附件三特殊材料給付品項暨支付標準表™„件三_特殊... · 37.1 bbp0100774f4...

附件三特殊材料給付品項暨支付標準表

特材代碼中英文名稱支付點數-105/01

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)

27.4

ACA0100CDVPW PERFECTI.V LOCK(NEEDLESS SAFETY)"普惠"注射帽(免針安全型) 27.4

ACA0108008SG IV CAP 注射帽 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 27.4

ACA01NFS00M6 “宇仁”免針型輸液加藥器 “IMM” NEEDLE FREE SET 27.4

ACC0100360BT PLASTIC CONNECTOR 兩尖型 17.4

ACC0100361BT PLASTIC CONNECTOR 一尖一平塑膠連接頭 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

ACM0101280BB HIGH PRESSURE MANIFOLDS TRIPLE 35 BAR 211

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

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

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



211



261

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 MERITMANIFOLD: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



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



路引流器

523

670


ACM01MA2PTGJ MANIFOLDS (2 PORT 500PSI W/PVC PT)多路引流器(含PVC壓力連接

管)

188

ACM01MA2PUGJ JSMMANIFOLDS(2 PORT/500PSI W/PU 1200PSI)"吉生"多路引流器 287

ACM01MA2PVGJ JSMMANIFOLDS(2 PORT/500PSI W/PVC 1000PSI)"吉生"多路引流器 250


管)

218




管)

278



ACM01MAN2NBQ 邦特多管道引流器 184

ACM01MAN2PGJ MANIFOLDS (2 PORT 500PSI)多路引流器 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


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

ACP01CA123R5 索倫心臟麻痺轉接器(開心用灌流接頭/直型、Y型接頭)"SORIN"

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

ACPD1C4129BT 百特鈦金屬接頭 "BAXTER" ADAPTER FOR PERITONEAL DIALYSIS

CATHETER

1482

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

ACS01AM01H3B 康德萊旋塞閥"KDL"STOPCOCK(500PSI) 34

ACS01AM01L3B 康德萊旋塞閥"KDL"STOPCOCK(45PSI) 7.8

ACS01AM01M3B 康德萊旋塞閥"KDL"STOPCOCK(1200PSI) 70

ACS01D010NPW DISPOSABLE INFUSION SET 3 WAY STOPCOCK 7.8

ACS01H3SNCMR MARQUIES SERIES STOPCOCKS 1050PSI 70

ACS01M3SNCMR MARQUIS SERIES STOPCOCK 500PSI 34

ACS01NCN3SNR 3 WAY STOPCOCK 塑膠三極栓 7.8

ACS01STP34H9 華億體外循環管組"HYM"HEART LUNG PACK-3 & 4 WAY STOPCOCKS 7.8

671


ACS01TS201SG 3 WAY STOPCOCK W/LOCK 7.8

ACS01V68MPTP PREDURA PRESSURE RESISTAN THREE WAY STOPCOCK V-TYPE 1000PSI 70

ACS01VP004LL LILY3 WAY STOPCOCK"怡安"輸液三通閥 7.8

ACS036494CBB “柏朗”輸液轉換活塞 DISCOFIX MULTIDIRECTIONAL STOPCOCKS 25

ACS03SMT01SG 1000PSI HIGH PRESSURE 3 WAY 70

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

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 GOODTECY-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

ACY01HV001BQ 邦特Y型連接器組"BIOTEQ" Y CONNECTOR SET 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 MERITANGIOPLASTY PACKS & HEMOSTASIS VALVES"美瑞特"血管成型術

止血閥組

979

ACY01NYC00GJ JSMY CONNECTOR KIT "吉生"Y 型連接器組 979

ACY01NYC10GJ JSMY CONNECTOR KIT W/INSERTION TOOL"吉生"Y 型連接器組含導引

支撐器

979

ACY01NYC11GJ JSMY 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

BBF0373006KD KENDALL KANGAROO ENTERAL FEEDING PUMP SETS*"肯特利"袋鼠灌食

機用套組

100

BBF0373622KD KENDALLKANGAROO 924 PUMP SETS"肯特利"袋鼠灌食機用套組 100

BBF0373642SH KENDALL KANGAROO ENTERAL FEEDING PUMP SETS"肯特利" 袋鼠灌食

管及袋子

100

672


BBF0373656KD KENDALLKANGAROO EPUMP FEEDING SETS "肯特利"袋鼠電子灌食機用

灌食套組

100

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

100

BBF03E1002M6 宇仁餵食引導器 (未滅菌)-PUMP SET 餵食袋IMM FEEDING TUBE

ACCESSORIES(NON-STERILE)

100

BBF03E2002M6 宇仁餵食引導器 (未滅菌)-重力式餵食袋IMM FEEDING TUBE

ACCESSORIES(NON-STERILE)

72

BBF03F1200SG FEEDING PUMP SET※適應症請見備註欄 100

BBF03FB030P2 PAHSCOFEEDING BAG雙袋重力式餵食袋*適應症請見備註欄 72

BBF03FB040P2 PAHSCOFEEDING BAG雙袋機械式餵食袋*適應症請見備註欄 100

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 CONVATECNATURA 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

BBP0100774F4 CONVATECESTEEM 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

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， CLEAR FILM 32-

70MM

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)- CLOSED BAG， NON WOVEN BACKING ，

CLEAR FILM 32-70MM

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， COMFORT BACKING， OPAQUE FILM

32-70MM

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)- CLOSED BAG， NON WOVEN BACKING ，

OPAQUE FILM 32-70MM

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 CONVATECNATURA 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


透明開口便袋38-57MM(未滅菌)*適應症請見備註欄

37.1


透明開口便袋38-57MM(未滅菌)*適應症請見備註欄

37.1

BBP0400472F4 CONVATECNATURA 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 CONVATECESTEEM 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 CONVATECESTEEM 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 ConvatecSUR-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 ConvatecSUR-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

673


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 鶴牌造口術用袋及其附件 (未滅菌)-卡拉亞開口便袋(含人工

皮)"HOLLISTER"OSTOMY POUCH AND ACCESSORIES(NON-STERILE)-

KARAYA 5 SEAL RING DRAINABLE POUCH (INCLUDING SKIN BARRIER)

37.6

BBP0403250HL 鶴牌造口術用袋及其附件 (未滅菌)-開口便袋 (含人工皮、不織

布)"HOLLISTER"OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-

POST OPERATION COMPACT DRAINABLE POUCH (INCLUDING SKIN

BARRIER， NONWOVEN)

51.5

BBP0403796HL 鶴牌造口術用袋及其附件-小兒單片式便袋(含人工皮、不織


POUCHKINS ONE-PIECE DRAINABLE POUCH (INCLUDING SKIN BARRIER

， NONWOVEN)

51.5

BBP0403802HL 鶴牌造口術用袋及其附件 (未滅菌)-中央點鎖透明可引流便

袋"HOLLISTER"OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-

DRAINABLE POUCH 44MM

37.1

BBP0403806HL 鶴牌造口術用袋及其附件 (未滅菌)-中央點鎖透明可引流便



42.3

BBP0403807HL 鶴牌造口術用袋及其附件(未滅菌)-中央點鎖便袋"HOLLISTER"OSTOMY

POUCH AND ACCESSORIES (NON-STERILE)-CENTERPOINTLOCK

DRAINABLE POUCH*限住院患者申報

37.1

BBP0403857HL 鶴牌造口術用袋及其附件 (未滅菌)-中央點鎖式兩式便


OSTOMY TWO-PIECE WITH TRANSPARENT 57MM

37.1

BBP0405403F4 CONVATECESTEEMSYNERGY DRAINABLE POUCH TRANSPARENT 35/48/61MM

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 鶴牌造口術用袋及其附件 (未滅菌)-單片附人造皮便袋 (含人工

皮)"HOLLISTER"OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-

STONINAL ONE PIECE POUCH 51MM (INCLUDING SKIN BARRIER)

37.6

BBP0408531HL 鶴牌造口術用袋及其附件 (未滅菌)-單片黏捲式便袋(含人工皮、不

織布)"HOLLISTER"OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-

PREMIER DRAINABLE POUCH (INCLUDING SKIN BARRIER， NONWOVEN)

51.5

BBP0408631HL 鶴牌造口術用袋及其附件(未滅菌)-單片附紙膠型便袋(含人工皮"不

織布)"HOLLISTER"OSTOMY POUCH AND ACCESSORIES(NON-STERILE)-


51.5

BBP0408651HL 鶴牌造口術用袋及其附件 (未滅菌)-單片式透明便袋(含人工皮、不

織布)"HOLLISTER"OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-


51.5

BBP0409243F4 CONVATECESTEEMSYNERGY CLOSE POUCH TRANSPARENT35/48/61MM雙片

式造口袋*限住院患者申報

37.1

BBP0410384CA COLOPLASTOSTOMY 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

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 CLOSED BAG， NON WOVEN

BACKING， 13-64MM

51.5

BBP0412131A5 PROCARE-2 DRAINABLE POUCH 30，40，50MM*限住院患者申報 51.5

674


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

BBP0413351A5 POSPACK-B、K 60，70MM*限住院患者申報 51.5

BBP0413860CA COLOPLASTALTERNA 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 COLOPLASTALTERNA 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

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 COLOPLASTSENSURA 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

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 鶴牌造口術用袋及其附件 (未滅菌)-新象便袋"HOLLISTER"OSTOMY

POUCH AND ACCESSORIES (NON-STERILE)-NEW IMAGE LOCK'N ROLL


42.3

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 POUCH

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 DRAINABLE POUCH

42.3

BBP0418102HL 鶴牌造口術用袋及其附件 (未滅菌)-新象便袋"HOLLISTER"OSTOMY

POUCH AND ACCESSORIES (NON-STERILE)-NEW IMAGE DRAINABLE

POUCH 2 PIECE 44:70MM

37.1

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， TRANSPARENT WITH FILTER

37.1

BBP0419020CA COLOPLASTSENSURA 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 ConvatecACTIVE 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

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、不織布)"HOLLISTER" OSTOMY POUCH AND ACCESSORIES (NON-

STERILE)-ONE PIECE HIGH OUTPUT WITH FLEXTEND， SKIN BARRIER

AND SOFT DRAIN TAP (INCLUDING SKIN BARRIER， NONWOVEN)

51.5

675


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

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， COMFORT BACKING， CLEAR FILM

32-70MM

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)- DRAINABLE BAG， NON WOVEN BACKING

， CLEAR FILM 32-70MM

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 BAG， COMFORT BACKING， OPAQUE FILM

32-70MM

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)- DRAINABLE BAG， NON WOVEN BACKING

， OPAQUE FILM 32-70MM

37.1

BBP0456860CA 康樂保愛特大造口術用袋及其附件 (未滅菌) _含人工皮+不織布"

COLOPLAST" ALTERNA OSTOMY POUCH AND ACCESSORIES (NON-

STERILE)

51.5

BBP0459850CA COLOPLASTALTERNA 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

BBP0488800HL 鶴牌造口術用袋及其附件-單片迷你便袋附除臭片(含人工皮、不織


PREMIER MINI DRAINABLE POUCH (INCLUDING SKIN BARRIER，

NONWOVEN)

51.5

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

BBU0101460HL 鶴牌造口術用袋及其附件 (未滅菌)-首選尿袋 (含人工


FIRST CHOICE UROSTOMY POUCH WITH CUT-TO-FIT BARRIER

(INCLUDING SKIN BARRIER)

90.1

BBU0101482HL 鶴牌造口術用袋及其附件 (未滅菌)-單片式尿袋附墊高片 (含人工


UROSTOMY POUCHS W CONVEX BARRIERS (INCLUDING SKIN BARRIER)

90.1

BBU0101544F4 ConvatecSUR-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 鶴牌造口術用袋及其附件 (未滅菌)-中央點鎖式透明尿


UROSTOMY POUCH 38MM

77

BBU0103944HL 鶴牌造口術用袋及其附件 (未滅菌)-中央點鎖式透明尿袋 (含人工


CENTER POINT LOCK UROSTOMY POUCH (INCLUDING SKIN BARRIER)

90.1

BBU0108432HL 鶴牌造口術用袋及其附件 (未滅菌)-單片式尿袋附墊高片 (含人工


UROSTOMY POUCHS W CONVEX BARRIERS (INCLUDING SKIN BARRIER)

90.1

676


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(含人

工皮)"HOLLISTER"OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-

PREMIER UROSTOMY POUCH (INCLUDING SKIN BARRIER)

90.1

BBU0111803CA COLOPLASTSENSURA 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 COLOPLASTSENSURA 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

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 鶴牌造口術用袋及其附件 (未滅菌)-新象尿袋(不含人工

皮)"HOLLISTER"OSTOMY POUCH AND ACCESSORIES (NON-STERILE)-NEW

IMAGE UROSTOMY POUCH (NON-INCLUDING SKIN BARRIER) 44:70MM

77

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 POUCH 38/45/60/70MM

77

BBU0155850CA UROSTOMY BAG MAXI 375ML ※限住院患者申報 90.1

BBU0164927F4 CONVATECACTIVE 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

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

BBW0104055P2 太平洋引流袋(腎臟造廔引流袋)"PAHSCO" DRAINAGE BAG(P.C.N.

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

BBW0185000AG 亞康恩導入/引流導管附件(滅菌)-造廔口引流袋"ARGON"

INTRODUCER/DRAINAGE CATHETER ACCESSORIES(STERILE)-OSTOMY

DRAINAGE BAG

34

BBW0185001PB 皮必恩引流袋(造廔口引流袋)PBN DRAINAGE BAG(Ostomy Drainage

Bag)

34

BBW01LU500BQ 邦特導入/引流導管附件(滅菌):腎臟造口引流袋 BIOTEQ

INTRODUCER/DRAINAGE CATHETER ACCESSORIES :P.C.N. 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):腎臟造口引流袋 BIOTEQ


BAG

34

BBW01UB201BQ 邦特導入/引流導管附件(滅菌):腎臟造口引流袋 BIOTEQ


BAG

34

677


CAE0101401BB PERIFIX ONE EPIDURAL

ANAESTHESIA(NEEDLE+CATH+CONNECTOR+FILTER+LOR

SYRINGE+SYRINGE)

389

CAE0105400AR 亞諾硬脊膜外麻醉導管組(針+導管+過濾器)"ARROW" EPIDURAL

CATHETERIZATION SET

362

CAE0112006BB EPIDURAL ANAESTHESIA SET 16:18G(N+C+F+S)(型號含04514300，

04515-013:021，-200:307，04516-206:303)

389

CAE0112170BB EPIDURAL ANAESTHESIA CATHETER 103

CAE0113010BB EPIDURAL ANAESTHESIA SET(N+C+S) 362

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

CAE0151238BB PERICAN EPIDURAL NEEDLE 110

CAE0151300BB PERIFIX EPIDURAL SET 208

CAE0151410BB PERIFIX FOR CONTINUOUS EPIDURAL AND CAUDAL ANAESTHESIA 400

SERIES

389

CAE01ANE153B 康德萊一次性使用麻醉針-硬膜外穿刺針"KDL"DISPOSABLE SPINAL

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.BRAUNPERIFIX CATHETERS FOR EPIDURAL ANAESTHESIA(CATHETER)"

柏朗"脊椎硬膜麻醉用穿刺套

103

CAE01SD300BB B.BRAUNPERIFIX CATHETERS FOR EPIDURAL ANAESTHESIA"柏朗"脊椎

硬膜麻醉用穿刺套(NEEDLE+CATHETER)

208

CAE01SD301BB B.BRAUNPERIFIX CATHETERS FOR EPIDURAL ANAESTHESIA:MINI SETS"

柏朗"脊椎硬膜麻醉用穿刺套(NEEDLE+CATHETER+FILTER或SYRINGE)

362

CAE01SD401BB B.BRAUNPERIFIX CATHETERS FOR EPIDURAL ANAESTHESIA:FILTER

SETS"柏朗"脊椎硬膜麻醉用穿刺套

(NEEDLE+CATHETER+FILTER+SYRINGE)

389

CBA010502SAR INTRA AORTIC BALLOON CATHETER (型號:IAB-04230U，04240U，

04250U，06830U，06840U，R950U自94.10.01起生效)

25364

CBA010AB46M4 MEDTRONICRELIANT STENT GRAFT BALLOON CATHETER"美敦力"瑞萊恩

球囊導管

22348

CBA0142912QM MAQUETINTRA AORTIC BALLOON (PUMP) FIDELITY 8FR 25CC"邁柯唯"

主動脈氣球導管

25364

CBA0143001QM MAQUETINTRA 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 MAQUETINTRA-AORTIC (PUMP)BALLOON 8FR 34CC 40CC"邁柯唯"主動脈

氣球導管

25364

CBA0147982QM MAQUETINTRA 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 EDWARDSFOGARTY OCCLUSION CATHETER(AORTIC)堵塞用導管 22348

