附件三特殊材料給付品項暨支付標準表修正特材代碼中英文名稱 ...
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Transcript of 附件三特殊材料給付品項暨支付標準表修正特材代碼中英文名稱 ...
附件三 特殊材料給付品項暨支付標準表修正
特材代碼 中英文名稱 支付點數-104/01/01
ACA0100ABNPW IV CAP 3
ACA0100CDNPW "普惠"注射帽(免針安全型)※給付規定請見備註欄"PERFECT:IV
LOCK(SAFETY)
43.1
ACA0108008SG IV CAP 注射帽 3
ACA011PN01NQ INJECTION CAP 3
ACA0121010TZ IV LOCK 3
ACA01AB00NPW IV LOCK 3
ACA01C1C02LL INJECTION CUP(IV LOCK) 3
ACA01NF005LL INJECTION CAP(安全型)※適應症請見備註欄 43.1
ACC0100360BT PLASTIC CONNECTOR 兩尖型 17.4
ACC0100361BT PLASTIC CONNECTOR 一尖一平塑膠連接頭 17.4
ACC0100362BT PLASTIC CONNECTOR 塑膠連接頭 17.4
ACC0100364BT PLASTIC CONNECTOR 直型塑膠連接頭 17.4
ACC01HSC60H6 PLASTIC CONNECTOR(兩尖型) 17.4
ACC01HSC61H6 PLASTIC CONNECTOR(一尖一平型) 17.4
ACC02VP004LL 3 WAY 7.8
ACM01PT003CK 2-PORTS MANIFOLD 連接頭 250
ACP011000NDL Y TYPE ADAPTOR 329
ACP0146201H9 "華億"體外循環管組"HYM"HEART LUNG PACK-Y & STRAIGHT &
REDUCER CONNECTOR(WITH LUER)
88
ACP0147166GJ “吉生”體外循環管組-Y型&直型&漸細連接器(附LUER) ”JSM”
HEART LUNG PACK-Y&STRAIGHT&REDUCER CONNECTOR(WITH LUER)
88
ACP01CA123L5 "加州"心臟麻痺轉接器 "CALIFORNIA" CARDIOPLEGIA ADAPTERS 88
ACP01ECTBSM6 EXTRACORPOREAL TUBING STRAIGHT CONNECTOR 88
ACP01ECTBYM6 EXTRACORPOREAL TUBING Y-CONNECTOR 88
ACP0214000DL MULTIPURPOSE PERFUSION SET WITH VENT LINE 889
ACP0214003DL MULTIPURPOSE PERFUSION SET※適應症請見備註欄 657
ACS0109512BB DISCOFIX C-3/-3 MULTIDIRECTIONAL STOPCOCKS"柏朗"輸液轉換
閥
7.8
ACS013CAPSM8 3 WAY STOPCOCK 7.8
ACS0168MPATP PREDURA PRESSURE RESISTAN THREE WAY STOPCOCK 1000PSI 70
ACS0170015NL 3-WAY NAMIC MORSE STOPCOCK (200PSI) 7.8
ACS0170035NL 3-WAY NAMIC MORSE STOPCOCK (400PSI) 34
ACS0170055NL 3-WAY NAMIC MORSE STOPCOCK (1050PSI) 70
ACS01D010NPW DISPOSABLE INFUSION SET 3 WAY STOPCOCK 7.8
ACS01H3FLCMR MANIFOLD HIGH PRESSURE 3 WAY STOPCOCK (1050PSI)(自
92.10.01起廠牌碼由ER改為MR)
70
ACS01H3SNCMR MARQUIES SERIES STOPCOCKS 1050PSI 70
ACS01M3SNCMR MARQUIS SERIES STOPCOCK 500PSI 34
ACS01NCN3SNR 3 WAY STOPCOCK 塑膠三極栓 7.8
ACS01S3SNCMR MANIFOLD 3 WAY STOPCOCK W/LUER LOCK(自92.10.01起廠牌碼由
ER改為MR)
34
ACS01STP34H9 "華億"體外循環管組"HYM"HEART LUNG PACK-3 & 4 WAY
STOPCOCKS
7.8
ACS01TS201SG 3 WAY STOPCOCK W/LOCK 7.8
ACS01V68MPTP PREDURA PRESSURE RESISTAN THREE WAY STOPCOCK V-TYPE
1000PSI
70
ACS01VP004LL "LILY"3 WAY STOPCOCK"怡安"輸液三通閥 7.8
ACS03SMT01SG 1000PSI HIGH PRESSURE 3 WAY 70
修正規定
731
特材代碼 中英文名稱 支付點數-104/01/01
ACVP205105B0 CSF CATHETER CONNECTOR,3-WAY 1600
ACVP221520CM "美杜思"愛可閥腦水腫引流管系統-3Way連接管"Medos"Accu-Flo
Hydrocephalus Shunt System-3Way connector
1600
ACVP245105PM 3 WAY CONNECTOR 1600
ACY010210NSD PTCA Y CONNECTOR 979
ACY010210XSD MYSHELL LITE Y CONNECTORS 麥雪兒萊Y型接頭 979
ACY0103331AB COPILOT BLEEDBACK CONTROL VALVE Y ADAPTOR 979
ACY010KAY2GG "GOODTEC"Y-CONNECTOR SET "固德克"Y型連接器套組 979
ACY016248VM4 ADJUSTABLE VALVE W/3-WAY STOPCOCK 979
ACY0191400NL NAMIC MORSE Y-ADAPTOR 979
ACY0191400SB NAMIC MORSE Y ADAPTOR 979
ACY01CFM01CK "曲克"闕克芙爾導管轉接頭“COOK”CHECK-FLO PERFORMER
ASSEMBLY
979
ACY01KESU1NX Y-CONNECTOR(PTCA,PTA用) 979
ACY01MAP13MR MONIFOLD W/HEMOSTASIS VALVE 200PSI 單Y型 979
ACY01MAP22MR ANGIOPLASTIC PACK & DOUBLE HEMOSTASIS VALVES 989
ACY01MAP32MR HONOR HEMOSTASIS VALVE ANGIOPLASTY PACK 979
ACY01MAP45MR "MERIT"ANGIOPLASTY PACKS & HEMOSTASIS VALVES"美瑞特"血管
成型術止血閥組
979
ACY01NYC00GJ "JSM"Y CONNECTOR KIT "吉生"Y 型連接器組 979
ACY01NYC10GJ "JSM"Y CONNECTOR KIT W/INSERTION TOOL"吉生"Y 型連接器組含
導引支撐器
979
ACY01NYC11GJ "JSM"Y CONNECTOR KIT W/INSERTION TOOL+TORQUE DEVICE"吉
生"Y型連接器組(含導引支撐器+扭力控制器)
979
ACY01PTBYCCK ADAPTERS PTCA用 979
ACY01YK100GJ "吉生"Y 型連接器組"JSM"Y CONNECTOR KIT 979
ACY01YK110GJ "吉生"Y 型連接器組(含導引支撐器)"JSM"Y CONNECTOR
KIT(INSERTION TOOL)
979
ACY01YK111GJ "吉生"Y 型連接器組(含導引支撐器+扭力控制器)"JSM"Y
CONNECTOR KIT(INSERTION TOOL+TORQUE DEVICE)
979
BBB01T060CTM TRANSFER BAG 600ML 60
BBB01T100BTM TRANSFER BAG 1000ML 60
BBF0320404LL "LILY"FEEDING SET ACCESSORIES雙袋機械(PUMP)式餵食袋*適應
症請見備註欄
110
BBF0320405LL "LILY"FEEDING SET ACCESSORIES雙袋重力式餵食袋*適應症請見
備註欄
72
BBF0373006KD KENDALL KANGAROO ENTERAL FEEDING PUMP SETS*"肯特利"袋鼠灌
食機用套組
110
BBF0373622KD "KENDALL"KANGAROO 924 PUMP SETS"肯特利"袋鼠灌食機用套組 110
BBF0373642SH "KENDALL" KANGAROO ENTERAL FEEDING PUMP SETS"肯特利" 袋鼠
灌食管及袋子
110
BBF0373656KD "KENDALL"KANGAROO EPUMP FEEDING SETS "肯特利"袋鼠電子灌食
機用灌食套組
110
BBF0377512KG APPLIX SMART/VISION PUMP SET BAG愛普仕管灌餵食管袋組合套*
適應症請見備註欄
110
BBF03F1200SG FEEDING PUMP SET※適應症請見備註欄 110
BBF03FB030P2 "PAHSCO"FEEDING BAG雙袋重力式餵食袋*適應症請見備註欄 72
BBF03FB040P2 "PAHSCO"FEEDING BAG雙袋機械式餵食袋*適應症請見備註欄 110
BBF03FB600P2 PAHSC0 FEEDING BAG 重力式 600ML*適應症請見備註欄 72
BBP0100070CA POST OPERATION OPEN TRANSPARENT BAG 康便舒手術後便袋*限住
院患者申報
25.1
BBP0100406F4 "CONVATEC"NATURA POUCH(NON-STERILE)"康威"益舒穩造口袋-雙
片式不透明封口便袋45-57MM(未滅菌)*適應症請見備註欄
37.1
732
特材代碼 中英文名稱 支付點數-104/01/01
BBP0100774F4 "CONVATEC"ESTEEM SYNERGY POUCH(NON-STERILE)"康威"新易優穩
造口袋-雙片式35-61MM(未滅菌)*適應症請見備註欄
37.1
BBP0101522F4 SUR-FIT NATURA POUCH(Non-sterile) 新舒穩雙片式造口袋(未滅
菌)*限住院患者申報
37.1
BBP011680NA5 YOUCARE C 14:59MM*限住院患者使用 25.1
BBP0121132LK “福立克”可樂適造口術用袋及其附件(未滅菌)-雙片式透明封口
便袋32-70MM“FLEXICARE” COLOSET OSTOMY BAG AND
ACCESSORIES (NON-STERILE)- CLOSED BAG,COMFORT BACKING,
37.1
BBP0121232LK “福立克”可樂適造口術用袋及其附件(未滅菌)-雙片式透明封口
便袋32-70MM(不織布) “FLEXICARE” COLOSET OSTOMY BAG AND
ACCESSORIES (NON-STERILE)- CLOS
37.1
BBP0122132LK “福立克”可樂適造口術用袋及其附件(未滅菌)-雙片式不透明封
口便袋32-70MM“FLEXICARE” COLOSET OSTOMY BAG AND
ACCESSORIES (NON-STERILE)- CLOSED BAG,
37.1
BBP0122232LK “福立克”可樂適造口術用袋及其附件(未滅菌)-雙片式不透明封
口便袋32-70MM(不織布) “FLEXICARE” COLOSET OSTOMY BAG
AND ACCESSORIES (NON-STERILE)- CL
37.1
BBP0400315DD ONE PIECE SOLO MINI DRAINABLE POUCH 15:50MM(含人工皮、不
織布)※限住院患者申報
51.5
BBP0400414F4 "CONVATEC"NATURA POUCH(NON-STERILE)"康威"益舒穩造口袋-雙
片式透明開口便袋38-70MM(未滅菌)*適應症請見備註欄
37.1
BBP0400415F4 "CONVATEC"NATURA POUCH(NON-STERILE)"康威"益舒穩造口袋-雙
片式不透明開口便袋38-57MM(未滅菌)*適應症請見備註欄
37.1
BBP0400420F4 "CONVATEC"NATURA POUCH(NON-STERILE)"康威"益舒穩造口袋-雙
片式不透明開口便袋38-57MM(未滅菌)*適應症請見備註欄
37.1
BBP0400472F4 "CONVATEC"NATURA POUCH(NON-STERILE)"康威"益舒穩造口袋-雙
片式透明開口便袋100MM(未滅菌)*適應症請見備註欄
42.3
BBP0400718F4 "CONVATEC"ESTEEM POUCH(NON-STERILE)"康威"新優穩造口袋-單
片(含人工皮、不織布 )(未滅菌)*適應症請見備註欄
51.5
BBP0400795F4 "CONVATEC"ESTEEM SYNERGY POUCH(NON-STERILE)"康威"新易優穩
造口袋-雙片式透明開口35-61MM(未滅菌)*適應症請見備註欄
37.1
BBP0400818DD SOLO DRAINABLE POUCHES(NON-STERILE) 10-40MM*限住院患者申
報
37.6
BBP0401512F4 "Convatec"SUR-FIT NATURA POUCH(Non-Sterile)"康威"新舒穩雙
片式造口袋(未滅菌)*限住院患者申報
37.1
BBP0401515F4 "Convatec"SUR-FIT NATURA POUCH(Non-Sterile)"康威"新舒穩雙
片式造口袋(未滅菌)*限住院患者申報
42.3
BBP0401927F4 "ConvaTec "Little Ones Pouch(non-sterile)- 2 PIECE
TRANSPARENT DRAINABLE POUCH "康威"幼兒造口袋-雙片式開口便
袋*限住院患者申報
37.1
BBP0403223HL "HOLLISTER"OSTOMY POUCH AND ACCESSORIES(NON-STERILE)-
KARAYA 5 SEAL RING DRAINABLE POUCH造口術用袋及其附件-卡拉
亞開口便袋*給付規定見備註
37.6
BBP0403250HL POST OPERATION COMPACT DRAINABLE POUCH(開口便袋)※限住院
患者申報
51.5
BBP0403802HL DRAINABLE POUCH 44MM *限住院患者申報 37.1
BBP0403806HL DRAINABLE POUCH 102MM *限住院患者申報 42.3
BBP0403857HL OSTOMY TWO-PIECE WITH TRANSPARENT 57MM 中央點鎖式兩式便袋
*限住院患者申報
37.1
BBP0405403F4 "CONVATEC"ESTEEMSYNERGY DRAINABLE POUCH TRANSPARENT
35/48/61MM雙片式造口袋*限住院患者申報
37.1
BBP0405420F4 "CONVATEC"ESTEEMSYNERGY DRAINABLE POUCH OPAQUE 35/48MM雙
片式造口袋*限住院患者申報
37.1
733
特材代碼 中英文名稱 支付點數-104/01/01
BBP0405436F4 "CONVATEC"ESTEEMSYNERGY CLOSE POUCH OPAQUE 35/48/61MM雙片
式造口袋*限住院患者申報
37.1
BBP0405441F4 "CONVATEC"ESTEEMSYNERGY CLOSE POUCH OPAQUE MINI 35/48MM雙
片式造口袋*限住院患者申報
37.1
BBP0406820CA POST OPEN BAG 100MM*限住院患者申報 42.3
BBP0407650HL STONINAL ONE PIECE POUCH 51MM 單片附人造皮便袋*限住院患者
申報
37.6
BBP0408631HL "HOLLISTER"OSTOMY POUCH AND ACCESSORIES(NON-STERILE)"鶴
牌"造口術用袋及其附件(未滅菌)(含人工皮"不織布)*適應症請見
備註欄
51.5
BBP0409243F4 "CONVATEC"ESTEEMSYNERGY CLOSE POUCH TRANSPARENT35/48/61MM
雙片式造口袋*限住院患者申報
37.1
BBP0410384CA "COLOPLAST"OSTOMY POUCH AND ACCESSORIES(NON-STERILE)造口
術用袋及其附件*限住院患者申報40MM:60MM
37.1
BBP0412131A5 PROCARE-2 DRAINABLE POUCH 30,40,50MM*限住院患者申報 51.5
BBP0412134A5 PROCARE-2 DRAINABLE POUCH 70MM*限住院患者申報 37.1
BBP0412501A5 LAPACK SUPER-G 人工肛門袋 G80*限住院患者申報 11
BBP0412502A5 LAPACK SUPER-G 人工肛門袋 G100*限住院患者申報 11
BBP0412511A5 LAPACK SUPER-C 100 人工肛門封口便袋*限住院患者申報 11
BBP0412521A5 LAPACK SUPER F簡易型夾鏈式開口便袋*限住院患者使用 11
BBP0413351A5 POSPACK-B、K 60,70MM*限住院患者申報 51.5
BBP0413860CA "COLOPLAST"ALTERNA OSTOMY POUCH AND ACCESSORIES(NON-
STERILE)"康樂保"愛特大造口術用袋及其附件(未滅菌)*限住院患
者申報。
51.5
BBP0413984CA "COLOPLAST"ALTERNA FREE WITH HIDE-AWAY OUTLET OSTOMY
POUCH 40MM 50MM60MM(TWO-PIECE)崇尚型易關式開口袋*適應證請
見備註欄
37.1
BBP0414212A5 PEDIATRIC PROCARE 1 POST-OP *限住院患者使用 45
BBP0415021A5 POSPACK B 60MM※限住院患者使用 51.5
BBP041503NA5 POSPACK LIGHT 60MM※限住院患者使用 34
BBP0415570CA "COLOPLAST"SENSURA OSTOMY POUCH AND ACCESSORIES(NON-
STERILE)善舒樂造口術用袋及其附件*給付規定請見備註欄
51.5
BBP0416623A5 YOUCARE 2 POUCH D 優護二件式開口便袋*限住院患者使用 37.1
BBP041662NA5 YOUCARE 2 POUCH D 優護二件式開口便袋*限住院患者使用 37.1
BBP0416771A5 YOUCARE D 14:59MM*限住院患者使用 51.5
BBP041678NA5 YOUCARE D 14:59MM*限住院患者使用 51.5
BBP0416960CA ILEOSTOMY BAG MAXI 40MM,50MM,60MM※限住院患者申報 37.1
BBP0417820CA ALTERNA CHILDREN 雙片OPEN TRANSPARENT BAG 40MM※限住院患
者申報
45
BBP0418006HL "HOLLISTER"OSTOMY POUCH AND ACCESSORIES-NEW IMAGE LOCK'N
ROLL DRAINABLE POUCH 新象便袋 102MM *適應症請件備註欄
42.3
BBP0418102HL NEW IMAGE DRAINABLE POUCH 2 PIECE 44:70MM *限住院患者申報 37.1
BBP0419020CA "COLOPLAST"SENSURA OSTOMY POUCH AND ACCESSORIES(NON-
STERILE)1-PIECE (含人工皮、不織布)"康樂保"善舒樂造口術用
袋及其附件*給付規定請見備註欄
51.5
BBP0420922F4 "ConvatecTec "Little Ones Pouch(non-sterile)-ONE PIECE
POUCH WITH SKIN BARRIER "康威"幼兒造口袋-單片式造口袋*限
住院患者申報。
45
BBP0422771F4 "Convatec"ACTIVE LIFE ONE-PIECE DRAINABLE POUCH(Non-
sterile) 19/64MM"康威"愛得富單片式造口袋(未滅菌)*限住院患
者申報。
51.5
734
特材代碼 中英文名稱 支付點數-104/01/01
BBP0431132LK “福立克”可樂適造口術用袋及其附件(未滅菌)-雙片式透明開口
便袋32-70MM“FLEXICARE” COLOSET OSTOMY BAG AND
ACCESSORIES (NON-STERILE)- DRAINABLE BAG
37.1
BBP0431232LK “福立克”可樂適造口術用袋及其附件(未滅菌)-雙片式透明開口
便袋32-70MM(不織布)“FLEXICARE” COLOSET OSTOMY BAG AND
ACCESSORIES (NON-STERILE)- DRAIN
37.1
BBP0432132LK “福立克”可樂適造口術用袋及其附件(未滅菌)-雙片式不透明開
口便袋32-70MM“FLEXICARE” COLOSET OSTOMY BAG AND
ACCESSORIES (NON-STERILE)- DRAINABLE B
37.1
BBP0432232LK “福立克”可樂適造口術用袋及其附件(未滅菌)-雙片式不透明開
口便袋32-70MM(不織布)“FLEXICARE” COLOSET OSTOMY BAG AND
ACCESSORIES (NON-STERILE)- DRA
37.1
BBP0459850CA "COLOPLAST"ALTERNA ILEOSTOMY BAGS 10-70MM愛特大迴腸造口袋
*適應症請見備註欄
51.5
BBP0480020CA ONE PIECE ALTERNA CHILDREN OPEN TRANSPARENT BAG 10:35MM※
限住院患者申報
45
BBU0101460HL FIRST CHOICE UROSTOMY POUCH WITH CUT-TO-FIT BARRIER(含人
工皮)※限住院串者申報
90.1
BBU0101482HL "HOLLISTER"OSTOMY POUCH AND ACCESSORIES(NON-STERILE)-
UROSTOMY POUCHS W CONVEX BARRIERS造口術用袋及其附件單片式
尿袋附墊高片*給付規定見備註
90.1
BBU0101544F4 "Convatec"SUR-FIT NATURA POUCH(Non-Sterile) -UROSTOMY
POUCH "康威"新舒穩雙片式造口袋(未滅菌)-透明尿袋*限住院患
者申報。
77
BBU0103907HL UROSTOMY POUCH 38MM*限住院患者申報 77
BBU0103944HL CENTER POINT LOCK UROSTOMY POUCH※限住院患者申報 90.1
BBU0108432HL "HOLLISTER"OSTOMY POUCH AND ACCESSORIES(NON-STERILE)-
UROSTOMY POUCHS W CONVEX BARRIERS造口術用袋及其附件單片式
尿袋附墊高片*給付規定見備註
90.1
BBU0111803CA "COLOPLAST"SENSURA OSTOMY POUCH AND ACCESSORIES(NON-
STERILE)-UROSTOMY BAGS"康樂保"善舒樂造口術用袋及其附件(未
滅菌)-尿造口袋*給付規定見備註欄
90.1
BBU0111854CA "COLOPLAST"SENSURA OSTOMY POUCH AND ACCESSORIES(NON-
STERILE)40-60MM"康樂保"善舒樂造口術用袋及其附件(未滅菌)※
限住院患者申報
77
BBU0112151A5 PROCARE-2 URINARY POUCH 30,40,50MM*限住院患者申報 77
BBU0112451A5 BIOURINE-B 50MM*限住院患者申報 90.1
BBU0114201A5 YOUCARE U優護一件式尿袋*限住院患者使用 90.1
BBU011666NA5 YOUCARE 2U優護二件式尿袋*限住院患者使用 77
BBU0117570CA COLOPLAST ALTERNA UROSTOMY BAG MAXI375ML※限住院患者申報 77
BBU0117890CA ALTERNA CHILDREN TRANSPARENT URINE BAG※限住院患者申報 77
BBU0118402HL NEW IMAGE UROSTOMY POUCH (不含人工皮) 44:70MM *限住院患者
申報
77
BBU0155850CA UROSTOMY BAG MAXI 375ML ※限住院患者申報 90.1
BBU0164927F4 "CONVATEC"ACTIVE LIFE ONE-PIECE UROSTOMY POUCH (Non-
sterile)19:45MM"康威"愛得富單片式造口袋(未滅菌)單片式尿袋
*限住院患者申報。
90.1
BBU0180090CA ONE PIECE ALTERNA CHILDREN TRANSPARENT URINE BAG
10:35MM(含人工皮)※限住院患者申報
90.1
BBW0104055P2 "太平洋"引流袋"PAHSCO" DRAINAGE BAG 34
BBW0104200P2 P.C.N. BAG (L) 腎臟造廔引流袋 34
BBW0145000TZ PCN BAG 腎臟造口引流袋 34
BBW0185001PB PBN DRAINAGE BAG 34
735
特材代碼 中英文名稱 支付點數-104/01/01
CAE0112170BB EPIDURAL ANAESTHESIA CATHETER 103
CAE0113010BB EPIDURAL ANAESTHESIA SET(N+C+S) 362
CAE0151238BB PERICAN EPIDURAL NEEDLE 110
CAE01E5400AR NON-KINGKING EPIDURAL CATHETER 20GA 91.4CM,19GAX92CM 362
CAE01PC383BB PERICAN NEEDLES FOR EPIDURAL ANAESTHESIA背利安硬脊膜麻醉
穿刺針
110
CAE01SD150BB "B.BRAUN"PERIFIX CATHETERS FOR EPIDURAL
ANAESTHESIA(CATHETER)"柏朗"脊椎硬膜麻醉用穿刺套
103
CAE01SD301BB "B.BRAUN"PERIFIX CATHETERS FOR EPIDURAL ANAESTHESIA:MINI
SETS"柏朗"脊椎硬膜麻醉用穿刺套(NEEDLE+CATHETER+FILTER或
SYRINGE)
362
CBA010502SAR INTRA AORTIC BALLOON CATHETER (型號:IAB-
04230U,04240U,04250U,06830U,06840U,R950U自94.10.01起生效)
25364
CBA010AB46M4 "MEDTRONIC"RELIANT STENT GRAFT BALLOON CATHETER"美敦力"瑞
萊恩球囊導管
22348
CBA0111612QM "MAQUET"PEDIATRIC INTRA AORTIC BALLOON (PUMP)CATHETER
FIDELITY 2.5CC 5CC 7CC 12CC 20CC"邁柯唯"主動脈氣球導管
25364
CBA0142912QM "MAQUET"INTRA AORTIC BALLOON (PUMP) FIDELITY 8FR 25CC"邁
柯唯"主動脈氣球導管
25364
CBA0143001QM "MAQUET"INTRA AORTIC BALLOON PUMP CATHETER 8FR 34CC"邁柯
唯"主動脈氣球導管
25364
CBA014300SLW "樂脈"非氣球型閉塞導管"LEMAITRE"THE UNBALLOON NON-
OCCLUSIVE MODELING CATHETER
22348
CBA0143012QM "MAQUET"INTRA-AORTIC (PUMP)BALLOON 8FR 34CC 40CC"邁柯唯"
主動脈氣球導管
25364
CBA0147982QM "MAQUET"INTRA AORTIC BALLOON(PUMP) CATHETER 7.5FR
25;34;40CC"邁柯唯"主動脈氣球導管
25364
CBA014830UAR NARROWFLEX UNIVERSAL IAB CATHETER 8FR.30CC,40CC 25364
CBA0162080ED "EDWARDS"FOGARTY OCCLUSION CATHETER(AORTIC)堵塞用導管 22348
CBA01B2640GX "GORE"TRI-LOBE BALLOON CATHETER(AORTIC)三葉球囊導管 22348
CBA01C0DA1CK "COOK"CODA BALLOON CATHETER (AORTIC)科達球曩導管 22348
CBA01C0DA2CK "COOK"CODA BALLOON CATHETER(AORTIC)科達球囊導管 22348
CBA01C0DA3CK "COOK"CODA 3G OCCLUSION BALLOON CATHETER"曲克"柯達閉合球
囊導管
22348
CBA01C0DA4CK "COOK"CODA LP BALLOON CATHETER"曲克"科達艾皮球囊導管 22348
CBA01REL46M4 "MEDTRONIC"RELIANT STENT GRAFT BALLOON CATHETER瑞萊恩氣球
導管
22348
CBA01S730CAR REDIGUARD IAB CATHETER 7,8,9FR. 30CC,40CC 25364
CBA02F6830AR "ARROW"FIBER OPTIC INTRA-AORTIC BALLOON CATHETER光纖感應
主動脈弓氣球導管
41110
CBA02SEN7FQM "MAQUET"SENSATION 7FR INTRA-AORTIC BALLOON CATHETER"邁柯
唯"光纖感應主動脈氣球導管*適應症請見備註欄
41110
CBA0321002LW "樂脈"普特主動脈阻斷導管"LEMAITRE"PRUITT AORTIC OCCLUSION
CATHETER*適應症請見備註欄
7623
CBB0106433SB ULTRA-THIN DIAMOND BALLOON DILATATION CATHETER 5398
CBB0112512SB BLUW MAX BALLOON DILATATION CATHETERS 5398
CBB0114508SB XXL BALLOON DILATATION CATHETER 5398
CBB0130240SB "BOSTON SCIENTIFIC"MUSTANG PTA BALLOON DILATATION
CATHETERS D 3:10;12MM; L 20:100MM "波士頓科技"瑪思丹氣球
擴張導管
5398
CBB0131555N5 GHOST II PTA ANGIOPLASTY CATHETER 5FR. 3:10MM *1.5:10CM,
40,75,120,150CM(衛署字號009069)
5398
736
特材代碼 中英文名稱 支付點數-104/01/01
CBB0139031SB "BOSTON SCIENTIFIC"STERLING BALLOON DILATATION CATHETERS
D 3:8MM L 10:60MM C USABLE 80;135CM氣球擴張導管
5398
CBB0139032SB "BOSTON SCIENTIFIC"STERLING BALLOON DILATATION
CATHETERS(OTW)D 4:10MM L 20:100MM C USABLE L40:135CM氣球
擴張導管
5398
CBB0139134SB "BOSTON SCIENTIFIC"STERLING BALLOON DILATATION
CATHETERS(OTW) D 1.5:4MM L 20:40MM C USABLE 142;145CM氣球
擴張導管
5398
CBB0139135SB "BOSTON SCIENTIFIC"STERLING BALLOON DILATATION
CATHETERS(Monorail) D 1.5:4MM L 20:40MM C USABLE
143;146CM氣球擴張導管
5398
CBB014105NCD POWERFLEX PTA BALLOON CATHTER 5FR 5398
CBB0141500CD POWERFLEX PTA CATHETER 5398
CBB0141550CD POWERFLEX PTA BALLOON 5398
CBB0141570CD POWERFLEX PTA BALLOON 5398
CBB0141590CD POWERFLEX PTA BALLOON 5398
CBB01420XNCD POWER FLEX PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY (PTA)
CATHETER 3MM:12MM 40,80,135CM
5398
CBB01424NWCD "CORDIS"AVIATOR PLUS PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY(PTA)BALLOON DILATATION CATHETER PTA氣球擴張導
管 4.0MM:6.0MM;7.0MM
5398
CBB0144028CD "CORDIS"POWERFLEX PRO PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY CATHETER 2:8CM"考迪斯"保飛力斯博經皮穿腔成型
術導管
5398
CBB0150500SB WANDA PTA BALLOON DILATATION CATHETER 5398
CBB0152111BQ "BIOTEQ"PTA BALLOON DILATATION CATHETER"邦特"血管氣球擴張
導管
5398
CBB0152115BQ "BIOTEQ"PTA BALLOON DILATATION CATHETER"邦特"血管氣球擴張
導管
5398
CBB0161111BQ "BIOTEQ"PTA BALLOON DILATATION CATHETER"邦特"血管氣球擴張
導管
5398
CBB0161115BQ "BIOTEQ"PTA BALLOON DILATATION CATHETER"邦特"血管氣球擴張
導管
5398
CBB01ADM18F2 "INVATEC"ADMIRAL XTREME PTA BALLOON CATHETER愛德米羅週邊
血管氣球導管3MM:12MM 20MM:120MM
5398
CBB01AP128AB FOX PLUS PTA CATHETER 5398
CBB01ARM35AB "ABBOTT"ARMADA 35/ARMADA 35LL PTA CATHETER"亞培"阿曼達周
邊血管球囊導管
5398
CBB01AT751BA BARD ATLAS PTA BALLOON DILATATION CATHETER 75CM,120CM 5398
CBB01AT752BA "BARD"ATLAS PTA BALLOON DILATATION CATHETER 5398
CBB01ATB01CK ALL-TERRAIN BALLOON PTA DILATATION CATHETERS 5398
CBB01ATB02CK "COOK"ALL-TERRAIN BALLOON PTA DILATATION CATHETER經皮穿刺
血管成形術用氣球擴張導管
5398
CBB01BTFLRQC "清流"班特弗洛里安經皮穿刺血管成形術導管 5398
CBB01BTM01QC "CLEARSTREAM"BANTAM PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY(PTA)CATHETER"清流"班特經皮穿刺血管成形術導管
5398
CBB01BTM02QC "CLEARSTREAM"BANTAM PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY(PTA)CATHETER 150MM-220MM"清流"班特經皮穿刺血
管成形術導管*給付規定請見備註欄
11140
CBB01CPAC1QC "CLEARSTREAM"CLEARPAC 歐美加 PTA CATHETER"清流"清派歐美
加經皮穿刺血管成形術導管
5398
737
特材代碼 中英文名稱 支付點數-104/01/01
CBB01CPAC2QC "CLEARSTREAM"CLEARPAC 歐美加 PTA CATHETER
120MM;150MM;220MM"清流"清派歐美加經皮穿刺血管成形術導管*
給付規定請見備註欄
11140
CBB01CQ120BA "BARD"CONQUEST PTA BALLOON DILATATION CATHETER氣球擴張導
管
5398
CBB01CQ575BA CONQUEST PTA BALLOON DILATATION CATHETER(型號CQ-50;75-
52;54;58自950401起生效,文號0940040071)
5398
CBB01CYTESSB "BOSTON SCIENTIFIC"COYOTE ES OTW MONORAIL PTA BALLOON
DILATATION CATHETERS D 1.5:4MM 20:40MM "波士頓科技"凱優帝
氣球擴張導管
5398
CBB01F0XSVAB "ABBOTT"FOX SV PTA BALLOON CATHETER D 2:6MM L 90 135
150CM周邊血管氣球導管
5398
CBB01FCPTAAB "ABBOTT"FOXCROSS PTA CATHETER周邊血管氣球導管 5398
CBB01G11XXN5 "NUMED"GHOST II PTA CATHETER 40CM 75CM 120CM 135CM 150CM 5398
CBB01L2457KE "KANEKA"PTA BALLOON CATHETER 經皮穿腔成型術氣球導管 5398
CBB01MG1XXN5 NUMED MINI GHOST DILATATION CATHETER 2MM-6MM 2CM:4CM
40CM:150CM
5398
CBB01PCF18F2 "INVATEC"PACIFIC XTREME PTA BALLOON CATHETER派斯飛克血管
治療導管
5398
CBB01PTA14Y9 NANOCROSS .014 OTW PTA DILATATION CATHETER D 1.5:3.5MM L
20:120MM 導管長度90;150CM娜諾血管擴張氣球導管
5398
CBB01PTA15Y9 NANOCROSS.014 OTW PTA DILATATION CATHETER D 4.0MM L
20;40;80;120MM 導管長度90;150CM娜諾血管擴張氣球導管
5398
CBB01PTA18Y7 POWERCROSS .018 OTW PTA DILATATION CATHETER包爾血管擴張氣
球導管 導管長度90CM 150CM 球囊直徑2MM:6MM 球囊長度
20MM:200MM
5398
CBB01PTA31K7 SD PTA DILATATION CATHETER迅捷血管擴張氣球導管 5398
CBB01PTA35Y8 EVERCROSS .035 OTW PTA DILATATION CATHETER D 3.0:12.0MM L
15:200MM 導管長度40,80,135CM艾維血管擴張氣球導管
5398
CBB01PTA41CK "COOK"ADVANCED 18LP LOW PROFILE PTA BALLOON DILATATION
CATHETER艾德凡絲小剖面經皮穿刺血管成形術球曩擴張導管80CM
135CM
5398
CBB01PTA51CK "COOK"ADVANCED 35LP LOW PROFILE PTA BALLOON DILATION
CATHETER 5-7 FR 80/135CM艾德凡絲小剖面經皮穿刺血管成形術
球囊
5398
CBB01REU35F2 "INVATEC"REEF HP PTA BALLOON CATHETER D 4.0:8.0MM L
20:80MM USE LENGTH 50 80 120CM週邊血管氣球導管
5398
CBB01RV135BA "BARD"RIVAL PTA BALLOON DILATATION CATHETER氣球擴張導管
SHAFT 80&135CM D 4:10MM L 2:15CM
5398
CBB01SBR18F2 "INVATEC"SUBMARINE RAPIDO PTA BALLOON CATHETER 直徑
2.00MM-7.00MM,長度20MM:40MM,60MM,80MM 。USE
LENGTH:75CM,135CM潛艇周邊血管治療導管
5398
CBB01SMTRYSB "BOSTON SCIENTIFIC"SYMMETRY BALLOON DILATATION CATHETER
1.5MM-6.0MM 2CM-10CM對稱式氣球裝導管
5398
CBB01USSV1SB "BOSTON SCIENTIFIC"ULTRA-SOFT SV BALLOON DILATATION
CATHETER4.0MM:7.0MM 1.5CM:2.0CM 3.1CM/3.1CM:3.4CM/3.1CM
90FR,150FR
5398
CBB0221055LW "LEMAITRE"DISTAL PERFUSION CATHETER"樂脈"遠端灌流導管 6590
CBB0344010CD "CORDIS"POWERFLEX PRO PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY CATHETER 10CM"考迪斯"保飛力斯博經皮穿腔成型術
導管*給付規定請見備註
8455
738
特材代碼 中英文名稱 支付點數-104/01/01
CBB0344022CD "CORDIS"POWERFLEX PRO PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY CATHETER 12:22CM"考迪斯"保飛力斯博經皮穿腔成
型術導管*給付規定請見備註
11140
CBB0351240SB "BOSTON SCIENTIFIC"MUSTANG PTA BALLOON DILATATION
CATHETERS D 3:8MM; L 120:200MM "波士頓科技"瑪思丹氣球擴張
導管*適應症請見備註欄
11140
CBB03AB210Y9 NANOCROSS.014 OTW PTA DILATATION CATHETER D:2.0MM:4.0MM
L:150MM,210MM娜諾血管擴張氣球導管(下肢血管)*適應症請見備
註欄
11140
CBB03AMD21F2 "INVATEC"AMPHIRION DEEP PTA BALLOON CATHETER D:2.0:4.00MM
L:120:210MM"英泰克"安菲允血管治療導管*適應症請見備註欄
11140
CBB03AMD80F2 "INVATEC"AMPHIRION DEEP PTA BALLOON CATHETER D:1.5:4.00MM
L:20:80MM"英泰克"安菲允血管治療導管*適應症請見備註欄
8455
CBB03ARMA1AB "ABBOTT"ARMADA 14 PTA CATHETER D:1.5MM-4.0MM L:20MM:80MM"
亞培"阿曼達周邊血管球囊導管*適應症請見備註欄
8455
CBB03ARMA2AB "ABBOTT"ARMADA 14 PTA CATHETER D:1.5MM-4.0MM
L:120MM:200MM"亞培"阿曼達周邊血管球囊導管*適應症請見備註
欄
11140
CBB03BTMA1QC "CLEARSTREAM"BANTAM阿爾發PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY(PTA) CATHETER 15-100MM"清流"班特阿爾發經皮穿
刺血管成形術導管*給付規定見備註。
8455
CBB03BTMA2QC "CLEARSTREAM"BANTAM阿爾發PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY CATHETER 120-220MM"清流"班特阿爾發經皮穿刺血
管成形術導管*給付規定見備註。
11140
CBB03CYTLTSB "BOSTON SCIENTIFIC"COYOTE PTA BALLOON DILATATION
CATHETERS D 2.0:4MM;L 120:220MM "波士頓科技"凱優帝氣球擴
張導管*適應症請見備註欄
11140
CBB03CYTSTSB "BOSTON SCIENTIFIC"COYOTE OTW.MONORAIL PTA BALLOON
DILATATION CATHETERS D 1.5:4MM; 40:100MM "波士頓科技"凱優
帝氣球擴張導管*適應症見備註
8455
CBB03PTAX1CK "COOK"ADVANCED 14LP LOW PROFILE PTA BALLOON DILATATION
2:4MM 2:8CM經皮穿刺血管成形術球曩擴張導管*適應症請見備註
欄
8455
CBB03PTAX2CK "COOK"ADVANCED 14LP LOW PROFILE PTA BALLOON DILATATION
2:4MM 12:20CM經皮穿刺血管成形術球曩擴張導管*適應症請見備
註欄
11140
CBB03STSL1SB "BOSTON SCIENTIFIC"STERLING PTA BALLOON DILATATION
CATHETERS L:120:220MM"波士頓科技"施特靈氣球擴張導管
11140
CBB03STSL8SB "BOSTON SCIENTIFIC"STERLING PTA BALLOON DILATATION
CATHETERS D:2.0:4.00MM L:80,100MM"波士頓科技"施特靈氣球
擴張導管*適應症請見備註欄
8455
CBB03SV435CD "CORDIS"SAVVY PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY ( PTA
) CATHETER D:2.0:6.0MM L:20:100MM"考迪斯"沙維 PTA 擴張導
管*給付規定請見備註欄
8455
CBB04JS0S1CK "COOK"SOS BAKRI TAMPONADE BALLOON 500ML(含60ML針筒)"曲克"
貝克利填塞氣球*適應症請見備註欄
7470
CBC0110101AB "ABBOTT"RX ACCULINK CAROTID STENT SYSTEM亞科林頸動脈支架
系統*適應症請見備註欄
28608
CBC01PCRXCCD "CORDIS"PRECISE PRO RX NITINOL STENT SYSTEM普塞斯普羅鎳鈦
支架系統(頸動脈支架)*適應症請見備註欄
28608
739
特材代碼 中英文名稱 支付點數-104/01/01
CBC01PR0TEY7 "EV3"PROTEGE RX CAROTID STENT SYSTEMS STRAIGHT L:20:60MM
D:6:10MM TAPERED L:30;40MM D:8X6;10X7MM波特捷自動擴張式頸
動脈支架系統*適應症見備註
28608
CBC01SCH64SB OTW&MONORAIL CAROTID WALLSTENT D:6:10MM,L:30:50MM*使用規
範請見備註欄
28608
CBC01SCH65SB OTW&MONORAIL CAROTID WALLSTENT*適應症請見備註欄 28608
CBC0210125AB "亞培"全能自擴型血管支架系統"ABBOTT"ABSOLUTE PRO VASCULAR
SELF-EXPANDING STENT SYSTEM
27129
CBC0222820SB "波士頓科技"艾柏克鎳鈦合金血管支架系統"BOSTON
SCIENTIFIC"EPIC NITINOL VASCULAR STENT SYSTEM*給付規定請
見備註欄
27129
CBC0249380SB "BOSTON SCIENTIFIC "EXPRESS LD ILIAC PREMOUNTED STENT
SYSTEM"波士頓科技"極速腸骨支架系統*適應症請見備註欄
27129
CBC0249381SB "BOSTON SCIENTIFIC "EXPRESS LD ILIAC PREMOUNTED STENT
SYSTEM"波士頓科技"極速腸骨支架系統*給付規定請見備註欄
27129
CBC0271200SB BOSTON SCIENTIFIC WALLSTENT ILIAC ENDOPROSTHESIS WITH
UNISTEP PLUS DELIVERY SYSTEM*"波士頓科技"華斯登腸骨支架系
統*適應症請見備註欄
27129
CBC02ASSURM4 "MEDTRONIC"ASSURANT COBALT OVER THE WIRE ILIAC STENT
SYSTEM腸骨血管支架系統*適應症請見備註欄
27129
CBC02C0810CD "CORDIS"S.M.A.R.T.CONTROL NITINOL STENT SYSTEM(ILIAC)"考
迪斯 "史瑪特鎳鈦支架系統(腸骨支架)*適應症請見備註欄
27129
CBC02C0MSEM4 "MEDTRONIC"COMPLETE SE ILIAC STENT SYSTEM D:4.0-10MM
L:20:150MM CATHETER:80-130CM"美敦力"康博立腸骨血管支架系
統*適應症請見備註欄
27129
CBC02GENESCD "CORDIS"PALMAZ GENESIS PERIPHERAL STENT AND DELIVERY
SYSTEM "考迪斯"帕瑪傑耐周邊血管支架及氣球輸送系統(腸骨動
脈支架)*適應症見備註欄
27129
CBC02MP628F2 "INVATEC"MARIS PERIPHERAL SELF-EXPANDING STENT
SYSTEM(ILIAC ARTERY)瑪瑞斯自膨式週邊血管支架系統*適應症請
見備註欄
27129
CBC02SCA35F2 "INVATEC"SCUBA PERIPHERAL STENT SYSTEM 80CM 130CM腸骨血管
支架系統*適應症請見備註欄
27129
CBC02Z1V60CK "COOK"ZILVER VASCULAR STENT SYS(ILIAC ARTERY) "曲克"麗而
服血管支架系統(腸骨動脈)*適應症請見備註欄
27129
CBC02Z1V62CK "COOK"ZILVER SELF EXPANDABLE VASCULAR STENTS(ILIAC
ARTERY)"曲克"麗而服自展性血管支架*適應症請見備註欄
27129
CBC02Z1V63CK "COOK"ZILVER VASCULAR STENTS(ILIAC)6:10MMX20:80MM"曲克"麗
而服血管支架(腸骨血管支架)*適應症請見備註欄
27129
CBC02ZFV61CK "COOK"ZILVER FLEX 35 VASCULAR STENTS(ILIAC ARTERY)直徑
5:10MM 長度20:140MM"曲克"麗而服福雷斯血管支架(腸骨動脈支
架)
27129
CBC02ZVM04AN "ANGIOMED"BARD E.LUMINEXX VASCULAR STENT"安吉美爾德"巴德.
依路明尼斯血管支架(腸骨血管支架)*適應症請見備註欄
27129
CBC02ZVS04AN "ANGIOMED"BARD E.LUMINEXX VASCULAR STENT 巴德依.路明尼斯
血管支架(腸骨血管支架) 直徑4MM:10MM;12MM;14MM 長度
60CM;135CM*適應症請見備註欄
27129
CBC0320714TM "TERUMO"ANACONDA AAA STENT GRAFT SYSTEM"泰爾茂"安康達腹主
動脈人工血管支架系統(主體+分支體*2)*給付規定請見備註欄
427500
CBC0320715TM "TERUMO"ANACONDA AAA STENT GRAFT SYSTEM -AORTIC CUFF腹主
動脈人工血管支架系統-輔助配件*適應症請見備註欄
56686
740
特材代碼 中英文名稱 支付點數-104/01/01
CBC0320716TM "TERUMO"ANACONDA AAA STENT GRAFT SYSTEM-ILIAC LEGS"泰爾
茂"安康達腹主動脈人工血管支架系統-輔助配件*給付規定請見備
註欄
56686
CBC03AAA01CK ZENITH FLEX AAA ENDOVASCULAR GRAFT W/THE H&L-B ONE-SHOT
INTRO SYS腹主動脈瘤支架暨輸送系統(主體+分支體*2)*適應症見
備註
427500
CBC03AAA01M4 "MEDTRONIC"TALENT AAA STENT GRAFT W THE XCELERANT HYDRO
DELIVERY SYS腹主動脈支架系統(主體+分支體)*適應症請見備註
欄
427500
CBC03AAA02CK ZENITH FLEX AAA ENDOVASCULAR GRAFT W/THE H&L-B ONE-SHOT
INTRODUCTION SYS腹主動脈瘤支架暨輸送系統-輔助配件*適應症
見備註
56686
CBC03AAA02M4 "MEDTRONIC"TALENT AAA STENT GRAFT W THE XCELERANT HYDRO
DELIVERY SYS(AORTIC,ILIAC EXT)腹主動脈支架系統(主動脈,
髂動脈延長段)*適應症見備註
56686
CBC03AAA03CK "COOK"ZENITH AAA ENDOVASCULAR GRAFT W/H&L-B ONE-SHOT
INTRO SYS腹主動脈瘤支架暨輸送導引系統(主體+分支體*2)*適應
症見備註
427500
CBC03AAA03M4 "MEDTRONIC"ENDURANT STENT GRAFT SYSTEM"美敦力"茵德倫覆膜
支架系統(主體+分支體)*適應症請見備註欄
427500
CBC03AAA04CK "COOK"ZENITH AAA ENDOVASCULAR GRAFT W/H&L-B ONE-SHOT
INTRO SYS腹主動脈瘤支架暨輸送導引系統-輔助配件*適應症見備
註
56686
CBC03AAA04M4 "MEDTRONIC"ENDURANT STENT GRAFT SYSTEM"美敦力"茵德倫覆膜
支架系統(輔助配件-主動脈.髂動脈延長段)*適應症請見備註欄
56686
CBC03AAA05M4 "美敦力"茵德倫第二代覆膜支架系統(主體+分支
體)"MEDTRONIC"ENDURANT Ⅱ STENT GRAFT SYSTEM
427500
CBC03AAA06M4 "美敦力"茵德倫第二代覆膜支架系統(AUI主體+分支
體)"MEDTRONIC"ENDURANT Ⅱ STENT GRAFT SYSTEM
427500
CBC03AAA07M4 "美敦力"茵德倫第二代覆膜支架系統(輔助配件-主動脈.髂動脈延
長段)"MEDTRONIC"ENDURANT Ⅱ STENT GRAFT SYSTEM
56686
CBC03AX101CK "COOK"ZENITH RENU AAA ANCILLARY GRAFT W/H&L-B ONE-SHOT
INTRO SYS腹主動脈瘤支架暨輸送導引系統(主體+分支體*2)*適應
症請見備註
427500
CBC03AZT01CK "COOK"ZENITH FLEX AAA ENDOVASCULAR GRAFT /W Z-TRAK INTRO
SYS主動脈瘤支架暨輸送導引系統(主體+分支體*2)*適應症見備註
427500
CBC03LEZT1CK "COOK"ZENITH FLEX AAA ENDOVASCULAR GRAFT W Z-TRAK INTRO
SYS"曲克"蘭尼斯腹主動脈瘤支架暨輸送導引系統-輔助配件(髂動
脈延長段)*適應症見備註欄
56686
CBC03PA23NGX "GORE"EXCLUDER AAA ENDOPROSTHESIS- AORTIC EXTENDER "戈爾"
易時固得腹主動脈瘤支架(腹主動脈瘤主體延伸支架)
56686
CBC03PC12NGX "GORE"EXCLUDER AAA ENDOPROSTHESIS(CONTRALATERAL LEG
ENDOPROSTHESIS)"戈爾"易時固得腹主動脈瘤支架(腹主動脈瘤對
側腳支架)
56686
CBC03PL10NGX "GORE"EXCLUDER AAA ENDOPROSTHESIS(ILIAC EXTENDER
ENDOPROSTHESIS)"戈爾"易時固得腹主動脈瘤支架(髂動脈分支延
伸體)
56686
CBC03PX23NGX "GORE"EXCLUDER AAA ENDOPROSTHESIS"戈爾"易時固得腹主動脈瘤
支架(腹主動脈瘤主體同側腳支架+對側腳支架+股動脈延伸支架)
427500
741
特材代碼 中英文名稱 支付點數-104/01/01
CBC03RX101CK "COOK"ZENITH RENU AAA ANCILLARY GRAFT WITH H&L-B ONE-SHOT
INTRODUCTION SYS腹主動脈瘤支架暨輸送導引系統-輔助配件(延
伸主體)*適應症請見備註欄
56686
CBC03ZFEN1CK "COOK"ZENITH FENESTRATED AAA ENDOVASCULAR GRAFT W/H&L-B
ONE-SHOT INTRO SYS腹主動脈瘤支架暨導引系統(主體+分支體
*2)*適應症見備註
427500
CBC03ZSLE1CK "COOK"ZENITH SPIRAL-Z AAA ILIAC LEG W/THE Z-TRAK
INTRODUCTION SYS腹主動脈瘤支架暨輸送系統-輔助配件*給付規
定見備註
56686
CBC0599999CK "COOK"ZENITH TX2 TAA ENDOVAS GRAFT W THE Z-TRAK PLUS
INTRO SYS胸主動脈支架手術出院後之滲漏特殊個案,得申報需另
修補之輔助配件*給付規定見備註
164666
CBC0599999GX "GORE" TAG THORACIC ENDOPROSTHESIS*胸主動脈支架手術出院後
之滲漏特殊個案,得申報需另修補之輔助配件*給付規定請見備註
欄
164666
CBC0599999L1 "BOLTON"RELAY PLUS THORAC STENT GRAFT W A TRANSPORT
DELIVERY SYS胸主動脈支架手術出院後之滲漏個案,得申報需另
修補之輔助配件*給付規定見備註
164666
CBC0599999M4 "MEDTRONIC"VALIANT THORA STENT GRAFT W CAPTIVIA DELIVERY
SYS胸主動脈支架手術出院後之滲漏特殊個案,得申報需另修補之
輔助配件*給付規定見備註
164666
CBC05RE145L1 "BOLTON"RELAY PLUS THORAC STENT GRAFT W A TRANSPORT
DELIVERY SYS胸主動脈支架暨輸送系統*整組費用含門急診及當次
住院所有置放支架*給付規定見備註
468000
CBC05RELAYL1 "BOLTON"RELAY PLUS THORAC STENT GRAFT W A TRANSPORT
DELIVERY SYS胸主動脈支架暨輸送系統*整組費用含門急診及當次
住院所有置放支架*給付規定見備註
468000
CBC05TAA01CK "COOK"ZENITH TX2 TAA ENDOVASCULAR GRAFT W THE Z-TRAK PLUS
INTRODUCTION SYS胸主動脈支架*整組費用,含門急診及當次住院
所有置放支架*適應症見備註
468000
CBC05TAA02CK "COOK"ZENITH TX2 TAA ENDOVASCULAR GRAFT W PTO-FORM"曲克"
蘭尼思胸主動脈瘤支架*整組費用,含門急診及當次住院所有置放
支架*適應症見備註欄
468000
CBC05TG26NGX "戈爾" 胸主動脈瘤支架暨遞送系統 "GORE" TAG THORACIC
ENDOPROSTHESIS*整組費用,含門急診及當次住院所有置放支架*
給付規定請見備註欄
468000
CBC05TT26NGX "戈爾" 胸主動脈瘤支架暨遞送系統 "GORE" TAG THORACIC
ENDOPROSTHESIS*整組費用,含門急診及當次住院所有置放支架*
給付規定請見備註欄
468000
CBC05TX201CK "COOK"ZENITH TX2 DISSECTION ENDOVAS GRAFT W PTO-
FORM+INTRO SYSTEM"曲克"蘭尼思胸主動脈剝離血管支架及其輸送
系統*整組費用,含門急診及當次住院置放支
468000
CBC05VLCAPM4 "MEDTRONIC"VALIANT THORACIC STENT GRAFT W THE CAPTIVIA
DELIVERY SYS范倫特胸主動脈支架系統。整組含門、急診及當次
住院所有支架*給付規定見備註。
468000
CBC05VLTAAM4 "MEDTRONIC"VALIANT THORACIC STENT GRAFT W THE XCELERANT
DELIVERY SYS胸主動脈支架系統*整組費用,含門急診及當次住院
所有置放支架*適應症見備註
468000
CBP0103012UZ TURQUOISE PTCA BALLOON DILATATION CATHETER D 1.5MM:4.5MM
綠松石冠狀動脈氣球擴張導管
6843
CBP010MEGASB "BOSTON SCIENTIFIC"OMEGA MONORAIL PTCR CORONARY STENT
SYSTEM "波士頓科技"*亞美加單軌冠狀動脈支架系統*適應症請見
備註欄
16293
742
特材代碼 中英文名稱 支付點數-104/01/01
CBP01103TBRB "ORBUSNEICH"SAPPHIRE CORONARY DILATATION CATHETER
1.5MM:4.0MM 10MM:30MM塞費爾冠狀動脈球曩擴張術導管
6843
CBP01104TBRB "ORBUSNEICH"SAPPHIRE NC CORONARY DILATATION CATHETER神飛
冠狀動脈球囊擴張術導管
6843
CBP01105TBRB "ORBUSNEICH"SAPPHIRE II CORONARY DILATATION CATHETER"奧
爾"第二代塞費爾冠狀動脈球曩擴張術導管
6843
CBP01106TBRB "ORBUSNEICH"SAPPHIRE NC CORONARY DILATATION CATHETER"奧
爾"神飛冠狀動脈球囊擴張術導管
6843
CBP0112510UV INVADER CTO CORONARY ANGIOPLASTY BALLOON CATHETER入侵者慢
性全閉塞氣球擴張導管
6843
CBP011NTEGM4 "MEDTRONIC"INTEGRITY RAPID EXCHANGE CORONARY STENT
SYSTEM"美敦力"英泰爾快速交換冠狀動脈血管支架系統*適應症請
見備註欄
16293
CBP0122545SB "BOSTON SCIENTIFIC"OMEGA MONORAIL PTCR CORONARY STENT
SYSTEM"波士頓科技"亞美加單軌冠狀動脈支架系統*給付規定請見
備註欄
16293
CBP012535SHC HELISTENT CORONARY STENT W/DELIVERY SYSTEM *適應症請見備
註欄(原文號910034694)
16293
CBP012540SHC HELISTENT CORONARY STENT W/DELIVERY SYSTEM *適應症請見備
註欄(原文號910034694)
16293
CBP0138938SB LIBERTE MONORAIL CORONARY STENT SYSTEM*適應症請見備註欄 16293
CBP0150200BB COROFLEX CORONARY STENT SYSTEM(W/DELIVERY SYSTEM)*適應症
請見備註欄
16293
CBP0150201BB COROFLEX CORONARY STENT SYSTEM(W/DELIVERY SYSTEM)*適應症
請見備註欄
16293
CBP0150212BB "B.BRAUN"SEQUENT PTCA CATHETER"柏朗"適可穩經皮穿刺汽球擴
張導管
6843
CBP0182926AB ABBOTT FLEXMASTER F1 CORONARY STENT WITH DELIVERY SYSTEM
適應症請見備註欄
16293
CBP01AU729RB "ORBUSNEICH"AZULE CORONARY STENT DELIVERY SYSTEM"奧爾"雅
助冠狀動脈血管支架輸送系統*適應症請見備註欄
16293
CBP01BL729RB "ORBUSNEICH"BLAZER CORONARY STENT DELIVERY SYSTEM布雷冠狀
動脈血管支架輸送系統*適應症請見備註欄
16293
CBP01BLUE1BB "B.BRAUN"COROFLEX BLUE CORONARY STENT SYSTEM普弩冠狀動脈
血管支架系統*適應症請見備註欄
16293
CBP01BLUE2BB "B.BRAUN"COROFLEX BLUE CORONARY STENT SYSTEM普弩冠狀動脈
血管支架系統
16293
CBP01CSUNATM TSUNAMI CORONARY STENT SYSTEM(WITH BALLOON)*適應症請見備
註欄
16293
CBP01CT480Y0 "擴適達"高斯喜通冠狀動脈氣球導管"ACROSTAK"ACROSS CTO PTCA
BALLOON CATHETER
6843
CBP01DFX08JF "DURAFLEX"CORONARY STENT SYSTEM"杜拉佛克斯"冠狀動脈血管支
架系統支架 支架長度8MM:25MM 支架內徑2.5MM:4.0MM*適應症請
見備註欄
16293
CBP01DVW35AS "ASAHI"DOUVAN PTCA DILATATION CATHETER"朝日"朵凡氣球擴張
導管
6843
CBP01FCBRVF2 "INVATEC"FALCON BRAVO PTCA BALLOON CATHETER獵鷹柏拉弗冠狀
動脈氣球導管 直徑1.5:4.0MM BALLOON LENGTH
10,14,20,30,40MM CATHETER LENGTH 145CM
6843
CBP01FF22BF2 "INVATEC"FALCON FORTE PTCA BALLOON CATHETER冠狀動脈氣球導
管直徑2.00MM:4.00MM,4.50MM,5.00MM,長度145CM
6843
CBP01FLC10F2 "INVATEC"FALCON CTO PTCA BALLOON CATHETER冠狀動脈氣球導管 6843
743
特材代碼 中英文名稱 支付點數-104/01/01
CBP01GAZSTBS "BIOSENSORS"GAZELLE CORONARY STENT SYSTEM冠狀動脈內支架系
統*適應症請見備註欄
16293
CBP01KANMETM "TERUMO"KANAME COBALT-CHROMIUM CORONARY STENT SYSTEM"泰爾
茂"凱樂鎂冠狀動脈血管支架系統*適應症請見備註欄
16293
CBP01ML8STAB "ABBOTT"MULTI-LINK 8 CORONARY STENT SYSTEM"亞培"第八代冠
狀動脈支架系統 D 2.25:4.00MM L:8MM:38MM*適應症請見備註欄
16293
CBP01MLVSTAB "ABBOTT"MULTI-LINK VISION RX CORONARY STENT SYSTEM"亞培"
冠狀動脈支架系統*適應症請見備註欄
16293
CBP01PWRLNBS "BIOSENSORS"POWERLINE PTCA CATHETER經皮冠狀動脈成形術球囊
導管
6843
CBP01TRKNCAB "ABBOTT"NC TREK RX CORONARY DILATATION CATHETER"亞培"恩希
快克冠狀動脈氣球擴張導管
6843
CBP01TSUG2TM "TERUMO"TSUNAMI CORONARY STENT SYSTEM冠狀動脈血管支架*適
應症請見備註欄
16293
CBP01TSUG3TM "TERUMO"TSUNAMI CORONARY STENT SYSTEM冠狀動脈血管支架系統
*適應症請見備註欄
16293
CBP01TSUGDTM "TERUMO"TSUNAMI CORONARY STENT SYSTEM冠狀動脈血管支架*適
應症請見備註欄
16293
CBP01TSUNATM TSUNAMI CORONARY STENT SYSTEM(WITH BALLOON)*適應症請見備
註欄
16293
CBP01V1S1NAB "ABBOTT"MULTI-LINK VISION RX CORONARY STENT
SYSTEM2.75MM:4MM 8MM:28MM適見冠狀動脈支架系統*適應症請見
備註欄
16293
CBP01V7844AB "ABBOTT"MULTI-LINK VISION RX CORONARY STENT SYSTEM
2.75:4.00MM 8:28MM"亞培"冠狀動脈支架系統*適應症請見備註欄
16293
CBP01VYGNCAB "ABBOTT"VOYAGER NC CORONARY DILATATION CATHETER航行家恩希
冠狀動脈擴張導管2.00MM:5.00MM 6MM:25MM
6843
CBP01ZETANAB "ABBOTT"MULTI-LINK RX ZETA CORONARY STENT SYSTEM智達冠狀
動脈支架系統*適應症請見備註欄
16293
CBP02NCSP1M4 "MEDTRONIC"NC SPRINTER RAPID EXCHANGE BALLOON DILATATION
CATHETER"美敦力"史賓特高壓快速交換氣球擴張導管
6843
CBP02NCSPRM4 "MEDTRONIC"NC SPRINTER RAPID EXCHANGE BALLOON DILATATION
CATHETER"美敦力"史賓特高壓快速交換氣球擴張導管
6843
CBP02R5A85KE FORTIS II PTCA CATHETER 2.50MM:4.50MM佛緹斯冠狀動脈成型術
導管
6843
CBP02R7R7FKE "KANEKA"IKAZUCHI RAPID EXCHANGE PTCA BALLOON CATHETER雷快
速抽換冠狀動脈氣球導管
6843
CBP02R7REVKE "KANEKA"PTCA CATHETER IKAZUCHI REV "卡內卡"冠狀動脈氣球導
管
6843
CBP02SPR32M4 MEDTRONIC SPRINTER OVER-THE-WIRE BALLOON DILATATION
CATHETER 1.5MM:4.0MM 6MM:30MM
6843
CBP02SPRL1M4 "MEDTRONIC"SPRINTER LEGEND RAPID EXCHANGE BALLOON
DILATATION CATHETER快速交換氣球擴張導管
6843
CBP02SPRLGM4 "MEDTRONIC"SPRINTER LEGEND RAPID EXCHANGE BALLOON
DILATATION CATHETER (D:1.25MM:4MM,L:6MM:30MM)
6843
CBP02SPRNTM4 SPRINTER RAPID EXCHANGE BALLOON DILATION CATHETER 6843
CBP031016TTM "TERUMO"RYUJIN PLUS PTCA DILATATION CATHETER琉均柏柆思冠
狀動脈氣球擴張導管
6843
CBP031215NTM RYUJIN PTCA DILATATION CATHETER RX-1 6843
CBP0314038TM TERUMO RYUJIN PLUS PTCA DILATATION CATHETER 6843
744
特材代碼 中英文名稱 支付點數-104/01/01
CBP0314039TM TERUMO RYUJIN PLUS PTCA DILATATION CATHETER 6843
CBP0318634TM RYUJIN PLUS OTW PTCA DILATATION CATHETER冠狀動脈氣球擴張
導管
7809
CBP032015NTM RYUJIN PTCA DILATATION CATHETER RX-1 6843
CBP0337910SB "BOSTON SCIENTIFIC"MAVERICK XL MONORAIL PTCA DILATATION
CATHETER 馬文瑞克氣球擴張導管
6843
CBP0338080SB QUANTUM MAVERICK MONORAIL DILATION CATHETER(PTCA BALLOON
CATHETER)
6843
CBP0338081SB "BOSTON SCIENTIFIC"QUANTUM MAVERICK PTCA DILATATION
CATHETER D 2.0:5.0MM L8:30MM冠狀動脈擴張導管
7809
CBP0338928SB MAVERICK 2 MONORAIL BALLOON CATHETER *自92.7.1改按條支付 6843
CBP0338960SB "BOSTON SCIENTIFIC"APEX OTW PTCA DILATATION CATHETER氣球
擴張導管
7809
CBP0338961SB "BOSTON SCIENTIFIC"APEX PTCA DILATATION CATHETER氣球擴張
導管
6843
CBP03389XXSB "BOSTON SCIENTIFIC"APEX MONORAIL PTCA DILATATION CATHETER
D 1.50MM:5.0MM L8MM:40MM艾佩斯單軌氣球擴張導管
6843
CBP0339124SB "BOSTON SCIENTIFIC"NC QUANTUM APEX PTCA DILATATION
CATHETER(MONORAIL)康騰艾佩斯氣球擴張導管2.0:5.0MM 6:30MM
6843
CBP0339125SB "BOSTON SCIENTIFIC"NC QUANTUM APEX PTCA DILATATION
CATHETER(OTW)康騰艾佩斯氣球擴張導管2.0:5.0MM 6:30MM
7809
CBP035265NAB "ABBOTT"CROSSSAIL CORONARY DILATATION CATHETER可思爾冠狀
動脈擴張導管
6843
CBP03701XNCD "CORDIS"DURA STAR RX PTCA DILATATION CATHETER杜芮星冠狀動
脈擴張導管
6843
CBP03801XNCD "CORDIS"FIRE STAR RX PTCA DILATATION CATHETER法爾星冠狀動
脈擴張導管
6843
CBP03ACRHPY0 "ACROSTAK"ACROSS HP PTCA BALLOON CATHETER"擴適達"高斯高壓
冠狀動脈氣球導管
6843
CBP03CT481Y0 "擴適達"高斯喜通冠狀動脈氣球導管"ACROSTAK"ACROSS CTO PTCA
BALLOON CATHETER(OTW)
7809
CBP03DCRK1TM "TERUMO"TAZUNA PTCA DILATATION CATHETER"泰爾茂"鈦速納冠狀
動脈氣球擴張導管
6843
CBP03EMERMSB "BOSTON SCIENTIFIC"EMERGE PTCA DILATATION
CATHETER(MONORAIL) D:1.20MM:4.00MM L:8MM:30MM"波士頓科技"
宜加冠狀動脈擴張導管
6843
CBP03EMERTSB "BOSTONSCIENTIFIC"EMERGEPTCADILATATIONCATHETERD:1.20MM:4.
00MML:8MM:30MM"波士頓科技"宜加同軸冠狀動脈擴張導管
7809
CBP03EP75RCD "CORDIS"EMPIRA NC RX PTCA DILATATION CATHETER"考迪斯"安博
冠狀動脈擴張導管
6843
CBP03EP85RCD "CORDIS"EMPIRA RX PTCA DILATATION CATHETER"考迪斯"安博冠
狀動脈擴張導管
6843
CBP03EPNCRCD "CORDIS"EMPIRA NC RX PTCA DILATATION CATHETER"考迪斯"安博
冠狀動脈擴張導管
7547
CBP03H1RU1TM "TERUMO"HIRYU PTCA DILATATION CATHETER 2.25:5.0MM 6:20MM
冠狀動脈氣球擴張導管
6843
CBP03M3115AB JOCATH MERCURY PTCA CATHETER 6843
CBP03R2A15KE KANEKA RX CATHETER AEROCROSS FIGHTER 1.5MM:4.0MM
15MM:20MM
6843
CBP03R4K15KE KANEKA RX CATHETER OTTIMO 1.5MM:4.0MM 10MM:20MM 6843
CBP03RAF25HC "HEXACATH"RAFALE PTCA DILATATION CATHETER旋風冠狀動脈氣球
擴張導管
6843
745
特材代碼 中英文名稱 支付點數-104/01/01
CBP03SL0TWM4 "MEDTRONIC"SPRINTER LEGEND OVER-THE-WIRE BALLOON
DILATATION CATHETER同軸導線球囊擴張導管
7809
CBP03TREK1AB "ABBOTT"TREK AND MINI TREK RX CORONARY DILATATION
CATHETER"亞培"快克/小快克冠狀動脈擴張導管
6843
CBP03TREK2AB "ABBOTT"TREK AND MINI TREK OTW CORONARY DILATATION
CATHETER"亞培"快克/小快克冠狀動脈氣球擴張導管
7809
CBP03V0TWNAB "ABBOTT"VOYAGER OTW CORONARY DILATATION CATHETER莫雅佳甌
第冠狀動脈擴張導管
7809
CBP03V391NAB "ABBOTT"VOYAGER RX CORONARY DILATATION CATHETER莫雅佳冠狀
動脈擴張導管
6843
CBP0510128AB "亞培"冠狀動脈包覆支架"ABBOTT"GRAFTMASTER RX CORONARY
STENT GRAFT SYSTEM(WITH DELIVERY SYSTEM)*給付規定請見備註
欄
49500
CBP05210CGAB "ABBOTT"JOSTENT GRAFTMASTER CORONARY STENT GRAFT(WITH
DELIVERY SYSTEM)*適應症請見備註欄.
49500
CBP06ELUT1AB "ABBOTT"XIENCE V EVEROLIMUS ELUTING CORONARY STENT SYSTEM
艾諾莉茉斯冠狀動脈塗藥支架,部分給付品項,適應症見備註欄
,並註明其禁忌症勿使用。
16293
CBP06ELUT1BB COROFLEX PLEASE PACLITAXEL-ELUTING CORONARY STENT SYSTEM
部分給付品項紫杉醇釋放型冠狀動脈血管支架*適應症見備註,並
註明其禁忌症勿使用。
16293
CBP06ELUT1BK "BIOTRONIK"ORSIRO SIROLIMUS ELUTING CORONARY STENT
SYSTEM"百多力"歐禧樂西羅莫司冠狀動脈塗藥支架系統(自付差額
品項)
16293
CBP06ELUT1BS "BIOSENSORS"BIOMATRIX DRUG ELUTING CORONARY STENT SYS釋放
型冠狀動脈支架系統部分給付品項*適應症見備註,並註明禁忌症
不可使用。
16293
CBP06ELUT1HC "HEXACATH"PREMOUNTED CORONARY STENT HELISTENT TITAN2"海斯
凱"泰坦2(塗層)冠狀動脈血管支架*部分給付品項,適應症見備註
欄,並註明禁忌症不可用。
16293
CBP06ELUT1RB "ORBUS"GENOUS R STENT傑納斯冠狀動脈血管支架輸送系統
2.5MM:4.0MM 9MM:33MM 部分給付品項.適應症請見備註欄.並註明
其禁忌症不可使用.
16293
CBP06ELUT1TM "TERUMO"NOBORI DRUG STENT SYSTEM 2.5MM:3.5MM 8MM:28MM冠狀
動脈塗藥支架 部分給付品項*適應症請見備註,並註明其禁忌症
不可使用。
16293
CBP06ELUT1YV "CID"JANUS OPTIMA CARBOSTENT W DELIVERY SYS"喜安汀"真神奧
普帝馬塗藥冠狀動脈血管支架,部分給付品項*給付規定見備註欄
,並註明其禁忌症不可使用。
16293
CBP06ELUT2BS "BIOSENSORS"BIOMATRIX FLEX DRUG ELUTING CORONARY STENT
SYS拜美翠弗雷絲藥物釋放冠狀動脈支架,部分給付品項*適應症
見備註,並註明禁忌症不可用。
16293
CBP06ELUT2SB TAXUS LIBERTE MONORAIL PACLITAXEL-ELUTING CORONARY STENT
SYSTEM 2.25:3.5MM 8:32MM.部分給付品項.適應症請見備註欄.並
註明其禁忌症不可使用
16293
CBP06ELUT3AB "ABBOTT"XIENCE PRIME EVEROLIMUS ELUTING CORONARY STENT
SYSTEM冠狀動脈塗藥支架系統部份給付品項*適應症請見備註欄,
並註明其禁忌症不可使用。
16293
CBP06ELUT3M4 ENDEAVOR RESOLUTE ZOTAROLIMUS-ELUTING CORONARY STENT
SYSTEM釋放型冠狀動脈支架系統,部分給付品項,適應症見備註
,並註明其禁忌症不可用。
16293
CBP06ELUT3SB "BOSTON SCIENTIFIC"TAXUS LIBERTE LONG MONORAIL
PACLITAXEL-ELUTING CORONARY STENT SYS紫杉醇釋放型冠狀動脈
支架*適應證見備註
16293
746
特材代碼 中英文名稱 支付點數-104/01/01
CBP06ELUT4AB "ABBOTT"XIENCE XPEDITION EVEROLIMUS ELUTING CORONARY
STENT SYSTEM"亞培"賽恩斯征艾諾莉茉斯冠狀動脈塗藥支架系統
(自付差額品項)
16293
CBP06ELUT4M4 "MEDTRONIC"ENDEAVOR RESOLUTE ZOTAROLIMUS-ELUTING CORONARY
STENT SYS釋放型冠狀動脈支架系統。部分給付品項,適應症見備
註,並註明其禁忌症勿用。
16293
CBP06ELUT4SB "BOSTON SCIENTIFIC"TAXUS ELEMENT PACLITAXEL-ELUTING
CORONARY STENT SYS冠狀動脈塗藥支架系統*部分給付品項,適應
症見備註,並註明禁忌症不可用
16293
CBP06ELUT5M4 "MEDTRONIC"RESOLUTE INTEGRITY ZOTAROLIMUS-ELUTING
CORONARY STENT SYS"美敦力"釋放型冠狀動脈支架*部分給付,給
付規定見備註,並註明禁忌症勿用
16293
CBP06ELUT5SB "BOSTON SCIENTIFIC"PROMUS ELEMENT EVEROLIMUS-ELUTING
CORONARY STENT SYS冠狀動脈塗藥支架系統*部分給付品項,適應
症見備註,並註明禁忌症不可用
16293
CBP06ELUT6SB "波士頓科技"博謨適艾勒門艾諾莉茉斯冠狀動脈塗藥支架系
統"BOSTON SCIENTIFIC"PROMUS ELEMENT PLUS EVEROLIMUS-
ELUTING CORONARY STENT SYSTEM 部分給付品
16293
CBP0750222BB "B.BRAUN"SEQUENT PLEASE PACLITAXEL-RELEASING RAPID
EXCHANGE PTCA BALLOON CATHETER"柏朗"喜寬普利斯紫杉醇釋放
型冠狀動脈氣球導管*適應證見備註
47000
CBS01RASHKM4 "MEDTRONIC"RASHKIND BALLOON SEPTOSTOMY CATHETER"美敦力"球
囊中膈切除術導管
9000
CBS01SPTXXN5 "NUMED"Z-5 ATRIOSEPTOSTOMY CATHETER 9000
CBS029ASDAG6 "AGA"AMPLATZER SEPTAL OCCLUDER 4:20MM,22MM:38MM,40MM"銨積
維"安普拉茲心房關閉器
138000
CBS029ASDNG6 "AGA"AMPLAATZER SEPTAL OCCLUDER WITH DELIVERY SYSTEM"銨積
維"安普拉茲心房關閉器※給付規定請見備註欄
143762
CBS029CR19G6 AMPLATZER CRIBRIFORM OCCLUDER安普拉茲多孔心房中膈關閉器*
給付規定請見備註欄
138000
CBS029DEL5G6 "AGA"AMPLATZER DELIVERY SYSTEM 5-9FR*安普拉茲遞送導管系統
*給付規定請見備註欄(自981001起適應症代碼由A213-4更改為
A213-5)。
12000
CBS029DEL9G6 "AGA"AMPLATZER DELIVERY SYSTEM 9FR,10FR,12FR"銨積維"安普
拉茲遞送導管系統*給付規定請見備註欄
12000
CBS029DELNG6 "AGA"AMPLATZER DELIVERY SYSTEM 6:8FR*"銨積維"安普拉茲遞送
導管系統*給付規定請見備註欄
12000
CBS029DELTG6 "AGA"AMPLATZER DELIVERY SYSTEM"銨積維"安普拉茲遞送導管系
統5F:10F,12:13F*給付規定請見備註欄
12000
CBS029SZB2G6 AMPLATZER SIZING BALLOON II 安普拉茲測量氣球導管*給付規定
請見備註欄
14476
CBS029TVEXG6 "AGA"AMPLATZER TORQ VUE EXCHANGE SYSTEM安普拉茲托克交換導
管系統6F:12F*給付規定請見備註欄
12000
CBS02F2ASDJ7 "奧圖"菲雷心房中隔補綴器"OCCLUTECH"FIGULLA FLEX Ⅱ ASD *
給付規定請見備註欄
138000
CBS02FASDNJ7 "OCCLUTECH"FIGULLA ASD OCCLUDERS"奧圖"心房中隔補綴器*適應
症請見備註欄
138000
CBS02FX2PFJ7 "奧圖"菲雷卵圓孔補綴器"OCCLUTECH"FIGULLA FLEX ⅡPFO 138000
CBS02PFC98G6 "安普拉茲"卵圓孔關閉器"AMPLATZER" PFO OCCLUDER 138000
CBS02PTSXXN5 PTS SIZING CATHETER 20:40MM 3:5CM 80CM 0.035" GUIDE WIRE
※適應症請見備註欄
14476
CBS02TV454G6 AMPLATZER TORQVUE 45X45 DELIVERY SHEATH安普拉茲托菲遞送導
管*給付規定請見備註欄
12000
747
特材代碼 中英文名稱 支付點數-104/01/01
CBS02TVLA1G6 AMPLATZER TORQVUE LA DELIVERY SHEATH安普拉茲托菲樂爾遞送
導管*給付規定請見備註欄
12000
CBS02TVLP4G6 AMPLATZER TORQVUE LP DELIVERY SYSTEM安普拉茲托菲遞送導管
系統*給付規定請見備註欄
12000
CBS02TVLPCG6 AMPLATZER TORQVUE LP CATHETER 安普拉茲特維力普導管*給付規
定請見備註欄
12000
CBS039PDAAG6 "AGA"AMPLATZER DUCT OCCLUDER"銨積維"安普拉茲開放性動脈導
管關閉器*適應症請見備註欄
66941
CBS03AD029G6 安普拉茲開放性動脈導管關閉器第二代 AMPLATZER DUCT
OCCLUDERⅡ
66941
CBS03AD0ASG6 安普拉茲艾絲開放性動脈導管關閉器第二代 AMPLATZER DUCT
OCCLUDER Ⅱ ADDITIONAL SIZES *給付規定請見備註欄
66941
CBS04407XXST "聖猷達" 房中膈穿刺針"SJM" BRK TRANSSEPTAL NEEDLE 6379
CBS059AVP2G6 "AMPLATZER"VASCULAR PLUG II 3MM:22MM"安普拉茲"II型血管塞
(含遞送導管)
24990
CBS059AVP4G6 "AMPLATZER"VASCULAR PLUG&DELIVERY SYSTEM 4MM:16MM血管塞含
遞送導管
22750
CBT020712NAR ARROW BALLOON WEDGE-PRESSURE CATHETERS 4:8FR 60:110CM "亞
諾"肺動脈楔壓導管(順流導管雙腔)
1709
CBT022014LPU PULSIOCATH CONTINUOUS CARDIAC OUTPUT THERMODILUTION
CATHETER
5775
CBT022014NPU PULSIOCATH THERMODILUTION CATHETERS(PICCO2) 普新卡熱稀釋
導管(含CATHETER+NITINOL GUIDE WIRE)
5775
CBT022015LPU "PULSION"PULSIOCATH THERMODILUTION CATHETER 5775
CBT0405000AR "ARROW"BALLOONTHERMODILUTION CATHETERS(HEPARIN-COATED)
FOUR LUMEN"亞諾"熱稀釋順流導管
2143
CBT0405050AR "ARROW"BALLOONTHERMODILUTION CATHETERS(HEPARIN-COATED) 5
LUMEN"亞諾"熱稀釋順流導管
2143
CBT0407044AR "ARROW" THERMODILUTION BALLOON CATHETER(4 LUMEN) 4FR 75CM
"亞諾"熱稀釋順流導管(兒童)
1962
CBT0407055AR "ARROW"BALLOON THERMODILUTION CATHETER 4FRX75CM
5FRX80CM(HEPARIN COATED) 4 LUMENS "亞諾"熱稀釋順流導管
2143
CBT0407365AR "ARROW"BALLOON THERMODILUTION CATHETER 6FRX80CM;110CM
7FRX110CM(HEPARIN COATED) 4 LUMENS "亞諾"熱稀釋順流導管
2143
CBT0407367AR "ARROW" THERMODILUTION BALLOON CATHETER(4 LUMEN) 7FR
110CM "亞諾"熱稀釋順流導管
1610
CBT04131HVED EDWARDS SWAN-GANZ THERMODILUTION CATHETER 4LUMEN
7FR,W/AMC THROMBOSHIELD COATING
2143
CBT04132F5ED "EDWARDS"SWAN-GANZ THERMODILUTION CATHETER 4LUMEN 5FR
75CM(兒童用)史望康熱稀釋導管
1962
CBT041704HBS THERMODILUTION CATHETER 測輸量順流導管(四腔)7fr 110cm 1610
CBT04254NDBS THERMODILUTION CATHETER 5FR 4 LUMEN, 6FR 4 LUMEN ,7FR 4
LUMEN 順流導管(四腔)
1962
CBT0445080AG "ARGON"CRITICATH THERMODILUTION CATHETERS(HEPARIN
COATING) 4 LUMEN 5F 80CM"愛琅"熱稀釋導管
2143
CBT0445110AG "ARGON"CRITICATH THERMODILUTION CATHETERS(HEPARIN
COATING)4 LUMEN 5F 110CM"愛琅"熱稀釋導管
2143
CBT045107SAG "ARGON"CRITICATH THERMODILUTION CATHETERS(HEPARIN
COATING)4 LUMEN 7FR 110CM"愛琅"熱稀釋導管
2143
CBT0493137ED SWAN-GANZ THERMODILUTION CATHETER FOUR LUMEN/AMC
THROMBOSHIELD(HEPARIN)熱稀釋導管
2143
CBT04C144HED "EDWARDS"SWAN-GANZ THERMODILUTION CATHETER 4 LUMEN 7FR
W/AMC THROMBOSHIELD COATING
2143
748
特材代碼 中英文名稱 支付點數-104/01/01
CBT04H5107AG "ARGON"CRITICATH THERMODILUTION CATHETERS(HEPARIN
COATING)4 LUMEN 7FR 110CM"愛琅"熱稀釋導管
2143
CBT05175HDBS THERMODILUTION CATHETER 7.5FR 5 LUMEN 2143
CBT0550324U2 "愛西優"流量導向導管/測血氧"ICU"FLOW-DIRECTED CATHETERS 7148
CBT055507SAG "ARGON"CRITICATH THERMODILUTION CATHETERS(HEPARIN
COATING)5 LUMEN 7.5FR 110CM"愛琅"熱稀釋導管
2143
CBT0574175ED SWAN GANZ OXIMETRY AND VOLUMETRIC CATHETER*適應症請見備註
欄
7148
CBT05831HFED "EDWARDS"SWAN-GANZ THERMODILUTION CATHETERS 5 LUMEN 7FR
W/AMC THROMBOSHIELD COATING史望康熱稀釋管
2143
CBT05831HVED EDWARDS SWAN-GANZ THERMODILUTION CATHETER 5LUMEN
7.5FR,W/AMC THROMBOSHIELD COATING
2143
CBT0617775ED SWAN GANZ CONTINUOUS CARDIAC /END DIASTOLIC VOLUME
THERMODILUTION CATHETER CCO/cEDV*適應症請見備註欄
5756
CBT0652510U2 "愛西優"流量導向導管"ICU"FLOW-DIRECTED CATHETERS OPTI-Q
SVO2/CCO CATHETER
6548
CBT0652515U2 "愛西優"流量導向導管"ICU"FLOW-DIRECTED CATHETERS 5886
CBT06746F8ED SWAN GANZ CONTINUOUS CARDIAC /END DIASTOLIC VOLUME
THERMODILUTION CATHETER CCO/SVO2/VIP*適應症請見備註欄
6548
CBT06757HFED SWAN GANZ CONTINUOUS CARDIAC /END DIASTOLIC VOLUME
THERMODILUTION CATHETER CCO/SVO2/EDV/VIP*適應症請見備註欄
6548
CBT0677475ED "EDWARDS"SWAN GANZ CONTINUOUS CARDIAC OUTPUT/END
DIASTOLIC VOLUME THERMODILUTION CATH CCO/SVO2/CEDV熱稀釋
導管*適應症見備註
6548
CBT06777F8ED SWAN GANZ CONTINUOUS CARDIAC /END DIASTOLIC VOLUME
THERMODILUTION CATHETER CCO/SVO2/CEDV/VIP*適應症請見備註
欄
6548
CBT06831HFED "EDWARDS"SWAN-GANZ THERMODILUTION CATHETERS 6 LUMEN 7FR
W/AMC THROMBOSHIELD COATING史望康熱稀釋管
2924
CBT07MHD68ED FLOTRAC SENSOR KIT W/60" OR 84" PRESSURE TUBING弗羅威克感
應器組
6138
CBT07MHDAZED FLOTRAC SENSOR KIT W/60" PRESSURE TUBING & VAMP ADULT
SYSTEM 弗羅威克感應器組附血液管理保護系統
6138
CBT08VLV8RED "EDWARDS"VOLUME VIEW SET(VOLUME VIEW SENSOR W TUBING
SET+FEMORAL CATH KIT+VENOUS INJECTATE KIT W DPT) "愛德華"
體積監視套組
7068
CBV020MS2NTR PTMC BALLOON CATHETER 33700
CBV02PDCXXN5 PERCUTANEOUS TRANSLUMINAL VALVULOPASTY (PTV)CATHETER
4.0MM:30.0MM,2.0CM:8.0CM
12301
CBV02PDZXXN5 NUMED Z-MED II PERCUTANEOUS TRANSULUMINAL VALVULOPLASTY
(PTV)CATHETER 4:30MM 2:10CM 100CM
12301
CBV02PTVNXN5 "NUMED"NUCLEUS PTV DILATATION CATHETER 二尖瓣及主動脈瓣氣
球擴張導管
33700
CCC030980EHA THERAPEUTIC AND AUTOLOGOUS ERYTHROPHERESIS SET 3014
CCC030981EHA THERAPEUTIC AND AUTOLOGOUS ERYTHROPHERESIS SET 3014
CCC03BT271YT "SAFETRAN"BLOOD COMPONENTS APHERESIS"笙創"血液成份分離器
(離心杯275CC+體外血液迴路管)
3014
CCC03BX051YT "SAFETRAN"BLOOD COMPONENTS APHERESIS"笙創"血液成份分離器
(離心杯50CC+體外血液迴路管)
3014
CCC03BX221YT "SAFETRAN"BLOOD COMPONENTS APHERESIS"笙創"血液成份分離器
(離心杯225CC+體外血液迴路管)
3014
CCC03BX371YT "SAFETRAN"BLOOD COMPONENTS APHERESIS"笙創"血液成份分離器
(離心杯375CC+體外血液迴路管)
3014
749
特材代碼 中英文名稱 支付點數-104/01/01
CCC110971EHA PERIPHERAL BLOOD STEM CELLS SET 3622
CCC1300200HA 自體血液回收系統管套CELL SAVER COLLECTION RESERVOIR ※適
應症請見備註欄
3900
CCC13BT894R5 "SORIN"AUTOTRANSFUSION RESERVOIR SET自動輸血組儲血器*適
應症請見備註欄
3900
CCC1400260HA CELL SAVER 5 FAST PACK 225ML 體血液收集洗滌套※適應症請
見備註欄
7260
CCC1400261HA "漢尼帝克"自體血液回收系統管套" HAEMONETICS " CELL SAVER
SET FOR AUTOTRANSFUSION SYSTEM 70ML BOWL *適應症請見備註
欄
7260
CCC1400265HA "漢尼帝克"自體血液回收系統管套"HAEMONETICS" CELL SAVER
SET FOR AUTOTRANSFUSION SYSTEM-125ML BOWL *給付規定請見備
註欄
7260
CCC1400ATFVB AUTOTRANSFUSION FAST START KIT(AUTOTRANSFUSION
SET+AUTOTRANSFUSION RESERVOIR+ATS SUCTION LINE)*適應症請
見備註欄
7260
CCC1400CSEHA "漢尼帝克"依利特自體輸血系統管套"HAEMONETICS" CELL SAVER
ELITE SYSTEM DISPOSABLE SET-70,125,225ML BOWL *給付規定請
見備註欄
7260
CCC1402001M4 AUTOLOG WASH KIT*適應症請見備註欄 7260
CCC14745E5R5 "SORIN"AUTOTRANSFUSION KITS FOR ELECTA(WASH
SET+AUTOTRANSFUSION RESERVOIR SET+LINE)依雷塔專用自體輸血
組*適應症請見備註欄
7260
CCC1474E55R5 "SORIN"WASH SET血液洗淨組*適應症請見備註欄 3974
CCC1520503AH "ATRIUM"OCEAN WATER SEAL CHEST DRAINS海洋自體血液回收胸腔
引流儲血器(單管回流式)*適應症請見備註欄
3882
CCC1520523AH "ATRIUM"OCEAN WATER SEAL CHEST DRAINS海洋自體血液回收胸腔
引流儲血器(雙管回流式)*適應症請見備註欄
4158
CDCC243418PM C.S.F CARDIAC CATHETER REDUCED TIP BARIUM IMPREGNATED 2418
CDCC2PCS01CK "曲克" 心包引流管組"COOK"PERICARDIOCENTESIS SET 2300
CDCC2PCS02CK "曲克"心包引流管組"COOK" PERICARDIOCENTESIS SET 1652
CDCC2PPD01CK 〝曲克〞費曼胸膜腔/心包積氣引流組"COOK"FUHRMAN
PLEURAL/PNEUMOPERICARDIAL DRAINAGE SET
2000
CDCG20RCA1RC "RANFAC"INTRODUCTION DRAINAGE CATHETER"仁斐"導入及引流導
管(術中膽管攝影導管)
460
CDCS126101CM ACCU-FLO CSF RESERVOIR(含CONNECTOR,CATHETER) 3500
CDD010212NFM SILICONE T DRAINAGE TUBE W/EYES 12:24FR 205
CDD010810NFM SILICONE T-DRAINGE TUBE 8#:24# 205
CDD012014NFM SILICONE Y DRAINAGE TUBE 14:24FR 205
CDD0133008KK SILICON T-TUBE 5M/M:13M/M (TRACHEAL) 2825
CDD0200114FM SILICONE ABDOMINAL SUMP DRAIN 14" 7MMX13MM 273
CDD0200120FM SILICONE ABDOMINAL SUMP DRAIN 20" 7MMX13MM 273
CDD0200804BA "BARD"NONPOWERED WOUND SUCTION DEVICES:SILICONE 3 LUMEN
W/FILTER"巴德"非動力式傷口抽吸器具
1222
CDD0210050M4 "MEDTRONIC"SUCTION TUBES "美敦力"抽吸管 398
CDD0246148H9 INTRACARDIAC SUCKER 398
CDD02SUCKEM6 EXTRACORPOREAL SUCKER 398
CDD0401201ED PERICARDIAL SUMP(1/4") 431
CDD0403300ED SUCTION WAND(9F-22F) 431
CDD0404300SA RIGID I-C SUCKER 431
CDD0404360BA 400CC THREE-SPRING EVACUATOR KIT W/PVC ROUND DRAIN 271
CDD0404366BA 400CC THREE-SPRING EVACUATOR KIT W/SILICONE ROUND DRAIN 455
CDD0406648PC TLS BULB DRAINAGE SYSTEM 100CC 10.5FR(球+管) 455
CDD0408705P2 PVC VAC (球+管) 450CC 1/8",3/16",1/4" 271
750
特材代碼 中英文名稱 支付點數-104/01/01
CDD0408770P2 SILICON VAC (球+管) 100CC,200CC 1/8",3/16",1/4" 455
CDD0408902P2 MINIVAC WOUND DRAINAGE SYSTEM(PVC DRAIN 6FR WITH PVC
RESERVOIR 50ML)
196
CDD0408903P2 MINIVAC WOUND DRAINAGE SYSTEM(PVC DRAIN 6FR WITH PVC
RESERVOIR 20ML)
196
CDD0410440LL WOUND DRAINAGE SYSTEM 400ML真空傷口引流套(PVC引流管+PVC吸
引球+穿刺針)
271
CDD0420131FM ALL SILICONE C.W.V SET(RESERVOIR 100CC+DRAIN 7MM,10MM) 455
CDD0420132FM ALL SILICONE C.W.V SET(RESERVOIR 100CC+DRAIN 13MM) 455
CDD0420133FM ALL SILICONE C.W.V SET(RESERVOIR 150CC+DRAIN 7MM,10MM) 455
CDD0420134FM ALL SILICONE C.W.V SET(RESERVOIR 150CC+DRAIN 13MM) 455
CDD0420135FM ALL SILICONE C.W.V SET(RESERVOIR 400CC+DRAIN 7MM,10MM) 455
CDD0420136FM ALL SILICONE C.W.V SET(RESERVOIR 400CC+DRAIN 13MM) 455
CDD0425001Z1 HEMOVAC 271
CDD042535NZ1 MINI SNYDER HEMOVAC SILICONE DRAIN 3/32 1/8",3/16",1/4"
SILICONE EVACUATOR 100ML(球+管+針)
455
CDD042541NZ1 400ML HEMOVAC COMPACT EVACUATOR KIT SILICONE DRAIN
1/8",3/16",1/4(球+管)
417
CDD042560NZ1 MINI SNYDER HEMOVAC SILICONE DRAIN 7MM,10MM SILICONE
EVACUATOR 100ML(球+管+針)
455
CDD042564NZ1 EVAC KITS 100ML FLAT DRAIN W/O TROCAR 7MM,10MM(球+管) 455
CDD0425904Z1 HEMOVAC 271
CDD0425951Z1 PVC HEMOVAC COMPACT EVACUATOR KIT 3/32",3/16" 7,15FR 271
CDD0430101P2 WOUND DRAINAGE SYSTEM (PAHSCO-VAC)450ML(BAG+TUBE+TROCAR) 271
CDD0450511P2 太平洋密閉式真空傷口引流套(滅菌) "PAHSCO"CLOSED WOUND
DRAINAGE SYSTEM(STERILE) 400ML球PVC、管SILICONE(球+管+針)
417
CDD0453101P2 CLOSED WOUND DRAINAGE SYSTEM 450MLPVC (球+管+針) 271
CDD0454101P2 CLOSED WOUND DRAINAGE SYSTEMPVC WOUND DRAINAGE SYSTEM
20ML (BAG+TUBE+TROCAR)
196
CDD0454302P2 CLOSED WOUND DRAINAGE SYSTEMPVC WOUND DRAINAGE SYSTEM
50ML (BAG+TUBE+TROCAR)
196
CDD0456001P2 CLOSED SYSTEM SUCTION DRAINAGE SET 800ML 1/4〞,1/8〞,3/16
〞(球100CC+管+針)
271
CDD0456025P2 CLOSED WOUND DRAINAGE SYSTEM 400CCPVC (球+管+針) 271
CDD048410NM5 WOUND-EVC ET(EASY TOUCH)(PVC RESERVOIR 400ML,SILICONE
TUBING 1/8",3/16",1/4")
417
CDD04CSB00LL "LILY"WOUND DRAINAGE SYSTEM(SILICONE)"怡安"真空傷口引流套
/套組(矽質引流管+矽質吸引球+穿刺針)
455
CDD04CWBSTSG "SIGMA" INTRODUCTION DRAINAGE CATHETER AND ACCESSORIES
(SILICONE) 100;125;150;400CC+7;10;13MM+TROCAR 十美牌導入
/引流導管及其附件(球+管+針)
455
CDD04CWCV1EF SILICONE C.W.V SET(100CC,150CC,400CC+7MM,10MM,13MM)矽質真
空傷口引流球+引流管
455
CDD04CWVS1SG SIGMA SILICONE C.W.V SET 100;125;150;400CC+7;10;13MM 十美
牌矽質真空引流球+矽質引流管組
455
CDD04HS2XXH0 "HOSMED"CLOSED WOUND VACUUM DRAINAGE SYSTEM:SILICONE CWV
RESERVOIR+DRAIN "世新" 密閉式真空傷口引流系統:矽質引流球+
引流管
455
CDD04MB125SG SILICON MINI VACCUM BLUB 125CC(MB125)+FLAT TUBE OR ROUND
TUBE MD-118 7:9MM(HF107:9)
455
CDD04PP400WN BAROVAC CLOSED WOUND DRAINAGE SYSTEMS (PVC DRAIN
3/32",1/8",3/16",1/4"WITH PVC RESERVOIR 400ML)
271
751
特材代碼 中英文名稱 支付點數-104/01/01
CDD04PT503TM PORTABLE WOUND SUCTION UNIT(球+管) 271
CDD04SS100WN ALL SILICONE CLOSED WOUND DRAINAGE SYSTEMS(SILICONE DRAIN
WITH RESERVOIR 100ML)
455
CDD04SS200WN ALL SILICONE CLOSED WOUND DRAINAGE SYSTEMS 200ML(SILICONE
DRAIN WITH RESERVOIR 200ML)
455
CDD05000SMWN ALL SILICONE WOUND TUBINGW/TROCAR NEEDLE 3.2MM,4.8MM(圓
型)
271
CDD0500SJPWN ALL SILICONE WOUND TUBINGW/TROCAR NEEDLE 4.8MM(扁型) 271
CDD0500SMAWN "世運"傷口引流套(滅菌)"SEWOON"CLOSED WOUND DRAINAGE
SYSTEM(STERILE)-矽膠傷口引流管(不附針)3.2MM:13MM
271
CDD0500SXLWN "世運"傷口引流套(滅菌)"SEWOON"CLOSED WOUND DRAINAGE
SYSTEM(STERILE)-矽膠傷口引流管(附針)6.4MM;13MM
271
CDD0501310C8 JACKSON-PRATT SILICONE DRAINS 7MM, 10MMJACKSON-PRATT矽質
傷口引流管
271
CDD0501310L6 JACKSON-PRATT HUBLESS FLAT SILICONE DRAINS W/O TROCAR 271
CDD0501407FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON DRAINS TUBE 7MM"富強"
傷口引流系統:矽膠引流管
271
CDD0501410FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON DRAINS TUBE 10MM"富
強"傷口引流系統:矽膠引流管
271
CDD0501413FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON DRAINS TUBE 13MM"富
強"傷口引流系統:矽膠引流管
271
CDD0501420FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON DRAINS TUBE 10:29FR "
富強"傷口引流系統:矽膠引流管
271
CDD050208NFM SILICONE ROUND DRAIN END PERFORATED 8,10,16,20FR 900MM 271
CDD0502099FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON DRAINS TUBE+TROCAR "
富強"傷口引流系統:矽膠引流管+穿刺針
271
CDD05020XXH0 "HOSMED"CLOSED WOUND VACUUM DRAINAGE SYSTEM:SILICONE CWV
DRAIN "世新" 密閉式真空傷口引流系統:矽質引流管
271
CDD0502185ET "ETHICON"J-VAC CLOSED WOUND DRAINAGE SYSTEM BLAKE SILICON
DRAINS WITH TROCAR捷凡克封閉式引流系統
271
CDD0502187ET "ETHICON"J-VAC CLOSED WOUND DRAINAGE SYSTEM BLAKE SILICON
DRAINS WITH TROCAR捷凡克封閉式引流系統
298
CDD050308NFM SILICONE ROUND DRAIN MIDDLE PERFORATED 8,10,16,20FR
1100MM
271
CDD0503203SM EXTRA STRENGTH FLAT SUCTION DRAIN 7MM 271
CDD0503204SM EXTRA STRENGTH FLAT SUCTION DRAIN 10MM 271
CDD0508711P2 SILICON VAC DRAINAGE & TROCAR 271
CDD0510101P2 CLOSED WOUND DRAINAGE SYSTEMPVC VAC DRAINAGE 125
CDD0513101P2 CLOSED WOUND DRAINAGE SYSTEMSILICONE VAC DRAINAGE 271
CDD052540NZ1 MINI-SNYDER HEMOVAC SILICONE DRAIN 3/32",1/8",3/16",1/4"
7MM,10MM W/TROCAR
271
CDD052542NZ1 DRAIN ROUND W/O TROCAR 3/32",1/8",3/16",1/4 SILICONE(管) 271
CDD052569NZ1 DRAIN FLAT W/O TROCAR 7MM,10MM SILICONE 271
CDD0530502P2 CLOSED WOUND DRAINAGE SYSTEMSILICONE VAC DRAINAGE &TROCAR 271
CDD0566481B0 SILICONE BULB DRAINAGE CATHETER 7MM 真空傷口引流管 271
CDD0566482B0 SILICONE BULB DRAINAGE CATHETER 真空傷口引流管 271
CDD0566483B0 SILICONE BULB RESERVOIR 100CC 真空傷口引流球 210
CDD0566484B0 SILICONE BULB DRAINAGE CATHETER 10MM 真空傷口引流管 271
CDD05CSC00LL LILY WOUND DRAINAGE SYSTEM:SILICON SUCTION DRAINAGE TUBE
怡安真空傷口引流套:矽質傷口引流管
271
CDD05CV110EF SILICONE C.W.V DRAIN 271
CDD05MF104SG SILICONE SUCTION DRAINAGE TUBE(FLAT) 4,7,10MM 271
752
特材代碼 中英文名稱 支付點數-104/01/01
CDD05MFTR1SG "SIGMA" INTRODUCTION DRAINAGE CATHETER AND ACCESSORIES
(SILICONE) 7;10;13MM+TROCAR 十美牌導入/引流導管及其附件
(管+針)
271
CDD0600640FM SILICONE CLOSED WOUND VACUUM RESERVOIR 400CC 210
CDD0601305C8 JACKSON-PRATT SILICONE BULB RESERVOIR 100CC & 400CC矽質真
空傷口引流儲液器
210
CDD0602160JJ J-VAC RESERVOIR SILICON 100CC 210
CDD0602161JJ J-VAC RESERVOIR 150CC,450CC(PVC球) 146
CDD06021XXH0 "HOSMED"CLOSED WOUND VACUUM DRAINAGE SYSTEM:SILICONE CWV
RESERVOIR "世新" 密閉式真空傷口引流系統:矽質引流球
210
CDD0603101SM SUCTION RESERVOIR 242
CDD0608709P2 SILICON VAC RESERVOIR 100CC,200CC 210
CDD060S100WN ALL SILICONE BAROVAC RESERVOIR 100ML 210
CDD060S200WN ALL SILICONE BAROVAC RESERVOIR 200ML 210
CDD060S400WN "世運"傷口引流套(滅菌)"SEWOON"CLOSED WOUND DRAINAGE
SYSTEM(STERILE)-矽膠吸引球 400CC
210
CDD0613150FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON RESERVOIR 100CC,150CC
"富強"傷口引流系統:矽膠真空吸球
210
CDD0620201P2 太平洋真空傷口引流套(滅菌)PAHSCO WOUND DRAINAGE
SYSTEM(STERILE)-SILICONE EVACUATOR 125ML 、200ML
210
CDD0623009P2 太平洋真空傷口引流套(滅菌)PAHSCO WOUND DRAINAGE
SYSTEM(STERILE)-PVC PAHSCO-VAC 150ML、200ML、250ML、
300ML、450ML
146
CDD0625681Z1 SIKICONE MINI SNYDER HEMOVAC 100ML 210
CDD06CSB00LL LILY WOUND DRAINAGE SYSTEM:SILICON SURGICAL CWV
RESERVOIR 100ML;125ML;150ML;200ML怡安真空傷口引流套:矽質
真空傷口引流蓄液球
210
CDD06CW1S1EF SILICONE C.W.V RESERVOIR 100CC,150CC,400CC 210
CDD06CWVB1SG SIGMA SILICONE MINI BULB 100;125;150;400CC 十美牌矽質真空
引流球
210
CDD06MB125SG MINI BULB 125CC 真空吸引球 210
CDD1012001P2 DIAMOND TIP THROACIC CANNULA 8:16FR 259
CDD1012007P2 DIAMOND TIP THROACIC CANNULA 20:32FR 259
CDD1021110MA "麥林可" 套針導管“MALLINCKRODT” TROCAR CATHETER
10FR,12FR,16FR
259
CDD1021120MA "麥林可" 套針導管“MALLINCKRODT” TROCAR CATHETER
20FR,24FR,28FR,32FR
259
CDD1056080AY "肯麥斯"亞羅套針導管"KENMEX" ARGYLE TROCAR CATHETER-8FR 259
CDD1056101AY "肯麥斯"亞羅套針導管"KENMEX" ARGYLE TROCAR CATHETER-
10:32FR
259
CDD1056702AY INGRAM TROCAR CATHETER 12FR,16FR 膀胱穿刺針組 465
CDD1080116PX " SMITHS"PORTEX CHEST DRAINAGE CATHETER"史密斯"保德士胸腔
引流管
259
CDD10TDC10EE THORACIC DRAINAGE CATHETER W/TROCAR 259
CDD1100001ET TROCAR KIT穿刺套管2-12MM(穿剌針1+外管1+內建可變式轉接頭
1)(511;512HA;NA;DA;355NA;DA;35LNA;LDA;FPK02自980701刪除)
1459
CDD1100001PA 〝安培〞安全穿刺套管系統〝APPLIED〞TROCAR SYSTEM KIT 5-
12MM(穿剌針1+外管1+內建可變式轉接頭1)
1459
CDD1100001U7 SURGICAL TROCAR SYSTEM 5-12MM (穿剌針1+外管1+內建可變式轉
接頭1)
1459
CDD1100002PA 〝安培〞安全穿刺套管系統〝APPLIED〞TROCAR SYSTEM(5-12MM多
孔道平滑拋棄剝離式套管)(穿剌針1+外管1+內建可變式轉接頭1)
1459
753
特材代碼 中英文名稱 支付點數-104/01/01
CDD1100002U7 SURGICAL TROCAR SYSTEM 5-12MM (穿剌針1+外管2+內建可變式轉
接頭2)
1509
CDD1100002ZH DETACHAPORT OBTURATOR AND SEAL SET:TROCAR SLEEVE(1支外管
+1支固定轉接頭)
917
CDD1100003PA TROCAR SYSTEM:SEPARATOR ACCESS SYSTEM11X100MM
12X100MM(穿剌針1+外管1+內建可變式轉接頭1)
1459
CDD1100003ZH DETACHAPORT OBTURATOR AND SEAL SET:TROCAR KIT(1支穿刺針
+2支外管+2支固定轉接頭)
1509
CDD1100004KM "METROMED"TROCAR "益鳴"穿刺套管(穿剌針1+外管1+固定轉接頭
1)
1116
CDD1100004PA SEPARATOR OBTURATOR 內視鏡手術剝離式穿刺針 553
CDD1100005PA CANNULAS WITH DISPOSABLE SEAL內視鏡手術拋棄式套筒組(穿刺
外管+可變式轉接頭)
955
CDD1100005U7 SURGICAL TROCAR SYSTEM 5-12MM (穿剌針1+外管1+內建可變式轉
接頭1)
1459
CDD1100006U7 SURGICAL TROCAR SYSTEM 5-12MM (穿剌針1+外管2+內建可變式轉
接頭2)
1509
CDD1100007PA PREMIUM DISPOSABLE TROCAR SYSTEM W/UNIVERSAL SEAL通用孔道
拋棄式穿刺系統(穿剌針1+外管1+內建可變式轉接頭1)
1459
CDD1100007U7 SURGICAL TROCAR SYSTEM 5MM (穿剌針1+外管1+內建固定式轉接
頭1)
1116
CDD1100008U7 SURGICAL TROCAR SYSTEM 5MM (穿剌針1+外管2+內建固定式轉接
頭2)
1509
CDD1100009U7 SURGICAL TROCAR SYSTEM 5-12MM (穿剌針1+外管1+內建可變式轉
接頭1)
1459
CDD1100010U7 SURGICAL TROCAR SYSTEM 5-12MM (穿剌針1+外管2+內建可變式轉
接頭2)
1509
CDD1100011U7 SURGICAL TROCAR SYSTEM 5MM (穿剌針1+外管1+內建固定式轉接
頭1)
1116
CDD1100012ET TROCAR KIT穿刺套管雙支包裝(穿刺針1+外管2+內建可變式轉接頭
2)
1509
CDD1100012U7 SURGICAL TROCAR SYSTEM 5MM (穿剌針1+外管2+內建固定式轉接
頭2)
1509
CDD1100013U7 SURGICAL TROCAR SYSTEM 5MM (穿剌針1+外管1+內建固定式轉接
頭1)
1116
CDD110005NPA CANNULAS WITH DISPOSABLE SEAL內視鏡手術拋棄式套筒組(穿刺
外管+可變轉接頭)
955
CDD1100066KM "METROMED"TROCAR "益鳴"穿刺套管(穿剌針1+外管2+固定轉接頭
2)
1509
CDD1100K1TPA TROCAR KIT(穿刺針X1+外管X2+可變轉接頭X2) 1509
CDD1105121L7 TROCAR KIT 10-12MM TROCAR AND CANULA 穿刺套管組(防滑套管1
支,穿刺針1支,多功能轉換器1組)
1459
CDD1105122L7 TROCAR KIT 5-12MM TROCAR AND CANULA 穿刺套管組(防滑套管1
支,穿刺針1支,多功能轉換器1組)
1459
CDD1105123L7 TROCAR KIT 5-12MM TROCAR AND CANULA 穿刺套管組(防滑套管2
支,穿刺針1支,多功能轉換器2組)
1509
CDD1105124L7 TROCAR KIT 5-12MM TROCAR AND CANULA穿刺套管組(防滑套管1支
,穿刺針1支,多功能轉換器1組)
1459
CDD1105125L7 TROCAR KIT 5-12MM TROCAR AND CANULA 穿刺套管組(防滑套管2
支,穿刺針1支,多功能轉換器2組)
1509
CDD110612AL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管5-6MM(穿刺套管1支+穿刺
針1支+固定式轉接頭1支)
1116
CDD110612CL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管5-12MM(穿刺套管2支+穿
刺針1支+固定式轉接頭2支)
1509
754
特材代碼 中英文名稱 支付點數-104/01/01
CDD110612DL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管5-6MM(穿刺套管1支+穿刺
針1支+固定式轉接頭1支)
1116
CDD110612EL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管5-6MM(穿刺套管2支+穿刺
針1支+固定式轉接頭2支)
1509
CDD110612FL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管5-6MM(穿刺套管1支+固定
式轉接頭1支)
917
CDD110612HL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管5-12MM(穿刺套管1支+穿
刺針1支+可變式轉接頭1支)
1459
CDD110612JL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管5-12MM(穿刺套管1支+可
變式轉接頭1支)
955
CDD110612LL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管5-12MM(穿刺套管2支+穿
刺針1支+可變式轉接頭2支)
1509
CDD110612NL7 LAGIS TROCAR 大吉士穿刺套管(穿刺套管1支+可變式轉接頭1支+
穿刺針1支)
1459
CDD110612PL7 LAGIS TROCAR 大吉士穿刺套管(穿刺套管2支+可變式轉接頭2支+
穿刺針1支)
1509
CDD110612QL7 LAGIS TROCAR 大吉士穿刺套管(穿刺套管1支+可變式轉接頭1支+
穿刺針1支+套管固定器1組)
2233
CDD11090PF2C "柯惠"可變徑式V型安全穿刺套管 "COVIDIEN" AUTOSUTURE
VERSAPORT PLUS V2 W/FIXATION CANNULA 11-12MM (外管+可變轉
接頭)
955
CDD11095PF2C "柯惠"可變徑式V型安全穿刺套管 "COVIDIEN" AUTOSUTURE
VERSAPORT PLUS V2 W/FIXATION CANNULA 11-12MM (穿刺內管+外
管+可變轉接頭)
1459
CDD11100011T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 5MM 鈍頭(穿刺
針1+外管1+固定轉接頭1)
1116
CDD11100021T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 5MM 鈍頭(穿刺
針1+外管2+固定轉接頭2)
1509
CDD1110051L9 ENDOSCOPIC INSTRUMENT內視鏡器械(含:穿刺針*1+外管*1+固定
式轉接頭*1)
1116
CDD1110092L9 ENDOSCOPIC INSTRUMENT內視鏡器械(含:穿刺針*1+外管*2+固定
式轉接頭*2)
1509
CDD11101011T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 5MM 軟管(穿刺
針1+外管1+固定轉接頭1)
1116
CDD11101021T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 5MM 軟管(穿刺
針1+外管2+固定轉接頭2)
1509
CDD11200011T SURGICAL TROCAR SET 5MM(穿刺內管X1+穿刺外管X1+固定式轉接
頭X1)
1116
CDD11200021T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 5MM (穿刺針1+
外管2+固定轉接頭2)
1509
CDD11201011T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 5MM 尖頭硬管
(穿刺針1+外管1+固定轉接頭1)
1116
CDD11201021T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 5MM (穿刺針1+
外管2+固定轉接頭2)
1509
CDD11210011T SURGICAL TROCAR SET 5-10MM(穿刺內管X1+穿刺外管X1+可變式轉
接頭X1)
1459
CDD11210021T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 10MM (穿刺針1+
外管2+可變式轉接頭2)
1509
CDD11220011T SURGICAL TROCAR SET 5-12MM(穿刺內管X1+穿刺外管X1+可變式轉
接頭X1)
1459
CDD11220021T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 12MM(穿刺針1+
外管2+可變式轉接頭2)
1509
CDD11300031T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 5MM (穿刺針1+
外管3+固定式轉接頭3)
2530
755
特材代碼 中英文名稱 支付點數-104/01/01
CDD11310041T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 5MM (穿刺針1+
外管4+固定式轉接頭4)
3358
CDD11320031T "TOPBOUND"SURGICAL TROCAR SET "仁齊"穿刺器 (5MM:穿刺針1+
外管3+固定式轉接頭3)+(10MM:穿刺針1+外管1+可變式轉接頭1)
3913
CDD114216K2C "柯惠"可充氣穿刺套管"COVIDIEN" AUTO SUTURE THREADED
TROCAR SLEEVES WITH WOODFORD SPIKE TROCAR AND INSUFFATION
PORT(穿剌針1+外管2+固定轉接頭2)
1509
CDD117092F2C "柯惠"可變徑式V型安全穿刺套管 "COVIDIEN" AUTOSUTURE
VERSAPORT PLUS V2 W/FIXATION CANNULA 5MM (外管+固定轉接
頭)
917
CDD11770922C ”柯惠”安全穿刺套管組 "COVIDIEN" AUTO SUTURE VERSAPORT
PLUS RPF TROCAR SYSTEM 5MM(外管+固定式轉接頭1)
917
CDD11770962C "柯惠"安全穿刺套管組 "COVIDIEN" AUTO SUTURE VERSAPORT
PLUS RPF TROCAR SYSTEM 5/10-12MM (外管1+內建式可變轉接頭
1)
955
CDD1178062US "優施西"可變式穿刺套管組"USSC" VERSAPORT RPF SINGLE USE
RADIOLUCENT TROCAR KIT 5/10MM(穿剌針1+外管2+內建可變式轉
接頭2)
1509
CDD1178064US "優施西"可變式穿刺套管組"USSC" VERSAPORT RPF SINGLE USE
RADIOLUCENT TROCAR KIT 5MM(穿剌針1+外管2+內建固定式轉接頭
2)
1509
CDD1179079US "優施西"腹腔穿刺套管"USSC" AUTO SUTURE SURGISPIKE TROCAR
5MM(穿剌針1+外管1+固定式轉接頭1)
1116
CDD11790932C "柯惠"V型刀片穿刺套管 "COVIDIEN" AUTO SUTURE VERSAPORT V2
SINGLE USE WITH RADIOLUCENT TROCAR SLEEVE(內管+外管+固定
式接頭)
1116
CDD11790952C "柯惠"V型刀片穿刺套管 "COVIDIEN" AUTO SUTURE VERSAPORT V2
SINGLE USE WITH RADIOLUCENT TROCAR SLEEVE(內管+外管+可變
轉接頭)
1459
CDD11793052C "柯惠"胸腔穿刺套管 "COVIDIEN" THORACOPORT TROCAR 1116
CDD11906892C "柯惠"安全穿刺套管組 "COVIDIEN" AUTO SUTURE VERSAPORT
PLUS RPF TROCAR SYSTEM 5MM (穿剌針1+外管1+固定式轉接頭1)
1116
CDD119075P2C "柯惠"開放性腹腔鏡手術用之一次性穿刺器"COVIDIEN"AUTO
SUTURE BLUNTPORT PLUS 5-12MM (穿刺針1+外管1+可變式轉接頭
1+袋口結固定器)
2233
CDD119076P2C "柯惠"安全穿刺套管組 "COVIDIEN" AUTO SUTURE VERSAPORT
PLUS RPF TROCAR SYSTEM 5/10-12MM (穿剌針1+外管1+內建可變
式轉接頭1)
1459
CDD119094F2C "柯惠"可變徑式V型安全穿刺套管 "COVIDIEN" AUTOSUTURE
VERSAPORT PLUS V2 W/FIXATION CANNULA 5MM (穿刺內管+外管+
固定轉接頭)
1116
CDD11976892C "柯惠"穿刺套管 "COVIDIEN" AUTO SUTURE VERSAPORT RT
OBTURATOR 5MM(穿剌針1+外管1+固定式轉接頭1)
744
CDD119776P2C "柯惠"穿刺套管 "COVIDIEN" AUTO SUTURE VERSAPORT RT
OBTURATOR 10-12MM(穿剌針1+外管1+內建可變式轉接頭1)
1010
CDD11BASXCET BASX BLADELESS TROCAR 外套管+可變式轉接頭 955
CDD11BASXTET BASX BLADELESS TROCAR 穿刺器+外套管+可變式轉接頭 1459
CDD11EPATHET "ETHICON"ENDOPATH XCEL TROCAR"愛惜康"安德派思外科穿刺器
(穿刺針+外管+可變式轉接頭)
1459
CDD11K1101PA TROCAR SYSTEM(穿剌針1+外管1+可變式轉接頭1) 1459
CDD11K1102PA 〝APPLIED〞TROCAR SYSTEM〝安培〞安全穿刺套管系統(穿剌針1+
外管1+可變式轉接頭1)
1459
756
特材代碼 中英文名稱 支付點數-104/01/01
CDD11K1103PA TROCAR SYSTEM(穿剌針1+外管1+可變式轉接頭1) 1459
CDD11K1104PA 〝APPLIED〞TROCAR SYSTEM 〝安培〞安全穿刺套管系統(穿剌針
1+外管1+可變式轉接頭1)
1459
CDD11K1105PA 〝APPLIED〞TROCAR SYSTEM〝安培〞安全穿刺套管系統(穿剌針1+
外管2+可變式轉接頭2)
1509
CDD11K1106PA TROCAR SYSTEM(穿剌針1+外管2+可變式轉接頭2) 1509
CDD11K1107PA 〝APPLIED〞TROCAR SYSTEM〝安培〞安全穿刺套管系統(穿剌針1+
外管2+可變式轉接頭2)
1509
CDD11K1108PA 〝APPLIED〞TROCAR SYSTEM〝安培〞安全穿刺套管系統(外管1+可
變式轉接頭1)
955
CDD11K1109PA 〝APPLIED〞TROCAR SYSTEM〝安培〞安全穿刺套管系統(穿剌針1+
外管1+可變式轉接頭1)
1459
CDD11K1110PA "APPLIED" TROCAR SYSTEM(KIIFIOS)"安培"安全穿刺套管系統(含
外管+可變式轉接頭+內管(附充氣功能)
1857
CDD11NB12F2C "柯惠"無刀刃可變式穿刺套管"COVIDIEN"VERSAPORT BLADELESS
AND VERSAPORT PLUS BLADELESS SINGLE USE BLADELESS
TROCAR(內管1+外管1+可變轉接頭1)
1459
CDD11NB5LP2C "柯惠"無刀片薄型穿刺套管含固定套管(穿剌針1+外管1+固定轉接
頭1)"COVIDIEN"VERSAPORT BLADELESS LOW PROFILE TROCAR WITH
FIXATION CANNULA
1116
CDD11NBFCA2C "柯惠"無刀刃可變式穿刺套管"COVIDIEN"VERSAPORT BLADELESS
AND VERSAPORT PLUS BLADELESS SINGLE USE BLADELESS
TROCAR(外管1+固定式轉接頭1)
917
CDD11XCEL2ET ”愛惜康”安德派思外科穿刺器 雙外管"ETHICON"ENDOPATH XCEL
TROCAR
1509
CDD11XCELBET ”愛惜康”安德派思外科穿刺器"ETHICON"ENDOPATH XCEL
TROCAR(BLADELESS)
1459
CDD11XCELLET ”愛惜康”安德派思外科穿刺器 "ETHICON"ENDOPATH XCEL
TROCAR
1459
CDD11XCELSET ”愛惜康”安德派思外科穿刺器-外套管+固定式頭"ETHICON"
TROCAR SLEEVE(BLADELESS)
917
CDD11XCELVET ”愛惜康”安德派思外科穿刺器-外套管+可變式頭"ETHICON"
TROCAR SLEEVE(BLADELESS)
955
CDD12BAL40JU "帕將克"環形球囊套管組"PAJUNK"RING-ANCHOR BALLOON SET 3039
CDD12BAL50JU "帕將克"球囊套管組"PAJUNK" BALLOON SET 2370
CDD12K1109PA TROCAR SYSTEM充氣式(穿剌針1+外管1+可變式轉接頭1) 3039
CDD12MSBT12C "柯惠"腹腔鏡汽球固定式鈍頭穿刺套管組"COVIDIEN" AUTO
SUTURE BLUNT TIP TROCAR AND SYRINGE
3039
CDD12MSXB1US ”優施西”可視式腹腔鏡汽球撐開式套管 2370
CDD12PDBS22C "柯惠"腹腔鏡汽球撐開式套管"COVIDIEN"PDB STERILE BALLOON 2370
CDD13DGC01CK "COOK"JABCZENSKI DUCTOGRAM CANNULA 30 GAGE(乳管攝影導管) 943
CDD13DGK00ZM "MD TECH"ANGIOTECH INTRODUCTION/DRAINAGE CATHETER "美迪
克"安酋導入及引流導管(乳管攝影導管)
943
CDD13G1U30RC INTRODUCTION DRAINAGE CATHETER 導入及引流導管(乳管攝影導
管)
943
CDDF100794SN "史耐輝"負壓傷口治療敷料"SMITH & NEPHEW" RENASYS DRESSING
KIT WITH SOFTPORT
2355
CDDF100795SN "史耐輝"負壓傷口治療敷料"SMITH & NEPHEW" RENASYS DRESSING
KIT WITH SOFTPORT
2603
CDDF100796SN "史耐輝"負壓傷口治療敷料"SMITH & NEPHEW"RENASYS DRESSING
KIT WITH SOFTPORT
2715
CDDF162151LN “美尼克”艾薇斯敷料(滅菌) “MOLNLYCKE”AVANCE DRESSING
KIT (STERILE)-SMALL
2355
757
特材代碼 中英文名稱 支付點數-104/01/01
CDDF162251LN “美尼克”艾薇斯敷料(滅菌) “MOLNLYCKE”AVANCE DRESSING
KIT (STERILE)-MEDIUM
2603
CDDF162351LN “美尼克”艾薇斯敷料(滅菌) “MOLNLYCKE”AVANCE DRESSING
KIT (STERILE)-LARGE
2715
CDLP244513PM C.S.F. LUMBOPERITONEAL RESERVOIR 3305
CDP0104015MV FLEXIMA NASOBILIARY CATH W/GUIDEWIRE(CATH+TRANSFER
TUBE+DRAINAGE CANNECTOR TUBE+GUIDEWIRE)
5198
CDP0104015SB FLEXIMA NASOBILIARY CATHETER (CATH+TRANSFER TUBE+DRAINAGE
CONNECTOR TUBE+GUIDE WIRE)
5198
CDP010A001CK OASIS ONE ACTION STENT INTRODUCER SYSTEM 2000
CDP010ACL1CK OASIS PRE-LOADED STENT INTRODUCTION SYSTEM 4458
CDP010ACL3CK "曲克" 膽道支架暨支架引導系統"COOK" COTTON-LEUNG BILIARY
STENTS AND INTRODUCERS
4458
CDP010ATS1CK 歐爾喜斯一步式支架引導系統膽道支架"COOK"OASIS ONE ACTION
STENT INTRODUCTION SYSTEM WITH ST-2 SOEHENDRA TANNENBAUM
BILIARY STENT
4458
CDP0111270CL P.T.C.D SET 矽質膽道膽囊穿刺套 2649
CDP0111807CL P.T.C.D KIT (ONE STEP) 1720
CDP011STWNCY PERCUTANEOUS DIRECT ACCESS KIT 1720
CDP0120702SB ACCUSTICK II PERCUTANEOUS INTRODUCER
SYSTEM(NEEDLE+INTRODUCER+GUIDEWIRE*2)
2700
CDP0120704SB ACCUSTICK II PERCUTANEOUS INTRODUCER
SYSTEM(NEEDLE+INTRODUCER+GUIDEWIRE*1)
1666
CDP0121333BQ "BIOTEQ"INTRODUCER SET"邦特"穿刺導入系統組(含穿刺針
+INTRODUCER+0.018"GUIDE WIREX1支+0.035"或0.038"GUIDE
WIREX1支)
2700
CDP012633NC3 ULTRASONICALLY GUIDED ONE-STEP DRAINAGE SET 1720
CDP0145550SB MICROVASIVE RAPID EXCHANGE BILIARY STENT SYSTEM(含推進導
管及導引導管)
3929
CDP0165150PB INTRODUCER SET(NEEDLE+INTRODUCER+GUIDE WIREX2) 2700
CDP0175110PB SKATER DRAINAGE CATHETER 6:16FR 25-35CM 1352
CDP0175601PB SKATER ONE STEP DRAINAGE CATHETER 6:16FR 20:25CM 1720
CDP0175651PB SKATER ONE STEP DRAINAGE CATHETER 6:16FR 20:25CM 1720
CDP01ABSDSSB "波士頓"阿德凡斯膽道支架"BOSTON SCIENTIFIC"ADVANIX
BILIARY STENT
2033
CDP01ABSPLSB "波士頓科技"阿德凡斯膽道支架"BOSTON SCIENTIFIC"ADVANIX
BILIARY STENT WITH NAVIFLEX RX DELIVERY SYSTEM
4458
CDP01BCLN1CK "曲克"多功能引流導管組"COOK”MULTIPURPOSE DRAINAGE
CATHETER SET
1720
CDP01BS001SB AMSTERDAM BILIARY STENT KIT
7,8.5,10,11.5FRX5,7,10,12,15CM(含推進導管及導引導管)
4458
CDP01BSK12SB AMSTERDAM BILIARY STENT KIT (含推進導管) 2401
CDP01BSK1TSB AMSTERDAM BILIARY STENT KIT 10,12FRX5,7,10,12,15CM(含推進
導管及導引導管)
4458
CDP01BTPD2BQ PIGTAIL DRAINAGE CATHETER SET (ONE SETP)7:14FR 19:39CM含
導管及穿刺針
1720
CDP01BTPDABQ PIGTAIL DRAINAGE CATHETER SET(ONE STEP TYPE)(含穿刺針組+
引流管)
1720
CDP01BTPDBBQ PIGTAIL DRAINAGE CATHETER SET(ONE STEP TYPE)(含穿刺針組+
引流管)
1720
CDP01BTPDCBQ PIGTAIL DRAINAGE CATHETER SET(ONE STEP)(含引流管及穿刺針
組)
1720
CDP01BTPDDBQ PIGTAIL DRAINAGE CATHETER SET(ONE STEP)(含引流管及穿刺針
組)
1720
758
特材代碼 中英文名稱 支付點數-104/01/01
CDP01BTPDSBQ "邦拓"豬尾巴引流導管組(直接穿刺型)"BIOTEQ"PIGTAIL
DRAINAGE CATHETER SET(ONE STEP TYPE)
1720
CDP01CHB1NCK COTTON HUIBREGTSE BILIARY STENT SET 4458
CDP01CL120CK MAC-LOC BILIARY DRAINAGE CATH 12,14F 1720
CDP01CLB85CK "曲克" 經皮引流導管針組(滅菌) "COOK" DRAINAGE CATHETER
NEEDLE SET(STERILE) 6~16FR
1720
CDP01CLBS2CK "COOK"COTTON-LEUNG BILIARY STENTS AND INTRODUCERS 5:14FR
膽道支架暨支架引導系統
4458
CDP01DTVN1CK ”曲克”經皮引流導管針組(滅菌)”COOK” DRAINAGE CATHETER
NEEDLE SET(STERILE)
1720
CDP01DTVN2CK ”曲克”經皮引流導管針組”COOK” DRAINAGE CATHETER NEEDLE
SET
1720
CDP01DTVN3CK ”曲克”經皮引流導管針組”COOK” DRAINAGE CATHETER NEEDLE
SET
1720
CDP01E001NCK LIGUORY ENDOSCOPIC NASAL BILIARY DRAINAGE SET 5:7FR 5198
CDP01EC01NCK LIGUORY ENDOSCOPIC NASAL BILIARY DRAINAGE CATHETER 2333
CDP01EC02NCK NAGARAJA ENDOSCOPIC NASAL BILIARY DRAINAGE CATHETER 內視
鏡經膽道引流管
730
CDP01ENBD1CK "曲克" 鼻-膽道引流管組"COOK" NASAL BILIARY DRAINAGE SET 5198
CDP01ENBD2CK "曲克" 鼻-膽道引流管"COOK" NASAL BILIARY DRAINAGE
CATHETER
2200
CDP01FSA01CK "曲克" 歐爾西思單動支架置入系統"COOK" OASIS ONE ACTION
STENT INTRODUCTION SYSTEM
2000
CDP01GEPD2CK "曲克"吉南胰管支架組"COOK"GEENEN PANCREATIC STENT SET 4087
CDP01GPL00KQ “優式”導入/引流導管及其附件(滅菌) “URESIL”
INTRODUCTION/DRAINAGE CATHETER AND ACCESSORIES (STERILE)
1720
CDP01GPPS1FG "福萊克斯"支架放置套組"ENDO-FLEX" STENT INTRODUCTION SET
GPPS
4458
CDP01L001NCK COTTON LEUNG BILIARY STENT SET 4458
CDP01MAS18MR "美瑞特" 福祿小血管導引鞘"MERIT" PRELUDE MINI ACCESS
SHEATH INTRODUCERS(7,11CM
SHEATH+SIDEPORT+VALVE+DILATOR+0.018GW+NEEDLE)
1666
CDP01MD102CK ULTRATHANE MULTIPUEPOSE DRAINAGE CATH 12,14F,25CM,18G 1720
CDP01MDC85CK ULTRATHANE MULTIPURPOSE DRAINAGE CATH 8.5,10.2F,25CM,18G 1720
CDP01MP1S1CK "COOK"MICROPUNCTURE INTRODUCER SETS 4F:5F 0.018英吋 21G
微穿刺引導器組
1666
CDP01N0DNNBA OPTI-DRAIN MULTI-USE DRAINAGE CATHETER 8-12FR 1720
CDP01NNUNNBA DRAINAGE CATHETERS AND ACCESSORIES(含穿刺針組+引流管) 1720
CDP01NPAS1CK "COOK"NEFF PERCUTANEOUS ACCESS SETS"曲克"涅夫經皮引導組
6FR 20CM 0.018 60CM
1666
CDP01NPAS2CK "COOK"NEFF PERCUTANEOUS ACCESS SETS"曲克"涅夫經皮引導組
6FR 20CM 0.018 60CM
1666
CDP01NPAS3CK "COOK"NEFF PERCUTANEOUS ACCESS SETS 4.0/7.0 20CM 22/15CM
.018 4.0/6.0 20CM 21/15CM:22/15CM .018
1666
CDP01NPDS1CK NASAL PANCREATIC DRAINAGE SET 5198
CDP01P001NCK "COOK"BILIARY DRAINAGE CATHETER"曲克"膽道引流導管 800
CDP01P008NCK "COOK"BILIARY DRAINAGE CATHETER"曲克"膽道引流導管 832
CDP01PAS30BA NAVARRE PERCUTANEOUS ACCESS SET 1666
CDP01PDD10BQ "邦特" 豬尾巴引流導管組(直接穿刺型) "BIOTEQ" PIGTAIL
DRAINAGE CATHETER SET(ONE STEP TYPE
1720
CDP01PDD2WBQ "邦特" 豬尾巴引流導管組(直接穿刺型) "BIOTEQ" PIGTAIL
DRAINAGE CATHETER SET(ONE STEP TYPE
1720
759
特材代碼 中英文名稱 支付點數-104/01/01
CDP01PDD30BQ "邦特" 豬尾巴引流導管組(直接穿刺型) "BIOTEQ" PIGTAIL
DRAINAGE CATHETER SET(ONE STEP TYPE
1720
CDP01PDD4WBQ "邦特" 豬尾巴引流導管組(直接穿刺型) "BIOTEQ" PIGTAIL
DRAINAGE CATHETER SET(ONE STEP TYPE
1720
CDP01PDS50BQ "邦特" 豬尾巴引流導管組(直接穿刺型) "BIOTEQ" PIGTAIL
DRAINAGE CATHETER SET(ONE STEP TYPE
1720
CDP01PDS6WBQ "邦特" 豬尾巴引流導管組(直接穿刺型) "BIOTEQ" PIGTAIL
DRAINAGE CATHETER SET(ONE STEP TYPE
1720
CDP01PDS70BQ "邦特" 豬尾巴引流導管組(直接穿刺型) "BIOTEQ" PIGTAIL
DRAINAGE CATHETER SET(ONE STEP TYPE
1720
CDP01PDS8WBQ "邦特" 豬尾巴引流導管組(直接穿刺型) "BIOTEQ" PIGTAIL
DRAINAGE CATHETER SET(ONE STEP TYPE
1720
CDP01PV600LY "奧林柏斯"膽道引流管(膽道支架暨支架引導組)"OLYMPUS"
BILIARY DRAINAGE TUBE (BILIARY STENT KIT)
4458
CDP01PV601LY "奧林柏斯"膽道引流管(膽道支架暨支架引導組)"OLYMPUS"
BILIARY DRAINAGE TUBE (BILIARY STENT KIT)
4458
CDP01PV602LY "奧林柏斯"膽道引流管(膽道支架暨支架引導組)"OLYMPUS"
BILIARY DRAINAGE TUBE (BILIARY STENT KIT)
4458
CDP01RLC38MR "MERIT"RESOLVE DRAINAGE CATHETERS(ONE STEP含引流管及穿刺
針組)(STERILE)"美瑞特"通用引流管(滅菌)
1720
CDP01TQT01CK "COOK" THAI-QUICK ABSCESS DRAINAGE CATHETER(STERILE) "曲
克"泰坤膿腫引流管
1720
CDP01U004NCK RING BILIARY DUCT DRAINAGE SET 2649
CDP01UC102CK ULTRATHANE UNIVERSAL CURVED DRAINAGE CATH 10.2F,25CM,18G 1720
CDP01UCD70CK ULTRATHANE UNIVERSAL CURVED DRAINAGE CATH 7,8.5F,25CM,18G 1720
CDP01UL120CK MAC-LOC ULTRATHANE DRAINAGE CATH 10.2,12F,25CM,18G 1720
CDP01UL140CK MAC-LOC MULTIPURPOSE DRAINAGE CATHETER 12,14F 25CM,18G 1720
CDP01ULT01CK "曲克"經皮引流導管針組"COOK" DRAINAGE CATHETER NEEDLE
SET(BILIARY DRAINAGE CATHETERS)
1720
CDP01ULT50CK MAC-LOC ULTRATHANE DRAINAGE CATH 5,6F,25CM,23,20G 1720
CDP01ULT70CK MAC-LOC ULTRATHANE DRAINAGE CATH 1720
CDP01ULT85CK "曲克"經皮引流導管針組"COOK"DRAINAGE CATHETER NEEDLE
SET(STERILE)-MAC-LOC MULTIPURPOSE 8.5,10F-14F,25CM
1720
CDP01ZEBD1CK ZIMMON ENDOSCOPIC BILIARY STENT SET 5:7FR(STENT GUIDEWIRE
INTRODUCER CATHETER)
4458
CDP01ZEBD2CK ”曲克”膽道留置管組”COOK”BILIARY STENT SET 4458
CDP01ZEBD4CK “曲克” 膽道支架暨支架引導系統“COOK” ZIMMON BILIARY
STENTS AND INTRODUCERS
4458
CDP0240110MV FLEXIMA NASOBILIARY CATH(NASOBILIRY CATH+NASAL TRANSFER
TUBE+DRAINAGE CANNECTOR TUBE)
2200
CDP0240110SB FLEXIMA NASOBILIARY CATHETER (CATH+TRANSFER TUBE+DRAINAGE
CONNECTOR TUBE)
2200
CDP0242010CL P.T.C.D. INTERNAL DRAINAGE TUBE (SILICON) 832
CDP02CHB1NCK COTTON HUIBREGTSE BILIARY STENT ONLY 2033
CDP02CLS01CK "COOK"COTTON-LEUNG BILIARY STENTS 5:14FR膽道支架 2033
CDP02LS01NCK COTTON LEUNG BILIANY STENT ONLY 2033
CDP02PADBSSB AMSTERDAM BILIARY STENT 2033
CDP02PEBSTFG "福萊克斯" 膽道引流管 "ENDO-FLEX" BILIARY STENT 2033
CDP02PTFESFG "福萊克斯" 膽道引流管 "ENDO-FLEX" PTFE BILIARY STENT 2033
CDP02SPS12CK "曲克" 西門胰管支架組 "COOK" ZIMMON PANCREATIC STENT SET 2033
760
特材代碼 中英文名稱 支付點數-104/01/01
CDP02TTS02CK “曲克”所亨多坦念包膽道支架“COOK” ST-2 SOEHENDRA
TANNENBAUM BILIARY STENT
2033
CDP02ZS001CK ZIMMON ENDOSCOPIC BILIARY STENT ONLY 5:7FR 4,7,10CM 2033
CDP02ZS003CK “曲克” 膽道支架“COOK” ZIMMON BILIARY STENT 2033
CDPC103105B0 PERITONEAL CATHETER 1897
CDPC121303CM ACCU-FLO BARIUM PISTAL SLIT VALVE PERITONEAL CATHETER 2191
CDPC123045CM HAKIM PERITONEAL CATHETER 1897
CDPC143103PM C.S.F CARDIAC/PERITONEAL CATHETER 1897
CDPC143209M4 CSF FLOW CONTROL SHUNTS AND
ACCESSORIES(CARDIAC/PERITONEAL CATHETERS )
1897
CDPC19007MM4 CSF FLOW CONTROL SHUNTS AND ACCESSORIES CSF CARDIAC
PERITONEAL CATHETER WITH PRESSURE
2191
CDSR104111B0 VENTRICULAR RESERVOIR 4352
CDSR123038M4 "美敦力"腦脊髓液儲液囊"MEDTRONIC" RESERVOIRS 4352
CDSR144111PM VENTRICULAR ACCESS DEVICE BURR HOLE 12MM 4352
CDV0121700CM EXTERNAL DRAINAGE COLLECTION KIT 腦室體外引流組 4850
CDV0121701CM EXTERNAL DRAINAGE SYSTEM(E.D.S.) SET (不含VENTRICULAR
SET)
3220
CDV0121702CM EXTERNAL DRAINAGE SYSTEM(E.D.S.) COLLECTION BAG 539
CDV0121705CM EXTERNAL DRAINAGE SYSTEM(E.D.S.)VENTRICULAR SET (不含
TUBING AND BAG)
1664
CDV0121720CM EXTERNAL DRAINAGE SYSTEM EDSII (VENTRICULAR
CATH+TUBING+BAG)
4850
CDV0121721CM EXTERNAL DRAINAGE SYSTEM EDSII WITHOUT CATH(TUBING+BAG) 3220
CDV0121732CM 柯特曼體外引流集液袋"CODMAN" EDS CSF COLLECTION BAGS 539
CDV0201000TP VENTRICULAR DRAINAGE KIT(VENTRICULAR CATH+TUBING+BAG) 4850
CDV0201101B0 VENTRICULAR CATHETER 1074
CDV0202070TP VENTRICULAR DRAINAGE KIT(VENTRICULAR CATH+TUBING+BAG) 4850
CDV0202204TP VENTRICULAR DRAINAGE SET(TUBING+BAG) 3220
CDV0202207TP VENTRICULAR DRAINAGE BAG 539
CDV0206115B0 EDMS VENTRICULAR CATHETER 20CM W/STYLET 1074
CDV0206124B0 EDMS DRAINAGE BAG 700ML 539
CDV0206126B0 EDMS PATIENT CONNECTION LINE ASSEMBLY 162CM 1167
CDV0206128B0 EXTERNAL DRAINAGE MONITORING SYSTEM 63X11CM 84CM 3220
CDV0221731CM CODMAN EXTERNAL DRAINAGE SYSTEM 3 WITHOUT VENTRICULAR
CATHETER
3220
CDV0246124PM BECKER EDMS DRAINAGE BAG 700ML 539
CDV0246126PM EDMS PATIENT CONNECTION LINE ASSEMBLY 1167
CDV0246128PM I.C.P SHUNT BECKER 3220
CDV0246700M4 EXTERNAL DRAINAGE AND MONITORING SYSTEM 3220
CDV0246710M4 EXACTA DRAINAGE BAG 600ML 539
CDV02ND200TP VENTRICULAR CATH 1074
CDV0506118B0 EDMS VENTRICULAR CATHETER 35CM W/STYLET+TROCAR 型
號:06118S自94年10月1日起生效(文號0940021120)
1664
CDV0523041CM HAKIM VENTRICULAR CATHETER W/INTRODUCER 1664
CDV0527703M4 "美敦力"體外引流及監測用腦室導管"MEDTRONIC" EXTERNAL
DRAINAGE AND MONITORING VENTRICULAR
1664
CDV0546118PM VENTRICULAR CATHETER WITH TROCAR 1664
CDV0619181CM "CODMAN" BACTISEAL EVD CATHETER
SET(CATHETER+STYLET+CLIP+TROCAR) "柯特曼"貝特斯引流管組*
適應症請見備註欄
10000
CDV0621125CM "CODMAN" BACTISEAL EVD CATHETER
SET(CATHETER+STYLET+TROCAR+CLIP) "柯特曼"貝特斯引流管組*
適應症請見備註欄
10000
761
特材代碼 中英文名稱 支付點數-104/01/01
CDVC121201CM ACCU-FLO VENTRICULAR CATHETER 1074
CDVC141101M4 EXTERNAL DRAINAGE AND MONITORING VENTRICULAR CATHETER 1074
CDVC141101PM VENTRICULAR CATHETER 1074
CDVP123011CM HAKIM PRECISION VALVE PRECHAMBER ONLY W/INTRODUCER 5520
CDVP19003AM4 CSF FLOW CONTROL SHUNTS AND ACCESSORIES V-PSHUNT KIT (腦
室引流管+腹腔導管+CTR RESERVOIR+CONX2)
7127
CDVP19003DM4 CSF FLOW CONTROL SHUNTS AND ACCESSORIES V-PSHUNT KIT (腦
室引流管+腹腔導管+CTR RESERVOIR+CONX2)
7127
CDVP19040BPM V-P SHUNT 腦室腹腔分流術導管組 7127
CDVP19040EPM V-P SHUNT 腦室腹腔分流術導管組 7127
CDVP323001CM HYDROCEPHALUS SHUNT SYSTEM 7127
CDVP323016CM VALVE UNIT+PERITONEAL C+VENTRICULAR
C+ADAPTER+CONNECTOR+VALVE INTRODUCER
7127
CDVP323281CM CODMAN HAKIM RIGHT ANGLE VALVES SYSTEM(腦室導管+腹腔導管+
定壓引流閥)
7127
CDVP328501CM UNI-SHUNT WITH ENLARGED DOME RESERVOIR 7127
CDVP346024PM C.S.F UNITIZED SHUNT KIT 7127
CEE010090NPW EXTENSION TUBE 6.3
CEE010150CLL EXTENSION TUBE 90CM,100CM,120CM,150CM 6.3
CEE010150NPW EXTENSION TUBE 6.3
CEE010180NPW EXTENSION TUBE 6.3
CEE0108003P2 EXTENSION TUBE WITH Y 10CM 24.6
CEE0108005P2 EXTENSION TUBE WITH SAMPLING PORT 60CM,70CM 6.3
CEE0108007P2 EXTENSION TUBE WITH SAMPLING PORT 85CM:95CM 6.3
CEE0108100P2 EXTENSION TUBE WITH T 15CM 14
CEE0108300P2 IV EXTENSION TUBE 輸液延長管 45CM 6.3
CEE0108301P2 IV EXTENSION TUBE 輸液延長管 60CM 6.3
CEE0108302P2 EXTENSION TUBE 90CM 6.3
CEE0108303P2 IV EXTENSION TUBE 輸液延長管 120CM 6.3
CEE0108308P2 IV EXTENSION TUBE 輸液延長管 180CM 6.3
CEE010E877SG EXTENSION TUBE MALE-FEMALE LUER LUCK 100CM 6.3
CEE0110655LL "LILY"EXTENSION TUBE 15CM"怡安"輸液延長管 6.3
CEE0110656LL "LILY"EXTENSION TUBE(NEEDLE FREE)"怡安"輸液延長管:免針加
藥座
43.1
CEE012000EJ6 "CAREFUSION"SMARTSITE NEEDLE FREE VALVE EXTENSION SETS
AND COMPONENTS "卡爾費森"無針輸注閥組及配件:無針輸注閥
43.1
CEE0120039J6 "CAREFUSION"SMARTSITE NEEDLE FREE VALVE EXTENSION SETS
AND COMPONENTS "卡爾費森"無針輸注閥組及配件:無針輸注閥延
長管
43.1
CEE0125120M8 EXTENSION TUBE 25:120CM 6.3
CEE0172310CN 2 WAY Y CONNECTOR 24.6
CEE0180015P2 EXTENSION TUBE WITH 3-WAY 15CM 17.3
CEE01A101NPW EXTENSION TUBE 6.3
CEE01A110NPW EXTENSION TUBE WITH T 14
CEE01AS303SG "十美牌"輸液器(免針安全型)"SIGMA"INFUSION SET 43.1
CEE01B430BBQ "BIOTEQ"ANGIOGRAPHIC SYRINGE KIT(LOW PRESSURE TUBE)"邦特"
攝影導管用注射筒套組(螺旋連接管)
40
CEE01BTXDABQ "BIOTEQ"CONTRAST MEDIA DELIVERY SET "邦特"顯影藥物輸液套
組:病人端輸液管(含捲型幫浦輸液管-系統管)
280
CEE01C1000U2 "ICU"CLAVE CONNECTOR AND ACCESSORIES DEVICES:CLAVE
NEEDLELESS CONNECTOR "愛喜優"克萊福無針式接頭 ※適應症請
見備註欄
43.1
CEE01C2000U2 "ICU"CLAVE NEEDLELESS CONNECTOR EXTENSION SET "愛喜優”克
萊福無針式延長管※適應症請見備註欄
43.1
762
特材代碼 中英文名稱 支付點數-104/01/01
CEE01C4200U2 "ICU"CLAVE NEEDLELESS PIGGYBACK EXTENSION SET DUAL PORT "
愛喜優"克萊福無針式雙接頭延長管※適應症請見備註欄
99
CEE01CH100U2 "ICU"CLAVE DRUG PREPARATION SYSTEM:ACCESS DEVICE IV BAG
CLAVE CONNECTOR"愛喜優"克萊福藥物準備系統組件
70
CEE01CH150U2 "ICU"CLAVE DRUG PREPARATION SYSTEM:IV BAG ACCESS SPIKE
CLAVE CHECK VALVE)"愛喜優"克萊福藥物準備系統組件(玻璃瓶
用)
70
CEE01CH303U2 "ICU"CLAVE DRUG PREPARATION SYSTEM:5" (13CM)BAG SPIKE
ADAPTER W/SPIROS NON-DEHP TUBING"愛喜優"克萊福藥物準備系
統組件
134
CEE01DCTPQUL XD2001 CT INJECTOR MISSOURI:PATIENT HOSE AND PUMP HOSE
密蘇里造影劑注射器:病人端輸液管(含捲型幫浦輸液管)
280
CEE01E0085SG EXTENSION TUBE 6.3
CEE01E010NPW "普惠"靜注延長管Y型(免針安全型)給付規定請見備註
欄"PERFECT"EXTENSION TUBE Y TYPE(SAFETY)
43.1
CEE01E030NPW "普惠"輸液套(免針安全型)※給付規定請見備註
欄"PERFECT"DISPOSABLE INFUSION SET(SAFETY)
43.1
CEE01E050NPW "普惠"靜注延長管(免針安全型)給付規定請見備註
欄"PERFECT"EXTENSION TUBE(SAFETY)
43.1
CEE01ENT10SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE T-TYPE
EXTENSION TUBE"十美牌"免針輸液接頭T型延長管 ※適應症請見
備註欄
43.1
CEE01ENY10SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE Y EXTENSION
TUBE"十美牌"免針輸液接頭Y延長管 ※適應症請見備註欄
51.5
CEE01ENY20SG "十美牌"免針輸液接頭"SIGMA"NEEDLELESS INJECTION ACCESS
DEVICE-Y三路免針輸液接頭 *適應症請見備註欄
99
CEE01ES107SG EXTENSION TUBE 6.3
CEE01ET015SG T-CONNECTOR 14
CEE01ET067BB SAFSITE NEEDLE FREE EXTENSION SET※適應症請見備註欄 43.1
CEE01ET112LL EXTENSION TUBE 6.3
CEE01ET116BB SAFSITE NEEDLE FREE EXTENSION SET※適應症請見備註欄 43.1
CEE01ET12CLL EXTENSION TUBE 6.3
CEE01ET20ULL 2 WAY EXTENSION TUBE 24.6
CEE01ET24ULL 4-WAY EXTENSION TUBE 48.3
CEE01ET33SBB SAFSITE NEEDLE FREE EXTENSION SET(二個NEEDLE FREE)※適應
症請見備註欄
99
CEE01ET60SLL SAFETY EXTENSION TUBE※適應症請見備註欄 23
CEE01ETB05NQ Y-CONNECTOR(Y-IV EXTENSION TUBE) 24.6
CEE01ETC01NQ IV EXTENSION SET 6.3
CEE01ETN10SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE SINGLE
EXTENSION TUBE"十美牌"免針輸液接頭延長管 ※適應症請見備註
欄
43.1
CEE01ETN20SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE DOUBLE
EXTENSION TUBE"十美牌"免針輸液接頭2路延長管 ※適應症請見
備註欄
99
CEE01ETN51SG EXTENSION TUBE W/FREE SITE 無針式接頭+延長管*適應症請見備
註欄
43.1
CEE01H001NCK CONNECTING TUBE 314
CEE01H003NCK CONNECTING TUBE WITH DRAINAGE BAG CONNECTOR PCN連接管 305
CEE01HPC03CK CONNECTING TUBE BRAIDED POLYETHYLENE 1200PSI 連接管雙層 314
CEE01LP160MH LOW PRESSURE COUNECTOR TUBE 300PSI(螺旋連接管) 40
CEE01LRX50TP EXTENSION TUBE 50CM W/3 WAY STOPCOCK 17.3
763
特材代碼 中英文名稱 支付點數-104/01/01
CEE01N8000SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE "十美牌"免針輸
液接頭 ※適應症請見備註欄
43.1
CEE01NFEYSLL "怡安"點滴輸液套(附免針式安全型加藥座)"LILY"INFUSION
SET+NEEDLE FREE
43.1
CEE01P8100SG "SIGMA"NEEDLELESS || INJECTION ACCESS DEVICE "十美牌"免針
||型輸液接頭 ※適應症請見備註欄
43.1
CEE01PET10SG "SIGMA"NEEDLELESS || INJECTION ACCESS DEVICE SINGLE
EXTENSION TUBE "十美牌"免針||型輸液接頭延長管 ※適應症請
見備註欄
43.1
CEE01PET20SG "SIGMA"NEEDLELESS || INJECTION ACCESS DEVICE DOUBLE
EXTENSION TUBE "十美牌"免針||型輸液接頭2路延長管 ※適應症
請見備註欄
99
CEE01PEY10SG "SIGMA"NEEDLELESS || INJECTION ACCESS DEVICE Y EXTENSION
TUBE "十美牌"免針||型輸液接頭Y延長管 ※適應症請見備註欄
51.5
CEE01PTT10SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE T-TYPE
EXTENSION TUBE "十美牌"免針||型輸液接頭T延長管 ※適應症請
見備註欄
43.1
CEE01Q5100BD Q-SYTE LUER ACCESS SITE(無針式接頭)※適應症請見備註欄 43.1
CEE01Q5101BD Q-SYTE LUER ACCESS SITE EXTENSION SETS 延長型無針式輸液套
接頭 ※適應症請見備註欄
43.1
CEE01Q5102BD Q-SYTE LUER ACCESS SITE EXTENSION SETS 延長型無針式輸液套
接頭 ※適應症請見備註欄
43.1
CEE01R1000BB SAFSITE VALVES AND ACCESSORIES※適應症請見備註欄 43.1
CEE01T1100U2 "ICU"NON-DEHP MINIBORE EXT SET T-CONNECTOR AND BONDED
CLAVE CONNECTOR"愛喜優”克萊福無針式T延長管※適應症請見備
註欄
43.1
CEE01TC15NLL T-SITE CONNECTOR 14
CEE01TC15SLL "怡安"T型延長管"LILY"T-SITE CONNECTOR:免針式安全型*給付規
定請見備註欄
43.1
CEE01VP003LL EXTENSION TUBE W/3 WAY 17.3
CEP0108314P2 PRESSURE MONITOR LINES 24"-48" 30.7
CEP0108317P2 PRESSURE MONITOR LINES 60"-72" 30.7
CEP010A01NPW EXTENSION TUBE 800PSI高壓延長管 57
CEP0111507BB 1200PSI ANGIODYN HIGH PRESSURE TUBINGS PUR(雙層) 314
CEP011200PTP ANGIOGRAPHIC TUBE 1200PSI 雙層血管造影劑注入延長管 314
CEP012100DCD EXTENSION CATHETER 45CM,65CM,100CM (88/8/1改按條給付) 314
CEP0142373AB ARTERIAL PRESSURE TUBING 30.7
CEP0190701SB PRESSUREE MONITORING LINE 6":96" 30.7
CEP0190702NL PRESSURE MONITORING LINE 6":96" 30.7
CEP0191031NL CONTRAST INJECTION LINES (1200PSI雙層)顯影劑注射導線 314
CEP01A813ABQ 1200PSI HIGH PRESSURE CONNECTING TUBE (雙層) 314
CEP01A841ABQ 900PSI HIGH PRESSURE CONNECTING TUBE(單層) 57
CEP01A851ABQ 1200PSI HIGH PRESSURE CONNECTING TUBE(單層) 57
CEP01AL150SD "SEDAT"ALGAFLEX CONNECTION LINES 1200PSI(HIGH PRESSURE
LINE)"西達"艾加非司壓力連接管
314
CEP01B024NPW HIGH PRESSURE CONNECTING TUBE※限連接測壓導管或檢查導管及
注射造影劑使用
57
CEP01B330BBQ PRESSURE CONNECTING TUBE 500PSI 30.7
CEP01ETP01M6 PRESSURE TUBE 500PSI 30.7
CEP01ETP19M6 PRESSURE TUBE 800-1000PSI 57
CEP01HP20EMR HIGH PRESSURE TUBING 20" 1200PSI(雙層) 314
CEP01HP30EMR HIGH PRESSURE TUBING 30" 1200PSI(雙層) 314
CEP01HP48EMR HIGH PRESSURE TUBING 48" 1200PSI(雙層) 314
764
特材代碼 中英文名稱 支付點數-104/01/01
CEP01HP50EMR HIGH PRESSURE TUBING 500PSI(雙層) 230
CEP01PT006AG "ARGON"DISPOSABLE PRESSURE MONITOR:PRESSURE TUBING"愛琅"
血壓監視組合套:壓力連接管
30.7
CEP01PT012BD ARTERIAL PRESSURE TUBING 30.7
CEP01PT024BD ARTERIAL PRESSURE TUBING 30.7
CEP01PT048AG "ARGON"DISPOSABLE PRESSURE MONITOR:PRESSURE TUBING"愛琅"
血壓監視組合套:壓力連接管
30.7
CEP01PT072BD ARTERIAL PRESSURE TUBING 30.7
CEP01PT483GJ "JSM"PRESSURE TUBING "吉生"壓力連接管(500PSI PVC 每包3條) 92
CEP01PT500GJ PRESSURE TUBING 壓力連接管(500PSI PVC) 30.7
CEP01PT500H9 PRESSURE TUBING 500PSI 壓力連接管 30.7
CEP01PT500SG ARTERIAL PRESSURE TUBING 500PSI 6":72" 30.7
CEP01PT501GJ "JSM"PRESSURE TUBING "吉生"壓力連接管(500PSI/PVC) 30.7
CEP01PTH12SG ARTERIAL PRESSURE TUBING 1200PSI 6":72" 57
CEP01PTHP1GJ "JSM"PRESSURE TUBING:HIGH PRESSURE TUBING"吉生" 壓力連接
管(1200PSI PU 雙層)
314
CEP01PTHPTGJ PRESSURE TUBING:HIGH PRESSURE TUBING 壓力連接管(1200PSI
PU 雙層)
314
CEP01PTHPTH9 PRESSURE TUBING 1200PSI 壓力連接管(雙層) 314
CEP01PTPV1GJ "JSM"PRESSURE TUBING:HIGH PRESSURE TUBING 壓力連接管
(1000PSI/PVC)
57
CEP01PTPVCGJ PRESSURE TUBING:HIGH PRESSURE TUBING 壓力連接管(1000PSI
PVC)
57
CEP01PTPVCH9 HIGH PRESSURE TUBING PVC 1000PSI 高壓力連接管 57
CET0105180BB T-CONNECTOR 15CM 14
CET01B024NPW EXTENSION TUBE 6.3
CET01B032NPW EXTENSION TUBE W/T 14
CEV010KMS1TR PTMV(經皮穿靜脈氣球導管二尖瓣成形術)METAL TUBE 3615
CFD0120936CU CORFLO ENTERAL FEEDING TUBE 36" 6FR;8FR;10FR(含STYLE)※限
G-I手術後併G-I TRACT溢漏或吻合須NPO者
450
CFD0120943CU CORFLO ENTERAL FEEDING TUBE 43" 8FR;10FR;12FR(含STYLE)※
限G-I手術後併G-I TRACT溢漏或吻合須NPO者
450
CFD0120955CU "CORPAK"CORFLO ENTERAL FEEDING TUBES"蔻沛"可福樂管灌餵食
管
450
CFD0179801FL AG FREKA FEEDING TUBE SET 15FR. 100CM 艾極管灌餵食管袋組
合套 *適應症請見備註欄
450
CFD01BSTPUEE ENTERAL FEEDING TUBE 8,10,12,14,16FGX125CM*適應症請見備註
欄
125
CFD0280845SH KANGAROO ENTERNAL FEEDING TUBE 8,10,12FR 附導線 ※適應症
請見備註欄
450
CFD05BPU08EE PU STOMACH CATHETER 聚胺酯胃管 ※適應症請見備註欄 115
CFD0601006BA "BARD"PONSKY PULL PEG KIT (TUBE+WIRE+S+N+ADAP+BOL)"巴德"
經皮內視鏡胃造口組(半套)※適應症請見備註欄
3634
CFD060644NK4 "KIMBERLY-CLARK"PEG
KIT(TUBE+ADAPTER+RING+NEEDLE+WIRE+CLAMP)〝金百利克拉克〞
經皮內視鏡胃造廔組(半套)※適應症請見備註欄
3634
CFD060644NLZ PEG KIT(半套)經皮內視鏡胃造廔組(PEG
TUBE,ADAPTER,EXTERNAL RETENTION RING,INTRODUCER
NEEDLE,WIRE,TUBING CLAMP)※適應症請見備註欄
3634
CFE02MBL01CK "COOK"4,6,10 SHOOTER SAEED MULTI-BAND LIGATOR "曲克"多發
型結紮器※給付規定請見備註欄
4000
CFE02MBL02CK "COOK"SAEED MULTI-BAND LIGATOR(NON-STERILE)4;6;10 "曲克"
結紮器(未滅菌)※給付規定請見備註欄
4000
765
特材代碼 中英文名稱 支付點數-104/01/01
CFE02SUPERSB 〝BOSTON SCIENTIFIC〞SPEEDBAND SUPERVIEW SUPER7 MULTIPLE
BAND LIGATOR〝波士頓科技〞多發式靜脈瘤結紮環組※適應症請
見備註欄
4000
CGAP1AP212GJ "吉生"心導管包"JSM"ANGIO PACK-基本包(含N+導引鞘組
+GW/0.035"260/300CM+3PORT多路引流器*2+壓力連接管500PSI*4+
壓力連接管1200PSI雙層)
3127.8
CGAP1AP313GJ "吉生"心導管包"JSM"ANGIO PACK-基本包(含N+導引鞘組+GW/不鏽
鋼 0.035"260/300CM+3PORT多路引流器*2+壓力連接管500PSI*4+
壓力連接管1200PSI雙層)
2197.8
CGAP1AP414GJ "吉生"心導管包"JSM"ANGIO PACK-基本包(含N+導引鞘組
+GW/0.035"120~180CM+3PORT多路引流器*2+壓力連接管500PSI*4+
壓力連接管1200PSI雙層)
2507.8
CGAP1AP515GJ "吉生"心導管包"JSM"ANGIO PACK-基本包(含N+導引鞘組+GW/不鏽
鋼 0.035"120~180CM+3PORT多路引流器*2+壓力連接管500PSI*4+
壓力連接管1200PSI雙層)
2087.8
CGAP1AP620GJ "吉生"心導管包"JSM"ANGIO PACK-基本包無導引鞘組(含穿刺針+
導引線/ 0.035"260/300CM+3PORT多路引流器*2+壓力連接管
500PSI*4+壓力連接管1200PSI雙層)
2412.8
CGAP1AP721GJ "吉生"心導管包"JSM"ANGIO PACK-基本包無導引鞘組(N+GW/不鏽
鋼 0.035"260/300CM+3PORT多路引流器*2+壓力連接管500PSI*4+
壓力連接管1200PSI雙層)
1482.8
CGAP1AP822GJ "吉生"心導管包"JSM"ANGIO PACK-基本包無導引鞘組(含
N+GW/0.035"120~180CM+3PORT多路引流器*2+壓力連接管
500PSI*4+壓力連接管1200PSI雙層)
1792.8
CGAP1AP923GJ "吉生"心導管包"JSM"ANGIO PACK-基本包無導引鞘組(N+GW/不鏽
鋼 0.035"120~180CM+3PORT多路引流器*2+壓力連接管500PSI*4+
壓力連接管1200PSI雙層)
1372.8
CGAP1APMAXGJ "吉生"心導管包"JSM"ANGIO PACK-最大包(N*2+導引鞘組
+GW/0.035"260/300CM+4PORT多路引流器*2+壓力連接管500PSI*4+
壓力連接管1200PSI雙層)
3309.8
CGAP1HY100H9 HYM ANGIO PACK 心導管包(GWX1+SHEATHX1+ARTERIAL
NEEDLEX1+MANIFOLDX2+PRESSURE TUBINGX4+HIGHT PRESSURE
TUBINGX1)
2413
CGAP1HY211H9 HYM ANGIO PACK "華億"心導管包(ARTERIAL
NEEDLEX1+MANIFOLDX1+PRESSURE TUBINGX2+HIGH PRESSURE
TUBINGX1)
880
CGBK1AFGV4LY "奧林柏斯"單次用取石網"OLYMPUS"SINGLE USE GRASPING
FORCEPS
12365
CGBK1FSLX1CK "COOK"EXTRACTION BASKETS"曲克"取石網 12365
CGBK1MB501CK "COOK"EXTRACTION BASKETS"曲克"取石網 12365
CGBK1MSB01CK "COOK"EXTRACTION BASKETS"曲克"取石網 12365
CGBK1TRWRBSB "BOSTON SCIENTIFIC"TRAPEZOID RX WIREGUIDED RETRIEVAL
BASKET"波士頓科技"快速交換取石籃
12365
CGDW10113NAN STAINLESS GUIDE WIRE 0.025~0.035" 125~150CM 311
CGDW10117NAN STAINLESS GUIDE WIRE 0.025~0.045" 40~100CM 140
CGDW101228CD MINI GUIDE WIRE 140
CGDW10220NAN GUIDE WIRE 80CM:150CM 0.018":0.038"泌尿科使用 313
CGDW10222NAN STAINLESS PTFE-COATED GUIDE WIRE 0.018~0.038" 80~100CM 277
CGDW10225NAN GUIDE WIRE 200CM:260CM 0.018":0.038"(型號0300,0302-0060)
泌尿科使用
437
CGDW10227NAN STAINLESS GUIDE WIRE PTFE-COATED 0.018~0.038"125CM 313
CGDW10227WAN STAINLESS GUIDE WIRE PTFE-COATED 0.018~0.038"175~200CM 313
CGDW10228NAN STAINLESS GUIDE WIRE PTFE-COATED 0.018~0.038"150CM 313
CGDW10229NAN STAINLESS GUIDE WIRE PTFE-COATED 0.018~0.038" 220CM 437
766
特材代碼 中英文名稱 支付點數-104/01/01
CGDW10233NAN STAINLESS GUIDE WIRE PTFE-COATED 0.018~0.038" 260~500CM 437
CGDW10252NCD EMERALD GUIDE WIRE FIXED-CORE STRAIGHT TIP 0.025" :0.038"
125:175CM
313
CGDW10253NCD EMERALD GUIDE WIRE FIXED-CORE STRAIGHT TIP 0.025":0.038"
