular partial pelvic replacement and acetabula reconstruction device in case of large bone defects</Description><Size>10mm x 65, 75, 85mm, 8mm x 65, 75, 85mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1820</GroupID><ARTGs><ARTG>236007</ARTG><ARTG>236018</ARTG></ARTGs><MinimumBenefit>5833</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH530</BillingCode><Name>Cervical Spine Truss System</Name><Description>Cage</Description><Size>5-16mm Height</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>252733</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ662</BillingCode><Name>EPORE Acetabular Augment System</Name><Description>Washer</Description><Size>8mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1456</GroupID><ARTGs><ARTG>389721</ARTG></ARTGs><MinimumBenefit>484</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH665</BillingCode><PriorBillingCodes><PriorBillingCode>OO125</PriorBillingCode></PriorBillingCodes><Name>MUTARS Glenosphere</Name><Description>MUTARS glenosphere</Description><Size>40mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5469</SubGroupID><ARTGs><ARTG>227771</ARTG></ARTGs><MinimumBenefit>7111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH674</BillingCode><PriorBillingCodes><PriorBillingCode>OO135</PriorBillingCode></PriorBillingCodes><Name>MUTARS Glenoid</Name><Description>MUTARS Glenoid</Description><Size>1 size</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5469</SubGroupID><ARTGs><ARTG>227161</ARTG></ARTGs><MinimumBenefit>7111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ424</BillingCode><PriorBillingCodes><PriorBillingCode>LM539</PriorBillingCode></PriorBillingCodes><Name>Omni Stable AF Plating System</Name><Description>Simple Plates Straight, Y and L shaped plates</Description><Size>2 - 6 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH863</BillingCode><PriorBillingCodes><PriorBillingCode>LM475</PriorBillingCode></PriorBillingCodes><Name>TriMed ASET Foot Plating System</Name><Description>Non-Locking Cortical Bone Screws (Small)</Description><Size>2.71mm – 4.49mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH630</BillingCode><PriorBillingCodes><PriorBillingCode>OO044</PriorBillingCode></PriorBillingCodes><Name>IC Cerclage System</Name><Description>IC Bone Cerclage System, pure titanium</Description><Size>8mm wide</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5370</SubGroupID><ARTGs><ARTG>197728</ARTG></ARTGs><MinimumBenefit>434</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH803</BillingCode><PriorBillingCodes><PriorBillingCode>LM005</PriorBillingCode></PriorBillingCodes><Name>TriMed Fixation Systems</Name><Description>Multiple stainless steel wire forms</Description><Size>various sizes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5370</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>434</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ363</BillingCode><PriorBillingCodes><PriorBillingCode>LM278</PriorBillingCode></PriorBillingCodes><Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Locking Cortical Screw</Name><Description>Locking Cortical Screw</Description><Size>3.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182168</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH155</BillingCode><PriorBillingCodes><PriorBillingCode>TB155</PriorBillingCode></PriorBillingCodes><Name>Sugita Microneurosurgical AVM Clips</Name><Description>Composition: Cobalt-Chromium-molybdenum based alloy</Description><Size>One Size Each</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>218</SubCategoryID><GroupID>1656</GroupID><ARTGs><ARTG>100108</ARTG></ARTGs><MinimumBenefit>244</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH820</BillingCode><PriorBillingCodes><PriorBillingCode>LM125</PriorBillingCode><PriorBillingCode>LM099</PriorBillingCode></PriorBillingCodes><Name>TriMed Sidewinder</Name><Description>Ankle Fixation Plate</Description><Size>≤ 6 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH816</BillingCode><PriorBillingCodes><PriorBillingCode>LM121</PriorBillingCode><PriorBillingCode>LM002</PriorBillingCode></PriorBillingCodes><Name>'TriMed Wire Plates</Name><Description>Wire Fixation plate</Description><Size>3 &amp; 5 hole</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH850</BillingCode><PriorBillingCodes><PriorBillingCode>LM333</PriorBillingCode></PriorBillingCodes><Name>Internal joint articulating fixator Elbow</Name><Description>Internal joint articulating fixator Elbow</Description><Size>One size - adjustable</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>2945</GroupID><SubGroupID>7348</SubGroupID><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>2416</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH817</BillingCode><PriorBillingCodes><PriorBillingCode>LM122</PriorBillingCode><PriorBillingCode>LM002</PriorBillingCode></PriorBillingCodes><Name>TriMed Periarticular Plate</Name><Description>Periarticular Plates</Description><Size>≤ 6 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>250</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH829</BillingCode><PriorBillingCodes><PriorBillingCode>LM145</PriorBillingCode><PriorBillingCode>LM007</PriorBillingCode></PriorBillingCodes><Name>TriMed Bone Screw</Name><Description>Locking Bone Screw</Description><Size>3.2mm x 8-30mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH587</BillingCode><Name>Cervical Spine Truss System - Stand Alone Cage and screw</Name><Description>Stand alone Cervical Interbody Fusion Device</Description><Size>12-14 x 15-17 x 5-12mm</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>252733</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ409</BillingCode><PriorBillingCodes><PriorBillingCode>LM521</PriorBillingCode></PriorBillingCodes><Name>OMNI Plating System</Name><Description>Locking Screws</Description><Size>2.8mm &amp; 3.5mm diameter; 8-70 length</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH878</BillingCode><PriorBillingCodes><PriorBillingCode>LM559</PriorBillingCode></PriorBillingCodes><Name>TriMed Compression Screws</Name><Description>Cannulated compression Screws</Description><Size>4 x 35-60mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>229704</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ400</BillingCode><PriorBillingCodes><PriorBillingCode>LM503</PriorBillingCode></PriorBillingCodes><Name>Non-Locking Screws (Small)</Name><Description>Non-Locking Screws (Small)</Description><Size>2.71mm – 4.49mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH959</BillingCode><PriorBillingCodes><PriorBillingCode>LM563</PriorBillingCode></PriorBillingCodes><Name>TriMed Small Threaded IM Nails</Name><Description>Cannulated dual threaded nails</Description><Size>3 x 30-65mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>229704</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH513</BillingCode><Name>Martin Osteosynthesis 1.5mm System Mesh 1mm 4-7 hole plate</Name><Description>Plate, Titanium</Description><Size>1.0-1.99mm thick, 4-7 holes</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH651</BillingCode><PriorBillingCodes><PriorBillingCode>OO110</PriorBillingCode></PriorBillingCodes><Name>Mutars – end piece</Name><Description>Mutars – end piece</Description><Size>1 size</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1395</GroupID><ARTGs><ARTG>221738</ARTG><ARTG>284235</ARTG></ARTGs><MinimumBenefit>633</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH831</BillingCode><PriorBillingCodes><PriorBillingCode>LM147</PriorBillingCode><PriorBillingCode>LM007</PriorBillingCode></PriorBillingCodes><Name>TriMed Bone Screw</Name><Description>Locking Compression Bone Screw</Description><Size>4mm x 35-60mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ346</BillingCode><PriorBillingCodes><PriorBillingCode>LM252</PriorBillingCode></PriorBillingCodes><Name>OsteoMed FPS</Name><Description>Bone screws</Description><Size>3.5/4mm x 10-70mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ408</BillingCode><PriorBillingCodes><PriorBillingCode>LM520</PriorBillingCode></PriorBillingCodes><Name>OMNI Plating System</Name><Description>Non-Locking Screws</Description><Size>2.8-3.5mm x 8-70mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH558</BillingCode><Name>Atlas (Anterior Odontoid Fixation System)</Name><Description>Cannulated Bone Screw</Description><Size>(4.0 - 4.5)mm diameter  x  (28-55)mm  length</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>275605</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ341</BillingCode><PriorBillingCodes><PriorBillingCode>LM315</PriorBillingCode></PriorBillingCodes><Name>Headless Compression Screws</Name><Description>Compression Screws</Description><Size>3.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>279795</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ366</BillingCode><PriorBillingCodes><PriorBillingCode>LM280</PriorBillingCode></PriorBillingCodes><Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Post Cap Screw</Name><Description>Post Cap Screw</Description><Size>2.7 mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>182168</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH790</BillingCode><PriorBillingCodes><PriorBillingCode>CB018</PriorBillingCode></PriorBillingCodes><Name>Skater Nephrostomy Drainage Catheter</Name><Description>A drainage catheter intended for use for Nephrostomy applications either by direct stick or modified seldinger technique.</Description><Size>6 - 14 Fr</Size><SupplierCode>LH</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>234</SubCategoryID><GroupID>1718</GroupID><ARTGs><ARTG>223260</ARTG></ARTGs><MinimumBenefit>91</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH578</BillingCode><Name>Pine Adjustable Cross Link</Name><Description>Rod - Rod Connector</Description><Size>30-80mm</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>274913</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH527</BillingCode><Name>MIDCAL Ring</Name><Description>Adjustable Gastric Ring</Description><Size>65-80 mm circumference</Size><SupplierCode>LH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1781</GroupID><ARTGs><ARTG>229709</ARTG></ARTGs><MinimumBenefit>2073</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH688</BillingCode><PriorBillingCodes><PriorBillingCode>OO139</PriorBillingCode></PriorBillingCodes><Name>Implantcast delta ceramic liner</Name><Description>Biolox delta cup liner</Description><Size>32/39, 32/44,36/44, 32/48,36/48,32/52, 36/52, 40/48, 40/52</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4022</SubGroupID><ARTGs><ARTG>233781</ARTG></ARTGs><MinimumBenefit>1636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH613</BillingCode><PriorBillingCodes><PriorBillingCode>OO021</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System</Name><Description>Revision tibial component, cementless porous coated, for use with augments and straight or offset stems.</Description><Size>Left and Right, Sizes 2- 6</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1360</GroupID><Suffix>Revision</Suffix><ARTGs><ARTG>265612</ARTG></ARTGs><MinimumBenefit>3314</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ372</BillingCode><PriorBillingCodes><PriorBillingCode>LM531</PriorBillingCode></PriorBillingCodes><Name>Align Radial Head </Name><Description>CoCr Radial Head with Lock Screw</Description><Size>18 - 26mm </Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1275</GroupID><SubGroupID>3675</SubGroupID><ARTGs><ARTG>279801</ARTG></ARTGs><MinimumBenefit>1267</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH889</BillingCode><PriorBillingCodes><PriorBillingCode>QQ643</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Bone Screw</Name><Description>Non locking bone screw</Description><Size>3.0 - 3.5mm x 6 - 70mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ412</BillingCode><PriorBillingCodes><PriorBillingCode>LM535</PriorBillingCode></PriorBillingCodes><Name>Omni Stable AF Plating System</Name><Description>Fully Threaded Syndesmosis Screws</Description><Size>4.0 x 40-60mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH629</BillingCode><PriorBillingCodes><PriorBillingCode>OO043</PriorBillingCode></PriorBillingCodes><Name>IC bone screw</Name><Description>Cancellous bone screw</Description><Size>6.5mm x 15/20/25/30/35/40/45/50/55/60/65/70/75/80/85mm length.</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1450</GroupID><ARTGs><ARTG>237075</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH757</BillingCode><PriorBillingCodes><PriorBillingCode>LM424</PriorBillingCode><PriorBillingCode>NK047</PriorBillingCode></PriorBillingCodes><Name>Silex Washer</Name><Description>Silex Washer</Description><Size>13mm</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1482</GroupID><ARTGs><ARTG>228758</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH951</BillingCode><PriorBillingCodes><PriorBillingCode>VK051</PriorBillingCode></PriorBillingCodes><Name>Orthofix AHN</Name><Description>Hindfoot Fusion Nailing System, titanium.</Description><Size>10, 11, 12mm diameter.  150 - 300mm length.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3332</SubGroupID><ARTGs><ARTG>377916</ARTG></ARTGs><MinimumBenefit>3300</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH839</BillingCode><PriorBillingCodes><PriorBillingCode>LM310</PriorBillingCode></PriorBillingCodes><Name>Skeletal Dynamics Bone Screw Locking</Name><Description>Bone Screw Locking</Description><Size>3.0m and 3.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH670</BillingCode><PriorBillingCodes><PriorBillingCode>OO131</PriorBillingCode></PriorBillingCodes><Name>MUTARS humerus screw</Name><Description>MUTARS humerus screw</Description><Size>15mm,35mm,55mm,75mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5404</SubGroupID><ARTGs><ARTG>246973</ARTG><ARTG>250513</ARTG></ARTGs><MinimumBenefit>1767</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH664</BillingCode><PriorBillingCodes><PriorBillingCode>OO124</PriorBillingCode></PriorBillingCodes><Name>MUTARS Humerus diaphyseal implant</Name><Description>MUTARS Humerus diaphyseal implant</Description><Size>8-9 mm diameter, 80mm resection length</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5412</SubGroupID><ARTGs><ARTG>221739</ARTG><ARTG>284242</ARTG></ARTGs><MinimumBenefit>4173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH753</BillingCode><PriorBillingCodes><PriorBillingCode>LM466</PriorBillingCode><PriorBillingCode>NK033</PriorBillingCode></PriorBillingCodes><Name>Silex Sacroiliac Joint Fusion System</Name><Description>Washers for the Silex Sacroiliac Joint Fusion System</Description><Size>11, 13 &amp; 15mm</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1482</GroupID><ARTGs><ARTG>228758</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH699</BillingCode><PriorBillingCodes><PriorBillingCode>OO156</PriorBillingCode></PriorBillingCodes><Name>MUTARS GenuX MK Coupling</Name><Description>MUTARS GenuX MK Coupling</Description><Size>12.5, 15, 17.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1393</GroupID><ARTGs><ARTG>244653</ARTG></ARTGs><MinimumBenefit>2454</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH855</BillingCode><PriorBillingCodes><PriorBillingCode>LM368</PriorBillingCode></PriorBillingCodes><Name>Intramedullary Beam</Name><Description>Intramedullary Beam</Description><Size>All sizes</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>164980</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH367</BillingCode><PriorBillingCodes><PriorBillingCode>TB367</PriorBillingCode></PriorBillingCodes><Name>Fassier-Duval Telescopic IM System Component: Male</Name><Description>The Fassier-Dual Telescopic IM System is an endomedular nail designed for patients suffering from Osteogenesis Impecfecta (OI), Skeletal Displasia, Congenital Tibial Pseudoarthrosis, Limb lengthening over nail, Segmental Tumour removal and other bone deformities</Description><Size>The system is composed of a total of 108 rods in 9 different diameters per type.  The nail is manufactured in both Ti alloy (Ti6A14V ASTM-136) and medical grade Stainless Steel (315L, ASTM 138).  It is available in five diameters: 3.2, 4,4.8,5.6 and 6.4 mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3330</SubGroupID><Suffix>Gth</Suffix><ARTGs><ARTG>141020</ARTG></ARTGs><MinimumBenefit>3348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH960</BillingCode><PriorBillingCodes><PriorBillingCode>LM564</PriorBillingCode></PriorBillingCodes><Name>TriMed Small Threaded IM Nails</Name><Description>Cannulated dual threaded nails</Description><Size>1.8mm x 14- 45mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>229704</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH611</BillingCode><PriorBillingCodes><PriorBillingCode>OO019</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System - ACS SC Revision Tibial component, Cemented</Name><Description>Revision MB base plate for use with augments and straight or offset stems</Description><Size>Sizes 2,3,4,5,6</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><Suffix>Revision</Suffix><ARTGs><ARTG>265619</ARTG></ARTGs><MinimumBenefit>3402</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ414</BillingCode><PriorBillingCodes><PriorBillingCode>LM507</PriorBillingCode></PriorBillingCodes><Name>Partially threaded cannulated screw</Name><Description>Partially threaded cannulated screw</Description><Size>≥4.5mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>306780</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH877</BillingCode><PriorBillingCodes><PriorBillingCode>LM558</PriorBillingCode></PriorBillingCodes><Name>TriMed Compression Screws</Name><Description>Dual thread compression screws</Description><Size>2 x 11-14mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>DT</Suffix><ARTGs><ARTG>229704</ARTG></ARTGs><MinimumBenefit>200</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH640</BillingCode><PriorBillingCodes><PriorBillingCode>OO098</PriorBillingCode></PriorBillingCodes><Name>MUTARS Genux Hinge locking mechanism</Name><Description>Connecting piece; connecting distal femoral and proximal tibial replacement.</Description><Size>Genux Hinge Component</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1393</GroupID><ARTGs><ARTG>234172</ARTG></ARTGs><MinimumBenefit>2454</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH700</BillingCode><PriorBillingCodes><PriorBillingCode>OO157</PriorBillingCode></PriorBillingCodes><Name>MUTARS GenuX MK Tibial Component, cemented</Name><Description>MUTARS GenuX MK Tibial Component, cemented</Description><Size>2-6</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>238837</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ357</BillingCode><PriorBillingCodes><PriorBillingCode>LM256</PriorBillingCode></PriorBillingCodes><Name>Osteomed Screws</Name><Description>Bone Screws - threaded/lag</Description><Size>1.2/1.6/2.0mm x 4-36mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH687</BillingCode><PriorBillingCodes><PriorBillingCode>OO179</PriorBillingCode><PriorBillingCode>OO006</PriorBillingCode><PriorBillingCode>OO008</PriorBillingCode></PriorBillingCodes><Name>ACS Mobile Tibial Component Cemented</Name><Description>Tibia Base Plate Cemented for use with a Mobile Bearing insert - TiN Coated</Description><Size>2-7</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><ARTGs><ARTG>265622</ARTG><ARTG>265672</ARTG></ARTGs><MinimumBenefit>2005</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH368</BillingCode><PriorBillingCodes><PriorBillingCode>TB368</PriorBillingCode></PriorBillingCodes><Name>Fassier-Duval Telescopic IM System Component: Female</Name><Description>The Fassier-Duval Telescopic IM System is an endomedular nail designed for patients suffering from Osteogenesis Imperfecta (OI), Skeletal Displasia, Congenital Tibial Pseudoarthrosis, Limb lengthening over nail, Segmental Tumor removal and other bone defo</Description><Size>The system is composed of a total of 108 rods in 9 different diameters per type.  The nail is manufactured in both Ti alloy (Ti6A14V ASTM-136) and medical grade stainless steel (316L, ASTM 138).  It is available in five diameters: 3.2,4.4,8,5.6 and 6.4mm;</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3330</SubGroupID><Suffix>Gth</Suffix><ARTGs><ARTG>141020</ARTG></ARTGs><MinimumBenefit>3348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH941</BillingCode><PriorBillingCodes><PriorBillingCode>VK041</PriorBillingCode></PriorBillingCodes><Name>TrueLok/TL-HEX/EVO Threaded rods</Name><Description>Threaded rods.</Description><Size>60mm - 400mm.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4509</SubGroupID><Suffix>Standard</Suffix><ARTGs><ARTG>177324</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH902</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Circular frame footplates, single and double rows including full ring</Description><Size>140mm - 220mm </Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4506</SubGroupID><ARTGs><ARTG>177324</ARTG><ARTG>229624</ARTG></ARTGs><MinimumBenefit>1872</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ362</BillingCode><PriorBillingCodes><PriorBillingCode>LM281</PriorBillingCode></PriorBillingCodes><Name>PANTERA Proximal Humerus Fracture Fixation Plate System - Cross Element Screw</Name><Description>Cross Element Screw</Description><Size>1.9 mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>182168</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH822</BillingCode><PriorBillingCodes><PriorBillingCode>LM131</PriorBillingCode><PriorBillingCode>LM049</PriorBillingCode></PriorBillingCodes><Name>TriMed Compression Screws</Name><Description>Compression screws</Description><Size>1.7mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>229704</ARTG></ARTGs><MinimumBenefit>346</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH784</BillingCode><PriorBillingCodes><PriorBillingCode>CB011</PriorBillingCode></PriorBillingCodes><Name>Microplex Coils</Name><Description>Framing and filling coils</Description><Size>Diam: 1-24mm
Length: 1-68cm</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1688</GroupID><ARTGs><ARTG>137934</ARTG></ARTGs><MinimumBenefit>1043</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH659</BillingCode><PriorBillingCodes><PriorBillingCode>OO119</PriorBillingCode></PriorBillingCodes><Name>MUTARS - Arthrodesis Tibial component</Name><Description>MUTARS - Arthrodesis Tibial component</Description><Size>45mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5477</SubGroupID><ARTGs><ARTG>242292</ARTG><ARTG>284589</ARTG></ARTGs><MinimumBenefit>6242</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH903</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Rocker rails</Description><Size>One Size</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4506</SubGroupID><ARTGs><ARTG>177324</ARTG></ARTGs><MinimumBenefit>1872</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH626</BillingCode><PriorBillingCodes><PriorBillingCode>OO040</PriorBillingCode></PriorBillingCodes><Name>Mutars RS revision system - metaphyseal component</Name><Description>RS metaphyseal component</Description><Size>0mm, 50mm, 40mm tapered, 50mm tapered</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1411</GroupID><SubGroupID>3969</SubGroupID><Suffix>Cone</Suffix><ARTGs><ARTG>223511</ARTG></ARTGs><MinimumBenefit>2954</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH906</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Oblique support</Description><Size>Oblique</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4509</SubGroupID><Suffix>Small</Suffix><ARTGs><ARTG>177324</ARTG></ARTGs><MinimumBenefit>137</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH900</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Threaded and threaded hinge rods
</Description><Size>30mm - 400mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4509</SubGroupID><Suffix>Standard</Suffix><ARTGs><ARTG>177324</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH509</BillingCode><Name>Martin Osteosynthesis 1.5mm System Mesh 50cm2</Name><Description>Mesh, Titanium</Description><Size>0.5-0.8mm thick, 11-50cm2</Size><SupplierCode>LH</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4208</SubGroupID><ARTGs><ARTG>202851</ARTG></ARTGs><MinimumBenefit>388</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH612</BillingCode><PriorBillingCodes><PriorBillingCode>OO020</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System</Name><Description>Revision base plate, cemented, for use with augments and straight or offset stems</Description><Size>Left and Right, Sizes 2-6</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><Suffix>Revision</Suffix><ARTGs><ARTG>265611</ARTG></ARTGs><MinimumBenefit>2647</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH529</BillingCode><Name>ALIF Spine Truss System</Name><Description>Cage</Description><Size>8-20mm height</Size><SupplierCode>LH</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>252733</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH783</BillingCode><PriorBillingCodes><PriorBillingCode>CB010</PriorBillingCode></PriorBillingCodes><Name>Hydrocoils</Name><Description>Framing and filling coils with Hydrogel.</Description><Size>Diam: 1-24mm  Length: 1-50cm</Size><SupplierCode>LH</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1688</GroupID><ARTGs><ARTG>137933</ARTG></ARTGs><MinimumBenefit>1043</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ398</BillingCode><PriorBillingCodes><PriorBillingCode>LM389</PriorBillingCode></PriorBillingCodes><Name>Modular Thumb Head and Stem </Name><Description>Modular Thumb Head and Stem</Description><Size>Suitable for patient anatomy</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6041</SubGroupID><ARTGs><ARTG>329234</ARTG></ARTGs><MinimumBenefit>420</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH608</BillingCode><PriorBillingCodes><PriorBillingCode>OO016</PriorBillingCode></PriorBillingCodes><Name>ACS Knee System - ACS SC Revision Femoral component, Cemented</Name><Description>Cemented femoral component, Cemented</Description><Size>Left/Right Sizes 2/2.5/3/4/5/6</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Revision</Suffix><ARTGs><ARTG>265609</ARTG></ARTGs><MinimumBenefit>5450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH684</BillingCode><PriorBillingCodes><PriorBillingCode>OO174</PriorBillingCode></PriorBillingCodes><Name>EPORE Cones/Components</Name><Description>Femoral/Tibial metaphyseal Cones and Components, 3D Printed titanium</Description><Size>Sizes 2-6 for Femur and Tibia, Left and Right</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>221737</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH935</BillingCode><PriorBillingCodes><PriorBillingCode>VK031</PriorBillingCode></PriorBillingCodes><Name>Orthofix Circular Frame Foot Plate</Name><Description>The Orthofix circular frame is a surgeon designed, user-friendly ring fixation system for trauma applications, limb lengthening and deformity correction. It is based on the science, methodology and principles of Prof Ilizarov. The circular frame is simple, offering preassembled functional components that are easy to connect and operate. The frame is stable with anti-rotational feature on connection elements that prevents any undesirable movement. Its unique wire and half pin fixation elements provide efficient bone segment stabilisation. A biomechanically superior metal-plastic interface is stable both during and between adjustments. The system is versatile, consisting of rings, half-rings, foot plates, 5/8 rings and arches. Full control of bone segments accomplished with Orthofix circular frame allows precise movement of segments without compromising stability.</Description><Size>100mm - 220mm foot plates</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4506</SubGroupID><ARTGs><ARTG>177324</ARTG><ARTG>229624</ARTG></ARTGs><MinimumBenefit>1872</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ350</BillingCode><PriorBillingCodes><PriorBillingCode>LM304</PriorBillingCode></PriorBillingCodes><Name>OsteoMed FPS</Name><Description>Titanium locking footplates</Description><Size>3.5mm and 4mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>202319</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH866</BillingCode><PriorBillingCodes><PriorBillingCode>LM525</PriorBillingCode></PriorBillingCodes><Name>Proximal Ulna Plate</Name><Description>Proximal Ulna Plate</Description><Size>73 to 151 mm</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5280</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>278692</ARTG></ARTGs><MinimumBenefit>1198</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH703</BillingCode><PriorBillingCodes><PriorBillingCode>OO127</PriorBillingCode></PriorBillingCodes><Name>MUTARS Humerus cap</Name><Description>MUTARS Humerus cap</Description><Size>Small, medium and large. +5 and +10mm offset
Standard / Inverse</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1778</GroupID><SubGroupID>5422</SubGroupID><ARTGs><ARTG>227772</ARTG><ARTG>234173</ARTG></ARTGs><MinimumBenefit>4047</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH788</BillingCode><PriorBillingCodes><PriorBillingCode>CB016</PriorBillingCode></PriorBillingCodes><Name>Skater All-Purpose Drainage Catheter</Name><Description>Locking and non-locking catheter sets with removable pigtail straightener, metal stiffening cannula, flexible stiffening Cannula (not available on 6F and 7F) and locking system with snap-off tab (not available on non-locking pigtail catheters)</Description><Size>Catheter french size  6-16F by 15-60cm length</Size><SupplierCode>LH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>4243</SubGroupID><ARTGs><ARTG>223261</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH908</BillingCode><Name>TrueLok External Fixation Systems</Name><Description>Tornado Hinge pack of 2</Description><Size>One size only</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4513</SubGroupID><Suffix>CDD</Suffix><ARTGs><ARTG>229624</ARTG></ARTGs><MinimumBenefit>3866</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH702</BillingCode><PriorBillingCodes><PriorBillingCode>OO159</PriorBillingCode></PriorBillingCodes><Name>MUTARS GenuX MK Femoral Component Cemented</Name><Description>MUTARS GenuX MK Femoral Component Cemented</Description><Size>Left/Right
2,3,4,5,6</Size><SupplierCode>LH</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Hinged</Suffix><ARTGs><ARTG>238795</ARTG></ARTGs><MinimumBenefit>5887</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH622</BillingCode><PriorBillingCodes><PriorBillingCode>OO035</PriorBillingCode></PriorBillingCodes><Name>Bi-polar head</Name><Description>Bipolar head</Description><Size>38mm - 62mm</Size><SupplierCode>LH</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1424</GroupID><SubGroupID>4004</SubGroupID><ARTGs><ARTG>271212</ARTG></ARTGs><MinimumBenefit>654</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH940</BillingCode><PriorBillingCodes><PriorBillingCode>VK040</PriorBillingCode></PriorBillingCodes><Name>TrueLok Ring Fixation System - Hinges</Name><Description>Universal and inline hinges.</Description><Size>Standard.</Size><SupplierCode>LH</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1237</GroupID><SubGroupID>4513</SubGroupID><ARTGs><ARTG>177324</ARTG></ARTGs><MinimumBenefit>428</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LC174</BillingCode><PriorBillingCodes><PriorBillingCode>LC039</PriorBillingCode></PriorBillingCodes><Name>SMR - Glenoid Component UHMWPE</Name><Description>Glenoid - MB Liner - UHMWPE</Description><Size>3 to 6mm thick x small-R to Large</Size><SupplierCode>LC</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>3704</SubGroupID><ARTGs><ARTG>221714</ARTG></ARTGs><MinimumBenefit>1862</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LC026</BillingCode><Name>Lima Accent Hip System</Name><Description>Femoral Stem Cemented, tapered, polished</Description><Size>1 -6</Size><SupplierCode>LC</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>168581</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO032</BillingCode><Name>Link acetabular cup system</Name><Description>Titanium, grit blast, HA</Description><Size>40 - 68mm  Small, medium, large</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1427</GroupID><SubGroupID>4015</SubGroupID><ARTGs><ARTG>212117</ARTG><ARTG>212232</ARTG></ARTGs><MinimumBenefit>2191</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO036</BillingCode><Name>LINK Vario bipolar Cup</Name><Description>Shell with unmodified polyethylene plus locking ring</Description><Size>Inner diameter: 28 - 32mm  Outer diameter: 44 - 65mm</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1424</GroupID><SubGroupID>4004</SubGroupID><ARTGs><ARTG>212055</ARTG></ARTGs><MinimumBenefit>654</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO031</BillingCode><Name>LINK Endo-Model Partial Pelvis Replacement</Name><Description>Fixation Screws, for Obturator Foramen, including screw lock</Description><Size>20mm - 35mm; four (4) sizes</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1450</GroupID><ARTGs><ARTG>140660</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO013</BillingCode><Name>Link Acetabular Reconstruction Cup System</Name><Description>Acetabular reconstruction shell</Description><Size>45 - 66 mm  Small, Medium, Large</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1432</GroupID><SubGroupID>4034</SubGroupID><ARTGs><ARTG>212102</ARTG><ARTG>212118</ARTG><ARTG>212130</ARTG></ARTGs><MinimumBenefit>2658</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO180</BillingCode><Name>Endo-Model Rotational and Hinge Knee Prosthesis</Name><Description>Augments, spacers, segments</Description><Size>(5-15) mm height, (X-Small, Small, Medium or Large) footprint  UHMWPE</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>245854</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO170</BillingCode><PriorBillingCodes><PriorBillingCode>LO041</PriorBillingCode></PriorBillingCodes><Name>LINK Endo Model Rotational and Hinge Knee Prostheses</Name><Description>Femoral Components</Description><Size>Extra Small - Extra Large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><ARTGs><ARTG>157545</ARTG></ARTGs><MinimumBenefit>3053</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO167</BillingCode><PriorBillingCodes><PriorBillingCode>LO046</PriorBillingCode></PriorBillingCodes><Name>Link Modular Knee Prosthesis System</Name><Description>Stems</Description><Size>100, 120, 130, 160, 200, 240, 280, 320 and 360</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1386</GroupID><ARTGs><ARTG>157545</ARTG><ARTG>222182</ARTG><ARTG>245852</ARTG><ARTG>245853</ARTG></ARTGs><MinimumBenefit>2648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO029</BillingCode><Name>LINK Partial Pelvis Replacement</Name><Description>Acetabular reconstruction cage with inferior flange</Description><Size>48-67mm</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1432</GroupID><SubGroupID>4035</SubGroupID><ARTGs><ARTG>237076</ARTG></ARTGs><MinimumBenefit>1197</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO162</BillingCode><PriorBillingCodes><PriorBillingCode>LO046</PriorBillingCode></PriorBillingCodes><Name>Link Modular Knee Prosthesis System</Name><Description>Stem extender, segment</Description><Size>30mm - 250mm</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3938</SubGroupID><ARTGs><ARTG>245852</ARTG></ARTGs><MinimumBenefit>3838</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO188</BillingCode><Name>Link MP Reconstruction Expansion Bolt</Name><Description>MP Reconstruction Expansion Bolt</Description><Size>41mm, 61mm</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1434</GroupID><ARTGs><ARTG>257495</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO151</BillingCode><Name>Link Acetabular Cup System</Name><Description>Ceramic Insert</Description><Size>32mm -40mm  Small, medium, large</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4022</SubGroupID><ARTGs><ARTG>212119</ARTG></ARTGs><MinimumBenefit>1636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO021</BillingCode><Name>Link MP Reconstruction Hip Prosthesis</Name><Description>Stem, grit blast, titanium non HA</Description><Size>12 - 25mm x 160mm</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>114169</ARTG><ARTG>51002</ARTG></ARTGs><MinimumBenefit>2619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO157</BillingCode><PriorBillingCodes><PriorBillingCode>LO046</PriorBillingCode></PriorBillingCodes><Name>Link Modular Knee Prosthesis System</Name><Description>Femoral Components</Description><Size>Extra Small - Extra Large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>221853</ARTG><ARTG>224956</ARTG></ARTGs><MinimumBenefit>5887</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO161</BillingCode><PriorBillingCodes><PriorBillingCode>LO046</PriorBillingCode></PriorBillingCodes><Name>Link Modular Knee Coupling</Name><Description>Coupling</Description><Size>One Size only</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3937</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>245852</ARTG></ARTGs><MinimumBenefit>6356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO164</BillingCode><PriorBillingCodes><PriorBillingCode>LO046</PriorBillingCode></PriorBillingCodes><Name>Link Modular Knee Prosthesis System</Name><Description>Collar Couplings</Description><Size>Terminal round: 14 and 16mm
Oval Terminal: 26 x 34, 30 x 44, 34 x 48mm
Support Ring: 10mm
Coupling: Short and Long</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1387</GroupID><SubGroupID>3936</SubGroupID><ARTGs><ARTG>257497</ARTG><ARTG>257500</ARTG><ARTG>257612</ARTG></ARTGs><MinimumBenefit>3923</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO020</BillingCode><Name>Link MP Reconstruction Hip Prosthesis</Name><Description>Titanium, Grit blast, femoral Body</Description><Size>Length 35-65 mm   Offset Standard, XXL lateral</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Body</Suffix><ARTGs><ARTG>223282</ARTG></ARTGs><MinimumBenefit>2401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO060</BillingCode><Name>LINK Endo-Model SLED Uni Tibial Tray </Name><Description>Uni tibial tray including UHMWPE insert, cemented, CoCr tray</Description><Size>7mm-13mm in 45, 50, 55 diameter</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>152</SubCategoryID><GroupID>1365</GroupID><ARTGs><ARTG>140653</ARTG></ARTGs><MinimumBenefit>1744</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO182</BillingCode><Name>Link Biolox Delta Ceramic Head &gt; 32mm</Name><Description>Biolox Delta Ceramic Head &gt; 32mm</Description><Size>36mm - 40mm diameter</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>212053</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO156</BillingCode><PriorBillingCodes><PriorBillingCode>LO046</PriorBillingCode></PriorBillingCodes><Name>Link Modular Knee Prosthesis  System</Name><Description>Femoral Component</Description><Size>Extra Small - Extra Large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1380</GroupID><SubGroupID>3931</SubGroupID><ARTGs><ARTG>222087</ARTG><ARTG>225703</ARTG><ARTG>225704</ARTG><ARTG>226433</ARTG></ARTGs><MinimumBenefit>6984</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO183</BillingCode><Name>Link Prosthesis Femoral Head, &gt;32mm</Name><Description>CoCr Femoral Head, &gt;32mm</Description><Size>36mm diameter</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>212089</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO043</BillingCode><Name>LINK Endo Model Rotational and Hinge Knee Prosthesis System</Name><Description>Full tibial blocks made of UHMWPE </Description><Size>Small, Medium, Large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1397</GroupID><ARTGs><ARTG>51002</ARTG><ARTG>140652</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO159</BillingCode><PriorBillingCodes><PriorBillingCode>LO046</PriorBillingCode></PriorBillingCodes><Name>LINK Endo Model M Modular Knee Prostheses System</Name><Description>Centering Stars</Description><Size>Small, medium, large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1397</GroupID><ARTGs><ARTG>257592</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO171</BillingCode><PriorBillingCodes><PriorBillingCode>LO041</PriorBillingCode></PriorBillingCodes><Name>Link Endo Model Rotational and Hinge Knee Prostheses</Name><Description>Tibial Components</Description><Size>Extra small - extra large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><ARTGs><ARTG>157545</ARTG></ARTGs><MinimumBenefit>2005</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO059</BillingCode><Name>LINK Endo-Model SLED Uni femoral componet</Name><Description>Uni Femoral Component, cemented, CoCr</Description><Size>Short, medium-short, medium &amp; large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>150</SubCategoryID><GroupID>1353</GroupID><ARTGs><ARTG>271932</ARTG></ARTGs><MinimumBenefit>2007</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO172</BillingCode><PriorBillingCodes><PriorBillingCode>LO041</PriorBillingCode></PriorBillingCodes><Name>Link Endo Model Rotational and Hinge Knee Prostheses</Name><Description>Plastic insert</Description><Size>Extra small - Extra large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>157545</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO019</BillingCode><Name>Lubinus Eccentric Acetabular Cup</Name><Description>UHMWPE constrained</Description><Size>44 - 68mm</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4008</SubGroupID><ARTGs><ARTG>223209</ARTG><ARTG>223210</ARTG><ARTG>234119</ARTG></ARTGs><MinimumBenefit>699</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO185</BillingCode><Name>Link MP Reconstruction Prosthesis Stem, cementless</Name><Description>Link MP Reconstruction Prosthesis Stem, with Microporous surface, cementless</Description><Size>180 mm - 330 mm;   12 mm - 25 mm</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1412</GroupID><SubGroupID>3971</SubGroupID><Suffix>Stem</Suffix><ARTGs><ARTG>234224</ARTG></ARTGs><MinimumBenefit>3877</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO034</BillingCode><Name>CFP Hip Stem</Name><Description>Titanium, grit blast,  HA</Description><Size>Extra small to Extra Large</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>223134</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO166</BillingCode><PriorBillingCodes><PriorBillingCode>LO046</PriorBillingCode></PriorBillingCodes><Name>Link Modular Knee Prosthesis System</Name><Description>Augments</Description><Size>X-Small, Small, Medium and Large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1385</GroupID><ARTGs><ARTG>224949</ARTG><ARTG>245854</ARTG></ARTGs><MinimumBenefit>1864</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO026</BillingCode><Name>Link spacer</Name><Description>Titanium, grit blast, non HA </Description><Size>10mm - 40mm</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Spacer</Suffix><ARTGs><ARTG>114169</ARTG><ARTG>51002</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO173</BillingCode><PriorBillingCodes><PriorBillingCode>LO041</PriorBillingCode></PriorBillingCodes><Name>Link Endo Model Rotational and Hinge Knee Prostheses</Name><Description>Stems</Description><Size>Extra small - Extra large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>157545</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO042</BillingCode><Name>LINK Knee Patella Component</Name><Description>Patella Component, UHMWPE, cemented</Description><Size>Diameter: 25, 28, 30, 31, 34, 35 and 40mm
Height: 7, 8, 9 and 10mm</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>223374</ARTG><ARTG>231794</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO187</BillingCode><Name>Link MP Reconstruction Proximal Spacer</Name><Description>MP Reconstruction Proximal Spacer, CoCrMO</Description><Size>5 mm, 10 mm; 20 mm</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3961</SubGroupID><Suffix>Spacer</Suffix><ARTGs><ARTG>245855</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO163</BillingCode><PriorBillingCodes><PriorBillingCode>LO046</PriorBillingCode></PriorBillingCodes><Name>Link Modular Knee Prosthesis System</Name><Description>Hinge components</Description><Size>Small, Medium, Large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1393</GroupID><ARTGs><ARTG>223279</ARTG><ARTG>226253</ARTG></ARTGs><MinimumBenefit>2454</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO190</BillingCode><Name>TrabecuLink Femoral Cones</Name><Description>Trabecular Tilastan Femoral void filling cone intended for proximal metaphyseal bone surrounding stem, full or stepped</Description><Size>3 - Zones: 2- Zones: Proximal:  right; left:  XS - x-small; S - small; M - medium; L - large:  Depth: 26.00 mm - 32 mm:  Width: 37 mm - 52 mm:  Height: 30 mm - 60 mm</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>373076</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO111</BillingCode><Name>Beta-Cone Cementless Hip Prosthesis</Name><Description>Titanium, grit blast, with HA</Description><Size>9 Stem sizes 1-9 plus additional 9 stems with XL neck length.  Total 18 Sizes</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>114169</ARTG><ARTG>51002</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO184</BillingCode><Name>Link Biolox Delta Head, ≤32mm</Name><Description>Link Biolox Delta Head, ≤32mm</Description><Size>28 mm - 32 mm diameter</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>212053</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO186</BillingCode><Name>Link MP Reconstruction Neck Segment, Tilastan, HX-coated</Name><Description>MP Reconstruction Prosthesis, Neck Segment, Tilastan, HX-coated</Description><Size>35 mm - 65 mm; 126° - 135°CCD</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1411</GroupID><SubGroupID>3966</SubGroupID><Suffix>Body</Suffix><ARTGs><ARTG>222181</ARTG></ARTGs><MinimumBenefit>2106</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO133</BillingCode><Name>Link MP Reconstruction Hip Prosthesis</Name><Description>Link body, Titanium, grit blast, HA</Description><Size>35-65mm IN 126 &amp; 135 degrees</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1411</GroupID><SubGroupID>3966</SubGroupID><Suffix>Body</Suffix><ARTGs><ARTG>222181</ARTG></ARTGs><MinimumBenefit>2106</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO189</BillingCode><Name>TrabecuLink Tibial Cones</Name><Description>Trabecular Tilastan Tibial void filling cone intended for proximal metaphyseal bone surrounding stem, full or stepped</Description><Size>Full; right half; left half  XS - x-small; S - small; M - medium; L - large  Depth: 33.00 mm - 37.50 mm  Width: 48 mm - 66 mm  Height: 12 mm - 30 mm</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>373076</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO181</BillingCode><Name>SPII Model Lubinus Standard Hip Stem</Name><Description>Anatomical shaped hip prosthesis stem for cemented fixation in the human body.