CBA01B2640GX GORETRI-LOBE BALLOON CATHETER(AORTIC)三葉球囊導管 22348

CBA01C0DA1CK COOKCODA BALLOON CATHETER (AORTIC)科達球曩導管 22348

CBA01C0DA2CK COOKCODA BALLOON CATHETER(AORTIC)科達球囊導管 22348

CBA01C0DA3CK COOKCODA 3G OCCLUSION BALLOON CATHETER"曲克"柯達閉合球囊導管 22348

678


CBA01C0DA4CK COOKCODA LP BALLOON CATHETER"曲克"科達艾皮球囊導管 22348

CBA01S730CAR REDIGUARD IAB CATHETER 7，8，9FR. 30CC，40CC 25364

CBA02F6830AR ARROWFIBER OPTIC INTRA-AORTIC BALLOON CATHETER光纖感應主動脈

弓氣球導管

41110

CBA02SEN7FQM MAQUETSENSATION 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

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

CBB0130240SB BOSTON SCIENTIFICMUSTANG 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

CBB0139031SB BOSTON SCIENTIFICSTERLING BALLOON DILATATION CATHETERS D

3:8MM L 10:60MM C USABLE 80;135CM氣球擴張導管

5398

CBB0139032SB BOSTON SCIENTIFICSTERLING BALLOON DILATATION CATHETERS(OTW)D

4:10MM L 20:100MM C USABLE L40:135CM氣球擴張導管

5398

CBB0139134SB BOSTON SCIENTIFICSTERLING BALLOON DILATATION CATHETERS(OTW)

D 1.5:4MM L 20:40MM C USABLE 142;145CM氣球擴張導管

5398

CBB0139135SB BOSTON SCIENTIFICSTERLING 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



CBB01420XNCD POWER FLEX PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY (PTA)

CATHETER 3MM:12MM 40，80，135CM

5398

CBB01424NWCD CORDISAVIATOR PLUS PERCUTANEOUS TRANSLUMINAL

ANGIOPLASTY(PTA)BALLOON DILATATION CATHETER PTA氣球擴張導管

4.0MM:6.0MM;7.0MM

5398

CBB0142610CD CORDISMAXI LD LARGE DIAMETER BALLOON PERCUTANEOUS

TRANSLUMINAL ANGIOPLASTY(PTA)DILATATION CATHETER D:14:25MM

L:2:8CM"考迪斯"邁晰大直徑氣球擴張導管

5398

CBB0144028CD CORDISPOWERFLEX 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 BIOTEQPTA BALLOON DILATATION CATHETER"邦特"血管氣球擴張導管 5398




679


CBB01ADM18F2 INVATECADMIRAL XTREME PTA BALLOON CATHETER愛德米羅週邊血管氣

球導管3MM:12MM 20MM:120MM

5398

CBB01ADMXTF2 INVATECADMIRAL XTREME PTA BALLOON CATHETER"英泰克"愛德米羅周

邊血管球囊導管D:3MM:12MM L:20MM:300MM

5398

CBB01AP128AB FOX PLUS PTA CATHETER 5398

CBB01ARM35AB ABBOTTARMADA 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 BARDATLAS PTA BALLOON DILATATION CATHETER 5398

CBB01ATB01CK ALL-TERRAIN BALLOON PTA DILATATION CATHETERS 5398

CBB01BTFLRQC 清流班特弗洛里安經皮穿刺血管成形術導管 5398

CBB01BTM01QC CLEARSTREAMBANTAM PERCUTANEOUS TRANSLUMINAL

ANGIOPLASTY(PTA)CATHETER"清流"班特經皮穿刺血管成形術導管

5398

CBB01BTM02QC CLEARSTREAMBANTAM 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

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

CBB01CH458XW 朗迪可樂士高壓氣球導管"RONTIS"CRONUS HP PTA BALLOON CATHETER 5398

CBB01CPAC1QC CLEARSTREAMCLEARPAC 歐美加 PTA CATHETER"清流"清派歐美加經皮

穿刺血管成形術導管

5398

CBB01CPAC2QC CLEARSTREAMCLEARPAC 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 BARDCONQUEST 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 SCIENTIFICCOYOTE 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 ABBOTTFOX SV PTA BALLOON CATHETER D 2:6MM L 90 135 150CM周邊

血管氣球導管

5398

CBB01FCPTAAB ABBOTTFOXCROSS PTA CATHETER周邊血管氣球導管 5398

CBB01G11XXN5 NUMEDGHOST II PTA CATHETER 40CM 75CM 120CM 135CM 150CM 5398

CBB01L2457KE KANEKAPTA 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

CBB01PAS35BK 百多力帕希爾18周邊血管氣球擴張導管"BIOTRONIK"PASSEO-18 PTA

BALLOON CATHETER 20:80MM

8455

CBB01PAS36BK 百多力帕希爾18周邊血管氣球擴張導管"BIOTRONIK"PASSEO-18 PTA


11140

CBB01PAS38BK 百多力帕希爾35周邊血管氣球擴張導管"BIOTRONIK"PASSEO-35，PTA


8455

CBB01PCECAF2 INVATECPACIFIC PLUS PTA CATHETER"英泰克"派斯飛克普拉斯周邊血

管治療導管

5398

CBB01PCF18F2 INVATECPACIFIC 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

680


CBB01PTA16EY 瑞提快速交換血管擴張氣球導管"EV3"RAPIDCROSS PTA RAPID

EXCHANGE BALLOON DILATATION CATHETER

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 艾維血管擴張氣球導管EVERCROSS .035 OTW PTA DILATATION

CATHETER D 3.0:12.0MM L 15:120MM 導管長度40，80，135CM

5398

CBB01PTA41CK COOKADVANCED 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 COOKADVANCED 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 INVATECREEF 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

CBB01RFLX1QC 清流銳弗斯經皮穿刺血管成形術導管"CLEARSTREAM"REEFLEX PTA

CATHETER L40:80MM

5398

CBB01RV135BA BARDRIVAL PTA BALLOON DILATATION CATHETER氣球擴張導管 SHAFT

80&135CM D 4:10MM L 2:15CM

5398

CBB01SBR18F2 INVATECSUBMARINE 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 SCIENTIFICSYMMETRY BALLOON DILATATION CATHETER 1.5MM-

6.0MM 2CM-10CM對稱式氣球裝導管

5398

CBB01USSV1SB BOSTON SCIENTIFICULTRA-SOFT SV BALLOON DILATATION

CATHETER4.0MM:7.0MM 1.5CM:2.0CM 3.1CM/3.1CM:3.4CM/3.1CM 90FR

，150FR

5398

CBB01VTR14AB 亞培懷維克周邊血管擴張導管"ABBOTT"VIATRAC 14 PLUS PERIPHERAL

DILATATION CATHETER

5398

CBB0221055LW LEMAITREDISTAL PERFUSION CATHETER"樂脈"遠端灌流導管 6326

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


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


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 SCIENTIFICMUSTANG 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

681


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 INVATECAMPHIRION 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 INVATECAMPHIRION 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 ABBOTTARMADA 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 ABBOTTARMADA 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

CBB03ARMA3AB ABBOTTARMADA 14 XT PTA CATHETER D:1.2MM-2.0MM L:6MM:20MM"亞

培"阿曼達凱蒂周邊血管球囊導管

8455

CBB03BTMA1QC CLEARSTREAMBANTAM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 CLEARSTREAMBANTAM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 SCIENTIFICCOYOTE 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 SCIENTIFICCOYOTE 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

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

CBB03PAS13BK 百多力帕希爾14周邊氣球擴張導管"BIOTRONIK"PASSEO-14

PERIPHERAL DILATATION CATHETER 140:220MM

11140

CBB03PAS14BK 百多力帕希爾14周邊氣球擴張導管"BIOTRONIK"PASSEO-14

PERIPHERAL DILATATION CATHETER 20:100MM

8455

CBB03PAS23BK 百多力帕希爾35周邊血管氣球擴張導管"BIOTRONIK"PASSEO-35，PTA


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

CBB03PTA35Y8 艾維血管擴張氣球導管EVERCROSS .035 OTW PTA DILATATION

CATHETER L 150:200MM

11140

CBB03PTAX1CK COOKADVANCED 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 COOKADVANCED 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

CBB03RFLX2QC 清流銳弗斯經皮穿刺血管成形術導管"CLEARSTREAM"REEFLEX PTA

CATHETER L120:220MM

11140

682


CBB03RKRS2QC CLEARSTREAMREEKROSS 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 CLEARSTREAMREEKROSS 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

CBB03SAB15CD 考迪斯沙博擴張導管"CORDIS"SABER OTW PERCUTANEOUS

TRANSLUMINAL ANGIOPLASTY(PTA)DILATATION CATHETER 15:30CM

11140

CBB03STSL1SB BOSTON SCIENTIFICSTERLING PTA BALLOON DILATATION CATHETERS

L:120:220MM"波士頓科技"施特靈氣球擴張導管

11140

CBB03STSL8SB BOSTON SCIENTIFICSTERLING PTA BALLOON DILATATION CATHETERS

L:15:100MM"波士頓科技"施特靈氣球擴張導管

8455

CBB03SV435CD CORDISSAVVY PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY ( PTA )

CATHETER D:2.0:6.0MM L:20:100MM"考迪斯"沙維 PTA 擴張導管*給


8455

CBB03URX01BA 巴德艾特凡斯快速更換經皮穿刺血管成形術導管"BARD"ULTRAVERSE

RX PTA DILATATION CATHETER L15-100MM

8455

CBB03URX02BA 巴德艾特凡斯快速更換經皮穿刺血管成形術導管"BARD"ULTRAVERSE

RX PTA DILATATION CATHETER L120-300MM

11140

CBB04JS0S1CK COOKSOS 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 ABBOTTRX ACCULINK CAROTID STENT SYSTEM亞科林頸動脈支架系統*

適應症請見備註欄

28608

CBC01PCRXCCD CORDISPRECISE 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

CBC01PR0TEY7 EV3PROTEGE 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

CBC01XACTCAB 亞培確位頸動脈支架系統"ABBOTT"XACT CAROTID STENT SYSTEM 28608

CBC0210125AB 亞培全能自擴型血管支架系統"ABBOTT"ABSOLUTE PRO VASCULAR

SELF-EXPANDING STENT SYSTEM

27129

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

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*


27129

CBC02ASSURM4 MEDTRONICASSURANT COBALT OVER THE WIRE ILIAC STENT SYSTEM腸

骨血管支架系統*適應症請見備註欄

27129

683


CBC02C0810CD CORDISS.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)

27129

CBC02C0MSEM4 MEDTRONICCOMPLETE 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*


27129

CBC02GENESCD CORDISPALMAZ 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 INVATECMARIS 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

CBC02V1EL6AN ANGIOMEDBARD 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 ANGIOMEDBARD 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

CBC02Z1V60CK COOKZILVER 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

CBC02ZFV61CK COOKZILVER 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 ANGIOMEDBARD 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 ANGIOMEDBARD 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 TERUMOANACONDA 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

405000

CBC0320715TM TERUMOANACONDA 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

CBC0320716TM TERUMOANACONDA 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

405000

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

CBC03AAA03CK COOKZENITH 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

405000

CBC03AAA03M4 MEDTRONICENDURANT 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

405000

CBC03AAA04CK COOKZENITH 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 MEDTRONICENDURANT 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

CBC03AAA05CK 曲克蘭尼思腹主動脈瘤輔助組件暨其輸送導引系統(轉換體+主體延伸

支架+髂動脈延伸支架)"COOK"ZENITH AAA ANCILLARY COMPONENTS

WITH THE Z-TRAK INTRODUCTION SYSTEM

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

405000

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

405000

684


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 COOKZENITH 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

405000

CBC03AZT01CK COOKZENITH 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

405000

CBC03FENP1CK COOKZENITH FENESTRATED AAA ENDOVASCULAR GRAFT WITH THE H&L-B

ONE-SHOT INTRODUCTION SYSTEM"曲克"藍尼思有孔腹主動脈瘤血管支

架暨導引系統(近端體支架+輸送導引系統)

236112

CBC03LEZT1CK COOKZENITH 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 GOREEXCLUDER 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 GOREEXCLUDER 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 GOREEXCLUDER 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 GOREEXCLUDER 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)

405000

CBC03RL23NGX 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+髂動脈延伸支架)"GORE"EXCLUDER AAA ENDOPROSTHESIS

405000

CBC03RX101CK COOKZENITH 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 COOKZENITH FENESTRATED AAA ENDOVASCULAR GRAFT W/H&L-B ONE-

SHOT INTRO SYS"曲克"腹主動脈瘤支架暨導引系統(主體+分支體*2)

405000

CBC03ZSLE1CK COOKZENITH 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

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

CBC04EX06CAN ANGIOMEDBARD 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 ANGIOMEDBARD 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 ANGIOMEDBARD 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 ANGIOMEDBARD 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

685


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

CBC04MAR1SF2 INVATECMARIS 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

CBC04PR120EY EV3PROTEGE 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 EV3PROTEGE 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

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

CBC04PUL14BK 百多力帕撒18自行擴張周邊支架系統(淺股動脈血管支

架)"BIOTRONIK" PULSAR-18 SELF EXPANDING PERIPHERAL STENT

SYSTEM L20:120MM

28773

CBC04PUL20BK 百多力帕撒18自行擴張周邊支架系統(淺股動脈血管支

架)"BIOTRONIK" PULSAR-18 SELF EXPANDING PERIPHERAL STENT

SYSTEM L150:200MM

44293

CBC04SC210CD CORDISS.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

CBC04SFALLM4 MEDTRONICCOMPLETE 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 MEDTRONICCOMPLETE 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

CBC04SN120CD CORDISS.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 CORDISS.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 COOKZILVER 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 COOKZILVER 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

CBC050PEN2QV E-VITAOPEN PLUS STENT GRAFT SYSTEM"依威達"開放加強式血管支架

系統(使用2支)

468000


系統(使用3支)

468000


系統(使用4支(含)以上)

468000

CBC050PENPQV E-VITAOPEN PLUS STENT GRAFT SYSTEM"依威達"開放加強式血管支架

系統(使用1支)

305007

686


CBC05CT262GX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用2

支)

468000

CBC05CT263GX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用3

支)

468000

CBC05CT264GX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用4支

(含)以上)

468000

CBC05CT26NGX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用1

支)

305007

CBC05NBS01L1 BOLTONRELAY NBS THORACIC STENT-GRAFT WITH PLUS DELIVERY

SYSTEM"博而騰"瑞磊恩伯斯胸主動脈覆膜支架暨導載輸送系統(使用1

支)

305007



支)

468000



支)

468000



支(含)以上)

468000

CBC05RE145L1 BOLTONRELAY PLUS THORACIC STENT GRAFT WITH A TRANSPORT

DELIVERY SYSTEM"博而騰"瑞磊胸主動脈覆膜支架暨導載輸送系統(使

用1支)

305007



用2支)

468000



用3支)

468000



用4支(含)以上)

468000

CBC05RELAYL1 BOLTONRELAY PLUS THORACIC STENT GRAFT WITH A TRANSPORT


用1支)

305007

CBC05TAA01CK COOKZENITH TX2 TAA ENDOVASCULAR GRAFT WITH THE Z-TRAK PLUS

INTRODUCTION SYSTEM"曲克"蘭尼思胸主動脈瘤支架暨輸送導引系統

(使用1支)

305007

CBC05TAA02CK COOKZENITH TX2 TAA ENDOVASCULAR GRAFT WITH PRO-FORM"曲克"蘭

尼思胸主動脈瘤支架(使用1支)

305007



(使用2支)

468000



(使用3支)

468000



(使用4支(含)以上)

468000



468000



468000


尼思胸主動脈瘤支架(使用4支(含)以上)

468000

687


CBC05TG262GX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用2

支)

468000

CBC05TG263GX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用3

支)

468000

CBC05TG264GX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用4支

(含)以上)

468000

CBC05TG26NGX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用1

支)

305007

CBC05TT262GX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用2

支)

468000

CBC05TT263GX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用3

支)

468000

CBC05TT264GX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用4支

(含)以上)

468000

CBC05TT26NGX GORE TAG THORACIC ENDOPROSTHESIS"戈爾"胸主動脈瘤支架(使用1

支)

305007

CBC05TX201CK COOKZENITH TX2 DISSECTION ENDOVASCULAR GRAFT WITH PRO-FORM

AND THE Z-TRAK PLUS INTRODUCTION SYSTEM"曲克"蘭尼思胸主動脈

剝離血管支架及其輸送系統(使用1支)

305007




468000




468000



剝離血管支架及其輸送系統(使用4支(含)以上)

468000

CBC05VLCA2M4 MEDTRONICVALIANT THORACIC STENT GRAFT WITH THE CAPTIVIA

DELIVERY SYSTEM"美敦力"范倫特胸主動脈支架系統(使用2支)

468000



468000


DELIVERY SYSTEM"美敦力"范倫特胸主動脈支架系統(使用4支(含)以

上)

468000

CBC05VLCAPM4 MEDTRONICVALIANT THORACIC STENT GRAFT WITH THE CAPTIVIA


305007

CBC06F0RX1CK COOKFORMULA 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 INVATECHIPPOCAMPUS 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 SCIENTIFICEXPRESS 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 ABBOTTRX 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