125:175CM
313
CGDW10254NCD EMERALD GUIDE WIRE FIXED-CORE STRAIGHT TIP 0.025":0.038"
125:175CM
313
CGDW102555CD EMERALD GUIDE WIRE FIXED-CORE STRAIGHT TIP 0.035" 260CM 437
CGDW102560CD EMERALD GUIDE WIRE FIXED-CORE STRAIGHT TIP 0.035" 150CM 313
CGDW10430NAN STAINLESS GUIDE WIRE PTFE-COATED 0.018~0.038" 150CM 313
CGDW104435AR "ARROW"SPRING GUIDE WIRE 0.035" 60CM"亞諾”導引線 140
CGDW10541NAN NITINOL GUIDE WIRE 0.021~0.035" 145~200CM 751
CGDW10542NAN NITINOL GUIDE WIRE STIFF SHAFF 0.035" 145CM 779
CGDW10620NMV GUIDE WIRE(0.035" 0.038" 150CM) 313
CGDW108005ST "聖猷達"海卓史蒂爾導引線"ST.JUDE"HYDROSTEER GUIDEWIRE
0.035:0.038" 150CM,180CM(鎳合金)
751
CGDW108011ST "聖猷達"海卓史蒂爾導引線"ST.JUDE"HYDROSTEER
GUIDEWIRE0.035:0.038" 260CM(鎳合金)
1359
CGDW111011PB WORKER GUIDE WIRE〈100CM STRAIGHT 277
CGDW111012PB WORKER GUIDE WIRE 100-200CM STRAIGHT(型號
114035120,113935150,112035150自92/7/1生效)
313
CGDW111051PB WORKER GUIDE WIRE〈100CM CURVE 277
CGDW111052PB WORKER GUIDE WIRE 100-200CM CURVE(型號113735,110518-150自
92/7/1生效)
313
CGDW111053PB WORKER GUIDE WIRE 200-300CM CURVE 437
CGDW111080C3 GUIDE WIRE 80CM 277
CGDW111420PB AMPLATZ GUIDE WIRE EXTRA STIFF 0.035" 150CM 779
CGDW112511PB CANALIZER GUIDE WIRE 0.035" 150CM,180CM 751
CGDW112512PB CANALIZER GUIDE WIRE 0.035" 260CM 1359
CGDW112901PB CANALIZER GUIDE WIRE STIFF 0.035" 150CM,180CM 779
CGDW1145FSBA "BARD"UROLOGICAL CATHETER ACCESSORIES:HYDROGLIDE
GUIDEWIRES(STAINLESS STEEL)0.035" 145CM "巴德"泌尿導管附
件:親水性塗層導線
313
CGDW114735AR "ARROW”SPRING WIRE GUIDE 0.035 68CM“亞諾"導引線 140
CGDW116402AR "ARROW" SPRING GUIDE WIRE 0.018" 68CM (DUOFKEX)"亞諾”導
引線
140
CGDW135153WT WATSON GUIDE WIRE STAINLESS WITH PTFE 150CM 0.021:0.038" 313
CGDW135206AG SPRING GUIDE WIRE 0.025",0.035",0.038" 40:65CM FIXED CORE
STRAIGHT
140
CGDW135225AG GUIDE WIRE 0.021,0.025,0.032" 150CM TF/FC/ST 313
CGDW135231AG GUIDE WIRE 0.035" 150CM STRAIGHT 313
CGDW135234AG GUIDE WIRE 0.038" 150CM STRAIGHT 313
CGDW135263WT WATSON GUIDE WIRE STAINLESS WITH PTFE 260CM 0.025:0.038" 437
CGDW135282AG GUIDE WIRE J-TIP 0.035" 150CM 3MM 313
CGDW135284AG SPRINGE GUIDE WIRE 150CM 311
CGDW135368AG GUIDE WIRE 0.032" 260CM 437
CGDW135369AG GUIDE WIRE EXTENSIVE 0.035" 260CM 437
CGDW135415AG SPRING GUIDE WIRE 0.025",0.032",0.035",0.038" 50,65CM
FIXED CORE,3MMJ STRAIGHT
140
CGDW135451AG SPRING GUIDE WIRE 0.018",0.021" 25:80CM FIXED CORE
STRAIGHT
140
767
特材代碼 中英文名稱 支付點數-104/01/01
CGDW135454AG SPRING GUIDE WIRE 0.018",0.021",0.025" 40,50CM FIXED
CORE,3MMJ
140
CGDW135464AG GUIDE WIRE 0.018" 50CM 277
CGDW135470AG GUIDE WIRE 0.018" 150CM TF/FC/1.5MMJ 313
CGDW135522AG GUIDE WIRE 0.018:0.038" 260CM TF/ST 437
CGDW135523AG GUIDE WIRE 0.018:0.038" 125CM,150CM TF/FC/3MMJ 313
CGDW135541AG GUIDE WIRE 0.021" 50CM 277
CGDW135550AG GUIDE WIRE 0.025" 50CM 277
CGDW135585AG GUIDE WIRE 0.025" 260CM 437
CGDW135703AG GUIDE WIRE 0.035" 200CM EXCHANGE TF/ST 437
CGDW135711AG GUIDE WIRE 75CM 140
CGDW135730AG SPRING GUIDE WIRE 0.018",0.021",0.025",50CM FIXED
CORE,6MMJ STRAIGHT
140
CGDW135787AG GUIDE WIRE J-TIP 0.035" 150CM 1.5MM 313
CGDW135798AG SPRING GUIDE WIRE 0.035",0.038" 70,80CM FIXED CORE,3MMJ 140
CGDW135817AG GUIDE WIRE 0.038" 200CM TF/3MMJ 437
CGDW135839AG GUIDE WIRE 0.032,0.035,0.038" 260CM TF/3MMJ 437
CGDW135963AG GUIDE WIRE 0.021" 260CM 437
CGDW135964AG GUIDE WIRE 0.018" 260CM 437
CGDW135968AG SPRING GUIDE WIRE 0.028",0.032",0.035" 40,50CM FIXED
CORE,3MMJ
140
CGDW135989AG GUIDE WIRE 0.028" 50CM 140
CGDW140455ST "聖猶達"蓋瑞特導引線"ST.JUDE " GUIDERIGHT GUIDEWIRE 50CM 277
CGDW14652NMT AMPLATZ SUPER STIFF GUIDE WIRE 779
CGDW14652NSB "波士頓科技"安普拉茲超硬導線"BOSTON SCIENTIFIC"AMPLATZ
SUPER STIFF GUIDEWIRE 0.035/0.038" 145CM,180CM
779
CGDW14656NSB "波士頓科技"安普拉茲超硬導線"BOSTON SCIENTIFIC"AMPLATZ
SUPER STIFF GUIDEWIRE 0.035/0.038" 75CM
779
CGDW1465AMSB "波士頓科技"安普拉茲超硬導線"BOSTON SCIENTIFIC"AMPLATZ
SUPER STIFF GUIDEWIRE 0.035/0.038"X260CM
923
CGDW149101SB STARTER GUIDE WIRE FIXED CORE STR TIP 3.5CM FIEXIBLE TIP
0.032-0.035,100-150CM
313
CGDW149110SB STARTER GUIDE WIRE MOVEABLE CORE STR TIP & J-CURVE TIP
0.035:0.038 150CM
313
CGDW149115SB STARTER GUIDE WIRE FIXED CORE J-CURVE 3.5CM FIEXIBLE TIP
0.025:0.038 120-180CM
313
CGDW14914NSB STARTER GUIDE WIRE NEW BENSON TYPE 0.035 150:180CM 313
CGDW149150SB STARTER GUIDE WIRE NEWTON & NEWTON(LLT)TYPE 0.035 150CM 313
CGDW149155SB STARTER GUIDE WIRE ROSEN HEAVY DUTY TYPE 0.035 180CM 313
CGDW149200LR STARTER GUIDEWIRE 0.018":0.038" 100:180CM(產品型號含
M001492351:81;2501:11)
313
CGDW149200SB STARTER GUIDE WIRE FIXED CORE STR TIP 3.5CM FIEXIBLE TIP
0.018:0.032,100-150CM
313
CGDW149201LR STARTER GUIDEWIRE 0.025":0.035" 40CM,80CM 277
CGDW149201SB STARTER GUIDE WIRE FIXED CORE STR TIP 3.5CM FIEXIBLE TIP
0.025:0.035,40,80CM
277
CGDW149212SB STARTER GUIDE WIRE FIXED CORE STR TIP 3.5CM FIEXIBLE TIP
0.035:0.038,100-180CM
313
CGDW149213LR STARTER GUIDEWIRE 0.035";0.038" 260CM 437
CGDW149213SB STARTER GUIDE WIRE FIXED CORE STR & 3CM J SHAPE 3.5CM
FLEXIBLE TIP 0.035,0.038 260CM
437
CGDW149220SB STARTER GUIDE WIRE DOUBLE END STR TIP& J CURVE TIP 0.035
150CM
313
768
特材代碼 中英文名稱 支付點數-104/01/01
CGDW149221SB STARTER GUIDE WIRE FIXED CORE J-CURVE 3.5CM FIEXIBLE TIP
0.035,0.038 100-180CM
313
CGDW149222SB STARTER GUIDE WIRE FIXED CORE J-CURVE 3.5CM FIEXIBLE TIP
0.035 40,80CM
277
CGDW149250SB STARTER GUIDE WIRE HEAVY DUTY TYPE 0.035 150CM 313
CGDW150270CD GUIDE WIRE TEFLON 0.035" 80CM 277
CGDW15027XCD GUIDE WIRE TEFLON 0.035";0.038" 260CM 437
CGDW15410NAN NITINOL GUIDE WIRE 0.021~0.035" 220~400CM 1359
CGDW15FS38BA "BARD"UROLOGICAL CATHETER ACCESSORIES:HYDROGLIDE
GUIDEWIRES(STAINLESS STEEL)0.038" 145CM "巴德"泌尿導管附
件:親水性塗層導線
313
CGDW163541CK "COOK"URETERAL WIRE GUIDES "曲克"輸尿管導線145CM
0.035;0.038
313
CGDW163845CK AMPLATZ STIFF WIRE GUIDE 145cm 779
CGDW172600PB NITINOL GUIDE WIRE 0.018" 80CM 653
CGDW17900JVQ "VOLCANO"PRIMEWIRE PRESSURE GUIDE WIRE"火山"壓力偵測導線
※給付規定請見備註欄
20000
CGDW18185JVQ "VOLCANO"PRIMEWIRE PRESTIGE PRESSURE GUIDE WIRE"火山"壓力
偵測導線※給付規定請見備註欄
20000
CGDW1960012C "柯惠"肯特利慢性血液透析導管"COVIDIEN"KENDALL CHRONIC
HEMODIALYSIS CATHETERS-GUIDE WIRE 0.035" 0.038" 70CM
140
CGDW1A1340BQ "邦特"血管外引導鋼線"BIOTEQ"GUIDEWIRE PTFE 0.018~0.065"
40~100CM
277
CGDW1A1346BQ "邦特"血管外引導鋼線"BIOTEQ"GUIDEWIRE PTFE 0.018~0.065"
220~500CM
437
CGDW1A1347BQ "邦特"血管外引導鋼線"BIOTEQ"GUIDEWIRE PTFE 0.018~0.065"
120~200CM
313
CGDW1A2131BQ BIOTEQ URETERAL STENT SET DOUBLE J TYPE:GUIDE WIRE
0.028":0.038" 120CM;150CM 邦特輸尿管導管組(雙J型):引導鋼
線
313
CGDW1A3513TM RADIFOCUS GUIDE WIRE 0.025":0.038" 150CM ANGLED TIP 751
CGDW1A3515TM RADIOFOCUS GUIDE WIRE 0.025",0.035" 150CM (ANGLE) 751
CGDW1A3518TM RADIFOCUS GUIDE WIRE 0.032":0.038" 150CM FLEXIBLE TIP 751
CGDW1A3530TM RADIOFOCUS GUIDE WIRE 0.035" 300CM 1359
CGDW1AER25ST 〝SJM〞PRESSURE WIRE AERIS(FFR)(含0.014"導引線+傳輸器+旋
轉頭)"聖猷達〞壓力感應金屬導引線※給付規定請見備註欄
20000
CGDW1AES01CK "COOK"AMPLATZ EXTRA STIFF FIXED CORE WIRE GUIDE (PTFE
CODE)"曲克"安培茲硬導線0.025";0.035";0.038" 145CM
779
CGDW1ANG11M4 "美敦力"血管診斷攝影用導線"MEDTRONIC"ANGIOGRAPHIC
GUIDEWIRES 0.025~0.038" 120~145CM PTFE
313
CGDW1ANG12M4 "美敦力"血管診斷攝影用導線"MEDTRONIC"ANGIOGRAPHIC
GUIDEWIRES 0.025~0.038" 145~175CM PTFE
313
CGDW1ANG13M4 "美敦力"血管診斷攝影用導線"MEDTRONIC"ANGIOGRAPHIC
GUIDEWIRES 0.035~0.038" 260CM PTFE EXTRA SUPPORT
923
CGDW1ANG14M4 "美敦力"血管診斷攝影用導線"MEDTRONIC"ANGIOGRAPHIC
GUIDEWIRES 0.063" 160CM PTFE EXTRA SUPPORT
779
CGDW1APGW1H9 ANGIO PACK:GUIDE WIRE 0.035" 150CM PTFE 313
CGDW1APGW2H9 ANGIO PACK:GUIDE WIRE 0.035" 260CM PTFE 437
CGDW1AUS21CK "COOK" GUIDE WIRE ULTRA STIFF STAINLESS STEEL TFE COATING
0.035" 0.038" 260CM "曲克"導線
923
CGDW1B1340BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE 0.018~0.045"
40~100CM
277
CGDW1B1341BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE 0.018~0.045"
120~200CM
313
769
特材代碼 中英文名稱 支付點數-104/01/01
CGDW1B1346BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE 0.018~0.045"
220~500CM
437
CGDW1B3450BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE HYDROPHILIC
0.016~0.038" 40~100CM
653
CGDW1B3551BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE HYDROPHILIC
0.025~0.038" 120~200CM
751
CGDW1B3557BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE HYDROPHILIC
0.016~0.018" 120~200CM
751
CGDW1B5250BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE AMPLATZ
0.025~0.035" 90CM
779
CGDW1B5251BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE AMPLATZ
0.025~0.035" 145~180CM
779
CGDW1B5252BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE AMPLATZ
0.025~0.035" 260CM
923
CGDW1B7361BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE 0.035~0.038"
150CM
313
CGDW1BA340BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE 0.018~0.045"
40~100CM
140
CGDW1BA344BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE 0.018~0.045"
120~200CM
311
CGDW1BC423BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE HYDROPHILIC
0.016~0.038" 400~450CM
1359
CGDW1BC457BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE HYDROPHILIC
0.016~0.038" 120~200CM
751
CGDW1BC521BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE HYDROPHILIC
0.025~0.038" 220~450CM
1359
CGDW1BC552BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE HYDROPHILIC
0.025~0.038" 220~300CM
1359
CGDW1C6121BQ "BIOTEQ"DRAINAGE CATHETER & INTRODUCER SET:NITINOL GUIDE
WIRE 0.018" 80CM "邦特"引流導管及穿刺導入系統:鎳鈦合金引
導鋼線
653
CGDW1CERTUST 〝SJM〞PRESSURE WIRE CERTUS(FFR)(含0.014"導引線+傳輸器+旋
轉頭)"聖猷達〞壓力感應金屬導引線※給付規定請見備註欄
20000
CGDW1EMER1CD "CORDIS"GUIDE WIRE "考迪斯"引導線 PTFE 125;150;175;180CM 313
CGDW1EMER2CD "CORDIS"GUIDE WIRE "考迪斯"引導線 PTFE 220;260CM 437
CGDW1G002ACK GUIDE WIRE STRAIGHT 50CM,80CM 277
CGDW1G002NCK GUIDE WIRE STRAIGHT (100,125,145CM) 313
CGDW1G003ACK GUIDE WIRE AMPLATZ EXTRA-STIFF 145CM,180CM 779
CGDW1G003NCK GUIDE WIRE AMPLATZ EXTRA-STIFF 923
CGDW1G004NCK GUIDE WIRE COONS INTERVENTIONAL 313
CGDW1G005NCK TIP DEFLECTING GUIDE WIRE 822
CGDW1G006ACK GUIDE WIRE CURVED 50CM, 80CM 277
CGDW1G006NCK GUIDE WIRE CURVED 50:145CM(100,125,145CM) 313
CGDW1G007ACK GUIDE WIRE CURVED 180CM 313
CGDW1G007NCK "曲克"導線"COOK"GUIDE WIRE CURVED 180:260CM(260CM) 437
CGDW1G008ACK GUIDE WIRE CURVED 50CM, 80CM 277
CGDW1G008NCK GUIDE WIRE CURVED 50:145CM(100,125,145CM) 313
CGDW1G009ACK GUIDE WIRE CURVED 80CM 277
CGDW1G009NCK GUIDE WIRE CURVED (100,125,145CM) 313
CGDW1G011ACK "曲克"導線"COOK"GUIDE WIRE STRAIGHT 0.018~0.021"
50CM,80CM
277
CGDW1G011NCK "曲克"導線"COOK"GUIDE WIRE STRAIGHT 0.018~0.021"
100,125,145CM
313
770
特材代碼 中英文名稱 支付點數-104/01/01
CGDW1G012NCK "曲克"導線"COOK"GUIDE WIRE STRAIGHT 0.018~0.052" 260CM 437
CGDW1G013NCK SOS INTERVENTIONAL GUIDE WIRE 145CM 952
CGDW1G016ACK "曲克"導線"COOK"GUIDE WIRE STRAIGHT 0.025~0.052"
50CM,80CM
277
CGDW1G016NCK "曲克"導線"COOK"GUIDE WIRE STRAIGHT 0.025~0.052"
100,125,145CM
313
CGDW1G017NCK "COOK"GUIDE WIRE TEFCOR MOVABLE CURVED"曲克"導線 313
CGDW1G018NCK GUIDE WIRE LUNDERQUIST EXCHANGE 120CM 787
CGDW1GAGSNTM RADIFOCUS GUIDEWIRE(SHAPEABLE TYPE
ANGLE,STRAIGHT)0.018":0.038"120:150CM
751
CGDW1GKGLNTM RADIFOCUS GUIDEWIRE(SHAPEABLE TYPE
ANGLE,STRAIGHT)0.018":0.038"120:180CM
751
CGDW1GW001G6 'AGA' AMPLATZER GUIDE WIRE (PDA OCCLUDER 用)※適應症請見
備註欄
1600
CGDW1GW003G6 "銨積維"導引導管"AGA" AMPLATZER GUIDEWIRE (OCCLUDER 用)※
給付規定請見備註欄
1600
CGDW1H1258GJ "JSM"GUIDE WIRE (HYDROPHILIC PVP PRE-COATED)
0.018"~0.038"120;150;180CM "吉生"導引線
751
CGDW1H2630GJ "JSM"GUIDE WIRE (HYDROPHILIC PVP PRE-COATED)
0.018"~0.038" 260;300CM "吉生"導引線
1359
CGDW1HAHSNTM RADIFOCUS GUIDEWIRE HALFSTIFF(SHAPEABLE TYPE
ANGLE,STRAIGHT)0.018":0.038"120:180CM
779
CGDW1HSF01CK LUNDERQUIST RING TORQUE GUIDE WIRE 變換金屬導線 787
CGDW1HW001CK HYDROPHILIC WIRE GUIDES 150CM,180CM 0.025" 0.035" 0.038" 751
CGDW1HW018CK HYDROPHILIC WIRE GUIDES 180CM 0.018" 2781
CGDW1HWA01CK HYDROPHILIC WIRE GUIDES 150CM,180CM 0.025" 0.035" 0.038" 751
CGDW1HWA02CK HYDROPHILIC WIRE GUIDES 260CM 0.025" 0.035" 0.038" 1359
CGDW1HWA18CK HYDROPHILIC WIRE GUIDES 150CM 180CM 0.018" 2781
CGDW1HWA28CK HYDROPHILIC WIRE GUIDES 260CM 0.018" 2800
CGDW1HWAS1CK HYDROPHILIC WIRE GUIDES EXTRA SUPPORT(STIFF SHAFT)150CM
180CM 0.035" 0.038"
779
CGDW1HWAS2CK HYDROPHILIC WIRE GUIDES 260CM 0.035" 0.038" 1359
CGDW1HWS01CK HYDROPHILIC WIRE GUIDES EXTRA SUPPORT(STIFF SHAFT)150CM
180CM 0.035" 0.038"
779
CGDW1LC181TM RADIFOCUS GUIDE WIRE M 0.018"~0.038"120CM,150CM,180CM 751
CGDW1LC182TM RADIFOCUS GUIDE WIRE M STIFF WIRE 0.025"~0.038"
150CM,180CM
779
CGDW1LC183TM RADIFOCUS GUIDE WIRE M STIFF WIRE 0.018" 180CM 779
CGDW1LC18NTM RADIFOCUS GUIDE WIRE M 0.018"~0.038" 120CM,150CM,180CM 751
CGDW1LC301TM RADIFOCUS GUIDE WIRE M STIFF WIRE 0.018"~0.038"
220CM,260CM,300CM
1359
CGDW1LC303TM "泰爾茂"導引導線"TERUMO"RADIFOCUS GUIDE WIRE M STIFF WIRE
0.025",0.035" 260CM,300CM
1359
CGDW1LC30NTM RADIFOCUS GUIDE WIRE M 0.018"~0.038" 220CM,260CM,300CM 1359
CGDW1MSU70MW GUIDE WIRE 股靜脈、鎖骨下靜脈導管 140
CGDW1N405HST GUIDERIGHT GUIDEWIRE HEPARIN COATED FIXED CORE
0.035",0.038" 150CM;180CM
313
CGDW1N4568ST "聖猷達"蓋瑞特導引線"ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313
CGDW1N4577ST "聖猷達"蓋瑞特導引線"ST.JUDE " GUIDERIGHT GUIDEWIRE 260CM 437
771
特材代碼 中英文名稱 支付點數-104/01/01
CGDW1N458NST GUIDERIGHT GUIDEWIRE SUPER STIFF FIXED CODE 0.032",0.038"
180CM
779
CGDW1N4610ST "聖猷達"蓋瑞特導引線"ST.JUDE"GUIDERIGHT GUIDEWIRE 150CM
180CM
313
CGDW1N4840ST "聖猷達"蓋瑞特導引線"ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313
CGDW1N4841ST "聖猷達"蓋瑞特導引線"ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313
CGDW1N4870ST "聖猷達"蓋瑞特導引線"ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313
CGDW1N4948ST "聖猷達"蓋瑞特導引線"ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313
CGDW1N4998ST "聖猷達"蓋瑞特導引線"ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313
CGDW1N5018ST "聖猷達"蓋瑞特導引線"ST.JUDE " GUIDERIGHT GUIDEWIRE 260CM 437
CGDW1PA353TM "泰爾茂"血管攝影用導線"TERUMO"RADIFOCUS GUIDE WIRE M
0.035":0.038" 80:180CM STIFF TYPE
779
CGDW1PMG01CK COPE NITINOL MANDRIL WIRE GUIDE(PLATINUM TIP)0.018" 25-
200CM 加蓋軸心鎳鉻合金導線
1655
CGDW1PTGW1GJ STAINLESS STEEL GUIDE WIRE0.018"~0.038" 50CM;80CM W/PTFE 277
CGDW1PTGW1H9 STAINLESS W/PTFE GUIDE WIRE 0.018":0.038" 50CM:80CM 277
CGDW1PTGW2GJ STAINLESS STEEL GUIDE WIRE0.018"~0.038" 120CM;150CM;180CM
W/PTFE
313
CGDW1PTGW2H9 STAINLESS W/PTFE GUIDE WIRE 0.018":0.038"
120CM;150CM;180CM
313
CGDW1PTGW3GJ STAINLESS STEEL GUIDE WIRE0.018"~0.038" 260CM;300CM
W/PTFE
437
CGDW1PTGW3H9 STAINLESS W/PTFE GUIDE WIRE 0.018":0.038" 260CM;300CM 437
CGDW1PWC28ST "SJM"PRESSUREWIRE(含0.014"導引線+可拆解接線+旋轉頭)"聖猷
達"壓力感應金屬導線
20000
CGDW1R402NST GUIDERIGHT GUIDEWIRE HEPARIN COATED MOVABLE CORE
0.035",0.038" 150CM
313
CGDW1R455NST GUIDERIGHT GUIDEWIRE INTRODUCER
0.021",0.025",0.032",0.035",0.038 50CM,80CM
277
CGDW1R45DDST GUIDERIGHT GUIDEWIRE DOUBLE DISTAL FIXED CORE
0.035",0.038" 150CM,180CM
313
CGDW1R45J2ST GUIDERIGHT GUIDEWIRE J TIP FIXED CORE 0.32",0.35",0.038"
260CM
437
CGDW1R45NNST GUIDERIGHT GUIDEWIRE J TIP FIXED CORE
0.21",0.25",0.30",0.32",0.35",0.038,0.65" 150CM,180CM
313
CGDW1R4876ST GUIDERIGHT GUIDEWIRE SUPER STIFF FIXED CODE 0.038" 260CM 923
CGDW1R48NNST GUIDERIGHT GUIDEWIRE STRAIGHT FIXED CORE
0.021",0.025",0.032",0.035",0.038" 150CM
313
CGDW1R48SFST GUIDERIGHT GUIDEWIRE STRAIGHT FIXED CORE 0.035",0.038"
260CM
437
CGDW1R4946ST GUIDERIGHT GUIDEWIRE J TIP MOVABLE CORE 0.035",0.038"
150CM
313
CGDW1R4950ST GUIDERIGHT GUIDEWIRE STRAIGHT MOVABLE CORE 0.035",0.038"
150CM
313
CGDW1R5018ST GUIDERIGHT GUIDEWIRE HEPARIN COATED FIXATED CORE 0.035"
260CM
437
772
特材代碼 中英文名稱 支付點數-104/01/01
CGDW1RFPC1CK ROADRUNNER GUIDE WIRE 0.035",0.038" 145CM,180CM/TIP 7CM 751
CGDW1RFPC2CK ROADRUNNER GUIDE WIRE 0.035",0.038" 260CM/TIP 7CM 1359
CGDW1RFSP1CK ROADRUNNER WIRE GUIDE 0.035",0.038" 145CM,180CM 751
CGDW1RFSP2CK ROADRUNNER WIRE GUIDE 0.035",0.038" 260CM 1359
CGDW1RLPC1CK ROADRUNNER GUIDE WIRE 0.035",0.038" 145CM,180CM/TIP 16CM 751
CGDW1RLPC2CK ROADRUNNER GUIDE WIRE 0.035",0.038" 260CM/TIP 16CM 1359
CGDW1RPC1XCK ROADRUNNER GUIDE WIRE 0.035",0.038" 145CM,180CM/TIP 8CM 751
CGDW1RPC2XCK ROADRUNNER GUIDE WIRE 0.035",0.038" 260CM/TIP 8CM 1359
CGDW1S3515TM RADIOFOCUS GUIDE WIRE 0.035" 150CM (STRAIGHT) 751
CGDW1S3530TM RADIOFOCUS GUIDE WIRE 0.035" 300CM 1359
CGDW1SFA35C3 GUIDE WIRE 0.035" 150CM 313
CGDW1SPCG1AB "亞培"高鐸格超核心血管導線"ABBOTT"HI-TORQUE SUPRA CORE 35
GUIDE WIRE 0.035" 145CM,190CM
779
CGDW1SPCG3AB "亞培"高鐸格超核心血管導線"ABBOTT"HI-TORQUE SUPRA CORE 35
GUIDE WIRE 0.035" 300CM
923
CGDW1SUPERG6 'AGA' AMPLATZER GUIDE WIRE (ASD OCCLUDER 用)※適應症請見
備註欄
1600
CGDW1THSF1CK GUIDE WIRE STAINLESS STEEL TFE COATING 0.035";0.038"
260CM
437
CGDW1TSF01CK "曲克"導線 "COOK" GUIDE WIRE STAINLESS TEFLON-COATED
0.018~0.038"145;180CM
313
CGDW1TSM01CK MOVABLE CORE STRAIGHT SAFELY GUIDE WIRE 安全導線
100,145CM(90/10/1產品型號 TSM-32:38-80另編代碼)
313
CGDW1TSM0ACK MOVABLE CORE STRAIGHT SAFETY GUIDE WIRE 80CM 277
CGDW1UA35BAS "朝日"優你客血管造影導線"ASAHI" UNIQUAL ANGIOGRAPHIC
GUIDE WIRE 0.035" 50-80CM
653
CGDW1UJAJNAS ASAHI UNIQUAL ANGIOGRAPHIC GUIDE WIRE 0.025":0.038"
150CM:200CM
751
CGDW1UJBESAS ASAHI UNIQUAL ANGIOGRAPHIC GUIDE WIRE 0.025":0.038"
220CM:300CM
1359
CGDW1USAJNAS ASAHI UNIQUAL ANGIOGRAPHIC GUIDE WIRE 0.025":0.038"
150CM:200CM
751
CGDW1USBESAS ASAHI UNIQUAL ANGIOGRAPHIC GUIDE WIRE 0.025":0.038"
220CM:300CM
1359
CGDW1USUJ3AS "朝日"優你客血管造影導線"ASAHI" UNIQUAL ANGIOGRAPHIC
GUIDE WIRE 0.035" 220CM~300CM
1359
CGDW1USUJBAS "朝日"優你客血管造影導線"ASAHI" UNIQUAL ANGIOGRAPHIC
GUIDE WIRE 0..35" 150CM~200CM
751
CGDW1Z1P26SB ZIPWIRE HYDROPHILIC GUIDE WIRE STIFF/STANDARD
0.025",0.035",0.038" 260CM 利博親水性導線
1359
CGDW1ZSD58SB ZIPWIRE HYDROPHILIC GUIDE WIRE 0.025",0.035",0.038"
150CM,180CM 利博親水性導線
751
CGDW1ZSF58SB ZIPWIRE HYDROPHILIC GUIDE WIRE STIFF 0.025",0.035",0.038"
150CM,180CM 利博親水性導線
779
CGDW1ZSF80SB ZIPWIRE HYDROPHILIC GUIDE WIRE STIFF 0.035",0.038" 80CM
利博親水性導線
779
CGPG11001NAC VIKING CORONARY GUIDING CATHETER 6:10FR※自92.7.1改按條支
付
1744
CGPG11006NAC VIKING CORONARY GUIDING CATHETER*自92.7.1改按條支付 1744
CGPG110264SB MACH 1 PERIPHERAL GUIDING CATHETER 6:8F 55,90CM 1744
CGPG118084ZF "史特勞斯"區克斯極緻/選擇支撐導管(直線
型)"SPECTRANETICS"QUICK-CROSS EXTREME/SELECT SUPPORT
CATHETERS
8715
773
特材代碼 中英文名稱 支付點數-104/01/01
CGPG118085ZF "史特勞斯"區克斯極緻/選擇支撐導管(角度
型)"SPECTRANETICS"QUICK-CROSS EXTREME/SELECT SUPPORT
CATHETERS
8715
CGPG134356SB "波士頓科技"馬克導引導管"BOSTON SCIENTIFIC"MACH 1 GUIDE
CATHETER 6:8FR
1744
CGPG138969SB RUNWAY GUIDE CATHETER 6FR 1744
CGPG151038ZF "史特勞斯"區克斯導管"SPECTRANETICS"QUICK-CROSS SUPPORT2
CATHETERS
8715
CGPG15565FCD VISTABRITETIP GUIDING CATHETERS 5F 0.056(ALL CURVE STYLE)
*自92.7.1改按條支付
1744
CGPG1574XNCD VISTABRITETIP GUIDING CATHETER 7FR 0.074",0.078"※自
92.7.1改按條支付
1744
CGPG1586XNCD "CORDIS"VISTABRITETIP GUIDING CATHETER 8FR 0.086",0.088""
考迪斯"導引導管※自92.7.1改按條支付
1744
CGPG158882CD VISTA BRITE TIP GUIDING CATHETER 8FR 0.088 *自92.7.1改按
條支付(型號5888200:2自92/7/1生效)
1744
CGPG15888FCD PERIPHERAL GUIDING CATHETER 8FR 0.088※自92.7.1改按條支付 1744
CGPG159892CD VISTA BRITE TIP GUIDING CATHETER 9FR 0.098 *自92.7.1改按
條支付(型號5989200:2自92/7/1生效)
1744
CGPG15989FCD PERIPHERAL GUIDING CATHETER 9FR 0.098※自92.7.1改按條支付 1744
CGPG16676FCD VISTABRITEIP GUIDING CATHETER 6FR 0.67(ALL CURVE STYLE)※
自92.7.1改按條支付
1744
CGPG16706FCD "CORDIS"VISTABRITETIP GUIDING CATHETERS 6FR .070"考迪斯"
導引導管※(自92/7/1改按條支付)
1744
CGPG17787FCD VISTABRITETIP GUIDING CATHETERS 7F 0.078(ALL CURVE STYLE)
*自92.7.1改按條支付
1744
CGPG1AB035BQ GUIDING CATHETER 1744
CGPG1AB131BQ GUIDING CATHETER 1744
CGPG1AB234BQ GUIDING CATHETER 1744
CGPG1CA031BQ GUIDING CATHETER 1744
CGPG1CA131BQ GUIDING CATHETER 1744
CGPG1CA214BQ GUIDING CATHETER 1744
CGPG1CAS31BQ GUIDING CATHETER 1744
CGPG1CGC58MR "MERIT" CONCIERGE GUIDING CATHETER(5~8F)"美瑞特"康捷導引
導管
1744
CGPG1CNCRGMR "MERIT" CONCIERGE GUIDING CATHETER(5~8F)"美瑞特"康捷導引
導管
1744
CGPG1CNVEYSB "波士頓科技"康必導引導管"BOSTON SCIENTIFIC"CONVEY GUIDING
CATHETER 5FR
1744
CGPG1CX101CK CXI SUPPORT CATHETER(含4個不透線標記)西斯艾支持導管 8715
CGPG1CX102CK CXI SUPPORT CATHETER(含4個不透射線標記)西斯艾支持導管 8715
CGPG1CXC01CK "COOK" CROSSCATH SUPPORT CATHETER (單腔含3個探
頭)3.0~4.8FR 90~150CM"曲克" 庫斯凱支持導管
8715
CGPG1GCF60TM HEARTRAIL PTCA GUIDING CATHETER 5:8FR 100CM 哈得睿兒導引
導管
1744
CGPG1GCF70TM HEARTRAIL PTCA GUIDING CATHETER 5:8FR 100CM 哈得睿兒導引
導管
1744
CGPG1GCF90TM HEARTRAIL II PTCA GUIDING CATHETER哈得睿兒導引導管第二代 1744
CGPG1GCH60TM "泰爾茂"哈得睿兒導引導管"TERUMO"HEARTRAIL PTCA GUIDING
CATHETER STANDARD TYPE 5:8FR
1744
774
特材代碼 中英文名稱 支付點數-104/01/01
CGPG1JLJRAAS "ASAHI" ZENYTEEX PTCA GUIDING CATHETER "朝日"辛尼堤經皮冠
狀動脈成型術導引導管
1744
CGPG1KMF4AKE CRUSADE CORONARY ANGIOPLASTY CATHETER 2 LUMEN 140CM
3.2FR(冠狀動脈成型術探測導管)
8951
CGPG1LA006M4 "美敦力"浪曲導引導管"MEDTRONIC"LAUNCHER GUIDE CATHETERS
6FR
1744
CGPG1LA501M4 "美敦力"浪曲導引導管"MEDTRONIC"LAUNCHER GUIDE CATHETERS
5FR
1744
CGPG1LA502M4 "美敦力"浪曲導引導管"MEDTRONIC"LAUNCHER GUIDE CATHETERS
5FR
1744
CGPG1LA701M4 "美敦力"浪曲導引導管"MEDTRONIC"LAUNCHER GUIDE CATHETERS
7FR
1744
CGPG1LA702M4 LAUNCHER GUIDE CATHETER 7FR 1744
CGPG1LA801M4 "美敦力"浪曲導引導管"MEDTRONIC"LAUNCHER GUIDE CATHETERS
8FR
1744
CGPG1LA802M4 LAUNCHER GUIDE CATHETER 8FR 1744
CGPG1MSC57VS MINNIE SUPPORT CATHETER(含3個探頭) 8715
CGPG1PBSMPAS "ASAHI" ZENYTEEX PTCA GUIDING CATHETER "朝日"辛尼堤經皮冠
狀動脈成型術導引導管
1744
CGPG1SC014Y7 "伊維三"崔爾巴特支持導管"EV3"TRAILBLAZER SUPPORT CATHETER 8715
CGPG1SCBR1CK SLIP-CATH GUIDING CATHETERS 4.0FR 40:150CM 1744
CGPG1SCBR2CK SLIP-CATH GUIDING CATHETERS 4.5:6.5FR 75:135CM 1744
CGPG1SCBR3CK SLIP-CATH GUIDING CATHETERS 5.0FR 40:125CM 1744
CGPG1SCBR4CK SLIP-CATH GUIDING CATHETERS 5.0FR 65:90CM 1744
CGPG1SELE2M4 "美敦力"艾坦賽勒傳送導管系統"MEDTRONIC"ATTAIN SELECT II
DELIVERY CATHETER SYSTEM
1744
CGPG1SHA01M4 SHERPA NX ACTIVE GUIDE CATHETERS 5:6F 1744
CGPG1SHA02M4 SHERPA NX ACTIVE GUIDE CATHETERS 5:6F 1744
CGPG1SHA03M4 "MEDTRONIC"SHERPA NX ACTIVE GUIDE CATHETERS 5:6F"美敦力"
雪爾帕導引導管
1744
CGPG1SHB01M4 SHERPA NX BALANCED GUIDE CATHETERS 6:8F 1744
CGPG1SHB02M4 SHERPA NX BALANCED GUIDE CATHETERS 6:8F 1744
CGPG1SHB03M4 "MEDTRONIC"SHERPA NX BALANCED GUIDE CATHETERS 6:8F"美敦
力"雪爾帕導引導管
1744
CGPG1SW510VS SKYWAY SUPPORT CATHETER 0.014" 138CM(多功能) 8715
CGPG2CFLNRVS 〝VASCULAR SOLUTIONS〞GUIDELINER CATHETER "法斯樂舒順"冠
連導管※適應症請見備註欄
18617
CGPG2GDLV2VS "法斯樂舒順"第2代冠連導管"VASCULAR SOLUTIONS"GUIDELINER
V2 CATHETER※給付規定請見備註欄
18617
CGPG338942SB "BOSTON SCIENTIFIC"ATLANTIS SR CORONARY IMAGING CATHETER
W/SLED"波士頓"亞蘭提斯冠狀動脈攝影導管-血管內超音波導管及
橇型板※適應症請見備註欄
20480
CGPG385900VQ "VOLCANO"EAGLE EYE F/X 2.9F INTRAVASCULAR ULTRASOUND
IMAGING CATHETER"火山"血管內超音波影像導管(彩色)※給付規
定請見備註欄
20480
CGPG38590PVQ "VOLCANO"EAGLE EYE PLATINUM DIGITAL IVUS CATHETER"火山"數
位式血管內超音波影像導管(彩色)※給付規定請見備註欄
20480
CGPG389000VQ "VOLCANO"REVOLUTION ROTATIONAL IVUS IMAGING CATHETER"火
山"血管內超音波影像導管※給付規定請見備註欄
20480
CGPW10462HAB HI-TORQUE BALANCE HEAVY WEIGHT GUIDE WIRE PTFE SUPPORT
0.014" 190CM
2817
CGPW10463HAB HI-TORQUE BALANCE HEAVY WEIGHT GUIDE WIRE PTFE SUPPORT
0.014" 300CM
2870
775
特材代碼 中英文名稱 支付點數-104/01/01
CGPW108001ST "聖猷達"海卓史蒂爾導引線"ST.JUDE"HYDROSTEER GUIDEWIRE
0.018" 150CM,180CM(鎳合金)
2430
CGPW11048NAB HI-TORQUE PILOT 150 200 GUIDE WIRE 0.014" 300CM 2870
CGPW112154SB CHOICE GUIDE WIRE 0.014" 300CM 2587
CGPW112160SB CHOICE GUIDE WIRE 0.014" 182CM 2353
CGPW112201SB "波士頓科技"凱耐帝斯導引線"BOSTON SCIENTIFIC"KINETIX
GUIDE WIRE PTFE 0.014" 185CM
2430
CGPW112202SB "波士頓科技"凱耐帝斯導引線"BOSTON SCIENTIFIC"KINETIX
GUIDE WIRE PTFE 0.014" 300CM
2587
CGPW114901SB PT GRAPHIX GUIDE WIRE 0.014" 182CM 2353
CGPW114913SB PT GRAPHIX GUIDE WIRE 0.014" 300CM 2587
CGPW11740NAB HI-TORQUE SUPER SUPPORT PTCA GUIDE WIRE 0.014" 190CM 2817
CGPW11741NAB HI-TORQUE ALL STAR PTCA GUIDE WIRE 0.014" 300CM 2870
CGPW11780NAB HI-TORQUE GUIDE WIRE EXTRA SUPPORT 190CM 2817
CGPW11782NAB HI-TORQUE GUIDE WIRE EXTRA SUPPORT 300CM 2870
CGPW11834HAB HI-TORQUE WHISPER EXTRA SUPPORT GUIDE WIRE 190CM 0.014" 2817
CGPW11835HAB HI-TORQUE WHISPER EXTRA SUPPORT GUIDE WIRE 300CM 0.014" 2870
CGPW118688TM RUNTHROUGH NS PTCA GUIDE WIRE W/PTFE 不鏽鋼 0.014" 150CM 2353
CGPW12224NAB HI-TORQUE EXTRE SUPPORT GUIDE WIRE 0.014" 190CM 2817
CGPW12234NAB HI-TORQUE EXTRA SUPPORT GUIDE WIRE 0.014" 300CM 2870
CGPW1223HNAB HI-TORQUE PTCA GUIDE WIRE W/HYDROCOAT 0.014" 190CM 2353
CGPW1223MNAB HI-TORQUE PTCA GUIDE WIRE W/MICROGLIDE COATING 0.014"
190CM
2353
CGPW128000AB HI-TORQUE GUIDE WIRE W/HYDROCOAT 0.014" 190CM EXTRA
SUPPORT
2817
CGPW128001AB HI-TORQUE GUIDE WIRE W/HYDROCOAT 0.014" 300CM EXTRA
SUPPORT
2870
CGPW13309NAB HI-TORQUE CROSS-IT PTCA GUIDE WIRE 0.014" 190CM 2353
CGPW13310NAB HI-TORQUE CROSS-IT PTCA GUIDE WIRE 0.014" 300CM 2587
CGPW1379MNAB HI-TORQUE PTCA GUIDE WIRE W/MICROGLIDE COATING 0.014"
300CM
2587
CGPW138931SB PT2 GUIDEWIRE HYDROPHILIC COATING 0.014" 185CM 2353
CGPW138932SB PT2 GUIDEWIRE HYDROPHILIC COATING 0.014" 300CM 2587
CGPW138950SB IQ GUIDE WIRE 0.014" 185CM 2353
CGPW138951SB IQ GUIDE WIRE 0.014" 300CM 2587
CGPW14181ATM RUNTHROUGH NS PTCA GUIDE WIRE 嵐鍶路導引導線 2353
CGPW1418FATM RUNTHROUGH NS PTCA GUIDE WIRE HYDROPHILLIC COATING 180CM
0.014"
2353
CGPW1418XATM "TERUMO"RUNTHROUGH PTCA GUIDE WIRE(0.014" 180CM
W/COATING)"泰爾茂"嵐鍶路導引導線
2430
CGPW143092AS "朝日"周邊血管導引線"ASAHI"PERIPHERAL GUIDEWIRE
0.014";0.018" 180CM;190CM
2430
CGPW1430RSTM PTCA GUIDE WIRE W/HYDROPHILIC COATING 0.014" 180:300CM 2353
CGPW143392AS "朝日"周邊血管導引線"ASAHI"PERIPHERAL GUIDEWIRE
0.014";0.018" 300CM
2800
CGPW144586AB "亞培"亥托克新輕巧型導管引線"Abbott"HI-TORQUE ADVANCE
LITE GUIDE WIRE W/HYDROCOAT HYDROPHILIC COATING 0.014"
190CM
2353
CGPW144587AB "亞培"亥托克新輕巧型導管引線"Abbott"HI-TORQUE ADVANCE
LITE GUIDE WIRE W/HYDROCOAT HYDROPHILIC COATING 0.014"
300CM
2587
CGPW144588AB HI-TORQUE ADVANCE GUIDE WIRE 190CM 0.014" 2353
CGPW144589AB HI-TORQUE ADVANCE GUIDE WIRE 300CM 0.014" 2587
776
特材代碼 中英文名稱 支付點數-104/01/01
CGPW146850SB V-18 CONTROL WIRE 0.018" 150-200CM W/HYDROPHILIC COATING 2781
CGPW146860SB V-18 CONTROL WIRE 0.018" 300CM W/HYDROPHILIC COATING 2800
CGPW1480P5AB HI-TORQUE PILOT 50 GUIDE WIRE 0.014" 190CM 2353
CGPW1483P5AB HI-TORQUE PILOT 50 GUIDE WIRE 0.014" 300CM 2587
CGPW148P15AB HI-TORQUE PILOT 150 200 GUIDE WIRE 0.014" 190CM 2817
CGPW149283SB THRUWAY GUIDEWIRE 0.018"*300CM 2800
CGPW1492TWSB THRUWAY GUIDEWIRE 0.018"*130,190CM 2781
CGPW15024XCD GUIDE WIRE TEFLON 0.018" 150CM;260CM 2430
CGPW1503XACD 0.018 SMALL VESSAL PERIPHERAL GUIDE WIRE 180CM 2430
CGPW1503XNCD 0.018 SMALL VESSEL PERIPHERAL GUIDE WIRE 300CM(90/10/1型
號503458,558,658,758-G刪除)
2800
CGPW15079ACD STEERABLE GUIDE WIRE 0.014" STRAIGHT TIP 3CM RADIOPAQUE
TIP 180CM
2353
CGPW15357NAB HI-TORQUE WHISPER GUIDE WIRE 0.014" 190CM 2353
CGPW15359NAB HI-TORQUE WHISPER GUIDE WIRE 0.14" 300CM 2587
CGPW1547XACD SHINOBI GUIDE WIRE 0.014" 180CM 2353
CGPW1547XNCD SHINOBI GUIDEWIRE 0.014 300CM (90/10/1原180CM規格另編碼) 2587
CGPW1595M0CD ATW STEERABLE GUIDEWIRE(MARKER WIRE)0.014" 195CM 2353
CGPW1595M1CD ATW STEERABLE GUIDEWIRE(MARKER WIRE)0.014" 300CM 2587
CGPW1595XACD ATW STEERABLE GUIDE WIRE 0.014" 195CM 2353
CGPW1595XNCD ATW STEERABLE GUIDEWIRE 300CM (90/10/1原型號595014,595-
J,X,Y,E-014另編碼)
2587
CGPW19660NAB HI-TORQUE GUIDE WIRE EXTRA SUPPORT 190CM 2817
CGPW19661NAB HI-TORQUE GUIDE WIRE EXTRA SUPPORT 300CM 2870
CGPW196646AB "Abbott"HI-TORQUE BALANCE MIDDLEWEIGHT UNIVERSAL II GUIDE
WIRE W/HYDROCOAT HYDROPHILIC COATING 0.014" 190CM
2353
CGPW196657AB "Abbott"HI-TORQUE BALANCE MIDDLEWEIGHT UNIVERSAL II GUIDE
WIRE W/HYDROCOAT HYDROPHILIC COATING 0.014" 300CM
2587
CGPW1ACUMMSB "波士頓科技"艾裘帝靜脈導線"BOSTON SCIENTIFIC"ACUITY
STRAIT-TRAK AND MAILMAN VENOUS GUIDE WIRES
2353
CGPW1ADDWRLR "大湖區"愛德延伸導線"LAKE REGION"ADDWIRE EXTENSION WIRE
0.014" 145CM
2353
CGPW1AG141AS PTCA GUIDE WIRE PTFE SOFT INTERMEDIATE 0.014 (自971001由
175CM改為180CM)
2353
CGPW1AG143AS PTCA GUIDE WIRE 0.014 STANDARD, STANDARD J,
EXTENSION(AG149000仍為150CM,其他型號自971001由175CM改為
180CM)
2353
CGPW1AG149AS "朝日"冠狀動脈延長導引線"ASAHI"PTCA GUIDE WIRE EXTENSION
PTFE 0.014" 150;165CM
2353
CGPW1AGH14AS NEO'S PTCA GUIDE WIRE EXTRA SUPPORT 0.014" (自971001由
175CM改為180CM)
2817
CGPW1AGH46AS "ASAHI"PTCA GUIDE WIRE EXTRA SUPPORT PTFE 0.014" 180CM "
朝日"冠狀動脈導引線
2817
CGPW1AGH47AS "ASAHI"PTCA GUIDE WIRE PTFE 0.014" 150CM;180CM "朝日"冠狀
動脈導引線
2353
CGPW1AGM46AS "ASAHI"PTCA GUIDE WIRE EXTRA SUPPORT PTFE 0.014" 180CM "
朝日"冠狀動脈導引線
2817
CGPW1AGM47AS "ASAHI"PTCA GUIDE WIRE PTFE 0.014" 150CM;180CM "朝日"冠狀
動脈導引線
2353
CGPW1AGP14AS PTCA GUIDE WIRE 0.014 EXTRA SUPPORT(自971001由175CM改為
180CM)
2817
777
特材代碼 中英文名稱 支付點數-104/01/01
CGPW1AGPFCAS PTCA GUIDE WIRE HYDROPHILIC COATING EXTRA SUPPORT 0.014"
175CM 180CM
2817
CGPW1AHWR3AS "ASAHI"PTCA GUIDE WIRE ASAHI SION 0.014" 300CM(PTFE
COATING EXTRA SUPPORT)"朝日"冠狀動脈導引線紫苑
2587
CGPW1AHWRSAS "ASAHI"PTCA GUIDE WIRE ASAHI SION 0.014" 180CM (PTFE
COATING EXTRA SUPPORT)"朝日"冠狀動脈導引線紫苑
2817
CGPW1B8611BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE HEAVY DUTY
STIFFNESS TIP 0.014" 180CM
2828
CGPW1B8612BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE HEAVY DUTY
STIFFNESS TIP 0.014" 300CM
2870
CGPW1BE611BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE 0.014" 180CM 2587
CGPW1BE612BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE 0.014" 300CM 2587
CGPW1BMWE3AB "ABBOTT"HI-TORQUE BALANCE MIDDLEWEIGHT ELITE GUIDE WIRE
HYDROPHILIC COATING 0.014" 300CM "亞培"高鐸格寶馬精英導線
2587
CGPW1BMWE9AB "ABBOTT"HI-TORQUE BALANCE MIDDLEWEIGHT ELITE GUIDE WIRE
HYDROPHILIC COATING 0.014" 190CM "亞培"高鐸格寶馬精英導線
2353
CGPW1CMW01CK APPROACH PRO LT MICRO WIRE GUIDE 0.014" 135CM,190CM 2828
CGPW1CMW02CK APPROACH PRO LT MICRO WIRE GUIDE 0.014" 300CM 2870
CGPW1CMW03CK APPROACH PRO LT MICRO WIRE GUIDE 0.018" 135CM;190CM 2828
CGPW1CMW04CK APPROACH PRO LT MICRO WIRE GUIDE 0.018" 300CM 2870
CGPW1CNGW1AB 亞培高鐸格聯康血管導線 ABBOTT HI-TORQUE CONNECT GUIDE
WIRE 0.018" PTFE 145;195CM
2430
CGPW1CNGW3AB 亞培高鐸格聯康血管導線 ABBOTT HI-TORQUE CONNECT GUIDE
WIRE 0.018" PTFE 300CM
2800
CGPW1CT190M4 WIRE WORK GUIDE WIRES 190CM 0.014" NITINOL HYDROPHILLIC
COATING
2587
CGPW1CT300M4 WIRE WORK GUIDE WIRES 300CM 0.014" NITINOL HYDROPHILLIC
TEFLON COATING
2587
CGPW1D0CNNAB "亞培"鐸格延長導線"Abbott"DOC GUIDE WIRE EXTENSION 0.014"
145CM
2353
CGPW1EEL14JV "日本來富恩" 艾斯利特伊爾導引線"JAPAN LIFELINE" ATHLETE
EEL PTCA GUIDE WIRE(冠狀動脈擴張導引線0.014,178CM直型)
2430
CGPW1HMW01CK APPROACH HYDRO ST MICRO WIRE GUIDE W/HYDROPHILIC COATING
親水性塗層微細導線0.014" 300CM
2587
CGPW1HMW02CK APPROACH HYDRO ST MICRO WIRE GUIDE W/HYDROPHILIC COATING
親水性塗層微細導線0.014" 135,190CM
2353
CGPW1HYBGWM4 "美敦力" 艾坦導引導線"MEDTRONIC" ATTAIN HYBRID GUIDE WIRE 2353
CGPW1JUN18SB "BOSTON SCIENTIFIC"JOURNEY GUIDEWIRE(W/HYDROCOAT 0.014"
185CM)"波士頓科技"哲尼導引線
2817
CGPW1JUN30SB "BOSTON SCIENTIFIC"JOURNEY GUIDEWIRE(W/HYDROCOAT 0.014"
300CM)"波士頓科技"哲尼導引線
2587
CGPW1LW26EMR "美瑞特"桂冠親水性導引導線"MERIT"LAUREATE HYDROPHILIC
GUIDE WIRE 0.035" 260CM EXCHANGE
2800
CGPW1LWS35MR "美瑞特"桂冠親水性導引導線"MERIT"LAUREATE HYDROPHILIC
GUIDE WIRE 0.035" 150;180CM
2781
CGPW1N6W19AB “亞培”第六代血栓防護盾系統-過濾輸送金屬絲“ABBOTT”
EMBOSHIELD NAV6 EMBOLIC PROTECTION SYSTEM-BAREWIRE 190CM
2353
CGPW1N6W31AB “亞培”第六代血栓防護盾系統-過濾輸送金屬絲“ABBOTT”
EMBOSHIELD NAV6 EMBOLIC PROTECTION SYSTEM-BAREWIRE 315CM
2587
778
特材代碼 中英文名稱 支付點數-104/01/01
CGPW1PAGH3AS PERIPHERIAL GUIDE WIRE 0.018" 300CM 2800
CGPW1PAGHSAS PERIPHERIAL GUIDE WIRE 0.018" 180CM 2430
CGPW1PAGP3AS PERIPHERIAL GUIDE WIRE 0.014" 300CM 2800
CGPW1PAGPSAS PERIPHERIAL GUIDE WIRE 0.014" 180CM 2430
CGPW1PRGW3AB ABBOTT HI-TORQUE PROGRESS GUIDE WIRE 0.014" 300CM 亞培博
格斯血管導線
2587
CGPW1PRGW9AB ABBOTT HI-TORQUE PROGRESS GUIDE WIRE 0.014" 190CM 亞培博
格斯血管導線
2353
CGPW1PS180M4 WIRE WORK GUIDE WIRE W/COATING HYDRO-TRACK,PRO/PEL 180CM
0.014"沃爾沃克導引導線
2353
CGPW1PS300M4 WIRE WORK GUIDE WIRE W/COATING HYDRO-TRACK,PRO/PEL 300CM
0.014"沃爾沃克導引導線
2587
CGPW1PTGW3AB "ABBOTT"HI-TORQUE POWERTURN GUIDE WIRE HYDROPHILIC
COATING 0.014" 300CM "亞培"高鐸格寶特導線
2587
CGPW1PTGW9AB "ABBOTT"HI-TORQUE POWERTURN GUIDE WIRE HYDROPHILIC
COATING 0.014" 190CM "亞培"高鐸格寶特導線
2353
CGPW1PV1A1M4 "MEDTRONIC"PROVIA/INTUITION GUIDE WIRE W/COATING HYDRO-
TRACK,PRO/PEL 180CM 0.014" "美敦力"波維亞/英特迅導引導線
2353
CGPW1PV1A2M4 "MEDTRONIC"PROVIA/INTUITION GUIDE WIRE W/COATING HYDRO-
TRACK,PRO/PEL 300CM 0.014" "美敦力"波維亞/英特迅導引導線
2587
CGPW1PV1A3M4 "MEDTRONIC"PROVIA/INTUITION GUIDE WIRE W/COATING HYDRO-
TRACK,PRO/PEL EXTRA SUPPORT 180CM 0.014" "美敦力"波維亞/
英特迅導引導線
2817
CGPW1RSTF0CK ROADRUNNER EXTRA-SUPPORT WIRE GUIDES 180,270,300CM 2817
CGPW1SK1P1F2 "INVATEC"SKIPPER DEEP GUIDE WIRE W/COATING
0.014"250CM;300CM"英泰克"賽艇帝普導引導絲
2587
CGPW1SK1P2F2 "INVATEC"SKIPPER DEEP GUIDE WIRE W/COATING 0.014"195CM"英
泰克"賽艇帝普導引導絲
2817
CGPW1SN18JAS "朝日"冠狀動脈導引線紫苑"ASAHI"PTCA GUIDE WIRE ASAHI SION
0.014"180CM HYDROPHILIC EXTRA SUPPORT
2817
CGPW1TH491SB THRUWAY GUIDEWIRE PTFE EXTRA SUPPORT 0.014" 130,190CM 2817
CGPW1TH492SB THRUWAY GUIDEWIRE PTFE 0.014" 300CM 2587
CGPW1THDR1M4 WIRE WORK GUIDE WIRES 190CM 0.014" STAINLESS STEEL
TEFLON(PRO/PEL) COATING EXTRA SUPPORT
2817
CGPW1V1430SB "BOSTON SCIENTIFIC" V14 CONTROLWIRE GUIDEWIRE 0.014"
300CM "波士頓科技"康卓導引線
2870
CGPW1V1482SB "BOSTON SCIENTIFIC" V14 CONTROLWIRE GUIDEWIRE 0.014"
182CM "波士頓科技"康卓導引線
2817
CGPW1VGW19SB "波士頓科技"勝利導線"BOSTON SCIENTIFIC"VICTORY
GUIDEWIRE(PERIPHERAL) PTFE 0.014";0.018" 195CM
2430
CGPW1VGW30SB "波士頓科技"勝利導線"BOSTON SCIENTIFIC"VICTORY
GUIDEWIRE(PERIPHERAL) PTFE 0.014";0.018" 300CM
2800
CGPW1WNGW3AB "亞培"高鐸格威恩血管導線"ABBOTT"HI-TORQUE WINN GUIDE WIRE
0.014" 300CM
2587
CGPW1WNGW9AB "亞培"高鐸格威恩血管導線"ABBOTT"HI-TORQUE WINN GUIDE WIRE
0.014" 190CM
2353
CGPW1ZH180M4 WIRE WORK GUIDE WIRES 180CM 0.014" STAINLESS STEEL
HYDROPHILLIC COATING
2353
CGPW1ZH300M4 WIRE WORK GUIDE WIRES 300CM 0.014" STAINLESS STEEL
HYDROPHILLIC COATING
2587
CGS0100011VE PERCUTANEOUS CATHETER INTRODUCERS W/DILATOR,GUIDEWIRE
11CM 5:9FR
583
779
特材代碼 中英文名稱 支付點數-104/01/01
CGS0100023VE PERCUTANEOUS CATHETER INTRODUCERS W/DILATOR 23CM 6:9FR 887
CGS0100412K0 ANGIOGATE HV INTRODUCER KIT 12CM (S+D+GW+3WAY+SI) 583
CGS0101200AR HI-FLOW TRUAMA SET 700
CGS010511MCD "考迪斯"皮膜鞘導引器"CORDIS"BRITE TIP INTERVENTIONAL
SHEATH 5.5;
11CM(DILATOR+SIDEARM+VALVE+GUIDEWIRE+3WAY+RADIOPAQUE
BRITETIP)
820
CGS010512TK0 ANGIOGATE TRANSRADIAL INTRODUCER KIT 12CM
(S+D+N+GW+3WAY+SI)
715
CGS010519TK0 ANGIOGATE TRANSRADIAL INTRODUCER KIT 19CM,24CM
(S+D+N+GW+3WAY+SI)
1067
CGS010601NBA "BARD"PTFE PEEL-APART PERCUTANEOUS INTRODUCER KITS"巴德"
剝撕式經皮導引套組
864
CGS010610NST "聖猷達"費思凱斯導管導引器"SJM"FAST-CATH HEMOSTASIS
INTRODUCER 12CM(S+D+SV+GW+SY+N+保護套)
875
CGS0106249ST "聖猷達"麥克斯導管導引器"SJM"MAXIMUM HEMOSTASIS
INTRODUCER 12CM 4:9FR 0.025:0.038"(W/S+D+V+G.W+SI)
583
CGS0106255ST "聖猷達"麥克斯導管導引器"SJM"MAXIMUM HEMOSTASIS
INTRODUCER 8.5CM 4:7FR
0.021:0.025"(W/SHEATH+DILATOR+VALVE+G.W+SIDEPORT)
583
CGS0106351ST "聖猷達"麥克斯導管導引器"SJM"MAXIMUM HEMOSTASIS
INTRODUCER 5CM 4:6FR
0.021"(W/SHEATH+DILATOR+VALVE+G.W+SIDEPORT)
583
CGS010658NBA "BARD"PTFE PEEL-APART PERCUTANEOUS INTRODUCER
KITS"(MICROINTRODUCER)巴德"剝撕式經皮導引套組
864
CGS0106660ST "聖猷達"麥克斯導管導引器"SJM"MAXIMUM HEMOSTASIS
INTRODUCER 23CM 5:8FR 0.038"(W/S+D+G.W+SI+V+N)
1067
CGS0106667ST "聖猷達"麥克斯導管導引器"SJM"MAXIMUM HEMOSTASIS
INTRODUCER 12CM
715
CGS0106668ST "聖猷達"麥克斯導管導引器"SJM"MAXIMUM HEMOSTASIS
INTRODUCER 23CM
1067
CGS010674NST "聖猷達"費思凱斯導管導引器"SJM"FAST-CATH HEMOSTASIS
INTRODUCERS 45CM 30度(S+D+SV+3WAY)
1400
CGS0107688ST "聖猷達"雅帝明導管導引器"SJM"ULTIMUM INTRODUCER WITH
HEMOSTASIS VALVE( 35CM 16FR 0.035"
W/SHEATH+DILATOR+GW+SIDEPORT+VALVE)
977
CGS010768NST "聖猷達"雅帝明導管導引器"SJM"ULTIMUM INTRODUCER WITH
HEMOSTASIS VALVE( 30CM 14:20FR 0.035"
W/SHEATH+DILATOR+GW+SIDEPORT+VALVE)
977
CGS0107691ST "聖猷達"雅帝明導管導引器"SJM"ULTIMUM INTRODUCER WITH
HEMOSTASIS VALVE(25CM 22FR 0.035" W/SHEATH+
DILATOR+GW+SIDEPORT+VALVE)
977
CGS0107830ST "聖猷達"雅帝明導管導引器"SJM"ULTIMUM INTRODUCER SET
(S+H+V+G+SIDEPORT)
583
CGS0107835ST "聖猷達"雅帝明導管導引器"SJM"ULTIMUM INTRODUCER SET 8.5CM
W/HEMOSTASIS VALVE(S+H+V+G+SIDEPORT)
583
CGS0107840ST "聖猷達"雅帝明導管導引器"SJM"ULTIMUM INTRODUCER
SETW/HEMOSTASIS VALVE 12CM (S+H+V+G+SIDEPORT)
583
CGS0107851ST "聖猷達"雅帝明導管導引器"SJM"ULTIMUM INTRODUCER SET
W/HEMOSTASIS VALVE 23CM (S+H+V+G+SIDEPORT)
977
CGS0108403AR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM 4FR X 7.5CM
(S+D+GW+SV+3WAY+N)“亞諾”經皮導引鞘組
790
780
特材代碼 中英文名稱 支付點數-104/01/01
CGS0108503AR "ARROW"PERCUTANEOUS SHEATH WITH SPRING WIRE GUIDE(
S+D+G+SV+3 WAY)4:6FR 7.5CM;5:9FR 11CM"亞諾"經皮導引鞘組
583
CGS0108530VE MULLINS TRANSSEPTAL INTRODUCER SET PRDIATRIC 44CM 6:8FR 1400
CGS0108550VE MULLINS TRANSSEPTAL INTRODUCER SET AUDLT 59CM 6:8FR 1400
CGS0109600AR PERCUTANEOUS INTRODUCER SYSTEM KIT 6FR 11CM 875
CGS0109803AR PERCUTANEOUS INTRODUCER SYSTEM KIT
8FR(SHE+DIL+SIDEPORT+G.W+NE+一般空針)
715
CGS0109808AR PERCUTANEOUS INTRODUCER SYSTEM KIT 8FR 11CM 875
CGS0109870AR PERCUTANEOUS SHEATH INTRODUCER SET 8.5FR 875
CGS011101AVE PERCUTANEOUS CATHETER INTRODUCERS 11CM(5F:9F),WITH
DILATOR, GUIDE WIRE
583
CGS0111A00BQ "邦特"導引鞘"BIOTEQ" SHEATH INTRODUCER KIT 5:14CM 4:9FR
WITHOUT GUIDEWIRE
470
CGS0111A10BQ "邦特"導引鞘"BIOTEQ" SHEATH INTRODUCER KIT 5:14CM 4:9FR
(S+D+GW+V+SIDEPORT+3WAY)
583
CGS0111A13BQ "邦特"導引鞘"BIOTEQ" SHEATH INTRODUCER KIT 5:14CM 4:9FR
(S+D+GW+V+SIDEPORT+3WAY+N+SYRINGE)
790
CGS0111A16BQ "邦特"導引鞘"BIOTEQ" SHEATH INTRODUCER KIT 5:14CM 4:9FR
(S+D+GW+V+SIDEPORT+3WAY+N)
715
CGS0111B00BQ "邦特"導引鞘"BIOTEQ" SHEATH INTRODUCER KIT 16:35CM 4:9FR
(S+D+V+SIDEPORT+3WAY)
887
CGS0111B10BQ "邦特"導引鞘"BIOTEQ" SHEATH INTRODUCER KIT 16:35CM 4:9FR
(S+D+V+GW+SIDEPORT+3WAY)
977
CGS0111B16BQ "邦特"導引鞘"BIOTEQ" SHEATH INTRODUCER KIT 16:35CM 4:9FR
(S+D+V+GW+SIDEPORT+3WAY+N)
1067
CGS0113059ED INTRO-FLEX PERCUTANEOUS SHEATH INTRODUCER SET 10CM(S+SV+4
WAY+D+GW+N+保護套)
875
CGS011389HED INTRO-FLEX PERCUTANEOUS SHEATH INTRODUCER SET 10CM
W/COATING(S+SV+4 WAY+D+GW+N+保護套)
875
CGS01200392C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM-9 FR PEEL-AWAY SHEATH
INTRODUCER KIT
864
CGS01200892C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM -7 FR PEEL-AWAY SHEATH
INTRODUCER KIT
864
CGS0121322ST FAST-CATH HEMOSTASIS INTRODUCER 費思凱絲止血導管導引器 583
CGS012335MCD "考迪斯"皮膜鞘導引器"CORDIS"BRITE TIP INTERVENTIONAL
SHEATH 23;35CM(DILATOR+SIDEARM+VALVE+3WAY+RADIOPAQUE
BRITETIP)
887
CGS0130085ED INTRO-FLEX PERCUTANEOUS SHEATH INTRODUCER SET 8.5FR
10CM(S+D+SI+V+GW+N+保護套+SY)
875
CGS0130185ED INTRO-FLEX PERCUTANEOUS SHEATH INTRODUCER SET AMC COATED
8.5FR 10CM(S+D+SI+V+GW+N+保護套)
875
CGS0130484BB INTRODUCER KIT,7F,9F,11F *適應症請見備註欄 864
CGS0135023BK "百多力"思考導線引入裝置系統"BIOTRONIK"SCOUTPRO CORONARY
SINUS LEAD DELIVERY SYSTEM*適應症請見備註欄
6528
CGS0140009AG P.T.C.A LONG SHEATH 23CM 887
CGS01402ANCD AVANTI PLUS SHEATH INTRODUCER 11CM(4:11FR WITHOUT
GUIDEWIRE)
470
CGS01402RNCD AVANTI PLUS SHEATH INTRODUCER 5CM(4:8FR WITHOUT
GUIDEWIRE)
470
CGS014065NST "聖猷達"麥克斯導管導引器"SJM" MAXIMUM HEMOSTASIS
INTRODUCER
835
781
特材代碼 中英文名稱 支付點數-104/01/01
CGS0140764ST ULTIMUM INTRODUCER WITH HEMOSTASIS VALVE) SHEATH;
DILATOR;HEMOSTASIS VALVE;GUIDEWIRE; SIDEPORT ( 3WAY)
12CM 0.035"
583
CGS0140765ST ULTIMUM INTRODUCER WITH HEMOSTASIS VALVE) SHEATH;
DILATOR;HEMOSTASIS VALVE;GUIDEWIRE; SIDEPORT ( 3WAY)
23CM 0.035"
977
CGS014076NST ULTIMUM INTRODUCER WITH HEMOSTASIS VALVE) SHEATH;
DILATOR;HEMOSTASIS VALVE;GUIDEWIRE; SIDEPORT ( 3WAY)
5CM 0.035"
583
CGS0141040K0 "KIMAL"ANGIOGATE INTRODUCER KIT(0.018"NITINOL
GUIDEWIRE+4FR 5FR+21G NEEDLE)"期茂"導引鞘組:微型導引器組
1661
CGS0141060K0 "KIMAL"ANGIOGATE INTRODUCER KIT(0.018"NITINOL
GUIDEWIRE+4FR 5FR+21G NEEDLE)"期茂"導引鞘組:微型導引器組
1661
CGS01440042C "柯惠"肯特利慢性血液透析導管"COVIDIEN"KENDALL CHRONIC
HEMODIALYSIS CATHETERS-PULL-APART INTRODUCER
SET(10,12,14,16FR)(C+D+GW+N+SY)
864
CGS01440132C "柯惠"肯特利慢性血液透析導管"COVIDIEN"KENDALL CHRONIC
HEMODIALYSIS CATHETERS-OVAL PULL-APART INTRODUCER
SET(PEEL-AWAY)(SH+DIL+GW+SYR+NE)
864
CGS014555MCD "考迪斯"皮膜鞘導引器"CORDIS"BRITE TIP INTERVENTIONAL
SHEATH 45;55CM(DILATOR+SIDEARM+VALVE+3WAY+RADIOPAQUE
BRITETIP)
1400
CGS0146005AG SHEATH INTRODUCER 5:9FR 583
CGS0146064AG PEDIATRIC INTRODUCER KIT(SHEATH+DILATOR+GUIDE WIRE) 583
CGS0146070AG SHEATH INTRODUCER 583
CGS0146131AG ONE PIECE TUOHY-BORST INTRODUCER 5:9FR(INTRODUCER+GUIDE
WIRE+DILATOR)
583
CGS0146132AG INTRODUCER KIT 583
CGS0146133AG SHEATH INTRODUCER 7FR 583
CGS0146134AG SHEATH INTRODUCER 8FR 583
CGS0146151AG INTRODUCER KIT(SHEATH,DILATOR,SIDE PORT,3 WAY,GUIDE WIRE) 583
CGS0150461CD AVANTI PLUS CATHETER SHEATH INTRODUCER TRANSRADIAL KIT
11CM
835
CGS0150462CD AVANTI PLUS CATHETER SHEATH INTRODUCER TRANSRADIAL KIT
23CM
1262
CGS01504PNCD AVANTI PLUS SHEATH INTRODUCER 5CM(4:8FR WITH
GUIDEWIRE,DILATOR)
583
CGS01504TNCD AVANTI PLUS SHEATH INTRODUCER 23CM(4:11FR WITHOUT
GUIDEWIRE)
887
CGS01504XNCD AVANTI PLUS SHEATH INTRODUCER 11CM(4:11FR WITH
GUIDEWIRE,DILATOR)
583
CGS0150562CD "考迪斯"雷帝索經橈骨皮膜鞘導引器"CORDIS" RADIALSOURCE
TRANSRADIAL ACCESS KIT 4~6FR 20CM
1363
CGS015056XCD "考迪斯"雷帝索經橈骨皮膜鞘導引器"CORDIS" RADIALSOURCE
TRANSRADIAL ACCESS KIT 4~6FR 6.5;10CM
902
CGS0158F38MR "美瑞特"動脈導引鞘"MERIT"PRELUDE SHEATH INTRODUCER 583
CGS016014NDV HICKMAN INTRODUCER 864
CGS016031NBA INTRO-EZE PERCUTANEOUS INTRODUCER KIT 5:15FR
10:16CM(SH+DI+GW+SY+N)
864
CGS016207DM4 DUAL CHAMBER PERCUTANEOUS LEAD INTRODUCER
60CM(2SH+2D+2GW+N+SY)
1198
782
特材代碼 中英文名稱 支付點數-104/01/01
CGS016207NM4 PERCUTANEOUS LEAD INTRODUCER 60CM(SH+D+GW+N+SY) 864
CGS016207SM4 PERCUTANEOUS LEAD INTRODUCER 60CM(SH+D+GW+N+SY) 864
CGS0162BTKM4 PERCUTANEOUS LEAD INTRODUCER 60CM(SH+D+GW+N+SY) 864
CGS0167090GQ "葛貝可"可剝式導入管工具組"GREATBATCH" PTFE PEELABLE
INTRODUCER KIT(S+D+SY+N+G.W)
864
CGS016890MCD "考迪斯"皮膜鞘導引器"CORDIS"BRITE TIP INTERVENTIONAL
SHEATH 90CM(DILATOR+SIDEARM+VALVE+3WAY+RADIOPAQUE
BRITETIP)
2850
CGS0190703M0 "MEDCOMP"CENTRAL VENOUS CATHETERS AND
ACCESSORIES(PEELABLE INTRODUCER)(S+D+GW+N)"美德康"中央靜
脈導管與配件(剝式導管導引器)
864
CGS0193001GQ "葛貝可"帶閥撕裂式導引器"GREATBATCH" OPTISEAL VALVED PTFE
PEELABLE INTRODUCER (S+D+SY+N+G.W)
864
CGS01A1MDSST "SJM" CPS AIM SL SLITTABLE INNER CATHETER(CATHETER+SIDE
PORT+TOOL)"聖猷達"縱裂式內導管
1810
CGS01A1MWSST "SJM" CPS AIM SL SLITTABLE INNER CATHETER(
CATHETER+TOOL)"聖猷達"縱裂式內導管
1810
CGS01A40GNTM RADIOFOCUS INTRODUCER II 16CM 4:6FR WITH 0.025" GUIDE
WIRE
1262
CGS01A40K1TM RADIFOCUS INTRODUCER II 4FR
10CM(W/SHEATH,DILATOR,GUIDEWIRE,NEEDLE)
835
CGS01A40K2TM RADIFOCUS INTRODUCER II 4:11FR
25CM(W/SHEATH,DILATOR,GUIDEWIRE,NEEDLE)
1262
CGS01ACUBASB "波士頓科技"艾裘帝突破導線導管"BOSTON SCIENTIFIC"ACUITY
BREAK-AWAY GUIDE CATHETER(CATHETER+CUTTER+GW
INTRODUCER+TORQUE DEVICE+FINISH WIRE)
6528
CGS01AL191TM "泰爾茂"攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-
11FR,16;25CM
1262
CGS01APASDKH "奧斯卡"導管導引器"OSCOR"ADELANTE PEEL AWAY INTRODUCER
SET(SHEATH+DILATOR)
864
CGS01APK1TKH "奧斯卡"導管導引器"OSCOR"ADELANTE PEEL AWAY INTRODUCER
SET(SHEATH+DILATOR+GW+NEEDLE+SYRINGE)
864
CGS01APSHKH9 ANGIO PACK INTRODUCER SHEATH KIT(W/SH+GW+SI+N+V) 715
CGS01AS035TM "泰爾茂"攝影引導套(附針,針筒)"TERUMO"RADIFOCUS INTRODUCER
II(WITH NEEDLE/SYRINGE)
835
CGS01AS073TM "泰爾茂"血管攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-
11FR 7CM,10CM
835
CGS01AS091TM "泰爾茂"攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-
11FR,5-10CM
835
CGS01ATTANM4 “美敦力” 安坦左心室傳送系統“MEDTRONIC IRELAND” ATTAIN
LEFT-HEART DELIVERY SYSTEM*適應症請見備註欄
6528
CGS01ATTCSM4 "美敦力"艾坦左心室傳送系統"MEDTRONIC" ATTAIN COMMAND LEFT
HEART DELIVERY SYSTEM *適應症請見備註欄
6528
CGS01AVK11TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR 30-100MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線+針筒+導入針、SIDEARM、
W/VALVE)
835
CGS01AVK12TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR 30-100MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線+針筒+導入針、SIDEARM、
W/VALVE)
835
CGS01AVK13TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR 30-100MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線+針筒+導入針、SIDEARM、
W/VALVE)
835
783
特材代碼 中英文名稱 支付點數-104/01/01
CGS01AVK14TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR 30-100MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線+針筒+導入針、SIDEARM、
W/VALVE)
835
CGS01AVK21TM "TERUMO"RADIFOCUS INTRODUCER II(4-10FR 160-250MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線+針筒+導入針、SIDEARM、
W/VALVE)
1262
CGS01AVK22TM "TERUMO"RADIFOCUS INTRODUCER II(4-10FR 160-250MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線+針筒+導入針、SIDEARM、
W/VALVE)
1262
CGS01B11MQTM RADIFOCUS INTRODUCER II 11FR 0.035"(GW+SH+SD)不含NEEDLE 820
CGS01B40G7TM RADIFOCUS INTRODUCER II 7CM 4:5FR 835
CGS01B50N1TM RADIFOCUS INTRODUCER II AND WIRE 10CM 5:11FR 835
CGS01B50N2TM RADIFOCUS INTRODUCER II 25CM 5:11FR AND WIRE 1098
CGS01BL073TM "泰爾茂"血管攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-
11FR 7CM,10CM
820
CGS01BL191TM "泰爾茂"攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-
11FR,25,40CM
1098
CGS01BL192TM "泰爾茂"攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-
11FR,16,25CM
1262
CGS01BS073TM "泰爾茂"血管攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-
11FR 25CM,40CM
1098
CGS01BS091TM "泰爾茂"攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-
11FR,7;10CM
820
CGS01BS092TM "泰爾茂"攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-
11FR,7;10CM
835
CGS01BVK11TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR 70-100MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線SIDEARM、W/VALVE)
820
CGS01BVK12TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR 70-100MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線SIDEARM、W/VALVE)
820
CGS01BVK13TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR 70-100MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線SIDEARM、W/VALVE)
820
CGS01BVK14TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR 70-100MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線SIDEARM、W/VALVE)
820
CGS01BVK21TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR 160-250MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線SIDEARM、W/VALVE)
1098
CGS01BVK22TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR 160-250MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線SIDEARM、W/VALVE)
1098
CGS01BVK23TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR 160-250MM)"泰爾茂"
血管攝影引導套(鞘+擴張器+導線SIDEARM、W/VALVE)
1098
CGS01BVK31TM "TERUMO"RADIFOCUS INTRODUCER II(7FR 450MM)"泰爾茂"血管攝
影引導套(鞘+擴張器+導線SIDEARM、W/VALVE)
1400
CGS01C407NST ULTIMUM INTRODUCER WITH HEMOSTASIS VALVE(SHEATH;
DILATOR;HEMOSTASIS VALVE;GUIDEWIRE;NEEDLE)12CM
TRANSRADIAL KITS
835
CGS01C4852ST "SJM"ENGAGE ENGAGE TR INTRODUCER (FEMORAL)25CM
0.035"0.038"(SH+DIL+VALVE+GUIDE WIRE+SIDEPORT 3WAY)"聖猷
達"茵給桔導管導引器
977
CGS01C485NST "SJM"ENGAGE ENGAGE TR INTRODUCER (FEMORAL)12CM
0.035"0.038"(SH+DIL+VALVE+GUIDE WIRE+SIDEPORT 3WAY)"聖猷
達"茵給桔導管導引器
583
CGS01CL711AR "亞諾"經皮導引鞘組(可彎折式)"ARROW"PERCUTANEOUS SHEATH
INTRODUCER SYSTEM(SUPER ARROW KINK-RESISTANT)5:10FR
11CM(S+D+SIDEARM+V+3WAY)
966
784
特材代碼 中英文名稱 支付點數-104/01/01
CGS01CL724AR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM (SUPER
ARROW-FLEX NON-KINKING)5:10FR 24CM“亞諾”經皮導引鞘組(可
彎折式)
1470
CGS01CL735AR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM (SUPER
FLEX)35CM(S+D+SV+3 AWY)“亞諾”經皮導引鞘組(可彎折式)
1470
CGS01CL745AR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM (SUPER
ARROW-FLEX NON-KINKING)5:8FR,10FR 45CM“亞諾”經皮導引鞘
組(可彎折式)
2780
CGS01CL765AR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM (SUPER
ARROW-FLEX NON-KINKING) 6,7,9,10FR 65CM“亞諾”經皮導引鞘
組(可彎折式)
3000
CGS01CL775AR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM(SUPER FLEX)
65:100CM(S+D+SV+3 AWY)“亞諾”經皮導引鞘組(可彎折式)
3000
CGS01CP711AR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM(SUPER ARROW-
FLEX NON-KINKING)5:10FR 11CM“亞諾”經皮導引鞘組(可彎折
式)
1094
CGS01CPSAMST "聖猷達"內導管"SJM" CPS AIM INNER CATHETER 1810
CGS01CPSDSST "SJM"CPS DIRECT SL II SLITTABLE OUTER GUIDE CATHETER "聖
猷達"縱裂式外導引導管(導管+擴張器+縱裂器(含導引絲)+止血閥
旁縱裂器)※適應症請見備註欄
6528
CGS01CPSPLST 縱裂式外導引導管 CPS DIRECT PL PEELABLE OUTER CATHETER(導
管+擴張器+止血閥接合器(含導引絲)+止血閥旁縱裂器)※適應症
請見備註欄
6528
CGS01CPSSLST 縱裂式外導引導管 CPS DIRECT SL OUTER CATHETER(導管+擴張器
+止血閥接合器(含導引絲)+止血閥旁縱裂器)※適應症請見備註欄
6528
CGS01CS11NYZ SUPERSHEATH INTRODUCER SET 11CM(SH+DI+GW+N+SI+V) 715
CGS01CS25NYZ SUPERSHEATH INTRODUCER SET 25CM(SH+DI+GW+N+SI+V) 1067
CGS01CW08NAR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM WITH CATH-
GARD 5:9FRX7.5,11CM (S+D+SV+GW+N+SY+3 WAY)“亞諾”經皮導
引鞘組
790
CGS01DUH25SB SUPER SHEATH INTRODUCER SHEATH 25CM 5-9FR 0.035",0.038"
(SHEATH+DILATOR+SIDEARM+VALVE,GUIDEWIRE)
977
CGS01EX124AG "愛琅"前引導組 "ARGON"PERCUTANEOUS SHEATH INTRODUCER KIT-
TRAY KITS 6:9FR(W/DILATOR,GUIDE WIRE,NEEDLE,保護套)
875
CGS01EX132AG "愛琅"前引導組 "ARGON"PERCUTANEOUS SHEATH INTRODUCER KIT-
LINK KITS 6:9FR(W/DILATOR,GUIDE WIRE,NEEDLE)
715
CGS01EX134AG "愛琅"前引導組 "ARGON"PERCUTANEOUS SHEATH INTRODUCER KIT-
POPULAR KITS 6:9FR(W/DILATOR,GUIDE WIRE,NEEDLE)
715
CGS01KCFN1CK "曲克"福來瑟橈動脈導入鞘組"COOK"FLEXOR RADIAL INTRODUCER
SHEATH SET 0.018" 5~7FR 7;13CM
902
CGS01KCFN2CK "曲克"福來瑟橈動脈導入鞘組"COOK"FLEXOR RADIAL INTRODUCER
SHEATH SET 0.018" 5~7FR 23CM
1363
CGS01KCFN3CK "曲克"引導器"COOK"FLEXOR INTRODUCER-FLEXOR CHECK FLO
MICROPUNCTURE INTRODUCER SETS 0.018" 6~7FR 7;13CM
902
CGS01KCFN4CK "曲克"引導器"COOK"FLEXOR INTRODUCER-FLEXOR CHECK FLO
MICROPUNCTURE INTRODUCER SETS 0.018" 6~7FR 23CM
1363
CGS01MASNTMR "MERIT" PRELUDE MINI ACCESS SHEATH
INTRODUCERS(SHEATH+SIDEPORT+DILATOR+NITINOL GW+21G
NEEDLE) "美瑞特"福祿小血管導引鞘
1661
CGS01MPS01CK "COOK"MICROPUNCTURE INTRODUCER SETS(W0.018 NITINOL GUIDE
WIRE+4-5FR CATHETER+21G NEEDLE)"曲克"微穿刺引導器組
1661
785
特材代碼 中英文名稱 支付點數-104/01/01
CGS01MPS02CK "COOK"MICROPUNCTURE INTRODUCER SETS(W0.018 NITINOL GUIDE
WIRE+4-5FR CATHETER+21G NEEDLE)"曲克"微穿刺引導器組
1661
CGS01MPS03CK "COOK"MICROPUNCTURE INTRODUCER SETS(W0.018 NITINOL GUIDE
WIRE+4-5FR CATHETER+21G NEEDLE)"曲克"微穿刺引導器組
1661
CGS01N6100ST "聖猷達"費思凱絲導管導引器"SJM" FAST-CATH HEMOSTASIS
INTRODUCERS WITH HEMOSTASIS VALVE 12CM SHEATH
583
CGS01N6123ST "聖猷達"費思凱絲導管導引器"SJM" FAST-CATH HEMOSTASIS
INTRODUCERS WITH HEMOSTASIS VALVE 12CM SHEATH
583
CGS01N6138ST "聖猷達"費思凱絲導管導引器"SJM" FAST-CATH HEMOSTASIS
INTRODUCERS WITH HEMOSTASIS VALVE 23CM SHEATH
977
CGS01N6151ST "聖猷達"費思凱絲導管導引器"SJM" FAST-CATH HEMOSTASIS
INTRODUCERS WITH HEMOSTASIS VALVE 12CM SHEATH
583
CGS01N6159ST "聖猷達"費思凱絲導管導引器"SJM" FAST-CATH HEMOSTASIS
INTRODUCERS WITH HEMOSTASIS VALVE 5CM SHEATH
583
CGS01N6160ST "聖猷達"費思凱絲導管導引器"SJM" FAST-CATH HEMOSTASIS
INTRODUCERS WITH HEMOSTASIS VALVE 5CM SHEATH
583
CGS01N6560ST "聖猷達"費思凱絲導管導引器"SJM" FAST-CATH HEMOSTASIS
INTRODUCERS WITH HEMOSTASIS VALVE 70CM SHEATH
2850
CGS01N6656ST "聖猷達"麥克斯導管導引器"SJM" MAXIMUM HEMOSTASIS
INTRODUCER
1262
CGS01N6700ST "聖猷達"費思凱絲導管導引器"SJM" FAST-CATH HEMOSTASIS
INTRODUCERS WITH HEMOSTASIS VALVE 12CM SHEATH
583
CGS01N6773ST "聖猷達"費思凱絲導管導引器"SJM" FAST-CATH HEMOSTASIS
INTRODUCERS WITH HEMOSTASIS VALVE 98CM SHEATH
2850
CGS01N6784ST "聖猷達"費思凱絲導管導引器"SJM" FAST-CATH HEMOSTASIS
INTRODUCERS WITH HEMOSTASIS VALVE 40CM SHEATH
1400
CGS01PA140ST "SJM"PEEL-AWAY INTRODUCERS 14CM 5:16FR(SHEATH+DILATOR)"聖
猷達"剝式導管導引器
864
CGS01PA14NST "SJM"PEEL-AWAY INTRODUCERS 14CM
5:16FR(SHEATH+DILATOR+SYRINGE+NEEDLE+GUIDE WIRE)"聖猷達"
剝式導管導引器
864
CGS01PA230ST "SJM"PEEL-AWAY INTRODUCERS 23CM
7:14FR(SHEATH+DILATOR+SYRINGE+NEEDLE+GUIDE WIRE)"聖猷達"
剝式導管導引器
864
CGS01PA6CMST "SJM"PEEL-AWAY INTRODUCERS 6CM 4;5;6FR(SHEATH+NEEDLE)"聖
猷達"剝式導管導引器
864
CGS01PLD11MR PRELUDE SHEATH INTRODUCER 11CM
(W/SHEATH+SIDEPORT+VALVE+DILATOR+G.W)
583
CGS01PLD23MR PRELUDE SHEATH INTRODUCER 23CM
(W/SHEATH+SIDEPORT+VALVE+DILATOR+G.W)
977
CGS01PS11GMR PRELUDE SHEATH INTRODUCER 11CM
(W/SHEATH+SIDEPORT+VALVE+DILATOR+G.W+NEEDLE)
715
CGS01PS18TMR "MERIT"PRELUDE SHORT SHEATH INTRODUCER(DILATOR+MARKER TIP
SHEATH+STOPCOCK+0.018"GUIDE WIRE) "美瑞特"福祿動靜脈廔管
用導引鞘
1308
CGS01PSSMTMR "MERIT"PRELUDE SHORT SHEATH INTRODUCER(DILATOR+MARKER TIP
SHEATH+STOPCOCK) "美瑞特"福祿動靜脈廔管用導引鞘
1024
CGS01RCF01CK CHECK-FLO PERFORMER INTRODUCER SETS 25CM(SH+DI+SI+V+GW) 977
CGS01RCF02CK CHECK-FLO PERFORMER INTRODUCER SETS 30CM
W/RADIOLOGY(SH+DI+SI+V+GW)
1262
CGS01RCF03CK CHECK-FLO PERFORMER INTRODUCER SETS 45CM
W/RADIOLOGY(SH+DI+SI+V+GW)
1262
786
特材代碼 中英文名稱 支付點數-104/01/01
CGS01RCF04CK CHECK-FLO PERFORMER INTRODUCER SETS
5:13CM(S+D+GW+N+SV+SY+3WAY)0.021",0.035",0.038"
835
CGS01RCFN1CK "COOK"CHECK-FLO PERFORMER INTRODUCER SETS 4.0:9.0 FR.
5.5:13 CM(SHEATH,DILATOR,SIDE+V,RADIOLOGY GW,NEEDLE)"曲
克"闕克芙爾引導器組
835
CGS01RCFN2CK "COOK"CHECK-FLO PERFORMER INTRODUCER SETS 4.0:9.0 FR.
23CM(SHEATH,DILATOR,SIDE+V,RADIOLOGY GW,NEEDLE)"曲克"闕克
芙爾引導器組
1262
CGS01RPDCAGU 雷必多可切開式導管組合系統 RAPIDO CUT-AWAY GUIDING
CATHETER SYSTEM(CATHETER+FINISH WIRE+CUTTER+RHV+BCV)※適
應症請見備註欄
6528
CGS01SC001CK SCHWARZ CATHETER INTRODUCTION SET 2200
CGS01SEA14ST "SJM"PEEL-AWAY INTRODUCERS 14CM
7:12FR(SHEATH+VALVE+DILATOR+SYRINGE+NEEDLE+GUIDE WIRE)"聖
猷達"剝式導管導引器
864
CGS01SHK1TGJ "JSM"SHEATH KIT "吉生"導引鞘組
(SH+SIDEPORT+VALVE+DIL+G.W+N+IV CATHETER+SYN)
715
CGS01SHKLAGJ "JSM"SHEATH KIT "吉生"導引鞘組
(SH+SIDEPORT+VALVE+DIL+G.W+N+IV CATHETER+SYN+保護套)
875
CGS01SHSH7SB SUPER SHEATH INTRODUCER SHEATH 4-9FR 7CM 0.035",0.308"
(SHEATH+DILATOR+SIDEARM+VALVE,GUIDEWIRE)
583
CGS01SPTSWYZ 玫締特導引鞘組MEDIKIT INSERT SUPER SHEATH SET 3~9FR,
5:7:11CM(SH+DI+GW+SI+V+N)
715
CGS01SUH11SB SUPER SHEATH INTRODUCER SHEATH 11CM 4-9FR 0.035",0.038"
(SHEATH+DILATOR+SIDEARM+VALVE,GUIDEWIRE)
583
CGS01SUM11SB SUPER SHEATH INTRODUCER SHEATH 4-9FR 11CM 0.035",0.038"
(SHEATH+DILATOR+SIDEARM+VALVE,GUIDEWIRE)
583
CGS01SUM25SB SUPER SHEATH INTRODUCER SHEATH 5-9FR 25CM 0.038"
(SHEATH+DILATOR+SIDEARM+VALVE,GUIDEWIRE)
977
CGS01TR482ST "SJM"ENGAGE ENGAGE TR INTRODUCER(RADIA INTRODUCER)12CM
0.025"(SH+DIL+VALVE GUIDE WIRE+SIDEPORT 3WAY+NEEDLE)"聖猷
達"茵給桔導管導引器
835
CGS01TR485ST "SJM"ENGAGE ENGAGE TR INTRODUCER(RADIA INTRODUCER)25CM
0.025"(SH+DIL+VALVE GUIDE WIRE+SIDEPORT 3WAY+NEEDLE)"聖猷
達"茵給桔導管導引器
1262
CGS01TR487ST "SJM"ENGAGE ENGAGE TR INTRODUCER(RADIA INTRODUCER)7CM
0.025"(SH+DIL+VALVE GUIDE WIRE+SIDEPORT 3WAY+NEEDLE)"聖猷
達"茵給桔導管導引器
835
CGS01TS20NGX "GORE"INTRODUCER SHEATH WITH SILICONE PINCH
VALVE(W/DILATOR)30CM 20:24FR帶矽膠夾管閥導鞘
887
CGS0209880AR PERCUTANEOUS SHEATH 875
CGS0306018M9 DILATOR(FACIAL)6:18FR 23CM 153
CGS0311110BQ "BIOTEQ"INTRODUCER SET:DILATOR 4:16FR 5:30CM"邦特"穿刺導
入系統組:引流用擴張管
153
CGS0360508PB DILATOR 5:8FR 20CM 153
CGS0361040PB DILATOR 4:8FR 0.035:0.038" 20:35CM 153
CGS0361090PB DILATOR 9:18FR 0.038:0.052" 25CM 153
CGS03J001NCK "曲克"擴張器"COOK"DILATORS 153
CGS03JCD03CK DILATOR 擴張器(JCD20:24-45:52-20自86.10.27生效) 449
CGS04C304SM4 "美敦力"賽勒克可調彎導管系統 "MEDTRONIC"SELECTSITE
DEFLECTABLE CATHETER SYSTEM*適應症請見備註欄
2257
CGVD10DMS1TR PTMV(經皮穿靜脈氣球導管二尖瓣成形術)DILATOR 3615
CGVW10GMS1TR PTMV(經皮穿靜脈氣球導管二尖瓣成形術)GUIDE WIRE 3615
CGVW20SMS1TR PTMV(經皮穿靜脈氣球導管二尖瓣成形術)STYLET 3615
787
特材代碼 中英文名稱 支付點數-104/01/01
CHA0106642TM AORTIC ARCH CANNULA 6.5MM 20FR 565
CHA0106672TM AORTIC ARCH CANNULA 8MM 24FR 565
CHA0159100AY "肯特利"亞羅主動脈灌流導管 "Kendall" Argyle Thi Aortic
Perfusion Cannula
565
CHA0165264TM AORTIC ARCH CANNULA 8MM 24FR 790
CHA0175324DL PEDIATRIC STRAIGHT ARTERIAL CANNULA 18FR:24FR 565
CHA0188020DL ARTERIAL CANNULA 20:24FR 565
CHA01A085BED AORTIC PERFUSION CANNULAE(8-16F) 565
CHA01AS202ED AORTIC PERFUSION CANNULA 790
CHA0305761TM SOFT-FLOW AORTIC ARCHCANNULAE W/WIRE REINFORCED 7MM,8MM
21FR,24FR
790
CHA0305779TM SOFT-FLOW AORTIC ARCH CANNULA 7MM,8MM 21FR,24FR 565
CHA0306395TM SOFT-FLOW AORTIC ARCH CANNULAE WITH WIRE REINFORCED 790
CHA0306397TM SOFT-FLOW AORTIC ARCH CANNULAE WITHOUT REINFORCED 515
CHA031137CL5 AORTIC ARCH CANNULAE WIRE-REINFORCED 6,7,8MM/18,21,24FR 790
CHA031206CL5 AORTIC ARCH CANNULA W/WIRE REINFORCED 6:24FR 790
CHA0312305TM HIGH FLOW AORTIC ARCH CANNULA 565
CHA0313010TM FLEXIBLE ARTERIAL CANNULA 20:24FR 565
CHA0320STAED "愛德華" 動脈灌注導管"EDWARDS" AORTIC PERFUSION CANNULAE 790
CHA0387020M4 DLP ARTERIAL CANNULAE WIREWOUND BODY 20FR,22FR,24FR 790
CHA03NA120L5 AORTIC ARCH CANNULAE 565
CHA03NA343L5 AORTIC ARCH CANNULAE FLEXIBLE STRAIGHT TIP WITH MOVABLE
SUTURE RING NON-REINFORCED 6,7,8MM/18,21,24FR
565
CHA03RA213L5 AORTIC ARCH CANNULAE STRAIGHT TIP WIRE-REINFORCED
6,7,8MM/18,21,24FR
790
CHAT100009ED CARDIOPLEGIA DELIVERY SETS(9F) 135
CHAT110016S6 AORTA/VEIN PUNCH 4:6MM 918
CHAT131001DL IMA CANNULA 內乳動脈導管 530
CHAT131002DL ARTERIOTOMY CANNULA 2:3MM 1 1/4 ,2 1/4 295
CHAT131003M4 ARTERIOTOMY CANNULAE 295
CHAT180271A9 "奧圖"旋轉式主動脈打孔器"ALTO" A/E ROTATING AORTIC PUNCH 918
CHAT1PUNCHGJ "吉生"主動脈打孔器(滅菌)"JSM"AORTIC PUNCH(STERILE) 918
CHAT1PUNCHQT “科斯特”主動脈打孔器(滅菌) “QUEST” AORTIC PUNCH
(STERILE)
918
CHAT1VCANNL5 "加州" 血管套管"CALIFORNIA" VESSEL CANNULAE 135
CHC0100200ED CARDIOPLEGIA DELIVERY SETS(2 LINES) 329
CHC0100400ED CARDIOPLEGIA DELIVERY SETS(3 LINES) 657
CHC0110001M4 ADAPTERS 轉接器 (結合心肺繞道手術使用) 329
CHC0113000M4 "美敦力"順行/逆行性結合選擇開關"MEDTRONIC" ARISS
ANTEGRADE/RETROGRADE INTEGRAL SELECTOR SWITCH
1035
CHC0114006M4 "美敦力"多重灌流組"MEDTRONIC" DLP MULTIPLE PERFUSION SETS 990
CHC0130010DL CORONARY CANNULA 10:14FR 611
CHC01CA123L5 "加州"心臟麻痺轉接器"CALIFORNIA" CARDIOPLEGIA ADAPTERS 329
CHC01CA410L5 MULTIPLE PERFUSION ADAPTER 657
CHC01CA420L5 MULTIPLE PERFUSION ADAPTER WITH VENT LINE 15 INCH※適應症
請見備註欄
889
CHC01CA430L5 MULTIPLE PERFUSION ADAPTER WITH VESSEL CANNULA三條(VC-
11000,VC-11010)
990
CHC01CA810L5 CARDIOPLEGIA PERFUSION ADAPTERS WITH MONITORING SET*適應
症請見備註欄
1035
CHC01CP110L5 CORONARY ARTERY PERFUSION CANNULAE 611
788
特材代碼 中英文名稱 支付點數-104/01/01
CHC01CP212L5 CORONARY ARTERY PERFUSION CANNULAE WITH BALLOON 611
CHC01MS001ED CARDIOPLEGIA DELIVERY SETS(MONITORING SET) 1035
CHF0696345M4 BIO-MEDICUS CANNULA套管及導管(ADULT)23:29FR*使用參考請見
備註欄
16771
CHF0696570M4 BIO-MEDICUS CANNULA套管及導管(ADULT)15:21FR*使用參考請見
備註欄
16771
CHF0696825M4 BIO-MEDICUS CANNULA套管及導管(PEDIATRIC)8:14FR*使用參考請
見備註欄
16771
CHF06CAVALM4 "MEDTRONIC"CARPENTIER BI-CAVAL FEMORAL CANNULA
24/29FR;30/33FR 75CM"美敦力"雙腔式股靜脈套管
16771
CHF06CB965M4 "美敦力"皮下套管組-動脈"MEDTRONIC"BIO-MEDICUS ONE-PC
FEMORAL CANNULA KIT-ARTERIAL W/INTRODUCER SET
18230
CHF06CB966M4 "美敦力"皮下套管組-靜脈"MEDTRONIC"BIO-MEDICUS ONE-PC
FEMORAL CANNULA KIT-VENOUS W/INTRODUCER SET
18230
CHF06D008VED FEM-FLEX II DURAFLO HEPARIN TREATED FEMORAL CANNULAE SET
W/INTRODUCER 芬弗列克肝素塗層股靜脈導管及導引組 ※使用參
考請見備註欄
18230
CHF06EBSAXTM "泰爾茂"人工心肺新式導管套"TERUMO" CAPIOX EBS CANNULA KIT
WITH X COATING(ARTERIAL CANNULATION KIT W/INTRODUCER)*適
應症請見備註欄
18230
CHF06EBSCATM ARTRIAL CAPIOX EBS CANNULATION KIT W/INTRODUCER SET
13.5,15,16.5FR※使用參考請見備註欄
18230
CHF06EBSCVTM VENOUS CAPIOX EBS CANNULATION KIT W/INTRODUCER SET
18,19.5,21FR※使用參考請見備註欄
18230
CHF06EBSVXTM "泰爾茂"人工心肺新式導管套"TERUMO" CAPIOX EBS CANNULA KIT
WITH X COATING(VENOUS CANNULATION KIT W/INTRODUCER)*適應
症請見備註欄
18230
CHF06ELS88QM ELS CANNULA 雙腔靜脈引流灌注導管(含PU導管+血管擴張器+導線
+穿刺針) ※適應症請見備註欄
18230
CHF06EZFACE8 "艾斯泰格"動脈導管"ESTECH"EASYFLOW AORTIC CANNULA 11572
CHF06FEM08ED FEM-FLEX II FEMORAL ACCESS CANNULAE SET W/INTRODUCER 股動
/靜脈導管及導引管組(無肝素塗層) ※使用參考請見備註欄
12404
CHF06FEM14ED FEM-FLEX II DURAFLO HEPARIN TREATED FEMORAL CANNULAE SET
W/INTRODUCER 芬弗列克肝素塗層股動脈導管及導引組 ※使用參
考請見備註欄
18230
CHF06HLSCAQM "邁柯唯"動靜脈導管-股動脈導管 "MAQUET" HLS CANNULAE
/BIOLINE COATING/含INTRODUCER SET
18230
CHF06HLSCVQM "邁柯唯"動靜脈導管-股靜脈導管 "MAQUET" HLS CANNULAE
/BIOLINE COATING/含INTRODUCER SET
18230
CHF06MED1CM4 "MEDTRONIC"BIO-MEDICUS FEMORAL ARTERIAL/VENOUS CANNULA
8:29FR"美敦力"股動/靜脈套管*適應症請見備註欄
16771
CHF06MEFKAML FEMORAL CANNULAE 股動靜脈導管※適應症請見備註欄 16771
CHF06RAPFVE8 "艾斯泰格"雷卜股靜脈導管"ESTECH"RAP FEMORAL VENOUS
CANNULA
11572
CHF06VFEM1ED FEM-FLEX II FEMORAL ACCESS CANNULAE SET W/INTRODUCER 股動
/靜脈導管及導引管組(無肝素塗層) ※使用參考請見備註欄
12404
CHG0204427TM RETROGRADE CARDIOPLEGIA CANNULAE MANUAL INFLATE 13FR,17FR 3129
CHG0204429TM RETROGRADE CARDIOPLEGIA CANNULA 3129
CHG0294006M4 DLP RETROGRADE CORONARY SINUS PERFUSION CANNULA 3129
CHG02RCM14L5 RETROGRADE CARDIOPLEGIA CANNULAE 6,10,13,15FR 3129
CHG02RCS14L5 RETROGRADE CARDIOPLEGIA CANNULAE 13,14,15FR 3129
CHG02RCS35L5 RETROGRADE CARDIOPLEGIA CANNULAE 13FR,14FR,15FR 逆向心臟
麻痺液灌注套管
3129
789
特材代碼 中英文名稱 支付點數-104/01/01
CHG02SGK14QM RETROGRADE CARDIOPLEGIA CANNULA 3129
CHH0112001DL LEFT HEART VENT CATHETER 13FR 568
CHH0112002DL VENT CATHETER 645
CHH0112008M4 DLP LEFT HEART VENT CATHETER 568
CHH01EE061ED "EDWARDS"LEFT VENTRICULAR VENT CATHETER左心室用導管 568
CHH01PE062ED LEFT VENTRICULAR VENT CATHETER 645
CHH01VT573L5 “加州”心肺手術用引流導管“CALIFORNIA VENT CATHETERS 568
CHH025902MAY “肯特利”左心室導管 "Kendall" Argyle Left Ventricular
Sump Vent Catheters
568
CHR0100011RM AORTIC ROOT CANNULA 616
CHR010014VED AORTIC PERFUSION CANNULAE(14G) 797
CHR0110009DL AORTIC ROOT CANNULA 9FR:18FR 616
CHR0110012DL AORTIC CANNULA 12:18G 410
CHR0116094TM AORTIC CANNULA 24FR 加強型動脈導管 797
CHR01AR012ED AORTIC ROOT CANNULA主動脈根部套管 616
CHR01AR109L5 AORTIC ROOT CANNULAE 9:18GA 410
CHR01AR112L5 AORTIC ROOT CANNULAE 12:16GA 410
CHR01AR212L5 AORTIC ROOT CANNULAE WITH VENT LINE 12:16G 616
CHR01CA16VQM ANTEGRADE CARDIOPLEGIA CANNULAE W/VENT 順行性心臟麻醉導管 616
CHR01CAS16QM ANTEGRADE CARDIOPLEGIA CANNULAE 順行性心臟麻醉導管 410
CHR0220009M4 AORTIC ROOT CANNULAE WITH VENT LINE 616
CHR0220014DL AORTIC ROOT CANNULA WITH VENT LINE 616
CHR0300014ED RETROGRADE CARDIOPLEGIA CANNULAE(14F) 3129
CHR03RC014ED RETROGRADE CARDIOPLEGIA CANNULAE 3129
CHR03RC301ED RETROGRADE CARDIOPLEGIA CANNULAE 3129
CHSU116022AY “肯特利”亞羅臍脈導管 "Kendall" Argyle Umbilical Vessel
Catheter
170
CHSU116035KD "柯惠"肯特利亞羅臍脈導管"COVIDIEN"KENDALL ARGYLE
UMBILICAL VESSEL CATHETER
170
CHT0104413TM CONDUCER CARDIOPLEGIA SET W/MP-4 1:1,4:1,8:1 3173
CHT0106375TM CONDUCER CARDIOPLEGIA SSET W/MP-4 AND BRIDGE 4:1 3173
CHT0109457TM CONDUCER CARDIOPLEGIA SET 4:1,2:1 BLOOD MIXING 2884
CHT0109499TM CONDUCER CARDIOPLEGIA SET(含DOMEXI,ARTERIAL PRESSURE
TUBINGX3,3-WAY STOPCOCKX1)
3173
CHT0132301GJ “吉生”體外循環管組(ORGANIZER+PRE-BYPASS FILTER+SUCKER X
2+ARTERIAL FILTER+ISOLATOR+TUBING+PRIMING LINE)”JSM”
HEART LUNG PACK
7315
CHT0132501GJ “吉生”體外循環管組(含PRE-BYPASS FILTER)”JSM” HEART
LUNG PACK
4137
CHT0132701GJ “吉生”體外循環管組(含TUBING+ORGANIZER+PRE-BYPASS
FILTER)”JSM” HEART LUNG PACK
4770
CHT0179003DL PEDIATRIC TOURNIQUET KIT 255
CHT01A32NSH9 HEART LUNG PACK:A32 CUSTOMER PACK(TUBING+ORGANIZER+PRE-
BYPASS FILTER)
4770
CHT01CH207H9 HEART LUNG PACK(含PRE-BYPASS FILTER) 4137
CHT01CHX30QM PLEGIOX CARDIOPLEGIA HEAT EXCHANGER(含DIA-CONN,PVC-
75SH,PUMP CONN,SILICONE,PVC-70SH,Y-CONN,ONE WAY
VALVE,DIA-CONN/BL)
3173
CHT01CPSETGJ “吉生”麻痺液輸送管路組“JSM”CARDIOPLEGIA SET 3173
CHT01CSS01TV "康翠特"灌流管組"CONTRACT"CSS PERFUSION TUBING SET (含
TUBING+PRE-BYPASS FILTER+ORGANIZER+SUCKER X 2)
5218
CHT01CSS02TV CSS PERFUSION TUBING SET (含TUBING+PRE-BYPASS
FILTER+SUCKER X 2)
4996
790
特材代碼 中英文名稱 支付點數-104/01/01
CHT01CSS03TV CSS PERFUSION TUBING SET (含TUBING+PRE-BYPASS FILTER) 4137
CHT01CSS04TV CSS PERFUSION TUBING SET (只含TUBING) 3748
CHT01ECTB1M6 EXTRACORPOREAL TUBING PACK(含PRE-BYPASS
FILTER+SUCKERX2+ORGANIZER)
5218
CHT01ECTBSM6 EXTRACORPOREAL TUBING PACK(含PRE-BYPASS FILTER) 4137
CHT01HL106H9 "華億" 體外循環管組"HYM" HEART LUNGPACK(含ORGANIZER+PRE-
BYPASS FILTER+SUCKER*2)
5218
CHT01HS101H9 HEART LUNG PACK(含ORGANIZER+PRE-BYPASS FILTER+SUCKERX2) 5218
CHT01HTA12H9 HEART LUNG PACK HSIN TUNG A12 ADULT(含ORGANIZER+PRE-
BYPASS FILTER+SUCKER X2+ARTERIAL FILTER)
7315
CHT01MY100M4 MYOTHERMXP CARDIOPLEGIA DELIVERY SYSTEM(BLOOD
MIXING+CONDUCER+COIL TUBING+MP4)
3173
CHT01P0201QM BLOOD CARDIOPLEGIA SET W/PLEGIOX 具自動熱交換功能(含DIA-
CONN,PVC-75SH,PUMP CONN,SILICONE,PVC-70SH,Y-CONN,ONE WAY
VALVE,DIA-CONN/BL)
3173
CHT01TS100L5 TOURNIQUET KIT WITH SNARE 255
CHT01TS130L5 TOURNIQUET KIT 255
CHT01VBC4CGH VISION BLOOD CARDIOPLEGIA(BLOOD MIXING+CONDUCER+COIL
TUBING+MP4)具熱交換功能
3173
CHT01VBCBRGH VISION BLOOD CARDIOPLEGIA SYSTEM(BLOOD
MIXING+CONDUCER+COIL TUBING)
2884
CHT0332401GJ “吉生”體外循環管組-預充管路組”JSM” HEART LUNG PACK-
PRIMING LINE
276
CHT03A25PLH9 HEART LUNG PACK:A25 PRIME LINE(TUBING 49"+ Y CONNECTOR) 276
CHT03CB993M4 "美敦力"血液套裝組-有塗層"MEDTRONIC"BLOOD TUBING PACK-
WITH COATING(TUBING ONLY)
3829
CHT0546202H9 HEART LUNG PACK:FLOW PROBE CONNECTOR 914
CHT0546203GJ “吉生”體外循環管組-動脈&靜脈氧分壓接頭”JSM” HEART
LUNG PACK-PO2 ARTERIAL & VENOUS CONNECTOR
914
CHT0546203H9 HEART LUNG PACK:STATSAT CONNECTOR 1/4;3/8;1/2氧分壓測定接
頭*適應症請見備註欄
914
CHT0546212GJ “吉生”體外循環管組-流量測定接頭”JSM” HEART LUNG PACK-
FLOW PROBE CONNECTOR
914
CHT0569120TM CDI HEMATOCRIT SATURATION CUVETTE 血氧感知器 914
CHT05TMC25M4 TMC TRI-OPTIC MEASUREMENT CELL 914
CHV0100012ED SINGLE STAGE VENOUS RETURN CANNULAE(12:40FR/直) 771
CHV0100028ED SINGLE STAGE VENOUS RETURN CANNULAE 771
CHV0100040ED SINGLE STAGE VENOUS RETURN CANNULAE(12:40FR/彎) 771
CHV0104882TM MALLEABLE VENOUS RETURN CATHETER REINFORCED 24FR 977
CHV0166112M4 SINGLE STAGE VENOUS CANNULA 771
CHV0167312DL VENOUS CANNULAR 12,16,20,31FR (PEDIATRIC) 1002
CHV0168112M4 "MEDTRONIC"SINGLE STAGE VENOUS CANNULA"美敦力"單孔型靜脈
套管12:40FR
977
CHV0169312DL VENOUS CANNULAR 12:31FR (HIGH FLOW) 1002
CHV0169424DL VENOUS CANNULAR 12:31FR (ADULT) 1002
CHV0191228M4 TWO STAGE VENOUS CANNULA 803
CHV01LRD41L5 "CALIFORNIA" DUAL STAGEVENOUS RETURN CANNULAE(WIRE-
REINFORCED)"加州"二階靜脈引流導管
803
CHV01RV110L5 WIRE REINFORCED VENOUS RETURN CANNULAE24,28,32,34,36,40 771
CHV01RV224L5 "CALIFORNIA"VENOUS RETURN CANNULAE(WIRE-REINFORCED)"加州"
靜脈回流導管
771
CHV01TF008ED SINGLE STAGE VENOUS RETURN CANNULAE 靜脈引流導管 771
CHV01XRDS2L5 DUAL STAGE VENOUS RETURN CANNULAE 32:36FR 803
791
特材代碼 中英文名稱 支付點數-104/01/01
CHV0329370ED DUAL STAGE VENOUS RETURN CANNULAE(29/37F) 1002
CHV0336460ED DUAL STAGE VENOUS RETURN CANNULAE(36/46F) 1002
CHV03TF334ED "愛德華" 二階靜脈引流導管"EDWARDS" DUAL STAGE VENOUS
RETURN CANNULAE
1002
CHV03TR283ED DUAL STAGE VENOUS RETURN CANNULA 803
CHV03TRF29ED DUAL STAGE VENOUS CANNULAE 1002
CKB0144002BB CYSTOFIX 10:15FR 8:12CM 542
CKB0144205BB CYSTOFIX 10:15FR 8:12CM 542
CKB0144212BB CYSTOFIX 10:15FR 8:12CM 542
CKB0144215BB CYSTOFIX 10:15FR 8:12CM 542
CKB0156116BA SUPRAPUBIC CATHETERISATION KIT 膀胱穿刺針組 16CH 590
CKB0160600AN VESICO SET 膀胱穿刺引流組 542
CKD0100950CK DOUBLE PIGTAIL(J)STENT SET 4.7:8.2FR(stent+guide
wire+pusher)
1132
CKD01BTDJ2BQ DOUBLE J URETERAL STENT SET(STENT+GUIDE+PUSHER) 1117
CKD01US101CK "COOK"UNIVERSA FIRM AND SOFT URETERAL STENT SET(雙
JSTENT+GUIDE WIRE+PUSHER)"曲克"由尼維莎結實型和柔軟型輸尿
管內置支架組
1132
CKD01US102CK "COOK"UNIVERSA FIRM AND SOFT URETERAL STENT SET(雙
JSTENT+GUIDE WIRE+PUSHER)"曲克"由尼維莎結實型和柔軟型輸尿
管內置支架組
1132
CKD030472NAN DOUBLE J-STENT 4,7FR 24CM:7FR 32CM 1132
CKD035550NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1132
CKD035572NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1132
CKD035591NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1132
CKD035610NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1132
CKD035704NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1132
CKD035723NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1132
CKD035921NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1132
CKD0380155MV CONTOUR SOFT PERCUFLEX STENTS W/HYDROPLUS
COATING+GUIDEWIRE+PUSHER+CLAMP
1416
CKD0380220MV CONTOUR SOFT PERCUFLEX STENTS W/HYDROPLUS
COATING+GUIDEWIRE+PUSHER+CLAMP
1416
CKD0380244MV CONTOUR SOFT PERCUFLEX STENTS W/HYDROPLUS
COATING+GUIDEWIRE+PUSHER+CLAMP
1416
CKD0380801MV CONTOUR SOFT PERCUFLEX STENTS W/HYDROPLUS
COATING+GUIDEWIRE+PUSHER+CLAMP
1416
CKD03STRVLSB "BOSTON SCIENTIFIC" STRETCH VL STENT WITH HYDROPLUS "波士
頓科技"伸展輸尿管支架
1416
CKD0512135BQ "BIOTEQ"URETERAL STENT SET(DOUBLE J TYPE)( W/HYDROPHILIC
COATING+GUIDE WIRE+PUSHER+CLIP)"邦特"輸尿管導管組(雙J型)
1416
CKD0542135BQ "BIOTEQ"URETERAL STENT SET(DOUBLE J TYPE)( W/HYDROPHILIC
COATING+GUIDE WIRE+PUSHER+CLIP)"邦特"輸尿管導管組(雙J型)
1416
CKD057774NBA URETERAL STENT WITH HYDROPLUS COATING+GUIDE
WIRE+PUSHER+CLAMP
1416
CKD0577848BA "BARD"INLAY URETERAL STENT( WITH HYDROPLUS
COATING)+PUSHER+CLAMP"巴德"輸尿管導管組
1348
CKD05BTDJ3BQ URETERAL STENT(DOUBLE J TYPE)(STENT WITH HYDROPHILIC
COATING+GUIDE WIRE+PUSHER+CLIP)
1416
CKD05DSHFNGT DOUBLE PIGTAIL URETERAL STENT SET(stent with
hydromer+guide wire+pusher)
1416
792
特材代碼 中英文名稱 支付點數-104/01/01
CKD05DUSPNGT DOUBLE PIGTAIL URETERAL STENT SET(stent with
hydromer+guide wire+pusher)
1416
CKD05DUTWNGT DOUBLE PIGTAIL URETERAL STENT SET(stent with
hydromer+guide wire+pusher)
1416
CKD05J3114BQ "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH
HYDROPHILIC+GUIDE WIRE+PUSHER)"邦特"輸尿管導管組(長效型)
1416
CKD05J3125BQ "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH
HYDROPHILIC+GUIDE WIRE+PUSHER)"邦特"輸尿管導管組(長效型)
1416
CKD05K3114BQ "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH
HYDROPHILIC+GUIDE WIRE+PUSHER)"邦特"輸尿管導管組(長效型)
1416
CKD05K3125BQ "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH
HYDROPHILIC+GUIDE WIRE+PUSHER)"邦特"輸尿管導管組(長效型)
1416
CKD05R3214BQ "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH
HYDROPHILIC+GUIDE WIRE+PUSHER)"邦特"輸尿管導管組(長效型)
1416
CKD05R3225BQ "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH
HYDROPHILIC+GUIDE WIRE+PUSHER)"邦特"輸尿管導管組(長效型)
1416
CKD05S3214BQ "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH
HYDROPHILIC+GUIDE WIRE+PUSHER)"邦特"輸尿管導管組(長效型)
1416
CKD05S3225BQ "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH
HYDROPHILIC+GUIDE WIRE+PUSHER)"邦特"輸尿管導管組(長效型)
1416
CKD05T3114BQ "BIOTEQ"URETERAL STENT SET(W HYDROPHILIC)(LONG-TERM
TYPE)(+PUSHER+CLAMP)"邦特"輸尿管導管組
1348
CKD05T3125BQ "BIOTEQ"URETERAL STENT SET(W HYDROPHILIC)(LONG-TERM
TYPE)(+PUSHER+CLAMP)"邦特"輸尿管導管組
1348
CKD05U3214BQ "BIOTEQ"URETERAL STENT SET(W HYDROPHILIC)(LONG-TERM
TYPE)(+PUSHER+CLAMP)"邦特"輸尿管導管組
1348
CKD05U3225BQ "BIOTEQ"URETERAL STENT SET(W HYDROPHILIC)(LONG-TERM
TYPE)(+PUSHER+CLAMP)"邦特"輸尿管導管組
1348
CKD05USH01CK "COOK"UNIVERSA STENT FIRM AQ AND SOFT AQ SET (STENT-WITH
HYDROPHILIC COATING+GUIDE WIRE+PUSHER)由尼維莎輸尿管內置
支架組
1416
CKD0706016BA SILICON FLOURO-4 URETERAL STENT(stent+introducer kit) 1972
CKDD20450NBA HICKMAN HEMODIALYSIS CATHETER KIT(CATH+INTRODUCER KIT)永
植型
3509
CKDD20452NBA HICKMAN HEMODIALYSIS CATHETER KIT(CATH+INTRODUCER KIT)永
植型
3509
CKDD214554NL "NAVILYST"VAXCEL PLUS CHRONIC DIALYSIS CATHETERS
KIT(CATHETER+INTRODUCER KIT)"娜維利斯特"斐克希長期透析用
導管
3509
CKDD2330742C "柯惠"肯特利慢性血液透析導管"COVIDIEN"KENDALL CHRONIC
HEMODIALYSIS CATHETERS-MAHURKAR 13.5FR CUFFED CATHETER
KIT
3509
CKDD2450142C "COVIDIEN"KENDALL PALINDROME CATHETER KIT AND
SPORTPACK(CATH+INTRODUCER KIT)"柯惠"肯特利沛霖卓導管組(永
植型)
3509
793
特材代碼 中英文名稱 支付點數-104/01/01
CKDD2480012C "柯惠"肯特利慢性血液透析導管"COVIDIEN"KENDALL CHRONIC
HEMODIALYSIS CATHETERS-PERMCATH CATHETER KIT
36~45CM(CATH+INTRODUCER KIT)
3509
CKDD256631BA HEMOGLIDE HEMODIALYSIS CATHETER KIT(CATH+INTRODUCER KIT)
永植型
3509
CKDD257331BA "BARD"HEMOSPLIT HEMODIALYSIS CATHETER(CATH+INTRODUCER
KIT)"巴德"思伯利特血液透析導管.永植型
3509
CKDD25833NBA "BARD"HemoStar HEMODIALYSIS CATHETER KITS(CATH+INTRODUCER
KIT)永植型
3509
CKDD266606BA HICKMAN HEMODIALYSIS CATHETER KIT(CATH+INTRODUCER KIT)永
植型
3509
CKDD2690012C "柯惠"肯特利慢性血液透析導管"COVIDIEN"KENDALL CHRONIC
HEMODIALYSIS CATHETERS-PERMCATH CATHETER KIT
28CM(CATH+INTRODUCER KIT)
3509
CKDD2881452C "柯惠"肯特利慢性血液透析導管"COVIDIEN"KENDALL CHRONIC
HEMODIALYSIS CATHETERS-MAHURKAR MAXID 14.5FR.雙腔導管
(CATH+INTRODUCER KIT)
3509
CKDD2SL12PM0 "MEDCOMP"SILICONE DOUBLE LUMEN CATHETERS AND
ACCESSORIES(CATHETER+NEEDLE+GUIDE WIRE+DILATOR)"美德康"矽
質血液透析導管與配件
3509
CKDD2SL18PM0 "MEDCOMP"HEMO-CATH LONG TERM DIALYSIS CATHETERS (DOUBLE
LUMEN )AND ACCESSORIES(CATHETER+INTRODUCER KIT)"美德康"長
期矽質血液透析導管與配件
3509
CKDD312123AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION
SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR)"亞諾"多重輸液導管套
1738
CKDD323334BQ "BIOTEQ"HEMODIALYSIS CATHETER KIT(3 LUMEN
CATHETER+NEEDLE+GUIDE WIRE+DILATOR)血液透析導管組
1738
CKDD325123AR "ARROW"ARROWGARD CATHETERS
SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR+SHEATH) 3 LUMEN "亞諾"
抗感染安全尖端導管
1738
CKDD3456032C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-三腔透析導管(C+N+G+D)
1738
CKF0201237BA "BARD"75CC BARDEX LUBRICATH LATEX FOLEY CATHETER,2 WAY"巴
德"導尿管*給付規定請見備註欄
106
CKF0222630BA "BARD"BARDEX PEDIATRIC FOLEY CATHETER,LUBRICIOUS COATED,2
WAY 3CC導尿管*適應症請見備註欄
106
CKF0222656BA "BARD"FOLEY CATHETER二叉滑潤長期導尿管5CC,30CC*適應症請
見備註欄
106
CKF025118NUW "UNOMEDICAL"FOLEY CATHETERS(HYDROPHILIC 2-WAY)3CC-30CC"巫
諾"導尿管*適應症請見備註欄
106
CKF02H2265BA BIOCATH HYDROGEL COATING 2 WAY FOLED 8:24FR 5CC,30CC ※適
應症請見備註欄
106
CKF02L0165BA LUBRICATH 2 WAY FOLED 8:26FR 3CC,5CC ※適應症請見備註欄 106
CKF02M5118UM "UNOMEDICAL"FOLEY CATHETERS(HYDROPHILIC 2-WAY)3CC-30CC"巫
諾"親水性雙叉導尿管*適應性請見備註欄
106
CKF0300006FM 2 WAY SILICONE FOLEY BALLOON CATH 1.5CC 6FR,3CC 8:10FR※
適應症請見備註欄
93.1
CKF030012NFM 2 WAY SILICONE FOLEY BALLOON CATHETER 5CC,30CC 12:26FR※
適應症請見備註欄
93.1
CKF0300142R4 2 WAY ALL SILICONE FOLEY BALLOON CATHETER 5CC 12:24FR※適
應症請見備註欄
93.1
CKF0300212YN 2 WAY ALL SILICONE FOLEY BALLOON CATH 12:26FR 5CC※適應症
請見備註欄
93.1
794
特材代碼 中英文名稱 支付點數-104/01/01
CKF0300242R4 2 WAY ALL SILICONE FOLEY BALLOON CATHETER 30CC 16:26FR※
適應症請見備註欄
93.1
CKF0300506FM "富強"導尿管(二叉矽質)"FORTUNE"UROLOGICAL CATHETER(ALL
SILICON 2-WAY)
93.1
CKF0301641W6 ALL SILICONE 2 WAY FOLEY CATHETER 6FR:26FR*適應症請見備註
欄
93.1
CKF0303201EW E-UP SILICONE FOLEY CATHETER FOR SINGLE USE(2 WAY 1-3ML)
毅升一次性使用純矽膠球囊導尿管*給付規定請見備註欄。
93.1
CKF0303203EW E-UP SILICONE FOLEY CATHETER FOR SINGLE USE(2 WAY 5-10ML)
毅升一次性使用純矽膠球囊導尿管*給付規定請見備註欄。
93.1
CKF0303205EW E-UP SILICONE FOLEY CATHETER FOR SINGLE USE(2 WAY 5-15ML)
毅升一次性使用純矽膠球囊導尿管*給付規定請見備註欄。
93.1
CKF0303207EW E-UP SILICONE FOLEY CATHETER FOR SINGLE USE(2 WAY 30ML)毅
升一次性使用純矽膠球囊導尿管*給付規定請見備註欄。
93.1
CKF0303308P2 SILICON 2 WAY FOLEY CATHETER*適應症請見備註欄 93.1
CKF030512NFM 2 WAY SILICONE FOLEY BALLOON CATH W/X-RAY5CC,30CC 12:26FR
※適應症請見備註欄
93.1
CKF030513NCL SILICONE 2-WAY FOLEY CATHE 6:26FR ※適應症請見備註欄 93.1
CKF0312352BA "BARD"BARDIA 2-WAY FOLEY CATHETER(5;30CC/12:30FR)"巴德"巴
迪亞二叉導尿管※適應症請見備註欄
93.1
CKF0376SF6MU MODERN ALL SILICONE FOLEY CATHETER導尿管*適應症請見備註欄 93.1
CKF03F0101SG SILICONE 2 WAY FOLEY CATHETER*適應症請見備註欄 93.1
CKF03FC001SG SILICON FOLEY BALLOON CATHETER*適應症請見備註欄 93.1
CKF03S2100WN SILICONE 2WAY FOLEY CATHE 3:50ML ※適應症請見備註欄 93.1
CKF0404303EW E-UP SILICONE FOLEY CATHETER FOR SINGLE USE(3 WAY 5-10ML)
毅升一次性使用純矽膠球囊導尿管*給付規定請見備註欄。
170
CKF0404305EW E-UP SILICONE FOLEY CATHETER FOR SINGLE USE(3 WAY 5-15ML)
毅升一次性使用純矽膠球囊導尿管*給付規定請見備註欄。
170
CKF0404307EW E-UP SILICONE FOLEY CATHETER FOR SINGLE USE(3 WAY 30ML)毅
升一次性使用純矽膠球囊導尿管*給付規定請見備註欄。
170
CKF040514NFM 3 WAY SILICONE FOLEY BALLOON CATHETER W/X-RAY 30CC
14:26FR※適應症請見備註欄
170
CKF0412343BA "BARD"BARDIA 3-WAY FOLEY CATHETER(30CC/16:26FR)"巴德"巴迪
亞三叉導尿管※適應症請見備註欄
164
CKF041426NFM SILICONE 3 WAY FOLEY CATHETER 14:26FR ※適應症請見備註欄 170
CKF042103NWN SILICONE 3 WAY FOLEY CATHETER 5CC,30CC 16:26FR ※適應症請
見備註欄
170
CKF045518NUW "UNOMEDICAL"FOLEY CATHETERS(HYDROPHILIC 3-WAY)5CC-30CC"巫
諾"導尿管*適應症請見備註欄
164
CKF04H1875BA LUBRICATH 3 WAY FOLEY CATHETER 75CC 18:24FR ※適應症請見
備註欄
278
CKF04H2267BA BIOCATH 3 WAY FOLEY CATHETER 30:50CC 18:24FR ※適應症請見
備註欄
164
CKF04L1630BA HYDROGEL 3 WAY FOLEY CATHETER 30CC 16:26FR ※適應症請見備
註欄
164
CKF04M5118UM "UNOMEDICAL"FOLEY CATHETERS(HYDROPHILIC 3-WAY)5CC-30CC"巫
諾"親水性三叉導尿管*適應性請見備註欄
164
CKF04Y0630GC 三叉矽質導尿管*適應症請見備註欄 170
795
特材代碼 中英文名稱 支付點數-104/01/01
CKN0108000CK PERCUTANEOUS PIGTAIL NEPHROSTOMY SETS 6.0:10FR 15:30CM(標
準型)
2640
CKN0111245BQ "BIOTEQ"DRAINAGE CATHETERAND INTRODUCER SET/KIT(C+N+G+D+
引流管袋+固定貼布)導管5-16FR 20-50CM
2580
CKN0113113BQ "BIOTEQ"DRAINAGE CATHETER&INTRODUCER
SET/KIT(HYDROPHILIC)5-16FR 20-50CM(NEEDLE+GUIDE
WIRE+DILATOR+引流管袋+固定貼布)引流導管及穿刺導入系統
2580
CKN011450NC3 PERCUTANEOUS NEPHROSTOMY SET PIGTAIL TYPE(chiba N+initial
N+D+G+C)
2640
CKN011460NC3 PERCUTANEOUS NEPHROSTOMY SET PIGTAIL TYPE(chiba N+initial
N+D+G+C)
2640
CKN011470NC3 PERCUTANEOUS NEPHROSTOMY SET PIGTAIL TYPE(chiba N+initial
N+D+G+C)
2640
CKN011897SAN "ANGIOMED"INTRODUCTION/DRAINAGE CATHETER AND
ACCESSORIES(STERILE)SOFT-DRAIN DIRECT PUNCTURE SET(ONE-
STEP)"安吉美爾德"導入/引流導管及其附件
1720
CKN0120111MV PCN NEPHROSTOMY SET 8FR 30CM(C+N+D+G+cannecting tube) 2651
CKN0120111SB PERCUTANEOUS NEPHROSTOMY SET-PIGTAIL DESIGN(C+N+D+G) 2640
CKN0141010CL PCN NEPHROSTOMY KIT WITH SILICON WALECOT 10FR:14FR(C+穿刺
N+顯影N+G+D+引流管)
3120
CKN015500PAN "ANGIOMED"INTRODUCTION/DRAINAGE CATHETER AND
ACCESSORIES:PERCUT NEPHROSTOMY SET(C+CHIBA N+INITIAL
N+D+G+固定盤)導入/引流導管及附件
2511
CKN015520PAN "ANGIOMED"INTRODUCTION/DRAINAGE CATH AND
ACCESSORIES:NEPHROPUR NEPHROSTOMY SET(C+CHIBA N+INITIAL
N+D+G+引流管袋+固定盤)導入/引流導管及附件
2640
CKN015521LAN "ANGIOMED"INTRODUCTION/DRAINAGE CATH AND
ACCESSORIES:NEPHROPUR NEPHROSTOMY SET(C+CHIBA N+INITIAL
N+D+G+引流管袋+固定盤)導入/引流導管及附件
2640
CKN015522SAN "ANGIOMED"INTRODUCTION/DRAINAGE CATHETER AND
ACCESSORIES:NEPHROSTOMY SET(C+INITIAL N+D+G+引流管袋)"安
吉美爾德"導入/引流導管及附件
2651
CKN0178000PB PIGTAIL NEPHROSTOMY SET(自950401起增加型號780016030.文號
0940041345)
2767
CKN0178050PB PIGTAIL NEPHROSTOMY SET W/SAFETY STRING LOCK SYSTEM(自
950401起增加型號780516030.文號0940041345)導管
(HYDROFEEL)+STIFFENER+GX2+D+固定貼布
2746
CKN01PNS01CK SAFE-T-J CURVED WIRE GUIDE 277
CKN01RLCTRMR "MERIT"RESOLVE LOCKING DRAINAGE CATHETERS(HYDROPHILIC)
SET(引流管+NX2+G+D+引流管袋)(STERILE)"美瑞特"通用引流管
(滅菌)
2797
CKN0218522FM SILICONE 2WAY NEPHROSTOMY BALLOON CATHETER X-RAY OPEN TIP
8:24FR
331
CKN0218523FM SILICONE 3WAY NEPHROSTOMY BALLOON CATHETER X-RAY OPEN TIP
14:24FR
349
CKN0218562FM SILICONE 2WAY NEPHROSTOMY BALLOON CATHETER TIEMANN TIP 331
CKN0218563FM SILICONE 3WAY NEPHROSTOMY BALLOON CATHETER TIEMANN TIP 349
CKN0251608CL SILICON NEPHROSTOMY BALLOON CATHETER 8:10FR 球型腎臟造廔
管
331
CKN0251612CL SILICON NEPHROSTOMY BALLOON CATHETER 12:24FR 球型腎臟造廔
管
331
CKN0252116CL SILICON 3 WAY FOLEY CATHETER 16:26FR ※適應症請見備註欄 170
CKN02N2108YN ALL SILICONE NEPHROSTOMY BALLOON CATHETER 8:24FR1.5:5CC 331
CKN02NS001SG SIGMA NEPHROSTOMY CATHETER(SILICON)*適應症請見備註欄 331
796
特材代碼 中英文名稱 支付點數-104/01/01
CKN02S0101SG SILICONE 2 WAY NEPHROSTOMY CATHETER 331
CKN0318552FM SILICONE NEPHROSTOMY CATHETER WITH DETACHABLE FUNNEL
14:24FR
331
CKN0351912CL SILICON NEPHROSTOMY BALLOON CATHETER W/REMOVABLE 12:24FR
可分離式腎臟造廔管
530
CKN0410111MV PERCUTANEOUS NEPHROSTOMY CATHETER WITH LOOP LOCKING
RETENSION 豬尾巴導管
829
CKN0418572FM SILICONE NEPHROSTOMY PIGTAIL PATTERN CATHETER 12FR 331
CKN045522SAN "ANGIOMED"INTRODUCTION/DRAINAGE CATHETER AND
ACCESSORIES:NEPHROSTOMY SLIM SET "安吉美爾德"導入/引流導
管及附件
524
CKN04BTPDSBQ NEPHROSTOMY CATHETER(WITH STYLET&FLEXIBLE CANNULA) 829
CKN0508240CK MALECOT CATHETER 885
CKN051111NWN MALECOT CATHETER 4 WING 12:40FR 273
CKN0514010CL SILICON 4 WING MALECOT 10:26FR 梅花型腎臟造廔管 885
CKN051840NFM "FORTUNE"SILICONE MALECOT CATHETER 14:36FR矽質梅花型引流
管
885
CKN0583808CK "COOK"SILICONE MALECOT CATHETERS 8:24FR"曲克"矽膠蕈狀導管 885
CKN0586010BA MALECOT NEPHROSTOMY TUBE 16:36FR 273
CKN0718512FM SILICONE 2WAY NEPHROSTOMY CATHETER X-RAY OPAQUE TIP
8:24FR
331
CKN0718513FM SILICONE 3WAY NEPHROSTOMY CATHETER X-RAY OPAQUE TIP
14:24FR
349
CKP0413836FA "FRESENIUS"PD ACCESSORIES SLEEP.SAFE SET/SET PLUS"費森尤
斯"自動腹膜透析管組
232
CKS016020NAN "ANGIOMED"URETERAL STENTS(STENT+GUIDE+PUSHER) 1117
CKS0257071CK "COOK"URETERAL AND URETHRAL STENTS(URETERAL STENT+GUIDE
WIRE+SHEATH+PUSHER)"曲克"輸尿管及尿道內置管祖
1257
CKU0303903P2 URETERAL CATHETER STRAIGHT TIP 3:7FR 75CM 153
CKU0324103CK "COOK"URETERAL CATHETER輸尿管導管 153
CKU0336504BA URETERAL CATHETER (OLIVE TIP) 4:6FR 153
CKU0337504BA URETERAL CATHETER (SPIRAL) 4:6FR 153
CKU0338008BA URETERAL CATHETER (CONE TIP) 8:12FR 153
CKU0362400AN URETERAL CATHETER 153
CKU0362433AN URETERAL CATHETER 153
CKU036243NAN URETERAL CATHETER 153
CKU0362453AN URETERAL CATHETER 153
CKU036245NAN URETERAL CATHETER 153
CKU0362500AN URETERAL CATHETER 153
CKU036251NAN URETERAL CATHETER CYLINDERAL 4:8CH 70CM 斑馬線導管 153
CKU0362930AN URETERAL CATHETER 153
CKU036313NAN URETERAL CATHETER 153
CKUB101000CK URETeRAL BALLOON dilator CATHETER 65CM 5FR,7FR 4032
CKUB101415CK BALLOON URETERAL(UREThERAL自980401起改為URETERAL) DILATOR
SETS 5:7FR 65CM(CATH+GUIDE WIRE)
5068
CKUB107835CK "COOK"URETEROSCOPY BALLOON CATHETER(CATHETER+GUIDE WIRE)
輸尿管氣球導管
5068
CKUB121810SB "BOSTON SCIENTIFIC"PASSPORT UROLOGICAL BALLOON DILATATION
CATHETER WITH HYDRO PLUS BONDED HYDROGEL COATING"波士頓科
技"帕斯泌尿科氣球擴張導管
5068
CKUB122510MV UROMAX ULTRA HIGH PRESSURE URETERAL CATHETER W/SHEATH 5068
CKUB128005CK "COOK" UPJ OCCLUSION BALLOON CATHETER SETS(CATH+GUIDE
WIRE)"曲克"優皮傑閉合氣球導管組
5068
797
特材代碼 中英文名稱 支付點數-104/01/01
CKUB18884NBA UROFORCE BALLOON DILATION CATHETER 4032
CKUB1AUBS1CK COOK ASCEND AQ URETERAL DILATION BALLOON CATHETER
4CM:10CM
4032
CKUB2UNB01CK "COOK"ULTRAXX NEPHROSTOMY BALLOON AND SETS(WITH SHEATH)"
曲克"奧創腎造口術氣球套組
5068
CKUB2XFN30BA “巴德” 艾克-佛斯腎造口手術氣球擴張導管 “BARD”X-FORCE
NEPHROSTOMY BALLOON DILATION CATHETER (WITH SHEATH)
5068
CKUD126100SB BOSTON SCIENTIFIC AMPLATZ TYPE GRADUATED RENAL DILATOR
SET
953
CKUD126120SB "BOSTON SCIENTIFIC"AMPLATZ TYPE GRADUATED RENAL
STYLET/SHEATH
695
CKUD1261XXSB "BOSTON SCIENTIFIC" AMPLATZ TYPE GRADUATED RENAL DILATOR
SET(INDIVIDUAL) "波士頓科技"安普拉斯腎臟擴張導管組(單支)
953
CKUD160300AN RENAL DILATOR W/SHEATH 695
CKUD200040AN PTFE DILATOR 4:9FR 110
CKUD200120AN PTFE DILATOR 12:14FR 154
CKUD20012DAN "ANGIOMED"DILATATION SET 12FR擴張器組 154
CKUD200160AN PTFE DILATOR 16FR 220
CKUS22614NSB AMPLATZ TYPE RENAL SHEATH SET 818
CKUS26015NSB "BOSTON SCIENTIFIC"AMPLATZ TYPE RENAL SHEATH
SET/INDIVIDUAL SHEATHS
818
CKUS2AMPV1CK TFE SHEATHS FOR AMPLATZRENAL DILATORS 10:36FR,16:40CM 818
CLPA102001HJ "史密斯"內植用輸液管/用於靜脈*給付規定請見備註
欗"SMITHS"IMPLANTABLE ACCESS SYSTEM
7539
CLPA102002HJ "史密斯"內植用輸液管/用於動脈*給付規定請見備註
欗"SMITHS"IMPLANTABLEACCESSSYSTEM/ARTERIAL
10137
CLPA105041AR 1 LUMEN PICC RADIOLOGY SELDINGER ACCESS
SET(CATHETER+NEEDLE+DILATOR+GUIDE WIRE)※適應症請見備註欄
2884
CLPA105052AR DUAL LUMEN PICC RADIOLOGY SELDINGER ACCESS SET(C+G+I+T-
PORT)※適應症請見備註欄
3335
CLPA10604NBA MRI SINGLE LUMEN IMPLANTED PORTS(PORT+C+N)*適應症請見備註
欄
7539
CLPA10615NBA MRI DUAL-LUMEN IMPLANTED PORTS(PORT+C+N)*適應症請見備註欄 7804
CLPA107500BA X-PORT ISP IMPLANTED PORT (P+C+N)*適應症請見備註欄 7539
CLPA107530BA X-PORT ISP IMPLANTED PORT (P+C+N+I)*適應症請見備註欄 7712
CLPA11019NYP "PEROUSE"POLYSITE IMPLANTABLE PORT(PORT+CATHETER)"普羅斯"
植入式動脈血管輸注器
9285
CLPA119S20M0 "MEDCOMP"VASCU-PICC PERIPHERALLY INSERTED CENTRAL VEIN
ACCESS CATHETER(1 LUMEN)(C+N+G+D)"美德康"週邊置入中央靜脈
導管組*給付規定請見備註欄
2884
CLPA11PS0TCK VITAL-PORT VASCULAR ACCESS SYSTEMS(P+C+N+I+GW)※適應症請
見備註欄
7712
CLPA1200202C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE)※適應
症請見備註欄
7539
CLPA1200212C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM(P+C+N+I)※適應症請見備註
欄
7712
798
特材代碼 中英文名稱 支付點數-104/01/01
CLPA1200222C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE)※適應
症請見備註欄
7539
CLPA1200232C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE)※適應
症請見備註欄
7539
CLPA1200242C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM(P+C+N)※適應症請見備註欄
7539
CLPA1200262C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE)※適應
症請見備註欄
7539
CLPA1200272C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE)※適應
症請見備註欄
7539
CLPA1200442C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE)※適應
症請見備註欄
7539
CLPA1200452C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM(P+C+N+I)※適應症請見備註
欄
7712
CLPA1200852C "柯惠"植入型注射系統"COVIDIEN"AUTO SUTURE CHEMOSITE
IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE)※適應
症請見備註欄
7539
CLPA12023A2C "柯惠"輕薄型植入式釋藥系統"COVIDIEN"CHEMOSITE IMPLANTABLE
DRUG DELIVERY SYSTEM/AUTO SUTURE
CHEMOSITE(PORT+CATH+NEEDLE)※給附規定請見備註欄
7539
CLPA130000BB SINGLE TITANIUM MBS CELSITE PORT(PORT+CATH+NEEDLE)※適應
症請見備註欄
7539
CLPA13007NYP "PEROUSE"POLYSITE IMPLANTABLE PORT(P+C+N+I)全套式植入式血
管輸注器
7712
CLPA130085BB SINGLE TITANIUM EPOXY CELSITE PORT(PORT+CATH+NEEDLE)※適
應症請見備註欄
7539
CLPA13008NYP "PEROUSE"POLYSITE IMPLANTABLE PORT(PORT+CATH)植入式血管輸
注器*適應症請見備註欄
7470
CLPA130395BB CELSITE IMPLANTABLE PORT ,STANDARD (P+C+N+I)*適應症請見備
註欄
7712
CLPA130893BB CELSITE IMPLANTABLE PORT ,SMALL (P+C+N+I)*適應症請見備註
欄(型號04436962文號:920036552)(型號04436806自940701起刪
除)
7712
CLPA132045BB SINGLE TITANIUM MBS CELSITE
PORT(PORT+CATH+NEEDLE+INTRODUCER)※適應症請見備註欄
7712
CLPA14025NHJ TITANIUM PORT-A-CATH (P+C+N+I) ※適應症請見備註欄 7712
CLPA14072NHJ "SMITHS"IMPLANTABLE ACCESS SYSTEM內植用輸液管
(P+C+N+I+GRIPPER NEEDLE)*適應症請見備註欄
7712
CLPA14130NBA SINGLE LUMEN PER-Q-CATHETER WITH GUIDWIRE 2.0:5.0FR※適應
症請見備註欄
2798
CLPA145213NL "NAVILYST"VAXCEL IMPLANTABLE PORTS/W PASV TECHNOLOGY (1
LUMEN)(P+C+N+I)斐克希植入式輸液座*適應症請見備註欄
7712
CLPA145455NL VAXCEL PERIPHERALLY INSERTED CENTRAL CATHETER(PICC)(1
LUMEN)/W PASV VALVE TECHNOLOGY週邊導入中央靜脈導管*適應症
見備註
2798
799
特材代碼 中英文名稱 支付點數-104/01/01
CLPA145458NL "NAVILYST"VAXCEL PERIPHERALLY INSERTED CENTRAL
CATHE(PICC)W PASV VALVE TECHNOLOGY(1 LUMEN)(C+N+D+G)週邊
導入中央靜脈導管*適應症見備註
2884
CLPA145470NL VAXCEL PERIPHERALLY INSERTED CENTRAL CATHETER(PICC)(2
LUMEN)/W PASV VALVE TECHNOLOGY週邊導入中央靜脈導管*適應症
見備註
2858
CLPA145478NL "NAVILYST"VAXCEL PERIPHERALLY INSERTED CENTRAL
CATHE(PICC)W PASV VALVE TECHNOLOGY(2 LUMEN)(C+N+D+G)週邊
導入中央靜脈導管*適應症見備註
3335
CLPA1501112A "迪特適"內植輸液導管座及其附件"DISTRICATH" IMPLANTABLE
CATHETER PORTS AND ACCESSORIES
7712
CLPA1501122A "迪特適"內植輸液導管座及其附件"DISTRICATH" IMPLANTABLE
CATHETER PORTS AND ACCESSORIES
7712
CLPA1501132A "迪特適"內植輸液導管座及其附件"DISTRICATH" IMPLANTABLE
CATHETER PORTS AND ACCESSORIES
7712
CLPA1501142A "迪特適"內植輸液導管座及其附件"DISTRICATH" IMPLANTABLE
CATHETER PORTS AND ACCESSORIES
7712
CLPA1501152A "迪特適"內植輸液導管座及其附件"DISTRICATH" IMPLANTABLE
CATHETER PORTS AND ACCESSORIES
7712
CLPA1501162A "迪特適"內植輸液導管座及其附件"DISTRICATH" IMPLANTABLE
CATHETER PORTS AND ACCESSORIES
7712
CLPA150120FM "FORTUNE"IMPLANTABLE VASCULAR ACCESS
PORT(PORT+CATH+NEEDLE+INTRODUCER)"富強"植入型血管輸液系統
*適應症請見備註欄
7712
CLPA15105KHZ "HORIZEN"VORTEX VTX TITANIUM VASCULAR ACCESS
PORTS(P+C+N+I)*給付規定請見備註欄
8196
CLPA160260DV SINGLE PLASTIC HICKMAN PORT(PORT+CATH+NEEDLE) ※適應症請
見備註欄
7539
CLPA160284BA SINGLE MRI PLASTIC PORT W/GROSHONG 3-WAY(P+C+N) (型號
0604510自91/07/01生效)※適應症請見備註欄
7539
CLPA161635PF ARTERIAL PORT CATH組(PORT+CATH+NEEDLE+INTRODUCER)※給付規
定請見備註欄
10370
CLPA161636PF SINGLE LUMEN PFM VASCULAR ACCESS SYSTEM JET
(C+G+N+I+GRIPPER NEEDLE)*適應症請見備註欄
7712
CLPA165750BA X-PORT ISP IMPLANTED PORT WITH MICROINTRODUCER
KIT(P+C+N+I)*適應正請見備註欄
7712
CLPA166041M0 "MEDCOMP"LOW PROFILE SHAPED CT PORTS AND
ACCESSORIES(P+C+N+I)薄型植入式輸液座與導管組*適應症請見備
註欄
7712
CLPA166801M0 "MEDCOMP"MID-SIZE SHAPED CT PORTS AND
ACCESSORIES(P+C+N+I) 中型植入式輸液座與導管組*適應症請見
備註欄
7712
CLPA170754BA X-PORT ISP IMPLANTED PORT WITH INTERMEDIATE KIT(P+C+N+I)*
適應正請見備註欄
7712
CLPA17505NBA "BARD"GROSHONG PERIPHERALLY INSERTED CENTRAL VENOUS DUAL-
LUMEN W/INTRODUCER KIT*適應症請見備註欄
3335
CLPA176174BA "BARD"GROSHONG NXT CLEAR VUE 4FR.SINGLE LUMEN(PICC)葛羅祥
刻立回中央靜脈導管*適應症請見備註欄
2798
CLPA17715NBA SINGLE LUMEN GROSHONG PERIPHERALLY INSERT CENTRAL VENOUS
CATH 3,4FR※適應症請見備註欄
2798
CLPA196001M0 "MEDCOMP"PRO-FUSE AND ACCESSORIES(P+C+N+I)普羅福斯植入式
輸液座與導管組*適應症請見備註欄
7712
800
特材代碼 中英文名稱 支付點數-104/01/01
CLPA1ABRM1CK "COOK"SPECTRUM TURBO-JECT PICC SETS 4-5FR
60CM(CATH+INTRODUCER) "曲克"史派純特波傑特周邊血管導入套
組(單腔)
3900
CLPA1ABRM2CK "COOK"SPECTRUM TURBO-JECT PICC SETS 4-5FR 50CM
(CATH+INTRODUCER)"曲克"史派純特波傑特周邊血管導入套組(雙
腔)
4100
CLPA1P0R45SB "BOSTON SCIENTIFIC"VAXCEL IMPLANTABLE PORTS WITH PASV
TECHNOLOGY (SINGLE LUMEN)(P+C+NX2+I)斐克希植入式輸液座*適
應症請見備註欄
7712
CLPA1P1CC1CK TURBO-FLO PERIPHERALLY INSERTED CENTRAL VENOUS
CATHETER(PICC) SET-ONE LUMEN (C+D+G+N)*適應請見備註欄
2884
CLPA1P1CC2CK TURBO-FLO PERIPHERALLY INSERTED CENTRAL VENOUS
CATHETER(PICC) SET-ONE LUMEN (C+D+G+N)*適應請見備註欄
2884
CLPA1P1CC3CK TURBO-FLO PERIPHERALLY INSERTED CENTRAL VENOUS
CATHETER(PICC) SET-TWOLUMEN (C+D+G+N)*適應請見備註欄
3335
CLPA1P1CC4CK TURBO-FLO PERIPHERALLY INSERTED CENTRAL VENOUS
CATHETER(PICC) SET-TWOLUMEN (C+D+G+N)*適應請見備註欄
3335
CLPA1P1CC5CK TURBO-FLO OVER THE WIRE PERIPHERALLY INSERTED CENTRAL
VENOUS CATHETER(PICC)SET(SINGLE LUMEN C+I+G)*適應症請見備
註欄
2884
CLPA1P1CC6CK TURBO-FLO OVER THE WIRE PERIPHERALLY INSERTED CENTRAL
VENOUS CATHETER(PICC)SET(DOUBLE LUMEN C+I+G)*適應症請見備
註欄
3335
CLPA1P1CC7CK "COOK"TURBO-JECT PICC SET(CATH+INTRODUCER)週邊導入中央靜
脈導管組(單腔)*適應症請見備註欄
2884
CLPA1P1CC8CK "COOK"TURBO-JECT PICC SET(CATH+INTRODUCER)週邊導入中央靜
脈導管組(雙腔)*適應症請見備註欄
3335
CLPA1V1TA1CK "COOK"VITAL-PORT VASCULAR ACCESS SYSTEM注射口組(P+C+N+I)
適應症請見備註欄
7712
CLPA1VRXTRRH “瑞塔”植入型注射系統 “RITA” VORTEX TR PORT SYSTEM 8196
CLS040114NPW INFUSION SET W/BURETTE W/VALVE 100CC 41
CLS0404965HR "赫士睿"微量輸液套"Hospira"SOLUSET 100X60 PRECISION
VOLUME IV SET W/100ML BURETTE AND MICRODRIP DRIP CHAMBER
※適應症請見備註欄
94.5
CLS040520VBB DOSIFIX VOLUME CONTROL ADMMINISTRATION SET 120ML WITH
VALVE
41
CLS040708NPW PERFECT DISPOSABLE INFUSION SET(W/BURETTE W/VALVE) 41
CLS041VC02TZ "善德"定量型輸液套"SUNDER" VOLUME CONTROL I.V.