- Minimal bone resection
- Uniform cement mantle around the whole stem
- Anatomically shaped stem resists rotational forces
Modular system allows adjustment to suit anatomical conditions</Description><Size>Stem Length: 130mm-170mm Throat Length: Short; Medium; Large; XL CCD Angle: 117 degrees; 126 degrees; 135 degrees Shape: Left; Right</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3939</SubGroupID><ARTGs><ARTG>212075</ARTG></ARTGs><MinimumBenefit>1312</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO158</BillingCode><PriorBillingCodes><PriorBillingCode>LO046</PriorBillingCode></PriorBillingCodes><Name>Link Modular Knee Prosthesis System</Name><Description>Tibial Components</Description><Size>Extra Small - Extra Large</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><Suffix>Hinged</Suffix><ARTGs><ARTG>221853</ARTG><ARTG>225001</ARTG><ARTG>225784</ARTG><ARTG>226252</ARTG></ARTGs><MinimumBenefit>3619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO179</BillingCode><Name>MegaSystem-C, Neck Segments</Name><Description>Massive, titanium</Description><Size>(35 - 65mm) length, (135 or 126) degree neck angle</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1410</GroupID><SubGroupID>3965</SubGroupID><Suffix>Body, Tumour</Suffix><ARTGs><ARTG>223281</ARTG></ARTGs><MinimumBenefit>4322</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO033</BillingCode><Name>Link acetabular Insert</Name><Description>UHMWPE Insert, Cross-linked</Description><Size>28mm - 36mm  Small, medium, large</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4020</SubGroupID><ARTGs><ARTG>212120</ARTG></ARTGs><MinimumBenefit>688</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO022</BillingCode><Name>Link Prosthesis Femoral Head</Name><Description>Prosthesis Head "B" CoCrMo</Description><Size>Short/medium-short/medium/Long/X-long  22mm - 32mm: Length -3.5 to +10.5</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>212089</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO100</BillingCode><Name>LINK Knee Fusion Nail</Name><Description>Cobalt Chromium</Description><Size>180mm, 220mm, 260mm</Size><SupplierCode>LO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>3331</SubGroupID><ARTGs><ARTG>140661</ARTG><ARTG>140663</ARTG></ARTGs><MinimumBenefit>4464</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO106</BillingCode><Name>LINK Intramedullary Plug</Name><Description>P/E Intramedullary Plug</Description><Size>12 to 20 mm</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1437</GroupID><ARTGs><ARTG>157547</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO018</BillingCode><Name>LINK IP Acetabular Cup</Name><Description>UHMWPE unmodified</Description><Size>40 - 64mm</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4006</SubGroupID><ARTGs><ARTG>223527</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO152</BillingCode><Name>BetaCup Cementless Acetabular Cup System</Name><Description>UHMWPE Insert</Description><Size>26mm&gt;</Size><SupplierCode>LO</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4020</SubGroupID><ARTGs><ARTG>140650</ARTG></ARTGs><MinimumBenefit>688</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LO160</BillingCode><PriorBillingCodes><PriorBillingCode>LO046</PriorBillingCode></PriorBillingCodes><Name>Link Modular Knee Prosthesis System</Name><Description>Tibial Components</Description><Size>Small, Medium and Large
60, 65 and 70mm</Size><SupplierCode>LO</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>157</SubCategoryID><GroupID>1381</GroupID><SubGroupID>3933</SubGroupID><ARTGs><ARTG>225030</ARTG></ARTGs><MinimumBenefit>7006</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>LEM04</BillingCode><Name>Cornea for Endothelial Lamellar Keratoplasty</Name><SupplierCode>LEM</SupplierCode><CategoryID>41</CategoryID><ARTGs><ARTG>234997</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4000</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>LEM01</BillingCode><Name>Cornea</Name><SupplierCode>LEM</SupplierCode><CategoryID>41</CategoryID><ARTGs><ARTG>234997</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3200</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>LEM05</BillingCode><Name>Cornea Preloaded for Endothelial Keratoplasty</Name><Size>N/A -  DMEK tissue itself is 12 microns thick and trephined to 8mm</Size><SupplierCode>LEM</SupplierCode><CategoryID>41</CategoryID><ARTGs><ARTG>234997</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4800</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>LEM02</BillingCode><Name>Sclera</Name><SupplierCode>LEM</SupplierCode><CategoryID>41</CategoryID><ARTGs><ARTG>234997</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>500</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>LAB03</BillingCode><Name>Cornea for Endothelial Keratoplasty (LEW03)</Name><SupplierCode>LAB</SupplierCode><CategoryID>41</CategoryID><ARTGs><ARTG>239107</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>4500</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>LAB04</BillingCode><Name>Cornea for intrastromal ring segments</Name><SupplierCode>LAB</SupplierCode><CategoryID>41</CategoryID><ARTGs><ARTG>239107</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1400</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>LAB05</BillingCode><Name>Sclera (LEW02)</Name><SupplierCode>LAB</SupplierCode><CategoryID>41</CategoryID><ARTGs><ARTG>239107</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>325</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>LAB02</BillingCode><Name>Cornea (LEW01)</Name><SupplierCode>LAB</SupplierCode><CategoryID>41</CategoryID><ARTGs><ARTG>239107</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>3700</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>LAB01</BillingCode><Name>FROZEN CORNEA</Name><Size>one corneo-scleral disc - frozen</Size><SupplierCode>LAB</SupplierCode><CategoryID>41</CategoryID><ARTGs><ARTG>239107</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>700</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SA175</BillingCode><PriorBillingCodes><PriorBillingCode>RA002</PriorBillingCode></PriorBillingCodes><Name>VNS Therapy Lead</Name><Description>Model 302</Description><Size>One size only</Size><SupplierCode>SA</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>224</SubCategoryID><GroupID>1685</GroupID><SubGroupID>5351</SubGroupID><ARTGs><ARTG>131047</ARTG></ARTGs><MinimumBenefit>3069</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SA129</BillingCode><PriorBillingCodes><PriorBillingCode>TM003</PriorBillingCode></PriorBillingCodes><Name>Optiform</Name><Description>Mechanical Valve</Description><Size>19mm to 33mm</Size><SupplierCode>SA</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>178</SubCategoryID><GroupID>1497</GroupID><ARTGs><ARTG>150082</ARTG></ARTGs><MinimumBenefit>4962</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SA185</BillingCode><Name>VNS Therapy Demipulse Generator 103</Name><Description>The generator is an implantable multiprogrammable pulse generator that delivers electrical signals to the vagus nerve. The pulse generator is housed in a hermetically sealed titanium case and is powered by a single battery. Electrical signals are transmitted from the pulse generator to the vagus nerve
by the lead. The VNS Therapy System is indicated for use as an adjunctive
therapy in reducing the frequency of seizures in patients whose epileptic disorder is dominated by partial seizures (with or without secondary generalization) or generalized seizures that are refractory to seizure medications.</Description><Size>Lead Receptacle 0.126 in (3.2 mm)
Dimension 1.8 in x 1.3 in x 0.27 in (45 mm x 32 mm x 6.9mm)
Weight 0.56 oz (16 g)

The 103 is smaller than previous devices, and fits in the palm of your hand and may be used in pediatric patients</Size><SupplierCode>SA</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>224</SubCategoryID><GroupID>1685</GroupID><SubGroupID>4493</SubGroupID><ARTGs><ARTG>168817</ARTG></ARTGs><MinimumBenefit>11435</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SA187</BillingCode><Name>VNS Therapy PerenniaFLEX Model 304.2 &amp; 304.3</Name><Description>Model 304 lead is a silicone insulated implantable patient lead, delivering the electrical signal from the Pulse Generator to the Vagus Nerve.</Description><Size>Lead Body 
Diameter : 2mm (.08 in)
Insulation: Silicone
Overall Length: 43cm

Inner Diameter of Helix
Model 304.20 ; 2mm (.08 in) inner diameter
Model 304.30 ; 3mm (.12 in) inner diameter</Size><SupplierCode>SA</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>224</SubCategoryID><GroupID>1685</GroupID><SubGroupID>5351</SubGroupID><ARTGs><ARTG>192081</ARTG></ARTGs><MinimumBenefit>3069</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SA174</BillingCode><PriorBillingCodes><PriorBillingCode>RA001</PriorBillingCode></PriorBillingCodes><Name>VNS Therapy Pulse/Pulse Duo</Name><Description>Model 102/102R Generator</Description><Size>One size only</Size><SupplierCode>SA</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>224</SubCategoryID><GroupID>1685</GroupID><SubGroupID>4493</SubGroupID><ARTGs><ARTG>130202</ARTG><ARTG>130203</ARTG><ARTG>131044</ARTG><ARTG>131045</ARTG><ARTG>131046</ARTG><ARTG>131047</ARTG><ARTG>168817</ARTG><ARTG>169837</ARTG><ARTG>192080</ARTG><ARTG>192081</ARTG></ARTGs><MinimumBenefit>11435</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SA190</BillingCode><Name>LivaNova Demipulse Duo Model 104 Generator for Vagus Nerve Stimulation</Name><Description>The LivaNova Demipulse Duo Model 104 is an implantable, dual pin lead compatible and multiprogrammable pulse generator that delivers electrical signals to the vagus nerve.</Description><Size>one size only</Size><SupplierCode>SA</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>224</SubCategoryID><GroupID>1685</GroupID><SubGroupID>4493</SubGroupID><ARTGs><ARTG>169837</ARTG></ARTGs><MinimumBenefit>11435</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SA186</BillingCode><Name>Aspire SR Pulse Generator Model 106</Name><Description>The 106 VNS therapy system is indicated for use as a adjunctive therapy in reducing the frequency of seizures in patients whose epileptic disorder is dominated by partial seizures (with or without secondary generalization) or generalized seizures that are refractory to seizure medications. Model 106 has the added feature of Autostim. In patients who experience Ictal Tachycardia which is defined as an increase in heart rate during a seizure specifically from baseline to a rate greater than 100 BPM and is at least 55% increase or 35 BPM increase from baseline delivering a therapeutic stimulation automatically delivered on detection of a physiological signal indicative of the onset of a seizure.</Description><Size>Lead receptacle -  0.126 in (3.2 mm) nominal
Dimensions -2.0 in x 2.0 in x 0.27 in (52 mm x 52 mm x 6.9 mm)
Weight- 0.88 oz (25 g)</Size><SupplierCode>SA</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>224</SubCategoryID><GroupID>1685</GroupID><SubGroupID>4493</SubGroupID><ARTGs><ARTG>275135</ARTG></ARTGs><MinimumBenefit>11435</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SA127</BillingCode><PriorBillingCodes><PriorBillingCode>TM001</PriorBillingCode></PriorBillingCodes><Name>AnnuloFlo Annuloplasty System</Name><Description>Annuloflex Ring or AnnuloFlo Ring</Description><Size>26-36mm</Size><SupplierCode>SA</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1841</GroupID><ARTGs><ARTG>155662</ARTG></ARTGs><MinimumBenefit>2090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>SA191</BillingCode><Name>LivaNova PerenniaDURA Lead Model 303 for Vagus Nerve Stimulation</Name><Description>The PerenniaDURA Lead Model 303 is a silicone insulated implantable patient lead, delivering the electrical signal from the VNS Generators to the left vagus nerve.</Description><Size>Available in two sizes: Model 303.20 (2.0 millimeter inner diameter of helical coil) and Model 303.30 (3.0 millimeter inner diameter of helical coil).</Size><SupplierCode>SA</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>224</SubCategoryID><GroupID>1685</GroupID><SubGroupID>5351</SubGroupID><ARTGs><ARTG>192080</ARTG></ARTGs><MinimumBenefit>3069</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LM258</BillingCode><PriorBillingCodes><PriorBillingCode>OH461</PriorBillingCode></PriorBillingCodes><Name>Bone Screws - cannulated</Name><Description>Screws - cannulated</Description><Size>2.0mm x 6.0-36.0mm</Size><SupplierCode>LM</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>202320</ARTG></ARTGs><MinimumBenefit>346</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH824</BillingCode><PriorBillingCodes><PriorBillingCode>LM135</PriorBillingCode><PriorBillingCode>LM072</PriorBillingCode></PriorBillingCodes><Name>TriMed Hook Plate</Name><Description>Hook Plate</Description><Size>4 to 6 holes</Size><SupplierCode>LM</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>572</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LH825</BillingCode><PriorBillingCodes><PriorBillingCode>LM136</PriorBillingCode><PriorBillingCode>LM072</PriorBillingCode></PriorBillingCodes><Name>TriMed Ankle Plates</Name><Description>Hook Plates</Description><Size>8 to 12 holes</Size><SupplierCode>LM</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, LK</Suffix><ARTGs><ARTG>182677</ARTG></ARTGs><MinimumBenefit>916</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LM257</BillingCode><PriorBillingCodes><PriorBillingCode>OH460</PriorBillingCode></PriorBillingCodes><Name>OsteoMed HPS</Name><Description>Bone screws - angled locking</Description><Size>1.6/2mm x 6-36mm</Size><SupplierCode>LM</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>202230</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ706</BillingCode><Name>Accufuser Select </Name><Description>The Accufuser select is an advanced disposable infusion device that delivers fluid and
medication at an accurate and selectable flow rate.</Description><Size>100ml 200ml 300ml 600ml 0 -15.0ml/hr</Size><SupplierCode>LE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5359</SubGroupID><ARTGs><ARTG>329420</ARTG></ARTGs><MinimumBenefit>142</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ703</BillingCode><Name>Accufuser Plus PCA</Name><Description>The Accufuser Plus - PCA is an advanced infusion device that delivers fluid and
medication at an acccurate and selectable flow rate and the ability to provide PCA bolus
function. It is indicated for continuous regional nerve block, surgical site and palliative care
infusions</Description><Size>60ml , 100ml, 200ml, 300ml, 600ml, Variable basal, PCA bolus and lock out select capability </Size><SupplierCode>LE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5359</SubGroupID><Suffix>Bolus</Suffix><ARTGs><ARTG>329420</ARTG></ARTGs><MinimumBenefit>367</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ701</BillingCode><Name>Accufuser Set Rate</Name><Description>Set Rate Elastomeric Pump</Description><Size>60ml 100ml  200ml 300ml  (o.5 ml hr to 100ml per hr) </Size><SupplierCode>LE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1524</GroupID><SubGroupID>5358</SubGroupID><ARTGs><ARTG>329420</ARTG></ARTGs><MinimumBenefit>28</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LE002</BillingCode><Name>Springfusor Infusion System  - Component # 1 Springfusor Pump/s</Name><Description>#1 Spring Powered Fixed Rate Ambulatory Infusion Pump </Description><Size> Pumps are available as 10ml, 30ml, 50ml</Size><SupplierCode>LE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1540</GroupID><SubGroupID>4188</SubGroupID><Suffix>Set</Suffix><ARTGs><ARTG>159494</ARTG></ARTGs><MinimumBenefit>233</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ705</BillingCode><Name>CIMPAX C CAT Catheter</Name><Description>Surgical Site Infusion Catheters</Description><Size> Catheter Kit 6 hole 2.5cm Catheter Kit 12 hole 6.5cm Catheter Kit 30 hole 15cm Catheter Kit 42 hole 21cm Catheter Kit 60 hole 30cm</Size><SupplierCode>LE</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1541</GroupID><SubGroupID>4194</SubGroupID><ARTGs><ARTG>331701</ARTG></ARTGs><MinimumBenefit>45</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LN005</BillingCode><Name>ALSAFIT TORIC VF</Name><Description>Single piece toric aspheric foldable intraocular lens for implantation into the capsular bag. Violet filter.</Description><Size>Diopter power range: Sphere: From 0.0 D to +32.00 D (0.50 D increments). Cylinder: From +0.50 D to +6.00 D (0.50 D increments).
Optic size: 6mm. Overall length: 11.0mm.</Size><SupplierCode>LN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1, vblf</Suffix><ARTGs><ARTG>268033</ARTG></ARTGs><MinimumBenefit>471</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ622</BillingCode><Name>Asqelio Soft Hydrophobic Intraocular Lens</Name><Description>One-piece foldable posterior chamber, UV absorbing IOL</Description><Size>Diopter power range: 0 to +10 in 1 diopter increments, and +10 to +30 diopters in 0.5 diopter increments. Overall diameter 13mm, Optic diameter 6mm.</Size><SupplierCode>LN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>350671</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ566</BillingCode><Name>Asqelio Toric Soft Hydrophobic Intraocular Lens</Name><Description>One-piece foldable posterior chamber, UV absorbing IOL</Description><Size>Diopter power range: +10.0 D to +30.0 D in 0.5 D increments; Cylinder power: 0.5 D to 6.0 D in 0.5 D increments. Overall diameter 13mm, Optic diameter 6mm.</Size><SupplierCode>LN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>350671</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LN001</BillingCode><Name>Inside CTR</Name><Description>Preloaded PMMA capsular tension ring</Description><Size>Type 14 (12.3mm open, 10.0mm compressed), Type 14C (13.0mm open, 11.0mm compressed), Type 14A ( 14.5mm open, 12.0mm compressed), Type 13 ( 12.3mm open, 10.0mm compressed), Type 13A ( 13.0mm open, 11.0mm compressed), Type 13B ( 14.5mm open, 12.0mm compressed), Type 19D (11.6 mm open, 10.0/9.5/9.0/8.5mm compressed), Type 10C ( 12.1mm open, 11.0mm compressed)Type 15A ( 13.0mm open, 11.0mm compressed), Type 15B ( 14.5mm open, 12.0mm compressed).</Size><SupplierCode>LN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>143</SubCategoryID><GroupID>1331</GroupID><Suffix>pl</Suffix><ARTGs><ARTG>235092</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LN015</BillingCode><Name>DyeBlue</Name><Description>Dyeblue is a sterile intraocular solution containing Trypan Blue without preservatives. Dyeblue is indicated for anterior capsule colouring during ophthalmic surgeries.</Description><Size>1 mL vial, 1.1 mL syringe  </Size><SupplierCode>LN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1330</GroupID><ARTGs><ARTG>399953</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LN011</BillingCode><Name>I-Stream Pre-Loaded Aspheric Hydrophobic</Name><Description>Single piece, pre-loaded aspheric  hydrophobic acrylic IOL</Description><Size>Optic diameter: 6mm
Total diameter: 13mm
Power range: +9.0 to +32.0D</Size><SupplierCode>LN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, pl</Suffix><ARTGs><ARTG>307407</ARTG></ARTGs><MinimumBenefit>239</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LN008</BillingCode><Name>ALSIOL</Name><Description>Single piece aspheric foldable intraocular lens for implantation into the capsular bag.</Description><Size>Diopter power range: 0.0 D to +32.00 D (0.50 D increments). Optic size: 6 mm. Overall length: 11.0 mm.</Size><SupplierCode>LN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>277174</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LN002</BillingCode><Name>Ahmed Glaucoma Valve Model FP7</Name><Description>A sterile device designed to regulate  the flow of Fluid between the anterior chamber and the space around the conjunctiva of the eye be allowing flow when the pressure in the chamber is above a pre-set value (e.g., 8 to 10 mmHg). Made of medical grade silicone</Description><Size>one size</Size><SupplierCode>LN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>144</SubCategoryID><GroupID>1333</GroupID><Suffix>v</Suffix><ARTGs><ARTG>242076</ARTG></ARTGs><MinimumBenefit>564</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LN003</BillingCode><Name>ALSAFIT</Name><Description>Single piece aspheric foldable intraocular lens for implantation into the capsular bag.</Description><Size>Diopter power range: 0.0 D to 32.00 D (0.50 D increments). Optic size: 6mm. Overall length: 11.0mm.</Size><SupplierCode>LN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at</Suffix><ARTGs><ARTG>268033</ARTG></ARTGs><MinimumBenefit>232</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LN016</BillingCode><Name>AJL CELL</Name><Description>AJL CELL 2% is made up of 2% hydroxypropyl methylcellulose (HPMC) in a phosphate-buffered saline solution that is administered into the anterior chamber of the eye during intraocular surgery using a prepared sterile syringe and cannula suitable for the surgical technique.</Description><Size>2mL</Size><SupplierCode>LN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>142</SubCategoryID><GroupID>1329</GroupID><ARTGs><ARTG>413398</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>LN010</BillingCode><Name>I-stream Toric Hydrophilic</Name><Description>One-piece posterior chamber lens with aspherical surface for capsular bag fixation.</Description><Size>Optic diameter: 6mm
Total diameter: 11mm
Diopter range: +15.0 to +25.0D (standard), 1.0 to 14.5D and 25.5 to 40.0D (made to order)
Cylinder range: 0.75 to 6.0D</Size><SupplierCode>LN</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>141</SubCategoryID><GroupID>1327</GroupID><SubGroupID>3892</SubGroupID><Suffix>at, t1</Suffix><ARTGs><ARTG>307407</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU033</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ073</PriorBillingCode><PriorBillingCode>EF019</PriorBillingCode></PriorBillingCodes><Name>Arix Hand Plating System</Name><Description>Mini Plates</Description><Size>≤ 6 holes</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>239812</ARTG></ARTGs><MinimumBenefit>907</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU006</BillingCode><PriorBillingCodes><PriorBillingCode>QQ210</PriorBillingCode></PriorBillingCodes><Name>ARIX 2.0-3.5mm Locking screws </Name><Description>Locking screws</Description><Size>2.0-3.5mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU037</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ077</PriorBillingCode><PriorBillingCode>EF026</PriorBillingCode></PriorBillingCodes><Name>Arix Locking Screw</Name><Description>Locking Screw</Description><Size>2.01 – 2.7 mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>239817</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU003</BillingCode><PriorBillingCodes><PriorBillingCode>QQ198</PriorBillingCode></PriorBillingCodes><Name>ARIX Wrist System - Carpal Fusion Plate</Name><Description>Carpal Fusion Plate</Description><Size>6 holes </Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU025</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ059</PriorBillingCode></PriorBillingCodes><Name>Lyka Smith Jeil Le Fort Locking Screws</Name><Description>Titanium Locking Screws</Description><Size>Diameter 2-2.4mm  Length 4-20mm</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>310093</ARTG></ARTGs><MinimumBenefit>88</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU028</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ062</PriorBillingCode></PriorBillingCodes><Name>Lyka Smith Jeil Le Forte Plates 8-32 Holes</Name><Description>Titanium plates in a variety of shapes for reconstruction</Description><Size>Thickness 0.5 - 0.8mm  8-20 Holes</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><ARTGs><ARTG>310093</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU008</BillingCode><PriorBillingCodes><PriorBillingCode>QQ212</PriorBillingCode></PriorBillingCodes><Name>ARIX Elbow System- Olecranon</Name><Description>Olecranon, Medial, Lateral, Posterolateral</Description><Size>5-17 holes </Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5280</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>1198</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU011</BillingCode><PriorBillingCodes><PriorBillingCode>QQ332</PriorBillingCode></PriorBillingCodes><Name>ARIX Elbow System- Olecranon</Name><Description>Olecranon, Medial, Lateral, Posterolateral</Description><Size>5-17 holes </Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5280</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>1198</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU038</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ078</PriorBillingCode><PriorBillingCode>EF029</PriorBillingCode></PriorBillingCodes><Name>Bone Screw</Name><Description>Cortical Bone Screw</Description><Size>2.01mm – 2.7mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>239817</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU041</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ112</PriorBillingCode></PriorBillingCodes><Name>ARIX 2.5mm Non-locking</Name><Description>Non-locking screws </Description><Size>2.5mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU012</BillingCode><PriorBillingCodes><PriorBillingCode>QQ668</PriorBillingCode></PriorBillingCodes><Name>ARIX 2.5mm Non-locking</Name><Description>Non-locking screws </Description><Size>2.5mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU017</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ044</PriorBillingCode></PriorBillingCodes><Name>OrthoTin TMJ Fossa Component</Name><Description>Titanium fossa component with UHMWPE bearing surface</Description><Size>The device is custom made so the size will vary</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4354</SubGroupID><ARTGs><ARTG>293845</ARTG></ARTGs><MinimumBenefit>4114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU018</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ045</PriorBillingCode></PriorBillingCodes><Name>OrthoTin TMJ Ramus Component</Name><Description>TiN coated titanium mandibular ramus</Description><Size>The device is custom made so the size will vary</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><ARTGs><ARTG>293845</ARTG></ARTGs><MinimumBenefit>4738</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU019</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ046</PriorBillingCode></PriorBillingCodes><Name>OrthoTin Anatomic Biomodel</Name><Description>Anatomic Biomodel</Description><Size>The device is custom so the size will vary</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1807</GroupID><ARTGs><ARTG>293845</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU029</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ063</PriorBillingCode></PriorBillingCodes><Name>Lyka Smith Jeil Le Forte Locking Plates 4-7 Holes</Name><Description>Titanium locking plates of various shapes for reconstruction</Description><Size>4-7 holes  Thickness - 0.5-0.99mm</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>310093</ARTG></ARTGs><MinimumBenefit>190</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU023</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ050</PriorBillingCode></PriorBillingCodes><Name>Lyka-Smith Anatomical Biomodel</Name><Description>Three-dimensional anatomical biomodel</Description><Size>The device is custom made so the size will vary</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1807</GroupID><ARTGs><ARTG>293845</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU021</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ048</PriorBillingCode></PriorBillingCodes><Name>Lyka Smith Patient Specific Plate</Name><Description>3D printed custom plate</Description><Size>The device is custom so the size will vary</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>293845</ARTG></ARTGs><MinimumBenefit>2952</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU034</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ074</PriorBillingCode><PriorBillingCode>EF020</PriorBillingCode></PriorBillingCodes><Name>Arix Hand Plating System</Name><Description>Mini Locking Plates</Description><Size>≤ 6 holes</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>239812</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU026</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ060</PriorBillingCode></PriorBillingCodes><Name>Lyka Smith Jeil Le Forte Plates 4-7 Holes</Name><Description>Titanium plates in a variety of shapes for reconstruction</Description><Size>Thickness - 0.5-0.8mm   4-7 Holes</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>310093</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU027</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ061</PriorBillingCode></PriorBillingCodes><Name>Lyka Smith Jeil Le Forte Locking Plates 8-32 holes</Name><Description>Titanium locking plates for craniofacial reconstruction</Description><Size>Thickness - 0.8mm  Holes - 8-32</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>310093</ARTG></ARTGs><MinimumBenefit>259</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU009</BillingCode><PriorBillingCodes><PriorBillingCode>QQ330</PriorBillingCode></PriorBillingCodes><Name>ARIX 2.0-3.5mm Locking screws </Name><Description>Locking screws</Description><Size>2.0-3.5mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU042</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ113</PriorBillingCode></PriorBillingCodes><Name>ARIX Wrist System - Ulna Plates</Name><Description>Ulna Osteotomy Plates</Description><Size>7 holes</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU016</BillingCode><PriorBillingCodes><PriorBillingCode>QQ803</PriorBillingCode></PriorBillingCodes><Name>ARIX Wrist System - Volar Distal Radius Plates </Name><Description>Volar Distal Radius Plates </Description><Size>8-11 holes</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU010</BillingCode><PriorBillingCodes><PriorBillingCode>QQ331</PriorBillingCode></PriorBillingCodes><Name>ARIX 2.0mm Non-Locking screws </Name><Description>Non-Locking screws</Description><Size>2.00mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU040</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ111</PriorBillingCode></PriorBillingCodes><Name> ARIX Wrist System, STARIX Locking Screw</Name><Description>Locking screws</Description><Size>2.5mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU002</BillingCode><PriorBillingCodes><PriorBillingCode>QQ194</PriorBillingCode></PriorBillingCodes><Name>ARIX Clavicle System-Hook Plates</Name><Description>3.5mm clavicle hook plate</Description><Size>5-6 holes</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5270</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>1261</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU022</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ049</PriorBillingCode></PriorBillingCodes><Name>Lyka Smith Patient Specific Guides</Name><Description>Patient specific surgical guide</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>293845</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU015</BillingCode><PriorBillingCodes><PriorBillingCode>QQ802</PriorBillingCode></PriorBillingCodes><Name>ARIX Wrist System - Carpal Fusion Plate</Name><Description>Carpal Fusion Plate</Description><Size>7 holes </Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU024</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ058</PriorBillingCode></PriorBillingCodes><Name>Lyka Smith Jeil LeForte System Screws</Name><Description>Self tapping and self drilling screws</Description><Size>Diameter- 1.3 - 2.7mm  Length 2-20mm</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>310093</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU020</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ047</PriorBillingCode></PriorBillingCodes><Name>OrthoTin Surgical Guide</Name><Description>Patient specific surgical guide</Description><Size>The device is custom so the size may vary</Size><SupplierCode>XU</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>293845</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU013</BillingCode><PriorBillingCodes><PriorBillingCode>QQ669</PriorBillingCode></PriorBillingCodes><Name>ARIX Wrist System - Distal Ulna Plates</Name><Description>Distal Ulna Plates</Description><Size>7 holes</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU035</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ075</PriorBillingCode><PriorBillingCode>EF021</PriorBillingCode></PriorBillingCodes><Name>Locking Plate System</Name><Description>Variable Locking Plate</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>239812</ARTG></ARTGs><MinimumBenefit>797</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU014</BillingCode><PriorBillingCodes><PriorBillingCode>QQ693</PriorBillingCode></PriorBillingCodes><Name>ARIX Elbow System- Proximal Radius Plates </Name><Description>Proximal Radius Plates </Description><Size>7-10 holes </Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU036</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ076</PriorBillingCode><PriorBillingCode>EF022</PriorBillingCode></PriorBillingCodes><Name>Arix Hand Plating System</Name><Description>Mini Locking Plate</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>239812</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU031</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ071</PriorBillingCode><PriorBillingCode>EF010</PriorBillingCode></PriorBillingCodes><Name>Bone Screw</Name><Description>Locking Screw</Description><Size>2.71mm – 4.49mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>239817</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU004</BillingCode><PriorBillingCodes><PriorBillingCode>QQ208</PriorBillingCode></PriorBillingCodes><Name>ARIX 1.5-2.0 Locking screws</Name><Description>Locking screws</Description><Size>1.5-2.0mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU039</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ079</PriorBillingCode><PriorBillingCode>EF014</PriorBillingCode></PriorBillingCodes><Name>Bone Screw</Name><Description>Locking Screw</Description><Size>≤ 2.0mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>239817</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU032</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ072</PriorBillingCode><PriorBillingCode>EF015</PriorBillingCode></PriorBillingCodes><Name>Bone Screw</Name><Description>Cortical Bone Screw</Description><Size>≤ 2.0mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>239817</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU005</BillingCode><PriorBillingCodes><PriorBillingCode>QQ209</PriorBillingCode></PriorBillingCodes><Name>ARIX 1.5-2.3 Non-Locking screws</Name><Description>Non-Locking screws</Description><Size>1.5-2.0mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU007</BillingCode><PriorBillingCodes><PriorBillingCode>QQ211</PriorBillingCode></PriorBillingCodes><Name>ARIX 2.0mm Non-Locking screws </Name><Description>Non-Locking screws</Description><Size>2.00mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU001</BillingCode><PriorBillingCodes><PriorBillingCode>QQ193</PriorBillingCode></PriorBillingCodes><Name>ARIX 3.5mm Non-Locking screws </Name><Description>3.5mm Non-Locking screws</Description><Size>3.5mm </Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>409165</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XU030</BillingCode><PriorBillingCodes><PriorBillingCode>ZZ070</PriorBillingCode><PriorBillingCode>EF007</PriorBillingCode></PriorBillingCodes><Name>Bone Screw</Name><Description>Cortical Bone Screw</Description><Size>2.71mm – 4.49mm</Size><SupplierCode>XU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>239817</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PT001</BillingCode><Name>Blom-Singer® Dual Valve and Advantage Voice Prosthesis</Name><Description>A range of valved silicone voice prostheses with specific anti-fungal and anti-leakage attributes, that are placed into a tracheoesophageal puncture at the time of surgery. The Prosthesis resides between the back wall of the trachea into the esophageal wall to enable tracheosophageal speech.</Description><Size>Dual Valve: 16 French and 20 French diameters 4-14mm length 
Advantage: 20 French diameter 6-14mm length
(2mm increments)</Size><SupplierCode>PT</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1569</GroupID><ARTGs><ARTG>278705</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PT002</BillingCode><Name>Blom-Singer® Classic, Rapid Response Indwelling Voice Prostheses</Name><Description>A range of valved silicone voice prostheses that are placed into a tracheoesophageal puncture at the time of surgery. The Prosthesis resides between the back wall of the trachea into the esophageal wall to enable tracheosophageal speech.

Benefit: Voice is produced by temporarily blocking the stoma so that exhaled pulmonary air can be directed from the trachea, through the prosthesis into the oesophagus, producing voice in the TEP segment. Fluent, conversational speech may be acquired within just a few days.

Blom-Singer Rapid Response VP’s are available with extended tracheal and oesophageal flanges to overcome peripheral valve leakage. In addition, valve weighting can be adjusted to manage reflux and central valve leakage. This range of valves is also available in special lengths.</Description><Size>16 French and 20 French diameters, 4-20mm length (2mm increments)</Size><SupplierCode>PT</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1569</GroupID><ARTGs><ARTG>278705</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PT003</BillingCode><PriorBillingCodes><PriorBillingCode>BQ009</PriorBillingCode><PriorBillingCode>BQ002</PriorBillingCode></PriorBillingCodes><Name>Tracheal Speaking Valve</Name><Description>Passy Muir Tracheal Speaking Valve</Description><Size>one size</Size><SupplierCode>PT</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1569</GroupID><ARTGs><ARTG>279056</ARTG></ARTGs><MinimumBenefit>92</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PT006</BillingCode><PriorBillingCodes><PriorBillingCode>BQ006</PriorBillingCode><PriorBillingCode>TX052</PriorBillingCode></PriorBillingCodes><Name>Extra-tracheal Cannula</Name><Description>a) Montgomery Short-Term Cannula   b) Montgomery Long-Term Cannula</Description><Size>a) 4, 6, 8, 10 b) 4, 6, 8, 10 for Stoma Sizes 17-25, 25-33, 33-41, 41-49, 49-57, 57-65mm</Size><SupplierCode>PT</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1574</GroupID><Suffix>Extra-tracheal</Suffix><ARTGs><ARTG>119737</ARTG></ARTGs><MinimumBenefit>269</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PT005</BillingCode><PriorBillingCodes><PriorBillingCode>BQ003</PriorBillingCode><PriorBillingCode>TX053</PriorBillingCode></PriorBillingCodes><Name>Intra-tracheal Cannula</Name><Description>Montgomery Safe-T-Tubes Clear and Radiopaque except c)   a) Paediatric   b) Standard   c) Hebeler    d) Thoracic    e) Extra-Long    f) Tapered   g) Montgomery Salivary Bypass Tube   h) Har-el Pharyngeal Tube   i) Montgomery Esophageal Tube  j) Trachael Fenestrator  k) Moore Trache</Description><Size>a) 6, 7, 8, 9   b) 10, 11, 12, 13, 14. 15, 16  c) 12, 15, 18   d) 10, 11, 12, 13, 14, 15, 16   e) 10, 11, 12, 13, 14, 15, 16   f) 8/10, 10/13   g) 8, 10, 12, 14, 16, 18, 20   h) one size only   i) one size only  j) size 6, 8 and 10  k) size 6 and 8</Size><SupplierCode>PT</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1574</GroupID><Suffix>Intra-tracheal</Suffix><ARTGs><ARTG>119736</ARTG><ARTG>119737</ARTG></ARTGs><MinimumBenefit>425</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PT004</BillingCode><PriorBillingCodes><PriorBillingCode>BQ001</PriorBillingCode><PriorBillingCode>TX050</PriorBillingCode></PriorBillingCodes><Name>Vocal Chord Medialisation Implant</Name><Description>Montgomery Laryngeal Keel</Description><Size>12, 14, 16 - Clear and Radiopaque</Size><SupplierCode>PT</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1570</GroupID><ARTGs><ARTG>119029</ARTG></ARTGs><MinimumBenefit>248</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PT007</BillingCode><PriorBillingCodes><PriorBillingCode>BQ005</PriorBillingCode><PriorBillingCode>TX051</PriorBillingCode></PriorBillingCodes><Name>Thyroplasty</Name><Description>Montgomery Thyroplasty Implant System</Description><Size>male - 8,9,10,11,12,13  female - 6,7,8,9,10</Size><SupplierCode>PT</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>198</SubCategoryID><GroupID>1573</GroupID><ARTGs><ARTG>117683</ARTG></ARTGs><MinimumBenefit>1057</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PQ004</BillingCode><Name>Reactiv8 Implantable Pulse Generator</Name><Description>Two channel implantable stimulator</Description><Size>One size only</Size><SupplierCode>PQ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1677</GroupID><SubGroupID>4480</SubGroupID><ARTGs><ARTG>327089</ARTG></ARTGs><MinimumBenefit>17283</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PQ003</BillingCode><Name>Reactiv8 Percutaneous Lead</Name><Description>Four electrode lead kit</Description><Size>45cm; 65cm</Size><SupplierCode>PQ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>4 electrodes</Suffix><ARTGs><ARTG>327091</ARTG></ARTGs><MinimumBenefit>3041</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PQ001</BillingCode><Name>Reactiv8 Magnet</Name><Description>Communication Magnet</Description><Size>One size</Size><SupplierCode>PQ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4485</SubGroupID><ARTGs><ARTG>327094</ARTG></ARTGs><MinimumBenefit>1264</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PQ005</BillingCode><Name>Reactiv8 Activator</Name><Description>Patient Activator for use with Reactiv8 Implantable Pulse Generator </Description><Size>One size only</Size><SupplierCode>PQ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4483</SubGroupID><ARTGs><ARTG>327090</ARTG></ARTGs><MinimumBenefit>1354</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PQ007</BillingCode><Name>Adelante Peel-Away Introducer Set</Name><Description>The Adelante Peel-Away Introducer Set is comprised of an assortment of sterile, single use, percutaneous introducer materials used to assist in the placement of a neuroelectrode array.  Specifically, each kit contains 1 peel-away sheath (7F), 1 dilator, 1 needle, and 2 guidewires 50 cm, 0.035 inch, straight tip.    The introducer set is designed to accompany the ReActiv8 neurostimulation system that allows for the placement of the ReActiv8 percutaneous lead (ARTG 327091).</Description><Size>Length: 16 cm; width: 7F (2.30 mm) for the introducer.  Length: 50 cm; width: 0.035 inches for the guidewires.</Size><SupplierCode>PQ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>405210</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PQ006</BillingCode><Name>Mainstay Tunneller</Name><Description>Catheter tunnellng tool to establish subcutaneous lead delivery pathway</Description><Size>One size</Size><SupplierCode>PQ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>283718</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>PQ002</BillingCode><Name>Reactiv8 Torque Wrench</Name><Description>A tool used to set or release the Implantable Pulse Generator (IPG) set screw  that connects an implanted lead to the IPG header.</Description><Size>One size</Size><SupplierCode>PQ</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>284000</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DF004</BillingCode><Name>DANA-i Insulin Pump</Name><Description>ACE (Alternate Control Enabled) secure Bluetooth low energy insulin pump.  EC certified to be connected to approved CGM systems and approved control algorithms (APS - Artificial Pancreas Systems).  </Description><Size>97mm x 44mm x 20mm 85grams</Size><SupplierCode>DF</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4183</SubGroupID><Suffix>DE, SS</Suffix><ARTGs><ARTG>340938</ARTG></ARTGs><MinimumBenefit>8077</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MJ013</BillingCode><PriorBillingCodes><PriorBillingCode>FI056</PriorBillingCode></PriorBillingCodes><Name>Saiph Knee System APS Tibial Insert</Name><Description>Compression Moulded Anterior Posterior Stablilised Tibial Bearing</Description><Size>A - F, Left &amp; Right 10 - 20mm</Size><SupplierCode>MJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>117769</ARTG><ARTG>192415</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MJ009</BillingCode><PriorBillingCodes><PriorBillingCode>FI054</PriorBillingCode></PriorBillingCodes><Name>Saiph Knee System Tibial Component Cemented</Name><Description>CoCr Tibial Component, Cemented</Description><Size>A - F, Standard and Long Stem</Size><SupplierCode>MJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>117769</ARTG><ARTG>192371</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MJ015</BillingCode><PriorBillingCodes><PriorBillingCode>FI057</PriorBillingCode></PriorBillingCodes><Name>Saiph Knee System Patella Component</Name><Description>Polyethylene Patella Component</Description><Size>Diameter 23mm - 42mm</Size><SupplierCode>MJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>209578</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MJ027</BillingCode><Name>ReCerf Ceramic Resurfacing Head</Name><Description>Biolox Delta Resurfacing Head Cemented</Description><Size>Diameter 40mm to 64mm</Size><SupplierCode>MJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1422</GroupID><SubGroupID>20000</SubGroupID><ARTGs><ARTG>470548</ARTG></ARTGs><MinimumBenefit>3179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MJ026</BillingCode><Name>ReCerf Acetabular Cup</Name><Description>Biolox Delta Acetabular Cup Cementless with Plasma Titanium and HA Coating</Description><Size>46mm to 70mm</Size><SupplierCode>MJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1431</GroupID><SubGroupID>20001</SubGroupID><ARTGs><ARTG>470549</ARTG></ARTGs><MinimumBenefit>4885</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MJ005</BillingCode><PriorBillingCodes><PriorBillingCode>FI052</PriorBillingCode></PriorBillingCodes><Name>Saiph Knee System Femoral Component Cemented</Name><Description>CoCr Polished Cemented Femoral Component</Description><Size>1 - 8 Left &amp; Right</Size><SupplierCode>MJ</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>117768</ARTG><ARTG>192370</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MJ002</BillingCode><PriorBillingCodes><PriorBillingCode>FI059</PriorBillingCode><PriorBillingCode>DY548</PriorBillingCode></PriorBillingCodes><Name>Adept MoM Acetabular Component</Name><Description>Porocast beaded Shell , Co Cr, HA coated size 44-66mm</Description><Size>44-66mm Outer diameter going up in 2mm increments</Size><SupplierCode>MJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1431</GroupID><SubGroupID>4032</SubGroupID><ARTGs><ARTG>192533</ARTG><ARTG>192534</ARTG></ARTGs><MinimumBenefit>4322</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MJ001</BillingCode><PriorBillingCodes><PriorBillingCode>FI058</PriorBillingCode><PriorBillingCode>DY546</PriorBillingCode></PriorBillingCodes><Name>ADEPT MoM Resurfacing Head</Name><Description>Resurfacing Head MoM, Cast CoChr</Description><Size>38-58 going up in 2mm increments</Size><SupplierCode>MJ</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1422</GroupID><SubGroupID>4000</SubGroupID><ARTGs><ARTG>192534</ARTG><ARTG>192533</ARTG></ARTGs><MinimumBenefit>2812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BF001</BillingCode><PriorBillingCodes><PriorBillingCode>AJ020</PriorBillingCode></PriorBillingCodes><Name>Vigor/X'Plo PEEK Interbody Fusion Cage</Name><Description>Rotatable posterior lumbar interbody fusion cage</Description><Size>Heights: 7mm, 8mm, 9mm, 10mm, 11mm, 12mm, 14mm, 16mm and Lengths: 24mm, 26mm, 32mm</Size><SupplierCode>BF</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>211536</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BF013</BillingCode><Name>Redmond Lumbar Cage System</Name><Description>ALIF PEEK &amp; Titanium Cage, Locking &amp; Oversized Screws and Locking Cap</Description><Size>Cage: Angle 12 - 18 degrees; Height 12-18mm; W36-43mm x L28-32mm; Screws 5.5 &amp; 5.7mm - L25-35mm</Size><SupplierCode>BF</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>211536</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BF006</BillingCode><PriorBillingCodes><PriorBillingCode>AJ022</PriorBillingCode></PriorBillingCodes><Name>Smartloc Spinal Fixation System/ Polyaxial Pedicle Screw &amp; Reduction Screw</Name><Description>Polyaxial Pedicle Screw and Reduction Screw</Description><Size>Length 30mm – 55mm; Diameter 4.5mm, 5.5mm, 6.0mm, 6.5mm, 7.0mm, 7.5mm, 8.0mm</Size><SupplierCode>BF</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>150778</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BF005</BillingCode><PriorBillingCodes><PriorBillingCode>AJ021</PriorBillingCode></PriorBillingCodes><Name>Smartloc Spinal Fixation System / Fixation Rod</Name><Description>Fixation Rod for Smartloc Spinal Fixation System</Description><Size>40mm - 80mm</Size><SupplierCode>BF</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>150778</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BF007</BillingCode><PriorBillingCodes><PriorBillingCode>AJ023</PriorBillingCode></PriorBillingCodes><Name>Smartloc Spinal Fixation System/Transverse Link</Name><Description>Cross link for Smartloc Spinal Fixation System</Description><Size>Telescopes to 70mm</Size><SupplierCode>BF</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>150778</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BF033</BillingCode><Name>BEE HA Cage cervical</Name><Description>PEEK-OPTIMA HA ENHANCED cervical interbody fusion cage with titanium alloy (Ti6Al4V) pins.</Description><Size>Lordosis 4-12 degrees, Width 14-18mm, Depth 12-15mm, Height 4-10mm</Size><SupplierCode>BF</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>499734</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BF022</BillingCode><Name>Redmond Cervical Cage with cap and screws</Name><Description>Stand-alone cervical interbody fusion cage with locking cap and screws</Description><Size>Cages Angles 5, 8 degrees, W 14 - 20 mm; L 12 - 18; H 5 - 10mm; Screws diam 4 - 4.5 mm; L 12 - 18 mm; Cap Diam. 8.6mm, L 6.5mm</Size><SupplierCode>BF</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>211536</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BF008</BillingCode><PriorBillingCodes><PriorBillingCode>AJ024</PriorBillingCode></PriorBillingCodes><Name>Smartloc Spinal Fixation System / Set Screw</Name><Description>Set screw for poyaxial pedicle screw</Description><Size>8mm diameter, 5mm height</Size><SupplierCode>BF</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>150778</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BF011</BillingCode><Name>WinLoc Cervical Plate System - screw</Name><Description>Variable self drilling screw/self tapping screw/oversized screw, expandable screw</Description><Size>Length: 12mm, 14mm, 16mm, 18mm
Diameter:  4.0mm, 4.5mm</Size><SupplierCode>BF</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>218438</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BF034</BillingCode><Name>BEE Cage cervical</Name><Description>Titanium alloy (Ti6Al4V) cervical interbody fusion cage.</Description><Size>Lordosis 4-12 degrees, Width 14-18mm, Depth 12-15mm, Height 4-10mm</Size><SupplierCode>BF</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>499728</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>BF032</BillingCode><Name>BEE PLIF Cage</Name><Description>Titanium PLIF Cage</Description><Size>Lordosis 0-18 degrees, Nominal height 7-16mm, Width 8-9.5mm, Length 30-36mm</Size><SupplierCode>BF</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>499728</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OG001</BillingCode><Name>OMX Solutions patient Optimized Guide system</Name><Description>CT Based Patient Specific Surgical Guide</Description><Size>The device is patient specific so size will vary</Size><SupplierCode>OG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>276176</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OG007</BillingCode><Name>MAXONIQ Surgical Guide Dental (STMN)</Name><Description>The MAXONIQ Surgical Dental Guide is a patient-specific and single use device that is intended to be used in conventional and multiple dental, partial and full dental arch and zygomatic implantation procedures to be used with Straumann Implant systems. It is designed from patient scan data or surgical restoration templates and is given a predefined shape and hole configuration to guide the placement of dental-guided surgery reference pins. It is also used as a drill guide for the placement of dental implants in the early stages of dental implantation procedures. The surgical guides manufactured by MAXONIQ Pty Ltd using the coDiagnosiX software are specifically designed to be used with Straumann dental implants listed under the following rebate codes, SB008, SB009, SB015, SB018, SB029, SB030 and SB035.</Description><Size>Sizes vary</Size><SupplierCode>OG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>404632</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OG005</BillingCode><Name>Custom Plate</Name><Description>A titanium plate designed to be attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as the bone heals. The device is used for fixation of maxillofacial, mandibular fractures and reconstructions.</Description><Size>Customised to patients</Size><SupplierCode>OG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>330150</ARTG></ARTGs><MinimumBenefit>2952</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OG006</BillingCode><Name>MAXONIQ Surgical Guide Dental (Southern Implants)</Name><Description>The MAXONIQ Surgical Dental Guide is a patient-specific and single use device that is intended to be used in conventional and multiple dental, partial and full dental arch and zygomatic implantation procedures to be used with Southern Dental Implant systems. It is designed from patient scan data or surgical restoration templates and is given a predefined shape and hole configuration to guide the placement of dental-guided surgery reference pins. It is also used as a drill guide for the placement of dental implants in the early stages of dental implantation procedures. The surgical guides manufactured by MAXONIQ Pty Ltd using the coDiagnosiX software are specifically designed to be used with Southern Implants listed under the following rebate codes, IC008.</Description><Size>Sizes vary</Size><SupplierCode>OG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>5498</SubGroupID><Suffix>Biomodelled</Suffix><ARTGs><ARTG>404632</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ132</BillingCode><Name>OsseoFrame</Name><Description>The MAXONIQ OsseoFrame is a subperiosteal, titanium (Ti64), patient-specific surgical
implant individually designed from a 3D Computed Tomography (CT) or Cone Beam CT
(CBCT) scan provided to MAXONIQ by the referring surgeon. The OsseoFrame is
fixated to alveolar bone of the maxilla or mandible to fit the natural contours. An
OsseoFrame is comprised of a baseplate with holes for screw fixation and transmucosal
connectors for dental prosthesis attachment. The OsseoFrame is intended to be used on
the alveolar bone of the mandible or maxilla to provide a stable and permanent platform for
fixation of the dental prosthesis. The OsseoFrame is indicated to restore oral function
and facial aesthetics in edentulous patients missing 3 or more adjacent teeth with atrophic
jaws, low sinus floors or who have undergone partial jaw resection. The OsseoFrame
may also be beneficial for patients who cannot tolerate removable dentures and desire a
fixed solution; who cannot tolerate complex bone graft surgery to support dental implants;
or if they want replacement teeth immediately after surgery. The dental prosthesis is
supplied separately and is to be fitted by surgeon, a restorative dentist or a prosthodontist.