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

CBC0715841AH 亞翠恩艾德凡達V12聚四氟乙烯覆膜支架-RX(D5:7MM;遞送系統

140CM)"ATRIUM"ADVANTA V12 PTFE COVERED STENT

79852

CBC0715842AH 亞翠恩艾德凡達V12聚四氟乙烯覆膜支架(D5:10MM;遞送系統

80:120CM)"ATRIUM"ADVANTA V12 PTFE COVERED STENT

79852

688


CBC0715843AH 亞翠恩艾德凡達V12聚四氟乙烯覆膜支架-LARGE DIAMETER(D12:16MM;

遞送系統80:120CM)"ATRIUM"ADVANTA V12 PTFE COVERED STENT

96390

CBC07FLA01BA BARDFLAIR ENDOVASCULAR STENT GRAFT D6:9MM L3:7CM"巴德"福萊爾

周邊血管內套膜支架(含輸送系統)

62370

CBC07VB10NGX GOREVIABAHN 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 GOREVIABAHN 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 GOREVIABAHN 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

CBP0103012UZ TURQUOISE PTCA BALLOON DILATATION CATHETER D 1.5MM:4.5MM綠松

石冠狀動脈氣球擴張導管

6217

CBP010MEGASB BOSTON SCIENTIFICOMEGA 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

14099

CBP01103TBRB ORBUSNEICHSAPPHIRE CORONARY DILATATION CATHETER 1.5MM:4.0MM

10MM:30MM塞費爾冠狀動脈球曩擴張術導管

6217

CBP01104TBRB ORBUSNEICHSAPPHIRE NC CORONARY DILATATION CATHETER神飛冠狀動

脈球囊擴張術導管

6217

CBP01105TBRB ORBUSNEICHSAPPHIRE II CORONARY DILATATION CATHETER"奧爾"第二

代塞費爾冠狀動脈球曩擴張術導管

6217

CBP01106TBRB ORBUSNEICHSAPPHIRE NC CORONARY DILATATION CATHETER"奧爾"神飛

冠狀動脈球囊擴張術導管

6217

CBP0112510UV INVADER CTO CORONARY ANGIOPLASTY BALLOON CATHETER入侵者慢性

全閉塞氣球擴張導管

6217

CBP011NTEGM4 MEDTRONICINTEGRITY 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

14099

CBP01204TBRB ORBUSNEICHSAPPHIRE Ⅱ NC CORONARY DILATATION CATHETER"奧爾"

第二代神飛冠狀動脈球囊擴張術導管

6217

CBP0122545SB BOSTON SCIENTIFICOMEGA 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

14099

CBP012535SHC HELISTENT CORONARY STENT W/DELIVERY SYSTEM *適應症請見備註欄

(原文號910034694)

14099

CBP012540SHC HELISTENT CORONARY STENT W/DELIVERY SYSTEM *適應症請見備註欄

(原文號910034694)

14099

CBP0138938SB LIBERTE MONORAIL CORONARY STENT SYSTEM*適應症請見備註欄 14099

CBP0150212BB B.BRAUNSEQUENT PTCA CATHETER"柏朗"適可穩經皮穿刺汽球擴張導管 6217

CBP0182926AB ABBOTT FLEXMASTER F1 CORONARY STENT WITH DELIVERY SYSTEM適應

症請見備註欄

14099

CBP01AU729RB ORBUSNEICHAZULE 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

14099

CBP01BC001BQ BIOTEQPTCA BALLOON DILATATION CATHETER"邦特"冠狀動脈氣球擴張

導管

6217

CBP01BL729RB ORBUSNEICHBLAZER 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

14099

CBP01BLUE1BB B.BRAUNCOROFLEX BLUE CORONARY STENT SYSTEM普弩冠狀動脈血管支

架系統*適應症請見備註欄

14099

CBP01BLUE2BB B.BRAUNCOROFLEX BLUE CORONARY STENT SYSTEM普弩冠狀動脈血管支

架系統

14099

CBP01CHRCCYV CIDCHRONO CARBOSTENT CORONARY STENT WITH DELIVERY SYSTEM"喜

安汀"康保冠狀動脈血管支架

14099

689


CBP01CT480Y0 擴適達高斯喜通冠狀動脈氣球導管"ACROSTAK"ACROSS CTO PTCA

BALLOON CATHETER

6217

CBP01DFX08JF DURAFLEXCORONARY 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

14099

CBP01DVW35AS ASAHIDOUVAN PTCA DILATATION CATHETER"朝日"朵凡氣球擴張導管 6217

CBP01FF22BF2 INVATECFALCON 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

6217

CBP01FLC10F2 INVATECFALCON CTO PTCA BALLOON CATHETER冠狀動脈氣球導管 6217

CBP01GAZSTBS BIOSENSORSGAZELLE CORONARY STENT SYSTEM冠狀動脈內支架系統*適


14099

CBP01HPERBYC 樂普琥珀經皮穿刺冠狀動脈球囊導管"LEPU"HOPER PTCA BALLOON

DILATATION CATHETER

6217

CBP01KANMETM TERUMOKANAME 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

14099

CBP01ML8STAB ABBOTTMULTI-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

14099

CBP01MLVSTAB ABBOTTMULTI-LINK VISION RX CORONARY STENT SYSTEM"亞培"冠狀動

脈支架系統*適應症請見備註欄

14099

CBP01MTLNCHC 海斯凱敏追冠狀動脈氣球擴張導管(NC系列)"HEXACATH"PTCA

DILATATION CATHETER MISTRAL

6586

CBP01MTLSCHC 海斯凱敏追冠狀動脈氣球擴張導管(SC系列)"HEXACATH"PTCA

DILATATION CATHETER MISTRAL

6217

CBP01MZXXXQR 渼瑞爾莫利克冠狀動脈氣球擴張導管"MERIL"MOZEC RX PTCA BALLOON

DILATATION CATHETER

6217

CBP01PALE0BK BIOTRONIKPANTERA LEO FAST-EXCHANGE PTCA CATHETER"百多力"帕得

拉禮歐快速交換式冠狀動脈導管

6217

CBP01PKE36BK 百多力普凱能鈷鉻冠狀動脈支架系統"BIOTRONIK"PRO-KINETIC

ENERGY COBALT CHROMIUM (COCR) CORONARY STENT SYSTEM

14099

CBP01PWRLNBS BIOSENSORSPOWERLINE PTCA CATHETER經皮冠狀動脈成形術球囊導管 6217

CBP01REBELSB 波士頓科技瑞柏爾單軌冠狀動脈支架系統"BOSTON SCIENTIFIC"REBEL

MONORAIL PTCR CORONARY STENT SYSTEM

14099

CBP01TREK3AB 亞培第二代小快克冠狀動脈氣球擴張導管"ABBOTT"MINI TREK Ⅱ OTW

CORONARY DILATATION CATHETER

6535

CBP01TRKNCAB ABBOTTNC TREK RX CORONARY DILATATION CATHETER"亞培"恩希快克

冠狀動脈氣球擴張導管

6217

CBP01V1S1NAB ABBOTTMULTI-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

14099

CBP01V7844AB ABBOTTMULTI-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

14099

CBP01VYGNCAB ABBOTTVOYAGER NC CORONARY DILATATION CATHETER航行家恩希冠狀

動脈擴張導管2.00MM:5.00MM 6MM:25MM

6217

CBP01ZETANAB ABBOTTMULTI-LINK RX ZETA CORONARY STENT SYSTEM智達冠狀動脈支

架系統*適應症請見備註欄

14099

CBP02NCSPRM4 MEDTRONICNC SPRINTER RAPID EXCHANGE BALLOON DILATATION

CATHETER"美敦力"史賓特高壓快速交換氣球擴張導管

6217

CBP02R5A85KE FORTIS II PTCA CATHETER 2.50MM:4.50MM佛緹斯冠狀動脈成型術導

管

6217

CBP02R7R7FKE KANEKAIKAZUCHI RAPID EXCHANGE PTCA BALLOON CATHETER雷快速抽

換冠狀動脈氣球導管

6217

690


CBP02R7REVKE KANEKAPTCA CATHETER IKAZUCHI REV "卡內卡"冠狀動脈氣球導管 6217

CBP02SPR32M4 美敦力史賓特同軸導線氣球擴張導管"MEDTRONIC"SPRINTER OVER-

THE-WIRE BALLOON DILATATION CATHETER 1.5MM:4.0MM 6MM:30MM

6535

CBP02SPRLGM4 MEDTRONICSPRINTER LEGEND RAPID EXCHANGE BALLOON DILATATION

CATHETER (D:1.25MM:4MM，L:6MM:30MM)

6217

CBP031016TTM TERUMORYUJIN PLUS PTCA DILATATION CATHETER琉均柏柆思冠狀動脈

氣球擴張導管

6217

CBP0314038TM TERUMO RYUJIN PLUS PTCA DILATATION CATHETER 6217

CBP0314039TM TERUMO RYUJIN PLUS PTCA DILATATION CATHETER 6217

CBP0318634TM RYUJIN PLUS OTW PTCA DILATATION CATHETER冠狀動脈氣球擴張導管 6535

CBP0337910SB BOSTON SCIENTIFICMAVERICK XL MONORAIL PTCA DILATATION

CATHETER 馬文瑞克氣球擴張導管

6217

CBP0338080SB QUANTUM MAVERICK MONORAIL DILATION CATHETER(PTCA BALLOON

CATHETER)

6217

CBP0338081SB BOSTON SCIENTIFICQUANTUM MAVERICK PTCA DILATATION CATHETER D

2.0:5.0MM L8:30MM冠狀動脈擴張導管

6535

CBP0338928SB MAVERICK 2 MONORAIL BALLOON CATHETER *自92.7.1改按條支付 6217

CBP0338960SB BOSTON SCIENTIFICAPEX OTW PTCA DILATATION CATHETER氣球擴張導

管

6535

CBP0338961SB BOSTON SCIENTIFICAPEX PTCA DILATATION CATHETER氣球擴張導管 6217

CBP03389XXSB BOSTON SCIENTIFICAPEX MONORAIL PTCA DILATATION CATHETER D

1.50MM:5.0MM L8MM:40MM艾佩斯單軌氣球擴張導管

6217

CBP0339124SB BOSTON SCIENTIFICNC QUANTUM APEX PTCA DILATATION

CATHETER(MONORAIL)康騰艾佩斯氣球擴張導管2.0:5.0MM 6:30MM

6217

CBP0339125SB BOSTON SCIENTIFICNC QUANTUM APEX PTCA DILATATION

CATHETER(OTW)康騰艾佩斯氣球擴張導管2.0:5.0MM 6:30MM

6535

CBP035265NAB ABBOTTCROSSSAIL CORONARY DILATATION CATHETER可思爾冠狀動脈擴

張導管

6217

CBP03701XNCD CORDISDURA STAR RX PTCA DILATATION CATHETER杜芮星冠狀動脈擴

張導管

6217

CBP03801XNCD CORDISFIRE STAR RX PTCA DILATATION CATHETER法爾星冠狀動脈擴

張導管

6217

CBP03ACRHPY0 ACROSTAKACROSS HP PTCA BALLOON CATHETER"擴適達"高斯高壓冠狀

動脈氣球導管

6217

CBP03CT481Y0 擴適達高斯喜通冠狀動脈氣球導管"ACROSTAK"ACROSS CTO PTCA

BALLOON CATHETER(OTW)

6535

CBP03DCRK1TM TERUMOTAZUNA PTCA DILATATION CATHETER"泰爾茂"鈦速納冠狀動脈

氣球擴張導管

6217

CBP03EMERMSB BOSTON SCIENTIFICEMERGE 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

6217

CBP03EMERTSB BOSTONSCIENTIFICEMERGEPTCADILATATIONCATHETERD:1.20MM:4.00MML

:8MM:30MM"波士頓科技"宜加同軸冠狀動脈擴張導管

6535

CBP03EP75RCD CORDISEMPIRA NC RX PTCA DILATATION CATHETER"考迪斯"安博冠狀

動脈擴張導管

6217

CBP03EP85RCD CORDISEMPIRA RX PTCA DILATATION CATHETER"考迪斯"安博冠狀動脈

擴張導管

6217

CBP03EPNCRCD CORDISEMPIRA NC RX PTCA DILATATION CATHETER"考迪斯"安博冠狀

動脈擴張導管

6586

691


CBP03ERUNCXW 朗迪優霸恩喜冠狀動脈氣球導管"RONTIS"EUROPA ULTRA NC PTCA

BALLOON CATHETER

6586

CBP03H1RU1TM TERUMOHIRYU PTCA DILATATION CATHETER 2.25:5.0MM 6:20MM冠狀動

脈氣球擴張導管

6217

CBP03R2A15KE KANEKA RX CATHETER AEROCROSS FIGHTER 1.5MM:4.0MM 15MM:20MM 6217

CBP03R4K15KE KANEKA RX CATHETER OTTIMO 1.5MM:4.0MM 10MM:20MM 6217

CBP03RAF25HC HEXACATHRAFALE PTCA DILATATION CATHETER旋風冠狀動脈氣球擴張

導管

6217

CBP03SL0TWM4 MEDTRONICSPRINTER LEGEND OVER-THE-WIRE BALLOON DILATATION

CATHETER同軸導線球囊擴張導管

6535

CBP03TREK1AB ABBOTTTREK AND MINI TREK RX CORONARY DILATATION CATHETER"亞

培"快克/小快克冠狀動脈擴張導管

6217

CBP03TREK2AB ABBOTTTREK AND MINI TREK OTW CORONARY DILATATION CATHETER"亞

培"快克/小快克冠狀動脈氣球擴張導管

6535

CBP03V0TWNAB ABBOTTVOYAGER OTW CORONARY DILATATION CATHETER莫雅佳甌第冠狀

動脈擴張導管

6535

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 ABBOTTJOSTENT GRAFTMASTER CORONARY STENT GRAFT(WITH DELIVERY

SYSTEM)*適應症請見備註欄.

49500

CBP06ELUT1AB ABBOTTXIENCE 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。

14099

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。

14099

CBP06ELUT1BK BIOTRONIKORSIRO 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)

14099

CBP06ELUT1HC HEXACATHPREMOUNTED 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。

14099

CBP06ELUT1QR MERILBIOMIME 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)

14099

CBP06ELUT1RB ORBUSGENOUS 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.

14099

CBP06ELUT1TM TERUMONOBORI 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。

14099

CBP06ELUT1YV CIDJANUS 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。

14099

CBP06ELUT2BS BIOSENSORSBIOMATRIX 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。

14099

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

14099

CBP06ELUT2TM TERUMOULTIMASTER SIROLIMUS ELUTING CORONARY STENT SYSTEM"泰

爾茂"阿提瑪斯特冠狀動脈塗藥支架系統(自付差額)

14099

CBP06ELUT2YV CIDCRE8 ELUTING CORONARY STENT WITH DELIVERY SYSTEM"喜安汀"

擴立安塗藥冠狀動脈血管支架(自付差額)

14099

692


CBP06ELUT3AB ABBOTTXIENCE 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。

14099

CBP06ELUT3BS BIOSENSORSBIOMATRIX NEOFLEX DRUG ELUTING CORONARY STENT

SYSTEM"柏盛"拜美翠尼奧弗雷絲藥物釋放冠狀動脈支架系統(自付差

額品項)

14099

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。

14099

CBP06ELUT4AB ABBOTTXIENCE 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)

14099

CBP06ELUT4BS BIOSENSORSAXXESS DRUG ELUTING CORONARY BIFURCATION STENT

SYSTEM"柏盛"亞瑟士藥物釋放型冠狀動脈分叉支架系統(自付差額品

項)

14099

CBP06ELUT4M4 MEDTRONICENDEAVOR 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。

14099

CBP06ELUT4SB BOSTON SCIENTIFICTAXUS 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

14099

CBP06ELUT5AB ABBOTTXIENCE 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)

14099

CBP06ELUT5M4 MEDTRONICRESOLUTE 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

14099

CBP06ELUT5SB BOSTON SCIENTIFICPROMUS 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

14099

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 部分給付品項*給付規定請見備註欄.並註明其禁忌症

不可使用

14099

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 CORONARY STENT SYSTEM

14099

CBP06ELUT8SB 波士頓科技新納吉艾諾莉茉斯冠狀動脈塗藥支架系統 (自付差額品

項)"BOSTON SCIENTIFIC"SYNERGY EVEROLIMUS-ELUTING PLATINUM

CHROMIUM CORONARY STENT SYSTEM

14099

CBP06ELUT9SB 波士頓科技新能吉艾諾莉茉斯冠狀動脈塗藥支架系統 (自付差額品

項)"BOSTON SCIENTIFIC"SYNERGY EVEROLIMUS-ELUTING CORONARY

STENT SYSTEM

14099

CBP0750222BB B.BRAUNSEQUENT 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