ADMINISTRATION SET
41
CLS041VPB3JS JMS INFUSION SET WITH BURET 100CC 41
CLS046369NPW INFUSION SET W/BURETTE W/VALVE 150CC,200CC 41
CLS04BR150SG VOLUME METERIC ADMINISTRATION SET W/FILTER 41
CLS04BS120SG VOLUME METERIC ADMISTRATION SET W/VALVE W/FILTER 41
CLS04BS150SG VOLUME METERIC ADMINISTRATION SET W/VALUE W/FILTER 41
CLS04BT100SG VOLUMEMETRIC ADMINSTRATION SET 41
CLS04BT120SG VOLUME METERIC ADMISTRATION SET W/FILTER 41
CLS04BT163BQ Infusion set 100ml with valve &filter 41
CLS04BT164BQ Infusion set 150ml with valve &filter 41
CLS04BV100SG VOLUMEMMETRIC ADMINSTRATION SET 100ML WITH VALVE 41
CLS04BV150SG VOLUMEMMETRIC ADMINSTRATION SET 150ML WITH VALVE 41
CLS04C1BESLL "怡安"精密輸液套"LILY"VOLUME METRIC ADMINISTRATION SET 41
CLS04CSBACLL "LILY"VOLUME METERIC ADMINISTRATION SET W/VALVE精密輸液套 41
CLS04CSBESLL "LILY"VOLUME METERIC ADMINISTRATION SET(W/VALVE)* 41
801
特材代碼 中英文名稱 支付點數-104/01/01
CLS04CSBVFLL VOLUME METERIC ADMINISTRATION SET 100ML 120ML 150ML附過濾
網
41
CLS04CSBVSLL VOLUME METERIC ADMINISTRATION SET 100ML 120ML 150ML
W/VALVE附止水閥、附過濾網
41
CLS04IVPBFJS INFUSION SET PEDIATRIC 100ML BURET W/FLOAT VALVE 41
CLS04M270LTM TERUFUSION VOLUMETRIC SOLUTION ADMINISTRAION SET WITH
VALVE
41
CLS04SBAFHLL VOLUME METERIC ADMINISTRATION SET 150CC W/VALVE 41
CLS0501648HR PLUMSET I.V PUMP SET*適應症請見備註欄 152
CLS0501756HR PRIMARY IV PUMP SET*適應症請見備註欄 152
CLS0502210ZL "CARDINAL" ADMINSTRATION SET※適應症請見備註欄 152
CLS0502230ZL "CARDINAL" ADMINSTRATION SET(0.2MICRO FILTER) 261
CLS0502260ZL "CARDINAL" ADMINISTRATION SET 230
CLS0502280ZL "CARDINAL" ADMINSTRATION SET※適應症請見備註欄 152
CLS05036SPBB "B.BRAUN"INFUSOMAT SPACE LINE柏朗史倍司輸液套*適應症請見
備註欄
152
CLS050800BTM "TERUMO"TERUFUSION SOLUTION ADMINISTRATION SET FOR
INFUSION PUMP(IV PUMP SET)"泰爾茂"輸液套*給付規定請見備註
欄
75
CLS05095SPBB 柏朗史倍司輸液套 INFUSOMAT SPACE LINE INFUSION PUMP
ADMINISSTRATION SETS
261
CLS0511943HR “Hospira” Lifeshield Plum Pump Sets “赫士睿”浦朗幫浦
輸液套(附無針式接頭1個)
195
CLS0511948HR "HOSPIRA"LIFESHIELD PLUM PUMP SETS W/BURETTE"赫士睿"浦朗
幫浦輸液套(BURETTE幫浦輸液套附無針式接頭3個)※給付規定請
見備註欄
326
CLS0512030HR “Hospira” Lifeshield Plum Pump Sets “赫士睿”浦朗幫浦
輸液套(附無針式接頭2個)
238
CLS05130PUSG "SIGMA"INFUSION PUMP SET 幫浦輸液套*適應症請見備註欄 152
CLS052027HM8 "MEDITOP"INFUSION SET FOR INFUSION PUMP輸液套(輸液幫浦用) 75
CLS0541950KG "KABI"VOLUMAT LINE INFUSION SETS- STANDARD PUMP SET FOR
INFUSION "卡比"路美輸液組合套-一般幫浦輸液套*給付規定請見
備註欄
152
CLS0543150KG "KABI"VOLUMAT LINE INFUSION SETS- PUMP DUAL SET FOR
TRANSFUSION AND INFUSION "卡比"路美輸液組合套-幫浦用Y型輸
血套
230
CLS0543650KG "KABI"VOLUMAT LINE INFUSION SETS- PVC-FREE SET FOR
INFUSION OF NTG AND DRUGS INCOMPATIBLE WITH PVC "卡比"路
美輸液組合套-NTG幫浦輸液套
230
CLS0544950KG "KABI"VOLUMAT LINE INFUSION SETS- PVC-FREE PUMP SET FOR
INFUSION OF LIGHT SENSITIVE DRUGS "卡比"路美輸液組合套-幫
浦用避光輸液套
188
CLS0545250KG "KABI"VOLUMAT LINE INFUSION SETS- INFUSION PUMP SET WITH
150ML GRADUATED BURETTE "卡比"路美輸液組合套-幫浦用精密
輸液套*給付規定請見備註欄
197
CLS0560103J6 "卡爾費森"輸液套(含量筒附無針式接頭二個)“CAREFUSION”
ALARIS GP INFUSION SETS(WITH BURETTE, 2*NEEDLE-FREE VALVE
PORT)
283
CLS0563200J6 "卡爾費森"輸液套"CAREFUSION"ALARIS GP INFUSION SETS 152
CLS0563401J6 "卡爾費森"輸液套(含無針式接頭一個)“CAREFUSION” ALARIS
GP INFUSION SETS(WITH 1*NEEDLE-FREE VALVE PORT)
195
CLS0563420J6 "卡爾費森"輸液套(含無針式接頭二個)“CAREFUSION” ALARIS
GP INFUSION SETS(WITH 2*NEEDLE-FREE VALVE PORT)
238
802
特材代碼 中英文名稱 支付點數-104/01/01
CLS05A200LTM TERUFUSION IV PUMP SET WITHOUT BAG※適應症請見備註欄 75
CLS05T037HTP INFUSION PUMP SET※適應症請見備註欄 75
CLS0602241ZL "CARDINAL" ADMINSTRATION SET※適應症請見備註欄 197
CLS0602427HR PUMP SET(NITROGLYCERIN) 230
CLS06080PUSG "SIGMA"INFUSION PUMP SET WITH BURETTE幫浦輸液套*適應症請
見備註欄
197
CLS060L218HR NTG PUMP SET WITH LIGHT PROTECTIVE POLYETHYLENE TUBINGING 188
CLS0611706HR BURETTE PUMP SET*適應症請見備註欄 197
CLS0611879HR "赫士睿"浦朗幫浦靜脈輸液套"Hospira"PLUMSET IV PUMP SET
W/FILTER
261
CLS06120PUSG "SIGMA"INFUSION PUMP SET LIGHT-RESISTANT 幫浦輸液套(不透
光型)
188
CLS0612339HR “Hospira” Lifeshield Plum Pump Sets W/Light-resistance
“赫士睿”浦朗幫浦輸液套(避光幫浦輸套附無針式接頭1個)
231
CLS06125SPBB INFUSOMAT SPACE LINE UV-PROTECT史倍司輸液套(不透光型) 188
CLS06294SPBB "B.BRAUN"INFUSOMAT SPACE LINE WITH BURETTE+NEEDLE-FREE
ACCESS PORT 柏朗史倍司輸液套(含儲藥筒)*適應症請見備註欄
197
CLS06731SPBB INFUSOMAT SPACE LINE PVC-FREE SET FOR THE ADMINISTRATION
OF CYTOTOXIC AGENTS史倍司輸液套
188
CLS06C7553BT (NON-)VENTED PACLITAXEL SET W/0.22MICRON FILTER 261
CLS06C9644BT LIGHT SENSITIVE CLEARLINK SET無針系統含過濾器避光輸液套※
適應症請見備註欄
265
CLS06C9651BT BURETROL PUMP SET W/BURETTE※適應症請見備註欄 197
CLS06M270LTM TERUFUSION IV PUMP SET WITH BAG 100CC※適應症請見備註欄 122.6
CLS06V9607BT "BAXTER"LIGHT SENSITIVE DRUGS SET避光靜脈輸液管組 188
CLS070800BTM "TERUMO"TERUFUSION PLATELET ADMINISTRATION SET"泰爾茂"血
小板輸液套
17
CLS071724NPW TRANSFUSION SET 17
CLS07A130NPW PERFECT DISPOSABLE TRANSFUSION (L TYPE ) 17
CLS07BT110SG 十美牌輸血套-單腔型DEHP SIGMA BLOOD TRANSFUSION SET–
SINGLE TYPE DEHP
17
CLS07BT120SG 十美牌輸血套-單腔型DEHP FREE SIGMA BLOOD TRANSFUSION SET
–SINGLE TYPE DEHP FREE
17
CLS07BT350JS BLOOD TRANSFUSION SET 17
CLS08066SPBB INFUSOMAT SPACE LINE TRANSFUSION WITH 200UM BLOOD FILTER
史倍司輸血套
230
CLS0808949HR Y-TYPE BLOOD SET WITH PUMP 230
CLS0811664HR "赫士睿"Y型輸血用幫浦套"Hospira"Y-TYPE BLOOD PLUMSET 230
CLS0812259HR “Hospira” Lifeshield Plum Pump Sets W/Y Pump Set “赫士
睿”浦朗幫浦輸液套(附無針式接頭2個)
316
CLS08140PUSG "SIGMA"INFUSION PUMP SET BLOOD FILTER 幫浦輸血輸液套 230
CLS08150PUSG "SIGMA"INFUSION PUMP SET Y-SITE BLOOD FILTER Y 型幫浦輸血
輸液套
230
CLS0900BTYJS Y TYPE BLOOD TRANSFUSION SET 22
CLS0902004TM Y TYPE ADMINISTRATION SET 22
CLS0902005TM Y TYPE ADMINISTRATION SET 22
CLS09A140NPW PERFECT DISPOSABLE TRANSFUSION (Y TYPE ) 22
CLS09B140NPW Y TYPE BLOOD TRANSFUSION SET 22
CLS09BT210SG 十美牌輸血套-雙腔Y型DEHP SIGMA BLOOD TRANSFUSION SET–
DOUBLE Y TYPE DEHP
22
CLS09BT220SG 十美牌輸血套-雙腔Y型DEHP SIGMA BLOOD TRANSFUSION SET–
DOUBLE Y TYPE DEHP FREE
22
803
特材代碼 中英文名稱 支付點數-104/01/01
CLS1202427HR PUMP SET(NITROGLYCERIN) 230
CLS1400737BX "BAXA"EXACTA-MIX EVA CONTAINER 250ML"柏瑟"靜脈營養術灌注
袋
101
CLS1400738BX "BAXA"EXACTA-MIX EVA CONTAINER 500ML"柏瑟"靜脈營養術灌注
袋
101
CLS1400739BX "BAXA"EXACTA-MIX EVA CONTAINER 1000ML"柏瑟"靜脈營養術灌注
袋
127
CLS14B8084CT VIAFLEX TPN BAG 1000C.C. 125
CLS14B8112CT ALL-IN-ONE BAG 1000CC 127
CLS14B8152CT ALL-IN-ONE BAG 500 CC 101
CME01MABDLBL MAGIC CATHETER WITH BALLOON EMBOLIZATION
SET(BALLOON+MICRO CATH+MANDRIA)※適應症請見備註欄
36019
CME01MABDXBL MAGIC CATHETER WITH BALLOON EMBOLIZATION
SET(BALLOON+MICRO CATH+MANDRIA)※適應症請見備註欄
36019
CME02BC04XMS “麥新”史凱特閉塞球囊導管組(含“麥新”翠克絲微導線)
“MICROVENTION”SCEPTER OCCLUSION BALLOON CATHETER
(INCLUDE “MICROVENTION” TRAXCESS GUIDEWI
33164
CME02BCXXXMS “麥新”史凱特閉塞球囊導管“MICROVENTION”SCEPTER
OCCLUSION BALLOON CATHETER*給付規定請見備註欄
29261
CME02GL1DEV9 "MTI"OCCLUSION BALLOON SYSTEM(HYPERGLIDE)(含GUIDE WIRE及
卡式注射器)"恩提愛"閉塞球囊系統*適應症請見備註欄
33164
CME02HYPERV9 "MTI"OCCLUSION BALLOON SYSTEM(HYPERFORM)(含GUIDE WIRE及卡
式注射器)"恩提愛"閉塞球囊系統
35267
CMV0107056UF "PENUMBRA"NEURON INTRACRANIAL ACCESS SYSTEM"彼娜波"紐諾顱
內導入系統(NEURON傳送導管)
12000
CMV0118298SB RENEGADE HI-FLO MICROCATHETER KIT(MICROCATH+G
WIRE+HEMASTATIC)*適應症請見備註欄
13810
CMV0149152SB SPINNAKER ELITE FLOW DIRECTED INFUSION CATHETER
SET(INFUSION CATH+MICRO GUIDEWIRE+HEMASTATIC )*適應症請見
備註欄
13810
CMV0149152TA SPINNAKER INFUSION CATHTER(CATH+GUIDEWIRE+HEMASTATIC)※適
應症請見備註欄
13810
CMV0149181SB EXCELSIOR MICROCATHETER LENGTH 150/6 TIP CONFIGURATION
1,2 MARKER *適應症請見備註欄
7440
CMV0149189SB EXCELSIOR PRE-SHAPED MICROCATHETER*適應症請見備註欄 7440
CMV0150103SB FAS TRACKER INFUSON CATHETER KIT(CATH+GUIDE
WIRE+HEMASTATIC)*適應症請見備註欄
13810
CMV016060NCM "CODMAN"PROWLER INFUSION CATHETER"科特曼"保勒注射導管※適
應症請見備註欄
7440
CMV016061NCM "CODMAN"PROWLER INFUSION CATHETER"科特曼"保勒注射導管※適
應症請見備註欄
7440
CMV01606S1CM "CODMAN"PROWLER LP&LP-ES INFUSION CATHETER"科特曼"保勒注
射導管※適應症請見備註欄
7440
CMV01606S2CM "CODMAN"PROWLER PLUS INFUSION CATHETER"科特曼"保勒注射導
管※適應症請見備註欄
7440
CMV01606XNCM "CODMAN"PROWLER INFUSION CATHETER"科特曼"保勒注射導管※適
應症請見備註欄
7440
CMV016251NCM "CODMAN"PROWLER INFUSION CATHETER"科特曼"保勒注射導管※適
應症請見備註欄
7440
CMV018F088UF "彼娜波"紐諾邁克斯系統-8F傳送導管(NEURON傳送導
管)"PENUMBRA"NEURON MAX SYSTEM-8F DELIVERY CATHETER
12000
CMV01E2710TM PROGREAT CATHETER(MICRO CATH+INTRODUCER
WIRE+COATING+HEMASTATIC)※適應症請見備註欄
13810
804
特材代碼 中英文名稱 支付點數-104/01/01
CMV01ECHL0V9 "MTI"ECHELON MICRO CATHETERS "恩提愛"微導管(CATH+MICRO
GUIDE WIRE+HEMASTATIC)*適應症請見備註欄
13810
CMV01FS135MR "MERIT"FOUNTAIN INFUSION SYSTEM(CATH+GUIDE
WIRE+HEMASTATIC)芳登灌輸系統*適應症請見備註欄
13810
CMV01HEADWMS "MICROVENTION"HEADWAY MICROCATHETER(導管+止血閥+導引器)"
麥新"前進微導管*給付規定請見備註欄
13810
CMV01MC1S2CK "COOK"MULTI-SIDEPORT CATHETER INFUSION SET多側孔注射導管
組*適應症請見備註欄
7440
CMV01MF251CK "COOK"MIRA-FLEX 18 MICROCATHETER*適應症請見備註欄 7440
CMV01MF252CK "COOK"CANTATA 2.5 AND CANTATA 2.8 MICROCATHETER"曲克"坎塔
塔微導管*適應症請見備註欄
7440
CMV01MFNT1CK "COOK"MIRAFLEX MICROCATHETER麥拉菲微導管*適應症請見備註欄 7440
CMV01MFNT2CK "COOK"MIRAFLEX MICROCATHETER 2.5FR 100:150CM麥拉菲微導管*
適應症請見備註欄
7440
CMV01MFS01CK MICROFERRET-21 HIGH FLOW INFUSION CATH
SET(C+G+CONNE.+TOR.DEVICE)※適應症請見備註欄
13810
CMV01MFS11CK COOK MICROFERRET-18 INFUSION CATHETER SET(CATH+GUIDE
WIRE+HEMASTATIC)*適應症請見備註欄
13810
CMV01MFS15CK COOK MICROFERRET-18 INFUSION CATHETER SET(CATH+GUIDE
WIRE+HEMASTATIC)*適應症請見備註欄
13810
CMV01P2710TM PROGREAT CATHETER(MICRO CATH+INTERODUCER
WIRE+COATING+HEMASTATIC)※適應症請見備註欄
13810
CMV01PC241TM PROGREAT CATHETER(MICRO CATH+INTRODUCER
WIRE+COATING+HEMASTATIC)※適應症請見備註欄
13810
CMV01PX400UF "PENUMBRA"MICROCATHETER(導管+止血閥+導引器)"彼娜波"*微導
管*給付規定請見備註欄
13810
CMV01REBARV9 MTI REBAR MICRO CATHETER SET(MICRO CATH+GUIDE
WIRE+HEMASTATIC)恩提愛瑞霸微導管*適應症請見備註欄
13810
CMV01RENFASB "BOSTON SCIENTIFIC"RENEGADE HI-FLO FATHOM KIT (CATH+GUIDE
WIRE+HEMASTATIC)AND SYSTEM "波士頓科技"瑞能蓋高流動探測組
*適應症請見備註欄
13810
CMV01SCR3NCK "COOK"MULTI-SIDEPORT CATHETER INFUSION SET 多側孔注射導管
組*適應症請見備註欄
7440
CMV01SCWHVMR "MERIT"FOUNTAIN INFUSION SYSTEM(CATH+GUIDE
WIRE+HEMASTATIC)芳登灌輸系統*適應症請見備註欄
13810
CMV01SMAGXBL BALT MAGIC CATHETER SET ※適應症請見備註欄 18227
CMV01SQ135MR "MERIT"FOUNTAIN INFUSION SYSTEM(CATH+GUIDE
WIRE+HEMASTATIC)芳登灌輸系統*適應症請見備註欄
13810
CMV020402XGT "GOODTEC"BALLOON CATHETER-ARTERIAL EMBOLECTOMY CATHETER"
固特克"球型導管
995
CMV0205102SB FAS TRACKER INFUSON CATHETER*適應症請見備註欄 7440
CMV020F20LQM "MAQUET"AXIUS CORONARY SHUNT"邁柯唯"艾齊克氏冠狀動脈分流
管*適應症請見備註欄
2696
CMV0210042SB "BOSTON SCIENTIFIC"GUIDER SOFTIP XF GUIDING CATHETER*適應
症請見備註欄
6535
CMV0210062SB "BOSTON SCIENTIFIC"GUIDER SOFTIP XF GUIDING CATHETER*適應
症請見備註欄
6535
CMV02120FFED EDWARDS FOGARTY ARTERIAL EMBOLECTOMY CATHETER 995
CMV02120XNED FORGATY ARTERIAL EMBOLECTOMY CATHETER 2:7FR 40:80MM 995
CMV021240NBT FORGATY EMBOLECTOMY CATHETER 995
CMV021280NBT FORGATY EMBOLECTOMY CATHETER 995
CMV0212TLWED FOGARTY THRU-LUMEN EMBOLECTOMY CATHETER(2 LUMEN CATH) 1895
CMV0214270SB TRACKER EXCEL-14 MICROCATHETER*適應症請見備註欄 7440
805
特材代碼 中英文名稱 支付點數-104/01/01
CMV0214270TA TARGET THERAPEUTICS TRACKER EXCEL-14 MICROCATHETER*適應症
請見備註欄
7440
CMV02142NNTA TARGET THERAPEUTICS TRACKER EXCEL-14 MICROCATHETER*適應症
請見備註欄
7440
CMV021601SLW "LEMAITRE"EMBOLECTOMY CATHETERS單腔式動脈血栓清除導管 995
CMV0216510LW "LEMAITRE"EMBOLECTOMY CATHETERS導引線式動脈血栓清除導管
(雙腔)
1895
CMV0218251SB RENEGADE MICROCATHETER*適應症請見備註欄 7440
CMV0218251TA RENAGADE FIBER BRAIDED MICRO CATH PROXIMAL/DISTAL 3F/2.5F
130,150CM※適應症請見備註欄
7440
CMV0218282SB RENEGADE HI-FLO MICROCATHETER OD=3.0F/2.8F ID=0.027/0.027
L80/150CM *適應症請見備註欄
7440
CMV0218284SB RENEGADE HI-FLO MICROCATHETER O.D 3.0,2.8F I.D 0.027 L
80,150CM *適應症請見備註欄
7440
CMV021CXXXMS "MICROVENTION"CHAPERON GUIDING CATHETER SYSTEM"麥新"護航
導引導管系統*給付規定請見備註欄
6535
CMV021VS12ED ANASTA FLO INTRAVASCULAR SHUNT*適應症請見備註欄 2696
CMV0231100M4 CLEARVIEW INTRACORONARY SHUNT*適應症請見備註欄 2696
CMV0232080ED FORGATY VENOUS THROMBECTOMY CATHETER 995
CMV02403VBCD "CORDIS"VISTA BRITE TIP INTRODUCER GUIDING "考迪斯"導引導
管*適應症請見備註欄
6535
CMV02600XNCM "CODMAN"TRANSIT INFUSION CATHETER"科特曼"微細血管注射導管
*適應症請見備註欄
7440
CMV02A4400A4 SYNTEL ARTERIAL EMBOLECTOMY CATHETER 3:7FR/40,50,80CM 995
CMV02A4E09A4 PYTHON DUAL LUMEN EMBOLECTOMY CATHETER(CATH+GUIDE
WIRE+INTRODUCER)
2556
CMV02A4F00A4 SYNTEL ARTERIAL EMBOLECTOMY CATHETER 2:7FR 40,60,80CM 995
CMV02C1254B2 FLORESTER CORONARY ARTERY OCCLUDER 冠狀動脈血管阻塞棒 2591
CMV02C5015S7 "SYNOVIS"FLO-RESTER VESSEL OCCLUDERS血管閉塞器 2591
CMV02EL134BS ARTERIAL EMBOLECTOMY CATHETER"拜爾生"血栓清除導管 995
CMV02EL326BS EMBOLECTOMY CATHETER 995
CMV02FT012B2 FLO-THRU INTRALUMINAL SHUNT 血管通路器 *適應症請見備註欄 2696
CMV02FT012S7 FLO-THRU INTRALUMINAL SHUNT 血管通路器*適應症請見備註欄 2696
CMV02GCXXXMS "MICROVENTION"CHAPERON GUIDING CATHETER SYSTEM"麥新"護航
導引導管系統*給付規定請見備註欄
6535
CMV02GNDRAVS "VASCULAR SOLUTIONS"GANDRAS INTRAVASCULAR
CATHETER(INFUSION)"法斯樂舒順"恩德拉血管內導管*適應症請見
備註欄
7440
CMV02GSFK1TM "TERUMO"DESTINATION GUIDING SHEATH"泰爾茂"諦思迪迅導引套*
給付規定請見備註欄
6535
CMV02KCFW1CK "COOK"FLEXOR GUIDING CATHETERS 福雷色引導導管*適應症請見
備註欄
6535
CMV02KCFW2CK "COOK"FLEXOR GUIDING CATHETERS "曲克"服來瑟引導導管
4.0~12.0FR,30~110CM
6535
CMV02KCFW3CK "COOK"FLEXOR GUIDING CATHETERS "曲克"服來瑟引導導管
5.0~10.0FR,55~90CM
6535
CMV02KCFW4CK "COOK"FLEXOR GUIDING CATHETERS "曲克"福雷色引導導管
4.0~12.0FR,40~110CM
6535
CMV02KSAW1CK "COOK "FLEXOR GUIDING CATHETERS "曲克"服來瑟引導導管*適應
症請見備註欄
6535
CMV02KSAW2CK COOK FLEXOR GUIDING CATHETERS 0.038" 70:90CM*適應症請見備
註欄
6535
806
特材代碼 中英文名稱 支付點數-104/01/01
CMV02KSAW3CK "COOK"FLEXOR GUIDING CATHETERS 5.0FR:8.0FR
0.018/0.038:0.038 40CM:90CM
6535
CMV02KSAW4CK "COOK"FLEXOR GUIDING CATHETERS弗萊色引導導管*適應症請見備
註欄
6535
CMV02KSAW5CK "COOK"FLEXOR GUIDING CATHETERS弗萊色引導導管*適應症請見備
註欄
6535
CMV02KSAW6CK "COOK"FLEXOR GUIDING CATHETERS5-8FR 55:110MM服來瑟引導導
管*適應症請見備註欄
6535
CMV02LMGN1CK "COOK"NORTHSTAR LUMAX FLEX GUIDING CATHETERS諾斯達盧馬福
雷司導引導管*適應症請見備註欄
6535
CMV02LMGN2CK "COOK"WHITE LUMAX GUIDING CATHETERS懷特盧馬導引導管*適應
症請見備註欄
6535
CMV02MC172MS "MICROVENTION"HEADWAY MICROCATHETER前進微導管*給付規定請
見備註欄
7440
CMV02MF001CK MICROFERRET-18 INFUSION CATHETER SET 3FR *適應症請見備註
欄
7440
CMV02PNS13UF "PENUMBRA"NEURON INTRACRANIAL ACCESS SYSTEM-SELECT
CATHETER顱內導入系統導管*適應症請見備註欄
7440
CMV02V3064B2 FLORESTER VASCULAR OCCLUDER 週邊動脈血管阻塞棒 2591
CMV0346802SB TRANSEND GUIDE WIRE *適應症請見備註欄 4650
CMV0361414CM "CODMAN"AGILITY STEERABLE GUIDEWIRE"科特曼"愛捷第導引線※
適應症請見備註欄
4650
CMV03614XNCM "CODMAN"AGILITY STEERABLE GUIDEWIRE"科特曼"愛捷第導引線※
適應症請見備註欄
4650
CMV03FA509SB "BOSTON SCIENTIFIC"FATHOM-16 STEERABLE GUIDEWIRE菲森可控
式導線*適應症請見備註欄
4650
CMV03FWR45MR "MERIT"FOUNTAIN INFUSION SYSTEM(GUIDE WIRE+TORQUE)芳登灌
輸系統*適應症請見備註欄
4650
CMV03GW14XMS "MICROVENTION"TRAXCESS GUIDE WIRE"麥新"翠克絲微導線*適應
症請見備註欄
4650
CMV03MT1GWV9 "MTI"GUIDEWIRE導引線(親水性導入線+扭轉器+導入線導入鞘)*適
應症請見備註欄
4650
CMV03S0RXXBL "BALT"SORCERER GUIDEWIRE魔術師導線*適應症請見備註欄 4650
CMV03STM48AS ASAHI MICRO GUIDEWIRE 0.014" 0.018"*適應症請見備註欄 4650
CMV03STMGWAS "ASAHI"STREAMING MICRO GUIDEWIRE 0.014" 0.018"朝日"微導引
線*給付規定請見備註欄
4650
CMV03TPMG1CK MICRO GUIDE WIRE 0.14INCH *適應症請見備註欄 4650
CMV03TPMG2CK "COOK"MICRO WIRE GUIDE 導線*適應症請見備註欄 4650
CMV03XCEGWV9 "MTI"X-CELERATOR GUIDEWIRE 0.010",0.014"300CM "恩提愛"愛
克西亞導引線(親水性導引線+扭轉器+導入線導入鞘)
4650
CMV0403010TA FIBERED PLATINUM COIL※適應症請見備註欄 2971
CMV0403120TA FIBERED PLATINUM COIL2:30MMX2:100MM※適應症請見備註欄 2971
CMV0436010SB GDC-SYNERG OCCLUSION COIL*適應症請見備註欄(型號:347204-SR
自951001起生效)
16876
CMV0436018SB GDC-SYNERG OCCLUSION COIL*適應症請見備註欄 16876
CMV0437204TA VASCULAR PLATINUM COIL※適應症請見備註欄 2971
CMV0437230SB FIBERED PLATINUM COILS*適應症請見備註欄 2971
CMV04AX1UMV9 "MTI"AXIUM DETACHABLE COILS SYSTEM西恩分離式閉塞捲
1.5MM:25MM,1CM:50CM*適應症請見備註欄
15780
CMV04C0SM0MS "MICROVENTION"MICROPLEX COIL SYSTEM COSMOS COMPLEX
COILS(10,18 SYSTEM)"麥新"微導線圈栓塞系統*適應症請見備註
欄
16876
CMV04DCS01CK DETACHABLE EMBOLIZATION COIL(機械式旋轉方式解離)*適應症請
見備註欄
13696
807
特材代碼 中英文名稱 支付點數-104/01/01
CMV04DCS01CM "CODMAN"TRUFILL DCS DETACHABLE COIL SYSTEM"柯特曼"楚菲爾
分離式白金纖維環系統*適應症請見備註欄
16876
CMV04DCS02CM "CODMAN"TRUFILL DCS DETACHABLE COIL SYSTEM"柯特曼"楚菲爾
分離式白金纖維環系統*適應症請見備註欄
16876
CMV04DCS03CM "CODMAN"TRUFILL DCS DETACHABLE COIL SYSTEM"柯特曼"楚菲爾
分離式白金纖維環系統*適應症請見備註欄
16876
CMV04DPLBP2E "麥克思"微白金纖維環輸送系統“MICRUS” MICROCOIL DELIVERY
SYSTEM
16876
CMV04DPQBP2E "麥克思"微白金纖維環輸送系統“MICRUS” MICROCOIL DELIVERY
SYSTEM
16876
CMV04GDC10SB "BOSTON SCIENTIFIC"GDC DETACHABLE COIL 2,2.5,3,4,5,6,7MM
古利艾美分離式閉塞捲*適應症請見備註欄
16876
CMV04GDC10TA GDC OCCLUSION COILS(OD 2:20MM 1:30CM) 適應症見備註(355-
8254,10:20-34 92.7.1生效920009154)
16876
CMV04GDC11SB GDC DETACHALE COIL*適應症請見備註欄 16876
CMV04GDC12SB GDC DETACHALE COIL*適應症請見備註欄 16876
CMV04GDC18SB GDC DETACHALE COIL*適應症請見備註欄 16876
CMV04GDC19SB GDC DETACHALE COIL*適應症請見備註欄 16876
CMV04H2HSVMS "MICROVENTION"HYDROCOIL(HYDROSOFT HELICAL) EMBOLIC
SYSTEM(10 COIL SIZE)1.5MM:10MM 2CM:30CM親水性線圈栓塞系統
*適應症請見備註欄
18302
CMV04HCSVXMS "MICROVENTION"MICROPLEX COIL SYSTEM微導線圈栓塞系統*適應
症請見備註欄
16876
CMV04HESVXMS HYDROCOIL EMBOLIC SYSTEM (HES)親水性線圈栓塞系統*適應症請
見備註欄
18302
CMV04HFLLVMS "麥新"親水性線圈栓塞系統"MICROVENTION"HYDROCOIL EMBOLIC
SYSTEM (HYDROFILL)D:2MM:24MM L:2CM:50CM *適應症請見備註欄
18302
CMV04HFRMVMS "MICROVENTION"HYDROCOIL EMBOLIC SYSTEM(HES) D:3MM:8MM
L:6CM:33CM;" D:6MM:20MM L:19CM:48CM麥新"親水性線圈栓塞系
統*適應症請見備註欄
18302
CMV04M000TCK TORNADO EMBOLIZATION MICROCOIL 0.018,2:14CM 2:10MM※適應
症請見備註欄
2971
CMV04M001NCK "COOK"EMBOLIZATION COILS"曲克:栓塞環*適應症請見備註欄 1862
CMV04M002NCK "COOK"EMBOLIZATION COILS"曲克:栓塞環*適應症請見備註欄 1862
CMV04M003NCK TORNADO EMBOLIZATION MICROCOIL 0.035,0.038,3:14CM,3:10MM
※適應症請見備註欄
2971
CMV04M005NCK "曲克"犀厲彈簧栓塞"COOK" HILAL EMBOLIZATION MICROCOILS 2971
CMV04M006NCK EMBOLIZATION COILS *適應症請見備註欄 1862
CMV04M007NCK COOK NESTER EMBOLIZATION COILS*適應症請見備註欄 2971
CMV04M008NCK COOK MREYE EMBOLIZATION COILS AND DETACHABLE COILS 0.025
英吋.1:5公分 0.035英吋.1:20公分 0.038英吋.1:20公分*適應請
見備註欄
2971
CMV04MAX05SB MATRIX2 DETA.COIL D:2-24MM L:2-40CM 360度COMP SHAPE-360度
FIRM.360度STANDARD SR.360度SOFT SR.HELICAL SHAPE-HELICAL
ULTRA SOFT SR*適應症見備註
18302
CMV04MAX06SB MATRIX COIL D:2-20MM L:4:30CM 3D OMEGA SHAPE-3D OMEGA
FIRM;STANDARD HELICAL SHAPE-2DFIRM;STANDARD SR;SOFT
SR;HELICAL SOFT SR*適應症見備註
18302
CMV04MCSVXMS "MICROVENTION"MICROPLEX COIL SYSTEM微導線圈栓塞系統*適應
症請見備註欄
16876
CMV04MWCE1CK "COOK"MREYE EMBOLIZATION COILS密絲特艾栓塞線圈,伸展之栓
塞長度1:20公分,線圈狀栓塞直徑2:25公厘*適應症請見備註欄
2971
808
特材代碼 中英文名稱 支付點數-104/01/01
CMV04NEST2CK "COOK"NESTER EMBOLIZATION COILS(PLATINUM)"曲克"奈斯特彈簧
栓塞*適應症請見備註欄
2971
CMV04NEXUSV9 "MTI"NEXUS DETACHABLE COILS SYSTEM 雷瑟斯分離式閉塞捲 *適
應症請見備註欄
18302
CMV04NYL0NV9 "MTI"AXIUM NYLON DETACHABLE COILS SYSTEM"恩提愛"艾司恩分
離式閉塞捲,D 1.5MM-10MM,L 1CM-30CM*適應症請見備註欄
18302
CMV04PC400UF "PENUMBRA"PENUMBRA COIL SYSTEM"彼娜波"栓塞環系統*給付規定
請見備註欄
16876
CMV04PGLACV9 "MTI"AXIUM PGLA DETACHABLE COILS SYSTEM"恩提愛"艾恩斯分離
式閉塞捲,直徑1.5MM-10MM,長度1CM-30CM*適應症請見備註欄
18302
CMV04SPHBP2E "麥克思"微白金纖維環輸送系統“MICRUS” MICROCOIL DELIVERY
SYSTEM
16876
CMV04SRCBP2E "麥克思"微白金纖維環輸送系統“MICRUS” MICROCOIL DELIVERY
SYSTEM
16876
CMV04SSRXL2E "麥克思"微白金纖維環輸送系統“MICRUS” MICROCOIL DELIVERY
SYSTEM
16876
CMV04TARGTSB "BOSTON SCIENTIFIC"TARGET DETACHABLE COIL "波士頓科技"塔
吉特分離線圈*適應症請見備註欄
16876
CMV0621029LW "LEMAITRE"PRUITT IRRIGATION OCCLUSION CATHETER普特灌沖血
管閉塞導管
2396
CMV0621036LW "LEMAITRE"PRUITT OCCLUSION CATHETER普特血管閉塞導管 2466
CMV070NYXXV9 "MTI"ONYX LIQUID EMBOLIC SYSTEM歐尼斯液態栓塞系統 57467
CMV0755055V9 "MTI"MARATHON FLOW DIRECTED MICRO CATHETERS梅洛森微導管 11600
CMV0755105V9 “恩提愛”馬克司孟導管 “MTI”MARKSMAN CATHETER 11600
CPC0101406M0 SINGLE LUMEN INFUSION CATHETER SET(C+D+GW+N) 439
CPC0102005M0 SINGLE LUMEN INFUSION CATHETER SET 20G;24G(C+D+GW+N) 679
CPC0104706AR "ARROW"CENTRAL VEIN CATHETERIZATION SET I
LUMEN(CATH+NEEDLE+DILATOR+GUIDE WIRE+SYRING)"亞諾"中央靜
脈導管組
439
CPC01114G53D "福尼亞"中心靜脈導管/單腔"FORNIA"DISPOSABLE CENTRAL
VENOUS CATHETER KITS/1LUMEN
439
CPC01116G53D "福尼亞"中心靜脈導管/小兒用單腔"FORNIA"DISPOSABLE CENTRAL
VENOUS CATHETER KITS/PEDIATRIC 1LUMEN
679
CPC0141320BA SILICONE PER-Q CATHETER(PICC)(CATH W/STYLET,INTRODUCER
NEEDLE)2,3FR 28CM,60CM
1043
CPC014132NBA SINGLE LUMEN SILICONE PER-Q CATHETER BASIC TRAY 2FR 1043
CPC0147630AG CVP KIT MINI (含GUIDE WIRE, CATHETER, NEEDLE) 16FR 439
CPC0147631AG CVP KIT MINI (含GUIDE WIRE, CATHETER, NEEDLE) 16FR 439
CPC0160004DV SINGLE LUMEN BROVIAC CATHETER 布羅斐式導管(用於化療患者)
2.7FR 90CM
2412
CPC016816NAG "愛琅"中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-1
LUMEN 5:7FR (C+N+D+G+S)
439
CPC01A4301AR "ARROW"ARROWGARD CATHETERS:ANTISEPTIC SINGLE LUMEN CVP
CATHETER 16GX20CM (C+N+D+G+S)"亞諾"抗感染安全尖端導管※適
應症請見備註欄
548
CPC01A4650AR "ARROW"CENTRAL VEIN CATHETERIZATION SET I
LUMEN(PEDIATRIC)(CATH+NEEDLE+DILATOR+GUIDE WIRE+SYRING)"
亞諾"中央靜脈導管組
679
CPC01B1161AG "ARGON"HYDROCATH ASSURE HYDROPHILIC ANTI-MICROBIAL
CENTRAL VENOUS CATHETER:1 LUMEN(C+N+D+G+S)"愛琅"抑菌中心
靜脈導管:單腔※適應症請見備註欄
548
CPC01BCV11EE 1 LUMEN CVP CATHETER(CATHETER+GW+DILATOR+SYRINGE) 439
809
特材代碼 中英文名稱 支付點數-104/01/01
CPC01C4400AR "ARROW"CENTRAL VEIN CATHETERIZATION SET I
LUMEN(CATH+NEEDLE+DILATOR+GUIDE WIRE+SYRING)"亞諾"中央靜
脈導管組
439
CPC01E4301AR "ARROW"CENTRAL VEIN CATHETERIZATION SET I
LUMEN(CATH+NEEDLE+DILATOR+GUIDE WIRE+SYRING)"亞諾"中央靜
脈導管組
439
CPC01E4700AR "ARROW"CENTRAL VEIN CATHETERIZATION SET(1
LUMEN)(CATHETER+NEEDLE+DILATOR+GUIDE WIRE+SYRINGE)"亞諾"
中央靜脈導管組
439
CPC01ECL11BB CERTOFIX CENTRAL VENOUS CATHETER (1
LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦單腔
中心靜脈導管組
439
CPC01H1056AG "愛琅"中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-1
LUMEN 5:7FR(C+N+D+G+S)
439
CPC01M1142ED 1 LUMEN MULTI-MED CENTRAL CATHETER SET W/AMC
THROMBOSHIELD※適應症請見備註欄
548
CPC01M1162ED 1 LUMEN MULTI-MED CENTRAL CATHETER SET(C+N+GW+DIL+SY) 439
CPC01M1201ED 1 LUMEN CVP CATHETER W/AMC THROMBOSHIELD
COATING(C+N+D+GW+S)※適應症請見備註欄
548
CPC01P1051AG "愛琅"中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-1
LUMEN 2.5:4FR(PEDIATRIC)(C+N+D+G+S)
679
CPC01PED01BB CERTOFIX CENTRAL VENOUS CATHETER(PEDIATRIC 1
LUMEN)(CATHETER+GUIDEWIRE+NEEDLE+SCALPEL+3 WAY)舒鈦單腔
小兒用中心靜脈導管組
679
CPC01PMS01CK "COOK" FEMORAL DISTAL AORTIC PRESSURE MONITORING SET
2.5:5.0 FR. "曲克"動脈壓力監測組
(CATHETER+WIRE+NEEDLE+SYRINGE)※適應症請見備註欄
1490
CPC01PMS02CK "COOK" FEMORAL DISTAL AORTIC PRESSURE MONITORING SET
2.5:5.0 FR. "曲克"動脈壓力監測組
(CATHETER+WIRE+NEEDLE+SYRINGE)※適應症請見備註欄
1490
CPC01PMS03CK "COOK" FEMORAL DISTAL AORTIC PRESSURE MONITORING SET
2.5:5.0 FR. "曲克"動脈壓力監測組
(CATHETER+WIRE+NEEDLE+SYRINGE)※適應症請見備註欄
1490
CPC01PTT11BB CERTOFIX CENTRAL VENOUS CATHETER(PROTECT 1 LUMEN)
(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦抗感染單腔
中心靜脈導管組
548
CPC01R4020AR "ARROW"ARTERIAL CATHETERIZATION SET(RA-
04220,04122,FA04018,04016自91/07/01生
效))(SAC00324;524;01616;02316自100年4月1日刪除)動脈測壓導
管
381
CPC01STD11BB CERTOFIX CENTRAL VENOUS CATHETER(1
LUMEN)(CATHETER+DILATOR+GUIDEWIRE +NEEDLE+SYRINGE)舒鈦單
腔中心靜脈導管組
439
CPC01SWL12W8 SINGLE LUMEN PEDIATRIC CENTRAL VENOUS CATHETER SET
5FR(C+N+S+GW+D+ INJECTION CAP)
679
CPC01SWL13W8 SINGLE LUMEN CENTRAL VENOUS CATHETER SET
6FR(C+N+S+GW+D+INJECTION CAP)
439
CPC01SWL21W8 DOUBLE LUMEN INFANT CENTRAL VENOUS CATHETER SET
4FR(C+N+S+GW+D+ INJECTION CAP)
1568
CPC01SWL22W8 DOUBLE LUMEN PEDIATRIC CENTRAL VENOUS CATHETER SET
5FR(C+N+S+GW+D+ INJECTION CAP)
1568
CPC01SWL23W8 DOUBLE LUMEN CENTRAL VENOUS CATHETER SET
7FR(C+N+S+GW+D+INJECTION CAP)
951
810
特材代碼 中英文名稱 支付點數-104/01/01
CPC01SWL33W8 TRIPLE LUMEN CENTRAL VENOUS CATHETER SET
7FR(C+N+S+GW+D+INJECTION CAP)
1118
CPC0214402AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION SETS:2
LUMEN (早產兒) 4FR 13CM" 亞諾"多重輸液導管
1568
CPC0217702AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION SETS:2
LUMEN(C+N+GW+SY+D)" 亞諾"多重輸液導管
951
CPC0222502AR "ARROW"ARROWGARD CATHETERS:ANTISEPTIC PEDIATRIC DOUBLE
LUMEN (C+N+D+G+S)"亞諾"抗感染安全尖端導管※適應症請見備註
欄
1835
CPC02245F53D "福尼亞"中心靜脈導管/小兒用雙腔"FORNIA"DISPOSABLE CENTRAL
VENOUS CATHETER KITS/PEDIATRIC 2LUMEN
1568
CPC02278F53D "福尼亞"中心靜脈導管/雙腔"FORNIA"DISPOSABLE CENTRAL
VENOUS CATHETER KITS/2LUMEN
951
CPC022L715M0 DOUBLE LUMEN INFUSION CATHETER SET (C+D+GW+N+SY) 951
CPC022LP35M0 DOUBLE LUMEN INFUSION CATHETER SET 4FR,5FR(C+D+GW+N+SY) 1568
CPC0260048DV DUAL LUMEN HICKMAN CATHETER"巴德"希克曼血液透析導管 2743
CPC026817NAG "愛琅"中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-2
LUMEN 7FR(C+N+D+G+S)
951
CPC02A7702AR "ARROW"ARROWGARD CATHETER (DOUBLE LUMEN )14FR X
15CM(C+N+D+G+S)"亞諾"抗感染安全尖端導管(大管徑)※適應症請
見備註欄
1428
CPC02B1150AG "ARGON"HYDROCATH ASSURE HYDROPHILIC ANTI-MICROBIAL
CENTRAL VENOUS CATHETER:2 LUMEN(C+N+D+G)"愛琅"抑菌中心靜
脈導管:2腔※適應症請見備註欄
1141
CPC02B1152AG "愛琅"抑菌中心靜脈導管(2腔)"ARGON"HYDROCATH ASSURE
HYDROPHILIC ANTI-MICROBIAL CENTRAL VENOUS
CATHETER(2LUMEN)
1428
CPC02BCV22EE 2 LUMEN CVP CATHETER/SET 二腔中央靜脈導管組
(CATH+NEEDLE+DILATOR+GUIDEWIRE+SYRINGE)
951
CPC02CUDLMCK 2 LUMEN SPECTRUM AND SPECTRUM GLIDE CENTRAL VENOUS
CATHETERS AND SETS(C+N+D+GW+SY)※適應症請見備註欄
1428
CPC02CV782BS "BIOSENSORS"CENTRAL VENOUS CATHETER KIT
2LUMEN(CATH+NEEDLE+DILATOR+GUIDEWIRE+SYRINGE)"拜爾生"中央
靜脈導管組
951
CPC02ECL12BB CERTOFIX CENTRAL VENOUS CATHETER (2 LUMEN)
(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+ SYRINGE)舒鈦雙腔中心
靜脈導管組
951
CPC02M2716ED 2 LUMEN CVP CATHETER W/AMC THROMBOSHIELD
COATING(C+N+D+GW+S)※適應症請見備註欄
1428
CPC02M271SED 2 LUMEN MULTI-MED CENTRAL CATHETER SET(C+N+GW+DIL+SY) 951
CPC02M27S1ED 2 LUMEN CVP CATHETER W/AMC THROMBOSHIELD
COATING(C+N+D+GW+S)※適應症請見備註欄
1428
CPC02N7702AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION SETS:2
LUMEN(C+N+GW+SY+D)" 亞諾"多重輸液導管
951
CPC02P1065AG "愛琅"中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-2
LUMEN 4:5FR(PEDIATRIC)(C+N+D+G+S)
1568
CPC02PED02BB CERTOFIX CENTRAL VENOUS CATHETER (PEDIATRIC 2
LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦雙腔
小兒用中心靜脈導管組
1568
CPC02PEDSUCK SPECTRUM PEDIATRIC 2 LUMEN CVP CATHETER
4FR,5FR(C+D+GW+N+S)※適應症請見備註欄
1835
CPC02PEDUDCK 2 LUMEN SPECTRUM GLIDE CENTRAL VENOUS CATHETERS AND SETS
4.0-5.0FR 8CM 小兒用(C+N+D+G+S)抗感染導管※適應症請見備註
欄
1835
811
特材代碼 中英文名稱 支付點數-104/01/01
CPC02PEUD1CK SPECTRUM AND SPECTRUM PEDIATRIC 2 LUMEN CVP CATHETER
4.0~5.0FR(C+N+D+G+S)※適應症請見備註欄
1835
CPC02PTT12BB CERTOFIX CENTRAL VENOUS CATHETER (PROTECT 2 LUMEN)
(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦抗感染雙腔
中心靜脈導管組
1428
CPC02SDLM1CK SPECTRUM PEDIATRIC 2 LUMEN CVP CATHETER 4.0FR(C+N+D+G+S)
※適應症請見備註欄
1835
CPC02STD12BB CERTOFIX CENTRAL VENOUS CATHETER(2
LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦雙腔
中心靜脈導管組
951
CPC02SUDLMCK SPECTRUM 2 LUMEN CVP CATHETER(C+D+GW+N+S)※適應症請見備註
欄
1428
CPC02SWL24W8 DOUBLE LUMEN CENTRAL VENOUS CATHETERIZATION
SET(C+N+GW+S+D)
951
CPC02UDL81CK 2 LUMEN SPECTRUM GLIDE CENTRAL VENOUS CATHETERS AND SETS
8.0FR 15CM (C+N+D+G+S)抗感染導管※適應症請見備註欄
1428
CPC02UDLM2CK SPECTRUM AND SPECTRUM 2 LUMEN CVP CATHETER 7.5-
8.0FR(C+N+D+G+S)※適應症請見備註欄
1428
CPC02UDLM3CK 2 LUMEN SPECTRUM CENTERAL VENOUS CATHETER 抗感染導管※適
應症請見備註欄
1428
CPC0312123AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION
SETS:LARGE BORE 3 LUMEN CVP CATHETER 12FR(C+N+D+G+S)"亞
諾"多重輸液導管套(大管徑)
1664
CPC0314553AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION
SETS:PEDATRIC 3 LUMEN CVP SET 5.5FR 30CM(C+N+GW+SY+D)" 亞
諾"多重輸液導管
2050
CPC0314703AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION
SETS:TRIPLE-LUMEN C+N+GW+SY+D)" 亞諾"多重輸液導管
1118
CPC0315703AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION
SETS:TRIPLE-LUMEN (CATH+NEEDLE+DILATOR+GW+SYRING)"亞諾"多
重輸液導管
1118
CPC0316553AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION
SETS:TRIPLE-LUMEN (CATH+NEEDLE+DILATOR+GW+SYRING)5.5FR
13CM"亞諾"多重輸液導管
2050
CPC03345F53D "福尼亞"中心靜脈導管/小兒用三腔"FORNIA"DISPOSABLE CENTRAL
VENOUS CATHETER KITS/PEDIATRIC 3LUMEN
2050
CPC03378F53D "福尼亞"中心靜脈導管/三腔"FORNIA"DISPOSABLE CENTRAL
VENOUS CATHETER KITS/3LUMEN
1118
CPC033L715M0 TRIPLE LUMEN INFUSION CATHETER SET (C+D+GW+N+SY) 1118
CPC033LP58M0 TRIPLE LUMEN INFUSION CATHETER SET 5.5FR(C+D+GW+N+SY) 2050
CPC0368172AG "愛琅"中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-3
LUMEN 7FR(C+N+D+G+S)
1118
CPC03A4703AR "ARROW"ARROWGARD CATHETERS:ANTISEPTIC TRIPLE-LUMEN
(C+N+D+G+S)"亞諾"抗感染安全尖端導管※適應症請見備註欄
1905
CPC03A5123AR "ARROW"ARROWGARD CATHETERS:ANTISEPTIC LARGE BORE TRIPLE-
LUMEN (C+N+D+G+S)"亞諾"抗感染安全尖端導管※適應症請見備註
欄
1905
CPC03B1158AG "愛琅"抑菌中心靜脈導管(3腔)"ARGON"HYDROCATH ASSURE
HYDROPHILIC ANTI-MICROBIAL CENTRAL VENOUS CATHETER(3LUMEN
1905
CPC03BCV31EE 3 LUMEN CVP CATHETER 三腔中央靜脈導管組
(CATHETER+GW+DILATOR+SYRINGE+NEEDLE)
1118
CPC03CUTLMCK 3 LUMEN SPECTRUM AND SPECTRUM GLIDE CENTRAL VENOUS
CATHETERS AND SETS(C+N+D+GW+SY)※適應症請見備註欄
1905
812
特材代碼 中英文名稱 支付點數-104/01/01
CPC03CV783BS "BIOSENSORS"CENTRAL VENOUS CATHETER KIT
3LUMEN(CATH+NEEDLE+DILATOR+GUIDEWIRE+SYRINGE)"拜爾生"中央
靜脈導管組
1118
CPC03ECL13BB CERTOFIX CENTRAL VENOUS CATHETER (3 LUMEN)
(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦三腔中心靜
脈導管組
1118
CPC03HFL13BB CERTOFIX CENTRAL VENOUS CATHETER(3
LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦三腔
中心靜脈導管組
1664
CPC03M3716ED 3 LUMEN CVP CATHETER W/AMC THROMBOSHIELD
COATING(C+N+D+GW+S)※適應症請見備註欄
1905
CPC03M371SED 3 LUMEN MULTI-MED CENTRAL CATHETER SET(C+N+GW+DIL+SY) 1118
CPC03M37S1ED 3 LUMEN CVP CATHETER W/AMC THROMBOSHIELD
COATING(C+N+D+GW+S)※適應症請見備註欄
1905
CPC03P1139AG "愛琅"中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-3
LUMEN 5FR(PEDIATRIC)(C+N+D+G+S)
2050
CPC03PED03BB CERTOFIX CENTRAL VENOUS CATHETER (PEDIATRIC 3
LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦三腔
小兒用中心靜脈導管組
2050
CPC03PEDUTCK SPECTRUM PEDIATRIC 3 LUMEN CVP CATHETER 5FR(C+D+GW+N+S)※
適應症請見備註欄
2200
CPC03PTT13BB CERTOFIX CENTRAL VENOUS CATHETER(PROTECT 3 LUMEN)
(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦抗感染三腔
中心靜脈導管組
1905
CPC03STD13BB CERTOFIX CENTRAL VENOUS CATHETER(3
LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦三腔
中心靜脈導管組
1118
CPC03SWL34W8 TRIPLE LUMEN CENTRAL VENOUS CATHETERIZATION
SET(C+N+GW+S+D)
1118
CPC03UTLM1CK SPECTRUM AND SPECTRUM 3 LUMEN CVP CATHETER 7.0-
9.0FR(C+N+D+G+S)※適應症請見備註欄
1905
CPC03UTLM3CK 3 LUMEN SPECTRUM CENTERAL VENOUS CATHETER 抗感染導管※適
應症請見備註欄
1905
CPC03UTLMACK "COOK"SPECTRUM AND SPECTRUM GLIDE 3 LUMEN CVP CATHETER
5FR,7FR(C+D+GW+N+S)"曲克"史派純和史派純革來得中央靜脈導管
組※適應症請見備註欄
1905
CPC03UTPE2CK SPECTRUM GLIDE CENTRAL VENOUS CATHETERS AND SETS 3 LUMEN
5FR(C+D+GW+N+S)※適應症請見備註欄
2200
CPC03UTPEDCK SPECTRUM AND SPECTRUM PEDIATRIC 3 LUMEN CVP CATHETER
5FR(C+N+D+G+S)※適應症請見備註欄
2200
CPC05S1000AG "愛琅"中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-CVP
CATHETER 14G:18G 90MM:160MM
210
CPC0885HS1ED AVA ADVANCED VENOUS ACCESS DEVICES(AVA 3XI)(CVP KIT+保護
套+SHEATH+SIDE ARM)*適應症請見備註欄
2734
CPC089FHS1ED AVA ADVANCED VENOUS ACCESS DEVICES(AVA HF)(CVP KIT+保護套
+SHEATH)*適應症請見備註欄
2600
CPC0902022PU CEVOX CENTRAL VENOUS OXYGEN SATURATION MONITORING
SYSTEM:FIBROPTIC PROBE CATHETER 中央靜脈血氧飽和度:光纖
探針導管※適應症請見備註欄
5500
CPC0977475ED 3 LUMEN PRESEP CENTRAL VENOUS OXIMETRY CATHETER
SET(CVPC+PROBE+N+GW+D+SY)※適應症請見備註欄
7300
CPC09X3820ED PRESEP OXIMETRY CATHETER 3LUMEN (PROBE+3 LUMEN CVP
KIT(CATHETER+DILATOR+GUIDE WIRE+NEEDLE+SYRINGE)裴瑟週邊血
氧濃度導管
7300
813
特材代碼 中英文名稱 支付點數-104/01/01
CPD011010DBD PRESSURE MONITOR DOME 154
CPD011011DBD DOME 154
CPD01BTR00GJ "JSM"PRESSURE MONITORING KIT: BIOTRANS DOME "吉生"血壓監
視組合套:DOME
154
CPD01BTR01BS PRESSURE MONITOR DOME 154
CPD01BTR01H9 BIOTRANS DOME 154
CPM01SC441SG CVP SCALE SYSTEM+3 WAY 114
CPM01VP001LL CVP SCALE SYSTEM(MONITOR+3 WAY) 114
CPM020460TBD 1DOME PRESSURE MONITORING KIT 310
CPM021560TBD 1 DOME PRESSURE MONITORING KIT 310
CPM028603NSG PRESSURE MONITORING KIT 1DOME 310
CPM02BT481GJ "JSM"PRESSURE MONITORING KIT: 1 DOME PRESSURE MONITORING
KIT(DOME+FD+TUBING+3 WAYX2) "吉生"血壓監視組合套:1 DOME
KIT
310
CPM02BT482GJ "JSM"PRESSURE MONITORING KIT :2 DOME 3WAY PRESSURE
MONITORING KIT 2X(DOME+FD+3WAYX2+TUBING)"吉生"血壓監視組
合套:2 DOME KIT
664
CPM02BT483GJ "JSM"PRESSURE MONITORING KIT :3 DOME 3WAY PRESSURE
MONITORING KIT 3X(DOME+FD+3WAYX2+TUBING)"吉生"血壓監視組
合套:3 DOME KIT
978
CPM02BTR24BS 2 DOME 3WAY PRESSURE MONITORING KIT
2X(DOME+FLUSH+TUBING+3WAYX2)
664
CPM02BTR24H9 2 DOME 3WAY PRESSURE MONITORING KIT
2X(DOME+DEVICE+TUBING+3 WAYX2)
664
CPM02BTR33BS 3 DOME 3WAY PRESSURE MONITORING KIT
3X(DOME+FLUSH+TUBING+3WAYX2)
978
CPM02BTR48BS 1DOME 3WAY PRESSURE MONITORING
KIT(DOME+DEVICE+TUBING+3WAYX2)
310
CPM02BTR48H9 1 DOME 3WAY PRESSURE MONITORING KIT(DOME+DEVICE+TUBING+3
WAYX2)
310
CPM02BTRDLGJ "JSM"PRESSURE MONITORING KIT :1 DOME 3WAY PRESSURE
MONITORING KIT 1X(DOME+FDX2+3WAYX4+TUBINGX2)"吉生"血壓監
視組合套:1 DOME 2WAY KIT
369
CPM02DL418BS 1DOME 2WAY PRESSURE MONITORING KIT
1X(DOME+FLUSH+TUBINGX2+3WAYX4)
369
CPM02DL418H9 1 DOME 2WAY PRESSURE MONITORING KIT
1X(DOME+DEVICE+TUBINGX2+3 WAYX4)
369
CPM02HP60RBD PRESSURE MONITORING KIT 1DOME 310
CPM030TNFRAG "ARGON"DISPOSABLE PRESSURE MONITOR:TRANSDUCER "愛琅"血壓
監視組合套:壓力轉換器
369
CPM0342584HR TRANSPAC IV MONITORING KIT(TRAN+FLUSH+TUBING+3WAYX2) 369
CPM0342584U2 "ICU"TRANSPAC IV MONITORING
KIT(TRAN+FLUSH+TUBING+3WAYX2)"愛西優"壓力監測套
369
CPM0342591HR TRIFURCATED KITS WITH 3 DISPOSABLE TRANSDUCER 1105
CPM0342591U2 "ICU"3 TRANSPAC IV MONITORING KIT
3X(TRAN+FLUSH+TUBING+3WAYX2)"愛西優"壓力監測套
1105
CPM0342597HR TRANSPAC IV MONITORING KIT WITH 2 DISPOSABLE TRANSDUCER 915
CPM0342652HR TRANSPAC IV MONITORING KIT WITH 2 DISPOSABLE TRANSDUCER 915
CPM0342652U2 "ICU"2 TRANSPAC IV MONITORING KIT
2X(TRAN+FLUSH+TUBING+3WAYX2)"愛西優"壓力監測套
915
CPM034812DAG "ARGON"DISPOSABLE PRESSURE MONITOR KIT:2 TRANSDUCER
(TR+FL+TU+3WAYX4)"愛琅"血壓監視組合套
915
CPM034812TAG "ARGON"DISPOSABLE PRESSURE MONITOR KIT:3 TRANSDUCER
(TR+FL+TU+3WAYX6)"愛琅"血壓監視組合套
1105
814
特材代碼 中英文名稱 支付點數-104/01/01
CPM0352026BB COMBITRANS MONITORING SETS(FD+TR+3WAYX2+TUBING) 康比得壓
力監測組
369
CPM0352036BB COMBITRANS MONITORING SETS: DISPOSABLE TRANSDUCER 康比得
壓力監測組:壓力轉換器
369
CPM038603ASG DISPOSABLE PRESSURE MONITOR KIT 1 DOME
W/TRANSDUCER(TR+FLU+TUB+3WAYX2)
369
CPM038603BSG DISPOSABLE PRESSURE MONITOR KIT 2 DOME W/TRANSDUCER
2(TR+FLU+TUB+3WAYX2)
915
CPM038603CSG DISPOSABLE PRESSURE MONITOR KIT 3 DOME W/TRANSDUCER
3(TR+FLU+TUB+3WAYX2)
1105
CPM038603TSG PRESSURE MONITOR KIT 1 DOME WITH TRANSDUCER 369
CPM03ADP00GJ "JSM"PRESSURE MONITORING KIT(TRANSDUCER)"吉生"血壓監視組
合套
369
CPM03ADP3WGJ "JSM"PRESSURE MONITORING KIT(TRANSDUCER+3WAY)"吉生"血壓監
視組合套
369
CPM03ADPT1GJ "JSM"PRESSURE MONITORING KIT :TRANSDUCER PRESSURE
MONITORING KIT(TR+FD+3WAYX2+TUBING)"吉生"血壓監視組合
套:1TR
369
CPM03ADPT2GJ "JSM"PRESSURE MONITORING KIT: 2 TRANSDUCER PRESSURE
MONITORING KIT 2X(TR+FD+3WAYX2+TUBING)"吉生"血壓監視組合
套:2TR
915
CPM03ADPT3GJ "JSM"PRESSURE MONITORING KIT: 3 TRANSDUCER PRESSURE
MONITORING KIT 3X(TR+FD+3WAYX2+TUBING)"吉生"血壓監視組合
套:3TR
1105
CPM03ADPTDGJ "JSM"PRESSURE MONITORING KIT: TRANSDUCER PRESSURE
MONITORING 2 WAY KIT (TR+FDX2+3WAYX4+TUBINGX2)"吉生"血壓
監視組合套:1TR 2WAY
644
CPM03AT148H9 PRESSURE MONITORING KIT(TR+FD+3 WAYX2+TUBING) 369
CPM03D2020AG "ARGON"DISPOSABLE PRESSURE MONITOR:TRANSDUCER W/FLUSH"愛
琅"血壓監視組合套:壓力轉換器
369
CPM03D4812AG "ARGON"DISPOSABLE PRESSURE MONITOR KIT:1 TRANSDUCER "愛
琅"血壓監視組合套
369
CPM03D4812HM DISPOSABLE PRESSURE MONITORING KIT WITH TRANSDUCER 369
CPM03DDL60AG "ARGON"DISPOSABLE PRESSURE MONITOR KIT:1 TRANSDUCER
2WAY(1TR+2(FL+TU+3WAYX2)"愛琅"血壓監視組合套
644
CPM03DNN12AG "ARGON"DISPOSABLE PRESSURE MONITOR KIT:1 TRANSDUCER
(TR+FL+TU+3WAYX2)"愛琅"血壓監視組合套
734
CPM03DP240H9 2 TRANSDUCER PRESSURE MONITORING KIT 2X(TR+FD+3
WAYX2+TUBING)
915
CPM03DP340H9 3 TRANSDUCER PRESSURE MONITORING KIT 3X(TR+FD+3
WAYX2+TUBING)
1105
CPM03DPT24H9 TREANSDUCER PRESSURE MONITORING KIT(TR+FD+3 WAYX2+TUBING) 369
CPM03PV800PU PCCO MONITORING KIT 30CM,100CM,150CM(TX1+FX1+TX2+3-
WAYX2)(含溫度感應器,與CBT022014LPU及CBT022015LPU搭配使
用)
650
CPM03PX12NED "EDWARDS"TRUWAVE NEONATAL PEDIATRIC DISPOSABLE PRESSURE
TRANSDUCER (1 TR) ( TR+FD+TUBING+3WAYX2)"愛德華"凸威壓力
傳導器:1TR 小兒
734
CPM03PX1X0ED "EDWARDS"TRUWAVE DISPOSABLE PRESSURE TRANSDUCER (1 TR
2WAY) 2X( TR+FD+TUBING+3WAYX2)"愛德華"凸威壓力傳導器:1TR
2WAY
644
CPM03PX260ED "EDWARDS"TRUWAVE DISPOSABLE PRESSURE TRANSDUCER (1 DOME)(
TR+FD+TUBING+3WAY)"愛德華"凸威壓力傳導器:1TR
369
815
特材代碼 中英文名稱 支付點數-104/01/01
CPM03PX2X2ED "EDWARDS"TRUWAVE DISPOSABLE PRESSURE TRANSDUCER (2 TR)
2X( TR+FD+TUBING+3WAY)"愛德華"凸威壓力傳導器:2TR
915
CPM03PX3X7ED "EDWARDS"TRUWAVE DISPOSABLE PRESSURE TRANSDUCER (3 TR)
3X( TR+FD+TUBING+3WAYX2)"愛德華"凸威壓力傳導器:3TR
1105
CPM03PX604ED "EDWARDS"TRUWAVE DISPOSABLE PRESSURE TRANSDUCER(FLUSH
DEVICE X1+ STOPCOCK 1)"愛德華"凸威壓力傳導器:1TR
369
CPM04ABV30WP "沃夫德李"艾比凡瑟腹內壓力監測組"WOLFE TORY"ABVISER
INTRA-ABDOMINAL PRESSURE MONITORING KIT
2100
CRB01000282C "柯惠"麥林可雙腔支氣管內管"COVIDIEN" MALLINCKRODT
BRONCHO-CATH ENDOBROCHIAL TUBE
1490
CRB0224390FJ “富士”塞爾布朗支氣管閉鎖導管-雙腔左彎/右彎“FUJI”
SILBRONCHO ENDOTRACHEAL TUBE
1490
CRB0303104FJ "富世"支氣管內管阻隔器(小兒用)"FUJI" UNIBLOCKER AND
FUGGIANO BLOCKER
4000
CRB0324477FJ "富世"支氣管閉鎖導管"FUJI"UNIVENT TUBE(TCB TYPE) 3675
CRB0324480FJ "富世"支氣管內管阻隔器"FUJI" UNIBLOCKER AND FUGGIANO
BLOCKER
3675
CRB03AEBS1CK ARNDT ENDOBRONCHIAL BLOCKER SET 9.0FR. 78CM *給付規定請
見備註欄
3675
CRB03AEBS2CK ”曲克”支氣管內管阻隔管組ARNDT ENDOBRONCHIAL BLOCKER SET
7.0FR. 65CM *給付規定請見備註欄
3675
CRB03AEBS3CK ”曲克”支氣管內管阻隔管組ARNDT ENDOBRONCHIAL BLOCKER SET
5.0FR. 50CM,65CM *給付規定請見備註欄
4000
CRB03BBTAEDZ ”大研”支氣管閉鎖導管”DAIKEN” COOPDECH ENDOBRONCHIAL
BLOCKER TUBE給付規定請見備註欄
3675
CRE01C00402C "柯惠"麥林可顯微喉手術氣管插管 "COVIDIEN" MALLINCKRODT
MLT MICROLARYNGEAL TUBE
159
CRE01C4060EU NON-KINKING ENDOTRACHEAL TUBE ARMOURED CUFF 6.0:8.5MM ※
處置使用可申報手術使用不另給付。
300
CRE01C6121UW "巫諾" 氣管內管"UNOMEDICAL" ENDOTRACHEAL TUBES(增強型
CUFF,ID5:9MM)*處置使用可申報,手術使用不另給付。
300
CRE01U0030EU NON-KINKING ENDOTRACHEAL TUBE ARMOURED UNCUFF 3.0:5.5MM
※處置使用可申報手術使用不另給付。
328
CRE01U6113UW "巫諾" 氣管內管"UNOMEDICAL" ENDOTRACHEAL TUBES(增強型
UNCUFFED,ID2.5:9MM)*處置使用可申報,手術使用不另給付。
328
CRE03118302C "柯惠"麥林可加強型氣管內管"COVIDIEN" MALLINCKRODT SAFETY-
FLEX REINFORCED TRACHEAL TUBE*處置使用可申報,手術使用不另
給付
300
CRE03C055NFM SILICONE ENDOTRACHEAL TUBE W/CUFF 5.5:10.0MM※處置使用可
申報手術使用不另給付
300
CRE03U025NFM SILICONE ENDOTRACHEAL TUBE W/WIRE WITHOUT CUFF 2.5:5.0MM
※處置使用可申報手術使用不另給付
328
CRE04C00402C "柯惠"麥林可彎型氣管內管"COVIDIEN" MALLINCKRODT RAE ORAL
AND NASAL TRACHEAL TUBE- 鼻彎有氣囊
202
CRE04C0060PP NASAL CURVED W/CUFF ENDOTRACHEAL TUBE 6:8MM ※處置使用可
申報,手術使用不另給付
202
CRE04C0060UW "巫諾" 氣管內管"UNOMEDICAL" ENDOTRACHEAL TUBES(鼻彎低壓氣
囊) *處置使用可申報,手術使用不另給付
202
CRE04C6131UW "巫諾" 氣管內管"UNOMEDICAL" ENDOTRACHEAL TUBES(鼻彎型CUFF
ID6:8MM)*處置使用可申報,手術使用不另給付。
202
CRE04U030N2C "柯惠"麥林可彎型氣管內管"COVIDIEN" MALLINCKRODT RAE ORAL
AND NASAL TRACHEAL TUBES- 鼻彎無氣囊
188
CRE04U3030UW "巫諾" 氣管內管"UNOMEDICAL" ENDOTRACHEAL TUBES(鼻彎型
UNCUFFED,ID3:7MM)*處置使用可申報,手術使用不另給付。
188
816
特材代碼 中英文名稱 支付點數-104/01/01
CRE04U6133UW "巫諾"氣管內管"UNOMEDICAL" ENDOTRACHEAL TUBES(鼻彎型氣管
內管-無閥)*處置使用可申報,手術使用不另給付。
188
CRE06C00402C "柯惠"麥林可彎型氣管內管"COVIDIEN" MALLINCKRODT RAE ORAL
AND NASAL TRACHEAL TUBES-口彎有氣囊
201
CRE06C0040UW "巫諾" 氣管內管"UNOMEDICAL" ENDOTRACHEAL TUBES(口彎低壓氣
囊) *處置使用可申報,手術使用不另給付
201
CRE06C0050MU MODERN ENDOTRACHEAL TUBE(CUFFED)華新氣管內管*處置使用可申
報、手術使用不另申報。
201
CRE06C0453W6 ENDOTRACHEAL TUBE (WITH/CUFF)*處置使用可申報,手術使用不另
給付.
201
CRE06C3060UW "巫諾" 氣管內管"UNOMEDICAL" ENDOTRACHEAL TUBES(口彎型
CUFF,ID4:9MM)*處置使用可申報,手術使用不另給付。
201
CRE06U0030UW "巫諾" 氣管內管"UNOMEDICAL" ENDOTRACHEAL TUBES處置使用可
申報,手術使用不另給付
143
CRE06U0304W6 ENDOTRACHEAL TUBE (WITHOUT/CUFF)處置使用可申報,手術使用不
另給付.
143
CRE06U045N2C "柯惠"麥林可彎型氣管內管"COVIDIEN" MALLINCKRODT RAE ORAL
AND NASAL TRACHEAL TUBES-口彎無氣囊
143
CRE06U6123UW "巫諾" 氣管內管"UNOMEDICAL" ENDOTRACHEAL TUBES(口彎型
UNCUFFED,ID3:9MM)*處置使用可申報,手術使用不另給付。
143
CRE07C00452C "柯惠" 麥林可鐳射氣管內管 “COVIDIEN” MALLINCKRODT
LASER-FLEX TRACHEAL TUBES
2451
CRG0100BN1QD “崇仁”嬰兒持續正壓鼻部給氧管路組及配件“GALEMED”NCPAP
NASAL KIT AND ACCESSORY*給付規定請見備註欄
1120
CRG010168NHU "哈德森" 嬰兒型連續正壓氣道給氧管路-全套"HUDSON" INFANT
CPAP CANNULAS(SYSTEM) NO.0:N0.5 ※適應症請見備註欄
1120
CRG010169NHU "哈德森" 嬰兒型連續正壓氣道給氧管路-半套"HUDSON" INFANT
CPAP CANNULAS(SET) NO.0:N0.5 ※適應症請見備註欄
654
CRG01407NNW7 "嬰克"嬰兒經鼻式氧氣鼻套管"INCA" INFANT NASAL OXYGEN CPAP
CANNULA*適應症請見備註欄
654
CRG01427NNW7 "嬰克"嬰兒經鼻式氧氣鼻套管"INCA" INFANT NASAL OXYGEN CPAP
CANNULA*適應症請見備註欄
1120
CRG0212520KV "費雪派克" 正壓呼吸輔助系統-半套"FISHER & PAYKEL" BUBBLE
CPAP SYSTEM*給付規定請見備註欄
1216
CRG02BC161KV "費雪派克" 正壓呼吸輔助系統-全套"FISHER & PAYKEL" BUBBLE
CPAP SYSTEM*給付規定請見備註欄
3049
CRN0185067NU NASAL NASOPHARYNX APPLICATION 後荷式咽插管 2960
CRT0155050VK “旭邦”柔得多內管型氣切管“VITALTEC”ROTA-TRACH INNER
CANNULA TRACHEOSTOMY TUBE
865
CRT01TTLPCS5 雪莉氣切套管及其附件 SHILEY TRACHEOSTOMY CANNULAE AND
ACCESSORIES—有氣囊、無開窗/LONG TERM CARE使用)
865
CRT01U0025ZG "富齡"氣切管"ALLY" TRACHEOSTOMY TUBE(UNCUFF, ID 2.5-
5.5MM)
328
CRT01U0060WN TEFLON TRACHEOSTOMY TUBE(DOUBLE TUBE)6:12MM外徑 525
CRT0236368KK "高研"氣管套管"KOKEN" TRACHEAL CANNULA 525
CRT0252608KK "高研"比比氣管套管"KOKEN" TRACHEAL CANNULA PP 493
CRT0253065VK “旭邦”柔得多標準型氣切管(一次使用型)-有氣囊/有孔
“VITALTEC”ROTA-TRACH STANDARD TRACHEOSTOMY TUBE
(DISPOSABLE)
332
CRT0254060VK “旭邦”柔得多標準型氣切管(一次使用型)-無氣囊/有孔
“VITALTEC”ROTA-TRACH STANDARD TRACHEOSTOMY TUBE
(DISPOSABLE)
328
CRT02673502C "柯惠" 麥林可恰可舒氣切管”COVIDIEN” MALLINCKRODT
TRACHESOFT TRACHEOSTOMY CANNULAE-標準型無氣囊
328
817
特材代碼 中英文名稱 支付點數-104/01/01
CRT02673752C "柯惠" 麥林可恰可舒氣切管"COVIDIEN" MALLINCKRODT
TRACHESOFT TRACHEOSTOMY CANNULAE
328
CRT02C0030UW "花瑪"氣切套管 PHARMA TRACHEOSTOMY TUBE UNCUFF 3:10MM 328
CRT02C00502C "柯惠" 麥林可恰可舒氣切管”COVIDIEN” MALLINCKRODT
TRACHESOFT TRACHEOSTOMY CANNULAE-可調整型
332
CRT02C0050SG TRACHEOSTOMY TUBE W/CUFF 5.0:9.0MM 332
CRT02C0050TP SILICONE TRACHEOSTOMY TUBE 5.0MM:9.5MM 577
CRT02C0050WN ALL SILICONE TRACHEOSTOMY TUBE WITH CUFF 22:42FR 5.0:10MM
內徑產品型號2217-035:100自93.1.1生效
577
CRT02C0060UW TRACHEOSTOMY TUBE,REGULAR HVLP CUFF,ID 6:10MM氣切套管(有
閥)
332
CRT02C0060ZG "富齡"氣切管"ALLY" TRACHEOSTOMY TUBE(W/CUFF, ID 6.0-
9.0MM)
332
CRT02C0062UW "花瑪"氣切套管 PHARMA TRACHEOSTOMY TUBE W/CUFF 6:10MM 332
CRT02C0065MU 華新氣切套管 MODERN TRACHEOSTOMY TUBE 332
CRT02C0065UW "巫諾" 氣管切開套管 "UNOMEDICAL" TRACHEOSTOMY TUBE 332
CRT02C00802C "柯惠" 麥林可恰可舒氣切管”COVIDIEN” MALLINCKRODT
TRACHESOFT TRACHEOSTOMY CANNULAE-標準型
332
CRT02C0793W6 TRACHEOSTOMY TUBE (WITH/CUFF) 332
CRT02C1560FM 氣切套管FORTUNE TRACHEOSTOMY TUBE ID2.0MM:12.0MM(普通球) 577
CRT02C1565FM 氣切套管FORTUNE TRACHEOSTOMY TUBE ID2.0MM:12.0MM(低壓球) 577
CRT02C5060UW “巫諾”氣管切開套管-有閥“UNOMEDICAL” TRACHEOSTOMY
TUBE-HIGH VOLUME LOW PRESSURE CUFF (HVLP CUFF),ID 6:10MM
332
CRT02C595NFM SILICONE TRACHEOSTOMY TUBE W/CUFF 5.5:9.5MM 577
CRT02C6262UW “巫諾”氣管切開套管-可調式(有閥)“UNOMEDICAL”
TRACHEOSTOMY TUBE-WITH ADJUSTABLE FLANGE (TTAF) WITH HVLP
CUFF, ID 6:11MM
332
CRT02CP050YN ALL SILICONE TRACHEOSTOMY TUBE W/CUFF 5.0:10.0MM(PRE-
FORMED TYPE)
577
CRT02TT016SG SIGMA TRACHEOSTOMY TUBE 332
CRT02TT046SG SIGMA TRACHEOSTOMY TUBE(SILICON) 577
CRT02U0025WN ALL SILICONE TRACHEOSTOMY TUBE WITHOUT CUFF 12:42FR
2.5:10.0MM內徑
460
CRT02U0030UW TRACHEOSTOMY TUBE,PLAIN,UNCUFF,ID 3:10MM氣切套管(無閥) 328
CRT02U0030YN ALL SILICONE TRACHEOSTOMY TUBE UNCUFF 3.0:10.0MM(PLAIN
TYPE)
460
CRT02U0045S5 雪莉氣切套管SHILEY TRACHEOSTOMY CANNULAE—小兒用( WITH
OBTURATION)
893
CRT02U0062UW "巫諾" 氣管切開套管"UNOMEDICAL" TRACHEOSTOMY TUBE 328
CRT02U0065MU 華新氣切套管MODERN TRACHEOSTOMY TUBE 332
CRT02U1561FM 氣切套管FORTUNE TRACHEOSTOMY TUBE ID2.0MM:12.0MM(無球型) 460
CRT02U5060UW “巫諾”氣管切開套管-無閥“UNOMEDICAL” TRACHEOSTOMY
TUBE-PLAIN (WITHOUT CUFF), ID 3:10MM
328
CRT04C678MHJ "史密斯"百弗納氣切套管與配件"SMITHS" BIVONA TRACHEOSTOMY
TUBE AND ACCESSORIES*使用規定請見備註欄
3800
CRT04C750MHJ "史密斯"百弗納氣切套管與配件"SMITHS" BIVONA TRACHEOSTOMY
TUBE AND ACCESSORIES*使用規定請見備註欄
3800
CRT04C850MHJ "史密斯"百弗納氣切套管與配件"SMITHS" BIVONA TRACHEOSTOMY
TUBE AND ACCESSORIES*使用規定請見備註欄
3800
818
特材代碼 中英文名稱 支付點數-104/01/01
CRT0552518KK "高研"比比氣切套管-無氣囊、開窗/LONG TERM CARE使
用"KOKEN"TRACHEAL CANNULA PP
850
CRT0555150VK “旭邦”柔得多內管型氣切管“VITALTEC”ROTA-TRACH INNER
CANNULA TRACHEOSTOMY TUBE
865
CRT0556150VK “旭邦”柔得多內管型氣切管“VITALTEC”ROTA-TRACH INNER
CANNULA TRACHEOSTOMY TUBE
850
CRT05C0050S5 雪莉氣切套管及其附件 SHILEY TRACHEOSTOMY CANNULAE AND
ACCESSORIES—有氣囊、開窗/LONG TERM CARE使用
865
CRT05C7271UW “巫諾”氣管切開套管-雙管型(有閥)“UNOMEDICAL”
TRACHEOSTOMY TUBE-TTIC WITH HVLP CUFF, FENESTRATED ID
6:10MM*LONG TERM CARE使用
865
CRT05C7272UW “巫諾”氣管切開套管-雙管型(有閥)“UNOMEDICAL”
TRACHEOSTOMY TUBE-TTIC WITH HVLP CUFF, ID 6:10MM*LONG
TERM CARE使用
865
CRT05U0050S5 雪莉氣切套管SHILEY TRACHEOSTOMY CANNULAE—無氣囊、開窗
/LONG TERM CARE使用
850
CRT05U7273UW “巫諾”氣管切開套管-雙管型(無閥)“UNOMEDICAL”
TRACHEOSTOMY TUBE- TTIC PLAIN (WITHOUT CUFF), FENESTRATED
ID 6:10MM*LONG TERM CARE使用
493
CRT09C6262UW “巫諾”氣管切開套管-可調式增強型(有閥)“UNOMEDICAL”
TRACHEOSTOMY TUBE-ADJUSTABLE FLANGE(TTAF)WITH HVLP
CUFF,REINFORCED(ID6:11MM)
450
CRT09U6264UW “巫諾”氣管切開套管-可調式增強型(無閥)“UNOMEDICAL”
TRACHEOSTOMY TUBE-ADJUSTABLE FLANGE(TTAF)WITH HVLP
WITHOUT CUFF,REINFORCED(ID6:11MM)
450
CRT1000543PX "史密斯"保德士經皮式氣切套管組"SMITHS" PORTEX
PERCUTANEOUS TRACHEOSTOMY KIT*適應症請見備註欄
1951
CRT10PTS01CK 〝曲克〞藍犀牛氣管引導器組〝COOK〞CIAGLIA BLUE RHINO
PERCUTANEOUS TRACHEOSTOMY INTRODUCER SET*適應症請見備註欄
4500
CRT10PTS02CK 〝曲克〞藍犀牛氣管引導器組〝COOK〞CIAGLIA BLUE RHINO
PERCUTANEOUS TRACHEOSTOMY INTRODUCER SET*適應症請見備註欄
4500
CRT10PTS03CK "曲克"藍犀牛氣管引導器組*給付規定請見備註欄"COOK"CIAGLIA
BLUE RHINO PERCUTANEOUS TRACHEOSTOMY INTRODUCER SET
5365
CVA0100490M4 PROFLO ANGIOGRAPHIC CATHETER 6F,7F*100,110,125CM (衛署字
號009770)
594
CVA0107130AR "ARROW"BERMAN ANGIOGRAPHIC CATHETER(PEDIATRIC) 4:8FR
50:110CM “亞諾”帕曼心臟血管攝影用導管
1750
CVA011MG31SB IMAGER11 ANGIOGRAPHIC CATH(4-
5FRX40,65,90,100CM)0.035,0.038(型號M001316021:M001316911
自92/7/1生效)
594
CVA01451XNCD "CORDIS"TEMPO ANGIOGRAPHIC CATHETER TEMPO4,TEMPO5田布血管
造影導管
594
CVA014A00NM4 SITESEER CARDIOVASCULAR ANGIOGRAPHIC CATHETER 4FR 594
CVA01512HNMR IMPRESS ANGIOGRAPHIC CATHETERS 0.035",0.038" 100,125CM 映
象血管攝影導管
594
CVA01565CBMR IMPRESS ANGIOGRAPHIC CATHETERS 0.035",0.038" 65CM,100CM
映象血管攝影導管
594
CVA01565REMR IMPRESS ANGIOGRAPHIC CATHETERS 0.035",0.038"
40CM,65,80,100CM 映象血管攝影導管
594
CVA01565SMMR IMPRESS ANGIOGRAPHIC CATHETERS 0.035",0.038" 65CM,100CM
映象血管攝影導管
594
819
特材代碼 中英文名稱 支付點數-104/01/01
CVA01565VEMR IMPRESS ANGIOGRAPHIC CATHETERS 0.035",0.038"
65CM,100,125CM 映象血管攝影導管
594
CVA015A00NM4 SITESEER CARDIOVASCULAR ANGIOGRAPHIC CATHETER 5FR 594
CVA016A00NM4 SITESEER CARDIOVASCULAR ANGIOGRAPHIC CATHETER 6FR 594
CVA017779AMR PERFORMA DIAGNOSTIC RADIOLOGY CATHETERS 594
CVA01A80CMTM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4FR
80CM 歐帝克血管攝影導管
594
CVA01B001NCK CEREBRAL CATHETER 594
CVA01H001NCK ANGIO CATHETER CEREBRAL CATHETER 594
CVA01H1234BQ ANGIOGRAPHIC CATHETER 4:5FR 100CM(腦部血管用) 594
CVA01HN001CK ROYAL FLUSH PLUS HIGH FLOW ANGIOGRAPHIC FLUSH CATHETER
0.035,0.038 4:6FR 70:110CM
594
CVA01HNB01CK TORCON NB ANGIOGRAPHIC CATHETER 4.1FR 50:125CM(CEREBRAL
PULMONARY MUTIPURPOSE VISCERAL CATH)
594
CVA01HNB02CK TORCON NB ANGIOGRAPHIC CATHETER 5.0,6.0FR
50:125CM(CEREBRAL PULMONARY MUTIPURPOSE VISCERAL CATH)
594
CVA01HNB03CK TORCON NB ANGIOGRAPHIC CATHETER 4.1,5.0,6.0FR 70:110CM(
CORONARY CATH)
594
CVA01HNBR1CK ANGIOGRAPHIC CATHETER W/RADIOPAQUE TIPS 4.1FR 50:125CM 594
CVA01HNBR2CK ANGIOGRAPHIC CATHETER W/RADIOPAQUE TIPS 5.0FR 50:125CM 594
CVA01HNBR3CK ANGIOGRAPHIC CATHETER W/RADIOPAQUE TIPS 4.1FR,5.0FR
70:110CM CORONARY CATH
594
CVA01HNBR4CK TORCON NB ANGIOGRAPHIC CATHETER 594
CVA01HNBR5CK TORCON NB ANGIOGRAPHIC CATHETER 594
CVA01HNBR6CK "COOK" BEACON TIP TORCON NB ADVANTAGE CATHETER 4.0
FR,40~100 CM "曲克" 遠端導引託鏗增益導管
594
CVA01HNBR7CK "COOK" BEACON TIP TORCON NB ADVANTAGE CATHETER 4.0
FR,65~125CM "曲克" 遠端導引託鏗增益導管
594
CVA01HNBR8CK "COOK" BEACON TIP TORCON NB ADVANTAGE CATHETER 4.0
FR,80CM "曲克" 遠端導引託鏗增益導管
594
CVA01HNR01CK ROYAL FLUSH PLUS ANGIOGRAPHIC CATHETER 0.35" 65-110CM 594
CVA01HNR02CK ROYAL FLUSH PLUS ANGIOGRAPHIC CATHETER 0.035" 0.038" 65-
110CM
594
CVA01N001NCK ANGIO CATHETER VISCERAL CATHETER 65:100CM 594
CVA01NP4RCGT "GOODTEC"ANGIOGRAPHY CATHETER "固特克"血管攝影導管 594
CVA01P027NCK ANGIO CATHETER 50:110CM 594
CVA01RC123BQ ANGIOGRAPHIC CATHETER 4:5FR 65~80CM(周邊血管用) 594
CVA020TL0KTM "泰爾茂"歐路克血管造影導管"TERUMO" OUTLOOK ANGIOGRAPHIC
CATHER
594
CVA024SP68TM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER
PIGTAIL"泰爾茂"歐帝克血管攝影導管
594
CVA0295007TM "TERUMO"RADIOFOCUS YASHIRD ANGIOGRAPHIC CATHETER"泰爾茂"
血管攝影導管
594
CVA02AB441TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR COBRA 594
CVA02ABCDGTM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-5FR
65-80CM"泰爾茂"歐帝克血管攝影導管
594
CVA02AC341TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR SHEPHERD
HOOK
594
CVA02AD441TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR J CURVE 594
CVA02AE441TM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER"泰爾
茂"歐帝克血管攝影導管
594
CVA02AG341TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4FR RH 594
CVA02AG941TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR YASHIRO 594
820
特材代碼 中英文名稱 支付點數-104/01/01
CVA02APLPRTM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-6FR
80-100CM"泰爾茂"歐帝克血管攝影導管
594
CVA02APRHLTM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-6FR
100-110CM"泰爾茂"歐帝克血管攝影導管
594
CVA02BABCHTM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-5FR
65-100CM"泰爾茂"歐帝克血管攝影導管
594
CVA02BB141TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR HEADHUNTER 594
CVA02BC141TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR NEWTON 594
CVA02BE141TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR BENTSON 594
CVA02CLRJRTM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-6FR
80-110CM"泰爾茂"歐帝克血管攝影導管
594
CVA02CRFJRTM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-6FR
80-100CM"泰爾茂"歐帝克血管攝影導管
594
CVA02DADBETM "TERUMO"RADIFOCUS ANGIOGRAPHIC CATHETER 5FR/65,80CM"泰爾
茂"血管攝影導管
594
CVA02DB450TM RADIFOCUS COBRA ANGIOGRAPHIC CATHETER 5:6FR 65:100CM 594
CVA02DCDEGTM "TERUMO"RADIFOCUS ANGIOGRAPHIC CATHETER 5FR/65,80CM"泰爾
茂"血管攝影導管
594
CVA02DD450TM RADIFOCUS J CURVE ANGIOGRAPHIC CATHETER 5:7FR 65CM 594
CVA02DG350TM "TERUMO"RADIFOCUS RH ANGIOGRAPHIC CATHETER 5FR 65CM"泰爾
茂"血管攝影導管
594
CVA02DG450TM RADIFOCUS RS ANGIOGRAPHIC CATHETER 5FR 65CM 594
CVA02DGEA9TM "TERUMO"RADIFOCUS ANGIOGRAPHIC CATHETER 5FR 65,80;100CM"
泰爾茂"血管攝影導管
594
CVA02EA150TM RADIFOCUS SIMMONS ANGIOGRAPHIC CATHETER 5:6FR 100CM 594
CVA02EB150TM RADIFOCUS HEADHUNTER ANGIOGRAPHIC CATHETER 5:7FR 100CM 594
CVA02EBCGJTM "TERUMO"RADIFOCUS ANGIOGRAPHIC CATHETER 5FR 100CM"泰爾茂"
血管攝影導管
594
CVA02EE150TM RADIFOCUS BENTSON ANGIOGRAPHIC CATHETER 5FR 100CM 594
CVA02FGFKLTM "TERUMO"RADIFOCUS ANGIOGRAPHIC CATHETER 5FR 6FR
65,80;100;110CM"泰爾茂"血管攝影導管
594
CVA02RDTR9TM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 5-6FR
80-110CM"泰爾茂"歐帝克血管攝影導管
594
CVA02RQ4FNTM OUTLOOK ANGIOGRAPHIC CATHETER 4FR 60CM:110CM ANY CURVE
(衛署字號9685)
594
CVA02RQ5FNTM OUTLOOK ANGIOGRAPHIC CATHETER 5FR 60CM:110CM ANY CURVE
(衛署字號9685)
594
CVC0132400CD VISCERAL COBRA FEMORAL CATHETER 594
CVC0132412CD ANGIO CATHETER FEMORAL AORTIC FLUSH (PIGTAIL) 594
CVC013241NCD ANGIO CATHETER FEMORAL VISCERAL (SIDEWINDER) 594
CVC0132420CD ANGIO CATHETER FEMORAL AORTIC FLUSH (STRAIGH) 594
CVC013243NCD ANGIO CATHETER FEMORAL VISCERAL (BENTSON) 594
CVC013244NCD ANGIO CATHETER FEMORAL VISCERAL J CURVE (SHEPHERD HOOK) 594
CVC0132461CD ANGIO CATHETER FEMORAL VISCERAL (HEADUNTER) 594
CVC0132474CD ANGIO CATHETER FEMORAL VISCERAL (SHEPHERD HOOK) 594
CVC0132545CD NIH CATHETER 5:8FR 80:100CM 594
CVC0134610UV ALVISION CARDIOVASCULAR ANGIOGRAPHIC CATHETER 艾微視心血
管攝影導管
594
CVC014505NCD INFINITI DIAGNOSTIC CARDIOLOGY CATHETER 5FR 594
CVC015325NCD PIGTAIL CATHETER 5:8FR 594
CVC015334NCD CARDIOLOGY ANGIOGRAPHIC CATHETER 4.1FR 65:100CM 594
CVC015335NCD CARDIOLOGY ANGIOGRAPHIC CATHETER 5.2FR 65:125CM 594
CVC015336NCD CARDIOLOGY ANGIOGRAPHIC CATHETER 6FR 80:100CM 594
CVC015346NCD INFINITI DIAGNOSTIC CARDIOLOGY CATHETER 6FR 594
821
特材代碼 中英文名稱 支付點數-104/01/01
CVC015384XCD INFINITI DIAGNOSTIC CARDIOLOGY CATHETER 4FR 594
CVC01752F1MR ANGIO CATHETER 594
CVC018526NSB EXPO ANGIOGRAPHIC CATHETER 100:125CM 5F:7F 594
CVC01AMK4JK0 CARDIAC CATHETER(AMPLATZ)4-6FR 100CM 594
CVC01CAPGTMR ANGIOGRAPHIC CATHETERS PIGTAIL CATHETER 594
CVC01HF456BK HYPERFLOW DIAGNOSTIC CATHETER 594
CVC01JKK4JK0 CARDIAC CATHETER(JUDKINS)4-6FR 100CM 594
CVC01JL235BQ ANGIOGRAPHIC CATHETER JL4,JL3.5 594
CVC01JR235BQ ANGIOGRAPHIC CATHETER JR4,JR3.5 594
CVC01MLK4JK0 CARDIAC CATHETER(MULTIPURPOSE)4-6FR 100CM 594
CVC01N001NCK ANGIO CATHETER CORONARY CATHETER 110:150CM 594
CVC01P1451BQ ANGIOGRAPHIC CATHETER 4:6FR 100~110CM(冠狀動脈用) 594
CVC01P1K4JK0 CARDIAC CATHETER(PIGTAIL)4-6FR 110-130CM 594
CVC01PG155BQ ANGIOGRAPHIC CATHETER P155,P1G 594
CVC01RAK4JK0 CARDIAC CATHETER(INTERNAL MAMMARY, CORONARY BYPASS,
RADIAL)4-6FR 100CM
594
CVC01RH001TM TERUMO RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 泰爾茂
歐帝克血管攝影導管
594
CVC01RH002TM TERUMO RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 泰爾茂
歐帝克血管攝影導管
594
CVC01RHAL1TM OPTITORQUE ANGIOGRAPHIC CATHETER AMPLATZ LEFT 1:3,5:6FR
100CM
594
CVC01RHAR1TM OPTITORQUE ANGIOGRAPHIC CATHETER AMPLATZ RIGHT 1-3 5:6FR
100CM
594
CVC01RHJL4TM OPTITORQUE ANGIOGRAPHIC CATHETER JUDKINS LEFT 3.5:5.0MM
4:6FR 100CM
594
CVC01RHJR4TM OPTITORQUE ANGIOGRAPHIC CATHETER JUDKINS RIGHT 3.5:5.0CM
4:6FR 100CM
594
CVC01RHSP6TM OPTITORQUE ANGIOGRAPHIC CATHETER STRAIGHT PIGTAIL 4:6FR
110CM
594
CXE0100624BA "巴德"歐文四極診斷電極導管"BARD"WOVEN DIAGNOSTIC
ELECTRODE CATHETER
7191
CXE0102943BA QUADPOLAR ELECTRODE 6FR 110CM 1CM 7191
CXE0104019BA WOVEN TRIPOLAR ELECTRODE CATHETER 7191
CXE0107150BA NBIH BIPOLAR PACING ELECTRODE 5:7FR 100:125CM 5905
CXE0108567BA QUADPOLAR ELECTRODE 6FR 120CM 7191
CXE0120011BA "巴德"歐文診斷電極導管"BARD" WOVEN DIAGNOSTIC ELECTRODE
CATHETERS四極
7191
CXE0120015BA WOVEN QUADPOLAR ELECTRODE
CATH200150:3,200055P,56,56E,57P,58,58E,59P,60,60E,61P,62E
,63P,64P
7191
CXE0120016BA WOVEN QUADPOLAR ELECTRODE
CATHETER201400,200066:69,202,203,472,473,574,578,582:586,
7191
CXE0120035BA WOVEN DECAPOLAR ELECTRODE CATHETER 9882
CXE0120061BA "巴德"歐文診斷電極導管"BARD" WOVEN DIAGNOSTIC ELECTRODE
CATHETERS十極
9882
CXE0120076BA OPEN-LUMEN QUADPOLAR ELECTRODE 6FR 110CM 1CM 6889
CXE0120077BA OPEN-LUMEN QUADPOLAR ELECTRODE 6FR 110CM 5MM 6889
CXE0120140BA WOVEN PENTAPOLAR ELECTRODE CATHETER 7191
CXE0140003BA VIKING DECAPOLAR ELECTRODE
CATHETER400030:36,400070:71,400074:75
9882
CXE014000NBA VIKING QUADPOLAR ELECTRODE
CATHETER400001:12,400041:48,400050:51,400091P,
7191
822
特材代碼 中英文名稱 支付點數-104/01/01
CXE0140010BA "巴德"維克診斷電極導管"BARD" VIKING DIAGNOSTIC ELECTRODE
CATHETER十極
9882
CXE0140012BA "巴德"維克診斷電極導管-四極"BARD" VIKING DIAGNOSTIC
ELECTRODE CATHETER
7191
CXE0140050BA VIKING SOFT TIP QUADPOLAR ELECTRODE CATHETER
400501:512,400541:542
7191
CXE0140053BA VIKING SOFT TIP DECAPOLAR ELECTRODE
CATHETER400530:536,400570:571
9882
CXE0140054BA "巴德"探戈診斷電極導管-四,五極"BARD" TANGO DIAGNOSTIC
ELECTRODE CATHETERS
7191
CXE0140057BA "巴德"探戈診斷電極導管"BARD" TANGO DIAGNOSTIC ELECTRODE
CATHETERS十極
9882
CXE01CDFNNYB "爾灣"電生理診斷導管"IBI"ELECTROPHYSIOLOGY DIAGNOSTIC
CATHETER-INQUIRY FIXED SOFT TIP DIAGNOSTIC CATH.-
DECAPOLAR
9882
CXE01EPEXDSB "波士頓科技"診斷電極導管"BOSTON SCIENTIFIC" EXPLORER
FIXED CURVE DIAGNOSTIC CATHETER 十極
9882
CXE01EPEXQSB "波士頓科技"診斷電極導管"BOSTON SCIENTIFIC" EXPLORER
FIXED CURVE DIAGNOSTIC CATHETER 四極
7191
CXE01EPF10JV "日本來富恩" 菲克斯固定彎電極導管"JAPAN LIFELINE" EPSTAR
FIX ELECTROPHYSIOLOGY CATHETER(4FR./10電極)
9882
CXE01F0400CV ELECTRODE CATH.4極,型號F4:6,65-QA,D,E,F,H,K,L-2,5,10,252-
RT;F5,6-
7191
CXE01F1000CV ELECTRODE CATH.DECAPOLAR,型號F5A-DP-282,P10-RT;F6-DA,
F,G,P-
9882
CXE01F1001CV ELECTRODE CATH.DECAPOLAR,型號F6A-DP-282-RT;F7LA-DP-P10-
RT
9882
CXE01F5120JV "日本來富恩" 菲克斯固定彎電極導管"JAPAN LIFELINE" EPSTAR
FIX ELECTROPHYSIOLOGY CATHETER(4,5FR./5電極)
7191
CXE01LUMENST 雷斯龐生理電極導管RESPONSE ELECTROPHYSIOLOGY CATHETERS 11060
CXE01Q0405YB "爾灣"電生理診斷導管"IBI"ELECTROPHYSIOLOGY DIAGNOSTIC
CATHETER-INQUIRY 4F FIXED DIAGNOSTIC CATH.-QUADRAPOLAR
7191
CXE01RDECAST 雷斯龐生理電極導管RESPONSE ELECTROPHYSIOLOGY CATHETERS
6F,7F,DECAPOLAR
9882
CXE01RQUADST 雷斯龐生理電極導管RESPONSE ELECTROPHYSIOLOGY CATHETERS
5F,6F,QUADRIPOLAR
7191
CXE01SDECAST 「“聖猷達”史普力米生理電極導管”SJM”SUPREME
ELECTROPHYSIOLOGY CATHETER」十極
9882
CXE01SQUADST 「“聖猷達”史普力米生理電極導管”SJM”SUPREME
ELECTROPHYSIOLOGY CATHETER」-四極
7191
CXE0201101BA DYNAMIC XT STEERABLE DECAPOLAR ELECTRODE CATHETER 14154
CXE0201103BA DYNAMIC XT STEERABLE QUADPOLAR ELECTRODE CATHETER 12284
CXE0210MCSJV "日本來富恩" 意皮斯塔單向電極導管"JAPAN LIFELINE"
STEERABLE ELECTROPHYSIOLOGY CATHETER(可控式5FR./10電極)
14154
CXE022005NBA EP.XT STEERABLE QUADPOLAR ELECTRODE CATH.200525:527:
735:737:741:769:770:898
12284
CXE0223076BA 巴德”雷迪雅斯特操控式電極導管-四極“BARD”RADIA XT
STEERABLE ELECTRODE CATHETER(6F;110CM;QUADPOLAR)
12284
CXE0223077BA 巴德”雷迪雅斯特操控式電極導管-六極“BARD”RADIA XT
STEERABLE ELECTRODE CATHETER(6F;110CM;HEXAPOLAR)
12255
CXE0223079BA 巴德”雷迪雅斯特操控式電極導管-八極“BARD”RADIA XT
STEERABLE ELECTRODE CATHETER(6F;110CM;OCTAPOLAR)
12255
CXE0223107BA 巴德”雷迪雅斯特操控式電極導管-十極“BARD”RADIA XT
STEERABLE ELECTRODE CATHETER(6F;110CM;DECAPOLAR)
14154
823
特材代碼 中英文名稱 支付點數-104/01/01
CXE0255120JV "日本來富恩" 意皮斯塔單向電極導管"JAPAN LIFELINE"
STEERABLE ELECTROPHYSIOLOGY CATHETER(可控式5FR./5電極)
12284
CXE02557XSSB "波士頓科技" 診斷用導管"BOSTON SCIENTIFIC" POLARIS DX
STEERABLE DIAGNOSTIC CATHETER
12284
CXE02567STYB "爾灣"電生理診斷導管"IBI"ELECTROPHYSIOLOGY DIAGNOSTIC
CATHETER-INQUIRY SOFT TIP STEERABLE DIAGNOSTIC CATH.-
DECAPOLAR
14154
CXE0281504YB "爾灣"電生理診斷導管 "IBI" ELECTROPHYSIOLOGY DIAGNOSTIC
CATHETER(十極)
14154
CXE0281920YB "爾灣" 電生理診斷導管-十極"IBI" ELECTROPHYSIOLOGY
DIAGNOSTIC CATHETER
14154
CXE028478NYB "爾灣"電生理診斷導管 "IBI" ELECTROPHYSIOLOGY DIAGNOSTIC
CATHETER-QUADRIPOLAR STEERABLE 5F
12284
CXE02848STYB "爾灣"電生理診斷導管 "IBI" ELECTROPHYSIOLOGY DIAGNOSTIC
CATHETER(四極)
12284
CXE02849STYB "爾灣"電生理診斷導管 "IBI" ELECTROPHYSIOLOGY DIAGNOSTIC
CATHETER(四極)
12284
CXE02D0400CV ELECTRODE CATH.可彎式四極,型號D5S-270L-B2-RT;D5S-AL-
252-RT;D5S-270L-
12284
CXE02D0401CV ELECTRODE CATH.四極可彎,型號D6,7-DR-5,10,252-RT;D6,7-
AGALBGBLCGCLDGDL
12284
CXE02D1000CV "百歐森偉伯司特" 電極導管-可彎十極"BIOSENSE WEBSTER"
ELECTROPHYSIOLOGY CATHETERS,6,7-10DR,FR-2,5,P10,
252-RT;
14154
CXE02D6DR2CV SMALL DOME DEFLECTABLE QUADRAPOLAR EP CATHETER (可彎式四
極)
12284
CXE02LVW04ST “聖猷達”可控式生理電極導管”SJM”LIVEWIRE STEERABLE
ELECTROPHYSIOLOGY CATHETER-4極
12284
CXE02LVW10ST “聖猷達”可控式生理電極導管”SJM”LIVEWIRE STEERABLE
ELECTROPHYSIOLOGY CATHETER-10極
14154
CXE02QSNSTYB "爾灣"電生理診斷導管"IBI"ELECTROPHYSIOLOGY DIAGNOSTIC
CATHETER-INQUIRY SOFT TIP STEERABLE DIAGNOSTIC CATH.-
QUADRAPOLAR
12284
CXE0321000BA "巴德"史汀格除顫電極導管"BARD"STINGER ABLATION CATHETERS 21479
CXE0331000BA "巴德"天蠍電燒電極導管"BARD"SCORPION ABLATION CATHETER 21479
CXE033100TBA "巴德"天蠍電燒電極導管"BARD" SCORPION ABLATION CATHETER 21479
CXE034500TSB "波士頓科技"布雷瑟心臟除顫系統"BOSTON SCIENTIFIC" BLAZER
II XP CARDIAC ABLATION SYSTEM
21479
CXE035086TSB "波士頓科技" 布雷瑟除顫電極導管"BOSTON SCIENTIFIC" BLAZER
II/BLAZER II HTD ABLATION CATHETER
21479
CXE0360811M4 CARDIOBLATE SURGICAL ABLATION SYSTEM心臟電燒系統 *適應症
請見備註欄(產品型號60813,60814自94年10月1日生效)
40854
CXE038336NYB "爾灣"除顫電極導管"IBI"ABLATION ELECTROPHYSIOLOGY
CATHETER
21479
CXE038337NYB "爾灣"瑟爾皮除顫電極導管"IBI"THERAPY DUAL-8 ABLATION
CATHETER
21479
CXE038344NYB "爾灣"瑟爾皮熱阻電燒導管"IBI" THERAPY 8MM TIP THERMISTOR
ABLATION CATHETER
21479
CXE038372NYB "爾灣"除顫電極導管"IBI" ABLATION ELECTROPHYSIOLOGY
CATHETER
21479
CXE03ASU23FW "艾科" 電刀設備及其附件"ATRICURE" ABLATION AND SENSING
UNIT AND ACCESSORIES*適應症請見備註欄
40854
824
特材代碼 中英文名稱 支付點數-104/01/01
CXE03BD74LWE “百歐森偉伯斯特”易擊史遞兒雙向可彎式診斷/電燒導管
“BIOSENSE WEBSTER”EZ STEER BI-DIRECTIONAL
DIAGNOSTIC/ABLATION DEFLECTABLE TIP CATHETER
21479
CXE03BD78LWE “百歐森偉伯斯特”易擊史遞兒雙向可彎式診斷/電燒導管
BIOSENSE WEBSTER EZ STEER DS BI-DIRECTIONAL
DIAGNOSTIC/ABLATION DEFLECTABLE TIP CATHETER
21479
CXE03BPLARE8 "艾斯泰格"康柏拉電雙極套"ESTECH"COBRA BIPOLAR INSERTS**限
心臟外科手術時使用並附AF心電圖報告術前術中或術後
40854
CXE03CBBRAE8 "艾斯泰格"康柏拉電雙極套"ESTECH"COBRA BIPOLAR INSERTS**限
心臟外科手術時使用並附AF心電圖報告術前術中或術後
40854
CXE03CRY02FW "艾科"冷凍治療系統-探針"ATRICURE" CRYO MODULE SYSTEM-
ABLATION PROBE*使用規定請見備註欄
40210
CXE03CRYCSFW "艾科"冷凍治療儀專用探針"ATRICURE" CRYO1 CRYO-ABLATION
PROBE*使用規定請見備註欄
40210
CXE03CS007E8 "艾斯泰格"康柏拉電刀用內建導線電極"ESTECH"COBRA SURGICAL
PROBE WITH INTEGRATED CABLE**限心臟外科手術時使用並附AF心
電圖報告術前術中或術後
40854
CXE03CS927E8 "ESTECH"COBRA SURGICAL PROBE "艾斯泰格"康柏拉電刀用電極*
限心臟外科手術時使用並附AF心電圖報告術前術中或術後
40854
CXE03EMR23FW "艾科" 外科手術剝離夾鉗 "ATRICURE" ISOLATOR SURGICAL
ABLATION CLAMPS*適應症請見備註欄
40811
CXE03EP920CV 電生理導管(四極可控式溫控導管)(型號
含:D7TAG;TCAGFL252RT;TPSL252RT,D8BTBL;BTCBL:FG252RT,
D8BTCCG;BTCL:F5L252RT)
21479
CXE03EP920WE "百歐森偉伯司特"電生理導管(四極可控式溫控導管) "BIOSENSE
WEBSTER"ELECTROPHYSIOLOGY CATHETER
21479
CXE03LVWTCST "聖猷達" 除顫電燒導管"SJM" LIVEWIRE TC ABLATION CATHETER 21479
CXE03MARNXM4 美敦力瑪林射頻電燒導管MEDTRONIC MARINR STEERABLE ABLATION
CATHETER
21479
CXE03P4500SB "波士頓科技" 布雷瑟除顫電極導管"BOSTON SCIENTIFIC" BLAZER
PRIME TEMPERATURE ABLATION CATHETER
21479
CXE03P5031SB "波士頓科技" 布雷瑟除顫電極導管"BOSTON SCIENTIFIC" BLAZER
PRIME TEMPERATURE ABLATION CATHETER
21479
CXE03SAFFRST "聖猷達" 雙向電燒導管"SJM" SAFIRE BI-DIRECTIONAL ABLATION
CATHETER
21479
CXE03WAUW2ER "愛匹克"心臟燒灼系統"EPICOR"CARDIAC ABLATION SYSTEM限心臟
外科手術時使用並附AF心電圖報告術前術中或術後
40854
CXE03WULP2ER "愛匹克" 心臟燒灼系統 "EPICOR" CARDIAC ABLATION SYSTEM*適
應症請見備註欄
40854
CXE04EACECST "聖猷達" 恩賽導管"SJM" ENSITE ARRAY CATHETER*適應症請見備
註欄
48097
CXE04NS7TCWE 〝百歐森偉伯司特〞藍星導管"BIOSENSE WEBSTER" NAVI-STAR
CATHETER*適應症請見備註欄
48097
FAD01000S2ZJ AHMED GLAUCOMA VALVE壓滅青光眼用舒壓導流瓣膜*適應症請見備
註欄
19900
FAD0150200UX "OPTONOL"EX-PRESS MINIATURE GLAUCOMA SHUNT AND
ACCESSORIES(EDS)"歐能"伊倍視小型眼房水調整閥及其配件*適應
症請見備註欄
19900
FAD0150201UX EX-PRESS GLAUCOMA FILTRATION DEVICE伊倍視青光眼房水調整裝
置*給付規定請見備註欄
19900
FALSM95UVNSZ PMMA I.O.L. 1555
FALSMAAB00A2 "AMO"SENSAR I-PIECE ACRYLIC IOL"眼力健"勝視明單片型摺疊式
人工水晶體
2744
825
特材代碼 中英文名稱 支付點數-104/01/01
FALSMACRA11X "CROMA"ACRYLIC INTRAOCULAR LENS"克洛瑪"人工水晶體 2744
FALSMAR40NA2 "AMO" SENSAR ACRYLIC POSTERIOR CHAMBER INTRAOCULAR LENS "
艾米歐"勝色人工水晶體眼球
2744
FALSMCR5BUA1 PMMA I.O.L 1555
FALSMCSFLXRY "RAYNER"INJECTABLE IOL SYSTEM PACK(HYDROPHILIC ACRYLIC)"
銳能"推注式人工水晶體系統包
2744
FALSMDL52NA2 DURALENS II IOL 1555
FALSMHAKR0ZX AKREOS FOLDABLE INTRAOCULAR LENSES(ACRYLIC W/UV FILTER) 2744
FALSMHBEC11B OII HYDROPHOBIC ACRYLIC POSTERIOR CHAMBER INTRAOCULAR
LENS W/U.V. ABSORBER 艾絲抗紫外線疏水性丙烯酸脂後房人工水
晶體
2744
FALSMHBEC11E "AAREN"HYDROPHOBIC ACRYLIC POSTERIOR CHAMBER INTRAOCULAR
LENS W/U.V. ABSORBER "愛銳"抗紫外線疏水性丙烯酸脂後房人工
水晶體
2744
FALSMHBEC21E "AAREN"SINGLE-PIECE HYDROPHOBIC ACRYLIC POSTERIOR CHAMBAR
IOL W/U.V ABS0RBER"愛銳"單片型抗紫外線疏水性丙烯酸脂後房
人工水晶體
2744
FALSMLS100LS INTRAOCULAR LENS 1555
FALSMMA30BA1 ACRYSOF INTRAOCULAR LENSES 2744
FALSMMC71CA1 PMMA I.O.L. UV,UV+LASER 1555
FALSMMZ30BA1 "ALCON" CILCO INTRAOCULAR LENSES(PMMA)"愛爾康"視而卡人工
水晶體
1555
FALSMNEFL1RQ NEO EYE FOLDABLE INTRAOCULAR LENS新視軟式人工水晶體 2744
FALSMNERP1RQ "ROHTO"NEO EYE INTRAOCULAR LENS RP-11;RP12 "樂敦"新視人工
水晶體
1555
FALSMSA30AA1 ACRYSOF SINGLE-PIECE FOLDABLE ACRYLIC POSTERIOR CHAMBER
INTRAOCULAR LENSES
2744
FALSMSA60AA1 ACRYSOF SINGLE PIECE INTRAOCULAR LENS"愛爾康愛爾蘭廠"可舒
單片型軟式人工水晶體
2744
FALSMSFLEXB9 SILICONE SOFLEX(SOFLEX SE) INTRAOCULAR LENS(可折疊式矽膠) 2744
FALSMSTEC1LS ACRYLIC INTRAOCULAR LENS 2744
FALSNCRYA0B9 "BAUSCH&LOMB"CRYSTALENS ASPHERIC OPTIC ACCOMMODATING
INTRAOCULAR LENS"博士倫”晶鑽非球面調節式人工水晶體※按一
般功能給付,超過部分病患自付
2744
FALSNCRYHDB9 "BAUSCH&LOMB"CRYSTALENS ACCOMMODATING INTRAOCULAR LENS "
博士倫"晶鑽調節式人工水晶體,按一般功能人工水晶體價格給付
,超過部分由病患自付
2744
FALSNMULT1A2 REZOOM ACRYLIC MULTIFOCAL IOL多焦點軟式人工水晶體,按一般
功能人工水晶體價格給付,超過部分由病患自付
2744
FALSNMULT1LS TETRAFLEX INTRAOCULAR LENS 多焦點軟式人工水晶體,按一般功
能人工水晶體價格給付,超過部分由病患自付
2744
FALSNMULT1RY M-FLEX MULTIFOCAL INJECTABLE ACRYLIC LENS INJECTION
SYSTEM 敏視多焦點推注式人工水晶體系統,按一般功能人工水晶
體價格給付,超過部分由病患自付
2744
FALSNMULT2A1 ACRYSOF IQ RESTOR MULTI FOCAL INTRAOCULAR LENS 可舒銳視妥
智慧型非球面多焦點軟式人工水晶體(可濾部分藍光),部分給付
品項,差額由病患自付。
2744
FALSNMULT2RY "RAYNER"SULCOFLEX HYDROPHILIC INTRAOCULAR LENSES"銳能"視
飛克斯人工水晶體(多焦點型)按一般功能人工水晶體價格給付,
超過部分由病患自付
2744
FALSNMULT3A2 "眼力健"添視明單片型多焦點人工水晶體:多焦點軟式人工水晶體
※自付差額品項,超過部分由病患自付"AMO"TECNIS MULTIFOCAL
1-PIECE INTRAOCULAR
2744
826
特材代碼 中英文名稱 支付點數-104/01/01
FALSNMULT3RY "RAYNER"M-FLEX TORIC HYDROPHILIC INTRAOCULAR LENSES"銳能"
多焦點散光推注式人工水晶體※按一般功能人工水晶體價格給付
,超過部分由病患自付
2744
FALSNMULT4A2 "眼力健"添視明多焦點散光矯正單片型人工水晶體(自付差額品
項)"AMO"TECNIS TORIC MULTIFOCAL 1-PIECE SOFT ACRYLIC LENS
2744
FALSNMULT4RY "銳能"視飛克斯人工水晶體:多焦點散光型(自付差額品
項)"RAYNER"SULCOFLEX HYDROPHILIC INTRAOCULAR LENSES
2744
FALSNMULTTA1 ACRYSOF IQ RESTOR MULITFOCAL TORIC IOL"愛爾康"可舒視爾特
智慧型非球面多焦點散光矯正單片軟式人工水晶體(可過濾部分藍
光)※部分給付項目
2744
FALSNNATU1A1 ACRYSOF NATURAL STERILE UV-ABSORBING ACRYLIC FOLDABLE
SINGLE PIECE IOL 黃色軟式人工水晶體,按一般功能人工水晶體
價格給付,超過部分由病患自付
2744
FALSNNATU2A1 ACRYSOF NATURAL SINGLE PIECE IOL "愛爾康愛爾蘭廠"可舒視然
單片型軟式人工水晶體(可過濾部分藍光),按一般功能人工水晶
體給付,超過部分由病患自付
2744
FALSNT0RC1A1 ACRYSOF TORIC SINGLE PIECE NATURAL IOL 散光功能軟式人工水
晶體,按一般功能人工水晶體價格給付,超過部分由病患自付
2744
FALSNT0RC1A2 "AMO"TECNIS TORIC I-PIECE SOFT ACRYLIC LENS"眼力健"添視明
散光矯正單片型折疊式人工水晶體,按一般功能人工水晶體價格
給付,超過部分由病患自付
2744
FALSNT0RC1RY T-FLEX TORIC INJECTABLE ACRYLIC LENS INJECTION SYSTEM 散
光功能軟式人工水晶體,按一般功能人工水晶體價格給付,超過
部分由病患自付
2744
FALSNT0RC2A1 ACRYSOF IQ TORIC SINGLE PIECE NATURAL IOL "愛爾康"可舒智
慧型妥瑞明非球面散光矯正軟式人工水晶體,按一般功能人工水
晶體給付,超過部分由病患自付
2744
FALSNT0RC2RY "RAYNER"SULCOFLEX HYDROPHILIC INTRAOCULAR LENSES"銳能"視
飛克斯人工水晶體(散光型)按一般功能人工水晶體價格給付,超
過部分由病患自付
2744
FALSNT0RCARY "RAYNER"T-FLEX ASPHERIC HYDROPHILIC INTRAOCULAR LENSES"銳
能"散光非球面人工晶體,按一般功能人工水晶體價格給付,超過
部分由病患自付
2744
FALSNT0RTU1D "DR.SCHMIDT"SILICONE INTRAOCULAR LENS MICROSIL TORIC"史密
舒"散光人工水晶體,按一般功能人工水晶體價格給付,超過部分
由病患自付
2744
FALSNT0RTY1D "DR.SCHMIDT"SILICONE INTRAOCULAR LENS MICROSIL TORIC"史密
舒"散光人工水晶體,按一般功能人工水晶體價格給付,超過部分
由病患自付
2744
FALSNWAVE11D "DR.SCHMIDT"ACRYLIC INTRAOCULAR LENS MICROCRYL "史密舒"單
片型軟式人工水晶體體(非球面),按一般功能人工水晶體價格給
付,超過部分由病患自付
2744
FALSNWAVE11E "AAREN"HYDROPHILIC ACRYLIC INTRAOCULAR LENS W/U.V
ABSORBER(ASPHERIC)"愛銳"抗紫外線人工水晶體(非球面),按一
般功能水晶體給付,超過部分民眾自付
2744
FALSNWAVE11K "XCELENS"IDEA INTRAOCULAR LENS(ASPHERIC)"愛瑟樂視"人工水
晶體※非球面軟式人工水晶體,按一般功能人工水晶體價格給付
,超過部分由病患自付
2744
FALSNWAVE11X "CROMA"PRELOADED ACRYLIC INTRAOCULAR LENS "克洛瑪"植入器
預載式人工水晶體(非球面),按一般功能水晶體給付,超過部分
由民眾自付
2744
827
特材代碼 中英文名稱 支付點數-104/01/01
FALSNWAVE1A1 ACRYSOF ASPHERIC NATURAL IQ SINGLE PIECE IOL 非球面軟式人
工水晶體,按一般功能人工水晶體價格給付,超過部分由病患自
付
2744
FALSNWAVE1B9 SOFPORT ADVANCED OPTICS ASPHERIC LENS 非球面軟式人工水晶
體,按一般功能人工水晶體價格給付,超過部分由病患自付
2744
FALSNWAVE1HY "HOYA"HOYA-PS AF-I(UY)INTRAOCULAR LENS"豪雅"植入器預載式
人工水晶體※非球面過瀘藍光人工水晶體,超過部分由病患自付
2744
FALSNWAVE1LS ASPHERIC IOL 非球面人工水晶體,按一般功能人工水晶體價格給
付,超過部分由病患自付
2744
FALSNWAVE1RY ASPHERIC INJECTABLE ACRYLIC LENS INJECTION SYSTEM 非球面
推注式人工水晶體,按一般功能人工水晶體價格給付,超過部分
由病患自付
2744
FALSNWAVE21D "DR.SCHMIDT"ACRYLIC INTRAOCULAR LENS MICROCRYL "史密舒"單
片型軟式人工水晶體(非球面藍光防護),按一般功能人工水晶體
給付,超過部分由病患自付
2744
FALSNWAVE21E "AAREN"SINGLE-PIECE HYDROPHILIC ACRYLIC POSTERIOR CHAMBER
IOL W/U.V ABSORBER(ASPHERIC)"愛銳"單片型抗紫外線人工水晶
體(非球面),部分給付項目
2744
FALSNWAVE21X "CROMA"BARRETT ACRYLIC INTRAOCULAR LENS ASPHERIC"克洛瑪"
植入器預載式非球面人工水晶體,按一般功能水晶體給付,超過
部分由民眾自付
2744
FALSNWAVE2A1 ACRYSOF RESTOR APODIZED DIFFRACTIVE ASPHERIC IOL 非球面軟
式人工水晶體(含多焦點及可過濾藍光)按一般功能人工水晶體價
格給付,超過部分由病患自付
2744
FALSNWAVE2A2 TECNIS FOLDABLE ACRYLIC IOL 非球面軟式人工水晶體,按一般
功能人工水晶體價格給付,超過部分由病患自付
2744
FALSNWAVE2HY "豪雅"植入器預載單片式非球面黃色人工水晶體(自付差額品
項)"HOYA"ISERT PRELOADED IOL
2744
FALSNWAVE2LS "蘭斯特克"人工水晶體(非球面,自付差額品
項)"LENSTEC"INTRAOCULAR LENS:BI-ASPHERIC IOL
2744
FALSNWAVE2RY "RAYNER"SULCOFLEX HYDROPHILIC INTRAOCULAR LENSES"銳能"視
飛克斯人工水晶體(非球面型)按一般功能人工水晶體價格給付,
超過部分由病患自付
2744
FALSNWAVE3A1 ACRYSOF IQ ASPHERIC NATURAL SINGLE PIECE IOL 可舒愛視明智
慧型非球面單片型軟式人工水晶體(可濾部分藍光),按一般功能
給付,超過部分由病患自付
2744
FALSNWAVE4A2 TECNIS 1 PIECE ACRYLIC INTRAOCULAR LENS 非球面,按一般功
能人工水晶體價格給付,超過部分由病患自付
2744
FALSNWAVE4B9 AKREOS AO MICRO INCISION LENS 非球面軟式人工水晶體,按一
般功能人工水晶體價格給付,超過部分由病患自付
2744
FALSNWAVE5B9 "BAUSCH&LOMB"AKREOS INTRAOCULAR LENS "博士倫〞優視非球面
人工水晶體,按一般功能人工水晶體價格給付,超過部分由病患
自付
2744
FALSNWAVE6B9 "BAUSCH&LOMB"AKREOS AO MICRO INCISION LENS"博士倫”優視微
切口人工水晶體※非球面人工水晶體,按一般功能人工水晶體給
付,超過部分由病患自付
2744
FALSNWAVE7B9 "博士倫"恩視非球面人工水晶體(自付差額品
項)"BAUSCH&LOMB"ENVISTA HYDROPHOBIC ACRYLIC INTRAOCULAR
LENS
2744
FAV01AP050B9 "博士倫"安視平人工玻璃體0.5ML"BAUSCH&LOMB"AMVISC PLUS
VISCOELASTIC
1564
FAV01AP080B9 "博士倫"安視平人工玻璃體0.8ML"BAUSCH&LOMB"AMVISC PLUS
VISCOELASTIC
1785
828
特材代碼 中英文名稱 支付點數-104/01/01
FAV01AV050B9 "博士倫"安視可人工玻璃體0.5ML"BAUSCH&LOMB"AMVISC
VISCOELASTIC
1564
FAV01AV080B9 "博士倫"安視可人工玻璃體0.8ML"BAUSCH&LOMB"AMVISC
VISCOELASTIC
1785
FAV01B0050A1 0.5ML VISCOAT STERILE OCULAR VISCOELASTIC SOLUTION 玻離體
替代物
1564
FAV01B0075A1 0.75CC VISCOAT-STERILE OCULAR VISCOELASTIC SOLUTION 1785
FAV01BC1001X CROMA-PHARMA"BIOCORNEAL II 1CC"克洛法瑪"拜耳克尼人工玻璃
體
1785
FAV01C0100R9 MEGACROM 1.8% 1CC 明佳人工玻璃體 1785
FAV01C0150R9 VISICROM 2% 1.5ML 2.5ML人工玻璃體 2021
FAV01C0200R9 "CROMA"EYEFILL HD VISCOELASTIC SOLUTION 2.5ML;1.5ML "寇
瑪"艾飛爾人工玻璃體
2021
FAV01C0300R9 "CROMA"EYEFILL M.B VISCOELASTIC SOLUTION 1.8% 0.55ML+1.4%
0.8ML "寇瑪"艾飛雙劑人工玻璃體
2021
FAV01C0400R9 "CROMA"EYEFILL S.C. VISCOELASTIC SOLUTION 0.9ML"寇瑪"艾飛
人工玻璃體
1785
FAV01D0100A1 DISCOVISC OPHTHALMIC VISCOSURGICAL DEVICE 1CC(人工玻璃體) 1785
FAV01D3540A1 0.75ML DUOVISC VISCOELASTIC SYSTEM 1785
FAV01H0055A2 HEALON 0.55ML 1564
FAV01H0506A2 HEALON 5 0.6ML 1564
FAV01HGV55A2 HEALON GV 0.55ML 1564
FAV01HGV85A2 HEALON GV 0.85ML 1785
FAV01P0040A1 0.4ML PROVISC 玻離體替代物 1415
FAV01P0055A1 0.55ML PROVISC 玻離體替代物 1564
FAV01P0085A1 0.85CC PROVISC 玻離體替代物 1785
FAV01RN085RY RAYVISC OPHTHALMIC VISCOELASTIC 0.85ML 人工玻璃體 1785
FAV01VA08CLB VISCAID 0.8ML 1785
FAV01VA10CLB "MBI"VISCAID OPHTHALMIC VISCOELASTIC(1.0CC)"和康"維視愛眼
科黏彈劑
1785
FAV01VA204LB VISCAID OPHTHALMIC VISCOELASTIC 維視愛眼科黏彈劑(0.4CC
1.5% SODIUM HYALURONATE)
1415
FAV01VA205LB VISCAID OPHTHALMIC VISCOELASTIC 維視愛眼科黏彈劑(0.55CC
1.5% SODIUM HYALURONATE)
1564
FAV01VA208LB VISCAID OPHTHALMIC VISCOELASTIC 維視愛眼科黏彈劑(0.8CC
1.5% SODIUM HYALURONATE)
1785
FAV01VA210LB VISCAID OPHTHALMIC VISCOELASTIC 維視愛眼科黏彈劑(1.0CC
1.5% SODIUM HYALURONATE)
1785
FBA0228607SN KRACKOW HTO BLADE STAPLES (鈷鉻鉬) 2473
FBA022860NSN KRACKOW HTO BLADE STAPLE (鈷鉻鉬) 2473
FBA0228673SN OSTEOTOMY FIXATION STAPLES(鈷鉻鉬) 1637
FBA022867NSN OSTEOTOMY STAPLE(鈷鉻鉬) 1637
FBA022868NSN TABLE FIXATION STAPLE(鈷鉻鉬) 2005
FBA0228690SN REGULAR FIXATION STAPLES(鈷鉻鉬) 978
FBA0228698SN TABLE FIXATION STAPLES(鈷鉻鉬) 2005
FBA022869NSN BONE STAPLE(ㄇ型)(鈷鉻鉬) 978
FBA0228720SN SHORT LEG FIXATION STAPLES(鈷鉻鉬) 978
FBA022872NSN BONE STAPLE IRREGULAR/SHORT FIXATION STAPLE(ㄇ型)(鈷鉻
鉬)
978
FBA040053NZ0 TRIOSITE BONE SUBSTITUTES 5CC *適應症請見備註欄 4197
FBA0401202XR "歐斯金"泰普人工代用骨"ORTHOGEM"TRIPORE HA SYNTHETIC BONE
GRAFT 2CC
3150
829
特材代碼 中英文名稱 支付點數-104/01/01
FBA0401210XR "歐斯金"泰普人工代用骨"ORTHOGEM"TRIPORE HA SYNTHETIC BONE
GRAFT 1CC
1923
FBA0402405XR "歐斯金"泰普人工代用骨"ORTHOGEM"TRIPORE HA SYNTHETIC BONE
GRAFT 5CC
4197
FBA0402410XR "歐斯金"泰普人工代用骨"ORTHOGEM"TRIPORE HA SYNTHETIC BONE
GRAFT 10CC
8457
FBA0402420XR "歐斯金"泰普人工代用骨"ORTHOGEM"TRIPORE HA SYNTHETIC BONE
GRAFT 20CC
12062
FBA0403G05BC "BIOMATLANTE"MBCP BONE SUBSTITUTE GRANULES 2-3MM 5CC"瑪蘭
尼"博萌得多孔雙相人工替代物*適應症請建備註欄
4197
FBA040C02BWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE塊材(2.0CM3)"台微
醫"康骨益人工骨替代物*適應症請見備註欄
3150
FBA040C05BFQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE塊材(5.0CM3)紐創康骨
益人工骨替代物*適應症請見備註欄
4197
FBA040C05BWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE塊材(5.0CM3)"台微
醫"康骨益人工骨替代物*適應症請見備註欄
4197
FBA040C05GWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE顆粒(5.0CM3)"台微
醫"康骨益人工骨替代物*適應症請見備註欄
4197
FBA040C07BFQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE塊材(7.0CM3)紐創康骨
益人工骨替代物*適應症請見備註欄
4197
FBA040C07BWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE塊材(7.0CM3)"台微
醫"康骨益人工骨替代物*適應症請見備註欄
4197
FBA040C07GFQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE顆粒(7.0CM3)紐創康骨
益人工骨替代物*適應症請見備註欄
4197
FBA040C07GWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE顆粒(7.0CM3)"台微
醫"康骨益人工骨替代物*適應症請見備註欄
4197
FBA040C10BFQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE塊材(10.0CM3)紐創康骨
益人工骨替代物*適應症請見備註欄
8457
FBA040C10BWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE塊材(10.0CM3)"台
微醫"康骨益人工骨替代物*適應症請見備註欄
8457
FBA040C10GFQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE顆粒(10.0CM3)紐創康骨
益人工骨替代物*適應症請見備註欄
8457
FBA040C10GWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE顆粒(10.0CM3)"台
微醫"康骨益人工骨替代物*適應症請見備註欄
8457
FBA040CB01FQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE STICK 5X5X20MM(2CM3)
人工骨替代物*適應症請見備註欄
3150
FBA040CB02FQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE STICK 5X5X10MM(2CM3)
人工骨替代物*適應症請見備註欄
3150
FBA040CG01FQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE GRANULE 2-3MM(5CM3)
人工骨替代物*適應症請見備註欄
4197
FBA040CG02FQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE GRANULE 1-2MM(5CM3)
人工骨替代物*適應症請見備註欄
4197
FBA040CG03FQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE GRANULE 0.5-
1MM(5CM3)人工骨替代物*適應症請見備註欄
4197
FBA041000NS1 CHRON OS GRANULE,60%POROSITY,1.0CC *適應症請見備註欄 1923
FBA041001NS1 CHRON OS GRANULE,60%POROSITY,5.0CC*適應症請見備註欄 4197
FBA041002NS1 CHRON OS GANULE,60%POROSITY,10CC*適應症請見備註欄 8457
FBA0410045S1 CHRON OSTM BLOCK,70%POROSITY,12.5X12.5X10MM*適應症請見備
註欄
3150
FBA0410047S1 CHRON OS BLOCK,70%POROSITY,20X20X10MM*適應症請見備註欄 3150
FBA0410101FV BONAGRAFT SYNTHETIC BONE SUBSTITUTE 1GM(1CC)博納骨人工骨
替代物*適應症請見備註欄
1923
FBA0410102FV BONAGRAFT SYNTHETIC BONE SUBSTITUTE 2.5GM(2.5CC)博納骨人
工骨替代物*適應症請見備註欄
3150
830
特材代碼 中英文名稱 支付點數-104/01/01
FBA0410103FV BONAGRAFT SYNTHETIC BONE SUBSTITUTE 5GM(5CC)博納骨人工骨
替代物*適應症請見備註欄
4197
FBA0410500M4 "MEDTRONIC"MASTERGRAFT RESORBABLE CERAMIC GRANULES"美敦
力"瑪斯特可吸收性骨填充物5CC
4197
FBA0411000M4 "MEDTRONIC"MASTERGRAFT RESORBABLE CERAMIC GRANULES"美敦
力"瑪斯特可吸收性骨填充物10CC
8457
FBA041142NZ0 TRIOSITE BONE SUBSTITUTES 2CC適應症請見備註欄 3150
FBA0411500M4 "MEDTRONIC"MASTERGRAFT RESORBABLE CERAMIC GRANULES"美敦
力"瑪斯特可吸收性骨填充物15CC
10236
FBA041151NZ0 BIOMATLANTE TRIOSITE BONE SUBSTITUTES 10CC*適應症請見備註
欄
8457
FBA0413000M4 "MEDTRONIC"MASTERGRAFT RESORBABLE CERAMIC GRANULES"美敦
力"瑪斯特可吸收性骨填充物30CC
16100
FBA041300NZ0 TRIOSITE BONE SUBSTITUTES 2CC適應症請見備註欄 3150
FBA044020RW2 OSTEOSET BONE VOID FILLER 4.8MM 20 PELLETS(2CC) ※適應症
請見備註欄
3150
FBA044050RW2 OSTEOSET BONE VOID FILLER 4.8MM 50 PELLETS(5CC) ※適應症
請見備註欄
4197
FBA044050TW2 OSTEOSET T BONE VOID FILLER W/TOBRAMYCIN 4.8MM 50顆 5CC※
限骨感染需補骨時使用,適應症見備註欄
10246
FBA0463005Z8 STIMULAN CALCIUM SULPHATEBONE GRAFT 3.0MM 5CC*適應症請見
備註欄
4197
FBA0463010Z8 STIMULAN CALCIUM SULPHATEBONE GRAFT 3.0MM 10CC*適應症請見
備註欄
8457
FBA0464010Z8 STIMULAN CALCIUM SULPHATEBONE GRAFT 4.8MM 10CC*適應症請見
備註欄
8457
FBA0464020Z8 STIMULAN CALCIUM SULPHATEBONE GRAFT 4.8MM 20CC*適應症請見
備註欄
12062
FBA0480005Z8 ALLOGRAN-R BONE VOID FILLER 5CC *適應症請見備註欄 4197
FBA0490G10BC MSCP BONE SUBSTITUTE 10CC*適應症請見備註欄 8457
FBA0499205DP CONDUIT TCP(TRICALCIUM PHOSPHATE)GRANULES 5CC※適應症請見
備註欄
4197
FBA0499210DP CONDUIT TCP(TRICALCIUM PHOSPHATE)GRANULES 10CC※適應症請
見備註欄
8457
FBA0499215DP CONDUIT TCP(TRICALCIUM PHOSPHATE)GRANULES 15CC※適應症請
見備註欄
10236
FBA0499230DP CONDUIT TCP(TRICALCIUM PHOSPHATE)GRANULES 30CC(2X15CC)※
適應症請見備註欄
16100
FBA04A2Q05RJ "GRAFTYS"RESORBABLE BONE VOID FILLER 5CC可吸收性骨填充物*
適應症請見備註欄
4197
FBA04A2Q10RJ "GRAFTYS"RESORBABLE BONE VOID FILLER 10CC可吸收性骨填充物
*適應症請見備註欄
8457
FBA04A3Q10RJ "GRAFTYS"RESORBABLE BONE VOID FILLER 10CC可吸收性骨填充物
*適應症請見備註欄
8457
FBA04AG01RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID
FILLER)1ML"台塑生醫"人工代用骨(再吸收骨填充物)*適應症請見
備註欄
1923
FBA04AG03RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER)
3 ML人工代用骨(再吸收骨填充物)*適應症請見備註欄
3150
FBA04AG05RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER)
5 ML人工代用骨(再吸收骨填充物)*適應症請見備註欄
4197
FBA04AG10RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID
FILLER)10ML"台塑生醫"人工代用骨(再吸收骨填充物)*適應症請
見備註欄
8457
831
特材代碼 中英文名稱 支付點數-104/01/01
FBA04AG15RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID
FILLER)15ML"台塑生醫"人工代用骨(再吸收骨填充物)*適應症請
見備註欄
10236
FBA04AG20RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID
FILLER)20ML"台塑生醫"人工代用骨(再吸收骨填充物)*適應症請
見備註欄
12062
FBA04AX0A1HY 艾沛瓷骨移植替代物:塊狀:APACERAM BONE GRAFT SUBSTITUTE-
TYPE AX BLOCK
1923
FBA04AX0A2HY 艾沛瓷骨移植替代物:塊狀:APACERAM BONE GRAFT SUBSTITUTE-
TYPE AX BLOCK
3150
FBA04AX0A3HY 艾沛瓷骨移植替代物:塊狀:APACERAM BONE GRAFT SUBSTITUTE-
TYPE AX BLOCK
4197
FBA04B01141U 尼諾斯人工替代骨(滅菌)NUROS BONE GRAFT
SUBSTITUTE(STERILE)-1CC *適應症請見備註欄
1923
FBA04B02151U 尼諾斯人工替代骨(滅菌)NUROS BONE GRAFT
SUBSTITUTE(STERILE)-2.5CC *適應症請見備註欄
3150
FBA04B03161U 尼諾斯人工替代骨(滅菌)NUROS BONE GRAFT
SUBSTITUTE(STERILE)-5CC *適應症請見備註欄
4197
FBA04B04171U 尼諾斯人工替代骨(滅菌)NUROS BONE GRAFT
SUBSTITUTE(STERILE)-10CC *適應症請見備註欄
8457
FBA04B05181U 尼諾斯人工替代骨(滅菌)NUROS BONE GRAFT
SUBSTITUTE(STERILE)-20CC *適應症請見備註欄
12062
FBA04B06191U 尼諾斯人工替代骨(滅菌)NUROS BONE GRAFT
SUBSTITUTE(STERILE)-30CC *適應症請見備註欄
16100
FBA04BC02BWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE塊材(2.0CM3)"台微醫"
喜瑞骨人工骨替代物*適應症請見備註欄
3150
FBA04BC05BFQ NANO BICERA BONE GRAFT SUBSTITUTE塊狀(5.0CM3)紐創喜瑞骨人
工骨替代物*適應症請見備註欄
4197
FBA04BC05BWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE塊材(5.0CM3)"台微醫"
喜瑞骨人工骨替代物*適應症請見備註欄
4197
FBA04BC05GWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE顆粒(5.0CM3)"台微醫"
喜瑞骨人工骨替代物*適應症請見備註欄
4197
FBA04BC07BFQ NANO BICERA BONE GRAFT SUBSTITUTE塊狀(7.0CM3)紐創喜瑞骨人
工骨替代物*適應症請見備註欄
4197
FBA04BC07BWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE塊材(7.0CM3)"台微醫"
喜瑞骨人工骨替代物*適應症請見備註欄
4197
FBA04BC07GFQ NANO BICERA BONE GRAFT SUBSTITUTE顆粒(7.0CM3)紐創喜瑞骨人
工骨替代物*適應症請見備註欄
4197
FBA04BC07GWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE顆粒(7.0CM3)"台微醫"
喜瑞骨人工骨替代物*適應症請見備註欄
4197
FBA04BC10BFQ NANO BICERA BONE GRAFT SUBSTITUTE塊狀(10.0CM3)紐創喜瑞骨
人工骨替代物*適應症請見備註欄
8457
FBA04BC10BWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE塊材(10.0CM3)"台微
醫"喜瑞骨人工骨替代物*適應症請見備註欄
8457
FBA04BC10GFQ NANO BICERA BONE GRAFT SUBSTITUTE顆粒(10.0CM3)紐創喜瑞骨
人工骨替代物*適應症請見備註欄
8457
FBA04BC10GWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE顆粒(10.0CM3)"台微
醫"喜瑞骨人工骨替代物*適應症請見備註欄
8457
FBA04BCB01FQ NANO BICERA BONE GRAFT SUBSTITUTE GRANULE 5X5X20MM(2 CM3)
人工骨替代物*適應症請見備註欄
3150
FBA04BCB02FQ NANO BICERA BONE GRAFT SUBSTITUTE GRANULE 5X5X10MM(2 CM3)
人工骨替代物*適應症請見備註欄
3150
FBA04BCG01FQ NANO BICERA BONE GRAFT SUBSTITUTE GRANULE2-3MM(5.0 CM3)人
工骨替代物*適應症請見備註欄
4197
832
特材代碼 中英文名稱 支付點數-104/01/01
FBA04BCG02FQ NANO BICERA BONE GRAFT SUBSTITUTE GRANULE 1-2MM(5.0 CM3)
人工骨替代物*適應症請見備註欄
4197
FBA04BCG03FQ NANO BICERA BONE GRAFT SUBSTITUTE GRANULE 0.5-1MM(5.0
CM3)人工骨替代物*適應症請見備註欄
4197
FBA04CA01RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID
FILLER)1ML"台塑生醫"人工代用骨(再吸收骨填充物)*適應症請見
備註欄
1923
FBA04CA03RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER)
3 ML人工代用骨(再吸收骨填充物)*適應症請見備註欄
3150
FBA04CA05RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER)
5 ML人工代用骨(再吸收骨填充物)*適應症請見備註欄
4197
FBA04CA10RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER)
10 ML人工代用骨(再吸收骨填充物)*適應症請見備註欄
8457
FBA04CA15RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER)
15 ML人工代用骨(再吸收骨填充物)*適應症請見備註欄
10236
FBA04CA20RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER)
20 ML人工代用骨(再吸收骨填充物)*適應症請見備註欄
12062
FBA04CS005Z6 UNI-OSTEO 5CC*適應症請見備註欄 4197
FBA04CS010Z6 UNI-OSTEO 10CC*適應症請見備註欄 8457
FBA04CS102Z6 "MERRIES"UNI-OSTEO "美瑞世"人工骨2GM(2CC)*適應症請見備註
欄
3150
FBA04CS105Z6 "MERRIES"UNI-OSTEO "美瑞世"人工骨5GM(5CC)*適應症請見備註
欄
4197
FBA04CS110Z6 "MERRIES"UNI-OSTEO "美瑞世"人工骨10GM(10CC)*適應症請見備
註欄
8457
FBA04CS120Z6 "MERRIES"UNI-OSTEO "美瑞世"人工骨20GM(20CC)*適應症請見備
註欄
12062
FBA04FM01GLB 富瑞密骨骼填補顆粒FORAMIC BONE SUBSTITUTE GRANULES
1CC(0.25CC*4VIALS/BOX;0.5CC*2VIALS/BOX;1CC*1VIAL/BOX) ※
給付規定請見備註欄
1923
FBA04FM02CLB 富瑞密骨骼填補顆粒FORAMIC BONE SUBSTITUTE GRANULES 2CC ※
給付規定請見備註欄
3150
FBA04FM05CLB FORAMIC BONE GRAFT SUBSTITUTE 5CC*適應症請見備註欄 4197
FBA04FM10CLB FORAMIC BONE GRAFT SUBSTITUTE 10CC*適應症請見備註欄 8457
FBA04FM20CLB FORAMIC BONE GRAFT SUBSTITUTE 20CC*適應症請見備註欄 12062
FBA04HS001Z6 "MERRIES" K-PHATE BONE SUBSTITUTE 1CC/TUBE"美瑞世"凱飛人
工骨
1923
FBA04HS205Z6 MERRIES K-PHATE BONE SUBSTITUTE 5CC*適應症請見備註欄 4197
FBA04HT020PQ "PURZER"SINBONEHT BONE REPLACEMENT (7立方公分)生骨替代物
二代*適應症請見備註欄
4197
FBA04HT021PQ "PURZER"SINBONEHT BONE REPLACEMENT(1立方公分)*適應症請見
備註欄
1923
FBA04HT022PQ "PURZER"SINBONEHT BONE REPLACEMENT(2立方公分)*適應症請見
備註欄
3150
FBA04HT023PQ "PURZER"SINBONEHT BONE REPLACEMENT(5立方公分)*適應症請見
備註欄
4197
FBA04HT024PQ "PURZER"SINBONEHT BONE REPLACEMENT (10立方公分)生骨替代物
二代*適應症請見備註欄
8457
FBA04HT040PQ "PURZER"SINBONEHT BONE REPLACEMENT (7立方公分)生骨替代物
二代*適應症請見備註欄
4197
833
特材代碼 中英文名稱 支付點數-104/01/01
FBA04HT041PQ "PURZER"SINBONEHT BONE REPLACEMENT(1立方公分)*適應症請見
備註欄
1923
FBA04HT042PQ "PURZER"SINBONEHT BONE REPLACEMENT(2立方公分)*適應症請見
備註欄
3150
FBA04HT043PQ "PURZER"SINBONEHT BONE REPLACEMENT(5立方公分)*適應症請見
備註欄
4197
FBA04HT050PQ "PURZER"SINBONEHT BONE REPLACEMENT (7立方公分)生骨替代物
二代*適應症請見備註欄
4197
FBA04HT051PQ "PURZER"SINBONEHT BONE REPLACEMENT (1立方公分)生骨替代物
二代*適應症請見備註欄
1923
FBA04HT052PQ "PURZER"SINBONEHT BONE REPLACEMENT (2立方公分)生骨替代物
二代*適應症請見備註欄
3150
FBA04HT053PQ "PURZER"SINBONEHT BONE REPLACEMENT (5立方公分)生骨替代物
二代*適應症請見備註欄
4197
FBA04HT054PQ "PURZER"SINBONEHT BONE REPLACEMENT (10立方公分)生骨替代物
二代*適應症請見備註欄
8457
FBA04HT091PQ "PURZER"SINBONEHT BONE REPLACEMENT(1立方公分)*適應症請見
備註欄
1923
FBA04HT092PQ "PURZER"SINBONEHT BONE REPLACEMENT(2立方公分)*適應症請見
備註欄
3150
FBA04HT093PQ "PURZER"SINBONEHT BONE REPLACEMENT(5立方公分)*適應症請見
備註欄
4197
FBA04MA001HY 艾沛瓷骨移植替代物:顆粒:APACERAM BONE GRAFT
SUBSTITUTE,TYPE AX GRANULE
1923
FBA04MA002HY 艾沛瓷骨移植替代物:顆粒:APACERAM BONE GRAFT
SUBSTITUTE,TYPE AX GRANULE
3150
FBA04MA005HY 艾沛瓷骨移植替代物:顆粒:APACERAM BONE GRAFT
SUBSTITUTE,TYPE AX GRANULE
4197
FBA04MA010HY 艾沛瓷骨移植替代物:顆粒:APACERAM BONE GRAFT
SUBSTITUTE,TYPE AX GRANULE
8457
FBA04P6922BZ SBM BIOSORB BONE SUBSTITUTES 2CC*適應症請見備註欄 3150
FBA04P6944BZ SBM BIOSORB BONE SUBSTITUTES 5CC*適應症請見備註欄 4197
FBA04P6946BZ SBM BIOSORB BONE SUBSTITUTES 15CC*適應症請見備註欄(產品型
號:P822893229自940701起生效)
10236
FBA04PB005YG OSTEO-G BONE VOID FILLER DEVICE 6G 奧斯吉骨填充裝置*適應
症請見備註欄
4197
FBA04PB103YG OSTEO-G BONE VOID FILLER DEVICE 3 CC奧斯吉骨填充裝置*適應
症請見備註欄
3150
FBA04PB106YG OSTEO-G BONE VOID FILLER DEVICE 6 CC奧斯吉骨填充裝置*適應
症請見備註欄
4197
FBA04PSB01PQ 瑞安保立堅骨替代物 PURZER BIPOLYSORB BONE REPLACEMENT 3CC
*給付規定請見備註欄
3150
FBA04SB050PQ "PURZER"SINBONE BONE REPLACEMENT 7.0CM3"瑞安"生骨替代物 3416
FBA04SB054PQ "PURZER"SINBONE BONE REPLACEMENT 10CM3"瑞安"生骨替代物 5492
FBA04SB0X0PQ SINBONE BONE REPLACEMENT (SB020:5MM*5MM*5MM 7.0 CM3)
(SB010自970701起將5MM*5MM*40MM 7.0 CM3變更為5MM*5MM*20MM
7.0 CM3)*適應症請見備註欄
3416
FBA070942NH1 X-CHANGE MESH 5250
FBA1422321Z1 CABLE-READY COBALT CHROME CABLE+SLEEVE※適應症請見備註欄 3546
FBA1422322Z1 STAINLESS CABLE-READY PLATE 6:8HOLE ※適應症請見備註欄 7384
FBA1422323Z1 TITANIUM CABLE-READY GRIP(SHORT)※適應症請見備註欄 4975
FBA142232NZ1 STAINLESS CABLE-READY+SLEEVE 1.3MM,1.8MM ※適應症請見備註
欄
3341
834
特材代碼 中英文名稱 支付點數-104/01/01
FBA143704NH1 DALL-MILES STAINLESS CABLE BONE PLATE ※適應症請見備註欄 7384
FBD00001NNY2 DCS PLATE 6:22HOLE 6748
FBD00001XNY2 DHS PLATE 135:150度 2:12HOLE(產品型號
281420:410,281540:560)
6796
FBD000095NZ1 VERSA-FX SUPRACONDYLAR FIXATION SYSTEM 6748
FBD000135NZ1 VERSA-FX FEMORAL FIXATION SYSTEM 6796
FBD0011931Z1 VERSA-FX II SUPRACONDYLAR FIXATION SYSTEM 90,95度
(PLATEX1+LAG SCREWX1+COMP SCREWX1)
6748
FBD001193NZ1 VERSA-FX II FEMORAL FIXATION SYSTEM 130,135度(PLATEX1+LAG
SCREWX1+COMP SCREWX1)
6796
FBD002412NSN COMPRESSION HIP SCREW SYSTEM (DHS) 6796
FBD0028110WG 威創骨釘骨板植入物(骨釘+骨板)WILTROM BONE SCREW&BONE
PLATE IMPLANT
6796
FBD0028190WG 威創骨釘骨板植入物(骨釘+骨板)WILTROM BONE SCREW&BONE
PLATE IMPLANT
6748
FBD00281CNS1 "SYNTHES"BONE PLATE IMPLANT:COMPRESSION HIP
SYSTEM(DHS)130-150度"信迪思"骨板植入物:動力髖螺釘骨板
6796
FBD00281NNS1 DCS PLATE SYSTEM 95度 6748
FBD003281NZ6 STAINLESS COMPRESSION HIP SCREW SYSTEM 95:140度(PX1+COM
SCREWX1+LAG SCREWX1)
6796
FBD00401NNY2 TITANIUM DCS PLATE 6:22HOLE 7287
FBD00401XNY2 TITANIUM DHS PLATE 135:150度 2:10HOLE 7339
FBD004819N2W "MICROWARE"BONE PLATE:DYNAMIC CONDYLAR SCREW PLATE
SET(PLATE+SCREWX3)"全微"動態膝部骨板骨釘組(骨板+動態拉力
骨釘+壓迫螺絲)
6748
FBD0048NNN2W "MICROWARE"BONE PLATE:DYNAMIC HIP SCREW PLATE
SET(PLATE+SCREWX3)"全微"動態髖部骨板骨釘組(骨板+動態拉力
骨釘+壓迫螺絲)
6796
FBD005963NS9 OMEGA II LOW PROFILE:CHS SYSTEM 135-150度(PLATEX1+LAG
SCREWX1+COMPRESSION SCREWX1)
6796
FBD005966NS9 OMEGA II SYSTEM:SUPRACONDYLAR PLATE 95度(PLATE+LAG
SCREW+COMPRESSION SCREW)
6748
FBD005970NS9 "STRYKER"OMEGA3 HIP PLATE CHS SYSTEM "史賽克"歐米加三固定
系統(PLATEX1+LAG SCREW+COMP SCREW)
6796
FBD005973NS9 OMEGA3 HIP PLATE SYSTEM 歐米加三固定系統(PLATEX1+LAG
SCREW+COMP SCREW)
6748
FBD00K004NAE COMPRESSION HIP SCREW(DHS) 6796
FBD01244XNSN DCS COMPRESSION TUBE PLATE SYSTEM(PLATE+LAG
SCREW+COMPRESSING SCREW)
6748
FBEF100002RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-UNI-LENGTHENING
瑞寶億骨外固定系統-單邊延長組 (PIN CLAMPX2+DISTR&COMP
RODX1) ※適應症請見備註欄
12155
FBEF100003RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-PELVIC FRAME瑞寶
億骨外固定系統-骨盆架框組(PINCLAMPX2+SMOOTH RODX3+ROD
CONNECTORX2)※適應症請見備註欄
21000
FBEF110001D1 TRAUMA-FIX EXTERNAL FIXTOR:FEMORAL BASIC FRAME 股骨基本組
※適應症請見備註欄
18900
FBEF110002D1 TRAUMA-FIX EXTERNAL FIXTOR:FEMORAL LENGTHENING FRAME 股骨
延長組 ※適應症請見備註欄
25722
FBEF110003D1 TRAUMA-FIX EXTERNAL FIXTOR:FEMORAL BONE TRANSPORT FRAM 股
骨移位組 ※適應症請見備註欄
18900
FBEF127500R1 ILIZAROV External Fixator System :FEMORAL BASIC SET 股骨
基本組 ※適應症請見備註欄
18900
835
特材代碼 中英文名稱 支付點數-104/01/01
FBEF135000R1 ILIZAROV External Fixator System :FEMORAL LENGTHENING SET
股骨延長組 ※適應症請見備註欄
25722
FBEF141800R1 ILIZAROV External Fixator System :FEMORAL DOUBLE
LENGTHENING SET股骨雙層延長組※適應症請見備註欄
35112
FBEF1D0001RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-FEMORAL BASIC
FRAME瑞寶億骨外固定系統-股骨基本組(全環+半環+連結桿+螺栓+
鉸+螺帽+桿座)*適應症見備註欄
18900
FBEF1D0002RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM 瑞寶億骨外固定系
統-股骨延長組(全環+半環+連結桿+螺栓+鉸+延長桿+桿座)*適應
症見備註欄
25722
FBEF1D0003RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-FEMORALBONE
TRANSPORT瑞寶億骨外固定系統-股骨移位組(全環+半環+連結桿+
螺栓+螺帽+溝槽墊片)*適應症見備註
18900
FBEF200004RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-UNI-BASIC FRAME瑞
寶億骨外固定系統:單一基本架框組(PIN CLAMPX2+RODX1) ※適應
症請見備註欄
8755
FBEF2199XNS1 DISPOFIX SYSTEM(EXTERNAL
FIXATOR)(SELDRILLX4+CLAMPX4+RODX1+BARX1)※適應症請見備註
欄
8755
FBEF220001D1 TRAUMA-FIX EXTERNAL FIXTOR:TIBIAL BASIC FRAME 脛骨基本組
※適應症請見備註欄
16500
FBEF220002D1 TRAUMA-FIX EXTERNAL FIXTOR:TIBIAL BONE TRANSPORT FRAM 脛
骨移位組 ※適應症請見備註欄
20625
FBEF220003D1 TRAUMA-FIX EXTERNAL FIXTOR:SINGLE LEVEL TIBIAL
LENGTHENING FRAM ※適應症請見備註欄
23100
FBEF220004D1 TRAUMA-FIX EXTERNAL FIXTOR:DOUBLE LEVEL TIBIAL
LENGTHENING FRAM ※適應症請見備註欄
33948
FBEF220005D1 TRAUMA-FIX EXTERNAL FIXTOR:TIBIAL DEFORMITY FRAM ※適應症
請見備註欄
18040
FBEF22010NZ6 HUMERUS FRAME SET(美瑞世肱骨外固定器組)一支連接桿+二支多
向球)※適應症請見備註欄
8755
FBEF223000R1 ILIZAROV External Fixator System :TIBIAL BASIC SET 脛骨基
本組 ※適應症請見備註欄
16500
FBEF228750R1 ILIZAROV External Fixator System :TIBIAL BONE TRANSPORT
SET 脛骨移位組 ※適應症請見備註欄
20625
FBEF231900R1 ILIZAROV External Fixator System :TIBIAL LENGTHENING SET
脛骨延長組 ※適應症請見備註欄
23100
FBEF241400R1 ILIZAROV External Fixator System :TIBIAL DOUBLE
LENGTHENING SET 脛骨雙層延長組 ※適應症請見備註欄
33948
FBEF2D0004RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM 瑞寶億骨外固定系
統-脛骨基本組(全環+半環+連結桿+螺栓+螺帽+溝槽墊片+桿座)*
適應症見備註欄
16500
FBEF2D0005RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-TIBIAL BONE
TRANSPORT瑞寶億骨外固定系統-脛骨移位組(全環+半環+連結桿+
螺栓+溝槽墊片)*適應症見備註欄
20625
FBEF2D0006RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM 瑞寶億骨外固定系
統-脛骨延長組(全環+半環+連結桿+螺栓+延長桿+溝槽墊片+桿
座)*適應症見備註欄
23100
FBEF2D0007RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM 瑞寶億骨外固定系
統-脛骨雙層延長組(全環+半環+連結桿+螺栓+螺帽+延長桿+溝槽
墊片+桿座)*適應症見備註欄
33948
FBEF2D0008RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-TIBIAL DEFORMITY
瑞寶億骨外固定系統-脛骨變形組(全環+半環+連結桿+螺栓+鏈+鉸
+螺帽+桿座)*適應症見備註欄
18040
836
特材代碼 中英文名稱 支付點數-104/01/01
FBEF32180NR1 ILIZAROV External Fixator System:ANKLE BASIC SET 踝骨基本
組 ※適應症請見備註欄
20866
FBEF330001D1 TRAUMA-FIX EXTERNAL FIXTOR:ANKLE BASIC SET 踝骨基本組 ※
適應症請見備註欄
20866
FBEF3D0009RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-ANKLE BASIC瑞寶億
骨外固定系統-踝骨基本組(全環+半環+連結桿+螺栓+鏈+螺帽+溝
槽墊片+桿座)*適應症見備註欄
20866
FBEF421800R1 ILIZAROV External Fixator System :HUMERAL BASIC SET 肱骨
基本組 ※適應症請見備註欄
17500
FBEF440001D1 TRAUMA-FIX EXTERNAL FIXTOR:HUMERAL BASIC SET 肱骨基本組
※適應症請見備註欄
17500
FBEF440002D1 TRAUMA-FIX EXTERNAL FIXTOR:HUMERAL TRANSPORT FRAME 肱骨移
位組 ※適應症請見備註欄
17500
FBEF4D0010RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-HUMERAL BASIC SET
瑞寶億骨外固定系統-肱骨基本組(全環+半環+螺帽+溝槽墊片+桿
座)*適應症見備註欄
17500
FBEF4D0011RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-HUMERAL TRANSPORT
FRAME 瑞寶億骨外固定系統-肱骨移位組(全環+半環+螺帽+溝槽墊
片)*適應症見備註欄
17500
FBEF500017D1 TELES CONNECTING ROD 341
FBEF50019ND1 EXTERNAL FIXATOR SYSTEM:ADJUSTABLE TELESCOPICCONNECTING
ROD調整桿
1692
FBEF50019NRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-ADJUSTABLE
TELESCOPIC CONNECTING ROD 瑞寶億骨外固定系統-調整桿 ※適
應症請見備註欄
1692
FBEF5U1U2ND1 EXTERNAL FIXATOR SYSTEM:PIN CLAMP針夾(DIA.15:20MM) 3767
FBEF5U1U2NRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-PIN CLAMP 瑞寶億
骨外固定系統-針夾 ※適應症請見備註欄
3767
FBEF5U3U4ND1 EXTERNAL FIXATOR SYSTEM:SMOOTH ROD 連結桿
(DIA.20MM*L200:300MM)
866
FBEF5U3U4NRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-CONNECTING ROD 瑞
寶億骨外固定系統-連結桿 ※適應症請見備註欄
866
FBEF5U6U7ND1 EXTERNAL FIXATOR SYSTEM:ROD CONNECTOR桿連結器
(DIA.8:20MM*DIA.20MM)
3971
FBEF5U6U7NRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-ROD CONNECTOR 瑞
寶億骨外固定系統-桿連結器 ※適應症請見備註欄
3971
FBEFP02106SN ILIZAROV WIRE 1.5MM (WITH STOPPER) ※適應症請見備註欄 1337
FBEFP02107SN ILIZAROV WIRE 1.8MM(WITH STOPPER) ※適應症請見備註欄 1337
FBEFP0640ND1 EXTERNAL FIXATION SYSTEM:WIRE WTITH OLIVE 1.5MM:2.0MM
300:400MM ※適應症請見備註欄
1337
FBEFP294XNY2 SKELETAL TRACTION PIN 319
FBEFP295XNY2 HALF PIN 319
FBEFP296XNY2 TRANSFIXING PIN 319
FBEFPW0002RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-OLIVE WIRE 瑞寶億
骨外固定系統-橄欖針 *適應症見備註欄
1337
FBFW14885NW2 SWANSON WRIST JOINT IMPLANT 11052
FBHCM1100NU0 CUSTOM MADE FEMORAL PROXIMAL TUMOR PROTHSIS
SYSTEM(H+I+C+S)※申報費用時應檢附發票備查
144250
FBHCM2475NH1 "HOWMEDICA"MODULAR REPLACEMENT SYSTEM -HIP※申報時應檢附
該被保險人之發票備查
187000
FBHCM6485NH1 "HOWMEDICA"MODULAR REPLACEMENT SYSTEM -HIP ※申報費用應檢
附發票備查
187000
FBHCMXXXXNW2 CUSTOM MADE HIP SYSTEM(HEAD+INSERT+CUP+FEMORAL STEM)※申
報費用時應檢附該被保險人之發票備查
187000
837
特材代碼 中英文名稱 支付點數-104/01/01
FBHS32000NW2 PERFECTA REVISION HIP STEM(NECK+BODY+STEM)※適應症請見備
註欄
56371
FBHS51108NU0 G.T.F HIP STEM大粗隆股骨柄※適應症請見備註欄 24750
FBHU1113NNDP GLOBAL HUMERAL HEAD 11557
FBHU143001Z1 BIGLIANI/FLATOW HEMI SHOULDER(STEM+HEAD) 38489
FBHU143002Z1 BIGLIANI/FLATOW MONOBLOCK SHOULDER(STEM+HEAD) 38489
FBHU14300NZ1 BIGLIANI/FLATOW HUMERAL STEMS 26932
FBHU14301NZ1 BIGLIANI/FLATOW MODULAR HEAD 11557
FBHU15301NS2 SHOULDER SYSTEM(HEAD+STEM) 38489
FBHU15350NS2 SHOULDER HUMERAL HEAD(鈷鉻) 11557
FBHU15351NS2 SHOULDER HUMERAL STEM(TITANIUM) 26932
FBKCM1101NU0 CUSTOM MADE KNEE JOINT TUMOR PROSTHESIS※申報費用時應檢附
該被保險人之發票備查
177137
FBKCM2475NH1 "HOWMEDICA"GLOBAL MODULAR REPLACEMENT SYSTEM -KNEE※適應
症請見備註欄,申報費用時應附發票備查
187962
FBKCM6485NH1 "HOWMEDICA"GLOBAL MODULAR REPLACEMENT SYSTEM -KNEE※申報
費用應檢附發票備查
187962
FBKCMXXXXNW2 CUSTOM-MADE TOTAL KNEE PROTHESIS ※適應症請見備註欄,申報
費用檢附發票
187962
FBKF22105NU0 FEMUR COMPONENT 訂製型股骨植入物※適應症請見備註欄 89000
FBKF25393NH1 ROTATINGE HINGE TOTAL KNEE SYSTEM:FEMORAL COMPONENT※適應
症請見備註欄
41032
FBKF25880TZ1 NEXGEN ROTATING HINGE KNEE FEMORAL COMPONENT※適應症請見
備註欄
80658
FBKF25926TZ1 "ZIMMER"GENDER SOLUTION PATELLOFEMORAL JOINT
SYSTEM:FEMORAL COMPONENT "捷邁"皮富捷髕骨股骨人工關節:髕
股骨關節股骨組件※適應症請見備註欄
40550
FBKF26430NH1 "HOWMEDICA"AVON PATELLO-FEMORAL JOINT PROSTHESIS-FEMORAL
COMPONENT"好美得卡"阿文股骨膝蓋人工關節-股骨組件
40550
FBKFA5000TZ1 "ZIMMER"GENDER SOLUTION PATELLOFEMORAL JOINT SYSTEM "捷
邁"皮富捷髕骨股骨人工關節※適應症請見備註欄
46894
FBKFA6430NH1 "HOWMEDICA"AVON PATELLO-FEMORAL JOINT PROSTHESIS"好美得
卡"阿文股骨膝蓋人工關節
46894
FBKL25880NZ1 NEXGEN ROTATING HINGE KNEE ARTICULAR SURFACE※適應症請見
備註欄
11684
FBKP21190NH1 ROTATINGE HINGE TOTAL KNEE SYSTEM :DOME PATELLAR (型號
6485-19,39,59-15自93/4/1生效)※適應症請見備註欄
11672
FBKRA6475NH1 ROTATING HINGE TOTAL KNEE SYSTEM (FE+TI PLUG+PA+
BEARING+AXLE+BUMPER+BUSHINGX2)※適應症請見備註欄
117924
FBKS129051U0 SEGMENT PART 訂製型脛骨中段延伸件※適應症請見備註欄 23000
FBKS12905NU0 STEM 訂製型脛骨下段延伸件※適應症請見備註欄 25000
FBKT21872NW2 TIBIAL BASE WITH WEDGE ※限人工膝關節再置換時使用 16704
FBKT222059U0 TIBIAL BEARING COMPONENT 訂製型脛骨連接件※適應症請見備註
欄
18000
FBKT22205NU0 TIBIAL COMPONENT 訂製型脛骨植入物※適應症請見備註欄 33000
FBKT253933H1 ROTATINGE HINGE TOTAL KNEE SYSTEM:TIBIAL BEARING
COMPONENT(型號6485-8435自93/4/1生效※適應症請見備註欄
23335
FBKT253940H1 ROTATINGE HINGE TOTAL KNEE SYSTEM:AXLE ※適應症請見備註欄 8370
FBKT253942H1 ROTATINGE HINGE TOTAL KNEE SYSTEM:BUMPER COMPONENT(型號
6485-4100自93/4/1生效※適應症請見備註欄
5205
FBKT253944H1 ROTATINGE HINGE TOTAL KNEE SYSTEM:BUSHING (型號6485-2460
自93/4/1生效 )※適應症請見備註欄
2344
838
特材代碼 中英文名稱 支付點數-104/01/01
FBKT25394NH1 ROTATINGE HINGE TOTAL KNEE SYSTEM:TIBIAL PLUG (型號6485-
2008:2421自93/4/1生效※適應症請見備註欄
23622
FBKT25880NZ1 NEXGEN ROTATING HINGE KNEE TIBIAL PLATE※適應症請見備註欄 17992
FBN0212206SN R-T RECONSTRUCTION NAIL ※限股骨粗隆下骨折及股骨粗隆複合
骨折患者申報
6933
FBN04102XNU0 HUMERAL LOCKING SCREW※適應症請見備註欄 899
FBN0412223SN R-T PROXIMAL SCREW ※適應症請見備註欄 899
FBN0412226SN FEMORAL LOCKING SCREW ※適應症請見備註欄 899
FBN04303XNU0 FEMORAL&TIBIAL LOCKING SCREW W/SET SCREW※適應症請見備註
欄
899
FBN04403SSY2 STAINLESS INTERLOCKING SCREW 骨髓內固定螺絲 ※適應症請見
備註欄
899
FBN04403STY2 TITANIUM KING BO INTERLOCKING SCREW 鈦合金骨髓內固定螺絲
※適應症請見備註欄
970
FBN04520XNU0 NAIL LOCKING SCREW※適應症請見備註欄 899
FBN05002XNY2 HUMERAL NAIL 7.0:9.0X210:280※適應症請見備註欄 7890
FBN05003XNY2 FEMORAL NAIL 10:17,18,19,300:480,400:180※適應症請見備註
欄
7890
FBN05004XNY2 TIBIAL NAIL 9:13 255:420(產品型號
251280:420,252280:420,253280:420)※適應症請見備註欄
7890
FBN0512202R1 FEMORAL NAIL SYSTEM※適應症請見備註欄 7890
FBN0512202SN FEMORAL NAIL SYSTEM(含NAIL+SCREW)※適應症請見備註欄 7890
FBN0512217R1 TIBIAL NAIL SYSTEM※適應症請見備註欄 7890
FBN0512217SN TIBIAL NAIL SYSTEM(含NAIL+SCREW)※適應症請見備註欄 7890
FBN051722NS9 S2 NAIL SYSTEM:TIBIAL(NX1+SX3)※適應症請見備註欄 7890
FBN051732NS9 S2 NAIL SYSTEM:FEMORAL(NX1+SX3)※適應症請見備註欄 7890
FBN05251XNS1 TIBIAL NAIL SYSTEM※適應症請見備註欄 7890
FBN05274XNS1 FEMORAL NAIL SYSTEM※適應症請見備註欄 7890
FBN05301XNU0 HUMERAL NAIL SYSTEM(NAILX1+SCREWX3)※適應症請見備註欄 7890
FBN05402XNY2 TITANIUM UNREAMED HUMERAL NAIL(NAILX1+LOCKING BOLTX4)※適
應症請見備註欄
7879
FBN05403FSY2 STAINLESS FEMUR INTERLOCKING NAIL(NAILX1+SCREWX3)股骨髓內
釘組※適應症請見備註欄
7890
FBN05403FTY2 TITANIUM KING BO FEMUR INTERLOCKING NAIL
SYSTEM(NAILX1+LOCKING BOLTX3)鈦合金股骨髓內釘組 ※適應症
請見備註欄
7879
FBN05403HSY2 STAINLESS HUMERAL INTERLOCKING NAIL(NAILX1+SCREWX3)肱骨髓
內釘組※適應症請見備註欄
7890
FBN05403HTY2 TITANIUM KING BO HUMERAL INTERLOCKING NAIL
SYSTEM(NAILX1+LOCKING BOLTX3)※適應症請見備註欄
7879
FBN05403TSY2 STAINLESS TIBIA INTERLOCKING NAIL(NAILX1+SCREWX3)脛骨髓內
釘組※適應症請見備註欄
7890
FBN05403TTY2 TITANIUM TIBIA INTERLOCKING NAIL SYSTEM(NAILX1+LOCKING
BOLTX3) 脛骨髓內釘組※適應症請見備註欄
7879
FBN05403XNY2 TITANIUM UNREAMED FEMORAL NAIL(NAILX1+LOCKING BOLTX4)※適
應症請見備註欄
7879
FBN05404XNY2 TITANIUM UNREAMED TIBIAL NAIL(NAILX1+LOCKING BOLTX4)※適
應症請見備註欄
7879
FBN05601XNU0 FEMORAL&TIBIAL NAIL SYSTEM(NX1+SX3)(或SCREW型號5201-
1085:1105)※適應症請見備註欄
7890
FBN05KA36NAE FEMORAL NAIL SYSTEM※適應症請見備註欄 7890
FBN05KC35NAE TIBIAL NAIL SYSTEM※適應症請見備註欄 7890
FBN070301YM1 INTRAMEDULLARY NAIL(KUNTSCHER NAIL)骨髓內釘 1534
839
特材代碼 中英文名稱 支付點數-104/01/01
FBN07KA12NAE KIRSCHNER I.M. PIN FEMUR 1534
FBN07KC11NAE KIRSCHNER I.M.PIN HUMERUS/TIBIAL 1534
FBN080481YM1 INTRAMEDULLARY TIBIA (KUNTSCHER)下腿用骨髓內釘 1534
FBN084041NZ1 KUNTSCHER NAIL 14:15MM 1534
FBNG1273XNS1 PROXIMAL FEMORAL NAILS STAINLESS
STEEL(273.125:137+080:120+234.075:120+259.260:960) ※適應
症請見備註欄
16675
FBNG13120NS9 GAMMMA3 TI SYSTEM 鈦合金股骨固定系統(NX1+SX3) 19440
FBNG14003NS9 GAMMA3 SYSTEM STAINLESS STEEL 脛股骨固定系統
(NAILX1+SCREWX3)※適應症請見備註欄
16675
FBNG1403GSY2 STAINLESS GAMMA INTERLOCKING NAIL SYSTEM
(NAILX1+LOCKINGX3)伽瑪釘單孔(骨髓內釘組)※適應症請見備註
欄
16675
FBNG1403GTY2 TITANIUM KING BO GAMMA LOCKING NAIL SYSTEM(NAILX1+LOCKING
BOLTX3)※適應症請見備註欄
19440
FBNG1473XNS1 TI PROXIMAL FEMORAL NAIL※適應症請見備註欄 18302
FBNG2148GSY2 "SYNTEC"KING BO HUMERAL INTERLOCKING NAILS SYSTEM:GAMMA
SYSTEM:NAIL "亞太醫療"金寶骨髓內釘系統:股骨頸髓內釘※適應
症請見備註欄
10190
FBNG24060NS9 GAMMA3 SYSTEM:NAIL ※適應症請見備註欄 10190
FBNG3161GSY2 "SYNTEC"KING BO HUMERAL INTERLOCKING NAILS SYSTEM:GAMMA
SYSTEM:SET SCREW "亞太醫療"金寶骨髓內釘系統:固定釘※適應
症請見備註欄
865
FBNG3162GSY2 "SYNTEC"KING BO HUMERAL INTERLOCKING NAILS SYSTEM:GAMMA
SYSTEM:LAG SCREW "亞太醫療"金寶骨髓內釘系統:空心鎖釘※適
應症請見備註欄
1997
FBNG34003NS9 GAMMA3 SYSTEM:SET SCREW ※適應症請見備註欄 865
FBNG34004NS9 GAMMA3 SYSTEM:LAG SCREW ※適應症請見備註欄 1997
FBP01007XNY2 4.5 SEMI-TUBULAR PLATE 2:12HOLE 500
FBP01008XNY2 3.5 1/3 TUBULAR PLATE 2:12HOLE 441
FBP01009XNY2 2.7 1/4 TUBULAR PLATE 2:8HOLE 380
FBP011403NSN ONE-THIRD TUBULAR PLATE 2:8HOLE,9:12HOLE 441
FBP011413NSN SEMI-TUBULAR PLATE 2:7HOLE,8:12HOLE 500
FBP011480NSN QUARTER TUBULAR PLATE 3:8HOLE 380
FBP01222NNS1 SEMI-TUBULAR PLATE 2:12 HOLE 39:199MM 500
FBP012413NS1 "SYNTHES"ONE-THIRD TUBULAR PLATE 2:12HOLE 28:148MM"信迪
思"三分之一管狀骨板
441
FBP012420NS1 QUARTER TUBULAR PLATE 3:8 HOLE 380
FBP013020NS9 ONE THIRD TUBULAR PLATE 2:14HOLE 441
FBP01407XNY2 TITANIUM SEMI-TUBULAR PLATE 4.5MM 2:12HOLE 539
FBP01408XNY2 TITANIUM ONE-THIRD TUBULAR PLATE 3.5MM 2:12HOLE 441
FBP01409XNY2 TITANIUM QUARTER TUBULAR PLATE 2.7MM 2:8HOLE 409
FBP01422NN2W "MICROWARE"BONE PLATE:SEMI-TUBULAR PLATE 4.5MM, 2:12
HOLE"全微"骨板:半管型骨板
500
FBP01427NN2W "MICROWARE"BONE PLATE:LENGTHENING PLATE 4.5MM,8:10 HOLE,
BROAD,135:249MM"全微"骨板:寬加長型骨板
1849
FBP01441NN2W "MICROWARE"BONE PLATE:ONE-THIRD TUBULAR PLATE 3.5MM, 2:12
HOLE"全微"骨板:管型骨板
441
FBP014420N2W "MICROWARE"BONE PLATE:QUARTER TUBULAR PLATE 2.7MM,3:8
HOLE"全微"骨板:管型骨板
380
FBP0149274Z1 ONE-QUARTER TUBULAR PLATE 3:8HOLE 380
FBP0149351Z1 ONE-THIRD TUBULAR PLATE 2:12HOLE 441
FBP0149452Z1 SEMI-TUBULAR PLATE 2:12HOLE 500
FBP01LM30NAE 1/3 TUBULAR PLATE 3.5MM 441
840
特材代碼 中英文名稱 支付點數-104/01/01
FBP01LM32NAE SEMI-TUBLUAR PLATE 4.5 MM 500
FBP01LN25NAE QUARTER TUBULAR PLATE 2.7 MM 380
FBP01LN2SNAE SMALL FRAGMENT PLATE 2.7MM 230
FBP02010XNY2 4.5 BROAD DYNAMIC COMPRESSION PLATE 6:18HOLE 1782
FBP02011XNY2 4.5 BROAD LENGTHENING PLATE 8:10HOLE 1849
FBP02012XNY2 4.5 NARROW DYNAMIC COMPRESSION PLATE 2:17HOLE 1228
FBP02013XNY2 4.5 NARROW LENGTHENING PLATE 30:80MM 1849
FBP02015XNY2 2.0,2.7,3.5 DYNAMIC COMPRESSION PLATE 2:12HOLE(產品型號
243540:580)
1782
FBP020559NS9 FEMORAL PLATE DISTAL 6-10HOLE(配合4.5MM,6.5MM SCREW用) 3157
FBP021045NS9 L-BUTTRESS PLATE 67:339MM 3:20HOLE 2130
FBP021402NSN 3.5MM SMALL PLATE 2:12HOLE 952
FBP021412NSN 4.5MM BROAD PLATE 6:18HOLE 1782
FBP021414NSN 4.5MM NARROW PLATE 2:16HOLE,18:24HOLE 1228
FBP021460NSN 2.0MM STRAIGHT PLATE3:6HOLE 230
FBP022235NS1 LC-DCP 3.5 PLATE 4:12HOLE 977
FBP022245NS1 LC-DCP 4.5 NARROW PLATE 2:16HOLE 1228
FBP02224NNS1 NARROW DYNAMIC COMPRESSION PLATE DCP 2:18 HOLE 1228
FBP022265NS1 LC-DCP 4.5 BROAD PLATE 6:18HOLE 1782
FBP02226NNS1 BROAD DYNAMIC COMPRESSION PLATE DCP 6:18 HOLE 103:295MM 1782
FBP022278NS1 BROAD LENGTHENING PLATE 8 HOLE 135:165MM 1849
FBP02228NNS1 NARROW LENGTHENING PLATE 8 HOLE 135:185MM 1787
FBP022431NS1 MINI STRAIGHT PLATE 3:6 HOLE 17:35MM 230
FBP022435NS1 MINI DYNAMIC COMPRESSION PLATE DCP 4:8 HOLE 22:42MM 1173
FBP022440NS1 MINI DYNAMIC COMPRESSION PLATE 2:12 HOLE 20:100MM 1173
FBP022480NS1 DYNAMIC COMPRESSION PLATE DCP 2:12 HOLE 26:146MM 977
FBP023002NS9 SMALL COMPRESSION BONE PLATE ACP 2:30HOLE 1782
FBP023102NS9 SMALL T BONE PLATE ACP 3:4HOLE 952
FBP023205NS9 NARROW BONE PLATE 38:542MM 2:30HOLE 1228
FBP023215NS9 WIDE BONE PLATE ACP 4:30HOLE 1782
FBP02410XNY2 TITANIUM BROAD DYNAMIC COMPRESSION PLATE 4.5MM 6:18HOLE 1296
FBP02412XNY2 TITANIUM NARROW DYNAMIC COMPRESSION PLATE 4.5MM 2:16HOLE 924
FBP02415XNY2 TITANIUM DYNAMIC COMPRESSION PLATE 2.0MM:3.5MM 2:12HOLE 761
FBP02424NN2W "MICROWARE"BONE PLATE:DYNAMIC COMPRESSION PLATE 4.5MM,
NARROW,2:17 HOLE"全微"骨板:窄動態加壓骨板
1228
FBP02426NN2W "MICROWARE"BONE PLATE:DYNAMIC COMPRESSION PLATE 4.5MM,
BROAD,6:22 HOLE"全微"骨板:寬動態加壓骨板
1782
FBP024288N2W "MICROWARE"BONE PLATE:LENGTHENING PLATE 4.5MM,8
HOLES,NARROW, 135:185MM"全微"骨板:窄加長型骨板
1787
FBP02448NN2W "MICROWARE"BONE PLATE:DYNAMIC COMPRESSION PLATE 2.0MM,
2.7MM, 3.5MM, 2:12 HOLEMM"全微"骨板:動態加壓骨板
977
FBP0249202Z1 2.0MM MINI COMPRESSION PLATE 4:12HOLE 1173
FBP0249203Z1 2.0MM STRAIGHT PLATE 3:6HOLE 17:35MM 230
FBP0249272Z1 2.7MM MINI COMPRESSION PLATE 2:12HOLE 977
FBP024935NZ1 3.5MM COMPRESSION PLATE 2:22HOLE 977
FBP0249451Z1 4.5MM BVROAD COMPRESSION PLATE 5:26HOLE 1782
FBP024945NZ1 4.5MM NARROW COMPRESSION PLATE 2:24HOLE 1228
FBP026028NSN MINI STRAIGHT PLATE 20 HOLE 2.0MM 2686
FBP02LM26NAE NARROW LENGTHING PLATE 4.5 MM 1787
FBP02LM28NAE BROAD LENGTHING PLATE 4.5 MM 1849
FBP02LM40NAE NARROW BONE PLATE 4.5 MM 1228
FBP02LM42NAE BROAD BONE PLATE 4.5 MM 1782
FBP02LN027AE MULTIPLE FRAGMENT PLATE 230
841
特材代碼 中英文名稱 支付點數-104/01/01
FBP02LN28NAE DCP 2.0MM SMALL PLATE 1173
FBP03016XNY2 4.5 T-PLATE HOLE 2130
FBP03017NNY2 L-TIBIAL BUTTRESS PLATE 5:13HOLE 2130
FBP03017XNY2 4.5 L/T-BUTTRESS PLATE 3:6HOLE 2130
FBP03018XNY2 4.5 SPOON PLATE 5:6HOLE 1762
FBP03019XNY2 4.5 COBRA HEAD PLATE 8:11HOLE 3892
FBP03021XNY2 4.5 CONDYLAR BUTTRESS PLATE 7:15HOLE 3493
FBP03022XNY2 SMALL T-PLATE 3:6HOLE 952
FBP03023XNY2 CLOCERLEAF PLATE 3:6HOLE,CALCANEAL PLATE 60:70MM 1603
FBP03024XNY2 1.5/2.0 MINI T-PLATE 3:4HOLE,2.0/2.7 L-PLATE 336
FBP03025XNY2 1.5/2.0/2.7 MINI CONDYLAR PLATE 2829
FBP03026XNY2 MINI PLATE STRAIGHT 3:6HOLE 230
FBP03027XNY2 MINI PLATE(H PLATE 4HOLE,STR 100MM,ADAPTATION PLATE
100MM)
2686
FBP03028XNY2 "SYNTEC"SMALL PLATE:RECONSTRUCTION PLATE 5:22HOLE"亞太醫
療"小型骨板:重建骨板(4HOLE自100.10.01生效)
3487
FBP031005NSN STAINLESS LATERAL TIBIAL HEAD BUTTRESS PLATE 5:13HOLE
118:246MM
3157
FBP031179NZ1 RECONSTRUCTION PLATE 3487
FBP031400NSN 4.5MM RECONTRACTION PLATE 3:16HOLE 3487
FBP031406NSN CLOVERLEAF PLATE 3:6HOLE 1603
FBP031407NSN T-BUTTRESS PLATE 4:6HOLE,L-BUTTRESS PLATE TIBIAL 2130
FBP031415NSN SPOON PLATE 5:6HOLE 1762
FBP031416NSN T-PLATE 3:8HOLE 2130
FBP03229NNS1 PELVIC RECONSTRUCTION PLATE 3:16 HOLE 45:253MM 3487
FBP03229XNY2 STRAIGHT RECONSTRUCTION PLATE 4.5 3:16HOLE 3487
FBP032400NS1 SPOON PLATE 5:6:12 HOLE 100:120MM 1762
FBP032401NS1 T PLATE 3:12 HOLE 2130
FBP032403NS1 SUPPORTING T PLATE 4:6 HOLE 81:112MM 2130
FBP032404NS1 SUPPORTING PLATE(L-BUTTRESS PLATE) 3:6 HOLE 2130
FBP032405NS1 LATERAL TIBIAL BUTTRESS PLATE 5:13HOLE 3157
FBP032407NS1 DISTAL FEMUR PLATE 7:15 HOLE (CONDYLAR BUTTRESS PLATE) 3493
FBP0324080S1 HOOK PLATE 128MM 3151
FBP0324080Y2 HOOK PLATE 4.5 123MM 3151
FBP032409NS1 COBRA HEAD PLATE 8:11 HOLE 3892
FBP032411NS1 SMALL T PLATE RIGHT ANGLE 3/3:6/4 HOLE 50:78MM 952
FBP032412NS1 SMALL T PLATE OLIQUE ANGLE 3/3:5/3 HOLE 52:74MM 952
FBP032416NS1 CALCANEAL PLATE 3.5 3104
FBP032418NS1 CLOVERLEAF PLATE 3:6 HOLE 1603
FBP032423NS1 MINI L FINGER JOINT-HEAD PLATE 336
FBP0324241S1 MINI T FINGER JOINT-HEAD PLATE 336
FBP0324319S1 MINI PLATE 1.5:2.0 2686
FBP032433NS1 MINI L FINGER JOINT HEAD PLATE 336
FBP0324341S1 MINI T FINGER JOINT HEAD PLATE 336
FBP0324348S1 MINI PLATE 1.5:2.0 2686
FBP032451NS1 RECONSTRUCTION PLATE STRAIGHT 5:22 HOLE 58:262MM 3487
FBP032453NS1 RECONSTRUCTION PLATE BENT 6:18 HOLE 70:214MM 3487
FBP03245XNY2 PELVIC RECONSTRUCTION PLATE 3.5 6:18HOLE 3487
FBP03246NNS1 MINI T-PLATE 1.5,2.0 9HOLE 2686
FBP033100NS9 OBLIQUE PLATE 3:8HOLE 952
FBP033104NS9 CLOVERLEAF PLATE 4/6 5/6HOLE 3:10HOLE 1603
FBP033110NS9 CALCANEAL PLATE 14HOLE 3104
FBP033220NS9 RECONSTRUCTION 4.5MM PLATE 3:30HOLE(型號430104:430122自
93/1/1生效)
3487
842
特材代碼 中英文名稱 支付點數-104/01/01
FBP033310NS9 V-PLATE T-PLATE 63:335MM 3:20HOLE 2130
FBP033315NS9 T-PLATE 65:337MM 3:20HOLAE 3157
FBP03401XNSN 3.5MM RECONTRACTION PLATE 4:22HOLE,CURVED RECONTRACTION
PLATE 6:18HOLE
3487
FBP03404XNSN SMALL T-PLATE PT ANGLE 3:6HOLE 952
FBP03405XNSN SMALL T-PLATE OBLIQUE 3:5HOLE 952
FBP03416XNY2 TITANIUM T-PLATE 4.5MM 3:8HOLE 1637
FBP03417XNY2 TITANIUM L/T BUTTRESS PLATE 4.5MM 3:6HOLE,L TIBIAL
BUTTRESS PLATE 5:13HOLE
2288
FBP03418XNY2 TITANIUM SPOON PLATE 4.5MM 5:6HOLE 1358
FBP03421XNY2 TITANIUM CONDYLAR BUTTRESS PLATE 4.5MM 7:15HOLE 2901
FBP03422XNY2 TITANIUM SMALL T-PLATE 3.5MM,4.0MM 710
FBP03423XNY2 TITANIUM CLOVERLEAF PLATE 3.5MM,4.0MM,CALCANEAL PLATE
60:70MM
1221
FBP03424XNY2 TITANIUM MINI T-PLATE 1.5MM:2.0MM 3:4HOLE,MINI L-PLATE
2.0MM,2.7MM
240
FBP034256NS9 PELVIS AND ACETABULUM PLATES 2:30HOLE(型號 425654:425772
自93/1/1生效)
3487
FBP03425XNY2 TITANIUM MINI CONDYLAR PLATE 1.5,2.0,2.7MM 2059
FBP03427NNY2 TITANIUM STRAIGHT MINI H-PLATE 1.5,2.0MM 20HOLE 2059
FBP03427XNY2 TITANIUM MINI H-PLATE 1.5,2.0MM 4HOLE 2059
FBP03428XNY2 TITANIUM RECONSTRUCTION PLATE 3.5MM 5:22HOLE 3463
FBP034293N2W "MICROWARE"BONE PLATE:RECONSTRUCTION PLATE 4.5MM,
STRAIGHT,3:16 HOLE"全微"直線型重建骨板
3487
FBP034301NS9 RECONSTRUCTION 4.5MM PLATE 2:30 HOLES 3487
FBP034400N2W "MICROWARE"BONE PLATE:SPOON PLATE 4.5MM, 5:6 HOLE"全微"匙
型骨板
1762
FBP034403N2W "MICROWARE"BONE PLATE:T-BUTTRESS PLATE 4.5MM,4:6 HOLE"全
微"T型支撐骨板
2130
FBP03440502W "MICROWARE"BONE PLATE:L-BUTTRESS PLATE 4.5MM, LEFT/
RIGHT, 3:6 HOLE"全微"左/右邊型L型支撐骨板
2130
FBP03440552W "MICROWARE"BONE PLATE:LATERAL TIBIAL HEAD PLATE
4.5MM,LEFT / RIGHT LEG 5:13 HOLE"全微"左/右邊型側邊脛骨骨
板
3157
FBP03440902W "MICROWARE"BONE PLATE:CONDYLAR BUTTRESS PLATE 4.5MM,
LEFT/RIGHT,7:15 HOLE"全微"右邊型骨踝支撐骨板
3493
FBP034409N2W "MICROWARE"BONE PLATE:COBRA HEAD PLATE 4.5MM 8:11 HOLE"全
微"眼鏡蛇骨板
3892
FBP03440NN2W "MICROWARE"BONE PLATE:T-PLATE 4.5MM, 3:12 HOLE"全微"骨
板:4.5MM T型骨板
2130
FBP03440XNSN CALCANEAL Y-PLATE 9HOLE 3104
FBP034411N2W "MICROWARE"BONE PLATE:SMALL T-PLATE 3.5MM, RIGHT
ANGLED,3:8 HOLE "全微" 3.5MM 右角T型骨板
952
FBP034412N2W "MICROWARE"BONE PLATE:SMALL T-PLATE 3.5MM, OBLIQUE
ANGLED, 3:5 HOLE"全微" 3.5MM 斜角T型骨板
952
FBP034416N2W "MICROWARE"BONE PLATE:CALCANEAL PLATE 3.5MMT,60:70MM"全
微"跟骨骨板
3104
FBP034418N2W "MICROWARE"BONE PLATE:CLOVERLEAF PLATE 3.5MM, 3:9 HOLE"全
微"葉型骨板
1603
FBP03443312W "MICROWARE"BONE PLATE:MINI L-PLATE 2.0MM, 2.7MM,
LEFT/RIGHT"全微"L型骨板
336
FBP03443332W "MICROWARE"BONE PLATE:MINI L-PLATE 2.0MM,
2.7MM,LEFT/RIGHT,OBLIQUE"全微"L型骨板
336
843
特材代碼 中英文名稱 支付點數-104/01/01
FBP034433N2W "MICROWARE"BONE PLATE:MINI T-PLATE 2.0MM, 2.7MM"全微" T型
骨板
336
FBP034450N2W "MICROWARE"BONE PLATE:RECONSTRUCTION PLATE 3.5MM,
STRAIGHT,5:22 HOLE"全微"直線型重建骨板
3487
FBP034453N2W "MICROWARE"BONE PLATE:RECONSTRUCTION PLATE 3.5MM, CURVED,
6:18 HOLE"全微"弧線型重建骨板
3487
FBP03446192W "MICROWARE"BONE PLATE:MINI STRAIGHT PLATE 20 HOLE 1.5MM,
2.0MM"全微"直線骨板
2686
FBP034462N2W "MICROWARE"BONE PLATE:MINI T-PLATE 1.5MM,2.0MM,3:4 HOLE"
全微"T型骨板 長軸9孔,3:4孔
2686
FBP034464N2W "MICROWARE"BONE PLATE:MINI H-PLATE 1.5MM, 2.0MM "全微" H
型骨板
336
FBP034466N2W "MICROWARE"BONE PLATE:CONDYLAR PLATE 1.5MM,2.0MM,2.7MM
LEFT/ RIGHT"全微"左/右邊型骨踝骨板
2829
FBP03460XNSN 2.0MM T-PLATE,L-PLATE,H-PLATE(型號7114-6030,032,048自
93/1/1起刪除)
336
FBP0349151Z1 1.5MM,2.0MM MINI STRAIGHT PLATE 20HOLE 2686
FBP034915NZ1 1.5MM,2.0MM MINI H-PLATE 4HOLE 2686
FBP0349201Z1 2.0MM MINI L-PLATE 4HOLE 336
FBP0349271Z1 2.7MM MINI L-PLATE 5HOLE 336
FBP0349273Z1 2.7MM MULTIPLE FRAGMENT PLATE 7HOLE 230
FBP034927NZ1 2.7MM MINI T-PLATE 5HOLE 336
FBP0349352Z1 3.5MM T-PLATE 3:4+3:8HOLE 952
FBP0349353Z1 3.5MM OBLIQUE T-PLATE 3+3:5HOLE 952
FBP0349354Z1 3.5MM CLOVERLEAF PLATE 3:10HOLE 1603
FBP0349355Z1 3.5MM CALCANEAL PLATE 60:70MM 3104
FBP0349356Z1 3.5MM CALCANEAL Y-PLATE 3104
FBP0349453Z1 4.5MM T-PLATE 3:8HOLE 2130
FBP0349454Z1 4.5MM T-BUTTRESS PLATE 4:6HOLE 2130
FBP0349455Z1 4.5MM L-BUTTRESS PLATE 4HOLE 2130
FBP0349456Z1 4.5MM SPOON PLATE 5:6HOLE 1762
FBP0349457Z1 4.5MM COBRA HEAD PLATE 8:11HOLE 3892
FBP0349XXNZ1 1.5MM,2.0MM T-PLATE (3:4+9HOLE) 2686
FBP035020NSN STAINLESS MINI STRAIGHT PLATE 20HOLE 1.5MM 2686
FBP035030NSN 1.5MM H-PLATE 4HOLE 2686
FBP036030NSN 2.0MM T-PLATE 9HOLE 2686
FBP037012NSN MULTI FRAGMENT PLATE 7HOLE 230
FBP0371147SN L-PLATE,T-PLATE 2.7MM 3HOLE 336
FBP03LM16NAE CLOVERLEAF PLATE 4.5 MM 3,4 HOLE 1603
FBP03LM17NAE L/T PLATE 4.5 MM 2130
FBP03LM18NAE T-BUTTRESS PLATE 4.5 MM 4,5,6 HOLE 2130
FBP03LM19NAE L-BUTTRESS PLATE 4.5 MM L/R 4 HOLE 2130
FBP03LM50NAE COBRA HEAD PLATE 3892
FBP03LM95NAE SPOON PLATE 4.5MM 5,6 HOLE 1762
FBP03LN02NAE L-PLATE 2.7 MM 336
FBP03LN15NAE RECONSTRUCTION PLATE 3.5 MM 3487
FBP03LN16NAE RECONSTRUCTION PLATE 2.7MM 3487
FBP03LN190AE Y-PLATE 3104
FBP03LN20NAE STRAIGHT/L PLATE 2.0 MM 230
FBP03LN225AE T-MINI FINGER PLATE 336
FBP03LN22NAE L-MINI PLATE 2.0MM 336
FBP03LN26NAE DCP 2.7 MM SMALL PLATE 1173
FBP03LN278AE MAXILLO-RECOSTRUCTION PLATE 2.0MM 3487
FBP03LN29NAE DCP PLATE 2.7MM 1173
844
特材代碼 中英文名稱 支付點數-104/01/01
FBP03LN31NAE MAXILLA PLATE 2.7MM 463
FBP03LN32NAE T-PLATE 3.5 MM 952
FBP03LN33NAE SMALL T-PLATE 3.5MM 952
FBP03LN34NAE PCP PLATE 3.5 MM 952
FBP04142XNSN CONDYLAR PLATE 7:15HOLE LT,RT 3941
FBP042351NS1 HIP DCP PLATE CHILD 2315
FBP042351NY2 ANGLED BLADE PLATES FOR INTERTROCHANTERIC FEMORAL
OSTEOTOMIES IN CHILDREN
2315
FBP042356NS1 TEENAGER HIP PLATE 2315
FBP04236NNY2 ANGLED BLADE PLATES FOR INTERTROCHANTERIC FEMORAL
OSTEOTOMIES IN SMALL ADULTS
2315
FBP04236XNS1 BABY HIP PLATE 2315
FBP04236XNY2 ANGLED BLADE PLATES 90度 FOR INTERTROCHANTERIC FEMORAL
OSTEOTOMIES IN INFANT
2315
FBP042372NS1 CONDYLAR PLATE 95度 12 HOLE 50:80MM 3941
FBP042372NY2 CONDYLAR PLATE 95度 FOR ADULTS AND 5:18HOLE 3941
FBP042375NS1 CONDYLAR PLATE 95度 5 HOLE 50:80MM 3941
FBP042377NS1 CONDYLAR PLATE 95度 7 HOLE 50:80MM 3941
FBP042379NS1 CONDYLAR PLATE 95度 9 HOLE 50:80MM 3941
FBP04238NNS1 ANGLED BLADE PLATE 130度 4:12 HOLE 50:110MM 2927
FBP04238NNY2 ANGLED BLADE PLATES 130度4:12HOLE 50:110MM 2927
FBP042392NS1 HIP PLATE 90:130度 2927
FBP042392NY2 ANGLED BLADE PLATES FOR INTERTROCHANTERIC FEMORAL
OSTEOTOMIES IN ADULTS
2927
FBP042436NS1 MINI CONDYLAR PLATE 2.0:2.7 2829
FBP042466NS1 MINI CONDYLAR PLATE 2829
FBP04254XNSN ADULT CONDYLAR PLATE 95度 5:16HOLE 3941
FBP04282XNS1 CONDYLAR PLATE 2927
FBP04282XNY2 CONDYLAR PLATE 95度 FOR SMALL ADULTS AND ADOLESCENTS 2927
FBP04283XNS1 ANGLED BLADE PLATE 130度 4:9HOLE 2927
FBP04283XNY2 ANGLED BLADE PLATES 130度 FOR SMALL STATURED ADULTS AND
ADOLESCENTS 4:9HOLE
2927
FBP0449XXNZ1 1.5MM,2.0MM,2.7MM MINI CONDYLAR PLATE 7HOLE 2829
FBP045026NSN CONDYLAR PLATE 7HOLE 1.5MM RT,LT 2829
FBP046040NSN CONDYLAR PLATE 7HOLE 2.0MM RT,LT 2829
FBP04K012NAE CONDYLAR PLATE 95度 4.5MM 3941
FBP04K021NAE ANGLED PLATE 90:130度 4.5MM 2927
FBP04LM15NAE CONDYLAR BUTTRESS PLATE 4.5 MM 3493
FBP094102NU0 STAINLESS ANATOMIC FEMUR PLATE 4:8HOLE※限EPIPHYSIS、
METAPHYSIS骨折使用
8744
FBP09510SNY2 STAINLESS ANATOMICAL PLATE (TIBIAL,FEMUR,FIBULAR) ※適應
症請見備註欄
8744
FBPN10579NM1 STEINMANN PIN 180:230MM 184
FBPN12910NY2 STEINMANN PINS(SHANK)2.0MM:4.8MM *9"(230MM) 184
FBPN12915NY2 STEINMANN PINS(THREADED)2.0MM:4.8MM *9"(230MM) 279
FBPN12920NY2 STEINMANN PINS(SHANK)0.8MM:3.0MM *70MM 184
FBPN129210V2 STEINMANN PINS(SHANK) 0.8MM:5.0MM 184
FBPN12921NY2 STEINMANN PINS(SHANK)0.8MM:3.0MM *150MM 184
FBPN12922NY2 STEINMANN PINS(SHANK)0.8MM:3.0MM *280MM 184
FBPN12923NY2 STEINMANN PINS(SHANK)0.8MM:3.0MM *400MM 184
FBPN1292XNY2 STEINMANN PIN 70MM 150MM 184
FBPN12936NS1 STEINMANN PIN WITH THREAD 279
FBPN12936NY2 STEINMANN PIN W/MIDDLE THREADED 279
FBPN1293NNS1 STEINMANN PIN 184
845
特材代碼 中英文名稱 支付點數-104/01/01
FBPN1293NNY2 STEINMANN PIN W/TROCAR TIP 184
FBPN1KX10NAE STEINMANN PIN 184
FBPN1KX30NAE STEINMANN PIN WITH THREAD 279
FBPN20750NM1 KNOWLES PIN 65MM:120MM 879
FBPN22811NZ1 KNOWLES PIN 2.5":4" 879
FBPN22815NZ1 KNOWLES PIN 5 1/4":6" 879
FBPN22818NZ1 KNOWLES PIN 4 1/4":5" 879
FBPN2282XNSN KNOWLES PIN 879
FBPN2283XNSN KNOWLES PIN 879
FBPN22991NY2 KNOWLES PINS(HEX.DRIVE)4.0/4.8MM *2.5":6"(63.5MM:152.4MM) 879
FBPN22993NY2 KNOWLES PINS(SQUARE DRIVE)4.0/4.8MM
*2.5":6"(63.5MM:152.4MM)
879
FBPN30531YM1 MR-500型髓內釘(RUSH PIN) 722
FBPN3KJ10NAE RUSH PIN 722
FBPS1000XNX0 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNX1 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNX2 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNX4 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNX5 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNX6 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNX7 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNX8 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNX9 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNXB PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNXC PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNXD PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNXE PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNXF PARTIAL FOOT PROSTHESIS 健保給寸部分足義肢 ※適應症請見備
註欄.