The OsseoFrame may be supplied with a biomodel and a surgical guide, both these items
have separate Prosthesis Listings.</Description><Size>The OsseoFrame may be supplied as either a 2 post, 3 post or 4 post variant of the prosthesis. Effectively, these size variants are designed for partial overdentures (2 and 3 post variants) or a 4 post variant for full arch restoration. The 4 post, full arch variant is designed to treat a fully edentulous patient, whilst the 2 and 3 post variants are designed to treat patients missing 3 or more teeth. The clinician and prosthodontist will determine the appropriate number of posts for an individual patient.</Size><SupplierCode>OG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>201</SubCategoryID><GroupID>2968</GroupID><ARTGs><ARTG>286266</ARTG></ARTGs><MinimumBenefit>3254</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OG002</BillingCode><Name>OMX Solutions Melbourne TMJ Mandibular Ramus</Name><Description>Custom 3D printed mandible component constructed of titanium alloy</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>OG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><ARTGs><ARTG>276176</ARTG></ARTGs><MinimumBenefit>4738</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OG004</BillingCode><Name>The OMX Solutions Biomodel</Name><Description>CT Based Patient Specific Anatomical Biomodel</Description><Size>The device is patient specific so size will vary</Size><SupplierCode>OG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1807</GroupID><ARTGs><ARTG>276753</ARTG></ARTGs><Note>Prescribed List reimbursement is restricted to the use of the device in craniomaxillofacial surgery procedures involving insertion of an implantable medical device, where that implantable device is listed in either sub-category 07.01 - Craniomaxillofacial Reconstruction &amp; Fixation, or 07.02 – Craniomaxillofacial Implants, or 07.04 – Distractor Systems of Schedule 1, or sub-category 07.03 - Dental Implants, but only if the implantable dental medical device is explicitly identified in the product name or description of the billing code for the surgical guide or biomodel and is used in hospital. Not limiting the above, for a claim for any implantation procedure (defined by the respective MBS items stated in the claim) for a patient, the Prescribed List reimbursement is limited to 6 PL benefits for any billing codes for surgical guides and/or biomodels, which have been used in an implantation procedure for a patient. This restriction is not impacted by the number of devices implanted during the procedure, for which claim has been submitted.</Note><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>OG003</BillingCode><Name>OMX Solutions Melbourne TMJ Glenoid Fossa Component</Name><Description>Universal glenoid fossa component constructed of UHMWP</Description><Size>The device is custom made so the size will vary.</Size><SupplierCode>OG</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4354</SubGroupID><ARTGs><ARTG>276176</ARTG></ARTGs><MinimumBenefit>4114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XV003</BillingCode><PriorBillingCodes><PriorBillingCode>LM241</PriorBillingCode></PriorBillingCodes><Name>Exabone Paste</Name><Description>Preloaded Paste in Syringe</Description><Size>10cc</Size><SupplierCode>XV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>232998</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XV002</BillingCode><PriorBillingCodes><PriorBillingCode>LM240</PriorBillingCode></PriorBillingCodes><Name>Exabone Paste</Name><Description>Preloaded Paste in Syringe</Description><Size>0.5cc, 1cc, 2cc, 2.5cc, 5cc</Size><SupplierCode>XV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>232998</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XV005</BillingCode><PriorBillingCodes><PriorBillingCode>LM235</PriorBillingCode></PriorBillingCodes><Name>HA/TCP Granules</Name><Description>HA/TCP Bone graft substitute Granules</Description><Size>2.5cc, 5cc</Size><SupplierCode>XV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>232997</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XV001</BillingCode><PriorBillingCodes><PriorBillingCode>LM239</PriorBillingCode></PriorBillingCodes><Name>Exabone HA/TCP Wedges, Blocks, Discs</Name><Description>HA/TCP Bone Substitute</Description><Size>Wedges: 15-35mm width x 20-15mm length x 6-14mm height 1 X 4-10mm height 2
Blocks: 4-20mm length x 10-30mm width x 10-45mm height
Discs: 5-20mm diameter x 5-20mm height</Size><SupplierCode>XV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>232997</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XV004</BillingCode><PriorBillingCodes><PriorBillingCode>LM242</PriorBillingCode></PriorBillingCodes><Name>Exabone Paste</Name><Description>Preloaded Paste in Syringe</Description><Size>15cc</Size><SupplierCode>XV</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><ARTGs><ARTG>232998</ARTG></ARTGs><MinimumBenefit>1425</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XV006</BillingCode><PriorBillingCodes><PriorBillingCode>GQ008</PriorBillingCode></PriorBillingCodes><Name>Minimizer Ring</Name><Description>Adjustable Gastric Ring</Description><Size>One size ranging from 6.5cm to a 8.0cm diameter</Size><SupplierCode>XV</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1781</GroupID><ARTGs><ARTG>379010</ARTG></ARTGs><MinimumBenefit>2073</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>XV007</BillingCode><PriorBillingCodes><PriorBillingCode>GQ009</PriorBillingCode></PriorBillingCodes><Name>MiniMizer gastric band.</Name><Description>Adjustable Silicone band which is placed around the upper part of the stomach to reduce  the volume and speed of intake of food.</Description><Size>Regular, large and extra large</Size><SupplierCode>XV</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>190</SubCategoryID><GroupID>1548</GroupID><ARTGs><ARTG>379010</ARTG></ARTGs><MinimumBenefit>2791</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU168</BillingCode><Name>In'Oss</Name><Description>Synthetic Bone Graft Putty Hydroxyapatite/Beta Calcium Phosphate (HA/beta-TCP) and Hydroxpropylmethylcellulose hydrogel carrier (HPMC).</Description><Size>0.5 ÷ 5ml</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>303932</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU237</BillingCode><PriorBillingCodes><PriorBillingCode>PJ054</PriorBillingCode></PriorBillingCodes><Name>Parcus AP knotless</Name><Description>AP knotless push in anchors</Description><Size>2.8, mm Anchors</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>375791</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU231</BillingCode><PriorBillingCodes><PriorBillingCode>PJ047</PriorBillingCode><PriorBillingCode>SV077</PriorBillingCode><PriorBillingCode>SV036</PriorBillingCode></PriorBillingCodes><Name>Parcus MiTi Titanium Screw In Suture Anchor - Medium and XL</Name><Description>Threaded, tapered fastener for attachment of soft tissue to bone. The device is made from a Titanium Alloy, Ti-6A1-4V.</Description><Size>2.5mm  3.5mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU208</BillingCode><Name>MectaGlass Injectable Putty 1cc-5cc</Name><Description>Injectable putty for bone grafting</Description><Size>1cc - 5cc</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>452645</ARTG></ARTGs><MinimumBenefit>1026</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU022</BillingCode><Name>Versafitcup Dual Mobility Acetabular Shell</Name><Description>Stainless steel, with titanium plasma coating and HA, and polished inner surface for dual articulation</Description><Size>from diameter 46mm to 64mm in 2mm increments</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1427</GroupID><SubGroupID>4018</SubGroupID><ARTGs><ARTG>208323</ARTG></ARTGs><MinimumBenefit>2079</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU116</BillingCode><Name>Mectacer Biolox Option Sleeves</Name><Description>Biolox Option Titanium Sleeve</Description><Size>S, M, L, XL</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1451</GroupID><ARTGs><ARTG>206685</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU175</BillingCode><Name>3DMetal Diaphyseal Femoral Cones</Name><Description>Femoral cone</Description><Size>Small, Medium, Large, Extra Large</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>254755</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU236</BillingCode><PriorBillingCodes><PriorBillingCode>PJ053</PriorBillingCode></PriorBillingCodes><Name>Parcus Knotless PEEK push in  suture anchor</Name><Description>Knotless PEEK push in suture anchors w/suture passer</Description><Size>2.8mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU008</BillingCode><Name>Versafitcup Acetabular Shell</Name><Description>Titanium, plasma spray, with HA, variable holes</Description><Size>40 to 64</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1427</GroupID><SubGroupID>4018</SubGroupID><ARTGs><ARTG>209003</ARTG><ARTG>215938</ARTG><ARTG>215939</ARTG></ARTGs><MinimumBenefit>2079</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU126</BillingCode><Name>M.U.S.T Monoaxial and Uniplanar Pedicle Screws</Name><Description>Monoaxial Screws</Description><Size>4 - 8mm; Length 20-90 mm.</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>196964</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU212</BillingCode><Name>Moto Partial Knee System Femoral component</Name><Description>Femoral Component, cemented, CoCr</Description><Size>1 to 10 - Left and Right - Medial</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>150</SubCategoryID><GroupID>1353</GroupID><ARTGs><ARTG>325976</ARTG></ARTGs><MinimumBenefit>2007</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU070</BillingCode><Name>GMK Unicompartmental Full - PE Tibia Component</Name><Description>cemented unicompartmental all polyethylene fixed component</Description><Size>1 to 5, left and right, 8/9/10/11/12/14mm  thicknesses</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>152</SubCategoryID><GroupID>1363</GroupID><ARTGs><ARTG>211419</ARTG></ARTGs><MinimumBenefit>1090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU207</BillingCode><Name>MectaGlass Injectable Putty 10cc</Name><Description>Injectable putty for bone grafting</Description><Size>10cc</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><Suffix>AUG</Suffix><ARTGs><ARTG>452645</ARTG></ARTGs><MinimumBenefit>2185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU092</BillingCode><Name>UC fixed insert for Evolis tibial revision</Name><Description>Polyethylene ultra-congruent fixed insert for Evolis tibial revision (using a GMK tibia)</Description><Size>Size 1 to 6, each one available in 5 thicknesses: 10, 12, 14, 17 20mm</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>211448</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU060</BillingCode><Name>Unicompartmental femoral component</Name><Description>cemented unicompartmental femoral component</Description><Size>1 to 4</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>150</SubCategoryID><GroupID>1353</GroupID><ARTGs><ARTG>223021</ARTG></ARTGs><MinimumBenefit>2007</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU105</BillingCode><Name>Mectalif Transforaminal</Name><Description>Transforaminal Interbody Fusion Device _ Banana Shape - made with PEEK</Description><Size>Width: 12 and 14 mm. Length: 30 and 34 mm. Height from 8 to 15 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>180172</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU039</BillingCode><Name>Evolis Knee System Femoral Component </Name><Description>Femoral component, uncemented, CoCr, titanium plasma spray, posterior stabilised </Description><Size>1 - 6, left to right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1351</GroupID><SubGroupID>3915</SubGroupID><ARTGs><ARTG>204595</ARTG></ARTGs><MinimumBenefit>3314</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU125</BillingCode><Name>M.U.S.T Monoaxial and Uniplanar Pedicle Screws Cannulated</Name><Description>Monoaxial screws cannulated</Description><Size>4.5 - 7 mm, Length 20- 90 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>196964</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU157</BillingCode><Name>MUST MINI Lateral Connector</Name><Description>Lateral Connector</Description><Size>Diameter 3.5  Lenght 10 ÷ 30  mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>291175</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU104</BillingCode><Name>Mectalif Posterior</Name><Description>Posterior Interbody Fusion Device PEEK and TiPEEK</Description><Size>Width: 9 and 11mm. Length: 19, 22 and 25 mm. Height: from 7 to 15 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>180172</ARTG><ARTG>404156</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU094</BillingCode><Name>GMK Revision tibial wedge</Name><Description>Cemented tibial baseplate augmentation</Description><Size>Size 0 to 6   4 thicknesses available: 5, 10, 15, 20 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>254755</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU005</BillingCode><Name>Quadra Hip Femoral Head</Name><Description>CoCr</Description><Size>Dia 22mm (S to M)  Dia 28mm (S to XXL)  Dia 32mm (S to XXL)</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3989</SubGroupID><ARTGs><ARTG>210392</ARTG></ARTGs><MinimumBenefit>621</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU204</BillingCode><Name>M.U.S.T. Mini Cross Connectors</Name><Description>Top Loading Cross Connectors</Description><Size>21-68 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>404164</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU217</BillingCode><PriorBillingCodes><PriorBillingCode>PJ030</PriorBillingCode><PriorBillingCode>SV057</PriorBillingCode></PriorBillingCodes><Name>Knotless PEEK CF Suture Anchors</Name><Description>Suture Anchor, PEEK CF</Description><Size>2.8mm   3.5mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU106</BillingCode><Name>M.U.S.T Polyaxial Pedicle Screws Cannulated</Name><Description>Polyaxial Screws, Cannulated. Standard, LT, MC, MIS and Reduction Screws with full and partial threads. </Description><Size>4.5-10mm; Length 20 -120mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>196964</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU124</BillingCode><Name>M.U.S.T LINK - Cross Connector, M.U.S.T MC- Cross Connector</Name><Description>M.U.S.T LINK - Cross Connector, M.U.S.T MC- Cross Connector</Description><Size>Rod diameter 5.5 mm &amp; 6.0 and length 19-98</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>222457</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU085</BillingCode><Name>GMK Revision femoral distal wedge</Name><Description>Screwed femoral distal augmentation</Description><Size>Size 1 to 6, each one available in 5 thicknesses: 4mm, 8mm, 12mm, 16 mm, 20 mm.</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>254755</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU034</BillingCode><PriorBillingCodes><PriorBillingCode>MU037</PriorBillingCode></PriorBillingCodes><Name>Evolis Knee System Tibial Insert   </Name><Description>Tibial Insert, UHMWPE, fixed  </Description><Size>1 - 6, 9/11/13/16/19mm thickness</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>204596</ARTG><ARTG>205623</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU107</BillingCode><Name>M.U.S.T. Set Screw</Name><Description>Set Screw</Description><Size>One Size</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>196964</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU153</BillingCode><Name>MUST MINI Polyaxial Screws</Name><Description>Polyaxial Screw</Description><Size>Diameter from 3.5 to 6  Length  from 10 to 50 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>291175</ARTG><ARTG>404164</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU185</BillingCode><Name>PAO Cortical Screw Ø3.5</Name><Description>Peri-Acetabular Osteotomy Cortical Screw</Description><Size>Ø3.5 L 20-140 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>219907</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU095</BillingCode><Name>Biolox Delta Ceramic Ball heads</Name><Description>Ceramic femoral heads, BIOLOX® Delta Ai2 O3 -ZrO2</Description><Size>Ball Head 12/14 Ø 36 Sizes: S, M, L and XL
Ball Head 12/14 Ø 40 Sizes: S, M, L and XL
Ball Head 12/14 Ø 44 Sizes: S, M, L and XL</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>205465</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU118</BillingCode><Name>Mectacer Biolox Option Ceramic Heads (&gt;32)</Name><Description>Biolox Option Ceramic Femoral Heads</Description><Size>36mm, 40mm, 44mm, 48mm</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3998</SubGroupID><ARTGs><ARTG>206684</ARTG></ARTGs><MinimumBenefit>1792</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU147</BillingCode><Name>M.U.S.T. Fenestrated Polyaxial Cannulated Pedicle Screw</Name><Description>Fenestrated Polyaxial Cannulated Pedicle Screw</Description><Size>Diameter 4.5-10mm, Length 25-100mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>196964</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU087</BillingCode><Name>GMK Revision femoral posterior wedge</Name><Description>Screwed femoral posterior augmentation</Description><Size>Size 1 to 6, each one available in 4 thicknesses: 4mm, 5mm, 8mm 10mm</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1390</GroupID><ARTGs><ARTG>254755</ARTG></ARTGs><MinimumBenefit>1119</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU161</BillingCode><Name>MUST MINI Hooks</Name><Description>Hooks</Description><Size>4.5-6.0 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>291175</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU098</BillingCode><Name>HX UHMWPE Constrained Liner</Name><Description>Double Mobility Liner, Highcross Liner for Dual Mobility Acetabular Shell. </Description><Size>From diameter 40 to diameter 64mm for head diameter 22.2mm. From diameter 46 to diameter 64mm for head diameter 28mm.</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4024</SubGroupID><ARTGs><ARTG>208705</ARTG></ARTGs><MinimumBenefit>1540</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU088</BillingCode><Name>GMK Revision offset adaptor</Name><Description>Offset adaptor for tibial and femoral revision extension stem</Description><Size>3mm and 5mm offset</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1396</GroupID><ARTGs><ARTG>211488</ARTG></ARTGs><MinimumBenefit>1178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU154</BillingCode><Name>MUST MINI Cannulated Polyaxial Screw</Name><Description>Cannulated Polyaxial Screw</Description><Size>Diameter: 4 - 6  Length: 10 - 50 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>291175</ARTG><ARTG>404164</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU172</BillingCode><Name>Cortical Fixation System</Name><Description>ACL Femoral Cortical Fixation</Description><Size>Length 15mm to 40mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>320480</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU220</BillingCode><PriorBillingCodes><PriorBillingCode>PJ035</PriorBillingCode><PriorBillingCode>SV038</PriorBillingCode><PriorBillingCode>AE130</PriorBillingCode></PriorBillingCodes><Name>Parcus - GFS II Large and GFS Mini</Name><Description>Parcus - GFS Fixation for knee ligament reconstruction</Description><Size>Button Sizes:   3.9mm-4.4mm in width x 12mm-16.5mm in length.  Loop sizes:  12mm, 15mm, 20mm, 25mm, 30mm, 35mm, 40mm, 45mm, 50mm, 55mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>178101</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU206</BillingCode><Name>Mpact 3D Metal Monocer</Name><Description>Device is a cementless hemispherical acetabular shell realized by the sintering powder technology, and ceramic liner preassembled.</Description><Size>Outer Diameter 42mm to 66mm</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1429</GroupID><SubGroupID>4030</SubGroupID><ARTGs><ARTG>370967</ARTG></ARTGs><MinimumBenefit>4381</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU103</BillingCode><Name>Mectalif Oblique</Name><Description>Oblique Transforaminal Interbody Fusion Device PEEK and TiPEEK</Description><Size>Width: 10 and 12mm. Length 24, 28, 30, 32,34, 36 and 40 mm. Height: from 7 to 15 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>180172</ARTG><ARTG>404156</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU040</BillingCode><Name>Evolis Knee System Tibial baseplate  </Name><Description>Tibial baseplate, uncemented, titanium with titanium plasma spray, for fixed insert </Description><Size>1 -6</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1360</GroupID><ARTGs><ARTG>205559</ARTG></ARTGs><MinimumBenefit>2007</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU193</BillingCode><Name>MSS - Medacta Shoulder System Reverse Metaphysis</Name><Description>Humeral Reverse and Eccentric Reverse Metaphysis</Description><Size>+0mm, +3mm, +9mm 0°, +/-20°, L and R</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4060</SubGroupID><ARTGs><ARTG>400832</ARTG></ARTGs><MinimumBenefit>2451</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU225</BillingCode><PriorBillingCodes><PriorBillingCode>PJ040</PriorBillingCode><PriorBillingCode>PJ033</PriorBillingCode><PriorBillingCode>SV065</PriorBillingCode></PriorBillingCodes><Name>AcTiFlip Infinity loop</Name><Description>Button fixation, recommended for proximal and distal tendon and ligament repair.    Comes with one suture and one needle </Description><Size>12mm  10mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>178101</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU024</BillingCode><Name>Versafitcup UHMWPE  Constrained Liner</Name><Description>UHMWPE Constrained Liner for Versafitcup Dual Mobility Acetabular Shell</Description><Size>For head diameter 22mm sizes 42 - 64mm. For head diameter 28mm sizes 48 - 64mm.</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4024</SubGroupID><ARTGs><ARTG>208308</ARTG></ARTGs><MinimumBenefit>1540</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU205</BillingCode><Name>Orthobutton CL</Name><Description>Braided polyethylene continuous loop combined with a titanium plate </Description><Size>12 - 60 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>411650</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU062</BillingCode><Name>GMK Unicompartmental fixed tibia insert</Name><Description>cemented unicompartmental polyethylene fixed tibial insert</Description><Size>1 to 5, left and right, 8/9/10/11/12/14mm thiknesses</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>154</SubCategoryID><GroupID>1372</GroupID><ARTGs><ARTG>223023</ARTG></ARTGs><MinimumBenefit>689</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU114</BillingCode><Name>GMK Cemented FIXED Tibial Tray -TiNbN coated</Name><Description>Asymmetric polished cemented fixed tibial component, with TiNbN surface coating</Description><Size>1 to 6, left to right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>254614</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU109</BillingCode><Name>M.U.S.T. Polyaxial Pedicle Screws</Name><Description>Polyaxial Screws</Description><Size>4.0 -10mm; length 20 -100mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>196964</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU061</BillingCode><Name>GMK  Inset Patella</Name><Description>Inset cemented polyethylene patella</Description><Size>sizes 1-2; 3-4; 5-6 (20/24/28/32mm diameter)</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>210970</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU171</BillingCode><Name>Adjustable loop</Name><Description>Pullup and Mblock Adjustable fixation system</Description><Size>  4.5 mm    5 -10 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>322721</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU071</BillingCode><Name>GMK Standard Fixed Tibial Insert</Name><Description>Fixed polyethylene insert</Description><Size>1 to 6, left to right, 10/11/12/13/14/17/20mm thickness</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>132459</ARTG><ARTG>211413</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU148</BillingCode><Name>M.U.S.T. Fenestrated Polyaxial Pedicle Screw</Name><Description>Fenestrated Polyaxial Pedicle Screw</Description><Size>Diameter 5-10mm, Length 30-90mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>196964</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU197</BillingCode><Name>GMK Sphere CR Insert</Name><Description>Fixed polyethylene insert</Description><Size>1 to 6. 10 to 14 mm. Left and Right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>211413</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU135</BillingCode><Name>M.U.S.T Lateral Connectors</Name><Description>Lateral Connectors</Description><Size>20 - 150 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>222457</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU031</BillingCode><PriorBillingCodes><PriorBillingCode>MU033</PriorBillingCode></PriorBillingCodes><Name>Evolis Knee System Patella Component </Name><Description>All poly patella, cemented, UHMWPE</Description><Size>20, 24,28, 30, 33, 36, 39mm diam</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>205561</ARTG><ARTG>204598</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU224</BillingCode><PriorBillingCodes><PriorBillingCode>PJ039</PriorBillingCode><PriorBillingCode>PJ033</PriorBillingCode><PriorBillingCode>SV065</PriorBillingCode></PriorBillingCodes><Name>AcTiFlip Cinch loop</Name><Description>Button fixation recommended for biceps repair both proximal and distal repairs.   With one size two suture</Description><Size>12mm  10mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>178101</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU211</BillingCode><Name>Moto Partial Knee - Tibial Insert</Name><Description>Fixed UHMWPE Tibial Insert</Description><Size>8 - 14 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>154</SubCategoryID><GroupID>1372</GroupID><ARTGs><ARTG>325975</ARTG></ARTGs><MinimumBenefit>689</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU068</BillingCode><Name>GMK Standard mobile tibial insert</Name><Description>posterior cruciate retaining mobile polyethylene insert</Description><Size>size 1 to 7, 10/12/14/17/20mm thickness</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>210968</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU184</BillingCode><Name>FairFix Adjustable Button System</Name><Description>Button with non absorbable suture material</Description><Size>Adjustable loop length</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5389</SubGroupID><ARTGs><ARTG>365812</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU102</BillingCode><Name>Mecta-C</Name><Description>Cervical Interbody Fusion Device made with PEEK</Description><Size>Width: 12,14,and 15mm. Length: 14,16 and 18 mm. Height: from 4 to 9 mm. Flat Dome Shaped versions</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>191090</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU030</BillingCode><Name>Evolis Knee System Tibial baseplate  </Name><Description>Tibial baseplate, cemented, titanium for fixed insert </Description><Size>1 - 6</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>204203</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU163</BillingCode><Name>MectaLIF Anterior SIMPLE - PEEK Cages</Name><Description>PEEK and Ti-PEEK Anterior Cages - Simple</Description><Size>Cage dimensions: 24mm x 31mm, 27mm x 35mm, 30mm X 35mm, 30mm X 40mm
Height: 10-18mm in 2mm increments
Lordosis: from 5° to 20°.</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>291730</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU241</BillingCode><Name>MectaLIF 3DM Oblique </Name><Description>Oblique Transforaminal Interbody Fusion Device printed titanium.</Description><Size>Width: 10 and 12 mm; Length: 24,28,30,32,34,36 and 40 mm; Height: from 7 to 15 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>404156</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU021</BillingCode><Name>Medacta Bipolar Head</Name><Description>Stainless Steel, with UHMWPE insert</Description><Size>Ball head diameter 22.2mm, sizes: from 39 to 52mm.
Ball head diameter 28mm, sizes: from 42 to 60mm.</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1424</GroupID><SubGroupID>4004</SubGroupID><ARTGs><ARTG>217252</ARTG></ARTGs><MinimumBenefit>654</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU134</BillingCode><Name>M.U.S.T. Hooks</Name><Description>Hooks: Pedicle, Narrow, Extended Body, Wide Bladed, Offset L&amp;R, Angled L&amp;R</Description><Size>Various sizes</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>222457</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU074</BillingCode><Name>GMK ultracongruent Fixed tibial Insert</Name><Description>Ultracongruent fixed polyethylene insert</Description><Size>1 to 6, left to right, 10/12/14/17/20mm thickness</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>210969</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU138</BillingCode><PriorBillingCodes><PriorBillingCode>MU075</PriorBillingCode></PriorBillingCodes><Name>GMK Revision Cemented fixed Tibia Tray</Name><Description>Asymmetric polished cemented fixed tibial component</Description><Size>1 to 6, left to right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><Suffix>Revision</Suffix><ARTGs><ARTG>211447</ARTG></ARTGs><MinimumBenefit>2647</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU242</BillingCode><Name>MectaLIF 3DM Posterior</Name><Description>Posterior Interbody Fusion Device printed titanium</Description><Size>Width: 9 and 11 mm; Length: 19,22 and 25 mm;  Height: from 7 to 15 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>404156</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU152</BillingCode><Name>3D Metal Tibial Cone</Name><Description>Tibial Cone</Description><Size>Centred cones, sizes from XS to L, Height 20-25 mm
Eccentric cones, sizes from S to L, Height 20-25 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1400</GroupID><Suffix>Metaphyseal</Suffix><ARTGs><ARTG>254755</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU160</BillingCode><Name>MUST MINI Cross connector Clamp</Name><Description>Cross connector Clamp</Description><Size>one size only</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1471</GroupID><ARTGs><ARTG>291175</ARTG></ARTGs><MinimumBenefit>349</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU146</BillingCode><Name>GMK Sphere Flex Insert</Name><Description>Fixed polyethylene insert</Description><Size>1 to 6, 10-11-12-13-14-17-20 mm
Left &amp; Right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>211413</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU038</BillingCode><Name>Evolis Knee System Femoral Component </Name><Description>Femoral component, uncemented, CoCr, titanium plasma spray</Description><Size>1 - 6, left to right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1351</GroupID><SubGroupID>3914</SubGroupID><ARTGs><ARTG>204254</ARTG></ARTGs><MinimumBenefit>3226</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU072</BillingCode><Name>GMK Resurfacing Patella</Name><Description>resurfacing three pegged cemented polyethylene patella</Description><Size>sizes 1, 2, 3, 4</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>156</SubCategoryID><GroupID>1376</GroupID><ARTGs><ARTG>222424</ARTG></ARTGs><MinimumBenefit>337</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU214</BillingCode><Name>GMK-SPHERE tibial insert E-Cross Flex</Name><Description>UHMWPE E Cross Vitamin E Insert</Description><Size>1 to 6, thickness: 10,11,12,13,14,17,20 mm, left &amp; right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1369</GroupID><ARTGs><ARTG>406240</ARTG></ARTGs><MinimumBenefit>992</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU155</BillingCode><Name>MUST MINI Rod</Name><Description>Rod</Description><Size>Diameter 3.5  Lenght 30 - 350 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>291175</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU191</BillingCode><Name>MSS - Medacta Shoulder System Polyaxial Non-Locking Screws</Name><Description>Polyaxial Non-Locking Screws</Description><Size>from 14 to 50 mm in 4mm steps</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>400831</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU196</BillingCode><Name>MSS - Medacta Shoulder System Glenosphere</Name><Description>Glenosphere</Description><Size>Diameter 32, 36, 39 and 42 mm Standard +4mm and lateralized +9mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4079</SubGroupID><ARTGs><ARTG>400835</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU076</BillingCode><Name>GMK Uncemented mobile Tibia Tray</Name><Description>Asymmetric uncemented mobile tibia with titanium porous coating by an hydroxyapatite coating</Description><Size>1 to 6, left and right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1362</GroupID><SubGroupID>3924</SubGroupID><ARTGs><ARTG>210967</ARTG></ARTGs><MinimumBenefit>2409</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU232</BillingCode><PriorBillingCodes><PriorBillingCode>PJ048</PriorBillingCode><PriorBillingCode>SV078</PriorBillingCode><PriorBillingCode>SV036</PriorBillingCode></PriorBillingCodes><Name>Parcus MiTi Titanium Screw In Suture Anchor -Small</Name><Description>Threaded, tapered fastener for use in attachment of soft tissue to bone. The device is made from a Titanium alloy, TI-6A1-4V.</Description><Size>2.0mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU121</BillingCode><Name>MectaLIF Anterior Stand-Alone TiPEEK Cages.</Name><Description>TiPEEK Anterior Interbody cage with integral plate and screws</Description><Size>cages: 24x31, 27x35, 30x35, 30x40, 29x31, 32x35, 35x35, 35x40 mm. Height 10-18 in 2mm increments  plates various designs  screws with diameter: 5 &amp; 5.5mm and length: 25, 30, 35 &amp; 40mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>207288</ARTG><ARTG>222456</ARTG><ARTG>427190</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU219</BillingCode><PriorBillingCodes><PriorBillingCode>PJ032</PriorBillingCode><PriorBillingCode>SV060</PriorBillingCode></PriorBillingCodes><Name>Draw Tight Suture Anchors</Name><Description>Suture Anchor</Description><Size>1.8 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU178</BillingCode><Name>MectaLock and Snugfit All Suture Anchor Size 1</Name><Description>MectaLock and Snugfit All Suture Anchor</Description><Size>diameter 1.6 and 1.8mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5384</SubGroupID><ARTGs><ARTG>330998</ARTG></ARTGs><MinimumBenefit>294</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU117</BillingCode><Name>Mectacer Biolox Option Ceramic Heads (&lt;32)</Name><Description>Biolox Option Ceramic Femoral Heads</Description><Size>28mm &amp; 32mm</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>206684</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU067</BillingCode><Name>GMK Uncemented Fixed Tibia Tray</Name><Description>Asymmetric uncemented fixed tibial component</Description><Size>1 to 6, left and right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1360</GroupID><SubGroupID>3923</SubGroupID><ARTGs><ARTG>225045</ARTG></ARTGs><MinimumBenefit>2356</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU096</BillingCode><Name>Biolox Delta Ceramic Ball Heads</Name><Description>Ceramic femoral heads, BIOLOX® Delta AI2 O3 -ZrO2</Description><Size>Ball Head 12/14 Ø 28 Sizes: S, M and L
Ball Head 12/14 Ø 32 sizes: S, M, L and XL</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1419</GroupID><SubGroupID>3992</SubGroupID><ARTGs><ARTG>205465</ARTG></ARTGs><MinimumBenefit>1702</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU108</BillingCode><Name>M.U.S.T. Rods</Name><Description>Straight, Pre-Bent and Pre-Contoured Rods</Description><Size>Rod diameter 5.5 mm or 6.0 mm, length 25 mm-600 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>196964</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU091</BillingCode><Name>GMK Revision semi-constrained fixed tibial insert</Name><Description>Semi-constrained Posterior Stabilised fixed Tibial Insert</Description><Size>Size 1 to 6, each one available in 8 thicknesses: 10, 12, 14, 17, 20, 23, 26, 29mm</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>211428</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU032</BillingCode><Name>Evolis Knee System Tibial Insert   </Name><Description>Tibial Insert, UHMWPE, fixed, posterior stabilised </Description><Size>1 - 6, 9/11/13/16/19mm thickness</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>205560</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU090</BillingCode><Name>PS fixed insert for Evolis tibial revision</Name><Description>Polyethylene posterior-stabilised fixed insert for Evolis tibial revision (using a GMK tibia)</Description><Size>Size 1 to 6, each one available in 5 thicknesses: 10, 12, 14, 17 20mm</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>211449</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU097</BillingCode><Name>Femoral Head</Name><Description>CoCr Femoral Ball Head 12/14</Description><Size>Ø 36mm &amp; Ø 40mm: both of sizes S-M-L-XL-XXL</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>162</SubCategoryID><GroupID>1420</GroupID><SubGroupID>3995</SubGroupID><ARTGs><ARTG>210392</ARTG></ARTGs><MinimumBenefit>632</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU073</BillingCode><Name>GMK Ultracongruent Mobile Tibial Insert</Name><Description>Ultracongruent Mobile Polyethylene  Insert</Description><Size>size 1 to 7, 10/12/14/17/20mm thickness</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>210980</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU144</BillingCode><Name>APRICOT full PE Cemented Cup</Name><Description>Flat edge full PE cemented cup</Description><Size>002, 028, 032</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4006</SubGroupID><ARTGs><ARTG>230649</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU189</BillingCode><Name>FairFix Adjustable Button Extender</Name><Description>Button Extender</Description><Size>Various sizes</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>365812</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU059</BillingCode><Name>GMK Posterior Stabilised fixed tibial insert</Name><Description>Posterior Stabilised fixed polyethylene insert</Description><Size>size 1 to 6, 10/12/14/17/20mm thickness</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1370</GroupID><ARTGs><ARTG>140176</ARTG></ARTGs><MinimumBenefit>1020</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU227</BillingCode><PriorBillingCodes><PriorBillingCode>PJ042</PriorBillingCode><PriorBillingCode>SV076</PriorBillingCode></PriorBillingCodes><Name>PARCUS GFS Naked</Name><Description>Graft Fixation System  for use in the fixation of ligament or tendon repairs.</Description><Size>Button widths: 1.4mm -4.4mm   Button lengths: 5.9mm - 21mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>178101</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU180</BillingCode><Name>MectaFix Continuous Loop</Name><Description>ACL reconstructions</Description><Size>15 - 60 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>332525</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU151</BillingCode><Name>Extracortical Femoral Button</Name><Description>Extracortical Femoral Button</Description><Size>Single size</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>290768</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU017</BillingCode><Name>Medacta Acetabular Plug</Name><Description>Titanium Plug</Description><Size>no sizes</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1446</GroupID><ARTGs><ARTG>237072</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU156</BillingCode><Name>MUST MINI Transition Rod</Name><Description>Transition Rod</Description><Size>Diameter 3.5 / 5.5 &amp; 3.5 / 4.0
Lenght 120 ÷ 600 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>291175</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU150</BillingCode><Name>Tibial Pull Suture Plate (PSP)</Name><Description>Tibial Pull Suture Plate</Description><Size>Single size</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>290767</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU188</BillingCode><Name>Masterloc Stems - Ti + HA</Name><Description>Cementless Femoral Stem - Ti + HA Coated</Description><Size>1 to 12 - Std   1 to 14 - Lat.  4 to 14 - Lat Plus</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>286795</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU110</BillingCode><Name>X-Acta Femoral Stems</Name><Description>Stainless Steel Femoral Stems</Description><Size>Sizes 0 - 4 / Offsets 35.5 - 50 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>229510</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU004</BillingCode><Name>Quadra Hip Cemented Femoral Stem</Name><Description>High nitrogen stainless steel alloy, highly polished, double taper</Description><Size>Std 0 to 8. Lat 0 to 8  Std short neck 0 to 7.  Lat short neck 1 to 7.</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>210442</ARTG><ARTG>356196</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU201</BillingCode><Name>Quadra-P collarless</Name><Description>Titanium stem proximally coated with plasma spray and HA - collarless version</Description><Size>Std 00 to 10  Lat 0 to 10</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>314889</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ242</BillingCode><Name>X-acta Short Femoral Stem</Name><Description>Stainless Steel Femoral Stems</Description><Size>Sizes 0 - 4 / Offsets 37.5 - 44 - 50 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>229510</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU202</BillingCode><Name>Quadra-P collared</Name><Description>Titanium stem proximally coated with plasma spray and HA - collared version</Description><Size>Std 00 to 10 Lat 0 to 10</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>356197</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU001</BillingCode><Name>CONE Cemented Femoral Stem</Name><Description>CoCr, highly polished, triple taper</Description><Size>Standard sizes 1 to 8, Lateralized sizes 2 to 7</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>208874</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU198</BillingCode><Name>AMIStem-C Femoral stems</Name><Description>Stainless Steel Cemented Femoral Stems</Description><Size>00 to 8 std 0 to 8 lat</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1404</GroupID><SubGroupID>3941</SubGroupID><ARTGs><ARTG>233610</ARTG></ARTGs><MinimumBenefit>1762</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU199</BillingCode><Name>AMIStem-P collarless</Name><Description>Titanium, Plasma spray, proximal HA coating - collarless version</Description><Size>Std 00 to 9   Lat 0 to 8 </Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>314187</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ222</BillingCode><Name>Versacem Double Mobility cemented cup</Name><Description>Cemented metal acetabular dual mobility cup designed to be used with a polyethylene liner</Description><Size>from 38 to 56 mm diameter in 2mm increments</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4009</SubGroupID><ARTGs><ARTG>208703</ARTG></ARTGs><MinimumBenefit>1511</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU177</BillingCode><Name>Mecta-C Stand Alone System</Name><Description>TiPEEK Anterior cervical cages + screws</Description><Size>Height: from 5 mm to 12 mm in 1 mm increments  15 mm x 13 mm, 16 mm x 14 mm, 18 mm x 15 mm  7° lordosis</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>222456</ARTG><ARTG>333435</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU166</BillingCode><Name>MUST Mini Occipital Plate</Name><Description>Occipital Plate</Description><Size>Small to Large. X, Y and T Shape.</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>291175</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU127</BillingCode><Name>Medacta Cortical Bone Screws</Name><Description>Titanium cortical bone screws</Description><Size>25 - 70 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>219907</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU014</BillingCode><Name>Medacta Acetabular Screws</Name><Description>Titanium, cancellous screws</Description><Size>6.5 L 15-70mm</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1435</GroupID><ARTGs><ARTG>219907</ARTG></ARTGs><MinimumBenefit>111</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU203</BillingCode><Name>AMIStem-P collared</Name><Description>Titanium, Plasma spray, proximal HA coating, collared version</Description><Size>Std 00 to 9 Lat 0 to 8</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3952</SubGroupID><ARTGs><ARTG>388451</ARTG></ARTGs><MinimumBenefit>3263</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU167</BillingCode><Name>MUST Mini Occipital Screws</Name><Description>Occipital Bone Screws</Description><Size>Ø 4 and 5 mm. L 6÷16 mm.</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>222456</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU234</BillingCode><PriorBillingCodes><PriorBillingCode>PJ050</PriorBillingCode></PriorBillingCodes><Name>Parcus AP twist</Name><Description>Twist screw in AP anchor</Description><Size>4.5-6.5 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>375791</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU132</BillingCode><Name>Mecta C Screws 2x</Name><Description>Expansion Head Screws</Description><Size>Diameter 4 - 4.5. Length 12 - 22 mm.</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Expansion Screw / Expansion Head Screw</Suffix><ARTGs><ARTG>222456</ARTG></ARTGs><MinimumBenefit>274</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU019</BillingCode><Name>Medacta Highly Crosslinked UHMWPE Liner</Name><Description>Highly Crosslinked UHMWPE</Description><Size>Internal diameter 22, 28,32,36, 40 mm neutral &amp; hooded, 4mm offset, face changing 10 degrees</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4021</SubGroupID><ARTGs><ARTG>209250</ARTG></ARTGs><MinimumBenefit>930</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU165</BillingCode><Name>Mpact Acetabular System</Name><Description>3D Metal Augments</Description><Size>50-80 mm.  Thickness 10 ÷ 30 mm.</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1433</GroupID><Suffix>Bone Reconstruction</Suffix><ARTGs><ARTG>307500</ARTG></ARTGs><MinimumBenefit>2769</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU099</BillingCode><Name>GMK Hinge femur</Name><Description>Rotating hinge femoral component</Description><Size>1 to 6 Left and Right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3908</SubGroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>211408</ARTG></ARTGs><MinimumBenefit>5887</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU115</BillingCode><Name>GMK Mobile Cemented Tibial Tray  - TiNbN coated</Name><Description>Asymmetric mobile cemented tibial component, with TiNbN surface coating.</Description><Size>1 to 6, left to right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><ARTGs><ARTG>254615</ARTG></ARTGs><MinimumBenefit>2005</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU238</BillingCode><PriorBillingCodes><PriorBillingCode>PJ055</PriorBillingCode></PriorBillingCodes><Name>X-twist Knotless Suture Anchor </Name><Description>Knotless open architecture and fast inserting suture anchor system with multiple sliding suture or tissue sparing tape configurations and is available in PEEK Optima in 4.75mm, 5.5mm and 6.25mm diameters. The Anika X-Twist system is designed to be used in both single row and double row rotator cuff  repairs as well as other knotless or knotted soft tissue repairs.</Description><Size>4.75mm. 5.5mm, 6.25mm </Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>393388</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ569</BillingCode><Name>MUST pre-curvature rods</Name><Description>Spinal Pre-curvature rods</Description><Size>diameter 5.5-6 length 300-500</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>453885</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU077</BillingCode><Name>GMK Mobile Cemented Tibia Tray</Name><Description>Asymmetric mobile cemented tibial component</Description><Size>1 to 6, left to right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1359</GroupID><ARTGs><ARTG>210965</ARTG></ARTGs><MinimumBenefit>2005</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU139</BillingCode><Name>Reinforcement Cages</Name><Description>Acetabular Reinforcement Cage</Description><Size>Internal diameter from 40 to 62 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1432</GroupID><SubGroupID>4035</SubGroupID><ARTGs><ARTG>237104</ARTG></ARTGs><MinimumBenefit>1197</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU210</BillingCode><Name>Moto Partial Knee - Tibial Baseplate</Name><Description>Fixed Tibial Baseplate, Ti alloy</Description><Size>1 to 8, Left &amp; Right, Medial</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>152</SubCategoryID><GroupID>1364</GroupID><ARTGs><ARTG>325977</ARTG></ARTGs><MinimumBenefit>1352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU065</BillingCode><Name>GMK Unicompartmental fixed tibial baseplate</Name><Description>cemented unicompartmental fixed tibial component with peg and fixation keel</Description><Size>1 to 5, left and right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>152</SubCategoryID><GroupID>1364</GroupID><ARTGs><ARTG>223022</ARTG></ARTGs><MinimumBenefit>1352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU010</BillingCode><Name>Medacta UHMWPE Liner</Name><Description>UHMWPE</Description><Size>Internal diameter 22,28,32 mm, hooded &amp; neutral, hooded &amp; neutral</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4020</SubGroupID><ARTGs><ARTG>132458</ARTG><ARTG>211169</ARTG></ARTGs><MinimumBenefit>688</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU239</BillingCode><PriorBillingCodes><PriorBillingCode>PJ056</PriorBillingCode></PriorBillingCodes><Name>X-Twist Biocomposite Screw-In Suture Anchor</Name><Description>Biocomposite knotless suture anchor system; includes one or two sutures.</Description><Size>Diameter 4.75mm. 5.5mm, 6.25mm, Length 23mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>467726</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU002</BillingCode><Name>Medacta Femoral Stem Distal centraliser</Name><Description>PMMA</Description><Size>Distal centraliser, various sizes</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1438</GroupID><ARTGs><ARTG>233996</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU221</BillingCode><PriorBillingCodes><PriorBillingCode>PJ036</PriorBillingCode><PriorBillingCode>SV040</PriorBillingCode><PriorBillingCode>AE128</PriorBillingCode></PriorBillingCodes><Name>V-Lox Titanium Suture Anchors</Name><Description>Titanium Fully Threaded Suture Anchor</Description><Size>4.5mm; 5.0mm; 5.5mm; 6.5mm, double loaded and triple loaded suture anchors</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU143</BillingCode><Name>APRICOT full PE HC Cemented Cup</Name><Description>Flat Edge full High-Cross PE cemented Cup</Description><Size>022, 028, 032, 036</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1425</GroupID><SubGroupID>4007</SubGroupID><ARTGs><ARTG>281575</ARTG></ARTGs><MinimumBenefit>786</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU218</BillingCode><PriorBillingCodes><PriorBillingCode>PJ031</PriorBillingCode><PriorBillingCode>SV058</PriorBillingCode></PriorBillingCodes><Name>Knotless PEEK CF Suture Anchors</Name><Description>Suture Anchor, PEEK CF</Description><Size>4.5mm   5.5mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU226</BillingCode><PriorBillingCodes><PriorBillingCode>PJ041</PriorBillingCode><PriorBillingCode>SV041</PriorBillingCode><PriorBillingCode>AE129</PriorBillingCode></PriorBillingCodes><Name>V-Lox PEEK CF Suture Anchors</Name><Description>PEEK CF Fully Threaded Suture Anchor</Description><Size>4.5m; 5.5mm; 6.5mm,</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU230</BillingCode><PriorBillingCodes><PriorBillingCode>PJ046</PriorBillingCode><PriorBillingCode>PJ034</PriorBillingCode><PriorBillingCode>SV074</PriorBillingCode></PriorBillingCodes><Name>SLik Fix</Name><Description>Screw in system recomended for teh use in both large and small joint repairs made from PEEK carbon fiber</Description><Size>7mm, 8mm, 9mm </Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU233</BillingCode><PriorBillingCodes><PriorBillingCode>PJ049</PriorBillingCode></PriorBillingCodes><Name>Parcus AP large</Name><Description>AP knotless push in Anchors Large</Description><Size>4.5, 5,5 mm </Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><Suffix>AB</Suffix><ARTGs><ARTG>375791</ARTG></ARTGs><MinimumBenefit>501</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU228</BillingCode><PriorBillingCodes><PriorBillingCode>PJ044</PriorBillingCode></PriorBillingCodes><Name>Parcus Twist Screw in PEEK suture Anchors</Name><Description>Screw in PEEK CF anchors recommended for small and large joints. Optimal cortical fixation, Non aborbable, radiolucent. PEEK body anchors assembled with 0, 1, 2, 3 sutures or suture tape.  </Description><Size>4.25, 4.75, 5.5, 6.25, 6.5 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU229</BillingCode><PriorBillingCodes><PriorBillingCode>PJ045</PriorBillingCode><PriorBillingCode>PJ034</PriorBillingCode><PriorBillingCode>SV074</PriorBillingCode></PriorBillingCodes><Name>SLik Knot-less CF</Name><Description>Knot-less screw in anchor recommended for use in large and small joint repairs</Description><Size>5.5mm- 6.25mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU174</BillingCode><Name>MectaTap Ti</Name><Description>Suture Anchor</Description><Size>Ø 5 - 6.5</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>324941</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU173</BillingCode><Name>Mectalock Ti</Name><Description> Suture Anchor</Description><Size>Ø 5 - 6.5</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>324941</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU181</BillingCode><Name>MectaLock PEEK</Name><Description>Suture Anchor</Description><Size>Ø 4.5 - 5.5 - 6.5 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5387</SubGroupID><ARTGs><ARTG>320484</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU187</BillingCode><Name>Medacta Femoral Stem Proximal Centraliser</Name><Description>PMMA Proximal centraliser</Description><Size>Proximal Centraliser, various sizes</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1438</GroupID><ARTGs><ARTG>233996</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU170</BillingCode><Name>Mectalock PEEK</Name><Description>Suture Anchor</Description><Size>2.4 - 3.4 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>320484</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU223</BillingCode><PriorBillingCodes><PriorBillingCode>PJ038</PriorBillingCode><PriorBillingCode>PJ029</PriorBillingCode><PriorBillingCode>SV056</PriorBillingCode></PriorBillingCodes><Name>Draw tight</Name><Description>Draw tight suture based anchor with two suture tapes.  Recommended for use in both large and small joint repairs.</Description><Size>3.2</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU169</BillingCode><Name>Mectascrew PEEK</Name><Description>Interference Screw</Description><Size>6-12 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>320872</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU013</BillingCode><Name>Delta Ceramic Liners</Name><Description>Ceramic, Delta</Description><Size>28mm (A to G), 32mm (C to G), 36mm (E to G), 40mm (F to G)</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1428</GroupID><SubGroupID>4025</SubGroupID><ARTGs><ARTG>140177</ARTG><ARTG>205457</ARTG></ARTGs><MinimumBenefit>1690</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU058</BillingCode><Name>Quadra-R Hip Revision Stem</Name><Description>Uncemented revision stem, HA Coated</Description><Size>From size 0 to size 9`</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1409</GroupID><SubGroupID>3957</SubGroupID><ARTGs><ARTG>204290</ARTG></ARTGs><MinimumBenefit>4826</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU063</BillingCode><Name>GMK Primary Cemented Standard Femoral Component</Name><Description>Cemented standard femoral component</Description><Size>0 to 7, left to right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>211426</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU222</BillingCode><PriorBillingCodes><PriorBillingCode>PJ037</PriorBillingCode><PriorBillingCode>PJ029</PriorBillingCode><PriorBillingCode>SV056</PriorBillingCode></PriorBillingCodes><Name>Draw tight, </Name><Description>Push in anchors suture based. Recommended for use in both large and small repairs. with two sutures </Description><Size>3.2 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU129</BillingCode><Name>Mecta C Plates</Name><Description>Cervical Plates</Description><Size>L 3 to 4; 58 to 92 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>222455</ARTG></ARTGs><MinimumBenefit>908</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU130</BillingCode><Name>Mecta C Plates</Name><Description>Cervical Plates</Description><Size>L 1 to 3; 20 to 55 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4127</SubGroupID><ARTGs><ARTG>222455</ARTG></ARTGs><MinimumBenefit>1179</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU026</BillingCode><Name>Evolis Knee System Femoral Component </Name><Description>Femoral component, cemented, CoCr </Description><Size>1- 6, left and right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>204213</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU128</BillingCode><Name>AMIStem H Femoral Stem</Name><Description>Titanium, grit blast, HA coated</Description><Size>STD 00 to 9; LAT 0 to 8</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>218795</ARTG><ARTG>287484</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU194</BillingCode><Name>MSS - Medacta Shoulder System Reverse Liner</Name><Description>Humeral Reverse HC Liner</Description><Size>Diameter 32, 36, 39 and 42 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4069</SubGroupID><ARTGs><ARTG>400833</ARTG></ARTGs><MinimumBenefit>774</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU003</BillingCode><Name>Quadra Hip Femoral Stem</Name><Description>Titanium, grit blast, fully HA,</Description><Size>Std 0 to 10