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

CBS01RASHKM4 MEDTRONICRASHKIND BALLOON SEPTOSTOMY CATHETER"美敦力"球囊中

膈切除術導管

9000

CBS01SPTXXN5 NUMEDZ-5 ATRIOSEPTOSTOMY CATHETER 9000

CBS029ASDAG6 AGAAMPLATZER SEPTAL OCCLUDER 4:20MM，22MM:38MM，40MM"銨積維"

安普拉茲心房關閉器

138000

693


CBS029ASDNG6 AGAAMPLAATZER 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 AGAAMPLATZER 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 AGAAMPLATZER 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 AGAAMPLATZER 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 AGAAMPLATZER 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 AGAAMPLATZER 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 OCCLUTECHFIGULLA 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


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

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 AGAAMPLATZER 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

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

CBS059AVP2G6 AMPLATZERVASCULAR PLUG II 3MM:22MM"安普拉茲"II型血管塞(含遞

送導管)

24990

CBS059AVP4G6 AMPLATZERVASCULAR PLUG&DELIVERY SYSTEM 4MM:16MM血管塞含遞送

導管

22750

CBS05AVP03G6 AMPLATZER VASCULAR PLUG4 4MM:8MM 安普拉茲第四型血管塞(含遞送

導管)

24990

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

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

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

694


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 PULSIONPULSIOCATH THERMODILUTION CATHETER 5775

CBT0405000AR ARROWBALLOONTHERMODILUTION CATHETERS(HEPARIN-COATED) FOUR

LUMEN"亞諾"熱稀釋順流導管

2143

CBT0405050AR ARROWBALLOONTHERMODILUTION 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 ARROWBALLOON THERMODILUTION CATHETER 4FRX75CM

5FRX80CM(HEPARIN COATED) 4 LUMENS "亞諾"熱稀釋順流導管

2143

CBT0407365AR ARROWBALLOON 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 EDWARDSSWAN-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 ARGONCRITICATH THERMODILUTION CATHETERS(HEPARIN COATING) 4

LUMEN 5F 80CM"愛琅"熱稀釋導管

2143

CBT0445110AG ARGONCRITICATH THERMODILUTION CATHETERS(HEPARIN COATING)4

LUMEN 5F 110CM"愛琅"熱稀釋導管

2143

CBT045107SAG ARGONCRITICATH 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 EDWARDSSWAN-GANZ THERMODILUTION CATHETER 4 LUMEN 7FR W/AMC

THROMBOSHIELD COATING

2143

CBT04H5107AG ARGONCRITICATH 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 ARGONCRITICATH 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 EDWARDSSWAN-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

695


CBT06757HFED SWAN GANZ CONTINUOUS CARDIAC /END DIASTOLIC VOLUME

THERMODILUTION CATHETER CCO/SVO2/EDV/VIP*適應症請見備註欄

6548

CBT0677475ED EDWARDSSWAN 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 EDWARDSSWAN-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 EDWARDSVOLUME 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 NUMEDNUCLEUS 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 SAFETRANBLOOD COMPONENTS APHERESIS"笙創"血液成份分離器(離心

杯275CC+體外血液迴路管)

3014

CCC03BX051YT SAFETRANBLOOD COMPONENTS APHERESIS"笙創"血液成份分離器(離心


3014



3014



3014

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

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

CCC13BT894R5 SORINAUTOTRANSFUSION 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

696


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

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

CCC14745E5R5 SORINAUTOTRANSFUSION KITS FOR ELECTA(WASH

SET+AUTOTRANSFUSION RESERVOIR SET+LINE)依雷塔專用自體輸血組*


7260

CCC1474E55R5 SORINWASH SET血液洗淨組*適應症請見備註欄 3974

CCC1520503AH ATRIUMOCEAN 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 ATRIUMOCEAN 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

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

CDD0200114FM SILICONE ABDOMINAL SUMP DRAIN 14" 7MMX13MM 136

CDD0200120FM SILICONE ABDOMINAL SUMP DRAIN 20" 7MMX13MM 136

CDD0200804BA BARDNONPOWERED WOUND SUCTION DEVICES:SILICONE 3 LUMEN

W/FILTER"巴德"非動力式傷口抽吸器具

1222

CDD0210050M4 MEDTRONICSUCTION TUBES "美敦力"抽吸管 398

CDD0246148H9 INTRACARDIAC SUCKER 398

CDD0246398GJ 吉生體外循環管組-心臟內抽吸器"JSM"HEART LUNG PACK-

INTRACARDIAC SUCKER

398

CDD02SUCKEM6 EXTRACORPOREAL SUCKER 398

CDD0401201ED PERICARDIAL SUMP(1/4") 431

CDD0403300ED SUCTION WAND(9F-22F) 431

CDD0404360BA 400CC THREE-SPRING EVACUATOR KIT W/PVC ROUND DRAIN 259

CDD0406648PC TLS BULB DRAINAGE SYSTEM 100CC 10.5FR(球+管) 391

CDD0408705P2 PVC VAC (球+管) 450CC 1/8"，3/16"，1/4" 259

CDD0408770P2 SILICON VAC (球+管) 100CC，200CC 1/8"，3/16"，1/4" 391

CDD0420131FM ALL SILICONE C.W.V SET(RESERVOIR 100CC+DRAIN 7MM，10MM) 391

CDD0420132FM ALL SILICONE C.W.V SET(RESERVOIR 100CC+DRAIN 13MM) 391





CDD0425001Z1 HEMOVAC 259

CDD042535NZ1 MINI SNYDER HEMOVAC SILICONE DRAIN 3/32 1/8"，3/16"，1/4"

SILICONE EVACUATOR 100ML(球+管+針)

391

CDD042560NZ1 MINI SNYDER HEMOVAC SILICONE DRAIN 7MM，10MM SILICONE

EVACUATOR 100ML(球+管+針)

391

CDD0425904Z1 HEMOVAC 259

CDD0425951Z1 PVC HEMOVAC COMPACT EVACUATOR KIT 3/32"，3/16" 7，15FR 259

CDD0430101P2 WOUND DRAINAGE SYSTEM (PAHSCO-VAC)450ML(BAG+TUBE+TROCAR) 259

697


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)

389

CDD0453101P2 CLOSED WOUND DRAINAGE SYSTEM 450MLPVC (球+管+針) 259

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)

259

CDD0456025P2 CLOSED WOUND DRAINAGE SYSTEM 400CCPVC (球+管+針) 259

CDD048410NM5 WOUND-EVC ET(EASY TOUCH)(PVC RESERVOIR 400ML，SILICONE

TUBING 1/8"，3/16"，1/4")

389

CDD04CSB00LL LILYWOUND 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)

391

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)

391

CDD04CWCV1EF SILICONE C.W.V SET(100CC，150CC，400CC+7MM，10MM，13MM)矽質

真空傷口引流球+引流管

391

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

391

CDD04HS2XXH0 HOSMEDCLOSED 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

391

CDD04MB125SG SILICON MINI VACCUM BLUB 125CC(MB125)＋FLAT TUBE OR ROUND

TUBE MD-118 7:9MM(HF107:9)

391

CDD04PP400WN BAROVAC CLOSED WOUND DRAINAGE SYSTEMS (PVC DRAIN 3/32"，1/8"

，3/16"，1/4"WITH PVC RESERVOIR 400ML)

259

CDD04PT503TM PORTABLE WOUND SUCTION UNIT(球+管) 259

CDD04SS100WN ALL SILICONE CLOSED WOUND DRAINAGE SYSTEMS(SILICONE DRAIN

WITH RESERVOIR 100ML)

391

CDD04SS200WN ALL SILICONE CLOSED WOUND DRAINAGE SYSTEMS 200ML(SILICONE

DRAIN WITH RESERVOIR 200ML)

391

CDD05000SMWN ALL SILICONE WOUND TUBINGW/TROCAR NEEDLE 3.2MM，4.8MM(圓型) 243

CDD0500SJPWN ALL SILICONE WOUND TUBINGW/TROCAR NEEDLE 4.8MM(扁型) 243

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

243

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

243

CDD0501310C8 JACKSON-PRATT SILICONE DRAINS 7MM， 10MMJACKSON-PRATT矽質傷

口引流管

243

CDD0501310L6 JACKSON-PRATT HUBLESS FLAT SILICONE DRAINS W/O TROCAR 243

CDD0501407FM FORTUNEC.W.V DRAIN SYSTEM:SILICON DRAINS TUBE 7MM"富強"傷口

引流系統:矽膠引流管

243



243



243

CDD0501420FM FORTUNEC.W.V DRAIN SYSTEM:SILICON DRAINS TUBE 10:29FR "富強"

傷口引流系統:矽膠引流管

243

CDD050208NFM SILICONE ROUND DRAIN END PERFORATED 8，10，16，20FR 900MM 243

698


CDD0502099FM FORTUNEC.W.V DRAIN SYSTEM:SILICON DRAINS TUBE+TROCAR "富強"

傷口引流系統:矽膠引流管+穿刺針

243

CDD05020XXH0 HOSMEDCLOSED 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

243

CDD050308NFM SILICONE ROUND DRAIN MIDDLE PERFORATED 8，10，16，20FR

1100MM

243

CDD0503203SM EXTRA STRENGTH FLAT SUCTION DRAIN 7MM 243

CDD0503204SM EXTRA STRENGTH FLAT SUCTION DRAIN 10MM 243

CDD0508711P2 SILICON VAC DRAINAGE & TROCAR 243

CDD0510101P2 CLOSED WOUND DRAINAGE SYSTEMPVC VAC DRAINAGE 113

CDD0513101P2 CLOSED WOUND DRAINAGE SYSTEMSILICONE VAC DRAINAGE 243

CDD052540NZ1 MINI-SNYDER HEMOVAC SILICONE DRAIN 3/32"，1/8"，3/16"，1/4"

7MM，10MM W/TROCAR

243

CDD0530502P2 CLOSED WOUND DRAINAGE SYSTEMSILICONE VAC DRAINAGE &TROCAR 243

CDD0566481B0 SILICONE BULB DRAINAGE CATHETER 7MM 真空傷口引流管 243

CDD0566482B0 SILICONE BULB DRAINAGE CATHETER 真空傷口引流管 243

CDD0566483B0 SILICONE BULB RESERVOIR 100CC 真空傷口引流球 146

CDD0566484B0 SILICONE BULB DRAINAGE CATHETER 10MM 真空傷口引流管 243

CDD05CD000EF 貝斯美德導入/引流導管及其附件(滅菌)BESMED INTRODUCTION

DRAINAGE CATHETER AND ACCESSORIES (STERILE)

243

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

243

CDD05CV110EF SILICONE C.W.V DRAIN 243

CDD05MF104SG SILICONE SUCTION DRAINAGE TUBE(FLAT) 4，7，10MM 243

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)

243

CDD0600640FM SILICONE CLOSED WOUND VACUUM RESERVOIR 400CC 146

CDD0601305C8 JACKSON-PRATT SILICONE BULB RESERVOIR 100CC & 400CC矽質真空

傷口引流儲液器

146

CDD06021XXH0 HOSMEDCLOSED 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

146

CDD0603101SM SUCTION RESERVOIR 168

CDD0608709P2 SILICON VAC RESERVOIR 100CC，200CC 146

CDD060S100WN ALL SILICONE BAROVAC RESERVOIR 100ML 146

CDD060S200WN ALL SILICONE BAROVAC RESERVOIR 200ML 146

CDD060S400WN 世運傷口引流套(滅菌)"SEWOON"CLOSED WOUND DRAINAGE

SYSTEM(STERILE)-矽膠吸引球 400CC

146

CDD0613150FM FORTUNEC.W.V DRAIN SYSTEM:SILICON RESERVOIR 100CC，150CC "富

強"傷口引流系統:矽膠真空吸球

146

CDD0620201P2 太平洋真空傷口引流套(滅菌)PAHSCO WOUND DRAINAGE

SYSTEM(STERILE)-SILICONE EVACUATOR 125ML 、200ML

146

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 146

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

146

CDD06CW1S1EF SILICONE C.W.V RESERVOIR 100CC，150CC，400CC 146

CDD06CWVB1SG SIGMA SILICONE MINI BULB 100;125;150;400CC 十美牌矽質真空引

流球

146

CDD06MB125SG MINI BULB 125CC 真空吸引球 146

CDD1012001P2 DIAMOND TIP THROACIC CANNULA 8:16FR 259

699


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 SMITHSPORTEX 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


頭2)

1509

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

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


頭1)

1459

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


頭1)

1459


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


CDD1100014U7 普威穿刺導引器(穿刺針1+外管1(內含可變式轉接頭1)+ 袋口結固定

器1)"UNIMAX"SURGICAL TROCAR

2233

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

700


CDD110506JL7 大吉士穿刺套管5.8MMLAGIS TROCAR 1116

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



1509

CDD1105124L7 TROCAR KIT 5-12MM TROCAR AND CANULA穿刺套管組(防滑套管1支，


1459



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

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


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


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

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

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

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

CDD1110092L9 ENDOSCOPIC INSTRUMENT內視鏡器械(含：穿刺針*1+外管*2+固定式轉

接頭*2)

1509

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

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

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

701


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

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

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

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


TROCAR SYSTEM 5/10-12MM (外管1+內建式可變轉接頭1)

955

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

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

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

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

CDD11793052C 柯惠胸腔穿刺套管 "COVIDIEN" THORACOPORT TROCAR 1116


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

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

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

CDD119078P2C 柯惠安全穿刺套管組 10-15MM(穿刺內管1+外管1+可變式轉接頭

2+5MM轉接頭1)"COVIDIEN" AUTO SUTURE VERSAPORT PLUS RPF

TROCAR SYSTEM 10-15MM

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

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

702


CDD11EPATHET ETHICONENDOPATH 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

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

CDD11GT150QW 台灣先進拋棄式穿刺套管5-15MM(穿刺針1+外管1+內建可變式轉接頭

1)"TAIWAN SURGICAL" DISPOSABLE TROCAR 5-15MM

1459

CDD11GT301QW “台灣先進”拋棄式穿刺套管-3MM(穿刺針1+外管1+內建固定轉接頭

1)“TAIWAN SURGICAL” DISPOSABLE TROCAR

1116

CDD11GT500QW TAIWAN SURGICALDISPOSABLE 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

CDD11GTCS3QW “台灣先進”拋棄式穿刺套管-3MM(外管1+內建固定式轉接頭)

“TAIWAN SURGICAL” DISPOSABLE TROCAR

917

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

CDD11K1104PA 〝APPLIED〞TROCAR SYSTEM 〝安培〞安全穿刺套管系統(穿剌針1+外


1459



1509



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



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

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

CDD11NB15F2C 柯惠無刀刃可變式穿刺套管 15MM(穿刺內管1+外管1+可變式轉接頭

2+5MM轉接頭1)"COVIDIEN" VERSAPORT BLADELESS AND VERSAPORT

PLUS BLADELESS SINGLE USE BLADELESS TROCAR 15MM

1459

CDD11NB15S2C “柯惠”無刀刃可變式穿刺套管 15MM(穿刺內管1+外管1+可變式轉接

頭2+5MM轉接頭1)"COVIDIEN" VERSAPORT BLADELESS AND VERSAPORT

PLUS BLADELESS SINGLE USE BLADELESS TROCAR 15MM

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

703


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

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

CDD12PDBS22C 柯惠腹腔鏡汽球撐開式套管"COVIDIEN"PDB STERILE BALLOON 2370

CDD13DGC01CK COOKJABCZENSKI DUCTOGRAM CANNULA 30 GAGE(乳管攝影導管) 943

CDD13DGK00AG 亞康恩導入及引流導管(滅菌)(乳管攝影導管)"ARGON"

INTRODUCTION/DRAINAGE CATHETER (STERILE)

943

CDDC1039901V 雃博立補負壓傷口治療系統-真空罐含接頭及引管"APEX"ZIP

NEGATIVE PRESSURE WOUND THERAPY SYSTEM

1829

CDDC111682SN 史耐輝非動力式，單一病人使用，可攜帶式之抽吸器具(未滅

菌)"SMITH & NEPHEW" NONPOWERED， SINGLE PATIENT， PORTABLE

SUCTION APPARATUS (NON-STERILE)

1829

CDDC112010SN 史耐輝非動力式，單一病人使用，可攜帶式之抽吸器具(未滅

菌)"SMITH & NEPHEW" NONPOWERED， SINGLE PATIENT， PORTABLE

SUCTION APPARATUS (NON-STERILE)

1829

CDDC126329KC “凱西爾”訊息型負壓輔助癒合治療儀-滲液收集罐“KCI” INFOVAC

THERAPY UNIT 500ML

1829

CDDC126330KC “凱西爾”活動型負壓輔助癒合治療儀-滲液收集罐“KCI” ACTIVAC

THERAPY UNIT 300ML

1829

CDDC1S00DC5G 潔利定負壓傷口治療系統-單一病人使用可攜帶式之集液

瓶"GENADYNE" WOUND VACUUM SYSTEM 400ML 600ML

1829

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

CDDF10DLGF5G 潔利定負壓傷口治療系統-泡棉組"GENADYNE" WOUND VACUUM SYSTEM

260X150X33MM

2715

CDDF10DMDF5G 潔利定負壓傷口治療系統-泡棉組"GENADYNE" WOUND VACUUM SYSTEM

180X125X33MM

2603

CDDF162151LN “美尼克”艾薇斯敷料(滅菌) “MOLNLYCKE”AVANCE DRESSING KIT

(STERILE)-SMALL

2355


(STERILE)-MEDIUM

2603


(STERILE)-LARGE

2715

CDDF1D5051KC 凱西爾負壓輔助癒合敷料"KCI" V.A.C. GRANUFOAM DRESSING 2355

704




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

CDF0121000M4 美敦力腦脊髓液儲液囊及儲液座-腦脊髓液儲液囊"Medtronic"