19000
FBPS1000XNXG PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNXH PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNXJ PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNXK PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNXN PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 ※適應症請見備
註欄
19000
846
特材代碼 中英文名稱 支付點數-104/01/01
FBPS1000XNXS PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNXV PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄.
19000
FBPS1000XNXY PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備
註欄
19000
FBPS1001XNX0 SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNX1 SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNX2 SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNX4 SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNX5 SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNX6 SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNX7 SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNX8 SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNX9 SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXB SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXC SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXD SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXE SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXF SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXG SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXH SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXJ SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXK SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXN SYME"S PROSTHESIS 珊姆式小腿義肢(踝關節離斷) ※適應症請見
備註欄
24000
FBPS1001XNXS SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXV SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄.
24000
FBPS1001XNXY SYME"S PROSTHESIS 健保給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄
24000
FBPS1002XNX0 K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNX1 K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
847
特材代碼 中英文名稱 支付點數-104/01/01
FBPS1002XNX2 K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNX4 K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNX5 K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNX6 K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNX7 K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNX8 K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNX9 K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNXB K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNXC K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNXD K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNXE K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNXF K/D PROSTHESIS 健保給付膝關節離斷義肢 ※適應症請見備註欄. 48000
FBPS1002XNXG K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNXH K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNXJ K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNXK K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNXN K/D PROSTHESIS 膝關節離斷義肢 ※適應症請見備註欄 48000
FBPS1002XNXS K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNXV K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000
FBPS1002XNXY K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄 48000
FBPS1003XNX0 A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNX1 A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNX2 A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNX3 A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNX4 A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNX5 A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNX6 A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNX7 A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNX8 A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNX9 A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNXB A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNXC A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNXD A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNXE A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNXF A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNXG A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
848
特材代碼 中英文名稱 支付點數-104/01/01
FBPS1003XNXH A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNXJ A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNXK A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNXN A/K PROSTHESIS 膝上義肢 ※適應症請見備註欄 48000
FBPS1003XNXS A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNXV A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄. 48000
FBPS1003XNXY A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄 48000
FBPS1004XNX0 B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNX1 B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNX2 B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNX3 B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNX4 B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNX5 B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNX6 B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNX7 B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNX8 B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNX9 B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNXB B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNXC B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNXD B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNXE B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNXF B/K PROSTHESIS 健保給付膝下義肢 ※適應症請見備註欄. 34000
FBPS1004XNXG B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNXH B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNXJ B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNXK B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNXN B/K PROSTHESIS 膝下義肢 ※適應症請見備註欄 34000
FBPS1004XNXS B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNXV B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄. 34000
FBPS1004XNXY B/K PROSTHESIS 健保給付膝下義肢※適應症請見備註欄 34000
FBPS1005XNX0 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNX1 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNX2 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNX4 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNX5 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNX6 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNX7 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNX8 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNX9 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNXB H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNXC H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNXD H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
849
特材代碼 中英文名稱 支付點數-104/01/01
FBPS1005XNXE H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNXF H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNXG H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNXH H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNXJ H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNXK H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNXN H/D&H/P PROSTHESIS 髖關節離斷義肢 ※適應症請見備註欄 68000
FBPS1005XNXS H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNXV H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄.
68000
FBPS1005XNXY H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 ※適應症請見備
註欄
68000
FBPS1006XNX0 W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNX1 W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNX2 W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNX4 W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNX5 W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNX6 W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNX7 W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNX9 W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNXB W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNXC W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNXD W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNXE W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNXF W/D PROSTHESIS 健保給付腕關節離斷義肢 ※適應症請見備註欄. 42000
FBPS1006XNXG W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNXH W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄 42000
FBPS1006XNXJ W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNXK W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNXS W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
850
特材代碼 中英文名稱 支付點數-104/01/01
FBPS1006XNXV W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000
FBPS1006XNXY W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄 42000
FBPS1007XNX0 E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNX1 E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNX2 E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNX4 E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNX5 E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNX6 E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNX7 E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNX9 E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNXB E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNXC E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNXD E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNXE E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNXF E/D PROSTHESIS 健保給付肘關節離斷義肢 ※適應症請見備註欄. 62000
FBPS1007XNXG E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNXH E/D PROSTHESIS健保給付肘關節離斷義肢※適應症請見備註欄 62000
FBPS1007XNXJ E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNXK E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNXS E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNXV E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄. 62000
FBPS1007XNXY E/D PROSTHESIS 健保給付肘關節離斷義肢※適應症請見備註欄 62000
FBPS1008XNX0 A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNX1 A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNX2 A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNX4 A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNX5 A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNX6 A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNX7 A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNX9 A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNXB A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNXC A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNXD A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNXE A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNXF A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
851
特材代碼 中英文名稱 支付點數-104/01/01
FBPS1008XNXG A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNXH A/E PROSTHESIS 健保給付肘關節以上截肢義肢※適應症請見備註
欄
65000
FBPS1008XNXJ A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNXK A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNXS A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNXV A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000
FBPS1008XNXY A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄 65000
FBPS1009XNX0 B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNX1 B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNX2 B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNX4 B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNX5 B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNX6 B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNX7 B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNX9 B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNXB B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNXC B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNXD B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNXE B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNXF B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNXG B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNXH B/E PROSTHESIS 健保給付肘下功能性義肢※適應症請見備註欄 42000
FBPS1009XNXJ B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNXK B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNXS B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNXV B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄. 42000
FBPS1009XNXY B/E PROSTHESIS 健保給付肘下義肢 ※適應症請見備註欄 42000
FBPS1010XNX0 S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNX1 S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNX2 S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNX4 S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNX5 S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNX6 S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNX7 S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNX9 S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNXB S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNXC S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNXD S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNXE S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNXF S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
852
特材代碼 中英文名稱 支付點數-104/01/01
FBPS1010XNXG S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNXH S/D PROSTHESIS 健保給付功能性肩關節離斷義肢※適應症請見備
註欄
65000
FBPS1010XNXJ S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNXK S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNXS S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNXV S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1010XNXY S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000
FBPS1011XNX0 FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNX1 FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNX2 FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNX4 FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNX5 FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNX6 FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNX7 FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNX9 FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNXB FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNXC FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNXD FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNXE FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNXF FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNXG FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNXH FOREQUATER PROSTHESIS 健保給付肩胛截除義肢※適應症請見備
註欄
65000
FBPS1011XNXJ FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNXK FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNXS FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNXV FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄.
65000
FBPS1011XNXY FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備
註欄
65000
853
特材代碼 中英文名稱 支付點數-104/01/01
FBPS1012XNX0 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNX1 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNX2 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNX4 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNX5 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNX6 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNX7 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNX9 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNXB A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNXC A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNXD A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNXE A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNXF A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNXG A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNXH A/E COSMETIC PROSTHESIS 健保給付美觀性肘關節以上截肢義肢
※適應症請見備註欄
23000
FBPS1012XNXJ A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNXK A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNXN A/E COSMETIC PROSTHESIS 肘上美觀義肢 ※適應症請見備註欄 23000
FBPS1012XNXS A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNXV A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄.
23000
FBPS1012XNXY A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見
備註欄
23000
FBPS1013XNX0 B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNX1 B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNX2 B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNX4 B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNX5 B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNX6 B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
854
特材代碼 中英文名稱 支付點數-104/01/01
FBPS1013XNX7 B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNX9 B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNXB B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNXC B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNXD B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNXE B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNXF B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNXG B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNXH B/E COSMETIC PROSTHESIS健保給付肘關節以下美觀義肢※適應症
請見備註欄
14000
FBPS1013XNXJ B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNXK B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNXN B/E COSMETIC PROSTHESIS 肘下美觀義肢 ※適應症請見備註欄 14000
FBPS1013XNXS B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNXV B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄.
14000
FBPS1013XNXY B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見
備註欄
14000
FBPS1014XNX0 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNX1 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNX2 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNX4 S/D COSMETIC PROSTHESIS健保給付肩關節離斷美觀義肢 ※適應
症請見備註欄.
32300
FBPS1014XNX5 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNX6 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNX7 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNX9 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNXB 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNXC 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNXD 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNXE 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNXF 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNXG 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNXH S/D COSMETIC PROSTHESIS 健保給付美觀性肩關節離斷義肢※適
應症請見備註欄
32300
FBPS1014XNXJ 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNXK 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNXS 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNXV 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300
FBPS1014XNXY 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄 32300
FBPS1015XNX0 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNX1 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNX2 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
855
特材代碼 中英文名稱 支付點數-104/01/01
FBPS1015XNX4 TRANS-CARPAL COSMETIC PROSTHESIS健保給付橫掌截肢美觀義肢
※適應症請見備註欄.
7300
FBPS1015XNX5 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNX6 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNX7 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNX9 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNXB 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNXC 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNXD 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNXE 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNXF 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNXG 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNXH TRANS-CARPAL COSMETIC PROSTHESIS 健保給付橫掌截肢義肢※適
應症請見備註欄
7300
FBPS1015XNXJ 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNXK 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNXS 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNXV 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300
FBPS1015XNXY 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄 7300
FBPS1016XNX0 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNX1 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNX2 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNX4 PARTIAL FINGER COSMETIC PROSTHESIS健保給付手指截肢美觀義
肢 ※適應症請見備註欄.
4800
FBPS1016XNX5 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNX6 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNX7 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNX9 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNXB 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNXC 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNXD 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNXE 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNXF 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNXG 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNXH PARTIAL FINGER COSMETIC PROSTHESIS 健保給付手指截肢義肢※
適應症請見備註欄
4800
FBPS1016XNXJ 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNXK 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNXS 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNXV 健保給付手指截肢美觀義肢 ※適應症請見備註欄. 4800
FBPS1016XNXY 健保給付手指截肢美觀義肢 ※適應症請見備註欄 4800
FBPS2000XNX0 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNX1 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNX2 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNX4 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNX5 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNX6 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
856
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2000XNX7 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNX8 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNX9 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXB PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXC PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXD PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXE PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXF PARTIAL FOOT PROSTHESIS 部分給寸部分足義肢 ※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXG PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXH PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXJ PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXK PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXN PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXS PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2000XNXV PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備
註欄,按健保給付之部分足義肢給付,超過部分由病患自付.
19000
FBPS2001XNX0 SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNX1 SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNX2 SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNX4 SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNX5 SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNX6 SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNX7 SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNX8 SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
857
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2001XNX9 SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXB SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXC SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXD SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXE SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXF SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXG SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXH SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXJ SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXK SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXN SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXS SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2001XNXV SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適
應症請見備註欄,按健保給付之珊姆式小腿義肢(踝關節離斷)給
付,超過部分由病患自付.
24000
FBPS2002XNX0 K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNX1 K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNX2 K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNX4 K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNX5 K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNX6 K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNX7 K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
858
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2002XNX8 K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNX9 K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXB K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXC K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXD K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXE K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXF K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXG K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXH K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXJ K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXK K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXN K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXS K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2002XNXV K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄,
按健保給付之膝關節離斷義肢給付,超過部分由病患自付.
48000
FBPS2003XNX0 A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNX1 A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNX2 A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNX3 A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNX4 A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNX5 A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNX6 A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNX7 A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNX8 A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNX9 A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNXB A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNXC A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNXD A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
859
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2003XNXE A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNXF A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNXG A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNXH A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNXJ A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNXK A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNXN A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNXS A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2003XNXV A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄,按健
保給付膝上義肢給付,超過部分由病患自付.
48000
FBPS2004XNX0 B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNX1 B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNX2 B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNX3 B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNX4 B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNX5 B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNX6 B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNX7 B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNX8 B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNX9 B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNXB B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNXC B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNXD B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNXE B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNXF B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNXG B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNXH B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNXJ B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
860
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2004XNXK B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNXN B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNXS B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2004XNXV B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄,按健保
給付之膝下義肢給付,超過部分由病患自付.
34000
FBPS2005XNX0 H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNX1 H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNX2 H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNX4 H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNX5 H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNX6 H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNX7 H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNX8 H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNX9 H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNXB H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNXC H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNXD H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNXE H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNXF H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNXG H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
861
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2005XNXH H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNXJ H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNXK H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNXN H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNXS H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2005XNXV H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 ※適應症請見備
註欄,按健保給付之髖關節離斷義肢給付,超過部分由病患自付.
68000
FBPS2006XNX0 W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNX1 W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNX2 W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNX4 W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNX5 W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNX6 W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNX7 W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNX9 W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNXB W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNXC W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNXD W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNXE W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNXF W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNXG W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNXH W/D PROSTHESIS部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNXJ W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNXK W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNXN W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
862
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2006XNXS W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2006XNXV W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄,
按健保給付之腕關節離斷義肢給付,超過部分由病患自付.
42000
FBPS2007XNX0 E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNX1 E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNX2 E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNX4 E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNX5 E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNX6 E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNX7 E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNX9 E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXB E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXC E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXD E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXE E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXF E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXG E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXH E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXJ E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXK E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXN E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXS E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2007XNXV E/D PROSTHESIS 部分給付肘關節離斷義肢※適應症請見備註欄,
按健保給付之肘關節離斷義肢給付,超過部分由病患自付.
62000
FBPS2008XNX0 A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNX1 A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNX2 A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNX4 A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNX5 A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
863
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2008XNX6 A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNX7 A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNX9 A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNXB A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNXC A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNXD A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNXE A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNXF A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNXG A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNXH A/E PROSTHESIS部分給付肘關節以上截肢義肢※適應症請見備註
欄,按健保給付之肘關節以上截肢義肢給付,超過部分由病患自
付.
65000
FBPS2008XNXJ A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNXK A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNXN A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNXS A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2008XNXV A/E PROSTHESIS 部分給付肘上義肢※適應症請見備註欄,按健保
給付之肘上義肢給付,超過部分由病患自付.
65000
FBPS2009XNX0 B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNX1 B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNX2 B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNX4 B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNX5 B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNX6 B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNX7 B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNX9 B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNXB B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNXC B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNXD B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
864
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2009XNXE B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNXF B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNXG B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNXH B/E PROSTHESIS部分給付肘下功能性義肢※適應症請見備註欄,
按健保給付之肘下功能性義肢給付,超過部分由病患自付.
42000
FBPS2009XNXJ B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNXK B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNXN B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNXS B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2009XNXV B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄,按健
保給付之肘下義肢給付,超過部分由病患自付.
42000
FBPS2010XNX0 S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNX1 S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNX2 S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNX4 S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNX5 S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNX6 S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNX7 S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNX9 S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNXB S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNXC S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNXD S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNXE S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNXF S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNXG S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNXH S/D PROSTHESIS部分給付功能性肩關節離斷義肢※適應症請見備
註欄,按健保給付之功能性肩關節離斷義肢給付,超過部分由病患
自付.
65000
FBPS2010XNXJ S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNXK S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
865
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2010XNXN S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNXS S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2010XNXV S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄
,按健保給付之肩關節離斷義肢給付,超過部分由病患自付.
65000
FBPS2011XNX0 FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNX1 FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNX2 FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNX4 FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNX5 FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNX6 FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNX7 FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNX9 FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNXB FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNXC FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNXD FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNXE FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNXF FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNXG FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNXH FOREQUATER PROSTHESIS 部分給付肩胛截除義肢※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNXJ FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
866
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2011XNXK FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNXN FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNXS FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2011XNXV FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備
註欄,按健保給付之肩胛截除義肢給付,超過部分由病患自付.
65000
FBPS2012XNX0 A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNX1 A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNX2 A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNX4 A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNX5 A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNX6 A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNX7 A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNX9 A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNXB A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNXC A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNXD A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNXE A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNXF A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNXG A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
867
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2012XNXH A/E COSMETIC PROSTHESIS 部分給付美觀性肘關節以上截肢義肢
※適應症請見備註欄,按健保給付之美觀性肘關節以上截肢義肢
給付,超過部分由病患自付.
23000
FBPS2012XNXJ A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNXK A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNXN A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNXS A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2012XNXV A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見
備註欄,按健保給付之肘上美觀義肢給付,超過部分由病患自付.
23000
FBPS2013XNX0 B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNX1 B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNX2 B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNX4 B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNX5 B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNX6 B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNX7 B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNX9 B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNXB B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNXC B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNXD B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNXE B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
868
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2013XNXF B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNXG B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNXH B/E COSMETIC PROSTHESIS部分給付肘關節以下美觀義肢※適應症
請見備註欄,按健保給付之肘關節以下美觀義肢給付,超過部分由
病患自付.
14000
FBPS2013XNXJ B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNXK B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNXN B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNXS B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2013XNXV B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見
備註欄,按健保給付之肘下美觀義肢給付,超過部分由病患自付.
14000
FBPS2014XNX0 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNX1 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNX2 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNX4 S/D COSMETIC PROSTHESIS部分給付肩關節離斷美觀義肢 ※適應
症請見備註欄,按健保給付之肩關節離斷美觀義肢給付,超過部分
由病患自付.
32300
FBPS2014XNX5 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNX6 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNX7 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNX9 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNXB 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNXC 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNXD 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNXE 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNXF 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNXG 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
869
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2014XNXH S/D COSMETIC PROSTHESIS部分給付美觀性肩關節離斷義肢※適應
症請見備註欄,按健保給付之美觀性肩關節離斷義肢給付,超過部
分由病患自付
32300
FBPS2014XNXJ 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNXK 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNXS 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2014XNXV 部分給付肩關節離斷美觀義肢 ※適應症請見備註欄,按健保給付
之肩關節離斷美觀義肢給付,超過部分由病患自付.
32300
FBPS2015XNX0 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNX1 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNX2 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNX4 TRANS-CARPAL COSMETIC PROSTHESIS部分給付橫掌截肢美觀義肢
※適應症請見備註欄,按健保給付之橫掌截肢美觀義肢給付,超過
部分由病患自付.
7300
FBPS2015XNX5 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNX6 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNX7 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNX9 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNXB 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNXC 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNXD 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNXE 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNXF 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNXG 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNXH TRANS-CARPAL COSMETIC PROSTHESIS部分給付橫掌截肢義肢※適
應症請見備註欄,按健保給付之橫掌截肢義肢給付,超過部分由病
患自付.
7300
FBPS2015XNXJ 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNXK 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNXN 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNXS 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
FBPS2015XNXV 部分給付橫掌截肢美觀義肢 ※適應症請見備註欄,按健保給付之
橫掌截肢美觀義肢給付,超過部分由病患自付.
7300
870
特材代碼 中英文名稱 支付點數-104/01/01
FBPS2016XNX0 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNX1 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNX2 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNX4 PARTIAL FINGER COSMETIC PROSTHESIS部分給付手指截肢美觀義
肢 ※適應症請見備註欄,按健保給付之手指截肢美觀義肢給付,
超過部分由病患自付.
4800
FBPS2016XNX5 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNX6 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNX7 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNX9 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNXB 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNXC 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNXD 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNXE 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNXF 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNXG 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNXH PARTIAL FINGER COSMETIC PROSTHESIS部分給付手指截肢義肢※
適應症請見備註欄,按健保給付之手指截肢義肢給付,超過部分由
病患自付.
4800
FBPS2016XNXJ 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNXK 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNXN 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNXS 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBPS2016XNXV 部分給付手指截肢美觀義肢 ※適應症請見備註欄,按健保給付之
手指截肢美觀義肢給付,超過部分由病患自付.
4800
FBS01037XNY2 1.5,2.0,2.7,3.5 CORTEX SCREW(產品型號
202006:040,204010:110)
145
FBS01038XNY2 4.5 CORTEX SCREW(產品型號214228:250) 161
FBS010701NH1 CORTEX SMALL SCREW 3.5MM,4.5MM DIA 161
FBS011622NSN 1.5,2.0,2.7,3.5MM CORTEX SCREW (產品型號71162-
008:020,022:032,7122006:024,26:40,10:50,55:115)
145
FBS012042N2W "MICROWARE"BONE SCREW:SHAFT SCREW 3.5MM, 4.5MM, 12:115MM"
全微"骨釘:軸骨釘
145
FBS012100N2W "MICROWARE"BONE SCREW:CORTEX SCREW 1.5MM, 2.0MM, 2.7MM,
3.5MM, 6:110MM"全微"骨釘:皮質骨釘
145
FBS01210NNY2 STAINLESS CORTEX SCREW 1.5:3.5X6:110MM 145
FBS01211NNS1 CORTEX SCREW 1.5:4.0MM 145
871
特材代碼 中英文名稱 支付點數-104/01/01
FBS01214NN2W "MICROWARE"BONE SCREW:CORTEX SCREW 4.5MM, 12:140MM"全微"
骨釘:皮質骨釘
161
FBS01214NNS1 CORTEX SCREW 4.5MM 161
FBS01225XNSN 4.5MM CORTEX SCREW 14:70MM,72:145MM 161
FBS01270XNSN CORTEX BONE SCREW 161
FBS013861NS9 SMALL CORTEX SCREW 2.0/2.7/3.5MM 145
FBS014000NS3 CORTEX SCREW 1.5:3.5MM 6:9MM 145
FBS014000NS9 "STRYKER"BONE SCREW 1.5:3.5MM 6:9MM"史賽克"骨釘(原代碼
FBS014000NS3)
145
FBS014001NS3 CORTEX BONE SCREW 161
FBS014061NS9 CORTEX SCREW 4.5MM 14:150MM 161
FBS01410NNY2 TITANIUM CORTEX SCREW 1.5:3.5X6:110MM 183
FBS014148NY2 TITANIUM CORTEX SCREW 3.0:4.0X8:50MM 201
FBS01437XNY2 TITANIUM CORTEX SCREW 1.5MM:3.5MM (型號
402006:040,404010:110,404212:250)
183
FBS01438XNY2 TITANIUM CORTEX SCREW 4.5MM 201
FBS014800NZ1 1.5:3.5MM CORTICAL SCREW(型號482006:50-
01,02,03,482706:70-01,483510:150-01,-40:130-07,-16:50-04)
145
FBS014845NZ1 4.5MM CORTICAL SCREW 161
FBS01LA11NAE CORTEX SCREW 4.5MM 161
FBS01LB02NAE CORTEX SCREW 2.0MM 145
FBS01LB06NAE CORTEX SCREW 1.5MM 6:20MM 145
FBS01LB12NAE CORTEX SCREW 2.7MM 145
FBS01LB18NAE CORTEX SCREW 145
FBS02039XNY2 4.0 CANCELLOUS SCREW 144
FBS02040XNY2 6.5 CANCELLOUS SCREW(產品型號217045:150) 281
FBS022060N2W "MICROWARE"BONE SCREW:CANCELLOUS SCREW 4.0MM, 10:60MM"全
微"骨釘:海綿骨釘
144
FBS02207NNS1 CANCELLOUS BONE SCREW 3.5:4.0MM 144
FBS02218NN2W "MICROWARE"BONE SCREW:CANCELLOUS SCREW 6.5MM, 20:130MM"全
微"骨釘:海綿骨釘
281
FBS02218NNS1 CANCELLOUS BONE SCREW 6.5MM 281
FBS02223XNSN 4.0MM FULL,PART TH CANC SCREW 10:100,10:50,55:100MM 144
FBS02229XNSN 6.5MM CANC SCREW 16,32MM,FULL TH 25:150MM(產品型號7122-
8045:8110,8115:8150,9025:9110,9115:9150)
281
FBS022331NZ1 LONG CANCELLOUS SCREW FULLY THREAD 6.5MM 281
FBS024102NS3 CANCELLOUS BONE SCREW 281
FBS024103NS9 CANCELLOUS BONE SCREW 6.5MM(1/3) 115:150MM 281
FBS024203NS3 CANCELLOUS BONE SCREW 281
FBS024204NS9 CANCELLOUS BONE SCREW 6.5MM(2/3) 105:200M 281
FBS024302NS9 CANCELLOUS BONE SCREW 6.5MM 105:150M 281
FBS024303NS3 CANCELLOUS BONE SCREW 281
FBS02439XNY2 TITANIUM CANCELLOUS SCREW 4.0MM 144
FBS024402NU0 STAINLESS SELF-LOCKING SCREW 4.5MM 35:75MM 144
FBS02440XNY2 TITANIUM CANCELLOUS SCREW 6.5MM(型號417045:150) 259
FBS024541NS3 CANCELLOUS BONE SCREW (SMALL) 144
FBS024541NS9 SMALL CANCELLOUS BONE SCREW 4MM 144
FBS024551NS3 CANCELLOUS BONE SCREW (SMALL) 144
FBS024551NS9 SMALL CANCELLOUS BONE SCREW 4MM (1/2) 144
FBS024840NZ1 4.0MM CANCELLOUS SCREW 144
FBS024865NZ1 6.5MM CANCELLOUS SCREW 281
FBS02LA33NAE THREAD CANCELLOUS SCREW 6.5MM 281
FBS02LB35NAE CANCELLOUS SCREW 4.0MM 144
872
特材代碼 中英文名稱 支付點數-104/01/01
FBS03041XNY2 4.5 MALLEOLAR SCREW 269
FBS030811NH1 MALLEOLAR SCREW 踝質釘 269
FBS032150N2W "MICROWARE"BONE SCREW:MALLEOLAR SCREW 4.5MM, 25:70MM"全
微"骨釘:踝骨釘
269
FBS03215NNS1 MALLEOLAR SCREW (ANY SIZE) 269
FBS032252NSN 4.5MM MALLEOLAR SCREW 25:70MM 269
FBS034402NS3 MALLEOLAR SCREW 269
FBS034402NS9 MALLEOLAR SCREWS 4.5MM(原代碼FBS034402NS3) 269
FBS0348451Z1 4.5MM MALLEOLAR SCREW 269
FBS03LA22NAE MALLEOLAR SCREW 20:110MM 269
FBS04042XNY2 3.5,4.5 CANNULATED SCREW(產品型號214420:472,214620:672) 1544
FBS04043XNY2 6.5 CANNULATED SCREW(產品型號208620:730) 1544
FBS04044XNY2 7.0,7.3 CANNULATED SCREW(產品型號
209420:530,208830:950,209850:930)
1544
FBS041142NZ1 MINI MAGNA-FX CANNULATED SCREW 4.0MM,5.0MM 1544
FBS041146NZ1 MAGNA-FX CANNULATED SCREW 16MM,32MM 1544
FBS041155NZ1 HERBERT CANNULATED BONE SCREW 25:100MM 1544
FBS04202NNS1 3.0 CANNULATED SCREW 1544
FBS04202NNY2 STAINLESS CANNULATED SCREW 3.4:4.0X8:50MM 1544
FBS0420500WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:CANNULATED
SCREW 3.5,4.0,4.5威創骨釘骨板植入物:中空骨釘
1544
FBS04205NN2W "MICROWARE"BONE SCREW:CANNULATED SCREW 3.5MM, 4.0MM,
4.5MM, 10:72MM"全微"骨釘:中空骨釘
1544
FBS04205NNS1 3.5 CANNULATED SCREW 1544
FBS04207NNS1 4.0 CANNULATED SCREW 1544
FBS0420800WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:CANNULATED
SCREW 7.0,7.3威創骨釘骨板植入物:中空骨釘
1544
FBS0420840WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:CANNULATED
SCREW 6.5威創骨釘骨板植入物:中空骨釘
1544
FBS04208NN2W "MICROWARE"BONE SCREW:CANNULATED SCREW 7.3MM, 7.0MM,
20:150MM"全微"骨釘:中空骨釘
1544
FBS04208NNS1 "信迪思"骨螺釘植入物-中空螺釘(7.0MM及7.3MM)"SYNTHES"BONE
SCREW IMPLANT-CANNULATED SCREW
1544
FBS04209NNS1 CANNULATED SCREW 7.0MM 32MM L45:130MM 1544
FBS0421180WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:CANNULATED
SCREW 2.4,3.0威創骨釘骨板植入物:中空骨釘
1544
FBS04214NNS1 4.5 CANNULATED SCREW 1544
FBS0421654SN CANNULATED HIP PIN SYSTEM(STAINLESS STEEL) 1544
FBS04216XNSN CANNULATED HIP PIN 1544
FBS042170NSN CANNULATED SCREW D 8,6.5,4MM(產品型號
71100045:71100130,222820:870)
1544
FBS0421810SN CANNULATED SCREW(STAINLESS STEEL) 1544
FBS04218NNY2 STAINLESS CANNULATED SCREW 7.0:7.3X30:150MM 1544
FBS04286NN2W "MICROWARE"BONE SCREW:CANNULATED SCREW 6.5MM, 20:150MM"全
微"骨釘:中空骨釘
1544
FBS04402NNS1 TITANIUM 3.0 CANNULATED SCREW 1984
FBS04402NNY2 TITANIUM CANNULATED SCREW 3.0:4.0X8:50MM 1984
FBS0440500WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:TITANIUM
CANNULATED SCREW 3.5,4.0,4.5威創骨釘骨板植入物:鈦合金中空
骨釘
1984
FBS04407NNS1 TITANIUM 4.0 CANNULATED SCREW 1984
FBS0440800WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:TITANIUM
CANNULATED SCREW 7.0,7.3威創骨釘骨板植入物:鈦合金中空骨釘
1984
873
特材代碼 中英文名稱 支付點數-104/01/01
FBS0440840WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:TITANIUM
CANNULATED SCREW 6.5威創骨釘骨板植入物:鈦合金中空骨釘
1984
FBS04408NNS1 TITANIUM 7.3 CANNULATED SCREW 1984
FBS04408XNY2 TITANIUM CANNULATED SCREW 7.0X30:130MM 1984
FBS0441180WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:TITANIUM
CANNULATED SCREW 2.4,3.0威創骨釘骨板植入物:鈦合金中空骨釘
1984
FBS044144NY2 TITANIUM CANNULATED SCREW 4.5X20:72MM 1984
FBS04414NNS1 TITANIUM 4.5 CANNULATED SCREW 1984
FBS04418NNY2 TITANIUM CANNULATED SCREW 7.0:7.3X30:150MM 1984
FBS04442XNY2 TITANIUM CANNULATE SCREW 7.3MM 1984
FBS0461040SN CANNULATED SCREW(TITANIUM) 1984
FBS051150NZ1 HERBERT MINI BONE SCREW 10:24MM 1544
FBS051151NZ1 HERBERT SCREW 16:30MM 1544
FBS051152NZ1 HERBERT WHIPPLE BONE SCREW 12:30MM 1544
FBS051154NZ1 HERBERT BONE SCREW 12:30MM 1544
FBS05602XNS3 TITANIUM CANNULATED SCREW(604610:604670自88/09/01起生效) 1984
FBS05602XNS9 TITANIUM CANNULATED SCREW(原代碼FBS05602XNS3) 1984
FBS0649001Z1 CORTICAL NUT 48
FBS07044XNY2 4.5,7.0,7.3 WASHER 66
FBS071430NSN WASHER 10,7,13MM OD 66
FBS072199NS1 WASHER 66
FBS07219XNS1 WASHER/NUT 48
FBS072971N2W "MICROWARE"BONE PLATE:ROUND WASHER, 13.0, 7.0, 4.5, 10.0,
6.5MM"全微"圓滑司
66
FBS074199NS1 WASHER FOR TITANIUM CANNULATE SCREW 84
FBS07444XNY2 TITANIUM WASHER 84
FBS074900NZ1 1.5MM:4.5MM WASHER 66
FBS076199NS3 WASHER FOR TCS SCREWS(619905自88/09/01起生效) 84
FBS076199NS9 WASHER(原代碼FBS076199NS3) 84
FBS079001NS9 WASHER 66
FBS07LA196AE WASHER 4.5MM 66
FBS07LA198AE WASHER 1.3MM 66
FBS0801768SN "SMITH&NEPHEW"BIOSURE HA INTERFERENCE SCREW "史耐輝"可吸
收性固定螺絲※限十字韌帶重建手術使用
4234
FBS0804101NF BIODEGRADABLE MINI PLATING SYSTEM:ACL/PCL SCREW※限實施
十字韌帶重建手術患者使用
4234
FBS081322SAW FASTAK SUTURE ANCHOR 2.4MM縫合錨釘※限肩關節韌帶手術患者
使用
3268
FBS081370BAW BIO-INTERFERENCE SCREW※限實施十字韌帶重建手術患者使用 4234
FBS081370TAW CANNULATED INTERFERENCE SCREW ※限實施十字韌帶重手術使用 4113
FBS081915SAW SUTURE ANCHOR※限肩關節韌帶手術患者使用 3268
FBS082123NT1 MITEK ROTATOR CUFF ANCHOR ※限肩關節韌帶手術患者使用 3268
FBS082165NT1 SOFT TISSUE ANCHOR(G II SNAP-PAK MINI QUICK ANCHER)※限肩
關節韌帶手術患者使用
3268
FBS082545NT1 ABSOLUTE ABSORBABLE INTERFERENCE SCREW※限實施十字韌帶重
建手術患者使用
4234
FBS082870BKL MEGAFIX BIOABSORBABLE INTERFERENCE SCREW 可吸收性韌帶螺釘
※限用於十字韌帶重建手術者
4234
FBS082870TKL MEGAFIX-T INTERFERENCE SCREW ※限實施十字韌帶重手術使用 4113
FBS083512NLA LIGAMENT CANULATED SCREW※限十字韌帶重建手術使用 4113
874
特材代碼 中英文名稱 支付點數-104/01/01
FBS085015TLV "CONMED LINVATEC"MATRYX INTERFERENCE SCREW "康美靈威特"固
定螺釘(可吸收)※限十字韌帶重建手術使用
4234
FBS086101HLV "LINVATEC"REVO SOFT TISSUE ANCHOR"靈威特"軟組織固定錨釘※
限肩關節韌帶手術患者使用
3268
FBS086101NLV REVO SUTURE ANCHOR(CANCELLOUS SCREW)2.7,4MM (C6140,C6141
自91/10/01生效)※限肩關節韌帶手術患者使用
3268
FBS086140HLV "LINVATEC"SUPER REVO-FT SUTURE ANCHOR "靈威特"軟組織縫合
錨釘(肩關節)
3268
FBS08623MS2R "ORTHOMED"MISBIO BIOABSORBABLE INTERFERENCE SCREWS"奧圖
曼"可吸收介面骨釘※給付規定請見備註欄
4234
FBS08718HE2R "ORTHOMED"INTERFERENCE SCREWS"奧圖曼"介面螺釘※給付規定請
見備註欄
4113
FBS0872070SN SOFTSILK TM SCREW SYSTEM(型號含7207256:7207264)※限實施十
字韌帶重建手術使
4113
FBS0872075SN BIORCI SCREW SYSTEM RCI可吸收性介面固定螺絲※限十字韌帶重
建手術使用
4234
FBS087207NSN TITANIUM RCI SCREW 固定螺釘※限實施十字韌帶重建手術使用。 4113
FBS0872091SN TWINFIX SUTURE ANCHOR(TI)軟組織錨釘 ※限肩關節韌帶手術患
者使用
3268
FBS0872200SN TWINFIX SUTURE ANCHORS AND ACCESSORIES 3268
FBS088059NLV "LINVATEC"ENDOPEARL BIOABSORBABLE SOFT TISSUE FIXATION
DEVICE "靈威特"恩皮爾軟組織固定器
4100
FBS088320NLV LINVATEC CANNULATED INTEREFERENCE SCREW ※限實施十字韌帶
重建術患者使用
4113
FBS08ARWSFAW SUTURE ANCHOR W/FIBER WIRE 縫合錨釘含高鋼性縫線※限肩關節
韌帶手術患者使用
3918
FBS08C8000LV LINVATEC ABSORBABLE INTERFERENCE SCREW (型號C8030:39自
92/7/1生效)※限實施十字韌帶重建手術患者使用
4234
FBS08C8027LV LINVATEC BIOSCREW XTRALOK 9:11MMX35:40MM(加長型可吸收性固
定螺絲)※限用於十字韌帶重建手術者
4234
FBS08CPV10BC "BIOMATLANTE"OSTEOTWIN RESORBABLE COMPOSITE INTERFERENCE
SCREW"瑪蘭尼"使得挺吸收性複合式螺絲 7:10MM/25;30MM
4234
FBSCM1103NU0 CUSTOM MADE HUMERAL TUMOR PROSTHESIS ※申報費用時應檢附該
被保險人之發票備查
197000
FBSCM6487NH1 CASTOM MADE HUMERAL PROTHESIS※申報費用應檢附發票備查 197000
FBSF1000F21A "SPINEWAY" MONT BLANC SPINE SYSTEM (SX4+RX2)"施百威”脊椎
固定系統二節(免事前審查)
13816
FBSF1000F31A "SPINEWAY" MONT BLANC SPINE SYSTEM (SX6+RX2)"施百威”脊椎
固定系統三節(免事前審查)
20044
FBSF101640B0 TITANIUM LUMBAR SPINAL SYSTEM二節(PX2+SX4) 13816
FBSF101641B0 TITANIUM LUMBAR SPINAL SYSTEM三節(PX2+SX6) 20044
FBSF101642B0 TITANIUM LUMBAR SYSTEM二節(SX4+RX2)免事前審查 13816
FBSF101643B0 TITANIUM LUMBAR SYSTEM三節(SX6+RX2)免事前審查 20044
FBSF13800NS9 TITANIUM XIA SPINAL SCREW(免事審查) 3114
FBSF13802NS9 TITANIUM XIA SPINAL SYSTEM(二節SX4+RX2)(免事審查) 13816
FBSF13803NS9 TITANIUM XIA SPINAL SYSTEM(三節SX6+RX2)(免事審查) 20044
FBSF14994NS1 TITANIUM SPINAL SYSTEM 三節(SX6+RX2)免事前審查 20044
FBSF14995NS1 TITANIUM SPINAL SYSTEM 二節(SX4+RX2)免事前審查 13816
FBSF16201NS9 TITANIUM SPINAL IMPLANT (DIAPASON)(SX4+RX2)脊椎人工置換
組:二節(免事前審查)
13816
FBSF162200S9 TITANIUM ROD PLATE SPINE SYSTEM二節(RX2+SX4+BLOCKERX4) 13816
FBSF162300S9 TITANIUM ROD PLATE SPINE SYSTEM三節(RX2+SX6+BLOCKERX6) 20044
875
特材代碼 中英文名稱 支付點數-104/01/01
FBSF16301NS9 TITANIUM SPINAL IMPLANT (DIAPASON)(SX6+RX2)脊椎人工置換
組:三節(免事前審查)
20044
FBSF176902Y2 TITANIUM POSTERIOR SPINAL FIXATION SYSTEM二節(RX2+SX4)(原
產品型號769130:855+765905:930)
13816
FBSF176903Y2 TITANIUM POSTERIOR SPINAL FIXATION SYSTEM三節(RX2+SX6)(原
產品型號769130:855+765905:930)
20044
FBSF177002Y2 TITANIUM C TYPE SPINAL FIXATION SYSTEM二節 (RX2+SX4)(免術
前審查)
13816
FBSF177003Y2 TITANIUM C TYPE SPINAL FIXATION SYSTEM三節 (RX2+SX6)(免術
前審查)
20044
FBSF181NP2Y2 BRIDGE SPINAL FIXATION SYSTEM 二節(RX2+SX4) 免事前審查 13816
FBSF181NP3Y2 BRIDGE SPINAL FIXATION SYSTEM 三節(RX2+SX6) 免事前審查 20044
FBSF183NP2Y2 "SYNTEC" AREIKEN SPINAL FIXATION SYSTEM(RX2+SX4)"亞太醫
療"亞力健脊椎固定系統(二節)免事前審查
13816
FBSF183NP3Y2 "SYNTEC" AREIKEN SPINAL FIXATION SYSTEM(RX2+SX6)"亞太醫
療"亞力健脊椎固定系統(三節)免事前審查
20044
FBSF186001RK TITANIUM SPINAL SYSTEM (SX4 + RX2) 二節 免事前審查 13816
FBSF186002RK TITANIUM SPINAL SYSTEM (SX6+RX2) 三節 免事前審查 20044
FBSF1865N2M4 BASIS SPINAL SYSTEM TITANIUM二節 (SX4+RX2)(免事前審查) 13816
FBSF1865N3M4 BASIS SPINAL SYSTEM TITANIUM 三節(SX6+RX2)(免事前審查) 20044
FBSF188NP2Y2 "SYNTEC" COLISEUM SPINAL FIXATION SYSTEM "亞太醫療"高立捷
脊椎固定系統二節(RX2+SX4)
13816
FBSF188NP3Y2 "SYNTEC" COLISEUM SPINAL FIXATION SYSTEM "亞太醫療"高立捷
脊椎固定系統三節(RX2+SX6)
20044
FBSF1AS001AQ TITANIUM SPINAL OC-FIX SCREW SYSTEM二節(RX2+SX4)免術前審
查
13816
FBSF1AS002AQ TITANIUM SPINAL OC-FIX SCREW SYSTEM三節(RX2+SX6)免術前審
查
20044
FBSF1AS003AQ TITANIUM SPINAL FIXATION SYSTEM (SX4+RX2)二節 免事前審查 13816
FBSF1AS004AQ TITANIUM SPINAL FIXATION SYSTEM (SX6+RX2)三節 免事前審查 20044
FBSF1ASN01AQ TITANIUM SMARTLOC SPINAL SYSTEM(SX4+RX2)免事前審前 13816
FBSF1ASN02AQ TITANIUM SMARTLOC SPINAL SYSTEM(SX6+RX2)免事前審前 20044
FBSF1AYS2NXA Y TYPE POSTERIOR TITANIUM SPINAL SYSTEM二節(RX2+SX4)(免事
前審查)
13816
FBSF1AYS8NXA Y TYPE POSTERIOR TITANIUM SPINAL SYSTEM 三節(RX2+SX6)(免
事前審查)
20044
FBSF1CD2S2M4 TITANIUM CD SPINAL SYSTEM 二節(SX4+RX2)(免術前審查) 13816
FBSF1CD2S3M4 TITANIUM CD SPINAL SYSTEM 三節(SX6+RX2)(免術前審查) 20044
FBSF1LCLR2GZ SPINAL SYSTEM (RX2+SX4)脊椎系統二節 免事前審查 13816
FBSF1LCLR3GZ SPINAL SYSTEM (RX2+SX6)脊椎系統三節 免事前審查 20044
FBSF1M2SP2Z6 TITANIUM SPINAL SYSTEM二節(PX2+SX4或RX2+SX4) 13816
FBSF1M2SP3Z6 M2 SPINAL POSTERIOR SYSTEM 三節(ROD×2+SCREW×6或PLATE×
2+SCREW×6)M2脊椎後方固定系統 免事前審查
20044
FBSF1PCS01V2 "INTAI"SPINAL FIXATION SYSTEM(RX2+SX4)"鐿鈦"脊椎固定系統:
二節(免事前審查)
13816
FBSF1PCS01WG "WILTROM"SPINAL FIXATION SYSTEM(RX2+SX4)"威創"脊椎固定系
統二節(免事前審查)
13816
FBSF1PCS02V2 "INTAI"SPINAL FIXATION SYSTEM(RX2+SX6)"鐿鈦"脊椎固定系統:
三節(免事前審查)
20044
FBSF1PCS02WG "WILTROM"SPINAL FIXATION SYSTEM(RX2+SX6)"威創"脊椎固定系
統三節(免事前審查)
20044
FBSF1RF002RX RF SPINAL SYSTEM二節(SX4+RX2)(免事前審查) 13816
876
特材代碼 中英文名稱 支付點數-104/01/01
FBSF1RF003RX RF SPINAL SYSTEM三節(SX6+RX2)(免事前審查) 20044
FBSF1SX002AE TITANIUM SPINE SYSTEM EVOLUTION二節(SCREWX4+LODX2)(96年10
月1日起免事前審查)
13816
FBSF1SX003AE TITANIUM SPINE SYSTEM EVOLUTION三節(SCREWX6+LODX2)(96年10
月1日起免事前審查)
20044
FBSF1TS002JA TITANIUM SPINAL SYSTEM 二節(RX2+SX4)(免事前審查) 13816
FBSF1TS003JA TITANIUM SPINAL SYSTEM 三節(RX2+SX6)(免事前審查) 20044
FBSF2000F21A "SPINEWAY" MONT BLANC SPINE SYSTEM:ROD 40:64MM"施百威”脊
椎固定系統:固定桿(免事前審查)
679
FBSF21502NS1 TITANIUM UNIVERSAL SPINAL ROD 免事前審查 679
FBSF22040NS9 XIA TITANIUM SPINAL ROD 40:60MM(免事前審查) 679
FBSF265041S9 TITANIUM SPINAL IMPLANT (DIAPASON):ROD 40:60MM 脊椎人工
置換組:固定桿(免事審查)
679
FBSF277004Y2 TITANIUM SPINAL ROD 6X50:100MM 短節(免術前審查) 679
FBSF277104Y2 STAINLESS SPINAL ROD 4:10CM短節(免術前審查) 558
FBSF277111Y2 STAINLESS SPINAL ROD 11:30CM長節(免術前審查) 558
FBSF2820NSY2 TITANIUM SPINAL ROD 2:11CM 短節 免事前審查 679
FBSF2839NSY2 "SYNTEC" AREIKEN SPINAL FIXATION SYSTEM:ROD "亞太醫療"亞
力健脊椎固定系統:連結棒(短節)2~11CM,免事前審查
679
FBSF2860NSY2 ROD 連結棒-短節 679
FBSF286540M4 BASIS SPINAL TITANIUM ROD 51CM(免事前審查) 679
FBSF2911NSY2 "SYNTEC"COLISEUM SPINAL FIXATION SYSTEM:ROD 40:100MM"亞太
醫療"高立捷脊椎固定系統:連接桿(短節)免事前審查
679
FBSF2AS001AQ TITANIUM SPINAL ROD 5:10CM免術前審查 679
FBSF2ASNR1AQ TITANIUM SMARTLOC SPINAL ROD 40:100MM免事前審前 679
FBSF2B0001RK TITANIUM SPINAL ROD 40:100 MM(短節) 免事前審查 679
FBSF2LR001GZ SPINAL ROD 脊椎固定桿短節 免事前審查 679
FBSF2M2PLTZ6 M2 SPINAL POSTERIOR SYSTEM:PLATE M2脊椎後方固定系統:骨
板 免事前審查
679
FBSF2M2SRNZ6 TITANIUM SPINAL ROD 4.5:10.5CM 679
FBSF2PR040B0 TITANIUM SPINAL ROD 40MM:100MM免事前審查 679
FBSF2RD01TV2 "INTAI"SPINAL FIXATION SYSTEM:ROD 25:100MM"鐿鈦"脊椎固定
系統:連接桿(免事前審查)
679
FBSF2RD01TWG "WILTROM"SPINAL FIXATION SYSTEM:TITANIUM SPINAL ROD
50:100MM"威創"脊椎固定系統:連接桿50:100MM(免事前審查)
679
FBSF2RF00SRX RF SPINAL ROD 40:100MM(免事前審查) 679
FBSF2RY63NXA Y TYPE POSTERIOR TITANIUM SPINAL ROD 5:10CM(免事前審查) 679
FBSF2TS01TJA TITANIUM SPINAL ROD 30:100MM(免事前審查) 679
FBSF36132NY2 TITANIUM CERVICAL CLAMP(配合FBSF46132NY2使用) 4110
FBSF4000F41A "SPINEWAY" MONT BLANC SPINE SYSTEM:SCREW "施百威”脊椎固
定系統:固定釘(免事前審查)
3114
FBSF44002TWG "WILTROM"SPINAL FIXATION SYSTEM:PEDICLE SCREW U TYPE"威
創"脊椎固定系統:脊椎骨釘U型(免事前審查)
3114
FBSF44004TWG "WILTROM"SPINAL FIXATION SYSTEM:PEDICLE SCREW REDUCTION U
TYPE"威創"脊椎固定系統:脊椎骨釘U型折斷(免事前審查)
3114
FBSF44006TV2 "INTAI"SPINAL FIXATION SYSTEM:PEDICLE SCREW POLY AXIAL U
TYPE"鐿鈦"脊椎固定系統:脊椎骨釘-U型多軸向(免事前審查)
3114
FBSF44006TWG "WILTROM"SPINAL FIXATION SYSTEM:PEDICLE SCREW AXIAL U
TYPE"威創"脊椎固定系統:脊椎骨釘U型多軸向(免事前審查)
3114
FBSF44007TWG "WILTROM"SPINAL FIXATION SYSTEM:PEDICLE SCREW POLY-AXIAL
REDUCTION U TYPE"威創"脊椎固定系統:脊椎骨釘U型多軸向折斷
(免事前審查)
3114
FBSF44995NS1 TITANIUM CLICK'X PEDICLE SCREW (免事前審查) 3114
FBSF455030B0 TITANIUM SPINAL SCREW(免事前審查) 3114
877
特材代碼 中英文名稱 支付點數-104/01/01
FBSF464001S9 TITANIUM SPINAL (DIAPASON)SCREW脊椎人工置換組:骨釘(免事
前審查)
3114
FBSF4769NNY2 TITANIUM SPINAL PEDICLE SCREW 4.5:8,30:55MM 3114
FBSF4770NNY2 TITANIUM SPINAL PEDICLE SCREW(免術前審查) 3114
FBSF477253Y2 TITANIUM SPINAL OSTEOPOROTIC SCREW(免術前審查) 3114
FBSF4780NNY2 ARTEST SPINAL FIXATION SYSTEM:TITANIUM SPINAL PEDICLE
SCREW(免事前審查)
3114
FBSF4781NNY2 ARTEST SPINAL FIXATION SYSTEM:TITANIUM SPINAL POLYAXIAL
PEDICLE SCREW(免事前審查)
3114
FBSF4782NNY2 PEDICLE SCREW(免事前審查) 3114
FBSF4790NNY2 ARTEST SPINAL FIXATION SYSTEM:TITANIUM SPINAL CANNULATED
PEDICLE SCREW(免事前審查)
3114
FBSF4791NNY2 ARTEST SPINAL FIXATION SYSTEM:TITANIUM SPINAL CANNULATED
POLYAXIAL PEDICLE SCREW(免事前審查)
3114
FBSF4816NNY2 REDUCTION PEDICLE SCREW 免事前審查 3114
FBSF4818NNY2 POLYAXIAL PEDICLE SCREW 免事前審查 3114
FBSF4832NNY2 "SYNTEC" AREIKEN SPINAL FIXATION SYSTEM:MONOAXIAL SCREW"
亞太醫療"亞力健脊椎固定系統單軸骨釘,免事前審查
3114
FBSF4865MNM4 BASIS SPINAL TITANIUM SCREW(免事前審查) 3114
FBSF4886NNY2 MONOAXIAL SCREW 單軸骨釘 3114
FBSF4895NNY2 MONOAXIAL SCREW 單軸骨釘 3114
FBSF4AS001AQ TITANIUM SPINAL SCREW免術前審查 3114
FBSF4AS002AQ TITANIUM SPINAL FIXATION SYSTEM:SCREW 免事前審查 3114
FBSF4ASNS1AQ TITANIUM SMARTLOC SPINAL SCREW免事前審查 3114
FBSF4B0001RK TITANIUM SPINAL SCREW免事前審查 3114
FBSF4B0009RK "REBORN ESSENCE"LUMBAR FIXATION SYSTEM:MULTI SCREW"瑞寶
億"腰椎內固定系統:萬向螺釘(免事前審查)
3114
FBSF4LC004GZ "際仁"脊椎固定系統:固定釘(免事前審查)GEZEN SPINAL
FIXATION:SPINAL SCREW
3114
FBSF4M2PCNZ6 M2 SPINAL POSTERIOR SYSTEM:SCREW M2脊椎後方固定系統:骨
釘 免事前審查
3114
FBSF4M2PWNZ6 TITANIUM SPINAL SCREW 3114
FBSF4RF001RX RF SPINAL SCREW(免事前審查) 3114
FBSF4S8655M4 TITANIUM CD TULIP SCREW(免術前審查) 3114
FBSF4S9603M4 TITANIUM CD REDUCTION SCREW(免術前審查) 3114
FBSF4SX07NAE TITANIUM SPINE SCREW (96年10月1日起免事前審查) 3114
FBSF4TS01TJA TITANIUM SPINAL PEDICLE SCREW(免事前審查) 3114
FBSF4YP04NXA Y TYPE POSTERIOR TITANIUM SPINAL PEDICLE SCREW(免事前審
查)
3114
FBSFA000011A "SPINEWAY" TWIN PEAKS LUMBAR CAGES "施百威”腰椎椎間融合
器(後開型)※適應症請見備註欄
21971
FBSFA00001RK TITANIUM INTERVERTEBRAL CAGE 椎間融合器※適應症請見備註欄 13116
FBSFA00002RK TITANIUM INTERVERTEBRAL CAGE 椎間融合器※適應症請見備註欄 13116
FBSFA00003RK PEEK LUMBAR INTERVERTEBRAL CAGE 高分子材料腰椎椎間融合器
(後開型)※適應症請見備註欄
21971
FBSFA0001NS1 TRAVIOS IMPLANTS PEEK TLIF"信迪思"腰椎椎間支架(側開型每節
椎體限置放1個)※給付規定請見備註欄
43943
FBSFA01718DP "帝富脊椎"椎體置換系統:碳纖複合(每節限置放1個)※給付規定
請見備註欄"DEPUY SPINE"VBR SPINAL SYSTEM (TLIF)
45000
FBSFA0LY011S OLYS TRANSFORMINAL CAGE PEEK(側開型每節椎體限置放1個)※適
應症請見備註欄
43943
878
特材代碼 中英文名稱 支付點數-104/01/01
FBSFA1000NZ1 ZIMMER SPINE FIDJI LUMBAR CAGES( PLIF PEEK) "捷邁"斐濟腰
椎椎間融合器 ※適應症請見備註欄
21971
FBSFA10410DP "帝富脊椎"頸椎護架:碳纖複合※給付規定請見備註欄"DEPUY
SPINE"CERVICAL I/F CAGE
22500
FBSFA173NNDP "帝富脊椎"I/F 腰椎椎間骨融合器:碳纖複合※給付規定請見備註
欄"DEPUY SPINE"LUMBAR I/F CAGE(PLIF)
22500
FBSFA21001XP I-TYPE INTERVERTEBRAL SPACER PEEK CAGE 馬蹄式椎間填充塊
(頸椎)※適應症請見備註欄
21971
FBSFA22001XP II-TYPE INTERVERTEBRAL SPACER PEEK CAGE 錐頭式椎間填充塊
(後開型)※適應症請見備註欄
21971
FBSFA22002XP "寶楠"錐頭式椎間填充塊(聚醚醚酮)(側開型每節椎體限置放1
個)"PAONAN"II-TYPE INTERVERTEBRAL SPACER(PEEK)
43943
FBSFA2740LB0 TITANIUM LUMBAR SPINAL CAGE 腰椎椎間融合器 ※適應症請見備
註欄
13116
FBSFA29906M4 CAPSTONE SPINAL SYSTEM:TLIF PEEK SPACER(側開型每節椎體限
置放1個)※適應症請見備註欄
43943
FBSFA3000NS1 SYNCAGE IMPLANTS 辛凱吉椎間支架植入物(SYNCAGE-C TITANIUM
CERVICAL)※適應症請見備註欄
12110
FBSFA3605LU0 "UNITED"EXPRESS LUMBAR CAGE SYSTEM(PLIF PEEK)"聯合"快捷腰
椎融合器系統(後開型)※適應症請見備註欄
21971
FBSFA420MNM4 TELAMON FUSION DEVICE PEEK CAGE 泰拉蒙融合器(後開型)※適
應症請見備註欄
21971
FBSFA6000NDP "帝富脊椎"I/F 腰椎椎間骨融合器:碳纖複合※給付規定請見備註
欄"DEPUY SPINE"LUMBAR I/F CAGE(PLIF)
22500
FBSFA6284NM4 "美敦力"科能脊椎系統裝置(頸椎)※給付規定請見備註
欄"MEDTRONIC"CORNERSTONE PSR CERVICAL FUSION SYSTEM
CERVICAL INTERBODY FUSION DEVICE(PEEK)
21971
FBSFA6730NS9 OIC CAGE SYSTEM-PEEK IMPLANTS 椎體護架系統(後開型)※適應
症請見備註欄
21971
FBSFA6731NS9 "STRYKER" OGIVAL INTERBODY CAGE(TLIF) "史賽克" 腰椎間融合
器(側開型每個椎體限置放1個)※適應症請見備註欄
43943
FBSFA6741NS9 SOLIS CERVICAL CAGE SYSTEM 梭利斯椎頸護架系統(頸椎PEEK
CAGE)※適應症請見備註欄
21971
FBSFA6742NS9 "STRYKER" SOLIS AS PEEK SPACER "史賽克"椎間融合器(頸椎)※
適應症請見備註欄
21971
FBSFA6760NS9 OIC PL PEEK SPACER 椎間融合器(後開型)※適應症請見備註欄 21971
FBSFA706NNY2 TITANIUM VETEBRAL INTERBODY CAGE 高9:14MM長20:24※適應症
請見備註欄
13116
FBSFA7074NY2 TITANIUM VETEBRAE INTERBODY CAGE:ANTERIOR CERVICAL
INTERBODY CAGE 鈦合金椎籠:前方頸椎間融合器※適應症請見備
註欄
12110
FBSFA7091NY2 TITANIUM VETEBRAE INTERBODY CAGE 9:14MMX20:24MM※適應症請
見備註欄
13116
FBSFA7092NY2 TITANIUM VETEBRAE INTERBODY CAGE 9:14MMX20:24MM※適應症請
見備註欄
13116
FBSFA82501Y2 "SYNTEC"PEEK VERTEBRAE INTERBODY CAGE"亞太醫療"春菊聚醚醚
酮椎籠(腰椎後開型)※適應症請見備註欄
21971
FBSFA82526Y2 "SYNTEC"BARNANA PEEK TLIF VERTEBRA INTERBODY CAGE"亞太醫
療"巴拿馬腰椎椎間融合器(側開型每節椎體限置放1個)※適應症
請見備註欄
43943
FBSFA8380NS9 AVS TL PEEK SPACER SYSTEM(側開型每節椎體限置放1個)※適應
症請見備註欄
43943
FBSFA8984NS1 PLIVIOS IMPLANTS PEEK CAGE 腰椎椎間融合器(後開型)※適應症
請見備註欄
21971
879
特材代碼 中英文名稱 支付點數-104/01/01
FBSFA8992NS1 CERVIOS IMPLANTS WEDGE-SHAPED PEEK CAGE 頸椎椎間融合器※
適應症請見備註欄
21971
FBSFA8993NS1 CERVIOS IMPLANTS CURVED PEEK CAGE 頸椎椎間融合器※適應症
請見備註欄
21971
FBSFA908MNM4 TELAMON FUSION DEVICE※適應症請見備註欄 13116
FBSFA939MNM4 "MEDTRONIC"CRESCENT SPINAL SYSTEM:SPACER(PEEK)"美敦力"克
里森脊椎系統:椎體護架(側開型每個椎體限置放1個)※適應症請
見備註欄
43943
FBSFA9501NS1 TITANIUM CONTACT FUSION CAGE 9:15MM X8:11MM※適應症請見備
註欄
13116
FBSFAALS01AQ TITANIUM LUMBAR DISC SPACER ※適應症請見備註欄 13116
FBSFAALS01TT TITANIUM LUMBAR DISC SPACER※適應症請見備註欄 13116
FBSFAALS02AQ TITANIUM VIGOR CERVICAL DISC SPACER ※適應症請見備註欄 12110
FBSFAAP002AQ "A-SPINE"POLYMER LUMBAR DISC SPACER(PEEK)"冠亞"高分子複合
材料腰椎椎間融合器(後開型)*適應症請見備註欄
21971
FBSFAAP003AQ "A-SPINE"VIGOR PEEK CERVICAL DISC SPACER"冠亞"偉戈高分子
複合材料頸椎椎間融合器*適應症請見備註欄
21971
FBSFAAR004AQ X'PLO POLYMER LUMBAR CAGE (PEEK TLIF)"艾斯普"高分子複合材
料腰椎融合器(側開型,每節椎體限置放1個)※適應症請見備註欄
43943
FBSFAC000NZ1 "ZIMMER SPINE"FIDJI CERVICAL CAGES (PEEK)"捷邁"頸椎椎間融
合器 ※給付規定請見備註欄
21971
FBSFAC001NZ1 "ZIMMER SPINAL"FIDJI CERVICAL CAGES(PEEK)"捷邁"頸椎椎間融
合器※適應症請見備註欄
21971
FBSFAC0CCK1S SCIENT X LUMBAR CAGE(PEEK) 賽恩司腰椎融合器(後開型) ※適
應症請見備註欄
21971
FBSFAC2331DP "帝富脊椎"康赫脊椎護架系統:碳纖複合(每節限置放1個)※給付
規定請見備註欄"DEPUY SPINE"CONCORDE BULLET SPINAL SYSTEM
CARBON FIBER COMPOSITE(TLIF)
45000
FBSFACA11NXA TITANIUM VERTEBRAL FUSION CAGE 20:24MMX8:15MM※適應症請見
備註欄
13116
FBSFACC11NXA PEEK LUMBAR INTERBODY SPACER(側開型每節椎體限置放1個)※適
應症請見備註欄
43943
FBSFACCAGE1A "SPINEWAY" AYERS ROCK CERVICAL CAGES"(PEEK) 施百威"頸椎融
合器 ※適應症請見備註欄
21971
FBSFACD11NXA PEEK LUMBAR CAGE 聚醚醚酮腰椎椎間融合器(後開型)※適應症請
見備註欄
21971
FBSFACE11NXA CERVICAL CAGE 頸椎椎間融合器(頸椎PEEK CAGE)※適應症請見備
註欄
21971
FBSFACG11NXA TITANIUM CERVICAL CAGE 鈦合金頸椎椎間融合器※適應症請見備
註欄
12110
FBSFACG15NZ6 TITANIUM SPINAL SPACER 5:11MMX7:13MM※適應症請見備註欄 13116
FBSFACH11NXA TITANIUM CERVICAL CAGE 鈦合金頸椎椎間融合器※適應症請見備
註欄
12110
FBSFACR11NXA "全合"聚醚醚酮椎間支架系統:椎間支架(側開型每節椎體限置放1
個)“Aaxter”PEEK Lumbar Spacer System:PEEK Cage TLIF
43943
FBSFAF0001RK PEEK LUMBAR INTERVERTEBRAL CAGE 高分子材料腰椎椎間融合器
(側開型,每節椎體置放1個)※適應症請見備註欄
43943
FBSFAF0002RK REBORN ESSENCE PEEK LUMBAR INTERVERTEBRAL CAGE 瑞寶億高分
子材料腰椎椎間融合器(後開型) ※適應症請見備註欄
21971
FBSFAF0003RK REBORN ESSENCE PEEK CERVICAL INTERVERTEBRAL CAGE瑞寶億高
分子材料頸椎椎間融合器※適應症請見備註欄
21971
880
特材代碼 中英文名稱 支付點數-104/01/01
FBSFAFJ00CAE AESCULAP CESPACE PEEK CERVICAL FUSION SPACER 雅氏樹脂頸
椎融合植入物※適應症請見備註欄
21971
FBSFAFJ00NAE "AESCULAP"TSPACE PEEK TLIF SYSTEM "雅氏"樹脂椎間盤支撐架
植入物(側開型,每節椎體置放1個)※適應症請見備註欄
43943
FBSFAGCP012G 群力頸椎椎間融合器※給付規定請見備註欄"GIB"CERVICAL
SPINAL CAGE(PEEK)
21971
FBSFAJUL0L1C "SPINEART"JULIET OL LUMBAR CAGE(PEEK)"司佰特"茱麗葉腰椎融
合器(側開型每節椎體限置放1個)
43943
FBSFAJULPL1C SPINEART JULIET LUMBAR CAGE(PLIF)"司佰特"腰椎融合器※適應
症請見備註欄
21971
FBSFAJULTL1C SPINEART JULIET LUMBAR CAGE(TLIF)"司佰特"腰椎融合器(側開
型,每節椎體置放1個)※適應症請見備註欄
43943
FBSFAN0VSDL2 "ALPHATEC"NOVEL SPINAL SPACER SYSTEM-PEEK TLIF"佳鴻"諾歐
椎間融合器(側開型每節椎體限置放1個)
43943
FBSFAN0VTLL2 "ALPHATEC"NOVEL TL SPINAL SPACER SYSTEM-PEEK TLIF"佳鴻"諾
歐椎間融合器(側開型每節椎體限置放1個)
43943
FBSFAPCCNNJZ JO PEEK CERVICAL CAGE 傑奎高分子頸椎椎間融合器※適應症請
見備註欄
21971
FBSFAPCG01V2 "INTAI"INTERBODY FUSION SYSTEM(CERVICAL PEEK CAGE)"鐿鈦"
高分子複合椎間融合器(頸椎椎籠)※適應症請見備註欄
21971
FBSFAPCG01WG "WILTROM"INTERBODY FUSION SYSTEM:CERVICAL PEEK CAGE"威創"
高分子複合椎間融合器系統:頸椎椎籠※適應症請見備註欄
21971
FBSFAPLC30JZ "JO"PEEK LUMBAR CAGE(TLIF)"傑奎"高分子腰椎椎間融合器(側開
型每節椎體限置放1個)※給付規定請見備註欄
43943
FBSFAPLCNNJZ "JO"PEEK LUMBAR CAGE "傑奎"高分子腰椎椎間融合器(後開型)※
適應症請見備註欄
21971
FBSFAPPG01WG "WILTROM"INTERBODY FUSION SYSTEM:PLIF PEEK CAGE"威創"高分
子複合椎間融合器系統:胸腰椎椎籠※適應症請見備註欄
21971
FBSFAPR001AQ RAINBOO PEEK LUMBAR CAGE(側開型每節椎體限置放1個)※適應症
請見備註欄
43943
FBSFAPTG01WG "WILTROM"INTERBODY FUSION SYSTEM:TLIF PEEK CAGE"威創"高分
子複合椎間融合器系統(側開型腰椎椎籠,每節椎體限置放1個)※
給付規定請見備註欄
43943
FBSFARD1SNZ1 "ZIMMER"SPINE ARDIS INTERBODY SYSTEM(PEEK)"捷邁"亞帝斯脊
椎椎間穩定系統(側開型每節椎體限置放1個)※給付規定請見備註
欄
43943
FBSFASAMRY1S "SCIENT'X"ANTERIOR CAGE SAMARYS(PEEK) "賽恩司"莎美莉前路
頸椎融合器 ※適應症請見備註欄
21971
FBSFASJ00NAE AESCULAP PROSPACE PEEK POSTERIOR LUMBAR AND THORACIC
SPINE FUSION SYSTEM 雅氏後方樹脂胸腰椎融合植入物※適應症
請見備註欄
21971
FBSFASN00PAE "AESCULAP"PROSPACE PEEK"雅氏"博斯貝椎融間融合植入物※給付
規定請見備註欄
21971
FBSFATPG00V2 "INTAI"INTERBODY FUSION SYSTEM(TLIF PEEK)"鐿鈦"高分子複合
椎間融合系統(側開型每節椎體置放1個)※適應症請見備註欄
43943
FBSFATPG04V2 "INTAI"INTERBODY FUSION SYSTEM(TLIF PEEK)"鐿鈦"高分子複合
椎間融合系統(側開型每節椎體置放1個)※適應症請見備註欄
43943
FBSFATPG08V2 "INTAI"INTERBODY FUSION SYSTEM(TLIF PEEK)"鐿鈦"高分子複合
椎間融合系統(側開型每節椎體置放1個)※適應症請見備註欄
43943
FBSFATRYKC1C SPINEART CERVICAL IMPLANTS(PEEK) 司佰特頸椎椎間植入物 ※
適應症請見備註欄
21971
FBSFAWS141B0 LUMBAR SPINAL PEEK CAGE(側開型每節椎體限置放1個)※適應症
請見備註欄
43943
FBSFAWS16CB0 CERVICAL CAGE(PEEK)頸椎椎間融合器※適應症請見備註欄 21971
881
特材代碼 中英文名稱 支付點數-104/01/01
FBSFAWS41LB0 LUMBAR SPINAL CAGE PEEK CAGE 腰椎椎間融合器(後開型)※適應
症請見備註欄
21971
FBSFR6411LS1 "SYNTHES"VEPTR II RIB TO LUMBAR LAMINA"信迪思"第二代延展
式肋骨支撐架:肋骨至板狀腰椎組合
326712
FBSFR6412LS1 "SYNTHES"VEPTR II:RIB TO ILIUM"信迪思"第二代延展式肋骨支
撐架:肋骨至髂骨組合
300221
FBSFR6413LS1 "SYNTHES"VEPTR II:RIB TO RIB"信迪思"第二代延展式肋骨支撐
架:肋骨至肋骨組合
290247
FBSFR9701LS1 "SYNTHES"VEPTR RIB TO LUMBAR
LAMINA(CRS*1+L*3+EB*1+ER*1+H*1+FR*1)"信迪思"延展式肋骨支
撐架:肋骨至板狀腰椎組合※適應症請見備註欄
326712
FBSFR9702LS1 "SYNTHES"VEPTR:RIB TO
ILIUM(CRS*1+CHR*1+DL*3+EB*1+LER*1+AH*1+EC*1+FR*1)"信迪思"
延展式肋骨支撐架:肋骨至髂骨組合※適應症請見備註欄
300221
FBSFR9703LS1 "SYNTHES"VEPTR:RIB TO
RIB(CRS*1+CRS*1+CHR*2+DL*4+EB*1+FR*1)"信迪思"延展式肋骨支
撐架:肋骨至肋骨組合※適應症請見備註欄
290247
FBSFR9704LS1 "SYNTHES"VEPTR:DISTRACTION LOCKS"信迪思"延展式肋骨支撐架:
延展用鎖※適應症請見備註欄(整組使用者不得申報,只適用於組
件單獨使用者申報)
6584
FBSFR97057S1 "SYNTHES"VEPTR:CRANIAL RIB SUPPORT "信迪思"延展式助骨支撐
架(頭位肋骨支架)※適應症請見備註欄(整組使用者不得申報,只
適用於組件單獨使用者申報)
63303
FBSFR97065S1 "SYNTHES"VEPTR:CAUDAL RIB SUPPORT"信迪思"延展式助骨支撐
架:尾位直式肋骨支架※適應症請見備註欄(整組使用者不得申報
,只適用於組件單獨使用者申報)
84148
FBSFR97103S1 "SYNTHES"VEPTR:EXTENSION BAR"信迪思"延展橫槓※適應症請見
備註欄(整組使用者不得申報,只適用於組件單獨使用者申報)
71155
FBSFR97126S1 "SYNTHES"VEPTR:CLOSING HALF-RING FOR RIB SUPPORT"信迪思"
閉鎖半圓環※適應症請見備註欄(整組使用者不得申報,只適用於
組件單獨使用者申報)
19989
FBSFR97127S1 "SYNTHES"VEPTR:ROD"信迪思"橫槓※適應症請見備註欄(整組使用
者不得申報,只適用於組件單獨使用者申報)
14161
FBSFR97131S1 "SYNTHES"VEPTR:LUMBAR EXTENSION ROD"信迪思"板狀腰椎延展橫
槓※適應症請見備註欄(整組使用者不得申報,只適用於組件單獨
使用者申報)
80838
FBSFR97167S1 "SYNTHES"VEPTR:EXTENSION CONNECTOR"信迪思"延展連接器※適
應症請見備註欄(整組使用者不得申報,只適用於組件單獨使用者
申報)
14824
FBSFR97257S1 "SYNTHES"VEPTR:ALA HOOK "信迪思"薦骨翼鉤※適應症請見備註
欄(整組使用者不得申報,只適用於組件單獨使用者申報)
25033
FBSFR97261S1 "SYNTHES"VEPTR:LAMINIA HOOK "信迪思"板狀椎弓鉤※適應症請
見備註欄(整組使用者不得申報,只適用於組件單獨使用者申報)
66348
FBSFR98910S1 "SYNTHES"VEPTR:FIXATION RING FOR RODS"信迪思"橫槓固定環※
適應症請見備註欄(整組使用者不得申報,只適用於組件單獨使用
者申報)
5327
FBTCM1102NU0 CUSTOMER MADE TIBIAL TUMOR PROSTHESIS ※適應症請見備註欄
,申報費用應檢附發票備查
160000
FBTCM6495NH1 "HOWMEDICA" GLOBAL MODULAR REPLACEMENT SYSTEM(PROXIMAL
TIBIA)"好美得卡"整體人工替換物組合系統※適應症請見備註欄
,申報費用應檢附發票備查
160000
FBW0106321M1 KIRSCHNER WIRE (K-PIN) 1.0:1.2MM 300MM 72
882
特材代碼 中英文名稱 支付點數-104/01/01
FBW0106324M1 KIRSCHNER WIRE (K-PIN) 1.5:1.8MM 300MM 72
FBW0106325M1 KIRSCHNER WIRE (K-PIN) 2.0MM 300MM 72
FBW0106326M1 KIRSCHNER WIRE (K-PIN) 2.4MM 300MM 72
FBW0106327M1 KIRSCHNER WIRE (K-PIN) 3.0MM 300MM 72
FBW011610NSN K-WIRE 0.6:1.6MM,2.0MM 72
FBW012900NY2 KIRSCHNER WIRES(SHANK)0.7MM,0.9MM,1.1MM,1.6MM
*4"(101.6MM)
72
FBW0129101Y2 KIRSCHNER WIRE 72
FBW012910NY2 KIRSCHNER WIRES(SHANK)0.7MM,0.9MM,1.1MM,1.6MM *9"(230MM) 72
FBW012911NY2 KIRSCHNER WIRES(SHANK)0.7MM,0.9MM,1.1MM,1.6MM *12"(300MM) 72
FBW012915NY2 KIRSCHNER WIRES(THREADED)0.9MM,1.1MM,1.6MM *9"(230MM) 255
FBW012926NY2 KIRSCHNER WIRE W/THREADED 255
FBW012927NS1 K-PIN,GUIDEWIRE WITH THREAD 255
FBW01292NNS1 KIRSCHNER WIRE (K-PIN)0.6:3.0MM 72
FBW01294XNY2 KIRSCHNER WIRE WITH THREADED TIP 255
FBW01LX08NAE K-WIRE 0.8MM ,1.0MMX310MM 72
FBW01LX08SAE KIRSCHNER WIRE (K-PIN)0.8MMx150MM 72
FBW01LX105AE K-WIRE 2.5MMx70MM 72
FBW01LX10SAE KIRSCHNER WIRE (K-PIN)1.0MMx150MM 72
FBW01LX12NAE K-WIRE 310MM,1.2:1.7MM 72
FBW01LX12SAE KIRSCHNER WIRE (K-PIN)1.2MMx150MM 72
FBW01LX14SAE KIRSCHNER WIRE (K-PIN)1.4MMx150MM 72
FBW01LX15SAE KIRSCHNER WIRE (K-PIN)1.5MMx150MM 72
FBW01LX16SAE KIRSCHNER WIRE (K-PIN)1.6MMx150MM 72
FBW01LX17SAE K-WIRE 150MM 1.7MM 72
FBW01LX18NAE K-WIRE 310MM,1.8MM 72
FBW01LX18SAE KIRSCHNER WIRE (K-PIN)1.8MMx150MM 72
FBW01LX20NAE K-WIRE 310MM,2.0MM 72
FBW01LX20SAE KIRSCHNER WIRE (K-PIN)2.0MMx150MM 72
FBW01LX22NAE K-WIRE 310MM,2.2MM 72
FBW01LX22SAE KIRSCHNER WIRE (K-PIN)2.2MMx150MM 72
FBW01LX25NAE K-WIRE 310MM,2.5MM 72
FBW01LX25SAE KIRSCHNER WIRE (K-PIN)2.5MMx150MM 72
FBW01LX28SAE KIRSCHNER WIRE (K-PIN)0.8MMx150MM 72
FBW01LX30NAE K-WIRE 210MM,1.0MM(102.01.01更改為1.0X310MM) 72
FBW01LX30SAE KIRSCHNER WIRE (K-PIN)1.0MMx150MM 72
FBW01LX32NAE K-WIRE 310MM,1.2:1.6MM 72
FBW01LX32SAE KIRSCHNER WIRE (K-PIN)1.2MMx150MM 72
FBW01LX34SAE KIRSCHNER WIRE (K-PIN)1.4MMx150MM 72
FBW01LX35SAE KIRSCHNER WIRE (K-PIN)1.5MMx150MM 72
FBW01LX36SAE KIRSCHNER WIRE (K-PIN)1.6MMx150MM 72
FBW01LX37SAE KIRSCHNER WIRE 1.7MMx150MM 72
FBW01LX38NAE K-WIRE 310MM,1.8MM 72
FBW01LX38SAE KIRSCHNER WIRE (K-PIN)1.8MMx150MM 72
FBW01LX40NAE K-WIRE 310MM,2.0MM 72
FBW01LX40SAE KIRSCHNER WIRE (K-PIN)2.0MMx150MM 72
FBW01LX42NAE K-WIRE 310MM,2.2MM 72
FBW01LX42SAE KIRSCHNER WIRE (K-PIN)2.2MMx150MM 72
FBW01LX45NAE K-WIRE 310MM,2.5MM 72
FBW01LX45SAE KIRSCHNER WIRE (K-PIN)2.5MMx150MM 72
FBW01LX46SAE KIRSCHNER WIRE (K-PIN)3.0MMx150MM 72
FBW01LX47SAE KIRSCHNER WIRE 雅式鋼針 72
883
特材代碼 中英文名稱 支付點數-104/01/01
FBW01LX90NAE KIRSCHNER WIRE 雅式鋼針 72
FBW01LX915AE KIRSCHNER WIRE 雅式鋼針 72
FBW01LX91NAE KIRSCHNER WIRE 雅式鋼針 72
FBW01LX925AE KIRSCHNER WIRE 雅式鋼針 72
FBW01LX92NAE KIRSCHNER WIRE 雅式鋼針 72
FBW01LX955AE KIRSCHNER WIRE 雅式鋼針 72
FBW01LX95NAE KIRSCHNER WIRE 雅式鋼針 72
FBW01LX98SAE K-WIRE 0.8MM,1.0MMX70MM 72
FBW03C018NM1 KIRSCHNER WIRE(田島 PIN) 0.7:1.5MM 100:120MM 72
FEP0256234XT WIRE PISTON 2811
FEP0256235XT WIRE PISTON 2811
FEP0356324XT FISCH TEF-WIRE PISTON 1365
FEP0456210XT MCGEE MODIFIED LOOP PISTON 1250
FEP0456211XT MCGEE MODIFIED LOOP PISTON 1250
FEP0456212XT MCGEE MODIFIED LOOP PISTON 1250
FES0256362XT AUSTIN MODIFIED PARTIAL OSSICULAR REPLACEMENT 3500
FES0256363XT AUSTIN MODIFIED PARTIAL OSSICULAR REPLACEMENT 3500
FES0270141GS MICRON ALL TITANIUM PORP 全鈦部分人工聽小骨置換物 3500
FHFCD01701GU "佳騰"康達克艾維塔心臟再同步治療用去顫器"GUIDANT" CONTAK
RENEWALL 4 AVT CARDIAC RESYNCHRONIZATION THERAPY
DEFIBRILLATOR *適應症請見備註欄
500106
FHFCD07298M4 "美敦力"因信可植入式去纖維顫動器*適應症請見備註欄 500106
FHFCD32374ST "聖猷達"波默克卓植入式心律去顫器”SJM”PROMOTE QUADRA
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*使用規定請見備註欄
609212
FHFCD32454ST “聖猷達”優你法克卓植入式心律去顫器“SJM”UNIFY QUADRA
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*給付規定請見備註欄
609212
FHFCD354TMM4 "MEDTRONIC"PROTECTA XT CRT-D IMPLANTABLE CARDIOVERTER
DEFIBRILLATOR"美敦力"博特多艾緹植入式心臟去顫器*適應症請
見備註欄
591468
FHFCDAHF37ST "聖猷達"波默植入式心律去顫器"SJM"PROMOTE IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR(CRT-D) *適應症請見備註欄
500106
FHFCDC174AM4 "美敦力"康妥植入式心臟去顫器CONCERTO IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR*適應症請見備註欄
565882
FHFCDCD321ST "聖猷達" 波默艾塞爾植入式心律去顫器"SJM" PROMOTE ACCEL
CRT-D CARDIOVERTER/DEFIBRILLATOR*適應症請見備註欄
565882
FHFCDCD323ST "聖猷達" 植入式心律去顫器"SJM" UNIFY IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR(CRT-D)*適應症請見備註欄
565882
FHFCDCD40QST "聖猷達" 植入式心律去顫器"SJM" UNIFY IMPLANTABLE
CARDIOVERTER/DEFIBRILLATOR(CRT-D)*適應症請見備註欄
565882
FHFCDCDPLSST “聖猷達”波默普拉斯植入式心律去顫器“SJM”PROMOTE+
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR(CRT)*使用規定請見
備註欄
500106
FHFCDCRT19GU "佳騰"康達克心臟再同步治療用去顫器"GUIDANT"CONTAK RENEWAL
4&4 HE CARDIAC RESYNCHRONIZATION THERAPY*適應症請見備註欄
500106
FHFCDD214MM4 "美敦力"康賽特植入式心臟去顫器“MEDTRONIC”CONSULTA CRT-D
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR *適應症請見備註欄
565882
FHFCDD234TM4 "美敦力"康賽特植入式心臟去顫器“MEDTRONIC”CONSULTA CRT-D
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR *適應症請見備註欄
565882
884
特材代碼 中英文名稱 支付點數-104/01/01
FHFCDD284TM4 "美敦力"麥思蒙植入式心臟去顫器"MEDTRONIC" MAXIMO II CRT-D
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請見備註欄
500106
FHFCDD354TM4 "美敦力"博特多艾緹植入式心臟去顫器"MEDTRONIC" PROTECTA XT
CRT-D IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請見備
註欄
591468
FHFCDD364TM4 "美敦力"博特多植入式心臟去顫器"MEDTRONIC" PROTECTA CRT-D
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請見備註欄
500106
FHFCDDRF32ST "聖猷達" 波默植入式心律去顫器 "SJM" PROMOTE IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR(CRT-D)*適應症請見備註欄
500106
FHFCDP1068SB "波士頓科技" 康格斯心臟再同步治療用去顫器"BOSTON
SCIENTIFIC" COGNIS 100 HE CRT-D*適應症請見備註欄
500106
FHFCDQ3267ST “聖猷達”克卓亞速拉植入式心律去顫器-四極*給付規定請見備
註欄“SJM” QUADRA ASSURA IMPLANTABLE CARDIOVERTER
DEFIBRILLATOR
609212
FHFCDQMP32ST “聖猷達”克卓亞速拉多點式植入式心律去顫器“SJM”QUADRA
ASSURA MP IMPLANTABLE CARDIOVERTER DEFIBRILLATOR
609212
FHFCDSYN72M4 因信可植入式去纖維顫動器“MEDTRONIC” INSYNC ICD *適應症
請見備註欄
500106
FHFCDTBAD1M4 "美敦力"長青植入式心臟去顫器"MEDTRONIC"VIVA XT/S CRT-D
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR
591468
FHFCDTBAD4M4 "美敦力"長青植入式心臟去顫器""MEDTRONIC"VIVA XT/S CRT-D
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR
591468
FHFCDTBAQQM4 "美敦力"長青植入式心臟去顫器"MEDTRONIC"VIVA QUAD CRT-D
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR
591468
FHFCDUA326ST “聖猷達”優你法亞速拉植入式心律去顫器*給付規定請見備註欄
“SJM” UNIFY ASSURA IMPLANTABLE CARDIOVERTER
DEFIBRILLATOR-CRT-D
565882
FHG103010NGX 戈爾特賜內植人工血管-小兒用薄壁伸展性"GORE" GORE-TEX
VASCULAR GRAFTS-10CM
4289
FHG110304NGX STRAIGHT VASCULAR PROSTHESIS 3MM,4MM,5MM,6MM,7MM,8MM,10MM
40CM
10795
FHG110307NGX STRAIGHT VASCULAR PROSTHESIS 3MM,4MM,5MM,6MM,7MM,8MM,10MM
70CM
16800
FHG1104010MP STRAIGHT GRAFT 4MM 10CM 3363
FHG110401CMP CARBOFLO GRAFT,STRAIGHT,10CM 卡邦人工血管 3363
FHG1104040MP STRAIGHT GRAFT 4MM 40CM 10795
FHG110404CMP CARBOFLO GRAFT,STRAIGHT,40CM 卡邦人工血管 10795
FHG110405CMP CARBOFLO GRAFT,STRAIGHT,50CM 卡邦人工血管 12610
FHG1105040MP STRAIGHT GRAFT 5MM 40CM 10795
FHG1106020MP STRAIGHT GRAFT 6,8MM 20CM 6279
FHG1106020QM "邁柯唯"人工血管"MAQUET"EXXCEL SOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STRAIGHT4-8MM*20CM
6279
FHG110602CMP CARBOFLO GRAFT,STRAIGHT,20CM 卡邦人工血管 6279
FHG110603CMP CARBOFLO GRAFT,STRAIGHT,30CM 卡邦人工血管 8714
FHG1106040MP STRAIGHT GRAFT 6MM 40CM 10795
FHG1106040QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
4-6MM*40CM
10795
FHG1106040SB EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT 4:8MMX40CM
型號381046,47,48自92.10.1生效
10795
FHG1106050MP STRAIGHT GRAFT 6MM 50CM 12610
FHG1106050QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
6MM*50CM
12610
885
特材代碼 中英文名稱 支付點數-104/01/01
FHG1106050SB EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT 4:8MMX50CM
型號381056,57,58自92.10.1生效
12610
FHG1106060QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STRAIGHT 6MM*60CM
14780
FHG1106070MP STRAIGHT GRAFT 6MM 70CM 16800
FHG1106070QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STRAIGHT 4-8MM*70CM
16800
FHG110607CMP CARBOFLO GRAFT,STRAIGHT,70CM 卡邦人工血管 16800
FHG1106080QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STRAIGHT 4-8MM*80CM
17465
FHG110608CMP CARBOFLO GRAFT,STRAIGHT,80CM 卡邦人工血管 17465
FHG1106S10TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES STRAIGHT GRAFT 10CM*6,7,8,10MM
3363
FHG1106S20TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES STRAIGHT GRAFT 20CM*6,7,8,10MM
6279
FHG1106S30TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES STRAIGHT GRAFT 30CM*6,7,8,10MM
8714
FHG1106S40TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES STRAIGHT GRAFT 40CM*6,7,8,10MM
10795
FHG1106S50TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES STRAIGHT GRAFT 50CM*6,7,8,10MM
12610
FHG1106S60TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES STRAIGHT GRAFT 60CM*6,7,8,10MM
14780
FHG1106S70TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES STRAIGHT GRAFT 70CM*6,7,8,10MM
16800
FHG1106S80TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES STRAIGHT GRAFT 80CM*6,7,8,10MM
17465
FHG1107040MP STRAIGHT GRAFT 7MM 40CM 10795
FHG1116040QM "邁柯唯"人工血管"MAQUET" EXXCEL SOFT EPTFE VASCULAR GRAFT
5-8MM*40CM
10795
FHG1116050QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STRAIGHT 5-8MM*50CM
12610
FHG1121000AH "亞翠恩" 艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS STANDARD WALL-STRAIGHT,6MM 10CM
3363
FHG1130S06BA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR
GRAFT(STRAIGHT 6MM*30CM)
8714
FHG1140S08BA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR
GRAFT(STRAIGHT 3.5,8,10MM*40CM)
10795
FHG11D5008BA "巴德"迪斯塔人工血管"BARD"DISTAFLO BYPASS GRAFTS 50CM 12610
FHG11D500CBA "巴德"迪斯塔人工血管"BARD" DISTAFLO BYPASS GRAFTS 12610
FHG11D6008BA "巴德"迪斯塔人工血管"BARD"DISTAFLO BYPASS GRAFTS 60CM 14780
FHG11D600CBA "巴德"迪斯塔人工血管"BARD" DISTAFLO BYPASS GRAFTS 60CM 14780
FHG11D7008BA "巴德"迪斯塔人工血管"BARD"DISTAFLO BYPASS GRAFTS 70CM 16800
FHG11D700CBA "巴德"迪斯塔人工血管"BARD" DISTAFLO BYPASS GRAFTS 70CM 16800
FHG11D8008BA "巴德"迪斯塔人工血管"BARD"DISTAFLO BYPASS GRAFTS 80CM 17465
FHG11D800CBA "巴德"迪斯塔人工血管"BARD" DISTAFLO BYPASS GRAFTS 80CM 17465
FHG11V106CMP VENAFLO GRAFT,STRAIGHT,10CM維那人工血管 3363
FHG11V206CMP VENAFLO GRAFT,STRAIGHT,20CM維那人工血管 6279
FHG11V306CMP VENAFLO GRAFT,STRAIGHT,30CM維那人工血管 8714
FHG11V406CMP VENAFLO GRAFT,STRAIGHT,40CM維那人工血管 10795
FHG11V506CMP VENAFLO GRAFT,STRAIGHT,50CM維那人工血管 12610
FHG11VL100MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS-STRAIGHT
GRAFT(6,7MM,10CM)維那人工血管直式
3363
886
特材代碼 中英文名稱 支付點數-104/01/01
FHG11VL200MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS-STRAIGHT
GRAFT(6,7MM,20CM)維那人工血管直式
6279
FHG11VL300MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS-STRAIGHT
GRAFT(6,7MM,30CM)維那人工血管直式
8714
FHG11VL400MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS-STRAIGHT
GRAFT(6,7MM,40CM)維那人工血管直式
10795
FHG11VL500MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS-STRAIGHT
GRAFT(6,7MM,50CM)維那人工血管直式
12610
FHG120304NGX THIN WALLED VASCULAR GRAFT 3MM,4MM,5MM,6MM,7MM,8MM,10MM
40CM
10795
FHG120307NGX THIN WALLED VASCULAR GRAFT 3MM,4MM,5MM,6MM,7MM,8MM,10MM
70CM
16800
FHG120401TMP CARBOFLO GRAFT,STRAIGHT THINWALL,10CM 卡邦人工血管 3363
FHG120405TMP CARBOFLO GRAFT,STRAIGHT THINWALL,50CM 卡邦人工血管 12610
FHG120407TMP CARBOFLO GRAFT,STRAIGHT THINWALL,70CM 卡邦人工血管 16800
FHG120508TMP CARBOFLO GRAFT,STRAIGHT THINWALL,80CM 卡邦人工血管 17465
FHG1206020QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT 6-8MM*20CM
6279
FHG120602TMP CARBOFLO GRAFT,STRAIGHT THINWALL,20CM 卡邦人工血管 6279
FHG120603TMP CARBOFLO GRAFT,STRAIGHT THINWALL,30CM 卡邦人工血管 8714
FHG1206040QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT 6-10MM*40CM
10795
FHG120604TMP CARBOFLO GRAFT,STRAIGHT THINWALL,40CM 卡邦人工血管 10795
FHG1206050QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT 6-10MM*50CM
12610
FHG1206060QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT 6MM*60CM
14780
FHG1206070QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT 5-10MM*70CM
16800
FHG1206075TM "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELSOFT PLUS EXTERNALLY REINFORCED STRAIGHT
GRAFTS6:10MM 75CM
19012
FHG1206076TM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELSEAL EXTERNALLY REINFORCEED STRAIGHT 6:10MM
75CM
19012
FHG1206080QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT 5-10MM*80CM
17465
FHG1221185AH "亞翠恩" 艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS THIN WALL-STRAIGHT,6MM 7MM 8MM *70CM
16800
FHG1230STWBA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR
GRAFT(STRAIGHT THINWALL 6MM*30CM)
8714
FHG1240STWBA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR
GRAFT(STRAIGHT THINWALL 3,6,8MM*40CM)
10795
FHG12F0650MP FLEX GRAFT 6:10MM 50CM 16948
FHG12F0660MP FLEX GRAFT 6:10MM 60CM 20625
FHG12F0680MP FLEX GRAFT 6:10MM 80CM 25266
FHG130504NGX STANDARD STREATCH GRAFT 5MM,6MM,7MM,8MM,10MM 40CM 12721
FHG130507NGX STANDARD STRETCH GRAFT 5MM,6MM,7MM,8MM 70CM 18620
FHG1321010AH "亞翠恩"艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS(STANDARD 4MM,6-8MM,40CM)
10795
FHG1321015AH "亞翠恩"艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS(STANDARD 4-8MM;10MM*50CM)
12610
887
特材代碼 中英文名稱 支付點數-104/01/01
FHG1321024AH "亞翠恩"艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS(STANDARD 4:8MM,10MM 70CM)
16800
FHG1321179AH "亞翠恩"艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS(STANDARD 6MM*60CM)
14780
FHG1406070QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STRAIGHT EXTERNALLY SUPPORTED 6-
8MM*70CM*20-50CM
21700
FHG1406080QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STRAIGHT EXTERNALLY SUPPORTED 6-
8MM*80CM*20-50CM
22488
FHG1406545GX RINGED GRAFT 5CM 6MM 45CM 13639
FHG140657NGX RINGED GRAFT 50CM 6MM,8MM 70CM 21700
FHG1406C40QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
6MM*45CM
13639
FHG1406C40SB EXXCEL SOFT EPTFE GRAFT STRAIGHT CENTRALLY SUPPORTED
6MM/40CM,45CM/5CM
13639
FHG1406C50QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STRAIGHT CENTRALLY SUPPORTED
6MM*50CM*5CM
16948
FHG1408030QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STRAIGHT EXTERNALLY SUPPORTED
8MM*30CM*12CM
11447
FHG1416C40QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STRAIGHT CENTRALLY SUPPORTED
6MM*40CM*5CM
13639
FHG1421092AH "亞翠恩" 艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS STANDARD WALL-CENTER HELIX,6MM* 45CM
13639
FHG1506040QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6-
8MM*40CM*20-30CM
13639
FHG1506070QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
5MM*70CM
21700
FHG1506080QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6-
8MM*80CM*30-70CM
22488
FHG1506440QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED
6MM*40CM*40CM
13639
FHG1506550QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
6MM*50CM
16948
FHG1506550SB EXXCEL SOFT EPTFE VASCULAR THIN WALL GRAFT WITH
EXTERNALLY RING SUPPORTED 6MM,10MMX50CM/RING50CM
16948
FHG150657NGX RINGED THIN WALLED GRAFT 50CM 6MM,8MM,10MM 70CM 21700
FHG1506660QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
6MM*60CM
20625
FHG1506660SB EXXCEL SOFT EPTFE GRAFT THIN WALL STRAIGHT EXTERNALLY
SUPPORTED 6MM/60CM/60CM
20625
FHG1506770QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
6-8MM*70CM
22555
FHG1506770SB EXXCEL SOFT EPTFE GRAFT THIN WALL STRAIGHT EXTERNALLY
SUPPORTED 6MM,8MM,10MM/70CM/70CM
22555
FHG1506880QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
8MM*80CM
25266
888
特材代碼 中英文名稱 支付點數-104/01/01
FHG1506880SB EXXCEL SOFT EPTFE GRAFT THIN WALL STRAIGHT EXTERNALLY
SUPPORTED 6MM,8MM/80CM/80CM
25266
FHG1508030QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED
8MM*30CM*12CM
11447
FHG1516070QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6-
8MM*70CM*20-30CM
21700
FHG1516550QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED
10MM*50CM*50CM
16948
FHG1516880QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED
6MM*80CM*80CM
25266
FHG15F30TWBA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR GRAFT(FLEX
THINWALL 6MM*30CM)
11615
FHG15F4007BA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR GRAFT(FLEX
THINWALL 6,8MM*40CM)
14920
FHG15F408SBA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR GRAFT(FLEX
SMALL BEADING 8MM*40CM)
14920
FHG160577NGX REMOVABLE RINGED THIN WALLED GRAFT 70CM 5MM,6MM,8MM 70CM 22555
FHG160634NGX REMOVABLE RINGED THIN WALLED GRAFT 8MM 40CM 16306
FHG1606550QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STRAIGHT EXTERNALLY SUPPORTED 6-
8MM*50CM*50CM
16948
FHG1606660QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
5MM*70CM
20625
FHG1606670GX REMOVABLE RINGED THIN WALLED GRAFT 60CM 6MM 70CM 22555
FHG1606770QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
6MM*70CM
22555
FHG1606880QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
6-8MM*80CM
25266
FHG1606880SB EXXCEL SOFT EPTFE GRAFT STRAIGHT EXTERNALLY SUPPORTED
6MM,8MM/80CM/80CM
25266
FHG1606C40TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES CENTRAL SUPPORT STRAIGHT GRAFT 40CM*6,7,8,10MM
14920
FHG1606C50TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES CENTRAL SUPPORT STRAIGHT GRAFT 50CM*6,7,8,10MM
16948
FHG1606E50TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES END SUPPORT STRAIGHT GRAFT 50CM*6,7,8,10MM
16948
FHG1606S10TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES FULL SUPPORT STRAIGHT GRAFT 10CM*6,7,8,10MM
4289
FHG1606S20TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES FULL SUPPORT STRAIGHT GRAFT 20CM*6,7,8,10MM
8114
FHG1606S30TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES FULL SUPPORT STRAIGHT GRAFT 30CM*6,7,8,10MM
11615
FHG1606S40TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES FULL SUPPORT STRAIGHT GRAFT 40CM*6,7,8,10MM
14920
FHG1606S50TM "泰爾茂"緻密人工血管"TERUMO" SEALPTFE GELATIN SEALED
EPTFE VASCULAR PROSTHESES-PTFE FULL SUPPORT STRAIGHT
GRAFT 50CM*6,7,8,10MM
16948
889
特材代碼 中英文名稱 支付點數-104/01/01
FHG1606S60TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES FULL SUPPORT STRAIGHT GRAFT 60CM*6,7,8,10MM
20625
FHG1606S70TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES FULL SUPPORT STRAIGHT GRAFT 70CM*6,7,8,10MM
22555
FHG1606S80TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR
PROSTHESES FULL SUPPORT STRAIGHT GRAFT 80CM*6,7,8,10MM
25266
FHG16CF604MP CARBOFLO GRAFT,CENTERFLEX,40CM 卡邦人工血管 13639
FHG16CF605MP CARBOFLO GRAFT,CENTERFLEX,50CM 卡邦人工血管 16948
FHG16CV604MP VENAFLO GRAFT,CENTERFLEX,40CM維那人工血管 13639
FHG16CV605MP VENAFLO GRAFT,CENTERFLEX,50CM維那人工血管 16948
FHG16CVL40MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS CENTERFLEX(6-
7MM,40CM)印帕維那人工血管中間螺旋式
13639
FHG16CVL50MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS CENTERFLEX(6MM,50CM)
印帕維那人工血管中間螺旋式
16948
FHG16DF508BA "巴德"迪斯塔人工血管"BARD"DISTAFLO BYPASS GRAFTS WITH
FLEX SMALL BEADING 50CM
16948
FHG16DF5SCBA "巴德"迪斯塔人工血管"BARD" DISTAFLO BYPASS GRAFTS WITH
FLEX SMALL BEADING 50CM
16948
FHG16DF600BA "巴德"迪斯塔人工血管"BARD"DISTAFLO BYPASS GRAFTS WITH
FLEX SMALL BEADING 60CM
20625
FHG16DF6SCBA "巴德"迪斯塔人工血管"BARD" DISTAFLO BYPASS GRAFTS WITH
FLEX SMALL BEADING 60CM
20625
FHG16DF700BA "巴德"迪斯塔人工血管"BARD"DISTAFLO BYPASS GRAFTS WITH
FLEX SMALL BEADING 70CM
22555
FHG16DF7SCBA "巴德"迪斯塔人工血管"BARD" DISTAFLO BYPASS GRAFTS WITH
FLEX SMALL BEADING 70CM
22555
FHG16DF800BA "巴德"迪斯塔人工血管"BARD"DISTAFLO BYPASS GRAFTS WITH
FLEX SMALL BEADING 80CM
25266
FHG16DF8SCBA "巴德"迪斯塔人工血管"BARD" DISTAFLO BYPASS GRAFTS WITH
FLEX SMALL BEADING 80CM
25266
FHG16F0640MP FLEX GRAFT 6,7,8,10MM 40CM 14920
FHG16F3006BA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR GRAFT(FLEX
6MM*30CM)
11615
FHG16F4007BA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR GRAFT(FLEX
7;8;10MM*40CM)
14920
FHG16F401TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,10CM 卡邦人工
血管
4289
FHG16F507TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,70CM 卡邦人工
血管
22555
FHG16F601CMP CARBOFLO GRAFT,STRAIGHT FLEX,10CM 卡邦人工血管 4289
FHG16F603TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,30CM 卡邦人工
血管
11615
FHG16F604CMP CARBOFLO GRAFT,STRAIGHT FLEX,40CM 卡邦人工血管 14920
FHG16F605CMP CARBOFLO GRAFT,STRAIGHT FLEX,50CM 卡邦人工血管 16948
FHG16F605TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,50CM 卡邦人工
血管
16948
FHG16F606CMP CARBOFLO GRAFT,STRAIGHT FLEX,60CM 卡邦人工血管 20625
FHG16F606TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,60CM 卡邦人工
血管
20625
FHG16F607CMP CARBOFLO GRAFT,STRAIGHT FLEX,70CM 卡邦人工血管 22555
FHG16F608CMP CARBOFLO GRAFT,STRAIGHT FLEX,80CM 卡邦人工血管 25266
FHG16F608TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,80CM 卡邦人工
血管
25266
890
特材代碼 中英文名稱 支付點數-104/01/01
FHG16VXT80AH "亞翠恩"艾德凡達聚四氟乙烯人工血管"ATRIUM"ADVANTA PTFE
VASCULAR GRAFTS(STANDARD WALL RINGED 5-10MM 80CM)
22488
FHG1721068AH "亞翠恩"艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS(STANDARD WALL-HELIX SUPPORTED 4:8MM,70CM)
22555
FHG1721220AH "亞翠恩" 艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS THIN WALL-HELIX SUPPORTED,6MM 7MM 8MM*
70CM
22555
FHG1722063AH "亞翠恩"艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS(WALL-HELIX SUPPORTED STANDARD
5MM:8MM*50CM)
16948
FHG1806040GX "戈爾"戈爾特賜內植人工血管(內環伸展性人工血管)"GORE"
GORE-TEX VASCULAR GRAFTS(INTERING GRAFT)6MM X 40CM
14915
FHG180604NGX "戈爾"戈爾特賜內植人工血管(內環伸展性薄壁人工血管)"GORE"
GORE-TEX VASCULAR GRAFTS(INTERING GRAFT)6MM,7MM,8MM X
40CM
17990
FHG180606NGX "戈爾"戈爾特賜內植人工血管(內環伸展性薄壁人工血管)"GORE"
GORE-TEX VASCULAR GRAFTS(INTERING GRAFT)6MM,7MM,8MM X
60CM
26400
FHG180608NGX "戈爾"戈爾特賜內植人工血管(內環伸展性薄壁人工血管)"GORE"
GORE-TEX VASCULAR GRAFTS(INTERING GRAFT)6MM,7MM,8MM X
80CM
28330
FHG1825525AH "ATRIUM" FLIXENE VASCULAR GRAFTS"亞翠恩" 福立心人工血管 21170
FHG1861020GX "戈爾"戈爾特賜內植人工血管(內環伸展性人工血管)"GORE"
GORE-TEX VASCULAR GRAFTS(INTERING GRAFT)6MM X 10CM X 20CM
8926
FHG2106030TM "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELSEAL STRAIGHT GRAFTS6:10MM 30CM
8169
FHG2106031TM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELSEAL TRIAXIAL,GELSOFT STRAIGHT 6:10MM 30CM
8169
FHG2106060TM "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELSEAL STRAIGHT GRAFTS6:10MM 60CM
13580
FHG2106061TM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELSEAL TRIAXIAL,GELSOFT STRAIGHT 6:10MM 60CM
13580
FHG2112025TM "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELSEAL STRAIGHT GRAFTS12:18MM 25,30CM
7888
FHG211203NGX "戈爾" 戈爾特賜內植人工血管-伸展性直型人工血管"GORE"
GORE-TEX VASCULAR GRAFTS-STRETCH VASCULAR GRAFT STRAIGHT
12:18MM*30CM
9563
FHG2112050TM "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELSEAL STRAIGHT GRAFTS12:18MM 60CM
9836
FHG2112051TM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELSEAL TRIAXIAL,GELSOFT STRAIGHT 12:18MM
50,60CM
10234
FHG2120020TM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELSEAL TRIAXIAL,GELSOFT STRAIGHT 20:38MM
20,25CM
9140
FHG2120025TM "泰爾茂"傑斯弗特加強型人工血管"TERUMO" GELSOFT PLUS
GELATIN SEALED POLYESTER VASCULAR PROSTHESES-GELSEAL
STRAIGHT GRAFTS,20:24MM,25CM
9140
891
特材代碼 中英文名稱 支付點數-104/01/01
FHG212003NGX "戈爾" 戈爾特賜內植人工血管-伸展性直型人工血管"GORE"
GORE-TEX VASCULAR GRAFTS-STRETCH VASCULAR GRAFT STRAIGHT
20:24MM*30CM
11592
FHG2143108TM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR
PROSTHESES SPECIAL FOUR BRANCH(PLEXUS)40CM*4@15CM*適應症
請見備註欄
56028
FHG2173108TM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR
PROSTHESES SPECIAL FOUR BRANCH(PLEXUS)40CM*4@15CM *適應症
請見備註欄
56028
FHG21GK020V8 MAQUET INTERGARD KNITTED VASCULAR GRAFTS邁柯唯英特佳針織
系列人工血管6-10MM,20CM
5723
FHG21GK021V8 MAQUET INTERGARD KNITTED VASCULAR GRAFTS邁柯唯英特佳針織
系列人工血管12-24MM,20CM
7888
FHG21GK040V8 MAQUET INTERGARD KNITTED VASCULAR GRAFTS邁柯唯英特佳針織
系列人工血管6-10MM,40CM
9312
FHG21GK041V8 MAQUET INTERGARD KNITTED VASCULAR GRAFTS邁柯唯英特佳針織
系列人工血管12-24MM,40CM
10234
FHG21GK070V8 MAQUET INTERGARD KNITTED VASCULAR GRAFTS邁柯唯英特佳針織
系列人工血管6-10MM,70CM
13580
FHG21GK100V8 MAQUET INTERGARD KNITTED VASCULAR GRAFTS邁柯唯英特佳針織
系列人工血管8MM,100CM
18818
FHG21GK12SQM 邁柯唯英特佳塗銀人工血管和補片MAQUET INTERGARD SILVER
VASCULAR GRAFT AND PATCH(雙叉型)50CM 雙叉人工血管12-
24MM,50CM
15287
FHG21GK20SQM 邁柯唯英特佳塗銀人工血管和補片MAQUET INTERGARD SILVER
VASCULAR GRAFT AND PATCH 12-24MM,20CM
7888
FHG21GK40SQM 邁柯唯英特佳塗銀人工血管和補片MAQUET INTERGARD SILVER
VASCULAR GRAFT AND PATCH 12-24MM,40CM
10234
FHG21GK61SQM 邁柯唯英特佳塗銀人工血管和補片MAQUET INTERGARD SILVER
VASCULAR GRAFT AND PATCH 6-10MM,70CM
13580
FHG21GK67HQM 邁柯唯英特佳肝素膠原塗層人工血管MAQUET INTERGARD HEPARIN
VASCULAR GRAFT 6-10MM*70CM
16800
FHG21GK67SQM 邁柯唯英特佳塗銀人工血管和補片MAQUET INTERGARD SILVER
VASCULAR GRAFT AND PATCH 6-10MM,40CM
9312
FHG21GK68SQM 邁柯唯英特佳塗銀人工血管和補片MAQUET INTERGARD SILVER
VASCULAR GRAFT AND PATCH 6-8MM*20CM
5723
FHG21GKRS1QM 邁柯唯英特佳塗銀人工血管和補片MAQUET INTERGARD SILVER
VASCULAR GRAFT AND PATCH(徑向支撐型)6-8MM*70CM
21700
FHG21GKRS1V8 邁柯唯英特佳針織系列人工血管MAQUET INTERGARD KNITTED
VASCULAR GRAFTS RADIALLY SUPPORTED 6-8MM,70CM,R15-30CM
19012
FHG21GKRS2QM 邁柯唯英特佳塗銀人工血管和補片MAQUET INTERGARD SILVER
VASCULAR GRAFT AND PATCH(徑向支撐型)6-8MM*80CM
22488
FHG21GKRS2V8 邁柯唯英特佳針織系列人工血管MAQUET INTERGARD KNITTED
VASCULAR GRAFTS RADIALLY SUPPORTED ULTRA THIN
6MM,85CM,R45CM
20399
FHG21GKRS3QM 邁柯唯英特佳塗銀人工血管和補片MAQUET INTERGARD SILVER
VASCULAR GRAFT AND PATCH(徑向支撐型)8MM*100CM
25266
FHG21GKUT1V8 邁柯唯英特佳針織系列人工血管MAQUET INTERGARD KNITTED
VASCULAR GRAFTS ULTRA THIN 5-8MM,70CM
13580
FHG21GKUT2V8 邁柯唯英特佳針織系列人工血管MAQUET INTERGARD KNITTED
VASCULAR GRAFTS ULTRA THIN 5-8MM,40CM
9312
FHG21GKUT3V8 "英特維"英特佳"INTERVASCULAR" INTERGARD KNITTED VASCULAR
GRAFTS ULTRA THIN 6-8MM,20CM
5723
892
特材代碼 中英文名稱 支付點數-104/01/01
FHG21GKUT8QM 邁柯唯英特佳塗銀人工血管和補片MAQUET INTERGARD SILVER
VASCULAR GRAFT AND PATCH(超薄/非超薄徑向支撐型)8MM,40CM
13639
FHG21GKUTSQM 邁柯唯英特佳塗銀人工血管和補片MAQUET INTERGARD SILVER
VASCULAR GRAFT AND PATCH(超薄徑向支撐型)6-8MM,70CM
21700
FHG21HEWAAV8 MAQUET INTERGARD WOVEN VASCULAR GRAFTS邁柯唯英特佳編織系
列人工血管-四分叉主動脈弓人工血管20-34MM*8-10MM,50CM
56028
FHG21K1206V8 "INTERVASCULAR"INTERGARD KNITTED VASCULAR GRAFTS"英特維"
英特佳針織系列雙叉人工血管12-24MM,50CM
15287
FHG21KUT4HQM 邁柯唯英特佳肝素膠原塗層人工血管MAQUET INTERGARD HEPARIN
VASCULAR GRAFT 6-8MM*40CM
10795
FHG21KUT7HQM 邁柯唯英特佳肝素膠原塗層人工血管MAQUET INTERGARD HEPARIN
VASCULAR GRAFT 6-8MM*70CM
16800
FHG21W0630TM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS
30CM*6,8,10MM
8169
FHG21W0660TM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS 60CM*6-10MM
13580
FHG21W1230TM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS 30CM*12-18MM
9849
FHG21W1260TM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS 60CM*12-18MM
9836
FHG21W1407V8 MAQUET INTERGARD WOVEN VASCULAR GRAFTS邁柯唯英特佳編織系
列人工血管14-24MM,50CM
15287
FHG21W2030TM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS 30CM*20-38MM
11630
FHG21W2050TM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR
PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS 50CM*20-34MM
12416
FHG21WK015V8 MAQUET INTERGARD WOVEN VASCULAR GRAFTS邁柯唯英特佳編織系
列人工血管12-24MM,15CM
4608
FHG21WK016V8 MAQUET INTERGARD WOVEN VASCULAR GRAFTS邁柯唯英特佳編織系
列人工血管26-36MM,15CM
5587
FHG21WK030V8 MAQUET INTERGARD WOVEN VASCULAR GRAFTS邁柯唯英特佳編織系
列人工血管6-10MM,30CM
8169
FHG21WK031V8 MAQUET INTERGARD WOVEN VASCULAR GRAFTS邁柯唯英特佳編織系
列人工血管12-18MM,30CM
9849
FHG21WK032V8 MAQUET INTERGARD WOVEN VASCULAR GRAFTS邁柯唯英特佳編織系
列人工血管20-38MM,30CM
11630
FHG21WK060V8 MAQUET INTERGARD WOVEN VASCULAR GRAFTS邁柯唯英特佳編織系
列人工血管22-32MM,60CM
14899
FHG3140A64BA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR
GRAFT(SHORT TAPERED 6,7-4MM*40CM)
12527
FHG3146040QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL SHORT TAPER 4-7MM*40-45CM
12527
FHG3146040TM "泰爾茂"特普弗人工血管"TERUMO" TAPERFLO GELATIN SEALED
EPTFE VASCULAR PROSTHESES SHORT TAPER GRAFT40,45CM 4-6,4-
7MM
12527
FHG3146041TM "泰爾茂"麥斯弗人工血管"TERUMO" MAXIFLO EXPANDED EPTFE
VASCULAR PROSTHESES(SHORT TAPER GRAFT40,50CM*4-6:4-7MM)
12527
893
特材代碼 中英文名稱 支付點數-104/01/01
FHG3146045QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
4-7MM*45CM
12527
FHG3146045SB EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT(STEP)4-
6MM,4-7MMX45CM型號382456,57自92.10.1生效
12527
FHG3146050QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL SHORT TAPER 4-7MM*50CM
14973
FHG3146S30TM "泰爾茂"特普弗人工血管 TAPERFLO GELATIN SEALED EPTFE
VASCULAR PROSTHESES GELATIN SEALED STEPPED TAPER GRAFT
30,35CM 4-6:5-8MM
9040
FHG3146S40TM "泰爾茂"特普弗人工血管 TAPERFLO GELATIN SEALED EPTFE
VASCULAR PROSTHESES GELATIN SEALED STEPPED TAPER GRAFT
40,45CM 4-6:5-8MM
12527
FHG3146S41TM "泰爾茂"麥斯弗人工血管"TERUMO" MAXIFLO EXPANDED EPTFE
VASCULAR PROSTHESES(STEPPED TAPER GRAFT40,45CM*4-6:5-
8MM)
12527
FHG3146S45TM "泰爾茂"特普弗人工血管"TERUMO" TAPERFLO GELATIN SEALED
EPTFE VASCULAR PROSTHESES STEPPED TAPER CENTRAL SUPPORT
GRAFT 40,45CM 4-7,5-8MM
15800
FHG3146S46TM "泰爾茂"麥斯弗人工血管"TERUMO" MAXIFLO EXPANDED EPTFE
VASCULAR PROSTHESES(SHORT TAPER WITH CENTRAL
REINFORCEMENT40,45CM*4-7:5-8MM)
15800
FHG3146S50TM "泰爾茂"特普弗人工血管 TAPERFLO GELATIN SEALED EPTFE
VASCULAR PROSTHESES GELATIN SEALED STEPPED TAPER CENTRAL
SUPPORT GRAFT 50CM 4-7MM
14973
FHG3146W40TM “泰爾茂”特普弗人工血管“TERUMO” TAPERFLO GELATIN
SEALED EPTFE VASCULAR PROSTHESES EPTFE STEPPED TAPER
GRAFT40,45CM*4-6,5-8MM
12527
FHG3146W41TM “泰爾茂”特普弗人工血管“TERUMO”TAPERFLO GELATIN SEALED
EPTFE VASCULAR PROSTHESES EPTFE STEPPED TAPER
GRAFT40,50CM*4-6,4-7MM
12527
FHG3146W45TM “泰爾茂”特普弗人工血管"TERUMO”TAPERFLO GELATIN SEALED
EPTFE VASCULAR PROSTHESES STEPPED TAPER CENTRAL SUPPORT
GRAFT 40,45CM*4-7,5-8MM
15800
FHG3147030TM "泰爾茂"特普弗人工血管"TERUMO" TAPERFLO GELATIN SEALED
EPTFE VASCULAR PROSTHESES SHORT TAPER GRAFT 30CM 4-7MM
9040
FHG3147040GX TAPERED GRAFT 4-7MM 40CM 12527
FHG3147S45MP STEPPED GRAFT 4-7MM 45CM 12527
FHG3148045QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL STEP 4-6MM*45CM
12527
FHG3164A40MP CARBOFLO GRAFT,SHORT TAPERED,40CM 卡邦人工血管 12527
FHG316CF50MP CENTER FLEX 6:8MM 50CM 16948
FHG31T4645MP CARBOFLO GRAFT,STEPPED,45CM 卡邦人工血管 12527
FHG31T4750MP CARBOFLO GRAFT,STEPPED,50CM 卡邦人工血管 14973
FHG31VLT20MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS STEPPED GRAFT(4-6,4-
7MM,20CM,25CM)印帕維那人工血管階級式
6762
FHG31VLT30MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS STEPPED GRAFT(4-6,4-
7MM,30CM,35CM)印帕維那人工血管階級式
9040
FHG31VLT40MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS STEPPED GRAFT(4-6,4-
7MM,40CM,45CM)印帕維那人工血管階級式
12527
FHG31VT246MP VENAFLO GRAFT,STEPPED,20/25CM維那人工血管 6762
FHG31VT346MP VENAFLO GRAFT,STEPPED,30CM維那人工血管 9040
FHG3274070MP CARBOFLO GRAFT,TAPERED THINWALL,70CM 卡邦人工血管 18528
894
特材代碼 中英文名稱 支付點數-104/01/01
FHG3322114AH "亞翠恩"艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS(SHORT TAPER STANDARD WALL 4-6MM,4-
7MM*40CM,45CM)
12527
FHG3347040GX TAPERED STRETCH VASCULAR GRAFT 4:7MMX40CM 14640
FHG336CF40MP CENTER FLEX GRAFT 6:10MM 40CM 13639
FHG3447940QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR
GRAFT(STANDARD WALL SHORT TAPER CENTRALLY SUPPORTED 4-
7MM*40-45CM*5-10CM
14400
FHG3447C40QM "邁柯唯"人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT
4-7MM*45CM
14400
FHG3447C40SB EXXCEL SOFT EPTFE GRAFT SHORT TAPER ,STEP CENTRALLY
SUPPORTED 4-7MM/40CM,45CM/5-15CM
14400
FHG3447S45MP CENTERFLEX STEPPED GRAFT 4-7MM,5-8MM 45CM 14400
FHG34CF40ABA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR
GRAFT(SHORT TAPERED CENTERFLEX 6,7-4MM*40CM)
14400
FHG34CFT40BA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR
GRAFT(STEPPED CENTERFLEX 4-7MM*40CM)
14400
FHG3622125AH "亞翠恩"艾德凡達聚四氟乙烯人工血管"ATRIUM" ADVANTA PTFE
VASCULAR GRAFTS(SHORT TAPER CENTER HELIX STANDARD 4-
7MM*45CM)
15800
FHG3630A74BA "印帕"聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR
GRAFT(SHORT TAPERED 7-4MM*30CM)
9040
FHG3647145GX TAPERED GRAFT WITH REMOVAL RINGED 15800
FHG3674A40MP CARBOFLO GRAFT,SHORT TAPERED CENTERFLEX,40CM 卡邦人工血管 15800
FHG36CVLT4MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS STEPPED CENTERFLEX(4-
7MM,45CM)印帕維那人工血管階級中間螺旋式
14400
FHG36F7407MP CARBOFLO GRAFT,FLEX THINWALL TAPERED SMALL BEADING,70CM
卡邦人工血管
22179
FHG36T4740MP CARBOFLO GRAFT,STEPPED CENTERFLEX,40/45CM 卡邦人工血管 15800
FHG36T4750MP CARBOFLO GRAFT,STEPPED CENTERFLEX,50CM 卡邦人工血管 16374
FHG36VT454MP VENAFLO GRAFT,STEPPED CENTERFLEX,45CM維那人工血管 15800
FHG3847045GX 戈爾特賜內植人工血管(錐狀內環伸展性人工血管)GORE-TEX
VASCULAR GRAFTS(INTERING GRAFT)4-7MM X 45CM
17380
FHG4312645TM "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR
PROSTHESES BIFURCATION WOVEN GRAFTS12:24*6:12MM 45CM
15287
FHG4312646TM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR
PROSTHESES BIFURCATION WOVEN GRAFT 12:24*6:12MM 45CM
15287
FHG431401NGX "戈爾" 戈爾特賜內植人工血管-伸展性Y型人工血管"GORE" GORE-
TEX VASCULAR GRAFTS-STRETCH VASCULAR GRAFT BIFURCATED
14:24MM*7:12MM*40CM
15456
FHG43W1245TM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR
PROSTHESES BIFURCATION WOVEN GRAFT 12:24*6:12MM 45CM
15287
FHP0112400PR REGENCY SR+SSIR PULSE GENERATOR W/AUTOCAPTURE※須檢附心電
圖報告專案報備使用
64214
FHP0112402PR REGENCY SC+SSIC PULSE GENERATOR W/AUTOCAPTURE※須檢附心電
圖報告專案報備使用
61910
FHP0112525PR REGENCY/MICRONY SSIR PULSE GENERATOR須附心電圖報告專案報
備使用(不須事前審查)
64214
FHP011NGSRSB "波士頓科技"迎吉心臟節律器(單腔)"BOSTON
SCIENTIFIC"INGENIO PACEMAKER (SR)
64214
FHP011NGVRSB "波士頓科技"迎吉心臟節律器 (雙腔)"BOSTON
SCIENTIFIC"INGENIO PACEMAKER (VDDR)
93833
895
特材代碼 中英文名稱 支付點數-104/01/01
FHP012404NPR REGENCY SR SSIR PULSE GENERATOR WITHOUT LEAD※須檢附心電
圖報告專案報備使用
64214
FHP012406NPR REGENCY SC/SCX SSI PULSE GENERATOR WITHOUT LEAD※須檢附心
電圖報告專案報備使用
56540
FHP01ACCPMST "聖猷達"艾森心臟節律器(ACCENT IMPLANTABLE CARDIAC PULSE
GENERATOR) *適應症請見備註欄
64214
FHP01ACCRMST "聖猷達"艾森心臟節律器((ACCENT IMPLANTABLE CARDIAC PULSE
GENERATOR) *適應症請見備註欄
64214
FHP01ACCV2ST "聖猷達" 艾森艾斯特心臟節律器(單腔)"SJM" ACCENT ST PULSE
GENERATOR*適應症請見備註欄
64214
FHP01ACCVRST "聖猷達" 艾森艾斯特心臟節律器(單腔)"SJM" ACCENT ST PULSE
GENERATOR*適應症請見備註欄
64214
FHP01ADAPSM4 "MEDTRONIC" ADAPTA PACING SYSTEM"美敦力"黛拉心臟節律系統*
適應症請見備註欄
64214
FHP01ADD1SM4 "美敦力" 黛拉心臟節律器"MEDTRONIC" ADAPTA PACEMAKER-DDD*
使用規定請見備註欄
93833
FHP01ADSRSM4 "美敦力" 黛拉心臟節律器"MEDTRONIC" ADAPTA PACEMAKER-
AAI/VVI*使用規定請見備註欄
64214
FHP01ADVDSM4 "美敦力" 黛拉心臟節律器"MEDTRONIC" ADAPTA PACEMAKER-VDD*
使用規定請見備註欄
93833
FHP01ADVSRSB “波士頓科技”艾凡緹心臟節律器“BOSTON SCIENTIFIC”
ADVANTIO PACEMAKER
64214
FHP01AVTSRGU "佳騰"因施尼亞內植用雅密特心臟整律器"GUIDANT"INSIGNIA I
AVT PULSE GENERATOR SSIR*須檢附心電圖報告專案報備適用
64214
FHP01AVTSSGU "佳騰"因施尼亞內植用雅密特心臟整律器"GUIDANT"INSIGNIA I
AVT PULSE GENERATOR*須檢附心電圖報告專案報備適用
61910
FHP01DDD20SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 20
PACEMAKER *適應症見備註欄。
93833
FHP01EFTDDBK “百多力”艾飛塔植入式心律調節器(包含配件)*給付規定請見備
註欄“BIOTRONIK”EFFECTA IMPLANTABLE CARDIAC PACEMAKERS
INCL. ACCESSORIES-EFFECTA DDD
93833
FHP01EFTDRBK "百多力"艾飛塔植入式心律調節器(包含配件)(雙腔自付差
額)"BIOTRONIK"EFFECTA IMPLANTABLE CARDIAC PACEMAKERS
INCL. ACCESSORIES-EFFECTA DDDR
93833
FHP01EFTSRBK “百多力”艾飛塔植入式心律調節器(包含配件)*給付規定請見備
註欄“BIOTRONIK”EFFECTA IMPLANTABLE CARDIAC PACEMAKERS
INCL. ACCESSORIES-EFFECTA SR
64214
FHP01EFTSSBK “百多力”艾飛塔植入式心律調節器(包含配件)*給付規定請見備
註欄“BIOTRONIK”EFFECTA IMPLANTABLE CARDIAC PACEMAKERS
INCL. ACCESSORIES-EFFECTA S
61910
FHP01ESS1RM4 ENPULSE PACING GENERATOR須檢附心電圖報告專案報備使用 64214
FHP01EVASRBK "百多力" 艾維亞植入式心律調節器"BIOTRONIK" EVIA
IMPLANTABLE CARDIAC PACEMAKER*需檢附心電圖報告專案報備使
用
64214
FHP01MR224ST "聖猷達"艾森核磁共振心臟節律器"SJM"ACCENT MRI PULSE
GENERATOR
81477
FHP01PM134ST “聖猷達”薩斯坦植入式心臟節律器“SJM”SUSTAIN XL
IMPLANTABLE CARDIAC PULSE GENERATOR-SSI*需檢附心電圖報告
專案報備
61910
FHP01PM136ST “聖猷達”薩斯坦植入式心臟節律器“SJM”SUSTAIN XL
IMPLANTABLE CARDIAC PULSE GENERATOR-SSIR*需檢附心電圖報告
專案報備
64214
FHP01SD01SM4 "美敦力" 賽亞心臟節律器"MEDTRONIC" SENSIA PACEMAKER(DDD)*
需檢附心電圖報告專案報備使用
93833
896
特材代碼 中英文名稱 支付點數-104/01/01
FHP01SENAAM4 "美敦力"賽亞心臟節律系統"MEDTRONIC" SENSIA PACING SYSTEM
VVI/AAI*需檢附心電圖報告專案報備使用
61910
FHP01SENARM4 "美敦力"賽亞心臟節律系統"MEDTRONIC" SENSIA PACING SYSTEM
VVIR/AAIR*需檢附心電圖報告專案報備使用
64214
FHP01SR01SM4 "美敦力" 賽亞心臟節律器"MEDTRONIC" SENSIA
PACEMAKER(VVIR/AAIR)*需檢附心電圖報告專案報備使用
64214
FHP01SS01SM4 "美敦力" 賽亞心臟節律器"MEDTRONIC" SENSIA
PACEMAKER(VVI/AAI)*需檢附心電圖報告專案報備使用
61910
FHP01SSR20SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 20
PACEMAKER *適應症見備註欄。
64214
FHP01SSR40SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 40
PACEMAKER *適應症見備註欄
64214
FHP01SSR50SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 50
PACEMAKER *需檢附心電圖報告專案報備使用
64214
FHP01SSR60SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 60
PACEMAKER *需檢附心電圖報告專案報備使用
64214
FHP01SSS20SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 20
PACEMAKER *適應症見備註欄。
56540
FHP01UTASRGU "佳騰"因施尼亞內植用雅密特心臟整律器"GUIDANT"INSIGNIA I
ULTRA PULSE GENERATOR SSIR*須檢附心電圖報告專案報備適用
64214
FHP01V56SRST "聖猷達"維奇植入式心臟節律器"SJM" VICTORY IMPLANTABLE
CARDIAC PULSE GENERATOR * 須檢附心電圖報告專案報備使用
64214
FHP01VDSS5SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 50
PACEMAKER *適應症見備註欄
61910
FHP01VEESRST IMPLANTABLE CARDIAC PULSE GENERATOR單腔型植入式心臟節律器
*須檢附心電圖報告專案報備使用
64214
FHP01VERSCST 植入式心臟節律器IMPLANTABLE CARDIAC PULSE GENERATOR 61910
FHP01VERSRST 植入式心臟節律器IMPLANTABLE CARDIAC PULSE GENERATOR#須檢
附心電圖報告專案報備使用
64214
FHP01ZESR6ST "聖猷達"神風植入式心臟節律器"SJM" ZEPHYR IMPLANTABLE
CARDIAC PULSE GENERATOR *適應症請見備註欄
64214
FHP021A5DRM4 美敦力艾維莎植入式心臟節律器ADVISA DR IMPLANTABLE
PACEMAKERM*適應症請見備註欄,按同類近似特材支付點數支付,
超過部分由病患自付。
93833
FHP02A3DR1M4 "美敦力"艾維莎核磁共振植入式心臟節律器"MEDTRONIC"ADVISA
DR MRI SURESCAN IMPLANTABLE PACEMAKER*按近似特材102500點
支付,超過部分由病患自付。
93833
FHP02ACCDRST "聖猷達" 艾森艾斯特心臟節律器(雙腔)"SJM" ACCENT ST PULSE
GENERATOR*適應症請見備註欄,按同類近似特材支付點數支付,
超過部分由病患自付
93833
FHP02ACSDRST "聖猷達" 艾森艾斯特心臟節律器(雙腔)"SJM" ACCENT ST PULSE
GENERATOR*適應症請見備註欄,按同類近似特材支付點數支付,
超過部分由病患自付
93833
FHP02ACTDRST "聖猷達"艾森心臟節律器(IMPLANTABLE CARDIAC PULSE
GENERATOR雙腔型) *適應症請見備註欄,按同類近似特材支付點數
支付,超過部分由病患自付。
93833
FHP02ADDRSM4 "美敦力" 黛拉心臟節律器"MEDTRONIC" ADAPTA PACEMAKER-DDDR*
使用規定請見備註欄,,按同類近似特材支付點數支付,超過部分
由病患自付。
93833
FHP02ARFDRST "聖猷達"艾森心臟節律器(IMPLANTABLE CARDIAC PULSE
GENERATOR雙腔型) *適應症請見備註欄,按同類近似特材支付點數
支付,超過部分由病患自付。
93833
FHP02DDD2SST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄
93833
897
特材代碼 中英文名稱 支付點數-104/01/01
FHP02DDD2UST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄
93833
FHP02DDD32GU 內植用雅密特心臟整律器GUIDANT INSIGNIA I AVT PULSE
GENERATOR*適應症請見備註欄
93833
FHP02DDD50SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 50
PACEMAKER *需檢附心電圖報告專案報備使用
93833
FHP02DDD6SST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄
93833
FHP02DDD6UST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄
93833
FHP02DDDADM4 美敦力黛拉心臟節律器MEDTRONIC ADAPTA PACING GENERATOR*適
應症請見備註欄
93833
FHP02DDDSEM4 美敦力賽亞心臟節律器MEDTRONIC SENSIA PACING GENERATOR*適
應症請見備註欄
93833
FHP02DDR20SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 20
PACEMAKER *適應症見備註欄,按同類近似特材支付點數支付,超
過部分由病患自付。
93833
FHP02DDR31GU 內植用雅密特心臟整律器GUIDANT INSIGNIA I AVT PULSE
GENERATOR*適應症請見備註欄,按同類近似特材支付點數支付,超
過部分由病患自付。
93833
FHP02DDR3SST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄,按同類近似特材支付點數支付,超過部分由
病患自付。
93833
FHP02DDR3UST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄,按同類近似特材支付點數支付,超過部分由
病患自付。
93833
FHP02DDR40SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 40
PACEMAKER *適應症見備註欄,按同類近似特材支付點數支付,超
過部分由病患自付。
93833
FHP02DDR41GU 因施尼亞心臟整律器GUIDANT INSIGNIA I ULTRA PULSE
GENERATOR*適應症請見備註欄,按同類近似特材支付點數支付,超
過部分由病患自付。
93833
FHP02DDR50SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 50
PACEMAKER *適應症見備註欄,按同類近似特材支付點數支付,超
過部分由病患自付。
93833
FHP02DDR5SST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄,按同類近似特材支付點數支付,超過部分由
病患自付。
93833
FHP02DDR5UST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄,按同類近似特材支付點數支付,超過部分由
病患自付。
93833
FHP02DDR60SB "波士頓科技" 歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 60
PACEMAKER *適應症見備註欄,按同類近似特材支付點數支付,超
過部分由病患自付。
93833
FHP02DDR7UST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄,按同類近似特材支付點數支付,超過部分由
病患自付。
93833
FHP02DDR8SST 維奇植入式心臟節律器"SJM"VICTORY IMPLANTABLE CARDIAC
PULSE GENERATOR適應症請見備註欄,按同類近似特材支付點數
102500點支付,超過部分由病患自付
93833
FHP02DDR8UST 雙腔型心臟節律器"SJM" VICTORY IMPLANTABLE CARDIAC PULSE
GENERATOR *適應症請見備註欄,按同類近似特材支付點數支付,
超過部分由病患自付。
93833
898
特材代碼 中英文名稱 支付點數-104/01/01
FHP02DDRADM4 美敦力黛拉心臟節律器MEDTRONIC ADAPTA PACING GENERATOR*適
應症請見備註欄,按同類近似特材支付點數支付,超過部分由病
患自付。
93833
FHP02DDRSEM4 美敦力賽亞心臟節律器MEDTRONIC SENSIA PACING GENERATOR*適
應症請見備註欄,按同類近似特材支付點數支付,超過部分由病
患自付。
93833
FHP02DDRTHM4 植入式心臟節律系統ENRHYTHM IMPLANTABLE PACEMAKER SYSTEMS*
適應症請見備註欄,按同類近似特材支付點數支付,超過部分由
病患自付。
93833
FHP02DDRVEM4 美敦力維莎心臟節律器MEDTRONIC VERSA PACING GENERATOR*適應
症請見備註欄,按同類近似特材支付點數支付,超過部分由病患
自付。
93833
FHP02EMRDRBK "百多力"艾維亞植入式心律調節器(雙腔自付差
額)"BIOTRONIK"EVIA IMPLANTABLE CARDIAC PACEMAKERS(DR
PROMRI)
93833
FHP02EMRDTBK "百多力"艾維亞植入式心律調節器(雙腔自付差
額)"BIOTRONIK"EVIA IMPLANTABLE CARDIAC PACEMAKERS(DR-T
PROMRI)
93833
FHP02EN1DRM4 "美敦力"安信諾核磁共振植入式心臟節律器(雙腔自付差
額)"MEDTRONIC"ENSURA DR MRI SURESCAN IMPLANTABLE
PACEMAKER
93833
FHP02EVADRBK "百多力"艾維亞植入式心律調節器"BIOTRONIK" EVIA
IMPLANTABLE CARDIAC PACEMAKER(DDDR)*適應症見備註欄按近似
特材支付,超過部分由病患自付。
93833
FHP02MR224ST “聖猷達”艾森核磁共振心臟節律器-雙腔“SJM”ACCENT MRI
PULSE GENERATOR給付規定請見備註欄,按同類近似特材點數支付
,超過部分由病患自付
93833
FHP02MR226ST 聖猷達艾森艾斯特核磁共振心臟節律器-雙腔“SJM”ACCENT ST
MRI PULSE GENERATOR給付規定請見備註,按同類近似特材支付,
超過部分由病患自付
93833
FHP02PM234ST "聖猷達" 薩斯坦植入式心臟節律器"SJM" SUSTAIN XL
IMPLANTABLE CARDIAC PULSE GENERATOR(DDD)*需檢附心電圖報告
專案報備使用
93833
FHP02PM236ST 薩斯坦植入式心臟節律器"SJM"SUSTAIN XL IMPLANTABLE CARDIAC
PULSE GENERATOR-DDDR適應症見備註欄,按同類近似特材支付,
超過部分由病患支付
93833
FHP02SDR1SM4 "美敦力" 賽亞心臟節律器"MEDTRONIC" SENSIA
PACEMAKER(DDDR)*適應症請見備註欄,按同類近似特材支付點數
102500點支付,超過部分由病患自付。
93833
FHP02VDDADM4 美敦力黛拉心臟節律器MEDTRONIC ADAPTA PACING GENERATOR*適
應症請見備註欄
93833
FHP02VDR1SST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄
93833
FHP02VDR1UST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄
93833
FHP02VDR4SST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄
93833
FHP02VDR4UST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR
*適應症請見備註欄
93833
FHP02ZEDRSST 神風植入式心臟節律器"SJM"ZEPHYR IMPLANTABLE CARDIAC PULSE
GENERATOR適應症請見備註欄,按同類近似特材支付點數支付,超
過部分由病患自付。
93833
899
特材代碼 中英文名稱 支付點數-104/01/01
FHP02ZEDRUST 神風植入式心臟節律器"SJM"ZEPHYR IMPLANTABLE CARDIAC PULSE
GENERATOR適應症請見備註欄,按同類近似特材支付點數支付,超
過部分由病患自付。
93833
FHP1104700ED CVS DIVISION PERICARDIAL PATCH 10X15CM 7838
FHP1106120GX "戈爾"普瑞得福心包膜代用膜"GORE" PRECLUDE PRECARDIAL
MEMBRANE 6*12CM
4310
FHP1112120GX "戈爾"普瑞得福心包膜代用膜"GORE" PRECLUDE PRECARDIAL
MEMBRANE 12*12CM
8322
FHP1115200GX "戈爾"普瑞得福心包膜代用膜"GORE" PRECLUDE PRECARDIAL
MEMBRANE 15*20CM
14500
FHP11XA400ED EQUINE PERICARDIAL PATCH 10*10 CM 7838
FHP41V1017VW "維喜"人工血管接環"VASORING" VASCULAR RING CONNECTOR 35000
FHP5600782BA "巴德"心血管補片"BARD"CARDIOVASCULAR PATCH-CARDIOVASCULAR
FABRICS(15.2*15.2CM)
4935
FHP5600790BA "巴德"心血管補片"BARD"CARDIOVASCULAR PATCH-CARDIOVASCULAR
FABRICS(1.0*15.2CM)(2.1*5.1CM)
281
FHP5600793BA "巴德"心血管補片"BARD"CARDIOVASCULAR PATCH-CARDIOVASCULAR
FABRICS(2.5CM*10.2CM)
563
FHP5600794BA "巴德"心血管補片"BARD"CARDIOVASCULAR PATCH-CARDIOVASCULAR
FABRICS(5.1*10.2CM)
1697
FHP5600795BA "巴德"心血管補片"BARD"CARDIOVASCULAR PATCH-CARDIOVASCULAR
FABRICS(10.2*10.2CM)
2319
FHP5607018BA "巴德"心血管補片"BARD" CARDIOVASCULAR PATCH-SURGICAL
FELTS 2.5*2.5CM,0.6*5.1CM,1.3*10.2CM,2.5*2.5CM,1.0*15.2CM
281
FHP5607836BA "巴德"心血管補片"BARD" CARDIOVASCULAR PATCH-SURGICAL
FELTS 10.2*10.2CM
2319
FHP5607837BA "巴德"心血管補片"BARD" CARDIOVASCULAR PATCH-SURGICAL
FELTS 15.2*15.2CM
4935
FHP5607963BA "巴德"心血管補片"BARD" CARDIOVASCULAR PATCH-PTFE FELT
PLEDGETS 矩形4.86*6MM,9.5*4.8MM,7.9*7.9MM,6*6MM;橢圓形
4.8*6MM;圓形4.8MM,6MM
41
FHP5607968BA "巴德"心血管補片"BARD" CARDIOVASCULAR PATCH-SURGICAL
FELTS 2.5*10.2CM,5.1*5.1CM
563
FHP5607976BA "巴德"心血管補片"BARD" CARDIOVASCULAR PATCH-SURGICAL
FELTS 2.5*15.2CM
832
FHP5611073AE "雅氏" 人工血管補片"AESCULAP" VASCULAR
PATCH(2*9CM,1*7CM,3*4CM)
281
FHPCD1870VGU GUIDANT VITALITY AICD維達自動植入型心律去顫器*適應症請見
備註欄
315795
FHPCD1871DGU GUIDANT VITALITY AICD維達自動植入型心律去顫器*適應症請見
備註欄
383267
FHPCD214DMM4 "美敦力" 思格拉植入式心臟去顫器(雙腔)"MEDTRONIC" SECURA
DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*使用規定請見備
註欄
443350
FHPCD214VMM4 "美敦力" 思格拉植入式心臟去顫器(單腔)"MEDTRONIC" SECURA
VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*使用規定請見備
註欄
330345
FHPCD354DMM4 "MEDTRONIC"PROTECTA XT DR IMPLANTABLE CARDIOVERTER
DEFIBRILLATOR"美敦力"博特多艾緹植入式心臟去顫器*適應症請
見備註欄
483701
FHPCD354VMM4 "MEDTRONIC"PROTECTA XT VR IMPLANTABLE CARDIOVERTER
DEFIBRILLATOR"美敦力"博特多艾緹植入式心臟去顫器*適應症請
見備註欄
342335
900
特材代碼 中英文名稱 支付點數-104/01/01
FHPCDA155DGU "佳騰"維達艾維塔植入型心律去顫器"GUIDANT" VITALITY AVT
ICD*適應症請見備註欄
383267
FHPCDC164AM4 "美敦力"維多植入式心臟去顫器"MEDTRONIC" VIRTUOSO
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請見備註欄
443350
FHPCDD164VM4 "美敦力"維多植入式心臟去顫器"MEDTRONIC" VIRTUOSO
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請見備註欄
315795
FHPCDD234DM4 "美敦力"思格拉植入式心臟去顫器“MEDTRONIC”SECURA DR
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR *適應症請見備註欄
443350
FHPCDD234VM4 "美敦力"思格拉植入式心臟去顫器“MEDTRONIC”SECURA VR
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR *適應症請見備註欄
330345
FHPCDD284DM4 "美敦力"麥思蒙植入式心臟去顫器(雙腔)"MEDTRONIC" MAXIMO II
DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請見備註
欄
383267
FHPCDD284VM4 "美敦力"麥思蒙植入式心臟去顫器(單腔)"MEDTRONIC" MAXIMO II
VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請見備註
欄
315795
FHPCDD354DM4 "MEDTRONIC"PROTECTA XT DR IMPLANTABLE CARDIOVERTER
DEFIBRILLATOR"美敦力"博特多艾緹植入式心臟去顫器*適應症請
見備註欄
483701
FHPCDD354VM4 "MEDTRONIC"PROTECTA XT VR IMPLANTABLE CARDIOVERTER
DEFIBRILLATOR"美敦力"博特多艾緹植入式心臟去顫器*適應症請
見備註欄
342335
FHPCDD364DM4 "美敦力"博特多植入式心臟去顫器"MEDTRONIC" PROTECTA DR
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請見備註欄
383267
FHPCDD364VM4 "美敦力"博特多植入式心臟去顫器"MEDTRONIC" PROTECTA VR
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請見備註欄
315795
FHPCDDR259ST “聖猷達”弗帝法亞速拉植入式心律去顫器(射頻雙腔型)*給付規
定請見備註欄“SJM” FORTIFY ASSURA IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR
443350
FHPCDDR279ST “聖猷達”依利普植入式心律去顫器(射頻雙腔型)*給付規定請見
備註欄“SJM” ELLIPSE IMPLANTABLE CARDIOVERTER
DEFIBRILLATOR
483701
FHPCDDR36QST "聖猷達" 植入式心律去顫器"SJM" CURRENT ACCEL IMPLANTABLE
CARDIOVERTER/DEFIBRILLATOR(DR)*適應症請見備註欄
443350
FHPCDDRCD2ST "SJM" CURRENT ACCEL IMPLANTABLE
CARDIOVERTER/DEFIBRILLATOR"聖猷達"植入式心律去顫器*適應症
請見備註欄
443350
FHPCDDRF22ST "聖猷達" 弗帝法艾斯特植入式心律去顫器"SJM" FORTIFY ST
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請見備註欄
443350
FHPCDDRF23ST "聖猷達" 植入式心律去顫器"SJM" FORTIFY IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR(雙腔)*適應症請見備註欄
443350
FHPCDDRPLSST “聖猷達”克侖特普拉斯植入式心律去顫器-雙腔SJM”CURRENT+
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*使用規定請見備註欄
383267
FHPCDF102DSB "波士頓科技" 泰利均植入型心律去顫器 "BOSTON SCIENTIFIC"
TELIGEN 100 HE ICD*適應症請見備註欄
315795
FHPCDF110DSB "波士頓科技" 泰利均植入型心律去顫器 "BOSTON SCIENTIFIC"
TELIGEN 100 HE ICD*適應症請見備註欄
383267
FHPCDP0230ST PHOTON DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請
見備註欄
337982
901
特材代碼 中英文名稱 支付點數-104/01/01
FHPCDPD232ST PHOTON DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請
見備註欄
337982
FHPCDPD240ST PHOTON DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR※適應症
請見備註欄
337982
FHPCDPD243ST PHONTON DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR植入式雙
腔型心臟去顫器*適應症請見備註欄
383267
FHPCDPD26NST "聖猷達"植入式雙腔型心臟去顫器"SJM"PHONTON DR IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR*適應症請見備註欄
383267
FHPCDPD27NST "聖猷達"克侖特植入式心律去顫器"SJM"CURRENT IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR(雙腔) *適應症請見備註欄
383267
FHPCDPS168ST "聖猷達"植入式心律去顫器"SJM"IMPLANTABLE CARDIOVERTER
DEFIBRILLATORS*適應症請見備註欄
315795
FHPCDPS193ST 植入性心律去顫器IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適
應症請見備註欄
315795
FHPCDPS199ST IMPLANTABLE CARDIOVERTER DEFIBRILLATOR※適應症請見備註欄 285381
FHPCDPVRC7ST "聖猷達"克侖特植入式心律去顫器"SJM"CURRENT IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR(單腔) *適應症請見備註欄
315795
FHPCDRFD22ST "聖猷達" 克侖特植入式心律去顫器 "SJM" CURRENT IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR*適應症請見備註欄
383267
FHPCDRFVD2ST "聖猷達" 克侖特植入式心律去顫器 "SJM" CURRENT IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR*適應症請見備註欄
315795
FHPCDT167DGU "佳騰"維達第2代自動植入型心律去顫器"GUIDANT" VITALITY 2EL
ICD (雙腔)*適應症請見備註欄
383267
FHPCDT177DGU "佳騰"維達第2代自動植入型心律去顫器"GUIDANT" VITALITY 2EL
ICD (單腔)*適應症請見備註欄
315795
FHPCDVR259ST “聖猷達”弗帝法亞速拉植入式心律去顫器(射頻單腔型)*給付規
定請見備註欄“SJM” FORTIFY ASSURA IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR
330345
FHPCDVR279ST “聖猷達”依利普植入式心律去顫器(射頻單腔型)*給付規定請見
備註欄“SJM” ELLIPSE IMPLANTABLE CARDIOVERTER
DEFIBRILLATOR
342335
FHPCDVR36QST "聖猷達" 植入式心律去顫器"SJM" CURRENT ACCEL IMPLANTABLE
CARDIOVERTER/DEFIBRILLATOR*適應症請見備註欄
330345
FHPCDVRCD2ST "聖猷達" 植入式心律去顫器"SJM" CURRENT ACCEL IMPLANTABLE
CARDIOVERTER/DEFIBRILLATOR*適應症請見備註欄
330345
FHPCDVRF23ST "聖猷達" 植入式心律去顫器"SJM" FORTIFY IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR(單腔)*適應症請見備註欄
330345
FHPCDVRF35ST "聖猷達" 弗帝法艾斯特植入式心律去顫器(單腔)"SJM" FORTIFY
ST IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*適應症請見備註
欄
330345
FHPCDVRPLSST “聖猷達”克侖特普拉斯植入式心律去顫器-單腔SJM”CURRENT+
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR*使用規定請見備註欄
315795
FHPCL06935M4 "美敦力"史賓特導管"MEDTRONIC" SPRINT QUATTRO SECURE S
LEAD*適應症請見備註欄
76664
FHPCL06944M4 SPRINT LEAD(ICD)*適應症請見備註欄 75682
FHPCL06947M4 史賓特導線SPRINT LEAD 58,65,75,100CM *適應症請見備註欄 76664
FHPCL6935MM4 “美敦力”史賓特植入式導線“MEDTRONIC”SPRINT QUATTRO
SECURE IMPLANTABLE LEAD
76664
FHPCL6947MM4 “美敦力”史賓特植入式導線 “MEDTRONIC”SPRINT QUATTRO
SECURE IMPLANTABLE LEAD*給付規定請見備註欄
76664
FHPCLAF157GU 安達植入式去顫器電極導線ENDOTAK RELIANCE IMPLANTABLE
LEAD*適應症請見備註欄
76664
902
特材代碼 中英文名稱 支付點數-104/01/01
FHPCLB0147GU "佳騰"安達植入式去顫器電極導線"GUIDANT" ENDOTAK RELIANCE
IMPLANTABLE LEAD*適應症請見備註欄
75682
FHPCLB0157GU "佳騰"安達植入式電極導線"GUIDANT" ENDOTAK RELIANCE
IMPLANTABLE LEAD*適應症請見備註欄
76664
FHPCLB0170GU "GUIDANT"ENDOTAK RELIANCE SG IMPLANTABLE LEAD*適應症請見
備註欄
75682
FHPCLB0174GU "佳騰"安達集植入式電極導線"GUIDANT" ENDOTAK RELIANCE G
IMPLANTABLE LEAD*適應症請見備註欄
75682
FHPCLB0184GU "佳騰"安達集植入式電極導線"GUIDANT" ENDOTAK RELIANCE G
IMPLANTABLE LEAD*適應症請見備註欄
76664
FHPCLD712QST "聖猷達" 德拉多心臟導線"SJM" DURATA LEAD(FOR ICD)*適應症
請見備註欄
76664
FHPCLD717QST "聖猷達" 德拉多心臟導線"SJM" DURATA LEAD(FOR ICD)*適應症
請見備註欄
75682
FHPCLDU723ST "聖猷達"德拉多心臟導線"SJM" DURATA LEAD 76664
FHPCLDU7SWST "聖猷達" 德拉多心臟導線 "SJM" DURATA LEAD *適應症請見備註
欄
76664
FHPCLE0147GU 安達植入式去顫器電極導線ENDOTAK RELIANCE IMPLANTABLE
LEAD*適應症請見備註欄
75682
FHPCLLS359BK “百多力”霖納思(四極)心內除顫器被動導線“BIOTRONIK”
LINOX SMART TD IMPLANTABLE DEFIBRILLATOR LEADS INCL.