Std (shortneck) 00 to 10
Lat 1 to 7
Lat (shortneck) 1 to 7</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1407</GroupID><SubGroupID>3949</SubGroupID><ARTGs><ARTG>204336</ARTG></ARTGs><MinimumBenefit>3174</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU027</BillingCode><Name>Evolis Knee System Femoral Component </Name><Description>Femoral Component, cemented, CoCr, with TiNi (TiNibN) surface coating</Description><Size>1 - 6, left and right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><Suffix>Ceramic Surface</Suffix><ARTGs><ARTG>205141</ARTG></ARTGs><MinimumBenefit>3009</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU240</BillingCode><Name>GMK Sphere TiNbN coated</Name><Description>Cemented femoral component, with TiNbN surface coating</Description><Size>From 1 to 7 left and right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>322278</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU081</BillingCode><Name>GMK Revision cemented standard femur</Name><Description>Cemented minimally stabilised femoral component</Description><Size>Sizes 1 to 6, Left and Right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><Suffix>Revision</Suffix><ARTGs><ARTG>211444</ARTG></ARTGs><MinimumBenefit>5276</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU100</BillingCode><Name>GMK Hinge fixed tibial tray</Name><Description>Tibial Component cemented CoCr</Description><Size>1 to 6 Left and Right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><Suffix>Revision, Hinged</Suffix><ARTGs><ARTG>211409</ARTG></ARTGs><MinimumBenefit>3619</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU235</BillingCode><PriorBillingCodes><PriorBillingCode>PJ051</PriorBillingCode></PriorBillingCodes><Name>Parcus Interference Ti screws</Name><Description>Interference screws for soft tissue fixation (Titanium)</Description><Size>7-12 mm (20-35mm in length</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU179</BillingCode><Name>MectaLock and Snugfit All-Suture Anchor Size 2</Name><Description>MectaLock and Snugfit All-Suture Anchor</Description><Size>diameter  2.4 and 2.8 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>330998</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU215</BillingCode><PriorBillingCodes><PriorBillingCode>PJ024</PriorBillingCode><PriorBillingCode>SV039</PriorBillingCode><PriorBillingCode>AE127</PriorBillingCode></PriorBillingCodes><Name>Parcus PEEK CF Interface Screw</Name><Description>PEEK CF Interface Screw</Description><Size>7,8,9mm x 20-35mm 10,11,12mm x 25-35mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5391</SubGroupID><ARTGs><ARTG>177865</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU216</BillingCode><PriorBillingCodes><PriorBillingCode>PJ025</PriorBillingCode><PriorBillingCode>SV037</PriorBillingCode><PriorBillingCode>AE150</PriorBillingCode></PriorBillingCodes><Name>Parcus Series 3 Peek CF Suture Anchor</Name><Description>Knotless push in Anchor with 2 sutures and suture passer.</Description><Size>3.5mm diameter</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5385</SubGroupID><ARTGs><ARTG>177866</ARTG></ARTGs><MinimumBenefit>442</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU112</BillingCode><Name>GMK Cemented Standard Femur - TiNbN coated</Name><Description>Cemented standard femoral component, with TiNbN surface coating</Description><Size>sizes 0 to 7, left to right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>254612</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU162</BillingCode><Name>MUST MINI Screws</Name><Description>Set Screw / Locking Screw</Description><Size>Varius</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>291175</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU145</BillingCode><Name>GMK Sphere Femoral Component</Name><Description>Cemented femoral component</Description><Size>1 to 7 Left
1 to 7 Right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3906</SubGroupID><ARTGs><ARTG>211411</ARTG></ARTGs><MinimumBenefit>2793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU182</BillingCode><Name>Masterloc Stems - Ti</Name><Description>Cementless Femoral Stem - Ti Coated</Description><Size>1 to 12 - Std   1 to 14 - Lat  4 to 14 - Lat Plus</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>161</SubCategoryID><GroupID>1406</GroupID><SubGroupID>3948</SubGroupID><ARTGs><ARTG>286794</ARTG></ARTGs><MinimumBenefit>3100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU036</BillingCode><Name>Evolis Knee System Fixation Screw </Name><Description>Tibial screw for baseplate fixation to bone, titanium, optional </Description><Size>20/25/30/35/40/45mm (6.5mm diameter)</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1398</GroupID><ARTGs><ARTG>219907</ARTG></ARTGs><MinimumBenefit>123</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU164</BillingCode><Name>M.U.S.T. Sacro-Iliac Joint Screws and Washers</Name><Description>Headless and Standard Sacro-Iliac Joint Screws and Washers</Description><Size>Headless SI screws: Ø 7.5-11 mm, Lenght 30-100 mm.   Standard SI screws: Ø 8-10 mm, Lenght 25-80 mm.   Washers: Standard version Ø 13-20 mm; Favored angle version Ø 15-20 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>261</SubCategoryID><GroupID>1821</GroupID><Suffix>No Suffix</Suffix><ARTGs><ARTG>301842</ARTG></ARTGs><MinimumBenefit>1853</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU101</BillingCode><Name>GMK Hinge fixed tibial insert</Name><Description>Tibial Insert for GMK Hinge prosthesis, UHMWPE, fixed, includes hinge locking post</Description><Size>1 to 6 10-26mm</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>153</SubCategoryID><GroupID>1371</GroupID><ARTGs><ARTG>211410</ARTG></ARTGs><MinimumBenefit>1090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU183</BillingCode><Name>MectaPlug PE II</Name><Description>Cement restrictor</Description><Size>5 sizes  from Ø8 to Ø30</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1437</GroupID><ARTGs><ARTG>229714</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU111</BillingCode><Name>MectaPlug PE</Name><Description>Cement Restrictor</Description><Size>12 - 30 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>164</SubCategoryID><GroupID>1437</GroupID><ARTGs><ARTG>229714</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU133</BillingCode><Name>Mecta C Screws 4x</Name><Description>Expansion Head Screws</Description><Size>Diameters 4 - 4.5. Length 12 - 22 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Expansion Screw / Expansion Head Screw</Suffix><ARTGs><ARTG>222456</ARTG></ARTGs><MinimumBenefit>274</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU082</BillingCode><Name>GMK Revision cemented extension stem</Name><Description>Cemented tibia and femur extension stem</Description><Size>Diameters 11, 13 and 16mm, available in 2 or 3 lengths (65, 105, 150mm)</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>254754</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU035</BillingCode><Name>Evolis Knee System Tibial Stem </Name><Description>Tibial stems, titanium, cemented</Description><Size>30/60mm length (12mm diameter)</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>254754</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU137</BillingCode><PriorBillingCodes><PriorBillingCode>MU075</PriorBillingCode></PriorBillingCodes><Name>GMK Cemented fixed Tibia Tray</Name><Description>Asymmetric polished cemented fixed tibial component</Description><Size>1 to 6, left to right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>151</SubCategoryID><GroupID>1357</GroupID><ARTGs><ARTG>210966</ARTG></ARTGs><MinimumBenefit>1836</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU086</BillingCode><Name>GMK Revision uncemented extension stem</Name><Description>Uncemented tibia and femur extension stem</Description><Size>Multiple diameters (10, 11, 12, 13, 14, 15, 16, 18, 19, 20, 22mm) each one available in 3 lengths (65, 105, 150mm)</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>254754</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU159</BillingCode><Name>MUST MINI  Cross Connector</Name><Description>Cross Connector</Description><Size>15-70 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>291175</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU069</BillingCode><Name>GMK Tibial Extension Stem</Name><Description>Tibial Baseplate extension stem</Description><Size>diameter 11mm, length 65mm &amp; 30mm</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>159</SubCategoryID><GroupID>1399</GroupID><ARTGs><ARTG>241989</ARTG></ARTGs><MinimumBenefit>1098</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU213</BillingCode><Name>MUST Cross-Connectors Straight</Name><Description>Cross-Connectors Straight-fixed with inbuilt set screws</Description><Size>20-100 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>222457</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU064</BillingCode><Name>GMK posterior stabilised cemented femur</Name><Description>Cemented posterior stabilised femoral component</Description><Size>0 to 7, left to right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>223521</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU195</BillingCode><Name>MSS - Medacta Shoulder System Baseplate</Name><Description>Glenoid Baseplate</Description><Size>Diameter 22, 24.5 and 27 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1277</GroupID><SubGroupID>4078</SubGroupID><ARTGs><ARTG>400834</ARTG></ARTGs><MinimumBenefit>1991</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU029</BillingCode><Name>Evolis Knee System Femoral Component </Name><Description>Femoral Component, cemented, CoCr, posterior stabilised with TiNi (TiNibN) surface coating</Description><Size>1 - 6, left and right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>205777</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU089</BillingCode><Name>GMK Revision cemented posterior-stabilised femur</Name><Description>Cemented posterior stabilised femoral component</Description><Size>Sizes 1 to 6, Left and Right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><Suffix>Revision</Suffix><ARTGs><ARTG>211486</ARTG></ARTGs><MinimumBenefit>5363</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU113</BillingCode><Name>GMK Posterior Stabilised Cemented Femur -TiNbN coated</Name><Description>Cemented posterior stabilised femoral component, with TiNbN surface coating</Description><Size>sizes 0 to 7, left and right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>254613</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU028</BillingCode><Name>Evolis Knee System Femoral Component </Name><Description>Femoral Component, cemented, CoCr, posterior stabilised </Description><Size>1 - 6, left and right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1348</GroupID><SubGroupID>3907</SubGroupID><ARTGs><ARTG>205428</ARTG></ARTGs><MinimumBenefit>2855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU136</BillingCode><Name>M.U.S.T Screws for Pedicle Hooks</Name><Description>Bone Screws</Description><Size>Ø 3,5; L 15 - 20 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>222456</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU140</BillingCode><Name>Mpact Acetabular Shells</Name><Description>Cementless titanium acetabular shell, variable holes</Description><Size>42 to 66</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4014</SubGroupID><ARTGs><ARTG>209485</ARTG></ARTGs><MinimumBenefit>2812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU066</BillingCode><Name>GMK Uncemented Standard Femur</Name><Description>Uncemented standard femoral component with titanium porous covered by an hydroxyapatite coating</Description><Size>1 to 7, left and right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1352</GroupID><SubGroupID>3917</SubGroupID><ARTGs><ARTG>225044</ARTG></ARTGs><MinimumBenefit>3575</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU200</BillingCode><Name>GMK Sphere Femoral component</Name><Description>Cementless femoral component</Description><Size>1 to 7 Left and Right  </Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1352</GroupID><SubGroupID>3917</SubGroupID><ARTGs><ARTG>400440</ARTG></ARTGs><MinimumBenefit>3575</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU192</BillingCode><Name>MSS - Medacta Shoulder System Diaphysis</Name><Description>Uncemented Humeral Diaphysis Ti + HA coated</Description><Size>from 6 to 16 STD and Short</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1276</GroupID><SubGroupID>4064</SubGroupID><ARTGs><ARTG>400830</ARTG></ARTGs><MinimumBenefit>2660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU141</BillingCode><Name>Mpact Revision Acetabular Shells</Name><Description>Cementless titanium acetabular shell, variable holes</Description><Size>42 to 76</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4014</SubGroupID><ARTGs><ARTG>229108</ARTG></ARTGs><MinimumBenefit>2812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU209</BillingCode><Name>Mpact DM</Name><Description>Double Mobility Acetabular shell</Description><Size>diameter 42-66</Size><SupplierCode>MU</SupplierCode><CategoryID>18</CategoryID><SubCategoryID>163</SubCategoryID><GroupID>1426</GroupID><SubGroupID>4014</SubGroupID><ARTGs><ARTG>490828</ARTG></ARTGs><MinimumBenefit>2812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU078</BillingCode><Name>GMK Uncemented Posterior stabilised femur</Name><Description>Uncemented posterior stabilised femoral component with titanium porus coating covered by an hydroxyapatite coating</Description><Size>0 to 7, left to right</Size><SupplierCode>MU</SupplierCode><CategoryID>17</CategoryID><SubCategoryID>149</SubCategoryID><GroupID>1352</GroupID><SubGroupID>3918</SubGroupID><ARTGs><ARTG>211441</ARTG></ARTGs><MinimumBenefit>3663</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU186</BillingCode><Name>PAO Cortical Screw Ø4.5</Name><Description>Peri-Acetabular Osteotomy Cortical Screw</Description><Size>Ø4.5 L 50-140 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>219907</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU131</BillingCode><Name>Mecta C Screws</Name><Description>Expansion Head Screws</Description><Size>Diameters 4 - 4.5. Length 12 - 22mm.</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Expansion Screw / Expansion Head Screw</Suffix><ARTGs><ARTG>222456</ARTG></ARTGs><MinimumBenefit>274</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU158</BillingCode><Name>MUST MINI Rod To Rod Connector</Name><Description>Rod To Rod Connector</Description><Size>3.5-5.5</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>291175</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU149</BillingCode><Name>M.U.S.T. Connectors</Name><Description>Domino &amp; In-line Connectors</Description><Size>5.5 mm and 6.35 mm</Size><SupplierCode>MU</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>222457</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MU190</BillingCode><Name>MSS - Medacta Shoulder System Polyaxial Locking Screws</Name><Description>Glenoid Polyaxial Locking Screws</Description><Size>from 14 to 50 mm in 4mm steps</Size><SupplierCode>MU</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><ARTGs><ARTG>400831</ARTG></ARTGs><MinimumBenefit>57</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO113</BillingCode><Name>APTUS CCS</Name><Description>Cannulated Screws</Description><Size>Diameter ≤ 2.0mm  Length 6.0mm to 20.0mm</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO112</BillingCode><Name>APTUS Washer</Name><Description>Washers</Description><Size>5.0mm - 13.0mm</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3374</SubGroupID><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>49</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO126</BillingCode><Name>APTUS Shoulder Clavicle</Name><Description>Lateral clavicle plates</Description><Size>≥ 7 to ≤ 15 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5271</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>1320</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO077</BillingCode><PriorBillingCodes><PriorBillingCode>EO007</PriorBillingCode><PriorBillingCode>CD007</PriorBillingCode></PriorBillingCodes><Name>APTUS Screws</Name><Description>Cortical Screws</Description><Size>2.71mm – 4.49mm</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO138</BillingCode><Name>APTUS Hand plates</Name><Description>1.2/1.5 &amp; 2.0/2.3 Trilock frame &amp; grid plates &gt;= 16 holes
</Description><Size>16 to 20 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>1207</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO130</BillingCode><Name>MODUS Mesh </Name><Description>Titanium Mesh, Sterile </Description><Size>0.5-0.8mm thick, 51-200cm²</Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4209</SubGroupID><ARTGs><ARTG>350271</ARTG></ARTGs><MinimumBenefit>1146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO086</BillingCode><PriorBillingCodes><PriorBillingCode>EO064</PriorBillingCode><PriorBillingCode>EO008</PriorBillingCode></PriorBillingCodes><Name>APTUS Hand</Name><Description>Fixation Plates</Description><Size>1.2 - 2.3</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>431</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO062</BillingCode><Name>Aptus Wrist Arthrodesis</Name><Description>Total Wrist Fusion Plate, Straight, long bend and short bend</Description><Size>&gt;16 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5263</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>1180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO098</BillingCode><Name>MODUS Orthognathics</Name><Description>Indication-specific solutions for maxillary and mandibular orthognathic surgeries</Description><Size>1.3-1.99 Thickness, 8-15 Holes </Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4293</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>350270</ARTG><ARTG>350271</ARTG></ARTGs><MinimumBenefit>629</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO099</BillingCode><Name>MODUS Orthognathics</Name><Description>Indication-specific solutions for maxillary and mandibular orthognathic surgeries</Description><Size>2.0mm</Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4293</SubGroupID><ARTGs><ARTG>350270</ARTG><ARTG>350271</ARTG></ARTGs><MinimumBenefit>336</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO058</BillingCode><Name>APTUS CCS</Name><Description>Cannulated Screws</Description><Size>2.71 – 4.49 mm</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO073</BillingCode><PriorBillingCodes><PriorBillingCode>EO006</PriorBillingCode><PriorBillingCode>CD006</PriorBillingCode></PriorBillingCodes><Name>APTUS Screws</Name><Description>Aptus Locking Screws</Description><Size>2.5mm Diameter</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>141171</ARTG></ARTGs><MinimumBenefit>98</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO076</BillingCode><PriorBillingCodes><PriorBillingCode>EO007</PriorBillingCode><PriorBillingCode>CD007</PriorBillingCode></PriorBillingCodes><Name>APTUS Screws</Name><Description>Cortical Screws</Description><Size>2.3mm - 2.5mm Diameter</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><ARTGs><ARTG>141171</ARTG></ARTGs><MinimumBenefit>58</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO124</BillingCode><Name>MODUS Orthognathics Screw</Name><Description>Cortical Screw and Sliders </Description><Size>2-14mm</Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4321</SubGroupID><ARTGs><ARTG>350272</ARTG></ARTGs><MinimumBenefit>68</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO075</BillingCode><PriorBillingCodes><PriorBillingCode>EO007</PriorBillingCode><PriorBillingCode>CD007</PriorBillingCode></PriorBillingCodes><Name>APTUS Screws</Name><Description>Cortical Screws</Description><Size>1.5mm - 2.0mm Diameter</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>141171</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO137</BillingCode><Name>Medartis APTUS Elbow Dorsal Olecranon plates &gt;= 16 holes</Name><Description>Olecranon plates</Description><Size>&gt;=16 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5281</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>1433</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO060</BillingCode><Name>Aptus Wrist Arthrodesis</Name><Description>STT Fusion Plate</Description><Size>2.0 system</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO057</BillingCode><Name>Aptus CCS</Name><Description>2.01 - 2.7 Cannulated Compression Screw</Description><Size>(2.01 – 2.7 mm) diameter</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>348</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO069</BillingCode><PriorBillingCodes><PriorBillingCode>EO009</PriorBillingCode><PriorBillingCode>CD009</PriorBillingCode></PriorBillingCodes><Name>APTUS Wrist</Name><Description>2.5 TriLock Distal Radius Plates, Volar, Dorsal, Correction</Description><Size>2.5mm diameter system</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5278</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO123</BillingCode><Name>MODUS Mandible </Name><Description>MODUS Mandible - Complete Condylar Device system (Left and Right), inclusive of carrier element and connecting screws for Condylar Head Prosthesis. </Description><Size>Mandible Condylar Device, Left and Right   </Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4357</SubGroupID><ARTGs><ARTG>350311</ARTG></ARTGs><MinimumBenefit>1506</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO082</BillingCode><PriorBillingCodes><PriorBillingCode>EO065</PriorBillingCode><PriorBillingCode>EO008</PriorBillingCode></PriorBillingCodes><Name>APTUS Hand and Foot</Name><Description>TriLock Plates</Description><Size>1.2 - 2.3</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>971</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO084</BillingCode><PriorBillingCodes><PriorBillingCode>EO064</PriorBillingCode><PriorBillingCode>EO008</PriorBillingCode></PriorBillingCodes><Name>APTUS Hand</Name><Description>Fixation Plates</Description><Size>1.2 - 2.3</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5261</SubGroupID><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>417</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO116</BillingCode><Name>APTUS headedCCS</Name><Description>Headed Cannulated screws</Description><Size>&gt;2.7mm-4.49mm</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>178</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO115</BillingCode><Name>APTUS headedCCS</Name><Description>Headed Cannulated screws</Description><Size>&gt;2.01mm-2.7mm</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3371</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>156</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO074</BillingCode><PriorBillingCodes><PriorBillingCode>EO006</PriorBillingCode><PriorBillingCode>CD006</PriorBillingCode></PriorBillingCodes><Name>APTUS Screws</Name><Description>Aptus Locking Screws</Description><Size>2.8mm - 3.5mm Diameter</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>141171</ARTG></ARTGs><MinimumBenefit>102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO120</BillingCode><Name>MODUS Mandible </Name><Description>Locking Plates - Mandibular Reconstruction </Description><Size>6+19+6 Hole, Full Mandible Plate </Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4353</SubGroupID><ARTGs><ARTG>350270</ARTG><ARTG>350271</ARTG></ARTGs><MinimumBenefit>915</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO101</BillingCode><Name>Medartis All-in-One Staples</Name><Description>Orthopaedic Stainless Steel Bone Staple</Description><Size>8 - 10 mm</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1773</GroupID><SubGroupID>5514</SubGroupID><ARTGs><ARTG>322413</ARTG></ARTGs><MinimumBenefit>127</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO136</BillingCode><Name>APTUS </Name><Description>Variable Angle Locking Plates </Description><Size>7 - 15 holes </Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO088</BillingCode><Name>Aptus Shoulder (Spiral Blades )</Name><Description>Spiral Blades Proximal Humerus</Description><Size>3.5mm System</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>4521</SubGroupID><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>122</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO081</BillingCode><PriorBillingCodes><PriorBillingCode>EO066</PriorBillingCode><PriorBillingCode>EO008</PriorBillingCode></PriorBillingCodes><Name>APTUS Foot</Name><Description>TriLock Plates</Description><Size>2.8</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>793</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO106</BillingCode><Name>APTUS Foot &amp; Ankle</Name><Description>Tibia Plates</Description><Size>7 - 15 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5293</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>1489</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO133</BillingCode><Name>APTUS</Name><Description>Variable angle locking plate </Description><Size>7 - 15 holes </Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO134</BillingCode><Name>APTUS </Name><Description>Clavicle Variable Angle Locking Plates </Description><Size>7 - 15 holes </Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5259</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>577</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO118</BillingCode><Name>MODUS Mandible </Name><Description>Indication-specific solutions for mandibular orthognatic surgeries   </Description><Size>1.0-1.99 thickness, 16-32 Holes </Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><ARTGs><ARTG>350270</ARTG><ARTG>350271</ARTG></ARTGs><MinimumBenefit>199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO121</BillingCode><Name>MODUS Mandible </Name><Description>Titanium Mandibular locking plates, complex shape</Description><Size>16-20 holes, 1.3-1.5mm thickness. </Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>350270</ARTG><ARTG>350271</ARTG></ARTGs><MinimumBenefit>854</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO119</BillingCode><Name>MODUS Mandible </Name><Description>Mandible Locking Plates </Description><Size>16-21 Hole, 1.0-1.99 thickness</Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4296</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>350270</ARTG><ARTG>350271</ARTG></ARTGs><MinimumBenefit>798</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO107</BillingCode><Name>APTUS Wedge</Name><Description>Titanium Wedges</Description><Size>Wedges 4mm-12mm</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1777</GroupID><SubGroupID>5399</SubGroupID><Suffix>3D anatomical</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>1219</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO111</BillingCode><Name>APTUS</Name><Description>Insert for Suture or Screw Fixation</Description><Size>Various</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1774</GroupID><SubGroupID>5390</SubGroupID><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO095</BillingCode><Name>MODUS Orthognathics</Name><Description>Indication-specific solutions for maxillary and mandibular orthognathic surgeries</Description><Size>1.5mm - 29mm</Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>181396</ARTG><ARTG>350270</ARTG><ARTG>350271</ARTG></ARTGs><MinimumBenefit>240</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO104</BillingCode><Name>APTUS Foot &amp; Ankle</Name><Description>Fibula Plates</Description><Size>≥ 16 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5291</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>1102</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO117</BillingCode><Name>APTUS headedCCS</Name><Description>Headed Cannulated screws</Description><Size>≥4.50mm</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>185</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO068</BillingCode><PriorBillingCodes><PriorBillingCode>EO009</PriorBillingCode><PriorBillingCode>CD009</PriorBillingCode></PriorBillingCodes><Name>APTUS Wrist</Name><Description>2.5 TriLock Distal Radius Plates, Adaptive, Volar, Dorsal, Correction, Extra-articular</Description><Size>2.5mm diameter system</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5277</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO093</BillingCode><Name>APTUS SpeedTip CCS</Name><Description>APTUS SpeedTip CCS 5.0/7.0</Description><Size>5.0mm diameter and 7.0mm diameter. Short and long thread</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3369</SubGroupID><Suffix>CN,DT</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>351</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO131</BillingCode><Name>MODUS Mesh</Name><Description>Titanium Mesh, Sterile </Description><Size>0.5-0.8mm thick, 11-50cm²</Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4208</SubGroupID><ARTGs><ARTG>350271</ARTG></ARTGs><MinimumBenefit>388</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO070</BillingCode><PriorBillingCodes><PriorBillingCode>EO009</PriorBillingCode><PriorBillingCode>CD009</PriorBillingCode></PriorBillingCodes><Name>APTUS Wrist</Name><Description>2.5 TriLock Y Plate</Description><Size>2.5mm diameter system</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5280</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>1198</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO122</BillingCode><Name>MODUS Orbital Plating System</Name><Description>Orbital Floor Plate </Description><Size>Small - Large </Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1598</GroupID><SubGroupID>4367</SubGroupID><ARTGs><ARTG>350270</ARTG><ARTG>350271</ARTG></ARTGs><MinimumBenefit>868</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO063</BillingCode><Name>Aptus Elbow</Name><Description>Olecranon Plates Right, Left, Straight and Tension</Description><Size>&gt; 7 to &lt; 15 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5280</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>1198</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO085</BillingCode><PriorBillingCodes><PriorBillingCode>EO064</PriorBillingCode><PriorBillingCode>EO008</PriorBillingCode></PriorBillingCodes><Name>APTUS Hand</Name><Description>Fixation Plates</Description><Size>1.2 - 2.3</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO061</BillingCode><Name>Aptus Wrist Arthrodesis</Name><Description>RSL Fusion Plate</Description><Size>7 to 15 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO114</BillingCode><Name>APTUS</Name><Description>Variable angle locking plates</Description><Size>≥ 16 holes </Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5260</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>810</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO094</BillingCode><PriorBillingCodes><PriorBillingCode>EO071</PriorBillingCode><PriorBillingCode>EO009</PriorBillingCode></PriorBillingCodes><Name>APTUS Hand and Foot</Name><Description>TriLock Plates</Description><Size>1.2 - 2.3</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5262</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>812</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO103</BillingCode><Name>APTUS Foot &amp; Ankle</Name><Description>Tibia Plates</Description><Size>≥ 16 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5294</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>1636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO078</BillingCode><Name>Aptus Elbow</Name><Description>Distal Humerus Plpates, Lateral,Middle and Posterolateral</Description><Size>2.8mm</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5274</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>1513</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO105</BillingCode><Name>APTUS Foot &amp; Ankle</Name><Description>Tibia Plates</Description><Size>≤ 6 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5292</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>1474</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO125</BillingCode><Name>MODUS Orthognathic Screw</Name><Description>Cortical screw, TriLock locking Screw, TriLock Speed-Tip screw, Self-Tapping screw Screw </Description><Size>1.5-2.5 Diameter,  5-23mm lengths</Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>350272</ARTG><ARTG>350350</ARTG></ARTGs><MinimumBenefit>88</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO139</BillingCode><Name>KeriFlex Silicone Finger Joint Implants</Name><Description>Silicone finger joint </Description><Size>0, 1, 2, 3, 4, 5, 00, 10, 20, 30, 40, 50, 60</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>131</SubCategoryID><GroupID>1274</GroupID><SubGroupID>6146</SubGroupID><Suffix>Total</Suffix><ARTGs><ARTG>477526</ARTG><ARTG>477527</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO127</BillingCode><Name>MODUS Intermaxillary Fixation System </Name><Description>Titanium Arch Bar </Description><Size>One size </Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><Suffix>Locking</Suffix><ARTGs><ARTG>350314</ARTG></ARTGs><MinimumBenefit>259</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO096</BillingCode><Name>MODUS Orthognathic</Name><Description>Indication-specific solutions for maxillary and mandibular orthognathic surgeries. Le-Fort, Split, Grid, Bar plates, Sagittal split, X-Shaped, L-shaped, Z-shaped, T-shaped, Y-Shaped, straight plates, square, rectangular </Description><Size>0.5-0.7mm Thick, 8-32 Holes </Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4277</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>350270</ARTG><ARTG>350271</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO056</BillingCode><Name>Aptus Foot</Name><Description>Calcaneus Plates</Description><Size>Left and right plates, small, medium and large</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5296</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>1373</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO059</BillingCode><Name>APTUS</Name><Description>Ulna Plates</Description><Size>&lt;  or = 6 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5279</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>1287</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO128</BillingCode><Name>MODUS Mesh </Name><Description>Titanium Mesh, Sterile </Description><Size>0.2-0.49mm thick, 51-200cm²</Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4205</SubGroupID><ARTGs><ARTG>350271</ARTG></ARTGs><MinimumBenefit>1229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO072</BillingCode><PriorBillingCodes><PriorBillingCode>EO006</PriorBillingCode><PriorBillingCode>CD006</PriorBillingCode></PriorBillingCodes><Name>APTUS Screws</Name><Description>Aptus Locking Screws</Description><Size>1.5mm - 2.0mm Diameter</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>LK</Suffix><ARTGs><ARTG>141171</ARTG></ARTGs><MinimumBenefit>104</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO079</BillingCode><Name>Aptus Elbow</Name><Description>Distal Humerus Plates Posterolateral</Description><Size>2.8mm System</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5275</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>1643</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO129</BillingCode><Name>MODUS Mesh </Name><Description>Pre-shaped, contourable Titanium Mesh, Sterile </Description><Size>0.25-0.44mm thick, 11-50cm²</Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4204</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>350271</ARTG></ARTGs><MinimumBenefit>725</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO140</BillingCode><Name>Olive k-wires</Name><Description>Olive k-wires</Description><Size>2.0mm</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><Suffix>OL</Suffix><ARTGs><ARTG>200263</ARTG></ARTGs><MinimumBenefit>117</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO067</BillingCode><PriorBillingCodes><PriorBillingCode>EO009</PriorBillingCode><PriorBillingCode>CD009</PriorBillingCode></PriorBillingCodes><Name>Aptus Wrist</Name><Description>2.5 TriLock Distal Radius Small Fragment Plates</Description><Size>2.5mm diameter system</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5276</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>1372</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO091</BillingCode><Name>APTUS SpeedTip C System</Name><Description>APTUS SpeedTip C Screws</Description><Size>2.0mm diameter</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO132</BillingCode><Name>MODUS Mandible </Name><Description>Anatomical contoured Complex, pre-formed locking plates intended for orthognathic reconstruction, inclusive of C-shaped adaption plates.</Description><Size>16-32 holes, 2.0 thickness</Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4307</SubGroupID><Suffix>Complex, Locking</Suffix><ARTGs><ARTG>350270</ARTG><ARTG>350271</ARTG></ARTGs><MinimumBenefit>1287</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO092</BillingCode><Name>APTUS SpeedTip C System</Name><Description>APTUS SpeedTip C Screws</Description><Size>2.8mm diameter</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3370</SubGroupID><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>46</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO090</BillingCode><Name>APTUS SpeedTip C-Snap System</Name><Description>APTUS SpeedTip C-Snap Screws</Description><Size>2.0mm diameter</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1231</GroupID><SubGroupID>3372</SubGroupID><Suffix>Breakoff</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>273</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO089</BillingCode><Name>Aptus K-wires</Name><Description>K-wires</Description><Size>0.8mm - 2.2mm Diameter, various lengths</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5365</SubGroupID><ARTGs><ARTG>200263</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO097</BillingCode><Name>MODUS Orthognathics</Name><Description>Indication-specific solutions for maxillary and mandibular orthognathic surgeries</Description><Size>1.0-1.99mm, 4-7 Holes </Size><SupplierCode>EO</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4288</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>350270</ARTG><ARTG>350271</ARTG></ARTGs><MinimumBenefit>341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO102</BillingCode><Name>APTUS Foot &amp; Ankle</Name><Description>Fibula Plates</Description><Size>7 to 15 holes</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5290</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>1238</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO087</BillingCode><Name>Aptus Shoulder (Proximal Humerus Plates)</Name><Description>Proximal Humerus Fixation plates</Description><Size>3.5mm System</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5275</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>1643</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO135</BillingCode><Name>APTUS</Name><Description>Variable Angle Locking Plate </Description><Size>≤ 6 holes </Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>VAL</Suffix><ARTGs><ARTG>206157</ARTG></ARTGs><MinimumBenefit>594</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>EO080</BillingCode><PriorBillingCodes><PriorBillingCode>EO066</PriorBillingCode><PriorBillingCode>EO008</PriorBillingCode></PriorBillingCodes><Name>APTUS Foot</Name><Description>TriLock Plates</Description><Size>2.8</Size><SupplierCode>EO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5258</SubGroupID><Suffix>Com, VAL</Suffix><ARTGs><ARTG>141170</ARTG></ARTGs><MinimumBenefit>1159</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US033</BillingCode><Name>Passive Middle Ear Implant (partial tympanoplasty prosthesis and stapesplasty prosthesis)</Name><Description>The MED-EL passive middle ear implant – tympanoplasty and stapesplasty ossicular replacement prostheses are made of titanium with a bendable shaft (and headplate of the tympanoplasty prosthesis). MRI conditional up to 7.0 Tesla</Description><Size>mXACT, mCLIP, mCLIP ARC, mXACT PRO - FL 0.75-3.50mm;   mAXIS(Ø 0.4/0.5/0.6 x FL 3.50-5.50mm), mLOOP (Ø 0.4/0.6 x FL 3.50-10.00mm), mZAM (Ø 0.4/0.5/0.6 x FL 3.50-5.50mm), mFIX (Ø 0.4/0.6 x FL 3.50-5.50mm), </Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4156</SubGroupID><ARTGs><ARTG>393386</ARTG><ARTG>393392</ARTG></ARTGs><MinimumBenefit>227</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US019</BillingCode><Name>Vibrant Soundbridge System - Vibroplasty Couplers</Name><Description>Middle ear prostheses used with the Vibrant Soundbridge System VORP implant.  Facilitate coupling between the FMT and a vibratory structure of the middle ear.</Description><Size>Functional length:  Vibroplasty-OW-Coupler - 2.50, 3.00, 3.50, 4.00mm  Vibroplasty-CliP-Coupler - 0.20, 0.50, 1.00, 1.50mm  Vibroplasty-Bell-Coupler - 0.20, 0.50, 1.00, 1.50mm  Vibroplasty-RW-Coupler - 0.85mm  Incus-Symphonix-Coupler - Left and Right (2.5 x 3.3mm)  Incus-LP-Coupler - Left and Right (2.8 x 3.8mm)   Incus-SP-Coupler (2.9 x 4.4mm)  RW-Soft-Coupler (1 x 1.5mm)  Stapes-SH-Coupler (3.5 x 4.1mm)</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>6521</SubGroupID><Suffix>Coupler</Suffix><ARTGs><ARTG>185533</ARTG></ARTGs><MinimumBenefit>350</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US029</BillingCode><Name>SAMBA 2 Audio Processor</Name><Description>Single Unit audio processor for the Vibrant Soundbridge System, worn off the ear it is held in place by magnetic attraction over the implant. Designed to function similarly as the SAMBA audio processor but with improved battery life, noise reduction, ingress protection and Intelligent Sound Adapter 2.0</Description><Size>One Size - Lo/Hi, left/right versions with various magnet strengths, length = 36.4mm, width = 30.4mm, height = 10.2mm, weight 9.3g (inc battery)</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>6521</SubGroupID><Suffix>Programmable, Wireless-enabled, Autoscan</Suffix><ARTGs><ARTG>353970</ARTG></ARTGs><MinimumBenefit>7166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US028</BillingCode><Name>Mi1250 SYNCHRONY 2 Cochlear Implant /   Mi1250 SYNCHRONY 2 PIN Cochlear Implant</Name><Description>Ultra small titanium implant with symmetrical central and flexible atraumatic electrode arrays provide complete cochlea coverage.  Removable and self-aligning magnet is conditionally MRI  safe for 3.0 Tesla MRI scans (without magnet removal).</Description><Size>Stimulator Housing: L 47.3 mm, W 24 mm, Thin 4.5 mm, Weight 7.7g    Electrode: Standard (26.4mm), Medium (20.9mm), Compressed (12.1mm), FLEXsoft (26.4mm), FLEX28 (23.1mm),  FLEX26 (20.9mm), FLEX24 (20.9mm), FLEX20 (15.4mm), FORM24 (18.7mm), FORM19 (14.3mm)</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>389051</ARTG><ARTG>389052</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US021</BillingCode><Name>Vibrant Soundbridge System - Vibrating Ossicular Prosthesis VORP503</Name><Description>Part of the Vibrant Soundbridge System, VORP503 is an active implant, which is implanted into the temporal bone under the skin. The VORP 503 consists of the Floating Mass Transducer (FMT), a conductor link, the electronics (demodulator), fixation wings and a magnet surrounded by a receiver coil.</Description><Size>One size (left and right) Length: 118mm, Width: 28mm, Thickness: 4.4mm, Weight: 10.1g</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>6521</SubGroupID><ARTGs><ARTG>389014</ARTG></ARTGs><MinimumBenefit>7470</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US020</BillingCode><Name>Vibrant Soundbridge System - Samba Audio Processor</Name><Description>Middle ear implant audio processor.   The Samba audio processor is the externally worn component of the Vibrant Soundbridge System and connects to the implant through magnetic attraction.  Fitting the Samba audio processor activates the Soundbridge.</Description><Size>Samba Lo, Samba Hi left and right versions, length = 35mm, width = 30mm, height = 10mm, weight &lt;9g (inc battery</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>6521</SubGroupID><Suffix>Programmable, wireless - enabled</Suffix><ARTGs><ARTG>271112</ARTG></ARTGs><MinimumBenefit>6825</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US027</BillingCode><Name>Bone Conduction Implant Kit,  BCI 602 Kit</Name><Description>The BCI 602 Implant is an Active transcutaneous bone conduction implant consisting of attachment magnet, receiver coil, Bone Conduction-Floating Mass Transducer (BC-FMT) with electronics, bendable transition to FMT, implanted under intact skin. Included with the BCI 602 implant in the BCI602 Kit are 2 Self-Drilling Cortical Screws, an emergency screw and Surgical Screwdriver SD 2, as well as the BCI 602 Sizer Kit.</Description><Size>one size - 28.3 (w) x 64.3 (l) x 8.6 (h) mm</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>Implanted Transducer, Magnetic Coupler</Suffix><ARTGs><ARTG>389050</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US034</BillingCode><Name>Passive Middle Ear Implant (total tympanoplasty prosthesis)</Name><Description>The MED-EL passive middle ear implant – tympanoplasty ossicular  replacement prosthesis is made of titanium with a bendable shaft and headplate. MRI conditional up to 7.0 Tesla</Description><Size>mXACT (Offcenter and Center) and mXACT PRO - FL 3.00-7.00mm</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4157</SubGroupID><ARTGs><ARTG>393387</ARTG><ARTG>393391</ARTG></ARTGs><MinimumBenefit>343</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US012</BillingCode><Name>Mi1200 SYNCHRONY Cochlear Implant / Mi1200 SYNCHRONY PIN Cochlear Implant</Name><Description>Ultra small titanium implant with flexible atraumatic electrode arrays provide complete cochlea coverage. Removable and self-aligning magnet is MRI safe at 3.0 Tesla (without magnet removal)</Description><Size>Stimulator Housing: L 17.3mm, W 25.4mm, Thin 4.5mm, Weight 7.6g.  Electrode: Standard (26.4mm), Compressed (12.1mm), Medium (20.9mm), FLEX24 (20.9mm), FLEX26 (20.9mm), FLEXsoft (26.4mm), FLEX28 (23.1mm), FORM19 (14.3mm), FORM24 (18.7mm), FLEX20 (15.4mm)</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1526</GroupID><ARTGs><ARTG>389012</ARTG><ARTG>389013</ARTG></ARTGs><MinimumBenefit>12892</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US026</BillingCode><Name>BCI 602 Lifts (1mm)</Name><Description>BCI 602 Lifts (1mm) can be implanted together with the Bonebridge BCI 602, attached to the fixation wings of the BCI 602, serving as a spacer to increase distance between the fixation wings and the skull bone.</Description><Size>1mm</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4151</SubGroupID><Suffix>Lifts</Suffix><ARTGs><ARTG>329049</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US017</BillingCode><Name>Bonebridge Samba BB Audio Processor</Name><Description>The Samba BB is a wireless enabled audio processor and the externally worn component of the Bonebridge System.  It connects to the implant through magnetic attraction. Fitting the Samba BB audio processor activates the Bonebridge.</Description><Size>left and right versions, length = 35mm, width = 30mm, height = 10mm, weight &lt;9g (inc battery)</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4150</SubGroupID><Suffix>Programmable, Wireless-enabled</Suffix><ARTGs><ARTG>270912</ARTG></ARTGs><MinimumBenefit>6484</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US030</BillingCode><Name>SAMBA 2 BB Audio Processor</Name><Description>Single Unit audio processor for the Bonebridge System, worn off the ear it is held in place by magnetic attraction over the implant. Designed to function similarly as the SAMBA BB audio processor with improved battery life, noise reduction, ingress protection  and Intelligent Sound Adapter 2.0</Description><Size>One Size - left/right versions with various magnet strengths, length = 36.4mm, width = 30.4mm, height = 10.2mm, weight 9.3g (inc battery)</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1560</GroupID><SubGroupID>4150</SubGroupID><Suffix>Programmable, Wireless-enabled, Autoscan</Suffix><ARTGs><ARTG>353072</ARTG></ARTGs><MinimumBenefit>6808</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US036</BillingCode><Name>SONNET 3 EAS Audio Processor (Replacement)</Name><Description>Audio processor with electric and electric acoustic stimulation modes, worn behind