Reseroirs and Ports- Ventricular Reservoirs

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

CDLP16421TB0 長安腦脊髓分引流系統 "BMI"CSF SHUNTING SYSTEM 6599

CDLP244513PM C.S.F. LUMBOPERITONEAL RESERVOIR 3305

CDP0104015MV FLEXIMA NASOBILIARY CATH W/GUIDEWIRE(CATH+TRANSFER

TUBE+DRAINAGE CANNECTOR TUBE+GUIDEWIRE)

5143

CDP0104015SB FLEXIMA NASOBILIARY CATHETER (CATH+TRANSFER TUBE+DRAINAGE

CONNECTOR TUBE+GUIDE WIRE)

5143

CDP0107560AG 亞康恩導入/引流導管及其附件 (滅菌)"ARGON"

INTRODUCTION/DRAINAGE CATHETER AND ACCESSORIES (STERILE)

1720

CDP010ACL3CK 曲克膽道支架暨支架引導系統"COOK" COTTON-LEUNG BILIARY

STENTS AND INTRODUCERS

4400

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

4400

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)

1560

CDP0121333BQ BIOTEQINTRODUCER 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

CDP0122551SB 波士頓科技阿德凡斯膽道支架"BOSTON SCIENTIFIC" ADVANIX

BILIARY STENT WITH NAVIFLEX RX DELIVERY SYSTEM

4400

CDP012633NC3 ULTRASONICALLY GUIDED ONE-STEP DRAINAGE SET 1720

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

705


CDP0145550SB MICROVASIVE RAPID EXCHANGE BILIARY STENT SYSTEM(含推進導管及

導引導管)

3863

CDP0165150AG 亞康恩史凱特導引系統"ARGON"SKATER INTRODUCER SETS 2700

CDP0165150PB INTRODUCER SET(NEEDLE+INTRODUCER+GUIDE WIREX2) 2700

CDP0170030AG 亞康恩史凱特導管套針(引流)(滅菌)SKATER CENTISIS CATHETER

NEEDLE(STERILE)

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

CDP0175110PB SKATER DRAINAGE CATHETER 6:16FR 25-35CM 1314

CDP0175530AG 亞康恩導入/引流導管及其附件(滅

菌)"ARGON"INTRODUCTION/DRAINAGE CATHETER AND

ACCESSORIES(STERILE)

1720

CDP0175600AG 史凱特單步驟引流組"SKATER"SINGLE STEP DRAINAGE SET 1720

CDP0175601PB SKATER ONE STEP DRAINAGE CATHETER 6:16FR 20:25CM 1720

CDP0175650AG 史凱特單步驟引流組"SKATER"SINGLE STEP DRAINAGE SET 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

1912

CDP01ABSPLSB 波士頓科技阿德凡斯膽道支架"BOSTON SCIENTIFIC"ADVANIX BILIARY

STENT WITH NAVIFLEX RX DELIVERY SYSTEM

4400

CDP01ADVANSB 波士頓科技艾德凡尼胰管支架系統"BOSTON SCIENTIFIC" ADVANIX

PANCREATIC STENT WITH NAVIFLE DELIVERY SYSTEM AND PUSHER

4087

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)

4400

CDP01BSK12SB AMSTERDAM BILIARY STENT KIT (含推進導管) 2361

CDP01BSK1TSB AMSTERDAM BILIARY STENT KIT 10，12FRX5，7，10，12，15CM(含推

進導管及導引導管)

4400

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

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 4400

CDP01CLB85CK 曲克經皮引流導管針組(滅菌) "COOK" DRAINAGE CATHETER NEEDLE

SET(STERILE) 6~16FR

1720

CDP01CLBS2CK COOKCOTTON-LEUNG BILIARY STENTS AND INTRODUCERS 5:14FR膽道支

架暨支架引導系統

4400

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

CDP01ENBD1CK 曲克鼻-膽道引流管組"COOK" NASAL BILIARY DRAINAGE SET 5143

706


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

1965

CDP01GEPD2CK 曲克吉南胰管支架組"COOK"GEENEN PANCREATIC STENT SET 4070

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 4400

CDP01L001NCK COTTON LEUNG BILIARY STENT SET 4400

CDP01MAKSSMR 美瑞特馬克迷你血管導引套組"MERIT"MAK-MINI ACCESS KIT 1560

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)

1560

CDP01MDC85CK ULTRATHANE MULTIPURPOSE DRAINAGE CATH 8.5，10.2F，25CM，18G 1720

CDP01MP1S1CK COOKMICROPUNCTURE INTRODUCER SETS 4F:5F 0.018英吋 21G 微穿刺

引導器組

1560

CDP01NPAS1CK COOKNEFF PERCUTANEOUS ACCESS SETS"曲克"涅夫經皮引導組 6FR

20CM 0.018 60CM

1560

CDP01NPAS2CK COOKNEFF PERCUTANEOUS ACCESS SETS"曲克"涅夫經皮引導組 6FR

20CM 0.018 60CM

1560

CDP01NPAS3CK COOKNEFF PERCUTANEOUS ACCESS SETS 4.0/7.0 20CM 22/15CM .018

4.0/6.0 20CM 21/15CM:22/15CM .018

1560

CDP01NPDS1CK NASAL PANCREATIC DRAINAGE SET 5143

CDP01P001NCK COOKBILIARY DRAINAGE CATHETER"曲克"膽道引流導管 793

CDP01P008NCK COOKBILIARY DRAINAGE CATHETER"曲克"膽道引流導管 825

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


1720

CDP01PDS70BQ 邦特豬尾巴引流導管組(直接穿刺型) "BIOTEQ" PIGTAIL DRAINAGE


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)

4400



4400



4400

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

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

707


CDP01ZEBD1CK ZIMMON ENDOSCOPIC BILIARY STENT SET 5:7FR(STENT GUIDEWIRE

INTRODUCER CATHETER)

4400

CDP01ZEBD4CK “曲克” 膽道支架暨支架引導系統“COOK” ZIMMON BILIARY

STENTS AND INTRODUCERS

4400

CDP01ZEPDFCK “曲克”西門胰管支架組 “COOK”ZIMMON PANCREATIC STENT SET 4070

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) 825

CDP02ADVANSB 波士頓科技艾德凡尼胰管支架系統-胰管支架"BOSTON SCIENTIFIC"

ADVANIX PANCREATIC STENT WITH NAVIFLE DELIVERY SYSTEM AND

PUSHER-PANCREATIC STENT

2033

CDP02CHB1NCK COTTON HUIBREGTSE BILIARY STENT ONLY 1912

CDP02CLS01CK COOKCOTTON-LEUNG BILIARY STENTS 5:14FR膽道支架 1912

CDP02LS01NCK COTTON LEUNG BILIANY STENT ONLY 1912

CDP02PADBSSB AMSTERDAM BILIARY STENT 1912

CDP02PEBSTFG 福萊克斯膽道引流管 "ENDO-FLEX" BILIARY STENT 1912

CDP02PTFRBFG 福萊克斯膽道引流管"ENDO-FLEX" PTFE BILIARY STENT 1912

CDP02SPS12CK 曲克西門胰管支架組 "COOK" ZIMMON PANCREATIC STENT SET 1912

CDP02TTS02CK “曲克”所亨多坦念包膽道支架“COOK” ST-2 SOEHENDRA

TANNENBAUM BILIARY STENT

1912

CDP02ZS001CK ZIMMON ENDOSCOPIC BILIARY STENT ONLY 5:7FR 4，7，10CM 1912

CDP02ZS003CK “曲克” 膽道支架“COOK” ZIMMON BILIARY STENT 1912

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

CDPN1CASP1CK 曲克胸腔吸引導管組(滅菌)"COOK"SIMPLE PNEUMOTHORAX ASPIRATION

ACCESSORY SET(STERILE)

1281

CDPN1UTPT1CK COOKWAYNE 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

CDPN2G600NKQ ”優式”非動力式，單一病人使用，可攜帶式之抽吸器具-(滅菌)-全

密閉式引流袋 "URESIL" NON-POWERED， SINGLE PATIENT，

PORTABLE SUCTION APPARATUS (STERILE): GRAVITY BAGS

812

CDPN2S300DKQ ”優式”非動力式，單一病人使用，可攜帶式之抽吸器具-(滅菌)-全

密閉式吸取引流袋 "URESIL" NON-POWERED， SINGLE PATIENT，

PORTABLE SUCTION APPARATUS (STERILE):SUCTION BAGS

1820

CDPN2TQTS1CK COOKTHAL-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

CDSR104111B0 VENTRICULAR RESERVOIR 4352

CDSR123038M4 美敦力腦脊髓液儲液囊"MEDTRONIC" RESERVOIRS 4352

CDSR144111M4 美敦力腦脊髓液儲液囊及儲液座-腦脊髓液儲液囊及腦室導

管"MEDTRONIC" RESEROIRS AND PORTS -VENTRICULAR RESERVOIRS

AND VENTRICULAR CATHETER

4352

CDV0121700CM EXTERNAL DRAINAGE COLLECTION KIT 腦室體外引流組 4850

CDV0121702CM EXTERNAL DRAINAGE SYSTEM（E.D.S.) COLLECTION BAG 539

708


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 長安腦脊髓液體外引流系統:引流袋"BMI" CSF SHUNTING

SYSTEM:EDMS DRAINAGE BAG

539

CDV0206126B0 長安腦脊髓液體外引流系統:連接管組"BMI" CSF SHUNTING

SYSTEM:EDMS PATIENT CONNECTION LINE ASSEMBLY

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

CDVC121201CM ACCU-FLO VENTRICULAR CATHETER 1074

CDVC141101M4 美敦力體外引流及監測用腦室導管"MEDTRONIC" EXTERNAL DRAINAGE

AND MONITORING VENTRICULAR CATHETERS

1074

CDVC141101PM 美敦力腦脊髓液引流套件組及附件:體外引流管"MEDTRONIC" CSF

FLOW CONTROL SHUNTS AND ACCESSORIES: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

709


CDVP328501CM UNI-SHUNT WITH ENLARGED DOME RESERVOIR 7127

CDVP346024PM C.S.F UNITIZED SHUNT KIT 7127

CDVP424053M4 美敦力德爾塔腦脊髓液引流組-抗虹吸裝置"MEDTRONIC" DELTA

VALVES AND SHUNT ASSEMBLIES-CHAMBER

18788

CDVP4UGAV1BB 雅氏腦室分流系統-重力閥AESCULAP UNIGAV SHUNT SYSTEM-UNIGAV

VALVE

27000

CDVP4UGAV2BB 雅氏腦室分流系統-(重力閥+腹腔導管)AESCULAP UNIGAV SHUNT

SYSTEM-UNIGAV VALVE AND DISTAL CATHETER

28897

CDVP4UGAV3BB 雅氏腦室分流系統-(重力閥+腹腔導管+腦室導管+儲液槽)AESCULAP

UNIGAV SHUNT SYSTEM-UNIGAV SYSTEM

33249

CDVP4VA428M4 美敦力德爾塔腦脊髓液引流組-(固定壓力閥+抗虹吸裝

置)"MEDTRONIC" DELTA VALVES AND SHUNT ASSEMBLIES-VALVES

27000

CDVPA07374CM 美的思柯特曼霍金斯引流閥系統-抗菌引流導管(1條導管)"MEDOS"

CODMAN HAKIM VALVE SYSTEM-BACTISEAL SHUNT CATHETER(1

CATHETER)

10000

CDVPA23072CM 美的思柯特曼霍金斯引流閥系統-抗菌引流導管(2條導管)"MEDOS"

CODMAN HAKIM VALVE SYSTEM-BACTISEAL SHUNT CATHETER(2

CATHETERS)

15600

CDVPA55123CM 柯特曼貝特斯分流器"CODMAN" BACTISEAL UNIVERSAL SHUNT 20000

CDVPAARES1M4 美敦力瑞思腦室及腹膜抗菌導管(1條導管)"MEDTRONIC" ARES

ANTIBIOTIC-IMPREGNATED VENTRICULAR AND PERITONEAL

CATHETERS(1 CATHETER)

10000

CDVPAARES2M4 美敦力瑞思腦室及腹膜抗菌導管(2條導管)"MEDTRONIC" ARES

ANTIBIOTIC-IMPREGNATED VENTRICULAR AND PERITONEAL

CATHETERS(2 CATHETERS)

15600

CDVPB12626N7 英特佳內植用腦積水引流管組(自付差額)"INTEGRA" HYDROCEPHALUS

VALVE SYSTEMS AND ACCESSORIES

7127

CDVPB18HPVCM 美的思柯特曼霍金斯引流閥系統-可調式引流閥(自付差額)"MEDOS"

CODMAN HAKIM VALVE SYSTEM-PROGRAMMABLE VALVE

7127

CDVPB18SPGCM 柯特曼霍金斯引流閥系統-霍金斯可調式引流閥(具抗虹吸裝置)(自付

差額)"CODMAN" HAKIM VALVE SYSTEM-HAKIM PROGRAMMABLE VALVE

SHUNT SYSTEMS(WITH SIPHONGUARD)

7127

CDVPB23838CM 柯特曼霍金斯引流閥系統-霍金斯可調式引流閥(自付差額)"CODMAN"

HAKIM VALVE SYSTEM-HAKIM PROGRAMMABLE VALVE SHUNT SYSTEMS

7127

CDVPB28803CM “美的思”柯特曼史特斯引流閥-附配件及抗菌導管(自付差額)

“MEDOS” CODMAN CERTAS PROGRAMMABLE VALVE-ATTACHMENT AND

BACTISEAL CATHETER

7127

CDVPB28804CM “美的思”柯特曼史特斯引流閥-具抗虹吸裝置(自付差額) “MEDOS

” CODMAN CERTAS PROGRAMMABLE VALVE-SIPHONGUARD

7127

CDVPB28807CM “美的思”柯特曼史特斯引流閥-附配件、抗菌導管及具抗虹吸裝置

(自付差額) “MEDOS” CODMAN CERTAS PROGRAMMABLE VALVE-

ATTACHMENT、BACTISEAL CATHETER AND SIPHONGUARD

7127

CDVPB42335M4 美敦力史卓塔腦脊髓液可調式壓力閥-NSC(自付差額)"MEDTRONIC"

STRATA ADJUSTABLE VALVES-NSC

7127

CDVPB423SSM4 美敦力史卓塔腦脊髓液引流組-STRATA NSC 控制閥(自付差

額)"MEDTRONIC"STRATA SHUNTS-STRATA NSC VALVE

7127

CDVPB42836M4 美敦力史卓塔腦脊髓液可調式壓力閥(自付差額)"MEDTRONIC" STRATA

ADJUSTABLE VALVES

7127

CDVPB428SSM4 美敦力史卓塔腦脊髓液引流組-STRATA II 控制閥(自付差

額)"MEDTRONIC"STRATA SHUNTS-STRATA II VALVE

7127

CDVPB80102CM “美的思”柯特曼史特斯引流閥-附配件及導管(自付差額) “MEDOS

” CODMAN CERTAS PROGRAMMABLE VALVE-ATTACHMENT AND CATHETER

7127

710


CDVPB80506CM “美的思”柯特曼史特斯引流閥-附配件、導管及具抗虹吸裝置(自付

差額) “MEDOS” CODMAN CERTAS PROGRAMMABLE VALVE-

ATTACHMENT、CATHETER AND SIPHONGUARD

7127

CDVPBPGAV1AE 雅氏麥凱可調式腦脊髓液分流系統(自付差額)AESCULAP-MIETHKE

PROGAV ADJUSTABLE SHUNT SYSTEM

7127

CEE010090NPW EXTENSION TUBE 6.3

CEE010150CLL EXTENSION TUBE 90CM，100CM，120CM，150CM 6.3



CEE01050063B 康德萊延長管 "KDL" EXTENSION TUBES 6.3

CEE01050533B 康德萊延長管 (2路導管+無針加藥接頭)"KDL" EXTENSION TUBES(2-

WAY)