ACCESSORIES (包括附件)
75682
FHPCLR1ATAST TRANSVENOUS TACHYARRHYTHMIA LEAD※適應症請見備註欄(產品型
號RIATA1560:1562,1590:1592自94.4.1生效使用)
75682
FHPCLR700NST "聖猷達"經靜脈心搏過速導線"SJM" TRANSVENOUS
TACHYARRHYTHMIA LEAD*適應症請見備註欄
76664
FHPCLR704NST "聖猷達"經靜脈心搏過速導線※適應症見備"SJM”TRANSVENOUS
TACHYARRHYTHMIA LEAD
75682
FHPHF04193M4 ATTAIN OTW LEAD艾坦插入式導線※適應症請見備註欄 19845
FHPHF04194M4 "美敦力"艾坦插入式導線"MEDTRONIC"ATTAIN OTW LEAD*適應症請
見備註欄
19845
FHPHF04195M4 "美敦力"艾坦史塔菲導線"MEDTRONIC" ATTAIN STARFIX LEAD*適
應症請見備註欄
22655
FHPHF04196M4 "美敦力"艾坦艾比利導線"MEDTRONIC" ATTAIN ABILITY LEAD*適
應症請見備註欄
19952
FHPHF04591SB "波士頓"艾裘帝螺旋植入式電極導線"BOSTON SCIENTIFIC"
ACUITY SPIRAL IMPLANTABLE LEAD※適應症請見備註欄
19845
FHPHF08042M4 INSYNC III ATRIAL SYNCHRONOUS PACING DEVICE※適應症請見備
註欄
180228
FHPHF0C2TRM4 "美敦力"信可心臟再同步節律器"MEDTRONIC"SYNCRA CRT-P
CARDIAC RESYNCHRONIZATION THERAPY PACEMAKER*適應症請見備
註欄
180228
FHPHF1056NST 〝SJM〞LEFT VENTRICULAR LEAD〝聖猷達〞左心室心臟節律器導
線*適應症請見備註欄(產品型號QUICKSITE 1056T自95.1.1生效)
19845
FHPHF1058NST "聖猷達"左心室心臟節律器導線"SJM" LEFT VENTRICULAR LEAD*
適應症請見備註欄
19845
FHPHF11568ST "聖猷達" 左心導線 "SJM" QUICKFLEX LEAD*適應症請見備註欄 19845
FHPHF1258TST "聖猷達"快克弗里斯麥可左心導線"SJM" QUICKFLEX u LEAD*適應
症請見備註欄
19952
FHPHF32374ST "聖猷達"夸特左心導線“SJM”QUARTET LEFT HEART LEAD*使用規
定請見備註欄
22311
FHPHF96CRTST 〝SJM〞BIVENTRICULAR STIMULATION DEVICE〝聖猷達〞雙心室心
臟節律器*適應症請見備註欄
180228
903
特材代碼 中英文名稱 支付點數-104/01/01
FHPHFACUTYGU "佳騰"雅各易導型電極導管"GUIDANT"ACUITY STEERABLE LEAD*適
應症請見備註欄
19845
FHPHFEASY2GU "佳騰"易導型第二代雙電極導管"GUIDANT"EASYTRAK 2 IS-1
PACING LEAD*適應症請見備註欄
19845
FHPHFEASY3GU "佳騰"易導型第3代冠狀靜脈電極導線"GUIDANT"EASYTRAK 3
CORONARY VENOUS LEAD*適應症請見備註欄
19845
FHPHFEASYTGU ”佳騰”易導型電極導線”GUIDANT”EASYTRAK 2 PACING LEAD*
適應症請見備註欄
19845
FHPHFH1401GU "佳騰"控達刻脈搏產生器"GUIDANT" CONTAK RENEWAL CRT-P
PULSE GENERATOR*適應症請見備註欄
180228
FHPHFKX346BK "百多力"可洛植入式心導線"BIOTRONIK"COROX OTW LEAD*適應症
請見備註欄
19845
FHPHFPM2RTST "聖猷達"安勝心臟節律器"SJM" ANTHEM IMPLANTABLE CARDIAC
PULSE GENERATOR(CRT-P)*適應症請見備註欄
180228
FHPHFPM3RTST "聖猷達"安勝心臟節律器"SJM" ANTHEM IMPLANTABLE CARDIAC
PULSE GENERATOR(CRT-P)*適應症請見備註欄
180228
FHPHFW172ESB “波士頓科技”迎福心臟再同步治療用起搏器“BOSTON
SCIENTIFIC”INVIVE CRT-P
180228
FHPL104067M4 CAPSURE FIX LEAD *須檢附心電圖報告專案報備使用 7479
FHPL104073M4 CAPSURE SENSE LEAD蓋普夏導線※須附心電圖報告專案報備使用 7434
FHPL104074M4 "MEDTRONIC" CAPSURE SENSE LEAD "美敦力"蓋普夏導線*需檢附
心電圖報告專案報備使用
7434
FHPL104088GU "佳騰" 伸縮性雙極之心內膜心房電極導線 "GUIDANT" FLEXTEND
PACING LEAD*須檢附心電圖報告專案報備使用
7479
FHPL104965M4 CAPSURE EPICARDIA LEAD STEROID ELUTING ※須檢附心電圖專案
報備使用
7924
FHPL104968M4 CAPSURE EPICARDIAL LEAD *須檢附心電圖報告專案報備使用 7924
FHPL105054M4 CAPSURE Z PACING LEADS *須檢附心電圖報告專案報備使用 7592
FHPL105071M4 PACEMAKER LEAD (EPICARDIAL)※須檢附心電圖報告專案報備使用 7306
FHPL105076M4 CAPSURE FIX NOVUS LEAD *須檢附心電圖報告專案報備使用(型號
4076自94年7月1日生效)
7479
FHPL105594M4 CAPSURE SP NOVUS ENDOCARDIAL LEAD,STEROID ELUTING*須附心
電圖報告專案報備使用
7434
FHPL11368NST IMPLANTABLE CARDIAC VDD PACING LEAD 52CM,58CM,65CM *須檢
附心電圖報告專案報備使用
7434
FHPL11388NST PACESETTER TENDRIL IMPLANTABLE CARDIAC PACING LEAD※須檢
附心電圖報告專案報備使用
7479
FHPL11488NST PACESETTER TENDRIL IMPLANTABLE CARDIAC PACING LEDA *須檢
附心電圖報告專案報備使用
7479
FHPL11646TST IMPLANTABLE CARDIAC PACING LEAD※須檢附心電圖報告專案報備
使用1646T,1642T
7479
FHPL11646UST “聖猷達”心臟節律器導線“SJM”ISOFLEX S LEAD*需檢附心電
圖報告專案報備使用
7434
FHPL11688NST IMPLANTABLE CARDIAC PACING LEADS※須附心電圖報告專案報備
使用
7479
FHPL117882ST "聖猷達"心臟節律器導線"SJM" IMPLANTABLE CARDIAC PACING
LEADS*須附心電圖報告專案報備使用
7479
FHPL11888NST "聖猷達"心臟節律器導線"SJM" IMPLANTABLE CARDIAC PACING
LEADS*適應症請見備註欄
7479
FHPL11888UST “聖猷達”佩斯賽得心臟節律器導線"SJM"PACESETTER TENDRIL
IMPLANTABLE CARDIAC PACING LEAD*需檢附心電圖報告專案報備
使用
7479
904
特材代碼 中英文名稱 支付點數-104/01/01
FHPL140335GU GUIDANT SELUTE PICOTIP PACING 沖提心內膜心房電極導線*適應
症請見備註欄
7592
FHPL140535GU GUIDANT SWEET PICOTIP RX STEROID ELUTING POSITIVE-
FIXATION POROUS TIP PACING LEAD史威類固醇沖提正極固定多孔
尖端電極導線*適應症請見備註欄
7699
FHPL151121GQ "格列巴齊" 心臟節律器導線"GREATBATCH" MYOPORE BIPOLAR
SUTURELESS MYOCARDIAL LEAD*需檢附心電圖報告專案報備使用
7306
FHPL19288NST "聖猷達" 心臟節律器導線"SJM"IMPLANTABLE CARDIAC PACING
LEADS*須附心電圖報告專案報備使用。
7479
FHPL19288UST “聖猷達”佩斯賽得心臟節律器導線"SJM"PACESETTER TENDRIL
IMPLANTABLE CARDIAC PACING LEAD*需檢附心電圖報告專案報備
7479
FHPL1B4456GU "佳騰"纖幼植入式起搏電極導線"GUIDANT" FINELINE II PACING
LEAD*適應症請見備註欄
7434
FHPL1PPT99ST "聖猷達" 亞提仙司心臟導線"SJM" OPTISENSE LEAD *應檢附心電
圖報告專案報備使用
7479
FHPL1S9F4NST ”聖猷達”心臟節律器導線”SJM” IMPLANTABLE CARDIAC
PACING LEAD※須檢附心電圖報告專案報備使用
7434
FHPL1S9F4UST "聖猷達" 心臟節律器導線 "SJM" IMPLANTABLE CARDIAC PACING
LEADS ※須檢附心電圖報告專案報備使用
7434
FHPL1SE362BK "百多力"喜羅植入式心律調節器電極導線"BIOTRONIK"SIELLO
JT/T IMPLANTABLE ENDOCARDIAL LEADS INCL. ACCESSORIES*給付
規定請見備註欄
7434
FHPL1SR346BK "百多力"植入式心律調節器電極導線"BIOTRONIK" SELOX
ST/SELOX JT ENDOCARDIAL LEAD(SELOX ST 60,53; JT 53,45)*需
檢附心電圖報告專案報備使用
7434
FHPL1SS350BK "百多力"喜特植入式電極導線"BIOTRONIK" SETROX S
IMPLANTABLE ENDOCARDIAL LEADS*須檢附心電圖報告專案報備使
用
7479
FHPL1SS362BK "百多力"喜羅植入式電極導線(包括配件)"BIOTRONIK"SIELLO S
IMPLANTABLE ENDOCARDIAL LEADS INCL. ACCESSORIES*給付規定
見備註欄
7479
FHPL1VDD43GU "佳騰"類固醇(VDD型)心內膜心房電極導線"GUIDANT"SELUTE
PICOTIP VDD PACING LEADS*應檢附心電圖報告專案報備使用
7434
FHPL203830M4 "美敦力"賽西兒導線 "MEDTRONIC"SELECTSURE LEAD*適應症請見
備註欄
17197
FHPL205038M4 〝美敦力〞蓋普夏整律導管"METRONIC" CAPSURE VDD-2 LEAD*適
應症請見備註欄
14140
FHPL21368NST "聖猷達"植入式心臟節律器電刺激導線 "SJM" IMPLANTABLE
CARDIAC PACING LEAD*適應症請見備註欄
14140
FHPL2SLX65BK "百多力"世樂植入式電極導線 "BIOTRONIK" SOLOX IMPLANTABLE
ENDOCARDIAL LEAD*適應症請見備註欄
14140
FHV010019AST AORTIC VALVE 40196
FHV010025MST "聖猷達"人工機械瓣膜"ST.JUDE" MECHANICAL HEART VALVE 40196
FHV0117AHPST AORTIC VALVE 40196
FHV01A1927ST REGENT MECHANICAL HEART VALVE瑞珍機械性心臟瓣膜 50503
FHV01A1929F6 "翁克斯" 人工心瓣膜 "ON-X" PROSTHETIC HEART VALVE 19:29MM 40196
FHV01AMHPJST MECHANICAL HEART VALVE人工機械瓣膜 40196
FHV01APAVGM4 “美敦力”主動脈人工血管瓣膜 “MEDTRONIC”AORTIC VALVED
GRAFT*給付規定請見備註欄
60955
FHV01CAVGJST 馬斯特機械性人工心臟瓣膜MASTERS MECHANICAL HEART VALVE*適
應症請見備註欄
60955
FHV01CNNFVF6 "翁克斯"人工心瓣膜"ON-X" PROSTHETIC HEART VALVE 50503
905
特材代碼 中英文名稱 支付點數-104/01/01
FHV01DPMHVM4 “美敦力”心臟瓣膜“MEDTRONIC”OPEN PIVOT HEART VALVE 50503
FHV01M2333F6 "翁克斯" 人工心瓣膜 "ON-X" PROSTHETIC HEART VALVE 23:33MM 40196
FHV01VAVGJST "聖猷達"馬斯特機械性人工心臟瓣膜 "SJM" MASTERS MECHANICAL
HEART VALVE*適應症請見備註欄
85000
FHV0200995M4 FREESTYLE AORTIC ROOT BIOPROSTHESIS(19MM:27MM)※適應症請
見備註欄
63000
FHV02A2650ED "愛德華"卡本特愛德華人工心臟瓣膜"EDWARDS"CARPENTIER-
EDWADRS S.A.V. BIOPROSTHESIS
43613
FHV02B10AMST PORCIN HEART VALVE (AORTIC 21MM:29MM,MITRAL 25MM:35MM) 43613
FHV02B2933ST "聖猷達"豬組織瓣膜"SJM"PORCINE VALVE 43613
FHV02ELEAMST 〝SJM〞EPIC VALVE AORTIC-21A-31A MITRAL-25M-35M 43613
FHV02EPSAMST "聖猷達"豬組織瓣膜"SJM" EPIC VALVE 43613
FHV02T505TM4 HANCOCK II BIOPROSTHETIC HEART VALVE(AORTIC
21:29MM,MITRAL 25:33MM)
43613
FHVR104100ED 卡本特-麥卡錫亞當二尖瓣修補環"EDWARDS"CARPENTIER-
MCCARTHY-ADMA IMR ETLOGIX ANNULOPLASTY RING24MM:34MM
20100
FHVR104450ED C/E PHYSIO ANNULOPLASTY RING(24:40MM) 20100
FHVR104600ED COSGROVE-EDWARDS ANNULOPLASTY SYSTEM(26:38MM) 20100
FHVR1AFR23ST "聖猷達" 愛調環狀成形術環"SJM" ATTUNE FLEXIBLE ADJUSTABLE
ANNULOPLASTY RING
20100
FHVR1M4900ED "愛德華"三尖瓣環成形術系統"EDWARDS"MC3 TRICUSPID
ANNULOPLASTY SYSTEM
20100
FHVR1RSARNST "聖猷達"環狀成形術環"SJM" RIGID SADDLE RING 15700
FHVR1SARNNST 環狀成形術環 SEGUIN ANNULOPLASTY RING 20100
FHVR1SARPNST 環狀成形術環 SEGUIN ANNULOPLASTY RING 20100
FHVR1T4528ED CARPENTIER-EDWARDS CLASSIC ANNULOPLASTY RING(26:36MM) 15700
FHVR1TARNNST SJM TAILOR ANNULOPLASTY RING(25MM:35MM) 20100
FHVR1TARPNST TAILOR ANNULOPLASTY RING泰勒環狀成形術環 20100
FHX0229400M4 OCTOPUS 4 TISSUE STABILIZER SYSTEM (產品型號29403自94年10
月1日生效)29700&29800自95年9月1日刪除給付
44002
FHX02AM100QM “邁柯唯”阿克貝埃心臟不停跳穩定器系統 "MAQUET”ACROBAT I
OFF-PUMP SYSTEM -含ACCESSRAIL PLATFORM(BLADES)+SUCTION
TUBING PACK+STABLILIZER
44002
FHX02CB100QM "邁柯唯"噴射灌洗器(滅菌)"MAQUET" JET LAVAGE(STERILE)*適應
症請見備註欄
2178
FHX02E4012E8 SYNERGY ATTACHMENT *心臟不停跳冠狀動脈繞道手術用吸引式穩
定器
34805
FHX02E401SE8 CORONARY ARTERY STABILIZER *心臟不停跳冠狀動脈繞道手術用
穩定器
34805
FHX02E4031E8 “艾斯泰格”穩定器與定位器-心臟不停跳冠狀動脈繞道手術用穩
定器“ESTECH”STABILIZER AND POSITIONER-TITAN STABILIZER*
給付規定請見備註欄
34805
FHX02E4210E8 “艾斯泰格”穩定器與定位器-噴射灌洗器 (滅菌) “ESTECH”
STABILIZER AND POSITIONER-BLOW MISTER (STERILE)
2178
FHX02FX15RTM "泰爾茂"菲斯膜型人工心肺"TERUMO"CAPIOX FX(OXYGENATOR
WITHOUT RESERVOIR WITH HYDROPHILIC POLYMER COATED AND
ARTERIAL FILTER*適應症請見備註欄
20703
FHX02HMM50QM "邁柯唯"微孔膜氧合器"MAQUET" QUADROX-I SMALL ADULT
MICROPOROUS MEMBRANE OXGENATOR*適應症請見備註欄
12913
FHX02HMS70QM "邁柯唯"微孔膜氧合器"MAQUET" OXYGENATOR QUADROX-I WITH
SOFTLINE COATING *適應症請見備註欄
12913
FHX02LAVAGGJ "吉生"噴射灌洗器(滅菌)"JSM" JET LAVAGE(STERILE)*適應症請
見備註欄
2178
906
特材代碼 中英文名稱 支付點數-104/01/01
FHX02MBSTRM4 "美敦力"噴射灌洗器"MEDTRONIC" BLOWER/MISTER(WITH TUBING
SET)
2178
FHX02ME258ML “美德思”氧合器與硬殼靜脈儲血槽-中空纖維氧合器“MEDOS”
OXYGENATOR AND VENOUS HARDSHELL RESERVOIR-HOLLOW FIBER
OXYGENATOR
10073
FHX02MSSMVKZ "吉尼士" 心臟血管外科器械 (滅菌)-心外膜穩定器 "GENESEE"
CARDIOVASCULAR SURGICAL INSTRUMENTS (STERILE)-EPICARDIAL
STABILIZER FEET
34805
FHX02MT222L5 ”加州”灌洗器”CALIFORNIA” BLOWER/MISTER(WITH TUBING
SET) *適應症請見備註欄
2178
FHX02RX050TM CAPIOX RX HOLLOW FIBER OXYGENATOR WITHOUT RESERVOIR BY X-
COATING
10073
FHX02RX150TM ”泰爾茂”膜型人工心肺RX”TERUMO”CAPIOX RX
OXYGENATOR(WITHOUT RESERVOIR)*適應症請見備註欄
12913
FHX02RX250TM CAPIOX RX OXYGENATOR WITHOUT/RESERVOIR W/HYDROPHILIC
POLYMER COATED※適應症請見備註欄(二)(產品型號
CX*RX25W,CX*RX25E自94年10月1日生效)
12913
FHX02SCTSPM4 "美敦力"穩定器"MEDTRONIC" CARDIOVASCULAR SURGICAL
INSTRUMENTS(STERILE)-OCTOPUS TISSUE STABILIZER心臟不停跳
冠狀動脈繞道手術用穩定器
44002
FHX02STB70CX "雀斯"緯博心臟血管外科器械(滅菌) "CHASE" VIPER II
CARDIOVASCULAR SURGICAL INSTRUMENTS (STERILE)-"CHASE"
VIPER II VACUUM STABILIZER
44002
FHX02UM900QM ACROBAT VACUUM OFF PUMP SYSTEM(ACCESS RAIL
PLATFORM+STABILIZER+VACCUM TUBING SET)
44002
FHX02VF200ED "愛德華"噴射灌洗器(滅菌)"EDWARDS" VISUFLO ⅡSURGICAL SITE
VISUALIZATION WAND(STERILE) *適應症請見備註欄
2178
FHX0303301M4 MINIMAX PLUS OXYGENATOR WITH RESERVOIR 12124
FHX0305306R5 "索倫"亞文成人氧合器"SORIN" D903 DIDECO AVANT ADULT
OXYGENATOR
12124
FHX0307850TM 丟棄式離心幫浦"TERUMO" DISPOSABLE CENTRIFUGUAL PUMP適應症
請見備註欄
9062
FHX030BP80M4 BIO-PUMP ※適應症請見備註欄 9062
FHX030DP38M4 BIO-PROBE INSERT ※適應症請見備註欄 914
FHX0350515R5 "索倫" 康倍佛進化成人氧合器"SORIN" DIDECO COMPACTFLO
EVOLUTION ADULT OXYGENATOR(WITH HARDSHELL VENOUS
RESERVOIR)
12124
FHX0350516R5 "索倫" 康倍佛進化成人氧合器(具塗層)"SORIN" DIDECO
COMPACTFLO EVOLUTION ADULT OXYGENATOR(WITH HARDSHELL
VENOUS RESERVOIR/WITH PHISIO COATED)
14409
FHX0350531R5 "索倫"滴得可新生兒氧合器附靜脈儲血槽(具PHISIO塗層)"SORIN"
DIDECO KIDS-NEWBORN OXYGENATOR(WITH VENOUS HARDSHELL
RESERVOIR)PHISIO COATED適應症
22284
FHX0350534R5 "索倫" 滴得可-新生兒氧合器(具PHISIO塗層)"SORIN" DIDECO
KIDS-NEWBORN OXYGENATOR-PHISIO COATED*適應症請見備註欄
18688
FHX0350540R5 "索倫"滴得可嬰兒氧合器附靜脈儲血槽"SORIN" DIDECO KIDS-
INFANT OXYGENATOR(WITH VENOUS HARDSHELL RESERVOIR)PHISIO
COATED*給付規定見備註欄
22284
FHX0350543R5 "索倫" 滴得可-嬰兒氧合器(具PHISIO塗層)"SORIN" DIDECO
KIDS-INFANT OXYGENATOR-PHISIO COATED*適應症請見備註欄
18688
FHX03541TTM4 AFFINITY NT HOLLOW FIBER OXYGENATOR WITH TRILLIUM
BIOPASSIVE SURFACE AND INTEGRATED CVR NT 含心臟切開術靜脈
貯槽之人工心肺*適應症請見備註欄
14409
907
特材代碼 中英文名稱 支付點數-104/01/01
FHX03A5410M4 AFFINITY NT HOLLOW FIBER OXYGENATOR WITH TRILLIUM
BIOPASSIVE SURFACE AND INTEGRATED CVR NT
12124
FHX03A541TM4 AFFINITY NT HOLLOW FIBER OXYGENATOR W/RESERVOIR (TRILLIUM
COATED)※適應症請見備註欄
12368
FHX03BEHLSQM "邁柯唯"體外循環管路組及動靜脈導管"MAQUET"HLS SET WITH
BIOLINE COATING & HLS CANNULAE SET(認證可用30天)*給付規定
請見備註欄
428468
FHX03BPX80M4 BIO-PUMP PLUS CENTRIFUGAL BLOOD PUMP *適應症請見備註欄 9062
FHX03CB511M4 AFFINITY HOLLOW FIBER OXYGENATOR BIOACTIVE SURFACE※適應
症請見備註欄
12913
FHX03FC038TM ”泰爾茂” 血液幫浦-流量接頭”TERUMO”CAPIOX SP PUMP-FLOW
CONNECTOR*適應症請見備註欄
914
FHX03FS038TM CAPIOX SP BLOOD FLOW SENSOR ※適應症請見備註欄 914
FHX03FX15RTM "泰爾茂"菲斯膜型人工心肺"TERUMO"CAPIOX FX(OXYGENATOR WITH
RESERVOIR WITH HYDROPHILIC POLYMER COATED AND ARTERIAL
FILTER*適應症請見備註欄
24000
FHX03HMM51QM "邁柯唯"微孔膜氧合器"MAQUET" OXYGENATOR QUADROX-I WITH
SOFTLINE COATING*適應症請見備註欄
15046
FHX03HMM71QM "邁柯唯"微孔膜氧合器"MAQUET" QUADROX-I ADULT MICROPOROUS
MEMBRANE OXYGENATOR*適應症請見備註欄
15046
FHX03ME002ML HOLLOW FIBER OXYGENATOR WITH RESERVOIR,RHEOPARIN
COATED(HILITE 7000ADULT/HILITE 2800PEDIATRIC/HILITE
1000INFANT)適應症請見備註欄
12368
FHX03ME062ML HOLLOW FIBER OXYGENATOR WITH RESERVOIR,(HILITE
7000ADULT/HILITE 2800PEDIATRIC/HILITE 1000INFANT)
12124
FHX03ME622ML “美德思”氧合器與硬殼靜脈儲血槽"MEDOS” OXYGENATOR AND
VENOUS HARDSHELL RESERVOIR
12124
FHX03ME658ML "美德思"氧合器與硬殼靜脈儲血槽RHEOPARIN塗層(小孩,嬰兒)(氧
合器有COATING,儲血槽無COATING)"MEDOS"OXYGENATOR AND
VENOUS HARDSHELL RESERVOIR,RHEOPARIN
21985
FHX03MEC62ML “美德思”氧合器與硬殼靜脈儲血槽"MEDOS” OXYGENATOR AND
VENOUS HARDSHELL RESERVOIR-OXYGENATOR COATING
12368
FHX03MECL6ML "美德思"人工心肺"MEDOS"OXYGENATOR*適應症請見備註欄 22548
FHX03MECLRML “美德思”氧合器與硬殼靜脈儲血槽-中空纖維氧合器RHEOPARIN
塗層(ECMO使用長效型)"MEDOS" OXYGENATOR AND VENOUS
HARDSHELL RESERVOIR-OXYGENATOR(LONG TE
22548
FHX03MEDP2ML "美德思"血液幫浦系統"MEDOS"DELTASTREAM BLOOD PUMP SYSTEM*
適應症請見備註欄
9062
FHX03PHEADH9 "華億"體外循環管組"HYM" HEART LUNG PACK(PUMP HEAD)*適應症
請見備註欄
9062
FHX03PMAG1T8 “索羅格”善翠美血液幫浦“THORATEC”CENTRIMAG BLOOD PUMP*
適應症請見備註欄
350000
FHX03PMAG2T8 "索羅格"小兒血液幫浦"THORATEC" PEDIVAS BLOOD PUMP 350000
FHX03RRF32QM "邁柯唯" 離心幫浦(未含肝素塗層) "MAQUET" CENTRIFUGAL PUMP
ROTAFLOW WITHOUT BIOLINE COATING*適應症請見備註欄
9062
FHX03RX15RTM ”泰爾茂”膜型人工心肺RX”TERUMO”CAPIOX RX OXYGENATOR*適
應症請見備註欄
14409
FHX03RX25RTM CAPIOX RX OXYGENATOR W/RESERVOIR W/HYDROPHILIC COATED※適
應症請見備註欄(二)(產品型號CX*RX25RW,CX*RX25RE於941001生
效)
14409
FHX03SP045TM CAPIOX SP PUMP HEAD ※適應症請見備註欄 9062
FHX03SX10RTM CAPIOX SX MEMBRANE OXYGENATOR WITH HARD-SHELL RESERVOIR
(PEDIATRIC)
12124
908
特材代碼 中英文名稱 支付點數-104/01/01
FHX03SX18RTM CAPIOX SX MEMBRANE OXYGENATOR WITH HARD-SHELL RESERVOIR
(ADULT)
12124
FHX03VKM10QM 邁柯唯”嬰幼兒微孔膜氧合器附靜脈硬殼式儲血槽OXYGENATOR
QUADROX-I NEONATAL WITH SOFTLINE COATING WITH VENOUS
HARDSHELL RESERVOIR
22284
FHX03VKM11QM 嬰幼兒微孔膜氧合器附靜脈硬殼式儲血槽OXYGENATOR QUADROX-I
NEONATAL WITH SOFTLINE COATING WITH VENOUS HARDSHELL
RESERVOIR ARTERIAL FILTER
24000
FHX03VKM30QM “邁柯唯”幼兒微孔膜氧合器附靜脈硬殼式儲血槽“MAQUET”
OXYGENATOR QUADROX-I PEDIATRIC WITH SOFTLINE COATING WITH
VENOUS HARDSHELL RESERVOIR
22284
FHX03VKM31QM 邁柯唯幼兒微孔膜氧合器附靜脈硬殼式儲血槽OXYGENATOR
QUADROX-I PEDIATRIC WITH SOFTLINE COATING WITH VENOUS
HARDSHELL RESERVOIR ARTERIAL FILTER
24000
FHX03VKM51QM "邁柯唯"微孔膜氧合器附靜脈硬殼式儲血槽OXYGENATOR QUADROX-
I WITH SOFTLINE COATING WITH VENOUS HARDSHELL
RESERVOIR+FILTER*適應症見備註欄
16730
FHX03VKM55QM "邁柯唯"微孔膜氧合器附靜脈硬殼式儲血槽OXYGENATOR QUADROX-
I WITH SOFTLINE COATING WITH VENOUS HARDSHELL RESERVOIR
ARTERIAL*適應症備註欄
14409
FHX03VKM71QM "邁柯唯"微孔膜氧合器附靜脈硬殼式儲血槽OXYGENATOR QUADROX-
I WITH SOFTLINE COATING WITH VENOUS HARDSHELL
RESERVOIR+FILTER*適應症見備註欄
16730
FHX03VKM77QM "邁柯唯" 微孔膜氧合器附靜脈硬殼式儲血槽"MAQUET"OXYGENATOR
QUADROX-I WITH VENOUS HARDSHELL RESERVOIR WITH SOFTLINE
COATING適應症請見備註欄
14409
FHX0432201GJ “吉生”體外循環管組(PVC TUBING(WITH PHISIO
COATING)+OXYGENATOR+BIOLINE CENTRIFUGAL PUMP+ARTERIAL
FILTER WITH PHISIO COATING+AIR FILTER)”JSM” H
28984
FHX0432801GJ “吉生”體外循環管組(OXYGENATOR+PUMP HEAD+TUBING
SET+TRANSDUCER+CUVETTE)”JSM” HEART LUNG PACK
51883
FHX0432802GJ “吉生”體外循環管組(OXYGENATOR+TUBING
SET+TRANSDUCER+CUVETTE)”JSM” HEART LUNG PACK
42355
FHX04A20E1H9 "HYM" HEART LUNG PACK(W/OXYGENATOR+PUMP HEAD+FLOW
PROBE+TUBING SET等)適應症請見備註欄
44306
FHX04A21E1H9 "HYM" HEART LUNG PACK(W/OXYGENATOR+FLOW PROBE+TUBING SET
等)適應症請見備註欄
32432
FHX04A2729H9 "華億" 體外循環管組"HYM" HEART LUNGPACK給付規定請見備註欄
TUBING SET+PRE BYPASS FILTER+ORGANIZER+SUCKER*2+ARTERIAL
FILTER
8500
FHX04A2730H9 "華億" 體外循環管組"HYM" HEART LUNGPACK給付規定請見備註欄
TUBING SET+ORGANIZER+SUCKER*2+ARTERIAL FILTER
6270
FHX04A31CPH9 HEART LUNG PACK適應症備註PRE BYPASS
FILTER+ORGANIZER+SUCKER*2+ARTERIAL
FILTER+TRANSDUCER+PROBE CONNECTOR+SATURATION CUVETTE+PUMP
HEAD
19124
FHX04CB1V9M4 BLOOD TUBING PACK血液套裝組(OXYGENATOR+BIO-PUMP+TUBING
SET+DISPOSABLE PROBE)型號CB1Q91R4,CB2503R1自940701生效
44306
FHX04CB4P7M4 "美敦力"血液套裝組”MEDTRONIC”BLOOD TUBING PACK(WITHOUT
OXYGENATOR)*適應症請見備註欄
28028
FHX04CBCCSM4 ECMO CLOSE CHEST SUPPORT CIRCUIT W/OXYGENATOR+BIO-
PUMP+TUBING SET使用參考見備註欄CB2506於920401擴增
44306
FHX04CXESLTM CAPIOX EBS OXYGENATOR KIT(HP)人工心肺套 /OXYGENATOR+SP-
PUMP+TUBING SET※使用參考請見備註欄
44306
909
特材代碼 中英文名稱 支付點數-104/01/01
FHX04CXXSATM "泰爾茂"易倍適聚合物塗層人工心肺套CAPIOX EBS CIRCUIT WITH
X COATING/OXYGENATOR+SP-PUMP+FLOW SENSOR+COATING TUBING
SET※使用參考請見備註欄
44306
FHX04ME620ML ECMO LT SYSTEM(OXGENATOR+TUBING,A-V
LOOP,ADAPTOR,ACCESSORY+PUMP HEAD)適應症請見備註欄
44306
FHX04ME623ML ECMO LT SYSTEM WITHOUT PUMPHEAD適應症請見備註欄 32432
FHX04METUBML "美德思" 管路組"MEDOS" TUBING SETS(ECMO)*適應症請見備註欄 15437
FHX04XYPUMML "美德思" 管路組"MEDOS" TUBING SETS(ECMO長效型人工心肺組)
組件含OXYGENATOR+PUMP HEAD+TUBING SET*適應症請見備註欄
44419
FHX04XYTFLML "美德思" 管路組"MEDOS" TUBING SETS(ECMO長效型人工心肺組)
組件含OXYGENATOR+DISPOSABLE PROBE+TUBING SET*適應症請見備
註欄
37375
FHX04XYTUBML "美德思" 管路組"MEDOS" TUBING SETS(ECMO長效型人工心肺組)
組件含OXYGENATOR+TUBING SET*適應症請見備註欄
35346
FHXR20CR40TM CARDIOTOMY RESERVOIR 4000CC 3297
FHXR2EL400M4 CARDIOTOMY RESERVOIR*適應症請見備註欄 3420
FHXR2ME210ML “美德思”氧合器與硬殼靜脈儲血槽-儲血槽(小孩,嬰兒)"MEDOS
” OXYGENATOR AND VENOUS HARDSHELL RESERVOIR-VENOUS
HARDSHELL RESERVOIR (PEDIATRIC, INFA
3297
FHXR2MEMVCML “美德思”氧合器與硬殼靜脈儲血槽-儲血槽(大人)"MEDOS”
OXYGENATOR AND VENOUS HARDSHELL RESERVOIR-VENOUS
HARDSHELL RESERVOIR (ADULT)
3297
FHXR2VHK11QM "邁柯唯" 靜脈硬殼式儲血槽"MAQUET" VENOUS HARDSHELL
CARDIOTOMY RESERVOIR※適應症請見備註欄
3420
FHXR2VHK20QM "邁柯唯"開心術靜脈硬殼式儲血槽"MAQUET" VENOUS HARDSHELL
CARDIOTOMY RESERVOIR
3297
FNP9106010GX DURA SUBSTITUTE 6CMX10CM(代用人工腦膜) 11296
FNP910610XGX DURA SUBSTITUTE 6CMX10CM 11296
FPP0014202XU "合碩"顱顏骨固定系統:L形骨板4洞;5洞;8洞"CUSMED"CMF
FIXATION SYSTEM: MINI BONE PLATE TITANIUM L-TYPE
4HOLE;5HOLE;8HOLE
1380
FPP0074402XU "合碩"顱顏骨固定系統:T形骨板,6:7洞"CUSMED"CMF FIXATION
SYSTEM: MICRO T-TYPE BONE PLATE,PURE TITANIUM 6:7HOLE
4430
FPP0105152LE “史賽克 雷賓格爾”下頷骨系統;骨板Y型5-8孔1.7MM
““STRYKER LEIBINGER” UNIVERSAL MANDIBLE SYSTEM 1.7MM
LOCKING Y PLATE 5-8 HOLES
1743
FPP0105188LE STRYKER LEIBINGER UNIVERSAL MANDIBLE SYSTEM:1.7MM MID-
FACE CURVED PLATE 4-10 HOLES ※適應症請見備註欄
1562
FPP0105742LE STRYKER LEIBINGER UNIVERSAL MANDIBLE SYSTEM:1.7MM MID-
FACE SET LOCKING DOUBLE Y PLATE 7 HOLES※適應症請見備註欄
2469
FPP010574NLE MINI DOUBLE Y PLATE 7 HOLE※適應症請見備註欄 2469
FPP010575NLE MINI Y PLATE W/BAR 5 HOLE※適應症請見備註欄 1743
FPP010576NLE MINI LOCKING PLATE W/BAR 5-6 HOLE ※適應症請見備註欄 1380
FPP0106002M3 2HOLE MINI LOW PROFILE PLATE※適應症請見備註欄 975
FPP0106106LE 0.6,1.0MM MINI BONE PLATE 5,6HOLE REGULAR STR ※適應症請
見備註欄
975
FPP0106109LE 0.6,1.0MM MINI BONE PLATE 8HOLE REGULAR STR※適應症請見備
註欄
1134
FPP0106112LE 0.6,1.0MM MINI BONE PLATE 4 HOLE REGULAR STR ※適應症請見
備註欄
975
910
特材代碼 中英文名稱 支付點數-104/01/01
FPP0106120LE 0.6,1.0MM MINI L-PLATE REGULAR RIGHT 4HOLE ※適應症請見備
註欄
1380
FPP0106121LE L-PLATE LEFT 0.6MM ※適應症請見備註欄 1380
FPP0106122LE 0.6,1.0MM MINI L-PLATE LONG RIGHT 4HOLE ※適應症請見備註
欄
1380
FPP0106123LE 0.6,1.0MM MINI L-PLATE LONG LEFT 4HOLE ※適應症請見備註欄 1380
FPP0106124LE 0.6,1.0MM MINI L-PLATE REGULAR LEFT 4HOLE ※適應症請見備
註欄
1380
FPP0106140LE 0.6,1.0MM MINI T-PLATE REGULAR 90度 6HOLE ※適應症請見備
註欄
1885
FPP0106141LE 0.6,1.0MM MINI T-PLATE LONG 90度 5HOLE ※適應症請見備註欄 1885
FPP0106142LE 0.6,1.0MM MINI T-PLATE LONG 80度 RIGHT 5HOLE ※適應症請
見備註欄
1885
FPP0106143LE 0.6,1.0MM MINI T-PLATE LONG 80度 LEFT 5HOLE ※適應症請見
備註欄
1885
FPP0106144LE 0.6,1.0MM MINI DOUBLE T PLATE REGULAR 6HOLE ※適應症請見
備註欄
2270
FPP0106145LE 0.6,1.0MM MINI DOUBLE T LONG 90度 4HOLE ※適應症請見備註
欄
2270
FPP0106160LE 0.6,1.0MM MINI Y PLATE(REGULAR LONG)5HOLE ※適應症請見備
註欄
1743
FPP0106162LE 0.6,1.0MM MINI DOUBLE Y PLATE LONG 6HOLE ※適應症請見備註
欄
2469
FPP0106164LE 0.6,1.0MM MINI DOUBLE Y PLATE LONG EXTENDED 8HOLE ※適應
症請見備註欄
2469
FPP0106181LE LOW PROFILE ORBITA PLATE CURVE 6,8 HOLE 0.6MM REGULAR ※
適應症請見備註欄
1562
FPP0106214M3 TITANIUM 0.6MM MINI PLATE L SHAPE ※適應症請見備註欄 1380
FPP0106760LE 1.7 MID-FACE L-PLATE 5-6 HOLES ※適應症請見備註欄 1380
FPP0106763M3 0.6MM,1.0MM TIANIUM LOW PROFILE MINI PLATE DOUBLE Y 6HOLE
※適應症請見備註欄
2469
FPP010677NLE MINI T PLATE 5 HOLE※適應症請見備註欄 1885
FPP0106906M3 TITANIUM 0.6MM LOW PROFILE MINI PLATE ORBITA SHAPE 6,8
HOLES ※適應症請見備註欄
1562
FPP0108203LE 2.0 MINI PLATE BAR 4-6 HOLES※適應症請見備註欄 975
FPP0108216LE 1.0MM MINI BONE PLATE 16HOLE REGULAR STR ※適應症請見備註
欄
1565
FPP010821NLE 2.0 MINI PLATE BAR 16 HOLES※適應症請見備註欄 1565
FPP0108230LE 2.0 MINI PLATE L-PLATE 4-9 HOLES※適應症請見備註欄 1380
FPP0108240LE 2.0 MINI PLATE T-PLATE 6-8 HOLES※適應症請見備註欄 1885
FPP0108250LE 2.0 MINI PLATE Y-PLATE 5-8 HOLES※適應症請見備註欄 1743
FPP0108260LE 1.0MM MINI DOUBLE Y PLATE REGULAR 6HOLE ※適應症請見備註
欄
2469
FPP010826NLE 2.0 MINI PLATE DOUBLE Y-PLATE ※適應症請見備註欄 2469
FPP0108586LE 2.0 MINI PLATE CURVED PLATE 12 HOLES ※適應症請見備註欄 1562
FPP0110001EJ 2.0 MM MINI "L" PLATE 4 HOLE ※適應症請見備註欄 1380
FPP0110021EJ 2.0 MM MINI L PLATE 4 HOLE ※適應症請見備註欄 1380
FPP0110023EJ 2.0 MM MINI Y PLATE 7 HOLE ※適應症請見備註欄 1743
FPP0110030EJ 2.0 MM MINI STRAIGHT PLATE 4 HOLE ※適應症請見備註欄 975
FPP0110032EJ 2.0 MM MINI STRAIGHT PLATE 10 HOLE ※適應症請見備註欄 1134
FPP0110039EJ 2.0 MM MINI LARGE BUR HOLE PLATE 6 HOLE ※適應症請見備註
欄
5873
911
特材代碼 中英文名稱 支付點數-104/01/01
FPP0110052EJ 2.0 MM MINI X PLATE 4 HOLE ※適應症請見備註欄 2469
FPP0110103LE 1.0MM MINI BONE PLATE 4HOLE LONG STR ※適應症請見備註欄 975
FPP0110106LE 0.6,1.0MM MINI BONE PLATE 6HOLE LONG STR ※適應症請見備
註欄
1134
FPP0110230EJ 2.0 MM MINI STRAIGHT PLATE 4 HOLE ※適應症請見備註欄 975
FPP011051NLE MINI PLATE 16 HOLE※適應症請見備註欄 1565
FPP011054NLE “史賽克 雷賓格爾”下頷骨系統迷你骨板4孔“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM MINI PLATE 4 HOLE
975
FPP011056NLE "史賽克雷賓格爾"下頷骨系統迷你骨板 6孔"STRYKER LEIBINGER"
UNIVERSAL MANDIBLE SYSTEM MINI PLATE 6 HOLE
1134
FPP011057NLE MINI STRAIGHT PLATE 8 HOLE ※適應症請見備註欄 1134
FPP01105NNLE MINI LOCKING STRAIGHT PLATE 16 HOLES ※適應症請見備註欄 1565
FPP011067NLE MINI PLATE 4 HOLE W/BAR ※適應症請見備註欄 975
FPP0111031EJ 2.0 MM MINI STRAIGHT PLATE 6 HOLE ※適應症請見備註欄 1134
FPP0111032EJ 2.0 MM MINI STRAIGHT PLATE 8 HOLE ※適應症請見備註欄 1134
FPP0114008EJ 2.0 MM MINI TR BSSO PLATE 4 HOLE ※適應症請見備註欄 2270
FPP0120211Y2 MINI PLATE 1.0MM 4HOLE STR※適應症請見備註欄 975
FPP0120213Y2 MINI PLATE 1.0MM 8HOLE STR※適應症請見備註欄 1134
FPP0120216Y2 MINI PLATE 1.0MM 16HOLE STR※適應症請見備註欄 1565
FPP0120221Y2 MINI PLATE 1.0MM 4HOLE L-SHAPE※適應症請見備註欄 1380
FPP0120231Y2 MINI PLATE 1.0MM 5HOLE T-SHAPE 80,90度※適應症請見備註欄 1885
FPP0120241Y2 MINI PLATE 1.0MM 5HOLE DOUBLE T-SHAPE ※適應症請見備註欄 2270
FPP0120246Y2 MINI PLATE 1.0MM 6HOLE Y-SHAPE ※適應症請見備註欄 1743
FPP0120251Y2 MINI PLATE 1.0MM 6HOLE DOUBLE Y-SHAPE ※適應症請見備註欄 2469
FPP0120256Y2 MINI NASAL BONE PLATE 1.0MM※適應症請見備註欄 4479
FPP0141122XU "合碩"顱顏骨固定系統:直行骨板4洞"CUSMED"CMF FIXATION
SYSTEM: COMBINE MINI BONE PLATE TITANIUM STR 4HOLE
975
FPP0141126XU "合碩"顱顏骨固定系統:直行骨板6洞;8洞"CUSMED"CMF FIXATION
SYSTEM:MINI BONE PLATE TITANIUM STR 6HOLE;8HOLE
1134
FPP0141329XU "合碩"顱顏骨固定系統:連接形骨板12洞;16洞;24洞"CUSMED"CMF
FIXATION SYSTEM:MINI BONE PLATE TITANIUM ADAPTION
12HOLE;16HOLE;24HOLE
1565
FPP0142123XU "合碩"顱顏骨固定系統:L形骨板4洞;5洞;8洞"CUSMED"CMF
FIXATION SYSTEM: MINI BONE PLATE TITANIUM L-TYPE
4HOLE;5HOLE;8HOLE
1380
FPP0142224XU "合碩"顱顏骨固定系統:L中長形骨板4:5洞"CUSMED"CMF FIXATION
SYSTEM: MINI BONE PLATE TITANIUM L-TYPE 4:5HOLE
1380
FPP0142324XU "合碩"顱顏骨固定系統:L中長形骨板4:5洞"CUSMED"CMF FIXATION
SYSTEM: MINI BONE PLATE TITANIUM L-TYPE 4:5HOLE
1380
FPP0142424XU "合碩"顱顏骨固定系統;斜L形骨板,4:5洞"CUSMED"CMF FIXATION
SYSTEM:MINI BONE PLATE,PURE TITANIUM L-TYPE 4:5HOLE
1380
FPP0142524XU "合碩"顱顏骨固定系統;斜L形骨板,4:5洞"CUSMED"CMF FIXATION
SYSTEM:MINI BONE PLATE,PURE TITANIUM L-TYPE 4:5HOLE
1380
FPP0143022XU "合碩"顱顏骨固定系統:眼框形骨板,6洞,8洞"CUSMED"CMF
FIXATION SYSTEM: MINI BONE PLATE,PURE
TITANIUM,ORBITAL,6HOLE,8HOLE
1562
912
特材代碼 中英文名稱 支付點數-104/01/01
FPP0144022XU "合碩"顱顏骨固定系統:T形骨板,6:7洞"CUSMED"CMF FIXATION
SYSTEM: MINI T-TYPE BONE PLATE,PURE TITANIUM 6:7HOLE
1885
FPP0144121XU "合碩"顱顏骨固定系統:T形骨板,5洞"CUSMED"CMF FIXATION
SYSTEM: MINI T-TYPE BONE PLATE,PURE TITANIUM 5HOLE
1885
FPP0144221XU "合碩"顱顏骨固定系統:斜T形骨板,5洞"CUSMED"CMF FIXATION
SYSTEM: MINI T-TYPE ANGLED BONE PLATE,PURE TITANIUM 5HOLE
1885
FPP0145021XU "合碩"顱顏骨固定系統:雙T形骨板,4洞,6洞"CUSMED"CMF
FIXATION SYSTEM: MINI BONE PLATE,PURE TITANIUM,DOUBLE T-
TYPE 4HOLE,6HOLE
2207
FPP0146022XU "合碩"顱顏骨固定系統:Y形骨板,5:6洞"CUSMED"CMF FIXATION
SYSTEM: MINI BONE PLATE,PURE TITANIUM,Y-TYPE LONG 5:6HOLE
1743
FPP0147004S1 MINI PLATE 1.5/2.0 2:4HOLE 16:28MM ※適應症請見備註欄 975
FPP0147016S1 MINI PLATE 2.0 6HOLE 35:40MM ※適應症請見備註欄 1134
FPP0147018S1 2.0MM MANDIBLE MINI PLATE 6HOLE,70D(轉70度) TWISTED 40MM
※適應症請見備註欄
2001
FPP0147021XU "合碩"顱顏骨固定系統:雙Y形骨板,6洞,8洞"CUSMED"CMF
FIXATION SYSTEM: MINI BONE PLATE,PURE TITANIUM,DOUBLE Y-
TYPE 6HOLE,8HOLE
2469
FPP0147100S1 ADAPTION MINI PLATE 1.5,2.0 20HOLE STR ※適應症請見備註欄 1565
FPP0147220S1 ORBITAL RIM PLATE 1.5,2.0 CURVED 8:12 HOLES ※適應症請見
備註欄
1562
FPP01475NNS1 L- PLATE 1.5,2.0 5:10 HOLES ※適應症請見備註欄 1380
FPP0147620S1 Y- PLATE 1.5,2.0 5:8 HOLES ※適應症請見備註欄 1743
FPP0147680S1 DOUBLE Y-PLATE 2.0 8HOLE ※適應症請見備註欄 2469
FPP0147810S1 X-PLATE 1.5,2.0 4 HOLES ※適應症請見備註欄 2469
FPP0147850S1 MINI H-PLATE 2.0 8:9 HOLES ※適應症請見備註欄 4479
FPP0147910S1 MINI BURR HOLE COVER 1.5,2.0 6 HOLES ※適應症請見備註欄 5873
FPP0149024XU "合碩"顱顏骨固定系統:鑽孔蓋型骨板,6洞"CUSMED" CMF
FIXATION SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,BURR HOLE COVER ,6HOLE
5873
FPP0149124XU "合碩"顱顏骨固定系統:引流鑽孔蓋,骨板,5洞"CUSMED"
CMFFIXATION SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,BURR HOLE COVER FOR SHUNT OR DRAIN
5873
FPP0151004M3 TITANIUM 0.6MM,1.0MM MINI PLATE 4 HOLES STR ※適應症請見
備註欄
975
FPP0151006M3 TITANIUM 0.6MM,1.0MM MINIP LATE 6 HOLES STR ※適應症請見
備註欄
1134
FPP0151008M3 TITANIUM 0.6MM,1.0MM MINIP LATE 8HOLE STR ※適應症請見備
註欄
1134
FPP0151016M3 TITANIUM 0.6MM,1.0MM MINI PLATE 16 HOLE STR ※適應症請見
備註欄
1565
FPP0152014M3 TITANIUM 1.0MM MINI PLATE L SHAPE 4 HOLE ※適應症請見備註
欄
1380
FPP0152414M3 TITANIUM 0.6MM,1.0MM MINI PLATE L SHAPE 4HOLE ※適應症請
見備註欄
1380
FPP0152520M3 TITANIUM0.6MM,1.0MM MINI PLATE 110度 4HOLE ※適應症請見
備註欄
1380
FPP0154015M3 TITANIUM 0.6MM,1.0MM MIN IPLATE T SHAPE 90度 4HOLE ※適應
症請見備註欄
1885
FPP0154315M3 TITANIUM 0.6MM,1.0MM MINI PLATE T SHAPE 80度 4HOLE ※適應
症請見備註欄
1885
913
特材代碼 中英文名稱 支付點數-104/01/01
FPP0154816M3 TITANIUM 0.6MM,1.0MM MINI PLATE DOUBLE T SHAPE 90 度
4,6HOLE※適應症請見備註欄
2270
FPP0155015M3 TITANIUM0.6MM,1.0MM MINI PLATE Y SHAPE 5HOLE ※適應症請
見備註欄
1743
FPP0156016M3 TITANIUM 0.6MM,1.0MM MINI PLATE DOUBLE Y SHAPE 6HOLE ※
適應症請見備註欄
2469
FPP0156217M3 TITANIUM 0.6MM,1.0MM MINI PLATE DOUBLE Y SHAPE 7HOLE ※適
應症請見備註欄
2469
FPP0157012M3 TITANIUM 0.6MM,1.0MM MINI PLATE H SHAPE 12HOLE ※適應症請
見備註欄
4479
FPP0187004MC TITANIUM 1MM MINI PLATE 4HOLE STR ※適應症請見備註欄 975
FPP0187005MC TITANIUM 1MM MINI PLATE 5HOLE STR※適應症請見備註欄 975
FPP0187006MC TITANIUM 1MM MINI PLATE 6 HOLE STR ※適應症請見備註欄 1134
FPP0187008MC TITANIUM 1MM MINI PLATE 8 HOLE STR ※適應症請見備註欄 1134
FPP0187014MC TITANIUM 1MM MINI PLATE 4 HOLE 9MM STR ※適應症請見備註欄 975
FPP0187024MC TITANIUM 1MM MINI PLATE 4 HOLE 12MM STR ※適應症請見備註
欄
975
FPP0187030MC "MEDICON"TITANIUM 1MM MINI L-PLATE LEFT 9MM 4 HOLE 鈦金屬
顏面骨板系統:迷你骨板 ※適應症請見備註欄
1380
FPP0187031MC TITANIUM 1MM MINI L-PLATE RIGHT 9MM 4 HOLE※適應症請見備
註欄
1380
FPP0187032MC TITANIUM 1MM MINI L-PLATE LEFT 9MM 4 HOLE ※適應症請見備
註欄
1380
FPP0187033MC TITANIUM 1MM MINI L-PLATE R 9MM 4 HOLE ※適應症請見備註欄 1380
FPP0187034MC TITANIUM 1MM MINI L-PLATE LEFT 12MM 4 HOLE ※適應症請見備
註欄
1380
FPP0187053MC TITANIUM 1MM MINI Y PLATE 9MM 4 HOLE ※適應症請見備註欄 1743
FPP0187054MC TITANIUM 1MM MINI Y PLATE 12MM 4HOLE※適應症請見備註欄 1743
FPP0187055MC TITANIUM 1MM MINI DOUBLE Y PLATE 9MM 6HOLE ※適應症請見備
註欄
2469
FPP0187077MC TITANIUM 1MM MANDIBULAR ANGLE PLATE 4HOLE LEFT ※適應症請
見備註欄
1626
FPP0187078MC TITANIUM 1MM MINI MANDIBULAR ANGLE PLATE 4HOLE RIGHT ※適
應症請見備註欄
1626
FPP0187079MC TITANIUM 1MM MINI MANDIBULAR ANGLE PLATE 6HOLE LEFT ※適
應症請見備註欄
1836
FPP0187080MC TITANIUM 1MM MINI MANDIBULAR ANGLE PLATE 6HOLE RIGHT ※適
應症請見備註欄
1836
FPP0187085MC 1MM MINI TI-ORBITA PLATE 12MM 4HOLE※適應症請見備註欄 1562
FPP0189501MC TITANIUM MANDIBULAR RECONSTRUCTION PLATE STRAIGHT 100MM
2MM ※適應症請見備註欄
4230
FPP0189512MC TITANIUM MANDIBULAR RECONSTRUCTION PLATE ANGLE 105MM 2MM
14HOLE R/L※適應症請見備註欄
6720
FPP0208734LE BRIDGING PLATE STR 11:17 H
(5620011:7,8003:11,3,9012:6,5415070,5633034:139 92/1/1生
效)※適應症見備註
4230
FPP0208743LE BRIDGING PLATE ANGLE LEFT 11HOLE(4+3+4HOLE)2.8MM (型號
5415076自92/1/1/生效)※適應症請見備註欄
6720
FPP0208745LE BRIDGING PLATE L-ANGLE 12:21H(型號
5620048:59,8025:87,9038:76自92/1/1生效) ※適應症請見備註
欄
6720
914
特材代碼 中英文名稱 支付點數-104/01/01
FPP0208747LE BRIDGING PLATE ANGLE LEFT 15HOLE(4+7+4HOLE)2.8MM ※適應症
請見備註欄
6720
FPP0208755LE BRIDGING PLATE ANGLE RIGHT 13HOLE(4+5+4HOLE)2.8MM ※適應
症請見備註欄
6720
FPP0208757LE BRIDGING PLATE ANGLE RIGHT 15HOLE(4+7+4HOLE)2.8MM ※適應
症請見備註欄
6720
FPP0208770LE CONDYLAR IMPLANT LEFT 14MM ※適應症請見備註欄 6874
FPP0208771LE CONDYLAR IMPLANT RIGHT 14MM※適應症請見備註欄 6874
FPP0214201EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION
SYSTEM:RECONSTRUCTION PLATE 4+12 HOLE"歐美特"下頷骨折重建
系統,重建骨板單邊4+12洞
6720
FPP0214203EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION
SYSTEM:RECONSTRUCTION PLATE 5+16 HOLE"歐美特"下頷骨折重建
系統,重建骨板單邊5+16洞
6720
FPP0214205EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION
SYSTEM:RECONSTRUCTION PLATE FULL 5+20+5 5+16+5 HOLE"歐美
特"下頷骨折重建系統,重建骨板雙邊
14495
FPP0214207EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION
SYSTEM:RECONSTRUCTION PLATE 14HOLE"歐美特"下頷骨折重建系
統,重建直型骨板14洞
4230
FPP0214208EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION
SYSTEM:RECONSTRUCTION PLATE 18HOLE"歐美特"下頷骨折重建系
統,重建直型骨板18洞
4230
FPP021552NLE ANGLE PLATE 6-10 HOLE※適應症請見備註欄 5573
FPP021591NLE “史賽克 雷賓格爾”下頷骨系統重建型骨板11-30孔“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM RECON PLATE 11-30
HOLE
4230
FPP021592NLE “史賽克 雷賓格爾”下頷骨系統重建骨板全/半型“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM RECON PLATE HEMI /
FULL
6874
FPP0220511Y2 COMPRESSION PLATE 1.6MM 4,8HOLE STR※適應症請見備註欄 2722
FPP0220518Y2 COMPRESSION PLATE 1.6MM 16HOLE STR※適應症請見備註欄 4230
FPP0220521Y2 COMPRESSION PLATE 1.6MM 4HOLE STR/斜孔※適應症請見備註欄 2722
FPP0220610Y2 TOTAL MANDIBULAR BRIDGING STR PLATE 3.0MM(4+9+4) HOLE※
適應症請見備註欄
14495
FPP0220611Y2 MANDIBULAR BRIDGING STR PLATE 3.0MM(4+2+4) HOLE※適應症
請見備註欄
2722
FPP0220612Y2 MANDIBULAR BRIDGING STR PLATE 3.0MM(4+3,4,5,6,7+4)HOLE※
適應症請見備註欄
4230
FPP0220621Y2 MANDIBULAR BRIDGING STR PLATE 3.0MM(4+3,5,7,9+4)HOLE※適
應症請見備註欄
6720
FPP0240008M3 TITANIUM RECONSTRUCTION PLATE 8HOLE STR※適應症請見備註欄 2722
FPP0240010M3 TITANIUM RECONSTRUCTION PLATE 10:14HOLE STR※適應症請見備
註欄
4230
FPP0240016M3 TITANIUM RECONSTRUCTION PLATE 16,18HOLE STR※適應症請見備
註欄
4230
FPP0240028M3 TITANIUM RECONSTRUCTION PLATE 5+8HOLE ANG※適應症請見備註
欄
6720
FPP0240032M3 TITANIUM RECONSTRUCTION PLATE 5+12HOLE ANG※適應症請見備
註欄
6720
FPP0240036M3 TITANIUM RECONSTRUCTION PLATE 5+16HOLE,5+20HOLE ANG※適應
症請見備註欄
6720
915
特材代碼 中英文名稱 支付點數-104/01/01
FPP0240080M3 TITANIUM RECONSTRUCTION PLATE 5+20+5HOLE COMPLETE
MANDIBLE ※適應症請見備註欄
14495
FPP024009KM3 TITANIUM CONDYLAR PROTHESIS W/2 FIXATION HOLES※適應症請
見備註欄
6874
FPP0241220XU "合碩"顱顏骨固定系統:下顎直行骨板8洞"CUSMED"CMF FIXATION
SYSTEM: BONE PLATE TITANIUM MANDIBLE STR 8HOLE
2722
FPP0241221XU "合碩"顱顏骨固定系統:直行下顎骨板10洞;12洞;14洞;16洞;18
洞"CUSMED"CMF FIXATION SYSTEM: BONE PLATE TITANIUM
MANDIBLE STR 10HOLE;12HOLE;14HOLE;16HO
4230
FPP0241509LE COMPRESSION PLATE ANGLE 4HOLE※適應症請見備註欄 5573
FPP0242620XU "合碩"顱顏骨固定系統:斜角下顎骨板,13:25洞"CUSMED"CMF
FIXATION SYSTEM: BONE PLATE,PURE TITANIUM MANDIBLE ANGLED
13:25HOLE
6720
FPP0242720XU "合碩"顱顏骨固定系統:斜角下顎骨板,13:25洞"CUSMED"CMF
FIXATION SYSTEM: BONE PLATE,PURE TITANIUM MANDIBLE
ANGLED 13:25HOLE
6720
FPP0243520XU "合碩"顱顏骨固定系統:下顎雙斜角骨板,30洞"CUSMED"CMF
FIXATION SYSTEM: BONE PLATE,PURE TITANIUM MANDIBLE
DOUBLE-ANGLED 30HOLE
14495
FPP0245037S1 "SYNTHES"MATRIX MANDIBLE SYSTEM:20 HOLES STRAIGHT "信迪
思"下顎固定系統:直骨板※給付規定請見備註欄
4230
FPP0249630S1 2.4MM RECONSTRUCTION PLATE STRAIGHT 12HOLE 95MM ※適應症
請見備註欄
4230
FPP0249720S1 2.4MM RECONSTRUCTION PLATE STRAIGHT 20:24HOLE 159MM ※適
應症請見備註欄
4230
FPP024988NS1 2.4MM RECONSTRUCTION PLATE ANGLED 18:27HOLE 146MM ※適應
症請見備註欄
6720
FPP0269502MC TITANIUM MANDIBULAR RECONSTRACTION PLATE 14HOLE※適應症請
見備註欄
4230
FPP0269510MC TITANIUM MANDIBULAR RECONSTRACTION PLATE ANGLE 12HOLE※適
應症請見備註欄
6720
FPP027051NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:ADAPTION PLATES PURE
TITANIUMM 12;20 HOLES "信迪思"下顎固定系統:連結骨板
4230
FPP027171NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:PLATES PURE TITANIUMM 12
HOLES STRAIGHT "信迪思"下顎固定系統:直骨板
4230
FPP0308640LE FRACTURE PLATE 4:8HOLE 35MM 1.8MM(型號5415-
031:064,081:084自92/1/1生效) ※適應症請見備註欄
2722
FPP0308642LE FRACTURE PLATE 4 HOLE 40MM 1.8MM ※適應症請見備註欄 2722
FPP0308644LE FRACTURE PLATE 4 HOLE 50MM 1.8MM ※適應症請見備註欄 2722
FPP0308650LE FRACTURE PLATE 8 HOLE 60MM 1.8MM ※適應症請見備註欄 2722
FPP0308652LE FRACTURE PLATE 8 HOLE 70MM 1.8MM ※適應症請見備註欄 2722
FPP0308660LE MAND ANGLE PLATE 60 R "TS 1.8MM ※適應症請見備註欄 3519
FPP0308670LE FRACTURE PLATE 4H 35MM 1.8MM STR ※適應症請見備註欄 2722
FPP0308672LE FRACTURE PLATE 4H 40MM 1.8MM STR※適應症請見備註欄 2722
FPP0308674LE FRACTURE PLATE 4H 50MM 1.8MM STR ※適應症請見備註欄 2722
FPP0314080EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:BSSO
PLATE 4+6 HOLE"歐美特"下頷骨折重建系統,直型骨板4+6洞
2722
FPP0314210EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION
SYSTEM:FRACTURE PLATE 4:8 HOLE"歐美特"下頷骨折重建系統,骨
折骨板4;8洞
2722
FPP0314219EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION
SYSTEM:ANGLED FRACTION PLATE 2X2 3X3 HOLE"歐美特"下頷骨折
重建系統,成角骨折骨板4;6洞
5573
916
特材代碼 中英文名稱 支付點數-104/01/01
FPP0314222EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:RIGID
COMMINUTED FRACTURE PLATE 15HOLE"歐美特"下頷骨折重建系統,
硬式粉碎骨折骨板15洞
4230
FPP0314311EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.4
LOCKING FRACTURE PLATE 4;6 HOLE"歐美特"下頷骨折重建系
統,2.4鎖定骨折骨板4;6洞
2722
FPP0314400EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.0
LOCKING FRACTURE PLATE 4;6 HOLE"歐美特"下頷骨折重建系
統,2.0鎖定骨折骨板4;6洞
2722
FPP0314403EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.0
LOCKING COMMINUTION PLATE 15HOLE"歐美特"下頷骨折重建系
統,2.0鎖定粉碎骨板15洞
4230
FPP0315064LE MANDIBULAR COMPRESSION PLATE 8HOLE ※適應症請見備註欄 2722
FPP0315070LE MANDIBULAR COMPRESSION PLATE 14HOLE ※適應症請見備註欄 4230
FPP0315131M3 MRS FRACTURE BONE PLATE 4:8HOLE STR ※適應症請見備註欄 2722
FPP0315170M3 MRS FRACTURE BONE PLATE 14HOLE STR ※適應症請見備註欄 4230
FPP031550NLE “史賽克 雷賓格爾”下頷骨系統加壓骨板2-10孔“STRYKER
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2-10 HOLE
2722
FPP0320526Y2 COMPRESSION PLATE 1.6MM 4HOLE STR/60度※適應症請見備註欄 3519
FPP03434NNS1 2.0MM ZYGOMATIC DCP 4:6HOLE STR ※適應症請見備註欄 2722
FPP034503NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:RCCONSTRUCTION PLATE
7+23HOLES "信迪思"下顎固定系統:重建骨板※給付規定請見備
註欄
6720
FPP0349110S1 TENSION BAND PLATE 2.0,2.4 4:6HOLE STR 22:35MM ※適應症請
見備註欄
2722
FPP0349160S1 2.4MM LC-DCP STRAIGHT 4:6HOLE 36:52MM ※適應症請見備註欄 2722
FPP0349236S1 2.4MM LIMITED CONTACT-DCP ECCENTRIC 4:6HOLE 36:52MM ※適
應症請見備註欄
3519
FPP0349260S1 2.4MM LC-DCP CURVED 4:6HOLE 35:50MM ※適應症請見備註欄 3519
FPP0349380S1 UNIVERSAL FRACTURE PLATE 2.4 STRAIGHT 8 HOLES ※適應症請
見備註欄
2722
FPP0349400S1 UNIVERSAL FRACTURE PLATE 2.4 STRAIGHT 10 HOLES ※適應症請
見備註欄
2722
FPP0349424S1 UNIVERSAL FRACTURE PLATE 2.4 STRAIGHT 24 HOLES (447.021自
90/10/01生效)※適應症請見備註欄
4230
FPP034944NS1 UNIVERSAL FRACTURE PLATE 2.4 ANGLED 20:27 HOLES ※適應症
請見備註欄
6720
FPP034984NS1 UNIVERSAL FRACTURE PLATE 2.4 ANGLED 6:10 HOLES ※適應症請
見備註欄
5573
FPP035415NLE MANDIBULAR COMPRESSION PLATE 4:6HOLE ※適應症請見備註欄 2722
FPP0358104M3 MINIPLATE JALLUT GLIDING 4HOLE※適應症請見備註欄 2722
FPP037011NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:MINI TENSION BAND PLATES
1.0MM PURE TITANIUMM 4HOLE;6HOLE"信迪思"下顎固定系統:迷你
張力骨板
2722
FPP037101NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:DCP PLATES PURE TITANIUM
2+2 OR 3+3 HOLES"信迪思"下顎固定系統:動態加壓骨板
3519
FPP037111NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:PLATE(2+2HOLE)"信迪思"下
顎固定系統:下顎骨板※給付規定請見備註欄
2722
917
特材代碼 中英文名稱 支付點數-104/01/01
FPP037131NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:DCP PLATES PURE TITANIUMM
3+3 HOLES CRESCENT OR ANGLED"信迪思"下顎固定系統:動態加壓
新月型或曲型骨板
5573
FPP037151NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:PLATE(3+3HOLE)"信迪思"下
顎固定系統:下顎骨板※給付規定請見備註欄
2722
FPP037211NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:DCP PLATES PURE TITANIUMM
3+3 HOLES, CRESCENT OR ANGLED"信迪思"下顎固定系統:新月型
或曲型骨板
5573
FPP060573NLE “史賽克 雷賓格爾”下頷骨系統3D鎖定骨板6X2孔“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM 1.7MM MID-FACE SET
LOCKING 3-D PLATE 6X2 HOLES
10711
FPP0606310LE TITAN MINI 3-D BONE PLATE 2X2 HOLES SQUARE 0.6MM ※適應症
請見備註欄
3867
FPP0606312LE TITAN MINI 3-D BONE PLATE 2X2 HOLES RECTANGULAR SEGMENT
0.6MM ※適應症請見備註欄
3867
FPP060631NLE 2.0 MINI PLATE 3-D 2X2 HOLES 0.6MM※適應症請見備註欄 3867
FPP0606320LE TITAN MINI 3-D BONE PLATE 3X2 HOLES SQUARE SEGMENT 0.6MM
※適應症請見備註欄
4767
FPP0606322LE TITAN MINI 3-D BONE PLATE 3X2 HOLES RECTANGULAR SEGMENT
0.6MM ※適應症請見備註欄
4767
FPP060632NLE 2.0 MINI PLATE 3-D 3X2 HOLES 0.6MM※適應症請見備註欄 4767
FPP0606332LE TITAN 3-D BONE PLATE 4X2 HOLES RECTANGULAR SEGMENT 0.6MM
※適應症請見備註欄
5211
FPP0606731LE STRYKER LEIBINGER UNIVERSAL MANDIBLE SYSTEM:1.7MM MID-
FACE 3D PLATE 2X2 HOLES ※適應症請見備註欄
3867
FPP0610054EJ 2.0 MM MINI SQUARE PLATE 4 HOLE ※適應症請見備註欄 3867
FPP0610310LE TITAN MINI 3-D BONE PLATE 2X2 HOLES SQUARE SEGMENT 1.0MM
※適應症請見備註欄
3867
FPP0610312LE TITAN MINI 3-D BONE PLATE 2X2 HOLES RECTANGULAR SEGMENT
1.0MM ※適應症請見備註欄
3867
FPP0610322LE TITAN MINI 3-D BONE PLATE 3X2 HOLES RECTANGULAR SEGMENT
1.0MM ※適應症請見備註欄
4767
FPP0610330LE TITAN MINI 3-D BONE PLATE 4X2 HOLES SQUARE SEGMENT 1.0MM
※適應症請見備註欄
5211
FPP0610332LE TITAN MINI 3-D BONE PLATE 4X2 HOLES RECTANGULAR SEGMENT
1.0MM ※適應症請見備註欄
5211
FPP0610501EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:MINI
LOCKING STRUT PLATE CURVED 2X4HOLE"歐美特"下頷骨折重建系
統,迷你鎖定矩陣型骨板弧狀
5211
FPP0610502EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:MINI
LOCKING STRUT PLATE CURVED 2X6 HOLE"歐美特"下頷骨折重建系
統,迷你鎖定矩陣型骨板弧狀
10711
FPP0610503EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:MINI
LOCKING STRUT PLATE CURVED 2X8 HOLE"歐美特"下頷骨折重建系
統,迷你鎖定矩陣型骨板弧狀
10711
FPP0610532LE 3 D PLATE 3X2 HOLE※適應症請見備註欄 4767
FPP0610542LE 3 D PLATE 4X2 HOLE※適應症請見備註欄 5211
FPP0610562LE 3 D PLATE 6X2 HOLE※適應症請見備註欄 10711
FPP0620261Y2 MINI H-SHAPE(3-D)PLATE 2X2 HOLE※適應症請見備註欄 3867
FPP0620262Y2 MINI 1.0MM H-SHAPE(3-D)PLATE 3X2 HOLE※適應症請見備註欄 4767
FPP0620263Y2 MINI 1.0MM H-SHAPE(3-D)PLATE 4X2 HOLE※適應症請見備註欄 5211
FPP0620266Y2 MINI 1.0MM H-SHAPE(3-D)PLATE 2X2 HOLE※適應症請見備註欄 3867
FPP0620267Y2 MINI 1.0MM H-SHAPE(3-D)PLATE 3X2 HOLE※適應症請見備註欄 4767
FPP0620268Y2 MINI 1.0MM H-SHAPE(3-D)PLATE 4X2 HOLE※適應症請見備註欄 5211
918
特材代碼 中英文名稱 支付點數-104/01/01
FPP0648025XU "合碩"顱顏骨固定系統:正方型骨板,2*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,SQUARE,2*2HOLE
3867
FPP0648026XU "合碩"顱顏骨固定系統:正方型骨板,3*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,SQUARE,3*2HOLE
4767
FPP0648027XU "合碩"顱顏骨固定系統:正方型骨板,4*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,SQUARE,4*2HOLE
5211
FPP0648028XU "合碩"顱顏骨固定系統:正方型骨板,4*4洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,SQUARE,4*2HOLE
10383
FPP0648029XU "合碩"顱顏骨固定系統:正方型骨板,6*4洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,SQUARE,6*2HOLE
10711
FPP0648125XU "合碩"顱顏骨固定系統:矩形骨板,2*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,RECTANGULAR,2*2HOLE
3867
FPP0648126XU "合碩"顱顏骨固定系統:矩形骨板,3*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,RECTANGULAR,3*2HOLE
4767
FPP0648127XU "合碩"顱顏骨固定系統:矩形骨板,4*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,RECTANGULAR,4*2HOLE
5211
FPP0648128XU "合碩"顱顏骨固定系統:矩形骨板,4*4洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,RECTANGULAR,4*4HOLE
10383
FPP0648129XU "合碩"顱顏骨固定系統:矩形骨板,6*4洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MINI BONE PLATE,PURE
TITANIUM,RECTANGULAR,6*4HOLE
10711
FPP0657710M3 MINI 2000 CAD 4 HOLE PLATE SQUARE ,RECTANGULAR
0.6MM,1.0MM※適應症請見備註欄
3867
FPP0657720M3 MINI 2000 CAD 6 HOLE PLATE SQUARE ,RECTANGULAR
0.6MM,1.0MM※適應症請見備註欄
4767
FPP0657730M3 MINI 2000 CAD 8 HOLE PLATE SQUARE ,RECTANGULAR
0.6MM,1.0MM※適應症請見備註欄
5211
FPP069001NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:PREFORMED RECONSTRUCTION
PLATE"信迪思"下顎固定系統:立體重建骨板
10711
FPP0706104M3 MONDEAL TITANIUM 0.6MM MICRO 1200 PLATE 4HOLE STR ※限顏
面骨折患者使用
2498
FPP0706106M3 MONDEAL TITANIUM 0.6MM MICRO 1200 PLATE 6HOLE STR ※適應
症請見備註欄
2672
FPP0706107M3 MICRO 1200 TITANIUM STR PLATE 6HOLE 7.5MM※適應症請見備註
欄
2672
FPP0706108M3 MONDEAL TITANIUM 0.6MM MICRO 1200 8HOLE PLATE STR ※適應
症請見備註欄
2672
FPP0706114M3 MICRO 1200 TITANIUM STR PLATE 4HOLE 6MM:9MM※適應症請見備
註欄
2498
FPP0706116M3 MONDEAL TITANIUM 0.6MM MICRO 1200 16HOLE PLATE STR※適應
症請見備註欄
4246
FPP0706120M3 MONDEAL TITANIUM 0.6MM MICRO 1200 L PLATE 5,8HOLE ※適應
症請見備註欄
4085
FPP0706124M3 MONDEAL TITANIUM 0.6MM MICRO 1200 L PLATE 4HOLE ※適應症
請見備註欄
4085
919
特材代碼 中英文名稱 支付點數-104/01/01
FPP0706126M3 MONDEAL TITANIUM 0.6MM MICRO 1200 L PLATE 5HOLE ※適應症
請見備註欄
4085
FPP0706141M3 MONDEAL TITANIUM 0.6MM MICRO 1200 T PLATE 7 HOLE ※限顏面
骨折患者使用
4430
FPP0706142M3 MONDEAL TITANIUM 0.6MM MICRO 1200 T PLATE 4 HOLE ※適應症
請見備註欄
4430
FPP0706144M3 MONDEAL TITANIUM 0.6MM MICRO 1200 H PLATE 9,14HOLE ※限顏
面骨折患者使用
4633
FPP0706160M3 MONDEAL TITANIUM 0.6MM MICRO 1200 Y PLATE 6 HOLE※適應症
請見備註欄
4997
FPP0706162M3 MONDEAL TITANIUM 0.6MM MICRO 1200 X PLATE 6,7 HOLE※適應
症請見備註欄
5560
FPP0706174M3 MONDEAL TITANIUM 0.6MM MICRO 1200 Y PLATE 4 HOLE ※適應症
請見備註欄
4997
FPP0706182M3 MONDEAL TITANIUM 0.6MM MICRO 1200 ORBITAL 8HOLE※適應症請
見備註欄
3883
FPP0706204LE MICROPLUS BONE PLATE 0.55MM 4 HOLE STR ※適應症請見備註欄 2498
FPP0706206LE MICROPLUS BONE PLATE 0.55MM 6 HOLE STR ※適應症請見備註欄 2672
FPP0706208LE MICROPLUS BONE PLATE 0.55MM 8 HOLE STR ※適應症請見備註欄 2672
FPP0706209LE MICROPLUS BONE PLATE 0.55MM 12 HOLE STR ※適應症請見備註
欄
4246
FPP0706210LE MICROPLUS BONE PLATE 0.55MM 16HOLE STR ※適應症請見備註欄 4246
FPP0706211LE MICROPLUS BONE PLATE 0.55MM 24 HOLE STR ※適應症請見備註
欄
4246
FPP0706220LE MICROPLUS BONE PLATE 0.55MM L SHAPE 5 HOLE ※適應症請見備
註欄
4085
FPP0706222LE MICROPLUS BONE PLATE 0.55 MM L SHAPE 8 HOLE ※適應症請見
備註欄
4085
FPP070622NLE “史賽克 雷賓格爾”下頷骨系統直型骨板18-24孔“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM MICRO STRAIGHT
PLATE 18-24 HOLE
4246
FPP070623NLE “史賽克 雷賓格爾”下頷骨系統3D骨板2X2孔“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM MICRO 3D PLATE 2X2
HOLE
3867
FPP0706240LE MICROPLUS BONE PLATE 0.55MM T SHAPE 5 HOLE 90 DE ※適應症
請見備註欄
4430
FPP0706241LE MICROPLUS BONE PLATE 0.55MM T SHSPE 7 HOLE 90 DE ※適應症
請見備註欄
4430
FPP0706244LE MICROPLUS BONE PLATE 0.55MM DOUBLE T SHAPE 9 HOLE ※適應
症請見備註欄
4633
FPP0706246LE MICROPLUS BONE PLATE 0.55MM DOUBLE T SHAPE 14 HOLE ※適應
症請見備註欄
4633
FPP0706249LE MICROPLUS BONE PLATE 0.55MM DOUBLE T SHAPE 7 HOLE ※適應
症請見備註欄
4633
FPP070624NLE “史賽克 雷賓格爾”下頷骨系統雙Y微型骨板7孔“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM MICRO DOUBLE Y
PLATE 7 HOLE
5560
FPP070625NLE “史賽克 雷賓格爾”下頷骨系統微型眼眶骨板4孔;10孔
“STRYKER LEIBINGER” UNIVERSAL MANDIBLE SYSTEM MICRO
ORBITA PLATE 4HOLE;10 HOLE
3883
920
特材代碼 中英文名稱 支付點數-104/01/01
FPP0706260LE MICROPLUS BONE PLATE 0.55MM Y SHAPE 6 HOLE ※適應症請見備
註欄
4997
FPP0706262LE MICROPLUS BONE PLATE 0.55MM DOUBLE Y SHAPE 6 HOLE ※適應
症請見備註欄
5560
FPP0706263LE MICROPLUS BONE PLATE 0.55MM DOUBLE Y SHAPE 7 HOLE ※適應
症請見備註欄
5560
FPP070626NLE “史賽克 雷賓格爾”下頷骨系統L骨板4-8孔“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM MICRO L PLATE 4-8
HOLE
4085
FPP0706270LE MICROPLUS BURR 0.55MM H COVERING & BONE FLAP FIXATION
PLATE 7,10,14MM※適應症請見備註欄
5873
FPP070627NLE MICRO T PLATE 7HOLE ※適應症請見備註欄 4430
FPP0706282LE MICROPLUS BONE PLATE 0.55MM ORBITA PLATE 8 HOLE CURVED※
適應症請見備註欄
3883
FPP0706303M3 MONDEAL TITANIUM 0.6MM MICRO 1200 CAD PLATE 3 HOLE,4HOLE
SQUARE ※適應症請見備註欄
3867
FPP0706325M3 MONDEAL TITANIUM 0.6MM MICRO 1200 CAD PLATE 6HOLE ※適應
症請見備註欄
5679
FPP0706335M3 MONDEAL TITANIUM 0.6MM MICRO 1200 CAD PLATE 8HOLE ※適應
症請見備註欄
6805
FPP070633NLE “史賽克 雷賓格爾”下頷骨系統3D微骨板6X2孔“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM MICRO 3D PLATE 6X2
HOLE
10383
FPP070637NLE ““史賽克 雷賓格爾”下頷骨系統微型鑽孔覆蓋骨板7-14MM
“STRYKER LEIBINGER” UNIVERSAL MANDIBLE SYSTEM MICRO
MALLEABLE BURR HOLE COVER PLATE 7-14MM
5873
FPP0706415LE MICROPLUS BONE PLATE 0.55MM 4(2X2)HOLE SQUARE
SEGMENTS,REGANG ULAR SEGMENT ※適應症請見備註欄
3867
FPP0706425LE MICROPLUS BONE PLATE 0.55MM 6(3X2)HOLE SQUARE ,RECTANG
ULAR SEAGMENT ※適應症請見備註欄
5679
FPP0706435LE MICROPLUS BONE PLATE 0.55MM 8(4X2)HOLE SQUARE ,REGANG
ULAR SEGMENT ※適應症請見備註欄
6805
FPP0706445LE MICROPLUS BONE PLATE 0.55MM 16(4X4)HOLE SQUARE SEGMENTS
※適應症請見備註欄
10383
FPP0706467LE TITANIUM MICRO 3-D PLATE 0.55MM 6X4HOLE※適應症請見備註欄 11325
FPP0707007M3 MICRO BURR HOLE COVER PLATE 7:14MM ※適應症請見備註欄 5873
FPP0710220XU "合碩"顱顏骨固定系統:顱骨固定夾"CUSMED"CMF FIXATION
SYSTEM:FLAP FIXATOR
4000
FPP0710250XU "合碩"顱顏骨固定系統:顱骨固定夾"CUSMED"CMF FIXATION
SYSTEM:FLAP FIXATOR
4000
FPP0712001EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.2MM
12 HOLE CURVED PLAT※適應症請見備註欄
3883
FPP0712002EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.2MM 5
HOLE STRAIGHT PLATE ※適應症請見備註欄
2498
FPP0712003EJ M4 RIGID FIXATION SYSTEM 7, 11 HOLE Y PLATE, 0.5MM ※適應
症請見備註欄
4997
FPP0712004EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.2MM
18 HOLE STRAIGHT PLATE ※適應症請見備註欄
4246
FPP0712006EJ M4 RIGID FIXATION SYSTEM 6 HOLE LARGE, SMALL BUR HOLE
PLATE, 0.5MM※適應症請見備註欄
5873
FPP0712013EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.2MM 2
HOLE STRAIGHT PLATE:MEDIUM,LONG ※適應症請見備註欄
2498
921
特材代碼 中英文名稱 支付點數-104/01/01
FPP0712036EJ M4 RIGID FIXATION SYSTEM 12 HOLE CURVED PLATE, 0.55MM※適
應症請見備註欄
3883
FPP0712040EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.2MM
2X4 HOLE QUAD PLATE※適應症請見備註欄
6805
FPP0712045EJ M4 RIGID FIXATION SYSTEM 4 HOLE 13, 16 MM LEFT, RIGHT L
PLATE, 0.5MM※適應症請見備註欄
4085
FPP0712046EJ M4 RIGID FIXATION SYSTEM 2X4 HOLE QUAD PLATE, 0.5MM※適應
症請見備註欄
6805
FPP0712068EJ M4 RIGID FIXATION SYSTEM 5 HOLE X PLATE, 0.5MM ※適應症請
見備註欄
5560
FPP0712086EJ M4 RIGID FIXATION SYSTEM ORBITAL FLOOR PLATE
0.35MM;0.25MM※適應症請見備註欄
10437
FPP0712104EJ M4 RIGID FIXATION SYSTEM MICRO 6 HOLE DOUBLE Y PLATE,
0.5MM※適應症請見備註欄
5560
FPP0712130EJ M4 RIGID FIXATION SYSTEM MICRO 4 HOLE STRAIGHT PLATE,
0.5MM※適應症請見備註欄
2498
FPP0712134EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.2MM
SQUARE PLATE ※適應症請見備註欄
3867
FPP0712136EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.2MM
EXTENDED X PLATE ※適應症請見備註欄
5560
FPP0712138EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.2MM
DOUBLE Y PLATE※適應症請見備註欄
5560
FPP0712140EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.2MM
BUR HOLE PLATE SMALL LARGE X-LARGE※適應症請見備註欄
5873
FPP0712146EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.2MM
MESH PLATE 40X40MM 90X90MM※適應症請見備註欄
10992
FPP0712312EJ M4 RIGID FIXATION SYSTEM MICRO 6, 8 HOLE STRAIGHT PLATE,
0.5MM※適應症請見備註欄
2672
FPP0718001EJ "OSTEO MED"NEURO FIXATION SYSTEM 0.48MM(2HOLE PLATE
X3+SCREW*6) "歐特美"顱顏骨固定系統:含2 HOLE PLATE
X3+SCREWX6※適應症請見備註欄
15882
FPP0718002EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.6MM 5
HOLE STRAIGHT PLATE ※適應症請見備註欄
2498
FPP0718003EJ "OSTEOMED" FAST-FLAP NEURO FIXATION SYSTEM(3X2HOLE) "歐特
美"速固硬式固定系統※給付規定請見備註欄
5679
FPP0718004EJ "OSTEO MED"NEURO FIXATION SYSTEM0.48MM "歐特美"顱顏骨固定
系統:含2 HOLE PLATE X2+SCREWX4※適應症請見備註欄
10587
FPP0718005EJ "OSTEO MED"NEURO FIXATION SYSTEM 0.48MM "歐特美"顱顏骨固
定系統:含 BURR HOLE X1+SCREWX6※適應症請見備註欄
14133
FPP0718020EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.6MM
SQUARE PLATE 9MM ※適應症請見備註欄
3867
FPP0718022EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.6MM 2
HOLE STRAIGHT PLATE:MEDIUM,LONG,SHORT※適應症請見備註欄
2498
FPP0718028EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.6MM
DOUBLE Y PLATE※適應症請見備註欄
5560
FPP0718032EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.6MM
BUR HOLE PLATE SMALL LARGE X-LARGE※適應症請見備註欄
5873
FPP0718038EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.6MM
10 HOLE STRAIGHT PLATE ※適應症請見備註欄
2672
FPP0718059EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.6MM
2X3 HOLE QUAD PLATE※適應症請見備註欄
5679
FPP0718060EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.6MM
2X4 HOLE QUAD PLATE※適應症請見備註欄
6805
922
特材代碼 中英文名稱 支付點數-104/01/01
FPP0720010S1 MICRO STRUT PLATE 16:22HOLE(網狀) ※適應症請見備註欄 10383
FPP0720100S1 MICRO 0.5MM ADAPTION PLATE 24HOLES(型號420.100另編代碼
FPP072010N)適應症請見備註欄
4246
FPP072010NS1 MICRO 0.5MM ADAPTION PLATE 34HOLE ※適應症請見備註欄 4246
FPP0720111Y2 MICRO PLATE 0.6MM 4HOLE STR※適應症請見備註欄 2498
FPP0720112Y2 MICRO PLATE 0.6MM 6,8HOLE STR※適應症請見備註欄 2672
FPP0720114Y2 MICRO PLATE 0.6MM 12,16,24HOLE STR※適應症請見備註欄 4246
FPP0720121Y2 MICRO PLATE 0.6MM 5,8HOLE L-SHAPE※適應症請見備註欄 4085
FPP0720131Y2 MICRO PLATE 0.6MM 5,7HOLE T-SHAPE※適應症請見備註欄 4430
FPP0720135Y2 MICRO PLATE 0.6MM 6HOLE Y-SHAPE※適應症請見備註欄 4997
FPP0720136Y2 MICRO PLATE 0.6MM 6,7HOLE DOUBLE Y-SHAPE※適應症請見備註
欄
5560
FPP0720141Y2 MICRO ORBITA PLATE 0.6MM 8HOLE※適應症請見備註欄 3883
FPP0720150Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 2X2 HOLE※適應症請見備註欄 3867
FPP0720151Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 3X2 HOLE※適應症請見備註欄 5679
FPP0720152Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 4X2 HOLE※適應症請見備註欄 6805
FPP0720153Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 4X4 HOLE※適應症請見備註欄 10383
FPP0720154Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 6X4 HOLE※適應症請見備註欄 11325
FPP0720155Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 2X2 HOLE※適應症請見備註欄 3867
FPP0720156Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 3X2 HOLE※適應症請見備註欄 5679
FPP0720157Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 4X2 HOLE※適應症請見備註欄 6805
FPP0720158Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 4X4 HOLE※適應症請見備註欄 10383
FPP0720159Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 6X4 HOLE※適應症請見備註欄 11325
FPP072016NY2 MICRO BURR HOLES PLATE 0.6MM 7:14MM※適應症請見備註欄 5873
FPP0720210S1 MICRO 0.5MM ORBITAL RIM PLATE CURVED 8:12HOLE ※適應症請
見備註欄
3883
FPP07204NNS1 MICRO ORBITAL FLOOR PLATE UNIVERSAL/L/R (421.040,044,045
自89/10/1生效)※適應症請見備註欄
10437
FPP07205NNS1 MICRO 0.5MM L-PLATE 5:9HOLE ※適應症請見備註欄 4085
FPP0720620S1 MICRO 0.5MM Y-PLATE 5:13HOLE ※適應症請見備註欄 4997
FPP0720680S1 MICRO 0.5MM DOUBLE Y-PLATE 6HOLE(型號421.068,069自89/10/1
生效)※適應症請見備註欄
5560
FPP0720710S1 MICRO 0.5MM T-PLATE 7:12HOLE ※適應症請見備註欄 4430
FPP0720810S1 MICRO 0.5MM X-PLATE 4HOLE ※適應症請見備註欄 5560
FPP0720850S1 MICRO 0.5MM H-PLATE 6:11HOLE ※適應症請見備註欄 4633
FPP0720910S1 TITANIUM MICRO BURR HOLE COVER※適應症請見備註欄 5873
FPP0721024S1 MICRO 0.5MM PLATE 2:4HOLE STR ※適應症請見備註欄 2498
FPP0721096S1 MICRO BOX PLATE 4 HOLES ※適應症請見備註欄 3867
FPP0741020XU "合碩"顱顏骨固定系統:直行骨板 2洞"CUSMED"CMF FIXATION
SYSTEM:MICRO BONE PLATE TITANIUM STR 2HOLE
2498
FPP074102YXU "合碩"顱顏骨固定系統:2洞骨板*3,骨釘*6"CUSMED"CMF FIXATION
SYSTEM:CONDUCT.COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,2 HOLE PLATE*3 ,SCREW*6
15882
923
特材代碼 中英文名稱 支付點數-104/01/01
FPP074102ZXU "合碩"顱顏骨固定系統:2洞骨板,4個骨釘"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE TITANIUM,2 HOLE
PLATE ,SCREW*4
10587
FPP0741120XU "合碩"顱顏骨固定系統:直行骨板4洞"CUSMED"CMF FIXATION
SYSTEM: COMBINE MICRO BONE PLATE TITANIUM STR 4HOLE
2498
FPP0741121XU "合碩"顱顏骨固定系統:直行骨板6洞;8洞"CUSMED"CMF FIXATION
SYSTEM:MICRO BONE PLATE TITANIUM STR 6HOLE;8HOLE
2672
FPP0741323XU "合碩"顱顏骨固定系統:連接形骨板12洞;16洞;24洞"CUSMED"CMF
FIXATION SYSTEM:MICRO BONE PLATE TITANIUM ADAPTION
12HOLE;16HOLE;24HOLE
4246
FPP0742020XU "合碩"顱顏骨固定系統:L形骨板4洞;5洞;8洞"CUSMED"CMF
FIXATION SYSTEM: MICRO BONE PLATE TITANIUM L-TYPE
4HOLE;5HOLE;8HOLE
4085
FPP0742025Y2 "SYNTEC"TITANIUM MESH PLATE"亞太醫療"鈦合金網眼骨板※給付
規定請見備註欄
10437
FPP074202HY2 "SYNTEC"TITANIUM MESH PLATE:STRAIGHT 2HOLE "亞太醫療"鈦合
金網眼骨板:直型骨板※給付規定請見備註欄
2498
FPP0742051Y2 "SYNTEC"TITANIUM MESH PLATE"亞太醫療"鈦合金網眼骨板※給付
規定請見備註欄
10437
FPP0742120XU "合碩"顱顏骨固定系統:L形骨板4洞;5洞;8洞"CUSMED"CMF
FIXATION SYSTEM: MICRO BONE PLATE TITANIUM L-TYPE
4HOLE;5HOLE;8HOLE
4085
FPP07421FFY2 "SYNTEC"FLAPFIX SYSTEM"亞太醫療"顱骨固定系統※適應症請見
備註欄
4000
FPP0742220XU "合碩"顱顏骨固定系統:L形中長骨板左4:5洞"CUSMED"CMF
FIXATION SYSTEM: MICRO BONE PLATE TITANIUM L-TYPE
LONG,LEFT, 4:5HOLE
4085
FPP0742320XU "合碩"顱顏骨固定系統:L中長形骨板,右4:5洞"CUSMED"CMF
FIXATION SYSTEM: MICRO BONE PLATE TITANIUM L-TYPE,RIGHT,
4:5HOLE
4085
FPP0742420XU "合碩"顱顏骨固定系統:斜L形骨板4:5洞"CUSMED"CMF FIXATION
SYSTEM: MICRO BONE PLATE TITANIUM L-TYPE 4:5HOLE
4085
FPP0742520XU "合碩"顱顏骨固定系統;斜L形骨板,4:5洞"CUSMED"CMF FIXATION
SYSTEM:MICRO BONE PLATE,PURE TITANIUM L-TYPE 4:5HOLE
4085
FPP0743020XU "合碩"顱顏骨固定系統:眼框形骨板,6洞,8洞"CUSMED"CMF
FIXATION SYSTEM: MICRO BONE PLATE,PURE
TITANIUM,ORBITAL,6HOLE,8HOLE
3883
FPP0744120XU "合碩"顱顏骨固定系統:T形骨板,5洞"CUSMED"CMF FIXATION
SYSTEM: MICRO T-TYPE BONE PLATE,PURE TITANIUM 5HOLE
4430
FPP0744220XU "合碩"顱顏骨固定系統:斜T形骨板,5洞"CUSMED"CMF FIXATION
SYSTEM: MICRO T-TYPE ANGLED BONE PLATE,PURE TITANIUM
5HOLE
4430
FPP0745020XU "合碩"顱顏骨固定系統:雙T形骨板,4洞,6洞"CUSMED"CMF
FIXATION SYSTEM: MICRO BONE PLATE,PURE TITANIUM,DOUBLE T-
TYPE 4HOLE,6HOLE
4430
FPP0746020XU "合碩"顱顏骨固定系統:Y形骨板,5:6洞"CUSMED"CMF FIXATION
SYSTEM: MICRO BONE PLATE,PURE TITANIUM,Y-TYPE LONG
5:6HOLE
4997
FPP0747020XU "合碩"顱顏骨固定系統:雙Y形骨板,6洞,8洞"CUSMED"CMF
FIXATION SYSTEM: MICRO BONE PLATE,PURE TITANIUM,DOUBLE Y-
TYPE 6HOLE,8HOLE
5560
924
特材代碼 中英文名稱 支付點數-104/01/01
FPP0748020XU "合碩"顱顏骨固定系統:正方型骨板2*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,SQUARE,2*2HOLE
3867
FPP0748021XU "合碩"顱顏骨固定系統:正方型骨板,3*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,SQUARE,3*2HOLE
5679
FPP0748022XU "合碩"顱顏骨固定系統:正方型骨板,4*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,SQUARE,4*2HOLE
6805
FPP0748023XU "合碩"顱顏骨固定系統:正方型骨板,4*4洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,SQUARE,4*2HOLE
10383
FPP0748024XU "合碩"顱顏骨固定系統:正方型骨板,6*4洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,SQUARE,6*4HOLE
11325
FPP0748120XU "合碩"顱顏骨固定系統:矩形骨板,2*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,RECTANGULAR,2*2HOLE
3867
FPP0748121XU "合碩"顱顏骨固定系統:矩形骨板3*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,RECTANGULAR,3*2HOLE
5679
FPP0748122XU "合碩"顱顏骨固定系統:矩形骨板4*2洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,RECTANGULAR,4*2HOLE
6805
FPP0748123XU "合碩"顱顏骨固定系統:矩形骨板4*4洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,RECTANGULAR,4*4HOLE
10383
FPP0748124XU "合碩"顱顏骨固定系統:矩形骨板6*4洞"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,RECTANGULAR,6*4HOLE
11325
FPP0749020XU "合碩"顱顏骨固定系統:鑽孔蓋型骨板,6洞"CUSMED" CMF
FIXATION SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,BURR HOLE COVER ,6HOLE
5873
FPP074902ZXU "合碩"顱顏骨固定系統:骨板+骨釘BURR HOLE"CUSMED"CMF
FIXATION SYSTEM:CONDUCT.COMBINE CMF BONE PLATE,PURE
TITANIUM,BURR HOLE,SCREW*6
14133
FPP0749120XU "合碩"顱顏骨固定系統:引流鑽孔蓋,骨板,5洞"CUSMED" CMF
FIXATION SYSTEM:COMBINE CMF MICRO BONE PLATE,PURE
TITANIUM,BURR HOLE COVER FOR SHUNT OR DR
5873
FPP0750121XU "合碩"顱顏骨固定系統:骨網圓孔形,骨板"CUSMED"CMF FIXATION
SYSTEM:COMBINE CMF MESH, MICRO BONE PLATE,PURE
TITANIUM,ROUND HOLE
10992
FPP0750221XU "合碩"顱顏骨固定系統:MESH圓形孔"CUSMED"CMF FIXATION
SYSTEM:CONTOUR CMF MESH, PURE TITANIUM,MULTI-ROUND HOLE
10992
FPP0750306S1 CRANIAL PLATE 2:4HOLE ※適應症請見備註欄 2498
FPP075030NS1 MICRO T PLATE 3+4HOLE 0.5:0.8MM※適應症請見備註欄 4430
FPP075031NS1 ORBITAL RIM PLATE 12HOLE 0.4:0.7MM※適應症請見備註欄 3883
FPP0750321XU "合碩"顱顏骨固定系統:MESH菱形孔形"CUSMED"CMF FIXATION
SYSTEM:CONTOUR CMF MESH, PURE TITANIUM,RHOMBUS HOLE
10992
FPP075032NS1 MICRO ADAPTION PLATE 20HOLE 0.4:0.8MM※適應症請見備註欄 4246
FPP075033NS1 MICRO Y PLATE (3+2HOLE) 0.4:0.7MM※適應症請見備註欄 4997
FPP075034NS1 MICRO DOUBLE Y PLATE 6HOLE 0.4:0.7MM※適應症請見備註欄 5560
FPP075035NS1 MICRO BOX PLATE 4HOLE 0.4:0.7MM※適應症請見備註欄 3867
FPP075036NS1 MICRO X PLATE 4HOLE 0.4:0.7MM※適應症請見備註欄 5560
925
特材代碼 中英文名稱 支付點數-104/01/01
FPP075037NS1 MICRO STRUT PLATE 18HOLE 0.4:0.7MM※適應症請見備註欄 10383
FPP075038NS1 MICRO L PLATE 3+2HOLE 0.5:0.8MM※適應症請見備註欄 4085
FPP075039NS1 MICRO L PLATE 3+4HOLE;4+6HOLE 0.5:0.8MM※適應症請見備註欄 4085
FPP07503FNS1 ORBITAL FLOOR MESH PLATE 0.2:0.4MM※適應症請見備註欄 10437
FPP07503HNS1 MICRO H PLATE 11HOLE 0.5:0.8MM※適應症請見備註欄 4633
FPP07503NNS1 ANATOMICAL ORBITAL FLOOR PLATE ※適應症請見備註欄 10437
FPP07503XNS1 UNIVERSAL ORBITAL FLOOR PLATE 0.4:0.5MM※適應症請見備註欄 10437
FPP0750421XU "合碩"顱顏骨固定系統:MESH人孔形"CUSMED" CMF FIXATION
SYSTEM:CONTOUR CMF MESH, PURE TITANIUM,FLEXIBLE
10992
FPP0750521XU "合碩"顱顏骨固定系統:骨網網柵田孔形"CUSMED"CMF FIXATION
SYSTEM:CONTOUR CMF MESH, PURE TITANIUM,GRIDE
10992
FPP0750621XU "合碩"顱顏骨固定系統:MESH等線孔形"CUSMED"CMF FIXATION
SYSTEM:CONTOUR CMF MESH, PURE TITANIUM,ISOGRID
10992
FPP075403NLE ORBITAL FLOOR PLATE※適應症請見備註欄 10437
FPP0760101M4 "MEDTRONIC"INVISX CRANIAL FIXATION SYSTEM"美敦力"茵薇斯顱
骨固定系統※給付規定請見備註欄
4000
FPP077071NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:STRUT PLATES PURE
TITANIUMM 4 HOLES STRAIGHT"信迪思"下顎固定系統:網狀
3867
FPP077081NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:STRUT PLATES PURE
TITANIUM 8 HOLES"信迪思"下顎固定系統:網狀
6805
FPP07801FNS1 PREFORMED ORBITAL PLATE 0.4MM※適應症請見備註欄 10437
FPP0782146EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統:1.6MM
MESH PLATE 40X40MM 90X90MM 36X50MM 74X50MM 111X191MM※適
應症請見備註欄
10992
FPP0788704MC MICRO PLATE 4 HOLE 6.0,4.5MM 0.6MM STR ※適應症請見備註欄 2498
FPP0788706MC MICRO PLATE 6 HOLE 0.6MM STR ※適應症請見備註欄 2672
FPP0788708MC MICRO PLATE 8 HOLE 0.6MM STR ※適應症請見備註欄 2672
FPP0788734MC MICRO PLATE 4HOLE 7.5,9MM 0.6MM STR ※適應症請見備註欄 2498
FPP0788745MC MICRO PLATE 4HOLE 12MM 0.6MM STR ※適應症請見備註欄 2498
FPP0788747MC MICRO PLATE 6HOLE 7.5MM 0.6MM STR ※適應症請見備註欄 2672
FPP0788748MC MICRO PLATE 6HOLE 12MM 0.6MM STR ※適應症請見備註欄 2672
FPP0788750MC MICRO L-PLATE 4HOLE 7.5,9MM 0.6MM LEFT,RIGHT ※適應症請見
備註欄
4085
FPP0788754MC MICRO L-PLATE 6HOLE 12MM 0.6MM LEFT,RIGHT ※適應症請見備
註欄
4085
FPP0788760MC MICRO T-PLATE 4HOLE 7.5,9MM 0.6MM ※適應症請見備註欄 4430
FPP0788764MC MICRO T-PLATE 5HOLE 12MM 0.6MM※適應症請見備註欄 4430
FPP0788765MC TITANIUM MICRO 0.6MM H-PLATE 9HOLE※限顏面骨折患者使用 4633
FPP0788770MC TITANIUM 0.6MM MICRO Y-PLATE 4HOLE 8,12,15MM ※適應症請
見備註欄
4997
FPP0788774MC TITANIUM 0.6MM MICRO DOUBLE Y-PLATE 6,7HOLE ※適應症請見
備註欄
5560
FPP0788780MC TITANIUM MICRO 0.6MM ORBITAL PLATE 6,7HOLE 8,12,15MM※適
應症請見備註欄
3883
FPP0789050MC 0.4MM TITANIUM BURR HOLES PLATE 6:13MM ※適應症請見備註欄 5873
FPP07ASF01AQ A-FLAP CRANIAL FIXATION SYSTEM 艾弗勒顱骨固定系統 ※給付
規定請見備註欄
4000
FPP07FF460S1 "SYNTHES"FLAPFIX SYSTEM:FLAPFIX(PURE TITANIUM)"信迪思"顱
骨固定系統:皮瓣固定夾※給付規定請見備註欄
4000
926
特材代碼 中英文名稱 支付點數-104/01/01
FPP07FF490AE "AESCULAP"CRANIOFIX 2 TITANIUM CLAMP "雅氏"第二代鈦合金頭
骨固定夾※適應症請見備註欄
4000
FPP07FM960AE 0.6MM MICRO PLATE STRAIGHT 2HOLE,4 HOLE※適應症請見備註欄 2498
FPP07FM964AE 0.6MM MICRO Y PLATE 5 HOLE※適應症請見備註欄 4997
FPP07FM965AE 0.6MM MICRO PLATE STRAIGHT 16 HOLE※適應症請見備註欄 4246
FPP07FM966AE 0.6MM MICRO DOUBLE Y PLATE 6 HOLE※適應症請見備註欄 5560
FPP07FM968AE MICRO BOX CAR PLATE 4 HOLE※適應症請見備註欄 3867
FPP07FM969AE 0.6MM MICRO BOX CAR PLATE 6 HOLE※適應症請見備註欄 5679
FPP07FM970AE 0.6MM MICRO BOX CAR PLATE 8 HOLE※適應症請見備註欄 6805
FPP07FM971AE 0.6MM MICRO BURR HOLE COVER PLATE※適應症請見備註欄 5873
FPP07FM973AE "AESCULAP"CRANIOPLATE SYSTEM:0.6MM MICRO MESH,MINIFEN
PLATE"雅氏"顱顏骨釘骨板系統※適應症請見備註欄
10992
FPP07FM990AE "雅氏"顱顏骨釘骨板系統:雙孔骨板3個+骨釘6
個"AESCULAP"CRANIOPLATE SYSTEM(MICRO):2HOLEX3+SCREWX6
15882
FPP07FM991AE "雅氏"顱顏骨釘骨板系統:4孔骨板3個+骨釘12
個"AESCULAP"CRANIOPLATE SYSTEM(MICRO):4HOLEX3+SCREWX12
23826
FPP07FM992AE "雅氏"顱顏骨釘骨板系統:BURR HOLE 1個+雙孔骨板2個+骨釘10
個"AESCULAP"CRANIOPLATE SYSTEM(MICRO):BURR
HOLEX1+2HOLEX2+SCREWX10
24479
FPP07RFS75WR "BIOMET MICROFIXATION"RAPIDFLAP SPIN DOWN SYSTEM "生邁"顱
骨固定夾※給付規定請見備註欄
4000
FPP07SF12FJL 〝JEIL〞SPEEDY FLAP CRANIOPLASTY PLATE 〝偕猷〞顱骨板固定
系統 ※適應症請見備註欄
4000
FPP0903104LE TITANIUM LIGATURE WIRE 0.4MM 30CM ※適應症請見備註欄 120
FPP0903105LE TITANIUM LIGATURE WIRE 0.5MM 30CM ※適應症請見備註欄 120
FPP0903106LE TITANIUM LIGATURE WIRE 0.6MM 30CM ※適應症請見備註欄 120
FPP0909104LE "史賽克雷賓格爾"下頷骨系統迷你骨板6孔;4-12MM;“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM 2.0 MINI CHIN PLATE
6 HOLE 4-12MM
2700
FPP0913511LE CHIN PLATE 4MM ※適應症請見備註欄 2700
FPP0913512LE CHIN PLATE 6MM ※適應症請見備註欄 2700
FPP0913513LE CHIN PLATE 8MM ※適應症請見備註欄 2700
FPP0913514LE CHIN PLATE 10MM ※適應症請見備註欄 2700
FPP0913515LE CHIN PLATE 12MM ※適應症請見備註欄 2700
FPP0913516LE CHIN PLATE 14MM ※適應症請見備註欄 2700
FPP0920185Y2 SKULL TITANIUM WIRE 0.4:0.6MM※適應症請見備註欄 120
FPP094707NS1 TITANIUM MINI CHIN PLATE 2.0 DOUBLE BEND 5 HOLE ※適應症
請見備註欄
2700
FPP0957504M3 TIANIUM CHINPLATE 4HOLE 4:12MM※適應症請見備註欄 2700
FPP1042736W2 TENDON SPACER 3:6MM 2500
FPP1101501FV BONAMATES BIOFIXATION SYSTEM:STR 4 HOLE
1.0X1.5MM,1.2X2.0MM,1.5X2.5MM ※適應症請見備註欄
2498
FPP1101502FV BONAMATES BIOFIXATION SYSTEM:STR 6 HOLE
1.0X1.5MM,1.2X2.0MM,1.5X2.5MM ※適應症請見備註欄
2672
FPP1101503FV BONAMATES BIOFIXATION SYSTEM:C 型 7 HOLE
1.0X1.5MM,1.2X2.0MM ※適應症請見備註欄
3883
FPP1101504FV BONAMATES BIOFIXATION SYSTEM:Y 型 8 HOLE
1.0X1.5MM,1.2X2.0MM ,1.5X2.5MM ※適應症請見備註欄
4997
FPP1101505FV BONAMATES BIOFIXATION SYSTEM:L 型 8/10 HOLE
1.0X1.5MM,1.2X2.0MM ,1.5X2.5MM ※適應症請見備註欄
4085
FPP1101507FV BONAMATES BIOFIXATION SYSTEM:X 型 10 HOLE
1.0X1.5MM,1.2X2.0MM ,1.5X2.5MM ※適應症請見備註欄
5560
927
特材代碼 中英文名稱 支付點數-104/01/01
FPP1101508FV BONAMATES BIOFIXATION SYSTEM:STR 8 HOLE 1.5X2.5MM ※適應
症請見備註欄
2672
FPS0100001EJ "OSTEOMED"FAST-FLAP NEURO FIXATION SYSTEM:1.2MM AUTO-
DRIVE SCREW"歐特美"速固硬式固定系統自攻螺絲※適應症請見備
註欄
1361
FPS0100002EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.3MM
SAFETY SCREW "歐美特"下頷骨折重建系統,2.3MM 安全骨釘
579
FPS0100003EJ "OSTEOMED"FAST-FLAP NEURO FIXATION SYSTEM:1.5MM SAFETY
SCREW"歐特美"速固硬式固定系統安全螺絲※適應症請見備註欄
1361
FPS0100004EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.7MM
SCREW "歐美特"下頷骨折重建系統,2.7MM 骨釘
579
FPS0100005EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.4MM
SCREW "歐美特"下頷骨折重建系統,2.4MM 骨釘
579
FPS0100006EJ "OSTEOMED"FAST-FLAP NEURO FIXATION SYSTEM:1.6MM AUTO-
DRIVE SCREW"歐特美"速固硬式固定系統自攻螺絲※適應症請見備
註欄
1361
FPS0100007EJ "OSTEOMED"FAST-FLAP NEURO FIXATION SYSTEM:1.9MM SAFETY
SCREW"歐特美"速固硬式固定系統安全螺絲※適應症請見備註欄
1361
FPS010000NEJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.0MM
SCREW "歐美特"下頷骨折重建系統,2.0MM 骨釘
298
FPS010071NS1 1.5 MM CORTEX SCREW SELF-TAPPING 4:18 MM ※適應症請見備
註欄
298
FPS0100NNNS1 1.0:1.3 MM MICRO,1.2:1.7 MM EMERGENCY SCREW 2:8MM ※適應
症請見備註欄
1361
FPS010151NS1 2.4 MM,2.0MM CORTEX SCREW SELF-TAPPING 8:18 MM ※適應症
請見備註欄
579
FPS010156NS1 2.7MM EMERGENCY SCREW 8:18MM※適應症請見備註欄 579
FPS0108405LE MINI BONE SCREW 2.0X5MM(型號52-17012:52-82308自 90/07/01
生效)※適應症請見備註欄
298
FPS0108407LE MINI BONE SCREW 2.0x7MM ※適應症請見備註欄 298
FPS0108409LE MINI BONE SCREW 2.0x8MM/9MM ※適應症請見備註欄 298
FPS0108411LE MINI BONE SCREW 2.0x10MM/11MM ※適應症請見備註欄 298
FPS0108413LE MINI BONE SCREW 2.0x12MM/13MM ※適應症請見備註欄 298
FPS0108415LE MINI BONE SCREW 2.0x14MM/15MM ※適應症請見備註欄 298
FPS0108417LE MINI 2.0MM BONE SCREW 17MM ※適應症請見備註欄 298
FPS0108459LE MINI 2.3MM EMERGENCY BONE SCREW 9MM ※適應症請見備註欄 298
FPS0108780LE BRIFGING BONE SCREW 3.5X10MM※適應症請見備註欄 579
FPS0108786LE BRIDGING BONE SCREW (型號5227-375:822,5230-
008:135,5108:5130自92/1/1生效)※適應症請見備註欄
579
FPS0109650LE COMPREDSSION BONE SCREW SELF-TAPPING 2.7x10MM ※適應症請
見備註欄
579
FPS0109652LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x12MM ※適應症請見
備註欄
579
FPS0109654LE BONE SCREW SELF-TAPPING 2.7x14MM ※適應症請見備註欄 579
FPS0109656LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x16MM ※適應症請見
備註欄
579
FPS0109658LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x18MM ※適應症請見
備註欄
579
FPS0109660LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x20MM ※適應症請見
備註欄
579
FPS0109662LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x22MM ※適應症請見
備註欄
579
928
特材代碼 中英文名稱 支付點數-104/01/01
FPS0109664LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x24MM ※適應症請見
備註欄
579
FPS0109666LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x26MM ※適應症請見
備註欄
579
FPS0109668LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x28MM ※適應症請見
備註欄
579
FPS0109670LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x30MM ※適應症請見
備註欄
579
FPS0109674LE COMPRESSION EMERGENCY BONE SCREW 3.2x12MM ※適應症請見備
註欄
579
FPS0109676LE EMERGENCY BONE SCREW 3.2x16MM ※適應症請見備註欄 579
FPS0109678LE COMPRESSION EMERGENCY BONE SCREW 3.2x20MM ※適應症請見備
註欄
579
FPS0109680LE COMPRESSION EMERGENCY BONE SCREW 3.2x24MM ※適應症請見備
註欄
579
FPS01119NNS1 2MM MINI CORTEX 2.4MM,EMERGENCY SCREW SELF-TAPPING ※適應
症請見備註欄
298
FPS0112102LE MICROPLUS BONE SCREW SELF-TAPPING(型號52-10002:81409,59-
14105:14111自90/07/01生效)※適應症請見備註欄
1361
FPS0112104LE MICROPLUS BONE SCREW SELF-TAPPING 1.2x4MM,1.2x5MM ※適應
症請見備註欄
1361
FPS0112106LE MICROPLUS BONE SCREW SELF-TSPPING 1.2x6MM:1.2x12MM ※適應
症請見備註欄
1361
FPS011210NLE “史賽克 雷賓格爾”下頷骨系統骨釘;1.2MM/1.4MM“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM MICRO BONE
SCREW1.2MM/1.4MM
1361
FPS0114103LE MICROPLUS EMERGENCY BONE SCREW SELF-TAPPING 1.4x3MM ※適
應症請見備註欄
1361
FPS0115104LE BONE SCREW 1.5x4MM ※適應症請見備註欄 298
FPS0115105LE LOW PROFILE BONE SCREW 1.5x5MM ※適應症請見備註欄 298
FPS0115106LE LOE PROFILE BONE SCREW 1.5x6MM ※適應症請見備註欄 298
FPS0115107LE LOW PROFILE BONE SCREW 1.5x7MM ※適應症請見備註欄 298
FPS0115108LE LOW PROFILE BONE SCREW 1.5x8MM ※適應症請見備註欄 298
FPS0115109LE LOW PROFILE BONE SCREW 1.5x9MM ※適應症請見備註欄 298
FPS0115110LE LOW PROFILE BONE SCREW 1.5x10MM ※適應症請見備註欄 298
FPS0115111LE BONE SCREW 1.5x11MM ※適應症請見備註欄 298
FPS0115112LE BONE SCREW 1.5x12MM ※適應症請見備註欄 298
FPS0115113LE BONE SCREW 1.5x13MM ※適應症請見備註欄 298
FPS011700NLE MINI BONE SCREW 1.7MM,1.9MM ※適應症請見備註欄 298
FPS0120013M3 TITANIUM LOCK-DRIVE TRANSPLANT SCREW 2.0X7:17MM SELF-
CUTTING※適應症請見備註欄
579
FPS012009NLE TITANIUM FASTENING SCREW FOR TEMPORARY CONDYLAR
PROSTHESES※適應症請見備註欄
579
FPS012017NY2 MICRO BONE SCREW 1.2MM 2:12MM※適應症請見備註欄 1361
FPS0120220EJ M4 RIGID FIXATION SYSTEM 2.0MM SCREW ※適應症請見備註欄 298
FPS012028NY2 MINI BONE SCREW 2.0MM 5:19MM※適應症請見備註欄 298
FPS0120412EJ M4 RIGID FIXATION SYSTEM MICRO SCREW 1.2MM(SCREW 1.2 X 2,
3, 4, 6, 8, 10, 12, 14MM)※適應症請見備註欄
1361
FPS0120415EJ M4 RIGID FIXATION SYSTEM MICRO SAFETY SCREW 1.5MM※適應症
請見備註欄
1361
FPS012042NLE MINI SCREW 2.0:2.7MM※適應症請見備註欄 579
FPS012053NY2 COMPRESSION BONE SCREW 2.7,3.2MM※適應症請見備註欄 579
929
特材代碼 中英文名稱 支付點數-104/01/01
FPS0120624EJ M4 RIGID FIXATION SYSTEM 2.4MM MAXI FRACTURE SCREW ※適應
症請見備註欄
579
FPS0120641Y2 MANDIBULAR BONE SCREW 3.5MM 10:20MM※適應症請見備註欄 579
FPS0120704LE “史賽克 雷賓格爾”下頷骨系統骨釘 2.0MM“STRYKER
LEIBINGER” UNIVERSAL MANDIBLE SYSTEM 2.0 MM BONE SCREW
298
FPS0121112EJ M4 RIGID FIXATION SYSTEM:AUTO-DRIVE SCREW※適應症請見備
註欄
1361
FPS0121120EJ M4 RIGID FIXATION SYSTEM 2.0 MM SCREW ※適應症請見備註欄 298
FPS01291BSY2 "SYNTEC"TITANIUM MESH PLATE:SCREW "亞太醫療"鈦合金網眼骨
板:骨釘※給付規定請見備註欄
1361
FPS013015AXU "合碩"顱顏骨固定系統:骨釘,自鑽"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF,BONE SCREW,SELF-DRILLING, TITANIUM
ALLOY
1361
FPS013015FXU "合碩"顱顏骨固定系統:骨釘,自鑽"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF,BONE SCREW,SELF-DRILLING, TITANIUM
ALLOY
1361
FPS013015LXU "合碩"顱顏骨固定系統:骨釘,自鑽"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF MINI BONE SCREW,SELF-DRILLING,
TITANIUM ALLOY
298
FPS013015TXU "合碩"顱顏骨固定系統:骨釘,自鑽"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF BONE SCREW,SELF-DRILLING, TITANIUM
ALLOY
579
FPS01301BSY2 "SYNTEC"TITANIUM MESH PLATE:SCREW "亞太醫療"鈦合金網眼骨
板:骨釘※給付規定請見備註欄
1361
FPS013025CXU "合碩"顱顏骨固定系統:骨釘,應急自鑽"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF BONE SCREW,EMERGENCY,SELF-DRILLING,
TITANIUM ALLOY
1361
FPS013025EXU "合碩"顱顏骨固定系統:骨釘,應急自鑽"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF MICRO BONE SCREW,EMERGENCY,SELF-
DRILLING, TITANIUM ALLOY
1361
FPS013025PXU "合碩"顱顏骨固定系統:骨釘,應急自鑽"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF MICRO BONE SCREW,EMERGENCY,SELF-
DRILLING, TITANIUM ALLOY
298
FPS013025WXU "合碩"顱顏骨固定系統:骨釘,應急自鑽"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF BONE SCREW,EMERGENCY,SELF-DRILLING,
TITANIUM ALLOY
579
FPS013115AXU "合碩"顱顏骨固定系統:骨釘,自攻"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF,BONE SCREW,SELF-TAPPING, TITANIUM
ALLOY
1361
FPS013115CXU "合碩"顱顏骨固定系統:骨釘,應急自攻"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF,BONE SCREW,EMERGENCY SELF-TAPPING,
TITANIUM ALLOY
1361
FPS013115FXU "合碩"顱顏骨固定系統:骨釘,自攻"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF,BONE SCREW,SELF-TAPPING, TITANIUM
ALLOY
1361
FPS013115LXU "合碩"顱顏骨固定系統:骨釘,自攻"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF,BONE SCREW,SELF-TAPPING, TITANIUM
ALLOY
298
FPS013115TXU "合碩"顱顏骨固定系統:骨釘,自攻"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF,BONE SCREW,SELF-TAPPING, TITANIUM
ALLOY
579
FPS01311STY2 "SYNTEC"TITANIUM MESH PLATE:SCREW "亞太醫療"鈦合金網眼骨
板:骨釘※給付規定請見備註欄
1361
930
特材代碼 中英文名稱 支付點數-104/01/01
FPS013125EXU "合碩"顱顏骨固定系統:骨釘,應急自攻"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF,BONE SCREW,EMERGENCY,SELF-TAPPING,
TITANIUM ALLOY
1361
FPS013125PXU "合碩"顱顏骨固定系統:骨釘,應急自攻"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF,BONE SCREW,EMERGENCY,SELF-TAPPING,
TITANIUM ALLOY
298
FPS013125WXU "合碩"顱顏骨固定系統:骨釘,應急自攻"CUSMED"CMF FIXATION
SYSTEM:CONDUCT CMF,BONE SCREW,EMERGENCY,SELF-TAPPING,
TITANIUM ALLOY
579
FPS014009SM3 TITANIUM CONDYLAR PROTHESIS FIXATION SCREW※適應症請見備
註欄
579
FPS014051NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:SCREWS,SELF-TAPPING SCREW
2.0-2.4MM 5-18MM"信迪思"下顎固定系統:骨釘
579
FPS014651NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:EMERGENCY SELF-TAPPING
SCREW 2.7, 5-18MM"信迪思"下顎固定系統:骨釘
579
FPS014668NS1 2.4MM UNILOCK SCREW 自攻牙鎖定骨釘※適應症請見備註欄 579
FPS01503CNS1 "SYNTHES"MATRIX MIDFACE SYSTEM:1.5MM SELF-TAPPING MICRO
SCREW 3:12MM"信迪思"中顏面固定系統:固定螺釘 ※適應症請見
備註欄
1361
FPS01503DNS1 "SYNTHES"MATRIX MIDFACE SYSTEM:1.5MM SELF-DRILLING MICRO
SCREW 3:8MM "信迪思"中顏面固定系統:固定螺釘※適應症請見備
註欄
1361
FPS01503ENS1 "SYNTHES"MATRIX MIDFACE SYSTEM:1.8MM EMERGENCY MICRO
SCREW 3:12MM"信迪思"中顏面固定系統:固定螺釘 ※適應症請見
備註欄
1361
FPS015223NLE MANDIBULAR SCREW 2.3MM 6:22MM※適應症請見備註欄 579
FPS015227NLE MANDIBULAR SCREW 2.7MM 6:22MM※適應症請見備註欄 579
FPS0152306M3 MRS TITANIUM SCREW※適應症請見備註欄 579
FPS016051NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:LOCK SCREWS SELF-TAPPING
2.0-2.4MM"信迪思"下顎固定系統:骨釘
579
FPS016681NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:LOCK SCREWS SELF-TAPPING
2.9 MM"信迪思"下顎固定系統:骨釘
579
FPS017020NM3 MONDEAL TITANIUM 1.2MM MICRO LOCK DRIVE SCREW
2:8MM,1.5MMX4:6MM※適應症請見備註欄
1361
FPS01702NNM3 TITANIUM 1.2MM MICRO LOCK DRIVE SCREW ※適應症請見備註欄 1361
FPS0172005M3 TITANIUM 2.0MM MINI STANDARD SCREW 5MM:19MM ※適應症請見
備註欄
298
FPS0172007M3 TITANIUM 2.0MM MINI LOCK-DRIVE SCREW 5MM:19MM ※適應症請
見備註欄
298
FPS0172305M3 TITANIUM 2.3MM MINI EMERGENCY SCREW 5MM:9MM ※適應症請見
備註欄
298
FPS0172307M3 TITANIUM 2.3MM MINI EMERGENCY LOCK-DRIVE SCREW 5MM:9MM ※
適應症請見備註欄
298
FPS018020NM3 MONDEAL TITANIUM 1.2MM MICRO CROSS FIT SCREW
2:8MM,1.5X4:6MM※適應症請見備註欄
1361
FPS0182004M3 CROSS-FIT,LOCK-DRIVE SCREW 2.0 4MM ※適應症請見備註欄 298
FPS0182005M3 TITANIUM 2.0MM MINI CROSS-FIT SCREW 5MM:19MM ※適應症請見
備註欄
298
FPS0182305M3 TITANIUM 2.3MM MINI EMERGENCY CROSS-FIT SCREW 5MM:9MM ※
適應症請見備註欄
298
FPS0182716M3 TITANIUM LOCK-DRIVE SCREW 2.7X8:22MM SELF-CUTTING※適應症
請見備註欄
579
931
特材代碼 中英文名稱 支付點數-104/01/01
FPS0183012M3 TITANIUM LOCK-DRIVE EMERGENCY SCREW 3.0X8:14MM SELF-
CUTTING※適應症請見備註欄
579
FPS0187505MC TITANIUM 2MM MINI SCREW 5.5MM ※適應症請見備註欄 298
FPS0187507MC TITANIUM 2MM MINI SCREW 7MM ※適應症請見備註欄 298
FPS0187509MC TITANIUM 2MM MINI SCREW 9MM ※適應症請見備註欄 298
FPS0187511MC TITANIUM 2MM MINI SCREW 11MM ※適應症請見備註欄 298
FPS0187513MC "MEDICON"TITANIUM 2MM MINI SCREW 13MM 鈦金屬顏面骨板系統:
迷你骨釘 ※適應症請見備註欄
298
FPS0188303MC MICRO SCREW 3.5X1.5MM ※適應症請見備註欄 1361
FPS0188305MC MICRO SCREW 5X1.5MM ※適應症請見備註欄 1361
FPS0188307MC MICRO SCREW 7X1.5MM ※適應症請見備註欄 1361
FPS0188309MC MICRO SCREW 9X1.5MM ※適應症請見備註欄 1361
FPS0188311MC MICRO SCREW 11X1.5MM ※適應症請見備註欄 1361
FPS0188313MC TITANIUM 1.5MM MICRO SCREW 13,15,16,17MM※適應症請見備註
欄
1361
FPS0188334MC MICRO EMERGENCY SCREW 4X1.9MM ※適應症請見備註欄 1361
FPS0188339MC MICRO EMERGENCY SCREW 9X1.9MM ※適應症請見備註欄 1361
FPS0189520MC "MEDICON"TITANIUM MANDIBULAR RECONSTRUCTION SCREWS
2.7X7MM 鈦金屬顏面骨板系統:下顎骨釘※適應症請見備註欄
579
FPS0189521MC TITANIUM SCREWS 2.7X9MM ※適應症請見備註欄 579
FPS0189522MC TITANIUM SCREWS 2.7X11MM ※適應症請見備註欄 579
FPS0189523MC TITANIUM SCREWS 2.7X13MM ※適應症請見備註欄 579
FPS0189524MC TITANIUM SCREWS 2.7X15MM ※適應症請見備註欄 579
FPS0189525MC TITANIUM SCREWS 2.7X17MM ※適應症請見備註欄 579
FPS0189527MC TITANIUM SCREWS 2.7X21MM ※適應症請見備註欄 579
FPS0189531MC TITANIUM EMERGENCY SCREWS 3.2X9MM ※適應症請見備註欄 579
FPS0192004M3 NEWS S-DRIVE SELF-DRILLING SCREW(MINI 2000)※適應症請見備
註欄
298
FPS01FM940AE "AESCULAP"CRANIO PLATE SYSTEM:MICRO SCREW"雅式"顱顏骨釘骨
板系統:骨釘※適應症請見備註欄
1361
FPS0201N2NS1 2.0,2.4,2.7MM CORTEX SCREW 20:28MM ※適應症請見備註欄 749
FPS0201N3NS1 2.0,2.4,2.7MM CORTEX SCREW 30:40MM ※適應症請見備註欄 749
FPS1150400FV BONAMATES BIOFIXATION SYSTEM:SCREW 1.5X4.0~2.5X25MM(單支
包裝) ※適應症請見備註欄
1361
FPS1150401FV BONAMATES BIOFIXATION SYSTEM:SCREW 1.5X4.0~2.5X25MM(2支/
包) ※適應症請見備註欄
2722
FPS1150402FV BONAMATES BIOFIXATION SYSTEM:SCREW 1.5X4.0~2.5X25MM(4支/
包) ※適應症請見備註欄
5444
FPT0120789L0 "SILIMED"TISSUE EXPANDER "賜妳媚"組織擴張器※給付規定請見
備註欄
11500
FPT0135054NW "MENTOR"TISSUE EXPANDER"曼陀"組織擴張器 11500
FPT01SC088A2 "ALLERGAN" TISSUE EXPANDERS"愛力根"組織擴張器※適應症請見
備註欄
11500
FSAE171000SB TRACHEOBRONCHIAL WALLSTENT UNISTEP DELIVERY SYS. STENT5:
24*20:90MM適應症見備註M001711-000:390
32122
FSAE1GTBXXQS "博娜" 氣管及支氣管支架"BONASTENT" TRACHEAL/BRONCHIAL
STENT*適應症請見備註欄
32122
FSAE1GTBXXSB "BOSTON SCIENTIFIC"ULTRAFLEX TRACHEOBRONCHIAL STENT
SYSTEM歐超福雷斯氣管和支氣管支架系統*適應症請見備註欄
32122
FSAE1TBRXXWH "TAEWOONG"NITI-S TRACHEOBRONCHIAL STENT"泰悟"氣管支氣管支
架(含支架系統)*給付規定請見備註欄
32122
FSP6201127DV "DAVOL"BARD MESH PERFIX PLUG"德柏"巴德修補網:珀菲斯塞子
(高/直徑1"/1.35"、1.3"/1.55"、1.6"/1.9"、1.6"/2.0")
3800
932
特材代碼 中英文名稱 支付點數-104/01/01
FSP62P3DPAET "ETHICON"PROLENE(POLYPROPYLENE)3D PATCH"愛惜康"伯羅倫3D修
補網
3800
FSP62TECRTZQ "SOFRADIM"PARIETEX MESHES-PLUGS"舒法定"帕瑞得人工編網-立
體錐形塞編網
3800
FSP7103657AM "AMS"SPARC SLING SYSTEM懸吊手術系統(兩支不銹鋼彎曲弓狀穿
引針(不需再使用INTRODUCER)+一條聚丙烯懸帶)
13680
FSP7103831AM "AMS"MONARC SUBFACIAL HAMMOCK懸吊手術系統(兩支不銹鋼彎曲
弓狀穿引針(不需再使用INTRODUCER)+一條聚丙烯懸帶)
13680
FSP710BTRXSB "BOSTON SCIENTIFIC"OBTRYX SYSTEM"波士頓科技"歐碧翠系統(2
個輸送裝置+1個網狀結構)
13680
FSP7181004ET "ETHICON"TENSION-FREE VAGINAL TAPE(TVT)DEVICE 含
INTRODUCER 及RIGID CATHETER GUIDE
13680
FSP71ADVANSB "波士頓科技"艾凡極網片系統(1個輸送裝置+1個網狀結
構)"BOSTON SCIENTIFIC"ADVANTAGE SYSTEM
13680
FSP71BRD16BA "BARD"ALIGN URETHRAL SUPPORT SYSTEM(含INTRODUCER+MESH
ASSEMBLY)艾萊尿道支撐系統
13680
FSP71TVT0MYM GYNECARE TVT ABBREVO CONTINENCE SYSTEM蓋那客尿失禁手術用
懸吊帶愛不漏系統(含放置環、螺旋型導針、無創帶翼導引器)
13680
FSP71TVTRLYM "GYNECARE"TVTEXACT CONTINENCE SYSTEM"蓋那客"尿失禁手術用
懸吊帶依捷特系統(含放置環、螺旋型導針、無創帶翼導引器)
13680
FUK02CA101NV EXTRACORPOREAL TUBING SET(CAVH TUBING SET) 730
FUK02TS013FN 英弗梅體外血液迴路管-連續性動靜脈血液濾過套組 INFOMED
EXTRACORPOREAL BLOOD CIRCUIT-CONTINUOUS ARTERIO-VENOUS
HEMOFILTRATION,CAVH
730
FUK030300CGA ADSORBA 300GM 9982
FUK03300KTGA "GAMBRO"PRISMAFLEX ADSORBA 300KIT "衛寶"吸附器套組(灌注器
+體外血液迴路管)
11342
FUK03TS205FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS-HEMOPERFUSION英弗梅
體外血液迴路管-血液灌流
1274
FUK03TS206FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS-PEDIATRIC
HEMOPERFUSION英弗梅體外血液迴路管-小兒血液灌流
1274
FUK03TS407FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS-HEMOPERFUSION英弗梅
體外血液迴路管-血液灌流
1274
FUK03TS408FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS-PEDIATRIC
HEMOPERFUSION英弗梅體外血液迴路管-小兒血液灌流
1274
FUK0500M60GA PRISMA SET(CVVH TUBING+HEMOFILTER)膜面積0.6M平方,連續式血
液透析器及迴路套管*適應症請見備註欄
4579
FUK0501000GA PRISMAFLEX SET(CVVH TUBING+HEMOFILTER)膜面積1.1M平方*適應
症請見備註欄
5102
FUK0501400GA PRISMAFLEX SET(CVVH TUBING+HEMOFILTER)膜面積1.4M平方*適應
症請見備註欄
5102
FUK050M100GA PRISMA SET(CVVH TUBING+HEMOFILTER)膜面積0.9M平方,連續式血
液透析器及迴路套管*適應症請見備註欄
5102
FUK05DF080FN "INFOMED"CVVH HEMOFILTER 0.8M平方血液過濾器*適應症請見備
註欄
3596
FUK05DF140FN "INFOMED"CVVH HEMOFILTER 1.4M平方血液過濾器*適應症請見備
註欄
4002
FUK05DF190FN "INFOMED"CVVH HEMOFILTER 1.9M平方血液過濾器*適應症請見備
註欄
4002
FUK05F0M60GA PRISMAFLEX SET(CVVH TUBING+HEMOFILTER)0.6M平方*適應症請見
備註欄
4579
933
特材代碼 中英文名稱 支付點數-104/01/01
FUK05FM100GA PRISMAFLEX SET(CVVH TUBING+HEMOFILTER)0.9M平方*適應症請見
備註欄
5102
FUK05FM150GA "GAMBRO"PRISMAFLEX SET(CVVH TUBING+HEMOFILTER膜面積1.5M平
方)普利司馬弗列克斯套組*適應症請見備註欄
5102
FUK05HD200E9 CVVH HEMOFILTER*適應症請見備註欄 3596
FUK05HD300E9 CVVH HEMOFILTER*適應症請見備註欄 4002
FUK05PF150GA "GAMBRO"PRISMAFLEX SET*適應症請見備註欄 5102
FUK05PFXSTGA "GAMBRO"PRISMAFLEX SET(CVVH TUBING+HEMOFILTER)膜面積1M平
方*適應症請見備註欄.
5102
FUK05PR100GA "GAMBRO"PRISMA SET (CVVH TUBING+HEMOFILTER)1.15M平方*適應
症請見備註欄
5102
FUK05PST60GA "GAMBRO"PRISMAFLEX SET(CVVH TUBING+HEMOFILTER)膜面積0.6M
平方*適應症請見備註欄.
4579
FUK05RHF6SGA "GAMBRO"CVVH HEMOFILTER(0.6M平方)血液過濾器*適應症請見備
註欄
3596
FUK05ST100GA "GAMBRO"PRISMA SET(CVVH TUBING+HEMOFILTER)膜面積1.0M平方
連續式血液透析器及迴路管套*適應症請見備註欄
5102
FUK05ST60PGA "GAMBRO"PRISMA SET連續式血液透析器及迴路管套*適應症請見備
註欄
4579
FUK05TS200FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS FOR CF200- CVVH英弗
梅體外血液迴路管*適應症請見備註欄
1393
FUK05TS201K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUITS-CVVH英禾美體外血
液迴路管-血液濾過
1393
FUK05TS400FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS-CVVH英弗梅體外血液
迴路管*適應症請見備註欄
1393
FUK05TS403K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT-CONTINUOUS VENO-
VENOUS HEMOFILTRATION (CVVH)HF400/HF440用英禾美體外血液迴
路管-血液濾過
1393
FUK05U1000FA "FRESENIUS"POLYSULFONE HAEMOFILTERS(CVVH FILTER 1.8M平方
)人工合成膜血液過濾器*適應症請見備註欄
4002
FUK05U400SFA "FRESENIUS"POLYSULFONE HAEMOFILTERS(CVVH FILTER 0.7M平方)
人工合成膜血液過濾器*適應症請見備註欄
3596
FUK05U600SFA "FRESENIUS"POLYSULFONE HAEMOFILTERS(CVVH FILTER 1.4M平方)
人工合成膜血液過濾器*適應症請見備註欄
4002
FUS0100411AM "AMS"800 URINARY CONTROL SYSTEM(CONTROL PUMP+PRESSURE-
REGULATING BALLOON+BELT CUFFS+800 ACCESSORY KIT)"艾梅斯"
尿控系統*給付規定請見備註欄
155000
HEF0146092H9 "華億"體外循環管組"HYM"HEART LUNG PACK-ARTERIAL FILTER
3/8" ADULT 20 MICRO
1573
HEF0146093H9 HEART LUNG PACK:ARTERIAL FILTER WITH HEPARIN
COATING(ADULT;PEDIATRIC;INFANT)*體外循環120分以上用
1716
HEF0146163GJ “吉生”體外循環管組-動脈過濾器”JSM” HEART LUNG PACK-
ARTERIAL FILTER
1573
HEF0146247GJ “吉生”體外循環管組-PHISIO塗層動脈過濾器”JSM” HEART
LUNG PACK-ARTERIAL FILTER WITH PHISIO COATING
1716
HEF01ARF40H9 "華億" 體外循環管組-動脈過濾器"HYM" HEART LUNGPACK-
ARTERIAL FILTER 40MICRO
1573
HEF02A3510M4 AFFINITY ARTERIAL FILTER 1573
HEF02AF001TM ARTERY FILTER ADULT 1573
HEF02AF002TM ARTERY FILTER PEDIATRIC 1573
HEF02AF125TM CAPIOX ARTERIAL FILTER 1573
HEF02E3840P3 EXTRA CORTOREAL FILTER 體外循環血液過濾器(開心用) 1573
HEF02HBF14QM "邁柯唯"動脈過濾器"MAQUET" QUART ARTERIAL FILTER 1573
934
特材代碼 中英文名稱 支付點數-104/01/01
HEF02S4104M4 "美敦力" 艾芬你堤兒童動脈過濾器 "MEDTRONIC"AFFINITY
PEDIATRIC ARTERIAL FILTER
1573
HEF030P005AS "旭"血漿分離器"ASAHI"PLASMAFLO 4296
HEF030P008AS "旭"血漿分離器"ASAHI"PLASMAFLO(PLASMA FILTER) 4296
HEF032011NF5 MJ BLOOD LINE SET FOR BLOOD PURIFICATION邁捷血液淨化迴路
導管
1358
HEF03EC030AS "旭" 血漿成分分離器"ASAHI" CASCADEFLO EC PLASMA COMPONENT
SEPARATOR
4296
HEF03EVACLKA "川澄化工"膜型血漿分離器"KAWASUMI LABORATORIES" PLASMA
SEPARATOR EVACLIO
4296
HEF03EVAFLKA EVAFLUX 血液成份分離器加血液迴路管組 6000
HEF03EVAFXKA "川澄化工" 血漿成分分離器"KAWASUMI LABORATORIES" PLASMA
FRACTIONATOR EVAFLUX
4296
HEF03HD400E9 雙重濾過血液濾過器HEMOFILTER 6000
HEF03HD500E9 雙重濾過血液濾過器HEMOFILTER 6000
HEF03KPE88KA "KAWASUMI LABORATORIES" BLOOD TUBING LINE FOR PLASMA
EXCHANGE "川澄化工"血漿交換用血液迴路導管
1430
HEF03LF030FN "英弗梅"血漿過濾器"INFOMED"PLASMAFILTER 4296
HEF03LF050FN "英弗梅"血漿過濾器"INFOMED"PLASMAFILTER 4296
HEF03LF070FN "英弗梅"血漿過濾器"INFOMED"PLASMAFILTER 4296
HEF03P1DRYFA "費森尤斯"血漿過濾器"FRESENIUS" PLASMAFILTER 4296
HEF03PLA20E9 MEDICA PLASMAFILTERS 0.15平方公尺 4296
HEF03PLA40E9 MEDICA PLASMAFILTERS 0.35平方公尺 4296
HEF03PLA60E9 MEDICA PLASMAFILTERS 0.55平方公尺 4296
HEF03PRFPEGA "GAMBRO"PRISMAFLEX SET血漿透析器及血液迴路管 6000
HEF03PRLPEGA "GAMBRO"PRISMAFLEX SET 血液透析器及迴路管套 6000
HEF03PRTPEGA "GAMBRO"PRISMA SET 連續式血液透析器及迴路管套 6000
HEF03PS08SKA 川澄化工血漿分離器KAWASUMI LABORATORIES PLASMACURE PE
PLASMA SEPARATOR
4296
HEF03TS203FN 英弗梅體外血液迴路管INFOMED EXTRACORPOREAL BLOOD
CIRCUITS(FOR CF200 PLASMA EXCHANGE)
1430
HEF03TS203K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT FOR CF200-PLASMA
EXCHANGE 英禾美CF200用體外血液迴路管-血漿置換
1430
HEF03TS204FN 英弗梅體外血液迴路管INFOMED EXTRACORPOREAL BLOOD
CIRCUITS(FOR CF200-PEDIATRIC PLASMA EXCHANGE)
1430
HEF03TS204K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT FOR CF200-
PEDIATRIC PLASMA EXCHANGE 英禾美CF200用體外血液迴路管-小
兒血漿置換
1430
HEF03TS401FN 英弗梅體外血液迴路管INFOMED EXTRACORPOREAL BLOOD CIRCUITS 1358
HEF03TS401K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT-DOUBLE FILTRATION
HF400/HF440用英禾美體外血液迴路管-雙重濾過
1358
HEF03TS402K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT-PLASMA EXCHANGE體
外血液迴路管-血漿置換
1430
HEF03TS406K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT-PEDIATRIC PLASMA
EXCHANGE英禾美體外血液迴路管-小兒血漿置換
1430
HEF03TSP02FN 英弗梅體外血液迴路管INFOMED EXTRACORPOREAL BLOOD
CIRCUITS(FOR PLASMA EXCHANGE)
1430
HEF03TSP06FN 英弗梅體外血液迴路管INFOMED EXTRACORPOREAL BLOOD
CIRCUITS(PEDIATRIC PLASMA EXCHANGE)
1430
HEF05CPS02P3 PALL EXTRACORPOREAL CIRCUIT FILTER*適應症請見備註欄 722
HEF05VBT16QM "邁柯唯" 氣泡過濾器 "MAQUET" VENOUS BUBBLE TRAP 722
HEF060BC1BP3 PALL EXTRACORPOREAL CIRCUIT FILTER ※限開心手術使用於
BLOOD CARDIOPIEGIA SOLUTION 時申報
2735
935
特材代碼 中英文名稱 支付點數-104/01/01
HEH01511SLTM HEMOCONCENTRATOR W/HEMODIALYSIS OR HEMOCARE TUBING SET※
適應症請見備註欄
4118
HEH01HF53TFA "比孚"血液濃縮器"B.V."HEMOCONCENTRATORS(WITH TUBING)*適應
症請見備註欄
4118
HEH01HPHJUMY “美狄菲特”血液濃縮器“MEDIVATORS”Hemocor
Hemoconcentrator(小兒使用)*適應症請見備註欄
3300
HEH01HPHTSMY “美狄菲特”血液濃縮器“MEDIVATORS”Hemocor
Hemoconcentrator*適應症請見備註欄
4118
HFF0209930BB STERIFIX INFUSION FILTER 00.2UM(T.P.N) 68.3
HFF02C8363BT TPN 0.22 MICRO FILTER 68.3
HFF02E25YFLL TPN FILTER W/EXTENSION TUBE 68.3
HFF02EF010SG TPN FILTER SET 0.22UM 68.3
HFF02EF15YSG TPN FILTER SET 0.22UM 68.3
HHF01H4R70KW “芬沃”白血球過濾器“FENWAL”SEPACELL PLATELET AND
PLASMA COLLECTOR*給付規定請見備註欄
1162
HHF01P1ASDTM LEUKOCYTE REMOVAL FILTER IMUGARD III-PL*適應症請見備註欄 1162
HHF01P214YTM LEUKOCYTE REMOVAL FILTER IMUGARD III-PL 12UNIT Y TYPE※適
應症請見備註欄
1162
HHF01PL110WX "雙威" 單次使用濾除白血球過濾器(血小板用)"SHUANGWEI"
LEUKOCYTE REDUCTION FILTER FOR BLOOD
1162
HHF01PL210WX "雙威" 單次使用濾除白血球過濾器(血小板用)"SHUANGWEI"
LEUKOCYTE REDUCTION FILTER FOR BLOOD
1162
HHF01PL310WX "雙威" 單次使用濾除白血球過濾器(血小板用)"SHUANGWEI"
LEUKOCYTE REDUCTION FILTER FOR BLOOD
1162
HHF01PPBBFFA LENKOCYTE REMOVAL FILTER FOR PLATELET CONCENTRATES*適應症
請見備註欄
1162
HHF01PPBSFFA LENKOCYTE REMOVAL FILTER FOR PLATELET CONCENTRATES*適應症
請見備註欄
1162
HHF01PXL8YP3 LEUKOCYTE REMOVAL FILTER FOR PLATELATE ※適應症請見備註欄 1162
HHF01R0250JH 笙創白血球過濾器SAFETRAN LEUKOCYTE REDUCTION FILTER/紅血
球濃厚液 1UNIT*給付規定請見備註欄
487
HHF02H4RBCKW “芬沃”白血球過濾器“FENWAL”SEPACELL LEUKOCYTE
REDUCTION SET(2UNIT RED BLOOD CELL)*給付規定請見備註欄
778
HHF02R0500JH 笙創白血球過濾器SAFETRAN LEUKOCYTE REDUCTION FILTER/紅血
球濃厚液 2UNIT*給付規定請見備註欄
778
HHF02R204YTM LEUKOCYTE REMOVAL FILTER IMUGARD III-RC 500CC Y TYPE※適
應症請見備註欄
487
HHF02R602ETM IMUGARD III-RC LEUKOCYTE REMOVAL FILTER*適應症請見備註欄 487
HHF02RC101WX "雙威" 單次使用濾除白血球過濾器(全血及紅血球
用)"SHUANGWEI" LEUKOCYTE REDUCTION FILTER FOR
BLOOD(500CC)
487
HHF02RC102WX "雙威" 單次使用濾除白血球過濾器(全血及紅血球
用)"SHUANGWEI" LEUKOCYTE REDUCTION FILTER FOR
BLOOD(1000CC)
778
HHF02RC201WX "雙威" 單次使用濾除白血球過濾器(全血及紅血球
用)"SHUANGWEI" LEUKOCYTE REDUCTION FILTER FOR
BLOOD(500CC)
487
HHF02RC202WX "雙威" 單次使用濾除白血球過濾器(全血及紅血球
用)"SHUANGWEI" LEUKOCYTE REDUCTION FILTER FOR
BLOOD(1000CC)
778
HHF02RCL1YP3 LEUKOCYTE REMOVAL FILTER FOR RBC ※適應症請見備註欄 487
936
特材代碼 中英文名稱 支付點數-104/01/01
HHF02RPBBFFA LENKOCYTE REMOVAL FILTER FOR RED CELL CONCENTRATES*適應症
請見備註欄
487
HHF02RPBSFFA LENKOCYTE REMOVAL FILTER FOR RED CELL CONCENTRATES*適應症
請見備註欄
487
HHF02T1000JH 笙創白血球過濾器SAFETRAN LEUKOCYTE REDUCTION FILTER/血小
板用12U*給付規定請見備註欄
1162
HHM010040SP3 BLOOD TRANSFUSION FILTER 40UM 1500CC 305
HHM0103048WU “優樂”高佳輸血過濾器“EUROSETS” GOCCIA BLOOD FILTER 305
HHM0104435BB "柏朗"永久性腔靜脈過濾器"B.BRAUN" VENATECH LP PERMANENT
VENA CAVA FILTER(含PUNCTURE KIT,GUIDE WIRE,FILTER
INTRODUCER,DILATOR,FILTER,SHEATH)
33528
HHM0110940MH “美樂得”第二代快取血栓清除導管“MEDRAD”FETCH 2
ASPIRATION CATHETER*給付規定請見備註欄
14123
HHM0111649AB "亞培"阿克奈防血塊栓塞保護系統"ABBOTT" RX ACCUNET EMBOLIC
PROTECTION SYSTEM*適應症請見備註欄
33371
HHM012120FN6 "奈堤諾" 希門氏血栓過濾器組"NMT"SIMON NITINOL FILTER SET
含INTRODUCER CATH. WITH FILTER、GUIDEWIRE、ENTRY NEEDLE
33528
HHM01445TWSB FILTER WIRE EX SYETEM L 190CM,300CM*適應症請見備註欄 33371
HHM01466F2CD “考迪斯” 歐特易可回收血栓過濾網“CORDIS” OPTEASE
RETRIEVABLE VENA CAVA FILTER
33528
HHM01466XNCD TRAPEASE PERMANENT VENA CAVA FILTER AND INTRODUCTION KIT 33528
HHM01500TWSB GREENFIELD VENA CAVA FILTER
SET(INTRODUCER+FILTER+SHEATH/DILATOR+ADAPTER)
33528
HHM0150300SB GREENFIELD VENA CAVA FILTER
SYSTEM(INTRODUCER+FILTER+SHEATH/DILATOR+ADAPTER)
33528
HHM0150301SB GREENFIELD VENA CAVA FILTER
SYSTEM(INTRODUCER+FILTER+SHEATH/DILATOR+ADAPTER)
33528
HHM0181550VS “法斯樂舒順”普倫特血栓清除導管“VASCULAR SOLUTIONS”
PRONTO V3 EXTRACTION CATHETER*給付規定請見備註欄
14123
HHM0192010SB FILTERWIRE EMBOLIC PROTECTION SYSTEM L190CM,300CM*適應症
請見備註欄
33371
HHM01AEGSYJQ "先健" 腔靜脈過濾器 "LIFETECH" AEGISY VENA CAVA FILTER
SYSTEM(INTRODUCER CATH WITH FILTER,SHEATH/DILATOR)
33528
HHM01ANGRXCD "考迪斯"安琪歐卡爾德栓塞捕捉導引線系統"CORDIS"ANGIOGUARD
RX EMBOLIC CAPTURE GUIDEWIRE SYSTEM*適應症請見備註欄
33371
HHM01CELE1CK "曲克" 色列克特腔靜脈濾器組"COOK" CELECT VENA CAVA FILTER
SET
33528
HHM01CELECCK "曲克"色列克特腔靜脈濾器"COOK" CELECT VENA CAVA FILTER 33528
HHM01DVMAXF2 "英泰克" 戴芙血栓清除導管加大型"INVATEC" DIVER CE MAX
CLOT EXTRACTIOM CATHETER
14123
HHM01ELNATTM “泰爾茂”艾密麗血栓清除導管“TERUMO” ELIMINATE
ASPIRATION CATHETER*適應症請見備註欄
14123
HHM01ENAV6AB "亞培" 第六代血栓防護盾系統 "ABBOTT" EMBOSHIELD NAV6
EMBOLIC PROTECTION SYSTEM(FILTRATION SYSTEM & RX
RETRIEVAL CATH. PACK)*適應症請見備註欄
33371
HHM01EXPAPM4 美敦力”吸除導管"MEDTRONIC" EXPORT AP ASPIRATION
CATHETER*適應症請見備註欄
14123
HHM01EXPRTM4 美敦力”吸除導管"MEDTRONIC" EXPORT XT ASPIRATION
CATHETER*適應症請見備註欄
14123
HHM01FETCHF3 "普希士"快取血栓清除導管 "POSSIS" FETCH ASPIRATION
CATHETER*適應症請見備註欄
14123
937
特材代碼 中英文名稱 支付點數-104/01/01
HHM01G1462M4 "美敦力"保護導線加上暫時阻斷吸除系統GUARDWIRE PLUS
TEMPORARY OCCLUSION AND ASPIRATION SYSTEM(EXPORT XT
ASPIRATION CATHETER)*適應症請見備註欄
14123
HHM01G146SM4 GUARDWIRE PLUS TEMPORARY OCCLUSION AND ASPIRATION SYSTEM*
適應症請見備註欄
35000
HHM01M13A1F2 "英泰克" 莫瑪腦血管保護裝置"INVATEC" MO MA CEREBRAL
PROTECTION DEVICE*適應症請見備註欄
33371
HHM01P5010VS "法斯樂舒順"普倫特羅賓血栓清除導管"VASCULAR SOLUTIONS"
PRONTO LP EXTRACTION CATHETER*適應症請見備註欄
14123
HHM01Q5070VS "法斯樂舒順"快特血栓清除導管"VASCULAR SOLUTIONS" QXT
EXTRACTION CATHETER*適應症請見備註欄
14123
HHM01RF400BA "巴德"腔靜脈過濾器"BARD"G2 X VENA CAVA FILTER
(FILTER+INTRO+DILA+DELIVERY KIT+ADAPTER)
33528
HHM01SPDEREY 史派德栓塞防護系統"EV3"SPIDER FX EMBOLIC PROTECTION
DEVICE*適應症請見備註欄
33371
HHM01T2R9SKE ”卡內卡”史隆巴斯特血栓抽吸導管"KANEKA" THROMBUSTER II*
適應症請見備註欄
14123
HHM01TUL1PCK COOK GUNTHER TULIP VENA CAVA MREYE FILTER
SET(INTRODUCER+FILTER+SHEATH/DILATOR+ADAPTER)
33528
HHM01TULIPCK COOK GUNTHER TULIP VENA CAVA MREYE FILTER
SET(INTRODUCER+FILTER+SHEATH/DILATOR+ADAPTER)
33528
HHM01TULP1CK "曲克" 剛特圖利浦腔靜脈濾器"COOK" GUNTHER TULIP VENA CAVA
FILTER
33528
HHM02040SNP3 BLOOD TRANSFUSION FILTER 40UM 移除微血栓輸血過濾器(小兒科
專用)
305
LEE0106500M4 TEMPORARY MYOCARDIAL PACING LEAD 1036
LEE0107154AR "亞諾" 心律調整導管"ARROW" PACING CATHETERS 2846
LEE011210H2C "柯惠"羅勒電極貼片"COVIDIEN" LUDLOW MEDI-TRACE
DEFIBRILLATION ELECTRODES
652
LEE011410Z2C "柯惠"羅勒電極貼片"COVIDIEN" LUDLOW MEDI-TRACE
DEFIBRILLATION ELECTRODES
652
LEE012255R2C "柯惠"肯特利柯登斯去顫器電極貼片 "COVIDIEN" KENDALL MEDI-
TRACE CADENCE ELECTRODES
652
LEE012266P2C "柯惠"肯特利柯登斯去顫器電極貼片 "COVIDIEN" KENDALL MEDI-
TRACE CADENCE ELECTRODES (小兒用)
1050
LEE0125202A9 "奧圖"心肌導線"ALTO" Myo/Wire Temporary Cardiac Pacing
Wire
420
LEE0140176ST "聖猷達" 電極導線 "SJM" PACEL BIPOLAR PACING CATHETERS-
BALLOON CATH.