the ear with direct wireless audio streaming and a binaural wireless link for control data exchange between two audio processors in a bilateral configuration, and a lower profile, in addition to dual omnidirectional microphone, water-resistance, datalogging, signal processing, Adaptive Intelligence, Automatic Sound Management and wireless connectivity to assistive listening devices.</Description><Size>one size with battery options and various magnet strengths</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>462625</ARTG></ARTGs><MinimumBenefit>9078</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US031</BillingCode><Name>RONDO 3 Audio Processor (Replacement)</Name><Description>A Single Unit off-the-ear (OTE) audio processor for the MED-EL CI System, integrating two omni-directional microphones, coil, indicator LED, magnet &amp; electronics package, held in place over the implant by magnetic attraction. It features an integrated wirelessly rechargeable battery providing up to 24hr battery life, link monitoring, increased water  resistance (IP68), datalogging, Adaptive Intelligence, Automatic Sound Management, wireless connectivity to assistive listening devices.</Description><Size>One size - L 44.8 mm, W 35.7 mm, H 11.6 mm (with 5 magnet strengths and 2 cover options)</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>355351</ARTG></ARTGs><MinimumBenefit>8114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US015</BillingCode><Name>SONNET Audio Processor (Replacement)</Name><Description>Audio processor worn behind the ear with dual omnidirectional microphones, water-resistance, data logging, Automatic Sound Management, wireless connectivity to assistive listening devices</Description><Size>One size</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>Generation 4</Suffix><ARTGs><ARTG>232486</ARTG></ARTGs><MinimumBenefit>7648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US016</BillingCode><Name>SONNET EAS Audio Processor (replacement)</Name><Description>Audio processor worn behind the ear with dual omnidirectional microphones, water-resistance, data logging, Automatic Sound Management, wireless connectivity to assistive listening devices, electric and electric acoustic stimulation modes</Description><Size>One size</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>Electroacoustic</Suffix><ARTGs><ARTG>232487</ARTG></ARTGs><MinimumBenefit>8612</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US035</BillingCode><Name>SONNET 3 EAS Audio Processor (initial)</Name><Description>Audio processor with electric and electric acoustic stimulation modes, worn behind the ear with direct wireless audio streaming and a binaural wireless link for control data exchange between two audio processors in a bilateral configuration, and a lower profile, in addition to dual omnidirectional microphone, water-resistance, datalogging, signal processing, Adaptive Intelligence, Automatic Sound Management and wireless connectivity to assistive listening devices.</Description><Size>one size with battery options and various magnet strengths</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4145</SubGroupID><Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>462625</ARTG></ARTGs><MinimumBenefit>12796</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US024</BillingCode><Name>SONNET 2 EAS Audio Processor (replacement)</Name><Description>Audio processor with electric and electric acoustic stimulation modes, worn behind the ear with dual omnidirectional microphone, water-resistance, enhanced datalogging and signal processing, Adaptive Intelligence, Automatic Sound Management, wireless connectivity to assistive listening devices</Description><Size>one size with 3 battery options and various magnet strengths</Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4147</SubGroupID><Suffix>Electroacoustic, AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>319472</ARTG></ARTGs><MinimumBenefit>9078</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>US032</BillingCode><Name>RONDO 3 Audio Processor (initial)</Name><Description>A Single Unit off-the-ear (OTE) audio processor for the MED-EL CI System, integrating two omni-directional microphones, coil, indicator LED, magnet &amp; electronics package, held in place over the implant by magnetic attraction. It features an integrated wirelessly rechargeable battery providing up to 24hr battery life, link monitoring, increased water resistance (IP68), datalogging, Adaptive Intelligence, Automatic Sound Management, wireless connectivity to assistive listening devices.</Description><Size>One size - L 44.8 mm, W 35.7 mm, H 11.6 mm  (with 5 magnet strengths and 2 cover options)  </Size><SupplierCode>US</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1528</GroupID><SubGroupID>4145</SubGroupID><Suffix>AutoScan, 2.4GHz Wireless</Suffix><ARTGs><ARTG>355351</ARTG></ARTGs><MinimumBenefit>11392</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MO379</BillingCode><PriorBillingCodes><PriorBillingCode>MO150</PriorBillingCode></PriorBillingCodes><Name>Acumed Congruent Plate System</Name><Description>Foot and Ankle Plate itianium</Description><Size>≤ 6 hole</Size><SupplierCode>MO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1694</GroupID><SubGroupID>5298</SubGroupID><ARTGs><ARTG>98244</ARTG></ARTGs><MinimumBenefit>428</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MO451</BillingCode><Name>ToeGrip</Name><Description>toe interphalangeal joint arthrodesis implant</Description><Size>Extra-small, small, medium, large, extra large</Size><SupplierCode>MO</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1228</GroupID><SubGroupID>6561</SubGroupID><Suffix>Interphalangeal</Suffix><ARTGs><ARTG>369250</ARTG></ARTGs><MinimumBenefit>548</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>VS001</BillingCode><PriorBillingCodes><PriorBillingCode>DV230</PriorBillingCode></PriorBillingCodes><Name>Molteno 3</Name><Description>Drainage implant for glaucoma, made of silicon</Description><Size>Small &amp; Large size</Size><SupplierCode>VS</SupplierCode><CategoryID>1</CategoryID><SubCategoryID>144</SubCategoryID><GroupID>1333</GroupID><Suffix>v</Suffix><ARTGs><ARTG>128911</ARTG></ARTGs><MinimumBenefit>564</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS068</BillingCode><Name>ASEPT Peritoneal Drainage System</Name><Description>Indwelling tunnelled peritoneal catheter insertion kit</Description><Size>Catheter: 71 cm x 15.5F</Size><SupplierCode>MS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>4243</SubGroupID><ARTGs><ARTG>285155</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS056</BillingCode><Name>THD Slide</Name><Description>Transanal Haemorrhoidal Dearterilisation and Pexis System</Description><Size>One Size Only</Size><SupplierCode>MS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Doppler Guided, Endoscopic</Suffix><ARTGs><ARTG>377045</ARTG></ARTGs><MinimumBenefit>844</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS079</BillingCode><Name>Power Injectable Infusion Port</Name><Description>Single Chamber, MRI Conditional, Vascular Access Port with Vortex Technology</Description><Size>Catheter (French Size): 5Fr - 8Fr, Catheter (Length): 45 cm - 63 cm, Port Body (Height): 10.8 mm - 13.0 mm, Port Septum (Diameter): 10.2 mm - 12.7 mm</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>378930</ARTG><ARTG>378931</ARTG><ARTG>378932</ARTG></ARTGs><MinimumBenefit>510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS014</BillingCode><Name>Vortex Implantable Port</Name><Description>Implantable access device for administration of medications, fluids, etc. and for blood sampling</Description><Size>Catheter Size (Fr): 6.6 - 9.6</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><ARTGs><ARTG>155910</ARTG></ARTGs><MinimumBenefit>399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS016</BillingCode><Name>Smart Port CT</Name><Description>Power-Injectable, Single Chamber, Titanium, Vascular Access Port with Vortex Technology</Description><Size>Detached or Pre-Attached Catheter: 6.6 Fr - 9.6 Fr</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1652</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>169838</ARTG><ARTG>235097</ARTG><ARTG>235098</ARTG><ARTG>235099</ARTG></ARTGs><MinimumBenefit>510</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS075</BillingCode><Name>Peripherally Inserted Central Catheter (PICC)</Name><Description>Peripherally Inserted Central Catheter, Single Lumen, Power Injectable </Description><Size>4Fr - 5Fr</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>203832</ARTG><ARTG>215418</ARTG><ARTG>215419</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS080</BillingCode><PriorBillingCodes><PriorBillingCode>MS072</PriorBillingCode><PriorBillingCode>ER135</PriorBillingCode></PriorBillingCodes><Name>Peripherally Inserted Central Catheter, Multiple Lumen</Name><Description>Power injectable with Pressure Accivated Safety Valve (PASV) technology</Description><Size>5Fr x 55cm (Dual Lumen), 6Fr x 55cm (Dual Lumen), 6Fr x 55cm (Triple Lumen)</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>175080</ARTG><ARTG>178780</ARTG><ARTG>179150</ARTG><ARTG>203830</ARTG><ARTG>203831</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS078</BillingCode><Name>Peripherally Inserted Central Catheter, Single Lumen</Name><Description>Peripherally Inserted Central Catheter, Single Lumen, Anti-Thrombogenic Catheter  Material, Power Injectable</Description><Size>3Fr - 5Fr</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>203831</ARTG><ARTG>203832</ARTG><ARTG>215411</ARTG><ARTG>215412</ARTG><ARTG>215418</ARTG><ARTG>215419</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS038</BillingCode><Name>Titanized Mesh Implants [TiLENE, TiMESH, TiLOOP Bra Pocket)</Name><Description>Prosthetic warp-knitted fabric made of monofil polypropylene threads with an encapsulating titanic coating</Description><Size>Weight: 16 g/m² - 65 g/m²; Surface Area: 601cm² - 1000cm²</Size><SupplierCode>MS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>97288</ARTG></ARTGs><MinimumBenefit>1013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS065</BillingCode><Name>ASEPT Pleural Drainage System</Name><Description>Indwelling tunnelled pleural catheter insertion kit</Description><Size>15F x 66cm silicone catheter with fenestrations and cuff</Size><SupplierCode>MS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>193</SubCategoryID><GroupID>1577</GroupID><SubGroupID>4242</SubGroupID><ARTGs><ARTG>285155</ARTG></ARTGs><MinimumBenefit>384</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS015</BillingCode><Name>Injection/Infusion Ports Sterile</Name><Description>Plastic/titanium, dual lumen</Description><Size>10, 10.5, 12F</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1653</GroupID><ARTGs><ARTG>155909</ARTG></ARTGs><MinimumBenefit>636</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS030</BillingCode><Name>Titanized Mesh Implants [TiMESH, TiLENE, TiLENE Blue]</Name><Description>Prosthetic warp-knitted fabric made of monofil polypropylene threads with an encapsulating titanic coating</Description><Size>Weight: 16 g/m² - 65 g/m²; Surface Area: ≤ 200cm²</Size><SupplierCode>MS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>97288</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS076</BillingCode><Name>Peripherally Inserted Central Catheter (PICC)</Name><Description>Peripherally Inserted Central Catheter, Multiple Lumen, Power Injectable</Description><Size>5Fr - 6Fr</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>203832</ARTG><ARTG>215418</ARTG><ARTG>215419</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS077</BillingCode><Name>Peripherally Inserted Central Catheter, Multiple Lumen</Name><Description>Peripherally Inserted Central Catheter, Single Lumen, Anti-Thrombogenic Catheter Material, Power Injectable</Description><Size>5Fr - 6Fr</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>203831</ARTG><ARTG>203832</ARTG><ARTG>215411</ARTG><ARTG>215412</ARTG><ARTG>215418</ARTG><ARTG>215419</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS033</BillingCode><Name>Titanized Mesh Implants (TiMESH, TiLENE, TiLENE Blue, TiLOOP Bra, TiLOOP Bra MPX)</Name><Description>Prosthetic warp-knitted fabric made of monofil polypropylene threads with an encapsulating titanic coating</Description><Size>Weight: 16 g/m² - 65 g/m² ; Surface Area: 201cm² - 400cm²</Size><SupplierCode>MS</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5439</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>97288</ARTG></ARTGs><MinimumBenefit>721</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS069</BillingCode><Name>BioFlo Midline</Name><Description>Percutaneous Catheter, Single Lumen, Power Injectable</Description><Size>Length: 20 cm  French Size: 3Fr - 5Fr</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>312726</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS074</BillingCode><PriorBillingCodes><PriorBillingCode>ER134</PriorBillingCode></PriorBillingCodes><Name>Single Lumen Peripherally Inserted Central Catheter</Name><Description>Power injectable with Pressure Activated Safely Valve (PASV) technology</Description><Size>3F x55cm, 4F x 55cm, 5F x 55cm</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1649</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>175080</ARTG><ARTG>178780</ARTG><ARTG>179150</ARTG><ARTG>203831</ARTG></ARTGs><MinimumBenefit>130</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MS071</BillingCode><Name>BioFlo Midline</Name><Description>Percutaneous Catheter, Dual Lumen, Power Injectable</Description><Size>Length: 20 cm  French Size: 5Fr</Size><SupplierCode>MS</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>214</SubCategoryID><GroupID>1650</GroupID><Suffix>pi (power injection)</Suffix><ARTGs><ARTG>312726</ARTG></ARTGs><MinimumBenefit>131</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MZ010</BillingCode><Name>ABRA Abdominal Wall Closure Set</Name><Description>Abdominal Wall Closure System, for primary closure of large full thickness retrated adbominal wounds.</Description><Size>For wounds up to 30cm long up 30cm across.</Size><SupplierCode>MZ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1799</GroupID><SubGroupID>5499</SubGroupID><ARTGs><ARTG>181416</ARTG></ARTGs><MinimumBenefit>6253</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MZ019</BillingCode><Name>Strasbourg Costal Osteosynthesis System (StraCos/StraTos)</Name><Description>Titanium 3D Rib Clip, 6, 9 &amp; 13 Segments, Standard width and XL</Description><Size>6 segments (46 mm)
9 segments (70 mm)
13 segments XL (25.5 mm width)</Size><SupplierCode>MZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5938</SubGroupID><ARTGs><ARTG>235762</ARTG></ARTGs><MinimumBenefit>1010</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MZ011</BillingCode><Name>ABRA Abdominal Wall Closure Set (Extension Kit Only)</Name><Description>Extention Kit for use with ABRA Abdominal Wall Closure Set CWK08. Used when width or length of open abdomen exceeds 30cm. ABRA is for the primary closure of large full thickness retracted abdominal wounds</Description><Size>Extention Kit, used when wounds to be closed are larger than 30cm long and/or 30cm across.</Size><SupplierCode>MZ</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1799</GroupID><SubGroupID>5500</SubGroupID><ARTGs><ARTG>181416</ARTG></ARTGs><MinimumBenefit>1787</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MZ020</BillingCode><Name>Strasbourg Costal Osteosynthesis System (StraCos/StraTos) - Titanium 3D Rib Clips, Bar, Mounting</Name><Description>Titanium 3D Rib Clip, Bar Mounting, Straight and Angled 22.5 &amp; 45 degrees, Standard &amp; XL</Description><Size>Two widths: Standard (19mm) &amp; XL (27.5mm)
Three Angles: 0 (Straight), 22.5 &amp; 45 degrees</Size><SupplierCode>MZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5938</SubGroupID><Suffix>Modified</Suffix><ARTGs><ARTG>235762</ARTG></ARTGs><MinimumBenefit>1183</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MZ021</BillingCode><Name>Strasbourg Costal Osteosynthesis System (StraCos/StraTos) - Titanium Connecting Bar, (partially &amp; completely serrated)</Name><Description>Titanium Connecting Bar for Straight and Angled 3D Rip Clips
partially serrated
completely serrated</Description><Size>Three Sizes of Partially Serrated :
150, 190 &amp; 230mm;
Two sizes of Completely Serrated:
190 &amp; 230mm.</Size><SupplierCode>MZ</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>6181</SubGroupID><ARTGs><ARTG>235762</ARTG></ARTGs><MinimumBenefit>1190</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>WT002</BillingCode><Name>EvoFix Low Profile Various</Name><Description>Titanium craniofacial fixation plates</Description><Size>&lt;0.5mm thick, 4-7 holes</Size><SupplierCode>WT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4263</SubGroupID><ARTGs><ARTG>314801</ARTG></ARTGs><MinimumBenefit>137</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>WT001</BillingCode><Name>EvoFix Low Profile Burrhole Plate</Name><Description>Titanium craniofacial fixation plates</Description><Size>&lt;0.5mm thick, 4-7 holes</Size><SupplierCode>WT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4263</SubGroupID><Suffix>Burr</Suffix><ARTGs><ARTG>314801</ARTG></ARTGs><MinimumBenefit>155</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>WT004</BillingCode><Name>EvoFix Low Profile</Name><Description>Titanium craniofacial fixation plates </Description><Size>&lt;0.5mm thickness, &lt;4 holes</Size><SupplierCode>WT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4261</SubGroupID><ARTGs><ARTG>314801</ARTG></ARTGs><MinimumBenefit>63</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>WT003</BillingCode><Name>EvoFix Micro Screws </Name><Description>Titanium screws for craniofacial fixation </Description><Size>1. Diameter 1.5mm, Length 3.5mm to 6mm    2. Diameter 1.8mm, Length 4mm to 5mm</Size><SupplierCode>WT</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>314801</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>DH011</BillingCode><Name>KilRoid</Name><Description>KilRoid® is a disposable haemorrhoid suction ligator with and without tubing.</Description><Size>6 bands - available with and without tubing.</Size><SupplierCode>DH</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>5490</SubGroupID><ARTGs><ARTG>326510</ARTG></ARTGs><MinimumBenefit>36</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI286</BillingCode><Name>LiquiBand® Exceed™</Name><Description>Topical Tissue Adhesive with Applicator</Description><Size>0.8 mL, 0.36mL</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>266148</ARTG></ARTGs><MinimumBenefit>23</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS233</BillingCode><Name>Symbotex Composite Mesh with pre placed suture</Name><Description>Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.)</Description><Size>Rectangular 30x20 cm, Rectangular  25x20 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>270737</ARTG></ARTGs><MinimumBenefit>966</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ627</BillingCode><Name>Liquiband XL</Name><Description>Topical skin adhesive with self-adhering mesh. The billing code’s benefit ($128) is for catalogue number 72014019 which includes 22cm mesh and 2.7g adhesive.
The billing code is to be claimed twice for catalogue number 72014027 which includes 44cm mesh and 5.4g adhesive ($256 total benefit); and the billing code is to be claimed three times for catalogue number 72014046 which includes 66cm mesh and 8.1g adhesive ($384 total benefit).</Description><Size>22cm-66cm mesh and 2.7g-8.1g adhesive</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>383905</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS216</BillingCode><Name>Symbotex Composite Mesh</Name><Description>Non-absorbable three-dimensional polyester mesh provides long term reinforcement of soft tissues. (On the opposite side, the absorbable
hydrophilic film minimizes tissue attachment to the mesh in case
of direct contact with the viscera.)</Description><Size>Rectangular 30x20 cm,  
Rectangular 25x20 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>270735</ARTG></ARTGs><MinimumBenefit>966</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI317</BillingCode><PriorBillingCodes><PriorBillingCode>SQ124</PriorBillingCode></PriorBillingCodes><Name>INDERMIL Flexifuze</Name><Description>Topical Tissue Adhesive with Applicator</Description><Size>0.75g per ampoule</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>4247</SubGroupID><Suffix>Synthetic</Suffix><ARTGs><ARTG>322769</ARTG></ARTGs><MinimumBenefit>23</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA08</BillingCode><Name>Grafton Demineralized Bone Matrix: Flex, &gt;5cc to 10cc</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229634</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1539</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI051</BillingCode><Name>Medtronic Neurostimulation Tunnelling Tools</Name><Description>Tunnelling Tools</Description><Size>Various</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>121281</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI067</BillingCode><Name>Injex Anchor Kit</Name><Description>Neurostimulation Anchor Kit</Description><Size>One Size</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>133358</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA04</BillingCode><Name>Grafton Demineralized Bone Matrix: Matrix PLF, 2.5cm x 10cm x 0.8cm (2)</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229633</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1978</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI039</BillingCode><Name>Medtronic Neurostimulation Accessories (Needles)</Name><Description>Accessories for implant of neurostimulation lead</Description><Size>Various</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>405626</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC875</BillingCode><Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name><Description>Titanium, T Plate</Description><Size>4 - 7 hole</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS222</BillingCode><Name>Parietex Progrip Composite Mesh</Name><Description>Monofilament polyester with polylactic acid monofilament resorbable pins on one of the sides</Description><Size>Rectangular 30x15cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>157201</ARTG></ARTGs><MinimumBenefit>966</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC520</BillingCode><Name>TiMesh</Name><Description>X Plate</Description><Size>4 holes x 1mm - 4 holes x 2.2mm</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC519</BillingCode><Name>TiMesh</Name><Description>Squareplate</Description><Size>4 holes x 1mm - 4 holes x 2.2mm</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>QQ322</BillingCode><Name>Grafton DBF Inject</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>449685</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>581</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-08-08</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC868</BillingCode><Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name><Description>Titanium, Plate</Description><Size>Fan Blade 11-18mm, Mesh 11-25mm, 4 - 7 hole</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><Suffix>Burr</Suffix><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA05</BillingCode><Name>Grafton Demineralized Bone Matrix: Orthoblend, 5cc</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229633</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>581</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI169</BillingCode><Name>Interstim Trial Lead and Screener Kit </Name><Description>Trial lead and screener cables kit</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1714</GroupID><SubGroupID>6036</SubGroupID><ARTGs><ARTG>137440</ARTG></ARTGs><MinimumBenefit>753</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC909</BillingCode><Name>Timesh</Name><Description>Rigid Straight Plates</Description><Size>4 - 7 holes</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC576</BillingCode><Name>Timesh</Name><Description>Double Y Plates</Description><Size>3 Hole - 2.5mm - 7mm</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC885</BillingCode><Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name><Description>Titanium, H Plate</Description><Size>4 - 7 hole</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC870</BillingCode><Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name><Description>Titanium, Y Plate Double and Single</Description><Size>4 - 7 hole</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC883</BillingCode><Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name><Description>Titanium, L Plate (Left and right configurations)</Description><Size>4 to 7 holes</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI271</BillingCode><Name>Infinity Spinal System</Name><Description>Occipital Hinged Rod</Description><Size>Length 100 - 200mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1480</GroupID><SubGroupID>4133</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1350</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC951</BillingCode><Name>Multi-Lead Trialing Cable</Name><Description>Connector for implanted lead to External Neurostimulator</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4501</SubGroupID><ARTGs><ARTG>119991</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA07</BillingCode><Name>Grafton Demineralized Bone Matrix: Flex, 1.5cm x 1.5cm x 0.25cm</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229634</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>581</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC393</BillingCode><Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name><Description>Titanium, Z Plate Left and Right</Description><Size>4 hole - 5mm, 9.5mm</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4271</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>166</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI040</BillingCode><Name>Medtronic Infusion Pump Accessories</Name><Description>Accessories for refill/catheter access of infusion pumps</Description><Size>Various</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>223</SubCategoryID><GroupID>1684</GroupID><SubGroupID>5483</SubGroupID><ARTGs><ARTG>398941</ARTG><ARTG>398942</ARTG></ARTGs><MinimumBenefit>36</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI250</BillingCode><PriorBillingCodes><PriorBillingCode>MC408</PriorBillingCode></PriorBillingCodes><Name>CD Horizon</Name><Description>Crosslink Plates - Fixed</Description><Size>10 to 200mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI059</BillingCode><Name>Prestige Cervical Disc</Name><Description>Cervical intervertebral disc prosthesis with ball-and-trough designed articulation</Description><Size>5mm - 8mm x 12mm - 18mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>175</SubCategoryID><GroupID>1488</GroupID><SubGroupID>5487</SubGroupID><ARTGs><ARTG>100706</ARTG></ARTGs><MinimumBenefit>6021</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA09</BillingCode><Name>Grafton Demineralized Bone Matrix: Matrix PLF, 2.5cm x 5cm x 0.8cm (2)</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229636</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1539</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI458</BillingCode><PriorBillingCodes><PriorBillingCode>NK069</PriorBillingCode></PriorBillingCodes><Name>PASS LP System - Crosslinks</Name><Description>Crosslinks</Description><Size>Diameter: 5.5mm - 6.0mm Length: 10mm - 72mm; small and medium</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>295277</ARTG><ARTG>316001</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI474</BillingCode><PriorBillingCodes><PriorBillingCode>NK089</PriorBillingCode></PriorBillingCodes><Name>Crosslinks</Name><Description>Crosslinks</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4123</SubGroupID><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>389</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI027</BillingCode><Name>Medtronic Ascenda Intrathecal Catheter</Name><Description>Intrathecal Catheter</Description><Size>114cm, 140cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>223</SubCategoryID><GroupID>1683</GroupID><SubGroupID>4492</SubGroupID><Suffix>Reinforced</Suffix><ARTGs><ARTG>192057</ARTG><ARTG>192058</ARTG></ARTGs><MinimumBenefit>993</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI330</BillingCode><Name>Medtronic MiniMed 770G Insulin Pump</Name><Description>MiniMed 770G Insulin Pump with SmartGuard Hybrid Closed Loop (HCL) technology, with Bluetooth® connectivity and continuous glucose monitoring (CGM) capability which can be programmed to automatically adjust delivery of basal insulin based on CGM, and can suspend delivery of insulin when the sensor glucose value falls below or is predicted to fall below predefined threshold values.</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4187</SubGroupID><Suffix>DE, SS, ABD</Suffix><ARTGs><ARTG>332201</ARTG></ARTGs><MinimumBenefit>8574</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI452</BillingCode><Name>MiniMed 780G Insulin Pump</Name><Description>MiniMed 780G Insulin Pump with SmartGuard advanced Hybrid Closed Loop technology capable of operating in Manual Mode or Auto Mode, with Bluetooth connectivity and continuous glucose monitoring capability. Provides 3 user selectable targets and can be set to automatically adjust 
delivery of basal insulin based on CGM. This includes automatically suspending insulin delivery or providing additional insulin delivery as required.</Description><Size>One size only.</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>188</SubCategoryID><GroupID>1525</GroupID><SubGroupID>4187</SubGroupID><Suffix>DE, SS, ABD</Suffix><ARTGs><ARTG>484825</ARTG><ARTG>484826</ARTG></ARTGs><MinimumBenefit>8574</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC632</BillingCode><Name>Verte-Stack</Name><Description>XS Centre Piece. Stackable Corpectomy Device.</Description><Size>Height 5-50mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1493</GroupID><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>3529</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI550</BillingCode><Name>Concerto Detachable Coil System</Name><Description>Platinum alloy coils (including coils enlaced with PGLA filaments and Nylon Fibers)  attached to a composite implant delivery pusher with a radiopaque positioning marker. The proximal end of the pusher is loaded into the Actuator which detaches the coil.</Description><Size>Diameter:  7 - 20mm; Length:  30 - 50cm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5473</SubGroupID><Suffix>P (Platinum), repositionable</Suffix><ARTGs><ARTG>205313</ARTG><ARTG>337400</ARTG></ARTGs><MinimumBenefit>1064</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI287</BillingCode><Name>Tri-Staple  2.0 Reinforced reloads</Name><Description>Tri-Staple  2.0 Reinforced reload preloaded with polyglycolic acid staple line reinforcement mesh and with intelligent chip that communicates with Signia  stapler.</Description><Size>45mm, 60mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4319</SubGroupID><Suffix>Integrated</Suffix><ARTGs><ARTG>350110</ARTG></ARTGs><MinimumBenefit>521</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI533</BillingCode><Name>Concerto 3D Detachable Coil System </Name><Description>Platinum alloy coils (including coils enlaced with PGLA filaments) attached to a composite implant delivery pusher with a radiopaque positioning marker. The proximal end of the pusher is loaded into the Actuator which detaches the coil.</Description><Size> Diameter: 7-18mm; Length: 30-40cm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5473</SubGroupID><Suffix>P (Platinum), repositionable</Suffix><ARTGs><ARTG>478805</ARTG></ARTGs><MinimumBenefit>1064</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA03</BillingCode><Name>Grafton Demineralized Bone Matrix: Orthoblend, 15cc</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229633</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1978</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>QQ320</BillingCode><Name>Grafton DBF</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>449685</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1539</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-08-08</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC015</BillingCode><Name>Freestyle bioprosthesis</Name><Description>Models 995xx, 995MSxx</Description><Size>19 - 35mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1501</GroupID><Suffix>p</Suffix><ARTGs><ARTG>145752</ARTG></ARTGs><MinimumBenefit>4845</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS226</BillingCode><Name>Symbotex Composite Mesh with pre placed suture</Name><Description>Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.)</Description><Size>Rectangular 42x32 cm, Rectangular 37x28 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5505</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>270737</ARTG></ARTGs><MinimumBenefit>2875</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS231</BillingCode><Name>Symbotex Composite Mesh</Name><Description>Non-absorbable three-dimensional polyester composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera.</Description><Size>Rectangular 42x32cm,
Rectangular 37x28cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5505</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>270735</ARTG></ARTGs><MinimumBenefit>2875</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC618</BillingCode><Name>Medishield Anti-Adhesion Gel</Name><Description>MediShield Anti-Adhesion Gel is an adhesion barrier gel for prevention of complications after spinal surgery.  MediShield is a co-polymer gel composed of carboxymethylcellulose and polyethylene oxide.</Description><Size>3cc Syringe</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1579</GroupID><SubGroupID>5433</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>137951</ARTG></ARTGs><MinimumBenefit>1173</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC596</BillingCode><Name>Mastergraft</Name><Description>Calcium Phosphate Ceramic Granules</Description><Size>15cc Vial</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4094</SubGroupID><ARTGs><ARTG>96971</ARTG></ARTGs><MinimumBenefit>1425</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC825</BillingCode><Name>Medtronic Percutaneous Quad extension</Name><Description>Percutaneous extension (in line connector for quadripolar leads only)</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4500</SubGroupID><ARTGs><ARTG>239412</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI529</BillingCode><Name>Connector Plug</Name><Description>The Model B31060 Connector Plug is a sterile device used to cover the unused socket of a dual channel neurostimulator for unilateral implants in which only one socket on the internal neurostimulator is used.</Description><Size>Overall length = 17.1 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4500</SubGroupID><ARTGs><ARTG>386869</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC687</BillingCode><Name>Neurostimulation System - Accessory Kits</Name><Description>Lead Accessory Plug and Closed Boot Kit Model 3550-29</Description><Size>.</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4500</SubGroupID><ARTGs><ARTG>121280</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI445</BillingCode><Name>Neurostimulation System - Extensions</Name><Description>1 x 8 Extension Kit Model 37081</Description><Size>20, 40 &amp; 60cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1680</GroupID><ARTGs><ARTG>239412</ARTG><ARTG>426912</ARTG></ARTGs><MinimumBenefit>1362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC447</BillingCode><Name>UCSS</Name><Description>Cortical Screws </Description><Size>30 - 50mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC819</BillingCode><Name>Pyramid +4</Name><Description>Anterior Plate</Description><Size>Height: 33mm - 45mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI187</BillingCode><Name>PIVOX Oblique Lateral Spinal System</Name><Description>Plate</Description><Size>Small, Large</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI171</BillingCode><Name>Divergence-L Anterior/Oblique Lumbar Fusion System </Name><Description>Lumbar Plates </Description><Size>10-20mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC610</BillingCode><Name>Vantage</Name><Description>Vantage plates and Screws; Thoracic Plate</Description><Size>3.5 - 8cm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI280</BillingCode><Name>Intellis Wireless External Neurostimulator</Name><Description>Wireless External Neurostimulator</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>5854</SubGroupID><ARTGs><ARTG>293256</ARTG></ARTGs><MinimumBenefit>1083</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC612</BillingCode><Name>Vantage</Name><Description>Vantage Plates and Screws; ATL Plate</Description><Size>4 - 10cm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4126</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>2039</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI076</BillingCode><Name>Middle Ear Prostheses</Name><Description>Partial Ossicular Reconstruction Implant - malleus + incus</Description><Size>0.6-2.5 x 2.2-8.8 x 3.5 -10mm</Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4156</SubGroupID><ARTGs><ARTG>125831</ARTG></ARTGs><MinimumBenefit>227</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI146</BillingCode><Name>Atlas Cable System</Name><Description>Single</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5367</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>470</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI170</BillingCode><Name>Divergence-L Anterior/Oblique Lumbar Fusion System </Name><Description>Self-drilling and Self-tapping Screws</Description><Size>20-40 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI153</BillingCode><Name>ZEVO Anterior Cervical Plate System</Name><Description>Dual thread, self-drilling/self-tapping screw</Description><Size>Diameter: 3.5mm - 4.5mm; Length 10mm - 24mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI483</BillingCode><PriorBillingCodes><PriorBillingCode>NK075</PriorBillingCode></PriorBillingCodes><Name>PASS Spinal System Screw</Name><Description>PASS Spinal System Closed Iliac Screw</Description><Size>all sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Closed</Suffix><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI188</BillingCode><Name>PIVOX Oblique Lateral Spinal System</Name><Description>Bone Screw</Description><Size>Length: 20-50mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC448</BillingCode><Name>UCSS</Name><Description>Cortical Lag Screws</Description><Size>36 - 50mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC767</BillingCode><Name>Stimloc</Name><Description>Burr Hole Cover</Description><Size>14mm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4478</SubGroupID><ARTGs><ARTG>151095</ARTG></ARTGs><MinimumBenefit>497</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI492</BillingCode><Name>SenSight™ Burr Hole Device Kit</Name><Description>Intended to cover a burr hole on the skull and anchor a directional lead.</Description><Size>various</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4478</SubGroupID><ARTGs><ARTG>387430</ARTG><ARTG>387431</ARTG></ARTGs><MinimumBenefit>497</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC872</BillingCode><Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name><Description>Titanium, Straight Plate</Description><Size>&lt; 4 holes</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4267</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>76</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC462</BillingCode><Name>Zephir</Name><Description>Cancellous Screw</Description><Size>13-17mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Closed</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>171</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC908</BillingCode><Name>Timesh</Name><Description>Rigid Straight Plates</Description><Size>&lt; 4 holes</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1589</GroupID><SubGroupID>4267</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>76</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC853</BillingCode><Name>Nanostim</Name><Description>Synthetic Bone Paste</Description><Size>1cc</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>158926</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC296</BillingCode><Name>Vertex Spinal System</Name><Description>Occipital Screws</Description><Size> 3.0 - 5.0 mm diameter, 4 - 30 mm length</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC854</BillingCode><Name>Nanostim</Name><Description>Synthetic Bone Paste</Description><Size>2cc</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>158926</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC026</BillingCode><Name>Medtronic Transvene SVC Lead Model 6937;</Name><Description>Model 6937-35, Model 6937-52, Model 6937-58, Model 6937-110; Silicone;</Description><Size>35 - 110cm x  660mm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1737</GroupID><ARTGs><ARTG>136182</ARTG></ARTGs><MinimumBenefit>1291</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC415</BillingCode><Name>BCP</Name><Description>Biphasic Calcium Phosphate Reabsorbable Graft Supplement</Description><Size>1-3cc</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>144137</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC594</BillingCode><Name>Mastergraft</Name><Description>Calcium Phosphate Ceramic Granules</Description><Size>5cc Vial</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>96971</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC855</BillingCode><Name>Nanostim</Name><Description>Synthetic Bone Paste</Description><Size>5cc</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4092</SubGroupID><ARTGs><ARTG>158926</ARTG></ARTGs><MinimumBenefit>722</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI125</BillingCode><Name>Open Pivot Heart Valve AP360 - Aortic</Name><Description>Supra-annular mechanical valve; Pyrolythic Carbon, Double Velour Polyester, Titanium</Description><Size>Aortic: 16, 18, 20, 22, 24, 26 and 28 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>178</SubCategoryID><GroupID>1497</GroupID><ARTGs><ARTG>219162</ARTG></ARTGs><MinimumBenefit>4962</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI124</BillingCode><Name>Open Pivot Heart Valve AP360 - Mitral</Name><Description>Supra-annular mechanical valve; Pyrolythic Carbon, Double Velour Polyester, Titanium</Description><Size>Mitral: 16, 18, 20, 22, 24, 26,  28 and 30 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>178</SubCategoryID><GroupID>1497</GroupID><ARTGs><ARTG>219161</ARTG></ARTGs><MinimumBenefit>4962</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC980</BillingCode><PriorBillingCodes><PriorBillingCode>AB002</PriorBillingCode></PriorBillingCodes><Name>Open Pivot Heart Valve (Model 500FA)
Open Pivot Heart Valve (Model 500DM)</Name><Description>Pyrolythic Carbon, Double Velour Polyester, Titanium</Description><Size>16-33mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>178</SubCategoryID><GroupID>1497</GroupID><ARTGs><ARTG>127419</ARTG><ARTG>127478</ARTG></ARTGs><MinimumBenefit>4962</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS197</BillingCode><PriorBillingCodes><PriorBillingCode>EE028</PriorBillingCode></PriorBillingCodes><Name>LRS Actuator</Name><Description>LRS Actuator is a sterile, hand held mechanical unit with a thumb slide that detaches the coil. When the slider is retracted while the pusher is loaded, it releases the coil into the targeted vaculature. Coils cannot be deployed without the use of the actuator.</Description><Size>Length 5.75", Diameter 1", Weight 28 grams</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1689</GroupID><SubGroupID>4495</SubGroupID><ARTGs><ARTG>150013</ARTG></ARTGs><MinimumBenefit>211</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI285</BillingCode><Name>VenaSeal™ Closure System</Name><Description>A system including the cyanoacrylate liquid embolic material and accessories (delivery catheter, dispensing gun, adhesive (bottle), syringe, dispenser tip, introducer, dilator, straight tip guide)</Description><Size>One system</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1692</GroupID><SubGroupID>7041</SubGroupID><ARTGs><ARTG>421297</ARTG></ARTGs><MinimumBenefit>713</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI367</BillingCode><Name>Medtronic Activa Patient Programming System</Name><Description>Medtronic Activa Patient Programming System</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4474</SubGroupID><ARTGs><ARTG>339925</ARTG></ARTGs><MinimumBenefit>1264</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC027</BillingCode><Name>Model 6721 Unipolar Epicardial Patch Leads S/M/L</Name><Description>Model 6721S-50, Model 6721M-50, Model 6721L-50; Silicone</Description><Size>370, 660, 840mm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1745</GroupID><ARTGs><ARTG>136183</ARTG></ARTGs><MinimumBenefit>611</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI400</BillingCode><Name>Medtronic Percept Patient Programmer</Name><Description>Patient Programmer Model TH91D for Percept Neurostimulators</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4474</SubGroupID><ARTGs><ARTG>351590</ARTG></ARTGs><MinimumBenefit>1264</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC837</BillingCode><Name>Medtronic Activa Patient Programmer</Name><Description>Medtronic Activa Patient Programmer (Model 37642)</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4474</SubGroupID><ARTGs><ARTG>160115</ARTG></ARTGs><MinimumBenefit>1264</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI140</BillingCode><Name>Revision kit Surescan MRI leads</Name><Description>Sterile Revision Kit for Surescan MRI leads</Description><Size>60cm, 75cm, 90cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1690</GroupID><SubGroupID>4499</SubGroupID><ARTGs><ARTG>240576</ARTG></ARTGs><MinimumBenefit>492</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC530</BillingCode><Name>Hydrocephalus Shunt</Name><Description>Ventricular/Atrial, CSF Flow Control Shunts, Cont Small Valve</Description><Size>38cm-90cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Reservoir/Priming function</Suffix><ARTGs><ARTG>129681</ARTG></ARTGs><MinimumBenefit>898</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC649</BillingCode><Name>Delta Shunt Unitised</Name><Description>Delta valve is a fixed pressure CSF valve, available in four performance levels. Delta Unitised shunt includes a delta valve, pre-attached ventricular catheter, and a pre-attached peritoneal catheter. Right Angle Clip. Disposable Quick Release Ventricular</Description><Size>Delta Unitised Shunt small (Distal 65cm-90cm, ventricular 11cm) - 0.5, 1.0, 1.5 and 2.0. Delta Unitised Shunt regular (Distal 90cm, ventricular catheter 13cm) - 0.5, 1.0, 1.5 and 2.0</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>139696</ARTG></ARTGs><MinimumBenefit>1697</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI428</BillingCode><Name>RF Marinr</Name><Description>The Medtronic RF Marinr catheters are steerable, flexible, radiopaque ablation catheters, designed for intracardiac radiofrequency ablation. The catheters have  intracardiac recording and stimulation capabilities. </Description><Size>5Fr, 7Fr</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7372</SubGroupID><ARTGs><ARTG>202411</ARTG><ARTG>202423</ARTG></ARTGs><MinimumBenefit>900</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC647</BillingCode><Name>Delta Valve with Bioglide PSM range</Name><Description>CSF Flow Valve. Polypropylene and acetal plastic base. Silicone elastomer dome. Surface of valve bonded with hydrogel (Bioglide surface modification).</Description><Size>36-40mm x 9-20mm (0.5-2.0)</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Antisyphon function, Coating, Reservoir/Priming function</Suffix><ARTGs><ARTG>129681</ARTG></ARTGs><MinimumBenefit>1268</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC532</BillingCode><Name>Hydrocephalus Shunt</Name><Description>With Hydrostatic Valve, Delta Valves/Shunts/BioGlide, Vent Catheters</Description><Size>12mm-90cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Antisyphon function, Reservoir/Priming function</Suffix><ARTGs><ARTG>129681</ARTG></ARTGs><MinimumBenefit>1399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC650</BillingCode><Name>Delta Shunt Assembly</Name><Description>Delta valve is a fixed CSF pressure valve, available in four performance levels. Includes an Integral (distal) Peritoneal Catheter, Disposable Peritoneal Catheter Passer, Female Luer Adapter and Prefill Tubing.</Description><Size>90-120cm (0.5 - 2.0)</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Antisyphon function, Distal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>134740</ARTG></ARTGs><MinimumBenefit>1563</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC651</BillingCode><Name>Delta Valve Assembly with Bioglide PSM range</Name><Description>CSF Flow Valves. Polypropylene and acetal plastic base. Silicone elastomer dome. Assembly system includes the valve, integral peritoneal catheter, female luer adapter and prefill tubing. Surface of the valve bonded with hydrogel (Bioglide surface modifica</Description><Size>90-120cm (0.5, 1.0, 1.5, 2.0)</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Antisyphon function, Coating, Distal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>134740</ARTG></ARTGs><MinimumBenefit>1409</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS196</BillingCode><PriorBillingCodes><PriorBillingCode>EE026</PriorBillingCode></PriorBillingCodes><Name>Solitaire</Name><Description>Solitaire Neurovascular Remodelling Device is a self-expanding, fully retrievable device which can be delivered and deployed by a single operator.</Description><Size>Diameter: 3-6mm
Length: 15-40mm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1687</GroupID><ARTGs><ARTG>155038</ARTG></ARTGs><MinimumBenefit>6769</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC614</BillingCode><Name>Vantage</Name><Description>Vantage Plates and Screws; Staple (rostral/caudal)</Description><Size>One Size Only</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC437</BillingCode><Name>CD-Horizon</Name><Description>Staples</Description><Size>10 - 30mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1483</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>380</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC310</BillingCode><Name>Centerpiece</Name><Description>TiMesh LP</Description><Size>Screw</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC656</BillingCode><Name>Pyramid</Name><Description>Pyramid Bone Screws</Description><Size>6.5mm Diameter, 20 -60mm length in 5mm increments</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI057</BillingCode><Name>Atlantis Anterior Cervical Plate System - Bone Screw</Name><Description>Screws - Self-Tapping / Self-Drilling and Fixed / Variable Angle</Description><Size>Diameter: 4.0mm - 4.5mm; Length 11mm - 17mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI477</BillingCode><PriorBillingCodes><PriorBillingCode>NK092</PriorBillingCode></PriorBillingCodes><Name>Occipital Plate Screws</Name><Description>Occipital Plate Screws</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC613</BillingCode><Name>Vantage</Name><Description>Vantage Plates and Screws; ATL Screw</Description><Size>6.5 x 30-55mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC611</BillingCode><Name>Vantage</Name><Description>Vantage Plates and Screws; Thoracic Screw</Description><Size>5.5-10.5 x 15-100mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI462</BillingCode><PriorBillingCodes><PriorBillingCode>NK074</PriorBillingCode></PriorBillingCodes><Name>PASS LP System Screws</Name><Description>Sacral Screws, Iliosacral Screws</Description><Size>Diameter: 6.5mm - 8MM Length: 25mm - 95mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>295277</ARTG><ARTG>316001</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI143</BillingCode><Name>Mastergraft</Name><Description>Mastergraft Putty</Description><Size>&gt;5cc-10cc</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4115</SubGroupID><ARTGs><ARTG>215319</ARTG></ARTGs><MinimumBenefit>1889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC663</BillingCode><Name>Mastergraft</Name><Description>Matrix</Description><Size>10cc</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4115</SubGroupID><ARTGs><ARTG>283420</ARTG></ARTGs><MinimumBenefit>1889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC988</BillingCode><Name>Sovereign Spinal System - Screws</Name><Description>Sovereign Spinal System - Screws</Description><Size>20 - 35mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI268</BillingCode><Name>Infinity Spinal System</Name><Description>Occipital Plate</Description><Size>Small, standard</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI321</BillingCode><PriorBillingCodes><PriorBillingCode>ER487</PriorBillingCode></PriorBillingCodes><Name>Titan Spine Bone Screws</Name><Description>Titan Spine Bone Screws-Endoskeleton TCS/TAS, standard</Description><Size>dia (3.5-6.5mm) x length (13-35mm)</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>334300</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC293</BillingCode><Name>Vertex Spinal System</Name><Description>Occipital Plate</Description><Size>24 - 40 mm length</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI476</BillingCode><PriorBillingCodes><PriorBillingCode>NK091</PriorBillingCode></PriorBillingCodes><Name>Occipital plates</Name><Description>Occipital plates</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4129</SubGroupID><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>1728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI227</BillingCode><Name>Signia™ Powered Intelligent Stapling System</Name><Description>Powered, articulating, endoscopic intelligent stapler with Adaptive Firing and real time technology</Description><Size>30mm, 45mm, 60mm lengths</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating, Powered</Suffix><ARTGs><ARTG>287262</ARTG><ARTG>287417</ARTG><ARTG>287923</ARTG></ARTGs><MinimumBenefit>447</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI539</BillingCode><Name>Tri-Staple Series EEA OrVil for use with Circular Stapler</Name><Description>Transoral anvil. Device is used with the EEA Circular Stapler with Tri-Staple Technology (listed and reimbursed under a separate billing code).</Description><Size>21mm, 25mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>293808</ARTG></ARTGs><MinimumBenefit>357</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS134</BillingCode><Name>DST Series EEA Or Vil</Name><Description>Accessory</Description><Size>21mm, 25mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>178497</ARTG></ARTGs><MinimumBenefit>357</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS046</BillingCode><Name>Endo GIA Stapling System</Name><Description>Endoscopic/thoroscopic</Description><Size>12mm; One size only.</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4318</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>346475</ARTG></ARTGs><MinimumBenefit>357</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI306</BillingCode><Name>CryoFlex™ Surgical Clamp and Probe</Name><Description>The CryoFlex™ Surgical Clamp and Probe combines the utility of the CryoFlex™ Probe with the delivery of a clamp.</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2949</GroupID><SubGroupID>7359</SubGroupID><Suffix>Medtronic</Suffix><ARTGs><ARTG>158929</ARTG></ARTGs><MinimumBenefit>5095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI022</BillingCode><PriorBillingCodes><PriorBillingCode>MC533</PriorBillingCode></PriorBillingCodes><Name>Shunt Component Connector</Name><Description>Connectors, fixation tabs</Description><Size>Various</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1671</GroupID><SubGroupID>4470</SubGroupID><ARTGs><ARTG>128403</ARTG><ARTG>128523</ARTG><ARTG>134760</ARTG><ARTG>95539</ARTG></ARTGs><MinimumBenefit>34</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI176</BillingCode><PriorBillingCodes><PriorBillingCode>MI155</PriorBillingCode></PriorBillingCodes><Name>Divergence Anterior Cervical Fusion Mini-Plate System</Name><Description>Divergence Miniplate Screw - Dual thread self drilling/self tapping screw</Description><Size>4.0mm x 9-24mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC662</BillingCode><Name>Mastergraft</Name><Description>Matrix</Description><Size>20cc</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4116</SubGroupID><ARTGs><ARTG>283420</ARTG></ARTGs><MinimumBenefit>2143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI144</BillingCode><Name>Mastergraft</Name><Description>Mastergraft Strip</Description><Size>&gt;10cc-20cc</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4116</SubGroupID><ARTGs><ARTG>215317</ARTG></ARTGs><MinimumBenefit>2143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI498</BillingCode><Name>ZEVO Anterior Cervical Plate System</Name><Description>self-drilling/self-tapping screw</Description><Size>Diameter: 4.5mm; Length 13mm - 15mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI177</BillingCode><PriorBillingCodes><PriorBillingCode>MI155</PriorBillingCode></PriorBillingCodes><Name>Divergence Anterior Cervical Fusion Mini-Plate System</Name><Description>Divergence Miniplate Screw - Dual thread self drilling/self tapping screw</Description><Size>3.5mm x 9-24mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI515</BillingCode><Name>Anteralign - Bone Screws</Name><Description>Titanium bone screw to be used with the Anteralign TL cage and Anteralign Mini-Plate</Description><Size>Length: 20 mm - 50 mm; Diameter: 5 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>422154</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI481</BillingCode><PriorBillingCodes><PriorBillingCode>NK151</PriorBillingCode></PriorBillingCodes><Name>Fusion Cage Screws</Name><Description>Fusion Cage Screws</Description><Size>Multiple sizes to suit patient anatomy</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>295284</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI136</BillingCode><Name>Vectris Surescan MRI Neurostimulation Leads</Name><Description>Octad Compact Lead Kit Model 977A2, Subcompact lead Kit Model 977A1</Description><Size>60cm, 75cm, 90cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1679</GroupID><SubGroupID>4486</SubGroupID><Suffix>8 electrodes</Suffix><ARTGs><ARTG>214838</ARTG><ARTG>214839</ARTG></ARTGs><MinimumBenefit>3817</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI178</BillingCode><PriorBillingCodes><PriorBillingCode>MI163</PriorBillingCode></PriorBillingCodes><Name>Divergence Anterior Cervical Fusion Standalone System</Name><Description>Divergence anterior cervical fusion system Standalone screw</Description><Size>4.0mm x 9 -17mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI501</BillingCode><Name>Centerpiece 2.0 – Bone Screw</Name><Description>Bone screws</Description><Size>Diameter (2.0mm-2.4mm); Length (3mm-9mm)  </Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI175</BillingCode><Name>Venture Screws</Name><Description>Self drilling and self tapping screws (fixed and variable angle)</Description><Size>4.0mm x 8mm - 21mm; 4.5mm x 8mm - 21mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC734</BillingCode><Name>Quadripolar Stretch-Coil Extensions</Name><Description>Model 37082 Bifurcated, Silver and Silicone Rubber</Description><Size>20cm - 60cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1680</GroupID><ARTGs><ARTG>239412</ARTG></ARTGs><MinimumBenefit>1362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI179</BillingCode><PriorBillingCodes><PriorBillingCode>MI163</PriorBillingCode></PriorBillingCodes><Name>Divergence Anterior Cervical Fusion Standalone System</Name><Description>Divergence anterior cervical fusion system Standalone screw</Description><Size>3.5mm x 9 -17mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Dual Thread</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>401</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI488</BillingCode><Name>SenSight™ Directional Lead Kit</Name><Description>Deep brain stimulation lead with 8 proximal and distal contact electrodes. Distal orientation marker determines positioning of the electrodes under certain imaging modalities.</Description><Size>33cm and 42cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1674</GroupID><SubGroupID>4476</SubGroupID><Suffix>Current steering</Suffix><ARTGs><ARTG>387432</ARTG></ARTGs><MinimumBenefit>4120</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI261</BillingCode><Name>Infinity Spinal System</Name><Description>Occipital Screws</Description><Size>Diameter 4.5 - 5.0mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>186</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI320</BillingCode><PriorBillingCodes><PriorBillingCode>ER488</PriorBillingCode></PriorBillingCodes><Name>Titan Spine Bone Screws-locking</Name><Description>Titan Spine Endoskeleton TCS Bone Screws-locking</Description><Size>dia (3.5-3.8mm) x length (13-20mm)</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1464</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>334300</ARTG></ARTGs><MinimumBenefit>241</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI074</BillingCode><Name>Sacral Nerve Stimulation Lead</Name><Description>4 Electrode tined lead (Non-MRI and MRI Leads)</Description><Size>28 - 41cm</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1714</GroupID><SubGroupID>5339</SubGroupID><Suffix>tined</Suffix><ARTGs><ARTG>355030</ARTG><ARTG>355041</ARTG></ARTGs><MinimumBenefit>4199</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI399</BillingCode><Name>Freezor Cardiac Cryoablation Catheters</Name><Description>Freezor, Freezor Xtra, Freezor Max: Focal Cryoablation Catheters</Description><Size>7Fr, 9Fr</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2947</GroupID><SubGroupID>7352</SubGroupID><Suffix>Medtronic</Suffix><ARTGs><ARTG>412450</ARTG></ARTGs><MinimumBenefit>3550</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI301</BillingCode><Name>Arctic Front Advance Cardiac CryoAblation Catheter / Pro</Name><Description>A flexible, over-the-wire balloon catheter used to ablate cardiac tissue</Description><Size>23mm, 28mm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2947</GroupID><SubGroupID>7352</SubGroupID><ARTGs><ARTG>306567</ARTG><ARTG>396019</ARTG></ARTGs><MinimumBenefit>5100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC733</BillingCode><Name>Quadripolar Stretch-Coil Extensions</Name><Description>Model 37083 Single, Silver and Silicone Rubber</Description><Size>20cm - 60cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1680</GroupID><ARTGs><ARTG>239412</ARTG></ARTGs><MinimumBenefit>1362</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS184</BillingCode><Name>Permacol  Biological Implant</Name><Description>Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen.</Description><Size>18 x 28cm and 20 x 30cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5493</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>269662</ARTG></ARTGs><MinimumBenefit>3114</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC456</BillingCode><Name>Interfix </Name><Description>Titanium Cage</Description><Size>12 x 20mm - 24 x 50mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC577</BillingCode><Name>R90 Spacer</Name><Description>Spinal Implant (Peek)</Description><Size>Height 7 - 16mm