61.1

CEE01050603B 康德萊延長管(含無針加藥接頭)"KDL" EXTENSION TUBES 33.7

CEE01050613B 康德萊延長管(二路導管)"KDL" EXTENSION TUBES(2 WAY) 24.6

CEE01050623B 康德萊延長管(三路導管) "KDL" EXTENSION TUBES(3 WAY) 17.3

CEE01050633B 康德萊延長管(四路導管) "KDL" EXTENSION TUBES(4 WAY) 48.3

CEE010544A3N 根本高壓延長管-螺旋管"NEMOTO"PRESSURE TUBE300PSI 40

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 7

CEE0108300P2 IV EXTENSION TUBE 輸液延長管 45CM 6.3


CEE0108302P2 EXTENSION TUBE 90CM 6.3



CEE010E877SG EXTENSION TUBE MALE-FEMALE LUER LUCK 100CM 6.3

CEE0110655LL LILYEXTENSION TUBE 15CM"怡安"輸液延長管 6.3

CEE0110656LL LILYEXTENSION TUBE(NEEDLE FREE)"怡安"輸液延長管:免針加藥座 33.7

CEE0111215BQ 邦特導入/引流導管附件(滅菌) BIOTEQ INTRODUCER/DRAINAGE

CATHETER ACCESSORIES(STERILE)-PCN

305

CEE011VA27Q4 尼得立斯輸液套-免針式 "NEEDLELESS" I.V.ADMINISTRATION SET 33.7

CEE011VA27TZ 善德輸液套(免針式) "SUNDER"I.V. ADMINISTRATION SET 33.7

CEE012000EJ6 CAREFUSIONSMARTSITE 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

27.4

CEE0120039J6 CAREFUSIONSMARTSITE 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

33.7

CEE0125120M8 EXTENSION TUBE 25:120CM 6.3

CEE0135101TZ 善德延長管 "SUNDER" EXTENSION SETS 6.3

CEE0135T01TZ 善德延長管 (管端接T型接頭)"SUNDER" EXTENSION SETS 7

CEE0135T21Q4 尼得立斯延長管-免針式T型"NEEDLELESS" EXTENSION SETS 33.7

CEE0135T21TZ 善德延長管 -T型延長管(免針式)"SUNDER" EXTENSION SETS 33.7

CEE0135W01TZ 善德延長管 (管端接3WAY接頭)"SUNDER" EXTENSION SETS 17.3

CEE0135Y01TZ 善德延長管(Y型連接管)"SUNDER" EXTENSION SETS 24.6

CEE0135Y21Q4 尼得立斯延長管-免針式Y型"NEEDLELESS" EXTENSION SETS 33.7

CEE0135Y21TZ 善德延長管 -Y型延長管(免針式)"SUNDER" EXTENSION SETS 33.7

CEE0140474AG 亞康恩連接管 (滅菌)"ARGON" CONNECTING TUBES (STERILE)(FOR

DRAINAGE BAG CONNECTOR PCN))

305

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 7

711


CEE01AS303SG 十美牌輸液器(免針安全型)"SIGMA"INFUSION SET 33.7

CEE01B060NPW 普惠輸液套-Y管免針安全型"PERFECT" DISPOSABLE INFUSION SET-

SAFETY

33.7

CEE01B430BBQ BIOTEQANGIOGRAPHIC SYRINGE KIT(LOW PRESSURE TUBE)"邦特"攝影

導管用注射筒套組(螺旋連接管)

40

CEE01BTXDABQ BIOTEQCONTRAST 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 ICUCLAVE 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

27.4

CEE01C2000U2 ICUCLAVE NEEDLELESS CONNECTOR EXTENSION SET "愛喜優”克萊福

無針式延長管※適應症請見備註欄

38

CEE01C3300U2 ICUMICROCLAVE CONNECTOR AND ACCESSORIES DEVICES "愛西優"可來

福接頭及組件-無針式接頭

27.4

CEE01C3302U2 “愛西優”可來福接頭及組件(無針式接頭+延長管) “ICU”

MICROCLAVE CONNECTOR AND ACCESSORIES DEVICES

33.7

CEE01C3322U2 ICUMICROCLAVE CONNECTOR AND ACCESSORIES DEVICES "愛西優"可來

福接頭及組件-無針式雙接頭延長管

61.1

CEE01C4200U2 ICUCLAVE 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

61.1

CEE01C5060U2 “愛西優”可來福接頭及組件(無針式接頭+延長輸液套) “ICU”


33.7

CEE01CH100U2 ICUCLAVE DRUG PREPARATION SYSTEM:ACCESS DEVICE IV BAG CLAVE

CONNECTOR"愛喜優"克萊福藥物準備系統組件

70

CEE01CH140U2 ICUCLAVE 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

CEE01CH150U2 ICUCLAVE 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

CEE01CH225U2 ICUCLAVE DRUG PREPARATION SYSTEM"愛喜優"克萊福藥物準備系統組

件-4路輸液管含無針密閉接頭+輸液線含SPIKE*1

552



431



311

CEE01CH303U2 ICUCLAVE 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


件-輸液管含無針密閉接頭+輸液線含SPIKE*1

204

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

CEE01CT803UL 歐利奇莫迅造影劑注射器:病人輸液管(含捲型幫浦輸液

管)"ULRICH"INJECT CT MOTION CT CONTRAST AGENT INJECTOR

280

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

CEE01DMRPQUL 歐利奇田納西造影劑注射器:病人輸液管(含捲型幫浦輸液

管)"ULRICH"CT MRI INJECTOR TENNESSEE

280

CEE01E005NPW 普惠免針安全型T型輸液延長管"PERFECT"SAFETY EXTENSION TUBE

WITH T NEEDLE FREE

33.7

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)

33.7

CEE01E020NPW 普惠靜注延長管T型(免針安全型)"PERFECT"EXTENSION TUBE T

TYPE(SAFETY)

33.7

712


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)

33.7

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)

33.7

CEE01ENT10SG SIGMANEEDLELESS 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

33.7

CEE01ENY10SG SIGMANEEDLELESS 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

33.7

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

61.1

CEE01ES107SG EXTENSION TUBE 6.3

CEE01ET015SG T-CONNECTOR 7

CEE01ET067BB SAFSITE NEEDLE FREE EXTENSION SET※適應症請見備註欄 33.7

CEE01ET112LL EXTENSION TUBE 6.3

CEE01ET116BB SAFSITE NEEDLE FREE EXTENSION SET※適應症請見備註欄 33.7

CEE01ET12CLL EXTENSION TUBE 6.3

CEE01ET20ULL 怡安輸液延長管"LILY" EXTENSION TUBE 24.6

CEE01ET24ULL 怡安輸液延長管(4路)"LILY" EXTENSION TUBE 4-WAY EXTENSION

TUBE

48.3

CEE01ET33SBB SAFSITE NEEDLE FREE EXTENSION SET(二個NEEDLE FREE)※適應症請

見備註欄

61.1

CEE01ET60SLL SAFETY EXTENSION TUBE※適應症請見備註欄 19.8

CEE01ETAT1NQ 宇仁延長管-T型"INNOVATIVE"EXTENSION SET/T-CONNECTOR 7

CEE01ETB05NQ Y-CONNECTOR(Y-IV EXTENSION TUBE) 24.6

CEE01ETC01NQ IV EXTENSION SET 6.3

CEE01ETG2SLL 怡安輸液延長管(2-4路)-免針式安全型"LILY"EXTENSION TUBE 61.1

CEE01ETN10SG SIGMANEEDLELESS 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

33.7

CEE01ETN20SG SIGMANEEDLELESS 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

61.1

CEE01ETN51SG EXTENSION TUBE W/FREE SITE 無針式接頭+延長管*適應症請見備註

欄

33.7

CEE01ETNE1Q4 尼得立斯免針輸液接頭-延長管"NEEDLELESS"NEEDLELESS INJECTION

ACCESS DEVICE/EXTENSION TUBE

33.7

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

61.1

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

61.1

CEE01ETSTNLL 怡安輸液延長管(1路)-免針式安全型"LILY"EXTENSION TUBE 33.7

CEE01F020NPW 普惠靜注延長管(免針安全型) "PERFECT" EXTENSION TUBE 33.7

CEE01H001NCK CONNECTING TUBE 267

CEE01H003NCK CONNECTING TUBE WITH DRAINAGE BAG CONNECTOR PCN連接管 305

CEE01HPC03CK CONNECTING TUBE BRAIDED POLYETHYLENE 1200PSI 連接管雙層 267

CEE01LP160MH LOW PRESSURE COUNECTOR TUBE 300PSI(螺旋連接管) 40

CEE01LRX50TP EXTENSION TUBE 50CM W/3 WAY STOPCOCK 17.3

CEE01N8000SG SIGMANEEDLELESS INJECTION ACCESS DEVICE "十美牌"免針輸液接頭

※適應症請見備註欄

27.4

CEE01NE810Q4 尼得立斯免針輸液接頭-無針式接頭"NEEDLELESS"NEEDLELESS

INJECTION ACCESS DEVICE

27.4

CEE01NFA012U 佳承輸液點滴套-無針式接頭"CHIA CHERNE"I.V.ADMINISTRATION

SET/NEEDLELESS FEMALE ADAPTOR

27.4

713


CEE01NFEYSLL 怡安點滴輸液套(附免針式安全型加藥座)"LILY"INFUSION

SET+NEEDLE FREE

33.7

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

CEE01NFS10M6 宇仁免針型輸液加藥器-免針輸液延長管 "IMM" NEEDLE FREE SET 33.7

CEE01NFS20M6 宇仁免針型輸液加藥器-Y型免針輸液延長管 "IMM" NEEDLE FREE SET 33.7

CEE01NFSHYM6 宇仁免針型輸液加藥器-雙管路延長管"IMM" NEEDLE FREE SET 61.1

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

33.7

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

33.7

CEE01P8100SG SIGMANEEDLELESS || INJECTION ACCESS DEVICE "十美牌"免針||型

輸液接頭 ※適應症請見備註欄

27.4

CEE01PET10SG SIGMANEEDLELESS || 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

33.7

CEE01PET20SG SIGMANEEDLELESS || 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

61.1

CEE01PEY10SG SIGMANEEDLELESS 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

33.7

CEE01PTT10SG SIGMANEEDLELESS 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

33.7

CEE01Q5100BD Q-SYTE LUER ACCESS SITE(無針式接頭)※適應症請見備註欄 38

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

38

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

33.7

CEE01R1000BB SAFSITE VALVES AND ACCESSORIES※適應症請見備註欄 27.4

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

CEE01T1100U2 ICUNON-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

38

CEE01TC15NLL T-SITE CONNECTOR 7

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

33.7

CEE01VED02Q4 尼得立斯輸液套(免針加藥型)"NEEDLELESS" INFUSION SET 33.7

CEE01VP003LL EXTENSION TUBE W/3 WAY 17.3

CEP010544B3N 根本高壓延長管-直型管"NEMOTO"PRESSURE TUBE300PSI 25.3

714


CEP0108314P2 PRESSURE MONITOR LINES 24"-48" 25.3

CEP0108317P2 PRESSURE MONITOR LINES 60"-72" 25.3

CEP010A01NPW EXTENSION TUBE 800PSI高壓延長管 32.7

CEP0111507BB 1200PSI ANGIODYN HIGH PRESSURE TUBINGS PUR(雙層) 267

CEP011200PTP ANGIOGRAPHIC TUBE 1200PSI 雙層血管造影劑注入延長管 267

CEP012100DCD EXTENSION CATHETER 45CM，65CM，100CM (88/8/1改按條給付) 267

CEP0190701SB PRESSUREE MONITORING LINE 6":96" 25.3

CEP0190702NL PRESSURE MONITORING LINE 6":96" 25.3

CEP0191031NL CONTRAST INJECTION LINES (1200PSI雙層)顯影劑注射導線 267

CEP01A813ABQ 1200PSI HIGH PRESSURE CONNECTING TUBE (雙層) 267

CEP01AL1505P PEROUSEALGAFLEX CONNECTION LINES 1200PSI(HIGH PRESSURE

LINE)"普魯斯"艾加非司壓力連接管

267

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

32.7

CEP01B330BBQ PRESSURE CONNECTING TUBE 500PSI 25.3

CEP01ETP01M6 PRESSURE TUBE 500PSI 25.3

CEP01ETP19M6 PRESSURE TUBE 800-1000PSI 32.7

CEP01HP20EMR HIGH PRESSURE TUBING 20" 1200PSI(雙層) 267



CEP01HP50EMR HIGH PRESSURE TUBING 500PSI(雙層) 230

CEP01PT006AG ARGONDISPOSABLE PRESSURE MONITOR:PRESSURE TUBING"愛琅"血壓監

視組合套:壓力連接管

25.3

CEP01PT012BD ARTERIAL PRESSURE TUBING 25.3


CEP01PT048AG ARGONDISPOSABLE PRESSURE MONITOR:PRESSURE TUBING"愛琅"血壓監

視組合套:壓力連接管

25.3


CEP01PT483GJ JSMPRESSURE TUBING "吉生"壓力連接管(500PSI PVC 每包3條) 79.2

CEP01PT500GJ PRESSURE TUBING 壓力連接管(500PSI PVC) 25.3

CEP01PT500H9 PRESSURE TUBING 500PSI 壓力連接管 25.3

CEP01PT500SG ARTERIAL PRESSURE TUBING 500PSI 6":72" 25.3

CEP01PT501GJ JSMPRESSURE TUBING "吉生"壓力連接管(500PSI/PVC) 25.3

CEP01PTH12SG ARTERIAL PRESSURE TUBING 1200PSI 6":72" 32.7

CEP01PTHP1GJ JSMPRESSURE TUBING：HIGH PRESSURE TUBING"吉生" 壓力連接管

(1200PSI PU 雙層)

267

CEP01PTHPTGJ PRESSURE TUBING：HIGH PRESSURE TUBING 壓力連接管(1200PSI PU

雙層)

267

CEP01PTHPTH9 PRESSURE TUBING 1200PSI 壓力連接管(雙層) 267

CEP01PTPV1GJ JSMPRESSURE TUBING：HIGH PRESSURE TUBING 壓力連接管

(1000PSI/PVC)

32.7

CEP01PTPVCGJ PRESSURE TUBING：HIGH PRESSURE TUBING 壓力連接管(1000PSI

PVC)

32.7

CET0105180BB T-CONNECTOR 15CM 7

CET01B024NPW EXTENSION TUBE 6.3

CET01B032NPW EXTENSION TUBE W/T 7

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 CORPAKCORFLO 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

715


CFD01BSTPUEE ENTERAL FEEDING TUBE 8，10，12，14，16FGX125CM*適應症請見備

註欄

125

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

CFD0280845SH KANGAROO ENTERNAL FEEDING TUBE 8，10，12FR 附導線 ※適應症請

見備註欄

450

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 COOKNASAL 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

CFD05BPU08EE PU STOMACH CATHETER 聚胺酯胃管 ※適應症請見備註欄 115

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 BARDDUAL 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 BARDPONSKY 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

CFD0601006BA BARDPONSKY 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

CFD0601224TP TOP NEOFEED GASTROSTOMY TUBE(SILICONE BALLOON TYPE)"特浦"營

養供給用胃造？管※適應症請見備註欄

1541

CFD060640NK4 KIMBERLY-CLARKPEG

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

CFD060644NK4 KIMBERLY-CLARKPEG 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

CFD06108213U 優勢益經皮內視鏡胃造口術系統"U.S.E." FEEDING PEG KITS 3634

716


CFD0612LVNK4 KIMBERLY-CLARKGASTROSTOMY 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

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 COOKGASTROSTOMY 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※


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)※


4610

CFD06PEGJ1CK COOKGASTROSTOMY 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 COOKWILLS-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

CFE02MBL01CK COOK4，6，10 SHOOTER SAEED MULTI-BAND LIGATOR "曲克"多發型結

紮器※給付規定請見備註欄

3800

CFE02MBL02CK COOKSAEED MULTI-BAND LIGATOR(NON-STERILE)4 3800

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

3800

717


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)

3027

CGAP1AP313GJ 吉生心導管包"JSM"ANGIO PACK-基本包(含N+導引鞘組+GW/合金

0.035"260/300CM+壓力連接管500PSI*2+壓力連接管1200PSI雙層)

2453

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


2418

CGAP1AP515GJ 吉生心導管包"JSM"ANGIO PACK-基本包(含N+導引鞘組+GW/合金

0.035"120~180CM+壓力連接管500PSI*2+壓力連接管1200PSI雙層)

1901

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)

1449

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


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)

1342

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


3236

CGAP1HY100H9 HYM ANGIO PACK 心導管包(GWX1+SHEATHX1+ARTERIAL

NEEDLEX1+MANIFOLDX2+PRESSURE TUBINGX4+HIGHT PRESSURE

TUBINGX1)

2359

CGAP1HY211H9 HYM ANGIO PACK "華億"心導管包(ARTERIAL

NEEDLEX1+MANIFOLDX1+PRESSURE TUBINGX2+HIGH PRESSURE

TUBINGX1)