2846
LEE014017AST "聖猷達" 電極導線 "SJM" PACEL BIPOLAR PACING CATHETERS 2249
LEE014017VST "聖猷達" 電極導線 "SJM" PACEL BIPOLAR PACING CATHETERS 2249
LEE0160250JE "宜喜美"暫時性節律導線-雙極”ECM”TEMPORARY PACING WIRES-
BIPOLAR
2076
LEE016025SJE "宜喜美"暫時性節律導線"ECM"TEMPORARY PACING WIRES 1036
LEE0160BWQJE “宜喜美”暫時性節律導線-四極“ECM” TEMPORARY PACING
WIRES-QUADOPOLAR
3737
LEE016173PBA "巴德"暫時性電極導管"BARD"TEMPORARY BALLOON PACING
ELECTRODE CATHETER
2846
LEE016221PBA "巴德"暫時性電極導管"BARD"SEMI-FLOATING BIPOLAR PACING
ELECTRODE CATHETER
2249
LEE018153PBA "巴德"暫時性電極導管"BARD"SPECIAL CARE BIPOLAR PACING
ELECTRODE CATHETER
2249
LEE0197125ED "愛德華"史望康雙極心律導管組”EDWARDS”SWAN-GANZ BIPOLAR
CATHETER KIT
2846
938
特材代碼 中英文名稱 支付點數-104/01/01
LEE01AP518G2 PEDIATRIC DEFIB ELECTRODES體外心律調節器貼片 1050
LEE01AP919G2 MARGUETTE DEFIBRILLATION PACING MONITORING PADS 652
LEE01BP250BS BIPOLAR PACING CATHETER 5F,110CM(BALLOON
CATHETER,ADAPTOR,PEEL-AWAY SHEATH)
2846
LEE01BPX25BS BIPOLAR PACING CATHETER 5F,110CM 2249
LEE01KL180JC "耐倫科技" 哈特普拉斯自動體外心臟去顫電擊器-電極
片"NANOOMTECH" HEARTPLUS AUTOMATED EXTERNAL
DEFIBRILLATORS-ELECTRODE PAD
652
LEE01M1749HP DEFIB PACING PADS ADULT (2EA/SET) 652
LEE01M3501HP MULTIFUNCTION ADULT DEFIB ELECTRODES 652
LEE01M3504HP MULTIFUNCTION PEDIATRIC DEFIB ELECTRODES 1050
LEE01M3713HP MULTIFUNCTION ADULT PLUS PADS多功能電擊貼片 652
LEE01M3716HP MULTIFUNCTION ADULT RADIOLUCENT PADS多功能電擊貼片X光可穿
透型
652
LEE01M3717HP MULTIFUNCTION PEDIATRIC PLUS PADS多功能兒童用電擊貼片 1050
LEE01M3870HP INFANT/CHILD PADS多功能嬰幼兒用電擊貼片 1050
LEE01N1749HP DEFIB PACING PADS CHILD (2 EA/SET) 1050
LEE01P0510KT "日本光電" 心臟電極蘇復器-體外電極貼片"NIHON KOHDEN"
DEFIBRILLATOR-EXTERNAL PACING ELECTRODES
652
LEE01P0512KT "日本光電" 心臟電極蘇復器-體外電極貼片"NIHON KOHDEN"
DEFIBRILLATOR-EXTERNAL PACING ELECTRODES(CHILD)
1050
LEE01PADSTZ2 "佐爾" 電擊去顫器-電擊貼片"ZOLL" DEFIBRILLATOR-ADULT
MULTI-FUNCTION PACING/DEFIBRILLATION STAT PADZ
652
LEE01TBJFSKH “奧斯卡”暫時型心律調節器導線“OSCOR”TB TEMPORARY
BIPOLAR PACING LEAD
2249
LEE01TBVRHKH "奧斯卡"暫時型心律調節器導線"OSCOR" TB TEMPORARY BIPOLAR
PACING LEAD
2249
MA12345678NH 特殊材料管理費用 1500
NAN011430NBB "B.BRAUN"STERICAN SINGLE USE HYPODERMIC NEEDLE "必勃朗"注
射針
0.5
NAN011627NBB NEEDLE 0.5
NAN011826NV4 DISPOSABLE NEEDLE 18G:26G 0.5
NAN011827N3B "康德萊"一次性使用無菌注射針"KDL"DISPOSABLE NEEDLE 0.5
NAN011827NBD NEEDLE 0.5
NAN011827NNR NEEDLE 0.5
NAN011827NTM NEEDLE 0.5
NAN011827NTP NEEDLE 0.5
NAN011827NUY NEEDLE 0.5
NAN011830NTM "泰爾茂"亞加尼針頭"TERUMO"AGANI NEEDLE 0.5
NAN020030BFB FEEL-FINE INSULIN PEN NEEDLES桂台胰島素注射筆專用針頭 3.2
NAN020031N3B "康德萊"胰島素筆配套用針"KDL"INSULIN PEN NEEDLE 3.2
NAN020031NBD "BD"PEN NEEDLE"必帝"注射筆專用針(胰島素筆型針頭) 3.2
NAN020050NNR NOVOFINE NEEDLE 30G 胰島素筆型注射器針頭 3.2
NAN020632GNR NIPRO NOVOFINE NEEDLE 32G 尼普爾諾和筆注射針 3.2
NAN0291676BB OMNICAN FINE NEEDLES 29:31G 胰島素注射筆專用針頭 3.2
NAN041823NNR IC NEEDLE心肌長針 4.9
NAN061822NHK P.T.C.D NEEDLE 150:200MM 102
NAN061822NTP P.T.C.D NEEDLE 102
NAN061823MTP P.T.C.D NEEDLE MS TYPE 18G:23G 102
NAN0620200TP P.T.C.D NEEDLE 102
NAN0621150TP P.T.C.D NDDELE 102
NAN0622150TP P.T.C.D NEEDLE 102
NAN0623150TP P.T.C.D NEEDLE 23GX150MM 102
NAN1118275AG AMC/4 ARTERIAL NEEDLE 18Gx23/4"(7.0CM) 導線導引針 105
939
特材代碼 中英文名稱 支付點數-104/01/01
NAN1121200AG AMC/4 ARTERIAL NEEDLE 21Gx2"(5.1CM)導線導引針 105
NAN11A1820GJ "JSM"INTRODUCER NEEDLE"吉生"穿刺針 60
NAN11AP1NEH9 ANGIO PACK :INTRODUCER NEEDLE(單針) 60
NAN141822NCK DISPOSABLE ONE PART NEEDLE 導線導引針 105
NAN1418275AG AMC/4 ARTERIAL NEEDLE WITH FIXED WINGS 18Gx23/4"(7.0CM)
導線導引針
105
NAN1421100AG AMC/3 ARTERIAL NEEDLE 21Gx1"(2.5CM)導線導引針 105
NAN145312NAG AMC/3 ARTERIAL NEEDLE 18GX7CM,3.8CM 19GX3.8CM 105
NAN1521500C3 DISPOSABLE SELDING NEEDLE 18G 7.5CM 128
NAN1550400PB PUNCTURE NEEDLE W/STYLET雙針(外套管+內針) 128
NAN155324NAG PERCUTANEOUS ENTRY NEEDLE
16GX7.3CM,18GX7.3CM,19GX3.8,7.3CM,21GX3.8CM
128
NAN155324NAR "ARROW"MULTI-LUMEN CENTRAL VENOUS
CATHETERIZATION:INTRODUCER NEEDLE (外套管+內針)
128
NAN15ADVANMR ADVANCE ANGIOGRAPHIC NEEDLES 高昇血管攝影穿刺針(外管+內
針)
128
NAN15AN72SMR MAJESTIK SERIES ANGIOGRAPHY NEEDLES 16-21G(雙針) 128
NAN15DCM18CK "曲克"拋棄式經皮穿刺針"COOK"DISPOSABLE PERCUTANEOUS ENTRY
NEEDLES 18:22G 2.5:9.0CM
128
NAN165341NAG ARTERIAL CATHETER NEEDLE 16GX6.4CM,18GX6.4CM,20GX3.8CM 203
NAN16AN18TMR MAJESTIK SERIES ANGIOGRAPHY NEEDLES 18G 7CM(3-PART)(外管+
內針+填充器)
203
NBS010001NBD 1CC SYRINGE WITHOUT NEEDLE 1.9
NBS010001NSP 1CC SYRINGE WITHOUT NEEDLE 1.9
NBS010001NV4 1 CC SYRINGE WITHOUT NEEDLE 1.9
NBS010001PTM 1CC SYRINGE WITHOUT/NEEDLE 1.9
NBS010001SB8 "普康"注射筒 1CC 不附針頭"BU KWANG"DISPOSABLE SYRINGE
WITHOUT NEEDLE
1.9
NBS010001VPW 1CC SYRINGE WITHOUT NEEDLE 1.9
NBS010002NSP 2-3CC SYRINGE WITHOUT NEEDLE 1
NBS010003NBD 3CC SYRINGE WITHOUT NEEDLE 1
NBS010003NPW 3CC SYRINGE WITHOUT NEEDLE 1
NBS010003NV4 2 CC,3CC SYRINGE WITHOUT NEEDLE 1
NBS010003PTM 3CC SYRINGE WITHOUT/NEEDLE 1
NBS010003SB8 "普康"注射筒 3CC 不附針頭"BU KWANG"DISPOSABLE SYRINGE
WITHOUT NEEDLE
1
NBS010003VPW 3CC SYRINGE WITHOUT NEEDLE 1
NBS010005NBD 5CC SYRINGE WITHOUT NEEDLE 1.4
NBS010005NFR "FAIRY"SYRINGE 5CC WITHOUT NEEDLE"樺萊"塑膠注射筒(不附針) 1.4
NBS010005NSP 5CC SYRINGE WITHOUT NEEDLE 1.4
NBS010005NV4 5 CC SYRINGE WITHOUT NEEDLE 1.4
NBS010005PTM 5CC SYRINGE WITHOUT/NEEDLE 1.4
NBS010005SB8 "普康"注射筒 5CC 不附針頭"BU KWANG"DISPOSABLE SYRINGE
WITHOUT NEEDLE
1.4
NBS010005VPW 5CC SYRINGE WITHOUT NEEDLE 1.4
NBS010010NBD 10CC SYRINGE WITHOUT NEEDLE 2.4
NBS010010NFR 10 CC SYRINGE WITHOUT NEEDLE 2.4
NBS010010NPW 10CC SYRINGE WITHOUT NEEDLE 2.4
NBS010010NSP 10CC SYRINGE WITHOUT NEEDLE 2.4
NBS010010NUY 10CC SYRINGE WITHOUT/NEEDLE 2.4
NBS010010NV4 10 CC SYRINGE WITHOUT NEEDLE 2.4
NBS010010PTM 10CC SYRINGE WITHOUT/NEEDLE 2.4
940
特材代碼 中英文名稱 支付點數-104/01/01
NBS010010SB8 "普康"注射筒 10CC 不附針頭"BU KWANG"DISPOSABLE SYRINGE
WITHOUT NEEDLE
2.4
NBS010010VPW 10CC SYRINGE WITHOUT NEEDLE 2.4
NBS010020NBD 20 CC SYRINGE WITHOUT NEEDLE 2.9
NBS010020NFR 20 CC SYRINGE WITHOUT NEEDLE 2.9
NBS010020NNR 20 CC SYRINGE WITHOUT NEEDLE 2.9
NBS010020NPD 20CC SYRINGE WITHOUT NEEDLE 2.9
NBS010020NPW 20 CC SYRINGE WITHOUT NEEDLE 2.9
NBS010020NSP 20CC SYRINGE WITHOUT NEEDLE 2.9
NBS010020NTM 20 CC SYRINGE WITHOUT NEEDLE 2.9
NBS010020NTP 20 CC SYRINGE WITHOUT NEEDLE 2.9
NBS010020NUY 20CC SYRINGE WITHOUT/NEEDLE 2.9
NBS010020NV4 20CC SYRINGE WITHOUT NEEDLE 2.9
NBS010020NYF 20 CC SYRINGE WITHOUT NEEDLE 2.9
NBS010020PTM 20CC SYRINGE WITHOUT/NEEDLE 2.9
NBS010020SB8 "普康"注射筒 20CC 不附針頭"BU KWANG"DISPOSABLE SYRINGE
WITHOUT NEEDLE
2.9
NBS010020VPW 20CC SYRINGE WITHOUT NEEDLE 2.9
NBS010025NPW 25CC SYRINGE WITHOUT NEEDLE 2.9
NBS010030NBD 30 CC SYRINGE WITHOUT NEEDLE 6.6
NBS010030NFR 30 CC SYRINGE WITHOUT NEEDLE 6.6
NBS010030NNR 30 CC SYRINGE WITHOUT NEEDLE 6.6
NBS010030NPW 30 CC SYRINGE WITHOUT NEEDLE 6.6
NBS010030NSP 30CC SYRINGE WITHOUT NEEDLE 6.6
NBS010030NTM 30 CC SYRINGE WITHOUT NEEDLE 6.6
NBS010030NTP 30 CC SYRINGE WITHOUT NEEDLE 6.6
NBS010030NUY 30CC SYRINGE WITHOUT/NEEDLE 6.6
NBS010030NV4 30CC SYRINGE WITHOUT NEEDLE 6.6
NBS010030SB8 "普康"注射筒 30CC 不附針頭"BU KWANG"DISPOSABLE SYRINGE
WITHOUT NEEDLE
6.6
NBS010030TTM "TERUMO"DISPOSABLE SYRINGE:30CC WITHOUT NEEDLE"泰爾茂"注
射針筒:30CC不附針
6.6
NBS010030VPW 30CC SYRINGE WITHOUT NEEDLE 6.6
NBS010050NBD 50 CC SYRINGE WITHOUT NEEDLE 9.5
NBS010050NFR 50CC SYRINGE WITHOUT NEEDLE 9.5
NBS010050NNR 50 CC SYRINGE WITHOUT NEEDLE 9.5
NBS010050NPW 50 CC SYRINGE WITHOUT NEEDLE 9.5
NBS010050NSP 50CC,60CC SYRINGE WITHOUT NEEDLE 9.5
NBS010050NTM 50 CC SYRINGE WITHOUT NEEDLE 9.5
NBS010050NTP 50 CC SYRINGE WITHOUT NEEDLE 9.5
NBS010050NUY 60CC SYRINGE WITHOUT/NEEDLE 9.5
NBS010050NV4 50CC SYRINGE WITHOUT NEEDLE 9.5
NBS010050SB8 "普康"注射筒 50CC 不附針頭"BU KWANG"DISPOSABLE SYRINGE
WITHOUT NEEDLE
9.5
NBS010050VPW 50CC SYRINGE WITHOUT NEEDLE 9.5
NBS010060NPW 60CC SYRINGE WITHOUT NEEDLE 9.5
NBS010060TTM "TERUMO"DISPOSABLE SYRINGE:60CC WITHOUT NEEDLE"泰爾茂"注
射針筒:60CC不附針
9.5
NBS0100N20BD PLASTIPAK SYRINGE 20CC WITHOUT NEEDLE 2.9
NBS0100N30BD PLASTIPAK SYRINGE 30CC WITHOUT NEEDLE 6.6
NBS0100N50BD PLASTIPAK SYRINGE 50CC WITHOUT NEEDLE 9.5
NBS010301SSG SIGMA SYRINGE WITHOUT NEEDLE 3CC 十美牌注射筒不附針3CC 1
NBS010303SSG SIGMA SYRINGE WITHOUT NEEDLE 3CC SAFETY 十美牌注射筒不附
針安全型3CC※適應症請見備註欄
1.8
941
特材代碼 中英文名稱 支付點數-104/01/01
NBS010501SSG SIGMA SYRINGE WITHOUT NEEDLE 5CC 十美牌注射筒不附針5CC 1.4
NBS010503SSG SIGMA SYRINGE WITHOUT NEEDLE SAFETY 5CC 十美牌注射筒不附
針安全型5CC※適應症請見備註欄
2.6
NBS011001SSG SIGMA SYRINGE WITHOUT NEEDLE 10CC 十美牌注射筒不附針10CC 2.4
NBS011003SSG SIGMA SYRINGE WITHOUT NEEDLE SAFETY 10CC 十美牌注射筒不附
針安全型10CC※適應症請見備註欄
4
NBS012001SSG SIGMA SYRINGE WITHOUT NEEDLE 20CC 十美牌注射筒不附針20CC 2.9
NBS012003SSG SIGMA SYRINGE WITHOUT NEEDLE SAFETY 20CC 十美牌注射筒不附
針安全型20CC※適應症請見備註欄
6.6
NBS0120CC1BD "必帝"塑膠注射筒(不附針):20CC"BD"DISPOSABLE
SYRINGE(WITHOUT NEEDLE):20CC
2.9
NBS0216154NN NOVOPEN 4 WITHOUT NEEDLE(筆型胰島素注射筒)※每支以使用三
年以上為原則
900
NBS0216158NN "NOVOPEN ECHO"諾和筆易兒樂(筆型胰島素注射筒)※每支以使用
三年以上為原則
900
NBS02M9662HQ INSULIN DELIVERY DEVICE 胰島素注射筆,每支以使用三年以上為
原則※適應症請見備註欄
900
NBS02M9673HQ HUMAPEN LUXURA HD INSULIN DELIVERY DEVICE 胰島素注射筆,每
支以使用三年以上為原則※適應症請見備註欄
900
NBS0700096LF OPTIVANTAGE DUAL-HEAD INJECTOR 200CC SYRINGE (注射筒X1+吸
管X1)
222
NBS0700099LF OPTIVANTAGE DUAL-HEAD INJECTOR 200CC SYRINGE (注射筒X1+吸
管X1+螺旋管X1)
313
NBS0700150MH CONTRAST MEDIUM INJECTION SYRINGE 130,150CC(型號DSK130自
91/4/1生效)
222
NBS0700172LF "LF"DISPOSABLE SYRINGE FOR DIGITAL INJECTION 130CC W/H-
FIL"理博"高壓注射器用拋棄式針筒
222
NBS0700200MH CONTRAST MEDIUM INJECTION SYRINGE 200CC顯影劑注射筒 222
NBS0701021N8 MRI SYRINGE SET 顯影劑注射筒(60CC SYRINGEX1+25CC
SYRINGEX1+SPIKEX2+Y型螺旋管X1)
435
NBS070150QMH DISPOSABLE SYRINGE 150CC W/FILL TUBE顯影劑注射筒 222
NBS0701800N8 MRI SYRINGE SET 顯影劑注射筒(60CC SYRINGEX2+SPIKEX2+Y型螺
旋管X1)
435
NBS0701801N8 MRI SYRINGE W/SPIKE 顯影劑注射筒 60CC 222
NBS070200FMH CONTRAST MEDIUM INJECTION SYRINGE 200CC 222
NBS070200QMH CONTRAST MEDIUM INJECTION SYRINGE 200ML W/FILL TUBE顯影劑
注射筒
222
NBS07065VSMH DISPOSABLE SYRINGE KIT 顯影劑注射筒(注射筒2+剌針2+低壓螺
旋管與T型連接管1)
435
NBS071010TTY OPTIRAY 350 造影劑注射筒 222
NBS07115VSMH DISPOSABLE SYRINGE KIT 顯影劑注射筒(注射筒2+剌針2+低壓螺
旋管與T型連接管1)
435
NBS07137NESD ANGIOGRAPHIC POWER SYRINGE 150ML W/J-CURVED FILL TUBE 222
NBS0714158MR "MERIT"MEDALLION SERIES SYRINGES"美瑞特"馬德廉注射筒
1CC;3CC;6CC
174
NBS07150AQMH DISPOSABLE SYRINGE 150CC W/FILL TUBE顯影劑注射筒 222
NBS07150EQ2M "IMAXEON"SYRINGE AND QUICK FILL TUBE"愛美聖"注射筒及填充
管
222
NBS07200FCMH DISPOSABLE SYRINGE KIT 200ML(注射筒+吸管+螺旋連接管) 313
NBS07200FQMH DISPOSABLE SYRINGE 200CC W/FILL TUBE顯影劑注射筒 222
NBS0730210N8 DISPOSABLE SYRINGE SYSTEM WITH ACCESSORIES(注射筒+吸管) 222
942
特材代碼 中英文名稱 支付點數-104/01/01
NBS0732377MA OPTIRAY 320 IOVERSOL INJECTION SYRINGE 125ML歐得利320造影
劑注射筒
222
NBS0744020LF OPTIVANTAGE DUAL-HEAD INJECTOR(注射筒X1+吸管X1+Y型螺旋接
管X1)
313
NBS0744022LF OPTIVANTAGE DUAL-HEAD INJECTOR(注射筒X2+吸管X2+Y型螺旋接
管X1)
435
NBS0760269N8 DISPOSABLE SYRINGE SYSTEM WITH ACCESSORIES(注射筒+吸管+螺
旋低壓連接管)
313
NBS07700SRMH "MEDRAD"DISPOSABLE SYRINGE KIT"美樂得"注射筒組套:拋棄式注
射筒及填充管
222
NBS0784402LF "LF"OPTIVANTAGE DUAL-HEAD INJECTOR"理博"雙驅動自動注射系
統 (注射筒X2+吸管X2+Y型螺旋接管X1)
455
NBS0785003NL NAMIC ANGIOGRAPHIC CONTROL SYRINGES (8:20ML)血管造影控制
注射系統
174
NBS0790103N8 DISPOSABLE SYRINGE SYSTEM 150CC W/HANDI FIL LINDEN LUER
注射筒+吸管
222
NBS07AG115BQ ANGIOGRAPHIC SYRINGE (注射筒X1+抽藥管X1) 222
NBS07AG215BQ ANGIOGRAPHIC SYRINGE (注射筒X1+抽藥管X1) 222
NBS07CCS60MR CORONARY CONTROL SYRINGE 6CC 10CC 12CC 174
NBS07CT119BQ ANGIOGRAPHIC SYRINGE KIT (注射筒X1+抽藥管X1+螺旋管X1) 313
NBS07CT129BQ ANGIOGRAPHIC SYRINGE KIT (注射筒X2+抽藥管X2+螺旋管X1) 435
NBS07CT219BQ ANGIOGRAPHIC SYRINGE KIT (注射筒X1+抽藥管X1+螺旋管X1) 313
NBS07CT229BQ ANGIOGRAPHIC SYRINGE KIT (注射筒X2+抽藥管X2+螺旋管X1) 435
NBS07DCTPQMH DISPOSABLE 200 CC SYRINGE 二支 KIT(注射筒X2+吸管+連接管
+PRIME TUBE)
455
NBS07DCTPSMH DISPOSABLE 200 CC SYRINGE 二支 KIT(注射筒X2+SPIKE+連接管
+PRIME TUBE)
435
NBS07MR123BQ ANGIOGRAPHIC SYRINGE KIT (60CC注射筒X2+抽藥管X1+Y螺旋管
X1)
435
NBS07MR214BQ ANGIOGRAPHIC SYRINGE KIT (65CC注射筒X2+抽藥管X1+Y螺旋管
X1)
435
NBS07SCTPQMH DISPOSABLE 200 CC SYRINGE KIT(含吸管+連接管+PRIME TUBE) 313
NBS07SSQFTMH DISPOSABLE 200 CC SYRINGE KIT(含吸管) 222
NBS07ZY3202M "IMAXEON"SALIENT SYRINGE KIT W/QUICK FILL TUBE"愛美聖"注
射筒套組(含填充管1支)
222
NBS07ZY3212M "IMAXEON"SALIENT SYRINGE KIT W/SPIKE"愛美聖"注射筒套組(含
刺針)
222
NCS010001N3B "康德萊"一次性使用無菌注射器附針1ML"KDL"FOR SINGLE USE
STERILE SYRINGE W/NEEDLE
2
NCS010001NBD 1 CC SYRINGE 2
NCS010001NDD 1CC SYRINGE 2
NCS010001NFR 1 CC SYRINGE 2
NCS010001NNR 1 CC SYRINGE 2
NCS010001NPD 1CC SYRINGE W/NEEDLE 2
NCS010001NPW 1 CC SYRINGE 2
NCS010001NSH 1 CC SYRINGE 2
NCS010001NSP 1CC SYRINGE W/NEEDLE 2
NCS010001NTM 1 CC SYRINGE 2
NCS010001NTP 1 CC SYRINGE 2
NCS010001NUY 1 CC SYRINGE W/NEEDLE 2
NCS010001NV4 1CC SYRINGE W/NEEDLE 2
NCS010001PTM 1CC SYRINGE W/NEEDLE 2
NCS010001SB8 "普康"注射筒 1CC 附針頭"BU KWANG"DISPOSABLE SYRINGE WITH
NEEDLE
2
943
特材代碼 中英文名稱 支付點數-104/01/01
NCS010001VPW 1CC SYRINGE W/NEEDLE 2
NCS010002N3B "康德萊"一次性使用無菌注射器附針2ML;2.5ML "KDL"FOR SINGLE
USE STERILE SYRINGE W/NEEDLE
1.4
NCS010002NPW 2 CC SYRINGE 1.4
NCS010002NSP 2-3CC SYRINGE W/NEEDLE 1.4
NCS010003N3B "康德萊"一次性使用無菌注射器附針3ML"KDL"FOR SINGLE USE
STERILE SYRINGE W/NEEDLE
1.4
NCS010003NBD 3 CC SYRINGE 1.4
NCS010003NDD 3CC SYRINGE 1.4
NCS010003NFR 3CC SYRINGE W/NEEDLE 1.4
NCS010003NNR 3 CC SYRINGE 1.4
NCS010003NPD 3CC SYRINGE W/NEEDLE 1.4
NCS010003NPW 3 CC SYRINGE 1.4
NCS010003NSH 3 CC SYRINGE 1.4
NCS010003NTM 3 CC SYRINGE 1.4
NCS010003NTP 3 CC SYRINGE 1.4
NCS010003NUY 3 CC SYRINGE W/NEEDLE 1.4
NCS010003NV4 2CC,3CC SYRINGE W/NEEDLE 1.4
NCS010003NYF 3 CC SYRINGE 1.4
NCS010003PTM 3CC SYRINGE W/NEEDLE 1.4
NCS010003SB8 "普康"注射筒 3CC 附針頭"BU KWANG"DISPOSABLE SYRINGE WITH
NEEDLE
1.4
NCS010003VPW 3CC SYRINGE W/NEEDLE 1.4
NCS010005N3B "康德萊"一次性使用無菌注射器附針5ML"KDL"FOR SINGLE USE
STERILE SYRINGE W/NEEDLE
1.8
NCS010005NBD 5 CC SYRINGE 1.8
NCS010005NDD 5CC SYRINGE 1.8
NCS010005NFR 5CC SYRINGE W/NEEDLE 1.8
NCS010005NNR 5 CC SYRINGE 1.8
NCS010005NPD 5CC SYRINGE W/NEEDLE 1.8
NCS010005NPW 5 CC SYRINGE 1.8
NCS010005NSP 5CC SYRINGE W/NEEDLE 1.8
NCS010005NTM 5 CC SYRINGE 1.8
NCS010005NTP 5 CC SYRINGE 1.8
NCS010005NUY 5CC SYRINGE W/NEEDLE 1.8
NCS010005NV4 5CC SYRINGE W/NEEDLE 1.8
NCS010005NYF 5 CC SYRINGE 1.8
NCS010005PTM 5CC SYRINGE W/NEEDLE 1.8
NCS010005SB8 "普康"注射筒 5CC 附針頭"BU KWANG"DISPOSABLE SYRINGE WITH
NEEDLE
1.8
NCS010005VPW 5CC SYRINGE W/NEEDLE 1.8
NCS010010N3B "康德萊"一次性使用無菌注射器附針10ML"KDL"FOR SINGLE USE
STERILE SYRINGE W/NEEDLE
2.5
NCS010010NBD 10 CC SYRINGE 2.5
NCS010010NDD 10CC SYRINGE 2.5
NCS010010NFR 10CC SYRINGE W/NEEDLE 2.5
NCS010010NNR 10 CC SYRINGE 2.5
NCS010010NPD 10CC SYRINGE W/NEEDLE 2.5
NCS010010NPW 10 CC SYRINGE 2.5
NCS010010NSP 10CC SYRINGE W/NEEDLE 2.5
NCS010010NTM 10 CC SYRINGE 2.5
NCS010010NTP 10 CC SYRINGE 2.5
NCS010010NUY 10CC SYRINGE W/NEEDLE 2.5
NCS010010NV4 10CC SYRINGE W/NEEDLE 2.5
944
特材代碼 中英文名稱 支付點數-104/01/01
NCS010010NYF 10 CC SYRINGE 2.5
NCS010010PTM 10CC SYRINGE W/NEEDLE 2.5
NCS010010SB8 "普康"注射筒 10CC 附針頭"BU KWANG"DISPOSABLE SYRINGE WITH
NEEDLE
2.5
NCS010010VPW 10CC SYRINGE W/NEEDLE 2.5
NCS01001HZ2P 嘉鎂一次性使用無菌自毀式注射器1ML附針"EWNL"AUTO DISABLE
SYRINGE W/NEEDLE
2
NCS010020N3B "康德萊"一次性使用無菌注射器附針20ML"KDL"FOR SINGLE USE
STERILE SYRINGE W/NEEDLE
3.1
NCS010020NBD 20 CC SYRINGE (附針) 3.1
NCS010020NDD 20CC SYRINGE 3.1
NCS010020NFR 20CC SYRINGE W/NEEDLE 3.1
NCS010020NNR 20 CC SYRINGE(附針) 3.1
NCS010020NPD 20CC SYRINGE W/NEEDLE 3.1
NCS010020NPW 20CC SYRINGE W/NEEDLE 3.1
NCS010020NSP 20CC SYRINGE W/NEEDLE 3.1
NCS010020NTM 20 CC SYRINGE (附針) 3.1
NCS010020NTP 20CC SYRINGE W/NEEDLE 3.1
NCS010020NUY 20CC SYRINGE W/NEEDLE 3.1
NCS010020NV4 20CC SYRINGE W/NEEDLE 3.1
NCS010020NYF 20 CC SYRINGE (附針) 3.1
NCS010020SB8 "普康"注射筒 20CC 附針頭"BU KWANG"DISPOSABLE SYRINGE WITH
NEEDLE
3.1
NCS010020VPW 20CC SYRINGE W/NEEDLE 3.1
NCS01002HZ2P 嘉鎂一次性使用無菌自毀式注射器2ML附針"EWNL"AUTO DISABLE
SYRINGE W/NEEDLE
1.4
NCS010030N3B "康德萊"一次性使用無菌注射器附針30ML"KDL"FOR SINGLE USE
STERILE SYRINGE W/NEEDLE
5.2
NCS010030NFR 30CC SYRINGE W/NEEDLE 5.2
NCS010030NPD 30CC SYRINGE W/NEEDLE 5.2
NCS010030NPW 30CC SYRINGE W/NEEDLE 5.2
NCS010030NSP 30CC SYRINGE W/NEEDLE 5.2
NCS010030NUY 30CC SYRINGE W/NEEDLE 5.2
NCS010030NV4 30CC SYRINGE W/NEEDLE 5.2
NCS010030SB8 "普康"注射筒 30CC 附針頭"BU KWANG"DISPOSABLE SYRINGE WITH
NEEDLE
5.2
NCS010030VPW 30CC SYRINGE W/NEEDLE 5.2
NCS01003HZ2P 嘉鎂一次性使用無菌自毀式注射器3ML附針"EWNL"AUTO DISABLE
SYRINGE W/NEEDLE
1.4
NCS010050N3B "康德萊"一次性使用無菌注射器附針50ML"KDL"FOR SINGLE USE
STERILE SYRINGE W/NEEDLE
8.5
NCS010050NFR 50CC SYRINGE W/NEEDLE 8.5
NCS010050NPD 50CC SYRINGE W/NEEDLE 8.5
NCS010050NPW 50CC SYRINGE W/NEEDLE 8.5
NCS010050NSP 50CC,60CC SYRINGE W/NEEDLE 8.5
NCS010050NTM "TERUMO"DISPOSABLE SYRINGE W/NEEDLE 50CC"泰爾茂"注射針筒
含針頭
8.5
NCS010050NUY 60CC SYRINGE W/NEEDLE 8.5
NCS010050NV4 50CC SYRINGE W/NEEDLE 8.5
NCS010050SB8 "普康"注射筒 50CC 附針頭"BU KWANG"DISPOSABLE SYRINGE WITH
NEEDLE
8.5
NCS010050VPW 50CC SYRINGE W/NEEDLE 8.5
NCS01005HZ2P 嘉鎂一次性使用無菌自毀式注射器5ML附針"EWNL"AUTO DISABLE
SYRINGE W/NEEDLE
1.8
945
特材代碼 中英文名稱 支付點數-104/01/01
NCS010060NTM "TERUMO"DISPOSABLE SYRINGE W/NEEDLE 60CC"泰爾茂"注射針筒
含針頭
8.5
NCS010102SSG SIGMA SYRINGE WITH NEEDLE 1CC 十美牌注射筒附針1CC 2
NCS01010HZ2P 嘉鎂一次性使用無菌自毀式注射器10ML附針"EWNL"AUTO DISABLE
SYRINGE W/NEEDLE
2.5
NCS010302SSG SIGMA SYRINGE WITH NEEDLE 3CC 十美牌注射筒附針3CC 1.4
NCS010502SSG SIGMA SYRINGE WITH NEEDLE 5CC 十美牌注射筒附針5CC 1.8
NCS011002SSG SIGMA SYRINGE WITH NEEDLE 10CC 十美牌注射筒附針10CC 2.5
NCS030000NUU RETRACTABLE SAFETY INSULIN SYRINGE W/NEEDLE※適應症請見備
註欄
6
NCS0300100NR INSULIN SYRINGE 1CC 3.7
NCS030310N3B "康德萊"一次性使用無菌胰島素注射器"KDL"DISPOSABLE INSULIN
SYRINGE
3.7
NCS030310NSP INSULIN SYRINGE W/NEEDLE 3.7
NCS030510NBD BD胰島素專用塑膠注射筒附針BD DISPOSABLE INSULIN SYRINGE
W/NEEDLE
3.7
NCS030510NMJ INSULIN SYRINGE 3.7
NCS030510NNR INSULIN SYRINGE 1 CC 3.7
NCS030510NPW INSULIN SYRINGE W/NEEDLE 3.7
NCS030510NTM INSULIN SYRINGE 0.3,0.5,1CC(0.3CC自87/12/19收錄)(型號
SS30M;05M3009(A)自911001生效)
3.7
NCS030510S3C "千禧光"附針安全注射器:胰島素注射器"SOL-CARE"SAFETYE
W/FIXED NEEDLE:INSULIN SYRINGE
6
NCS0330593BD BD SAFETYGLIDE INSULIN SYRINGE W/NEEDLE BD滑蓋式胰島素安
全注射筒附針※給付規定請見備註欄
6
NCS0388816KD INSULINE SYRINGE W/NEEDLE(8881-
600137,145,350,368,1358,1366,600700,800,601600)
3.7
NCS0391511BB OMNICAN INSULIN SYRINGES W/NEEDLE 0.5/1.0ML 3.7
NDD04N8008SG INJECTION CAP W/FREE SITE 無針式接頭*適應症請見備註欄 43.1
NDN0100022GW SCALP VEIN SET 22:25G 3.9
NDN01023XNPW SCALP NEEDLE 3.9
NDN011825NV4 SCALP SET 18G:25G 3.9
NDN011827NFR SCALP NEEDLE 3.9
NDN011827NJS SCALP NEEDLE 3.9
NDN011827NM8 "MEDITOP"TOP SCALP VEIN SET"邁迪特浦"特浦翼狀針 3.9
NDN011827NNR SCALP NEEDLE 3.9
NDN011827NTP SCALP NEEDLE 3.9
NDN011925NLL SCALP頭皮針 3.9
NDN011925NTM SCALP NEEDLE 3.9
NDN01A010NPW SCALP VEIN SET 16:27G 3.9
NDN020112NBA "BARD"HUBER PLUS NON-CORING NEEDLE SAFETY INFUSION SET
W/TUBING "巴德"賀伯氏安全性無心彎針附蝴蝶翼輸液套組※適應
症請見備註欄
91.5
NDN020119YBA "BARD"HUBER PLUS NON-CORING NEEDLE SAFETY INFUSION SET
W/Y-INJECTION SITE AND NEEDLESS INJECTION CAP"巴德"賀伯氏
安全性無心彎針附蝴蝶翼輸液套組※
91.5
NDN0202006HJ PORT-A-CATH NEEDLE※適應症請見備註欄 64
NDN02027NNHJ PORT-A-CATH GRIPPER NEEDLE W/EXTENSION TUBING※適應症請見
備註欄
64
NDN0206023BA STRAIGHT AND RIGHT-ANGLE NON-CORING NEEDLE 直式或直角無心
彎針 ※適應症請見備註欄
64
NDN0206025BA PORT-A NON-CORING NEEDLE ※限癌症化學治療及癌症未期之疼痛
治療使用
64
NDN0206033BA WINGED INFUSION SET 蝴蝶彎針注射套組 ※適應症請見備註欄 64
946
特材代碼 中英文名稱 支付點數-104/01/01
NDN0222052BA 蝴蝶彎針WINGED INFUSION SET※適應症請見備註欄 64
NDN0227600HJ "SMITHS"GRIPPER PLUS NEEDLE (SAFETY ) "史密斯"新式內植用
輸液管灌注針(安全型)※給付規定請見備註欄
91.5
NDN0227601HJ "SMITHS"GRIPPER PLUS NEEDLE (SAFETY ) "史密斯"新式內植用
輸液管灌注針(安全型)※給付規定請見備註欄
91.5
NDN0229490YP "普羅斯"植入式輸液座專用安全灌注針"POLYPERF SAFE 91.5
NDN0239759BB CYTOCAN NEEDLES FOR ACCESS PORT W/EXTENSION TUBING※適應
症請見備註欄
64
NDN0239953BB SURECAN NON-CORING NEEDLE FOR PORT A※適應症請見備註欄 64
NDN0248430BB SURECAN NON-CORING NEEDLE W/EXTENSION TUBE FOR ACCESS
PORTS※適應症請見備註欄
64
NDN02A180NPW WINGED CORE RESISTANT NEEDLE SETS※適應症請見備註欄 64
NDN02A190NPW WINGED NEEDLE SET(含輸液管)※適應症請見備註欄 64
NDN02LH29NBA "巴德"安全性賀伯注射針組"BARD"SAFESTEP HUBER NEEDLE SET
W/EXTENSION TUBE
91.5
NDN02LH29YBA "巴德"安全性賀伯注射針組"BARD"SAFESTEP HUBER NEEDLE SET
W/Y INJECTION SITE
91.5
NDN02PN001SG PORT ACCESS INFUSION SET※適應症請見備註欄 64
NDN04000011N "BIOCIV"I.V. CATHETER(TPU)"百仕韋"靜脈留置針 10.5
NDN040024CBB INTROCAN CERTO-IV CATHETER 24G(PU) 10.5
NDN0404000HJ "SMITHS"JELCO IV CATHETER TEFLON 14:24G "史密斯"杰可靜脈
留置針
9.5
NDN0405000HJ "SMITHS" OPTIVA IV CATHETER PU 14:24G "史密斯"奧迪發靜脈
留置針
10.5
NDN041214NAY IV CATHETER(TEFLON) 9.5
NDN041422CBB INTROCAN CERTO-IV CATHETER 14:22G (PU)(產品型號0405-
5756,64,72,6272,99)
10.5
NDN041422NBB IV CATHETER(TEFLON) 9.5
NDN041424NBD IV CATHETER(TEFLON) 9.5
NDN041424NTM IV CATHETER(TEFLON) 9.5
NDN041424P3B "康德萊"一次性使用留置針PU"KDL"IV CATHETER 10.5
NDN041424STM SURFLO IV CATHETER 14G:24G(ETFE) 9.5
NDN041622NBD IV CATHETER(TEFLON) 9.5
NDN041622NNR IV CATHETER(TEFLON) 9.5
NDN041622NTM IV CATHETER(TEFLON) 9.5
NDN041627NTM IV CATHETER 16:27G (PU) 10.5
NDN041824ATM SURSHIELD SURFLO II安全靜脈留置針※適應症請見備註欄 27.5
NDN041824NTP IV CATHETER MN(TEFLON) 9.5
NDN042400NBB IV CATHETER(TEFLON) 9.5
NDN042400NNR IV CATHETER(TEFLON) 9.5
NDN043818ABD INSYTE AUTOGUARD SHIELDED IV CATHETER 回縮式安全靜脈導管
※適應症請見備註欄
27.5
NDN0442603BB VASOFIX SAFETY I.V. CANNULAE 菲適免針加藥安全靜脈留置針※
適應症請見備註欄
33.8
NDN0442689BB VASOFIX I.V. CANNULAE 菲適免針加藥靜脈留置針 16.8
NDN0442CWSBB INTROCAN CERTO SAFETY PU 18:24G安全靜脈留置針※適應症請見
備註欄
27.5
NDN04FEP03BB INTROCAN SAFETY IVC CANNULAE ※適應症請見備註欄 27.5
NDN04PUR03BB INTROCAN SAFETY IVC CANNULAE ※適應症請見備註欄 27.5
NDN04S1424BD INSYTE IV CATHETER(VIALON) 10.5
NDN04SR01NTM SURFLO I.V CATHETER 14G:24G 9.5
NDN050024WBB INTROCAN CERTO IV CATHETER W/WING 24G(PU) 10.5
NDN050024WBD IV CATHETER 24G(TEFLON) 9.5
947
特材代碼 中英文名稱 支付點數-104/01/01
NDN051422WBB INTROCAN CERTO IV CATHETER W/WING (PU) 14:22G(產品型號
0405-6280,5780,5799,6264,7802)
10.5
NDN051622WBD IV CATHETER 16:22G(TEFLON) 9.5
NES010201NBA MAX-CORE DISPOSABLE BIOPSY INSTRUMENT 14:20G(自動式) 633
NES010804TZM "MD TECH"T-LOK BONE MARROW BIOPSY NEEDLES迪洛骨髓活體組織
切片針
598
NES0115011ZM BONE MARROW ASPIRATION NEEDLE 529
NES0118015ZM PEDIATRIC BONE MARROW NEEDLE 598
NES0182000ZM MD TECH SNARELOK BONE MARROW BIOPSY TRAY AND ACCESSORIES 598
NES01AM18NGP BONE MARROW ASPIRATION NEEDLE 529
NES01BM00XGP "GALLINI"BIOMID DISPOSABLE BONE MARROW ASPIRATION BIOPSY
NEEDLE"格利尼"可丟棄式骨髓吸取針
623
NES01BM13NGP BONE MARROW BIOPSY NEEDLE 598
NES01BMHN1ZM BONE MARROW HARVEST NEEDLE WITH SIDE HOLE 529
NES01BN160ZM OSTY CORE BONE BIOPSY NEEDLE 598
NES01MN120BA MAGNUM BIOPSY NEEDLE 633
NES01ST00NJ6 "CAREFUSION"STERNUM TEMNO DEVICE"卡弗迅"骨髓抽吸針 623
NES01TC00XC8 T-HANDLE JAMSHIDI BONE MARROW BIOPSY /ASPIRATION NEEDLES 623
NES01TC00XJ6 "CAREFUSION"T-HANDLE JAMSHIDI BONE MARROW
BIOPSY/ASPIRATION NEEDLES"卡弗迅"介入體骨髓切片/組織抽取
針
623
NES01TN00XC8 ILLINOIS STERNAL/ILIAC BONE MARROW ASPIRATION NEEDLES 529
NES01TN00XJ6 "CAREFUSION"ILLINOIS STERNAL/ILIAC BONE MARROW ASPIRATION
NEEDLES"卡弗迅"伊利諾胸骨/腸骨骨髓抽取針
529
NES0310800ZM "MD TECH"BIOPINCE FULL CORE BIOPSY INSTRUMENT 10CM"美迪
克"拜爾賓全組織切片器
633
NES0312182BA "BARD"MONOPTY BIOPSY INSTRUMENT組織取樣針 633
NES031406NJ6 "CAREFUSION"TEMNO BIOPSY NEEDLES "卡弗迅"生檢針 611
NES0315800ZM BIOPINCE FULL CORE BIOPSY INSTRUMENT 15CM"美迪克"拜爾賓全
組織切片器
633
NES0320800ZM BIOPINCE FULL CORE BIOPSY INSTRUMENT 20CM"美迪克"拜爾賓全
組織切片器
633
NES03315SDJU "PAJUNK"DELTA CUT BIOPSY SYSTEM生檢穿刺套管組14:20G 611
NES0370111ZM SUPER-CORE II ADJUSTABLE BIOPSY INSTRUMENT 彈簧組織切片針 611
NES0376260ZN ULTRA CORE BIOPSY NEEDLE FOR USE WITH BARD MAGNUM BIOPSY
INSTRUMENT(AUTOMATIC)
633
NES0376311ZR TRU-CORE II AUTOMATIC DISPOSABLE BIOPSY DEVICE 633
NES0376501ZM PRO-MAG AUTOMATIC BIOPSY NEEDLE 633
NES0376502ZM PRO-MAG AUTOMATIC BIOPSY NEEDLE 633
NES0376511ZM PRO-MAG AUTOMATIC BIOPSY NEEDLE 633
NES03TM14NGP SPRING LOADED BIOPSY NEEDLE(自動彈簧切片針) 611
NES03TM16NGP SPRING LOADED BIOPSY NEEDLE(自動彈簧切片針) 611
NES03TZ14NGP SPRING LOADED BIOPSY NEEDLE(自動彈簧切片針) 611
NES041218ABA "BARD"MONOPTY DISPOSABLE BIOPSY INSTRUMENT+TRUGUIDE
COAXIAL BIOPSY NEEDLE組織取樣針+同軸導引針
1380
NES041356NJ6 "CAREFUSION"UNIVERSAL COAXIAL INTRODUCER NEEDLE(STERILE)"
卡弗迅"同軸導引針(滅菌)*給付規定請見備註欄
889
NES041MBS9ZM "MD TECH"SUPER-CORE II ADJUSTABLE BIOPSY INSTRUMENT+MD
TECH CO-AXIAL INTRODUCER NEEDLE切片針+同軸導引針*適應症請
見備註欄
1380
948
特材代碼 中英文名稱 支付點數-104/01/01
NES04415SDJU “帕將克”生檢器+同軸導引針“PAJUNK”DELTACUT BIOPSY
SYSTEM + UNIVERSAL COAXIAL SLEEVE NEEDLE SET
1380
NES04ACNMFG5 "ANGIOTECH"ACN BIOPSY NEEDLES WITH CO-AXIAL NEEDLE愛仕恩
切片針(同軸庫針組)14-20G*適應症請見備註欄
1380
NES04C12ABBA "BARD"BIOPSY NEEDLE SYSTEM-TRUGUIDE COAXIAL BIOPSY
NEEDLE"巴德"組織取樣針-同軸組織取樣針*適應證請見備註欄
889
NES04CT14NJ6 "CAREFUSION"TEMNO BIOPSY NEEDLE + UNIVERSAL COAXIAL
INTRODUCER NEEDLE"卡弗迅"生檢針+同軸導引針*適應症請見備註
欄
1380
NES04MCTGABA "BARD"MAX-CORE DISPOSABLE BIOPSY INSTRUMENT+TRUGUIDE
COAXIAL BIOPSY NEEDLE組織取樣針+同軸導引針
1380
NES04MCXS0ZM "MD TECH"CO-AXIAL INTRODUCER NEEDLE"美迪克"同軸導引針*適
應症請見備註欄
889
NES04MCXS1ZM "MD TECH"CO-AXIAL INTRODUCER NEEDLE"美迪克"同軸導引針*適
應症請見備註欄
889
NES04QCS01CK "COOK"COAXIAL QUICK-CORE BIOPSY SETS"曲克"拋棄式取樣針
(組)(同軸庫)*適應症請見備註欄
1380
RRB0117301TX 泰利福”誘發性肺量計“TELEFLEX” INCENTIVE SPIROMETERS-
TRIFLO*給付規定請見備註欄
177
RRB0219009TX 泰利福”誘發性肺量計“TELEFLEX” INCENTIVE SPIROMETERS-
VOLDYNE5000*給付規定請見備註欄
140
RRB0219025TX 泰利福”誘發性肺量計“TELEFLEX” INCENTIVE SPIROMETERS-
VOLDYNE2500*給付規定請見備註欄
140
RRB024301NGF GALEMED SPIROMETER AND ACCESSORY*適應症請見備註欄 140
RRB024311NGF ”崇仁”三球式呼吸訓練器"及配件GALEMED"TRI-BALLS
INCENTIVE SPIROMETER AND ACCESSORY*適應症請見備註欄
177
RRB0293100EF "貝斯美德" 誘發型肺量計"BESMED" INCENTIVE SPIROMETER 177
SAS026025S2C "柯惠"GIA自動手術縫合器 "COVIDIEN"AUTO SUTURE MULTIFIRE
GIA DISPOSABLE SURGICAL STAPLER *適應症請見備註欄
2459
SAS02MLC60J8 "南京邁迪欣" 一次性使用直線型切割吻和器和釘倉"NANJING
MAIDIXIN" DISPOSABLE LINEAR CUTTER AND CARTRIDGE*適應症請
見備註欄
2403
SAS02MLC80J8 "南京邁迪欣" 一次性使用直線型切割吻和器和釘倉"NANJING
MAIDIXIN" DISPOSABLE LINEAR CUTTER AND CARTRIDGE*適應症請
見備註欄
2459
SAS02NTLC5ET "愛惜康"直線形切割縫合器和可調節釘匣"ETHICON ENDO-
SURGERY"LINEAR CUTTER 55MM AND SELECTABLE
CARTRIDGE/RELOADS(55MM)
2403
SAS02NTLC7ET "愛惜康"直線形切割縫合器和可調節釘匣"ETHICON ENDO-
SURGERY"LINEAR CUTTER 75MM AND SELECTABLE
CARTRIDGE/RELOADS(75MM)
2459
SAS02TCT55JJ LINEAR CUTTER SAFETY LOCKOUT 55MM 腸胃自動縫合器 ※適應症
請見備註欄
2403
SAS02TLC55JJ TITANIUM LINEAR CUTTER 55MM 腸胃自動縫合器 55MM ※適應症
請見備註欄
2403
SAS02TLC75JJ LINEAR CUTTER SAFETY LOCKOUT 75MM 腸胃自動縫合器 ※適應症
請見備註欄
2459
SAS02TLHNNJJ TITANIUM LINEAR STAPLE 30,60,90MM (自動縫合器+釘)※適應症
請見備註欄
2300
SAS03CDHXAET 愛惜康彎型管腔吻合器ETHICON ENDO-SURGERY CURVED
INTRALUMINAL STAPLERS(ILS)21,25,29,33MM
5196
SAS03CDHXXET "愛惜康"普克美釘合器"ETHICON"PROXIMATE ILS INTRALUMINAL
STAPLER*適應症請見備註欄
5196
949
特材代碼 中英文名稱 支付點數-104/01/01
SAS03EEA252C "柯惠"一次性彎形端對端縫合器 "COVIDIEN" AUTO SUTURE CEEA
SINGLE USE STAPLERS *適應症請見備註欄
5196
SAS03MCS21J8 "南京邁迪欣" 一次性使用管型消化道吻和器"NANJING MAIDIXIN"
DISPOSABLE CIRCULAR STAPLER*適應症請見備註欄
5196
SAS03PCEAT2C "柯惠"自動手術縫合器及縫合釘 "COVIDIEN" PREMIUM PLUS CEEA
SINGLE USE STAPLER *適應症請見備註欄
5196
SAS03PCEEA2C "柯惠"自動手術縫合器及縫合釘“COVIDIEN” AUTO SUTURE EEA
STAPLING INSTRUMENTS AND DISPOSABLE LOADING UNITS *適應症
請見備註欄
5196
SAS03SDH21JJ CIRCULAR STAPLE 消化道自動吻合器+釘 21,25,29,33MM ※適應
症請見備註欄
5196
SAS03SDHXAET 愛惜康直線型管腔吻合器ETHICON ENDO-SURGERY STRAIGHT
INTRALUMINAL STAPLERS(ILS)21,25,29,33MM
5196
SAU01103122C "柯惠"TA自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA
DISPOSABLE SURGICAL STAPLER AND LOADING UNIT ※適應症請見
備註欄
2293
SAU01103222C "柯惠"TA自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA
DISPOSABLE SURGICAL STAPLER AND LOADING UNIT ※適應症請見
備註欄
2153
SAU01154272C "柯惠"TA自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA
DISPOSABLE SURGICAL STAPLER AND LOADING UNIT ※適應症請見
備註欄
2293
SAU01154332C "柯惠"TA自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA
DISPOSABLE SURGICAL STAPLER AND LOADING UNIT ※適應症請見
備註欄
2293
SAU01154852C "柯惠"TA自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA
DISPOSABLE SURGICAL STAPLER AND LOADING UNIT ※適應症請見
備註欄
2153
SAU01MLSA3J8 "南京邁迪欣" 一次性使用直線型吻和器和釘倉"NANJING
MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 30*適應
症請見備註欄
2293
SAU01MLSA9J8 "南京邁迪欣" 一次性使用直線型吻和器和釘倉"NANJING
MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 90*適應
症請見備註欄
2153
SAU01MLSC3J8 "南京邁迪欣" 一次性使用直線型吻和器和釘倉"NANJING
MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 30*適應
症請見備註欄
2293
SAU01MLSC9J8 "南京邁迪欣" 一次性使用直線型吻和器和釘倉"NANJING
MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 90*適應
症請見備註欄
2153
SAU01TA30L2C "柯惠" TA自動手術縫合器及縫合釘 "COVIDIEN" TA STAPLERS
AND LOADING UNITS
2293
SAU01TA90L2C "柯惠" TA自動手術縫合器及縫合釘 "COVIDIEN" TA STAPLERS
AND LOADING UNITS
2153
SAU01TRH90JJ "ETHICON"DISPOSABLE STAPLER-PROXIMATE LINEAR RELOADING
UNIT( TITANIUM)90MM ※適應症請見備註欄
2153
SAU01XR30BJJ PROXIMATE RELOADABLE LINEAR STAPLER 30MM 3.5LEG,4.8LEG ※
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2293
SAU026025L2C "柯惠"GIA自動手術縫合器 "COVIDIEN"AUTO SUTURE MULTIFIRE
GIA DISPOSABLE SURGICAL STAPLER *適應症請見備註欄
2239
SAU0282534TY "優施西"生化可吸收性腸吻合環 "USS" VALTRAC DEVICES※適應
症請見備註欄
3900
950
特材代碼 中英文名稱 支付點數-104/01/01
SAU02SSR75ET "愛惜康"直線形切割縫合器和可調節釘匣-可調節釘匣"ETHICON
ENDO-SURGERY"LINEAR CUTTER 55/75MM AND SELECTABLE
CARTRIDGE/RELOADS(75MM)
2239
SAU02TRT75JJ RELOAD LINEAR CUTTER 75MM 腸胃自動縫合釘 ※適應症請見備註
欄
2239
SAU03102142C "柯惠"自動手術縫合器及縫合釘"COVIDIEN" AUTO SUTURE EEA
STAPLING INSTRUMENT AND DISPOSABLE LOADING UNITS ※適應症
請見備註欄
5087
SAU07304122C "柯惠" GIA自動手術縫合器-縫合釘匣"Covidien" AUTO
SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLER-STAPLE
5956
SAU07304162C "柯惠" GIA自動手術縫合器-縫合釘匣"Covidien" AUTO
SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLER-STAPLE
4000
SAU07304262C "柯惠" GIA自動手術縫合器-縫合釘匣"Covidien" AUTO
SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLER-STAPLE
4900
SAU07304502C "柯惠"GIA自動手術縫合器-旋轉式釘匣(30MM)"Covidien" AUTO
SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLER-
ROTICULATOR CARTRIDGE 30MM STAPLE
4000
SAU07304532C "柯惠"GIA自動手術縫合器-旋轉式釘匣(45MM)"COVIDIEN" AUTO
SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLER-
ROTICULATOR CARTRIDGE-45MM STAPLE
4900
SAU07304562C "柯惠"GIA自動手術縫合器-旋轉式釘匣(60MM)"COVIDIEN" AUTO
SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLER-
ROTICULATOR CARTRIDGE-60MM STAPLE
5956
SAU07CEC30J8 "南京邁迪欣"一次性使用旋轉切割吻合器-30MM縫合釘匣"Nanjing
Maidixin" Disposable Linear Cutter for Endoscope Use-30MM
STAPLE
4000
SAU07CEC45J8 " 南京邁迪欣" 一次性使用旋轉切割吻合器-45MM縫合釘匣"
Nanjing Maidixin" Disposable Linear Cutter for Endoscope
Use-45MM STAPLE
4900
SAU07CEC60J8 " 南京邁迪欣" 一次性使用旋轉切割吻合器-60MM縫合釘匣"
Nanjing Maidixin" Disposable Linear Cutter for Endoscope
Use-60MM STAPLE
5956
SAU07CFC30J8 "南京邁迪欣"一次性使用旋轉切割吻合器-30MM縫合釘匣"Nanjing
Maidixin" Disposable Linear Cutter for Endoscope Use-30MM
STAPLE
4000
SAU07CFC45J8 " 南京邁迪欣" 一次性使用旋轉切割吻合器-45MM縫合釘匣"
Nanjing Maidixin" Disposable Linear Cutter for Endoscope
Use-45MM STAPLE
4900
SAU07CFC60J8 "南京邁迪欣"一次性使用旋轉切割吻合器-60MM縫合釘匣"Nanjing
Maidixin" Disposable Linear Cutter for Endoscope Use-60MM
STAPLE
5956
SAU07ECR45ET "愛惜康"愛喜龍45安德派思縫合釘" Ethicon" ECHELON 45
ENDOPATH Endoscopic Linear Cutters and Reloads-STAPLE
4802
SAU07ECR60ET "愛惜康"愛喜龍安德派思縫合釘"ETHICON" ECHELON 60 ENDOPATH
STAPLER-STAPLE
5756
SAU07TR45BET "愛惜康"安德派思切割縫合釘"ETHICON" ENDOPATH ENDOSCOPIC
LINEAR CUTTER RELOADING UNIT-STAPLE
4802
SCV010412LV7 "維達力克" 鈦金屬血管夾系統(大)"VITALITEC" SLS-CLIP
TITANIUM HEMOSTATIC CLIP SYSTEM
35
SCV0104200TX "TELEFLEX" HORIZON METAL LIGATING CLIPS "泰利芙斯"金屬血
管夾(大) 6;24 CLIPS/排(L)
35
SCV010912LV7 "維達力克" 鈦金屬血管夾(大)"VITALITEC" NINE CLIP TITANIUM
HEMOSTATIC CLIP SYSTEM(LARGE)
35
951
特材代碼 中英文名稱 支付點數-104/01/01
SCV011500NS6 “司堅倫”單次用哈巴狗血管夾“SCANLAN”SINGLE-USE BULLDOG
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192
SCV01LT400JJ TITANIUM LIGA CLIP (L) 6 CLIP/排 35
SCV029400NM1 SUGITA ANEURYSM CLIP (STANDARD TYPE) 2256
SCV029401NM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801
SCV029402NM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801
SCV029404SM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801
SCV029406NM1 SUGITA ANEURYSM CLIP (STANDARD TYPE) 2256
SCV029406SM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801
SCV0294073M1 SURGITA ANEURYSM CLIPS LARGE TYPE N0.73 2801
SCV029407NM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801
SCV02FE60NAE ANEURYSM CLIP 2602
SCV0300005ET LIGACLIP MULTIPLE CLIP APPLIER多釘縫合釘 175
SCV031112CRG 內視鏡多發式可重複使用血管夾"MICROLINE"M/L-10 ENDOSCOPIC
MULTI-FIRE RATCHETED REUSABLE CLIP APPLIER-DISPOSABLE 19
TITANIUM CLIP
175
SCV031113LQX "麥克嵐潘特斯" 傑尼多發式血管夾 "MICROLINE PENTAX" GEMINI
MULTI-FIRE LARGE CLIP APPLIER
175
SCV03530MLCH "康美"拋棄式血管夾 "CONMED" DISPOSABLE CLIP APPLIER 175
SCV03615ML2C ”柯惠”內視鏡自動血管夾 "COVIDIEN" ENDO CLIP SINGLE USE
CLIP APPLIER
175
SCV03625LL2C ”柯惠”內視鏡自動血管夾 "COVIDIEN" ENDO CLIP SINGLE USE
CLIP APPLIER
200
SCV03EL5MLET "愛惜康"5毫米腹腔鏡多釘縫合器"ETHICON"LIGAMAX5 5MM
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200
TBCT10023TVR "EAGLE LABS"MANUAL OPHTHALMIC SURGICAL INSTRUMENT-
LACRIMAL INTUBATION SET"老鷹"手動式眼科手術器械-鼻淚管通
條
1773
TBCT10027TVR "EAGLE LABS"MANUAL OPHTHALMIC SURGICAL INSTRUMENT-
LACRIMAL INTUBATION SET"老鷹"手動式眼科手術器械-鼻淚管通
條
1773
TBCT102836HV "艾伯特海斯"手動式眼科手術器械-鼻淚管通條"ALBERT
HEISS"MANUAL OPHTHALMIC SURGICAL INSTRUMENT-LACHRYMAL
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1773
TBCT109600W5 CRAWFORD LARCRIMAL INTUBATION SET鼻淚管通條 1773
TBCT1L1S27QT "QUEST"MANUAL OPHTHALMIC SURGICAL INSTRUMENT:LACRIMAL
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1773
TBS01510101Z FCI SCLERAL BUCKLING IMPLANTS-BAND "佛朗惜眼"鞏膜環扣物 463
TBS01523101Z FCI SCLERAL BUCKLING IMPLANTS-TIRE "佛朗惜眼"鞏膜環扣物 661
TKP0113509WF EHL 9FR 電擊線 3477
TKP0113713WF EHL 3.5FR 電擊線 3477
TKP0113715WF EHL 5FR 電擊線 3477
TKP012280NWF LITHOTRIPTER:RIWOLITH PROBES 2280.XXX 3477
TKP012708NKL EHL PROBE電擊碎石線 3477
TKP0425000ZM 〝MD TECH〞BREAST LOCALIZATION NEEDLE(NEEDLE+HOOK WIRE)〝
美迪克〞乳房定位針
984
TKP0427100XL "首馬特"乳房定位針"SOMATEX"BREAST LOCALIZATION
NEEDLE(NEEDLE+HOOK WIRE)
984
TKP0460100XL "首馬特"乳房定位針"SOMATEX"BREAST LOCALIZATION
NEEDLE(MRI)
1287
TKP04B20032N "捷太"巴隆乳房定位針"GTA"BALON BREAST LOCALIZATION
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984
TKP04BLN00ZM 〝MD TECH〞BREAST LOCALIZATION NEEDLE(NEEDLE+HOOK WIRE)〝
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984
952
特材代碼 中英文名稱 支付點數-104/01/01
TKP04BREASBA "BARD"BREAST LOCALIZATION NEEDLE(NEEDLE+WIRE)"巴德"乳房定
位針
984
TKP04DKBL1CK "COOK" DISPOSABLE (KOPANS)BREAST LESION LOCALIZATION
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984
TKP04DKBL2CK "COOK" DISPOSABLE BREAST LESION LOCALIZATION DEVICES(可與
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1287
TKP04EZMB21G "E-Z-EM"PERCUGUIDE LESION MARKING SYSTEM(可與MRI相容)"易
置"乳房定位針
1287
TKP04EZN2X1G "E-Z-EM"PERCUGUIDE LESION MARKING SYSTEM(NEEDLE+HOOK
WIRE)"易置"乳房定位針
984
TKP04GTSMRBA "BARD" BREAST LOCALIZATION NEEDLE-MR BEADED BREAST
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房定位線
1287
TKP04REL01RC "RANFAC"BREAST MARKING SYSTEM:NEEDLE+HOOK WIRE(乳房定位器
材組)
984
TKP04SBS01RC "RANFAC"BREAST MARKING SYSTEM:NEEDLE+HOOK WIRE+STIFFENING
CANNULA(乳房定位器材組)
1123
TKVC10506NQQ "麥可威視"手動式眼科手術器械:玻璃體切除探頭(自103.08.01
起支付標準醫令代碼86207B、86409B、86410B及86411B使用者已
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TKVC105124QQ "麥可威視"手動式眼科手術器械:玻璃體切除探頭(自103.08.01
起支付標準醫令代碼86207B、86409B、86410B及86411B使用者已
內含不得另外申報)
4950
TKVC107402A1 STANDALONE ACCURUS PROBE(自103.08.01起支付標準醫令代碼
86207B、86409B、86410B及86411B使用者已內含不得另外申報)
4497
TKVC12405CZS "米睿"玻璃體切割系統配件(切除刀)(自103.08.01起支付標準醫
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申報)
4409
TKVC1267012D "竇可"歐索德晶體乳化切割儀:高速晶體切除器(自103.08.01起支
付標準醫令代碼86207B、86409B、86410B及86411B使用者已內含
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TKVC141018A1 玻璃體切除探頭(自103.08.01起支付標準醫令代碼86207B、
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TKVC201006A1 ANTERIOR ADVANCE TECHNOLOGY IRRIGATION OCUTOME PROBE
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TKVC208012A1 ANTERIOR VITRECTOMY PROBE(自103.08.01起支付標準醫令代碼
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WBB0402050MG "I-Ming" BANDAGE ELASTIC "愛民"彈性繃帶2"x5Y※適應症請見
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10.6
WBB0402050RL "RE-ORDER"ELASTIC BANDAGE(NON-STERILE)2吋X5碼 彈性繃帶*適
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WBB0402050UQ "U.A.TOP"ELASTIC BANDAGE(NON-STERILE)2"X5Y"優亞特"彈性繃
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WBB0403050F0 FOR CARE ELASTIC BANDAGE*適應正請見備註欄 11
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WBB0403050MG "I-Ming" BANDAGE ELASTIC "愛民"彈性繃帶3"x5Y※適應症請見
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11
WBB0403050RL "RE-ORDER"ELASTIC BANDAGE(NON-STERILE)3吋X5碼 彈性繃帶*適
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WBB0403050TW ELASTIC BANDAGE*適應症請見備註欄 11
WBB0403050UQ "U.A.TOP"ELASTIC BANDAGE(NON-STERILE)3"X5Y"優亞特"彈性繃
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WBB0403050YU YU CHUNG ELASTIC BANDAGE (NON-STERILE)*適應症請見備註欄 11
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WBB0404050MG "I-Ming" BANDAGE ELASTIC "愛民"彈性繃帶4"x5Y※適應症請見
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WBB0404050RL "RE-ORDER"ELASTIC BANDAGE(NON-STERILE)4吋X5碼 彈性繃帶*適
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WBB0406050RL "RE-ORDER"ELASTIC BANDAGE(NON-STERILE)6吋X5碼 彈性繃帶*適
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WBB0406050TW ELASTIC BANDAGE*適應症請見備註欄 18
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WBB0703030AZ "M&A"POP PLASTER OF PARIS BANDAGE EXTRA FAST SETTING
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WBB0703030NJ PLASTER BANDAGE 3"X3Y 22.7
WBB0703030QP "POP"PLASTER OF PARIS BANDAGE(NON-STERILE)3"X3Y"披歐披"石
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WBB0703030U6 PLASTER OF PARIS BANDAGE 3"X3Y 22.7
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WBB0703050JX "ANJI JIXIANG"PLASTER OF PARIS BANDAGES(NON-STERILE)"安吉
吉祥"石膏繃帶(未滅菌)3"X5Y
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WBB0703050QP "POP"PLASTER OF PARIS BANDAGE(NON-STERILE)3"X5Y"披歐披"石
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WBB0704040ZD DUK-IN PLASTER BANDAGE 34.1
WBB0704050A5 CAST BANDAGE 38.1
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WBB0704050C7 "CSD"PLASTER OF PAIRS BANDAGE (non-sterile)4"X5Y"中衛"石
膏繃帶(未滅菌)
38.1
WBB0704050JX "ANJI JIXIANG"PLASTER OF PARIS BANDAGES(NON-STERILE)"安吉
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38.1
WBB0704050U6 PLASTER OF PARIS BANDAGE 4"X5Y 38.1
WBB0704051A5 "ALCARE"P&O PLASTER OF PARIS BANDAGE 4"X5Y(10CMX4.5M)"愛
樂康"石膏繃帶
38.1
WBB0705050AZ "M&A"POP PLASTER OF PARIS BANDAGE EXTRA FAST SETTING
5"X5Y石膏繃帶
48.8
WBB0705050NJ PLASTER BANDAGE 5"X5Y 48.8
WBB0705050QP "POP"PLASTER OF PARIS BANDAGE(NON-STERILE)5"X5Y"披歐披"石
膏繃帶(未滅菌)
48.8
WBB0705050U6 PLASTER OF PARIS BANDAGE 5"X5Y 48.8
WBB0706030U6 PLASTER OF PARIS BANDAGE 6"X3Y 38
WBB0706040U6 PLASTER OF PARIS BANDAGE 6"X4Y 47
WBB0706040ZD DUK-IN PLASTER BANDAGE 47
WBB0706050A5 "Alcare"casting 6"x5y 50.1
WBB0706050AZ PLASTER OF PARIS BANDAGE 6"X5Y 50.1
WBB0706050C7 "CSD"PLASTER OF PAIRS BANDAGE (non-sterile)6"X5Y"中衛"石
膏繃帶(未滅菌)
50.1
WBB0706050JX "ANJI JIXIANG"PLASTER OF PARIS BANDAGES(NON-STERILE)"安吉
吉祥"石膏繃帶(未滅菌)6"X5Y
50.1
WBB0706050NJ PLASTER BANDAGE 6"X5Y 50.1
WBB0706050NS NOK-SAN CAST PLASTER BANDAGE 15CMX4.5M(6"X5Y) 50.1
WBB0706050QP "POP"PLASTER OF PARIS BANDAGE(NON-STERILE)6"X5Y"披歐披"石
膏繃帶(未滅菌)
50.1
WBB0706050U6 PLASTER OF PARIS BANDAGE 6"X5Y 50.1
WBB0706051A5 "ALCARE"P&O PLASTER OF PARIS BANDAGE 6"X5Y(15CMX4.5M)"愛
樂康"石膏繃帶
50.1
955
特材代碼 中英文名稱 支付點數-104/01/01
WBB0801020KB "KOB"KOBRA CAST 易速石膏繃帶(聚脂石膏繃帶)1吋X2碼*適應症
請見備註欄
85
WBB08020402B "瑪迪安納"樹脂石膏繃帶(未滅菌)"MEDIANA" CASTING TAPE
(NON-STERILE)
120
WBB08020403M SCOTCHCAST PLUS CASTING TAPE玻璃纖維石膏繃帶2吋X4碼*適應
症請見備註欄
120
WBB0802040HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE)樹脂石膏繃帶
(聚脂纖維)2吋X4.4碼*適應症請見備註欄
120
WBB0802040K3 "KANGDA"ORTHOPEDIC CASTING TAPE樹脂石膏繃帶(玻璃纖維)2吋4
碼*適應症請見備註欄
120
WBB0802040KB "KOB"KOBRA CAST 易速石膏繃帶(聚脂石膏繃帶)2吋X4碼*適應症
請見備註欄
196
WBB0802040Q3 "DONG HAE"ORTHOPEDIC CASTING TAPE輕石膏(玻璃纖維)2吋X4碼*
適應症請見備註欄
120
WBB0802040Q5 "S&F"ROBO CASTING TAPE若玻樹脂石膏繃帶(聚脂纖維)2吋X4碼*
適應症請見備註欄
120
WBB0802040Q6 NEMOA CAST ORTHOPAEDIC CASTING TAPE(POLYESTER)米尼亞聚脂
繃帶2吋X4碼*使用規範請見備註欄
120
WBB0802040Q7 "KJC"PP-BAND CASTING TAPE必庇綁樹脂石膏(聚脂纖維)2吋X4碼*
適應症請見備註欄
120
WBB0802040Q8 "OPTIMA CAST"ORTHOPAEDIC CASTING TAPE(NON-STERILE)樹脂石
膏繃帶(玻璃纖維)2吋X4碼*適應症請見備註欄
120
WBB0802040Q9 "TOMATO"ORTHOPAEDIC CASTING TAPE(NON-STERILE)玻璃纖維石膏
繃帶2吋X4碼*適應症請見備註欄
120
WBB0802040YK "CONNECT"ORTHOPEDIC CASTING TAPE 2"X4Y(5.0CMX360CM)(NON-
STERILE)"可耐特"樹脂石膏繃帶(未滅菌)*適應症請見備註欄
120
WBB08020413M SCOTCHCAST PREMIUM CASTING TAPE玻璃纖維石膏繃帶2吋X4碼*適
應症請見備註欄
120
WBB0802041HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NEAL CAST FIBERGLASS
ALPHA TYPE)樹脂石膏繃帶(玻璃纖維)2吋X4.4碼*適應症請見備註
欄
120
WBB0802041NJ POLYESTER CAST TAPE聚脂纖維石膏繃帶2吋X4Y*使用規範請見備
註欄
120
WBB08030402B "瑪迪安納"樹脂石膏繃帶(未滅菌) "MEDIANA" CASTING TAPE
(NON-STERILE)
140
WBB08030403M SCOTCHCAST PLUS CASTING TAPE玻璃纖維石膏繃帶3吋X4碼*適應
症請見備註欄
140
WBB0803040HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE)樹脂石膏繃帶
(聚脂纖維)3吋X4.4碼*適應症請見備註欄
140
WBB0803040K3 "KANGDA"ORTHOPEDIC CASTING TAPE樹脂石膏繃帶(玻璃纖維)3吋4
碼*適應症請見備註欄
140
WBB0803040KB "KOB"KOBRA CAST 易速石膏繃帶(聚脂石膏繃帶)3吋X4碼*適應症
請見備註欄
230
WBB0803040NJ FIBERGLASS CAST TAPE玻璃纖維石膏繃帶3吋X4Y*使用規範請見備
註欄
140
WBB0803040Q3 "DONG HAE"ORTHOPEDIC CASTING TAPE輕石膏(玻璃纖維)3吋X4碼*
適應症請見備註欄
140
WBB0803040Q5 "S&F"ROBO CASTING TAPE若玻樹脂石膏繃帶(聚脂纖維)3吋X4碼*
適應症請見備註欄
140
WBB0803040Q6 NEMOA CAST ORTHOPAEDIC CASTING TAPE(POLYESTER)米尼亞聚脂
繃帶3吋X4碼*使用規範請見備註欄
140
WBB0803040Q7 "KJC"PP-BAND CASTING TAPE必庇綁樹脂石膏(聚脂纖維)3吋X4碼*
適應症請見備註欄
140
956
特材代碼 中英文名稱 支付點數-104/01/01
WBB0803040Q8 "OPTIMA CAST"ORTHOPAEDIC CASTING TAPE(NON-STERILE)樹脂石
膏繃帶(玻璃纖維)3吋X4碼*適應症請見備註欄
140
WBB0803040Q9 "TOMATO"ORTHOPAEDIC CASTING TAPE(NON-STERILE)玻璃纖維石膏
繃帶3吋X4碼*適應症請見備註欄
140
WBB0803040YK "CONNECT"ORTHOPEDIC CASTING TAPE 3"X4Y(7.5CMX360CM)(NON-
STERILE)"可耐特"樹脂石膏繃帶(未滅菌)*適應症請見備註欄
140
WBB08030413M SCOTCHCAST PREMIUM CASTING TAPE玻璃纖維石膏繃帶3吋X4碼*適
應症請見備註欄
140
WBB0803041HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NEAL CAST FIBERGLASS
ALPHA TYPE)樹脂石膏繃帶(玻璃纖維)3吋X4.4碼*適應症請見備註
欄
140
WBB0803041NJ POLYESTER CAST TAPE聚脂纖維石膏繃帶3吋X4Y*使用規範請見備
註欄
140
WBB08040402B "瑪迪安納"樹脂石膏繃帶(未滅菌)"MEDIANA" CASTING TAPE
(NON-STERILE)
160
WBB08040403M SCOTCHCAST PLUS CASTING TAPE玻璃纖維石膏繃帶4吋X4碼*適應
症請見備註欄
160
WBB0804040HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE)樹脂石膏繃帶
(聚脂纖維)4吋X4.4碼*適應症請見備註欄
160
WBB0804040K3 "KANGDA"ORTHOPEDIC CASTING TAPE樹脂石膏繃帶(玻璃纖維)4吋4
碼*適應症請見備註欄
160
WBB0804040KB "KOB"KOBRA CAST 易速石膏繃帶(聚脂石膏繃帶)4吋X4碼*適應症
請見備註欄
265
WBB0804040NJ FIBERGLASS CAST TAPE玻璃纖維石膏繃帶4吋X4Y*使用規範請見備
註欄
160
WBB0804040Q3 "DONG HAE"ORTHOPEDIC CASTING TAPE輕石膏(玻璃纖維)4吋X4碼*
適應症請見備註欄
160
WBB0804040Q5 "S&F"ROBO CASTING TAPE若玻樹脂石膏繃帶(聚脂纖維)4吋X4碼*
適應症請見備註欄
160
WBB0804040Q6 NEMOA CAST ORTHOPAEDIC CASTING TAPE(POLYESTER)米尼亞聚脂
繃帶4吋X4碼*使用規範請見備註欄
160
WBB0804040Q7 "KJC"PP-BAND CASTING TAPE必庇綁樹脂石膏(聚脂纖維)4吋X4碼*
適應症請見備註欄
160
WBB0804040Q8 "OPTIMA CAST"ORTHOPAEDIC CASTING TAPE(NON-STERILE)樹脂石
膏繃帶(玻璃纖維)4吋X4碼*適應症請見備註欄
160
WBB0804040Q9 "TOMATO"ORTHOPAEDIC CASTING TAPE(NON-STERILE)玻璃纖維石膏
繃帶4吋X4碼*適應症請見備註欄
160
WBB0804040YK "CONNECT"ORTHOPEDIC CASTING TAPE 4"X4Y(10.0CMX360CM)(NON-
STERILE)"可耐特"樹脂石膏繃帶(未滅菌)*適應症請見備註欄
160
WBB08040413M SCOTCHCAST PREMIUM CASTING TAPE玻璃纖維石膏繃帶4吋X4碼*適
應症請見備註欄
160
WBB0804041HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NEAL CAST FIBERGLASS
ALPHA TYPE)樹脂石膏繃帶(玻璃纖維)4吋X4.4碼*適應症請見備註
欄
160
WBB0804041NJ POLYESTER CAST TAPE聚脂纖維石膏繃帶4吋X4Y*使用規範請見備
註欄
160
WBB08050402B "瑪迪安納"樹脂石膏繃帶(未滅菌)"MEDIANA" CASTING TAPE
(NON-STERILE)
180
WBB08050403M SCOTCHCAST PLUS CASTING TAPE玻璃纖維石膏繃帶5吋X4碼*適應
症請見備註欄
180
WBB0805040HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE)樹脂石膏繃帶
(聚脂纖維)5吋X4.4碼*適應症請見備註欄
180
957
特材代碼 中英文名稱 支付點數-104/01/01
WBB0805040K3 "KANGDA"ORTHOPEDIC CASTING TAPE樹脂石膏繃帶(玻璃纖維)5吋4
碼*適應症請見備註欄
180
WBB0805040KB "KOB"KOBRA CAST 易速石膏繃帶(聚脂石膏繃帶)5吋X4碼*適應症
請見備註欄
334
WBB0805040NJ FIBERGLASS CAST TAPE玻璃纖維石膏繃帶5吋X4Y*使用規範請見備
註欄
180
WBB0805040Q3 "DONG HAE"ORTHOPEDIC CASTING TAPE輕石膏(玻璃纖維)5吋X4碼*
適應症請見備註欄
180
WBB0805040Q5 "S&F"ROBO CASTING TAPE若玻樹脂石膏繃帶(聚脂纖維)5吋X4碼*
適應症請見備註欄
180
WBB0805040Q6 NEMOA CAST ORTHOPAEDIC CASTING TAPE(POLYESTER)米尼亞聚脂
繃帶5吋X4碼*使用規範請見備註欄
180
WBB0805040Q7 "KJC"PP-BAND CASTING TAPE必庇綁樹脂石膏(聚脂纖維)5吋X4碼*
適應症請見備註欄
180
WBB0805040Q8 "OPTIMA CAST"ORTHOPAEDIC CASTING TAPE(NON-STERILE)樹脂石
膏繃帶(玻璃纖維)5吋X4碼*適應症請見備註欄
180
WBB0805040Q9 "TOMATO"ORTHOPAEDIC CASTING TAPE(NON-STERILE)玻璃纖維石膏
繃帶5吋X4碼*適應症請見備註欄
180
WBB0805040YK "CONNECT"ORTHOPEDIC CASTING TAPE 5"X4Y(12.5CMX360CM)(NON-
STERILE)"可耐特"樹脂石膏繃帶(未滅菌)*適應症請見備註欄
180
WBB08050413M SCOTCHCAST PREMIUM CASTING TAPE玻璃纖維石膏繃帶5吋X4碼*適
應症請見備註欄
180
WBB0805041HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NEAL CAST FIBERGLASS
ALPHA TYPE)樹脂石膏繃帶(玻璃纖維)5吋X4.4碼*適應症請見備註
欄
180
WBB0805041NJ POLYESTER CAST TAPE聚脂纖維石膏繃帶5吋X4Y*使用規範請見備
註欄
180
WBB0806040K3 "KANGDA"ORTHOPEDIC CASTING TAPE樹脂石膏繃帶(玻璃纖維)6吋4
碼*適應症請見備註欄
200
WBB0806040Q3 "DONG HAE"ORTHOPEDIC CASTING TAPE輕石膏(玻璃纖維)6吋X4碼*
適應症請見備註欄
200
WBB0806040Q5 "S&F"ROBO CASTING TAPE若玻樹脂石膏繃帶(聚脂纖維)6吋X4碼*
適應症請見備註欄
207
WBB0806040Q6 NEMOA CAST ORTHOPAEDIC CASTING TAPE(POLYESTER)米尼亞聚脂
繃帶6吋X4碼*使用規範請見備註欄
207
WBB0806040YK "CONNECT"ORTHOPEDIC CASTING TAPE6"X4Y(15.0CMX360CM)(NON-
STERILE)"可耐特"樹脂石膏繃帶(未滅菌)*適應症請見備註欄
207
WBB0815382A5 玻璃纖維石膏繃帶3吋X4碼*使用規範請見備註欄 140
WBB0815383A5 玻璃纖維石膏繃帶4吋X4碼*使用規範請見備註欄 160
WBB0817942A5 聚脂纖維石膏繃帶3吋X4碼*使用規範請見備註欄 140
WBB0817943A5 聚脂纖維石膏繃帶4吋X4碼*使用規範請見備註欄 160
WBB0817944A5 聚脂纖維石膏繃帶5吋X4碼*使用規範請見備註欄 180
WBB0820400HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE)樹脂石膏繃帶
(玻璃纖維)2吋X4.4碼*適應症請見備註欄
120
WBB0820400Q5 "S&F"ROBO CASTING TAPE若玻樹脂石膏繃帶(玻璃纖維)2吋X4碼*
適應症請見備註欄
120
WBB0830400HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE)樹脂石膏繃帶
(玻璃纖維)3吋X4.4碼*適應症請見備註欄
140
WBB0840400HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE)樹脂石膏繃帶
(玻璃纖維)4吋X4.4碼*適應症請見備註欄
160
WBB0850400HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE)樹脂石膏繃帶
(玻璃纖維)5吋X4.4碼*適應症請見備註欄
180
958
特材代碼 中英文名稱 支付點數-104/01/01
WBB0850400Q5 "S&F"ROBO CASTING TAPE若玻樹脂石膏繃帶(玻璃纖維)5吋X4碼*
適應症請見備註欄
180
WBP0102030YK "CONNECT"CAST COTTON PADDING(NON-
STERILE)2"X3Y(5CMX270CM)"可耐特"石膏棉捲(未滅菌)
8
WBP0102040GM "卓和"繃帶(棉捲繃帶)"GMTH" BANDAGE(COTTON BANDAGES) 11
WBP0102040JN OPTIMA PAD石膏棉捲 11
WBP0102040QB "CHUAN SHUN"COTTON BANDAGES(NON-STERILE) 2"X4Y"銓順"石膏
棉捲(未滅菌)
11
WBP0103030C7 CSD ORTHOPAEDIC CAST COTTON PADDING 13
WBP0103030DQ SABHARWAL'S BANDAGE ORTHOPAEDIC CAST PADDING 13
WBP0103030YK "CONNECT"CAST COTTON PADDING(NON-
STERILE)3"X3Y(7.5CMX270CM)"可耐特"石膏棉捲(未滅菌)
13
WBP0103040C7 CSD ORTHOPAEDIC CAST COTTON PADDING 12.8
WBP0103040FC ORTHOPEDIC COTTON BANDAGE 12.8
WBP0103040GM "卓和"繃帶(棉捲繃帶)"GMTH" BANDAGE(COTTON BANDAGES) 12.8
WBP0103040JN OPTIMA PAD石膏棉捲 12.8
WBP0103040JX "ANJI JIXIANG"UNDERCAST PADDING BANDAGE(NON-STERILE)
3"X4Y"安吉吉祥"棉捲(未滅菌)
12.8
WBP0103040KF ORTHOPEDIC COTTON BANDAGE 12.8
WBP0103040QB "CHUAN SHUN"COTTON BANDAGES(NON-STERILE) 3"X4Y"銓順"石膏
棉捲(未滅菌)
12.8
WBP0104030C7 CSD ORTHOPAEDIC CAST COTTON PADDING 12.8
WBP0104030YK "CONNECT"CAST COTTON PADDING(NON-
STERILE)4"X3Y(10CMX270CM)"可耐特"石膏棉捲(未滅菌)
12.8
WBP0104033DQ ORTHOPAEDIC CAST PADDING 12.8
WBP0104040BP B.P.I UNDER CAST PADDING BANDAGE COTTON 17.3
WBP0104040C7 CSD ORTHOPAEDIC CAST COTTON PADDING 17.3
WBP0104040FC ORTHOPEDIC COTTON BANDAGE 17.3
WBP0104040GM "卓和"繃帶(棉捲繃帶)"GMTH" BANDAGE(COTTON BANDAGES) 17.3
WBP0104040JN OPTIMA PAD石膏棉捲 17.3
WBP0104040JX "ANJI JIXIANG"UNDERCAST PADDING BANDAGE(NON-STERILE)
4"X4Y"安吉吉祥"棉捲(未滅菌)
17.3
WBP0104040KF ORTHOPEDIC COTTON BANDAGE 17.3
WBP0104040NJ ORTHOPEDIC COTTON BANDAGE 17.3
WBP0104040QB "CHUAN SHUN"COTTON BANDAGES(NON-STERILE) 4"X4Y"銓順"石膏
棉捲(未滅菌)
17.3
WBP0104050C7 CSD ORTHOPAEDIC CAST COTTON PADDING 22.9
WBP0105040C7 CSD ORTHOPAEDIC CAST COTTON PADDING 22.9
WBP0106030C7 CSD ORTHOPAEDIC CAST COTTON PADDING 24
WBP0106030YK "CONNECT"CAST COTTON PADDING(NON-
STERILE)6"X3Y(15CMX270CM)"可耐特"石膏棉捲(未滅菌)
24
WBP0106033DQ ORTHOPAEDIC CAST PADDING 24
WBP0106040BP B.P.I UNDER CAST PADDING BANDAGE COTTON 25.6
WBP0106040C7 CSD ORTHOPAEDIC CAST COTTON PADDING 25.6
WBP0106040FC ORTHOPEDIC COTTON BANDAGE 25.6
WBP0106040GM "卓和"繃帶(棉捲繃帶)"GMTH" BANDAGE(COTTON BANDAGES) 25.6
WBP0106040JN OPTIMA PAD石膏棉捲 25.6
WBP0106040JX "ANJI JIXIANG"UNDERCAST PADDING BANDAGE(NON-STERILE)
6"X4Y"安吉吉祥"棉捲(未滅菌)
25.6
WBP0106040KF ORTHOPEDIC COTTON BANDAGE 25.6
WBP0106040NJ ORTHOPEDIC COTTON BANDAGE 25.6
WBP0106040QB "CHUAN SHUN"COTTON BANDAGES(NON-STERILE) 6"X4Y"銓順"石膏
棉捲(未滅菌)
25.6
WBP0106050A5 ORTHOPEDIC COTTON BANDAGE 31.5
959
特材代碼 中英文名稱 支付點數-104/01/01
WBP0106050C7 CSD ORTHOPAEDIC CAST COTTON PADDING 31.5
WBP0108030YK "CONNECT"CAST COTTON PADDING(NON-
STERILE)8"X3Y(20CMX270CM)"可耐特"石膏棉捲(未滅菌)
25.6
WDD0800008SN INTRASITE GEL 8GM *適應症請見備註欄 83.9
WDD08000153M 3M TEGADERM HYDROGEL WOUND FILLER(STERILE) 15GM水解凝膠*
適應症請見備註欄
140
WDD0800015SN INTRASITE GEL 15GM *適應症請見備註欄 140
WDD08000253M 3M TEGADERM HYDROGEL WOUND FILLER(STERILE)25GM水解凝膠*適
應症請見備註欄
276
WDD0800025SN INTRASITE GEL 25GM *適應症請見備註欄 276
WDD0800043SN "SMITH&NEPHEW"ALLEVYN ADHESIVE
DRESSING(STERILE)7.5CMX7.5CM"史耐輝"愛力膚親水性自黏敷料
(滅菌)*適應症請見備註欄
73
WDD0800044SN "SMITH&NEPHEW"ALLEVYN ADHESIVE
DRESSING(STERILE)12.5CMX12.5CM"史耐輝"愛力膚親水性自黏敷
料(滅菌)*適應症請見備註欄
177
WDD0800045SN "SMITH&NEPHEW"ALLEVYN ADHESIVE
DRESSING(STERILE)17.5CMX17.5CM"史耐輝"愛力膚親水性自黏敷
料(滅菌)*適應症請見備註欄
327
WDD0800046SN "SMITH&NEPHEW"ALLEVYN ADHESIVE
DRESSING(STERILE)22.5CMX22.5CM"史耐輝"愛力膚親水性自黏敷
料(滅菌)*適應症請見備註欄
395
WDD0800073SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL
DRESSING 7.5CMX7.5CM"史耐輝"愛力膚銀親水性抗菌敷料*適應症
請見備註欄
198
WDD0800078SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL
DRESSING 12.5CMX12.5CM"史耐輝"愛力膚銀親水性抗菌敷料*適應
症請見備註欄
320
WDD0800081SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL
DRESSING 17.5CMX17.5CM"史耐輝"愛力膚銀親水性抗菌敷料*適應
症請見備註欄
459
WDD0800083SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL
DRESSING 5CMX5CM"史耐輝"愛力膚銀親水性抗菌敷料*適應症請見
備註欄
56.4
WDD0800086SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL
DRESSING 10CMX10CM"史耐輝"愛力膚銀親水性抗菌敷料*適應症請
見備註欄
224
WDD0800089SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL
DRESSING 15CMX15CM"史耐輝"愛力膚銀親水性抗菌敷料*適應症請
見備註欄
406
WDD0800091SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL
DRESSING 20CMX20CM"史耐輝"愛力膚銀親水性抗菌敷料*適應症請
見備註欄
612
WDD0800248SN "SMITH&NEPHEW"ALLEVYN GENTLE SOFT GEL ADHESIVE
HYDROCELLULAR DRESSING 10CMX10CM"史耐輝"柔膠愛力膚敷料(滅
菌)*適應症請見備註欄
119
WDD0800249SN "SMITH&NEPHEW"ALLEVYN GENTLE SOFT GEL ADHESIVE
HYDROCELLULAR DRESSING 10CMX20CM"史耐輝"柔膠愛力膚敷料(滅
菌)*適應症請見備註欄
225
WDD0800250SN "SMITH&NEPHEW"ALLEVYN GENTLE SOFT GEL ADHESIVE
HYDROCELLULAR DRESSING 15CMX15CM"史耐輝"柔膠愛力膚敷料(滅
菌)*適應症請見備註欄
243
960
特材代碼 中英文名稱 支付點數-104/01/01
WDD0800251SN "SMITH&NEPHEW"ALLEVYN GENTLE SOFT GEL ADHESIVE
HYDROCELLULAR DRESSING 20CMX20CM"史耐輝"柔膠愛力膚敷料(滅
菌)*適應症請見備註欄
364
WDD0800270SN "SMITH & NEPHEW"ALLEVYN GENTLE BORDER
DRESSING(STERILE)10X10CM"史耐輝"矽膠愛力膚敷料(滅菌)*適應
症請見備註欄
119
WDD0800272SN "SMITH & NEPHEW"ALLEVYN GENTLE BORDER
DRESSING(STERILE)12.5X12.5CM"史耐輝"矽膠愛力膚敷料(滅菌)*
適應症請見備註欄
225
WDD0800273SN "SMITH & NEPHEW"ALLEVYN GENTLE BORDER
DRESSING(STERILE)17.5X17.5CM"史耐輝"矽膠愛力膚敷料(滅菌)*
適應症請見備註欄
364
WDD0800434SN "SMITH&NEPHEW"REPLICARE ULTRA HYDROCOLLOID WOUND
DRESSING(STERILE)10CMX10CM"史耐輝"力普佳敷料(滅菌)*給付規
定請見備註欄
53.2
WDD0800435SN "SMITH&NEPHEW"REPLICARE ULTRA HYDROCOLLOID WOUND
DRESSING(STERILE)15CMX15CM"史耐輝"力普佳敷料(滅菌)*給付規
定請見備註欄
116
WDD0800436SN "SMITH&NEPHEW"REPLICARE ULTRA HYDROCOLLOID WOUND
DRESSING(STERILE)20CMX20CM"史耐輝"力普佳敷料(滅菌)*給付規
定請見備註欄
192
WDD0800451SN "SMITH&NEPHEW"ALLEVYN DRESSING(SACRUM)22CMX22CM愛力膚親水
性的聚乙烯膚料*適應症請見備註欄
395
WDD0800505YY "CORELEADER" COLLA-ALGI FIBER WOUND DRESSING (STERILE) "
康力得"膠原藻酸纖維敷料(滅菌)※適應症請見備註欄
20.4
WDD0800510F4 DUODERM EXTRA THIN CGF DRESSING(2"x4") 5X10CM超薄型多愛膚
滅菌親水性敷料*給付規定請見備註欄。
41.1
WDD0800520F4 DUODERM EXTRA THIN CGF DRESSING (2"X8")5X20CM超薄型多愛膚
滅菌親水性敷料*適應症請見備註欄
53.2
WDD0800700SN "SMITH&NEPHEW"ALLEVYN DRESSING(SACRUM)17CMX17CM愛力膚親水
性的聚乙烯膚料*適應症請見備註欄
327
WDD0800707SN HYDROCELLULAR ADHESIVE DRESSING 7.5X7.5CM※適應症請見備註
欄
73
WDD0801008J9 "TRONJEN"HYDROCOLLOID DRESSING(STERILE)10CMX10CM"中鎮"親
水性敷料(滅菌)*適應症請見備註欄
119
WDD0801010F4 DUODERM EXTRA THIN CGF DRESSING (4"X4")10X10CM超薄型多愛
膚滅菌親水性敷料*給付規定請見備註欄。
53.2
WDD0801010HZ "和豐"保立美傷口敷料(滅菌)"HORIZON"POLYMEM WOUND PAD
DRESSING (STERILE)4"X4"(10CMX10CM)
119
WDD0801010J9 "TRONJEN"HYDROCOLLOID DRESSING(STERILE)10X10CM "中鎮"親水
性敷料(滅菌)(超薄)*適應症請見備註欄
53.2
WDD0801010SN HYDROPHILIC POLYURETHANE DRESSING 10X10CM※適應症請見備註
欄
119
WDD0801010YY "CORELEADER" COLLA-ALGI FIBER WOUND DRESSING (STERILE) "
康力得"膠原藻酸纖維敷料(滅菌)※適應症請見備註欄
112
WDD0801020SN HYDROPHILIC POLYURETHANE DRESSING 10X20CM※適應症請見備註
欄
245
WDD0801020YY "CORELEADER" COLLA-ALGI FIBER WOUND DRESSING (STERILE) "
康力得"膠原藻酸纖維敷料(滅菌)※適應症請見備註欄
125
WDD0801212SN HYDROCELLULAR ADHESIVE DRESSING 12.5X12.5CM※適應症請見備
註欄
177
WDD0801419BB "B.BRAUN"ASKINA GEL,15G 雅膚清創凝膠*適應症請見備註欄 140
WDD0801515F4 DUODERM EXTRA THIN CGF DRESSING (6"X6")15X15CM超薄型多愛
膚滅菌親水性敷料*給付規定請見備註欄。
116
961
特材代碼 中英文名稱 支付點數-104/01/01
WDD0801717SN HYDROCELLULAR ADHESIVE DRESSING 17.5X17.5CM※適應症請見備
註欄
327
WDD0802020SN HYDROPHILIC POLYURETHANE DRESSING 20X20CM※適應症請見備註
欄
395
WDD0802222SN HYDROCELLULAR ADHESIVE DRESSING 22.5X22.5CM※適應症請見備
註欄
395
WDD0803410CA "COLOPLAST" BIATAIN FOAM DRESSING(STERILE)-NON-ADHESIVE "
康樂保"平而坦泡綿敷料(滅菌)-非黏性※適應症請見備註欄
119
WDD0803413CA "COLOPLAST" BIATAIN FOAM DRESSING(STERILE)-NON-ADHESIVE "
康樂保"平而坦泡綿敷料(滅菌)-非黏性※適應症請見備註欄
245
WDD0803416CA "COLOPLAST" BIATAIN FOAM DRESSING(STERILE)-NON-ADHESIVE "
康樂保"平而坦泡綿敷料(滅菌)-非黏性※適應症請見備註欄
395
WDD0803420CA "COLOPLAST" BIATAIN FOAM DRESSING(STERILE)-ADHESIVE "康樂
保"平而坦泡綿敷料(滅菌)-黏性※適應症請見備註欄
177
WDD0803423CA "COLOPLAST" BIATAIN FOAM DRESSING(STERILE)-ADHESIVE "康樂
保"平而坦泡綿敷料(滅菌)-黏性※適應症請見備註欄
327
WDD0803470CA "COLOPLAST" BIATAIN FOAM DRESSING(STERILE)-SOFT-HOLD "康
樂保"平而坦泡綿敷料(滅菌)-自黏※適應症請見備註欄
119
WDD0803472CA "COLOPLAST" BIATAIN FOAM DRESSING(STERILE)-SOFT-HOLD "康
樂保"平而坦泡綿敷料(滅菌)-自黏※適應症請見備註欄
245
WDD0803475CA "COLOPLAST" BIATAIN FOAM DRESSING(STERILE)-SOFT-HOLD "康
樂保"平而坦泡綿敷料(滅菌)-自黏※適應症請見備註欄
245
WDD0803708F4 "CONVATEC"AQUACEL AG HYDROFIBER DRESSING 10X10CM(4"X4") "
康威"愛康膚-銀親水性纖維敷料*給付規定請見備註欄。
224
WDD0803710F4 "CONVATEC"AQUACEL AG HYDROFIBER DRESSING 15X15CM(6"X6")
"康威"愛康膚-銀親水性纖維敷料*給付規定請見備註欄。
406
WDD0803711F4 "CONVATEC"AQUACEL AG HYDROFIBER DRESSING 20X30CM (8"X12")
"康威"愛康膚-銀親水性纖維敷料*給付規定請見備註欄。
920
WDD0803712F4 "CONVATEC"AQUACEL AG HYDROFIBER DRESSING 2X45CM *適應症請
見備註欄
198
WDD0803760CA COLOPLAST SEASORB AG DRESSING 康樂保藻膠銀離子敷料
10CMX10CM*適應症請見備註欄
224
WDD0803771F4 "CONVATEC"AQUACEL AG HYDROFIBER DRESSING 2X45CM
(0.75"X18") "康威"愛康膚-銀親水性纖維敷料*給付規定請見備
註欄。
198
WDD0803780CA COLOPLAST SEASORB AG DRESSING 康樂保藻膠銀離子敷料
3CMX44CM*適應症請見備註欄
224
WDD080451CSN "SMITH&NEPHEW"ALLEVYN SACRUM DRESSING(STERILE)22CMX22CM"
史耐輝"愛力膚親水性自黏敷料(滅菌)*給付規定請見備註欄
395
WDD080505AVH "HOBE" HYDROPHILIC WOUND DRESSING-
ALGINATE(STERILE)5CMX5CM"梓源"親水性傷口敷料*給付規定請見
備註欄
20.4
WDD0805101YY "CORELEADER"HYDROCOLLOID DRESSING(STERILE)"康力得"親水性
敷料(滅菌)5CMX10CM*適應症請見備註欄
41.1
WDD0805201YY "CORELEADER"HYDROCOLLOID DRESSING(STERILE)"康力得"親水性
敷料(滅菌)5CMX20CM*適應症請見備註欄
53.2
WDD080700CSN "SMITH&NEPHEW"ALLEVYN SACRUM DRESSING(STERILE)17CMX17CM"
史耐輝"愛力膚親水性自黏敷料(滅菌)*給付規定請見備註欄
327
WDD08090023M 3MTEGASORB HYDROCOLLOID DRESSING親水性敷料 10CMX10CM*適應
症請見備註欄
119
962
特材代碼 中英文名稱 支付點數-104/01/01
WDD08090053M 3MTEGASORB HYDROCOLLOID DRESSING親水性敷料 15CMX15CM*適應
症請見備註欄
245
WDD0809238KD CURASORB CALCUIUM ALIGINATE DRESSINGS 20.32X10.16CM ※給
付規定請見備註欄
125
WDD0809622CA "COLOPLAST"BIATAIN AG FOAM DRESSING "康樂保"平而坦銀離子
泡綿敷料10CMX10CM*適應症請見備註欄
224
WDD0809625CA "COLOPLAST"BIATAIN AG FOAM DRESSING "康樂保"平而坦銀離子
泡綿敷料15CMX15CM*適應症請見備註欄
406
WDD0809801KD ULTEC PRO ALGINATE HYDROCOLLOID DRESSING
4X4(10.16X10.16CM)※給付規定請見備註欄
112
WDD0809802KD ULTEC PRO ALGINATE HYDROCOLLOID DRESSING
6X6(15.24X15.24CM)※給付規定請見備註欄
167
WDD0809804KD ULTEC PRO ALGINATE HYDROCOLLOID DRESSING
8X8(20.32X20.32CM)※給付規定請見備註欄
227
WDD0809921HL RESTORE EXTRA THIN 10CMMX10CM※適應症請見備註欄 53.2
WDD0809923HL RESTORE EXTRA THIN 15.2CMMX20.3CM※適應症請見備註欄 145
WDD0809937HL RESTORE CALCICARE WOUND CARE DRESSING STERILE 10X10CM ※
適應症請見備註欄
112
WDD0809938HL RESTORE CALCICARE WOUND CARE DRESSING STERILE 5X5CM ※適
應症請見備註欄
20.4
WDD0809939HL RESTORE CALCICARE WOUND CARE DRESSING STERILE 10X20CM ※
適應症請見備註欄
125
WDD0809955HL RESTORE PLUS WOUND CARE DRESSING STERILE 20X20CM※適應症
請見備註欄
395
WDD0809956HL RESTORE PLUS TAPERED EDGE WOUND CARE DRESSING STERILE
10X10CM※適應症請見備註欄
119
WDD0810100YY "CORELEADER"ALGINATE FIBER WOUND
DRESSING(STERILE)10CMX10CM"康力得"藻酸鹽纖維傷口敷料(滅
菌)*適應症請見備註欄
112
WDD0810101YY "CORELEADER"HYDROCOLLOID DRESSING(STERILE)"康力得"親水性
敷料(滅菌)10CMX10CM*適應症請見備註欄
53.2
WDD081010AVH "HOBE" HYDROPHILIC WOUND DRESSING-
ALGINATE(STERILE)10CMX10CM"梓源"親水性傷口敷料*給付規定請
見備註欄
112
WDD081010TSN REPLICARE ULTRA 10X10CM※適應症請見備註欄 53.2
WDD0810200YY "CORELEADER"ALGINATE FIBER WOUND
DRESSING(STERILE)10CMX20CM"康力得"藻酸鹽纖維傷口敷料(滅
菌)*適應症請見備註欄
125
WDD0810607F4 "ConvaTec"VERSIVA XC DRESSING(STERILE)-Non Adhesive
11CMX11CM"康威"威吸寶敷料(滅菌)-非粘性*給付規定請見備註
欄。
143
WDD0810608F4 "ConvaTec"VERSIVA XC DRESSING(STERILE)-Non Adhesive
15CMX15CM"康威"威吸寶敷料(滅菌)-非粘性*給付規定請見備註
欄。
243
WDD0810609F4 "ConvaTec"VERSIVA XC DRESSING(STERILE)-Adhesive
10CMX10CM"康威"威吸寶敷料(滅菌)-自粘性*給付規定請見備註
欄。
119
WDD0810610F4 "ConvaTec"VERSIVA XC DRESSING(STERILE)-Adhesive
14CMX14CM"康威"威吸寶敷料(滅菌)-自粘性*給付規定請見備註
欄。
225
WDD0810611F4 "ConvaTec"VERSIVA XC DRESSING(STERILE)-Adhesive
22CMX22CM"康威"威吸寶敷料(滅菌)-自粘性*給付規定請見備註
欄。
409
963
特材代碼 中英文名稱 支付點數-104/01/01
WDD0810612F4 "ConvaTec"VERSIVA XC DRESSING(STERILE)-Adhesive
18.5CMX20.5CM"康威"威吸寶敷料(滅菌)-自粘性*給付規定請見備
註欄。
364
WDD0810613F4 "ConvaTec"VERSIVA XC DRESSING(STERILE)-Adhesive
21CMX25CM"康威"威吸寶敷料(滅菌)-自粘性*給付規定請見備註
欄。
507
WDD0810614F4 "ConvaTec"VERSIVA XC DRESSING(STERILE)-Non Adhesive
20CMX20CM"康威"威吸寶敷料(滅菌)-非自粘性*給付規定請見備註
欄。
364
WDD0810615F4 "ConvaTec"VERSIVA XC DRESSING(STERILE)-Adhesive
19CMX19CM"康威"威吸寶敷料(滅菌)-自粘性*給付規定請見備註
欄。
364
WDD0811010F4 "CONVATEC"DUO DERM CGF CONTROL GEL FORMULA DRESSING
10X10CM親水性CGF敷料*適應症請見備註欄
119
WDD0812009F4 "CONVATEC" AQUACEL AG SURGICAL COVER DRESSING (STERILE) "
康威"愛康膚-銀手術覆蓋敷料(滅菌)
198
WDD0812010F4 "CONVATEC" AQUACEL AG SURGICAL COVER DRESSING (STERILE) "
康威"愛康膚-銀手術覆蓋敷料(滅菌)
224
WDD0812011F4 "CONVATEC" AQUACEL AG SURGICAL COVER DRESSING (STERILE) "
康威"愛康膚-銀手術覆蓋敷料(滅菌)
406
WDD0812012F4 "CONVATEC" AQUACEL AG SURGICAL COVER DRESSING (STERILE) "
康威"愛康膚-銀手術覆蓋敷料(滅菌)
459
WDD0812020F4 "CONVATEC"DUO DERM CGF CONTROL GEL FORMULA DRESSING
20X20CM親水性CGF敷料*適應症請見備註欄
395
WDD0812030F4 "CONVATEC"DUO DERM CGF CONTROL GEL FORMULA DRESSING
20X30CM親水性CGF敷料*適應症請見備註欄
689
WDD0815150YY "CORELEADER"ALGINATE FIBER WOUND
DRESSING(STERILE)15CMX15CM"康力得"藻酸鹽纖維傷口敷料(滅
菌)*適應症請見備註欄
167
WDD0815151YY "CORELEADER"HYDROCOLLOID DRESSING(STERILE)"康力得"親水性
敷料(滅菌)15CMX15CM*適應症請見備註欄
116
WDD081515TSN REPLICARE ULTRA 15X15CM※適應症請見備註欄 116
WDD0815183A5 KARAYAHESIVE HYDROCOLLOID WOUND DRESSING 113CM2,親水性敷
料*適應症請見備註欄
53.2
WDD081518TSN REPLICARE ULTRA 15X18CM※適應症請見備註欄 116
WDD0815192A5 KARAYAHESIVE HYDROCOLLOID WOUND DRESSING 100CM2,親水性敷
料*適應症請見備註欄
53.2
WDD081520AVH "HOBE" HYDROPHILIC WOUND DRESSING-
ALGINATE(STERILE)15CMX20CM"梓源"親水性傷口敷料*給付規定請
見備註欄
177
WDD0818752A5 "ALCARE"SI-AID SILICONE-FACED DRESSING(STERILE)10CMX10CM"
愛樂康"矽膠泡棉敷料(滅菌)親水性創傷覆蓋材
119
WDD0818753A5 "ALCARE"SI-AID SILICONE-FACED DRESSING(STERILE)10CMX20CM"
愛樂康"矽膠泡棉敷料(滅菌)親水性創傷覆蓋材
245
WDD082020TSN REPLICARE ULTRA 20X20CM※適應症請見備註欄 192
WDD0820619F4 “康威”愛康膚泡棉敷料 (滅菌):可黏性"CONVATEC" AQUACEL
FOAM HYDROFIBER DRESSING (STERILE)12.5 X 12.5cm
225
WDD0820621F4 "康威"愛康膚泡棉敷料(滅菌)可黏性"CONVATEC” AQUACEL FOAM
HYDROFIBER DRESSING (STERILE)17.5 X 17.5cm
364
WDD0820623F4 “康威”愛康膚泡棉敷料 (滅菌):可黏性“CONVATEC” AQUACEL
FOAM HYDROFIBER DRESSING (STERILE)21 X 21cm
409
964
特材代碼 中英文名稱 支付點數-104/01/01
WDD0820633F4 “康威”愛康膚泡棉敷料 (滅菌):非黏性“CONVATEC” AQUACEL
FOAM HYDROFIBER DRESSING (STERILE)10 X 10cm
119
WDD0820635F4 “康威”愛康膚泡棉敷料 (滅菌):非黏性“CONVATEC” AQUACEL
FOAM HYDROFIBER DRESSING (STERILE)15 X 15cm
243
WDD0820636F4 “康威”愛康膚泡棉敷料 (滅菌):非黏性“CONVATEC” AQUACEL
FOAM HYDROFIBER DRESSING (STERILE)20 X 20cm
364
WDD0820637F4 “康威”愛康膚泡棉敷料 (滅菌):非黏性“CONVATEC” AQUACEL
FOAM HYDROFIBER DRESSING (STERILE)15 X 20cm
326
WDD082100SBB "B.BRAUN"ASKINA SORB CALCIUM ALGINATE DRESSING(STERILE)
6CMX6CM雅膚藻酸鈣敷料*適應症請見備註欄
20.4
WDD082101SBB "B.BRAUN"ASKINA SORB CALCIUM ALGINATE DRESSING(STERILE)
10CMX10CM雅膚藻酸鈣敷料*適應症請見備註欄
112
WDD082102SBB "B.BRAUN"ASKINA SORB CALCIUM ALGINATE DRESSING(STERILE)
15CMX15CM雅膚藻酸鈣敷料*適應症請見備註欄
167
WDD082105SBB "B.BRAUN"ASKINA SORB CALCIUM ALGINATE DRESSING(STERILE)
2.7CMX34CM雅膚藻酸鈣敷料*適應症請見備註欄
61.7
WDD0831100CA COMFEEL PLUS ULCER DRESSING 10X10CM※適應症請見備註欄 119
WDD0831150CA COMFEEL PLUS ULCER DRESSING 15X15CM※適應症請見備註欄 245
WDD0831200CA COMFEEL PLUS ULCER DRESSING 20X20CM ※適應症請見備註欄 395
WDD0831460CA COMFEEL PLUS ULCER DRESSING 4X6CM※適應症請見備註欄 29.3
WDD0834210CA "COLOPLAST" BIATAIN FOAM DRESSING(STERILE)-ADHESIVE "康樂
保"平而坦泡綿敷料(滅菌)-黏性※適應症請見備註欄
243
WDD083488AYD "BCT"ANTIMICROBIAL DRESSING(STERILE)5CMX5CM"科云"抗菌敷料
(滅菌)*給付規定請見備註欄
56.4
WDD083488BYD "BCT"ANTIMICROBIAL DRESSING(STERILE)10CMX10CM"科云"抗菌敷
料(滅菌)*給付規定請見備註欄
224
WDD083488CYD "BCT"ANTIMICROBIAL DRESSING(STERILE)2.5CMX10CM"科云"抗菌
敷料(滅菌)*給付規定請見備註欄
56.4
WDD083488DYD "BCT"ANTIMICROBIAL DRESSING(STERILE)2.5CMX20CM"科云"抗菌
敷料(滅菌)*給付規定請見備註欄
198
WDD083488EYD "BCT"ANTIMICROBIAL DRESSING(STERILE)5CMX20CM"科云"抗菌敷
料(滅菌)*給付規定請見備註欄
224
WDD083488FYD "BCT"ANTIMICROBIAL DRESSING(STERILE)20CMX20CM"科云"抗菌敷
料(滅菌)*給付規定請見備註欄
612
WDD0835300CA COMFEEL PLUS TRANSPARENT DRESSING 5X7CM※適應症請見備註欄 26
WDD0835330CA COMFEEL PLUS TRANSPARENT DRESSING 10X10CM※適應症請見備註
欄
53.2
WDD0835361CA "COLOPLAST"COMFEEL PLUS DRESSINGS(STERILE)9CMX14CM"康樂
保"康惠爾親水性敷料(滅菌)*給付規定請見備註欄
55
WDD0835390CA COMFEEL PLUS TRANSPARENT DRESSING 15X15CM※適應症請見備註
欄
116
WDD0835421CA "COLOPLAST"COMFEEL PLUS DRESSINGS(STERILE)15CMX20CM"康樂
保"康惠爾親水性敷料(滅菌)*給付規定請見備註欄
145
WDD0835450CA COMFEEL PLUS TRANSPARENT DRESSING 20X20CM※適應症請見備註
欄
192
WDD0835481CA "COLOPLAST"COMFEEL PLUS DRESSINGS(STERILE)5CMX25CM"康樂
保"康惠爾親水性敷料(滅菌)*給付規定請見備註欄
55
WDD0837100CA "Coloplast" Biatain Alginate Dressing (Sterile)"康樂保"藻
膠敷料(滅菌) 10X10CM
119
WDD0837150CA "Coloplast" Biatain Alginate Dressing (Sterile)"康樂保"藻
膠敷料(滅菌) 15X15CM
245
WDD083736AYD "BCT"CALCIUM ALGINATE DRESSING(STERILE) 10CMX10CM"科云"藻
酸鈣敷料(滅菌)*給付規定請見備註欄
112
965
特材代碼 中英文名稱 支付點數-104/01/01
WDD0837400CA "Coloplast" Biatain Alginate Dressing (Sterile)"康樂保"藻
膠敷料(滅菌)3CMX44CM
118
WDD0839000CA COMFEEL PURILON GEL 15GM*適應症請見備註欄 140
WDD0839030CA COMFEEL PURILON GEL 25GM*適應症請見備註欄 276
WDD0841010BB "B.BRAUN"ASKINA FOAM WOUND DRESSING(STERILE)10CMX10CM雅膚
泡棉敷料*適應症請見備註欄
119
WDD0841210BB "B.BRAUN"ASKINA FOAM WOUND DRESSING(STERILE)0CMX20CM雅膚
泡棉敷料*適應症請見備註欄
245
WDD0842005BB "B.BRAUN"ASKINA FOAM WOUND DRESSING(STERILE)20CMX20CM雅
膚泡棉敷料*適應症請見備註欄
395
WDD0850557BB ASKINA THINSITE 5CMX20CM*適應症請見備註欄 53.2
WDD0856100LN MOLNLYCKE MELGISORB AG ANTIMICROBIAL ALGINATE DRESSING美
尼克美極收銀抗菌海藻鹽敷料10CMX10CM*適應症請見備註欄
224
WDD0856150LN MOLNLYCKE MELGISORB AG ANTIMICROBIAL ALGINATE DRESSING美
尼克美極收銀抗菌海藻鹽敷料15CMX15CM*適應症請見備註欄
406
WDD0856600LN MOLNLYCKE MELGISORB AG ANTIMICROBIAL ALGINATE DRESSING美
尼克美極收銀抗菌海藻鹽敷料3CMX44CM*適應症請見備註欄
224
WDD0860923P8 TENDERWET 7.5X7.5CM※適應症請見備註欄 73
WDD0860924P8 TENDERWET 10X10CM※適應症請見備註欄 119
WDD0862110BB "B.BRAUN"ASKINA CALGITROL AG"柏朗"雅膚凱奇樂藻酸銀敷料
10CMX10CM*適應症請見備註欄
224
WDD0862115BB "B.BRAUN"ASKINA CALGITROL AG雅膚凱奇樂藻酸銀敷料
15CMX15CM*適應症請見備註欄
406
WDD0862120BB "B.BRAUN"ASKINA CALGITROL AG"柏朗"雅膚凱奇樂藻酸銀敷料
20CMX20CM*適應症請見備註欄
612
WDD0868210F4 "ConvaTec"KALTOSTAT ALGINATE WOUND DRESSING(Sterile)
5X5CM"康威"藻酸鈣鈉鹽傷口敷料(滅菌)*給付規定請見備註欄。
20.4
WDD0868212F4 "ConvaTec"KALTOSTAT ALGINATE WOUND DRESSING(Sterile)
7.5X12CM"康威"藻酸鈣鈉鹽傷口敷料(滅菌)*給付規定請見備註
欄。
61.7
WDD0868214F4 "ConvaTec"KALTOSTAT ALGINATE WOUND DRESSING(Sterile)
10X20CM"康威"藻酸鈣鈉鹽傷口敷料(滅菌)*給付規定請見備註
欄。
125
WDD0868215F4 "ConvaTec"KALTOSTAT ALGINATE WOUND DRESSING(Sterile)
15X25CM"康威"藻酸鈣鈉鹽傷口敷料(滅菌)*給付規定請見備註
欄。
227
WDD0871500LN NORMLGEL 15GM*適應症請見備註欄 140
WDD0872041BB "B.BRAUN"ASKINA HYDRO 10CMX10CM雅膚親水膠敷料*適應症請見
備註欄
119
WDD0872045BB "B.BRAUN"ASKINA HYDRO 15CMX15CM雅膚親水膠敷料*適應症請見
備註欄
245
WDD0872047BB "B.BRAUN"ASKINA HYDRO 20CMX20CM雅膚親水膠敷料*適應症請見
備註欄
395
WDD0872050BB ASKINA BS,BP,BT 10X10CM,5X20CM ※適應症請見備註欄 119
WDD0872051BB ASKINA BS,BP,BT 15X15CM ※適應症請見備註欄 型號F72051、
F72015自93.1.1刪除
245
WDD0872052BB ASKINA BS,BT 20X20CM ※適應症請見備註欄 395
WDD0872789BB "B.BRAUN"ASKINA TRANSORBENT "柏朗"雅膚多聚泡棉敷料10X10CM
※適應症請見備註欄
119
WDD0872790BB "B.BRAUN"ASKINA TRANSORBENT"柏朗雅膚多聚泡綿敷料" 15X15CM
※適應症請見備註欄
245
WDD0872791BB ASKINA TRANSORBENT 20X20CM 柏朗雅膚多聚泡綿敷料※適應症請
見備註欄
395
966
特材代碼 中英文名稱 支付點數-104/01/01
WDD0877901F4 "ConvaTec"AQUACEL HYDROFIBER DRESSING(sterile)5cmx5cm"康
威"愛康膚親水性纖維敷料(滅菌)*給付規定請見備註欄。
29.3
WDD0877902F4 "ConvaTec"AQUACEL HYDROFIBER DRESSING(sterile)10cmx10cm"
康威"愛康膚親水性纖維敷料(滅菌)*給付規定請見備註欄。
119
WDD0877903F4 "ConvaTec"AQUACEL HYDROFIBER DRESSING(sterile)15cmx15cm"
康威"愛康膚親水性纖維敷料(滅菌)*給付規定請見備註欄。
245
WDD0884300LN "MOLNLYCKE"MEPILEX LITE SAFETAC ABSORBENT SOFT SILICONE
DRESSING 15X15CM "美尼克"美皮蕾薄型吸收軟性矽膠敷料 ※適
應症請見備註欄
243
WDD0887987F4 "CONVATEC"DUODERM HYDROACTIVE GEL(sterile) 30GM "康威"多
愛膚親水性凝膠(滅菌)*給付規定請見備註欄。
276
WDD0887990F4 "CONVATEC"DUODERM HYDROACTIVE GEL(sterile) 15GM "康威"多
愛膚親水性凝膠(滅菌)*給付規定請見備註欄。
140
WDD08900203M TEGASORB THIN HYDROCOLLOID DRESSING 5CMX10CM*適應症請見備
註欄
41.1
WDD08900223M HYDROCOLLOID DRESSING 10X10CM(薄) ※適應症請見備註欄 53.2
WDD08900273M 3M TEGASORB THIN HYDROCOLLOID DRESSING 15CMX15CM親水性敷
料*適應症請見備註欄
116
WDD08900283M 3M TEGASORB THIN HYDROCOLLOID DRESSING 20CMX20CM親水性敷
料*適應症請見備註欄
192
WDD08900333M TEGASORB THIN HYDROCOLLOID DRESSING 10CMX10CM *適應症請見
備註欄
53.2
WDD08900523M 3M TEGASORB THIN HYDROCOLLOID DRESSING 5CMX20CM*適應症請
見備註欄
53.2
WDD08901123M 3M TEGADERM HIGH INTEGRITY ALGINATE DRESSING(STERILE)海藻
酸鹽敷料10CMX10CM*適應症請見備註欄
112
WDD08902123M 3M TEGADERM HIGH GELLING ALGINATE DRESSING(STERILE)海藻酸
鹽敷料10CMX10CM*適應症請見備註欄
112
WDD0890510LN Mepitel 5cm x 7.5cm *適應症請見備註欄 65.9
WDD08906003M 3M HYDROPHILIC WOUND DRESSING親水性創傷覆蓋材(TEGADERM
FOAM 5CMX5CM)*適應症請見備註欄
29.3
WDD08906013M 3M HYDROPHILIC WOUND DRESSING親水性創傷覆蓋材(TEGADERM
FOAM 10CMX10CM)*適應症請見備註欄
119
WDD08906023M 3M HYDROPHILIC WOUND DRESSING親水性創傷覆蓋材(TEGADERM
FOAM 10CMX20CM)*適應症請見備註欄
245
WDD08906033M 3M HYDROPHILIC WOUND DRESSING親水性創傷覆蓋材(TEGADERM
FOAM 20CMX20CM)*適應症請見備註欄
395
WDD0890670P8 HYDROCOLL 10X10CM※適應症請見備註欄 119
WDD0890672P8 HYDROCOLL 15X15CM※適應症請見備註欄 245
WDD0890674P8 HYDROCOLL 20X20CM※適應症請見備註欄 395
WDD0890685P8 HYDROCOLL TRANSPARENT 10X10CM(薄)※適應症請見備註欄 53.2
WDD0890710LN Mepitel 7.5cm x10cm*適應症請見備註欄 98
WDD0891010LN MEPITEL 10cm x18cm*適應症請見備註欄(型號更正為291010) 185
WDD0892005LN Mepitel 20cm x30cm*適應症請見備註欄 619
WDD0894100LN MEPILEX STERILE 10CMX10CM※適應症請見備註欄 119
WDD0894200LN MEPILEX STERILE 10CMX20CM※適應症請見備註欄 225
WDD0894300LN MEPILEX STERILE 15CMX15CM※適應症請見備註欄 243
WDD0894400LN MEPILEX STERILE 20CMX20CM※適應症請見備註欄 364
WDD0895200LN MEPILEX BORDER SAFETAC SILICON FOAM DRESSING 7.5X7.5CM*適
應症請見備註欄
68
WDD0895300LN MEPILEX BORDER SAFETAC SILICON FOAM DRESSING 10X10CM*適應
症請見備註欄
119
967
特材代碼 中英文名稱 支付點數-104/01/01
WDD0895400LN MEPILEX BORDER SAFETAC SILICON FOAM DRESSING 15X15CM*適應
症請見備註欄
243
WDD0895600LN MEPILEX BORDER SAFETAC SELF-ADHERENT SOFT SILICONE FOAM
DRESSING 15CMX20CM*適應症請見備註欄
326
WDD0897121LN "MOLNLYCKE"MEPILEX AG ANTIMICROBIAL SOFT SILICONE FOAM
DRESSING美皮蕾銀抗菌軟性矽膠泡棉敷料12.5CM*12.5CM*適應症
請見備註欄
317
WDD0897321LN "MOLNLYCKE"MEPILEX AG ANTIMICROBIAL SOFT SILICONE FOAM
DRESSING美皮蕾銀抗菌軟性矽膠泡棉敷料17.5CM*17.5CM*適應症
請見備註欄
559
WDD0897510LN "MOLNLYCKE"MEPILEX AG ANTIMICROBIAL SOFT SILICONE FOAM
DRESSING美皮蕾銀抗菌軟性矽膠泡棉敷料20CM*50CM*適應症請見
備註欄
1040
WDD0899570HN "HARTMANN"ATRAUMAN AG SILVER DRESSING(5X5CM)含銀軟膏膚料*
適應證請見備註欄
56.4
WDD0899571HN "HARTMANN"ATRAUMAN AG SILVER DRESSING(10X10CM)含銀軟膏膚
料*適應證請見備註欄
224
WDD0899572HN "HARTMANN"ATRAUMAN AG SILVER DRESSING(10X20CM)含銀軟膏膚
料*適應證請見備註欄
406
WDD0899581P8 "HARTMANN"HYDROPHILIC WOUND
DRESSING(THIN)(STERILE)HYDROTUL 5X5CM親水性創傷覆蓋材*適
應症請見備註欄
26
WDD0899583P8 "HARTMANN"HYDROPHILIC WOUND
DRESSING(THIN)(STERILE)HYDROTUL 10X12CM親水性創傷覆蓋材*
適應症請見備註欄
53.2
WDD0899584P8 "HARTMANN"HYDROPHILIC WOUND
DRESSING(THIN)(STERILE)HYDROTUL 15X20CM親水性創傷覆蓋材*
適應症請見備註欄
145
WDD0899595P8 SORBALGON 10X10CM※適應症請見備註欄 119
WDD0899598P8 SORBALGON 5X5CM※適應症請見備註欄 29.3
WDD08A0112ZW SAVDERM ALGINATE DRESSING 舒膚貼藻酸鈣鹽敷料(5.5CMX8.5CM) 41.8
WDD08A0202ZW SAVDERM ALGINATE DRESSING 舒膚貼藻酸鈣鹽敷料(10CMX10CM) 112
WDD08A0520SN "SMITH&NEPHEW"ALGISITE M CALCIUM ALGINATE DRESSING"史耐
輝"海藻酸鈣敷料10X10CM*適應症請見備註欄
112
WDD08A0521SN "SMITH&NEPHEW"ALGISITE M CALCIUM ALGINATE DRESSING"史耐
輝"海藻酸鈣敷料15X20CM*適應症請見備註欄
177
WDD08A0522SN "SMITH&NEPHEW"ALGISITE M CALCIUM ALGINATE DRESSING"史耐
輝"海藻酸鈣敷料2X30CM*適應症請見備註欄
41.8
WDD08A1111QY "SYSTAGENIX"ACTISORB PLUS 25 ACTIVATED CHARCOAL DRESSING
WITH SILVER(STERILE)10.5CMX10.5CM"新世捷"愛克臭活性碳銀敷
料*給付規定請見備註。
224
WDD08A1911QY "SYSTAGENIX"ACTISORB PLUS 25 ACTIVATED CHARCOAL DRESSING
WITH SILVER(STERILE)19CMX10.5CM"新世捷"愛克臭活性碳銀敷料
*給付規定請見備註。
320
WDD08A6595QY "SYSTAGENIX"ACTISORB PLUS 25 ACTIVATED CHARCOAL DRESSING
WITH SILVER(STERILE)6.5CMX9.5CM"新世捷"愛克臭活性碳銀敷料
(滅菌)*給付規定請見備註。
198
WDD08B0110ZW "SAVDERM"BIOCELLULOSE FILM (6CMX6CM)"舒膚貼"生物合成纖維
膜*適應症請見備註欄
108
WDD08B0211ZW "SAVDERM"BIOCELLULOSE FILM (10CMX8CM) "舒膚貼"生物合成纖
維膜 *適應症請見備註欄
275
WDD08B0308ZW "SAVDERM"BIOCELLULOSE FILM (16CMX10CM)"舒膚貼" 生物合成纖
維膜 *適應症請見備註欄
438
968
特材代碼 中英文名稱 支付點數-104/01/01
WDD08B0409ZW "SAVDERM"BIOCELLULOSE FILM (21CMX16CM)"舒膚貼"生物合成纖
維膜*適應症請見備註欄
791
WDD08C0113ZW SAVDERM HYDROGEL(STERILE)30G 舒膚貼清創修護凝膠(滅菌)*適
應症請見備註欄
276
WDD08C0220ZW SAVDERM HYDROGEL(STERILE)25GM舒膚貼清創修護凝膠(滅菌)*適
應症請見備註欄
276
WDD08C0502ZW 舒膚貼抗菌親水性敷料(滅菌)SAVDERM ANTISEPTIC
HYDROCOLLOIDS THIN DRESSING (STERILE)10CMX10CM*給付規定請
見備註欄
224
WDD08C0506SN "SMITH&NEPHEW"CUTINOVA HYDRO DRESSING新世代人工皮膚
5CMX6CM*適應症請見備註欄
29.3
WDD08C1010QA SIFOTEC HYDROCOLLOID DRESSING (STERILE) "和豐"親水性敷料
(滅菌) 10CMX10CM
53.2
WDD08C1010SN "SMITH&NEPHEW"CUTINOVA HYDRO DRESSING 10X10CM*適應症請見
備註欄
119
WDD08C1515QA SIFOTEC HYDROCOLLOID DRESSING (STERILE) "和豐"親水性敷料
(滅菌) 15CMX15CM
116
WDD08C1520SN "SMITH&NEPHEW"CUTINOVA HYDRO DRESSING 15X20CM*適應症請見
備註欄
327
WDD08D0245SN "SMITH&NEPHEW"DURAFIBER GELLING FIBER
DRESSING(STERILE)2CMX45CM"史耐輝"愛爾膚纖維敷料(滅菌)*給
付規定請見備註欄
119
WDD08D0410SN "SMITH&NEPHEW"DURAFIBER GELLING FIBER
DRESSING(STERILE)4CMX10CM"史耐輝"愛爾膚纖維敷料(滅菌)*給
付規定請見備註欄
73
WDD08D0420SN "SMITH&NEPHEW"DURAFIBER GELLING FIBER
DRESSING(STERILE)4CMX20CM"史耐輝"愛爾膚纖維敷料(滅菌)*給
付規定請見備註欄
83.8
WDD08D0430SN "SMITH&NEPHEW"DURAFIBER GELLING FIBER
DRESSING(STERILE)4CMX30CM"史耐輝"愛爾膚纖維敷料(滅菌)*給
付規定請見備註欄
143
WDD08D0505SN "SMITH&NEPHEW"DURAFIBER GELLING FIBER
DRESSING(STERILE)5CMX5CM"史耐輝"愛爾膚纖維敷料(滅菌)*給付
規定請見備註欄
29.3
WDD08D1010SN "SMITH&NEPHEW"DURAFIBER GELLING FIBER
DRESSING(STERILE)10CMX10CM"史耐輝"愛爾膚纖維敷料(滅菌)*給
付規定請見備註欄
119
WDD08D1515SN "SMITH&NEPHEW"DURAFIBER GELLING FIBER
DRESSING(STERILE)15CMX15CM"史耐輝"愛爾膚纖維敷料(滅菌)*給
付規定請見備註欄
245
WDD08E1405K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND
DRESSING(STERILE)(STANDARD)10X10CM"優而美"舒肌親水性傷口
敷料*適應症請健備註欄
119
WDD08E1407K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND
DRESSING(STERILE)(STANDARD)20X20CM"優而美"舒肌親水性傷口
敷料*適應症請健備註欄
395
WDD08E1416K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND
DRESSING(STERILE)(STANDARD)15X15CM"優而美"舒肌親水性傷口
敷料*適應症請健備註欄
245
WDD08E2405K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND
DRESSING(STERILE)(BORDER)10X10CM"優而美"舒肌親水性傷口敷
料*適應症請健備註欄
119
969
特材代碼 中英文名稱 支付點數-104/01/01
WDD08E2407K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND
DRESSING(STERILE)(BORDER)20X20CM"優而美"舒肌親水性傷口敷
料*適應症請健備註欄
395
WDD08E2412K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND
DRESSING(STERILE)(BORDER-SACRAL)15X18CM"優而美"舒肌親水性
傷口敷料*適應症請健備註欄
327
WDD08E2416K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND
DRESSING(STERILE)(BORDER)15X15CM"優而美"舒肌親水性傷口敷
料*適應症請健備註欄
245
WDD08E2432K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND
DRESSING(STERILE)(BORDER-SACRAL LARGE BUTTERFLY)15X18CM"
優而美"舒肌親水性傷口敷料*適應症請健備註欄
327
WDD08E3205K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND
DRESSING(STERILE)(THIN)10X10CM"優而美"舒肌親水性傷口敷料*
適應症請健備註欄
53.2
WDD08E3216K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND
DRESSING(STERILE)(THIN)15X15CM"優而美"舒肌親水性傷口敷料*
適應症請健備註欄
116
WDD08E3515K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND
DRESSING(STERILE)(THIN)5X15CM"優而美"舒肌親水性傷口敷料*
適應症請健備註欄
41.1
WDD08F0102ZW "SAVDERM"FOAM DRESSING (STERILE)10X10CM泡棉敷料*適應症請
見備註欄
119
WDD08F0203ZW "SAVDERM"FOAM DRESSING(STERILE)10CM*20CM泡棉敷料(滅菌)*適
應症請見備註欄
245
WDD08F0301ZW "SAVDERM"FOAM DRESSING(STERILE)(5CMX5CM)泡棉敷料(滅菌)*適
應症請見備註欄
29.3
WDD08G0101ZW SAVDERM ANTISEPTIC AG FOAM DRESSING 5X5CM 舒膚貼抗菌含銀
泡棉敷料 *適應症請見備註欄
55.3
WDD08G0202ZW SAVDERM ANTISEPTIC AG FOAM DRESSING 10X10CM 舒膚貼抗菌含
銀泡棉敷料 *適應症請見備註欄
184
WDD08H0102ZW SAVDERM HYDROCOLLOIDS THIN DRESSING(STERILE)10X10CM親水性
敷料(滅菌)*適應症請見備註欄
53.2
WDD08H0206ZW SAVDERM HYDROCOLLOIDS THIN DRESSING(STERILE)15X15CM親水性
敷料(滅菌)*適應症請見備註欄
116
WDD08H0307ZW SAVDERM HYDROCOLLOIDS THIN DRESSING(STERILE)5X20CM親水性
敷料(滅菌)*適應症請見備註欄
53.2
WDD08HDGE12H 赫麗敷清創凝膠(滅菌) HERADERM GEL (STERILE)40GM 276
WDD08NG415QY "SYSTAGENIX"NU-GEL HYDROGEL WITH ALGINATE(STERILE)15G"新
世捷"紐潔海藻水凝膠*給付規定請見備註。
140
WDD08NG425QY "SYSTAGENIX"NU-GEL HYDROGEL WITH ALGINATE(STERILE)25G"新
世捷"紐潔海藻水凝膠*給付規定請見備註。
276
WDD08P9595QY "SYSTAGENIX"TIELLE PACKING HYDROPOLYMER DRESSING
(STERILE)9.5CMX9.5CM"新世捷"德力填塞型親水性敷料*給付規定
請見備註。
119
WDD08S2405K6 "EUROMED INC"SURESKIN SLIVER HYDROCOLLOID DRESSING
10CMX10CM(BORDER)"優而美"舒肌親水性含銀離子傷口敷料(滅
菌)(固定型)*適應症請見備註欄
224
WDD08S2407K6 "EUROMED INC"SURESKIN SLIVER HYDROCOLLOID DRESSING
20CMX20CM(BORDER)"優而美"舒肌親水性含銀離子傷口敷料(滅
菌)(固定型)*適應症請見備註欄
612
970
特材代碼 中英文名稱 支付點數-104/01/01
WDD08S2416K6 "EUROMED INC"SURESKIN SLIVER HYDROCOLLOID DRESSING
15CMX15CM(BORDER)"優而美"舒肌親水性含銀離子傷口敷料(滅
菌)(固定型)*適應症請見備註欄
406
WDD08T0510RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創
傷敷料(滅菌)5X10CM*(薄型)*適應症請見備註欄
41.1
WDD08T0520RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創
傷敷料(滅菌)5X20CM*(薄型)*適應症請見備註欄
53.2
WDD08T0709QY "SYSTAGENIX"TIELLE HYDROPOLYMER ADHESIVE DRESSING
(STERILE)7CMX9CM"新世捷"德力自黏親水性敷料*給付規定請見備
註。
73
WDD08T1010RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創
傷敷料(滅菌)10X10CM*(薄型)*適應症請見備註欄
53.2
WDD08T1111QY "SYSTAGENIX"TIELLE HYDROPOLYMER ADHESIVE DRESSING
(STERILE)11CMX11CM"新世捷"德力自黏親水性敷料*給付規定請見
備註。
143
WDD08T1515QY "SYSTAGENIX"TIELLE HYDROPOLYMER ADHESIVE DRESSING
(STERILE)15CMX15CM"新世捷"德力自黏親水性敷料*給付規定請見
備註。
245
WDD08T1515RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創
傷敷料(滅菌)15X15CM*(薄型)*適應症請見備註欄
116
WDD08T1520QY "SYSTAGENIX"TIELLE HYDROPOLYMER ADHESIVE DRESSING
(STERILE)15CMX20CM"新世捷"德力自黏親水性敷料*給付規定請見
備註。
327
WDD08T2020RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創
傷敷料(滅菌)20X20CM*(薄型)*適應症請見備註欄
192
WDD08W0505RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創
傷敷料(滅菌)5X5CM*適應症請見備註欄
29.3
WDD08W1010RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創
傷敷料(滅菌)10X10CM*適應症請見備註欄
119
WDD08W1020RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創
傷敷料(滅菌)10X20CM*適應症請見備註欄
245
WDD08W2020RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創
傷敷料(滅菌)20X20CM*適應症請見備註欄
395
WDD08X1111QY "SYSTAGENIX"TIELLE XTRA NON-ADHESIVE HYDROPOLYMER
DRESSING (STERILE)11CMX11CM"新世捷"德力裁剪型不自黏親水性
敷料*給付規定請見備註。
143
WDD08X1515QY "SYSTAGENIX"TIELLE XTRA NON-ADHESIVE HYDROPOLYMER
DRESSING (STERILE)15CMX15CM"新世捷"德力裁剪型不自黏親水性
敷料*給付規定請見備註。
245
WDD08X1520SY "SYSTAGENIX" TIELLE XTRA NON-ADHESIVE HYDROPOLYMER
DRESSING (STERILE) 15X20CM "新世捷"德力裁剪型不自粘親水性
敷料 ※適應症請見備註欄
327
WDD08Y0101ZW SAVDERM AQUAFABRIC DRESSING(STERILE)5X5公分舒膚貼親水性纖
維敷料(滅菌)*給付規定請見備註欄。
29.3
WDD08Y0202ZW SAVDERM AQUAFABRIC DRESSING(STERILE)10X10公分舒膚貼親水性
纖維敷料(滅菌)*給付規定請見備註欄。
119
WDD08Y0362ZW SAVDERM AQUAFABRIC DRESSING(STERILE)15X15公分舒膚貼親水性
纖維敷料(滅菌)*給付規定請見備註欄。
245
WDD08Y0463ZW SAVDERM AQUAFABRIC DRESSING(STERILE)2X45公分舒膚貼親水性
纖維敷料(滅菌)*給付規定請見備註欄。
119
ACM012P200NL "娜維利斯特"娜米克血管造影多路水接頭"NAVILYST"NAMIC
ANGIOGRAPHIC MANIFOLDS(2-PORT)
184
ACM014P200NL "娜維利斯特"娜米克血管造影多路水接頭"NAVILYST"NAMIC
ANGIOGRAPHIC MANIFOLDS(4-PORT)
261
971
特材代碼 中英文名稱 支付點數-104/01/01
ACM01MAN2NBQ "邦特"多管道引流器 184
ACM01MAN3NBQ "邦特"多管道引流器"BIOTEQ"MANIFOLDS 211
ACM01MAN4NBQ "邦特"多管道引流器"BIOTEQ"MANIFOLDS 261
BBF03E1002M6 宇仁餵食引導器 (未滅菌)-PUMP SET 餵食袋IMM FEEDING TUBE
ACCESSORIES(NON-STERILE)
110
BBP0408531HL "鶴牌"造口術用袋及其附件 (未滅菌)-單片黏捲式便
袋"HOLLISTER"OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-
PREMIER DRAINABLE POUCH
51.5
BBP0411210LK 福立克”可樂適造口術用袋及其附件(未滅菌)-單片式便袋13-
64MM(含人工皮、不織布)“FLEXICARE”COLOSET OSTOMY BAG AND
ACCESSORIES (NON-STERILE) –1 PCS
51.5
BBP0418012HL "鶴牌"造口術用袋及其附件 (未滅菌)-新象高流量便
袋"HOLLISTER" OSTOMY POUCH AND ACCESSORIES(NON-STERILE)-
NEW IMAGE HIGH OUTPUT ULTRA CLEAR DRAINABLE
37.1
BBP0418016HL "鶴牌"造口術用袋及其附件 (未滅菌)-新象高流量便
袋"HOLLISTER" OSTOMY POUCH AND ACCESSORIES (NON-STERILE)
-NEW IMAGE HIGH OUTPUT ULTRA CLEAR DRAINAB
42.3
BBP0418192HL "鶴牌"造口術用袋及其附件 (未滅菌)-新象便袋附除臭
片"HOLLISTER" OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-
NEW IMAGE LOCK’N ROLL DRAINABLE POUCH,
37.1
BBP0426064HL "鶴牌"造口術用袋及其附件 (未滅菌)-單片式便袋附除臭片(含人
工皮) "HOLLISTER" OSTOMY POUCH AND ACCESSORIES (NON-
STERILE)-ONE PIECE HIGH OUTPUT WITH
51.5
BBP042D7382Q 威樂造口術用袋及其附件(未滅菌)-穩立優雙片式便袋
38/45/60/70MM "WELLAND" OSTOMY POUCH AND ACCESSORIES
(NON-STERILE)-VALORE
37.1
BBP04TD7132Q 威樂造口術用袋及其附件(未滅菌)-穩立優便袋13-70MM
"WELLAND" OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-
VALORE DRAINABLE POUCH 13-70MM
51.5
BBU0108460HL "鶴牌"造口術用袋及其附件 (未滅菌)-單片人工皮附紙膠型尿
袋"HOLLISTER"OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-
PREMIER UROSTOMY POUCH
90.1
BBU012U7382Q 威樂造口術用袋及其附件(未滅菌)-穩立優雙片式尿造口袋
38/45/60/70MM "WELLAND" OSTOMY POUCH AND ACCESSORIES
(NON-STERILE)-VALORE UROSTOMY 2-PIECE POU
77
BBU01TU7132Q 威樂造口術用袋及其附件(未滅菌)-穩立優尿造口袋13-70MM
"WELLAND" OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-
VALORE UROSTOMY POUCH 13-70MM
90.1
BBW01LU500BQ "邦特"導入/引流導管附件(滅菌):引流袋 BIOTEQ
INTRODUCER/DRAINAGE CATHETER ACCESSORIES : DRAINAGE BAG
34
BBW01LU800BQ "邦特"導入/引流導管附件(滅菌):腎臟造口引流袋 BIOTEQ
INTRODUCER/DRAINAGE CATHETER ACCESSORIES(STERILE): PCN
DRAINAGE BAG
34
BBW01UB121BQ "邦特"導入/引流導管附件(滅菌):引流袋 BIOTEQ
INTRODUCER/DRAINAGE CATHETER ACCESSORIES : DRAINAGE BAG
34
BBW01UB201BQ "邦特"導入/引流導管附件(滅菌):引流袋 BIOTEQ
INTRODUCER/DRAINAGE CATHETER ACCESSORIES : DRAINAGE BAG
34
CAE01ANE153B "康德萊"一次性使用麻醉針-硬膜外穿刺針"KDL"DISPOSABLE
SPINAL NEEDLE
110
CBB0122064SB "波士頓科技"艾瑟羅血管氣球擴張導管"BOSTON SCIENTIFIC"XXL
VASCULAR BALLOON DILATATION CATHETER
5398
CBB01BTM03QC "清流"班特經皮穿刺血管成形術導管"CLEARSTREAM"BANTAM
PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY(PTA)CATHETER 280MM
11140
972
特材代碼 中英文名稱 支付點數-104/01/01
CBB01CH458XW "朗迪"可樂士高壓氣球導管"RONTIS"CRONUS HP PTA BALLOON
CATHETER
5398
CBB01PAS35BK "百多力"帕希爾18周邊血管氣球擴張導管"BIOTRONIK"PASSEO-18
PTA BALLOON CATHETER
5398
CBB01PAS36BK "百多力"帕希爾18周邊血管氣球擴張導管"BIOTRONIK"PASSEO-18
PTA BALLOON CATHETER 120:200MM
11140
CBB01PAS38BK "百多力"帕希爾35周邊血管氣球擴張導管"BIOTRONIK"PASSEO-
35,PTA BALLOON CATHETER
5398
CBB01PTA16EY 瑞提快速交換血管擴張氣球導管"EV3"RAPIDCROSS PTA RAPID
EXCHANGE BALLOON DILATATION CATHETER
5398
CBB01RFLX1QC "清流"銳弗斯經皮穿刺血管成形術導管"CLEARSTREAM"REEFLEX
PTA CATHETER L40:80MM
5398
CBB01RKRS1QC "CLEARSTREAM"REEKROSS PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY(PTA)CATHETER"清流"銳克斯經皮穿刺血管成形術導
管
5398
CBB01VTR14AB "亞培"懷維克周邊血管擴張導管"ABBOTT"VIATRAC 14 PLUS
PERIPHERAL DILATATION CATHETER
5398
CBB0342510CD "考迪斯"速立刻擴張導管"CORDIS"SLEEK PERCUTANEOUS
TRANSLUMINAL ANGIOPLASTY (PTA) CATHETER D2:4MM L40:100MM
8455
CBB0342522CD "考迪斯"速立刻擴張導管"CORDIS"SLEEK PERCUTANEOUS
TRANSLUMINAL ANGIOPLASTY (PTA) CATHETER D2:4MM L120:220MM
11140
CBB0342610CD "考迪斯"速立刻擴張導管"CORDIS"SLEEK OTW PERCUTANEOUS
TRANSLUMINAL ANGIOPLASTY (PTA) CATHETER L15:100MM
8455
CBB0342628CD "考迪斯"速立刻擴張導管"CORDIS"SLEEK OTW PERCUTANEOUS
TRANSLUMINAL ANGIOPLASTY (PTA) CATHETER L120:280MM
11140
CBB0343622CD "考迪斯"沙維長型PTA擴張導管"CORDIS"SAVVY LONG
PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY (PTA) CATHETER
D2:6MM L120:220MM
11140
CBB03LPAC1QC "清流"萊特派經皮穿刺血管成形術導管"CLEARSTREAM"LITEPAC
PTA CATHETER L15-100MM
8455
CBB03LPAC2QC "清流"萊特派經皮穿刺血管成形術導管"CLEARSTREAM"LITEPAC
PTA CATHETER L120-220MM
11140
CBB03PAS23BK "百多力"帕希爾35周邊血管氣球擴張導管"BIOTRONIK"PASSEO-
35,PTA BALLOON CATHETER 120:200MM
11140
CBB03PTA16EY 瑞提快速交換血管擴張氣球導管"EV3"RAPIDCROSS PTA RAPID
EXCHANGE BALLOON DILATATION CATHETER 氣球長度150:210MM
11140
CBB03PTA31CK "曲克"艾德凡絲麥可小剖面經皮穿刺血管成形術球曩擴張導
管"COOK"ADVANCED MICRO 14 ULTRA LOW PROFILE PTA BALLOON
CATHETER 2:10CM
8455
CBB03PTA32CK "曲克"艾德凡絲麥可小剖面經皮穿刺血管成形術球曩擴張導
管"COOK"ADVANCED MICRO 14 ULTRA LOW PROFILE PTA BALLOON
CATHETER 12CM
11140
CBB03RFLX2QC "清流"銳弗斯經皮穿刺血管成形術導管"CLEARSTREAM"REEFLEX
PTA CATHETER L120:220MM
11140
CBB03RKRS2QC "CLEARSTREAM"REEKROSS PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY(PTA)CATHETER L:40:80MM"清流"銳克斯經皮穿刺血
管成形術導管
8455
CBB03RKRS3QC "CLEARSTREAM"REEKROSS PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY(PTA)CATHETER L:120:220MM"清流"銳克斯經皮穿刺
血管成形術導管
11140
CBB03SAB02CD "考迪斯"沙博擴張導管"CORDIS"SABER OTW PERCUTANEOUS
TRANSLUMINAL ANGIOPLASTY(PTA)DILATATION CATHETER 2:10CM
8455
973
特材代碼 中英文名稱 支付點數-104/01/01
CBB03SAB15CD "考迪斯"沙博擴張導管"CORDIS"SABER OTW PERCUTANEOUS
TRANSLUMINAL ANGIOPLASTY(PTA)DILATATION CATHETER 15:30CM
11140
CBC01XACTCAB "亞培"確位頸動脈支架系統"ABBOTT"XACT CAROTID STENT SYSTEM 28608
CBC0210126AB "亞培"歐密林精英球囊擴張血管支架"ABBOTT"OMNILINK ELITE
VASCULAR BALLOON-EXPANDABLE STENT SYSTEM
27129
CBC021L1ACM4 "美敦力"康博立血管自膨式支架系統(腸股動脈血管支
架)"MEDTRONIC"COMPLETE SE VASCULAR STENT SYSTEM
27129
CBC02V1EL6AN "ANGIOMED"BARD LIFESTAR VASCULAR STENT SYSTEM"安吉美爾德"
巴德萊弗使達血管支架系統(腸骨血管支架)-輸送系統長135CM
27129
CBC02V1ES6AN "ANGIOMED"BARD LIFESTAR VASCULAR STENT SYSTEM"安吉美爾德"
巴德萊弗使達血管支架系統(腸骨血管支架)-輸送系統長80CM
27129
CBC04APL12AB "亞培"雅速博長型周邊血管自張支架系統(淺股動脈血管支
架)"ABBOTT"ABSOLUTE PRO LL PERIPHERAL SELF-EXPANDING
STENT SYSTEM L120MM
28773
CBC04APL15AB "亞培"雅速博長型周邊血管自張支架系統(淺股動脈血管支
架)"ABBOTT"ABSOLUTE PRO LL PERIPHERAL SELF-EXPANDING
STENT SYSTEM L150MM
44293
CBC04M1SG1TM "泰爾茂"彌薩爾周邊血管支架(淺股動脈血管支
架)"TERUMO"MISAGO SELF-EXPANDING PERIPHERAL STENT
L40:120MM
28773
CBC04M1SG2TM "泰爾茂"彌薩爾周邊血管支架(淺股動脈血管支
架)"TERUMO"MISAGO SELF-EXPANDING PERIPHERAL STENT L150MM
44293
CBC04PR200EY 愛爾飛絲自動擴張周邊血管支架系統"EV3"EVERFLEX SELF-
EXPANDING PERIPHERAL STENT SYSTEM 150:200MM
44293
CBC04PRB20EY 愛爾飛絲自動擴張周邊血管支架系統"EV3"EVERFLEX SELF-
EXPANDING PERIPHERAL STENT SYSTEM 20:120MM
28773
CBC04SFALLM4 "MEDTRONIC"COMPLETE SE VASCULAR STENT SYSTEM"美敦力"康博
立血管自膨式支架系統(淺股動脈血管支架)L150MM
44293
CBC04SFASLM4 "MEDTRONIC"COMPLETE SE VASCULAR STENT SYSTEM"美敦力"康博
立血管自膨式支架系統(淺股動脈血管支架)L20:120MM
28773
CBC06PBLUECD "考迪斯"帕瑪藍周邊血管支架系統(腎動脈支架及輸送系
統)"CORDIS"PALMAZ BLUE .014 PERIPHERAL STENT SYSTEM
31063
CBP01HPERBYC "樂普"琥珀經皮穿刺冠狀動脈球囊導管"LEPU"HOPER PTCA
BALLOON DILATATION CATHETER
6843
CBP01MZXXXQR "渼瑞爾"莫利克冠狀動脈氣球擴張導管"MERIL"MOZEC RX PTCA
BALLOON DILATATION CATHETER
6843
CBP03ERUNCXW "朗迪"優霸恩喜冠狀動脈氣球導管"RONTIS"EUROPA ULTRA NC
PTCA BALLOON CATHETER
7547
CBP06ELUT1QR "MERIL"BIOMIME SIROLIMUS ELUTING CORONARY STENT SYSTEM"渼
瑞爾"拜歐邁冠狀動脈塗藥支架系統(自付差額品項)
16293
CBP06ELUT5AB "ABBOTT"XIENCE XPEDITION 48 EVEROLIMUS ELUTING CORONARY
STENT SYSTEM"亞培"賽恩斯征長型艾諾莉茉斯冠狀動脈塗藥支架
系統(自付差額品項)
16293
CBP06ELUT7SB "波士頓科技"博謨適帕米爾艾諾莉茉斯冠狀動脈塗藥支架系統 ※
自付差額品項,超過部分由病患自付"BOSTON SCIENTIFIC"PROMUS
PREMIER EVEROLIMUS-ELUTING COR
16293
CBP07D1DEBEQ "優洛可"笛沃心臟經皮冠狀動脈氣球擴張導管"EUROCOR"DIOR
PACLITAXEL ELUTING PTCA BALLOON CATHETER
47000
974
特材代碼 中英文名稱 支付點數-104/01/01
CBS04D1400WE "百歐森偉伯司特" 摩比卡斯心房中膈穿刺針"BIOSENSE WEBSTER"
MOBICATH TRANSSEPTAL NEEDLE
6379
CBS06MUSP1G6 "銨積維"安普拉茲梗塞後肌肉性心室中膈缺損關閉器"AGA"
AMPLATZER MUSCULAR VSD PI OCCLUDER 16:24MM
121679
CCC1304260R5 "索倫"卓越自體輸血套組(含儲血槽+血液收集套組)"SORIN"XTRA
AUTOTRANSFUSION DISPOSABLE SET
3900
CCC1404250R5 "索倫"卓越自體輸血套組(含離心缽+血液回輸袋+廢液袋及預接管
路)"SORIN"XTRA AUTOTRANSFUSION DISPOSABLE SET 55:225ML
BOWL
7260
CDD0246398GJ "吉生"體外循環管組-心臟內抽吸器"JSM"HEART LUNG PACK-
INTRACARDIAC SUCKER
398
CDD110506AL7 "大吉士"穿刺套管"LAGIS" TROCAR(內管*1+外管*1+轉接頭*1) 1459
CDD110506BL7 "大吉士"穿刺套管"LAGIS" TROCAR(內管*1+外管*1+轉接頭*1) 1459
CDD110506CL7 "大吉士"穿刺套管"LAGIS" TROCAR(內管*1+外管*2+轉接頭*2) 1509
CDD110506DL7 "大吉士"穿刺套管"LAGIS" TROCAR(內管*1+外管*2+轉接頭*2) 1509
CDD110506EL7 "大吉士"穿刺套管"LAGIS" TROCAR(內管*1+外管*1+轉接頭*1) 1459
CDD110506FL7 "大吉士"穿刺套管"LAGIS" TROCAR(內管*1+外管*1+轉接頭*1) 1459
CDD110506GL7 "大吉士"穿刺套管"LAGIS" TROCAR(內管*1+外管*2+轉接頭*2) 1509
CDD110506HL7 "大吉士"穿刺套管"LAGIS" TROCAR(內管*1+外管*2+轉接頭*2) 1509
CDD11091PF2C "柯惠"可變徑式V型安全穿刺套管 "COVIDIEN" VERSAPORT PLUS
AUTOSUTURE V2 W/FIXATION CANNULA 5-11~12MM (外管+可變轉接
頭)
955
CDD11096PF2C "柯惠"可變徑式V型安全穿刺套管 "COVIDIEN"VERSAPORT PLUS
AUTOSUTURE V2 W/FIXATION CANNULA 5-12MM (穿刺內管+外管+可
變轉接頭)
1459
CDD111112AL7 "大吉士"穿刺套管"LAGIS" TROCAR(內管*1+外管*1+轉接頭*1) 1459
CDD111112BL7 "大吉士"穿刺套管"LAGIS" TROCAR(內管*1+外管*2+轉接頭*2) 1509
CDD114216U2C "柯惠"可充氣穿刺套管"COVIDIEN" AUTO SUTURE THREADED
TROCAR SLEEVES WITH WOODFORD SPIKE TROCAR AND INSUFFATION
PORT(穿剌針1+外管2+固定轉接頭2)
1509
CDD116626P2C "柯惠"開放性腹腔鏡手術用之一次性穿刺器"COVIDIEN"BLUNTPORT
PLUS AUTO SUTURE 5-12MM (穿刺針1+外管1+可變式轉接頭1+袋口
結固定器+螺紋固定器)
2233
CDD117092D2C ”柯惠”安全穿刺套管組 "COVIDIEN" AUTO SUTURE VERSAPORT
PLUS RPF TROCAR SYSTEM 5MM(外管+固定式轉接頭1)
917
CDD117093F2C "柯惠"可變徑式V型安全穿刺套管 "COVIDIEN" VERSAPORT PLUS
AUTOSUTURE V2 W/FIXATION CANNULA 5MM (外管+固定轉接頭)
917
CDD11770902C "柯惠"安全穿刺套管組 "COVIDIEN" AUTO SUTURE VERSAPORT
PLUS RPF TROCAR SYSTEM 5/11-12MM (外管1+可變轉接頭1)
955
CDD11790942C "柯惠"V型刀片穿刺套管 "COVIDIEN"VERSAPORT AUTO SUTURE
PLUS V2/V2 BLADED TROCAR (內管+外管+固定式接頭)
1116
CDD11790962C "柯惠"V型刀片穿刺套管 "COVIDIEN"VERSAPORT AUTO SUTURE
PLUS V2/V2 BLADED TROCAR(內管+外管+可變轉接頭)
1459
CDD119076D2C ”柯惠”安全穿刺套管組 "COVIDIEN" AUTO SUTURE VERSAPORT
PLUS RPF TROCAR SYSTEM 5-10MM(穿刺針1+外管1+可變式轉接頭
1)
1459
CDD119093F2C "柯惠"可變徑式V型安全穿刺套管 "COVIDIEN"VERSAPORT PLUS
AUTOSUTURE V2 W/FIXATION CANNULA 5MM (穿刺內管+外管+固定
轉接頭)
1116
CDD11FPK03ET "愛惜康"外科套管針"ETHICON" FLEXIPATH SURGICAL TROCAR(穿
剌針1+外管3+內建固定轉接頭3)
2530
CDD11GT100QW "台灣先進"拋棄式穿刺套管"TAIWAN SURGICAL"DISPOSABLE
TROCAR 5-10/12MM (穿剌針1+外管1+內建可變式轉接頭1)
1459
975
特材代碼 中英文名稱 支付點數-104/01/01
CDD11GT500QW "TAIWAN SURGICAL"DISPOSABLE TROCAR "台灣先進"拋棄式穿刺套
管(穿剌針1+外管1+調節旋塞1)
1116
CDD11GT501QW "台灣先進"拋棄式穿刺套管"TAIWAN SURGICAL"DISPOSABLE
TROCAR 5MM (穿剌針1+外管1+內建固定式轉接頭1)
1116
CDD11GTCS1QW "台灣先進"拋棄式穿刺套管"TAIWAN SURGICAL"DISPOSABLE
TROCAR 5MM (外管1+內建固定式轉接頭1)
917
CDD11GTCS2QW "台灣先進"拋棄式穿刺套管"TAIWAN SURGICAL"DISPOSABLE
TROCAR 5-10/12MM (外管1+內建可變式轉接頭1)
955
CDD11NB12S2C "柯惠"無刀刃可變式穿刺套管"COVIDIEN"VERSAPORT BLADELESS
AND VERSAPORT PLUS BLADELESS SINGLE USE BLADELESS
TROCAR(內管1+外管1+可變轉接頭1)
1459
CDD11NBFCS2C "柯惠"無刀刃可變式穿刺套管"COVIDIEN"VERSAPORT BLADELESS
AND VERSAPORT PLUS BLADELESS SINGLE USE BLADELESS
TROCAR(外管1+固定式轉接頭1)
917
CDD11TT012ET "愛惜康"外科套管針"ETHICON" FLEXIPATH SURGICAL TROCAR(穿
剌針1+外管1+內建固定轉接頭1)
1116
CDDF1D5051KC "凱西爾"負壓輔助癒合敷料"KCI" V.A.C. GRANUFOAM DRESSING 2355
CDDF1D5052KC "凱西爾"負壓輔助癒合敷料"KCI" V.A.C. GRANUFOAM DRESSING 2603
CDDF1D5053KC "凱西爾"負壓輔助癒合敷料"KCI" V.A.C. GRANUFOAM DRESSING 2715
CDDF1H11011V "雃博"立補負壓傷口治療系統_立補泡棉敷料(大)"APEX" ZIP
NEGATIVE PRESSURE WOUND THERAPY SYSTEM_ZIP FOAM
DRESSING(LARGE)
2715
CDDF1H11021V "雃博"立補負壓傷口治療系統_立補泡棉敷料(中)"APEX" ZIP
Negative Pressure Wound Therapy System_ZIP FOAM
DRESSING(MIDDLE)
2603
CDDF1H11031V "雃博"立補負壓傷口治療系統_立補泡棉敷料(小)"APEX" ZIP
NEGATIVE PRESSURE WOUND THERAPY SYSTEM_ZIP FOAM
DRESSING(SMALL)
2355
CDP0143110BQ "邦特"引流導管及穿刺導入系統"BIOTEQ"DRAINAGE
CATHETER&INTRODUCER SET/KIT(含導管及穿刺針)
1720
CDP0175110AG "亞康恩"導入引流導管及其附件(滅
菌)"ARGON"INTRODUCTION/DRAINAGE CATHETER AND
ACCESSORIES(STERILE)
1720
CDP0175530AG "亞康恩"導入/引流導管及其附件(滅
菌)"ARGON"INTRODUCTION/DRAINAGE CATHETER AND
ACCESSORIES(STERILE)
1720
CDP01MAKSSMR "美瑞特"馬克迷你血管導引套組"MERIT"MAK-MINI ACCESS KIT 1666
CDPN1CASP1CK "曲克"胸腔吸引導管組(滅菌)"COOK"SIMPLE PNEUMOTHORAX
ASPIRATION ACCESSORY SET(STERILE)
1281
CEE010544A3N "根本"高壓延長管-螺旋管"NEMOTO"PRESSURE TUBE300PSI 40
CEE01B060NPW "普惠"輸液套-Y管免針安全型"PERFECT" DISPOSABLE INFUSION
SET-SAFETY
43.1
CEE01C3300U2 "ICU"MICROCLAVE CONNECTOR AND ACCESSORIES DEVICES "愛西
優"可來福接頭及組件-無針式接頭
43.1
CEE01C3322U2 "ICU"MICROCLAVE CONNECTOR AND ACCESSORIES DEVICES "愛西
優"可來福接頭及組件-無針式雙接頭延長管
99
CEE01CH140U2 "ICU"CLAVE DRUG PREPARATION SYSTEM"愛喜優"克萊福藥物準備
系統-克萊福接頭+輸液袋接頭
70
CEE01CH318U2 "ICU"CLAVE DRUG PREPARATION SYSTEM"愛喜優"克萊福藥物準備
系統-輸液管含SPIROS注射調節接頭
134
CEE01CNE02Q4 "尼得立斯"免針輸液接頭-藥物準備系統組件/輸液
管"NEEDLELESS"NEEDLELESS INJECTION ACCESS DEVICE/TUBING
134
CEE01E005NPW "普惠"免針安全型T型輸液延長管"PERFECT"SAFETY EXTENSION
TUBE WITH T NEEDLE FREE
43.1
976
特材代碼 中英文名稱 支付點數-104/01/01
CEE01E020NPW "普惠"靜注延長管T型(免針安全型)"PERFECT"EXTENSION TUBE T
TYPE(SAFETY)
43.1
CEE01ETAT1NQ "宇仁"延長管-T型"INNOVATIVE"EXTENSION SET/T-CONNECTOR 14
CEE01ETNE1Q4 "尼得立斯"免針輸液接頭-延長管"NEEDLELESS"NEEDLELESS
INJECTION ACCESS DEVICE/EXTENSION TUBE
43.1
CEE01ETNE2Q4 "尼得立斯"免針輸液接頭-二路延長管"NEEDLELESS"NEEDLELESS
INJECTION ACCESS DEVICE/2-WAY EXTENSION TUBE
99
CEE01ETNE3Q4 "尼得立斯"免針輸液接頭-三路延長管"NEEDLELESS"NEEDLELESS
INJECTION ACCESS DEVICE/3-WAY EXTENSION TUBE
99
CEE01NE810Q4 "尼得立斯"免針輸液接頭-無針式接頭"NEEDLELESS"NEEDLELESS
INJECTION ACCESS DEVICE
43.1
CEE01NFA012U "佳承"輸液點滴套-無針式接頭"CHIA
CHERNE"I.V.ADMINISTRATION SET/NEEDLELESS FEMALE ADAPTOR
43.1
CEE01NFS012U "佳承"輸液點滴套-藥物準備系統組件/插入針"CHIA
CHERNE"I.V.ADMINISTRATION SET/NEEDLELESS FEMALE ADAPTOR
SPIKE(NON AIRVENTED)
70
CEE01NFS022U "佳承"輸液點滴套-藥物準備系統組件/插入針(玻璃瓶用)"CHIA
CHERNE"I.V.ADMINISTRATION SET/NEEDLELESS FEMALE ADAPTOR
SPIKE(AIRVENTED)
70
CEE01NMT012U "佳承"輸液點滴套-藥物準備系統組件/輸液管"CHIA
CHERNE"I.V.ADMINISTRATION SET/NEEDLELESS MALE ADAPTOR
TUBING
134
CEE01NSE01Q4 "尼得立斯"免針輸液接頭-藥物準備系統組件/插入
針"NEEDLELESS"NEEDLELESS INJECTION ACCESS DEVICE/SPIKE
70
CEE01NTE10Q4 "尼得立斯"免針輸液接頭-T型延長管"NEEDLELESS"NEEDLELESS
INJECTION ACCESS DEVICE/T-TYPE EXTENSION TUBE
43.1
CEE01NYE10Q4 "尼得立斯"免針輸液接頭-Y型延長管"NEEDLELESS"NEEDLELESS
INJECTION ACCESS DEVICE/Y-TYPE EXTENSION TUBE
51.5
CEE01SCE01Q4 "尼得立斯"免針輸液接頭-藥物準備系統組件/插入針(玻璃瓶
用)"NEEDLELESS"NEEDLELESS INJECTION ACCESS DEVICE/SPIKE
FOR GLASS BOTTLE
70
CEE01SEE02Q4 尼得立斯免針輸液接頭(藥物準備系統組件玻璃瓶
用)NEEDLELESS"NEEDLELESS INJECTION ACCESS DEVICE
70
CEP010544B3N "根本"高壓延長管-直型管"NEMOTO"PRESSURE TUBE300PSI 30.7
CGBK1BML20LY "奧林柏斯"機械式碎石器(碎石加取石網)"OLYMPUS"MECHANICAL
LITHOTRIPTOR
12365
CGBK1BML23LY "奧林柏斯"單次使用機械碎石器及附件(碎石加取石
網)"OLYMPUS"SINGLE USE MECHANICAL LITHOTRIPTOR AND
ACCESSORIES
12365
CGBK1BML43LY "奧林柏斯"單次使用機械碎石器(碎石加取石網)"OLYMPUS"SINGLE
USE MECHANICAL LITHOTRIPTOR
12365
CGDW1A8263TM "泰爾茂"導引導線"TERUMO"RADIFOCUS GUIDE WIRE M
STIFF/HALF-STIFF 0.018":0.038" 220;260CM
1359
CGDW1B3422BQ "邦特"血管內引導鋼線"BIOTEQ"GUIDEWIRE HYDROPHILIC
0.016~0.018" 220~300CM
1359
CGDW1G012ACK "曲克"導線"COOK"GUIDE WIRE 0.018~0.052" 180CM 313
CGDW1GA083TM "泰爾茂"導引導線"TERUMO"RADIFOCUS GUIDE WIRE M
0.018":0.038" 80CM
653
CGDW1GA153TM "泰爾茂"導引導線"TERUMO"RADIFOCUS GUIDE WIRE M
0.018":0.038" 120~180CM
751
CGDW1GW004G6 "銨積維"導引導管"AGA" AMPLATZER GUIDEWIRE (VSD OCCLUDER
用)
1600
CGDW1HPW01CK "曲克"路德朗優尼格親水性導線"COOK"ROADRUNNER UNIGLIDE
HYDROPHILIC WIRE GUIDE 0.018"~0.038" 150CM;180CM
751
977
特材代碼 中英文名稱 支付點數-104/01/01
CGDW1HPW02CK "曲克"路德朗優尼格親水性導線"COOK"ROADRUNNER UNIGLIDE
HYDROPHILIC WIRE GUIDE(STIFF SHAFT) 0.025"~0.038"
150CM;180CM
779
CGDW1HPW03CK "曲克"路德朗優尼格親水性導線"COOK"ROADRUNNER UNIGLIDE
HYDROPHILIC WIRE GUIDE 0.018"~0.038" 260CM
1359
CGDW1PA183TM "泰爾茂"導引導線"TERUMO"RADIFOCUS GUIDE WIRE M
STIFF/HALF-STIFF 0.020":0.038" 150:180CM
779
CGPG101827AS "朝日"瑪仕特微導管系列ASAHI MASTERS PARKWAY MICROCATHETER 8715
CGPG126046SB "波士頓科技"盧碧肯支撐導管"BOSTON SCIENTIFIC"RUBICON
SUPPORT CATHETERS
8715
CGPG12X400BB 柏朗導引導管B.BRAUN SERPIA HYDROPHILIC GUIDING CATHETER 1744
CGPG156FXBCM "柯特曼"導引導管"CODMAN"ENVOY GUIDING CATHETER 1744
CGPG1672ADCD "考迪斯"安卓特導引導管"CORDIS"ADROIT GUIDING CATHETERS
6FR
1744
CGPG1STD74AS "朝日"斯卓德微導管"ASAHI"STRIDE MICROCATHETER 2.2FR 8715
CGPG2GDLV3VS "法斯樂舒順"第3代冠連導管"VASCULAR SOLUTIONS"GUIDELINER
V3 CATHETER
18617
CGPG2GUDEASB "波士頓科技"蓋茲導引延長導管"BOSTON SCIENTIFIC"GUIDEZILLA
GUIDE EXTENSION CATHETER
18617
CGPG3137513L "萊特萊柏"光學同調斷層掃描影像系統-飛龍影像導管〝LIGHTLAB
〞OPTICAL COHERENT TOMOGRAPHY IMAGING SYSTEM
26009
CGPG3CA8643L "萊特萊柏"飛龍德爾影像導管〝LIGHTLAB〞DRAGONFLY DUO IMAGE
CATHETER
26009
CGPG3PTCRSSB "BOSTON SCIENTIFIC"OPTICROSS CORONARY IMAGING CATHETER
W/SLED"波士頓科技"艾地可冠狀動脈攝影導管-血管內超音波導管
及橇型板
20480
CGPW1165CMAS "朝日"冠狀動脈延長導引線"ASAHI"EXTENSION WIRE PTFE 0.014"
150;165CM
2353
CGPW1B1258GJ "吉生"周邊血管導引線"JSM"PERIPHERAL GUIDE WIRE
0.014~0.038" 120~180CM
2781
CGPW1B2630GJ "吉生"周邊血管導引線"JSM"PERIPHERAL GUIDE WIRE
0.014~0.038" 260~300CM
2800
CGPW1CMGW1AB "亞培"高鐸格康曼血管導線"ABBOTT" HI-TORQUE COMMAND GUIDE
WIRE 0.014" 190CM
2430
CGPW1CMGW3AB "亞培"高鐸格康曼血管導線"ABBOTT" HI-TORQUE COMMAND GUIDE
WIRE 0.014" 250~300CM
2800
CGPW1W1GG3AB "ABBOTT"HI-TORQUE WIGGLE GUIDE WIRE HYDROPHILIC COATING
0.014" 300CM "亞培"高鐸格偉格導線
2587
CGPW1W1GG9AB "ABBOTT"HI-TORQUE WIGGLE GUIDE WIRE HYDROPHILIC COATING
0.014" 190CM "亞培"高鐸格偉格導線
2353
CGPW1WZA01JV "日本來富恩"艾斯利特威札導引線"JAPAN LIFELINE" ATHLETE
WIZARD PTCA GUIDE WIRE 0.010-0.014";0.0078-0.010-0.014"
190CM
3324
CGS0119042M0 "美德康"微穿刺導引器組與配件"MEDCOMP"MICRO-STICK
INTRODUCER SET AND ACCESSORIES(4-5FR SHEATH+0.018 NITINOL
GUIDEWIRE+21G NEEDLE)
1661
CGS01ATT62M4 "美敦力"艾坦確保閥左心傳送系統"MEDTRONIC" ATTAIN
COMMAND+SUREVALVE LEFT-HEART DELIVERY SYSTEM
6528
CGS01MP1S1CK "曲克"微穿刺組"COOK"MICROPUNCTURE PEDAL ACCESS SET(0.018"
NITINOL GUIDE WIRE+4-5FR CATHETER+21G NEEDLE+轉接組)
2640
978
特材代碼 中英文名稱 支付點數-104/01/01
CGS01MRK23MR "MERIT"PRELUDE MARKER TIP SHEATH INTRODUCERS (4-8FR
23CM)"美瑞特"福祿可顯影導引鞘(鞘W/MARKER TIP+擴張器+導
線、SIDEARM、W/VALVE)
1098
CGS01MRKTPMR "MERIT"PRELUDE MARKER TIP SHEATH INTRODUCERS (4-8FR
11CM)"美瑞特"福祿可顯影導引鞘(鞘W/MARKER TIP+擴張器+導
線、SIDEARM、W/VALVE)
820
CGS01PMA25MR "美瑞特"福祿小血管導引鞘"MERIT"PRELUDE MINI ACCESS SHEATH
INTRODUCERS(SHEATH+DILATOR+SIDEARM+V+GW+NEEDLE) 7;11CM
835
CGS01PSS35MR "MERIT"PRELUDE SHORT SHEATH INTRODUCER(DILATOR+4CM MARKER
TIP SHEATH+STOPCOCK+0.035~0.038"GUIDE WIRE) "美瑞特"福祿
動靜脈廔管用導引鞘
1308
CGS01QG110TA "天地合"鞘管組"TARGET"DISPOSABLE INTRODUCER KIT 4:11FR
11CM(W/SHEATH,DILATOR,GUIDEWIRE,NEEDLE)
835
CGS01QG160TA "天地合"鞘管組"TARGET"DISPOSABLE INTRODUCER KIT 4:11FR
16;24CM(W/SHEATH,DILATOR,GUIDEWIRE,NEEDLE)
1262
CGS01SV12NGX "戈爾"密封閥導鞘"GORE"DRYSEAL SHEATH
28CM(DILATOR+SIDEARM+VALVE+2WAY活栓*2+RADIOPAQUE MARKER)
887
CHF06PT16AED "愛德華"動脈灌注導管(含導引管組)"EDWARDS"OPTISITE
ARTERIAL PERFUSION CANNULA W/INTRODUCER
12404
CHT0131601GJ "吉生"體外循環管組"JSM"HEART LUNG
PACK(TUBING+ORGANIZER+PRE-BYPASS FILTER+SUCKER*2)
5218
CKD03PERCPSB "波士頓科技"全立體彎曲輸尿管支架"BOSTON SCIENTIFIC"
PERCUFLEX PLUS URETERAL STENT
1416
CKD03STRV6SB "波士頓科技"伸展輸尿管支架"BOSTON SCIENTIFIC" STRETCH VL
STENT WITH HYDROPLUS
1416
CKDD269033BA "巴德"伊奎斯長期性血液透析導管"BARD" EQUISTREAM LONG-TERM
HEMODIALYSIS CATHETER
3509
CKF0304822FM "富強" 導尿管"FORTUNE" UROLOGICAL CATHETER 93.1
CKF03060312X "百合"矽質導尿管(雙叉)"BAIHE" DISPOSABLE SILICONE FOLEY
CATHETER(2 WAY)
93.1
CKF03060322X "百合"矽質導尿管(三叉)"BAIHE" DISPOSABLE SILICONE FOLEY
CATHETER(3 WAY)
170
CKF03FL000EF "貝斯美德"矽質導尿管(二叉)6FR:26FR "BESMED" SILICONE
FOLEY CATHETER(2 WAY)6FR:26FR
93.1
CKN0143115BQ "邦特"引流導管及穿刺導入系統"BIOTEQ"DRAINAGE CATHETER &
INTRODUCER SET
2580
CKN0143116BQ "邦特"引流導管及穿刺導入系統"BIOTEQ" DRAINAGE CATHETER &
INTRODUCER SET
2580
CKUD1VTD01CK "曲克"安培茲腎臟擴張器組(單支)"COOK" AMPLATZ RENAL
DILATOR SET AND DILATORS(INDIVIDUAL)
953
CLS041015B3B "康德萊"滴定管式輸液器"KDL" INFUSION SETS WITH BURETTE 41
CLS04MS1502U "佳承"輸液點滴套"CHIA CHERNE"I.V. ADMINISTRATION SET 63.4
CLS04MV1502U "佳承"輸液點滴套"CHIA CHERNE"I.V. ADMINISTRATION SET 41
CLS05087SPBB "柏朗"史倍司輸液套INFUSOMAT SPACE LINE INFUSION PUMP
ADMINISTRATION SETS
152
CLS06C5088U2 "愛西優"可來福接頭及組件-無針接頭含過濾器避光輸液套"ICU"
MICROCLAVE CONNECTOR AND ACCESSORIES DEVICES
265
CLS0863477J6 "卡爾費森"輸液套(輸血套組, 附無針式接頭1個)"CAREFUSION"
ALARIS GP INFUSION SETS(BLOOD SET, LSS VLV)
273
CMV0101437CM "柯特曼"安德普血管重建裝置及傳導系統"CODMAN" ENTERPRISE
VASCULAR RECONSTRUCTION DEVICE AND DELIVERY SYSTEM
94000
979
特材代碼 中英文名稱 支付點數-104/01/01
CMV0110527AS "朝日"瑪仕特微導管系列ASAHI MASTERS PARKWAY MICROCATHETER 13810
CMV0114300AS "朝日"神經血管導引線"ASAHI" NEUROVASCULAR GUIDE WIRE 4650
CMV013XT27S9 "史賽克"微導管"STRYKER"EXCELSIOR XT-27 MICROCATHETER 7440
CMV0149181S9 "史賽克" 超微細導管"STRYKER" EXCELSIOR MICROCATHETER 7440
CMV016FMLSUF "彼娜波"紐諾邁克斯系統"PENUMBRA" NEURON MAX SYSTEM 12000
CMV01C44562E "麥克思"中介導管"MICRUS" REVIVE INTERMEDIATE CATHETER 12000
CMV01STD22AS “朝日”斯卓德微導管“ASAHI”STRIDE MICROCATHETER 7440
CMV0205102S9 "史賽克"菲絲雀克灌注導管"STRYKER" FASTRACKER INFUSION
CATHETER
7440
CMV02DEF68TM "泰爾茂"諦思迪迅導引套"TERUMO" DESTINATION GUIDING SHEATH 6535
CMV03AMW01CK "曲克"萊特超選擇微導線"COOK" ALIGHT SUPERSELECTIVE
MICROWIRE GUIDES
4650
CMV04MAX05S9 "史賽克"瑪琪斯分離式閉塞捲"STRYKER " MATRIX2 DETACHABLE
COILS
18302
CMV04MAX06S9 "史賽克"瑪琪斯分離式閉塞捲"STRYKER " MATRIX2 DETACHABLE
COILS
18302
CMV04PR1MEV9 "恩提愛"艾欣波萊分離式閉塞捲"MTI" AXIUM PRIME DETACHABLE
COIL
15780
CMV04TARGTS9 "史賽克"塔吉特分離線圈"STRYKER" TARGET DETACHABLE COIL 16876
CMV04VFCVXMS "麥新"微導線圈栓塞系統"MICROVENTION"MICROPLEX COIL
SYSTEM(VFC)
16876
CPC01S14163G "以仁"中央靜脈導管組-成人單腔"ELINE"CENTRAL VENOUS
CATHETER SET-SINGLE LUMEN(C+N+D+G+S)
439
CPC01S20123G "以仁"中央靜脈導管組-嬰兒單腔"ELINE"CENTRAL VENOUS
CATHETER SET-SINGLE LUMEN(C+N+D+G+S)
679
CPC02D40053G "以仁"中央靜脈導管組-小兒雙腔"ELINE" CENTRAL VENOUS
CATHETER SET-DOUBLE LUMEN(C+N+D+G+S)
1568
CPC02D70163G "以仁"中央靜脈導管組-成人雙腔"ELINE"CENTRAL VENOUS
CATHETER SET-DOUBLE LUMEN(C+N+D+G+S)
951
CPC03T55083G "以仁"中央靜脈導管組-小兒三腔"ELINE"CENTRAL VENOUS
CATHETER SET-TRIPLE LUMEN(C+N+D+G+S)
2050
CPC03T70203G "以仁"中央靜脈導管組-成人三腔"ELINE"CENTRAL VENOUS
CATHETER SET-TRIPLE LUMEN(C+N+D+G+S)
1118
CRB0116100RU "路希"支氣管內管及配件"RUSCH" BRONCHIAL TUBES AND
ACCESSORIES
1490
CRB03AEBS4CK "曲克"支氣管內管阻隔管組"COOK"ENDOBRONCHIAL BLOCKER SET 3675
CRB03AEBS5CK "曲克"支氣管內管阻隔管組"COOK" ENDOBRONCHIAL BLOCKER SET 4000
CRE0400181RU "路希"氣管內管"RUSCH"ENDOTRACHEAL TUBE 188
CRE0411781RU "路希"氣管內管"RUSCH"ENDOTRACHEAL TUBE 202
CRE04ETPNC3G "以仁"氣管內管(朝北型/有氣囊)"ELINE" ENDOTRACHEAL
TUBE(NORTH POLAR PREFORMED)
202
CRE04ETPNU3G "以仁"氣管內管(朝北型/無氣囊)"ELINE" ENDOTRACHEAL
TUBE(NORTH POLAR PREFORMED)
188
CRE0600180RU "路希"氣管內管"RUSCH" ENDOTRACHEAL TUBE 143
CRE0611780RU "路希" 氣管內管"RUSCH" ENDOTRACHEAL TUBE 201
CRE06CPW033P "全安"氣管內管(口彎型且有氣囊)"PURECATH" PUREWAY TRACHEAL
TUBES
201
CRE06ETPSC3G "以仁"氣管內管(朝南型/有氣囊)"ELINE" ENDOTRACHEAL
TUBE(SOUTH POLAR PREFORMED)
201
CRE06ETPSU3G "以仁"氣管內管(朝南型/無氣囊)"ELINE" ENDOTRACHEAL
TUBE(SOUTH POLAR PREFORMED)
143
980
特材代碼 中英文名稱 支付點數-104/01/01
CRE06UPW033P "全安"氣管內管(口彎型且無氣囊)"PURECATH" PUREWAY TRACHEAL
TUBES
143
CRE0702004RU "路希"喉部雷射手術用氣管內管"RUSCH" LASER TRACHEAL TUBE 2451
CRG0212521KV "費雪派克"正壓呼吸輔助系統-半套"FISHER & PAYKEL" BUBBLE
CPAP SYSTEM
1216
CRG02BC151KV "費雪派克"正壓呼吸輔助系統-全套"FISHER & PAYKEL" BUBBLE
CPAP SYSTEM
3049
CRT02PW04T3P "全安"氣切套管(單管有氣囊)"PURECATH" PUREWAY TRACHEOSTOMY
TUBES
332
CRT02TS03U3G "以仁"氣切套管(標準型/無氣囊)"ELINE" TRACHEOSTOMY TUBE 328
CRT02TS05C3G "以仁"氣切套管(標準型/有氣囊)"ELINE" TRACHEOSTOMY TUBE 332
CRT02TS0U13G "以仁"氣切套管(標準型/無氣囊/有內管)"ELINE" TRACHEOSTOMY
TUBE
525
CRT05PW04S3P "全安"氣切套管(含抽痰管有氣囊)"PURECATH" PUREWAY
TRACHEOSTOMY TUBES
865
CRT05TSFC13G "以仁"氣切套管(發聲型/有氣囊/有內管)"ELINE" TRACHEOSTOMY
TUBE
865
CRT05TSFU13G "以仁"氣切套管(發聲型/無氣囊/有內管)"ELINE" TRACHEOSTOMY
TUBE
850
CRT05TSSC13G "以仁"氣切套管(抽痰型/有氣囊/有內管)"ELINE" TRACHEOSTOMY
TUBE
865
CRT1021549TX "泰利福" 快速經皮氣切組及配件"TELEFLEX" PERCUQUICK SET 5365
CVA0135125MR "美瑞特"迎晰血管攝影導管"MERIT"IMPRESS ANGIOGRAPHIC
CATHETERS(4-5FR,0.035"80:125CM)
594
CVA0135465MR "美瑞特"迎晰血管攝影導管"MERIT"IMPRESS ANGIOGRAPHIC
CATHETERS(4-5FR,0.035"40:65CM)
594
CVA0138125MR "美瑞特"迎晰血管攝影導管"MERIT"IMPRESS ANGIOGRAPHIC
CATHETERS(4-5FR,0.038"100:125CM)
594
CVA0138468MR "美瑞特"迎晰血管攝影導管"MERIT"IMPRESS ANGIOGRAPHIC
CATHETERS(4-5FR,0.038"40:80CM)
594
CVA014FLNBMR "美瑞特"迎晰血管攝影導管"MERIT"IMPRESS ANGIOGRAPHIC
CATHETERS(4FR,65:110CM;NON-BRAIDED)
594
CVA015FLNBMR "美瑞特"迎晰血管攝影導管"MERIT"IMPRESS ANGIOGRAPHIC
CATHETERS(5FR,65:110CM;NON-BRAIDED)
594
CVA01RFGC4TM "泰爾茂"葛來血管攝影導管"TERUMO" REDIFOCUS GLIDECATH 594
CVA0250115BB 柏朗血管造影導管(4-6FRENCH)B.BRAUN ANGIODYN ANGIOGRAPHIC
CATHETER
594
CVC01532XNCD "考迪斯"血管造影導管"CORDIS"SUPER TORQUE ANGIOGRAPHIC
CATHETER
594
CVC01CRDPGMR "美瑞特"普瑪豬尾巴導管"MERIT PERFORMA CARDIAC PIGTAIL
CATHETERS
594
CXE0132003BA "巴德"歐比特診斷電極導管-十極"BARD" ORBITER ST DIAGNOSTIC
ELECTRODE CATHETERS
9882
CXE02DP853YB "爾灣"電生理診斷導管-十極"IBI"ELECTROPHYSIOLOGY
DIAGNOSTIC CATHETER
14154
CXE02QP854YB "爾灣"電生理診斷導管-四極"IBI"ELECTROPHYSIOLOGY
DIAGNOSTIC CATHETER
12284
CXE0332214JV "日本來富恩"方騰斯塔溫控雙向電燒導管(4MM)"JLL"FANTASISTA
ABLATION CATHETER(4MM)
21479
CXE0332215JV "日本來富恩"方騰斯塔溫控雙向電燒導管(5MM)"JLL"FANTASISTA
ABLATION CATHETER(5MM)
21479
CXE0332218JV "日本來富恩"方騰斯塔溫控雙向電燒導管(6MM、
8MM)"JLL"FANTASISTA ABLATION CATHETER(6MM、8MM)
21479
981
特材代碼 中英文名稱 支付點數-104/01/01
CXE0344500SB "波士頓科技"布雷瑟心臟除顫電極導管(7F/8MM;10MM)"BOSTON
SCIENTIFIC" BLAZER II XP TEMPERATURE ABLATION
CATHETERS(7F/8MM;10MM)
21479
CXE0383351YB "爾灣"除顫電極導管"IBI" THERAPY ABLATION CATHETERS 21479
CXE03EPT45SB "波士頓科技"布雷瑟心臟除顫電極導管(8F/8MM:10MM)"BOSTON
SCIENTIFIC" BLAZER II XP TEMPERATURE ABLATION
CATHETERS(8F/8MM;10MM)
21479
CXE03LVW40ST "聖猷達"除顫電燒導管"SJM"LIVEWIRE TC ABLATION CATHETER 21479
CXE0570454ST "聖猷達"瑟爾皮庫爾帕斯杜爾心臟電燒導管"SJM" THERAPY COOL
PATH DUO SP ABLATION CATHETERS
74100
CXE05CFLEXST "聖猷達"瑟爾皮庫爾菲斯心臟電燒導管"SJM"THERAPY COOL FLEX
ABLATION CATHETERS
74100
CXE05CH1L2SB "波士頓科技"奇利液體冷卻除顫導管"BOSTON SCIENTIFIC"
CHILLI II COOLED ABLATION CATHETER
74100
CXE05D1316WE "百歐森偉伯司特"灌注冷卻式斯芙溫控單向導管"BIOSENSE
WEBSTER" THERMOCOOL SF UNI-DIRECTIONAL CATHETER
74100
CXE05D131FWE "百歐森偉伯司特"灌注冷卻式斯芙溫控導航單向導管"BIOSENSE
WEBSTER" THERMOCOOL SF NAV UNI-DIRECTIONAL CATHETER
74100
CXE05EBD75WE "百歐森偉伯司特"易擊灌注冷卻式溫控可彎式診斷/電燒導
管"BIOSENSE WEBSTER"EZ STEER THERMOCOOL
DIAGNOSTIC/ABLATION DEFLECTABLE TIP CATHETER
74100
CXE05EBN75WE "百歐森偉伯司特"易擊灌注冷卻式溫控導航可彎式診斷/電燒導
管"BIOSENSE WEBSTER"EZ STEER THERMOCOOL NAV
DIAGNOSTIC/ABLATION DEFLECTABLE TIP CATHETER
74100
CXE05EECATM4 "美敦力"心臟冷凍消融導管"MEDTRONIC" FREEZOR CARDIAC
CRYOABLATION CATHETER
74100
CXE05SBD35WE "百歐森偉伯司特"灌注冷卻式斯芙溫控雙向診斷/電燒可彎式導
管"Biosense Webster" ThermoCool SF Bi-Directional
Diagnostic/Ablation Deflectable Tip Cath
74100
CXE05SBN35WE "百歐森偉伯司特"灌注冷卻式斯芙溫控導航雙向診斷/電燒可彎式
導管"Biosense Webster" ThermoCool SF NAV Bi-directional
Diagnostic/Ablation Deflectable
74100
FALSNMULT0A1 "愛爾康"可舒銳視妥智慧型非球面多焦點軟式人工水晶體※自付
差額品項,超過部分由病患自付"ALCON"ACRYSOF IQ RESTOR
MULTIFOCAL INTRAOCULAR LENS
2744
FALSNMULT2LS "蘭斯特克"福來視人工水晶體:多焦點+非球面人工水晶體(自付差
額品項)"LENSTEC"TETRAFLEX INTRAOCULAR LENS
2744
FALSNMULTVA1 "愛爾康"可舒視爾特智慧型非球面多焦點散光矯正單片型軟式人
工水晶體※自付差額品項,超過部分由病患自付"ALCON"ACRYSOF
IQ RESTOR MULTIFOCAL TORIC INTRA
2744
FALSNWAVE11W 千禧力視單片軟式人工水晶體(非球面)(自付差額品項)MBI
PRECISAL ONE PIECE SOFT HYDROPHOBIC ACRYLIC INTRAOCULAR
LENS
2744
FALSNWAVE13Q "麥德仁"眉特視人工水晶體:非球面變色(自付差額品
項)"MEDENNIUM" MATRIX ACRYLIC (AURIUM) INTRAOCULAR LENS
2744
FALSNWAVE1RQ "樂敦"新視非球面人工水晶體:非球面軟式人工水晶體※自付差額
品項,超過部分由病患自付"ROHTO"NEO EYE ASPHERIC FOLDABLE
LENS
2744
FALSNWAVE3LS "蘭斯特克"後房型人工水晶體:雙非球面(自付差額品
項)"LENSTEC" POSTERIOR CHAMBER INTRAOCULAR LENS
2744
FALSNWAVE3RY "銳能"進階推注式非球面人工水晶體系統(自付差額品
項)"RAYNER"ADVANCE PRELOADED HYDROPHILIC ACRYLIC IOL
INJECTION SYSTEM
2744
982
特材代碼 中英文名稱 支付點數-104/01/01
FALSNWAVE4LS "蘭斯特克"雙非球面人工水晶體(自付差額品項)"LENSTEC" BI-
ASPHERIC INTRAOCULAR LENS
2744
FAV01E01003H "艾肯"明妥見人工玻璃體"EYEKON"EYE COAT SH SODIUM
HYALURONATE VISCOELASTIC
1785
FAV01PA001LB 護視安玻璃體替代物:0.55ML PREVISCAID OPHTHALMIC
VISCOELASTIC:0.55ML
1564
FAV01PA002LB 護視安玻璃體替代物:0.75ML PREVISCAID OPHTHALMIC
VISCOELASTIC:0.75ML
1785
FAV01PA003LB 護視安玻璃體替代物:1.0ML PREVISCAID OPHTHALMIC
VISCOELASTIC:1.0ML
1785
FAV01VT585A2 "眼力健"喜隆安多玻璃體替代物0.85ML"AMO"HEALON ENDOCOAT
OPHTHALMIC VISCOSURGICAL DEVICE(OVD)0.85ML
1785
FBA011200S2Z "泰瑞斯"低黏性骨水泥"TECRES"CEMEX XL 839
FBA0428022AE "雅氏"歐斯特福膠原骨彌補物
(1.5*1.5*0.5CM)"AESCULAP"OSTEOVIT
2563
FBA0428030AE "雅氏"歐斯特福膠原骨彌補物(2*2*1CM)"AESCULAP"OSTEOVIT 2563
FBA103005M5B 威力骨可吸收性磷酸鈣陶瓷MAXIBONE CALCIUM PHOSPHATE
CERAMIC(1.0-3.0MM GRANULES/5ML)
4197
FBD1028110V2 "鐿鈦"骨釘骨板植入物-股骨壓迫性骨板系統(壓迫性骨板,拉力骨
釘壓迫骨釘)"INTAI" BONE SCREW AND BONE PLATE IMPLANT-DHS
PLATE SYSTEM(DYNAMIC HIP PLATE,
6796
FBHBCCERA7U0 "聯合"雙極半髖人工髖關節:搭配襯套式陶瓷股小
球"UNITED"BIPOLAR SYSTEM:BIOLOX OPTION CERAMIC FRMORAL
HEAD(自付差額品項)
35195
FBHHCCERA7U0 "聯合"襯套式陶瓷股小球"UNITED"BIOLOX OPTION CERAMIC
FRMORAL HEAD(自付差額品項)
4352
FBHL16201NS2 "好美得卡奧斯得寧"采登特髖臼內墊系統(超耐磨髖臼內
墊)"HOWMEDICA OSTEONICS"TRIDENT ACETABULAR COMPONENT
SYSTEM(UHMWPE)
4018
FBHMCPCEA3S2 "史賽克"采登特MOORE人工髖關節系統(陶瓷HEAD)※自付差額品項
,超過部分由病患自付"STRYKER"TRIDENT MOORE HIP
SYSTEM(CERAMIC HEAD)
7733
FBHMCRCEA3S2 "史賽克"采登特MOORE人工髖關節再置換系統(陶瓷HEAD)※自付差
額品項,超過部分由病患自付"STRYKER"TRIDENT MOORE REVISION
HIP SYSTEM(CERAMIC HEAD)
7733
FBHPCCERA3S2 "史賽克"采登特髖關節系統(陶瓷HEAD)※自付差額品項,超過部
分由病患自付"STRYKER"TRIDENT HIP SYSTEM(CERAMIC HEAD)
39396
FBHRC6200NU0 "聯合"優磨二代重建型全人工髖關節:搭配襯套式陶瓷股小球及陶
瓷內襯"UNITED"U-MOTION II REVISION HIP SYSTEM:BIOLOX
OPTION CERAMIC FRMORAL HEAD TO DELT
52796
FBHRCCERA3S2 "史賽克"采登特髖關節再置換系統(陶瓷HEAD)※自付差額品項,
超過部分由病患自付"STRYKER"TRIDENT REVISION HIP
SYSTEM(CERAMIC HEAD)
52796
FBHRCCERA7U0 "聯合"重建型全人工髖關節:搭配襯套式陶瓷股小
球"UNITED"REVISION HIP SYSTEM:BIOLOX OPTION CERAMIC
FRMORAL HEAD(自付差額品項)
52796
FBKL12303TU0 "聯合"康膝人工膝關節:脛骨關節面襯墊"UNITED"U2 TOTAL KNEE
SYSTEM:TIBIAL INSERT
13109
FBKPA7000NU0 "聯合"康膝人工膝關節:模組式(高彎曲度155度)"UNITED"U2
TOTAL KNEE SYSTEM
51297
FBKT12203TU0 "聯合"康膝人工膝關節:脛骨基座模組式"UNITED"U2 TOTAL KNEE
SYSTEM:TIBIAL BASEPLATE CMA
14031
FBN05403S1Y2 "亞太醫療"金寶骨髓內釘系統-股骨髓內釘組"SYNTEC"KING BO
HUMERAL INTERLOCKING NAILS SYSTEM-FEMORAL
7890
983
特材代碼 中英文名稱 支付點數-104/01/01
FBN05403S2Y2 "亞太醫療"金寶骨髓內釘系統-脛骨髓內釘組"SYNTEC"KING BO
HUMERAL INTERLOCKING NAILS SYSTEM-TIBIA
7890
FBN07321004P "沛佳"法斯樂-杜瓦伸縮式髓內釘系統"PEGA"FASSIER-DUVAL
TELESCOPIC IM SYSTEM
140000
FBP0122201V2 "鐿鈦"骨釘骨板植入物(管型骨板4.5MM)"INTAI"BONE SCREW AND
BONE PLATE IMPLANT(TUBULAR PLATE4.5MM)
500
FBP0124131V2 "鐿鈦"骨釘骨板植入物(管型骨板3.5MM)"INTAI"BONE SCREW AND
BONE PLATE IMPLANT(TUBULAR PLATE3.5MM)
441
FBP0124201V2 "鐿鈦"骨釘骨板植入物(管型骨板2.7MM)"INTAI"BONE SCREW AND
BONE PLATE IMPLANT(TUBULAR PLATE 2.7MM)
380
FBP0222400V2 "鐿鈦"骨釘骨板植入物(窄動力加壓骨板4.5MM)"INTAI"BONE
SCREW AND BONE PLATE IMPLANT(NARROW DYNAMIC COMPRESSION
PLATE4.5MM)
1228
FBP0222600V2 "鐿鈦"骨釘骨板植入物(寬動力加壓骨板4.5MM)"INTAI"BONE
SCREW AND BONE PLATE IMPLANT(BROAD DYNAMIC COMPRESSION
PLATE4.5MM)
1782
FBP0222781V2 "鐿鈦"骨釘骨板植入物(加長型骨板4.5MM)"INTAI"BONE SCREW
AND BONE PLATE IMPLANT(LENGTHENING PLATE4.5MM)
1787
FBP0224311V2 "鐿鈦"骨釘骨板植入物(直型骨板2.0MM)"INTAI"BONE SCREW AND
BONE PLATE IMPLANT(MINI STRAIGHT PLATE)
230
FBP0224350V2 "鐿鈦"骨釘骨板植入物(動力加壓骨板3.5MM)"INTAI"BONE SCREW
AND BONE PLATE IMPLANT(DYNAMIC COMPRESSION PLATE)
977
FBP0324001V2 "鐿鈦"骨釘骨板植入物(匙型骨板4.5MM)"INTAI"BONE SCREW AND
BONE PLATE IMPLANT(SPOON PLATE 4.5MM)
1762
FBP0324031V2 "鐿鈦"骨釘骨板植入物(支撐骨板4.5MM)"INTAI"BONE SCREW AND
BONE PLATE IMPLANT(BUTTRESS PLATE4.5MM)
2130
FBP0324071V2 "鐿鈦"骨釘骨板植入物(脛骨支撐骨板4.5MM)"INTAI"BONE SCREW
AND BONE PLATE IMPLANT(BUTTRESS PLATE4.5MM)
3157
FBP0324091V2 "鐿鈦"骨釘骨板植入物(眼鏡蛇骨板4.5MM)"INTAI"BONE SCREW
AND BONE PLATE IMPLANT(COBRA HEAD PLATE4.5MM)
3892
FBP0324123V2 "鐿鈦"骨釘骨板植入物(T型骨板3.5MM)"INTAI"BONE SCREW AND
BONE PLATE IMPLANT(T-PLATE)
952
FBP0324167V2 "鐿鈦"骨釘骨板植入物(跟骨骨板3.5MM)"INTAI"BONE SCREW AND
BONE PLATE IMPLANT(CALCANEAL PLATE3.5MM)
3104
FBP0324181V2 "鐿鈦"骨釘骨板植入物(葉形骨板3.5MM)"INTAI"BONE SCREW AND
BONE PLATE IMPLANT(CLOVERLEAF PLATE3.5MM)
1603
FBP0324302V2 "鐿鈦"骨釘骨板植入物(重建骨板)"INTAI"BONE SCREW AND BONE
PLATE IMPLANT(RECONSTRUCTION PLATE)
3487
FBP0324331V2 "鐿鈦"骨釘骨板植入物(L型迷你型骨板)"INTAI"BONE SCREW AND
BONE PLATE IMPLANT(MINI L-PLATE)
336
FBP0324605V2 "鐿鈦"骨釘骨板植入物(H型迷你骨板1.5MM,2.0MM)"INTAI"BONE
SCREW AND BONE PLATE IMPLANT(H PLATE1.5MM,2.0MM)
336
FBP0324612V2 "鐿鈦"骨釘骨板植入物(直型骨板20洞2.0MM)"INTAI"BONE SCREW
AND BONE PLATE IMPLANT(STRAIGHT PLATE,2.0MM,20HOLE)
2686
FBP0324623V2 "鐿鈦"骨釘骨板植入物(T型迷你型骨板1.5MM,2.0MM)"INTAI"BONE
SCREW AND BONE PLATE IMPLANT(MINI T-PLATE,1.5MM,2.0MM)
336
FBP0324807V2 "鐿鈦"骨釘骨板植入物(骨踝支撐骨板4.5MM)"INTAI"BONE SCREW
AND BONE PLATE IMPLANT(CONDYLAR BUTTRESS PLATE4.5MM)
3493
FBS0120068V2 "鐿鈦"骨釘骨板植入物-皮質骨釘1.3/1.5/2.0/2.7/3.5MM"INTAI"
BONE SCREW AND BONE PLATE IMPLANT-CORTEX SCREW
145
984
特材代碼 中英文名稱 支付點數-104/01/01
FBS01445024C 華骨-髖骨板系統:皮質骨螺釘(4.5MM)ORDC-DYNAMIC HIP SCREW
SYSTEM:CORTEX SCREW(4.5MM)
161
FBS0221500V2 "鐿鈦"骨釘骨板植入物-海綿骨釘-4.5MM"INTAI" BONE SCREW AND
BONE PLATE IMPLANT-CANCELLOUS SCREW-4.5MM
144
FBS0221600V2 "鐿鈦"骨釘骨板植入物-海綿骨釘-6.5MM"INTAI" BONE SCREW AND
BONE PLATE IMPLANT-CANCELLOUS SCREW-6.5MM
281
FBS0800234S2 "史賽克"前十字韌帶界面固定螺釘"STRYKER"ACL INTERFERENCE
SCREW
4113
FBS081120MLV "靈威特"傑耐斯可吸收性螺釘"LINVATEC"GENESYS MATRYX
INTERFERENCE SCREW
4234
FBS08222FNT1 "邁特"軟組織固定錨"MITEK"ANCHOR SYSTEM-FOR SOFT TISSUE
REATTACHMENT
3268
FBS085020MLV "靈威特"傑耐斯可吸收性螺釘"LINVATEC"GENESYS MATRYX
INTERFERENCE SCREW
4234
FBS088020MLV "靈威特"傑耐斯可吸收性螺釘"LINVATEC"GENESYS MATRYX
INTERFERENCE SCREW
4234
FBS1121400V2 "鐿鈦"骨釘骨板植入物-皮質骨釘4.5MM"INTAI" BONE SCREW AND
BONE PLATE IMPLANT-CORTEX SCREW
161
FBS1220600V2 "鐿鈦"骨釘骨板植入物-海綿骨釘-4.0MM"INTAI" BONE SCREW AND
BONE PLATE IMPLANT-CANCELLOUS SCREW-4.0MM
144
FBSF11004LXP "寶楠"阿姆斯壯脊椎後路固定系統:二節(免事前審
查)"PAONAN"ARMSTRONG POSTERIOR SPINAL FIXATION
SYSTEM(S*4+R*2)
13816
FBSF11005LXP "寶楠"阿姆斯壯脊椎後路固定系統:三節(免事前審
查)"PAONAN"ARMSTRONG POSTERIOR SPINAL FIXATION
SYSTEM(S*6+R*2)
20044
FBSF11006LXP "寶楠"阿姆斯壯脊椎後路固定系統:二節"PAONAN"ARMSTRONG
POSTERIOR SPINAL FIXATION SYSTEM(S*4+R*2)
23358
FBSF11007LXP "寶楠"阿姆斯壯脊椎後路固定系統:三節"PAONAN"ARMSTRONG
POSTERIOR SPINAL FIXATION SYSTEM(S*6+R*2)
34118
FBSF1689D2S1 "信迪思"廣用型脊椎系統:2節(含萬用復位椎弓根螺釘系統:萬向
螺釘+固定桿)"SYNTHES"UNIVERSAL SPINE SYSTEM:2
LEVEL(RX2+SX4)
23358
FBSF1689D3S1 "信迪思"廣用型脊椎系統:3節(含萬用復位椎弓根螺釘系統:萬向
螺釘+固定桿)"SYNTHES"UNIVERSAL SPINE SYSTEM:3
LEVEL(RX2+SX6)
34118
FBSF1800023F "泰德"腰椎內固定系統:三節TEND LUMBAR FIXATION SYSTEM:3
LEVEL(SX6+RX2)
34118
FBSF1860013F "泰德"腰椎內固定系統:二節(免事前審查)TEND LUMBAR FIXATION
SYSTEM:2 LEVEL(SX4+RX2)
13816
FBSF1860023F "泰德"腰椎內固定系統:三節(免事前審查)TEND LUMBAR FIXATION
SYSTEM:3 LEVEL(SX6+RX2)
20044
FBSF1880013F "泰德"腰椎內固定系統:二節TEND LUMBAR FIXATION SYSTEM:2
LEVEL(SX4+RX2)
23358
FBSF188002RK 瑞寶億腰椎內固定系統:二節REBORN ESSENCE LUMBAR FIXATION
SYSTEM:2 LEVEL(SX4+RX2)
23358
FBSF188003RK 瑞寶億腰椎內固定系統:三節REBORN ESSENCE LUMBAR FIXATION
SYSTEM:3 LEVEL(SX6+RX2)
34118
FBSF1880043F "泰德"腰椎內固定系統:三節TEND LUMBAR FIXATION SYSTEM:3
LEVEL(SX6+RX2)
34118
FBSF1880053F "泰德"腰椎內固定系統:二節TEND LUMBAR FIXATION SYSTEM:2
LEVEL(SX4+RX2)
23358
985
特材代碼 中英文名稱 支付點數-104/01/01
FBSF216001XP "寶楠"阿姆斯壯脊椎後路固定系統:平滑桿(短)(免事前審
查)"PAONAN"ARMSTRONG POSTERIOR SPINAL FIXATION SYSTEM:ROD
30:100MM
679
FBSF216002XP "寶楠"阿姆斯壯脊椎後路固定系統:平滑桿(長)(免事前審
查)"PAONAN"ARMSTRONG POSTERIOR SPINAL FIXATION SYSTEM:ROD
130:500MM
1419
FBSF216003XP "寶楠"阿姆斯壯脊椎後路固定系統:平滑桿
(短)"PAONAN"ARMSTRONG POSTERIOR SPINAL FIXATION
SYSTEM:ROD 40:100MM
919
FBSF216004XP "寶楠"阿姆斯壯脊椎後路固定系統:平滑桿
(長)"PAONAN"ARMSTRONG POSTERIOR SPINAL FIXATION
SYSTEM:ROD 130:500MM
2662
FBSF2B00013F "泰德"腰椎內固定系統:固定桿(標準桿)(免事前審查)TEND
LUMBAR FIXATION SYSTEM:STANDARD ROD
679
FBSF2B00023F "泰德"腰椎內固定系統:固定桿(標準桿)(長節,免事前審查)TEND
LUMBAR FIXATION SYSTEM:STANDARD ROD
1419
FBSF2BA0013F "泰德"腰椎內固定系統:固定桿(標準桿)TEND LUMBAR FIXATION
SYSTEM:STANDARD ROD
919
FBSF2BA0023F "泰德"腰椎內固定系統:固定桿(平滑桿)(長節)TEND LUMBAR
FIXATION SYSTEM:SMOOTH ROD
2662
FBSF314001XP "寶楠"阿姆斯壯脊椎後路固定系統:固定鉤"PAONAN"ARMSTRONG
POSTERIOR SPINAL FIXATION SYSTEM:HOOK
3311
FBSF411061XP "寶楠"阿姆斯壯脊椎後路固定系統:螺釘(免事前審
查)"PAONAN"ARMSTRONG POSTERIOR SPINAL FIXATION
SYSTEM:SCREW
3114
FBSF411062XP "寶楠"阿姆斯壯脊椎後路固定系統:螺釘(免事前審
查)"PAONAN"ARMSTRONG POSTERIOR SPINAL FIXATION
SYSTEM:SCREW
3114
FBSF411063XP "寶楠"阿姆斯壯脊椎後路固定系統:螺釘"PAONAN"ARMSTRONG
POSTERIOR SPINAL FIXATION SYSTEM:SCREW
5380
FBSF411064XP "寶楠"阿姆斯壯脊椎後路固定系統:螺釘"PAONAN"ARMSTRONG
POSTERIOR SPINAL FIXATION SYSTEM:SCREW
5380
FBSF411751XP "寶楠"阿姆斯壯脊椎後路固定系統:骨水泥釘"PAONAN"ARMSTRONG
POSTERIOR SPINAL FIXATION SYSTEM:CEMENT SCREW
12960
FBSF411761XP "寶楠"阿姆斯壯脊椎後路固定系統:骨水泥釘"PAONAN"ARMSTRONG
POSTERIOR SPINAL FIXATION SYSTEM:CEMENT SCREW
12960
FBSF468959S1 "信迪思"萬用復位椎弓根螺釘系統:萬向螺釘"SYNTHES"UNIVERSAL
REDUCTION PEDICLE PEDICLE SCREW SYSTEM:UNIVERSAL DEGEN
SCREWS
5380
FBSF4ASYS8AQ 史麥特歐美加脊椎固定系統:多角度中空螺釘SMARTLOC OMEGA
SPINAL FIXATION SYSTEM:POLYAXIAL CANNULATED SCREW
12960
FBSF4ASYS9AQ SMARTLOC EVOLUTION SYSTEM:POLYAXIAL SCREW 史麥特艾爾脊椎
固定系統:多角度螺釘
5380
FBSF4B00013F "泰德"腰椎內固定系統:脊椎螺釘(免事前審查)TEND LUMBAR
FIXATION SYSTEM:SPINAL SCREW
3114
FBSF4BA0013F "泰德"腰椎內固定系統:脊椎螺釘TEND LUMBAR FIXATION
SYSTEM:SPINAL SCREW
5380
FBSF4BA0073F "泰德"腰椎內固定系統:中空萬向螺釘TEND LUMBAR FIXATION
SYSTEM:CANNULATED POLY AXIAL SCREW
5380
FBSF4BA0123F "泰德"腰椎內固定系統:中空萬向螺釘TEND LUMBAR FIXATION
SYSTEM:CANNULATED POLY AXIAL SCREW
12960
986
特材代碼 中英文名稱 支付點數-104/01/01
FBSF4P2GCPZ6 “美瑞世”普生二代後方脊椎固定器:固定釘"MERRIES”PROT II
POSTERIOR SPINE SYSTEM:POLY CANNULATED SCREW
5380
FBSF517021XP "寶楠"阿姆斯壯脊椎後路固定系統"橫向連結器(免事前審
查)"PAONAN"ARMSTRONG POSTERIOR SPINAL FIXATION
SYSTEM:CROSS LINK
2661
FBSF517022XP "寶楠"阿姆斯壯脊椎後路固定系統:橫向連結
器"PAONAN"ARMSTRONG POSTERIOR SPINAL FIXATION
SYSTEM:CROSS LINK
6108
FBSF5B00013F "泰德"腰椎內固定系統:橫向連結器(免事前審查)TEND LUMBAR
FIXATION SYSTEM:TRANSVERSE LINK
2661
FBSF5BA0013F "泰德"腰椎內固定系統:橫向連結器TEND LUMBAR FIXATION
SYSTEM:TRANSVERSE LINK
6108
FBSFA000021A “施百威”腰椎融合器(TLIF,每節椎體限置放1個)"SPINEWAY”
TWIN PEAKS OBLIQUE LUMBAR CAGE
43943
FBSFA000033F "泰德"高分子腰椎椎間融合器:後開型TEND PEEK LUMBAR
INTERBODY FUSION CAGE
21971
FBSFA22003XP "寶楠"錐頭式椎間填充塊(聚醚醚酮)(側開型每節椎體限置放1
個)"PAONAN"II-TYPE INTERVERTEBRAL SPACER(PEEK)
43943
FBSFA22004XP "寶楠"錐頭式椎間填充塊(側開型每節椎體限置放1
個)"PAONAN"II-TYPE INTERVERTEBRAL SPACER
43943
FBSFA6730SS9 "STRYKER"OIC PEEK CAGE(STERILE)"史賽克"後開腰椎護架系統
(滅菌)
21971
FBSFA6731SS9 "STRYKER"OGIVAL INTERBODY CAGE-PEEK(STERILE)"史賽克"側開
腰椎間融合器(每節椎體置放1個)(滅菌)
43943
FBSFA6741SS9 "STRYKER"SOLIS CERVICAL CAGE SYSTEM(STERILE)(PEEK)"史賽
克"梭利斯椎頸護架系統(滅菌)
21971
FBSFA6742SS9 "STRYKER"SOLIS AS PEEK SPACER(STERILE)"史賽克"椎間融合器
(滅菌)
21971
FBSFA6760SS9 "STRYKER"OIC PEEK CAGE(STERILE)"史賽克"後開腰椎護架系統
(滅菌)
21971
FBSFA8380SS9 "STRYKER"AVS TL PEEK SPACER(STERILE)"史賽克"脊椎襯墊系統
(側開型每節椎體置放1個)((滅菌)
43943
FBSFA919PRM4 "美敦力"克里森椎體填充器(側開型每個椎體限置放1
個)"MEDTRONIC"VERTE-STACK CRESCENT VERTEBRAL BODY SPACER
43943
FBSFACPLCNJZ "傑奎"碳纖維高分子複材腰椎融合器(碳纖維聚醚醚酮)(側開型每
節椎體限置放1個)"JO"CFR PEEK LUMBAR CAGE
43943
FBSFAF00013F "泰德"高分子腰椎椎間融合器:側開型(每椎節限制放1個)TEND
PEEK LUMBAR INTERBODY FUSION CAGE
43943
FBSFAF00023F "泰德"高分子腰椎椎間融合器:後開型TEND PEEK LUMBAR
INTERBODY FUSION CAGE
21971
FBSFAF00033F "泰德"高分子頸椎椎間融合器TEND PEEK CERVICAL INTERBODY
FUSION CAGE
21971
FBSFAPPG03V2 "鐿鈦"高分子複合材料椎間融合系統:胸腰椎椎籠(聚醚醚
酮)24;26MM "INTAI"INTERBODY FUSION SYSTEM:PLIF LUMBAR
CAGE(PEEK)
21971
FBSFAPTG02WG "威創"高分子複合/鈦合金材料椎間融合系統:聚醚醚酮(側開型每
節椎體限置放1個)"WILTROM"INTERBODY FUSION SYSTEM:PEEK
43943
FBSFAPTG03V2 "鐿鈦"高分子複合材料椎間融合系統:胸腰椎椎籠(聚醚醚
酮)28:36MM(脊椎側開型,每節椎體置放一個)"INTAI"INTERBODY
FUSION SYSTEM:LUMBAR CAGE(PEEK)
43943
FBSFAPTG03WG "威創"高分子複合椎間融合系統(飛梭胸腰椎椎籠,側開型每節椎
體限置放一個)32:36MM "WILTROM" INTERBODY FUSION
SYSTEM(PEEK)
43943
987
特材代碼 中英文名稱 支付點數-104/01/01
FBSFAWS419B0 "長安"腰椎椎間融合器(側開型每節椎體限置放1個)"BMI"LUMBAR
SPINAL CAGE(PEEK)
43943
FBSFC2LEVEM4 "美敦力"亞特蘭提斯前方頸椎骨板系統(二節)"MEDTRONIC”
ATLANTIS ANTERIOR CERVICAL PLATE SYSTEM(PX1+SX4)
18623
FBSFC312XXM4 "美敦力"亞特蘭提斯前方頸椎骨板系統-骨釘"MEDTRONIC”
ATLANTIS ANTERIOR CERVICAL PLATE SYSTEM-SCREW
984
FBSFC3LEVEM4 "美敦力"亞特蘭提斯前方頸椎骨板系統(三節)"MEDTRONIC”
ATLANTIS ANTERIOR CERVICAL PLATE SYSTEM(PX1+SX6)
20591
FBSFC4801NS9 "史賽克"頸椎後側固定系統-骨釘"STRYKER" OASYS SYSTEM-SCREW 8260
FBSFC4802NS9 "史賽克"頸椎後側固定系統-二節"STRYKER" OASYS SYSTEM-TWO
LEVEL(SCREWX4+RODX2或PLATEX2)
36940
FBSFC4803NS9 "史賽克"頸椎後側固定系統-三節"STRYKER" OASYS SYSTEM-
THREE LEVEL(SCREWX6+RODX2或PLATEX2)
53460
FBSFC4804NS9 "史賽克"頸椎後側固定系統-短骨板"STRYKER" OASYS SYSTEM-
PLATE
1950
FBSFC4805NS9 "史賽克"頸椎後側固定系統-短固定桿"STRYKER" OASYS SYSTEM-
ROD
1950
FBSFC4806NS9 "史賽克"頸椎後側固定系統-橫連結器組"STRYKER" OASYS
SYSTEM-CONNECTOR
7208
FBSFC4807NS9 "史賽克"頸椎後側固定系統-骨鉤"STRYKER" OASYS SYSTEM-HOOK 5375
FBSFC4808NS9 "史賽克"頸椎後側固定系統-長骨板"STRYKER" OASYS SYSTEM-
PLATE
3700
FBSFC4809NS9 "史賽克"頸椎後側固定系統-長固定桿"STRYKER" OASYS SYSTEM-
ROD
3700
FBSFCASC05AQ 穩特頸椎前路骨板系統:二節WINLOC ANTERIOR CERVICAL PLATE
SYSTEM(PX1+SX4)
18623
FBSFCASC06AQ 穩特頸椎前路骨板系統:三節WINLOC ANTERIOR CERVICAL PLATE
SYSTEM(PX1+SX6)
20591
FBSFCASC07AQ 偉歐頸椎鋼板固定系統:二節VELO CERVICAL PLATE SYSTEM:2
LEVEL(PX1+SX2)
18623
FBSFCASC08AQ 偉歐頸椎鋼板固定系統:三節VELO CERVICAL PLATE SYSTEM:3
LEVEL(PX1+SX3)
20591
FBSFCASCS3AQ 穩特頸椎前路骨板系統:螺釘WINLOC ANTERIOR CERVICAL PLATE
SYSTEM:SCREW
984
FBSFCASCS4AQ 偉歐頸椎鋼板固定系統:螺釘VELO CERVICAL PLATE SYSTEM:SCREW 984
FBSFCGPT012G 脊力頸椎骨板系統:二節GIB CERVICAL PLATE SYSTEM:TWO
LEVEL(PX1+SX4)
18623
FBSFCGPT022G 脊力頸椎骨板系統:三節GIB CERVICAL PLATE SYSTEM:THREE
LEVEL(PX1+SX6)
20591
FBSFCGPT032G 脊力頸椎骨板系統:螺釘GIB CERVICAL PLATE SYSTEM:SCREW 984
FBSFR64101S1 "信迪思"第二代延展式肋骨支撐架-肋骨翼金勾蓋"SYNTHES"VEPTR
VERTICAL EXPANDABLE PROSTHETIC TITANIUM RIB II-HOOK
CAP(整組使用者不得申報,只適用於組件
31000
FBSFR64102S1 "信迪思"第二代延展式肋骨支撐架-肋骨翼金勾"SYNTHES"VEPTR
VERTICAL EXPANDABLE PROSTHETIC TITANIUM RIB II-HOOK(整組
使用者不得申報,只適用於組件單獨使
40100
FBSFR64103S1 "信迪思"第二代延展式肋骨支撐架-近端延展桿"SYNTHES"VEPTR
VERTICAL EXPANDABLE PROSTHETIC TITANIUM RIB II-PROXIMAL
EXTENSION(220MM)(整組使用者不得申
64148
988
特材代碼 中英文名稱 支付點數-104/01/01
FBSFR64104S1 "信迪思"第二代延展式肋骨支撐架-遠端延展桿"SYNTHES"VEPTR
VERTICAL EXPANDABLE PROSTHETIC TITANIUM RIB II-DISTAL
EXTENSION(220MM)(整組使用者不得申報
64147
FBSFR64105S1 "信迪思"第二代延展式肋骨支撐架-近端延展桿"SYNTHES"VEPTR
VERTICAL EXPANDABLE PROSTHETIC TITANIUM RIB II-PROXIMAL
EXTENSION(500MM)(整組使用者不得申
88048
FBSFR64106S1 "信迪思"第二代延展式肋骨支撐架-遠端延展桿"SYNTHES"VEPTR
VERTICAL EXPANDABLE PROSTHETIC TITANIUM RIB II-DISTAL
EXTENSION(500MM)(整組使用者不得申報
88048
FBT01020MS4M 速普新關節內注射劑SUPLASYN STERILE SODIUM HYALURONATE
SOLUTION(2ML/注射筒裝)
709
FHFCD32354ST "聖猷達"優你法植入式心律去顫器"SJM" UNIFY IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR
565882
FHFCDLUXHFBK "拜耳德尼克"路麥斯核磁共振植入式心臟去顫器(HF-
T)"BIOTRONIK" LUMAX IMPLANTABLE DEFIBRILLATOR SYSTEMS
WITH A CONDITIONAL INTENDED USE IN A MRI ENVI
591468
FHFCDUA32MST "聖猷達"優你法亞速拉植入式心律去顫器"SJM" UNIFY ASSURA
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR
565882
FHFCDUA33MST "聖猷達"優你法亞速拉植入式心律去顫器"SJM"UNIFY ASSURA
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR
565882
FHG1825130AH "亞翠恩"福立心人工血管"ATRIUM" FLIXENE VASCULAR GRAFTS
30CM
14629
FHG1825140AH "亞翠恩"福立心人工血管"ATRIUM" FLIXENE VASCULAR GRAFTS
40CM
18122
FHG1825180AH "亞翠恩"福立心人工血管"ATRIUM" FLIXENE VASCULAR GRAFTS
80CM
29320
FHG2112026TM "泰爾茂"傑斯弗特加強型人工血管"TERUMO"GELSOFT PLUS
GELATIN SEALED POLYESTER VASCULAR PROSTHESES 12:16MM 30CM
9849
FHG3425145AH "亞翠恩"福立心人工血管"ATRIUM"FLIXENE VASCULAR GRAFTS 三
層錐型 4-6:5-8X45CM
18630
FHP011NGMRSB "波士頓科技"迎吉心臟節律器"BOSTON SCIENTIFIC"INGENIO MRI
PACEMAKER
81477
FHP01ACSRMST "聖猷達"愛森心臟節律器(單腔)"SJM"ACCENT PULSE
GENERATOR(SR)
64214
FHP01ADVMRSB "波士頓科技"艾凡緹心臟節律器"BOSTON SCIENTIFIC"ADVANTIO
MRI PACEMAKER
81477
FHP01EMRSRBK "百多力"艾維亞植入式心律調節器(單腔)"BIOTRONIK" EVIA
IMPLANTABLE CARDIAC PACEMAKERS(SR)
81477
FHP01EVASTBK "百多力"艾維亞植入式心律調節器"BIOTRONIK"EVIA IMPLANTABLE
CARDIAC PACEMAKERS
64214
FHP01VSR1UST "聖猶達"植入式心臟節律器(單腔)"SJM"IMPLANTABLE CARDIAC
PULSE GENERATOR(SR)
64214
FHP01ZESRMST "聖猷達"神風植入式心臟節律器(單腔)"SJM"ZEPHYR IMPLANTABLE
CARDIAC PULSE GENERATOR(SR)
64214
FHP021NGDRSB "波士頓科技"迎吉心臟節律器(雙腔自付差額)"BOSTON
SCIENTIFIC"INGENIO PACEMAKER(DDDR)
93833
FHP022A2ADSB "波士頓科技"艾凡緹心臟節律器(雙腔自付差額)"BOSTON
SCIENTIFIC"ADVANTIO MRI PACEMAKER(DDDR)
93833
FHP02A21DRSB "波士頓科技"迎吉心臟節律器(雙腔自付差額)"BOSTON
SCIENTIFIC"INGENIO MRI PACEMAKER(DDDR)
93833
FHP02ACDRMST "聖猷達"愛森心臟節律器(雙腔自付差額)"SJM" ACCENT PULSE
GENERATOR(DDDR)
93833
989
特材代碼 中英文名稱 支付點數-104/01/01
FHP02ADVDRSB "波士頓科技"艾凡緹心臟節律器(雙腔自付差額)"BOSTON
SCIENTIFIC"ADVANTIO PACEMAKER(DDDR)
93833
FHP02EVADTBK "百多力"艾維亞植入式心律調節器(雙腔自付差額)"BIOTRONIK"
EVIA IMPLANTABLE CARDIAC PACEMAKER(DDDR)
93833
FHPCDDD1S1M4 "美敦力"艾維拉植入式心臟去顫器(DR 34CM3)"MEDTRONIC"EVERA
XT/S IMPLANTABLE CARDIOVERTER DEFIBRILLATOR(DR 34CM3)
483701
FHPCDDDDF1M4 "美敦力"艾維拉植入式心臟去顫器(DR 33CM3)"MEDTRONIC"EVERA
XT/S IMPLANTABLE CARDIOVERTER DEFIBRILLATOR(DR 33CM3)
483701
FHPCDDR59MST "聖猷達"幅地法亞速拉植入式心律去顫器(雙腔)"SJM" FORTIFY
ASSURA IMPLANTABLE CARDIOVERTER DEFIBRILLATOR(DR)
443350
FHPCDDRF2MST "聖猷達"植入式心律去顫器-雙腔"SJM" FORTIFY IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR
443350
FHPCDDRFSMST "聖猷達" 幅地法艾斯特植入式心律去顫器-雙腔"SJM" FORTIFY
ST IMPLANTABLE CARDIOVERTER DEFIBRILLATOR
443350
FHPCDDVDF1M4 "美敦力"艾維拉植入式心臟去顫器(VR 33CM3)"MEDTRONIC"EVERA
XT/S IMPLANTABLE CARDIOVERTER DEFIBRILLATOR(VR 33CM3)
342335
FHPCDDVDF4M4 "美敦力"艾維拉植入式心臟去顫器(VR 34CM3)"MEDTRONIC"EVERA
XT/S IMPLANTABLE CARDIOVERTER DEFIBRILLATOR(VR 34CM3)
342335
FHPCDLUXDRBK "拜耳德尼克"路麥斯核磁共振植入式心臟去顫器(DR-
T)"BIOTRONIK" LUMAX IMPLANTABLE DEFIBRILLATOR SYSTEMS
WITH A CONDITIONAL INTENDED USE IN A MRI ENVI
483701
FHPCDLUXVDBK "拜耳德尼克"路麥斯核磁共振植入式心臟去顫器(VR-T
DX)"BIOTRONIK" LUMAX IMPLANTABLE DEFIBRILLATOR SYSTEMS
WITH A CONDITIONAL INTENDED USE IN A MRI E
342335
FHPCDLUXVRBK "拜耳德尼克" 路麥斯核磁共振植入式心臟去顫器(VR-
T)"BIOTRONIK" LUMAX IMPLANTABLE DEFIBRILLATOR SYSTEMS
WITH A CONDITIONAL INTENDED USE IN A MRI ENV
342335
FHPCDVR59MST "聖猷達"幅地法亞速拉植入式心律去顫器(單腔)"SJM" FORTIFY
ASSURA IMPLANTABLE CARDIOVERTER DEFIBRILLATOR(SR)
330345
FHPCDVRF1MST "聖猷達"植入式心律去顫器-單腔"SJM" FORTIFY IMPLANTABLE
CARDIOVERTER DEFIBRILLATOR
330345
FHPCDVRFSMST "聖猷達" 幅地法艾斯特植入式心律去顫器-單腔"SJM" FORTIFY
ST IMPLANTABLE CARDIOVERTER DEFIBRILLATOR
330345
FHPCL1S377BK "百多力"霖納思進化版(五極單環)心內除顫器植入式主動導線(包
括附件)"BIOTRONIK"LINOX SMART PROMRI S DX IMPLANTABLE
DEFIBRILLATOR LEADS INCL. ACCESSOR
76664
FHPCL1SSDPBK "百多力"霖納思進化版(四極)心內除顫器植入式主動導線(包括附
件)"BIOTRONIK"LINOX SMART PROMRI SD IMPLANTABLE
DEFIBRILLATOR LEADS INCL. ACCESSORIES
76664
FHPCL37716BK "百多力"霖納思進化版(三極)心內除顫器 植入式主動導線(包括
附件)"BIOTRONIK"LINOX SMART PROMRI S IMPLANTABLE
DEFIBRILLATOR LEADS INCL. ACCESSORIES
76664
FHPCL6946MM4 "美敦力"史賓特植入式導線"MEDTRONIC"SPRINT QUATTRO SECURE
IMPLANTABLE LEAD
76664
FHPCL6996SM4 "美敦力"皮下導線系統"MEDTRONIC" SUBCUTANEOUS LEAD SYSTEM 87034
FHPCLRE4ACSB "波士頓科技"芮萊安植入式電極導線(主動式固定)"BOSTON
SCIENTIFIC" RELIANCE 4-FRONT IMPLANTABLE LEAD(ACTIVE)
76664
FHPCLRE4PSSB "波士頓科技"芮萊安植入式電極導線(被動式固定)"BOSTON
SCIENTIFIC"RELIANCE 4-FRONT IMPLANTABLE LEAD(PASSIVE)
75682
990
特材代碼 中英文名稱 支付點數-104/01/01
FHPCLSD399BK "百多力"保心護心內除顫器植入式主動導線(包括附
件)"BIOTRONIK" PROTEGO PROMRI SD IMPLANTABLE
DEFIBRILLATOR LEADS INCL. ACCESSORIES
76664
FHPHF04X98M4 "美敦力"艾坦卓越電極導線"MEDTRONIC"ATTAIN PERFORMA LEAD 22311
FHPHF38153BK "百多力"艾維亞進化版植入式心律調節器"BIOTRONIK"EVIA HF-T
PROMRI IMPLANTABLE CARDIAC PACEMAKERS INCL. ACCESSORIES
180228
FHPHFCRXBPBK "百多力"可洛進化版植入式心導線(包括配件)"BIOTRONIK"COROX
PROMRI OTW IMPLANTABLE CORONARY SINUS LEADS INCL.