Lordosis 6 - 18 degrees</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC685</BillingCode><Name>Verte-Stack Crescent</Name><Description>PEEK</Description><Size>Height 6 - 18mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI085</BillingCode><Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name><Description>FlexMesh 1.0 - 2.2mm system. Composition : Titanium</Description><Size>51 to 100cm² area, 0.6mm thickness</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4209</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>1146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC976</BillingCode><Name>Capstone Cage</Name><Description>PLIF Vertebral Body Spacer</Description><Size>Length: 22mm - 26mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC877</BillingCode><Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name><Description>Titanium, Mesh</Description><Size>51 to 100 cm2 area, 0.6mm thickness</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4209</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>1146</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA01</BillingCode><Name>Grafton Plus Demineralized Bone Matrix: Paste, 10cc</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229635</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1539</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI284</BillingCode><Name>ARTiC Spinal System</Name><Description>Titanium Fusion Cage</Description><Size>Height: 8-15mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI329</BillingCode><Name>Elevate Spinal System</Name><Description>Expandable Lumbar Fusion Device - Paired</Description><Size>Height: 7-16mm  Width: 10mm  Length: 23mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC975</BillingCode><Name>Capstone Cage</Name><Description>DLIF Vertebral Body Spacer</Description><Size>Length: 40mm - 60mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA02</BillingCode><Name>Grafton Plus Demineralized Bone Matrix: Paste, 1-5cc</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229635</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>581</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC457</BillingCode><Name>LordoTec Cage (LT-Cage)</Name><Description>Titanium,  PEEK</Description><Size>18-28mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ754</BillingCode><Name>Catalyft PL Expandable Interbody Cage</Name><Description>PL and PL40 expandable titanium alloy interbody devices - paired</Description><Size>Length: 23.3 - 25.6mm  Width: 10-14mm  Height:7-11mm  Lordosis: 0-22 Degrees</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI508</BillingCode><Name>Fuse Spinal System - Cage</Name><Description>PLIF or TILF Vertebral Body Spacer</Description><Size>length (24.5mm), height (7-14mm), width (7-9.5mm) and lordosis (0-8ᵒ) </Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI331</BillingCode><Name>Elevate Expandable Interbody Device</Name><Description>Expandable Interbody Device - Single</Description><Size>Height: 7-16mm  Width: 10mm  Length: 28-32mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI172</BillingCode><Name>Divergence-L Anterior/Oblique Lumbar Fusion System </Name><Description>Interbody cage</Description><Size>10-20mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS214</BillingCode><Name>PROGRIP™ Laparoscopic Self-Fixating Composite Mesh</Name><Description>Laparoscopic self-fixating composite mesh (knitted monofilament polyester with monofilament polylactic acid resorbable grips on one side and a resorbable film made of collagen from porcine origin and glycerol, on the other side)</Description><Size>10 cm x 15 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>252653</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC668</BillingCode><Name>CD HORIZON Spinal System - Lateral Connector</Name><Description>Lateral Connector</Description><Size>10mm - 100mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS161</BillingCode><Name>Parietene ProGrip Mesh (PRE-SHAPED)</Name><Description>Pre-Cut, slit mesh with self gripping overlapping flap - right or left</Description><Size>12 x 8cm elliptic</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>149430</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS162</BillingCode><Name>Parietene ProGrip Mesh (FLAT)</Name><Description>Mesh with self gripping FLAT</Description><Size>15 x 9cm RECTANGLE</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>149430</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS219</BillingCode><Name>PROGRIP™ Laparoscopic Self-Fixating Composite Mesh</Name><Description>Laparoscopic self-fixating composite right or left or bilateral anatomical mesh (knitted monofilament polyester with monofilament polylactic acid resorbable grips on one side and a resorbable film made of collagen from porcine origin and glycerol, on the other side)</Description><Size>10x15 cm  Rectangular Bilateral Anatomical,  10x15 cm  Rectangular Right Anatomical, 10x15 cm  Left Anatomical,  13x09 cm  Right Anatomical, 
13x09 cm  Left Anatomical</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>252653</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS211</BillingCode><Name>Parietex Composite Ventral Patch</Name><Description>Parietex Composite ventral patch is used for the reinforcement of soft tissues during surgical repair. It is indicated for the treatment of ventral defects (primary and incisional hernias).</Description><Size>4.6cm, 6.6cm, 8.6cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>258212</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS224</BillingCode><Name>PROGRIP™ Laparoscopic Self-Fixating Composite Mesh</Name><Description>Laparoscopic self-fixating composite right or left anatomical mesh (knitted monofilament polyester with monofilament polylactic acid resorbable grips on one side and a resorbable film made of collagen from porcine origin and glycerol, on the other side)</Description><Size>16 x 12 cm right anatomical, 
16 x 12 cm left anatomical</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>252653</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS217</BillingCode><Name>Symbotex Composite Mesh with pre placed suture</Name><Description>Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.)</Description><Size>Rectangular 15x10 cm
Round 15 cm, 12 cm
Elliptical 17x10
Round 9cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>270737</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS235</BillingCode><Name>Symbotex Composite Mesh</Name><Description>Non-absorbable three-dimensional polyester composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera.</Description><Size>Round 15 cm, 12 cm, 9 cm
Elliptical 17x10 cm
Rectangular 15x10 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>270735</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS241</BillingCode><Name>Symbotex Skirted Composite Mesh</Name><Description>Non-absorbable three-dimensional polyester skirted composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera. A flap attached to the reinforcement helps place and fix the mesh.</Description><Size>8 cm Round, 15x10 cm Rectangle</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>270736</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS236</BillingCode><Name>Parietex Progrip Composite Mesh</Name><Description>Monofilament polyester with polylactic acid monofilament resorbable pins on one of the sides</Description><Size>15x9 rectangular</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>157201</ARTG></ARTGs><MinimumBenefit>352</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS220</BillingCode><Name>Parietex Progrip Composite Mesh</Name><Description>Pre-Cut, slit mesh with self gripping overlapping flap - right or left knitted (monofilament polyester with polylactic acid monofilament resorbable pins on one of the sides)</Description><Size>Elliptic slit 12x8cm left side, elliptic slit 12x8cm right side, elliptic slit 14x9 left side, elliptic slit right side 14x9cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5438</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>157201</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>QQ321</BillingCode><Name>Grafton DBF</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>449685</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>581</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-08-08</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>QQ323</BillingCode><Name>Grafton DBF Inject</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>449685</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1539</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-08-08</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI127</BillingCode><Name>Medtronic Cables</Name><Description>Stimulation Cables for Intraoperative testing</Description><Size>Various</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1715</GroupID><SubGroupID>5517</SubGroupID><ARTGs><ARTG>355030</ARTG><ARTG>355041</ARTG></ARTGs><MinimumBenefit>190</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS183</BillingCode><Name>Permacol  Biological Implant</Name><Description>Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen.</Description><Size>15 x 20cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5492</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>269662</ARTG></ARTGs><MinimumBenefit>1341</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC676</BillingCode><Name>SiLo</Name><Description>Lateral Connector</Description><Size>10-40mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI148</BillingCode><Name>Atlas Cable System</Name><Description>Crimp</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5371</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA10</BillingCode><Name>Grafton Demineralized Bone Matrix: Matrix Strips, 1cm x 20cm x 0.8cm (2)</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229636</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1978</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI265</BillingCode><Name>Infinity Spinal System</Name><Description>Offset connector: Offset Domino, Lateral, Multi Axial Screw Extension</Description><Size>Enables connection from 3.2 - 6.35mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS189</BillingCode><PriorBillingCodes><PriorBillingCode>EE006</PriorBillingCode><PriorBillingCode>EC031</PriorBillingCode><PriorBillingCode>EE005</PriorBillingCode><PriorBillingCode>EE015</PriorBillingCode><PriorBillingCode>EE016</PriorBillingCode></PriorBillingCodes><Name>Protege RX Self-expanding Carotid Stent</Name><Description>Protege RX Carotid Stent with delivery system.</Description><Size>Diameter 6-10mm, Length 20-60mm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>443617</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI518</BillingCode><Name>ModuLeX 5.5. Spinal System - Connector  </Name><Description>Connector</Description><Size>Diameter: 4.5-6mm </Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>422155</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI414</BillingCode><Name>Abre venous stent system</Name><Description>The Abre stent system consists of a stent and stent delivery system designed specifically for implantation in the peripheral venous system. The system consists of a flexible self expanding stent made of a nickel-titanium alloy (nitinol) provided in multiple lengths and diameters and an over-the wire stent delivery system.</Description><Size>Length: 40mm-120mm.  Diameter: 10mm-20mm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>448908</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA11</BillingCode><Name>Grafton Demineralized Bone Matrix: Matrix Strips, 1cm x 10cm x 0.8cm (2)</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229636</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1539</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI469</BillingCode><PriorBillingCodes><PriorBillingCode>NK084</PriorBillingCode></PriorBillingCodes><Name>Offset Connector</Name><Description>Offset Connector</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1473</GroupID><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>705</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI530</BillingCode><Name>EverFlex Peripheral Stent</Name><Description>EverFlex is a self expanding Nitinol stent premounted on an OTW delivery system.</Description><Size>Diameter 5-8, Length 20-120mm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>452685</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS194</BillingCode><PriorBillingCodes><PriorBillingCode>EE024</PriorBillingCode></PriorBillingCodes><Name>EverFlex Peripheral Stent</Name><Description>EverFlex is a self expanding Nitinol stent premounted on an OTW delivery system.</Description><Size>Diameter 5-8, Length 20-120mm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4440</SubGroupID><ARTGs><ARTG>215979</ARTG></ARTGs><MinimumBenefit>1201</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS223</BillingCode><Name>Symbotex Skirted Composite Mesh</Name><Description>Non-absorbable three-dimensional polyester skirted composite mesh. On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera. A flap attached to the reinforcement helps place and fix the mesh.</Description><Size>30x20 cm Rectangle
25x20 cm Rectangle</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5440</SubGroupID><Suffix>Coated, Contoured</Suffix><ARTGs><ARTG>270736</ARTG></ARTGs><MinimumBenefit>966</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC531</BillingCode><Name>Hydrocephalus Shunt</Name><Description>Ventricular/Peritoneal. CSF Flow Control Valves, BioGlide Contoured, Ventriculostomy Kit-E, Neonatal Delta Snap Shunt</Description><Size>12mm-90cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4469</SubGroupID><Suffix>Distal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>129681</ARTG></ARTGs><MinimumBenefit>1286</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI526</BillingCode><Name>Medtronic Activa SC Neurostimulator for Deep Brain Stimulation</Name><Description>Single channel neurostimulator for Deep Brain stimulation</Description><Size>Height: 55mm  Length: 60mm  Thickness: 11mm  Weight: 45g</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1672</GroupID><SubGroupID>4472</SubGroupID><ARTGs><ARTG>392210</ARTG></ARTGs><MinimumBenefit>8168</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI401</BillingCode><Name>Medtronic Percept PC Neurostimulator for Deep Brain Stimulation</Name><Description>Percept PC Dual channel primary cell neuro stimulator for Deep Brain Stimulation with Brain Sensing Technology</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1672</GroupID><SubGroupID>4472</SubGroupID><Suffix>Dual Channel</Suffix><ARTGs><ARTG>392263</ARTG></ARTGs><MinimumBenefit>13592</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI528</BillingCode><Name>InterStim MRI rechargeable neurostimulator – Recharger Kit (includes Recharger Dock)</Name><Description>Recharger kit (includes Recharger Dock)</Description><Size>One Size</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1713</GroupID><SubGroupID>7367</SubGroupID><ARTGs><ARTG>454447</ARTG></ARTGs><MinimumBenefit>1215</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI060</BillingCode><Name>Endurant II AAA Abdominal Tube</Name><Description>Endurant II Endoluminal Stent Graft System - Abdominal Tube</Description><Size>Proximal diameter: 23 to 36mm; Distal diameter: 23 to 36mm; Covered length: 70mm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1626</GroupID><ARTGs><ARTG>202471</ARTG></ARTGs><MinimumBenefit>4378</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC820</BillingCode><Name>T2</Name><Description>Expandable vertebral body replacement cage</Description><Size>Diameters: 13 - 31mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI298</BillingCode><Name>T2 Stratosphere Expandable Corpectomy System</Name><Description>Centrepiece</Description><Size>13-25mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4137</SubGroupID><Suffix>ThoracoLumbar</Suffix><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>3920</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC625</BillingCode><Name>Modified Dual TiMesh</Name><Description>TiMesh Surgical Mesh Modified, includes two cranial plates. Composition: Titanium</Description><Size>121mm x 77mm - 152mm x 152mm.</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1593</GroupID><SubGroupID>4343</SubGroupID><Suffix>Biomodelled, Dual Mesh</Suffix><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>10237</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC264</BillingCode><Name>Septal Button </Name><Description>Silicone</Description><Size>3cm </Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>197</SubCategoryID><GroupID>1568</GroupID><ARTGs><ARTG>169825</ARTG></ARTGs><MinimumBenefit>135</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ244</BillingCode><Name>Cardioblate BP2/PEN FT System</Name><Description>The Cardioblate BP2/PEN FT System includes both the FT-10 energy platform compatible Cardioblate BP2 surgical ablation device and Cardioblate PEN FT. This system features dual electrodes for the delivery of saline irrigated RF energy</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2948</GroupID><SubGroupID>7356</SubGroupID><Suffix>Medtronic - Cardioblate BP2</Suffix><ARTGs><ARTG>377936</ARTG></ARTGs><MinimumBenefit>4614</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI312</BillingCode><Name>Cardioblate® BP2 RF Surgical Ablation System</Name><Description>The Cardioblate® BP2 RF Surgical Ablation system features dual electrodes for the delivery of irrigated RF energy.  iRF technology combines saline to facilitate treatment</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2948</GroupID><SubGroupID>7356</SubGroupID><Suffix>Medtronic - Cardioblate BP2</Suffix><ARTGs><ARTG>146949</ARTG></ARTGs><MinimumBenefit>4614</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI310</BillingCode><Name>Cardioblate® Gemini® Surgical Ablation System</Name><Description>The Cardioblate® Gemini® Surgical Ablation System is designed for minimally invasive ablation procedures. Gemini-s combines the efficacy of irrigated RF energy through a bipolar jaw, to facilitate deeper energy penetration, with real time measured customised energy delivery for greater confidence in achieving transmural cardiac lesions.</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2948</GroupID><SubGroupID>7356</SubGroupID><Suffix>Medtronic - Cardioblate Gemini</Suffix><ARTGs><ARTG>153878</ARTG></ARTGs><MinimumBenefit>6040</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ245</BillingCode><Name>Cardioblate Gemini-S FT Clamp</Name><Description>Valleylab FT10 FT series energy platform compatible bipolar RF ablation catheter with saline irrigation designed for minimally invasive ablation procedures</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2948</GroupID><SubGroupID>7356</SubGroupID><Suffix>Medtronic - Cardioblate Gemini</Suffix><ARTGs><ARTG>377933</ARTG></ARTGs><MinimumBenefit>6040</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI185</BillingCode><Name>MVP Microvascular Plug System</Name><Description>MVP Microvascular Plug can be delivered through a microcatheter to enable rapid occlusion.</Description><Size>Unconstrained device diameter (mm): 5.3, 6.5, 9.2, &amp; 13.0</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1648</GroupID><Suffix>Microcatheter</Suffix><ARTGs><ARTG>332241</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC775</BillingCode><Name>Interstim Lead Introducer Kit</Name><Description>Lead Introducer Kit for Sacral Nerve Stimulation</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1715</GroupID><SubGroupID>5342</SubGroupID><ARTGs><ARTG>355030</ARTG><ARTG>355041</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ144</BillingCode><Name>Aurora EV-ICD MRI SureScan System </Name><Description>The Aurora EV-ICD System comprises the Aurora EV-ICD MRI SureScan Model DVEA3E4 single chamber, implantable cardioverter defibrillator (and torque wrench) and the Epsila EV MRI SureScan Model EV2401 extravascular lead .</Description><Size>Generator: 33cm3 77g , Leads: lengths 52 cm and 63 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>20000</GroupID><ARTGs><ARTG>450443</ARTG><ARTG>450444</ARTG></ARTGs><MinimumBenefit>28398</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI387</BillingCode><Name>InterStim - Revision Kit</Name><Description>Revision kit includes tunneling tool, torque wrench, test stimulation cable, directional guide, lead introducer, dilator and set screws</Description><Size>One size</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1715</GroupID><SubGroupID>5342</SubGroupID><ARTGs><ARTG>240576</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI444</BillingCode><Name>InterStim neurostimulator- Extension Lead</Name><Description>Sacral Nerve Stimulation Extension Lead</Description><Size>One size</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1715</GroupID><SubGroupID>5342</SubGroupID><ARTGs><ARTG>239412</ARTG></ARTGs><MinimumBenefit>514</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI332</BillingCode><Name>Cornerstone Cage Ti-Coated</Name><Description>Cervical interbody cage with titanium coating</Description><Size>14-18mm x Depth: 11-16mm x Height: 4-9mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI328</BillingCode><PriorBillingCodes><PriorBillingCode>ER461</PriorBillingCode><PriorBillingCode>OH493</PriorBillingCode></PriorBillingCodes><Name>Endoskeleton TC</Name><Description>Titanium coated anterior interbody fusion device for the cervical spine, sterile, nanoLock (TM) surface technology</Description><Size>Anterior Height: 5mm - 12mm; Small to Large</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC413</BillingCode><Name>Cornerstone Cage</Name><Description>Sterile and Non-sterile</Description><Size>4 - 14mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS188</BillingCode><PriorBillingCodes><PriorBillingCode>AS185</PriorBillingCode></PriorBillingCodes><Name>Permacol  Biological Implant</Name><Description>Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen.</Description><Size>20 x 50cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5495</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>269662</ARTG></ARTGs><MinimumBenefit>4964</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ313</BillingCode><Name>Anatomic Peek Fusion Cage</Name><Description>Fusion device for stabilization use and to promote bone fusion during the normal healing process following surgical correction of disorders of the spine
</Description><Size>Height: 5 - 14mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>422152</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-08-08</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI147</BillingCode><Name>Atlas Cable System</Name><Description>Double w/2 crimps</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5368</SubGroupID><ARTGs><ARTG>264077</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ153</BillingCode><Name>Cornerstone PSR – Fusion Cage</Name><Description>PEEK cervical fusion cage</Description><Size>Height: 4-13mm Width: 11-14mm Length: 11-14mm Lordosis 4 degrees</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>437270</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA06</BillingCode><Name>Grafton Demineralized Bone Matrix: Orthoblend, 10cc</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229633</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1539</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI156</BillingCode><Name>Divergence Anterior Cervical Fusion Mini-plate System</Name><Description>Divergence Anterior cervical fusion Mini-plate cage</Description><Size>Height 5-11mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4134</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2188</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI075</BillingCode><Name>Middle Ear Prostheses</Name><Description>Total Ossicular Reconstruction Implants</Description><Size>0.6-0.8mm x 3.0-4.0mm x 7.0-8.0mm</Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4157</SubGroupID><ARTGs><ARTG>125831</ARTG></ARTGs><MinimumBenefit>343</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI061</BillingCode><Name>Endurant II AAA Aortic Extension</Name><Description>Endurant II Endoluminal Stent Graft System - Aortic Extension</Description><Size>Proximal diameter: 23 to 36mm; distal diameter: 23 to 36mm; Covered length: 49mm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1631</GroupID><SubGroupID>4448</SubGroupID><ARTGs><ARTG>202471</ARTG></ARTGs><MinimumBenefit>2306</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC673</BillingCode><Name>Verte-Stack</Name><Description>Perimeter Cage</Description><Size>Extra Small, Small, Medium, Large, Extra Large</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI273</BillingCode><Name>AVILA</Name><Description>Oblique or Anterior Cage</Description><Size>Small, Medium, Large</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC914</BillingCode><Name>TiMesh Titanium Rigid Fixation Bone Grafting and Plating System</Name><Description>FlexMesh 1.5mm System. Composition: Titanium</Description><Size>26 to 50 cm2 area; 0.3mm thick</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4204</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>584</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI063</BillingCode><Name>Capstone Control</Name><Description>PLIF Vertebral Body Spacer</Description><Size>Length: 22-26mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC889</BillingCode><Name>TiMesh</Name><Description>Square-rectangular Gridmesh Panel</Description><Size>11 to 25 cm2 area</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4204</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>584</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Human Tissue</ItemType><BillingCode>MAA13</BillingCode><Name>Grafton Demineralized Bone Matrix: Flex, 2.5cm x 5cm</Name><SupplierCode>MAA</SupplierCode><CategoryID>3</CategoryID><ARTGs><ARTG>229634</ARTG></ARTGs><MinimumBenefit>0</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>1099</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI064</BillingCode><Name>Crescent Spinal System</Name><Description>Titanium</Description><Size>height: 7-16mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC974</BillingCode><Name>Capstone Cage</Name><Description>TLIF Vertebral Body Spacer</Description><Size>Length: 32mm - 36mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI062</BillingCode><Name>Capstone Control</Name><Description>TLIF vertebral Body Spacer</Description><Size>Length: 27-32mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI512</BillingCode><Name>Anteralign™ - TL cage</Name><Description>Interbody cage</Description><Size>Height: 8 mm - 16 mm; Width: 20 mm - 23 mm; Length: 40 mm - 60 mm; Lordosis: 6° - 24°</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>422152</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI396</BillingCode><Name>Adaptix Cage</Name><Description>PLIF Vertebral Body Spacer</Description><Size>Length: 24-28 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><Suffix>Paired</Suffix><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>2222</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI368</BillingCode><Name>Adaptix Cage</Name><Description>TLIF Vertebral Body Spacer</Description><Size>Length: 34-38 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI186</BillingCode><Name>PIVOX Oblique Lateral Spinal System</Name><Description>Interbody Cage</Description><Size>20-27mm width</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ753</BillingCode><Name>Catalyft PL Expandable Interbody Cage</Name><Description>PL and PL40 expandable titanium alloy interbody devices - single</Description><Size>Length: 27.3 - 29.6mm  Width: 10-14mm  Height:7-11mm  Lordosis: 0-20 Degrees</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI065</BillingCode><Name>Clydesdale Spinal System</Name><Description>Lateral vertebral body spacer (PEEK &amp; PTC)</Description><Size>Length: 40mm - 60mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1486</GroupID><SubGroupID>4135</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>3313</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI390</BillingCode><Name>Cobalt™ XT HF CRT-D MRI SureScan™ </Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1</Description><Size>35 cm3, 82g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d</Suffix><ARTGs><ARTG>392240</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI447</BillingCode><Name>Azure S SR MRI SureScanTM with BlueSync mobile remote monitoring</Name><Description>MR Conditional single chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-VVIR) with BlueSync mobile remote monitoring</Description><Size>12.25cm3 22.5g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><Suffix>Remote Monitoring Service</Suffix><ARTGs><ARTG>392531</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>5043</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI326</BillingCode><PriorBillingCodes><PriorBillingCode>ER469</PriorBillingCode><PriorBillingCode>OH492</PriorBillingCode></PriorBillingCodes><Name>Endoskeleton TAS</Name><Description>Endoskeleton TAS Interbody device with fixation screws</Description><Size>10-20mm Height, 32-40mm x 21-27mm Width, 7-24 Angles</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI517</BillingCode><Name>Onyx Frontier Zotarolimus-Eluting Coronary Stent System</Name><Description>Coronary stent system; drug-eluting.</Description><Size>Diameter: 2.00 to 5.00 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>408805</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC372</BillingCode><Name>CapSure Sense MRI SureScan pacemaker leads Models 4074 &amp; 4574</Name><Description>Bipolar, steroid, passive fixation pacing lead</Description><Size>Model 4074:  52 - 58cm; Model 4574: 45 - 53cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1753</GroupID><ARTGs><ARTG>134331</ARTG><ARTG>134426</ARTG></ARTGs><MinimumBenefit>420</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI446</BillingCode><Name>Azure XT SR MRI SureScan  with BlueSync mobile remote monitoring</Name><Description>MR Conditional single chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-VVIR) with BlueSync mobile remote monitoring</Description><Size>12.25cm3 22.5g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><Suffix>Remote Monitoring Service</Suffix><ARTGs><ARTG>392521</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>5043</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI375</BillingCode><Name>Crome™ HF CRT-D MRI SureScan™</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4</Description><Size>35 cm3, 82.1 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e</Suffix><ARTGs><ARTG>392274</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI246</BillingCode><Name>Azure XT SR MRI SureScan</Name><Description>MR Conditional single chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-VVIR)</Description><Size>12.25cm3 22.5g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><ARTGs><ARTG>392521</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI161</BillingCode><Name>Advisa SR MRI SureScan pacemaker A3SR01</Name><Description>Single chamber pacemaker with SureScan MRI Technology</Description><Size>11.9cm3 21g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><ARTGs><ARTG>392335</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI385</BillingCode><Name>Crome™ VR ICD MRI SureScan™</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF1</Description><Size>33.2 cm3, 79 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>392256</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI423</BillingCode><Name>Crome™ HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description><Size>35 cm3, 82.1 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>392274</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>30319</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI206</BillingCode><Name>Amplia MRI Quad CRT-D</Name><Description>ICD with CRT. MRI compatible, PhysioCurve Design, CardioSync Optimisation, VectorExpress, V Automated Test, Optimised Battery Chemistry, Smart Shock Technology 2.0. Complete Capture management. Quad DF4.</Description><Size>35cm3 81g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>393374</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI232</BillingCode><Name>Claria MRI CRT-D SureScan</Name><Description>Digital implantable cardioverter defibrillator with cardiac resynchronisation therapy and SureScanTM technology</Description><Size>35cm3 80g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d</Suffix><ARTGs><ARTG>393378</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI189</BillingCode><Name>Resolute Onyx Zotarolimus-Eluting Coronary Stent System</Name><Description>coronary stent system; drug eluting</Description><Size>diameter: 2mm to 5mm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>247</SubCategoryID><GroupID>1766</GroupID><SubGroupID>5346</SubGroupID><ARTGs><ARTG>263413</ARTG></ARTGs><MinimumBenefit>1095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI419</BillingCode><Name>Crome™ HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description><Size>35 cm3, 82 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d Remote Monitoring Service</Suffix><ARTGs><ARTG>392418</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>29919</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI425</BillingCode><Name>Cobalt™ XT HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description><Size>35 cm3, 82 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d Remote Monitoring Service</Suffix><ARTGs><ARTG>392240</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>29919</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI376</BillingCode><Name>Cobalt™ HF Quad CRT-D MRI SureScan™ </Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1</Description><Size>36.3 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d</Suffix><ARTGs><ARTG>392420</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS237</BillingCode><Name>Symbotex Composite Mesh with pre placed suture</Name><Description>Non-absorbable three-dimensional polyester composite mesh with pre placed sutures. (Non absorbable pre-placed sutures are tied to the mesh. A died marking is positioned on the center of the textile and helps center and orient the mesh.)</Description><Size>Elliptical 40x24cm, Elliptical 34x20 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>270737</ARTG></ARTGs><MinimumBenefit>1013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI412</BillingCode><Name>Crome™ VR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description><Size>33.2 cm3, 79 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a,d Remote Monitoring Service</Suffix><ARTGs><ARTG>392256</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>23670</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS123</BillingCode><Name>Parietene™ Flat Sheet Mesh; Parietene™ Lightweight Mesh</Name><Description>Parietene™ flat sheet mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile. Parietene™ lightweight mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile.</Description><Size>30 cm x 30 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5437</SubGroupID><ARTGs><ARTG>421377</ARTG><ARTG>421381</ARTG></ARTGs><MinimumBenefit>247</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI422</BillingCode><Name>Crome™ HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4 with BlueSync mobile remote monitoring</Description><Size>35.5 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>392239</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>30319</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS171</BillingCode><Name>Parietex™ Hydrophilic 2D Mesh; Parietex™ Hydrophilic 3D Mesh</Name><Description>Parietex™ hydrophilic 2-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 2-dimensional textile. The mesh is available in two versions: a standard version and a rigid version. Parietex™ hydrophilic 3-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 3-dimensional textile.</Description><Size>30 cm x 30 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5437</SubGroupID><ARTGs><ARTG>399214</ARTG><ARTG>399630</ARTG></ARTGs><MinimumBenefit>247</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI427</BillingCode><Name>Cobalt™ HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description><Size>35 cm3, 82.1 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>392273</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>30319</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI417</BillingCode><Name>Cobalt™ HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description><Size>35 cm3, 82 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d Remote Monitoring Service</Suffix><ARTGs><ARTG>392417</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>29919</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI256</BillingCode><PriorBillingCodes><PriorBillingCode>MI203</PriorBillingCode></PriorBillingCodes><Name>VISIA AF S ICDs/ VISIA AF MRI S SureScan ICDs</Name><Description>Digital single chamber implantable cardioverter defibrillator. PhysioCurve™ Design, SmartShock™ Technology, OptiVol™ 2.0 Fluid Status Monitoring, Complete Capture Management™ Diagnostic (RVCM), AF Diagnostics including SureScan/ MRI models</Description><Size>33cm³ 77g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>393380</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI254</BillingCode><PriorBillingCodes><PriorBillingCode>MI202</PriorBillingCode></PriorBillingCodes><Name>VISIA AF S MRI ICD</Name><Description>Single Chamber, MRI compatible, Implantable Cardioverter Defibrillator with AF detection and diagnosis, PhysioCurve Design, Optimised Battery Chemistry, Smart Shock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management. DF4</Description><Size>33cm³ 77g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d, e</Suffix><ARTGs><ARTG>393251</ARTG></ARTGs><MinimumBenefit>22650</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC571</BillingCode><Name>Timesh</Name><Description>12 Point Screws</Description><Size>3 - 20mm</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>128524</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI373</BillingCode><Name>Cobalt™ HF CRT-D MRI SureScan™</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4</Description><Size>35 cm3, 82.1g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e</Suffix><ARTGs><ARTG>392273</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ597</BillingCode><Name>Parietene Macroporous Mesh</Name><Description>Parietene macroporous mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile.
</Description><Size>30 cm x 30 cm, 10 cm x 45 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5437</SubGroupID><ARTGs><ARTG>449258</ARTG></ARTGs><MinimumBenefit>247</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI304</BillingCode><Name>ReliaTack Articulating Reloadable Fixation Device with Deep Purchase Tacks (Reloads x 5)</Name><Description>5 x absorbable deep purchase reloads to be used with ReliaTack articulating tacking device</Description><Size>7.0 mm  5 Tacks</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>6003</SubGroupID><Suffix>5 Tacks, Absorbable</Suffix><ARTGs><ARTG>315822</ARTG></ARTGs><MinimumBenefit>162</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS229</BillingCode><Name>ReliaTack™ Absorbable Tacks</Name><Description>10 x absorbable reloads to be used with ReliaTack atriculating tacking device</Description><Size>5.1mm, 10 tacks</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>6003</SubGroupID><Suffix>10 Tacks, Absorbable</Suffix><ARTGs><ARTG>315822</ARTG></ARTGs><MinimumBenefit>323</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI370</BillingCode><Name>Cobalt™ XT HF Quad CRT-D MRI SureScan™</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4</Description><Size>35.5 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e</Suffix><ARTGs><ARTG>392241</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS228</BillingCode><Name>ReliaTack™ Absorbable Tacks</Name><Description>5 x absorbable reloads to be used with ReliaTack articulating tacking device</Description><Size>5.1mm, 5 tacks</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>6003</SubGroupID><Suffix>5 Tacks, Absorbable</Suffix><ARTGs><ARTG>315822</ARTG></ARTGs><MinimumBenefit>162</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI426</BillingCode><Name>Cobalt™ HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4 with BlueSync mobile remote monitoring</Description><Size>35.5 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>392242</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>30319</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI407</BillingCode><Name>Cobalt™ XT VR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF4</Description><Size>32.8 cm3, 79 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>392264</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>24100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI305</BillingCode><Name>ReliaTack Articulating Reloadable Fixation Device with Deep Purchase Tacks (Reloads x 8)</Name><Description>8 x absorbable deep purchase reloads to be used with ReliaTack articulating tacking device</Description><Size>7.0 mm  8 tacks</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>6003</SubGroupID><Suffix>8 Deep Purchase Tack, absorbable</Suffix><ARTGs><ARTG>315822</ARTG></ARTGs><MinimumBenefit>258</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI205</BillingCode><Name>Amplia MRI CRT-D</Name><Description>ICD with CRT. MRI compatible, PhysioCurve Design, CardioSync Optimisation, VectorExpress, V Automated Test, Optimised Battery Chemistry, Smart Shock Technology 2.0. Complete Capture management. DF4.</Description><Size>35cm3 80g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e</Suffix><ARTGs><ARTG>393375</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI200</BillingCode><Name>Claria Quad MRI CRT-D</Name><Description>Digital implantable cardioverter defibrillator with cardiac resynchronisation therapy and SureScan™ Technology</Description><Size>35cm3 81g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>393252</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI083</BillingCode><Name>TiMesh Titanium rigid Fixation Bone Grafting and Plating System</Name><Description>FlexMesh 1.5mm - 2.2mm system. Composition: Titanium</Description><Size>148 - 154mm x 148 - 154mm, 0.6mm</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4210</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>2072</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI384</BillingCode><Name>Crome™ VR ICD MRI SureScan™</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4</Description><Size>32.8 cm3, 79 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d, e</Suffix><ARTGs><ARTG>392265</ARTG></ARTGs><MinimumBenefit>22650</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI525</BillingCode><Name>CSF-Lumboperitoneal Shunt</Name><Description>T-Tube and K-Tube</Description><Size>Length: 87cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1667</GroupID><ARTGs><ARTG>134740</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI527</BillingCode><Name>Timesh - Screws</Name><Description>Self-Drilling and Rescue Screws</Description><Size>Diameter: 1.6mm - 1.8mm Length: 3.0mm - 5.0mm</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1590</GroupID><SubGroupID>4323</SubGroupID><ARTGs><ARTG>128524</ARTG></ARTGs><MinimumBenefit>42</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC053</BillingCode><Name>Capsure EPI steroid eluting unipolar epicardial lead Model 4965 ventricle</Name><Description>Silicone</Description><Size>25 - 50cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1747</GroupID><ARTGs><ARTG>134427</ARTG></ARTGs><MinimumBenefit>753</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI255</BillingCode><PriorBillingCodes><PriorBillingCode>MI203</PriorBillingCode></PriorBillingCodes><Name>VISIA AF XT ICDs/ VISIA AF MRI XT SureScan ICDs</Name><Description>Digital single chamber implantable cardioverter defibrillator. PhysioCurve™ Design, SmartShock™ Technology, OptiVol™ 2.0 Fluid Status Monitoring, Complete Capture Management™ Diagnostic (RVCM), AF Diagnostics including SureScan/ MRI models</Description><Size>33cm³ 77g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>393270</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI386</BillingCode><Name>Cobalt™ VR ICD MRI SureScan™</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF1</Description><Size>33.2 cm3, 79 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>392255</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC449</BillingCode><Name>Pyramesh</Name><Description>Angled</Description><Size>25 - 150mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1494</GroupID><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>2616</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI257</BillingCode><PriorBillingCodes><PriorBillingCode>MI160</PriorBillingCode></PriorBillingCodes><Name>Evera MRI XT VR ICD</Name><Description>Single chamber implantable cardioverter defibrillators with SureScan MRI Technology</Description><Size>33cm³ 77g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d, e</Suffix><ARTGs><ARTG>393520</ARTG></ARTGs><MinimumBenefit>22650</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC451</BillingCode><Name>Pyramesh</Name><Description>Ovoid</Description><Size>8 - 130mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1494</GroupID><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>2616</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC529</BillingCode><Name>Lumboperitoneal Shunt</Name><Description>CSF Lumboperitoneal Catheter System; Lumbar Catheter Kit</Description><Size>84cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1667</GroupID><ARTGs><ARTG>140359</ARTG></ARTGs><MinimumBenefit>407</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI388</BillingCode><Name>Cobalt™ VR ICD MRI SureScan™</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4</Description><Size>32.8 cm3, 79 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d, e</Suffix><ARTGs><ARTG>392259</ARTG></ARTGs><MinimumBenefit>22650</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC378</BillingCode><Name>Pyramesh</Name><Description>Titanium Surgical Mesh</Description><Size>51 - 500mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1494</GroupID><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>2616</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI409</BillingCode><Name>Crome™ VR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description><Size>32.8 cm3, 79 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>392265</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>24100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC450</BillingCode><Name>Pyramesh</Name><Description>Curved / Round</Description><Size>20 - 150mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1494</GroupID><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>2616</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI478</BillingCode><PriorBillingCodes><PriorBillingCode>NK095</PriorBillingCode></PriorBillingCodes><Name>Curved Rods</Name><Description>Curved Rods</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC379</BillingCode><Name>Pyramesh</Name><Description>Titanium Surgical Mesh</Description><Size>5 - 50mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1494</GroupID><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>2616</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI123</BillingCode><PriorBillingCodes><PriorBillingCode>MI095</PriorBillingCode></PriorBillingCodes><Name>EDM Ventricular Catheter</Name><Description>External drainage ventricular catheter, non metallic latex free. Barium impregnated, includes stainless steel stylet.</Description><Size>35cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>255</SubCategoryID><GroupID>1796</GroupID><ARTGs><ARTG>141103</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI543</BillingCode><Name>ModuLeX Spinal System - Rod</Name><Description>Rod</Description><Size>Diameter: 5mm to 6mm Length: 424mm to 500mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>422153</ARTG><ARTG>422155</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI513</BillingCode><Name>Anteralign - LS cage</Name><Description>Interbody cage and fixation screws</Description><Size>Height: 10 mm - 20 mm; Width: 32 mm - 42 mm; Length: 25 mm - 32 mm; Lordosis: 6 - 30</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>422152</ARTG><ARTG>422154</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS191</BillingCode><PriorBillingCodes><PriorBillingCode>EE019</PriorBillingCode></PriorBillingCodes><Name>Onyx System</Name><Description>DSMO Liquid Embolic Material</Description><Size>500 Formulation</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1692</GroupID><Suffix>ids (integral delivery system)</Suffix><ARTGs><ARTG>151837</ARTG></ARTGs><MinimumBenefit>4468</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI208</BillingCode><Name>Onyx 6ml Kit</Name><Description>DMSO Liquid Embolic Material</Description><Size>6ml Kit</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1692</GroupID><ARTGs><ARTG>151837</ARTG></ARTGs><MinimumBenefit>7265</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS190</BillingCode><PriorBillingCodes><PriorBillingCode>EE018</PriorBillingCode></PriorBillingCodes><Name>Onyx</Name><Description>DSMO/Liquid Embolic Material</Description><Size>18, 20, 34 (formulations)</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1692</GroupID><ARTGs><ARTG>151837</ARTG></ARTGs><MinimumBenefit>2076</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC406</BillingCode><Name>CD HORIZON Spinal System - Hook</Name><Description>Hook - various</Description><Size>Extra Small - Large</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC638</BillingCode><Name>Peritoneal Catheter PSM range with Bioglide</Name><Description>Translucent silicone elastomer with Barium impregnated stripe.  Catheter surface bonded with Hydrogel.</Description><Size>60-90cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal, Coating</Suffix><ARTGs><ARTG>130410</ARTG></ARTGs><MinimumBenefit>202</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC987</BillingCode><Name>Sovereign Spinal System - Interbody Spacer</Name><Description>Interbody Spacer with Coverplate and fixation screws</Description><Size>Small - 32mm x 23mm, Medium - 37mm x 27mm, Large - 42mm x 30mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5486</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>5948</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI267</BillingCode><Name>Infinity Spinal System</Name><Description>Laminar Hook</Description><Size>4.5 - 6.0mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI463</BillingCode><PriorBillingCodes><PriorBillingCode>NK076</PriorBillingCode></PriorBillingCodes><Name>PASS LP System - Plates</Name><Description>Sacral Plate, Sacroilac Plate, Sacral Cap Plate Cover</Description><Size>one size</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>172</SubCategoryID><GroupID>1482</GroupID><ARTGs><ARTG>295277</ARTG><ARTG>316001</ARTG></ARTGs><MinimumBenefit>218</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC584</BillingCode><Name>CSF - Distal Catheters</Name><Description>Non metallic and latex free, Models 43418,43103,43111,43209,43522,43551,25024</Description><Size>Distal cardiac/peritoneal catheters ID 1.3mm OD 2.5mm Length 90cm, ID 1.2mm, OD 2.1mm, Length 58cm, 90cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>130410</ARTG><ARTG>140357</ARTG><ARTG>140360</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ684</BillingCode><Name>CD Horizon – Medtronic Rod Connector</Name><Description>Top-loading and side loading connectors</Description><Size>4.75mm - 6mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI168</BillingCode><Name>CD HORIZON SOLERA Spinal System </Name><Description>Apex and Tapered Rods</Description><Size>4.75mm to 6.3mm diameter</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC818</BillingCode><Name>Medtronic Intrathecal Catheter Revision Kit (Distal)</Name><Description>Revision kit to repair distal end of intrathecal catheter (8598A)</Description><Size>38.1cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>223</SubCategoryID><GroupID>1684</GroupID><SubGroupID>4503</SubGroupID><ARTGs><ARTG>153486</ARTG></ARTGs><MinimumBenefit>542</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI167</BillingCode><Name>ARES antibiotic-impregnated catheter kit</Name><Description>ARES antibiotic catheter kit includes ventricular and peritoneal catheter</Description><Size>23 - 120cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Antibiotics, Distal, Proximal</Suffix><ARTGs><ARTG>245275</ARTG></ARTGs><MinimumBenefit>609</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI523</BillingCode><Name>CD Horizon™ ModuLeX™ 5.5 Spinal System - Screw Shank </Name><Description>Screw Shank</Description><Size>Diameter: 4.5-7.5mm; Length 30-55mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>422153</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI408</BillingCode><Name>Cobalt™ VR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0 Technology, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description><Size>32.8 cm3, 79 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>392259</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>24100</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI260</BillingCode><Name>Infinity Spinal System</Name><Description>Multi-Axial Screws</Description><Size>Diameter 3.0 - 5.5mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI195</BillingCode><Name>TYRX / TYRX III Absorbable Antibacterial Envelope</Name><Description>Antibacterial surgically implanted mesh envelope which stabilises cardiac implantable electronic device (CIED) placement and prevents infection.</Description><Size>6.3 x 6.9cm, 7.4 x 8.5cm 6.3 x 6.9cm, 7.3 x 8.8cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1829</GroupID><ARTGs><ARTG>334380</ARTG><ARTG>522685</ARTG></ARTGs><MinimumBenefit>867</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI503</BillingCode><Name>PASS Polyaxial Spinal System - Pedicle Screws</Name><Description>Polyaxial Pedicle Screws</Description><Size>4.5 to 7.5mm diameter</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI470</BillingCode><PriorBillingCodes><PriorBillingCode>NK085</PriorBillingCode></PriorBillingCodes><Name>Straight rods</Name><Description>Straight rods</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC640</BillingCode><Name>Strata Shunt, Unitised</Name><Description>Adjustable CSF valve with five symmetric performance level steps.  Includes strata valve, pre-attached ventricular catheter, and a pre-attached peritoneal catheter. Right Angle Clip. Disposable Quick Release Ventricular Catheter Introducer. Disposable Sub</Description><Size>8-13.5cm x 9-120cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Antisyphon function, Distal catheter, Proximal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>129681</ARTG><ARTG>145335</ARTG></ARTGs><MinimumBenefit>2888</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI466</BillingCode><PriorBillingCodes><PriorBillingCode>NK081</PriorBillingCode></PriorBillingCodes><Name>Non-Cannulated Polyaxial Pedicle Screws</Name><Description>Non-Cannulated Polyaxial Pedicle Screws</Description><Size>4.5mm to 9.5mm diameter</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS195</BillingCode><PriorBillingCodes><PriorBillingCode>EE025</PriorBillingCode></PriorBillingCodes><Name>EverFlex Peripheral Stent</Name><Description>EverFlex is a self expanding Nitinol stent premounted on an OTW delivery system.</Description><Size>Diameter 5-8mm, Length 150mm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>215979</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI415</BillingCode><Name>Abre venous stent system</Name><Description>The Abre stent system consists of a stent and stent delivery system designed specifically for implantation in the peripheral venous system. The system consists of a flexible self expanding stent made of a nickel-titanium alloy (nitinol) provided in multiple lengths and diameters and an over-the wire stent delivery system.</Description><Size>Length: 150mm.  Diameter: 10mm-20mm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>448908</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ601</BillingCode><Name>Micra VR2 Transcatheter Pacemaker</Name><Description>Single chamber transcatheter leadless pacemaker with SureScan technology including a delivery catheter (MC2VR01). 