860

CGBK1AFGV4LY 奧林柏斯單次用取石網"OLYMPUS"SINGLE USE GRASPING FORCEPS 12365

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

CGBK1FSLX1CK COOKEXTRACTION BASKETS"曲克"取石網 12365

CGBK1MB501CK COOKEXTRACTION BASKETS"曲克"取石網 12365

CGBK1MLE26FG 福萊克斯碎石器-取石網"ENDO-FLEX"MECHANICAL LITHOTRIPTORS-

BASKET

12365

CGBK1MSB01CK COOKEXTRACTION BASKETS"曲克"取石網 12365

CGBK1TRWRBSB BOSTON SCIENTIFICTRAPEZOID RX WIREGUIDED RETRIEVAL BASKET"波

士頓科技"快速交換取石籃

12365

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

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

718


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

CGDW104435AR ARROWSPRING GUIDE WIRE 0.035" 60CM"亞諾”導引線 140

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

CGDW111011AG 亞康恩握科導引線"ARGON"WORKER GUIDEWIRES-STANDARD STAINLESS

PTFE 0.035" 80CM

277

CGDW111011PB WORKER GUIDE WIRE〈100CM STRAIGHT 277


PTFE 0.035~0.038" 150~180CM

313

CGDW111012PB WORKER GUIDE WIRE 100-200CM STRAIGHT(型號114035120，

113935150，112035150自92/7/1生效)

313


PTFE 0.035" 260~400CM

437

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

CGDW111401AG 亞康恩握科導引線"ARGON"WORKER GUIDEWIRES-AMPLATZ STAINLESS

PTFE 0.035" 80~90CM

779


PTFE 0.035" 150~180CM

779


PTFE 0.035" 260CM

923

CGDW111420PB AMPLATZ GUIDE WIRE EXTRA STIFF 0.035" 150CM 779

CGDW1145FSBA BARDUROLOGICAL 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

719


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

CGDW135454AG SPRING GUIDE WIRE 0.018"，0.021"，0.025" 40，50CM FIXED CORE

，3MMJ

140


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




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



CGDW135968AG SPRING GUIDE WIRE 0.028"，0.032"，0.035" 40，50CM FIXED CORE

，3MMJ

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


0.018:0.032，100-150CM

313

CGDW149201LR STARTER GUIDEWIRE 0.025":0.035" 40CM，80CM 277


0.025:0.035，40，80CM

277


0.035:0.038，100-180CM

313

CGDW149213LR STARTER GUIDEWIRE 0.035";0.038" 260CM 437

720


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


0.035，0.038 100-180CM

313


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

CGDW15FS38BA BARDUROLOGICAL 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 COOKURETERAL WIRE GUIDES "曲克"輸尿管導線145CM 0.035;0.038 313

CGDW172600PB NITINOL GUIDE WIRE 0.018" 80CM 653

CGDW17900JVQ VOLCANOPRIMEWIRE PRESSURE GUIDE WIRE"火山"壓力偵測導線※給付


20000

CGDW18185JVQ VOLCANOPRIMEWIRE 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


220~500CM

437


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

CGDW1A8263TM 泰爾茂導引導線"TERUMO"RADIFOCUS GUIDE WIRE M STIFF/HALF-

STIFF 0.018":0.038" 220:260CM

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 COOKAMPLATZ 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


0.025~0.038" 145~175CM PTFE

313


0.035~0.038" 260CM PTFE EXTRA SUPPORT

923


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

721


CGDW1B1340BQ 邦特血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE 0.018~0.045"

40~100CM

277


120~200CM

313


220~500CM

437

CGDW1B3422BQ 邦特血管內引導鋼線"BIOTEQ"GUIDEWIRE HYDROPHILIC 0.016~0.018"

220~300CM

1359


40~100CM

653


120~200CM

751


120~200CM

751

CGDW1B5250BQ 邦特血管內引導鋼線"BIOTEQ"GUIDEWIRE PTFE AMPLATZ

0.025~0.035" 90CM

779


0.025~0.035" 145~180CM

779


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


120~200CM

751


220~450CM

1359


220~300CM

1359

CGDW1C6121BQ BIOTEQDRAINAGE 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 CORDISGUIDE WIRE "考迪斯"引導線 PTFE 125;150;175;180CM 313

CGDW1EMER2CD CORDISGUIDE 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

CGDW1G005NCK 曲克導線"COOK" GUIDE WIRE (TIP DEFLECTING WIRE

GUIDES)0.025~0.045" 65:100CM

822

CGDW1G006NCK GUIDE WIRE CURVED 50:145CM(100，125，145CM) 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

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

722


CGDW1G012ACK 曲克導線"COOK"GUIDE WIRE 0.018~0.052" 180CM 313

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

CGDW1G018NCK GUIDE WIRE LUNDERQUIST EXCHANGE 120CM 787

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

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


1600

CGDW1GW004G6 銨積維導引導管"AGA" AMPLATZER GUIDEWIRE (VSD OCCLUDER 用) 1600

CGDW1H1258GJ JSMGUIDE WIRE (HYDROPHILIC PVP PRE-COATED)

0.018"~0.038"120;150;180CM "吉生"導引線

751

CGDW1H2630GJ JSMGUIDE 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

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


HYDROPHILIC WIRE GUIDE(STIFF SHAFT) 0.025"~0.038"

150CM;180CM

779


HYDROPHILIC WIRE GUIDE 0.018"~0.038" 260CM

1359

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


CGDW1N458NST GUIDERIGHT GUIDEWIRE SUPER STIFF FIXED CODE 0.032"，0.038"

180CM

779

723


CGDW1N4610ST 聖猷達蓋瑞特導引線"ST.JUDE"GUIDERIGHT GUIDEWIRE 150CM 180CM 313







CGDW1PA183TM 泰爾茂導引導線"TERUMO"RADIFOCUS GUIDE WIRE M STIFF/HALF-

STIFF 0.020":0.038" 80:180CM

779

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

CGDW1PTGW2GJ STAINLESS STEEL GUIDE WIRE0.018"~0.038" 120CM;150CM;180CM

W/PTFE

313

CGDW1PTGW3GJ STAINLESS STEEL GUIDE WIRE0.018"~0.038" 260CM;300CM W/PTFE 437

CGDW1PWC28ST SJMPRESSUREWIRE(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

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

724


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

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

CGDW1VERRAVQ VOLCANOVERRATA PRESSURE GUIDE WIRE"火山"薇娜塔壓力偵測導線

(含0.014"導引線+壓力轉換器+扭力裝置+連結裝置)

20000

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

CGPG101827AS 朝日瑪仕特微導管系列ASAHI MASTERS PARKWAY MICROCATHETER 8604

CGPG110264SB MACH 1 PERIPHERAL GUIDING CATHETER 6:8F 55，90CM 1513

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

8604

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

8604

CGPG126046SB 波士頓科技盧碧肯支撐導管"BOSTON SCIENTIFIC"RUBICON SUPPORT

CATHETERS

8604

CGPG12X400BB 柏朗導引導管B.BRAUN SERPIA HYDROPHILIC GUIDING CATHETER 1513

CGPG134356SB 波士頓科技馬克導引導管"BOSTON SCIENTIFIC"MACH 1 GUIDE

CATHETER 6:8FR

1513

CGPG151038ZF 史特勞斯區克斯導管"SPECTRANETICS"QUICK-CROSS SUPPORT2

CATHETERS

8604

CGPG15565FCD VISTABRITETIP GUIDING CATHETERS 5F 0.056(ALL CURVE STYLE)＊

自92.7.1改按條支付

1513

CGPG156FXBCM 柯特曼導引導管"CODMAN"ENVOY GUIDING CATHETER 1513

725


CGPG1574XNCD VISTABRITETIP GUIDING CATHETER 7FR 0.074"，0.078"※自92.7.1

改按條支付

1513

CGPG1586XNCD CORDISVISTABRITETIP GUIDING CATHETER 8FR 0.086"，0.088""考迪

斯"導引導管※自92.7.1改按條支付

1513

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)

1513

CGPG15888FCD PERIPHERAL GUIDING CATHETER 8FR 0.088※自92.7.1改按條支付 1513

CGPG15989FCD PERIPHERAL GUIDING CATHETER 9FR 0.098※自92.7.1改按條支付 1513

CGPG16676FCD VISTABRITEIP GUIDING CATHETER 6FR 0.67(ALL CURVE STYLE)※自

92.7.1改按條支付

1513

CGPG16706FCD CORDISVISTABRITETIP GUIDING CATHETERS 6FR .070"考迪斯"導引導

管※(自92/7/1改按條支付)

1513

CGPG1672ADCD 考迪斯安卓特導引導管"CORDIS"ADROIT GUIDING CATHETERS 6FR 1513

CGPG17787FCD VISTABRITETIP GUIDING CATHETERS 7F 0.078(ALL CURVE STYLE)＊

自92.7.1改按條支付

1513

CGPG17787FCM 柯特曼導引導管"CODMAN"ENVOY GUIDING CATHETER 7FR 1513

CGPG1CGC58MR MERIT CONCIERGE GUIDING CATHETER(5~8F)"美瑞特"康捷導引導管 1513

CGPG1CNCRGMR MERIT CONCIERGE GUIDING CATHETER(5~8F)"美瑞特"康捷導引導管 1513

CGPG1CNVEYSB 波士頓科技康必導引導管"BOSTON SCIENTIFIC"CONVEY GUIDING

CATHETER 5:8FR

1513

CGPG1CX101CK COOKCXI SUPPORT CATHETER(含4個不透線標記)"曲克"西斯艾支持導

管

8604

CGPG1CX103CK COOKCXI SUPPORT CATHETER"曲克"西斯艾支持導管 8604

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

8604

CGPG1GCF60TM HEARTRAIL PTCA GUIDING CATHETER 5:8FR 100CM 哈得睿兒導引導管 1513

CGPG1GCF70TM HEARTRAIL PTCA GUIDING CATHETER 5:8FR 100CM 哈得睿兒導引導管 1513

CGPG1GCF90TM TERUMOHEARTRAIL II PTCA GUIDING CATHETER"泰爾茂"哈得睿兒導引

導管第二代

1513

CGPG1GCH60TM 泰爾茂哈得睿兒導引導管"TERUMO"HEARTRAIL PTCA GUIDING

CATHETER STANDARD TYPE 5:8FR

1513

CGPG1JLJRAAS ASAHI ZENYTEEX PTCA GUIDING CATHETER "朝日"辛尼堤經皮冠狀動

脈成型術導引導管

1513

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 1513




CGPG1LA702M4 LAUNCHER GUIDE CATHETER 7FR 1513


CGPG1LA802M4 LAUNCHER GUIDE CATHETER 8FR 1513

CGPG1MSC57VS MINNIE SUPPORT CATHETER(含3個探頭) 8604

726


CGPG1PBSMPAS ASAHI ZENYTEEX PTCA GUIDING CATHETER "朝日"辛尼堤經皮冠狀動

脈成型術導引導管

1513

CGPG1SC014Y7 伊維三崔爾巴特支持導管"EV3"TRAILBLAZER SUPPORT CATHETER 8604

CGPG1SCBR1CK SLIP-CATH GUIDING CATHETERS 4.0FR 40:150CM 1513

CGPG1SCBR2CK SLIP-CATH GUIDING CATHETERS 4.5:6.5FR 75:135CM 1513



CGPG1SELE2M4 美敦力艾坦賽勒傳送導管系統"MEDTRONIC"ATTAIN SELECT II

DELIVERY CATHETER SYSTEM

1513

CGPG1SHA01M4 SHERPA NX ACTIVE GUIDE CATHETERS 5:6F 1513

CGPG1SHA02M4 SHERPA NX ACTIVE GUIDE CATHETERS 5:6F 1513

CGPG1SHA03M4 MEDTRONICSHERPA NX ACTIVE GUIDE CATHETERS 5:6F"美敦力"雪爾帕

導引導管

1513

CGPG1SHB01M4 SHERPA NX BALANCED GUIDE CATHETERS 6:8F 1513

CGPG1SHB02M4 SHERPA NX BALANCED GUIDE CATHETERS 6:8F 1513

CGPG1SHB03M4 MEDTRONICSHERPA NX BALANCED GUIDE CATHETERS 6:8F"美敦力"雪

爾帕導引導管

1513

CGPG1STD74AS 朝日斯卓德微導管"ASAHI"STRIDE MICROCATHETER 2.2FR 8604

CGPG1TAHSTM4 美敦力通透可疏疏通導管"MEDTRONIC" TOTAL ACROSS CROSSING

CATHETER

8604

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

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

CGPG338942SB BOSTON SCIENTIFICATLANTIS 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 VOLCANOEAGLE 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 VOLCANOEAGLE 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 VOLCANOREVOLUTION 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

CGPG3CA6453L 萊特萊柏飛龍歐普特斯影像導管"LIGHTLAB"DRAGONFLY OPTIS IMAGE

CATHETER

26009

CGPG3CA8643L 萊特萊柏飛龍德爾影像導管〝LIGHTLAB〞DRAGONFLY DUO IMAGE

CATHETER

26009

CGPG3PTCRSSB BOSTON SCIENTIFICOPTICROSS 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

CGPW10462HAB HI-TORQUE BALANCE HEAVY WEIGHT GUIDE WIRE PTFE SUPPORT

0.014" 190CM

2817

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

727


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

CGPW1165CMAS 朝日冠狀動脈延長導引線"ASAHI"EXTENSION WIRE PTFE 0.014"

150;165CM

2353

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


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 EXTRA 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

CGPW13309NAB HI-TORQUE CROSS-IT PTCA GUIDE WIRE 0.014" 190CM 2353

CGPW13310NAB HI-TORQUE CROSS-IT PTCA GUIDE WIRE 0.014" 300CM 2587

CGPW138931SB PT2 GUIDEWIRE HYDROPHILIC COATING 0.014" 185CM 2353

CGPW138932SB PT2 GUIDEWIRE HYDROPHILIC COATING 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 TERUMORUNTHROUGH 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

CGPW144588AB HI-TORQUE ADVANCE GUIDE WIRE 190CM 0.014" 2353

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

728


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

CGPW180233XZ 斯特勞布導引線"STRAUB"GUIDE WIRE 0.018~0.025" 220~320CM 2800


CGPW196646AB AbbottHI-TORQUE BALANCE MIDDLEWEIGHT UNIVERSAL II GUIDE WIRE

W/HYDROCOAT HYDROPHILIC COATING 0.014" 190CM

2353

CGPW196657AB AbbottHI-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

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 ASAHIPTCA GUIDE WIRE EXTRA SUPPORT PTFE 0.014" 180CM "朝日"

冠狀動脈導引線

2817

CGPW1AGH47AS 朝日冠狀動脈導引線"ASAHI"PTCA GUIDE WIRE PTFE 0.014"

150:180CM

2353

CGPW1AGM46AS ASAHIPTCA GUIDE WIRE EXTRA SUPPORT PTFE 0.014" 180CM "朝日"

冠狀動脈導引線

2817

CGPW1AGM47AS ASAHIPTCA 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

CGPW1AGPFCAS PTCA GUIDE WIRE HYDROPHILIC COATING EXTRA SUPPORT 0.014"

175CM 180CM

2817

CGPW1AHWR3AS ASAHIPTCA GUIDE WIRE ASAHI SION 0.014" 300CM(PTFE COATING

EXTRA SUPPORT)"朝日"冠狀動脈導引線紫苑

2587

CGPW1AHWRSAS ASAHIPTCA GUIDE WIRE ASAHI SION 0.014" 180CM (PTFE COATING

EXTRA SUPPORT)"朝日"冠狀動脈導引線紫苑

2817

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

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 ABBOTTHI-TORQUE BALANCE MIDDLEWEIGHT ELITE GUIDE WIRE

HYDROPHILIC COATING 0.014" 300CM "亞培"高鐸格寶馬精英導線

2587

CGPW1BMWE9AB ABBOTTHI-TORQUE BALANCE MIDDLEWEIGHT ELITE GUIDE WIRE

HYDROPHILIC COATING 0.014" 190CM "亞培"高鐸格寶馬精英導線

2353

729


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

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

CGPW1JET19AB 亞培高鐸格捷特導線"ABBOTT"HI-TORQUE JET GUIDE WIRE 190CM 2817

CGPW1JET30AB 亞培高鐸格捷特導線"ABBOTT"HI-TORQUE JET GUIDE WIRE 250;300CM 2870

CGPW1JUN18SB BOSTON SCIENTIFICJOURNEY GUIDEWIRE(W/HYDROCOAT 0.014"

185CM)"波士頓科技"哲尼導引線

2817

CGPW1JUN30SB BOSTON SCIENTIFICJOURNEY 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 0.018~0.038" 220;260CM

2800

CGPW1LWS35MR 美瑞特桂冠親水性導引導線"MERIT"LAUREATE HYDROPHILIC GUIDE

WIRE 0.018~0.038" 120:180CM

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

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

730


CGPW1PTGW3AB ABBOTTHI-TORQUE POWERTURN GUIDE WIRE HYDROPHILIC COATING

0.014" 300CM "亞培"高鐸格寶特導線

2587

CGPW1PTGW9AB ABBOTTHI-TORQUE POWERTURN GUIDE WIRE HYDROPHILIC COATING

0.014" 190CM "亞培"高鐸格寶特導線

2353

CGPW1PV1A1M4 MEDTRONICPROVIA/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