ACCESSORIES
19845
FHPL1SLS37BK "百多力"梭利亞雙極植入式導線(包括附件)"BIOTRONIK"SOLIA S
IMPLANTABLE ENDOCARDIAL LEADS INCL. ACCESSORIES
7479
FHPL1SLT37BK "百多力"梭利亞雙極節律器導線(包括附件)"BIOTRONIK"SOLIA T
IMPLANTABLE ENDOCARDIAL LEADS INCL. ACCESSORIES
7434
FHV01BMVALR5 "索倫"機械式心臟瓣膜"SORIN" BICARBON MECHANICAL HEART
VALVES
50503
FHV01CARBMR5 "索林"康保人工心臟瓣膜"SORIN" CARBOMEDICS PROSTHETIC
HEART VALVE
50503
FHV01VAA21R5 "索林"康保升主動脈人工瓣膜"SORIN" CARBOMEDICS CARBOSEAL
ASCENDING AORTIC PROSTHESIS
60955
FHV01VAC21R5 "索林"康保升主動脈人工瓣膜(VALSALVA)"SORIN" CARBOMEDICS
CARBOSEAL ASCENDING AORTIC PROSTHESIS(VALSALVA)
85000
FHVD128TFXED "愛德華"卡本特-愛德華沛旅旺心包生物瓣膜(PERIMOUNT主動脈
瓣,型號2800TFX)(自付差額)"EDWARDS" CARPENTIER-EDWARDS
PERIMOUNT PERICARDIAL BIOPROSTHESIS(
43613
FHVD13000TED "愛德華"卡本特-愛德華沛旅旺人工心瓣膜-MAGNA(自付差
額)"EDWARDS" CARPENTIER-EDWARDS PERIMOUNT PERICARDIAL
BIOPROSTHESIS-MAGNA
43613
FHVD169PTFED "愛德華"卡本特-愛德華沛旅旺人工心瓣膜(PERIMOUNT二尖瓣,型
號6900PTFX)(自付差額)"EDWARDS" CARPENTIER-EDWARDS
PERIMOUNT PERICARDIAL BIOPROSTHESIS(PER
43613
FHVD173TFXED "愛德華"卡本特-愛德華沛旅旺人工心瓣膜-MAGNA EASE(自付差
額)"EDWARDS" CARPENTIER-EDWARDS PERIMOUNT PERICARDIAL
BIOPROSTHESIS-MAGNA EASE
43613
FHVD1BRASLST "聖猷達"翠翡塔組織瓣膜(自付差額)"SJM"TRIFECTA VALVE 43613
FHVD1CSTRCST "聖猷達"翠翡塔組織瓣膜(自付差額)"SJM"TRIFECTA VALVE 43613
FHVD1MAPH1R5 "索林"脈長流主動脈人工心瓣膜(LX型)(自付差額)"SORIN"
MITROFLOW AORTIC PERICARDIAL HEART VALVE
43613
FHVD1MAPH2R5 "索林"脈長流主動脈人工心瓣膜(DL型)(自付差額)"SORIN"
MITROFLOW AORTIC PERICARDIAL HEART VALVE
43613
FHVD1MSPB3M4 "美敦力" 莫克人工豬心瓣膜-第三代(自付差額)"MEDTRONIC"
MOSAIC PORCINE BIOPROSTHESIS
43613
FHVD1USAWRST "聖猷達"翠翡塔組織瓣膜(自付差額)"SJM"TRIFECTA VALVE 43613
FHVR1A2636R5 "索林"康保瓣膜成形術環"SORIN"CARBOMEDICS ANNULOPLASTY
RING
20100
FHVR1SRBRMR5 "索倫"環狀成形術環"SORIN"SOVERING ANNULOPLASTY DEVICES 20100
FHVR1SRM3DR5 "索倫"環狀成形術環"SORIN" MEMO 3D ANNULOPLASTY RING 20100
FHX0250700R5 "索倫"英派爾氧合器(氧合器)"SORIN" INSPIRE
OXYGENATORS(OXYGENATOR)
12913
FHX02TS250M4 "美敦力"心臟血管外科器械(滅菌)-穩定器"MEDTRONIC"
CARDIOVASCULAR SURGICAL INSTRUMENTS (STERILE)-STABILIZER
44002
991
特材代碼 中英文名稱 支付點數-104/01/01
FHX032CL62ML "美德思"氧合器與硬殼靜脈儲血槽-中空纖維氧合器RHEOPARIN塗
層+硬殼靜脈儲血槽"MEDOS"OXYGENATOR AND VENOUS HARDSHELL
RESERVOIR
25845
FHX0350511R5 "索倫"立利普氧合器"SORIN"DIDECO D902 LILLIPUT 2
OXYGENATOR
22548
FHX0350521R5 "索倫"伊歐斯兒童-小成人氧合器以及迷你繞道手術系
統"SORIN"DIDECO D905 EOS PEDIATRIC-SMALL ADULT OXYGENATOR
AND MINI BYPASS SYSTEM
22548
FHX0350702R5 "索倫"英派爾氧合器(氧合器及動脈過濾器)"SORIN" INSPIRE
OXYGENATORS(OXYGENATOR AND ARTERIAL FILTER)
15046
FHX0350713R5 "索倫"英派爾氧合器(氧合器及硬式儲血槽)"SORIN" INSPIRE
OXYGENATORS(OXYGENATOR AND HARD SHELL VENOUS RESERVOIR)
14409
FHX0350715R5 "索倫"英派爾氧合器(氧合器、動脈過濾器及硬式儲血槽)"SORIN"
INSPIRE OXYGENATORS(OXYGENATOR AND ARTERIAL FILTER AND
HARD SHELL VENOUS RESERVOIR)
16730
FHX03AF811M4 "美敦力"艾芬你堤富生氧合處理系統-氧合器及動脈過濾
器"MEDTRONIC" AFFINITY FUSION OXYGENATION SYSTEM-
OXYGENATOR AND ARTERIAL FILTER
15046
FHX03AF841M4 "美敦力"艾芬你堤富生氧合處理系統-氧合器、動脈過濾器及儲血
槽"MEDTRONIC" AFFINITY FUSION OXYGENATION SYSTEM-
OXYGENATOR、ARTERIAL FILTER AND RESERVO
16542
FHX03BERASQM "邁柯唯"離心幫浦套管組(含BIOLINE)"MAQUET"ROTASSIST SET
WITH BIOLINE COATING
350000
FHX03BP211M4 "美敦力"艾芬你堤皮克斯氧合處理系統(OXYGENATOR WITH
COATING-小兒用)"MEDTRONIC" AFFINITY PIXIE OXYGENATION
SYSTEM(OXYGENATOR WITH COATING)
18688
FHX03BP241M4 "美敦力"艾芬你堤皮克斯氧合處理系統(OXYGENATOR WITH
COATING AND RESERVOIR WITH COATING-小兒用)"MEDTRONIC"
AFFINITY PIXIE OXYGENATION SYSTEM(OXYGEN
22284
FHX04BEPLSQM "邁柯唯"體外循環管路組(含BIOLINE塗層)"MAQUET" PERMANENT
LIFE SUPPORT-SET WITH BIOLINE COATING
98010
FHX04C3464ML "美德思"管路組(ECMO長效型人工心肺組-組件包括
OXYGENATOR+PUMP HEAD+TUBING SET)"MEDOS" TUBING SETS
44419
FHXR250704R5 "索倫"英派爾氧合器(硬式儲血槽)"SORIN" INSPIRE
OXYGENATORS(HARD SHELL VENOUS RESERVOIR)
3297
FHXR250705R5 "索倫"英派爾氧合器(硬式儲血槽具自體血液回收過濾器)"SORIN"
INSPIRE OXYGENATORS(DUAL HARD SHELL VENOUS RESERVOIR)
3420
FND01SC376M4 "美敦力"艾提神經刺激器-SC(單側)"MEDTRONIC" ACTIVA
NEUROSTIMULATOR-SC
231000
FND02PC376M4 "美敦力"艾提神經刺激器-PC(雙側)"MEDTRONIC" ACTIVA
NEUROSTIMULATOR-PC
462000
FPP0141021XU "合碩"顱顏骨固定系統-直行骨板2洞"CUSMED"CMF FIXATION
SYSTEM:MINI BONE PLATE TITANIUM STR 2HOLE
975
FPP0204449S1 "信迪思"髁頭重建系統(下顎髁頭固定器+固定骨
板)"SYNTHES"CONDYLAR HEAD ADD-ON SYSTEM(CONDYLAR HEAD
ADD-ON AND FIXATION PLATE)
6874
FPP0701526M4 "美敦力"顱骨固定系統:BURR HOLE*1;骨釘*6"MEDTRONIC"TIMESH
CRANIAL FIXATION SYSTEM:BURR HOLE*1;SCREW*6
14133
FPP0707014M3 "蒙締邇"顱骨口腔頷骨顏面骨接合系統-鈦質顯微網
片"MONDEAL"PLATING SYSTEMS FOR CRANIO ORAL AND
MAXILLOFACIAL OSTEOSYNTHESIS-TITANIUM MICROMESH
10992
992
特材代碼 中英文名稱 支付點數-104/01/01
FPP074112ZXU "合碩"顱顏骨固定系統(+骨板4洞*3+骨釘*12)"CUSMED"CMF
FIXATION SYSTEM(MICRO-4HOLE PLATE*3+SCREW*12)
23826
FPP074902XXU "合碩"顱顏骨固定系統(BURR HOLE*1+骨板2洞*2+骨釘
*10)"CUSMED"CMF FIXATION SYSTEM(MICRO-BURR HOLE*1+2 HOLE
PLATE*2+SCREW*10)
24479
FPP074902YXU "合碩"顱顏骨固定系統(BURR HOLE*1+骨釘*6)"CUSMED"CMF
FIXATION SYSTEM(MICRO-BURR HOLE*1+SCREW*6)
14133
FPS0104497S1 "信迪思"髁頭重建系統_下顎固定螺釘"SYNTHES"CONDYLAR HEAD
ADD-ON SYSTEM_SET SCREW
579
FPS012340NLE "史賽克雷賓格爾"下頷骨系統-骨釘(2.3及2.7MM)"STRYKER
LEIBINGER"UNIVERSAL MANDIBLE SYSTEM-BONE SCREW
579
FSP71SAF01QN "博美敦"蘇菲可調式懸吊帶系統(懸吊帶+置入
針)"PROMEDON"SAFYRE
13680
FUK02TS014FN 英弗梅體外血液迴路管-小兒連續性動靜脈血液濾過套組 INFOMED
EXTRACORPOREAL BLOOD CIRCUIT-CONTINUOUS ARTERIO-VENOUS
HEMOFILTRATION,CAVH-PED
839
FUK05TS404FN 英弗梅體外血液迴路管-連續靜靜脈血液透析INFOMED
EXTRACORPOREAL BLOOD CIRCUITS -CVVHD
1393
FUT01CYST12L "邁蘭"喜仕膀胱灌注液"MYLAN" CYSTISTAT STERILE SODIUM
HYALURONATE SOLUTION
4819
HEF01B4014M4 "美敦力"艾芬你堤皮克斯兒童動脈過濾器"MEDTRONIC"AFFINITY
PIXIE PEDIATRIC ARTERIAL FILTER
1716
HHF01PXL8HHA "漢尼帝克"血小板專用高效率去除白血球血液過濾
器"HAEMONETICS"LEUKOCYTE REDUCTION FILTER FOR PLATELETS
1162
HHF020NE01HA "漢尼帝克"紅血球專用去除白血球血液過濾器(嬰幼兒專
用)"HAEMONETICS" NEO NEONATAL HIGH EFFICIENCY LEUKOCYTE
REDUCTION FILTER FOR RED BLOOD CELLS
487
HHF020RCEZHA "漢尼帝克"去除白血球過濾器"HAEMONETICS"(EZ-PRIME) SELF-
PRIMING HIGH EFFICIENCY LEUKOCYTE REDUCTION FILTER SET
FOR SINGLE UNIT BLOOD TRANSFUSION
487
HHM010VX6HQL "克力玫"抽吸導管"QUALIMED"EMAX ASPIRATION CATHETER 14123
HHM01DL950BA "巴德"迪耐立腔靜脈過濾器"BARD" DENALI VENA CAVA FILTER 33528
HHM01M13X1F2 "英泰克"莫瑪極致腦血管保護裝置"INVATEC" MO.MA ULTRA
CEREBRAL PROTECTION DEVICE
33371
HHM01SCACTNX "尼瓦西斯"血栓吸除導管"MINVASYS"STEMICATH
THROMBOASPIRATION CATHETER
14123
HHM01SQ40SHA "漢尼帝克"篩選微集合體之輸血過濾器"HAEMONETICS" BLOOD
TRANSFUSION FILTER
305
LEE0111996PY "菲康"來沛去顫器/監視器及附件-EDGE SYSTEM電擊片(成人
用)"PHYSIO-CONTROL"LIFEPAK 20E DEFIBRILLATOR/MONITOR AND
ACCESSORIES-EDGE SYSTEM ELECTRODES
652
LEE01B1P0BQM "邁柯唯"暫時性電極導線-雙極"MAQUET" TEMPORARY PACING
ELECTRODE-BIPOLAR
2076
LEE01B1P0HQM "邁柯唯"暫時性電極導線-雙極且配有心肌穿刺針和電極護
套"MAQUET" TEMPORARY PACING ELECTRODE-BIPOLAR WITH
MYOCARDIAL NEEDLE AND ELECTRODE JACKET
2076
LEE01DBP0LQM "邁柯唯"暫時性電極導線-兩條雙極"MAQUET" TEMPORARY PACING
ELECTRODE-DOUBLE BIPOLAR
3737
LEE01M10061Q "施肯貼克"去顫器用電擊貼片(兒童型)"SKINTACT"
MULTIFUNCTION DEFIBRILLATION ELECTRODE
1050
LEE01M15101Q "施肯貼克"去顫器用電擊貼片(成人型)"SKINTACT"
MULTIFUNCTION DEFIBRILLATION ELECTRODE
652
993
特材代碼 中英文名稱 支付點數-104/01/01
LEE01P1199PY "菲康"來沛去顫器/監視器及附件-兒科EDGE SYSTEM RTS電擊片
(小兒用)"PHYSIO-CONTROL"LIFEPAK 20E DEFIBRILLATOR/MONITOR
AND ACCESSORIES-PEDIATRIC EDGE S
1050
LEE01QUAP0QM "邁柯唯"暫時性電極導線-四極"MAQUET" TEMPORARY PACING
ELECTRODE-QUADRIPOLAR
3737
LEE01UN1P0QM "邁柯唯"暫時性電極導線-單極"MAQUET" TEMPORARY PACING
ELECTRODE-UNIPOLAR
1036
NAN011830N3B "千禧光"安全注射針SOL-CARE SAFETY NEEDLE 1
NAN011830NBD BD塑膠注射針"B-D" DISPOSABLE NEEDLE 0.5
NAN020032NBD BD注射筆專用針:31~32G,4~8MM BD MICRO-FINE PEN
NEEDLE:31~32G,4~8MM
3.2
NAN0601823TP "特浦"造影針"TOP"P.T.C. NEEDLE 102
NBS010003S3C “千禧光”安全注射器3CC(不附針)SOL-CARE LUER LOCK SAFETY
SYRINGE 3CC(WITHOUT NEEDLE)
1.8
NBS010005S3C “千禧光”安全注射器5CC(不附針)SOL-CARE LUER LOCK SAFETY
SYRINGE 5CC (WITHOUT NEEDLE)
2.6
NBS010010NRW "勤達"一次性使用無菌注射器10CC無針"TEAM POWER"DISPOSABLE
SYRINGE 10CC WITHOUT NEEDLE
2.4
NBS010010S3C “千禧光”安全注射器10CC(不附針)SOL-CARE LUER LOCK SAFETY
SYRINGE 10CC (WITHOUT NEEDLE)
4
NBS010020NRW "勤達"一次性使用無菌注射器20CC無針"TEAM POWER"DISPOSABLE
SYRINGE 20CC WITHOUT NEEDLE
2.9
NBS010020S3C “千禧光”安全注射器20CC(不附針)SOL-CARE LUER LOCK SAFETY
SYRINGE 20CC (WITHOUT NEEDLE)
6.6
NBS010050NRW "勤達"一次性使用無菌注射器50CC無針"TEAM POWER"DISPOSABLE
SYRINGE 50CC WITHOUT NEEDLE
9.5
NBS01A003NPW "普惠"塑膠注射筒不附針(安全型)3CC"PERFECT" DISPOSABLE
SYRINGE WITHOUT NEEDLE(SAFETY)
1.8
NBS01A003VPW "普惠"塑膠注射筒不附針:3CC(安全型)"PERFECT" DISPOSABLE
SYRINGE WITHOUT NEEDLE:(SAFETY)
1.8
NBS01A005NPW "普惠"塑膠注射筒不附針(安全型)5CC"PERFECT" DISPOSABLE
SYRINGE WITHOUT NEEDLE(SAFETY)
2.6
NBS01A005VPW "普惠"塑膠注射筒不附針:5CC(安全型)"PERFECT" DISPOSABLE
SYRINGE WITHOUT NEEDLE:(SAFETY)
2.6
NBS01A010NPW "普惠"塑膠注射筒不附針(安全型)10CC"PERFECT" DISPOSABLE
SYRINGE WITHOUT NEEDLE(SAFETY)
4
NBS01A010VPW "普惠"塑膠注射筒不附針:10CC(安全型)"PERFECT" DISPOSABLE
SYRINGE WITHOUT NEEDLE:(SAFETY)
4
NBS01A020NPW "普惠"塑膠注射筒不附針(安全型)20CC"PERFECT"DISPOSABLE
SYRINGE WITHOUT NEEDLE(SAFETY)
6.6
NBS01A020VPW "普惠"塑膠注射筒不附針:20CC(安全型)"PERFECT"DISPOSABLE
SYRINGE WITHOUT NEEDLE:(SAFETY)
6.6
NBS01EME05BD BD注射筒(不含注射針)5CC BD EMERALD SYRINGE WITHOUT NEEDLE 1.4
NBS01EME10BD BD注射筒(不含注射針)10CC BD EMERALD SYRINGE WITHOUT
NEEDLE
2.4
NBS01EME20BD BD注射筒(不含注射針)20CC BD EMERALD SYRINGE WITHOUT
NEEDLE
2.9
NBS01EME23BD BD注射筒(不含注射針)2CC;3CC BD EMERALD SYRINGE WITHOUT
NEEDLE
1
NBS07390033N "根本"顯影注射筒 200ML"NEMOTO"DISPOSABLE SYRINGE 222
NBS07390083N "根本"顯影注射筒100ML "NEMOTO"DISPOSABLE SYRINGE 222
NBS073900A3N "根本"顯影注射筒附填充管200ML"NEMOTO"DISPOSABLE SYRINGE
WITH FILL TUBE(J TUBE)
222
994
特材代碼 中英文名稱 支付點數-104/01/01
NBS07390103N "根本"顯影注射筒 150ML附填充管"NEMOTO” DISPOSABLE
SYRINGE W/J TUBE
222
NBS07390153N "根本"顯影注射筒 50ML“NEMOTO” DISPOSABLE SYRINGE 222
NBS0739B0A3N "根本"顯影注射筒 150ML“NEMOTO” DISPOSABLE SYRINGE 222
NBS07AE100KZ "康康"一次性使用高壓造影注射筒及配件(注射筒*1+抽藥管*1+螺
旋管*1)"KK"SINGLE USE HIGH PRESSURE ANGIOGRAPHIC SYRINGES
AND ACCESSORIES
313
NBS07AE200KZ "康康"一次性使用高壓造影注射筒及配件:針筒+盤旋管+穿刺吸藥
器"KK" SINGLE-USE HIGH PRESSURE ANGIOGRAPHIC SYRINGES AND
ACCESSORIES:SYRINGE+COILED TUB
313
NBS07AG100KZ "康康"一次性使用高壓造影注射筒及配件(注射筒*2+SPIKE*2+Y型
螺旋管*1)"KK"SINGLE USE HIGH PRESSURE ANGIOGRAPHIC
SYRINGES AND ACCESSORIES
435
NBS07AG200KZ "康康"一次性使用高壓造影注射筒及配件:針筒X2+單向閥盤旋T管
+穿刺器"KK" SINGLE-USE HIGH PRESSURE ANGIOGRAPHIC
SYRINGES AND ACCESSORIES:2X SYRINGES+C
435
NCS010001N3C "千禧光"附針安全注射器:1.0ML附針SOL-CARE SAFETY SYRINGE
WITH FIXED NEEDLE:1.0ML
4.9
NCS010001NRW "勤達"一次性使用無菌注射器帶針1CC"TEAM POWER"DISPOSABLE
SYRINGE 1CC
2
NCS010001S1M "濟翔"自動回縮式安全針筒:1CC附針MYSAFETY SYRINGE:1CC WITH
NEEDLE
4.9
NCS010003N3C "千禧光"安全注射器:3CC附針SOL-CARE LUER LOCK SAFETY
SYRINGE:3CC WITH NEEDLE
4.9
NCS010003NRW "勤達"一次性使用無菌注射器帶針3CC"TEAM POWER"DISPOSABLE
SYRINGE 3CC W/NEEDLE
1.4
NCS010005N3C "千禧光"安全注射器:5CC附針SOL-CARE LUER LOCK SAFETY
SYRINGE:5CC WITH NEEDLE
4.9
NCS010005NRW "勤達"一次性使用無菌注射器帶針5CC"TEAM POWER"DISPOSABLE
SYRINGE 5CC W/NEEDLE
1.8
NCS010010N3C “千禧光”安全注射器10CC(附針)SOL-CARE LUER LOCK SAFETY
SYRINGE 10CC (WITH NEEDLE)
4.9
NCS010010NRW "勤達"一次性使用無菌注射器帶針10CC"TEAM POWER"DISPOSABLE
SYRINGE 10CC W/NEEDLE
2.5
NCS01001BR3E "博瑞司"自動回收式安全注射器(附
針)1CC"BRILLIAX"AUTOMATICALLY RETRACTABLE SAFETY SYRINGE
1CC W/NEEDLE
4.9
NCS010020N3C "千禧光"安全注射器:20ML附針SOL-CARE LUER LOCK SAFETY
SYRINGE:20ML WITH NEEDLE
7.1
NCS010020NRW "勤達"一次性使用無菌注射器帶針20CC"TEAM POWER"DISPOSABLE
SYRINGE 20CC W/NEEDLE
3.1
NCS01003BR3E "博瑞司"自動回收式安全注射器(附
針)3CC"BRILLIAX"AUTOMATICALLY RETRACTABLE SAFETY SYRINGE
3CC W/NEEDLE
4.9
NCS01005BR3E "博瑞司"自動回收式安全注射器(附
針)5CC"BRILLIAX"AUTOMATICALLY RETRACTABLE SAFETY SYRINGE
5CC W/NEEDLE
4.9
NCS01010BR3E "博瑞司"自動回收式安全注射器(附
針)10CC"BRILLIAX"AUTOMATICALLY RETRACTABLE SAFETY SYRINGE
10CC W/NEEDLE
4.9
NCS01020SS2P 嘉鎂一次性使用無菌回縮型自毀式注射器(安全型附針
20CC)"EWNL"SAFETY SYRINGE 20CC WITH NEEDLE
7.1
NCS01A003VPW "普惠"塑膠注射筒附針3CC(安全型)"PERFECT"DISPOSABLE
SYRINGE 3CC/NEEDLE(SAFETY)
4.9
995
特材代碼 中英文名稱 支付點數-104/01/01
NCS01A005VPW "普惠"塑膠注射筒附針5CC(安全型)"PERFECT"DISPOSABLE
SYRINGE 5CC/NEEDLE(SAFETY)
4.9
NCS01A010NPW "PERFECT"10CC DISPOSABLE SYRINGE(SAFETY) W/NEEDLE"普惠"塑
膠注射筒附針(安全型)
4.9
NCS01A010VPW "普惠"塑膠注射筒附針10CC(安全型)"PERFECT"DISPOSABLE
SYRINGE 10CC/NEEDLE(SAFETY)
4.9
NCS01A020NPW "PERFECT"20CC DISPOSABLE SYRINGE(SAFETY) W/NEEDLE"普惠"塑
膠注射筒附針(安全型)
7.1
NCS01A020VPW "普惠"塑膠注射筒附針20CC(安全型)"PERFECT"DISPOSABLE
SYRINGE 20CC/NEEDLE(SAFETY)
7.1
NCS01B030NPW "普惠"塑膠注射筒:安全型附針1CC"PERFECT"DISPOSABLE
SYRINGE:SAFETY WITH NEEDLE 1CC
4.9
NCS01C001NPW "普惠"塑膠注射筒:安全型附針1CC"PERFECT" DISPOSABLE
SYRINGE:SAFETY WITH NEEDLE 1CC
4.9
NCS01ECL01BD BD安全遮蔽防護式注射針(含1CC注射筒)BD ECLIPSE NEEDLE
W/SYRINGE 1CC
4.9
NCS01ECL02BD BD安全遮蔽防護式注射針(含3CC注射筒)BD ECLIPSE NEEDLE
W/SYRINGE 3CC
4.9
NCS01ECL03BD BD安全遮蔽防護式注射針(含5CC注射筒)BD ECLIPSE NEEDLE
W/SYRINGE 5CC
4.9
NCS01ECL04BD BD安全遮蔽防護式注射針(含10CC注射筒)BD ECLIPSE NEEDLE
W/SYRINGE 10CC
4.9
NCS01EME05BD BD注射筒(含注射針)5CC BD EMERALD SYRINGE W/NEEDLE 1.8
NCS01EME10BD BD注射筒(含注射針)10CC BD EMERALD SYRINGE W/NEEDLE 2.5
NCS01EME20BD BD注射筒(含注射針)20CC BD EMERALD SYRINGE W/NEEDLE 3.1
NCS01EME23BD BD注射筒(含注射針)2CC;3CC BD EMERALD SYRINGE W/NEEDLE 1.4
NCS01S001NTM “泰爾茂”確保安全針筒附針(1CC)“TERUMO” SURGUARD2
HYPODERMIC SYRINGE WITH SAFETY NEEDLE
4.9
NCS01S003NTM “泰爾茂”確保安全針筒附針(3CC)“TERUMO” SURGUARD2
HYPODERMIC SYRINGE WITH SAFETY NEEDLE
4.9
NCS01S005NTM “泰爾茂”確保安全針筒附針(5CC)“TERUMO” SURGUARD2
HYPODERMIC SYRINGE WITH SAFETY NEEDLE
4.9
NCS01S010NTM “泰爾茂”確保安全針筒附針(10CC)“TERUMO” SURGUARD2
HYPODERMIC SYRINGE WITH SAFETY NEEDLE
4.9
NCS03001DB2P 嘉鎂一次性使用無菌回縮型自毀式注射器(安全型胰島素注射筒附
針)"EWNL"SAFETY SYRINGE WITH NEEDLE(INSULIN SYRINGE)
6
NCS030310NFB "桂台"胰島素注射筒附針"FEELJECT"DISPOSABLE INSULIN
SYRINGES WITH NEEDLE
3.7
NCS030510VPW "普惠"塑膠注射筒:胰島素空針"PERFECT"DISPOSABLE
SYRINGE:INSULIN SYRINGE
3.7
NDN011828N3B "康德萊"頭皮針"KDL" SCALP VEIN SET 3.9
NDN02A430NPW "PERFECT"WINGED CORE RESISTANT NEEDLE SETS(SAFETY)"普惠"
蝴蝶彎針(安全型)
91.5
NDN041624N2F "美德芙"靜脈留置針"MEDIFIRST"CATH PRO I.V CATHETER(PU) 10.5
NDN041824N2F "美德芙"靜脈留置針"MEDIFIRST"CATH PRO I.V CATHETER(PU) 10.5
NDN0442511BB "柏朗"第三代安全靜脈留置針"B.BRAUN" INTROCAN SAFETY 3
CLOSED I.V. CATHETER
27.5
NDN0451SNW2K "欣意"安全靜脈留置針"MASTER&FRANK"SAFETY IV CATHETER 27.5
NDN04BC001BD BD INSYTE AUTOGUARD BC SHIELD IV CATHETER 16:24G BD 安全
性靜脈留置針-血液控制
27.5
NDN04SC5J1YZ “美迪克”安全性靜脈留置針"MEDIKIT” SUPERCATH 5 SAFETY
I.V.CATHETER
27.5
NDN04SC5V1YZ "美迪克"安全性靜脈留置針"MEDIKIT" SUPERCATH 5 SAFETY I.V.
CATHETER
27.5
996
特材代碼 中英文名稱 支付點數-104/01/01
NES0376330ZM "楚克"切片針"TRU-CORE" I BIOPSY NEEDLES 633
RRB01TB000EF "貝斯美德"誘發型肺量計"BESMED" INCENTIVE SPIROMETER 140
SAS06548872C "柯惠"可拆除式皮膚縫合釘(滅菌) "COVIDIEN" REMOVABLE SKIN
STAPLE (STERILE))
210
SAS06803522C "柯惠"可拆除式皮膚縫合釘(滅菌) "COVIDIEN" REMOVABLE SKIN
STAPLE (STERILE)
173
SAS06TS35RQW "台灣先進"可拆除式皮膚縫合釘(滅菌) "TAIWAN SURGICAL"
REMOVABLE SKIN STAPLE (STERILE)
173
SAS06TS35WQW "台灣先進"可拆除式皮膚縫合釘(滅菌) "TAIWAN SURGICAL"
REMOVABLE SKIN STAPLE (STERILE)
210
SAU01P130L2C "柯惠" 胸腹自動縫合器及縫合釘-縫合釘"COVIDIEN" AUTO
SUTURE PI DISPOSABLE STAPLER AND LOADING UNIT-SINGLE USE
LOADING UNIT
2293
SAU07304512C "柯惠"旋轉式內視鏡胃腸自動吻合釘匣"COVIDIEN"AUTO SUTURE
ENDO GIA UNIVERSAL ROTICULATOR SINGLE USE LOADING UNIT
4000
SAU07308052C "柯惠" 內視鏡GIA自動手術縫合器及縫合釘-縫合釘
匣"COVIDIEN" AUTO SUTURE MULTIFIRE ENDO GIA DISPOSABLE
SURGICAL STAPLER AND DISPOSABLE LOADING UN
4000
SCV01FD100TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip (M) 每盒10排
,每排25CLIP
15
SCV01FD135TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip(S) 每盒12排,
每排25CLIP
12.5
SCV01FD160TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip(M.L) 每盒20排
,每排10CLIP
18.6
SCV01FD170TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip(L) 每盒10排,
每排15CLIP
29.4
SCV01FD300TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip(M) 每盒20排,
每排10CLIP
15
SCV01FD335TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip(S) 每盒24排,
每排10CLIP
12.5
SCV01FD360TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip (ML) 每盒16排
,每排10CLIP
18.6
SCV01FD370TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip(L) 每盒12排,
每排10CLIP
29.4
SCV01FD800TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip-TITANIUM
(MEDIUM)
17.9
SCV01FD835TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip-TITANIUM
(SMALL)
15
SCV01FD860TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip-
TITANIUM(MEDIUM-LARGE)
20.2
SCV01FD870TX "泰利芙斯"血管夾"Teleflex Medical" Hemoclip-
TITANIUM(LARGE)
35
SCV029380NM1 "瑞穗"腦動脈瘤夾"MIZUHO"SUGITA ANEURYSM CLIP 2897
SCV0294050M1 "瑞穗"腦動脈瘤夾"MIZUHO"SUGITA ANEURYSM CLIP 2801
SCV0294069M1 "瑞穗"腦動脈瘤夾"MIZUHO"SUGITA ANEURYSM CLIP 2256
SCV2023703TX "泰利芙斯"希瑪克力普血管夾"Teleflex Medical" Hemoclip
Automatic Clip Applier With Clips-M20
98.7
TKP03700UB3R "安吉優戴爾美德"射頻燒灼手術系統及其配件(優你布
蕾)"ANGIODYNAMICS"RFA SURGICAL SYSTEM AND
ACCESSORIES:UNIBLATE
18800
TKP0427160XL "首馬特"乳房定位針"SOMATEX"BREAST LOCALIZATION NEEDLE 984
TKP04CHESBBA "巴德"乳房定位針(滅菌):切絲柏乳房定位導線"BARD" BREAST
LOCALIZATION NEEDLE (STERILE):CHESBROUGH BREAST
LOCALIZATION WIRES(NEEDLE+WIRE)
984
997
特材代碼 中英文名稱 支付點數-104/01/01
TSS0100003LQ "長庚"血糖檢測系統血糖試片(側吸式)(25*2瓶/組)"CHANG
GUNG"BLOOD GLUCOSE MONITORING SYSTEM BLOOD GLUCOSE TEST
STRIP(SIDE TYPE)(25*2 BOTTLES/SET)
8.1
TSS0100005LQ "長庚"血糖檢測系統血糖試片鋁箔包裝(側吸式)(單片鋁箔包50片
裝)"CHANG GUNG"BLOOD GLUCOSE MONITORING SYSTEM BLOOD
GLUCOSE TEST STRIP PACKAGE OF ALUMI
8.1
TSS0100008G8 測利得血糖檢測系統-測利得血糖試片(罐裝25片,50片,及鋁箔包
10片,25片,50片,100片)GLUCOLEADER BLOOD GLUCOSE MONITORING
SYSTEM-GLUCOLEADER BLOOD GLUCOS
8.1
TSS01101011Y 紅電血糖監測系統-紅電血糖測試片(25、40、50片盒裝)MEDACCU
BLOOD GLUCOSE MONITORING SYSTEM-MEDACCU BLOOD GLUCOSE
TEST STRIP(25、40、50 PCS)
8.1
TSS0125693AB 亞培輔理善越佳型醫院用血糖試紙(50片/盒)ABBOTT FREESTYLE
OPTIUM H BLOOD GLUCOSE TEST STRIPS
8.1
TSS0125879AB 亞培輔理善越佳型血糖試紙(10片,25片,50片/盒)ABBOTT
FREESTYLE OPTIUM BLOOD GLUCOSE TEST STRIP
8.1
TSS014132AK9 福爾愛立測血糖測試系統血糖試片(25片/罐,2罐/盒)FORA
IDIAMOND BLOOD GLUCOSE MONITORING SYSTEM BLOOD GLUCOSE
TEST STRIP
8.1
TSS0171191AB 亞培輔理善越巧型血糖試紙(50片/罐)ABBOTT FREESTYLE LITE
BLOOD GLUCOSE TEST STRIPS
8.1
TSS01AS0012J 捷兌佳攜帶型血糖測試系統-捷兌佳攜帶型血糖試片(25、2*25、
50片/罐)ALCOSE POCKET BLOOD GLUCOSE MONITORING SYSTEM-
ALCOSE BLOOD GLUCOSE STRIPS(25、2*2
8.1
TSS01EN003FY "愛科來"SIGMA血糖試紙(25片/盒,50片/盒)"ARKRAY"GLUCOCARD
SIGMA TEST STRIPS
8.1
TSS01GM250FS 瑞特血糖監測系統GM250-瑞特血糖測試片(10片/盒、25片/盒、50
片/盒、75片/盒、100片/盒、200片/盒)RIGHTEST BLOOD GLUCOSE
MONITORING SYSTEM GM250-BLOOD
8.1
TSS01GM260FS 瑞特血糖監測系統GM260-瑞特血糖測試片(10片/盒、25片/盒、50
片/盒、75片/盒、100片/盒、200片/盒RIGHTEST BLOOD GLUCOSE
MONITORING SYSTEM GM260-BLOOD G
8.1
TSS01GM720FS 瑞特血糖監測系統GM720-瑞特血糖監測試片(10片/罐,25片/罐,25
片/罐*2,25片/罐*3,25片/罐*4,25片/罐*8)RIGHTEST BLOOD
GLUCOSE MONITORING SYSTEM GM720-BLO
8.1
TSS01HL5221J 帝寶血糖試紙(25片/盒、50片/盒)TIPOCARE BLOOD GLUCOSE TEST
STRIP
8.1
TSS01NS0012Y 史丹斯翠血糖測定儀-血糖試片(50片/罐)STATSTRIP GLUCOSE
HOSPITAL METER-BLOOD GLUCOSE TEST STRIPS
8.1
TSS01TB001NR 測寶穩血糖試紙條(10片,50片,25片,25片*2瓶/盒)TRUEBALANCE
BLOOD GLUCOSE TEST STRIPS
8.1
TSS01VBM1A2V 美高安易型血糖監測系統-血糖試片(10片,25片,50片/盒)VERI-Q
BALANCE BLOOD GLUCOSE MONITORING SYSTEM-BLOOD GLUCOSE
TEST STRIPS
8.1
WBB0703035NJ "必史恩"義肢及裝具用附件-石膏繃帶 3"×3YDS "BSN"
PROSTHETIC AND ORTHOTIC ACCESSORY-PLASTER BANDAGE
22.7
WBB0704030C7 "中衛"石膏繃帶(未滅菌)"CSD"PLASTER OF PAIRS BANDAGE (NON-
STERILE)
24.4
WBB0704055NJ "必史恩"義肢及裝具用附件-石膏繃帶 4"×5YDS "BSN"
PROSTHETIC AND ORTHOTIC ACCESSORY-PLASTER BANDAGE
38.1
WBB0705055NJ "必史恩"義肢及裝具用附件-石膏繃帶 5"×5YDS
"BSN"PROSTHETIC AND ORTHOTIC ACCESSORY-PLASTER BANDAGE
48.8
WBB0706055NJ "必史恩"義肢及裝具用附件-石膏繃帶 6"×5YDS "BSN"
PROSTHETIC AND ORTHOTIC ACCESSORY-PLASTER BANDAGE
50.1
998
特材代碼 中英文名稱 支付點數-104/01/01
WBB0802040C7 "中衛"樹脂石膏繃帶 (未滅菌)"CSD" ORTHOPEDIC CASTING TAPE
(NON-STERILE)
120
WBB0803040C7 "中衛"樹脂石膏繃帶 (未滅菌)"CSD" ORTHOPEDIC CASTING TAPE
(NON-STERILE)
140
WBB0804040C7 "中衛"樹脂石膏繃帶 (未滅菌)"CSD" ORTHOPEDIC CASTING TAPE
(NON-STERILE)
160
WBB0805040C7 "中衛"樹脂石膏繃帶 (未滅菌)"CSD" ORTHOPEDIC CASTING TAPE
(NON-STERILE)
180
WBB0806040C7 "中衛"樹脂石膏繃帶 (未滅菌)"CSD" ORTHOPEDIC CASTING TAPE
(NON-STERILE)
207
WDD0809940HL "鶴牌"親水性創傷覆蓋材(滅菌)-無菌傷口滲出液貼
布"HOLLISTER"HYDROPHILIC WOUND DRESSING (STERILE)-RESTORE
CALCICARE WOUND CARE DRESSING STERILE
119
WDD0820671F4 〝康威〞愛康膚 強化吸收親水性纖維敷料 (滅菌)〝CONVATEC〞
AQUACEL EXTRA HYDROFIBER DRESSING (STERILE)5*5cm
29.3
WDD0820672F4 〝康威〞愛康膚 強化吸收親水性纖維敷料 (滅菌)〝CONVATEC〞
AQUACEL EXTRA HYDROFIBER DRESSING (STERILE)10*10cm
119
WDD0820673F4 〝康威〞愛康膚 強化吸收親水性纖維敷料 (滅菌)〝CONVATEC〞
AQUACEL EXTRA HYDROFIBER DRESSING (STERILE)15*15cm
245
WDD0820674F4 〝康威〞愛康膚 強化吸收親水性纖維敷料 (滅菌) 〝CONVATEC〞
AQUACEL EXTRA HYDROFIBER DRESSING (STERILE)10*12cm
143
WDD0839530LN "美尼克"美皮蕾防水型銀自黏抗菌軟性矽膠泡棉敷料"MOLNLYCKE"
MEPILEX BORDER AG SELF-ADHERENT ANTIMICROBIAL SOFT
SILICONE FOAM DRESSING
184
WDD0839570LN "美尼克"美皮蕾防水型銀自黏抗菌軟性矽膠泡棉敷料"MOLNLYCKE"
MEPILEX BORDER AG SELF-ADHERENT ANTIMICROBIAL SOFT
SILICONE FOAM DRESSING
460
WDD0839580LN "美尼克"美皮蕾防水型銀自黏抗菌軟性矽膠泡棉敷料"MOLNLYCKE"
MEPILEX BORDER AG SELF-ADHERENT ANTIMICROBIAL SOFT
SILICONE FOAM DRESSING
368
WDD0839590LN "美尼克"美皮蕾防水型銀自黏抗菌軟性矽膠泡棉敷料"MOLNLYCKE"
MEPILEX BORDER AG SELF-ADHERENT ANTIMICROBIAL SOFT
SILICONE FOAM DRESSING
559
WDD08C0501ZW 舒膚貼抗菌親水性敷料(滅菌)SAVDERM ANTISEPTIC
HYDROCOLLOIDS THIN DRESSING (STERILE)5×5cm
56.4
WDD08C0512ZW 舒膚貼抗菌親水性敷料(滅菌)5.5*8.5cm 56.4
WDD08C0563ZW 舒膚貼抗菌親水性敷料(滅菌)SAVDERM ANTISEPTIC
HYDROCOLLOIDS THIN DRESSING (STERILE)
224
WDD08C1001ZW 舒膚貼抗菌親水性敷料(滅菌)SAVDERM ANTISEPTIC
HYDROCOLLOIDS DRESSING (STERILE)5x5cm
56.4
WDD08C1002ZW 舒膚貼抗菌親水性敷料(滅菌)SAVDERM ANTISEPTIC
HYDROCOLLOIDS DRESSING (STERILE)10x10cm
224
WDD08C1004ZW 舒膚貼抗菌親水性敷料(滅菌)SAVDERM ANTISEPTIC
HYDROCOLLOIDS DRESSING (STERILE)20x20cm
612
WDD08C1006ZW 舒膚貼抗菌親水性敷料(滅菌)SAVDERM ANTISEPTIC
HYDROCOLLOIDS DRESSING (STERILE)15x15cm
406
WDD08C1012ZW 舒膚貼抗菌親水性敷料(滅菌)SAVDERM ANTISEPTIC
HYDROCOLLOIDS DRESSING (STERILE)
56.4
WDD08C1063ZW 舒膚貼抗菌親水性敷料(滅菌)SAVDERM ANTISEPTIC
HYDROCOLLOIDS DRESSING (STERILE)5x20cm
224
WDD08X1520QY "SYSTAGENIX" TIELLE XTRA NON-ADHESIVE HYDROPOLYMER
DRESSING (STERILE)"新世捷"德力裁剪型不自粘親水性敷料
327
ACM0101278BB HIGH PRESSURE MANIFOLDS DOUBLE W/ROTABLE ADAPTER 70 BAR 184
ACM0101280BB HIGH PRESSURE MANIFOLDS TRIPLE 35 BAR 211
999
特材代碼 中英文名稱 支付點數-104/01/01
ACM0101281BB HIGH PRESSURE MANIFOLDS TRIPLE W/ROTABLE ADAPTER 35 BAR 211
ACM0101284BB HIGH PRESSURE MANIFOLDS TRIPLE W/ROTABLE ADAPTER 70 BAR 211
ACM0101285BB ANGIODYN HIGHT PRESSURE MANIFOLDS STOPCOCKS DOUBLE PORTS
500PSI 1000PSI
184
ACM0101286BB ANGIODYN HIGHT PRESSURE MANIFOLDS STOPCOCKS TRIPLE PORTS
500PSI 1000PSI
211
ACM01202HFMR MANIFOLD 2-V 200PSI 184
ACM01253RXMR MANIFOLD 3 PORTS 200PSI;500PSI WITH HIGH PRESSURE TUBING
雙層 (可達1200PSI)
287
ACM012HFRXMR MANIFOLD 2-PORTS W/ HIGH PRESSURE TUBING(雙層可達1200PSI) 287
ACM013P700NL "娜維利斯特"娜米克血管造影多路水接頭"NAVILYST"NAMIC
ANGIOGRAPHIC MANIFOLDS(3-PORT)
211
ACM01502RXMR MANIFOLD 2-PORTS 500 PSI 184
ACM01503RXMR MANIFOLD 3-PORTS 500 PSI 211
ACM01504RXMR MANIFOLD 4 PORTS 200PSI;500PSI WITH HIGH PRESSURE TUBING
雙層 (可達1200PSI)
287
ACM0154PRTMR "MERIT"MANIFOLD:4 PORTS 200PSI;500PSI"美瑞特"多路水接頭:4
連接頭
261
ACM019310NAG MANIFOLDS 2 PORTS 184
ACM01APMF2H9 ANGIO PACK:MANIFOLDS 2 PORT/500 184
ACM01APMF3H9 ANGIO PACK:MANIFOLDS 3 PORT/500 211
ACM01M2P2HGJ "JSM" 2-PORTS MANIFOLDS (500PSI)+2條PRESSURE TUBING (PVC
可達500PSI)+1條HIGH PRESSURE TUBING (雙層PU可達1200PSI)"
吉生"多路引流器
464
ACM01M3P2HGJ "JSM" 3-PORTS MANIFOLDS (500PSI)+2條PRESSURE TUBING (PVC
可達500PSI)+1條HIGH PRESSURE TUBING (雙層PU可達1200PSI)"
吉生"多路引流器
478
ACM01M3P4HGJ "JSM" 2個3-PORTS MANIFOLDS (500PSI)+4條PRESSURE TUBING
(PVC可達500PSI)+1條HIGH PRESSURE TUBING (雙層PU可達
1200PSI)"吉生"多路引流器
721
ACM01M4P2HGJ "JSM" 4-PORTS MANIFOLDS (500PSI)+2條PRESSURE TUBING (PVC
可達500PSI)+1條HIGH PRESSURE TUBING (雙層PU可達1200PSI)"
吉生"多路引流器
523
ACM01MA2PTGJ MANIFOLDS (2 PORT 500PSI W/PVC PT)多路引流器(含PVC壓力連
接管)
188
ACM01MA2PUGJ "JSM"MANIFOLDS(2 PORT/500PSI W/PU 1200PSI)"吉生"多路引流
器
287
ACM01MA2PVGJ "JSM"MANIFOLDS(2 PORT/500PSI W/PVC 1000PSI)"吉生"多路引流
器
250
ACM01MA3PTGJ MANIFOLDS (3 PORT 500PSI W/PVC PT)多路引流器(含PVC壓力連
接管)
218
ACM01MA3PUGJ "JSM"MANIFOLDS(3 PORT/500PSI W/PU 1200PSI)"吉生"多路引流
器
287
ACM01MA3PVGJ "JSM"MANIFOLDS(3 PORT/500PSI W/PVC 1000PSI)"吉生"多路引流
器
250
ACM01MA4PTGJ MANIFOLDS (4 PORT 500PSI W/PVC PT)多路引流器(含PVC壓力連
接管)
278
ACM01MA4PUGJ "JSM"MANIFOLDS(4 PORT/500PSI W/PU 1200PSI)"吉生"多路引流
器
287
ACM01MA4PVGJ "JSM"MANIFOLDS(4 PORT/500PSI W/PVC 1000PSI)"吉生"多路引流
器
250
ACM01MAN2PGJ MANIFOLDS (2 PORT 500PSI)多路引流器 184
ACM01MAN3PGJ MANIFOLDS (3 PORT 500PSI)多路引流器 211
1000
特材代碼 中英文名稱 支付點數-104/01/01
ACM01MAN4PGJ MANIFOLDS (4 PORT 500PSI)多路引流器 261
ACM01TS520SG MANIFOLD 2 PORTS 184
ACM01TS530SG MANIFOLD 3 PORTS 211
ACM01TS540SG MANIFOLD 4 PORTS 261
ACPD1C4129BT "百特"鈦金屬接頭 "BAXTER" ADAPTER FOR PERITONEAL DIALYSIS
CATHETER
1482
ACVP105103B0 CSF CATHETER CONNECTOR,STRAIGHT 380
ACVP105104B0 CSF CATHETER CONNECTOR,RIGHT ANGLE 719
ACVP123048CM HAKIM STRAIGHT CONNECTOR 380
ACVP145103PM CONNECTOR 380
ACVP145104PM CONNECTOR L型 719
ACVP182150CM ACCU-FLO STRAIGHT CONNECTORS(METAL,PLASTIC) 380
ACVP182151CM ACCU-FLO RIGHT ANGLE CONNECTORS(METAL,PLASTIC) 719
CAE0101401BB PERIFIX ONE EPIDURAL
ANAESTHESIA(NEEDLE+CATH+CONNECTOR+FILTER+LOR
SYRINGE+SYRINGE)
389
CAE0112006BB EPIDURAL ANAESTHESIA SET 16:18G(N+C+F+S)(型號含
04514300,04515-013:021,-200:307,04516-206:303)
389
CAE0139101PX "保德士"硬膜外腔麻醉針組(1)"PORTEX"EPIDURAL MINIPACK
SYSTEMS(1) 16;18G(NEEDLE+CATHETER+FILTER+SYRINGE)
389
CAE0139411PX "保德士"硬膜外腔麻醉針組(4)"PORTEX"EPIDURAL MINIPACK
SYSTEMS(4) 16;18G(NEEDLE+CATHETER)
208
CAE014014NBD PERISAFE EPIDURAL ANAESTHESIA KIT NEEDLE 17,18G CATH
19,20G(N+C+FILTER+SYRINGE+GUIDE+CONNECTOR)
389
CAE0151300BB PERIFIX EPIDURAL SET 208
CAE0151410BB PERIFIX FOR CONTINUOUS EPIDURAL AND CAUDAL ANAESTHESIA
400 SERIES
389
CAE01SD300BB "B.BRAUN"PERIFIX CATHETERS FOR EPIDURAL ANAESTHESIA"柏朗"
脊椎硬膜麻醉用穿刺套(NEEDLE+CATHETER)
208
CAE01SD401BB "B.BRAUN"PERIFIX CATHETERS FOR EPIDURAL
ANAESTHESIA:FILTER SETS"柏朗"脊椎硬膜麻醉用穿刺套
(NEEDLE+CATHETER+FILTER+SYRINGE)
389
CBC04EX06CAN "ANGIOMED"BARD LIFESTENT VASCULAR STENT(DELIVERY
SYS+STENT)"安吉美爾德" 巴德萊弗丹血管支架,支架長20:120MM
28773
CBC04EX12LAN "ANGIOMED"BARD LIFESTENT SOLO VASCULAR STENT
SYSTEM(DELIVERY SYS+STENT)"安吉美爾德" 巴德萊弗丹舒樂血管
支架系統,支架長20:120MM
28773
CBC04EX15CAN "ANGIOMED"BARD LIFESTENT VASCULAR STENT(DELIVERY
SYS+STENT)"安吉美爾德" 巴德萊弗丹血管支架,支架長150:170MM
44293
CBC04EX20LAN "ANGIOMED"BARD LIFESTENT SOLO VASCULAR STENT
SYSTEM(DELIVERY SYS+STENT)"安吉美爾德" 巴德萊弗丹舒樂血管
支架系統,支架長150:200MM
44293
CBC04MAR1SF2 "INVATEC"MARIS PERIPHERAL SELF-EXPANDING STENT SYSTEM"英
泰克"瑪瑞斯自膨式周邊血管支架系統(淺股動脈血管支
架)L20:120MM D6:12MM*適應症請見備註
28773
CBC04NSFALSB "波士頓科技"宜諾自膨式支架系統(淺股動脈支架)"BOSTON
SCIENTIFIC"INNOVA SELF-EXPANDING STENT SYSTEM(DELIVERY
SYS+STENT)L150:201MM
44293
CBC04NSFASSB "波士頓科技"宜諾自膨式支架系統(淺股動脈支架)"BOSTON
SCIENTIFIC"INNOVA SELF-EXPANDING STENT SYSTEM(DELIVERY
SYS+STENT)L20:120MM
28773
1001
特材代碼 中英文名稱 支付點數-104/01/01
CBC04PR120EY "EV3"PROTEGE EVERFLEX SELF-EXPANDING BILIARY STENT SYS
20:120MM 5:8MM波特捷自動擴張式膽道支架系統-淺股動脈*適應
症請見備註欄
28773
CBC04PR150EY "EV3"PROTEGE EVERFLEX SELF-EXPANDING BILIARY STENT SYSTEM
150MM 6:8MM波特捷自動擴張式膽道支架系統-淺股動脈用
44293
CBC04SC210CD "CORDIS"S.M.A.R.T.CONTROL NITINOL STENT SYSTEM"考迪斯"史
瑪特鎳鈦支架系統(淺股動脈血管支架)D20:100MM L6:14MM
28773
CBC04SN120CD "CORDIS"S.M.A.R.T.NITINOL STENT SYSTEM"考迪斯"史瑪特鎳鈦
支架系統(淺股動脈血管支架)D 6:8MM L 120MM*給付規定請見備
註欄
28773
CBC04SN150CD "CORDIS"S.M.A.R.T.NITINOL STENT SYSTEM"考迪斯"史瑪特鎳鈦
支架系統(淺股動脈血管支架)D 6:8MM L 150MM*給付規定請見備
註欄
44293
CBC04ZFV61CK "COOK"ZILVER FLEX 35 VASCULAR STENTS"曲克"麗而服福雷斯血
管支架(淺股動脈血管支架)20:140MM 5:10MM*適應症請見備註欄
28773
CBC04ZFV62CK "COOK"ZILVER FLEX 35 VASCULAR STENTS"曲克"麗而服福雷斯血
管支架(淺股動脈血管支架)170:200MM 5-8MM
44293
CBC06F0RX1CK "COOK"FORMULA 414 RENAL STENT SYSTEM 支架5-7MMX12-24MM"曲
克"佛摩拉414腎臟血管支架系統*適應症請見備註欄
31063
CBC06H1PP0F2 "INVATEC"HIPPOCAMPUS RENAL STENT SYSTEM :D:4-7MM L:10-
24MM"英泰克"海馬腎動脈支架系統*給付規定請見備註欄
31063
CBC06H7493SB "BOSTON SCIENTIFIC"EXPRESS RENAL/BILIARY SD PREMOUNTED
STENT SYS"波士頓科技"極速腎臟/膽道用支架系統(腎臟支架系
統)*適應証見備註欄
31063
CBC06HLELTAB "ABBOTT"RX HERCULINK ELITE PERIPHERAL STENT SYSTEM"亞培"
赫可林精英周邊血管支架系統(腎動脈支架及輸送系統)*給付規定
請見備註欄
31063
CBC07VB10NGX "GORE"VIABAHN ENDOPROTHESIS D5:13MM.L10CM"戈爾"威爾棒周邊
血管支架(含傳輸裝置)*給付規定請見備註欄
76050
CBC07VB15NGX "GORE"VIABAHN ENDOPROTHESIS D5:10MM.L15CM"戈爾"威爾棒周邊
血管支架(含傳輸裝置)*給付規定請見備註欄
91800
CBC07VBC5NGX "GORE"VIABAHN ENDOPROTHESIS D5:8MM.L2.5CM,D5:13MM.L5CM"
戈爾"威爾棒周邊血管支架(含傳輸裝置)*給付規定請見備註欄
62370
CBS069MVSDG6 "銨積維"安普拉茲肌肉性心室中膈缺損關閉器"AGA" AMPLATZER
MUSCULAR VSD OCCLUDER 4:18MM
121679
CDF0121000M4 CSF FLOW CONTROL SHUNTS AND ACCESSORIES V-P-SHUNT
RESERVOIR
2653
CDF0121401CM ACCU-FLO SINGLE LUMEN RESERVOIR 2653
CDF0221411CM ACCU-FLO SINGLE LUMEN RESERVOIR 2653
CDF0242104PM C.S.F. FLOW CONTROL VALVE STANDARD 5568
CDF0302512B0 CSF VALVE BURR HOLE 5568
CDF0302812B0 CSF VALVE BURR HOLE 5568
CDF0342324PM C.S.F. FLOW CONTROL VALVE CONTOURED 5568
CDF0342544PM C.S.F. FLOW CONTROL VALVE BURR HOLE 5568
CDLP106418B0 "長安"腦脊髓分引流系統"BMI"CSF Shunting System 6599
CDLP144410PM "美敦力"腦脊髓液腰椎腹膜分流系
統"MEDTRONIC"LUMBOPERITONEAL SHUNT SYSTEM
6599
CDLP146418M4 "美敦力"體外腰椎引流監測系統"MEDTRONIC"EDM LUMBER
CATHETER 24CM;80CM
1903
1002
特材代碼 中英文名稱 支付點數-104/01/01
CDPN1UTPT1CK "COOK"WAYNE PNEUMOTHORAX SET(含單向引流閥+豬尾導管+0.035
導線+擴張器+3WAY+連接管+穿刺針*2)"曲克"威恩氣胸引流組
2908
CDPN2TQTS1CK "COOK"THAL-QUICK CHEST TUBE SET 8~36FR 18~41CM(穿刺針+擴
張器*3+導線+胸管插入器+胸管)"曲克"胸腔引流管組
1948
CFD0202308P2 "太平洋"胃管"PAHSCO"STOMACH TUBE SILICON*適應症請見備註欄 65.6
CFD0216120W6 SILICONE STOMACH TUBE 6FR:18FR*適應症請見備註欄 65.6
CFD022020NFM ALL SILICONE STOMACH(GASTRIC)TUBE 4:20FR ※適應症請見備註
欄
65.6
CFD0222070WN ALL SILICON LEVIN TUBE W/TAPER FUNNEL 2EYES※適應症請見備
註欄
65.6
CFD0222073WN "世運"矽質胃管附蓋子"SEWOON"GASTROINTESTINAL TUBE AND
CATHETER(SILICONE)
65.6
CFD0222074WN ALL SILICON LEVIN TUBE W/TAPER FUNNEL 4EYES※適應症請見備
註欄
65.6
CFD022207NWN Silicon Levin Tube W/Taper Funnel 8:22FR※適應症請見備註
欄
65.6
CFD0276ST6MU ALL SILICONE STOMACH TUBE※適應症請見備註欄 65.6
CFD02G0101SG SILICONE GASTRIC TUBE*適應症請見備註欄 65.6
CFD02GT001SG SIGMA GASTRIC TUBE(SILICON)*適應症請見備註欄 65.6
CFD02GT301EW E-UP STOMACH TUBE(SILICON) 毅升一次性使用胃管 65.6
CFD02GT501EW E-UP GASTRIC DUODENAL LEVIN TUBE (SILICON) 08~18FR 毅升胃
管
65.6
CFD02ST000EF BESMED SILICONE STOMACH TUBING*適應症請見備註欄 65.6
CFD04CNJFTCK 〝COOK〞TIGER TUBE FRICTIONAL NASAL JEJUNAL FEEDING
TUBE9(含導管、餵食管接頭)〝曲克〞泰格管菲宣那鼻空腸餵食管
※給付規定請見備註欄
4157
CFD04NJFT1CK "COOK"NASAL JEJUNAL FEEDING TUBE(含導線、餵食管、鼻引導
管、餵食管接頭)"曲克"經鼻腔空腸餵食管※適應症請見備註欄
2700
CFD0600026BA "BARD" BUTTON REPLACEMENT GASTROSTOMY DEVICE
(BUTTON+OBTURATOR+BOLUS AND F-TUBES+DECOMP TUBE+SY)"巴德"
鈕扣式置換胃造口組※適應症請見備註欄
4243
CFD0600031BA "BARD"DUAL PORT FEEDING ADAPTOR 經皮內視鏡胃造口組:雙座餵
食管接頭※適應症請見備註欄
204
CFD0600627BA "BARD"PONSKY PULL PEG DELUXE KIT
(TUBE+WIRE+S+N+ADAP+BOL+SNARE+SCISSOR)"巴德"經皮內視鏡胃
造口組(全套)※適應症請見備註欄
4610
CFD060640NK4 "KIMBERLY-CLARK"PEG
KIT(TUBE+SNARE+ADAPTER+RING+NEEDLE+WIRE+CLAMP)〝金百利克
拉克〞經皮內視鏡胃造廔組(全套)※適應症請見備註欄
4610
CFD060640NLZ PEG KIT(全套)經皮內視鏡胃造廔組(PEG TUBE,RETRIEVAL
SNARE,ADAPTER,RING,INTRODUCER NEEDLE,WIRE,TUBING CLAMP)※
適應症請見備註欄
4610
CFD0612LVNK4 "KIMBERLY-CLARK"GASTROSTOMY TUBE(SILICONE BALLOON TYPE)〝
金百利克拉克〞胃造廔管※適應症請見備註欄
1541
CFD0612LVNLZ GASTROSTOMY TUBE BALLOON FEEDING TUBE 胃造口術器材配件
/BALLOON型替換管※適應症請見備註欄
1541
CFD062019NFM "富強"胃造廔管 "FORTUNE" GASTROSTOMY CATHETERX *給付規定
請見備註欄
1541
CFD0630652CU "蔻沛"可福樂經皮內視鏡胃造口組"CORPAK"CORFLO-MAX
PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE KIT(PEG管+外固定
器*2+穿刺針+導線+Y型連接器+管線夾)
4610
1003
特材代碼 中英文名稱 支付點數-104/01/01
CFD0632000CU "蔻沛"可福樂胃造口管組"CORPAK"CORFLO GASTROSTOMY TUBE
KIT(CORFLO-DUAL GT) 12~24FR
1541
CFD0633000CU "蔻沛"可福樂胃造口管組"CORPAK"CORFLO GASTROSTOMY TUBE
KIT(CORFLO-TRIPLE GT) 16~24FR
1541
CFD0635000CU "蔻沛"可福樂低板胃造口替換組套"CORPAK"CORFLO-CUBBY LOW
PROFILE GASTROSTOMY DEVICE KIT
4243
CFD0679010FL PEG KIT(全套,含所材料在內)經皮內視鏡胃造廔組(PEG
TUBE,ADAPTER,RING,INTRODUCER NEEDLE,WIRE,TUBING CLAMP)※
適應症請見備註欄
4610
CFD0679010VZ FREKA PEG-SET GASTRIC(全套,含所有材料在內)福胃可胃造口術
胃管套組(PEG TUBE,ADAPTER,RING,INTRODUCER NEEDLE,TUBING
CLAMP)※適應症請見備註欄
4610
CFD0679819VZ FREKA PEG-SET GASTRIC福胃可胃造口術胃管套組:餵食管接頭※
適應症請見備註欄
204
CFD068000NCL GASTROSTOMY TUBE BALLOON FEEDING TUBE 胃造口術器材配件
/BALLOON型替換管※適應症請見備註欄
1541
CFD06BFA01CK PERCUTANEOUS ENDOSCOPIC GASTROSTOMY SYSTEM—ADAPTER 餵食
管接頭(TWO WAY OR ONE WAY)※適應症請見備註欄
204
CFD06BRT01CK "COOK"GASTROSTOMY DEVICES/ACCESSORIES BALLOON FEEDING
TUBE "曲克"胃造口術器材配件/BALLOON型替換管※適應症請見備
註欄
1541
CFD06FLW01CK PERCUTANEOUS ENDOSCOPIC GASTROSTOMY SYSTEM 經皮內視鏡胃造
口術系統(含FEEDING TUBE+鬱金香形頭+藍色導線+(A+N+D)※適應
症請見備註欄
4610
CFD06PASS1CK GASTROSTOMY DEVICES/ACCESSORIES LOW PROFILE FEEDING TUBE
胃造口術器材配件/低板胃造口術替換套組(鈕釦型替換管)※適應
症請見備註欄
4243
CFD06PCK01CK GASTROSTOMY DEVICES/ACCESSORIES PATIENT CARE KIT 護理套
組※適應症請見備註欄
1506
CFD06PEG01CK PERCUTANEOUS ENDOSCOPIC GASTROSTOMY SYSTEM 胃造口術裝置組
(含FEEDING TUBE+鬱金香形頭+藍色導線+(ADAPTER+
NEEDLE+DILATOR)※適應症請見備註欄
4610
CFD06PEGJ1CK "COOK"GASTROSTOMY DEVICES/ACCESSORIES JEJUNAL FEEDING
TUBE "曲克"胃造口術器材配件/空腸餵食管※適應症請見備註欄
3277
CFD07WGS01CK "COOK"WILLS-OGLESBY PERCUTANEOUS GASTROSTOMY CATHETER(餵
食管、矯直器通管針、接合器、連接管蓋)"曲克"威爾歐葛拜經皮
胃造廔導管
2472
CKDD112122AR LARGE-BORE MULTILUMEN HEMODIALYSIS CATHETER 1388
CKDD1135132C "COVIDIEN"KENDALL ACUTE HEMODIALYSIS CATHETERS(DUAL
LUMEN) KIT(C+N+G+D)"柯惠"肯特利急性血液透析導管
1388
CKDD115122AR ARROW-HOWES LARGE-BORE MULTI-LUMEN HEMODIALYSIS CATHETER
雙腔輸液導管組
724
CKDD1170052C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-MAHURKAR KIT(C+N+G+D)
1388
CKDD1170092C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-MAHURKAR KIT,CURVED EXT.(C+N+G+D)
1388
CKDD122122AR "ARROW"ARROWGARD CATHETERS
SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR+SHEATH) 2 LUMEN "亞諾"
抗感染安全尖端導管
1388
CKDD122334BQ "BIOTEQ"HEMODIALYSIS CATHETER KIT(2 LUMEN
CATHETER+NEEDLE+GUIDE WIRE+DILATOR)血液透析導管組
1388
1004
特材代碼 中英文名稱 支付點數-104/01/01
CKDD123122AR "ARROW"ARROWGARD CATHETERS
SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR+SHEATH)2LUMEN"亞諾"抗
感染安全尖端導管
1388
CKDD124334BQ "BIOTEQ"2 LUMEN HEMODIALYSIS CATHETER KIT(C+N+G+D)血液透
析導管組
1388
CKDD1390032C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-MAHURKAR DUAL LUMEN KIT(C+N+G+D)
1388
CKDD154334BQ "BIOTEQ"HEMODIALYSIS CATHETER KIT"邦特"血液透析導管組(雙
腔)
724
CKDD15553NBA DUAL-LUMEN NIAGARA SLIM CATH DIALYSIS CATH KIT(C+N+G+D) 1388
CKDD15554NBA DUAL-LUMEN NIAGARA SLIM CATH DIALYSIS CATH KIT(C+N+G+D) 1388
CKDD1881CK2C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-MAHURKAR KIT,CURVED EXT.(C+N+G+D)
1388
CKDD1881SK2C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-MAHURKAR KIT(C+N+G+D)
1388
CKDD1883CK2C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-MAHURKAR KIT,CURVED EXT.(C+N+G+D)
1388
CKDD1883SK2C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-MAHURKAR KIT(C+N+G+D)
1388
CKDD1K3500VC DIALYSIS CATHETERS KIT(CATH+DILATOR+GUIDE
WIRE+NEEDLE)12.5CM:24CM(自950401起型號更改為
5678125.5678150.5678240.文號0940040227
1388
CKDD1K4065VC 雙頭管路DIALYSIS CATHTER KIT(C+N+G+D)(自950401起型號更改
為5576100.5576125.5576150.文號0940040227)
1388
CKDD2140012C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-MAHURKAR CATHETER
724
CKDD2140022C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-MAHURKAR CATHETER,CURVED EXT.
724
CKDD2420052C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-MAHURKAR CATHETER
724
CKDD2450072C "柯惠"肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE
HEMODIALYSIS CATHETERS-MAHURKAR CATHETER,CURVED EXT.
724
CKDD260049BA HICKMAN HEMODIALYSIS CATHETER永植型 2603
CKDD2D3500BA DOUBLE LUMEN SUBCLAVIAN CANNULA 12.5CM(C+N+G+D)(自950401
起型號更改為5577165文號0940040227
1388
CKDD2D4000BA DOUBLE LUMEN SUBCLAVIAN CANNULA 15CM(C+N+G+D)((自950401起
型號更改為5577170文號0940040227)
1388
CKDD2D4400BA DOUBLE LUMEN SUBCLAVIAN CANNULA 20CM(C+N+G+D)((自950401起
型號更改為5577175文號0940040227)
1388
CKDD2J0KADJ0 DOUBLE LUMEN CATHETERS 724
CKDD2K4400BA DOUBLE LUMEN SUBCLAVIAN CANNULA 20(C+N+G+D)(CM(自950401起
型號更改為5678200文號0940040227)
1388
CKDD2L4424VC 雙頭管路 DIALYSIS CATHETER(自950401起型號更改為5577180文
號0940040227)
724
CKN0175030PB DRAINAGE SET AND ACCESSORIES導管(HYDROFEEL)+N+G+D+固定貼
布
2580
CKP010T2022C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETERS(TENCKHOFF
CATH T202)"柯惠"肯特利腹膜液透析導管
1488
CKP0119671FA PD CATHETER 1488
CKP018812N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETER"柯惠"肯特
利腹膜液透析導管系列
1488
1005
特材代碼 中英文名稱 支付點數-104/01/01
CKP018814N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETER"柯惠"肯特
利腹膜液透析導管系列
1488
CKP018817N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETER"柯惠"肯特
利腹膜液透析導管系列
1488
CKP018880N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETER"柯惠"肯特
利腹膜液透析導管系列
1488
CKP018884N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETERS(TENCKHOFF
PEDIATRIC)"柯惠"肯特利腹膜液透析導管
1488
CKP018888N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETERS(TENCKHOFF
CATH)"柯惠"肯特利腹膜液透析導管
1488
CKP018890N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETER"柯惠"肯特
利腹膜液透析導管系列
1488
CKP04C4479BT HOMECHOICE AUTOMATED PD SET全自動腹膜透析導管組 224
CKP04C8303BT "Baxter"HOMECHOICE PEDIATRIC /LOW RECIRCULATION VOLUME
APD SET WITH CASSETTE小兒全自動腹膜透析導管組
224
CLPA1P1CC1VY "VYGON" PERIPHERALLY INSERTED CENTRAL VENOUS
CATHETERS(P.I.C.C.)-PREMICATH "斐貢"周邊導入中央靜脈導管-
超低體重新生兒導管組※適應症請見備註欄
3316
CLPA1P1CC2VY "VYGON" PERIPHERALLY INSERTED CENTRAL VENOUS
CATHETERS(P.I.C.C.)-PREMICATH WITH STYLET"斐貢"周邊導入中
央靜脈導管-超低體重新生兒導管組附通條
4485
CLPA1P1CC3VY "VYGON" PERIPHERALLY INSERTED CENTRAL VENOUS
CATHETERS(P.I.C.C.)-EPICUTANEO-CAVA-CATHETER "斐貢"周邊導
入中央靜脈導管-經皮腔靜脈導管組※適應症請見
3316
CLPA1P1CC4VY "VYGON" PERIPHERALLY INSERTED CENTRAL VENOUS
CATHETERS(P.I.C.C.)- EPICUTANEO 2 "斐貢"周邊導入中央靜脈
導管-二代經皮腔靜脈導管組
4485
CLPA1P1CC5VY "VYGON" PERIPHERALLY INSERTED CENTRAL VENOUS
CATHETERS(P.I.C.C.)-NUTRILINE "斐貢"周邊導入中央靜脈導管-
新生兒導管組
3316
CLPA1P1CC6VY "VYGON" PERIPHERALLY INSERTED CENTRAL VENOUS
CATHETERS(P.I.C.C.)- NUTRILINE TWINFLO "斐貢"周邊導入中央
靜脈導管-新生兒雙腔導管組
4715
CLPA202701WY ACCUFUSER DISPOSABLE SILICONE BALLOON INFUSER-CONTI
TYPE(275ML-10ML;550ML-20ML;250ML-10ML/HR)輸液器-連續(1日
型))(雙層含外殼)*適應症請見備註
920
CLPA202702WY ACCUFUSER DISPOSABLE SILICONE BALLOON INFUSER-CONTI
TYPE(275ML-5.0ML;550ML-10.0ML;250ML-5.0ML/HR)輸液器-連續
(2日型)(雙層含外殼)*適應症見備註
920
CLPA205275SG "SIGMA"BALLOON PUMP INFUSION SET(275ML-5ML/HR)"十美牌"球
泵型微量輸液器(2日型)(雙層含外殼)*適應症請見備註欄
920
CLPA21009KBT 2日型 INFUSOR 輸液器(雙層含外殼)※適應症請見備註欄 920
CLPA210275SG "SIGMA"BALLOON PUMP INFUSION SET(275ML-10ML/HR)"十美牌"球
泵型微量輸液器(1日型)(雙層含外殼)*適應症請見備註欄
920
CLPA21063KBT 1日型 INFUSOR 輸液器(雙層含外殼)※適應症請見備註欄 920
CLS0405759BB DOSIFIX W/SAFESITE NEEDLE-FREE SYSTEM W/VALVE 120ML(自
92.03.01更改功能類別)*適應症請見備註欄
63.4
CLS04A260NPW "普惠"輸液套-計量點滴器附活塞免針安全型"PERFECT"
DISPOSABLE INFUSION SET- INFUSIOSON SET W/BURETTE W/VALVE
W/SAFESITE NEEDLE-FREE SYSTEM
63.4
CLS04C1BSSLL "怡安"精密輸液套-免針式安全型"LILY"VOLUME METRIC
ADMINISTRATION SET WITH VALVE-NEEDLE FREE
63.4
1006
特材代碼 中英文名稱 支付點數-104/01/01
CLS04E010NPW INFUSION SET W/BURETTE W/VALVE W/SAFESITE NEEDLE-FREE
SYSTEM*適應症請見備註欄
63.4
CLS04NB150SG SIGMA VOLUME METERIC ADMINISTRATION SET*適應症請見備註欄 63.4
CLS04NS120SG VOLUME METERIC ADMINISTRATION SET W/FREE SITE *適應症請見
備註欄
63.4
CLS04SBASSLL VOLUME METERIC ADMINISTRATIONN SET (安全型免針加
藥)W/VALVE*適應症請見備註欄
63.4
CLS1400740BX "BAXA"EXACTA-MIX EVA CONTAINER 2000ML"柏瑟"靜脈營養術灌注
袋
149
CLS1400741BX "BAXA"EXACTA-MIX EVA CONTAINER 3000ML"柏瑟"靜脈營養術灌注
袋
149
CLS1402000BB NUTRIENT MIXING BAG-NUTRIMIX 149
CLS1403000BB TPN BAG 3000CC 149
CLS14B8082CT VIAFLEX TPN BAG 250C.C. 93.2
CLS14B8083CT VIAFLEX TPN BAG 500C.C. 93.2
CLS14B8122CT ALL-IN-ONE BAG 2000C.C. 149
CLS14B8132CT ALL-IN-ONE BAG 3000C.C. 149
CRE03U00502C "柯惠"麥林可加強型氣管內管"COVIDIEN" MALLINCKRODT SAFETY-
FLEX REINFORCED TRACHEAL TUBE
300
CXE01EPF13JV “日本來富恩”菲克斯固定彎電極導管“JAPAN LIFELINE”
EPSTAR FIX ELECTROPHYSIOLOGY CATHETER
16180
CXE05BLZ01SB “波士頓科技”布雷瑟開放式灌注除顫導管“BOSTON SCIENTIFIC
”BLAZER OPEN-IRRIGATED ABLATION CATHETER
74100
CXE05D17LRWE 藍星攝氏灌注冷卻式溫控電生理導管BIOSENSE WEBSTER NAVI-
STAR/CELCIUS THERMOCOOL DIAGNOSTIC/ABLATION DEFLECTABLE
TIP CATHETER適應症見備註欄
74100
CXE05NN75TWE 藍星攝氏灌注冷卻式溫控電生理導管BIOSENSE WEBSTER NAVI-
STAR/CELCIUS THERMOCOOL DIAGNOSTIC/ABLATION DEFLECTABLE
TIP CATHETER適應症見備註欄
74100
CXE05SAFBDST "聖猷達" 薩爾普雙向電燒導管"SJM" SAFIRE BLU BI-
DIRECTIONAL ABLATION CATHETERS*適應症請見備註欄
74100
CXE05TCPACYB "爾灣" 瑟爾皮庫爾帕斯心臟電燒導管"IBI" THERAPY COOL PATH
ABLATION CATHETER*適應症請見備註欄
74100
CXE05TCPBDST 聖猷達瑟爾皮庫爾帕斯雙向心臟電燒導管 SJM THERAPY COOL
PATH BI-DIRECTIONAL ABLATION CATHETERS*適應症請見備註欄
74100
FBA0110001H1 BONE CEMENT40GM 839
FBA011101NZ1 OSTEOBOND COPOLYMER BONE CEMENT 40G/20ML 839
FBA011102NZ1 DOUGH TYPE BONE CEMENT 40GM 839
FBA011112NZ1 L.V.C BONE CEMENT 1285
FBA011200A2Z "泰瑞斯"低黏性骨水泥CEMEX RX 40GM 839
FBA0131050CM CRANIOPLASTY BONE CEMENT (2PKG/BOX)頭顱整形術專用 3622
FBA0131280DP CRANIOPLASTIC (POWDER 30G+LIQUID 16.17G/20分鐘)頭顱整形泥 7181
FBA0133CMWDP CMW BONE CEMENT 40GM(粉末+液體) 839
FBA100900NH1 HIP STEM PLUG 8:14MM 1019
FBA101905NU0 U2 HIP STEM PLUG 7:16 1019
FBA102002NW2 CEMENT CENTRALIZER 9:21MM 1019
FBA142300NH1 DALL-MILES STAINLESS CABLE ※適應症請見備註欄 1230
FBA142301NH1 DALL-MILES STAINLESS CABLE GRIP ※適應症請見備註欄 4528
FBA142305NH1 DALL-MILES STAINLESS CABLE SLEEVE(纜線套) ※適應症請見備
註欄
1707
FBA1428100S1 WIRE MOUNT骨板固定鈕※適應症請見備註欄 1707
1007
特材代碼 中英文名稱 支付點數-104/01/01
FBEF500001RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-PIN HOLDER CLAMP
瑞寶億骨外固定系統-針夾 ※適應症請見備註欄
627
FBEF500018D1 CONNECTING ROD 97.9
FBEF50001ND1 UNIVERSAL BALL JOINT 688
FBEF50001NRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-ARTICULATION
COUPLING 瑞寶億骨外固定系統-結合器 ※適應症請見備註欄
274
FBEF50001NZ6 5HOLE UNIVERSAL BALL JOINT(美瑞世五洞外固定器) 688
FBEF50001XD1 EXTERNAL FIXATOR SYSTEM:PIN HOLDER CLAMP(WITH ONE:TWO
DIA.8MM ROD , WITH ONE:TWO DIA.5MM ROD)針夾
627
FBEF50008ND1 EXTERNAL FIXATOR SYSTEM:ARTICULATION
COUPLING(DIA.5:8MM*DIA.3:8MM)結合器
274
FBEF50013ND1 ARTICULING COUPING 274
FBEF50014NZ6 ARTICULATION COUPLING 8X3,8X4,8X5MM(美瑞世多向外固定
器)(990701規格8*3更正為8*8MM)
274
FBEF50018ND1 EXTERNAL FIXATOR SYSTEM:CONNECTING ROD連結桿 97.9
FBEF50018NRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-CONNECTING ROD 瑞
寶億骨外固定系統-連結桿 ※適應症請見備註欄
97.9
FBEF50018NZ6 CONNECTING ROD 200,250,300MM(美瑞世骨外連接管) 97.9
FBEF50020NZ6 COLLES FRAME SET(美瑞世一支連接桿+二支多向球)※限橈骨和尺
骨雙骨折使用
3829
FBEF500S2ND1 EXTERNAL FIXATOR SYSTEM:COLLES-FOREARM FRAME 手腕組
(L170MM)
3829
FBEF55150NZ6 STAINLESS HALP PIN 5MM 796
FBEF5S0001RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-COLLES FOREARM
FRAME 瑞寶億骨外固定系統-手腕組 ※限橈骨和尺骨雙骨折使用
3829
FBEF5U5LEND1 EXTERNAL FIXATOR SYSTEM:DISTRACTION&COMPRESSION ROD伸縮
桿(250+50MM)
2643
FBEF5U5LENRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-
DISTRACTION&COMPRESSION ROD 瑞寶億骨外固定系統-伸縮桿 ※
適應症請見備註欄
2643
FBEFP02101SN ILIZAROV WIRE 1.5MM ※適應症請見備註欄 466
FBEFP02102SN ILIZAROV WIRE 1.8MM※適應症請見備註欄 466
FBEFP0666ND1 EXTERNAL FIXATION SYSTEM:WIRE 1.5MM 2.0MM 300:400MM ※適
應症請見備註欄
466
FBEFP0M30NRT EXTERNAL FIXATOR CORTICAL SCREW 1423
FBEFP1010NRT EXTERNAL FIXATOR CORTICAL SCREW 1423
FBEFP1012NRT CANCELLOUS SCREW(10.130:4,10.180:4自90/04/01起刪除) 1423
FBEFP2482NSN SKELETAL TRACTION HALF PIN 3MM (COVE POINT PIN) 519
FBEFP24831SN HALF PIN 4MM 519
FBEFP2483NSN SKELETAL TRACTION HALF PIN 5MM (COVE POINT PIN) 796
FBEFP248XNSN SKELETAL TRACTION FULL PIN ALL SIZE (COVE POINT PIN) 1114
FBEFP294NNS1 SCHANZ SCREW (FOR EXTERNAL FIXATION ) 410
FBEFP29771S1 "MATHYS" SCHANZ SCREW (SELDRILL) 4.0/3.0MM 837
FBEFP29774S1 "MATHYS" SCHANZ SCREW(SELDRILL) DIA 3.5-4.0MM 837
FBEFP29782S1 "MATHYS" SCHANZ SCREW(SELDRILL) DIA 4.4- 5.0MM 1023
FBEFP29792S1 SELDRILL 6.0MM 1050
FBEFP297XNY2 SCHANZ SCREW(型號294400,294520:70,294620:40)(90/04/01起型
號294300刪除,新增294960)
410
FBEFP3059NZ6 STAINLESS FULL PIN 4-5MM(兩截全針) 1114
FBEFP3070NZ6 TITANIUM HALF PIN 2.5-3MM,3-4MM(兩截半針) 1337
FBEFP3090NZ6 STAINLESS HALF PIN 4-5MM,5-6MM(兩截半針) 1023
FBEFP3109NZ6 TITANIUM HALF PIN 3MM 541
FBEFP4031NZ6 TITANIUM HALF PIN 4MM 612
1008
特材代碼 中英文名稱 支付點數-104/01/01
FBEFPA4001RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-HALF PIN DIA.3MM
瑞寶億骨外固定系統-半骨針 ※適應症請見備註欄
519
FBEFPA5002RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-HALF PIN DIA.4MM
瑞寶億骨外固定系統-半骨針 ※適應症請見備註欄
519
FBEFPA6005RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-HALF PIN DIA.4-
5MM 瑞寶億骨外固定系統-半骨針(雙直徑) ※適應症請見備註欄
1023
FBEFPA9003RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-HALF PIN DIA.5MM
瑞寶億骨外固定系統-半骨針 ※適應症請見備註欄
796
FBEFPAB004RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-HALF PIN DIA.2-
3MM;3-4MM 瑞寶億骨外固定系統-半骨針(雙直徑) ※適應症請見
備註欄
837
FBEFPAC006RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-FULL PIN DIA.4-
5MM 瑞寶億骨外固定系統-全骨針 ※適應症請見備註欄
1114
FBEFPFUP1ND1 EXTERNAL FIXATOR SYSTEM:FULL PIN 全針(DIA
3:6MM*L200:300MM)
1114
FBEFPHAP1ND1 EXTERNAL FIXATOR SYSTEM:HALF PIN 半針(DIA.2:3MM*L45:90MM) 444
FBEFPKX36NAE SCHANZ SCREW 410
FBEFPLX34NAE "SCHANZ" SCREW SCHRAUBEN HALF PIN 796
FBEFPLX74NAE SMALL EF SCHANZE SCREW AND PIN 943
FBEFPP1N56D1 EXTERNAL FIXATOR SYSTEM: HALF PIN 半針(DIA.5-
6MM*L150:180MM)
643
FBEFPPN040D1 EXTERNAL FIXATOR SYSTEM: HALF PIN 半針
(DIA.4MM*L150:180MM)
519
FBEFPPN234D1 EXTERNAL FIXATOR SYSTEM:HALF PIN 半針(DIA2:4MM*L70:150MM) 837
FBEFPPN456D1 EXTERNAL FIXATOR SYSTEM:HALF PIN 半針
(DIA.4:6MM*L150:180MM)
1023
FBEFPW0001RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-WIRE 瑞寶億骨外固
定系統-針 *適應症見備註欄
466
FBEH15000NS2 TOTAL ELBOW SYSTEM※適應症請見備註欄 60206
FBEH15005NS2 TOTAL ELBOW:HUMERAL COMPONENT※適應症請見備註欄 35692
FBEH18006NZ1 TOTAL ELBOW SYSTEM(HUMERAL+ULNAR) ※適應症請見備註欄 60206
FBEH181051Z1 COONRAD/MORREY HUMERAL COMPONENT(型號32-8105-025-04:036-
08自90/07/01生效)※適應症請見備註欄
35692
FBEH18105NZ1 "ZIMMER"COONRAD/MORREY TOTAL ELBOW SYSTEM(HUMERAL+ULNAR)"
捷邁"人工肘關節組 ※適應症請見備註欄
60206
FBEU15005NS2 TOTAL ELBOW:ULNA COMPONENT※適應症請見備註欄 24514
FBEU181052Z1 COONRAD/MORREY ULNAR COMPONENT(型號32-8105-053-01:093-02
自90/07/01生效)※適應症請見備註欄
24514
FBEU181053Z1 "ZIMMER"COONRAD/MORREY TOTAL ELBOW SYSTEM:ULNAR"捷邁"人工
肘關節組:尺骨件 ※適應症請見備註欄
24514
FBFJ11234NDP NEUFLEX FINGER IMPLANTS(SILICON) 3619
FBFJ1G470NW2 SWANSON FINGER JOINT(含鈦合金指套) 14144
FBHB1103XNDP CUP ※適應症請見備註欄 10334
FBHB11503NU0 "UNITED"HIP SYSTEM-U2 BIPOLAR IMPLANT:CUP+LINER "聯合"雙
極半髖人工髖關節:髖臼杯+內襯※適應症請見備註欄
10334
FBHB11700NW2 BIPOLAR CUP※適應症請見備註欄 7080
FBHB13110NW2 BIOPOLAR CUP&CUP INSERT※適應症請見備註欄 10334
FBHB1501XNU0 UNITED BIPOLAR CUP 聯髖半髖外帽 ※適應症請見備註欄 7080
FBHB15984NZ1 BIPOLAR CUP※適應症請見備註欄 10334
FBHB1NK04NAE BICONTACT BIPOLAR CUP※適應症請見備註欄 10334
1009
特材代碼 中英文名稱 支付點數-104/01/01
FBHB1UH10NS2 "HOWMEDICA-OSTEONICS" OMNIFIT HIP SYSTEM:CUP"好美得卡-奧
斯得寧"人工髖關節系統:髖臼杯※適應症請見備註欄
10334
FBHB21700NW2 BIPOLAR INSERT※適應症請見備註欄 3071
FBHB2601XNU0 UNITED BIPOLAR CUP LINER 聯髖半髖內襯 ※適應症請見備註欄 3071
FBHBA1000NAE BICONTACT BIPOLAR HIP SYSTEM ※適應症請見備註欄 35195
FBHBA1000NDP "DEPUY"BIPOLAR HIP SYSTEM"帝富"雙極式人工髖關節組※適應症
請見備註欄
35195
FBHBA1000NU0 UNITED BIPOLAR SYSTEM※適應症請見備註欄 35195
FBHBA1000NW2 BIOPOLAR HIP SYSTEM※適應症請見備註欄 35195
FBHBA1000TZ1 BIPOLAR HIP SYSTEM ※適應症請見備註欄 35195
FBHBA1100NDP "DEPUY"CORAIL BIPOLAR HIP SYSTEM"帝富:可瑞雙極式人工髖關
節組 ※適應症請見備註欄
35195
FBHBA2000NS2 "HOWMEDICA-OSTEONICS" OMNIFIT HIP SYSTEM:HA BIPOLAR
SYSTEM"好美得卡-奧斯得寧"人工雙極式髖關節系統 ※適應症請
見備註欄
35195
FBHBA2000NU0 UNITED U2 BIPOLAR SYSTEM※適應症請見備註欄 35195
FBHBA3000NU0 "UNITED"HIP SYSTEM-U2 BIPOLAR IMPLANT "聯合"雙極半髖人工
髖關節※適應症請見備註欄
35195
FBHBA3000TZ1 VERSYS BIPOLAR SYSTEM※適應症請見備註欄 35195
FBHBA5000NS2 "HOWMEDICA-OSTEONICS" OMNIFIT HIP SYSTEM:BIPOLAR SYSTEM"
好美得卡-奧斯得寧"人工雙極式髖關節系統※適應症請見備註欄
35195
FBHBA5500NS2 ACCOLADE BIPOLAR HIP SYSTEM(STEM+CUP+HEAD)※適應症請見備
註欄
35195
FBHBA6000NZ1 CLS BIOPOLAR SYSTEM(STEM+HEAD+CUP)※適應症請見備註欄 35195
FBHBA8000TZ1 BIPOLAR HIP SYSTEM(CUP+HEAD+STEM)※適應症請見備註欄 35195
FBHBAKTV1TZ1 "ZIMMER"KINECTIV M/L TAPER BIPOLAR HIP PROSTHESIS SYSTEM"
西美"組合式股骨柄可旋式雙極式全人工股骨修補系統※適應症請
見備註欄
45118
FBHBAPRFMRW2 "WRIGHT" BIPOLAR HIP SYSTEM(搭配組合式股骨柄) "瑞德"雙極
式人工髖關節系統※適應症請見備註欄
45118
FBHBAUTF1NU0 "聯合"雙極式人工髖關節系統(楔形骨柄)"UNITED”HIP BIPOLAR
SYSTEM(UTF STEM)
35195
FBHBCCERA1AE CERAMIC BIPOLAR HIP SYSTEM※符合傳統雙極式髖關節組適應症
者,如自願選用陶瓷雙極式人工髖關節組,則按傳統雙極式髖關
節組給付,超過部分由病患自付
35195
FBHBCCERA1DP CERAMIC BIPOLAR HIP SYSTEM※符合傳統雙極式髖關節組適應症
者,如自願選用陶瓷雙極式人工髖關節組,則按傳統雙極式髖關
節組給付,超過部分由病患自付
35195
FBHBCCERA1S2 CERAMIC BIPOLAR HIP SYSTEM※符合傳統雙極式髖關節組適應症
者,如自願選用陶瓷雙極式人工髖關節組,則按傳統雙極式髖關
節組給付,超過部分由病患自付
35195
FBHBCCERA1U0 CERAMIC BIPOLAR SYSTEM※符合傳統雙極式髖關節組適應症者,
如自願選用陶瓷雙極式人工髖關節組,則按傳統雙極式髖關節組
給付,超過部分由病患自付
35195
FBHBCCERA1W2 CERAMIC BIPOLAR HIP SYSTEM※符合傳統雙極式髖關節組適應症
者,如自願選用陶瓷雙極式人工髖關節組,則按傳統雙極式髖關
節組給付,超過部分由病患自付
35195
FBHBCCERA1Z1 BIPOLAR CERAMIC SYSTEM※符合傳統雙極式髖關節組適應症者,
如自願選用陶瓷雙極式人工髖關節組,則按傳統雙極式髖關節組
給付,超過部分由病患自付。
35195
1010
特材代碼 中英文名稱 支付點數-104/01/01
FBHBCCERA2AE CERAMIC BIPOLAR HIP SYSTEM※符合傳統雙極式髖關節組適應症
者,如自願選用陶瓷雙極式人工髖關節組,則按傳統雙極式髖關
節組給付,超過部分由病患自付
35195
FBHBCCERA2S2 "STRYKER"CERAMIC BIPOLAR SYSTEM※符合傳統雙極式髖關節適應
症,自願選用陶瓷HEAD,則按傳統雙極式髖關節組給付,超過部
分由病患自付
35195
FBHBCCERA2Z1 "ZIMMER"KINECTIV M/L TAPER CERAMIC BIPOLAR HIP PROSTHESIS
SYSTEM"西美"組合式股骨柄可旋式雙極式陶瓷人工股骨系統(部分
給付)
45118
FBHBCCERA3Z1 "ZIMMER"BIPOLAR BIOLOX DELTA HIP SYSTEM(CERAMIC)※符合傳
統雙極式適應症者,如自願選用陶瓷雙極式,按傳統髖關節組給
付,超過部分由病患自付
35195
FBHBCCERA4Z1 "ZIMMER"M/L TAPER BIPOLAR HIP PROSTHESIS W/KINECTIV
TECHNOLOGY"捷邁"康內特人工髖關節(雙極式陶瓷組合式股骨柄,
部分給付)※適應症請見備註欄
45118
FBHBCCERA5U0 "UNITED"CERAMIC BIPOLAR SYSTEM※符合傳統雙極式髖關節組適
應症者,如自願選用陶瓷雙極式人工髖關節組,則按健保局給付
,超過部分由病患自付
35195
FBHBCCERAZW2 "WRIGHT" CERAMIC BIPOLAR HIP SYSTEM(搭配組合式股骨柄) "瑞
德"陶瓷雙極式人工髖關節系統(部分給付項目,超過部分由病患自
付)※適應症請見備註欄
45118
FBHBCCERR5Z1 “捷邁”百優陶瓷半人工髖關節組“ZIMMER” BIOLOX OPTION
BIPOLAR HIP SYSTEM
35195
FBHBCUTF1TU0 "聯合"DELTA陶瓷球頭雙極式人工髖關節系統(楔形骨柄)(自付差
額品項)"UNITED”BIPOLAR SYSTEM (UTF STEM)-DELTA CERAMIC
HEAD
35195
FBHC11246NDP AML CUP+AML INSERT ※適應症請見備註欄 10334
FBHC1124XNDP AML CUP(型號96-23-23:80,24-09:10,50,51,53-22-040:153自
92/4/1生效)※適應症請見備註欄
10334
FBHC11455NDP DURALOC HIP IMPLANT:ACETABULAR CUP※適應症請見備註欄 10334
FBHC12540NS2 "HOWMEDICA-OSTEONICS" OMNIFIT HIP SYSTEM: HA ACETABULUM
CUP "好美得卡-奧斯得寧"人工髖關節系統:髖臼杯※適應症請見
備註欄
10334
FBHC12541NS2 "HOWMEDICA-OSTEONICS" SECUR-FIT HA HIP SYSTEM:HA SELL "好
美得卡-奧斯得寧"髖關節系統:髖臼杯(原健保碼為FBHC12540NS2)
※適應症請見備註欄
10334
FBHC1301XNU0 UNITED ACETABULAR CUP(型號1303-5044:5062自92/4/1生效) ※
適應症請見備註欄
10334
FBHC1302XNU0 TOTAL HIP CUP+LINER※適應症請見備註欄 10334
FBHC1303XNU0 TITANIUM U2 ACETABULAR CUP※適應症請見備註欄 10334
FBHC1306XNU0 "聯合"優磨二代全髖臼植入物:全髖臼外帽"UNITED”HIP
SYSTEM:U-MOTION II CUP
10334
FBHC13671NW2 HIP CUP (1808,3000,398-XXXX自88/10/1生效,3631,41,51-
39:57-0040:80自93/1/1生效)※適應症請見備註欄
10334
FBHC14262NZ1 ALLOFIT CUP SYSTEM※適應症請見備註欄 10334
FBHC15000NZ1 MULTIPOLAR BIPOLAR CUP 雙極式人工半髖臼杯 (型號5001自
92/1/1生效)※適應症請見備註欄
10334
FBHC154NXNS2 ACETABULUM CUP※適應症請見備欄 10334
FBHC16200NZ1 "捷邁"人工髖關節臼杯"ZIMMER"TRILOGY ACETABULAR
CUP(40:80MM)
10334
FBHC18005NZ1 ZCA ALL-POLY ACETABULAR CUP+INSERT ※適應症請見備註欄 14352
FBHC18753NZ1 "ZIMMER" TRILOGY IT ACETABULAR SYSTEM:SHELL"捷邁"崔勒艾提
髖臼杯系統 ※適應症請見備註欄
10334
1011
特材代碼 中英文名稱 支付點數-104/01/01
FBHC1DYNA2W2 "WRIGHT"DYNASTY ACETABULAR CUP SYSTEM:CUP"瑞德"戴內斯帝髖
臼杯系統※適應症請見備註欄
10334
FBHC1NA64NAE BICONTACT CUP 44:64MM(型號NH044T:068T自92/4/1生效) ※適應
症請見備註欄
10334
FBHC1NK810AE PE-ACETABULAR CUP+INSERT※適應症請見備註欄 10334
FBHC1P1CUPDP "DEPUY"PINNACLE HIP SYSTEM:CUP"帝富"必耐久人工髖臼系統:髖
臼杯※適應症請見備註欄
10334
FBHC1P1NNADP PINNACLE ACETABULAR CUP全人工髖關節髖臼杯 10334
FBHH101432DP "DEPUY"AML TOTAL HIP SYSTEM:FEMORAL HEAD"帝富"全人工髖關
節系統:股骨頭)※適應症請見備註欄
4352
FBHH1101XNDP AML FEMORAL HEAD(87/7/7 15190-51:60,136501:03,11:
15,21:25,29:30,43:48,9113112:13※適應症見備註
4352
FBHH11260NS2 "HOWMEDICA-OSTEONICS" OMNIFIT HIP SYSTEM: HA FEMORAL HEAD
"好美得卡-奧斯得寧"人工髖關節系統:股骨頭※適應症請見備註
欄
4352
FBHH11261NS2 "HOWMEDICA-OSTEONICS" OMNIFIT HIP SYSTEM: HA FEMORAL HEAD
"好美得卡-奧斯得寧"人工髖關節系統:股骨頭(原健保碼為
FBHH11260NS2)※適應症請見備註欄
4352
FBHH11262NS2 "BG" EXETER TOTAL HIP SYSTEM: HA FEMORAL HEAD "必吉"愛克
斯特人工髖關節: 人工股骨頭(原健保碼為FBHH11260NS2)※適應
症請見備註欄
4352
FBHH11840NDP CORAIL FEMORAL HEAD ※適應症請見備註欄 4352
FBHH1201XNU0 UNITED FEMORAL HEAD (BIPOLAR) ※適應症請見備註欄 4352
FBHH13611NW2 FEMORAL HEAD※適應症請見備註欄 4352
FBHH14003NH1 P.C.A.FEMORAL HEAD ※適應症請見備註欄 4352
FBHH16260NH1 V40/PCA FEMORAL HEAD※適應症請見備註欄 4352
FBHH16260NS2 HA FEMORAL HEAD ※適應症請見備註欄 4352
FBHH18018NZ1 FEMORAL HEAD※適應症請見備註欄(00-8018-036-01:05自981001
刪除)
4352
FBHH1ARTHDDP "DEPUY"ARTICUL/EZE HEADS "帝富"股骨頭系統※適應症請見備註
欄
4352
FBHH1NK33NAE FEMORAL HEAD※適應症請見備註欄 4352
FBHH1NK46NAE BICONTACT FEMORAL HEAD 28,32MM(NK330K:533K,NJ111K-134K自
92/4/1生效) ※適應症請見備註欄
4352
FBHHCCERA1AE CERAMIC HIP SYSTEM:HEAD※凡只更換股骨頭者,如自願選用陶瓷
股骨頭時,則按傳統股骨頭給付,超過部分由病患自付。
4352
FBHHCCERA1DP CERAMIC HIP SYSTEM:HEAD※凡只更換股骨頭者,如自願選用陶
瓷股骨頭時,則按傳統股骨頭給付,超過部分由病患自付。
4352
FBHHCCERA1S2 CERAMIC HIP SYSTEM:HEAD※凡只更換股骨頭者,如自願選用陶
瓷股骨頭時,則按傳統股骨頭給付,超過部分由病患自付。
4352
FBHHCCERA1U0 CERAMIC FEMORAL HEAD※凡只更換股骨頭者,如自願選用陶瓷股
骨頭時,則按傳統股骨頭給付,超過部分由病患自付。
4352
FBHHCCERA1W2 CERAMIC HIP SYSTEM:HEAD ※凡只更換股骨頭者,如自願選用陶
瓷股骨頭時,則按傳統股骨頭給付,超過部分由病患自付。
4352
FBHHCCERA1Z1 CERAMIC HIP SYSTEM:HEAD※凡只更換股骨頭者,如自願選用陶
瓷股骨頭時,則按傳統股骨頭給付,超過部分由病患自付。
4352
FBHHCCERA2AE CERAMIC HIP SYSTEM:HEAD※凡只更換股骨頭者,如自願選用陶瓷
股骨頭時,則按傳統股骨頭給付,超過部分由病患自付。
4352
FBHHCCERA2S2 "STRYKER"TRIDENT POLY ACETABULAR SYSTEM:CERAMIC HEAD※凡
只更換股骨頭者,如自願選用陶瓷股骨頭時,則按傳統股骨頭給
付,超過部分由病患自付。
4352
FBHHCCERA2W2 "WRIGHT"DYNASTY ACETABULAR CUP SYSTEM:CERAMIC HEAD 陶瓷股
骨頭※凡只更換股骨頭者,則按傳統股骨頭給付,超過部份由病
患自付。
4352
1012
特材代碼 中英文名稱 支付點數-104/01/01
FBHHCCERA2Z1 "ZIMMER"BIOLOX DELTA TAPER HEAD(CERAMIC)※符合傳統髖關節
股骨頭適應症者,如自願選用陶瓷股骨頭,按傳統髖關節組給付
,超過部分由病患自付
4352
FBHHCCERA3W2 "WRIGHT"DYNASTY ACETABULAR CUP SYSTEM:CERAMIC HEAD "瑞德"
戴內斯帝髖臼杯系統:陶瓷股骨頭(自付差額品項)。
4352
FBHHCCERA5U0 "UNITED"CERAMIC FEMORAL HEAD DELTA※凡只更換股骨頭者,如
自願選用陶瓷股骨頭時,則按健保局核價部份給付,超過部分由
病患自付。
4352
FBHHCCERR3Z1 “捷邁”百優陶瓷人工股骨頭(自付差額品項)“ZIMMER” BIOLOX
CERAMIC FEMORAL HEAD ─ BIOLOX OPTION HEAD
4352
FBHHMBFH01W2 "瑞德”康適服人工髖關節系統:金屬股骨頭※部分給付項目,超
過部分由病患自付"WRIGHT”CONSERVE HIP SYSTEM:METAL
FEMORAL HEAD
4352
FBHHMBFH02W2 "歐受曼"博飛達人工髖關節系統:金屬股骨頭※部分給付項目,超
過部分由病患自付"ORTHOMET”PERFECTA TOTAL HIP
SYSTEM:METAL FEMORAL HEAD
4352
FBHL11236NS2 "好美得卡奧斯得寧"雙動式人體結構型/組配型髖關節重建組件:
髖臼內墊(超高分子聚乙烯)"HOWMEDICA OSTEONICS"RESTORATION
ADM AND MDM HIP COMPONENT:INSERT
4018
FBHL11241NDP DURALOC HIP IMPLANT:ENDURON LINER※適應症請見備註欄 4018
FBHL11260NS2 HA HIP INSERT(型號2041C-26XX,28XX自91/01/01生效)※適應症
請見備註欄
4018
FBHL1241XNDP AML HIP INSERT(87/7/7新增產品型號1251-08:24,48:64) ※適應
症請見備註欄
4018
FBHL13820NW2 HIP CUP INSERT (3X15,5X00,5X15-XXXX自88/10/1生效,3641:47-
2200:4006自93/1/1生效)※適應症請見備註欄
4018
FBHL13830NW2 "WRIGHT"LINEAGE INTERSEAL HIP SYSTEM:A-CLASS ACETABLAR
LINER"瑞德"尼盈聚髖關節系統:髖白杯內櫬※適應症請見備註欄
4018
FBHL1401XNU0 UNITED ACETABULAR CUP LINER(型號1403-5044:5062自92/4/1生
效)※適應症請見備註欄
4018
FBHL1403XNU0 U2 ACETABULAR LINER※適應症請見備註欄 4018
FBHL1406XNU0 "聯合"優磨二代全髖臼植入物:高耐磨聚乙烯全髖臼內襯"UNITED
”HIP SYSTEM:U-MOTION II XPE LINER
4018
FBHL16200NS2 INSERT CUP※適應症請見備註欄 4018
FBHL16305NZ1 "捷邁"人工髖關節臼杯內襯"ZIMMER”LONGEVITY ACETABULAR CUP
LINER
4018
FBHL18751NZ1 “捷邁”隆傑艾提髖臼杯墊片※給付規定請見備註欄“ZIMMER”
LONGEVITY IT HIGHLY CROSSLINKED POLYETHYLENE LINERS
4018
FBHL1DYNA1W2 “瑞德”戴內斯帝髖臼杯系統:高耐磨襯墊※給付規定請見備註
欄"WRIGHT"DYNASTY ACETABULAR CUP SYSTEM:POLY LINER
4018
FBHL1NK17NAE BICONTACT INSERT 28,30MM(型號NA278:NA291自92/1/1生
效,NH171:476自92/4/1生效)※適應症請見備註欄
4018
FBHL1P1NPLDP "DEPUY"PINNACLE HIP SYSTEM:LINER "帝富"必耐久人工髖臼系
統:襯墊
4018
FBHL1PNNPEDP "DEPUY" PINNACLE ACETABULAR SYSTEM "帝富"可耐髖人工髖臼杯
系統(型號1218-22-138:146;26-144:146;1218:19-446自
102/08/01刪除)
4018
FBHLC406XNU0 "聯合"優磨二代全髖臼植入物:陶瓷全髖臼內襯(自付差額品
項)"UNITED”HIP SYSTEM:U-MOTION II DELTA CERAMIC LINER
4018
FBHLCCERA1AE CERAMIC TOTAL HIP SYSTEM:INSERT※凡只更換髖臼杯內襯者,如
自願選用陶瓷髖臼杯內襯時,則按傳統髖臼杯內襯給付,超過部
分由病患自付。
4018
1013
特材代碼 中英文名稱 支付點數-104/01/01
FBHLCCERA1S2 CERAMIC HIP SYSTEM:INSERT※凡只更換髖臼杯內襯者,如自願
選用陶瓷髖臼杯內襯時,則按傳統髖臼杯內襯給付,超過部分由
病患自付。
4018
FBHLCCERA1U0 CERAMIC FEMORAL INSERT※凡只更換髖臼杯內襯者,如自願選用
陶瓷髖臼杯內襯時,則按傳統髖臼杯內襯給付,超過部份由病患
自付
4018
FBHLCCERA1W2 CERAMIC HIP SYSTEM:INSERT ※凡只更換髖臼杯內襯者,如自願
選用陶瓷髖臼杯內襯時,則按傳統髖臼杯內襯給付,超過部分由
病患自付。
4018
FBHLCCERA1Z1 CERAMIC HIP SYSTEM:LINER※凡只更換髖臼杯內襯者,如自願選
用陶瓷髖臼杯內襯時,則按傳統髖臼杯內襯給付,超過部分由病
患自付。
4018
FBHLCCERA2Z1 "ZIMMER"BIOLOX DELTA TAPER LINER(CERAMIC)※符合傳統髖關節
髖臼內杯適應症者,如自願選用陶瓷髖臼內杯,按傳統髖關節組
給付,超過部分由病患自付
4018
FBHLMDYNA1W2 "瑞德"戴內斯帝髖臼杯系統:金屬髖臼內杯※部分給付項目,超過
部分由病患自付"WRIGHT"DYNASTY ACETABULAR CUP SYSTEM:METAL
LINER
4018
FBHMCBCER1AE CERAMIC BIPOLAR HIP SYSTEM※凡符合使用MOORE規定者,如自願
選用陶瓷雙極式人工髖關節組,則按MOORE人工髖關節給付,超過
部分由病患自付。
7733
FBHMCBCER1DP CERAMIC BIPOLAR HIP SYSTEM※凡符合使用MOORE規定者,如自願
選用陶瓷雙極式人工髖關節組,則按MOORE人工髖關節給付,超過
部分由病患自付。
7733
FBHMCBCER1S2 CERAMIC BIPOLAR HIP SYSTEM※凡符合使用MOORE規定者,如自願
選用陶瓷雙極式人工髖關節組,則按MOORE人工髖關節給付,超過
部分由病患自付。
7733
FBHMCBCER1U0 CERAMIC BIPOLAR SYSTEM ※凡符合使用MOORE規定者,如自願選
用陶瓷雙極式人工髖關節組,則按MOORE人工髖關節給付,超過部
分由病患自付。
7733
FBHMCBCER1W2 CERAMIC BIPOLAR HIP SYSTEM ※凡符合使用MOORE規定者,如自
願選用陶瓷雙極式人工髖關節組,則按MOORE人工髖關節給付,超
過部分由病患自付。
7733
FBHMCBCER1Z1 CERAMIC BIPOLAR HIP SYSTEM※凡符合使用MOORE規定者,如自願
選用陶瓷雙極式人工髖關節組,則按MOORE人工髖關節給付,超過
部分由病患自付。
7733
FBHMCBCER2AE CERAMIC BIPOLAR HIP SYSTEM※凡符合使用MOORE規定者,如自願
選用陶瓷雙極式人工髖關節組,則按MOORE人工髖關節給付,超過
部分由病患自付。
7733
FBHMCBCER2S2 "STRYKER"CERAMIC BIPOLAR HIP SYSTEM※符合使用MOORE規定者
,如使用雙極式人工髖關節組,部分給付品項)
7733
FBHMCBCER3Z1 "ZIMMER"BIPOLAR BIOLOX DELTA HIP SYSTEM(CERAMIC)※符合
MOORE規定者,如自願選用陶瓷雙極式,按傳統髖關節組給付,超
過部分由病患自付
7733
FBHMCBCER4Z1 “捷邁”百優陶瓷半人工髖關節組 (符合使用MOORE規定者)
“ZIMMER” BIOLOX OPTION BIPOLAR HIP SYSTEM
7733
FBHMCBCER5U0 "UNITED"CERAMIC BIPOLAR SYSTEM ※凡符合使用MOORE規定者,
如自願選用本陶瓷單極式人工髖關節組,則按健保局核價部份給
付,超過部分由病患自付。
7733
FBHMCPCEE4Z1 “捷邁”百優陶瓷全人工髖關節組(符合使用MOORE規定者)※
“ZIMMER” BIOLOX OPTION TOTAL HIP SYSTEM
7733
FBHMCPCEE5Z1 “捷邁”百優組合式陶瓷全人工髖關節組(符合使用MOORE規定者)
“ZIMMER” BIOLOX OPTION TOTAL HIP SYSTEM (KINECTIV)
7733
1014
特材代碼 中英文名稱 支付點數-104/01/01
FBHMCPCER1AE CERAMIC TOTAL HIP SYSTEM※凡符合使用MOORE規定者,如自願選
用陶瓷人工髖關節組,則按MOORE人工髖關節給付,超過部分由病
患自付。
7733
FBHMCPCER1DP CERAMIC TOTAL HIP SYSTEM※凡符合使用MOORE規定者,如自願選
用陶瓷人工髖關節組,則按MOORE人工髖關節給付,超過部分由病
患自付。
7733
FBHMCPCER1S2 CERAMIC HIP SYSTEM※凡符合使用MOORE者,自願選用陶瓷人工髖
關節組,按MOORE給付,超過部分由病患自付
7733
FBHMCPCER1U0 CERAMIC HIP SYSTEM※凡符合使用MOORE規定者,如自願選用陶瓷
人工髖關節組,則按MOORE人工髖關節給付,超過部分由病患自
付。
7733
FBHMCPCER1W2 CERAMIC TOTAL HIP SYSTEM ※凡符合使用MOORE規定者,如自願
選用陶瓷人工髖關節組,則按MOORE人工髖關節給付,超過部分由
病患自付。
7733
FBHMCPCER1Z1 CERAMIC TOTAL HIP SYSTEM※凡符合使用MOORE規定者,如自願選
用陶瓷人工髖關節組(自付差額品項,超過部分由病患自付)
7733
FBHMCPCER2AE CERAMIC TOTAL HIP SYSTEM※凡符合使用MOORE規定者,如自願選
用陶瓷人工髖關節組,則按MOORE人工髖關節給付,超過部分由病
患自付。
7733
FBHMCPCER2S2 "STRYKER"CERAMIC TOTAL HIP SYSTEM※符合使用MOORE規定者,
使用陶瓷全髖關節組,部分給付,超過部分由病患自付。
7733
FBHMCPCER3Z1 "ZIMMER"BIOLOX DELTA TOTAL HIP SYSTEM(CERAMIC)※符合MOORE
規定者,如自願選用陶瓷全人工髖關節組,按MOORE給付,超過部
分由病患自付
7733
FBHMCPCER4Z1 “捷邁”百優陶瓷全人工髖關節組(符合使用MOORE規定者)
“ZIMMER” BIOLOX OPTION TOTAL HIP SYSTEM
7733
FBHMCPCER5U0 "UNITED"CERAMIC HIP SYSTEM※凡符合使用MOORE規定者,如自願
選用本陶瓷雙極式人工髖關節組,則按健保局核價部份給付,超
過部分由病患自付。
7733
FBHMCPCER5Z1 "ZIMMER"BIOLOX DELTA CERAMIC TOTAL HIP SYSTEM※符合使用
MOORE規定者,如自願選用陶瓷HEAD,則按MOORE給付,超過部分
由病患自付。
7733
FBHMCPCER6Z1 "ZIMMER"BIOLOX DELTA CERAMIC TOTAL HIP SYSTEM※符合使用
MOORE規定者,如自願選用陶瓷HEAD(組合式股骨柄),則按MOORE
給付,超過部分由病患自付。
7733
FBHMCPCER7Z1 “捷邁”百優組合式陶瓷全人工髖關節組(符合使用MOORE規定者)
“ZIMMER” BIOLOX OPTION TOTAL HIP SYSTEM(KINECTIV)
7733
FBHMCRCEE5Z1 “捷邁”重建型百優陶瓷全人工髖關節組(符合使用MOORE規定者)
“ZIMMER” BIOLOX OPTION REVISION TOTAL HIP SYSTEM
7733
FBHMCRCEE6Z1 “捷邁”重建型百優組合式陶瓷全人工髖關節組(符合使用MOORE
規定者)“ZIMMER”BIOLOX OPTION REVISION TOTAL HIP
SYSTEM(ZMR)
7733
FBHMCRCER1AE CERAMIC REVISION HIP SYSTEM※凡符合使用MOORE規定者,如自
願選用陶瓷重建型人工髖關節組,則按MOORE人工髖關節給付,超
過部分由病患自付。
7733
FBHMCRCER1DP CERAMIC REVISION HIP SYSTEM※凡符合使用MOORE規定者,如自
願選用陶瓷重建型人工髖關節組,則按MOORE人工髖關節給付,超
過部分由病患自付。
7733
FBHMCRCER1S2 CERAMIC REVISION HIP SYSTEM※凡符合使用MOORE規定者,如自
願選用陶瓷重建型人工髖關節組,則按MOORE人工髖關節給付,超
過部分由病患自付。
7733
FBHMCRCER1U0 CERAMIC REVISION HIP SYSTEM※凡符合使用MOORE規定者,如自
願選用陶瓷重建型人工髖關節組,則按MOORE人工髖關節給付,超
過部分由病患自付。
7733
1015
特材代碼 中英文名稱 支付點數-104/01/01
FBHMCRCER1W2 CERAMIC REVISION HIP SYSTEM ※凡符合使用MOORE規定者,如自
願選用陶瓷重建型人工髖關節組,則按MOORE人工髖關節給付,超
過部分由病患自付。
7733
FBHMCRCER1Z1 CERAMIC REVISION HIP SYSTEM凡符合使用MOORE規定者,如選用
陶瓷重建型人工髖關節組(付差額品項,超過部分由病患自付)
7733
FBHMCRCER2AE CERAMIC REVISION HIP SYSTEM※凡符合使用MOORE規定者,如自
願選用陶瓷重建型人工髖關節組,則按MOORE人工髖關節給付,超
過部分由病患自付。
7733
FBHMCRCER2S2 "STRYKER"CERAMIC REVISION HIP SYSTEM※符合使用MOORE規定,
使用陶瓷重建型,部分給付)
7733
FBHMCRCER2Z1 "ZIMMER"BIOLOX DELTA CERAMIC REVISION HIP SYSTEM※符合使
用MOORE規定者,如自願選用陶瓷HEAD,則按MOORE給付,超過部
分由病患自付。
7733
FBHMCRCER3Z1 "ZIMMER"REVISION BIOLOX DELTA HIP SYSTEM(CERAMIC)※符合
MOORE規定者,如自願選用陶瓷重建型人工髖關節組,按MOORE給
付,超過部分由病患自付
7733
FBHMCRCER4Z1 "ZIMMER"BIOLOX DELTA CERAMIC REVISION HIP SYSTEM※符合使
用MOORE規定者,如自願選用陶瓷HEAD(骨缺損2度以上),則按
MOORE給付,超過部分病患自付。
7733
FBHMCRCER5U0 "UNITED"CERAMIC REVISION HIP SYSTEM ※凡符合使用MOORE規定
者,如自願選用本重建型人工髖關節組,則按健保局核價部份給
付,超過部分由病患自付。
7733
FBHMCRCER5Z1 “捷邁”重建型百優陶瓷全人工髖關節組(符合使用MOORE規定者)
“ZIMMER” BIOLOX OPTION REVISION TOTAL HIP SYSTEM
7733
FBHMCRCER6Z1 “捷邁”重建型百優組合式陶瓷全人工髖關節組(符合使用MOORE
規定者)“ZIMMER”BIOLOX OPTION REVISION TOTAL HIP
SYSTEM(ZMR)
7733
FBHMMLDH01W2 BIG FEMORAL HEAD TOTAL HIP SYSTEM(含固定樁) ※符合使用
MOORE規定者,如自願選用BFH人工髖關節組,按MOORE給付,超過
部分由病患自付
7733
FBHMMLDH01Z1 LDH TOTAL HIP SYSTEM ※符合使用MOORE規定者,如使用LDH人工
髖關節組,按MOORE給付,超過部分由病患自付
7733
FBHMMLDH02W2 BIG FEMORAL HEAD TOTAL HIP SYSTEM(不含固定樁) ※符合使用
MOORE規定者,如自願選用BFH人工髖關節組,按MOORE給付,超過
部分由病患自付
7733
FBHMMLDH02Z1 MMC CUP NON-HA VERSION (LDH TOTAL HIP SYSTEM)※符合使用
MOORE規定者,如使用LDH人工髖關節組,按MOORE給付,超過部分
由病患自付
7733
FBHMMMETA1DP PINNACLE METAL ON METAL TOTAL HIP SYSTEM金屬對金屬人工髖
關節組
7733
FBHMMMETA1Z1 METAL ON METAL TOTAL HIP SYSTEM ※符合使用MOORE規定者,如
使用METAL ON METAL人工髖關節組,按MOORE給付,超過部分由病
患自付
7733
FBHMMMETA2Z1 "ZIMMER" METAL ON METAL TOTAL HIP SYSTEM ※符合使用MOORE
規定者,如使用METAL ON METAL人工髖關節組,按MOORE給付,超
過部分由病患自付
7733
FBHPA1000NAE BICONTACT TOTAL HIP SYSTEM ※適應症請見備註欄 39396
FBHPA1000NDP AML TOTAL HIP SYSTEM ※適應症請見備註欄 39396
FBHPA1000NS2 "好美得卡奧斯得寧"全人工髖關節系統 "HOWMEDICA
OSTEONICS"OMNIFIT HIP SYSTEM※適應症請見備註欄
39396
FBHPA1000NU0 UNITED TOTAL HIP SYSTEM 聯髖人工髖關節 ※適應症請見備註欄 39396
FBHPA1000NW2 TOTAL HIP SYSTEM※適應症請見備註欄 39396
FBHPA1100NDP CORAIL TOTAL HIP SYSTEM ※適應症請見備註欄 39396
1016
特材代碼 中英文名稱 支付點數-104/01/01
FBHPA2000NS2 TOTAL HIP SYSTEM(STEM+CUP+INSERT+HEAD)※適應症請見備註欄 39396
FBHPA2000NU0 UNITED U2 TOTAL HIP SYSTEM※適應症請見備註欄 39396
FBHPA2000TZ1 HA/TCP TOTAL HIP SYSTEM ※適應症請見備註欄 39396
FBHPA3000NU0 TOTAL HIP SYSTEM (型號
13021044:62+11045034:67+12011126:1726)※適應症請見備註欄
39396
FBHPA4000NS2 "HOWMEDICA-OSTEONICS" OMNIFIT HIP SYSTEM "好美得卡-奧斯得
寧"全人工髖關節系統 ※適應症請見備註欄
39396
FBHPA4000TZ1 VERSYS TOTAL HIP SYSTEM※適應症請見備註欄 39396
FBHPA5500NS2 ACCOLADE TOTAL HIP SYSTEM(STEM+CUP+INSERT+HEAD)※適應症請
見備註欄
39396
FBHPA6000NZ1 CLS SPOTORNO SYSTEM(STEM+LINER+HEAD+ACETABULAR CUP)※適應
症請見備註欄
39396
FBHPA7000NU0 "聯合"優磨二代全髖關節組"UNITED”U-MOTION II TOTAL HIP
SYSTEM
39396
FBHPA8000TZ1 TOTAL HIP SYSTEM(CUP+LINER+HEAD+STEM)※適應症請見備註欄 39396
FBHPA9000TZ1 "捷邁"隆傑艾提全人工髖關節組"ZIMMER"LONGEVITY IT TOTAL
HIP SYSTEM
39396
FBHPA9979NDP SUMMIT TOTAL HIP SYSTEM(STEM+HEAD+CUP+INSERT)※適應症請見
備註欄
39396
FBHPAKTV1TZ1 "ZIMMER"KINECTIV M/L TAPER TOTAL HIP PROSTHESIS SYSTEM"西
美"組合式股骨柄可旋式全人工股骨修補系統※適應症請見備註欄
49319
FBHPAKTV2TZ1 "捷邁"隆傑艾提全人工髖關節組(搭配組合式股骨
柄)"ZIMMER"LONGEVITY IT TOTAL HIP SYSTEM (WITH KINECTIV)
49319
FBHPAPMAMLDP "DEPUY"PINNACLE HIP SYSTEM"帝富"必耐久人工髖臼系統※適應
症請見備註欄
39396
FBHPAPMARADP "DEPUY"TOTAL HIP SYSTEM"帝富"全人工髖關節組※適應症請見備
註欄
39396
FBHPAPRFMRW2 "WRIGHT"TOTAL HIP SYSTEM (搭配組合式股骨柄)"瑞德"全人工髖
關節系統※適應症請見備註欄
49319
FBHPAUTF1NU0 "聯合"全人工髖關節系統(楔形骨柄)"UNITED”TOTAL HIP
SYSTEM(UTF STEM)
39396
FBHPC7000NU0 "聯合"優磨二代全人工髖關節(陶瓷巨頭對高耐磨聚乙烯襯墊)(自
付差額品項)"UNITED”U-MOTION II TOTAL HIP SYSTEM:DELTA
CERAMIC HEAD
39396
FBHPC7100NU0 "聯合"優磨二代全人工髖關節(陶瓷巨頭對陶瓷襯墊)(自付差額品
項)"UNITED”U-MOTION II TOTAL HIP SYSTEM:DELTA CERAMIC
HEAD TO CERAMIC LINER
39396
FBHPCCERA1AE CERAMIC TOTAL HIP SYSTEM※凡符合傳統人工髖關節組之適應症
者,如自願選用陶瓷人工髖關節組時,則按傳統人工髖關節組給
付,超過部分由病患自付。
39396
FBHPCCERA1DP CERAMIC TOTAL HIP SYSTEM※凡符合傳統人工髖關節組之適應症
者,如自願選用陶瓷人工髖關節組時,則按傳統人工髖關節組給
付,超過部分由病患自付。
39396
FBHPCCERA1S2 CERAMIC TOTAL HIP SYSTEM※凡符合傳統髖關節組者,自願選用
陶瓷髖關節組,則按傳統髖關節組給付,超過部分由病患自付
39396
FBHPCCERA1U0 CERAMIC TOTAL HIP SYSTEM※凡符合傳統人工髖關節組之適應症
者,如自願選用陶瓷人工髖關節組時,則按傳統人工髖關節組給
付,超過部分由病患自付。
39396
1017
特材代碼 中英文名稱 支付點數-104/01/01
FBHPCCERA1W2 CERAMIC TOTAL HIP SYSTEM ※凡符合人工髖關節組者,如自願選
用陶瓷人工髖關節時(自付差額品項,超過部分由病患自付)。
39396
FBHPCCERA1Z1 CERAMIC TOTAL HIP SYSTEM※凡符合傳統人工髖關節組之適應症
者,如自願選用陶瓷人工髖關節組時,則按傳統人工髖關節組給
付,超過部分由病患自付。
39396
FBHPCCERA2AE CERAMIC TOTAL HIP SYSTEM※凡符合傳統人工髖關節組之適應症
者,如自願選用陶瓷人工髖關節組時,則按傳統人工髖關節組給
付,超過部分由病患自付。
39396
FBHPCCERA2S2 "STRYKER"CERAMIC TOTAL HIP SYSTEM※符合傳統人工髖關節適應
症者,自願選用陶瓷HEAD,則按傳統人工髖關節組給付,超過部
分由病患自付。
39396
FBHPCCERA2W2 CERAMIC TOTAL HIP SYSTEM ※凡符合傳統人工髖關節組之適應症
者,如自願選用陶瓷人工髖關節時,則按傳統人工髖關節組給付
,超過部分由病患自付。
39396
FBHPCCERA2Z1 "ZIMMER"KINECTIV M/L TAPER CERAMIC TOTAL HIP PROSTHESIS
SYSTEM"西美"組合式股骨柄可旋式陶瓷全人工股骨修補系統(部分
給付項目)※適應症請見備註欄
49319
FBHPCCERA3Z1 "ZIMMER"BIOLOX TOTAL HIP SYSTEM(CERAMIC)※符合傳統髖關節
組適應症者,如自願選用陶瓷全人工髖關節組,按傳統髖關節組
給付,超過部分由病患自付
39396
FBHPCCERA4W2 "WRIGHT" CERAMIC TOTAL HIP SYSTEM(搭配組合式股骨柄) "瑞
德"陶瓷全人工髖關節系統(部分給付項目,超過部分由病患自付)
※適應症請見備註欄
49319
FBHPCCERA4Z1 "ZIMMER"M/L TAPER HIP PROSTHESIS W/KINECTIV TECHNOLOGY"捷
邁"康內特人工髖關節(陶瓷,組合式股骨柄,部分給付項目,超過
部分自付
49319
FBHPCCERA5U0 "UNITED"CERAMIC TOTAL HIP SYSTEM ※凡符合傳統人工髖關節組
之適應症者,如自願選用陶瓷人工髖關節組,則按健保給付,超
過部分由病患自付。
39396
FBHPCCERA5W2 "WRIGHT" CERAMIC TOTAL HIP SYSTEM(搭配組合式股骨柄) "瑞
德"陶瓷全人工髖關節系統(部分給付項目,超過部分由病患自付)
※適應症請見備註欄
49319
FBHPCCERA5Z1 "ZIMMER"BIOLOX DELTA CERAMIC TOTAL HIP SYSTEM※符合傳統人
工髖關節適應症者,自願選用陶瓷HEAD,則按傳統人工髖關節組
給付,超過部分由病患自付。
39396
FBHPCCERA6W2 “瑞德”戴內斯帝陶瓷全人工髖關節系統(自付差額品
項)。"WRIGHT”DYNASTY CERAMIC TOTAL HIP SYSTEM
39396
FBHPCCERA6Z1 "ZIMMER"BIOLOX DELTA CERAMIC TOTAL HIP SYSTEM※符合傳統人
工髖關節適應症,選用陶瓷HEAD,則按傳統人工髖關節組給付(組
合式STEM),超過病患自付。
49319
FBHPCCERA7W2 “瑞德”戴內斯帝陶瓷全人工髖關節系統(搭配組合式股骨柄,自
付差額品項)"WRIGHT”DYNASTY CERAMIC TOTAL HIP SYSTEM
49319
FBHPCCERE7Z1 “捷邁”百優陶瓷全人工髖關節組“ZIMMER” BIOLOX OPTION
TOTAL HIP SYSTEM
39396
FBHPCCERE8Z1 “捷邁”百優陶瓷全人工髖關節組“ZIMMER” BIOLOX OPTION
TOTAL HIP SYSTEM(KINECTIV)
49319
FBHPCCERR7Z1 “捷邁”百優陶瓷全人工髖關節組“ZIMMER” BIOLOX OPTION
TOTAL HIP SYSTEM
39396
FBHPCCERR8Z1 “捷邁”百優陶瓷全人工髖關節組“ZIMMER” BIOLOX OPTION
TOTAL HIP SYSTEM(KINECTIV)
49319
FBHPCUTF1TU0 "聯合"全人工髖關節系統(楔形骨柄):DELTA巨頭陶瓷對陶瓷櫬墊
(自付差額品項)"UNITED”TOTAL HIP SYSTEM (UTF STEM)-DELTA
CERAMIC HEAD TO CERAMIC LINER
39396
1018
特材代碼 中英文名稱 支付點數-104/01/01
FBHPCUTF1XU0 "聯合"DELTA陶瓷球頭全人工髖關節系統(楔形骨柄)(自付差額品
項)"UNITED”TOTAL HIP SYSTEM(UTF STEM)(DELTA CERAMIC
HEAD)
39396
FBHPMLDH01W2 BIG FEMORAL HEAD TOTAL HIP SYSTEM (含固定樁)※符合傳統髖
關節組適應症者,如自願選用BFH人工髖關節組,按傳統髖關節組
給付,超過部分由病患自付
39396
FBHPMLDH01Z1 LARGE DIAMETER HEAD (LDH))TOTAL HIP SYSTEM※符合傳統髖關
節組適應症者,如自願選用LDH人工髖關節組,按傳統髖關節組給
付,超過部分由病患自付
39396
FBHPMLDH02W2 BIG FEMORAL HEAD TOTAL HIP SYSTEM(不含固定樁) ※符合傳統
髖關節組適應症者,如自願選用BFH人工髖關節組,按傳統髖關節
組給付,超過部分由病患自付
39396
FBHPMLDH02Z1 MMC CUP NON-HA VERSION (LDH TOTAL HIP SYSTEM)※符合傳統髖
關節組適應症者,如自願選用LDH人工髖關節組,按傳統髖關節組
給付,超過部分由病患自付
39396
FBHPMLDH03W2 "WRIGHT" BIG FEMORAL HEAD TOTAL HIP SYSTEM(含固定樁) (搭
配組合式股骨柄) "瑞德"巨頭全人工髖關節系統(部分給付項目)
※適應症請見備註欄
49319
FBHPMLDH03Z1 "ZIMMER"KINECTIV M/L TAPER LDH TOTAL HIP PROSTHESIS
SYSTEM"西美"組合式股骨柄可旋式巨頭全人工股骨修補系統(部分
給付項目)※適應症請見備註欄
49319
FBHPMLDH04W2 "WRIGHT" BIG FEMORAL HEAD TOTAL HIP SYSTEM (不含固定樁)
(搭配組合式股骨柄) "瑞德"巨頭全人工髖關節系統(部分給付項
目)※適應症請見備註欄
49319
FBHPMMETA1DP PINNACLE METAL ON METAL TOTAL HIP SYSTEM※符合傳統髖關節
組適應症者,如自願選用金屬人工髖關節組,按傳統髖關節組給
付,超過部分由病患自付
39396
FBHPMMETA1Z1 METASUL METAL ON METAL TOTAL HIP SYSTEM※符合傳統髖關節組
適應症者,如自願選用金屬人工髖關節組,按傳統髖關節組給付
,超過部分由病患自付
39396
FBHPMMETA2DP "DEPUY"PINNACLE METAL ON METAL TOTAL HIP SYSTEM※符合傳統
髖關節適應症者,如自願選用PINNACLE,按傳統髖關節組給付,
超過部分由病患自付
39396
FBHPMMETA2Z1 "ZIMMER"KINECTIV M/L TAPER METASUL TOTAL HIP PROSTHESIS
SYSTEM"西美"組合式股骨柄可旋式金屬對金屬(部分給付項目)※
適應症請見備註欄
49319
FBHPMMETA3W2 "瑞德"金屬對金屬全人工髖關節系統"WRIGHT"TOTAL HIP
SYSTEM(METAL ON METAL)※部分給付項目,超過部分由病患自付
39396
FBHPMMETA3Z1 "ZIMMER" METAL ON METAL TOTAL HIP SYSTEM ※符合傳統髖關節
組適應症者,如自願選用金屬人工髖關節組,按傳統髖關節組給
付,超過部分由病患自付
39396
FBHPMMETA4W2 "WRIGHT" METAL ON METAL TOTAL HIP SYSTEM (搭配組合式股骨
柄)"瑞德"金屬對金屬全人工髖關節系統※部分給付項目,超過部
分由病患自付
49319
FBHPMMETA4Z1 "ZIMMER"M/L TAPER HIP PROSTHESIS W/KINECTIV TECHNOLOGY"捷
邁"康內特人工髖關節組(金屬對金屬,組合式股骨柄,部分給付項
目)※適應症請見備註欄
49319
FBHRA1000NDP AML REVISION TOTAL HIP SYSTEM ※適應症請見備註欄 52796
FBHRA1000NW2 REVISION TOTAL HIP SYSTEM※適應症請見備註欄 52796
FBHRA1000TZ1 REVISION TOTAL HIP SYSTEM ※適應症請見備註欄 52796
FBHRA2000NW2 PERFECTA REVISION TOTAL HIP
SYSTEM(NECK+BODY+STEM+HEAD+CUP+INSERT)※適應症請見備註欄
70099
1019
特材代碼 中英文名稱 支付點數-104/01/01
FBHRA2000TZ1 VERSYS REVISION TOTAL HIP SYSTEM※適應症請見備註欄 52796
FBHRA3000NS2 "HOWMEDICA-OSTEONICS" RESTORATION HA HIP SYSTEM:REVISION
SYSTEM "好美得卡 奧斯得寧"再置換人工髖關節系統 ※適應症請
見備註欄
52796
FBHRA3000TZ1 VERSYS CEMENTED REVISION/CALCAR TOTAL HIP SYSTEM※適應症
請見備註欄
52796
FBHRA4000TZ1 ZMR REVISION HIP SYSTEM(BODY+STEM+HEAD+CUP+INSERT)※適應
症請見備註欄
70099
FBHRA5000NU0 U2 REVISION HIP SYSTEM※適應症請見備註欄 52796
FBHRA5000TZ1 CPT REVISION HIP SYSTEM(CUP+LINER+HEAD+STEM)捷奔特髖關節
組※適應症請見備註欄
52796
FBHRA6000NU0 "聯合"優磨二代重建型全髖關節組"UNITED”U-MOTION II
REVISION TOTAL HIP SYSTEM
52796
FBHRA6000TZ1 "ZIMMER"WAGNER SL REVISION HIP SYSTEM"捷邁"衛格能重建型髖
關節組※適應症請見備註欄
52796
FBHRA6260NH1 RESTORATION REVISION HIP SYSTEM※適應症請見備註欄 52796
FBHRA8000TZ1 "捷邁"隆傑艾提重建型人工髖關節組"ZIMMER"LONGEVITY IT
REVISION TOTAL HIP SYSTEM
52796
FBHRA9000TZ1 "捷邁"重建型人工髖關節組(隆傑艾提搭配組合式股骨
柄)"ZIMMER"LONGEVITY IT REVISION TOTAL HIP SYSTEM(WITH
ZMR)
70099
FBHRANK20NAE BICONTACY REVISION HIP SYSTEM(STEM+HEAD+CUP+INSERT)※適應
症請見備註欄
52796
FBHRAP1REVDP "DEPUY"PINNACLE HIP SYSTEM:REVISION"帝富"必耐久人工髖臼系
統:重建式※適應症請見備註欄
52796
FBHRC6000NU0 "聯合"優磨二代重建型全人工髖關節組(陶瓷巨頭對高耐磨聚乙烯
襯墊)(自付差額品項)"UNITED”U-MOTION II REVISION HIP
SYSTEM(DELTA CERAMIC HEAD TO XPE LI
52796
FBHRC6100NU0 "聯合"優磨二代重建型全人工髖關節組(陶瓷巨頭對陶瓷襯墊)(自
付差額品項)"UNITED”U-MOTION II REVISION HIP SYSTEM(DELTA
CERAMIC HEAD TO CERAMIC LINER
52796
FBHRCCERA1AE CERAMIC REVISION HIP SYSTEM※符合傳統重建型髖關節組適應症
者,如自願選用陶瓷重建型人工髖關節組,按傳統重建型髖關節
組給付,超過部分由病患自付
52796
FBHRCCERA1DP CERAMIC REVISION HIP SYSTEM※符合傳統重建型髖關節組適應症
者,如自願選用陶瓷重建型人工髖關節組,按傳統重建型髖關節
組給付,超過部分由病患自付
52796
FBHRCCERA1S2 CERAMIC REVISION HIP SYSTEM※符合傳統重建型髖關節組者,自
願選用陶瓷重建型髖關節組,按傳統重建型髖關節組給付,超過
部分由病患自付
52796
FBHRCCERA1U0 CERAMIC REVISION HIP SYSTEM※符合傳統重建型髖關節組適應症
者,如自願選用陶瓷重建型人工髖關節組,按傳統重建型髖關節
組給付,超過部分由病患自付
52796
FBHRCCERA1W2 CERAMIC REVISION HIP SYSTEM符合重建型髖關節組者,如自願選
用陶瓷重建型人工髖關節組(自付差額品項,超過部分由病患自
付)
52796
FBHRCCERA1Z1 REVISION CERAMIC HIP SYSTEM※符合傳統重建型髖關節組適應症
者,如自願選用陶瓷重建型人工髖關節組,按傳統重建型髖關節
組給付,超過部分由病患自付
52796
FBHRCCERA2AE CERAMIC REVISION HIP SYSTEM※符合傳統重建型髖關節組適應症
者,如自願選用陶瓷重建型人工髖關節組,按傳統重建型髖關節
組給付,超過部分由病患自付
52796
FBHRCCERA2S2 "史賽克"全人工陶瓷髖關節再置換系統(自付差額品
項)"STRYKER"CERAMIC REVISION HIP SYSTEM
52796
1020
特材代碼 中英文名稱 支付點數-104/01/01
FBHRCCERA2W2 CERAMIC REVISION HIP SYSTEM※符合傳統重建型(且骨頭缺損達
第二度以上者)者,自願選用陶瓷重建型髖關節組,超過部分由病
患自付
70099
FBHRCCERA2Z1 "ZIMMER"BIOLOX DELTA CERAMIC REVISION HIP SYSTEM※符合傳
統重建型髖關節適應症,選用陶瓷HEAD,則按傳統重建型髖關節
組給付,超過病患自付。
52796
FBHRCCERA3W2 “瑞德”戴內斯帝重建型陶瓷全人工髖關節系統(自付差額品
項)。"WRIGHT”DYNASTY REVISION CERAMIC TOTAL HIP SYSTEM
52796
FBHRCCERA3Z1 "ZIMMER"REVISION BIOLOX DELTA HIP SYSTEM(CERAMIC)※符合傳
統重建型適應症者,如自願選用陶瓷重建型,按傳統髖關節組給
付,超過部分由病患自付
52796
FBHRCCERA4W2 “瑞德”戴內斯帝重建型陶瓷全人工髖關節系統(搭配組合式股骨
柄,自付差額品項)"WRIGHT”DYNASTY REVISION CERAMIC TOTAL
HIP SYSTEM
70099
FBHRCCERA4Z1 "ZIMMER"BIOLOX DELTA CERAMIC REVISION HIP SYSTEM※符合重
建型(骨缺損2度以上)髖關節適應症,選用陶瓷HEAD,按傳統重建
髖關節給付,超過病患自付。
70099
FBHRCCERA5U0 "UNITED"CERAMIC REVISION HIP SYSTEM※符合傳統重建型髖關節
組適應症者,如自願選用陶瓷重建型人工髖關節組,則按健保局
給付,超過部分由病患自付
52796
FBHRCCERE5Z1 “捷邁”重建型百優陶瓷全人工髖關節組“ZIMMER” BIOLOX
OPTION REVISION TOTAL HIP SYSTEM
52796
FBHRCCERE6Z1 “捷邁”重建型百優組合式陶瓷全人工髖關節組“ZIMMER”
BIOLOX OPTION REVISION TOTAL HIP SYSTEM(ZMR)
70099
FBHRCCERR5Z1 “捷邁”重建型百優陶瓷全人工髖關節組“ZIMMER” BIOLOX
OPTION REVISION TOTAL HIP SYSTEM
52796
FBHRCCERR6Z1 “捷邁”重建型百優組合式陶瓷全人工髖關節組“ZIMMER”
BIOLOX OPTION REVISION TOTAL HIP SYSTEM(ZMR)
70099
FBHS1101XNU0 UNITED PRIMARY HIP STEM (BIPOLAR STEM) ※適應症請見備註欄 20692
FBHS11104NU0 UNITED U2 HIP STEM"聯合"U2人工髖關節股骨柄※適應症請見備
註欄
20692
FBHS11104RU0 U2 REVISION HIP SYSTEM:STEM※適應症請見備註欄 34092
FBHS1110XNU0 TOTAL HIP STEM(CEMENT STEM)※適應症請見備註欄 20692
FBHS11170NS2 HA PRIMARY STEM ※適應症請見備註欄 20692
FBHS11300NS2 ACCOLADE PRIMARY STEM ※適應症請見備註欄 20692
FBHS1135XNDP AML STEM(87/7/7新增1554,1557-02:08,42:48,1345-20:27)※適
應症請見備註欄
20692
FBHS115570DP "帝富"髖關節系統:股骨柄"DEPUY"AML TOTAL HIP
SYSTEM:FEMORAL STEM
20692
FBHS12900NZ1 CLS SPOTORNO STEM※適應症請見備註欄 20692
FBHS13708NW2 FEMORAL STEM (378X-XXXX自88/09/01起生效,385X,3793-XXXX自
88/10/1生效)※適應症請見備註欄
20692
FBHS16070NS2 "HOWMEDICA-OSTEONICS" OMNIFIT HIP SYSTEM: PRIMARY FEMORAL
STEM "好美得卡-奧斯得寧"人工髖關節系統:股骨柄※適應症請見
備註欄
20692
FBHS16260NH1 RESTORATION P/S LONG STEM※適應症請見備註欄 34092
FBHS16578NZ1 VERSYS HA/TCP FIBER METAL TAPER STEM※適應症請見備註欄 20692
FBHS17711NZ1 M/L TAPER HIP PROSTHESIS(STEM)※適應症請見備註欄 20692
FBHS17841NZ1 VERSYS FIBER METAL MIDCOAT HIP STEM(COLLARED)※適應症請見
備註欄
20692
FBHS17850NZ1 VERSYS ADVOCATE CEMENTED STEM※適應症請見備註欄 20692
FBHS17853NZ1 VERSYS CEMENTED TOTAL HIP STEM(7853-11:17-01:21自89/04/01
起生效)※適應症請見備註欄
20692
1021
特材代碼 中英文名稱 支付點數-104/01/01
FBHS17854NZ1 VERSYS CEMENTED HIP CT STEM※適應症請見備註欄 20692
FBHS17857NZ1 VERSYS HERITAGE CDH:FEMORAL STEM※適應症請見備註欄 20692
FBHS17862NZ1 VERSYS FIBER METAL TAPER HIP STEM※適應症請見備註欄 20692
FBHS1925XNDP CORAIL FEMORAL STEM ※適應症請見備註欄 20692
FBHS19979NDP SUMMIT HIP STEM※適應症請見備註欄 20692
FBHS1KTV1NZ1 "ZIMMER"KINECTIV M/L TAPER HIP PROSTHESIS SYSTEM:STEM"西
美"可旋式人工股骨修補系統:組合式股骨柄※適應症請見備註欄
30615
FBHS1L0820DP "帝富"可瑞髖關節系統:股骨柄"DEPUY"CORAIL HIP SYSTEM:STEM
※給付規定請見備註欄
20692
FBHS1L1020DP "帝富"可瑞髖關節系統:再置換式股骨柄"DEPUY"CORAIL HIP
SYSTEM:REVISION STEM※給付規定請見備註欄
34092
FBHS1NK62NAE BICONTACT PRIMARY STEM 10:21MM(型號NK010K-
18K,NJ009T:16T,NJ028-34K自92/4/1生效)※適應症請見備註欄
20692
FBHS1PRFMRW2 "WRIGHT"PROFEMUR HIP SYSTEM:MODULAR STEM"瑞德"博菲莫人工
髖關節系統:組合式股骨柄※適應症請見備註欄
30615
FBHS1UTF1NU0 "聯合"楔形骨柄"UNITED”HIP SYSTEM:UTF STEM 20692
FBHS2130LNS2 "HOWMEDICA-OSTEONICS"OMNIFIT HIP SYSTEM:OMNIFIT CEMENTED
LONG STEM"好美得卡-奧斯得寧"人工髖關節系統:股骨柄※適應症
請見備註欄
34092
FBHS23730NW2 REVISION HIP LONG STEM※適應症請見備註欄(型號3783-
XXXX,3784-XXXX自89/10/1生效)
34092
FBHS2601XNS2 "HOWMEDICA-OSTEONICS" RESTORATION HA HIP STEM好美得卡 奧
斯得寧"人工髖關節股骨柄:長股骨柄※適應症請見備註欄
34092
FBHS30102NZ1 "ZIMMER"WAGNER SL REVISION HIP SYSTEM:STEM"捷邁"衛格能重
建型髖關節組:股骨柄※適應症請見備註欄
34092
FBHS3354XNDP AML LONG STEM(87/11/2起1571-02-000:90-000,1573-03-000:19-
000)※適應症請見備註欄
34092
FBHS37846NZ1 "西美"威士人工髖關節:股骨柄(重建型)"ZIMMER"VERSYS HIP
SYSTEM:VERSYS BEADED FULLCOAT PLUS(REVISION)
34092
FBHS37855NZ1 VERSYS CEMENTED REVISION STEM 200:260MM※適應症請見備註欄 34092
FBHS37871NZ1 VERSYS CEMENTED REVISION/CALCAR STEM※適應症請見備註欄 34092
FBHS38114NZ1 CPT REVISION HIP SYSTEM:STEM 捷奔特髖關節系統(股骨柄)※
適應症請見備註欄
34092
FBHS39980NZ1 ZMR REVISION HIP STEM※適應症請見備註欄 13096
FBHS39990NZ1 ZMR REVISION HIP STEM BODY※適應症請見備註欄 38299
FBHS3NK21NAE REVISION HIP STEM※適應症請見備註欄 34092
FBHU143000Z1 BIGLIANI/FLATOW TOTAL SHOULDER(STEM+HEAD+CUP) 52893
FBHU14302NZ1 BIGLIANI/FLATOW GLENOID(PU CUP) 14404
FBHU15300NS2 TOTAL SHOULDER SYSTEM(GLENOID+HEAD+STEM) 52893
FBHU15362NS2 SOLAR TOTAL SHOULDER SYSTEM:SHOULDER GLENOID
COMP(PLASTIC)
14404
FBKA21872NW2 FEMORAL BUILD(WEDGE)※限用於人工膝關節再置換時使用 2989
FBKA22600NU0 FEMORAL AUGMENT SET(後端遠側-整塊)※適應症請見備註欄 5750
FBKA22603NU0 "聯合"康膝人工膝關節:股骨填補塊"UNITED"U2 TOTAL KNEE
SYSTEM:FEMORAL AUGMENT
2989
FBKA22803NU0 "聯合"康膝人工膝關節:脛骨填補塊"UNITED"U2 TOTAL KNEE
SYSTEM:TIBIAL AUGMENT
2989
FBKA23000NW2 REVISION FEMORAL WEDGE※限用於人工膝關節再置換時使用 2989
FBKA23001NW2 REVISION TIBIAL WEDGE※限用於人工膝關節再置換時使用 2989
FBKA25988NZ1 TIBIAL WEDGE※須事前審查限用於膝關節再置換時使用 2989
FBKA25990TZ1 FEMORAL AUGMENTATION ※須事前審查限用於膝關節再置換時使用 2989
1022
特材代碼 中英文名稱 支付點數-104/01/01
FBKA27510NS2 "HOWMEDICA OSTEONICS" SCORPIO TOTAL KNEE SYSTEM:FEMORAL
AUGMENTATION"斯高比歐膝關節股骨墊片※限用於人工膝關節再置
換時使用
2989
FBKA296080JJ TC3 PFC REVISION FEMORAL AUGMENTATION ※限用於人工膝關節
再置換時使用
2989
FBKB21759NW2 WHITESIDE ORTHOLOC REVISION TIBIAL STEM 5CM,6.25CM※適應
症請見備註欄
1179
FBKB21870NW2 REVISION TIBIAL LONG STEM 7.5CM,15CM ※限用於人工膝關節再
置換時使用
5682
FBKE21859NW2 WHITESIDE ORTHOLOC REVISION FEMORAL STEM 5CM ※適應症請見
備註欄
1289
FBKE21890NW2 REVISION FEMORAL LONG STEM 10CM,15CM ※限用於人工膝關節再
置換時使用
5682