</Description><Size>2.59cm length, 0.67cm outer diameter and 1.75 grams weight</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>2965</GroupID><ARTGs><ARTG>455509</ARTG></ARTGs><MinimumBenefit>10083</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI531</BillingCode><Name>EverFlex Peripheral Stent</Name><Description>EverFlex is a self expanding Nitinol stent premounted on an OTW delivery system.</Description><Size>Diameter 5-8mm, Length 150mm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>206</SubCategoryID><GroupID>1622</GroupID><SubGroupID>4441</SubGroupID><ARTGs><ARTG>452685</ARTG></ARTGs><MinimumBenefit>1394</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC269</BillingCode><Name>Medtronic Vent Tubes</Name><Description>Activent Antimicrobial Ventilation Tube</Description><Size>1.02 - 1.27mm x 0.9 - 2.4mm</Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><Suffix>Antibiotic</Suffix><ARTGs><ARTG>126695</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC268</BillingCode><Name>Medtronic Vent Tubes</Name><Description>Fluoroplastic</Description><Size>0.76 - 1.52mm x 2.1 - 9.5mm x 1.0 - 12.0mm</Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>126695</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC736</BillingCode><Name>Vertex Max Cannulated Screw</Name><Description>Posterior cannulated cervical screw</Description><Size>Diameter 3.5 - 4.5mm
Length 20 - 60mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-06-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC545</BillingCode><Name>Vertex Spinal System</Name><Description>Screws</Description><Size>Diameter 3.5 - 4.5mm Length 6 - 52mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI547</BillingCode><Name>Kyphon Xpede Bone Cement </Name><Description>PMMA bone cement, 30% barium sulfate.</Description><Size>20g powder, 9g vial</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4087</SubGroupID><ARTGs><ARTG>284119</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC984</BillingCode><Name>CD HORIZON Fenestrated Screw Cement</Name><Description>Fenestrated screw cement - High viscosity, radiopaque, PMMA bone cement</Description><Size>20g powder, 9g vial</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1279</GroupID><SubGroupID>4087</SubGroupID><ARTGs><ARTG>284119</ARTG></ARTGs><MinimumBenefit>152</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI154</BillingCode><Name>Divergence Anterior Cervical Fusion Standalone System</Name><Description>Divergence Standalone Interbody Cage and fixation screws</Description><Size>5-10mm height</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>174</SubCategoryID><GroupID>1485</GroupID><SubGroupID>5485</SubGroupID><ARTGs><ARTG>126313</ARTG></ARTGs><MinimumBenefit>4161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC597</BillingCode><Name>Mastergraft</Name><Description>Calcium Phosphate Ceramic Granules</Description><Size>30cc Vial</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4095</SubGroupID><ARTGs><ARTG>96971</ARTG></ARTGs><MinimumBenefit>1482</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI393</BillingCode><Name>Cobalt™ XT VR ICD MRI SureScan™</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF4</Description><Size>32.8 cm3, 79 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d, e</Suffix><ARTGs><ARTG>392264</ARTG></ARTGs><MinimumBenefit>22650</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI078</BillingCode><Name>Medtronic Ventilation Tubes</Name><Description>Medium to Long term vent tube</Description><Size>0.76-1.52mm x0.9-12.0mm</Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>126695</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI077</BillingCode><Name>Medtronic  Ventilation Tube</Name><Description>Medium to long term, antimicrobial vent tube</Description><Size>1.02 - 1.52mm x 1.3-12.0mm</Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><Suffix>Antibiotic</Suffix><ARTGs><ARTG>126695</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC927</BillingCode><Name>Medtronic Vent Tube</Name><Description>.</Description><Size>1.02 - 1.52mm x 1.3 - 12.0mm</Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1566</GroupID><ARTGs><ARTG>126695</ARTG></ARTGs><MinimumBenefit>18</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI141</BillingCode><Name>Reveal LINQ</Name><Description>Insertable Cardiac Monitor</Description><Size>44.8 mm x 7.2 mm x 4.0 mm,1.2 cm3</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>293</SubCategoryID><GroupID>2962</GroupID><Suffix>i</Suffix><ARTGs><ARTG>391831</ARTG></ARTGs><MinimumBenefit>2886</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC756</BillingCode><Name>InterStim iCON Patient Programmer</Name><Description>Hand held device Model 3037 to be used with implantable neurostimulation devices</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1713</GroupID><SubGroupID>5337</SubGroupID><ARTGs><ARTG>137808</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI520</BillingCode><Name>InterStim™ X System – Smart Programmer Kit</Name><Description>Smart programmer kit houses the patient communicator and handset. The therapy apps are loaded onto the patient handset.</Description><Size>One size</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1713</GroupID><SubGroupID>5337</SubGroupID><ARTGs><ARTG>402561</ARTG><ARTG>402562</ARTG><ARTG>419710</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI443</BillingCode><Name>InterStim neurostimulator- Programmer</Name><Description>Programmer</Description><Size>One size</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1713</GroupID><SubGroupID>5337</SubGroupID><ARTGs><ARTG>355036</ARTG></ARTGs><MinimumBenefit>1330</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI438</BillingCode><Name>Reveal LINQ II™</Name><Description>Insertable Cardiac Monitor</Description><Size>45.1 mm x 8mm x 4.2mm, 1.4cc</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>293</SubCategoryID><GroupID>2962</GroupID><Suffix>i</Suffix><ARTGs><ARTG>391830</ARTG></ARTGs><MinimumBenefit>2886</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI537</BillingCode><Name>Medtronic Evolut FX+ transcatheter aortic valve </Name><Description>Transcatheter aortic valve, self-expanding, re-sheath and/or complete recapture after partial deployment and redeployment including a loading system (L-EVOLUTFX-2329, L-EVOLUTFX-34) and a delivery catheter system (D-EVOLUTFX-2329, D-EVOLUTFX-34)</Description><Size>23mm-34mm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>267</SubCategoryID><GroupID>2641</GroupID><ARTGs><ARTG>503429</ARTG></ARTGs><MinimumBenefit>22932</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI389</BillingCode><Name>Cobalt™ HF Quad CRT-D MRI SureScan™</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4</Description><Size>35.5 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e</Suffix><ARTGs><ARTG>392242</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI210</BillingCode><Name>Claria MRI CRT-D</Name><Description>Digital implantable cardioverter defibrillator with cardiac resynchronisation therapy and SureScan™ Technology</Description><Size>35cm3 80g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>393376</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI418</BillingCode><Name>Crome™ HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description><Size>36.3 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d Remote Monitoring Service</Suffix><ARTGs><ARTG>392421</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>29919</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI424</BillingCode><Name>Cobalt™ XT HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description><Size>36.3 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d Remote Monitoring Service</Suffix><ARTGs><ARTG>392419</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>29919</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI377</BillingCode><Name>Cobalt™ HF CRT-D MRI SureScan™ </Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1</Description><Size>35 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d</Suffix><ARTGs><ARTG>392417</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI420</BillingCode><Name>Cobalt™ XT HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4 with BlueSync mobile remote monitoring</Description><Size>35.5 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>392241</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>30319</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI516</BillingCode><Name>Micra VR Transcatheter Pacemaker</Name><Description>Single chamber transcatheter leadless pacemaker with SureScan™ technology including a delivery catheter (MC1VR01).    </Description><Size>2.59cm length, 0.67cm outer diameter and 1.75 grams weight</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>2965</GroupID><ARTGs><ARTG>391832</ARTG></ARTGs><MinimumBenefit>10083</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ159</BillingCode><Name>Medtronic Evolut FX transcatheter aortic valve</Name><Description>Transcatheter aortic valve, self-expanding, re-sheath and/or complete recapture after partial deployment and redeployment including a loading system (L-EVOLUTFX-2329, L-EVOLUTFX-34) and a delivery catheter system (D-EVOLUTFX-2329, D-EVOLUTFX-34)</Description><Size>23mm-34mm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>267</SubCategoryID><GroupID>2641</GroupID><ARTGs><ARTG>430190</ARTG></ARTGs><MinimumBenefit>22932</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC012</BillingCode><Name>Medtronic Hancock Valved Conduit Model 150</Name><Description>Porcine bioprosthesis, dacron</Description><Size>12, 14, 16, 18, 20, 22, 25, 30mm.</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>180</SubCategoryID><GroupID>1503</GroupID><Suffix>p</Suffix><ARTGs><ARTG>145760</ARTG></ARTGs><MinimumBenefit>6460</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI230</BillingCode><Name>Claria MRI Quad CRT-D SureScan</Name><Description>Digital implantable cardioverter defibrillator with cardiac resynchronization therapy and SureScan™ Technology (DDE-DDDR), DF1</Description><Size>36 cm3 82 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d</Suffix><ARTGs><ARTG>393379</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI299</BillingCode><Name>T2 Stratosphere Expandable Corpectomy System</Name><Description>End Cap</Description><Size>13-30mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1492</GroupID><SubGroupID>4138</SubGroupID><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>928</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ724</BillingCode><Name>CD Horizon Spinal System - Offset Rods</Name><Description>Rod</Description><Size>11.4mm – 14.2mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI416</BillingCode><Name>Cobalt™ HF Quad CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description><Size>36.3 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d Remote Monitoring Service</Suffix><ARTGs><ARTG>392420</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>29919</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI371</BillingCode><Name>Cobalt™ XT HF CRT-D MRI SureScan™</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4</Description><Size>35 cm3, 82.1 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e</Suffix><ARTGs><ARTG>392422</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI126</BillingCode><Name>Verify External Neurostimulator</Name><Description>External Neurostimulator</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1713</GroupID><SubGroupID>5518</SubGroupID><ARTGs><ARTG>215635</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ549</BillingCode><Name>Location Reference Patch Kit </Name><Description>Mapping system Location Reference Patch Kit</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7350</SubGroupID><Suffix>Medtronic</Suffix><ARTGs><ARTG>464949</ARTG></ARTGs><MinimumBenefit>499</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI109</BillingCode><Name>VIVA QUAD XT CRT-D IS4/DF4</Name><Description>ICD with CRT. PhysioCurve Design, AdaptivCRT Algorithm, CardioSync Optimisation, VextorExpress, LV Automated Test, Optimised Battery Chemistry, Smart Shock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management and Atrial Therapies. IS4 DF4</Description><Size>35cm³ 81g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,d,e</Suffix><ARTGs><ARTG>392333</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI391</BillingCode><Name>Crome™ HF Quad CRT-D MRI SureScan™ </Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1</Description><Size>36.3 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d</Suffix><ARTGs><ARTG>392421</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI372</BillingCode><Name>Cobalt™ XT HF Quad CRT-D MRI SureScan™ </Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, DF1</Description><Size>36.3 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d</Suffix><ARTGs><ARTG>392419</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC506</BillingCode><Name>Orfil</Name><Description>Double Pearl-Tipped Wires</Description><Size>1 - 350mm</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1772</GroupID><SubGroupID>5364</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>11</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI228</BillingCode><Name>Attesta SR MRI SureScan pacemaker</Name><Description>MRI, single chamber rate responsive pacemaker (AAIR/VVIR, AAI/VVI)</Description><Size>9.7cm3 21.5g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><ARTGs><ARTG>393094</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI235</BillingCode><Name>Amplia MRI CRT-D SureScan IS1/DF1</Name><Description>Digital implantable cardioverter defibrillator with cardiac resynchronization therapy and SureScan™ Technology (DDE-DDDR), DF1</Description><Size>35cm3 80g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d</Suffix><ARTGs><ARTG>393377</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI421</BillingCode><Name>Cobalt™ XT HF CRT-D MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0+ Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF4 with BlueSync mobile remote monitoring</Description><Size>35 cm3, 82.1 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e Remote Monitoring Service</Suffix><ARTGs><ARTG>392422</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>30319</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI223</BillingCode><Name>Azure S SR MRI SureScan</Name><Description>MR Conditional single chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-VVIR)</Description><Size>12.25cm3 22.5g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><ARTGs><ARTG>392531</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI453</BillingCode><Name>Concerto Versa Detachable Coil</Name><Description>Platinum-tungsten embolization coil (enlaced with nylon fibers) attached to a composite delivery pusher, and a hand-held Instant Detacher.</Description><Size>Diameters 3–32 mm, Length 5-65 cm.</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5472</SubGroupID><Suffix>P, repositionable (Platinum, repositionable)</Suffix><ARTGs><ARTG>337400</ARTG></ARTGs><MinimumBenefit>825</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI536</BillingCode><Name>Percept RC System - Recharger Kit</Name><Description>The Recharger Kit is used to recharge the Percept RC neurostimulator. Recharger Kit includes the WR9230 Recharger, and CD9000 Recharger Dock.
</Description><Size>One Size</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4475</SubGroupID><ARTGs><ARTG>462931</ARTG></ARTGs><MinimumBenefit>1782</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI549</BillingCode><Name>Concerto Detachable Coil System</Name><Description>Platinum alloy coils (including coils enlaced with Nylon Fibers)  attached to a composite implant delivery pusher with a radiopaque positioning marker. The proximal end of the pusher is loaded into the Actuator which detaches the coil.</Description><Size>Diameter:  2- 6mm; Length:  4 - 20cm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5472</SubGroupID><Suffix>P, repositionable (Platinum, repositionable)</Suffix><ARTGs><ARTG>337400</ARTG></ARTGs><MinimumBenefit>825</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI378</BillingCode><Name>Crome™ HF CRT-D MRI SureScan™ </Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, Complete Capture Management, BlueSync technology, DF1</Description><Size>35 cm3, 82 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d</Suffix><ARTGs><ARTG>392418</ARTG></ARTGs><MinimumBenefit>28469</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC440</BillingCode><Name>CD Horizon</Name><Description>Eclipse:  4.5mm Rod</Description><Size>40 - 600mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI398</BillingCode><Name>Medtronic Activa RC System - Recharger Kit</Name><Description>Wireless Recharger Kit (RS6200) including Recharging Dock</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1673</GroupID><SubGroupID>4475</SubGroupID><ARTGs><ARTG>355990</ARTG></ARTGs><MinimumBenefit>1782</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC728</BillingCode><Name>Adapta Pacemaker</Name><Description>SR Pacemaker
Models ADSR01, ADSR06, ADSR03</Description><Size>9.7 - 11.0cc
21.5 - 22.5g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>239</SubCategoryID><GroupID>1730</GroupID><ARTGs><ARTG>396556</ARTG><ARTG>396557</ARTG><ARTG>396558</ARTG></ARTGs><MinimumBenefit>3593</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI253</BillingCode><PriorBillingCodes><PriorBillingCode>MI202</PriorBillingCode></PriorBillingCodes><Name>VISIA AF XT MRI ICD</Name><Description>Single Chamber, MRI compatible, Implantable Cardioverter Defibrillator with AF detection and diagnosis, PhysioCurve Design, Optimised Battery Chemistry, Smart Shock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management. DF4</Description><Size>33cm³ 77g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d, e</Suffix><ARTGs><ARTG>393250</ARTG></ARTGs><MinimumBenefit>22650</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI217</BillingCode><PriorBillingCodes><PriorBillingCode>AS006</PriorBillingCode><PriorBillingCode>AS131</PriorBillingCode><PriorBillingCode>AS132</PriorBillingCode></PriorBillingCodes><Name>Premium Surgiclip™</Name><Description>Ligation Clips - Disposable clip applier and ligating clips</Description><Size>Small, Medium, Large Clips</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Open</Suffix><ARTGs><ARTG>235587</ARTG></ARTGs><MinimumBenefit>128</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI114</BillingCode><Name>Evera MRI S VR SureScan DF1</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, Optimised Battery Chemistry, Smart Shock Technology 2.0, DF1</Description><Size>33cm³ 77g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>393538</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI534</BillingCode><Name>Concerto 3D Detachable Coil System </Name><Description>Platinum alloy coils (including coils enlaced with PGLA filaments) attached to a composite implant delivery pusher with a radiopaque positioning marker. The proximal end of the pusher is loaded into the Actuator which detaches the coil.
</Description><Size>Diameter:  2-6mm; Length:  2-20cm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>213</SubCategoryID><GroupID>1646</GroupID><SubGroupID>5472</SubGroupID><Suffix>P, repositionable (Platinum, repositionable)</Suffix><ARTGs><ARTG>478805</ARTG></ARTGs><MinimumBenefit>825</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS074</BillingCode><Name>ENDOCLIP*</Name><Description>Titanium Surgical Stapler</Description><Size>10mm (ML, M, L)-(20 clips)</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Laparoscopic</Suffix><ARTGs><ARTG>182307</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI309</BillingCode><Name>Cardioblate® Surgical Ablation Pen XL</Name><Description>The Cardioblate® Surgical Ablation Pen XL facilitates cardiac ablation in areas that are difficult to ablate with a bipolar device.</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2948</GroupID><SubGroupID>7354</SubGroupID><Suffix>Medtronic</Suffix><ARTGs><ARTG>140537</ARTG></ARTGs><MinimumBenefit>2876</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ246</BillingCode><Name>Cardioblate XL Pen VLFT</Name><Description>Monopolar radio-frequency catheter-pen for point-by-point cardiac ablation compatible with the Valleylab FT10 FT series energy platform  </Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2948</GroupID><SubGroupID>7354</SubGroupID><Suffix>Medtronic</Suffix><ARTGs><ARTG>377935</ARTG></ARTGs><MinimumBenefit>2876</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS230</BillingCode><Name>Symbotex Composite Mesh</Name><Description>Non-absorbable three-dimensional polyester composite mesh. (On the opposite side, the absorbable hydrophilic film minimizes tissue attachment to the mesh in case of direct contact with the viscera.)</Description><Size>Elliptical 40x24cm, 34x20cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1783</GroupID><SubGroupID>5503</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>270735</ARTG></ARTGs><MinimumBenefit>1013</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI374</BillingCode><Name>Crome™ HF Quad CRT-D MRI SureScan™</Name><Description>Implantable Cardioverter Defibrillator with Cardiac Resynchronisation therapy with PhysioCurve Design, MRI compatible, SmartShock 2.0 Technology, OptiVol 2.0 Fluid Status Monitoring, CardioSync Optimisation Test, VectorExpress LV Automated Test, Complete Capture Management, BlueSync technology, Quad DF4</Description><Size>35.5 cm3, 83 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>238</SubCategoryID><GroupID>1727</GroupID><Suffix>a,c,d,e</Suffix><ARTGs><ARTG>392239</ARTG></ARTGs><MinimumBenefit>28869</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI213</BillingCode><PriorBillingCodes><PriorBillingCode>AS073</PriorBillingCode><PriorBillingCode>AS137</PriorBillingCode></PriorBillingCodes><Name>Endo Clip</Name><Description>Laparoscopic Clip Applier</Description><Size>5mm device with various clip sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1581</GroupID><SubGroupID>4258</SubGroupID><Suffix>Laparoscopic</Suffix><ARTGs><ARTG>182307</ARTG></ARTGs><MinimumBenefit>180</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI509</BillingCode><Name>SimuPlus™ Annuloplasty Ring</Name><Description>Flexible mitral annuloplasty ring including accessories (tray, sizers and annuloplasty handles)</Description><Size>Ring size (mm): 26, 28, 30, 32, 34, 36, 38, 40, 42</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1841</GroupID><ARTGs><ARTG>394452</ARTG></ARTGs><MinimumBenefit>2090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI182</BillingCode><Name>SIMULUS Flexible Annuloplasty Band</Name><Description>Flexible mitral/tricuspid annuloplasty band</Description><Size>Band size (mm): 23, 25, 27, 29, 31, 33, 35, 37, 39</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1841</GroupID><ARTGs><ARTG>271814</ARTG></ARTGs><MinimumBenefit>2090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS246</BillingCode><PriorBillingCodes><PriorBillingCode>AS160</PriorBillingCode><PriorBillingCode>AS158</PriorBillingCode></PriorBillingCodes><Name>ABSORBATACK</Name><Description>Absorbable Fixation Device</Description><Size>5mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4331</SubGroupID><Suffix>Absorbable</Suffix><ARTGs><ARTG>181415</ARTG></ARTGs><MinimumBenefit>473</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC962</BillingCode><Name>Mosaic Cinch II</Name><Description>Aortic Bioprosthesis</Description><Size>19mm -29mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>145761</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC591</BillingCode><Name>Vertex Reconstructive System Laminar Hook</Name><Description>Composition -  titanium alloy</Description><Size>4.5 - 6.0mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI542</BillingCode><Name>ModuLeX Spinal System - Hook</Name><Description>Hook</Description><Size>Small, Medium, Large, Left and Right</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>422155</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC701</BillingCode><Name>Mosaic Cinch, Aortic, Mitral</Name><Description>Models 305cxx, 310cxx</Description><Size>19mm - 35mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>145761</ARTG><ARTG>145762</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI303</BillingCode><Name>ReliaTack™ Articulating Reloadable Fixation Device with Deep Purchase Tacks</Name><Description>Articulating, reloadable, sterile, single use fixation device pre-packaged with 29 tacks (three eight-tack deep purchase reloads, and one five tack deep purchase reload)</Description><Size>7.0 mm, 29 Tacks</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4331</SubGroupID><Suffix>Absorbable, Articulating/Roticulating</Suffix><ARTGs><ARTG>315822</ARTG></ARTGs><MinimumBenefit>653</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC534</BillingCode><Name>Pressure valve (anti-siphon device or  flushing valve or flush pump)</Name><Description>Neonatal Reservior, CSF Lumbo Peritoneal</Description><Size>2 - 90cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1670</GroupID><ARTGs><ARTG>129650</ARTG></ARTGs><MinimumBenefit>338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI454</BillingCode><Name>UNiD™ Rods </Name><Description>Curved rods that are preshaped to be patient specific</Description><Size>diameter: 3.5/5.5-6.0mm length: 120 - 750mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Shaped</Suffix><ARTGs><ARTG>368750</ARTG></ARTGs><MinimumBenefit>555</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC542</BillingCode><Name>Vertex Spinal System</Name><Description>Connector</Description><Size>Length 10 - 13mm; diameter 3.2 - 6.35mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI497</BillingCode><Name>Patient Communicator</Name><Description>The communicator allows the MyStim PC Therapy Application on the Patient Handset (Programmer) connect to the implantable neurostimulator</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4484</SubGroupID><ARTGs><ARTG>386870</ARTG><ARTG>391675</ARTG></ARTGs><MinimumBenefit>161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI264</BillingCode><Name>Infinity Spinal System</Name><Description>In-line connector - Axial Domino</Description><Size>Enables connection from 3.2 - 6.0mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI018</BillingCode><PriorBillingCodes><PriorBillingCode>MC535</PriorBillingCode></PriorBillingCodes><Name>Reservoir</Name><Description>CSF Reservoir, Port, Neonatal, Snap assembly</Description><Size>Various</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1670</GroupID><ARTGs><ARTG>129650</ARTG><ARTG>145332</ARTG><ARTG>145336</ARTG></ARTGs><MinimumBenefit>338</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ759</BillingCode><Name>SynchroMed III Pump</Name><Description>The implantable programmable infusion pump stores and delivers a prescribed drug to a specific site
</Description><Size>20 ml &amp; 40 ml</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>223</SubCategoryID><GroupID>1681</GroupID><Suffix>Variable Flow Rate</Suffix><ARTGs><ARTG>462226</ARTG></ARTGs><MinimumBenefit>14666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ824</BillingCode><Name>Avalus Ultra Bioprosthesis</Name><Description>Aortic valve bovine bioprosthesis</Description><Size>Valve size 19mm - 29mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>451628</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC313</BillingCode><Name>Synchro Med II Pump</Name><Description>Model No's 8637-20 &amp; 8637-40, Composition - Titanium</Description><Size>20 ml &amp; 40 ml</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>223</SubCategoryID><GroupID>1681</GroupID><Suffix>Variable Flow Rate</Suffix><ARTGs><ARTG>389968</ARTG></ARTGs><MinimumBenefit>14666</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI014</BillingCode><Name>Attain Ability Straight 4396/ Attain Ability Straight 4396 SureScan MRI</Name><Description>Over the wire dual left ventricular lead</Description><Size>78cm, 88cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1759</GroupID><ARTGs><ARTG>284541</ARTG></ARTGs><MinimumBenefit>2028</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC979</BillingCode><PriorBillingCodes><PriorBillingCode>AB001</PriorBillingCode></PriorBillingCodes><Name>Open Pivot Aortic Valved Graft (Model 502AG)</Name><Description>Pyrolythic Carbon, Double Velour Polyester, Titanium</Description><Size>21- 33mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>180</SubCategoryID><GroupID>1502</GroupID><ARTGs><ARTG>206262</ARTG></ARTGs><MinimumBenefit>6603</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC950</BillingCode><Name>Mosaic Ultra Cinch II</Name><Description>Small Aortic Root Bioprosthesis</Description><Size>19mm - 29mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>145761</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI283</BillingCode><Name>Attain Stability Quad MRI SureScan</Name><Description>Steroid-eluting, quadripolar electrode, transvenous, over-the-wire, cardiac vein pacing lead with active fixation</Description><Size>88 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1759</GroupID><ARTGs><ARTG>307331</ARTG></ARTGs><MinimumBenefit>2028</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC958</BillingCode><Name>Valiant Captivia</Name><Description>Valiant Stent Graft with Captivia Delivery System</Description><Size>24-46mm diameter, 200mm length</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1625</GroupID><SubGroupID>4443</SubGroupID><ARTGs><ARTG>169353</ARTG></ARTGs><MinimumBenefit>13086</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI455</BillingCode><Name>Tri-Staple GIA Reloading Units</Name><Description>Single use loading units</Description><Size>60mm, 80mm  </Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>331482</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI013</BillingCode><Name>Attain Ability Plus 4296/ Attain Ability Plus SureScan MRI 4296</Name><Description>Over the wire electrode left ventricular lead</Description><Size>78cm, 88cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1759</GroupID><ARTGs><ARTG>284542</ARTG></ARTGs><MinimumBenefit>2028</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI129</BillingCode><Name>Attain Performa Leads/ Attain Performa SureScan MRI Leads</Name><Description>LV lead family with four electrodes and an IS4 connector for LV pacing w/premium and standard IS4 CRT-D devices. The Attain Perfoma™ Lead provides LV pacing options to avoid the following: phrenic nerve stimulation, high pacing thresholds, and ischemic tissue (including MRI versions)</Description><Size>78, 88cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1759</GroupID><ARTGs><ARTG>284516</ARTG><ARTG>284517</ARTG><ARTG>284519</ARTG></ARTGs><MinimumBenefit>2028</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC811</BillingCode><Name>Attain Ability 4196 LV Lead/ Attain Ability SureScan 4196 MRI LV Lead</Name><Description>Over the wire dual electrode left ventricular lead</Description><Size>78, 88, and 103 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1759</GroupID><ARTGs><ARTG>284518</ARTG></ARTGs><MinimumBenefit>2028</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI270</BillingCode><Name>Infinity Spinal System</Name><Description>Straight Rod</Description><Size>Length 120 - 600 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI289</BillingCode><Name>Avalus Aortic Valve Bioprosthesis</Name><Description>Next generation aortic valve bovine bioprosthesis</Description><Size>19-29mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>179</SubCategoryID><GroupID>1499</GroupID><ARTGs><ARTG>302460</ARTG></ARTGs><MinimumBenefit>4750</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ236</BillingCode><Name>Prevail DCB</Name><Description>Paclitaxel-Coated PTCA Balloon Catheter
</Description><Size>Length (mm): 10-30; Diameter (mm): 2-4</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>297</SubCategoryID><GroupID>2970</GroupID><ARTGs><ARTG>427408</ARTG></ARTGs><MinimumBenefit>854</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS182</BillingCode><Name>Permacol  Biological Implant</Name><Description>Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen.</Description><Size>3 x 3cm, 5 x 5cm, 2 x 20cm, 5 x 10cm, 4 x 18cm, 10 x 10cm, 10 x 15cm, 6 x 3cm, 10 x 15cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5491</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>269662</ARTG></ARTGs><MinimumBenefit>710</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC694</BillingCode><Name>Restore Rechargeable Neurostimulation System</Name><Description>External Patient Programmer Antenna Model 37092</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4484</SubGroupID><ARTGs><ARTG>146936</ARTG></ARTGs><MinimumBenefit>161</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC251</BillingCode><Name>Implantable Subcutaneous Defibrillator Lead Model 6996SQ 41cm, 58cm, 85cm</Name><Description>Silicone and Platinum Alloy</Description><Size>Lengths 41-85cm inclusive</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>242</SubCategoryID><GroupID>1738</GroupID><ARTGs><ARTG>132315</ARTG></ARTGs><MinimumBenefit>1535</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI045</BillingCode><Name>Adaptor Kits</Name><Description>Lead adaptors</Description><Size>10-50cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>244</SubCategoryID><GroupID>1763</GroupID><ARTGs><ARTG>129420</ARTG><ARTG>137315</ARTG></ARTGs><MinimumBenefit>196</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC011</BillingCode><Name>Capsure EPI steroid eluting bipolar epicardial lead Model 4968 - ventricle</Name><Description>Silicone</Description><Size>25 - 60cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1746</GroupID><ARTGs><ARTG>134287</ARTG></ARTGs><MinimumBenefit>876</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI215</BillingCode><PriorBillingCodes><PriorBillingCode>AS025</PriorBillingCode><PriorBillingCode>AS026</PriorBillingCode><PriorBillingCode>AS030</PriorBillingCode></PriorBillingCodes><Name>PI/TA Reloading Units</Name><Description>PI/TA Disposable Surgical Loading Unit</Description><Size>30mm, 45mm, 60mm, 90mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>181429</ARTG><ARTG>185017</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI216</BillingCode><PriorBillingCodes><PriorBillingCode>AS116</PriorBillingCode><PriorBillingCode>AS016</PriorBillingCode><PriorBillingCode>AS017</PriorBillingCode><PriorBillingCode>AS114</PriorBillingCode><PriorBillingCode>AS118</PriorBillingCode><PriorBillingCode>AS013</PriorBillingCode></PriorBillingCodes><Name>GIA/ILA Reloading Units</Name><Description>Single Use Loading Units</Description><Size>50mm, 60mm, 80mm, 90mm, 100mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>181429</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ628</BillingCode><Name>Signia Small Diameter Reload</Name><Description>Staple reload</Description><Size>30-45mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>382171</ARTG><ARTG>382172</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS186</BillingCode><Name>Endo GIA™ Reload with TriStaple™ Technology</Name><Description>Endo GIA™ Reload with TriStaple™ Technology provides three staggered rows of staples on either side of the cut line.</Description><Size>45mm, 60mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>186247</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI471</BillingCode><PriorBillingCodes><PriorBillingCode>NK086</PriorBillingCode></PriorBillingCodes><Name>Dual diameter rod</Name><Description>Dual diameter rod</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><Suffix>Dual Diameter</Suffix><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>432</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI282</BillingCode><Name>Tri-Staple™ 2.0 reloads</Name><Description>Tri-Staple™ 2.0 reloads with intelligent chip that communicates with Signia™ stapler</Description><Size>30mm, 45mm, 60mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><Suffix>Endoscopic, Articulating/Roticulating</Suffix><ARTGs><ARTG>292807</ARTG><ARTG>350111</ARTG><ARTG>350112</ARTG></ARTGs><MinimumBenefit>318</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI240</BillingCode><Name>Axium Prime Detachable Coil - Extra Soft</Name><Description>Platinum alloy embolization coil attached to a composite implant delivery pusher with a radiopaque positioning marker and hand-held Instant Detacher, which when activated, mechanically detaches the coil from the delivery pusher tip.</Description><Size>3D Shape: diameter 1 to 3.5 mm;  length 2 to 10 cm; Volume 1.34 to 6.70 mm3
Helical Shape: diameter 1 to 3 mm;  length 1 to 10 cm; Volume 0.67  to 6.70 mm3</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1688</GroupID><ARTGs><ARTG>287418</ARTG></ARTGs><MinimumBenefit>1043</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS092</BillingCode><Name>ENDO - Herna reloading unit; VERSA TACK* reloading unit.</Name><Description>Titanium Surgical Stapler DLU</Description><Size>4mm, 4.8mm (10 staples).</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4317</SubGroupID><ARTGs><ARTG>181429</ARTG></ARTGs><MinimumBenefit>210</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI473</BillingCode><PriorBillingCodes><PriorBillingCode>NK088</PriorBillingCode></PriorBillingCodes><Name>Laminar Hooks</Name><Description>Laminar Hooks</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI464</BillingCode><PriorBillingCodes><PriorBillingCode>NK077</PriorBillingCode></PriorBillingCodes><Name>PASS LP System - Hooks</Name><Description>Pedicle Hook, Counter-Hooks, Hook Claws</Description><Size>One size</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>168</SubCategoryID><GroupID>1475</GroupID><ARTGs><ARTG>295277</ARTG><ARTG>316001</ARTG></ARTGs><MinimumBenefit>755</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS192</BillingCode><PriorBillingCodes><PriorBillingCode>EE022</PriorBillingCode></PriorBillingCodes><Name>Spider FX Embolic Protection Device</Name><Description>The Spider FX is a rapid exchange device percutaneously delivered distal embolic protection device with components designed to capture and remove debris from vessels during interventional procedures in the vasculature.</Description><Size>Filter:  3.0 - 7.0mm; Capture Wire:  190 and 320cm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>211</SubCategoryID><GroupID>1643</GroupID><ARTGs><ARTG>151258</ARTG></ARTGs><MinimumBenefit>1895</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI519</BillingCode><Name>InterStim X System – Neurostimulator</Name><Description>Recharge-free implantable neurostimulator</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1712</GroupID><SubGroupID>7380</SubGroupID><ARTGs><ARTG>421914</ARTG></ARTGs><MinimumBenefit>9606</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS193</BillingCode><PriorBillingCodes><PriorBillingCode>EE023</PriorBillingCode></PriorBillingCodes><Name>Axium Detachable Coil System</Name><Description>Platinum alloy coils (including coils enlaced with PGLA filaments and Nylon Fibers)  attached to a composite implant delivery pusher with a radiopaque positioning marker.  The proximal end of the pusher is loaded into the Actuator which detaches the coil.</Description><Size>Diameter: 1.5 - 25mm; Length: 1 - 50cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>225</SubCategoryID><GroupID>1688</GroupID><ARTGs><ARTG>149398</ARTG><ARTG>162494</ARTG><ARTG>162495</ARTG><ARTG>194132</ARTG><ARTG>388356</ARTG></ARTGs><MinimumBenefit>1043</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI521</BillingCode><Name>CD Horizon™ ModuLeX™ 5.5 Spinal System - Tulip Head</Name><Description>Tulip Head</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>422155</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI263</BillingCode><Name>Infinity Spinal System</Name><Description>Occipital Screw Connectors</Description><Size>Standard, offset, open angle</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC513</BillingCode><Name>TiMesh</Name><Description>Full Mandible</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4353</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>915</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC608</BillingCode><Name>TSRH</Name><Description>Connector</Description><Size>Small, Medium, Large</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC338</BillingCode><Name>Medtronic Capsurefix Novus Model 5076 Pacing Lead</Name><Description>Silicone; Contents: 1 x lead with anchoring sleeve, stylet &amp; guide, 1 x vein lifter, 2 x fixation tools, extra stylets</Description><Size>45-85cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1756</GroupID><ARTGs><ARTG>236828</ARTG></ARTGs><MinimumBenefit>441</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC985</BillingCode><Name>Vertex Spinal System</Name><Description>Connectors</Description><Size>Small, medium, large</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI546</BillingCode><Name>ModuLeX Spinal System - Tulip Head (with Set Screw)</Name><Description>Tulip Head packaged with break-off set screw (to be billed with billing code MI545 for Set Screw)</Description><Size>4.75/5.0 mm; 5.5/6.0 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>422155</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI548</BillingCode><Name>ModuLeX Spinal System - Tulip Head</Name><Description>Tulip Head - stand-alone packaged without a set screw </Description><Size>4.75/5.0 mm; 5.5/6.0 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1469</GroupID><ARTGs><ARTG>422155</ARTG></ARTGs><MinimumBenefit>686</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2026-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC919</BillingCode><Name>Middle Ear Prosthesis</Name><Description>Malleus</Description><Size>0.6 - 4.0mm x 2.7 - 5.0mm x 1.5 - 10.0mm</Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4155</SubGroupID><ARTGs><ARTG>125831</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI174</BillingCode><Name>Centerpiece</Name><Description>TiMesh LP</Description><Size>Various</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1477</GroupID><SubGroupID>4131</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>660</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS212</BillingCode><Name>Veriset</Name><Description>Veriset is an absorbable topical hemostatic device intended for use in surgical procedures as an adjunct to hemostatsis when conventional methods are ineffective or impractical.  Veriset does not consist of any human or animal components</Description><Size>2cm x 4cm (8cm2)</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1580</GroupID><SubGroupID>5424</SubGroupID><ARTGs><ARTG>202060</ARTG></ARTGs><MinimumBenefit>52</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI248</BillingCode><PriorBillingCodes><PriorBillingCode>MC295</PriorBillingCode><PriorBillingCode>MC544</PriorBillingCode></PriorBillingCodes><Name>Vertex Spinal System</Name><Description>Rods</Description><Size>20-600mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI269</BillingCode><Name>Infinity Spinal System</Name><Description>Pre - curved rod</Description><Size>Length 25 - 200mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC396</BillingCode><Name>TSRH Spinal Implant System</Name><Description>3D - Rod</Description><Size>Length 20-120mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI440</BillingCode><Name>Percepta MRI SureScan CRT-P  with BlueSync mobile remote monitoring</Name><Description>MR Conditional pacemaker with cardiac resynchronization therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR) with BlueSync mobile remote monitoring</Description><Size>20cm3 30g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>g, Remote Monitoring Service</Suffix><ARTGs><ARTG>393515</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>10454</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC833</BillingCode><Name>CapSureFix Novus Model 4076 Pacing Lead (MRI SureScan)</Name><Description>Active fixation pacemaker lead, including MRI compatible models</Description><Size>35 - 85cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1756</GroupID><ARTGs><ARTG>286952</ARTG></ARTGs><MinimumBenefit>441</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI439</BillingCode><Name>Percepta Quad MRI SureScan CRT-P  with BlueSync mobile remote monitoring</Name><Description>MR Conditional pacemaker with cardiac resynchronization therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR) with BlueSync mobile remote monitoring</Description><Size>20.5cm3 30g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>g, Remote Monitoring Service</Suffix><ARTGs><ARTG>393516</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>10454</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI244</BillingCode><Name>Serena MRI SureScan CRT-P</Name><Description>MR Conditional pacemaker with cardiac resynchronisation therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR)</Description><Size>20cm3 30g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>g</Suffix><ARTGs><ARTG>393517</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI442</BillingCode><Name>Serena MRI SureScan CRT-P  with BlueSync mobile remote monitoring</Name><Description>MR Conditional pacemaker with cardiac resynchronisation therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR) with BlueSync mobile remote monitoring</Description><Size>20cm3 30g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>g, Remote Monitoring Service</Suffix><ARTGs><ARTG>393517</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>10454</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI231</BillingCode><Name>Percepta MRI SureScan CRT-P</Name><Description>MR Conditional pacemaker with cardiac resynchronization therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR)</Description><Size>20cm3 30g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>g</Suffix><ARTGs><ARTG>393515</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI245</BillingCode><Name>Percepta Quad MRI SureScan CRT-P</Name><Description>MR Conditional pacemaker with cardiac resynchronisation therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR)</Description><Size>20.5cm3 30g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>g</Suffix><ARTGs><ARTG>393516</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI441</BillingCode><Name>Serena Quad MRI SureScan CRT-P  with BlueSync mobile remote monitoring</Name><Description>MR Conditional pacemaker with cardiac resynchronisation therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR) with BlueSync mobile remote monitoring</Description><Size>20.5cm3 30g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>g, Remote Monitoring Service</Suffix><ARTGs><ARTG>393518</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>10454</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI236</BillingCode><Name>Serena Quad MRI SureScan CRT-P</Name><Description>MR Conditional pacemaker with cardiac resynchronisation therapy, SureScan™ technology, and Bluetooth® wireless telemetry (OAE-DDDR)</Description><Size>20.5cm3 30g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>241</SubCategoryID><GroupID>1736</GroupID><Suffix>g</Suffix><ARTGs><ARTG>393518</ARTG></ARTGs><MinimumBenefit>9004</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC301</BillingCode><Name>SelectSecure Model 3830 and SelectSecure MRI SureScan Model 3830</Name><Description>Steroid eluting, bipolar, implantable, nonretractable screw-in, atrial/ventricular, catheter delivered, transvenous pacemaker lead.</Description><Size>49-110 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>243</SubCategoryID><GroupID>1756</GroupID><Suffix>j</Suffix><ARTGs><ARTG>131307</ARTG><ARTG>301080</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC817</BillingCode><Name>Medtronic Intrathecal Catheter Revision Kit (Proximal)</Name><Description>Revision kit to repair proximal end of intrathecal catheter (8596SC)</Description><Size>66cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>223</SubCategoryID><GroupID>1684</GroupID><SubGroupID>4503</SubGroupID><ARTGs><ARTG>153487</ARTG></ARTGs><MinimumBenefit>542</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI029</BillingCode><Name>Medtronic Ascenda Spinal Segment Revision Kit</Name><Description>Intrathecal Catheter Spinal Segment Revision Kit</Description><Size>One Size</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>223</SubCategoryID><GroupID>1684</GroupID><SubGroupID>4503</SubGroupID><ARTGs><ARTG>192043</ARTG></ARTGs><MinimumBenefit>542</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC404</BillingCode><Name>CD HORIZON Spinal System - Rod</Name><Description>Rod</Description><Size>20mm - 600mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI030</BillingCode><Name>Medtronic Ascenda Pump Segment Revision Kit</Name><Description>Intrathecal Catheter Pump Segment Revision Kit</Description><Size>One Size</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>223</SubCategoryID><GroupID>1684</GroupID><SubGroupID>4503</SubGroupID><ARTGs><ARTG>192044</ARTG></ARTGs><MinimumBenefit>542</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC998</BillingCode><Name>Endurant II AAA Aorto-Uni-Iliac</Name><Description>Endurant II Endoluminal Stent Graft System - AUI</Description><Size>Proximal diameter: 23 to 36mm; Distal daimeter: 14mm; Covered length: 102mm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1627</GroupID><ARTGs><ARTG>197539</ARTG></ARTGs><MinimumBenefit>9206</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC407</BillingCode><Name>CD Horizon</Name><Description>Domino</Description><Size>3.2mm, 3.5mm, 4.5mm, 5,5mm, 6.35mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI044</BillingCode><PriorBillingCodes><PriorBillingCode>MC036</PriorBillingCode></PriorBillingCodes><Name>Medtronic Upsizing Sleeve: Model 5866-45, Model 5866-46</Name><Description>5866-45: IS1 UNI Lead to 5/6mm UNI IPG; 5866-46: IS1 UNI Lead to 5mm UNI IPG or 5mm Bifurcated BI IPG</Description><Size>18-25mm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1765</GroupID><ARTGs><ARTG>129420</ARTG></ARTGs><MinimumBenefit>54</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC512</BillingCode><Name>TiMesh</Name><Description>Maxillary Prosthesis</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Maxilla</Suffix><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>1491</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC516</BillingCode><Name>TiMesh</Name><Description>Mandibular Symphysis</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Symphsis</Suffix><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>909</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC515</BillingCode><Name>TiMesh</Name><Description>Hemimandible, Left/Right</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1596</GroupID><SubGroupID>4358</SubGroupID><Suffix>Hemimandible</Suffix><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>453</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC409</BillingCode><Name>CD Horizon</Name><Description>Domino &amp; Axial Connector</Description><Size>4.5mm, 5.5mm and 6.35mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI538</BillingCode><Name>EEA Circular Stapler with Tri-Staple Technology for use with OrVil</Name><Description>Tri-Staple series circular stapler with 3 row staples, slope faced cartridge with a different staple size in each staple row. Device is used with Tri-Staple series EEA OrVil Transoral Anvil (listed and reimbursed under a separate billing code).</Description><Size>21mm, 25mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Endoscopic, Circular</Suffix><ARTGs><ARTG>293808</ARTG></ARTGs><MinimumBenefit>671</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI281</BillingCode><Name>EEA Circular Stapler with Tri Staple Technology</Name><Description>Circular staplers with 3 row staples, slope faced cartridge with a different  staple size in each staple row.</Description><Size>21mm to 33mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Endoscopic, Circular</Suffix><ARTGs><ARTG>293808</ARTG></ARTGs><MinimumBenefit>671</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI461</BillingCode><PriorBillingCodes><PriorBillingCode>NK072</PriorBillingCode></PriorBillingCodes><Name>PASS LP System - Connectors</Name><Description>Connectors</Description><Size>5.5 &amp; 6.0 mm rods</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1472</GroupID><ARTGs><ARTG>295277</ARTG><ARTG>316001</ARTG></ARTGs><MinimumBenefit>655</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI514</BillingCode><Name>Anteralign™ - Mini Plate</Name><Description>Standard and offset miniplate with titanium bolt to be used with the Anteralign™ TL cage</Description><Size>Width: 12 mm; Length: 20 mm, 23 mm; Offset: 0 mm, 2.5 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1467</GroupID><ARTGs><ARTG>422151</ARTG></ARTGs><MinimumBenefit>391</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI042</BillingCode><PriorBillingCodes><PriorBillingCode>MC036</PriorBillingCode></PriorBillingCodes><Name>Medtronic Lead End Cap Kit Model: 5867-3M</Name><Description>Lead End Cap Kit</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1765</GroupID><ARTGs><ARTG>131305</ARTG></ARTGs><MinimumBenefit>54</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC915</BillingCode><Name>TiMesh Titanium Rigid Fixation Bone Grafting and Plating System</Name><Description>FlexMesh 1.5mm System. Composition: Titanium</Description><Size>26 to 50 cm2 area; 0.6mm thick</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4208</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>388</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI214</BillingCode><PriorBillingCodes><PriorBillingCode>AS113</PriorBillingCode><PriorBillingCode>AS115</PriorBillingCode><PriorBillingCode>AS117</PriorBillingCode><PriorBillingCode>AS011</PriorBillingCode></PriorBillingCodes><Name>GIA™ Stapler With DST Series™</Name><Description>Single use reloadable linear cutting stapler designed with 4.8 mm, 3.8 mm, and 2.5 mm staple heights</Description><Size>2.5mm, 3.8mm, 4.8mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><ARTGs><ARTG>181272</ARTG></ARTGs><MinimumBenefit>292</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI456</BillingCode><Name>GIA Stapler with Tri-Staple technology</Name><Description>Single use, reloadable stapler</Description><Size>60mm, 80mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><ARTGs><ARTG>331481</ARTG></ARTGs><MinimumBenefit>292</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS179</BillingCode><Name>EEA Haemorrhoid and Prolapse Stapler</Name><Description>Stapling instrument for control of rectal prolapse and haemorrhoid disease.</Description><Size>33mm Circular Stapling line, 3.5 mm and 4.8mm Staple leg length.</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Circular</Suffix><ARTGs><ARTG>178674</ARTG></ARTGs><MinimumBenefit>648</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI212</BillingCode><PriorBillingCodes><PriorBillingCode>AS018</PriorBillingCode><PriorBillingCode>AS019</PriorBillingCode><PriorBillingCode>AS102</PriorBillingCode><PriorBillingCode>AS133</PriorBillingCode></PriorBillingCodes><Name>TA Stapler</Name><Description>Disposable Surgical Stapler and Loading Unit</Description><Size>30mm, 45mm, 60mm, 90mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><ARTGs><ARTG>181434</ARTG><ARTG>185015</ARTG></ARTGs><MinimumBenefit>292</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI479</BillingCode><PriorBillingCodes><PriorBillingCode>NK096</PriorBillingCode></PriorBillingCodes><Name>LigaPASS Spinal System - Sublaminar cables and connectors</Name><Description>The connectors and cables/bands work together as a bone anchor to provide stabilisation during the development of solid bony fusion and aid repair of bone fractures.</Description><Size>Connector: 20.8mm to 23mm; Band: 970mm to 1060mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1816</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>312320</ARTG></ARTGs><MinimumBenefit>757</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI297</BillingCode><Name>Translace Spinal Tethering System</Name><Description>Tether, tether connector, set screws</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1816</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>312380</ARTG></ARTGs><MinimumBenefit>757</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC857</BillingCode><Name>Small Lumen Peritoneal Catheter</Name><Description>CSF Distal Catheter</Description><Size>ID - 0.7mm OD - 2.5mm Length - 120cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Distal</Suffix><ARTGs><ARTG>130410</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI219</BillingCode><PriorBillingCodes><PriorBillingCode>AS135</PriorBillingCode><PriorBillingCode>AS119</PriorBillingCode><PriorBillingCode>AS072</PriorBillingCode></PriorBillingCodes><Name>EEA Circular Stapler</Name><Description>Circular staplers</Description><Size>21mm to 34mm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4320</SubGroupID><Suffix>Endoscopic, Circular</Suffix><ARTGs><ARTG>178517</ARTG></ARTGs><MinimumBenefit>671</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC185</BillingCode><Name>Sacral Nerve Stimulation Unilateral</Name><Description>Interstim Temporary test stimulation lead</Description><Size>Various</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1714</GroupID><SubGroupID>5340</SubGroupID><ARTGs><ARTG>137440</ARTG></ARTGs><MinimumBenefit>373</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ764</BillingCode><Name>PulseSelect Pulsed Field Ablation (PFA) catheter</Name><Description>Pulse Select is a 9Fr catheter with 25mm diameter circular end with fixed electrode spacing which allows for uniform waveform distribution</Description><Size>Distal Diameter 25 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2966</GroupID><SubGroupID>7379</SubGroupID><Suffix>Medtronic</Suffix><ARTGs><ARTG>461995</ARTG></ARTGs><MinimumBenefit>6399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ750</BillingCode><Name>Sphere-9 Catheter</Name><Description>The Sphere-9 Catheter is a sterile, single-use, bi-directional, 8F deflectable dual energy catheter (pulsed-field and radiofrequency) for cardiac ablation and mapping</Description><Size>Distal Diameter 9 mm</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2966</GroupID><SubGroupID>7379</SubGroupID><Suffix>Medtronic</Suffix><ARTGs><ARTG>468766</ARTG></ARTGs><MinimumBenefit>6399</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI166</BillingCode><Name>ARES antibiotic -impregnated catheter</Name><Description>ARES antibiotic-impregnated peritoneal catheter</Description><Size>120cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Antibiotics</Suffix><ARTGs><ARTG>245274</ARTG></ARTGs><MinimumBenefit>424</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC543</BillingCode><Name>Vertex Spinal System</Name><Description>Plate/rod</Description><Size>80 - 240mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>171</SubCategoryID><GroupID>1481</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1905</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI165</BillingCode><Name>ARES Antibiotic-Impregnated Catheter</Name><Description>ARES antibiotic-impregnated ventricular catheter</Description><Size>23cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Antibiotics</Suffix><ARTGs><ARTG>245273</ARTG></ARTGs><MinimumBenefit>424</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC436</BillingCode><Name>CD-Horizon</Name><Description>C-ring</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>173</SubCategoryID><GroupID>1484</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>306</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC521</BillingCode><Name>TiMesh</Name><Description>Naso-Orbital-Ethmoid </Description><Size>1mm - 2.2mm;  Complex 1, Complex 2, Complex 3</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>200</SubCategoryID><GroupID>1597</GroupID><SubGroupID>4364</SubGroupID><Suffix>Complex</Suffix><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>527</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI122</BillingCode><PriorBillingCodes><PriorBillingCode>MI095</PriorBillingCode></PriorBillingCodes><Name>Ventricular, Opus (Opus Stylet), snap shunt, Innervision (Slit tip) hydrocephalus catheters</Name><Description>Ventricular catheters, range: non-metallic latex free, barium impregnated, includes stainless steel stylet; snap shunt; snap base; slit tip</Description><Size>4.0 to 10 cm; 15 cm and 23.0 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal</Suffix><ARTGs><ARTG>141099</ARTG><ARTG>141100</ARTG><ARTG>141101</ARTG></ARTGs><MinimumBenefit>167</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI397</BillingCode><Name>DiamondTemp Ablation Catheter</Name><Description>An irrigated, multi-electrode, temperature-controlled, radio-frequency catheter for mapping, pacing and cardiac ablation</Description><Size>7.5F</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>290</SubCategoryID><GroupID>2946</GroupID><SubGroupID>7349</SubGroupID><Suffix>Medtronic</Suffix><ARTGs><ARTG>391792</ARTG><ARTG>391793</ARTG></ARTGs><MinimumBenefit>3700</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC639</BillingCode><Name>Ventricular Catheter PSM range with Bioglide</Name><Description>Translucent silicone elastomer with Barium impregnated stripe. Catheter surface bonded with Hydrogel.</Description><Size>15-23cm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1668</GroupID><Suffix>Proximal, Coating</Suffix><ARTGs><ARTG>141102</ARTG></ARTGs><MinimumBenefit>220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI151</BillingCode><Name>ALAR Nasal Valve Stent</Name><Description>Nasal valve stent for repair of nasal vestibular stenosis and nasal valve collapse.</Description><Size>20mm long x 16mm wide</Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>197</SubCategoryID><GroupID>1817</GroupID><ARTGs><ARTG>218121</ARTG></ARTGs><MinimumBenefit>172</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC637</BillingCode><Name>CD Horizon</Name><Description>Spire Plate</Description><Size>35-41mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>177</SubCategoryID><GroupID>1496</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1321</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC946</BillingCode><Name>Medtronic ACTIVA RC Neurostimulator for Deep  Brain Stimulation</Name><Description>ACTIVA RC Dual channel rechargeable neurostimulator for Deep Brain Stimulation (37612)</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1672</GroupID><SubGroupID>4473</SubGroupID><Suffix>Dual Channel</Suffix><ARTGs><ARTG>392011</ARTG></ARTGs><MinimumBenefit>17283</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI180</BillingCode><Name>MyCareLink Patient Monitor</Name><Description>Electronic cellular patient monitor which gathers and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment.</Description><Size>One size</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>266</SubCategoryID><GroupID>1832</GroupID><ARTGs><ARTG>297224</ARTG></ARTGs><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI043</BillingCode><PriorBillingCodes><PriorBillingCode>MC036</PriorBillingCode></PriorBillingCodes><Name>Medtronic DF-1 Port Pin Plug Kit: Model 6719; Medtronic IS-1 Port Pin Plug Kit: Model 6725</Name><Description>DF-1 unipolar connector port pin plug, one per kit</Description><Size>One size per model</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>246</SubCategoryID><GroupID>1765</GroupID><ARTGs><ARTG>132184</ARTG></ARTGs><MinimumBenefit>54</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI296</BillingCode><Name>MyCareLink Relay Home Communicator</Name><Description>Electronic cellular (optional wifi) patient monitor which gathers and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment</Description><Size>One size</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>266</SubCategoryID><GroupID>1832</GroupID><ARTGs><ARTG>313825</ARTG></ARTGs><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI196</BillingCode><Name>MyCareLink Smart Patient Reader</Name><Description>Electronic cellular patient reader which gathers and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment.</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>266</SubCategoryID><GroupID>1832</GroupID><ARTGs><ARTG>235570</ARTG></ARTGs><MinimumBenefit>1450</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI535</BillingCode><Name>Percept RC System - Neurostimulator</Name><Description>A dual channel, rechargeable INS platform that incorporates DBS features including, OverDrive Technology, BrainSense Technology, Distance Telemetry, 3T MRI compatibility.
</Description><Size>One Size</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1672</GroupID><SubGroupID>4473</SubGroupID><Suffix>Unlimited Deep Discharge Battery</Suffix><ARTGs><ARTG>462930</ARTG></ARTGs><MinimumBenefit>19855</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC387</BillingCode><Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name><Description>Titanium, Square Grid Mesh</Description><Size>Large</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4206</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>1462</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS095</BillingCode><Name>STATTACK </Name><Description>STATTACK  Titanium Helical Tacker</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4331</SubGroupID><ARTGs><ARTG>178498</ARTG></ARTGs><MinimumBenefit>234</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS045</BillingCode><Name>PROTACK; ENDO UNIVERSAL</Name><Description>Single-use titanium hernia mesh fixation device</Description><Size>5mm (Qty 30); 4mm, 4.8mm (Qty 10)</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4331</SubGroupID><Suffix>Endoscopic</Suffix><ARTGs><ARTG>178498</ARTG><ARTG>181429</ARTG></ARTGs><MinimumBenefit>374</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI449</BillingCode><Name>Azure S DR MRI SureScan with  BlueSync mobile remote monitoring</Name><Description>MR Conditional dual chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-DDDR) with BlueSync mobile remote monitoring</Description><Size>12.75 cm3 22.5g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>g, Remote Monitoring Service</Suffix><ARTGs><ARTG>392520</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>8023</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI003</BillingCode><Name>Medtronic DBS Tunneling Tool Accessory Kit</Name><Description>DBS Tunneling Tool Accessory Kit</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4498</SubGroupID><ARTGs><ARTG>121281</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2011-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC933</BillingCode><Name>Advisa DR MRI SureScan</Name><Description>Advisa DR MRI SureScan A3DR01 - Dual-chamber pacemaker</Description><Size>12.7cc, 22g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>g</Suffix><ARTGs><ARTG>396560</ARTG></ARTGs><MinimumBenefit>6573</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI448</BillingCode><Name>Azure XT DR MRI SureScan with BlueSync mobile remote monitoring</Name><Description>MR Conditional dual chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry with BlueSync mobile remote monitoring</Description><Size>12.75 cm3 22.5g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>g, Remote Monitoring Service</Suffix><ARTGs><ARTG>392519</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>8023</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC826</BillingCode><Name>Medtronic Accessory Kit for Deep Brain Stimulation</Name><Description>Boots accessory kit for DBS (3550-25)</Description><Size>N/A</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4498</SubGroupID><ARTGs><ARTG>240576</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI493</BillingCode><Name>SenSight™ Tunneler Kit   </Name><Description>Creates a subcutaneous path for tunnelling the lead to the intended location and retains the lead position.</Description><Size>one size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4498</SubGroupID><ARTGs><ARTG>372651</ARTG><ARTG>387433</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI489</BillingCode><Name>SenSight™ Lead Cap Kit</Name><Description>Protects and isolates the directional lead contacts after the implant but prior to extension connection.</Description><Size>one size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4498</SubGroupID><ARTGs><ARTG>387435</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC821</BillingCode><Name>T2</Name><Description>End Cap</Description><Size>13-31 mm, 0, 4, 8, 15 degree lordosis</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1495</GroupID><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>1030</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI494</BillingCode><Name>SenSight™ Connector Plug</Name><Description>Fits into an unused socket of a dual channel neurostimulator, or the distal end of an unused DBS extension.</Description><Size>one size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4498</SubGroupID><ARTGs><ARTG>387434</ARTG></ARTGs><MinimumBenefit>158</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI243</BillingCode><Name>Azure S DR MRI SureScan</Name><Description>MR Conditional dual chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-DDDR)</Description><Size>12.75cm3 22.5g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>g</Suffix><ARTGs><ARTG>392520</ARTG></ARTGs><MinimumBenefit>6573</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC726</BillingCode><Name>Adapta Pacemaker</Name><Description>DR Pacemaker
Models ADDR01, ADDRS1, ADDR03</Description><Size>11.1 - 13cc 23.6g - 28.1g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><ARTGs><ARTG>396550</ARTG><ARTG>396551</ARTG><ARTG>396559</ARTG></ARTGs><MinimumBenefit>5448</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI222</BillingCode><Name>Attesta DR MRI SureScan pacemaker</Name><Description>MRI safe, dual chamber rate responsive pacemaker (DDDR)</Description><Size>12.1cm3 23.6g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><ARTGs><ARTG>393093</ARTG></ARTGs><MinimumBenefit>5448</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI226</BillingCode><Name>Attesta L DR MRI SureScan pacemaker</Name><Description>MRI, dual chamber rate responsible pacemaker (DDDR)</Description><Size>13.1cm3 31.3g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><ARTGs><ARTG>393095</ARTG></ARTGs><MinimumBenefit>5448</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI237</BillingCode><Name>Azure XT DR MRI SureScan</Name><Description>MR Conditional dual chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry</Description><Size>12.75 cm3 22.5g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><Suffix>g</Suffix><ARTGs><ARTG>392519</ARTG></ARTGs><MinimumBenefit>6573</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI233</BillingCode><Name>Attesta S DR MRI SureScan pacemaker</Name><Description>MRI, dual chamber rate responsive pacemaker (DDDR)</Description><Size>11.1cm3 23.6g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>240</SubCategoryID><GroupID>1734</GroupID><ARTGs><ARTG>393096</ARTG></ARTGs><MinimumBenefit>5448</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2017-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC539</BillingCode><Name>Pyramesh</Name><Description>End ring/cap</Description><Size>10 - 25mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>176</SubCategoryID><GroupID>1495</GroupID><ARTGs><ARTG>169501</ARTG></ARTGs><MinimumBenefit>1030</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS227</BillingCode><Name>ReliaTack Articulating Reloadable Fixation Device</Name><Description>Articulating, reloadable, sterile, single use fixation device prepackaged with 30 standard single use, absorbable reloads</Description><Size>5.1mm, 30 tacks</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1582</GroupID><SubGroupID>4331</SubGroupID><Suffix>Absorbable, Articulating/Roticulating</Suffix><ARTGs><ARTG>315822</ARTG></ARTGs><MinimumBenefit>653</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC755</BillingCode><Name>InterStim II Neurostimulator</Name><Description>Model 3058 neurostimulator</Description><Size>Weight 22g</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1712</GroupID><ARTGs><ARTG>391141</ARTG></ARTGs><MinimumBenefit>9073</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2007-12-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI181</BillingCode><Name>SIMULUS Flexible Annuloplasty Ring</Name><Description>Flexible mitral/tricuspid annuloplasty ring</Description><Size>Ring size (mm): 23, 25, 27, 29, 31, 33, 35, 37, 39</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1841</GroupID><ARTGs><ARTG>271813</ARTG></ARTGs><MinimumBenefit>2090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC005</BillingCode><Name>Medtronic Duran Annuloplasty Ring; Duran Ancore Ring 620R; Duran Ancore Chordal Model 620RG</Name><Description>Annuloplasty Devices - Models 610R &amp; 620R Silicone / Barium Sulphate, Dacron.</Description><Size>Model 610R 25-35mm &amp; Model 620R 23-35mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1841</GroupID><ARTGs><ARTG>135737</ARTG></ARTGs><MinimumBenefit>2090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2005-10-31</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ646</BillingCode><Name>IN.PACT 018 Paclitaxel-coated PTA Balloon Catheter</Name><Description>The FreePac drug coating on the balloon of the IN.PACT 018 DCB consists of the drug paclitaxel and the excipient urea. </Description><Size>Balloon Diameter: 4 to 7 mm; Balloon Length: 40 to 150 mm; Catheter Usable Length: 80 to 130 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>296</SubCategoryID><GroupID>2967</GroupID><ARTGs><ARTG>449546</ARTG></ARTGs><MinimumBenefit>1245</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI192</BillingCode><PriorBillingCodes><PriorBillingCode>MC709</PriorBillingCode></PriorBillingCodes><Name>Duran Ancore Band 620B</Name><Description>Silicone / Barium Sulphate, Dacron</Description><Size>23-35mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1841</GroupID><ARTGs><ARTG>135738</ARTG></ARTGs><MinimumBenefit>2090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI507</BillingCode><Name>IN.PACT Admiral Paclitaxel-Coated PTA Balloon Catheter</Name><Description>The FreePac™ drug coating on the balloon of the IN.PACT Admiral DCB consists of the drug paclitaxel and the excipient urea. </Description><Size>The IN.PACT Admiral DCB variations are: Balloon Diameter: 4 -12mm; Balloon Length: 40 to 250 mm; Catheter Usable Length: 40 to 130 cm.  </Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>296</SubCategoryID><GroupID>2967</GroupID><ARTGs><ARTG>228876</ARTG></ARTGs><MinimumBenefit>1245</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI510</BillingCode><Name>SimuPlus™ Annuloplasty Band</Name><Description>Flexible mitral/tricuspid annuloplasty band including accessories (tray, sizers and annuloplasty handles)</Description><Size>Ring size (mm): 26, 28, 30, 32, 34, 36, 38, 40, 42</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1841</GroupID><ARTGs><ARTG>394453</ARTG></ARTGs><MinimumBenefit>2090</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC928</BillingCode><Name>Strata NSC L-P Shunt</Name><Description>Lumboperitoneal Shunt</Description><Size>44mm x 23mm x 12mm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Lumboperitoneal, Reservoir/Priming function</Suffix><ARTGs><ARTG>129681</ARTG></ARTGs><MinimumBenefit>2437</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI262</BillingCode><Name>Infinity Spinal System</Name><Description>Set screw</Description><Size>Standard, flat</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI080</BillingCode><Name>Strata NSC LP Shunt Kit</Name><Description>Strata NSC LP Shunt Kit with Lumbar Catheter and Peritoneal Catheter, Small Lumen</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Distal catheter, Lumboperitoneal, Proximal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>165018</ARTG></ARTGs><MinimumBenefit>2734</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI468</BillingCode><PriorBillingCodes><PriorBillingCode>NK083</PriorBillingCode></PriorBillingCodes><Name>Locking Nut</Name><Description>Locking Nut</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI522</BillingCode><Name>ModuLeX Spinal System – Set Screw</Name><Description>Break-off, non-break-off and reduction-break-off (to be used with pedicle screws, Tulip Heads, or hooks)</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>422155</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI112</BillingCode><Name>Evera XT VR DF1/ Evera MRI XT VR SureScan DF1</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, Optimised Battery Chemistry, SmartShock Technology 2.0, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management. DF1</Description><Size>33cm³ 77g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a, d</Suffix><ARTGs><ARTG>392334</ARTG><ARTG>393381</ARTG></ARTGs><MinimumBenefit>22220</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI545</BillingCode><Name>ModuLeX Spinal System - Set Screw (with Tulip Head)</Name><Description>Break-off set screw packaged with Tulip Head (to be billed with billing code MI546 for Tulip Head)</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>422155</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI410</BillingCode><Name>Cobalt™ XT VR ICD MRI SureScan™ with BlueSync mobile remote monitoring</Name><Description>Single Chamber Implantable Cardioverter Defibrillator with PhysionCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF1 with BlueSync mobile remote monitoring</Description><Size>33.2 cm3, 79 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>236</SubCategoryID><GroupID>1723</GroupID><Suffix>a,d Remote Monitoring Service</Suffix><ARTGs><ARTG>392254</ARTG></ARTGs><Note>The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.</Note><MinimumBenefit>23670</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC706</BillingCode><Name>Venture Anterior Cervical Plate</Name><Description>Single or multi level plate, titanium alloy and Nitinol</Description><Size>52.5mm - 55mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI152</BillingCode><Name>ZEVO Anterior Cervical Plate System</Name><Description>Anterior Cervical Plate</Description><Size>15mm - 55mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI162</BillingCode><Name>ZEVO Anterior Cervical Plate System</Name><Description>Anterior Cervical Plate</Description><Size>57 - 108mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><Suffix>&gt;55mm</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1419</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI157</BillingCode><Name>Divergence Anterior Cervical Fusion Mini-plate System</Name><Description>Divergence anterior cervical fusion mini-plate</Description><Size>15.5mm - 22.5mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2015-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC399</BillingCode><Name>TSRH Spinal Implant System</Name><Description>3D - Nut, Eyebolt locknot, locknut 1/2 inch, locking screws, double hex, flush break, universal breakoff</Description><Size>Each in one size</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC419</BillingCode><Name>Atlantis Anterior Cervical Plate</Name><Description>Anterior Cervical Plate</Description><Size>50mm - 55mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>169</SubCategoryID><GroupID>1476</GroupID><SubGroupID>4125</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1297</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI544</BillingCode><Name>ModuLeX Spinal System - Screw Shank</Name><Description>Screw Shank</Description><Size>Diameter: 4.0mm to 12.5mm Length: 15mm to 110mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>422153</ARTG><ARTG>422155</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI524</BillingCode><Name>CD Horizon™ ModuLeX™ 5.5 Spinal System - Rod</Name><Description>Rod</Description><Size>Diameter: 5.5mm; Length 25mm - 120mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>170</SubCategoryID><GroupID>1478</GroupID><ARTGs><ARTG>422153</ARTG></ARTGs><MinimumBenefit>340</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI079</BillingCode><Name>Middle ear prostheses</Name><Description>Stapes</Description><Size>0.4-1.17mm x 0.9-4.0 x 4.0 x4.0-10.2mm; 4.0 - 4.75mm</Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4154</SubGroupID><ARTGs><ARTG>125831</ARTG></ARTGs><MinimumBenefit>94</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI121</BillingCode><Name>Contour 3D Tricuspid Annuloplasty Ring</Name><Description>Annuloplasty Ring: Titanium core encapsulated with silicone, covered with polyester fabric</Description><Size>26, 28, 30 32, 34, 36mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1842</GroupID><ARTGs><ARTG>202774</ARTG></ARTGs><MinimumBenefit>2280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC918</BillingCode><Name>The Big Easy Piston</Name><Description>Big Easy Range - MRI Safe, Triple Width Platinum Band, Double Width Platinum Shaft with Offset Versions</Description><Size>0.4 - 1.17mm x 0.9 - 4.0mm x 4.0 x 10.2mm; 4.0 - 4.75mm</Size><SupplierCode>MI</SupplierCode><CategoryID>22</CategoryID><SubCategoryID>196</SubCategoryID><GroupID>1565</GroupID><SubGroupID>4154</SubGroupID><ARTGs><ARTG>125831</ARTG></ARTGs><MinimumBenefit>94</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC674</BillingCode><Name>CD HORIZON Spinal System - Set Screw</Name><Description>Set Screw</Description><Size>3.5mm - 6.35mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC525</BillingCode><Name>TiMesh</Name><Description>Sugar Mesh Panel / Grid</Description><Size>11 x 7.5cm</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4205</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>1229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC890</BillingCode><Name>TiMesh</Name><Description>Square-rectangular Gridmesh Panel</Description><Size>51 to 100 cm2 area</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4205</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>1229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC546</BillingCode><Name>Vertex Spinal System</Name><Description>Set screw</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC524</BillingCode><Name>TiMesh</Name><Description>Isogrid Panel</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4205</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>1229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC595</BillingCode><Name>Mastergraft</Name><Description>Calcium Phosphate Ceramic Granules</Description><Size>10cc Vial</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>96971</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI084</BillingCode><Name>TiMesh Rigid Fixation Bone Grafting and Plating System</Name><Description>FlexMesh 1.0 - 1.5mm system. Composition: Titanium</Description><Size>51 to 100cm² area, 0.3mm thickness</Size><SupplierCode>MI</SupplierCode><CategoryID>23</CategoryID><SubCategoryID>199</SubCategoryID><GroupID>1585</GroupID><SubGroupID>4205</SubGroupID><ARTGs><ARTG>128523</ARTG></ARTGs><MinimumBenefit>1229</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI459</BillingCode><PriorBillingCodes><PriorBillingCode>NK070</PriorBillingCode></PriorBillingCodes><Name>PASS LP System - Nut/Set Screw</Name><Description>Breakaway Nut, Break off set screw, Revision Post and Nut Set Screw</Description><Size>One size</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>295277</ARTG><ARTG>316001</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC394</BillingCode><Name>CD Horizon</Name><Description>Set screw</Description><Size>Each in one size</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC960</BillingCode><Name>Valiant Captivia</Name><Description>Valiant Stent Graft with captivia delivery system</Description><Size>22 - 46 mm diameter: 100mm length</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1625</GroupID><SubGroupID>4442</SubGroupID><ARTGs><ARTG>169353</ARTG></ARTGs><MinimumBenefit>9952</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI149</BillingCode><Name>Valiant Thoracic FreeFlo Tapered stent graft</Name><Description>Valiant Thoracic FreeFlo Tapered Stent Graft with Captivia Delivery System</Description><Size>Proximal diameter: 26 to 46 mm; distal diameter: 22 to 42 mm; stent graft covered length: 152 to 162 mm. Catheter outer diameter: 22 to 25F</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1625</GroupID><SubGroupID>4442</SubGroupID><ARTGs><ARTG>169353</ARTG></ARTGs><MinimumBenefit>9952</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI475</BillingCode><PriorBillingCodes><PriorBillingCode>NK090</PriorBillingCode></PriorBillingCodes><Name>Adjustable Crosslinks</Name><Description>Adjustable Crosslinks</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI467</BillingCode><PriorBillingCodes><PriorBillingCode>NK082</PriorBillingCode></PriorBillingCodes><Name>Cannulated Polyaxial Pedicle Screw</Name><Description>Cannulated Polyaxial Pedicle Screw</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC952</BillingCode><Name>Valiant Captivia</Name><Description>Valient Stent Graft with Captivia Delivery System</Description><Size>22-46mm diameter, 150mm length</Size><SupplierCode>MI</SupplierCode><CategoryID>24</CategoryID><SubCategoryID>207</SubCategoryID><GroupID>1625</GroupID><SubGroupID>4442</SubGroupID><ARTGs><ARTG>169353</ARTG></ARTGs><MinimumBenefit>9952</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2010-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC615</BillingCode><Name>Vantage</Name><Description>Vantage Plates and Screws; Lock Nut</Description><Size>One Size Only</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC856</BillingCode><Name>Nanostim</Name><Description>Synthetic Bone Paste</Description><Size>10cc</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4093</SubGroupID><ARTGs><ARTG>158926</ARTG></ARTGs><MinimumBenefit>1140</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI291</BillingCode><PriorBillingCodes><PriorBillingCode>MI247</PriorBillingCode><PriorBillingCode>MC634</PriorBillingCode><PriorBillingCode>MC708</PriorBillingCode></PriorBillingCodes><Name>CD Horizon</Name><Description>Crosslink Plates - Adjustable</Description><Size>10 to 200mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC667</BillingCode><Name>SiLo</Name><Description>Set Screw</Description><Size>One Size only</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI184</BillingCode><Name>SIMULUS Semi-Rigid Annuloplasty Band</Name><Description>Semi-rigid mitral annuloplasty band</Description><Size>Band size (mm): 24, 26, 28, 30, 32, 34, 36, 38, 40</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1842</GroupID><ARTGs><ARTG>271815</ARTG></ARTGs><MinimumBenefit>2280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC504</BillingCode><Name>CD Horizon</Name><Description>Breakoff Set Screw</Description><Size>25 - 55mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>166</SubCategoryID><GroupID>1465</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>143</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI266</BillingCode><Name>Infinity Spinal System</Name><Description>Crosslink Connector</Description><Size>Small, medium, large</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI272</BillingCode><Name>CD Horizon</Name><Description>Dual Rod Multi-Axial Screw</Description><Size>Diameter: 5.5-8.5mm  Length: 30-55mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Complex</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>996</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2018-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI472</BillingCode><PriorBillingCodes><PriorBillingCode>NK087</PriorBillingCode></PriorBillingCodes><Name>Polyaxial Pedicle Screws</Name><Description>Polyaxial Pedicle Screws</Description><Size>All sizes</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Shank</Suffix><ARTGs><ARTG>295277</ARTG></ARTGs><MinimumBenefit>524</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2021-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC590</BillingCode><Name>Vertex Reconstruction System</Name><Description>Crosslink/Bar</Description><Size>Extra small to  large</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>167</SubCategoryID><GroupID>1474</GroupID><SubGroupID>4124</SubGroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>1136</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS187</BillingCode><PriorBillingCodes><PriorBillingCode>AS185</PriorBillingCode></PriorBillingCodes><Name>Permacol  Biological Implant</Name><Description>Flat sheet of acellular porcine three-dimensional, crosslinked, dermal collagen.</Description><Size>20 x 40cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1798</GroupID><SubGroupID>5494</SubGroupID><Suffix>Coated</Suffix><ARTGs><ARTG>269662</ARTG></ARTGs><MinimumBenefit>4061</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI333</BillingCode><PriorBillingCodes><PriorBillingCode>MC186</PriorBillingCode><PriorBillingCode>MI318</PriorBillingCode></PriorBillingCodes><Name>Sacral Nerve Stimulation Accessories</Name><Description>Foramen Needle. Sterile individual units.Stainless steel.</Description><Size>8.9 to 12.7 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>26</CategoryID><SubCategoryID>232</SubCategoryID><GroupID>1715</GroupID><SubGroupID>5343</SubGroupID><ARTGs><ARTG>121280</ARTG></ARTGs><MinimumBenefit>21</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2020-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS170</BillingCode><Name>Parietex™ Hydrophilic 2D Mesh; Parietex™ Hydrophilic 3D Mesh</Name><Description>Parietex™ hydrophilic 2-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 2-dimensional textile. Parietex™ hydrophilic 3-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 3-dimensional textile.</Description><Size>20 cm x 20 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5435</SubGroupID><ARTGs><ARTG>399214</ARTG><ARTG>399630</ARTG></ARTGs><MinimumBenefit>77</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI082</BillingCode><Name>Strata Valve NSC PSM Range</Name><Description>Strata NSC, Strata NSC Burr Hole Valve. Adjustable cerebrospinal fluid (CSF) flow valve. Polypropylene and acetal plastic base. Silicone elastomer dome.</Description><Size>13-20mm x 23-35mm</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Reservoir/Priming function</Suffix><ARTGs><ARTG>129681</ARTG><ARTG>169054</ARTG></ARTGs><MinimumBenefit>2139</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2013-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ598</BillingCode><Name>Parietene Macroporous Mesh</Name><Description>Parietene macroporous mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile.</Description><Size>15 cm x 15 cm, 20 cm x 20 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5435</SubGroupID><ARTGs><ARTG>449258</ARTG></ARTGs><MinimumBenefit>77</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS165</BillingCode><Name>Parietex™ Hydrophilic 2D Mesh; Parietex™ Hydrophilic 3D Mesh</Name><Description>Parietex™ hydrophilic 2-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 2-dimensional textile. The mesh is available in two versions: a standard version and a rigid version. Parietex™ hydrophilic 3-dimensional mesh is made of non-absorbable multifilament polyester (polyethylene terephthalate) 3-dimensional textile.</Description><Size>15 cm x 15 cm,</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5435</SubGroupID><ARTGs><ARTG>399214</ARTG><ARTG>399630</ARTG></ARTGs><MinimumBenefit>77</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS122</BillingCode><Name>Parietene™ Flat Sheet Mesh; Parietene™ Lightweight Mesh</Name><Description>Parietene™ flat sheet mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile. Parietene™ lightweight mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile.</Description><Size>20 cm x 20 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5435</SubGroupID><ARTGs><ARTG>421377</ARTG><ARTG>421381</ARTG></ARTGs><MinimumBenefit>77</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-11-30</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>AS176</BillingCode><Name>Parietene™ Flat Sheet Mesh; Parietene™ Lightweight Mesh</Name><Description>Parietene™ flat sheet mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile. Parietene™ lightweight mesh is made of non-absorbable monofilament polypropylene 2-dimensional textile.</Description><Size>15 cm x 15 cm</Size><SupplierCode>MI</SupplierCode><CategoryID>21</CategoryID><SubCategoryID>194</SubCategoryID><GroupID>1782</GroupID><SubGroupID>5435</SubGroupID><ARTGs><ARTG>421377</ARTG><ARTG>421381</ARTG></ARTGs><MinimumBenefit>77</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI142</BillingCode><Name>Mastergraft</Name><Description>Mastergraft Putty</Description><Size>&gt;0cc-5cc</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4114</SubGroupID><ARTGs><ARTG>215319</ARTG></ARTGs><MinimumBenefit>808</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2014-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI490</BillingCode><Name>SenSight™ Lead Test Cable Kit</Name><Description>Connects the External Neurostimulator (ENS) with the directional lead.</Description><Size>one size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4479</SubGroupID><ARTGs><ARTG>359713</ARTG><ARTG>360032</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2022-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI191</BillingCode><PriorBillingCodes><PriorBillingCode>MC709</PriorBillingCode></PriorBillingCodes><Name>Colvin - Galloway Future Band Model 638B</Name><Description>Semi-rigid metal alloy core, silicone coating, polyester knit fabric</Description><Size>26-38mm</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1842</GroupID><ARTGs><ARTG>136235</ARTG></ARTGs><MinimumBenefit>2280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC660</BillingCode><Name>Mastergraft</Name><Description>Matrix</Description><Size>5cc</Size><SupplierCode>MI</SupplierCode><CategoryID>13</CategoryID><SubCategoryID>123</SubCategoryID><GroupID>1241</GroupID><SubGroupID>4114</SubGroupID><ARTGs><ARTG>283420</ARTG></ARTGs><MinimumBenefit>808</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC843</BillingCode><Name>Medtronic Screening Cable (Alligator Clip)</Name><Description>Screening Cable with Alligator Clip for Intraoperative testing</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4479</SubGroupID><ARTGs><ARTG>119991</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI036</BillingCode><Name>CD HORIZON Fenestrated Screw</Name><Description>Fenestrated multi-axial screw</Description><Size>Diameter:4.5 - 10.5mm, Length: 30 - 80mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1463</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>187126</ARTG></ARTGs><MinimumBenefit>1085</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2012-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI541</BillingCode><Name>ModuLeX Spinal System - Fixed Angle Screw</Name><Description>Fixed Angle Screw</Description><Size>Diameter: 4.0mm to 7.5mm Length: 20mm to 55mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>422153</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2025-11-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC842</BillingCode><Name>Medtronic Screening Cable (Twist Lock)</Name><Description>Screening Cable with Twist Lock for Intraoperative testing</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4479</SubGroupID><ARTGs><ARTG>119991</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2009-08-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC646</BillingCode><Name>Strata Valve Assembly NSC (non siphon control) PSM range</Name><Description>Adjustable CSF valve with five symmetrical performance level steps. Includes a strata valve, an integral distal peritoneal catheter and catheter passer, and a female leur adaptor and prefill tubing.</Description><Size>One size</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>220</SubCategoryID><GroupID>1666</GroupID><SubGroupID>4468</SubGroupID><Suffix>Distal catheter, Reservoir/Priming function</Suffix><ARTGs><ARTG>134740</ARTG></ARTGs><MinimumBenefit>2306</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2006-03-24</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MC770</BillingCode><Name>Snap Lid Connector</Name><Description>Connector for implanted lead to external Implantable Pulse Generator</Description><Size>2.5" x 5.0"</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>221</SubCategoryID><GroupID>1676</GroupID><SubGroupID>4479</SubGroupID><ARTGs><ARTG>119991</ARTG></ARTGs><MinimumBenefit>181</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2008-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI183</BillingCode><Name>SIMULUS Semi-Rigid Annuloplasty Ring</Name><Description>Semi-rigid mitral annuloplasty ring</Description><Size>Ring size (mm): 24, 26, 28, 30, 32, 34, 36, 38, 40</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>181</SubCategoryID><GroupID>1842</GroupID><ARTGs><ARTG>271812</ARTG></ARTGs><MinimumBenefit>2280</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2016-02-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI307</BillingCode><Name>SurgiFrost 10</Name><Description>SurgiFrost 10 is a malleable, single-use cryosurgical device developed to treat cardiac arrhythmias during heart surgery.  Freezing preserves tissue integrity. SurgiFrost10 features a malleable shaft and flexible tip with adjustable insulation sleeve.</Description><Size>One size ony</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2949</GroupID><SubGroupID>7358</SubGroupID><Suffix>Medtronic - SurgiFrost 10</Suffix><ARTGs><ARTG>158928</ARTG></ARTGs><MinimumBenefit>4095</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ218</BillingCode><Name>CD HORIZON Spinal System - Cannulated Sagittal Adjusting Screws</Name><Description>Cannulated Sagittal Adjusting Screws
</Description><Size>Diameter:  4.5mm - 7.5mm   Length: 25mm - 55mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><Suffix>Cannulated</Suffix><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>889</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI311</BillingCode><Name>CryoFlex™ Surgical Ablation Probe</Name><Description>The CryoFlex™ Surgical Ablation Probe utilises a gas for freezing cells in the surgical treatment of cardiac arrhythmias.</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>20</CategoryID><SubCategoryID>291</SubCategoryID><GroupID>2949</GroupID><SubGroupID>7358</SubGroupID><Suffix>Medtronic - CryoFlex</Suffix><ARTGs><ARTG>158928</ARTG></ARTGs><MinimumBenefit>4695</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2019-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI502</BillingCode><Name>Medtronic Patient Wireless Recharger System</Name><Description>Recharging system for rechargeable implantable neurostimulators (model RS7200) that comprises a Wireless Recharger and Charging Dock</Description><Size>One size only</Size><SupplierCode>MI</SupplierCode><CategoryID>25</CategoryID><SubCategoryID>222</SubCategoryID><GroupID>1678</GroupID><SubGroupID>4497</SubGroupID><ARTGs><ARTG>387302</ARTG></ARTGs><MinimumBenefit>1215</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2023-03-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>QQ220</BillingCode><Name>CD HORIZON Spinal System - Uniaxial Screws and Sagittal Adjusting Screws</Name><Description>CD HORIZON SOLERA Uniaxial Screws and Sagittal Adjusting Screws
</Description><Size>Diameter:  4.0mm - 8.5mm  Length: 20mm - 55mm</Size><SupplierCode>MI</SupplierCode><CategoryID>19</CategoryID><SubCategoryID>165</SubCategoryID><GroupID>1462</GroupID><ARTGs><ARTG>169514</ARTG></ARTGs><MinimumBenefit>728</MinimumBenefit><MaximumBenefit>0</MaximumBenefit><HumanTissueAmount>0</HumanTissueAmount><ActionFlag>No Change</ActionFlag><CycleStartDate>2024-07-01</CycleStartDate><CycleEndDate>2026-04-28</CycleEndDate></ProsthesisItem><ProsthesisItem><ItemType>Prosthesis</ItemType><BillingCode>MI392</BillingCode><Name>Cobalt™ XT DR ICD MRI SureScan™</Name><Description>Dual Chamber Implantable Cardioverter Defibrillator with PhysioCurve Design, MRI compatible, Optimised Battery Chemistry, SmartShock 2.0+ Technology, Optivol 2.0 Fluid Status Monitoring, Complete Capture Management, BlueSync technology, DF1</Description><Size>33.1 cm3, 79 g</Size><SupplierCode>MI</SupplierCode><CategoryID>27</CategoryID><SubCategoryID>237</SubCategoryID><GroupID>1725</GroupID><Su