FBKE22700NU0 CURVED EXTENSION STEM(型號2703-
5031:38;041:48;5132:38;42:48;5231:37;41:47自981001生效)
※適應症請見備註欄
5682
FBKE23000NW2 EXTENSION FEMORAL TIBIAL STEM※限用於人工膝關節再置換時使
用
5682
FBKE25988NZ1 STEM EXTENSION ※須事前審查限用於膝關節再置換時使用 5682
FBKE26478NS2 EXTENSION STEM 80MM:155MM※限用於人工膝關節再置換時使用 5682
FBKE286960JJ REVISION STEM EXTENSION(96-07,17-20,21,31,32自89/04/01生
效)※限用於人工膝關節再置換時使用
5682
FBKF10011NH1 FEMORAL COMPONENT EXTRA EXTRA-SMALL:LARGE ※適應症請見備
註欄
18197
FBKF10096PSN GENESIS II TOTAL KNEE SYSTEM(PS):FEMORAL COMPONENTS※適
應症請見備註欄
18197
FBKF10410NJJ PFC FEMORAL※適應症請見備註欄 18197
FBKF111027DP "帝富"全人工膝關節系統:股骨※給付規定請見備註欄"DEPUY:PFC
SIGMA RPF TOTAL KNEE SYSTEM:FEMORAL
18197
FBKF11880NW2 WHITESIDE ORTHOLOC FEMORAL COMPONENT(1840-
10XX;1870;75;80;85-00XX)(KFTC-XXXX自91/01/01生效) "瑞德"
人工膝關節系統:股骨※適應症請見備註欄
18197
FBKF11890NW2 "WRIGHT"ADVANCE TOTAL KNEE SYSTEM FEMORAL "瑞德"艾德凡斯
人工膝關節系統:股骨※適應症請見備註欄
18197
FBKF12000NW2 PSL FEMORAL COMPONENT ※適應症請見備註欄 18197
FBKF12101NU0 FEMORAL COMPONENT(PS)※適應症請見備註欄 18197
FBKF12103MU0 U2 TOTAL KNEE SYSTEM:FEMORAL※適應症請見備註欄 18197
FBKF12103NU0 U2 TOTAL KNEE SYSTEM:FEMORAL CRUCIATE RETAINING※適應症
請見備註欄
18197
FBKF1210XNU0 UNITED FEMORAL COMPONENT※適應症請見備註欄 18197
FBKF15500NH1 TRIATHLON FEMORAL COMPONENT ※適應症見備註欄 18197
FBKF15950TZ1 "西美"人工膝關節股骨組件"ZIMMER"NEXGEN CR-FLEX FEMORAL
COMPONENT ※適應症請見備註欄
18197
FBKF15964TZ1 "西美"人工膝關節股骨組件(LPS-FLEX)“ZIMMER” NEXGEN LPS-
FLEX FEMORAL COMPLETE※適應症請見備註欄(00-5964-012:018-
01:02;00-5964-011:018-51:52)
18197
FBKF15970NZ1 "西美"人工膝關節股骨組件(CR)“ZIMMER” NEXGEN FEMORAL
COMPONENT※適應症請見備註欄
18197
FBKF15996TZ1 "西美"人工膝關節股骨組件(LPS)"ZIMMER"NEXGEN FEMORAL
COMPONENT(LPS)※適應症請見備註欄
18197
FBKF17030NS2 "HOWMEDICA OSTEONICS" SCORPIO TOTAL KNEE SYSTEM: CR
FEMORAL COPMONENT "好美得卡-奧斯得寧"斯高比歐人工膝關節系
統:股骨※適應症請見備註欄
18197
1023
特材代碼 中英文名稱 支付點數-104/01/01
FBKF17130NS2 "HOWMEDICA OSTEONICS" SCORPIO TOTAL KNEE SYSTEM: FEMORAL
COPMONENT"好美得卡-奧斯得寧"斯高比歐人工膝關節系統:股骨※
適應症請見備註欄
18197
FBKF18000NS2 "HOWMEDICA OSTEONICS" SCORPIO NRG TOTAL KNEE SYSTEM:
FEMORAL COMPONENT"好美得卡-奧斯得寧"斯高比歐人工膝關節系
統:股骨※適應症請見備註欄
18197
FBKF19600NDP PFC SIGMA CRUCIATE RETAINING FEMORAL COMPONENT ※適應症請
見備註欄
18197
FBKF19600NJJ PFC E CURCIATE RETAINING FEMORAL ※適應症請見備註欄(96-
0042:58自89/7/1收,93/1/1由FBKF296008JJ調來)
18197
FBKF1N050NAE E.MOTION FEMORAL COMPONENT※適應症請見備註欄 18197
FBKF1S1G1RDP "DEPUY" SIGMA PS FEMORAL COMPONENTS"帝富"膝格瑪股骨組件※
適應症請見備註欄
18197
FBKF1S1GUSDP "DEPUY"SIGMA PS FEMORAL KNEE SYSTEM:FEMORAL"帝富"膝格瑪人
工股骨膝關節系統:股骨 ※適應症請見備註欄
18197
FBKF2179NNDP LCS REVISION FEMORAL COMPONENT※適應症請見備註欄 18197
FBKF21850NW2 WHITESIDE ORTHOLOC REVISION FEMORAL COMPONENT ※適應症請
見備註欄
17201
FBKF21857NW2 WHITESIDE ORTHOLOC P.S.L REVISION FEMORAL COMPONENT※適應
症請見備註欄
17201
FBKF22103NU0 FEMORAL COMPONENT PSA TYPE※適應症請見備註欄 18197
FBKF23000NW2 ADVANCE REVISION FEMORAL COMPONENT※適應症請見備註欄 18197
FBKF25976NZ1 NEXGEN FEMORAL COMPONENT(CRA)※適應症請見備註欄 18197
FBKF25994TZ1 NEXGEN FEMORAL COMPONENT(LCCK)※適應症請見備註欄 18197
FBKF26000NS2 “HOWMEDICA OSTEONICS" SCORPIO TOTAL KNEE SYSTEM: FEMORAL
COPMONENT"好美得卡-奧斯得寧"斯高比歐人工膝關節系統:股骨※
適應症請見備註欄
18197
FBKF26001NJJ PFC REVISION FEMORAL※適應症請見備註欄 18197
FBKF296008JJ TC3 PFC REVISION FEMORAL COMPONENTS (96-0042:96-0058自
93/01/01轉至FBKF19600NJJ)※適應症請見備註欄
18197
FBKL10460NDP PFC INSERT ※適應症請見備註欄 5348
FBKL10460NJJ PFC INSERT (96-0410:96-0467自89/07/01生效)※適應症請見備
註欄
5348
FBKL10802PSN GENESIS II TOTAL KNEE SYSTEM(PS):TIBIAL ARTICULAR
COMPONENTS※適應症請見備註欄
5348
FBKL11030NS2 OMNIFIT TIBIAL INSERT※適應症請見備註欄 5348
FBKL11501PSN PS HIGH FLEXION ARTICULAR INSERT ※適應症請見備註欄 13109
FBKL11770NW2 WHITESIDE ORTHOLOC TIBIAL INSERT(型號KITC,KIMP-XXXX自
91/01/01生效) ※適應症請見備註欄
5348
FBKL12000NW2 PSL TIBIAL INSERT ※適應症請見備註欄 5348
FBKL12301NU0 TIBIAL INSERT(PS)※適應症請見備註欄 5348
FBKL123033U0 U2 TOTAL KNEE SYSTEM:TIBIAL INSERT※適應症請見備註欄 5348
FBKL12303NU0 U2 TOTAL KNEE SYSTEM:TIBIAL INSERT CRUCIATE RETAINING※
適應症請見備註欄
5348
FBKL1230XNU0 UNITED TIBIAL INSERT PLAINED※適應症請見備註欄 5348
FBKL13000NW2 "WRIGHT"ADVANCE TOTAL KNEE SYSTEM:INSERT(DOUBLE HIGH)"瑞
德"艾德凡斯人工膝關節系統:脛骨襯墊※適應症請見備註欄
13109
FBKL15500NH1 TRIATHLON TIBIA INSERT ※適應症見備註欄 13109
FBKL15960NZ1 NEXGEN LPS-FLEX TIBIAL ARTICULAR SURFACE ※適應症請見備
註欄
13109
FBKL15971NZ1 ARTICULAR SURFACE※適應症請見備註欄 5348
FBKL15981NZ1 ARTICULAR SURFACE※適應症請見備註欄 5348
FBKL15996NZ1 NEXGEN TIBIAL ARTICULAR SURFACE※適應症請見備註欄 5348
FBKL17220NS2 SCORPIO CR INSERT COMPONENT※適應症請見備註欄 5348
1024
特材代碼 中英文名稱 支付點數-104/01/01
FBKL17230NS2 TIBIAL INSERT※適應症請見備註欄 5348
FBKL17250NS2 SCORPIO SUPERFLEX PS TIBIAL INSERT※適應症請見備註欄 13109
FBKL18200NS2 SCORPIO NRG TIBIAL INSERT※適應症請見備註欄 13109
FBKL19059NZ1 NEXGEN CR-FLEX TIBIAL ARTICULAR SURFACE ※適應症請見備註
欄
13109
FBKL19602NDP PFC E CURCIATE RETAINING TIBIAL INSERT ※適應症請見備註欄 5348
FBKL19602NJJ PFC E CURCIATE RETAINING TIBIAL INSERT ※適應症請見備註欄 5348
FBKL1962RPJJ PFC SIGMA RP KNEE SYSTEM ROTATING PLATFORM INSERT※適應症
請見備註欄
13109
FBKL1N064NAE E.MOTION TIBIA INSERT※適應症請見備註欄 13109
FBKL21658NW2 P.S.L REVISION TIBIAL INSERT(型號KIPS-0114:2625,KIRV-
110S,M:630S,M自93/1/1生效)※適應症請見備註欄
25015
FBKL22303NU0 TIBIAL INSERT PSA TYPE※適應症請見備註欄 25015
FBKL25970NZ1 NEXGEN TIBIAL ARTICULAR SURFACE(CRA) ※適應症請見備註欄 25015
FBKL25994NZ1 NEXGEN TIBIAL ARTICULAR SURFACE(型號5994-022:042-10:33自
92/10/01生效) ※適應症請見備註欄
25015
FBKL26000NS2 TIBIAL BEARING COMPONENT※適應症請見備註欄 25015
FBKL26040NJJ PFC REVISION INSERT※適應症請見備註欄 25015
FBKL27493NS2 SERIES 7000 TIBIAL INSERT※適應症請見備註欄 25015
FBKL296050JJ TC3 PFC REVISION TIBIAL INSERT※適應症請見備註欄 25015
FBKP10417NDP PFC PATELLA ※適應症請見備註欄 5961
FBKP10417NJJ PFC PATELLA ※適應症請見備註欄 5961
FBKP10566NSN GENESIS II TOTAL KNEE SYSTEM:PARELLAR COMPONENTS※適應症
請見備註欄
5961
FBKP11670NW2 WHITESIDE ORTHOLOC PATELLA(型號KPRC,KPON-XXXX自91/01/01生
效)※適應症請見備註欄
5961
FBKP12401NU0 TOTAL KNEE PATELLA 26:44MM※適應症請見備註欄 5961
FBKP12403NU0 UKNEE TOTAL KNEE SYSTEM:PATELLA※適應症請見備註欄 5961
FBKP1240XNU0 "UNITED"UKNEE TOTAL KNEE SYSTEM:PATELLA"聯合"聯膝人工膝關
節:髕骨植入物
5961
FBKP13420NS2 OMNIFIT PATELLA COMPONENT※適應症請見備註欄 5961
FBKP15500NH1 TRIATHLON PATELLA※適應症見備註欄 5961
FBKP15973NZ1 PATELLA COMPONENT※適應症請見備註欄 5961
FBKP16430NH1 "HOWMEDICA"AVON PATELLO-FEMORAL JOINT PROSTHESIS-PATELLA
COMPONENT"好美得卡"阿文股骨膝蓋人工關節-臏骨組件
5961
FBKP17331NS2 SCORPIO CR PATELLA※適應症請見備註欄 5961
FBKP19601NDP PFC SIGMA CRUCIATE RETAINING OVAL-DOME PATELLA ※適應症請
見備註欄
5961
FBKP19601NJJ PFC SIGMA CURCIATE RETAINING OVAL-DOME PATELLA (型號96-
0120:0122自90/10/01生效)※適應症請見備註欄
5961
FBKP1N048NAE E.MOTION PATELLA※適應症請見備註欄 5961
FBKP26035NJJ PFC REVISION PATELLA※適應症請見備註欄 5961
FBKPA1000NJJ PFC TOTAL KNEE SYSTEM ※適應症請見備註欄 43537
FBKPA1000NU0 UNITED TOTAL KNEE SYSTEM ※適應症請見備註欄 43537
FBKPA1000NW2 WHITESIDE ORTHOLOC TOTAL KNEE SYSTEM 瑞德人工膝關節系統
※適應症請見備註欄
43537
FBKPA1000PSN GENESIS II TOTAL KNEE SYSTEM(PS)※適應症請見備註欄 43537
FBKPA1100NDP "DEPUY"PFC SIGMA TOTAL KNEE
SYSTEM(TIBIAL+INSERT+PATELLA+FEMORAL)"帝富"全人工膝關節組
※適應症請見備註欄
43537
FBKPA1100NJJ PFC E KNEE SYSTEM※適應症請見備註欄 43537
1025
特材代碼 中英文名稱 支付點數-104/01/01
FBKPA129RPJJ PFC SIGMA RP KNEE SYSTEMW/ROTATING PLATFORM※適應症請見備
註欄
51297
FBKPA2000NU0 TOTAL KNEE SYSTEM(PS)※適應症請見備註欄 43537
FBKPA2000NW2 PSL TOTAL KNEE SYSTEM ※適應症請見備註欄 43537
FBKPA2000PSN GENESIS II TOTAL KNEE SYSTEM(PS-FLEX) 高彎曲度全人工膝關
節系統※適應症請見備註欄
51297
FBKPA3000NW2 "WRIGHT"ADVANCE TOTAL KNEE SYSTEM(DOUBLE HIGH) "瑞德"艾德
凡斯人工膝關節系統(高彎曲度)※適應症請見備註欄
51297
FBKPA5000NU0 U2 TOTAL KNEE SYSTEM-CRUCIATE RETAINING※適應症請見備註欄 43537
FBKPA5000TZ1 NEXGEN COMPLETE KNEE (CR)SYSTEM ※適應症請見備註欄 43537
FBKPA5100TZ1 NEXGEN MIS COMPLETE KNEE SOLUTION (CR)微創全人工膝關節組
※適應症請見備註欄
43537
FBKPA5500NH1 TRIATHLON TOTAL KNEE SYSTEM(含TIBIA INSERT+FEMORAL+TIBIA
TRAY+PATELLA) ※適應症見備註欄
51297
FBKPA6000NU0 U2 TOTAL KNEE SYSTEM-POSTERIOR STABILIZED※適應症請見備註
欄
43537
FBKPA6000TZ1 NEXGEN COMPLETE KNEE (PS)SYSTEM ※適應症請見備註欄 43537
FBKPA7000TZ1 NEXGEN COMPLETE KNEE SOLUTION (LPS)※適應症請見備註欄 43537
FBKPA7100NS2 SCORPIO TOTAL KNEE SYSTEM(PS)※適應症請見備註欄 43537
FBKPA7100TZ1 NEXGEN MIS COMPLETE KNEE SOLUTION (LPS)微創全人工膝關節組
※適應症請見備註欄
43537
FBKPA7200NS2 “HOWMEDICA OSTEONICS" SCORPIO TOTAL KNEE SYSTEM: CR
TOTAL KNEE SYSTEM"好美得卡-奧斯得寧"斯高比歐人工膝關節系
統※適應症請見備註欄
43537
FBKPA7300NS2 SCORPIO TOTAL KNEE SYSTEM※適應症請見備註欄 51297
FBKPA7800NS2 "HOWMEDICA"SCORPIO MOBILE BEARING KNEE SYSTEM"好美得卡-奧
斯得寧"人工膝關節系統※適應症請見備註欄
51297
FBKPA8000TZ1 NEXGEN LPS-FLEX COMPLETE KNEE SYSTEM ※適應症請見備註欄 51297
FBKPA8100NS2 SCORPIO NRG TOTAL KNEE SYSTEM※適應症請見備註欄 51297
FBKPA8100TZ1 NEXGEN MIS COMPLETE KNEE SOLUTION (LPS-FLEX)微創全人工膝
關節組 ※適應症請見備註欄
51297
FBKPA9000TZ1 NEXGEN CR-FLEX COMPLETE KNEE SOLUTION※適應症請見備註欄 51297
FBKPA9100TZ1 NEXGEN MIS COMPLETE KNEE SOLUTION (CR-FLEX)微創全人工膝關
節組※適應症請見備註欄
51297
FBKPAN000NAE E.MOTION KNEE SYSTEM FOLATING KNEE※適應症請見備註欄 51297
FBKRA1000NJJ PFC REVISION KNEE SYSTEM ※適應症請見備註欄 63204
FBKRA1000NW2 WHITESIDE ORTHOLOC LONG STEM REVISION TOTAL KNEE SYSTEM
※適應症請見備註欄
63204
FBKRA1000TZ1 M/G REVISION KNEE SYSTEM ※適應症請見備註欄 63204
FBKRA1001NW2 REVISION TOTAL KNEE SYSTEM W/TIBIA WEDGE ※適應症請見備註
欄,限需使用墊片者申報
67349
FBKRA11000JJ TC3 PFC REVISION KNEE SYSTEM※適應症請見備註欄 63204
FBKRA1100NU0 U2 REVISION TOTAL KNEE
SYSTEM(FEMORAL+TIBIAL+INSERT+PATELLA)※適應症請見備註欄
63204
FBKRA2000NW2 WHITESIDE ORTHOLOC P.S.L.TOTAL KNEE SYSTEM ※適應症請見備
註欄
63204
FBKRA3000NW2 ADVANCE REVISION TOTAL KNEE SYSTEM※適應症請見備註欄 63204
FBKRA3000TZ1 NEXGEN COMPLETE KNEE SOLUTION(LCCK)※適應症請見備註欄 63204
FBKRA4000TZ1 NEXGEN COMPLETE KNEE SOLUTION(CRA)※適應症請見備註欄 63204
FBKRA5000TZ1 NEXGEN ROTATING HINGE KNEE SYSTEM※適應症請見備註欄 116295
FBKRA6000NS2 “HOWMEDICA OSTEONICS" SCORPIO TOTAL KNEE SYSTEM:REVISION
SYSTEM”好美得卡-奧斯得寧"斯高比歐人工膝關節系統:再置換※
適應症請見備註欄
63204
1026
特材代碼 中英文名稱 支付點數-104/01/01
FBKS12703NU0 EXTENSION STRAIGHT STEM PSA TYPE※適應症請見備註欄 5682
FBKT10160NSN GENESIS II TOTAL KNEE SYSTEM:TIBIAL COMPONENTS※適應症請
見備註欄
14031
FBKT10411NDP PFC TIBIAL(PRIMARY或REVISION) ※適應症請見備註欄 14031
FBKT10411NJJ PFC TIBIAL(PRIMARY或REVISION)(型號86-4177:9自89/1/1生效)
※適應症請見備註欄
14031
FBKT11581NDP "DEPUY"SIGMA CO-CR TIBIAL TRAYS"帝富"人工膝關節脛骨盤※適
應症請見備註欄
14031
FBKT11870NW2 WHITESIDE ORTHOLOC TIBIAL BASE 脛骨基座 ※適應症請見備註
欄
12559
FBKT11871NW2 TIBIAL BASE※適應症請見備註欄 12559
FBKT11885NW2 CF TIBIAL STEM+TIBIAL BASE(型號KTCO,KTCC,KTTI-XXXX自
91/01/01生效) ※適應症請見備註欄
14031
FBKT12203NU0 U2 TOTAL KNEE SYSTEM:TIBIAL BASEPLATE※適應症請見備註欄 14031
FBKT1220XNU0 UNITED TIBIAL BASEPLATE WITH STEM(型號2201-3010:3060自
89/10/1生效)※適應症請見備註欄
14031
FBKT1432RPJJ PFC SIGMA RP KNEE SYSTEM MOBILE BEARING TIBIA BASEPLATE※
適應症請見備註欄
14031
FBKT15500NH1 TRIATHLON TIBIA TRAY※適應症見備註欄 14031
FBKT15950NZ1 NEXGEN MIS TIBIAL PLATE微創人工莖骨板 ※適應症請見備註欄 14031
FBKT15972NZ1 TIBIAL PLATE※適應症請見備註欄 14031
FBKT15982NZ1 TIBIAL PLATE※適應症請見備註欄 14031
FBKT17151NS2 "HOWMEDICA" SCORPIO MOBILE BEARING KNEE SYSTEM: TIBIAL
COMPONENT "好美得卡"人工膝關節系統:脛骨盤(原健保碼為
FBKT1715LNS2)※適應症請見備註欄
14031
FBKT1715LNS2 "HOWMEDICA-OSTEONICS" SERIES 7000 TOTAL KNEE SYSTEM:
TIBIAL COMPONENT "好美得卡-奧斯得寧" 7000系列全人工膝關節
系統:脛骨盤※適應症請見備註欄
14031
FBKT1AP0LYDP PFC SIGMA KNEE SYSTEM:ALL POLYETHYLENE TIBIAL+INSERT ※
適應症請見備註欄
14031
FBKT1N062NAE E.MOTION TIBIA FOLATING PLATE※適應症請見備註欄 14031
FBKT2179NNDP LCS REVISION ROTATING TIBIAL PLATEAU ※適應症請見備註欄 14031
FBKT22203NU0 TIBIAL BASEPLATE PSA TYPE※適應症請見備註欄 14031
FBKT26000NS2 “HOWMEDICA OSTEONICS" SCORPIO TOTAL KNEE SYSTEM:TIBIAL
TRAY”好美得卡-奧斯得寧"斯高比歐人工膝關節系統:脛骨盤※適
應症請見備註欄
14031
FBKT286000JJ TC3 PFC REVISION TIBIAL TRAY※適應症請見備註欄 14031
FBKUA1000TW2 UNICOMPARTMENTAL KNEE SYSTEM(FEMORAL+TIBIAL+INSERT)※適應
症請見備註欄
44983
FBKUA1000USN GENESIS UNICOMPARMENTAL KNEE SYSTEM※適應症請見備註欄 44983
FBKUA2000TZ1 "ZIMMER"UNICOMPARTMENTAL HIGH-FLEX SYSTEM 155度
(FEMORAL+TIBIAL +SURFACE)※適應症請見備註欄
44983
FBKUA9600NJJ PFC SIGMA UNICOMPARTMENTAL KNEE SYSTEM 人工半膝關節組※適
應症請見備註欄
44983
FBKW2280XNU0 TIBIAL WEDGE※限用於人工膝關節再置換時使用 2989
FBKW25220NZ1 TIBIAL WEDGE ※限用於人工膝關節再置換時使用 2989
FBKW286010JJ TC3 PFC REVISION TIBIAL WEDGE ※限用於人工膝關節再置換時
使用
2989
FBM011109NU0 MOORE HIP SYSTEM 7732
FBM01203XNSN MOORE PROSTHESES 7732
FBM014006NZ1 "ZIMMER"MOORE HIP PROSTHESIS "西美"莫爾人工髖關節 7732
FBM019138NH1 AUSTIN MOORE 7732
1027
特材代碼 中英文名稱 支付點數-104/01/01
FBSF1000021A MONT BLANC SPINAL SYSTEM二節(RX2+SX4)※適應症請見備註欄 23358
FBSF1000031A MONT BLANC SPINAL SYSTEM 三節(RX2+SX6)※適應症請見備註欄 34118
FBSF101626B0 TITANIUM SPINAL SYSTEM(RX2+SX4)※適應症請見備註欄 23358
FBSF101635B0 TITANIUM SPINAL SYSTEM(RX2+SX6或RX2+SX4+HX2)※適應症請見
備註欄
34118
FBSF110002U0 "UNITED"CENTURY SPINAL SYSTEM (S*4+R*2) "聯合"世紀脊椎固
定系統 二節※適應症請見備註欄
23358
FBSF110003U0 "UNITED"CENTURY SPINAL SYSTEM (S*6+R*2) "聯合"世紀脊椎固
定系統(三節)※適應症請見備註欄
34118
FBSF11002LTD TITANIUM TREND SPINAL SYSTEM二節(SX4+RX2)※適應症請見備註
欄
23358
FBSF11003LTD TITANIUM TREND SPINAL SYSTEM三節(SX6+RX2)※適應症請見備註
欄
34118
FBSF11302NB0 TITANIUM SPINAL FIXATION SYSTEM 脊椎固定系統二節(SX4+RX2)
※適應症請見備註欄
23358
FBSF11303NB0 TITANIUM SPINAL FIXATION SYSTEM 脊椎固定系統三節(SX6+RX2)
※適應症請見備註欄
34118
FBSF13820NS9 TITANIUM XIA SPINAL SYSTEM 二節前置脊椎固定(SX4+RX2)※適
應症請見備註欄
23886
FBSF140001RK TITANIUM ANTERIOR SPINAL SYSTEM(PX1+SX4)※適應症請見備註
欄
23886
FBSF148144S9 XIA 4.5 TITANIUM SPINAL IMPLANTS (SX4+RX2)二節(適用於兒童
或體型嬌小者)
24210
FBSF148145S9 XIA 4.5 TITANIUM SPINAL IMPLANTS (SX6+RX2)三節(適用於兒童
或體型嬌小者)
35358
FBSF148232S9 "STRYKER" XIA 3 SPINAL SYSTEM TWO LEVEL(SX4+RX2)"史賽克"
喜爾三脊椎系統二節 ※適應症請見備註欄
23358
FBSF148233S9 "STRYKER" XIA 3 SPINAL SYSTEM THERE LEVEL(SX6+RX2)"史賽
克"喜爾三脊椎系統三節 ※適應症請見備註欄
34118
FBSF1495XNS1 TITANIUM CLICK'X SPINAL SYSTEM上開式三節(SX6+RX2) ※適應
症請見備註欄
34118
FBSF14981NS1 TITANIUM UNIVERSAL SPINAL SYSTEM (二節 SCREWX4+RODX2)※適
應症請見備註欄,須事前審查
23358
FBSF14982NS1 VENTROFIX ANTERIOR SPINAL SYSTEM(RODX2+或X1+SCREWX4)※適
應症請見備註欄
23886
FBSF14985NS1 TITANIUM CLICK'X SPINAL SYSTEM上開式二節(SX4+RX2) ※適應
症請見備註欄
23358
FBSF1498XNS1 TITANIUM UNIVERSAL SPINAL SYSTEM (三節 SCREWX6+RODX2)※適
應症請見備註欄,須事前審查
34118
FBSF16200NDX TITANIUM SPINAL IMPLANT(RX2+SX4)二節 型號48485030:9060,XL
自90/07/01生效※適應症請見備註欄
23358
FBSF16200NS9 TITANIUM SPINAL IMPLANT(DIAPASON)(RX2+SX4)脊椎人工置換
組:二節 ※適應症請見備註欄
23358
FBSF16202NS1 TITANIUM PANGEA SPINAL SYSTEM(SX4+RX2) ※適應症請見備註欄 23358
FBSF16203NS1 TITANIUM PANGEA SPINAL SYSTEM(SX6+RX2) ※適應症請見備註欄 34118
FBSF162722DP DEPUY SPINE(DEPUY SPINE SARL)MOSS MIAMI SPINE
SYSTEM(RX2+SX4) 帝富脊椎莫斯(士)邁阿密脊椎系統(二節)※適
應症請見備註欄
23358
FBSF162723DP DEPUY SPINE(DEPUY SPINE SARL)MOSS MIAMI SPINE
SYSTEM(RX2+SX6) 帝富脊椎莫斯(士)邁阿密脊椎系統(三節)※適
應症請見備註欄
34118
1028
特材代碼 中英文名稱 支付點數-104/01/01
FBSF16300NDX TITANIUM SPINAL IMPLANT 三節(SX6+RX2)型號48485030:9060,XL
自90/07/01生效※適應症請見備註欄
34118
FBSF16300NS9 TITANIUM SPINAL IMPLANT(DIAPASON)(RX2+SX6)脊椎人工置換
組:三節 ※適應症請見備註欄
34118
FBSF1765P2Y2 TITANIUM SPINAL SYSTEM二節(RX2+SX4)※適應症請見備註欄 23358
FBSF1765P3Y2 TITANIUM SPINAL SYSTEM三節(RX2+SX6)※適應症請見備註欄 34118
FBSF177202Y2 TITANIUM SPINAL SYSTEM(RX2+SX4)二節※適應症請見備註欄 23358
FBSF177203Y2 TITANIUM SPINAL SYSTEM(RX2+SX6)三節※適應症請見備註欄 34118
FBSF177402Y2 TITANIUM O TYPE SPINAL SYSTEM 二節(RX2+SX4)※適應症請見備
註欄
23358
FBSF177403Y2 TITANIUM O TYPE SPINAL SYSTEM 三節(RX2+SX6)※適應症請見備
註欄
34118
FBSF180001RK TITANIUM SPINAL SYSTEM (SX4+RX2)二節※適應症請見備註欄 23358
FBSF180002RK TITANIUM SPINAL SYSTEM (SX6+RX2)三節 ※適應症請見備註欄 34118
FBSF180003RK TITANIUM SPINAL SYSTEM 二節(SX4+RX2) ※適應症請見備註欄 23358
FBSF180004RK TITANIUM SPINAL SYSTEM 三節(SX6+RX2) ※適應症請見備註欄 34118
FBSF180005RK TITANIUM SPINAL SYSTEM 二節(SX4+RX2) ※適應症請見備註欄 23358
FBSF180006RK TITANIUM SPINAL SYSTEM 三節(SX6+RX2) ※適應症請見備註欄 34118
FBSF180NP2Y2 ARTEST SPINAL FIXATION SYSTEM(SX4+RX2)二節 亞力士脊椎固定
系統※適應症請見備註欄
23358
FBSF180NP3Y2 ARTEST SPINAL FIXATION SYSTEM(SX6+RX2)三節 亞力士脊椎固定
系統 ※適應症請見備註欄
34118
FBSF1821XNDA TITANIUM ZPLATE ANTERIOR SPINAL SYSTEM (PLATEX1+SCREWX4)
※適應症請見備註欄,須事前審查
23886
FBSF1822MNM4 ZPLATE II ANTERIOR FIXATION SYSTEM(PX1+SX4)二節※適應症請
見備註欄
23886
FBSF1865P2M4 BASIS SPINAL SYSTEM 二節(ATL PLATE SYSTEM)(PX1+SX4)※適應
症請見備註欄
23358
FBSF188CP2Y2 "SYNTEC" COLISEUM SPINAL FIXATION SYSTEM "亞太醫療"高立捷
脊椎固定系統二節(RX2+SX4) ※適應症請見備註欄
23358
FBSF188CP3Y2 "SYNTEC" COLISEUM SPINAL FIXATION SYSTEM "亞太醫療"高立捷
脊椎固定系統三節 ※適應症請見備註欄
34118
FBSF1A3N2NXA A3 POSTERIOR TITANIUM SPINAL SYSTEM 二節(RX2+SX4)※適應症
請見備註欄
23358
FBSF1A3N3NXA A3 POSTERIOR TITANIUM SPINAL SYSTEM 三節(RX2+SX6)※適應症
請見備註欄
34118
FBSF1AAS2NXA TITANIUM SPINAL SYSTEM二節(RX2+SX4)※適應症請見備註欄 23358
FBSF1AAS8NXA TITANIUM SPINAL SYSTEM三節(RX2+SX6)※適應症請見備註欄 34118
FBSF1ASAT1AQ TITANIUM ANTERIOR SPINAL SYSTEM(PX1+SX4)※適應症請見備註
欄
23886
FBSF1ASPL1AQ TITANIUM SPINAL SYSTEM二節(RX2+SX4)※適應症請見備註欄 23358
FBSF1ASPL2AQ TITANIUM SPINAL SYSTEM二節(PX2+SX4)※適應症請見備註欄 23358
FBSF1ASPL3AQ TITANIUM SPINAL SYSTEM三節(RX2+SX6)※適應症請見備註欄 34118
FBSF1ASPL4AQ TITANIUM SPINAL SYSTEM三節(PX2+SX6)※適應症請見備註欄 34118
FBSF1ASY01AQ TITANIUM SMARTLOC SPINAL SYSTEM二節(SX4+RX2)※適應症請見
備註欄
23358
FBSF1ASY02AQ TITANIUM SMARTLOC SPINAL SYSTEM三節(SX6+RX2)※適應症請見
備註欄
34118
FBSF1ASY05AQ SMARTLOC EVOLUTION SPINAL SYSTEM (SX4+RX2)史麥特艾爾脊椎
固定系統:二節 ※適應症請見備註欄
23358
FBSF1ASY06AQ TITANIUM SMARTLOC EVOLUTION SPINAL SYSTEM(SX6+RX2)史麥特
艾爾脊椎固定系統:三節 ※適應症請見備註欄
34118
1029
特材代碼 中英文名稱 支付點數-104/01/01
FBSF1BAR121S "SCIENT'X"ISOBAR TTL VERTEBRAL CONNECTION SYSTEM "賽恩司"
脊椎連接系統:二節(SX4+RX2)※給付規定請見備註欄
23358
FBSF1BAR131S "SCIENT'X"ISOBAR TTL VERTEBRAL CONNECTION SYSTEM "賽恩司"
脊椎連接系統:三節(SX6+RX2)※給付規定請見備註欄
34118
FBSF1CDH2TDA TITANIUM CD HORIZON SPINAL SYSTEM二節(SCREWX4+RODX2)※適
應症請見備註欄
23886
FBSF1CDH3TDA TITANIUM CD HORIZON SPINAL SYSTEM三節(SCREWX6+RODX2)※適
應症請見備註欄
34118
FBSF1GS12NG0 GSS TITANIUM SPINAL SYSTEM 二節(RX2+SX4) ※適應症請見備註
欄
23358
FBSF1GS13NG0 GSS TITANIUM SPINAL SYSTEM 三節(RX2+SX6) ※適應症請見備註
欄
34118
FBSF1HUTR2GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX4)際仁脊椎固定系統(二
節)※適應症請見備註欄
23358
FBSF1HUTR3GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX6)際仁脊椎固定系統(三
節)※適應症請見備註欄
34118
FBSF1JAVA2JA TITANIUM SPINAL SYSTEM 二節(RX2+SX4)※適應症請見備註欄 23358
FBSF1JAVA3JA TITANIUM SPINAL SYSTEM 三節(RX2+SX6)※適應症請見備註欄 34118
FBSF1LERS2M4 "MEDTRONIC" CD HORIZON LEGACY SPINAL SYSTEM(RX2+SX4) "美
敦力"雷格斯脊椎矯正系統二節※適應症請見備註欄
23358
FBSF1LERS3M4 "MEDTRONIC" CD HORIZON LEGACY SPINAL SYSTEM(RX2+SX6) "美
敦力"雷格斯脊椎矯正系統三節※適應症請見備註欄
34118
FBSF1LSTR2GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX4)際仁脊椎固定系統(二
節)※適應症請見備註欄
23358
FBSF1LSTR3GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX6)際仁脊椎固定系統(三
節)※適應症請見備註欄
34118
FBSF1LUTR2GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX4)際仁脊椎固定系統二節
※適應症請見備註欄
23358
FBSF1LUTR3GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX6)際仁脊椎固定系統三節
※適應症請見備註欄
34118
FBSF1M3SP3Z6 TITANIUM M3 SPINAL POSTERIOR SYSTEM 三節(RX2+SX6)※適應症
請見備註欄
34118
FBSF1M8RS2M4 "美敦力"思迪M8脊椎固定系統-2節"MEDIRONIC"CD HORIZON M8
SPINAL SYSTEM
13816
FBSF1M8RS3M4 "美敦力"思迪M8脊椎固定系統-3節"MEDIRONIC"CD HORIZON M8
SPINAL SYSTEM
20044
FBSF1MES2NZ6 TITANIUM SPINAL SYSTEM二節(RODX2或PLATEX2+SCREWX4)※適應
症請見備註欄
23358
FBSF1MES3NZ6 TITANIUM SPINAL SYSTEM三節(RODX2或PLATEX2+SCREWX6)※適應
症請見備註欄
34118
FBSF1P2SP2Z6 "MERRIES"PROT II POSTERIOR SPINE SYSTEM(RX2+SX4) "美瑞世"
普生二代後方脊椎固定器二節※適應症請見備註欄
23358
FBSF1P2SP3Z6 "MERRIES"PROT II POSTERIOR SPINE SYSTEM (RX2+SX6) "美瑞
世"普生二代後方脊椎固定器三節※適應症請見備註欄
34118
FBSF1PCS03V2 "INTAI"SPINAL FIXATION SYSTEM(RX2+SX4)"鐿鈦"脊椎固定系統:
二節※給付規定請見備註欄
23358
FBSF1PCS03WG WILTROM SPINAL FIXATON SYSTEM (RX2+SX4) 威創脊椎固定系
統:二節※適應症請見備註欄
23358
FBSF1PCS04V2 "INTAI"SPINAL FIXATION SYSTEM(RX2+SX6)"鐿鈦"脊椎固定系統:
三節※給付規定請見備註欄
34118
FBSF1PCS04WG WILTROM SPINAL FIXATON SYSTEM (RX2+SX6) 威創脊椎固定系
統:三節※適應症請見備註欄
34118
FBSF1PCS05WG "WILTROM"SPINAL FIXATION SYSTEM(RX2+SX4)"威創"脊椎固定系
統:二節※給付規定請見備註欄
23358
1030
特材代碼 中英文名稱 支付點數-104/01/01
FBSF1PCS06WG "WILTROM"SPINAL FIXATION SYSTEM(RX2+SX6)"威創"脊椎固定系
統:三節※給付規定請見備註欄
34118
FBSF1R200NS9 XIA REDUCTION IMPLANTS 二節(RX2+SX4)※適應症請見備註欄 23358
FBSF1R300NS9 XIA REDUCTION IMPLANTS 三節(RX2+SX6)※適應症請見備註欄 34118
FBSF1SA1T2Y2 TITANIUM UNIVERSAL ANTERIOR SPINAL FIXATION
SYSTEM(SX4+PX1)※適應症請見備註欄
23886
FBSF1SA2T2Y2 TITANIUM UNIVERSAL ANTERIOR SPINAL FIXATION
SYSTEM(SX4+BLOCKX2+RODX2)※適應症請見備註欄
23886
FBSF1SW200AE "AESCULAP"TITANIUM S4 SPINAL SYSTEM二節(SX4+RX2)"雅氏"雅
士弗脊椎固定系統※適應症請見備註欄
23358
FBSF1SW300AE "AESCULAP"TITANIUM S4 SPINAL SYSTEM三節(SX6+RX2)"雅氏"雅
士弗脊椎固定系統※適應症請見備註欄
34118
FBSF1T2552DP M-M TITANIUM SPINAL SYSTEM(二節) ※適應症請見備註欄 23358
FBSF1T3553DP M-M TITANIUM SPINAL SYSTEM(三節) ※適應症請見備註欄 34118
FBSF1X200NS9 XIA TITANIUM SPINAL IMPLANTS 二節
(SX4+RX2)(03820425:860,03821425:760自92/4/1生效)※適應症
請見備註欄
23358
FBSF1X300NS9 XIA TITANIUM SPINAL IMPLANTS 三節
(SX6+RX2)(03820425:860,03821425:760自92/4/1生效)※適應症
請見備註欄
34118
FBSF2000021A MONT BLANC SPINAL ROD 短※適應症請見備註欄 919
FBSF2000041A MONT BLANC SPINAL ROD 長※適應症請見備註欄 2662
FBSF2000F41A "SPINEWAY" MONT BLANC SPINE SYSTEM:ROD 132:158MM"施百威”
脊椎固定系統:固定桿(免事前審查)
1419
FBSF20572NDP M-M TITANIUM ROD 30CM,48CM※適應症請見備註欄 2662
FBSF20574NDP M-M TITANIUM ROD 12CM※適應症請見備註欄 919
FBSF210002TT TITANIUM SPINAL ROD 110MM:450MM(免事前審查) 1419
FBSF210B2NZ6 TITANIUM SPINAL ROD 4.5:10.5CM※適應症請見備註欄 919
FBSF210B5NZ6 TITANIUM SPINAL ROD 12.5:20CM※適應症請見備註欄 2662
FBSF21534NS1 TITANIUM UNIVERSAL SPINAL ROD LONG 免事前審查 1419
FBSF21600LTD TITANIUM TREND SPINAL ROD 110:300MM※適應症請見備註欄 2662
FBSF21600STD TITANIUM TREND SPINAL ROD※適應症請見備註欄 919
FBSF22110NS9 XIA TITANIUM SPINAL ROD 110:350MM(免事前審查) 1419
FBSF248147S9 XIA TITANIUM SPINAL ROD 40:100MM(短節)(適用於兒童或體型嬌
小者)
957
FBSF248148S9 XIA TITANIUM SPINAL ROD 110:600MM (長節)(適用於兒童或體型
嬌小者)
2662
FBSF248232S9 "STRYKER" XIA 3 SPINAL SYSTEM:ROD 30:100MM "史賽克"喜爾三
脊椎系統:固定桿短節 ※適應症請見備註欄
919
FBSF248233S9 "STRYKER" XIA 3 SPINAL SYSTEM:ROD 11:600MM "史賽克"喜爾三
脊椎系統:固定桿長節 ※適應症請見備註欄
2662
FBSF24981NS1 TITANIUM UNIVERSAL SPINAL ROD ※適應症請見備註欄 919
FBSF24985NS1 TITANIUM PANGEA ROD 35:85MM ※適應症請見備註欄 919
FBSF2498XNS1 TITANIUM UNIVERSAL SPINAL ROD LONG ※適應症請見備註欄,應
事前審查
2662
FBSF254040B0 TITANIUM SPINAL ROD 40MM:110MM(短節)※適應症請見備註欄 919
FBSF254047B0 TITANIUM SPINAL ROD 120MM:200MM(長節)※適應症請見備註欄 2662
FBSF26202NS1 TITANIUM PANGEA ROD 200-500MM ※適應症請見備註欄 2662
FBSF26504NDX TITANIUM DIAPASON SPINAL ROD 40:100MM ※適應症請見備註欄
,須事前審查
919
FBSF26504NS9 TITANIUM SPINAL IMPLANT(DIAPASON):ROD 70:100MM 脊椎人工
置換組:固定桿※適應症請見備註欄
919
FBSF265111S9 TITANIUM SPINAL IMPLANT(DIAPASON):ROD 110:250MM脊椎人工
置換組:固定桿(免事前審查)
1419
1031
特材代碼 中英文名稱 支付點數-104/01/01
FBSF26511NDX TITANIUM DIAPASON SPINAL ROD 11:40CM ※適應症請見備註欄,
須事前審查
2662
FBSF26511NS9 TITANIUM SPINAL (DIAPASON)ROD 26:40CM脊椎人工置換組:固定
桿※適應症請見備註欄
2662
FBSF276590Y2 TITANIUM SPINAL ROD 5:10CM※適應症請見備註欄 919
FBSF27659NY2 TITANIUM SPINAL ROD 12:30CM※適應症請見備註欄 2662
FBSF277006Y2 TITANIUM SPINAL ROD短節※適應症請見備註欄 919
FBSF277011Y2 TITANIUM SPINAL ROD 6X110:300MM 長節固定四節以上(免術前審
查)
1419
FBSF277071Y2 TITANIUM SPINAL FIXATION PLATE 45:80MM※適應症請見備註欄 919
FBSF2785NLY2 ARTEST SPINAL FIXATION SYSTEM:ROD 115:450MM 亞力士脊椎固
定系統長節連接管※適應症請見備註欄
2662
FBSF2785NSY2 ARTEST SPINAL FIXATION SYSTEM:ROD 20:110MM 亞力士脊椎固
定系統短節連接管※適應症請見備註欄
919
FBSF2820NLY2 TITANIUM SPINAL ROD 11.5:45CM 長節 免事前審查 1419
FBSF2839NLY2 "SYNTEC" AREIKEN SPINAL FIXATION SYSTEM:ROD "亞太醫療"亞
力健脊椎固定系統:連結棒(長節)11.5~45CM,免事前審查
1419
FBSF2855LTDA TITANIUM CD HORIZON SPINAL ROD(長節) ※適應症請見備註欄 2662
FBSF2855STDA TITANIUM CD HORIZON SPINAL ROD(短節) ※適應症請見備註欄 919
FBSF2886NLY2 ROD 連結棒-長節 1419
FBSF2887CLY2 ROD 連結棒-長節 ※適應症請見備註欄 2662
FBSF2887CSY2 ROD 連結棒-短節 ※適應症請見備註欄 919
FBSF2911NLY2 "SYNTEC"COLISEUM SPINAL FIXATION SYSTEM:ROD 120:450MM"亞
太醫療"高立捷脊椎固定系統:連接桿(長節)免事前審查
1419
FBSF2913CLY2 "SYNTEC"COLISEUM SPINAL FIXATION SYSTEM:ROD 120:450MM"亞
太醫療"高立捷脊椎固定系統:連接桿(長節)※適應症請見備註欄
2662
FBSF2913CSY2 "SYNTEC"COLISEUM SPINAL FIXATION SYSTEM:ROD 40:100MM"亞太
醫療"高立捷脊椎固定系統:連接桿(短節)※適應症請見備註欄
919
FBSF2A3R1NXA A3 POSTERIOR TITANIUM SPINAL ROD 4:10CM※適應症請見備註欄 919
FBSF2A3R2NXA A3 POSTERIOR TITANIUM SPINAL ROD 11:50CM ※適應症請見備註
欄
2662
FBSF2ASLP1AQ TITANIUM SPINAL PLATE※適應症請見備註欄 919
FBSF2ASLR1AQ TITANIUM SPINAL ROD 20:90MM※適應症請見備註欄 919
FBSF2ASLR2AQ TITANIUM SPINAL ROD 110:450MM※適應症請見備註欄 2662
FBSF2ASNR2AQ TITANIUM SMARTLOC SPINAL ROD 110:450MM免事前審前 1419
FBSF2ASYR1AQ TITANIUM SMARTLOC SPINAL ROD 40:100MM※適應症請見備註欄 919
FBSF2ASYR2AQ TITANIUM SMARTLOC SPINAL ROD 110:480MM※適應症請見備註欄 2662
FBSF2ASYR3AQ TITANIUM SMARTLOC EVOLUTION SPINAL ROD 40MM:100MM ※適應
症請見備註欄
919
FBSF2ASYR4AQ TITANIUM SMARTLOC EVOLUTION SPINAL ROD 110:600MM ※適應症
請見備註欄
2662
FBSF2B0002RK TITANIUM SPINAL ROD 110:480MM(長節)免事前審查 1419
FBSF2BA001RK TITANIUM SPINAL ROD 40:100MM(短節)※適應症請見備註 919
FBSF2BA002RK TITANIUM SPINAL ROD 110:450MM(長節)※適應症請見備註欄 2662
FBSF2BA003RK TITANIUM SPINAL PLATE※適應症請見備註欄 919
FBSF2BAR2L1S "SCIENT'X"ISOBAR TTL VERTEBRAL CONNECTION SYSTEM:ROD
110~400MM"賽恩司"脊椎連接系統:固定桿(長節)※給付規定請見
備註欄
2662
1032
特材代碼 中英文名稱 支付點數-104/01/01
FBSF2BAR2S1S "SCIENT'X"ISOBAR TTL VERTEBRAL CONNECTION SYSTEM:ROD
45~95MM"賽恩司"脊椎連接系統:固定桿(短節)※給付規定請見備
註欄
919
FBSF2GS21NG0 GSS TITANIUM SPINAL ROD 40-100MM※適應症請見備註欄 919
FBSF2GS22NG0 GSS TITANIUM SPINAL ROD 110-600MM※適應症請見備註欄 2662
FBSF2L3401U0 "UNITED"CENTURY SPINAL SYSTEM:ROD 11:51CM "聯合"世紀脊椎
固定系統固定桿(長節)※適應症請見備註欄
2662
FBSF2LR002GZ GEZEN SPINAL FIXATION SYSTEM:ROD際仁脊椎固定系統:脊椎固定
桿長節 免事前審查
1419
FBSF2M3LRDZ6 TITANIUM M3 SPINAL POSTERIOR ROD 125:300MM※適應症請見備
註欄
2662
FBSF2P2LRDZ6 “美瑞世”普生二代後方脊椎固定器:固定桿"MERRIES”PROT II
POSTERIOR SPINE SYSTEM:ROD ※給付規定請見備註欄
2662
FBSF2P2SRDZ6 PROT II POSTERIOR SPINE ROD 4.5:10.5CM※適應症請見備註欄 919
FBSF2PR041B0 TITANIUM SPINAL ROD 110MM:450MM免事前審查 1419
FBSF2R063NXA TITANIUM SPINAL ROD 4:11CM※適應症請見備註欄 919
FBSF2R068NXA TITANIUM SPINAL ROD 13:40CM※適應症請見備註欄 2662
FBSF2R1797DP DEPUY SPINE MOSS MIAMI SPINE SYSTEM:ROD 帝富脊椎莫斯邁阿
密脊椎系統:固定桿※適應症請見備註欄
919
FBSF2R3401U0 "UNITED"CENTURY SPINAL SYSTEM:ROD 3:10CM "聯合"世紀脊椎固
定系統固定桿(短節)※適應症請見備註欄
919
FBSF2R482NS9 XIA REDUCTION ROD 30:90MM※適應症請見備註欄 919
FBSF2R8550M4 TITANIUM CD HORIZON M8 SPINAL ROD 20"(免術前審查) 1419
FBSF2R855LM4 TITANIUM CD HORIZON M8 SPINAL ROD長節 50.4CM※適應症請見
備註欄
2662
FBSF2R869SM4 "美敦力"思迪M8脊椎固定系統-短節固定桿"MEDTRONIC"CD
HORIZON M8 SPINAL SYSTEM:ROD 3CM,8CM
679
FBSF2RD02TV2 "INTAI"SPINAL FIXATION SYSTEM:ROD 110:500MM"鐿鈦"脊椎固定
系統:長節連接桿(免事前審查)
1419
FBSF2RD02TWG "WILTROM"SPINAL FIXATION SYSTEM:TITANIUM SPINAL ROD
125:500MM"威創"脊椎固定系統:連接桿125:500MM(免事前審查)
1419
FBSF2RD03TV2 "INTAI"SPINAL FIXATION SYSTEM:TITANIUM ROD 25:100MM"鐿鈦"
脊椎固定系統:連接桿※給付規定請見備註欄
919
FBSF2RD03TWG "WILTROM"SPINAL FIXATON SYSTEM:TITANIUM ROD 25:100MM "威
創"脊椎固定系統:連接桿
919
FBSF2RD04TV2 "INTAI"SPINAL FIXATION SYSTEM:TITANIUM ROD 110:500MM"鐿
鈦"脊椎固定系統:長節連接桿※給付規定請見備註欄
2662
FBSF2RD04TWG "WILTROM"SPINAL FIXATON SYSTEM:TITANIUM ROD 125:500MM "威
創"脊椎固定系統:連接桿
2662
FBSF2RF00LRX RF SPINAL ROD 110:150MM(免事前審查) 1419
FBSF2RL869M4 "MEDTRONIC" CD HORIZON LEGACY SPINAL SYSTEM:ROD 500MM "美
敦力"雷格斯脊椎矯正系統:固定桿長節※適應症請見備註欄
2662
FBSF2RS869M4 "MEDTRONIC" CD HORIZON LEGACY SPINAL SYSTEM:ROD 30-120MM
"美敦力"雷格斯脊椎矯正系統:固定桿短節※適應症請見備註欄
919
FBSF2RY68NXA Y TYPE POSTERIOR TITANIUM SPINAL ROD 12:40CM(免事前審查) 1419
FBSF2SR125Z6 TITANIUM SPINAL ROD 125MM:200MM(免事前審查) 1419
FBSF2SW35NAE "AESCULAP"TITANIUM S4 SPINAL SYSTEM:ROD 35MM:120MM"雅氏"
雅士弗脊椎固定系統:支撐桿※適應症請見備註欄
919
FBSF2SW50NAE "AESCULAP"TITANIUM S4 SPINAL SYSTEM:ROD 150MM:500MM"雅
氏"雅士弗脊椎固定系統:支撐桿※適應症請見備註欄
2662
FBSF2SX12NAE TITANIUM SPINE ROD 250-500MM (96年10月1日起免事前審查) 1419
1033
特材代碼 中英文名稱 支付點數-104/01/01
FBSF2T1FRMCM TI-FRAME TITANIUM(後頸椎固定架)※適應症請見備註欄 6656
FBSF2TL01TJA TITANIUM SPINAL ROD 30:100MM※適應症請見備註欄 919
FBSF2TL02TJA TITANIUM SPINAL ROD 120:800MM※適應症請見備註欄 2662
FBSF2TR001GZ GEZEN SPINAL FIXATION SYSTEM:ROD 40:105 MM 際仁脊椎固定系
統:固定桿(短)※適應症請見備註欄
919
FBSF2TR002GZ GEZEN SPINAL FIXATION SYSTEM:ROD 110-500 MM 際仁脊椎固定
系統:固定桿(長)※適應症請見備註欄
2662
FBSF2TS02TJA TITANIUM SPINAL ROD 120-200MM(免事前審查) 1419
FBSF2X204NS9 XIA TITANIUM SPINAL ROD 70:100MM※適應症請見備註欄 919
FBSF2X211NS9 XIA TITANIUM SPINAL ROD 360:600MM※適應症請見備註欄 2662
FBSF3000031A MONT BLANC SPINAL HOOK※適應症請見備註欄 3311
FBSF30559NDP M-M TITANIUM HOOK※適應症請見備註欄 3311
FBSF3140XNTD TITANIUM TREND SPINAL HOOK※適應症請見備註欄 3311
FBSF340051WG "WILTROM"SPINAL FIXATION SYSTEM:HOOK"威創"脊椎固定系統:椎
弓鉤※適應症請見備註欄
3311
FBSF348150S9 XIA TITANIUM SPINAL HOOK(適用於兒童或體型嬌小者) 4997
FBSF348232S9 "STRYKER" XIA 3 SPINAL SYSTEM:HOOK"史賽克"喜爾三脊椎系統:
骨鉤※適應症請見備註欄
3311
FBSF34983NS1 TITANIUM UNIVERSAL SPINAL HOOK ※適應症請見備註欄,須事前
審查
3311
FBSF36201NS1 TITANIUM PANGEA SPINAL HOOK※適應症請見備註欄 3311
FBSF375504Y2 STAINLESS SPINAL HOOK※適應症請見備註欄 2725
FBSF376504Y2 TITANIUM SPINAL HOOK※適應症請見備註欄 3311
FBSF377041Y2 TITANIUM SPINAL HOOK(免術前審查) 1490
FBSF3961TMDA TITANIUM CD HORIZON SPINAL HOOK ※適應症請見備註欄 3311
FBSF3ASLH1AQ TITANIUM SPINAL HOOK※適應症請見備註欄 3311
FBSF3ASYH1AQ TITANIUM SMARTLOC SPINAL HOOK※適應症請見備註欄 3311
FBSF3ASYH2AQ SMARTLOC EVOLUTION SYSTEM:HOOK 史麥特艾爾脊椎固定系統:固
定鉤※適應症請見備註欄
3311
FBSF3BA001RK TITANIUM SPINAL HOOK ※適應症請見備註欄 3311
FBSF3H212NXA TITANIUM SPINAL PEDICLE HOOK※適應症請見備註欄 3311
FBSF3H754PM4 "MEDTRONIC" CD HORIZON LEGACY SPINAL SYSTEM:HOOK "美敦力"
雷格斯脊椎矯正系統:骨鉤※適應症請見備註欄
3311
FBSF3H8415M4 TITANIUM CD REDUCTION SCREW CONNECTOR HOOK(免術前審查) 1490
FBSF3H859PM4 TITANIUM CDH M8 PEDIATRIC HOOK※適應症請見備註欄 3311
FBSF3H859SM4 TITANIUM CD HORIZON M8 SPINAL HOOK※適應症請見備註欄 3311
FBSF3H869RM4 TITANIUM CDH M8 REDUCTION SPINAL HOOK※適應症請見備註欄 3311
FBSF3LK003GZ GEZEN SPINAL FIXATION SYSTEM:HOOK 際仁脊椎固定系統:固定鉤
※適應症請見備註欄
3311
FBSF3R382NS9 XIA REDUCTION HOOK※適應症請見備註欄 3311
FBSF3X600NS9 XIA TITANIUM SPINAL HOOK※適應症請見備註欄
(03820200:20215;03820220;20221;20230;20231自980401生效)
3311
FBSF3XPDHTDP "DEPUY SPINE"EXPEDIUM SPINE SYSTEM:HOOK "帝富脊椎"易配置
脊椎系統:固定鉤※給付規定請見備註欄
3311
FBSF4000041A MONT BLANC SPINAL SCREW※適應症請見備註欄 5380
FBSF4010RNZ6 TITANIUM SPINAL SCREW※適應症請見備註欄 5380
FBSF40536NDP M-M TITANIUM SCREW MONO(型號1755-29125:29155自92/1/1生效)
※適應症請見備註欄
5380
FBSF40543NDP M-M TITANIUM SCREW POLY(型號1755-37125:37155自92/1/1生效)
※適應症請見備註欄
5380
FBSF409099DP TITANIUM MOSS MIAMI SPINAL SCREW※適應症請見備註欄 5380
FBSF4110XNTD TITANIUM TREND SPINAL SCREW※適應症請見備註欄 5380
FBSF41300NB0 TITANIUM SPINAL FIXATION SYSTEM:SCREW 脊椎固定螺絲 ※適
應症請見備註欄
5380
1034
特材代碼 中英文名稱 支付點數-104/01/01
FBSF41600NB0 "BMI"SPINAL FIXATION SYSTEM:OPS TITANIUM SPINAL SCREW "長
安"脊頸椎內固定系統:脊椎骨質疏鬆內固定釘※適應症請見備註
欄
12960
FBSF41797CDP DEPUY SPINE SARL MOSS MIAMI SPINE SYSTEM:SCREW 帝富脊椎莫
士邁阿密脊椎系統:固定釘※適應症請見備註欄
5380
FBSF41797UDP DEPUY SPINE MOSS MIAMI SPINE SYSTEM:SCREW 帝富脊椎莫斯邁
阿密脊椎系統:固定釘※適應症請見備註欄
5380
FBSF44005TWG "WILTROM"SPINAL FIXATION SYSTEM:CANNULATED REDUCTION
PEDICLE SCREW U TYPE"威創"脊椎固定系統:脊椎骨釘中空折斷U
型※適應症請見備註欄
5380
FBSF44008TWG "WILTROM"SPINAL FIXATION SYSTEM:CANNULATED PEDICLE SCREW
POLY-AXIAL U TYPE"威創"脊椎固定系統:脊椎骨釘中空U型多軸向
※適應症請見備註欄
5380
FBSF44009TWG "WILTROM"SPINAL FIXATION SYSTEM:CANNULATED PEDICLE SCREW
POLY-AXIAL REDUCTION U TYPE"威創"脊椎骨釘中空U型多軸向折
斷※適應症請見備註欄
5380
FBSF44010TWG "WILTROM"SPINAL FIXATION SYSTEM:CANNULATED PEDICLE SCREW
U TYPE"威創"脊椎固定系統:脊椎骨釘中空U型※適應症請見備註
欄
5380
FBSF44011TV2 "INTAI"SPINAL FIXATION SYSTEM:PEDICLE SCREW POLY-AXIAL U
TYPE"鐿鈦"脊椎固定系統:脊椎骨釘-U型多軸向※給付規定請見備
註欄
5380
FBSF44011TWG "WILTROM"SPINAL FIXATION SYSTEM:PEDICLE SCREW POLY-AXIAL
U TYPE"威創"脊椎固定系統:脊椎骨釘U型多軸向※給付規定請見
備註欄
5380
FBSF44012TV2 "INTAI"SPINAL FIXATION SYSTEM:CANNULATED PEDICLE SCREW
POLY-AXIAL U TYPE"鐿鈦"脊椎固定系統:脊椎骨釘-中空U型多向
12960
FBSF44012TWG "WILTROM"SPINAL FIXATION SYSTEM:CANNULATE PEDICLE SCREW
POLY-AXIAL U TYPE"威創"脊椎固定系統:脊椎骨釘中空U型多軸向
※給付規定請見備註欄
12960
FBSF448146S9 XIA 4.5 TITANIUM SPINAL SCREW(適用於兒童或體型嬌小者) 5574
FBSF448231S9 "STRYKER"XIA SPINAL SYSTEM:TITANIUM CANNULATED SCREW"史賽
克"喜爾脊椎系統:中空螺釘※給付規定請見備註欄
12960
FBSF448232S9 "STRYKER" XIA 3 SPINAL SYSTEM:SCREW"史賽克"喜爾三脊椎系
統:骨釘 ※適應症請見備註欄
5380
FBSF448233S9 "STRYKER" XIA 3 SPINAL SYSTEM:SCREW"史賽克"喜爾三脊椎系
統:骨釘 ※適應症請見備註欄
5380
FBSF44985NS1 TITANIUM UNIVERSAL SPINAL SCREW ※適應症請見備註欄 5380
FBSF44988NS1 TITANIUM CLICK'X SPINAL SCREW※適應症請見備註欄 5380
FBSF44989NS1 TITANIUM CLICK'X SPINAL SCREW ※適應症請見備註欄
(499.500V:507V;520V:527V自981001刪除)
5380
FBSF46121NY2 STAINLESS CERVICAL SCREW 17:24MM 164
FBSF461221Y2 STAINLESS SPINAL RESCUABLE SCREW(FBSF46121NY2失敗時用,配
合FBSF661202Y2用)
164
FBSF461321Y2 TITANIUM SPINAL RESCUABLE SCREW(FBSF66131NY2失敗時用,配合
FBSF661302Y2用)
180
FBSF46132NY2 TITANIUM CERVICAL SCREW(配合FBSF36132NY2使用) 2100
FBSF46201NS1 TITANIUM PANGEA PEDICLE SCREW※適應症請見備註欄 5380
FBSF46400NDX TITANIUM DIAPASON SPINAL SCREW型號48485030:9060,XL自
90/07/01生效 ※適應症請見備註欄
5380
FBSF46400NS9 TITANIUM SPINAL(DIAPASON)SCREW 脊椎人工置換組:骨釘※適應
症請見備註欄
5380
1035
特材代碼 中英文名稱 支付點數-104/01/01
FBSF471545B0 TITANIUM SPINAL SCREW(型號含120-6035:45)※適應症請見備註
欄
5380
FBSF4765NNY2 TITANIUM SPINAL SCREW※適應症請見備註欄 5380
FBSF4772NNY2 TITANIUM SPINAL SCREW ※適應症請見備註欄 5380
FBSF4774NNY2 TITANIUM O TYPE SPINAL FIXATION SCREW※適應症請見備註欄 5380
FBSF48010TY2 "SYNTEC"ARTEST SPINAL FIXATION SYSTEM:POLYAXIAL PEDICLE
SCREW"亞太醫療"亞力士脊椎固定系統:圓形中空外孔多軸向椎弓
足骨釘※給付規定請見備註欄
12960
FBSF48022TY2 "亞太醫療"亞力士脊椎固定系統:中空外孔復位椎弓骨釘※給付規
定請見備註欄"SYNTEC” ARTEST SPINAL FIXATION
SYSTEM:CANNULATED REDUCTION PEDICLE SCREW
12960
FBSF4803NNY2 ARTEST SPINAL FIXATION SYSTEM:PEDICLE SCREW 亞力士脊椎固
定系統:骨釘※適應症請見備註欄
5380
FBSF4804NNY2 ARTEST SPINAL FIXATION SYSTEM:CANNULATED PEDICLE SCREW
亞力士脊椎固定系統:骨釘※適應症請見備註欄
5380
FBSF4806NNY2 ARTEST SPINAL FIXATION SYSTEM:POLYAXIAL PEDICLE SCREW 亞
力士脊椎固定系統:骨釘※適應症請見備註欄
5380
FBSF4807NNY2 ARTEST SPINAL FIXATION SYSTEM:CANNULATED POLYAXIAL
PEDICLE SCREW 亞力士脊椎固定系統骨釘※適應症請見備註欄
5380
FBSF4807TMDA TITANIUM CD HORIZON SPINAL SCREW ※適應症請見備註欄 5380
FBSF481405Y2 "SYNTEC"LATILS FIXATION SPINAL SYSTEM:MONOAXIAL
CANNULATED SCREW"亞太醫療"拉提士脊椎固定系統:單軸中空骨鬆
骨釘※給付規定請見備註欄
12960
FBSF481507Y2 "SYNTEC"LATILS FIXATION SPINAL SYSTEM:POLYAXIAL
CANNULATED SCREW"亞太醫療"拉提士脊椎固定系統:多軸中空骨鬆
骨釘※給付規定請見備註欄
12960
FBSF4884CHY2 POLYAXIAL SCREW 多軸骨釘 ※適應症請見備註欄 5380
FBSF4896CHY2 POLYAXIAL SCREW 多軸骨釘 ※適應症請見備註欄 5380
FBSF4A3S1NXA A3 POSTERIOR TITANIUM SPINAL SCREW ※適應症請見備註欄 5380
FBSF4ASLS1AQ TITANIUM SPINAL SCREW※適應症請見備註欄 5380
FBSF4ASYS1AQ TITANIUM SMARTLOC SPINAL SCREW※適應症請見備註欄 5380
FBSF4ASYS3AQ TITANIUM SMARTLOC EVOLUTION SPINAL SCREW ※適應症請見備註
欄
5380
FBSF4ASYS6AQ SMARTLOC EVOLUTION SYSTEM:CANNULATED SCREW 史麥特艾爾脊椎
固定系統:中空螺釘※適應症請見備註欄
12960
FBSF4ASYS7AQ SMARTLOC EVOLUTION SYSTEM: SPINAL SCREW 史麥特艾爾脊椎固
定系統:骨釘※適應症請見備註欄
5380
FBSF4BA001RK TITANIUM SPINAL SCREW※適應症請見備註欄 5380
FBSF4BA002RK TITANIUM SPINAL SCREW※適應症請見備註欄 5380
FBSF4BA005RK TITANIUM SPINAL SCREW ※適應症請見備註欄 5380
FBSF4BA006RK TITANIUM SPINAL SCREW ※適應症請見備註欄 5380
FBSF4BA007RK TITANIUM SPINAL SCREW ※適應症請見備註欄 5380
FBSF4BA008RK "REBORN ESSENCE"LUMBAR FIXATION SYSTEM:PEDICLE LONG
SCREW"瑞寶億"腰椎內固定系統:椎弓根螺釘※適應症請見備註欄
5380
FBSF4BA011RK "REBORN ESSENCE"LUMBAR FIXATION SYSTEM:POLY AXIAL SCREW"
瑞寶億"腰椎內固定系統:萬向螺釘※適應症請見備註欄
5380
FBSF4BA012RK "REBORN ESSENCE"LUMBAR FIXATION SYSTEM:CANNULATED POLY
AXIAL SCREW"瑞寶億"腰椎內固定系統:中空萬向螺釘※給付規定
請見備註欄
12960
FBSF4BAR4S1S "SCIENT'X"ISOBAR TTL VERTEBRAL CONNECTION SYSTEM:SCREW"賽
恩司"脊椎連接系統:螺釘※給付規定請見備註欄
5380
FBSF4CSSCWZ6 "MERRIES"CANNULATED SPINAL SYSTEM:CANNULATED PEDICLE
SCREW "美瑞世"中空螺釘脊椎固定系統
12960
1036
特材代碼 中英文名稱 支付點數-104/01/01
FBSF4CU004GZ GEZEN SPINAL FIXATION SYSTEM:POLY AXIAL CANCELLOUS BONE
SCREW 際仁脊椎固定系統:多軸向鬆質骨骨釘※適應症請見備註欄
12960
FBSF4CV004GZ 際仁脊椎固定系統:鬆質骨骨釘※給付規定請備註欄GEZEN SPINAL
FIXATION SYSTEM:CANCELLOUS BONE SCREW
12960
FBSF4GS41NG0 GSS TITANIUM SPINAL PEDICLE SCREW※適應症請見備註欄 5380
FBSF4HU004GZ GEZEN SPINAL FIXATION SYSTEM:SCREW 際仁脊椎固定系統:骨釘
※適應症請見備註欄
5380
FBSF4LB05NAE STANLESS SPONGIOSA CERVICAL CASPAR SCREW 3.5MM WIDE
THREAD 10MM:19MM
164
FBSF4LB06NAE STANLESS SPONGIOSA CERVICAL CASPAR SCREW 3.5MM WIDE
THREAD 20MM 以上
164
FBSF4LS004GZ GEZEN SPINAL FIXATION SYSTEM:SCREW 際仁脊椎固定系統:骨釘
※適應症請見備註欄
5380
FBSF4LU004GZ GEZEN SPINAL FIXATION SYSTEM:SCREW 際仁脊椎固定系統:固定
釘※適應症請見備註欄
5380
FBSF4M3SSEZ6 TITANIUM M3 SPINAL POSTERIOR SCREW※適應症請見備註欄 5380
FBSF4MPS1NXA "AAXTER" MISS POSTERIOR SPINAL SYSTEM:CANNULATED SCREW "
全合"定位型脊椎後方固定器:中空螺釘※給付規定請見備註欄
12960
FBSF4P2PSPZ6 "MERRIES"PROT II POSTERIOR SPINE SYSTEM:SCREW "美瑞世"普
生二代後方脊椎固定器"固定釘※適應症請見備註欄
5380
FBSF4P2SCWZ6 PROT II POSTERIOR SPINE SCREW※適應症請見備註欄 5380
FBSF4R382NS9 XIA REDUCTION SCREW※適應症請見備註欄 5380
FBSF4S3101U0 "UNITED"CENTURY SPINAL SYSTEM:SCREW "聯合"世紀脊椎固定系
統骨螺絲※適應症請見備註欄
5380
FBSF4S754MM4 "MEDTRONIC" CD HORIZON LEGACY SPINAL SYSTEM:SCREW "美敦
力"雷格斯脊椎矯正系統:骨釘※適應症請見備註欄
5380
FBSF4S859FM4 "美敦力"思迪M8脊椎固定系統:固定角度骨釘"MEDIRONIC"CD
HORIZON M8 SPINAL SYSTEM:TITANIUM FIXED ANGLE SCREW
3114
FBSF4S869MM4 "美敦力"思迪M8脊椎固定系統-多角度骨釘"MEDIRONIC" CD
HORIZON M8 SPINAL SYSTEM:TITANIUM MULTI AXIAL SCREW
3114
FBSF4SW70NAE "AESCULAP"TITANIUM S4 SPINAL SYSTEM:TRANSPEDICULAR BONE
SCREW"雅氏"雅士弗脊椎固定系統:螺釘※適應症請見備註欄
5380
FBSF4TL01TJA TITANIUM SPINAL PEDICLE SCREW※適應症請見備註欄 5380
FBSF4UP04NXA TITANIUM SPINAL SCREW※適應症請見備註欄 5380
FBSF4X380NS9 "史賽克"喜爾脊椎系統-骨固定釘"STRYKER"XIA TITANIUM SPINAL
SCREW※給付規定請見備註欄
5380
FBSF5000051A MONT BLANC SPINAL TRANSVERSE CONNECTOR※適應症請見備註欄 6108
FBSF50001TV2 "INTAI"SPINAL FIXATION SYSTEM:CROSS LINK HOOK"鐿鈦"脊椎固
定系統:橫向連接鉤組合(免事前審查)
2661
FBSF50001TWG "WILTROM"SPINAL FIXATION SYSTEM:CROSS LINK"威創"脊椎固定
系統:橫向連接鉤(免事前審查)
2661
FBSF5000251A MONT BLANC SPINAL TRANSVERSE LINK 免事前審查 2661
FBSF50002TV2 "INTAI"SPINAL FIXATION SYSTEM:CROSS-LINK HOOK"鐿鈦"脊椎固
定系統:橫向連接鉤組合※給付規定請見備註欄
6108
FBSF50002TWG WILTROM SPINAL FIXATION SYSTEM:CROSS-LINK HOOK威創脊椎固
定系統:橫向連接鉤組合※給付規定請見備註欄
6108
FBSF50055TJA TITANIUM SPINAL TRANSVERSE CONNECTOR※適應症請見備註欄 6108
FBSF5010TNZ6 TITANIUM SPINAL TRANSVERSE LINK※適應症請見備註欄 6108
FBSF50380NS9 XIA SPINAL SYSTEM:CROSS LINK (免事前審查) 2661
FBSF50382NS9 XIA TITANIUM CROSS CONNECTOR ※適應症請見備註欄 6108
FBSF50565NDP M-M TITANIUM TRANSVERSE CONNECTOR ※適應症請見備註欄 6108
1037
特材代碼 中英文名稱 支付點數-104/01/01
FBSF5170XNTD TITANIUM TREND TRANSVERSE LINK※適應症請見備註欄 6108
FBSF518010B0 TITANIUM TRANSVERSE LINK※適應症請見備註欄 6108
FBSF518012B0 TITANIUM TRANSVERSE LINK(免事前審查) 2661
FBSF54107NS9 MAC TATINIUM TRANSVERSE LINK※適應症請見備註欄 6108
FBSF548149S9 XIA 4.5 TITANIUM SPINAL CROSSLINK (適用於兒童或體型嬌小
者)
6467
FBSF548232S9 "STRYKER" XIA 3 SPINAL SYSTEM:MONOBLOCK CONNECTOR "史賽
克"喜爾三脊椎系統:結合器組※適應症請見備註欄
6108
FBSF548233S9 "STRYKER" XIA 3 SPINAL SYSTEM:CROSS CONNECTOR "史賽克"喜
爾三脊椎系統:結合器組※適應症請見備註欄
6108
FBSF54977NS1 TITANIUM TRANSVERSE CONNECTORS 免事前審查 2661
FBSF54981NS1 TITANIUM UNIVERSAL SPINAL CROSS LINK ※適應症請見備註欄,
須事前審查
6108
FBSF56201NS1 TITANIUM TRANSVERSE CONNECTORS ※適應症請見備註欄 6108
FBSF56452NDX TITANIUM DIAPASON TRANSVERSE LINK※適應症請見備註欄
(730000+720040:100自86/11/17生效)
6108
FBSF57200NS9 TITANIUM TRANSVERSE LINKS(免事審查) 2661
FBSF57651NY2 TITANIUM SPINAL CROSS-LINK※適應症請見備註欄 6108
FBSF577003Y2 TITANIUM SPINAL TRANSVERSE LINK(免術前審查) 2661
FBSF5811XNDA TATINIUM TSRH LOW PROFILE CROSSLINK PLATE ※適應症請見備
註欄
6108
FBSF5821NHY2 BRIDGE TRANSVERSE LINK 免事前審查 2661
FBSF5821NTY2 "SYNTEC" AREIKEN SPINAL FIXATION SYSTEM:TRANSVERSE LINK "
亞太醫療"亞力健脊椎固定系統:橫向連結器,免事前審查
2661
FBSF5886CCY2 "SYNTEC" TRANSVERSE LINK "亞太醫療"高立捷橫向連結器 ※適
應症請見備註欄
6108
FBSF5886NCY2 "SYNTEC" TRANSVERSE LINK "亞太醫療"高立捷橫向連結器 2661
FBSF5A3C1NXA A3 POSTERIOR TITANIUM SPINAL CROSSLINK HOOK ※適應症請見
備註欄
6108
FBSF5AS001AQ TITANIUM SPINAL LINK免術前審查 2661
FBSF5ASLL1AQ TITANIUM SPINAL LINK※適應症請見備註欄 6108
FBSF5ASNL1AQ TITANIUM SMARTLOC TRANSVERSE LINK免事前審前 2661
FBSF5ASYL1AQ TITANIUM SMARTLOC TRANSVERSE LINK※適應症請見備註欄 6108
FBSF5ASYL2AQ TITANIUM SMARTLOC EVOLUTION TRANSVERSE LINK※適應症請見備
註欄
6108
FBSF5ASYL3AQ SMARTLOC EVOLUTION SYSTEM:TRANSVERSE LINK 史麥特艾爾脊椎
固定系統:橫向連接器※適應症請見備註欄
6108
FBSF5B0001RK TITANIUM SPINAL LINK 免事前審查 2661
FBSF5BA001RK TITANIUM SPINAL TRANSVERSE LINK ※適應症請見備註欄 6108
FBSF5BT001GZ GEZEN SPINAL FIXATION SYSTEM:TRANSVERSE LINK 際仁脊椎固定
系統:橫向連結組※適應症請見備註欄
6108
FBSF5C111NXA TITANIUM SPINAL CROSS LINK ※適應症請見備註欄 6108
FBSF5C3201U0 "UNITED"CENTURY SPINAL SYSTEM:CROSSLINK "聯合"世紀脊椎固
定系統交叉連桿※適應症請見備註欄
6108
FBSF5CY11NXA Y TYPE POSTERIOR TITANIUM SPINAL LINK(免事前審查) 2661
FBSF5DTT4TDA TITANIUM CD HORIZON SPINAL D.T.T#4(橫向固定桿) ※適應症請
見備註欄
6108
FBSF5GS51NG0 GSS TITANIUM SPINAL TRANSVERSE LINK※適應症請見備註欄 6108
FBSF5L8414M4 TITANIUM CD DTT #4 TRANSVERSE LINK(免術前審查) 2661
FBSF5LT001GZ GEZEN SPINAL FIXATION SYSTEM:TRANSVERSE LINK 際仁脊椎固定
系統:橫向連結器 ※適應症請見備註欄
6108
FBSF5LT005GZ GEZEN SPINAL FIXATION SYSTEM:TRANSVERSE LINK 際仁脊椎固定
系統:脊椎橫向連結器 免事前審查
2661
FBSF5M2TKNZ6 TITANIUM SPINAL TRANSVERSE LINK 2661
1038
特材代碼 中英文名稱 支付點數-104/01/01
FBSF5M3SLKZ6 TITANIUM M3 SPINAL POSTERIOR TRANSVERSE LINK※適應症請見
備註欄
6108
FBSF5P2CLKZ6 PROT II POSTERIOR SPINE CROSS LINK※適應症請見備註欄 6108
FBSF5P2CNTZ6 PROT II POSTERIOR SPINE ROD CONNECTOR※適應症請見備註欄 6108
FBSF5P2TLKZ6 PROT II POSTERIOR SPINE TRANSVERSE LINK※適應症請見備註欄 6108
FBSF5R382NS9 XIA REDUCTION CROSS LINK※適應症請見備註欄 6108
FBSF5RF001RX RF SPINAL LINK(免事前審查) 2661
FBSF5SW69NAE AESCULAP"TITANIUM S4 SPINAL SYSTEM:CROSS CONNECTOR"雅氏"
雅士弗脊椎固定系統:連接器※適應症請見備註欄
6108
FBSF5SX17NAE TITANIUM SPINE CROSSLINK (96年10月1日起免事前審查) 2661
FBSF5TS55TJA TITANIUM SPINAL TRANSVERSE CONNECTOR(免事前審查) 2661
FBSF5X380NS9 XIA TITANIUM SPINAL CROSS LINK※適應症請見備註欄 6108
FBSF610001TT TITANIUM CERVICAL PLATE(免術前審查) 3588
FBSF610002TT TITANIUM CERVICAL SCREW(免術前審查) 180
FBSF661202Y2 STAINLESS CERVICAL PLATE 28:72CM 3588
FBSF661302Y2 TITANIUM CERVICAL PLATE 28:72MM 3588
FBSF66131NY2 TITANIUM CERVICAL SCREW 17:24MM 180
FBSF6613NNY2 TITANIUM DYNAMIC CERVICAL FIXATION SYSTEM 180
FBSF6CPU16XA TITANIUM CERVICAL PLATE (免術前審查) 3588
FBSF6CSA35XA TITANIUM CERVICAL SCREW (免術前審查) 180
FBSF6FF930AE STANLESS CASPAR OSTEOSYNTH CERVICAL PLATE 28:33MM LONG 3588
FBSF6FF934AE STANLESS CASPAR OSTEOSYNTH CERVICAL PLATE 37:46MM LONG 3588
FBSF6FF947AE STANLESS CASPAR OSTEOSYNTH CERVICAL PLATE 72MM LONG 3588
FBSF7000271A MONT BLANC SPINAL HOOK SCREW SYSTEM(SX2+HX2+RX2)免事前審
查
23228
FBSF7295NNS1 STANLESS STEEL HOOK SCREW
SYSTEM(SCREWX2+HOOKX2+NUTX4+SPRINGX2)
21471
FBSF7804NHY2 BRIDGE SPINAL HOOK SCREW SYSTEM(HX2+SX4+NX2)免事前審查 23228
FBSF7SX25NAE TITANIUM SPINE EVOLUTION HOOK
SYSTEM(SCREWX2+HOOKX2+NUTX2)
23228
FBSF8T1SFWCM TITANIUM CABLE SOFWIRE(後頸椎固定軟鋼絲索) ※適應症請見備
註欄
7494
FBSFC014XNS1 "SYNTHES"VECTRA SYSTEM(P*1+S*4)"信迪思"頸椎固定系統(二節)
※適應症請見備註欄
18623
FBSFC10002U0 "UNITED"SLIMFIT ANTERIOR CERVICAL PLATE SYSTEM (P*1+S*4)"
聯合"史令飛頸前路骨板系統二節※適應症請見備註欄
18623
FBSFC10003U0 "UNITED"SLIMFIT ANTERIOR CERVICAL PLATE SYSTEM (P*1+S*6)"
聯合"史令飛頸前路骨板系統三節※適應症請見備註欄
20591
FBSFC10030AD TITANIUM PEAK ANTERIOR CERVICAL SCREW(型號含1749-
02019:13026)※適應症請見備註欄
984
FBSFC10108AD TITANIUM SLIM-LOC ANTERIOR CERVICAL SCREW※適應症請見備註
欄
984
FBSFC128XNS1 "SYNTHES"VECTRA SYSTEM(P*1+S*6)"信迪思"頸椎固定系統(三節)
※適應症請見備註欄
20591
FBSFC1742SDP TITANIUM PEAK ANTERIOR CERVICAL PLATE 二節※適應症請見備
註欄
18623
FBSFC1743SDP TITANIUM PEAK ANTERIOR CERVICAL PLATE 三節※適應症請見備
註欄
20591
FBSFC1792SDP TITANIUM SLIM-LOC ANTERIOR CERVICAL PLATE 二節※適應症請
見備註欄
18623
1039
特材代碼 中英文名稱 支付點數-104/01/01
FBSFC1793SDP TITANIUM SLIM-LOC ANTERIOR CERVICAL PLATE 三節※適應症請
見備註欄
20591
FBSFC20002U0 "UNITED"BOOSTER ANTERIOR CERVICAL PLATE SYSTEM (P*1+S*4)
"聯合"普斯特頸前路骨板系統二節※適應症請見備註欄
18623
FBSFC20003U0 "UNITED"BOOSTER ANTERIOR CERVICAL PLATE SYSTEM (P*1+S*6)
"聯合"普斯特頸前路骨板系統三節※適應症請見備註欄
20591
FBSFC2485NS9 REFLEX HYBRID ANTERIOR CERVICAL PLATE SYSTEM(PX1+SX4)二節
芮菲斯前置頸椎固定系統 ※適應症請見備註欄
18623
FBSFC27551B0 "長安"脊頸椎內固定系統:頸椎固定二節"BMI"SPINAL FIXATION
SYSTEM:TITANIUM CERVICAL SPINAL SYSTEM(PX1+SX4)
18623
FBSFC27553B0 "長安"脊頸椎內固定系統:頸椎固定三節"BMI"SPINAL FIXATION
SYSTEM:TITANIUM CERVICAL SPINAL SYSTEM(PX1+SX6)
20591
FBSFC27555B0 "長安"脊頸椎內固定系統:骨釘"BMI"SPINAL FIXATION
SYSTEM:TITANIUM CERVICAL SCREW
984
FBSFC27556B0 TITANIUM CERVICAL PLATE 24:90MM(免術前審查) 3588
FBSFC27557B0 TITANIUM CERVICAL SCREW(免術前審查) 180
FBSFC2869NS9 "STRYKER"REFLEX HYBRID ANTERIOR CERVICAL
PLATE:SYSTEM(PX1+SX4) "史賽克" 芮菲斯前置頸椎骨板系統:二
節※適應症請見備註欄
18623
FBSFC2Z86NS9 REFLEX ZERO PROFILE ANTERIOR CERVICAL PLATING SYSTEM 二節
(PLATE X1+SCREW X 4)※適應症請見備註欄
18623
FBSFC3400NZ1 TRINICA AND TRINICA SELECT ANTERIOR CERVICAL PLATE SYSTEM
二節(PX1+SX4)※適應症請見備註欄
18623
FBSFC3401NZ1 TRINICA AND TRINICA SELECT ANTERIOR CERVICAL PLATE SYSTEM
三節(PX1+SX6)※適應症請見備註欄
20591
FBSFC3485NS9 REFLEX HYBRID ANTERIOR CERVICAL PLATE SYSTEM(PX1+SX6)三節
芮菲斯前置頸椎固定系統 ※適應症請見備註欄
20591
FBSFC3869NS9 "STRYKER"REFLEX HYBRID ANTERIOR CERVICAL
PLATE:SYSTEM(PX1+SX6) "史賽克" 芮菲斯前置頸椎骨板系統:三
節※適應症請見備註欄
20591
FBSFC3Z86NS9 REFLEX ZERO PROFILE ANTERIOR CERVICAL PLATING SYSTEM 三節
(PLATE X1+SCREW X 6)※適應症請見備註欄
20591
FBSFC4020NS9 REFLEX HYBRID ANTERIOR CERVICAL SCREW 芮菲斯前置頸椎骨釘
※適應症請見備註欄
984
FBSFC4030NS9 RELFEX ZERO PROFILE ANTERIOR CERVICAL SCREW※適應症請見備
註欄
984
FBSFC450XNS1 CERVICAL SPINE SOLID EXPANSION HEAD SCREW 4.0/4.35MM 擴張
頭實心骨釘※適應症請見備註欄
984
FBSFC4869NS9 "STRYKER"REFLEX HYBRID ANTERIOR CERVICAL PLATE:SCREW "史
賽克" 芮菲斯前置頸椎骨板系統:骨釘※適應症請見備註欄
984
FBSFC4871NS1 TITANIUM CERVICAL SPINE LOCKING PLATE SYSTEM 二節※適應症
請見備註欄
18623
FBSFC487XNS1 TITANIUM CERVICAL SPINE LOCKING PLATE SYSTEM 三節※適應症
請見備註欄
20591
FBSFC6113NY2 TITANIUM CERVICAL SPINE SCREW※適應症請見備註欄 984
FBSFC612XNS1 "SYNTHES"VECTRA SYSTEM:CERVICAL SPINE SCREW"信迪思"頸椎固
定系統:多角度動態自攻牙頸椎骨螺釘※適應症請見備註欄
984
FBSFC8340NY2 TITANIUM CERVICAL PLATE FIXATION SYSTEM 三節(PX1+SX6) ※
適應症請見備註欄
20591
FBSFC834NNY2 TITANIUM CERVICAL PLATE FIXATION SYSTEM 二節(PX1+SX4) ※
適應症請見備註欄
18623
FBSFC835NNY2 TITANIUM CERVICAL BONE LOCKING SCREW ※適應症請見備註欄 984
1040
特材代碼 中英文名稱 支付點數-104/01/01
FBSFC8792NM4 ZEPHIR ANTERIOR CERVICAL SCREW ※適應症請見備註欄 984
FBSFC879N2M4 ZEPHIR ANTERIOR CERVICAL SYSTEM 二節(SX4+PX1) ※適應症請
見備註欄
18623
FBSFC879N3M4 ZEPHIR ANTERIOR CERVICAL SYSTEM 三節(SX6+PX1) ※適應症請
見備註欄
20591
FBSFCASC01AQ TITANIUM CERVICAL PLATE SYSTEM二節(PX1+SX4)※適應症請見備
註欄
18623
FBSFCASC02AQ TITANIUM CERVICAL PLATE SYSTEM三節(PX1+SX6)※適應症請見備
註欄
20591
FBSFCASC03AQ TITANIUM WINLOC CERVICAL PLATE SYSTEM 二節(PX1+SX4)※適應
症請見備註欄
18623
FBSFCASC04AQ TITANIUM WINLOC CERVICAL PLATE SYSTEM 三節(PX1+SX6)※適應
症請見備註欄
20591
FBSFCASCS1AQ TITANIUM CERVICAL SCREW※適應症請見備註欄 984
FBSFCASCS2AQ TITANIUM CERVICAL SCREW※適應症請見備註欄 984
FBSFCASP01AQ TITANIUM CERVICAL PLATE (免事前審查) 3588
FBSFCASS02AQ TITANIUM CERVICAL SCREW(免事前審查) 180
FBSFCB0003RK TITANIUM CERVICAL SCREW 免事前審查 180
FBSFCB0004RK TITANIUM CERVICAL PLATE 免事前審查 3588
FBSFCBA001RK TITANIUM CERVICAL PLATE SYSTEM (PX1+SX4) 二節 ※適應症請
見備註欄
18623
FBSFCBA002RK TITANIUM CERVICAL PLATE SYSTEM (PX1+SX6)三節 ※適應症請見
備註欄
20591
FBSFCBA003RK TITANIUM CERVICAL SCREW ※適應症請見備註欄 984
FBSFCCPCN2XA TITANIUM CERVICAL PLATE SYSTEM(PX1+SX4)二節 ※適應症請見
備註欄
18623
FBSFCCPCN3XA TITANIUM CERVICAL PLATE SYSTEM(PX1+SX6)三節 ※適應症請見
備註欄
20591
FBSFCCSC35XA TITANIUM CERVICAL SCREW ※適應症請見備註欄 984
FBSFCCSD35XA TITANIUM CERVICAL SCREW ※適應症請見備註欄 984
FBSFCCSF12Y2 TITANIUM CERVICAL SPINE FIXATION SYSTEM 二節(PX1+SX4)※適
應症請見備註欄
18623
FBSFCCSF13Y2 TITANIUM CERVICAL SPINEFIXATION SYSTEM 三節(PX1+SX6) ※適
應症請見備註欄
20591
FBSFCDC613Y2 "SYNTEC"DYNAMIC CERVICAL FIXATION STSTEM:DYNAMIC CERVICAL
PLATE"亞太醫療"微動頸椎固定系統:微動頸椎骨板(免事前審查)
3588
FBSFCFJ700AE TITANIUM ABC ANTERIOR CERVICAL PLATING SYSTEM(PX1+SX4)※
適應症請見備註欄
18623
FBSFCFJ710AE "AESCULAP" ABC CERVICAL PLATE AND SCRE 二節(PX1+SX4)W"雅
氏"前方頸椎骨釘骨板系統※適應症請見備註欄
18623
FBSFCFJ790AE ABC TITANIUM CERVICAL SCREW※適應症請見備註欄 984
FBSFCFJ800AE TITANIUM ABC ANTERIOR CERVICAL PLATING SYSTEM(PX1+SX6)※
適應症請見備註欄
20591
FBSFCFJ810AE "AESCULAP" ABC CERVICAL PLATE AND SCRE 三節(PX1+SX6)W"雅
氏"前方頸椎骨釘骨板系統※適應症請見備註欄
20591
FBSFCFJ900AE "AESCULAP" ABC CERVICAL SCREW"雅氏"前方頸椎骨釘※適應症請
見備註欄
984
FBSFCPLAT21A SPINE WAY BLUE MOUNTAIN CERVICAL SYSTEM 二節(PX1+SX4)施百
威藍山頸椎固定系統※適應症請見備註欄
18623
FBSFCPLAT31A SPINE WAY BLUE MOUNTAIN CERVICAL SYSTEM三節(PX1+SX5)施百
威藍山頸椎固定系統※適應症請見備註欄
19607
FBSFCS3102U0 "UNITED"SLIMFIT ANTERIOR CERVICAL PLATE SYSTEM:SCREW "聯
合"史令飛頸前路骨板系統:自攻螺絲 ※適應症請見備註欄
984
1041
特材代碼 中英文名稱 支付點數-104/01/01
FBSFCS3104U0 "UNITED"BOOSTER ANTERIOR CERVICAL PLATE SYSTEM:SCREW "聯
合"普斯特頸前路骨板系統:骨螺絲※適應症請見備註欄
984
FBSFCSCREW1A SPINE WAY BLUE MOUNTAIN CERVICAL SYSTEM:SCREW施百威藍山頸
椎固定系統※適應症請見備註欄
984
FBSFCTRYC21C SPINEART CERVICAL IMPLANTS 二節(PX1+SX4)司佰特頸椎間植入
物※適應症請見備註欄
18623
FBSFCTRYC31C SPINEART CERVICAL IMPLANTS 三節(PX1+SX6)司佰特頸椎間植入
物※適應症請見備註欄
20591
FBSFCTRYCS1C SPINEART CERVICAL IMPLANTS:SCREW司佰特頸椎間植入物:骨釘※
適應症請見備註欄
984
FBT01020MLHE SUPLASYN STERILE SODIUM HYALURONATE SOLUTION(2ML/瓶裝)每
次療程注射三次※適應症請見備註欄
705
FBT01025MLH8 HIKAMILON DISPO 1% 2.5ML/SYRINGE 25MG關節內注射劑(每次療
程注射五次)※適應症請見備註欄
425
FBT01025MLN0 "NISSIN"LUMISTERON DISPO (2.5ML/SYRINGE)"日新"倍利骨關節
腔注射劑(每次療程注射五次)※適應症請見備註欄
425
FBT01025MLR7 雅節關節內注射劑(每次療程注射三次)ARTZ/ARTZ DISPO 709
FBT01025MLU5 UNIHYLON DISPO 2.5ML W/SYRINGE(每次療程注射五次)※適應症
請見備註欄
425
FBT010HH253A 高海晶關節內注射劑HIGH HYAL 425
FBT01A25ML1F HYALUTOWA INJ"東和"關健關節注射劑(安瓿型,不含空針)(每次療
程注射5次)※適應症請見備註欄
421
FBT01AA25CLB ARTIAID INTRA-ARTICULAR INJECTION(每次療程注射5次)※適應
症請見備註欄
425
FBT01AAP20LB 優節益關節內注射劑ARTIAID PLUS INTRA-ARTICULAR
INJECTION2.0CC 1.5% SODIUM HYALURONATE
709
FBT01D25ML1F HUSREN DISPO"東和"關健關節內注射劑(每次療程注射5次)※適應
症請見備註欄
425
FBT01HJ001V0 HYA-JOINT SYNOVIAL FLUID SUPPLEMENT(2.5ML/支)每次療程注射
三次※適應症請見備註欄
709
FBT01HY001FD HYALGAN INTRA-ARTICULAR INJECTOR W/SYRINGE(自97年4月1日起
改每次療程注射3次)※適應症請見備註欄
709
FBT01HYRANLJ HYRUAN PLUS INJ.瀚樂骨關節腔注射液,每次療程注射三次※適應
症請見備註欄
709
FBT01N25MLR7 ARTZ/ARTZDISPO 2.5ML 25MG WITHOUT SYRINGE(每次療程注射五
次)※適應症請見備註欄
421
FBT01SA25CLB SYNOAID INTRA-ARTICULAR INJECTION欣節益關節內注射劑※適應
症請見備註欄
425
FBUF11001NW2 UNICOMPARTMENTAL KNEE FEMORAL COMPONENT※適應症請見備註欄 23268
FBUF15842NZ1 "ZIMMER"UNICOMPARTMENTAL HIGH-FLEX FEMORAL COMPONENT※適
應症請見備註欄
23268
FBUF172500SN UNICOMPARMENTAL KNEE FEMORAL※適應症請見備註欄 23268
FBUF19671NJJ PFC SIGMA UNICOMPARTMENTAL FEMORAL COMPONENT人工半膝關節
股骨元件※適應症請見備註欄
23268
FBUL15842NZ1 "ZIMMER"UNICOMPARTMENTAL HIGH-FLEX ARTICULAR SURFACE※適
應症請見備註欄
6980
FBUL171248SN UNICOMPARMENTAL KNEE TIBIAL INSERT※適應症請見備註欄 6980
FBUL19672NJJ PFC SIGMA(PFC)UNICOMPARTMENTAL TIBIAL INSERT COMPONENT 半
膝關節襯墊※適應症請見備註欄
6980
FBUT11002NW2 UNICOMPARTMENTAL KNEE TIBIAL+INSERT COMPONENT※適應症請見
備註欄
21709
FBUT15842NZ1 "ZIMMER"UNICOMPARTMENTAL HIGH-FLEX PRECOAT TIBIAL PLATE※
適應症請見備註欄
14735
1042
特材代碼 中英文名稱 支付點數-104/01/01
FBUT172610SN UNICOMPARMENTAL KNEE TIBIAL BASES※適應症請見備註欄 14735
FBUT19670NJJ PFC SIGMA(PFC)UNICOMPARTMENTAL TIBIAL TRAY COMPONENT 半膝
關節脛骨元件※適應症請見備註欄
14735
FBUT25842NZ1 "ZIMMER"UNICOMPARTMENTAL HIGH-FLEX ALL POLYETHYLENE
TIBIAL BASEPLATE(TIBIAL+SURFACE)※適應症請見備註欄
21709
FES0156295XT FISCH SPANDER II TOTAL WITH FOOTPLATE SHOE全聽 2599
FES0170142GS MICRON ALL TITANIUM TORP 全鈦全人工聽小骨置換物 2599
FHFCDLUMHFBK "百多力"路麥斯植入式心臟除顫器-心房同步雙心室“"百多力"路
麥斯植入式心臟除顫器(心房同步雙心室)"BIOTRONIK"LUMAX
TACHYARRHYTHMIA THERAPY IMPLANTABLE
591468
FHPCDLUMDRBK "百多力"路麥斯植入式心臟除顫器(雙腔)"BIOTRONIK"LUMAX
TACHYARRHYTHMIA THERAPY IMPLANTABLE DEFIBRILLATORS(DR-T)*
給付規定請見備註欄
483701
FHPCDLUMDXBK "百多力"路麥斯植入式心臟除顫器(單腔)"BIOTRONIK"LUMAX
TACHYARRHYTHMIA THERAPY IMPLANTABLE DEFIBRILLATORS(VR-T
DX)*給付規定請見備註欄
342335
FHPCDLUMVRBK "百多力"路麥斯植入式心臟除顫器(單腔)"BIOTRONIK"LUMAX
TACHYARRHYTHMIA THERAPY IMPLANTABLE DEFIBRILLATORS(VR-T)*
給付規定請見備註欄
342335
FHX03RX05RTM CAPIOX RX HOLLOW FIBER OXYGENATOR WITH RESERVOIR BY X-
COATING
22284
FNP9101473CM "柯特曼"人工腦膜 "CODMAN"DURAFORM DURAL GRAFT
IMPLANT(2.5CM*7.5CM)
3213
FNP9101475CM "柯特曼"人工腦膜 "CODMAN"DURAFORM DURAL GRAFT
IMPLANT(5CM*5CM)
4061
FNP9101477CM "柯特曼"人工腦膜 "CODMAN"DURAFORM DURAL GRAFT
IMPLANT(7.5CM*7.5CM)
10110
FNP9101480CM "柯特曼"人工腦膜 "CODMAN"DURAFORM DURAL GRAFT
IMPLANT(10CM*12.5CM)
21448
FNP9102010BB NEURO PATCH 2X10CM 3171
FNP9102010GX DURA SUBSTITUTE 2CMX10CM(代用人工腦膜) 3171
FNP910205XGX DURA SUBSTITUTE 2CMX5CM 1862
FNP910210XGX DURA SUBSTITUTE 2CMX10CM 3171
FNP9102575N7 DURAGEN DURAL GRAFT MATRIX 2.5CMX7.5CM 3213
FNP9104005BB NEURO PATCH 4X5CM 3171
FNP9104010BB NEURO PATCH 4X10CM 6033
FNP910404XGX DURA SUBSTITUTE 4CMX4CM 2773
FNP9105006GX DURA SUBSTITUTE 5CMX6CM(代用人工腦膜) 5865
FNP910506XGX DURA SUBSTITUTE 5CMX6CM 5865
FNP9106008BB NEURO PATCH 6X8CM 7588
FNP9106008S7 "司諾維思"腦膜補片"SYNOVIS"DURA-GUARD DURAL REPAIR PATCH
WITH APEX PROCESSING 6CM*8CM
9211
FNP9106014BB NEURO PATCH 6X14CM 14460
FNP9107575N7 DURAGEN DURAL GRAFT MATRIX 7.5CMX7.5CM 10110
FNP9108014S7 "司諾維思"腦膜補片"SYNOVIS"DURA-GUARD DURAL REPAIR PATCH
WITH APEX PROCESSING8CM*14CM
19427
FNP9110016S7 "司諾維思"腦膜補片"SYNOVIS"DURA-GUARD DURAL REPAIR PATCH
WITH APEX PROCESSING 10CM*16CM
22394
FNP9110125N7 DURAGEN DURAL GRAFT MATRIX 10CMX12.5CM 21448
FNP911012XGX DURA SUBSTITUTE 10CMX12CM 21389
FNP9112014BB "B.BRAUN"NEURO-PATCH 12CMX14CM 23897
FNP9115003BB NEURO PATCH 1.5X3CM 657
FNP9140380T0 WIRE MESH 10X10CM 248
FNP9166021AE "雅氏" 雷歐普代用腦膜 "AESCULAP" LYOPLANT 6CM*14CM 15842
1043
特材代碼 中英文名稱 支付點數-104/01/01
FNP9166048AE "雅氏" 雷歐普代用腦膜 "AESCULAP" LYOPLANT 4CM*10CM 7544
FNP9166064AE "雅氏" 雷歐普代用腦膜 "AESCULAP" LYOPLANT 4CM*5CM 3772
FNP9166080AE "雅氏" 雷歐普代用腦膜 "AESCULAP" LYOPLANT 2CM*10CM 3772
FNP9166102AE "雅氏" 雷歐普代用腦膜 "AESCULAP" LYOPLANT 1.5CM*3CM 848
FNP9166242AE "雅氏" 雷歐普代用腦膜 "AESCULAP" LYOPLANT 6CM*8CM 9211
FNP91CDUR1CK "COOK"DURASIS DURAL SUBSTITUTE"曲克"硬腦膜替代物 2CM*3CM 1039
FNP91CDUR2CK "COOK"DURASIS DURAL SUBSTITUTE"曲克"硬腦膜替代物 4CM*7CM 4183
FNP91DUR01CK "曲克"硬腦膜替代物"COOK" DURASIS DURAL SUBSTITUTE 7CM×
10CM
13404
FNP91DUR02CK "曲克"硬腦膜替代物"COOK" DURASIS DURAL SUBSTITUTE 7CM×
20CM
21749
FPM0119604HH MICROGRAFT GAUZE WITH CORKPLATE 1:4※適應症請見備註欄 1663
FPM0119606HH MICROGRAFT GAUZE WITH CORKPLATE 1:6※適應症請見備註欄 1663
FPM0119609HH MICROGRAFT GAUZE WITH CORKPLATE 1:9※適應症請見備註欄 1663
FSP6100611ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES"舒法定"帕瑞挺人
工聚丙烯編網06X11CM
922
FSP6101170BA "BARD"SOFT MESH柔軟修補網7.5CMX15CM 10CMX15CM (15CMX15CM
自970401起刪除)
1541
FSP6101171BA "BARD"SOFT MESH柔軟修補網5CMX10CM 4.5CMX10CM 6CMX13.7CM 922
FSP6101177BA "BARD"SOFT MESH"巴德" 柔軟修補網15CMX15CM 1603
FSP6101510ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES"舒法定"帕瑞挺人
工聚丙烯編網15X10CM
1541
FSP6101515ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES 15X15CM"舒法定"
帕瑞挺人工聚丙烯編網
1603
FSP6103030ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES 30X30CM"舒法定"
帕瑞挺人工聚丙烯編網
2848
FSP6105010BB PREMILENE MESH 2.5X10CM,5X10CM 922
FSP6106011ET "ETHICON"PROLENE POLYPROPYLENE MESH"愛惜康"伯羅林不可吸收
網6X11CM
922
FSP6106011JJ PROLENE POLYPROPYLENE MESH PMS,6*11CM 922
FSP6110611ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES 6X11CM"舒法定"帕
瑞挺人工聚丙烯編網
922
FSP6110650BB "B.BRAUN"OPTILENE MESH 歐特靈網片5CMX10CM 4.5CMX10CM
6CMX14CM
922
FSP6110651BB "B.BRAUN"OPTILENE MESH 歐特靈網片7.5CMX15CM 10CMX15CM 1541
FSP6110652BB "B.BRAUN"OPTILENE MESH 歐特靈網片15CMX15CM 1603
FSP6110653BB "B.BRAUN"OPTILENE MESH 歐特靈網片26CMX36CM 30CMX30CM 2848
FSP6111264DV MARLEX MESH 1"X4"X0.6MM(自980401起改為BARD MESH FLAT
SHEET1"X4")
922
FSP6111266DV MARLEX MESH 10"X14"(自980401起改為BARD MESH FLAT
SHEET10"X14")
2848
FSP6111267DV MARLEX MESH 2"X12"(自980401起改為BARD MESH FLAT
SHEET2"X12")
1541
FSP6111268DV MARLEX MESH 3"X6" (2PCS/BOX)(自980401起改為BARD MESH FLAT
SHEET3"X6")
1541
FSP6111510ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES 15X10CM"舒法定"
帕瑞挺人工聚丙烯編網
1541
FSP6115015BB PREMILENE MESH 7.5X15CM,15X15CM,5X30CM,10X15CM 1541
FSP6115015ET "ETHICON"PROLENE POLYPROPYLENE MESH"愛惜康"伯羅林不可吸收
網15CMX15CM
1603
FSP6115015JJ PROLENE POLYPROPYLENE MESH PMM,15*15CM 1603
FSP6130030BB PREMILENE MESH 30X30CM,26X36CM 2848
1044
特材代碼 中英文名稱 支付點數-104/01/01
FSP6130030ET "ETHICON"PROLENE POLYPROPYLENE MESH"愛惜康"伯羅林不可吸收
網30CMX30CM
2848
FSP6130030JJ PROLENE POLYPROPYLENE MESH PML,30*30CM 2848
FSP6130711AH "ATRIUM"PROLITE P0LYPROPYLENE MESH普來聚丙烯網片
(2.5CMX10CM,5CMX10CM)
922
FSP6130714AH "ATRIUM"PROLITE P0LYPROPYLENE MESH普來聚丙烯網片
(7.5CMX15CM,10CMX15CM)
1541
FSP6130717AH "ATRIUM"PROLITE P0LYPROPYLENE MESH普來聚丙烯網片
(15CMX15CM)
1603
FSP6130718AH "ATRIUM"PROLITE POLYPROPYLENE MESH PROLITE
ULTRA(20X25.4CM)普來聚丙烯網片
2702
FSP6130719AH "ATRIUM"PROLITE POLYPROPYLENE MESH PROLITE
ULTRA(25.4X25.4CM)普來聚丙烯網片
2702
FSP6130720AH "ATRIUM"PROLITE P0LYPROPYLENE MESH普來聚丙烯網片
(25.4CMX35.5CM,30CMX30CM)
2848
FSP61PL212AH "ATRIUM"PROLITE P0LYPROPYLENE MESH普來聚丙烯網片
(5CMX30CM)
1541
FSP61PL609AH "ATRIUM"PROLITE POLYPROPYLENE MESH PROLITE(15X23CM)普來聚
丙烯網片
2019
FSP61S00352C "COVIDIEN"SYNETURE SURGIPRO MESH 3"X5" "柯惠"舒耐久聚丙烯
編網
922
FSP61S01492C "COVIDIEN"SYNETURE SURGIPRO MESH 14"X9" "柯惠"舒耐久聚丙
烯編網
2848
FSP63CHM01CK "COOK"BIODESIGN SURGISIS INGUINAL HERNIA GRAFT"曲克"拜爾
迪賽瑟集喜司腹股溝疝氣支撐物10CMX15CM.6CMX13CM.8CMX15CM.*
適應症請見備註欄
8621
FUK02HEF2XGA "衛寶"血液濾過器(小兒用)"GAMBRO" HEMOFILTER 2305
FUK05DF030FN "英弗梅"血液過濾器(小兒用)"INFOMED"HEMOFILTER(CVVH) 4095
FUK05FHF20GA "衛寶"普利司馬弗列克斯套組(小兒用)"GAMBRO" PRISMAFLEX SET
(CVVH)
5286
FUK05HD150E9 "美蒂佳" 血液濾過器(小兒用)"MEDICA" HEMOFILTERS(CVVH) 4095
FUK05TS002FN 英弗梅體外血液迴路管(CF200-小兒血液濾過)INFOMED
EXTRACORPOREAL BLOOD CIRCUIT FOR CF200-PEDIATRIC
CONTINUOUS VENO-VENOUS HEMOFILTRATION(CVVH)
1500
FUK05TS202K5 英禾美體外血液迴路管(CF200-小兒血液濾過)HEMOSCIEN
EXTRACORPOREAL BLOOD CIRCUIT FOR CF200-PEDIATRIC
CONTINUOUS VENO-VENOUS HEMOFILTRATION(CVVH)
1500
FUK05TS405K5 英禾美體外血液迴路管(HF400/HF440-小兒血液濾過)HEMOSCIEN
EXTRACORPOREAL BLOOD CIRCUIT-PEDIATRIC CONTINUOUS VENO-
VENOUS HEMOFILTRATION(CVVH)
1500
FUK05TS504FN 英弗梅體外血液迴路管(HF400/HF440-小兒血液濾過)INFOMED
EXTRACORPOREAL BLOOD CIRCUIT–PEDIATRIC CONTINUOUS VENO-
VENOUS HEMOFILTRATION(CVVH)
1500
NCS010001NUU 1CC RETRACTABLE SAFETY SYRINGE W/NEEDLE※適應症請見備註欄 4.9
NCS010003NUU 3CC RETRACTABLE SAFETY SYRINGE W/NEEDLE※適應症請見備註欄 4.9
NCS010003S1M "MEDICAL CHAIN"MY SAFETY SYRINGE 3CC "濟翔"自動回縮式安全
針筒※適應症請見備註欄
4.9
NCS010003SYF 3CC DISPOSABLE SYRINGE W/NEEDLE (SAFETY) ※適應症請見備註
欄
4.9
NCS010005NUU 5CC RETRACTABLE SAFETY SYRINGE W/NEEDLE※適應症請見備註欄 4.9
1045
特材代碼 中英文名稱 支付點數-104/01/01
NCS010005SYF 5CC DISPOSABLE SYRINGE W/NEEDLE (SAFETY) ※適應症請見備註
欄
4.9
NCS01001SS2P 嘉鎂一次性使用無菌回縮型自毀式注射器(附針)"EWNL"SAFETY
SYRINGE W/NEEDLE 1CC
4.9
NCS01002SS2P 嘉鎂一次性使用無菌回縮型自毀式注射器(附針)"EWNL"SAFETY
SYRINGE W/NEEDLE 2CC
4.9
NCS01003SS2P 嘉鎂一次性使用無菌回縮型自毀式注射器(附針)"EWNL"SAFETY
SYRINGE W/NEEDLE 3CC
4.9
NCS01005SS2P 嘉鎂一次性使用無菌回縮型自毀式注射器(附針)"EWNL"SAFETY
SYRINGE W/NEEDLE 5CC
4.9
NCS010104SSG SIGMA SYRINGE WITH NEEDLE 1CC SAFETY 十美牌注射筒附針安全
型1CC※適應症請見備註欄
4.9
NCS01010SS2P 嘉鎂一次性使用無菌回縮型自毀式注射器(附針)"EWNL"SAFETY
SYRINGE W/NEEDLE 10CC
4.9
NCS010304SSG SIGMA SYRINGE WITH NEEDLE SAFETY 3CC 十美牌注射筒附針安全
型3CC※適應症請見備註欄
4.9
NCS010504SSG SIGMA SYRINGE WITH NEEDLE SAFETY 5CC 十美牌注射筒附針安全
型5CC※適應症請見備註欄
4.9
NCS011004SSG SIGMA SYRINGE WITH NEEDLE SAFETY 10CC 十美牌注射筒附針安
全型10CC※適應症請見備註欄
4.9
NCS0152612TZ 5CC SAFETY SYRINGE ※適應症請見備註欄 4.9
NCS01A003NPW 3CC SYRINGE W/NEEDLE(附安全護套)※適應症請見備註欄 4.9
NCS01A005NPW "PERFECT"5CC DISPOSABLE SYRINGE(SAFETY) W/NEEDLE"普惠"塑
膠注射筒附針(安全型)※給付規定請見備註欄
4.9
NES0102300CD BIOPSY FORCEPS(88/08/1再生效,300L,302L自88/08/01起生效) 6402
NES0114070HK SONO GUIDE BIOPSY NEEDLE 14G 16G 70CM ,170CM 358
NES0117070HK SONO GUIDE BIOPSY NEEDLE 17G 18G 70CM ,170CM 358
NES01174LNAN UNI-CUT NEEDLES 16G:18G 200MM 358
NES01174NNAN UNI-CUT NEEDLES 14G:18G 75:150MM 358
NES011762LAN VACU-CUT BIOPSY NEEDLES 18G:19.5G 200MM 618
NES011762NAN VACU-CUT BIOPSY NEEDLES 18G:19.5G 100:150MM 618
NES01176LNAN VACU-CUT BIOPSY NEEDLES 21G,22G 200MM 618
NES01176NNAN VACU-CUT BIOPSY NEEDLES 21G,22G 100:150MM 618
NES011815NHK "HAKKO"PTC CHIBA NEEDLE肝膽穿刺針150MM:250MM 358
NES015043NCD BIOPSY FORCEPS FOR ENDOMYOCADIAL BIOPSIES 6402
NES01CHN01CK "曲克"拋棄式取樣針(組)"COOK" DISPOSABLE BIOPSY NEEDLES
AND SETS-DISPOSABLE CHIBA BIOPSY NEEDLES 18~25GAGE /
5,10,15,20CM
358
NES01M1806ZM SOFT TISSUE BIOPSY NEEDLE 18G,9:15CM 358
NES01M1808ZM SOFT TISSUE BIOPSY NEEDLE 18G,20CM 358
NES01M2006ZM SOFT TISSUE BIOPSY NEEDLE 19:22G,9:15CM 358
NES01M2008ZM SOFT TISSUE BIOPSY NEEDLE 19:22G,20CM 358
NES0218150TP "TOP"ASPIRATION BIOPSY NEEDLE (18GX150MM)吸引生檢針 618
NES0218200TP "TOP"ASPIRATION BIOPSY NEEDLE (18GX200MM)吸引生檢針 618
NES0221150TP ASPIRATION BIOPSY NEEDLE (MAJIMA NEEDLE) 150MM 618
NES0221200TP "TOP"ASPIRATION BIOPSY NEEDLE (21GX200MM)吸引生檢針 618
SAS0652813TX "泰利芙斯"維瑟斯特可拆除式皮膚縫合釘"TELEFLEX
MEDICAL"VISISTAT REMOVABLE SKIN STAPLE(35 REGULAR)*適應症
請見備註欄
173
SAS0652823TX "泰利芙斯"維瑟斯特可拆除式皮膚縫合釘"TELEFLEX
MEDICAL"VISISTAT REMOVABLE SKIN STAPLE(35 WIDE)*適應症請
見備註欄
210
SAS06548732C "柯惠"可拆除式皮膚縫合釘及縫合器(滅菌)"COVIDIEN"
DISPOSABLE SKIN STAPLER AND LOADING UNITS(STERILE)
210
1046
特材代碼 中英文名稱 支付點數-104/01/01
SAS0680341TY 〝泰科〞拋棄式自動縫合鬆開皮膚縫合器(滅菌)"TYCO" APPOSE
DISPOSABLE SKIN STAPLER(STERILE) 25R※適應症請見備註欄
376
SAS0680351TY 〝泰科〞拋棄式自動縫合鬆開皮膚縫合器(滅菌)"TYCO" APPOSE
DISPOSABLE SKIN STAPLER(STERILE)35R*適應症請見備註欄
173
SAS0680361TY 〝泰科〞拋棄式自動縫合鬆開皮膚縫合器(滅菌)"TYCO" APPOSE
DISPOSABLE SKIN STAPLER(STERILE) 25W※適應症請見備註欄
376
SAS0680371TY 〝泰科〞拋棄式自動縫合鬆開皮膚縫合器(滅菌)"TYCO" APPOSE
DISPOSABLE SKIN STAPLER(STERILE) 35W※適應症請見備註欄
210
SAS06PMR35JJ REGULAR 35R MULTI-DIRECTION SKIN STAPLER※適應症請見備註
欄
173
SAS06PMW35JJ WIDE 35W MULTI-DIRECTION SKIN STAPLER※適應症請見備註欄 210
SAS06SK25RKX "凱棣"可拆除式皮膚縫合釘(滅菌) "KAYDEE" REMOVABLE SKIN
STAPLE (STERILE)-25窄針
376
SAS06SK25WKX "凱棣"可拆除式皮膚縫合釘(滅菌) "KAYDEE" REMOVABLE SKIN
STAPLE (STERILE)-25寬針
376
SAS06SK35RKX "凱棣"可拆除式皮膚縫合釘(滅菌) "KAYDEE" REMOVABLE SKIN
STAPLE (STERILE)-35窄針
173
SAS06SK35WKX "凱棣"可拆除式皮膚縫合釘(滅菌) "KAYDEE" REMOVABLE SKIN
STAPLE (STERILE)-35寬針
210
SAS06TS35RTS "台灣先進"可拆除式皮膚縫合釘(滅菌) "TAIWAN SURGICAL"
REMOVABLE SKIN STAPLE (STERILE)
173
SAS06TS35WTS "台灣先進"可拆除式皮膚縫合釘(滅菌) "TAIWAN SURGICAL"
REMOVABLE SKIN STAPLE (STERILE)
210
SAU01103182C "柯惠"TA自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA
DISPOSABLE SURGICAL STAPLER AND LOADING UNIT ※適應症請見
備註欄
2036
SAU01154412C "柯惠"TA自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA
DISPOSABLE SURGICAL STAPLER AND LOADING UNIT ※適應症請見
備註欄
2041
SAU01154512C "柯惠"TA自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA
DISPOSABLE SURGICAL STAPLER AND LOADING UNIT ※適應症請見
備註欄
2036
SAU01154582C "柯惠"TA自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA
DISPOSABLE SURGICAL STAPLER AND LOADING UNIT ※適應症請見
備註欄
2036
SAU01MLSA6J8 "南京邁迪欣" 一次性使用直線型吻和器和釘倉"NANJING
MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 60*適應
症請見備註欄
2036
SAU01MLSC6J8 "南京邁迪欣" 一次性使用直線型吻和器和釘倉"NANJING
MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 60*適應
症請見備註欄
2036
SAU01TA45L2C "柯惠" TA自動手術縫合器及縫合釘 "COVIDIEN" TA STAPLERS
AND LOADING UNITS
2036
SAU01TA60L2C "柯惠" TA自動手術縫合器及縫合釘 "COVIDIEN" TA STAPLERS
AND LOADING UNITS
2036
SAU01XR30RJJ PROXIMATE RELOADABLE LINEAR STAPLER 30MM VASCULAR ※適應
症請見備註欄
2041
SAU01XR30VET "愛惜康"普克美縫合釘"ETHICON" PROXIMATE LINEAR CUTTERS &
RELOAD UNITS(RELOADABLE LINEAR STAPLER)*適應症請見備註欄
2041
1047
特材代碼 中英文名稱 支付點數-104/01/01
SAU01XR60BJJ PROXIMATE RELOADABLE LINEAR STAPLER 60MM 3.5LEG,4.8LEG ※
適應症請見備註欄
2036
SAU02304242C "柯惠"GIA自動手術縫合器 "COVIDIEN"AUTO SUTURE MULTIFIRE
GIA DISPOSABLE SURGICAL STAPLER-LOADING UNIT *適應症請見
備註欄
2244
SAU02MLCCCJ8 "南京邁迪欣" 一次性使用直線型切割吻和器和釘倉"NANJING
MAIDIXIN" DISPOSABLE LINEAR CUTTER AND CARTRIDGE*適應症請
見備註欄
2244
SAU02SSR55ET "愛惜康"直線形切割縫合器和可調節釘匣-可調節釘匣"ETHICON
ENDO-SURGERY"LINEAR CUTTER 55/75MM AND SELECTABLE
CARTRIDGE/RELOADS(55MM)
2244
SAU02TCRNNJJ RELOAD LINEAR CUTTER 55MM,75MM 腸胃自動縫合釘 ※適應症請
見備註欄
2244
SAU02TRT55JJ RELOAD LINEAR CUTTER 55MM 腸胃自動縫合釘 ※適應症請見備註
欄
2244
SCS0101037CM RANEY SCALP CLIP 頭皮夾 20排/盒 10支/排 9.3
SCS0103100P2 "太平洋"頭皮夾"PAHSCO" SCALP CLIP 9.3
SCS01FF15PAE RANEY SCALP CLIPS 9.3
SCV0101200TX "TELEFLEX" HORIZON METAL LIGATING CLIPS "泰利芙斯"金屬血
管夾(小) 6;24 CLIPS/排(S)
15
SCV0102200TX "TELEFLEX" HORIZON METAL LIGATING CLIPS "泰利芙斯"金屬血
管夾(中) 6;24 CLIPS/排(M)
17.9
SCV0103200TX "TELEFLEX" HORIZON METAL LIGATING CLIPS "泰利芙斯"金屬血
管夾(中-大) 6;24 CLIPS/排(M-L)
20.2
SCV01B218MV7 "維達力克" 鈦金屬血管夾系統(中)"VITALITEC" SLS-CLIP
TITANIUM HEMOSTATIC CLIP SYSTEM(MEDIUM)
17.9
SCV01B918MV7 "維達力克" 鈦金屬血管夾(小)"VITALITEC" NINE CLIP TITANIUM
HEMOSTATIC CLIP SYSTEM(MEDIUM)
17.9
SCV01J118SV7 "維達力克" 鈦金屬血管夾系統(小)"VITALITEC" SLS-CLIP
TITANIUM HEMOSTATIC CLIP SYSTEM(SMALL)
15
SCV01J918SV7 "維達力克" 鈦金屬血管夾(小)"VITALITEC" NINE CLIP TITANIUM
HEMOSTATIC CLIP SYSTEM(SMALL)
15
SCV01LT100JJ TITANIUM LIGA CLIP (S) 6 CLIP/排 15
SCV01LT200JJ TITANIUM LIGA CLIP (M) 6 CLIP/排 17.9
SCV01LT300JJ TITANIUM LIGA CLIP (M-L) 6 CLIP/排 20.2
SCV01V312MV7 "維達力克" 鈦金屬血管夾系統(中-大)"VITALITEC" SLS-CLIP
TITANIUM HEMOSTATIC CLIP SYSTEM(MEDIUM/LARGE)
20.2
SCV01V912MV7 "維達力克" 鈦金屬血管夾(中大)"VITALITEC" NINE CLIP
TITANIUM HEMOSTATIC CLIP SYSTEM(MEDIUM/LARGE)
20.2
SCV029404NM1 SUGITA ANEURYSM CLIP (FENESTRATED LARGE TYPE) 2897
SCV029405NM1 SUGITA ANEURYSM CLIP (TEMPORARY TYPE) 2778
SCV029407SM1 SUGITA ANEURYSM CLIP (FENESTRATED LARGE TYPE) 2897
SCV029408SM1 SUGITA ANEURYSM CLIP (MINI TYPE) 2908
SCV2032091US SURGI-CLIP M-11 (每支20 CLIP) 98.7
SCV20340312C "柯惠"拋棄式自動血管夾 "COVIDIEN" AUTO SUTURE DISPOSABLE
AUTOMATIC CLIP APPLIER
98.7
SCV20340442C "柯惠"拋棄式自動血管夾 "COVIDIEN" AUTO SUTURE DISPOSABLE
AUTOMATIC CLIP APPLIER
98.7
SCV20340462C "柯惠"拋棄式自動血管夾(每支20 CLIP) "COVIDIEN" AUTO
SUTURE DISPOSABLE AUTOMATIC CLIP APPLIER(每支20 CLIP)
96.7
SCV20340482C "柯惠"拋棄式自動血管夾 "COVIDIEN" AUTO SUTURE DISPOSABLE
AUTOMATIC CLIP APPLIER
113
SCV20340512C "柯惠"自動連發式血管夾 "COVIDIEN" AUTO SUTURE PREMIUM
SURGICLIP APPLIER WITH CLIPS
98.7
1048
特材代碼 中英文名稱 支付點數-104/01/01
SCV20340532C "柯惠"自動連發式血管夾 "COVIDIEN" AUTO SUTURE PREMIUM
SURGICLIP APPLIER WITH CLIPS
98.7
SCV20MCL20JJ MULTIPLE CLIPS APPLIER (20 CLIP/PC) 113
SCV20MCM20JJ MULTIPLE CLIP APPLIER (20 CLIP/PC) 98.7
SCV20MCM30JJ MULTIPLE CLIP APPLIER (30 CLIP/PC) 98.7
SCV20MCS20JJ MULTIPLE CLIP APPLIER (20 CLIP/PC) 96.7
TKF0108120A1 LIGHT GUIDE 20G(自103.08.01起支付標準醫令代碼86207B、
86409B、86410B及86411B使用者已內含不得另外申報)
1435
TKF01269012D "竇可"歐索德晶體乳化切割儀:透照配件(自103.08.01起支付標準
醫令代碼86207B、86409B、86410B及86411B使用者已內含不得另
外申報)
1435
TKF0192801ZT 後房手術用光纖(自103.08.01起支付標準醫令代碼86207B、
86409B、86410B及86411B使用者已內含不得另外申報)
1435
TKF01B5X20B9 "博士倫"曙光進階超音波乳化系統手術包及配件(自103.08.01起
支付標準醫令代碼86207B、86409B、86410B及86411B使用者已內
含不得另外申報)
1435
TKF01C9606B9 "博士倫"眼科手術儀用光纖導管"BAUSCH&LOMB"ILLUMINATORS(自
103.08.01起支付標準醫令代碼86207B、86409B、86410B及86411B
使用者已內含不得另外申報)
1435
TKF01DP602B9 ILLUMINATORS 眼科手術儀用光纖導管(自103年8月1日起支付標準
醫令代碼86207B、86409B、86410B及86411B使用者已內含不得另
外申報
1435
TKF01MVS01B9 ILLUMINATORS 眼科手術儀用光纖導管(自103.08.01起支付標準醫
令代碼86207B、86409B、86410B及86411B使用者已內含不得另外
申報)
1435
TKP03ACT102C "柯惠"威利雷柏酷迪波無線電頻率電刀系統-冷循環式射頻燒灼電
極針組"COVIDIEN" VALLEYLAB COOL-TIP RF SYSTEM-RF
ELECTRODE KIT*給付規定請見備註欄
18800
TKP03LEVEESB LEVEEN COACCESS ELECTRODES SYSTEM AND LEVEEN NEEDLE
ELECTRODES勒鈖共進電極系統與勒鈖針狀電極探頭 ※適應症請見
備註欄
18800
TKP03RFA01XM "STARMED"ELECTROSURGICAL SYSTEM AND ACCESSORIES:RF
COAGULATION ELECTRODES"史達美克"電燒系統及附件:凝血電極針
(冷卻式)※適應症請見備註欄
18800
TKP03RFA20RX "RF"RADIOFREQUENCY ELECTROSURGICAL CAUTERY APPARATUS AND
ACCESSORIES"愛爾發"電子燒灼機及其附件:凝血電極針(水冷式)
18800
TKP03RFATA1H "MEDSPHERE"ELECTROSURGICAL RF ELECTRODES "邁德斯菲爾"電外
科電極 ※適應症請見備註欄
18800
TKP03STAR2XM "STARMED"STAR RF ELECTRODE-FIXED"史達美克"史達射頻電極-固
定式※給付規定請見備註欄
18800
TKP03STAR3XM "史達美克"史達射頻電極(單面)※給付規定請見備註
欄"STARMED"STAR RF ELECTRODE(UNI-FACED)
18800
TKVC1CX408B9 高速玻璃體切割頭(自103.08.01起支付標準醫令代碼86207B、
86409B、86410B及86411B使用者已內含不得另外申報)
4165
TKVS1D4801B9 "博士倫"玻璃體抽吸及切割器械包(含盒子)(自103.08.01起支付
標準醫令代碼86207B、86409B、86410B及86411B使用者已內含不
得另外申報)
4165
TKVS1D4801SZ BASIC POSTERIOR VITRECTOMY PACK(自103.08.01起支付標準醫令
代碼86207B、86409B、86410B及86411B使用者已內含不得另外申
報)
4165
1049
特材代碼 中英文名稱 支付點數-104/01/01
TKVS1D4803B9 "博士倫"玻璃體抽吸及切割器械包(不含盒子)(自103.08.01起支
付標準醫令代碼86207B、86409B、86410B及86411B使用者已內含
不得另外申報)
4165
TKVS1D4803SZ "博士倫"玻璃體抽吸及切割器械包(不含盒子)(自103.08.01起支
付標準醫令代碼86207B、86409B、86410B及86411B使用者已內含
不得另外申報)
4165
TSS01000011R 羅氏優勝血糖機組-羅氏優勝血糖試紙ACCU-CHEK PERFORMA TEST
STRIPS(10片,25片,50片,MIC50片/罐)*使用規定請見備註欄
8.1
TSS0100001G8 測利得超值型血糖檢測系統-血糖試片(25片、50片/盒)*使用規定
請見備註欄
8.1
TSS0100001J1 暐世血糖測試儀套組-血糖試紙*使用規定請見備註欄(25片,50片
/罐)
8.1
TSS0100001LQ “長庚”血糖檢測系統-血糖試紙“CHANG GUNG”BLOOD GLUCOSE
MONITORING SYSTEM-TEST STRIP
8.1
TSS01000021R 羅氏優勢血糖機組-羅氏優勢血糖試紙ACCU-CHEK ADVANTAGE TEST
STRIPS((10片,25片,50片/罐)*使用規定請見備註欄
8.1
TSS0100002G8 測利得超優型血糖檢測系統-血糖試片(25片、50片/盒)*使用規定
請見備註欄
8.1
TSS0100002J1 暐世新型血糖測試儀套組-血糖試紙*使用規定請見備註欄(50片,
25片/罐)
8.1
TSS0100002LQ “長庚”血糖檢測系統-血糖試紙“CHANG GUNG”BLOOD GLUCOSE
MONITORING SYSTEM-TEST STRIP
8.1
TSS01000031R 羅氏活力血糖機組-羅氏活力血糖試紙(10片,25片,50片/罐)*使用
規定請見備註欄
8.1
TSS0100003G8 好輕鬆血糖檢測系統-血糖試片(25片、50片/盒)*使用規定請見備
註欄
8.1
TSS0100003J1 暐世攜帶型血糖測試儀套組-血糖試紙*使用規定請見備註欄(10片
,15片/罐)
8.1
TSS01000041R 羅氏GO讚血糖機組-羅氏GO讚血糖試紙ACCU-CHEK GO TEST
STRIPS((10片,50片/罐)*使用規定請見備註欄
8.1
TSS0100004G8 日安血糖檢測系統-血糖試片(50片/盒)*使用規定請見備註欄 8.1
TSS0100004J1 暐世語音血糖測試儀套組-暐世語音血糖測片(10片,25片,50片/
罐) EBCHEK BLOOD GLUCOSE MONITORING SYSTEM-EBCHEK BLOOD
GLUCOSE TEST STRIPS(10PCS,25PCS,50
8.1
TSS01000051R 羅氏整合型血糖機組-羅氏整合型血糖試紙ACCU-CHEK INTEGRA
TEST STRIPS((17片/捲,3捲/盒)*使用規定請見備註欄
8.1
TSS0100005G8 好贊血糖試紙SO EASY BLOOD GLUCOSE TEST STRIP(25片、50片、
單片鋁箔包50片/盒)*使用規定請見備註欄
8.1
TSS0100005GV 樂適康血糖監測系統之血糖試紙GLUCO PLUS GLUCOSE MONITORING
SYSTEM'S BLOOD TEST STRIP(25片或50片/盒)*使用規定請見備註
欄
8.1
TSS0100006G8 測利得血糖檢測系統-測利得血糖試片 BLOOD GLUCOSE TEST
STRIP(25、50片/盒,10、25、50、100片/單片包)*使用規定見備
註
8.1
TSS0100006QG 好生活血糖檢測系統-血糖試片GL GOODLIFE SERIES BLOOD
GLUCOSE TEST STRIP 25片、50片/罐,單片鋁箔包25、50、100片
/盒,袋裝單片10*給付規定見備註
8.1
TSS0100007G8 好贊血糖檢測系統-好贊血糖試片 BLOOD GLUCOSE TEST
STRIP(25、50片/盒,10、25、50、100片/單片包)*使用規定見備
註
8.1
TSS01000USYJ 優速測血糖測試系統-血糖試片(10片/罐,50片/盒)*使用規定請
見備註欄
8.1
1050
特材代碼 中英文名稱 支付點數-104/01/01
TSS01001ESYE 優速安血糖測試系統-血糖試片(10片/罐,50片/盒)*使用規定請
見備註欄
8.1
TSS01002EKUE 優克糖血糖測試系統-血糖試片(10片/罐,50片/盒)*使用規定請
見備註欄
8.1
TSS0106301AB "亞培"信妥血糖試紙(50片,100片/罐)PRECISION PCX PLUS BLOOD
GLUCOSE TEST STRIPS*使用規定請見備註欄
8.1
TSS0111435AB "亞培"第二代醫療專用血糖試紙OPTIUM POINT OF CARE TEST
STRIPS(25片,50片,100片/罐)*使用規定請見備註欄
8.1
TSS0117311G7 龍易血糖測試系統-血糖試紙(50片/盒)*使用規定請見備註欄 8.1
TSS0119611AB "亞培" 歐騰血糖試紙 "ABBOTT" OPTIUM BLOOD GLUCOSE TEST
STRIPS(25片,50片/盒)*給付規定請見備註欄
8.1
TSS0122528AB "亞培" 利舒坦優血糖試紙"ABBOTT" FREESTYLE LITE BLOOD
GLUCOSE TEST STRIPS(50片,100片/罐)*使用規定請見備註欄
8.1
TSS013250BF9 福爾2合1血糖機之血糖試紙*使用規定請見備註欄(25片,50片/
盒)
8.1
TSS013252AK9 福爾舒康第二代2合1血糖血壓測試儀系統-血糖試片(25片、50片/
盒)*使用規定請見備註欄
8.1
TSS013261AK9 福爾益康語音型2合1血糖血壓測試系統-血糖試片(25片、50片/
盒)*使用規定請見備註欄
8.1
TSS014227AF9 福爾語音型血糖機之血糖試紙*使用規定請見備註欄(25片,50片/
盒)
8.1
TSS014230DF9 福爾舒康血糖測試系統之血糖試紙*使用規定請見備註欄(25片,
50片/盒)
8.1
TSS014231AF9 福爾易退片血糖機之血糖試紙*使用規定請見備註欄(25片,50片/
盒)
8.1
TSS014241AF9 福爾益康血糖機之血糖試紙*使用規定請見備註欄(25片,50片/
盒)
8.1
TSS014242AK9 福爾益康語音型血糖機-血糖試片(25片、50片/盒)*使用規定請見
備註欄
8.1
TSS014251AF9 福爾易退片血糖機之血糖試紙*使用規定請見備註欄(25片,50片/
盒)
8.1
TSS014256AK9 福爾益康背光型血糖機-血糖試片(25片、50片/盒)*使用規定請見
備註欄
8.1
TSS014272AK9 福爾倍康血糖機-血糖試片(25片、50片/盒)*使用規定請見備註欄 8.1
TSS014274AK9 福爾巧易測血糖機-血糖試片(25片、50片/盒)*使用規定請見備註
欄
8.1
TSS0145656GK 歐克葡萄糖試驗系統-歐克血糖試片(25片,50片/盒)*使用規定請
見備註欄
8.1
TSS0145657GK 歐克語音血糖監測系統-歐克語音血糖測試片(25片,50片/盒)*使
用規定請見備註欄
8.1
TSS0145658GK 歐克免設碼血糖監測系統-歐克免設碼血糖試片(25片,50片/盒)*
使用規定請見備註欄
8.1
TSS0145659GK 慧昇克立測血糖監測系統-慧昇克立測血糖試片(50片/盒)*使用規
定請見備註欄
8.1
TSS01505C2J3 "愛森斯" 快速測血糖試紙"I-SENS"CARESENS II BLOOD GLUCOSE
TEST STRIPS(10片,50片/罐)*適應症請見備註欄
8.1
TSS0193327BB “柏朗”貝優血糖測試系統-血糖試紙“B. BRAUN” OMNITEST 3
GLUCOSE MONITORING SYSTEM-BLOOD GLUCOSE TEST STRIPS(25片/
罐)給付規定請見備註欄
8.1
TSS01ACCP1FH 艾康血糖測試系統-血糖試紙ACON ON CALL PLUS BLOOD GLUCOSE
TEST STRIPS(50片/盒,25片(單片鋁箔包)/盒,1片(單片鋁箔包))*
使用規定請見備註欄
8.1
1051
特材代碼 中英文名稱 支付點數-104/01/01
TSS01AD0505A 欣瑞血糖測試系統-欣瑞血糖測試片(25片,50片/罐)*使用規定請
見備註欄
8.1
TSS01AP100FT 愛彼德血糖測試系統-血糖試紙(10片,25片/罐)*使用規定請見備
註欄
8.1
TSS01APPLUFT 愛彼德進階血糖測試系統-血糖測試片(10片,25片/罐)*適應症請
見備註欄
8.1
TSS01APVCCFT 愛彼德語音血糖測試系統-血糖測試片 AP VOICE BLOOD GLUCOSE
MONITORING SYSTEM-BLOOD GLUCOSE TEST STRIPS(10片,25片/
盒)*使用規定請見備註欄
8.1
TSS01B2001WB "拜安捷"血糖測試試紙ASCENSIA BREEZE 2 BLOOD GLUCOSE TEST
STRIPS(10片/DISC,5*10 STRIPS)*使用規定請見備註欄
8.1
TSS01BKG13GB 百捷瑞血糖檢驗系統-百捷瑞血糖試片(50、25片/盒)BENECHECK
IDEAL GLUCOSE MONITORING SYSTEM-BENECHECK IDEAL GLUCOSE
TEST STRIP
8.1
TSS01BKGS1GB 百捷血糖檢測系統-百捷血糖試片(25片,50片/盒)*使用規定請見
備註欄 BENECHECK BLOOD GLUCOSE MONITORING SYSTEM
8.1
TSS01BKPGSGB 百捷益血糖檢測系統-百捷益血糖試片(25片,50片/盒)*使用規定
請見備註欄
8.1
TSS01BKSG1GB 百捷優血糖檢驗系統-百捷優血糖試片(10片,25片,50片/盒)
BENECHECK PREMIUM GLU MONITORING SYSTEM-BENECHECK PREMIUM
GLU TEST STRIP(10 PCS,25PCS,50PCS/
8.1
TSS01CTS01WB "拜耳"拜安康血糖測試試紙"BAYER"CONTOUR TS BLOOD GLUCOSE
TEST STRIPS(50片/盒,2*25 STRIPS)*使用規定請見備註欄
8.1
TSS01DG050FK 糖易測血糖監測系統-血糖試紙*使用規定請見備註欄(10片,25
片,50片,75片,100片/罐)
8.1
TSS01DSACHJ5 優潔血糖監測系統-血糖試紙10片/25片/50片*使用規定請見備註
欄
8.1
TSS01EL001WB "拜耳"易理測血糖測試試紙ASCENSIA ELITE BLOOD GLUCOSE TEST
STRIPS(50片/盒)*使用規定請見備註欄
8.1
TSS01EN001FY "愛科來"葡萄糖檢測試紙II(50片/盒) *使用規定請見備註欄 8.1
TSS01EN002FY "愛科來"X-血糖檢測試紙 10片,50片/盒*適應症請見備註欄 8.1
TSS01EPSEZFU 勁速康血糖量測系統-血糖試紙(10片,25片,50片/盒)*使用規定請
見備註欄
8.1
TSS01EPSMTJG 邁士達血糖量測系統-血糖試片 25片/罐(2罐/盒)*使用規定請見
備註欄
8.1
TSS01G421SVL 愛奧樂血糖測試儀專用試紙*使用規定請見備註欄 8.1
TSS01G423SVL 愛奧樂血糖測試系統專用試紙*使用規定請見備註欄 8.1
TSS01GC2255A 欣云血糖測試片(10片/罐、25片/罐、30片/罐、25片/2罐、50片/
罐)GLUCOCLOUD BLOOD GLUCOSE TEST STRIP
8.1
TSS01GE100JW GE血糖監測系統-血糖測試片 GE BLOOD GLUCOSE MONITORING
SYSTEM-GE100 BLOOD GLUCOSE TEST STRIP(10片/罐,25片/罐)*
給付規定請見備註欄
8.1
TSS01GE200JW GE血糖監測系統-GE200血糖測試片(10片/罐、25片/罐)GE BLOOD
GLUCOSE MONITORING SYSTEM-GE200 BLOOD GLUCOSE TEST STRIP
8.1
TSS01GM100FS 瑞特血糖監測系統GM100-瑞特血糖測試片*(10片,25片,50片,100
片,200片/盒)*使用規定請見備註欄
8.1
TSS01GM210FS 瑞特血糖監測系統GM210-瑞特血糖測試片(10片,25片,50片,100
片,200片/盒)*使用規定請見備註欄
8.1
TSS01GM300FS 瑞特血糖監測系統GM300-瑞特血糖測試片*(10片,25片,50片,100
片/盒)*使用規定請見備註欄
8.1
TSS01GM550FS 瑞特血糖監測系統GM550-瑞特血糖測試片(10片,25片,50片,100
片,200片/盒)*使用規定請見備註欄
8.1
1052
特材代碼 中英文名稱 支付點數-104/01/01
TSS01GM700FS 瑞特血糖監測系統-血糖測試片RIGHTEST BLOOD GLUCOSE
MONITORING SYSTEM-BLOOD GLUCOSE TEST
STRIP(10,25,50,75,100,200片/盒)給付規定請見備註欄
8.1
TSS01GPLUSBB 柏朗貝佳血糖機-血糖試紙 OMNITEST PLUS GLUCOSE MONITORING
SYSTEM-TEST STRIPS(10片,25片,50片/罐)*使用規定請見備註欄
8.1
TSS01HE232JY 歐姆龍血糖監測系統-達安型-血糖試片OMRON BLOOD GLUCOSE
MONITORING SYSTEM HEA-232-BLOOD GLUCOSE STRIP(10,25,50/
罐)給付規定請見備註
8.1
TSS01HHRRZFZ 隨手測血糖試紙"ONETOUCH"HORIZON TM TEST STRIPS(25片/盒)*
使用規定請見備註欄
8.1
TSS01HL5888H 瑞康588自我血糖監控系統-瑞康血糖試紙(10片,25片,50片/盒)*
使用規定請見備註欄
8.1
TSS01LT2255A 欣巧血糖測試片GLUCOSURE LIGHT BLOOD GLUCOSE TEST STRIP 25
片1罐/盒,30片1罐/盒,25片2罐/盒,50片1罐/盒
8.1
TSS01MAJHRFT 茂晶血糖測試系統-血糖試紙(10片,25片/罐)*使用規定請見備註
欄
8.1
TSS01MAJJRFT 茂晶血糖測試系統-血糖試紙(10片,25片/罐)*使用規定請見備註
欄
8.1
TSS01NM001JY 歐姆龍血糖監測系統-達健型-血糖試片OMRON BLOOD GLUCOSE
MONITORING SYSTEM-HEA-230(25片/1罐)*給付規定請見備註欄
8.1
TSS01PGS01GB 百捷益血糖試片(10片,25片,50片,56片,100片/盒) BENECHECK
PLUS BLOOD GLUCOSE TEST STRIP
8.1
TSS01QS2255A 佳盛時血糖測試片QISSENSE BLOOD GLUCOSE TEST STRIP 25片1罐
/盒,30片1罐/盒,25片2罐/盒,50片1罐/盒
8.1
TSS01RMCB1RP 優盛血糖測試套組-血糖試紙(10片,25片,50片/罐,25片*2罐)*使
用規定請見備註欄
8.1
TSS01SC001KJ 掌上靈血糖測試系統-血糖測試片PALMLAB BLOOD GLUCOSE
MONITORING SYSTEM-BLOOD GLUCOSE TEST STRIP(25片/罐)*給付
規定請見備註欄
8.1
TSS01SE0505A 欣速血糖測試系統-欣速血糖測試片SENSOREX G TEST STRIPS(50
片/罐)*使用規定請見備註欄
8.1
TSS01SELECFZ 穩擇血糖試紙ONETOUCH SELECT TEST STRIPS(25片/瓶,50片/2
瓶)*給付規定請見備註欄
8.1
TSS01SG103FX 易立測血糖試紙(10片,25片,50片/盒)*使用規定請見備註欄 8.1
TSS01SG105J4 易美測I血糖試紙(25片/盒)*適應症請見備註欄 8.1
TSS01SG106FX 易立測II血糖試紙(10片,25片,50片/盒)*使用規定請見備註欄 8.1
TSS01SG203FX 易立測血糖試紙(25片*2盒)*使用規定請見備註欄 8.1
TSS01SG205J4 易美測I血糖試紙(25片*2盒)*適應症請見備註欄 8.1
TSS01SG206FX 易立測II血糖試紙(25片*2盒)*使用規定請見備註欄 8.1
TSS01SMC00FT 適美捷血糖測試系統-血糖試紙(10片,25片/罐)*使用規定請見備
註欄
8.1
TSS01STP1AJY 歐姆龍血糖試片二代(10片/罐、25片/罐、50片/罐、25片/2罐、
25片/盒)OMRON BLOOD GLUCOSE TEST STRIP
8.1
TSS01STP30JY 歐姆龍血糖試片(10片,25片,50片/罐,25片/2罐)*給付規定請見
備註欄OMRON BLOOD GLUCOSE TEST STRIP
8.1
TSS01T10255A 必立康GC血糖/膽固醇雙功能測試系統-虹吸2血糖測試片(25片,50
片/罐)*使用規定請見備註欄
8.1
TSS01T10505A 必立康血糖/尿酸雙功能測試系統-虹吸2血糖測試片(25片,50片/
罐)*使用規定請見備註欄
8.1
TSS01T12255A 速利測血糖測試系統-虹吸2血糖測試片(25片,50片/罐)*使用規定
請見備註欄
8.1
TSS01TB001F7 易速得-168血糖測試套組-易速得-168血糖測試片(10片,25片,50
片/罐;25片*2罐)*使用規定請見備註欄
8.1
1053
特材代碼 中英文名稱 支付點數-104/01/01
TSS01TB002F7 易速得-606血糖測試套組-易速得-606血糖測試片(10片,25片,50
片/罐;25片*2罐)*使用規定請見備註欄
8.1
TSS01TB003F7 易速得-608血糖測試套組-易速得-608血糖測試片(10片,25片,50
片/罐;25片*2罐)*使用規定請見備註欄
8.1
TSS01TB004F7 舒適測血糖測試套組-舒適測血糖測試片(10片,25片,50片/罐;25
片*2罐)*使用規定請見備註欄
8.1
TSS01TB005F7 特立捷血糖測試套組-特立捷血糖測試片(10片,25片,50片/罐;25
片*2罐)*使用規定請見備註欄
8.1
TSS01TB006F7 易速得血糖測試片10片,25片,50片/罐*使用規定請見備註欄 8.1
TSS01TB007F7 台欣TB100血糖測試片10片,25片,50片/罐*使用規定請見備註欄 8.1
TSS01TB008F7 台欣血糖測試套組-血糖測試片TYSONBIO AC200 BLOOD GLUCOSE
MONITORING SYSTEM-TEST STRIPS-10片,25片,50片/罐,25片*2罐*
給付規定請見備註
8.1
TSS01ULTRAFZ 穩豪血糖試紙"ONETOUCH" ULTRA TEST STRIPS(25片/罐,2罐/
盒;25片/盒100.1.1生效)*使用規定請見備註欄
8.1
TSS01VE2255A 欣聲血糖檢測試片(25片,30片,50片/罐)*使用規定請見備註欄 8.1
TSS01VV2255A 欣活血糖測試片GLUCOSURE VIVO BLOOD GLUCOSE TEST STRIPS 25
片1罐/盒,30片1罐/盒,25片2罐/盒,50片1罐/盒
8.1
1054