PRO/PEL 300CM 0.014" "美敦力"波維亞/英特迅導引導線

2587


PRO/PEL EXTRA SUPPORT 180CM 0.014" "美敦力"波維亞/英特迅導引

導線

2817

CGPW1PV1A4M4 MEDTRONICPROVIA/INTUITION GUIDE WIRES W/COATING HYDRO-TRACK

，PRO/PEL EXTRA SUPPORT 300CM 0.014" "美敦力"波維亞/英特迅導

引導線

2870

CGPW1RSTF0CK 曲克羅瑞爾加強支撐導線"COOK" ROADRUNNER EXTRA-SUPPORT WIRE

GUIDES 180，270，300CM

2817

CGPW1SK1P1F2 INVATECSKIPPER DEEP GUIDE WIRE W/COATING 0.014"250CM;300CM"

英泰克"賽艇帝普導引導絲

2587

CGPW1SK1P2F2 INVATECSKIPPER 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

CGPW1VER19AB 亞培高鐸格維特導線"ABBOTT"HI-TORQUE VERSATURN GUIDE WIRE

0.014" 190CM

2353

CGPW1VER30AB 亞培高鐸格維特導線"ABBOTT"HI-TORQUE VERSATURN GUIDE WIRE

0.014" 300CM

2587

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

CGPW1W1GG3AB ABBOTTHI-TORQUE WIGGLE GUIDE WIRE HYDROPHILIC COATING 0.014"

300CM "亞培"高鐸格偉格導線

2587

CGPW1W1GG9AB ABBOTTHI-TORQUE WIGGLE GUIDE WIRE HYDROPHILIC COATING 0.014"

190CM "亞培"高鐸格偉格導線

2353

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

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

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

731


CGS0100011VE PERCUTANEOUS CATHETER INTRODUCERS W/DILATOR，GUIDEWIRE 11CM

5:9FR

537

CGS0100023VE 艾必依經皮下導引套"AVE"PERCUTANEOUS CATHETER INTRODUCERS

23CM(6F:9F)，WITH DILATOR

887

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)

804

CGS010601NBA BARDPTFE PEEL-APART PERCUTANEOUS INTRODUCER KITS"巴德"剝撕式

經皮導引套組

785

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)

537


8.5CM 4:7FR

0.021:0.025"(W/SHEATH+DILATOR+VALVE+G.W+SIDEPORT)

537

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)

537

CGS010658NBA BARDPTFE PEEL-APART PERCUTANEOUS INTRODUCER

KITS"(MICROINTRODUCER)巴德"剝撕式經皮導引套組

785


23CM 5:8FR 0.038"(W/S+D+G.W+SI+V+N)

1067


12CM

715


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)

953

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)

953

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)

953

CGS0107830ST 聖猷達雅帝明導管導引器"SJM"ULTIMUM INTRODUCER SET

(S+H+V+G+SIDEPORT)

537

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)

537

CGS0107840ST 聖猷達雅帝明導管導引器"SJM"ULTIMUM INTRODUCER

SETW/HEMOSTASIS VALVE 12CM (S+H+V+G+SIDEPORT)

537

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)

953

CGS0108403AR ARROWPERCUTANEOUS SHEATH INTRODUCER SYSTEM 4FR X 7.5CM（

S+D+GW+SV+3WAY+N)“亞諾”經皮導引鞘組

784

CGS0108503AR ARROWPERCUTANEOUS 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

537

CGS0108530VE MULLINS TRANSSEPTAL INTRODUCER SET PRDIATRIC 44CM 6:8FR 1400

CGS0108550VE MULLINS TRANSSEPTAL INTRODUCER SET AUDLT 59CM 6:8FR 1400

732


CGS0109600AR PERCUTANEOUS INTRODUCER SYSTEM KIT 6FR 11CM 875

CGS0109800AR 亞諾經皮導引鞘組"ARROW"PERCUTANEOUS SHEATH INTRODUCER

PRODUCT(S+D+G+N) 8.5FR 10CM

715

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 艾必依經皮下導引套"AVE"PERCUTANEOUS CATHETER INTRODUCERS

7:11CM(5F:11F)，WITH DILATOR，GUIDE WIRE

537

CGS0111A00BQ 邦特導引鞘"BIOTEQ" SHEATH INTRODUCER KIT 5:14CM 4:9FR

WITHOUT GUIDEWIRE

456


(S+D+GW+V+SIDEPORT+3WAY)

537


(S+D+GW+V+SIDEPORT+3WAY+N+SYRINGE)

784


(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


(S+D+V+GW+SIDEPORT+3WAY)

953


(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

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)

1625

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

785

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

785

CGS0121322ST FAST-CATH HEMOSTASIS INTRODUCER 費思凱絲止血導管導引器 537


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 785

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

6377

CGS0140009AG P.T.C.A LONG SHEATH 23CM 887

CGS01402ANCD AVANTI PLUS SHEATH INTRODUCER 11CM(4:11FR WITHOUT GUIDEWIRE) 456

CGS01402RNCD AVANTI PLUS SHEATH INTRODUCER 5CM(4:8FR WITHOUT GUIDEWIRE) 456

CGS014065NST 聖猷達麥克斯導管導引器"SJM" MAXIMUM HEMOSTASIS INTRODUCER 834

733


CGS0140764ST ULTIMUM INTRODUCER WITH HEMOSTASIS VALVE) SHEATH; DILATOR；

HEMOSTASIS VALVE；GUIDEWIRE; SIDEPORT ( 3WAY) 12CM 0.035"

537

CGS0140765ST ULTIMUM INTRODUCER WITH HEMOSTASIS VALVE) SHEATH; DILATOR；


953

CGS014076NST ULTIMUM INTRODUCER WITH HEMOSTASIS VALVE) SHEATH; DILATOR；


537

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)

785

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)

785


45；55CM(DILATOR+SIDEARM+VALVE+3WAY+RADIOPAQUE BRITETIP)

1400

CGS0146005AG SHEATH INTRODUCER 5:9FR 537

CGS0146064AG PEDIATRIC INTRODUCER KIT(SHEATH+DILATOR+GUIDE WIRE) 537

CGS0146070AG SHEATH INTRODUCER 537

CGS0146131AG ONE PIECE TUOHY-BORST INTRODUCER 5:9FR(INTRODUCER+GUIDE

WIRE+DILATOR)

537

CGS0146132AG INTRODUCER KIT 537

CGS0146133AG SHEATH INTRODUCER 7FR 537

CGS0146134AG SHEATH INTRODUCER 8FR 537

CGS0146151AG INTRODUCER KIT(SHEATH，DILATOR，SIDE PORT，3 WAY，GUIDE

WIRE)

537

CGS0150461CD AVANTI PLUS CATHETER SHEATH INTRODUCER TRANSRADIAL KIT 11CM 834

CGS0150462CD AVANTI PLUS CATHETER SHEATH INTRODUCER TRANSRADIAL KIT 23CM 1235

CGS01504PNCD AVANTI PLUS SHEATH INTRODUCER 5CM(4:8FR WITH GUIDEWIRE，

DILATOR)

537

CGS01504TNCD AVANTI PLUS SHEATH INTRODUCER 23CM(4:11FR WITHOUT GUIDEWIRE) 887

CGS01504XNCD AVANTI PLUS SHEATH INTRODUCER 11CM(4:11FR WITH GUIDEWIRE，

DILATOR)

537

CGS0150562CD 考迪斯雷帝索經橈骨皮膜鞘導引器"CORDIS" RADIALSOURCE

TRANSRADIAL ACCESS KIT 4~6FR 20CM

1323

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

876

CGS0158F38MR 美瑞特動脈導引鞘"MERIT"PRELUDE SHEATH INTRODUCER 537

CGS016014NDV HICKMAN INTRODUCER 785

CGS016031NBA INTRO-EZE PERCUTANEOUS INTRODUCER KIT 5:15FR

10:16CM(SH+DI+GW+SY+N)

785

CGS016207DM4 DUAL CHAMBER PERCUTANEOUS LEAD INTRODUCER

60CM(2SH+2D+2GW+N+SY)

1104

CGS016207NM4 PERCUTANEOUS LEAD INTRODUCER 60CM(SH+D+GW+N+SY) 785

CGS016207SM4 PERCUTANEOUS LEAD INTRODUCER 60CM(SH+D+GW+N+SY) 785

CGS0162BTKM4 PERCUTANEOUS LEAD INTRODUCER 60CM(SH+D+GW+N+SY) 785

CGS0162MPRM4 美敦力艾坦確保閥左心傳送系統(不含導引線)"MEDTRONIC" ATTAIN

COMMAND+SUREVALVE LEFT-HEART DELIVERY SYSTEM

6217

CGS0167090GQ 葛貝可可剝式導入管工具組"GREATBATCH" PTFE PEELABLE

INTRODUCER KIT(S+D+SY+N+G.W)

785

734



90CM(DILATOR+SIDEARM+VALVE+3WAY+RADIOPAQUE BRITETIP)

2726

CGS0190703M0 MEDCOMPCENTRAL 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）

785

CGS0193001GQ 葛貝可帶閥撕裂式導引器"GREATBATCH" OPTISEAL VALVED PTFE

PEELABLE INTRODUCER (S+D+SY+N+G.W)

785

CGS01A1MDSST SJM CPS AIM SL SLITTABLE INNER CATHETER（CATHETER+SIDE

PORT+TOOL)"聖猷達"縱裂式內導管

1575

CGS01A1MWSST SJM CPS AIM SL SLITTABLE INNER CATHETER（CATHETER+TOOL)"聖猷

達"縱裂式內導管

1575

CGS01A40GNTM 泰爾茂攝影引導套"TERUMO"RADIOFOCUS INTRODUCER II 16CM 4:6FR

WITH 0.025" GUIDE WIRE

1235

CGS01A40K1TM RADIFOCUS INTRODUCER II 4FR 10CM(W/SHEATH，DILATOR，

GUIDEWIRE，NEEDLE)

834

CGS01A40K2TM RADIFOCUS INTRODUCER II 4:11FR 25CM(W/SHEATH，DILATOR，

GUIDEWIRE，NEEDLE)

1235

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

CGS01ACUPRSB 波士頓科技艾裘帝導引導管"BOSTON SCIENTIFIC"ACUITY PRO GUIDE

CATHETER(CATHETER+CUTTER+GW INTRODUCER+TORQUE DEVICE+TVI工具

*2+DILATOR)

6528

CGS01AL191TM 泰爾茂攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-11FR，

16;25CM

1235

CGS01APASDKH 奧斯卡導管導引器"OSCOR"ADELANTE PEEL AWAY INTRODUCER

SET(SHEATH+DILATOR)

785

CGS01APK1TKH 奧斯卡導管導引器"OSCOR"ADELANTE PEEL AWAY INTRODUCER

SET(SHEATH+DILATOR+GW+NEEDLE+SYRINGE)

785

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)

834

CGS01AS073TM 泰爾茂血管攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-11FR

7CM，10CM

834

CGS01AS091TM 泰爾茂攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-11FR，5-

10CM

834

CGS01ATT62M4 美敦力艾坦確保閥左心傳送系統"MEDTRONIC" ATTAIN

COMMAND+SUREVALVE LEFT-HEART DELIVERY SYSTEM

6528

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

6377

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

6377

CGS01AVK11TM TERUMORADIFOCUS INTRODUCER II(4-7FR 30-70MM)"泰爾茂"血管攝影

引導套(鞘+擴張器+導線+針筒+導入針、SIDEARM、W/VALVE)

834

CGS01AVK12TM TERUMORADIFOCUS INTRODUCER II(4-11FR 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)

834

CGS01AVK13TM TERUMORADIFOCUS INTRODUCER II(4-9FR 70-100MM)"泰爾茂"血管攝

影引導套(鞘+擴張器+導線+針筒+導入針、SIDEARM、W/VALVE)

834

CGS01AVK14TM TERUMORADIFOCUS INTRODUCER II(4-11FR 70-100MM)"泰爾茂"血管攝

影引導套(鞘+擴張器+導線+針筒+導入針、SIDEARM、W/VALVE)

834

735


CGS01AVK21TM TERUMORADIFOCUS 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)

1235

CGS01AVK22TM TERUMORADIFOCUS 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)

1235

CGS01B11MQTM RADIFOCUS INTRODUCER II 11FR 0.035"(GW+SH+SD)不含NEEDLE 804

CGS01B40G7TM RADIFOCUS INTRODUCER II 7CM 4:5FR 834

CGS01B50N1TM RADIFOCUS INTRODUCER II AND WIRE 10CM 5:11FR 834

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

804

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

1235

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

804

CGS01BS092TM 泰爾茂攝影引導管"TERUMO" RADIFOCUS INTRODUCER II 4-11FR，

7;10CM

834

CGS01BVK11TM TERUMORADIFOCUS 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)

804

CGS01BVK12TM TERUMORADIFOCUS INTRODUCER II(4-11FR 100MM)"泰爾茂"血管攝影

引導套(鞘+擴張器+導線SIDEARM、W/VALVE)

804

CGS01BVK13TM TERUMORADIFOCUS INTRODUCER II(4-7FR 70-100MM)"泰爾茂"血管攝

影引導套(鞘+擴張器+導線SIDEARM、W/VALVE)

804



804

CGS01BVK21TM TERUMORADIFOCUS INTRODUCER II(4-10FR 160-250MM)"泰爾茂"血管

攝影引導套(鞘+擴張器+導線SIDEARM、W/VALVE)

1098



1098

CGS01BVK31TM TERUMORADIFOCUS 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

834

CGS01C4852ST SJMENGAGE 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

953

CGS01C485NST SJMENGAGE ENGAGE TR INTRODUCER (FEMORAL)12CM

0.035"0.038"(SH+DIL+VALVE+GUIDE WIRE+SIDEPORT 3WAY)"聖猷達"


537

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

CGS01CL724AR ARROWPERCUTANEOUS 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 ARROWPERCUTANEOUS SHEATH INTRODUCER SYSTEM (SUPER

FLEX)35CM(S+D+SV+3 AWY)“亞諾”經皮導引鞘組(可彎折式)

1470

736



NON-KINKING)5:8FR，10FR 45CM“亞諾”經皮導引鞘組(可彎折式)

2780


NON-KINKING) 6，7，9，10FR 65CM“亞諾”經皮導引鞘組(可彎折

式)

3000

CGS01CL775AR ARROWPERCUTANEOUS 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 ARROWPERCUTANEOUS SHEATH INTRODUCER SYSTEM(SUPER ARROW-FLEX

NON-KINKING)5:10FR 11CM“亞諾”經皮導引鞘組(可彎折式)

1094

CGS01CPSDSST SJMCPS 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

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 ARROWPERCUTANEOUS 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

784

CGS01DUH25SB SUPER SHEATH INTRODUCER SHEATH 25CM 5-9FR 0.035"，0.038"

(SHEATH+DILATOR+SIDEARM+VALVE，GUIDEWIRE)

953

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

876

CGS01KCFN2CK 曲克福來瑟橈動脈導入鞘組"COOK"FLEXOR RADIAL INTRODUCER

SHEATH SET 0.018" 5~7FR 23CM

1323

CGS01KCFN3CK 曲克引導器"COOK"FLEXOR INTRODUCER-FLEXOR CHECK FLO

MICROPUNCTURE INTRODUCER SETS 0.018" 6~7FR 7;13CM

876

CGS01KCFN4CK 曲克引導器"COOK"FLEXOR INTRODUCER-FLEXOR CHECK FLO

MICROPUNCTURE INTRODUCER SETS 0.018" 6~7FR 23CM

1323

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

1625

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

CGS01MPS01CK COOKMICROPUNCTURE INTRODUCER SETS(W0.018 NITINOL GUIDE

WIRE+4-5FR CATHETER+21G NEEDLE)"曲克"微穿刺引導器組

1625



1625



1625

CGS01MR190M0 美德康微穿刺導引器組與配件"MEDCOMP"MICRO-STICK INTRODUCER

SET AND ACCESSORIES(3.5-6.5FR SHEATH+0.018 GUIDEWIRE+21G

NEEDLE)

1625

CGS01MRK23MR MERITPRELUDE 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

737


CGS01MRKTPMR MERITPRELUDE 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)

804

CGS01N6100ST 聖猷達費思凱絲導管導引器"SJM" FAST-CATH HEMOSTASIS

INTRODUCERS WITH HEMOSTASIS VALVE 12CM SHEATH

537



537



953



537



537



537



2726

CGS01N6656ST 聖猷達麥克斯導管導引器"SJM" MAXIMUM HEMOSTASIS INTRODUCER 1235



537



2726



1400

CGS01PA140ST SJMPEEL-AWAY INTRODUCERS 14CM 5:16FR(SHEATH+DILATOR)"聖猷達"

剝式導管導引器

785

CGS01PA14NST SJMPEEL-AWAY INTRODUCERS 14CM

5:16FR(SHEATH+DILATOR+SYRINGE+NEEDLE+GUIDE WIRE)"聖猷達"剝式

導管導引器

785

CGS01PA230ST SJMPEEL-AWAY INTRODUCERS 23CM

7:14FR(SHEATH+DILATOR+SYRINGE+NEEDLE+GUIDE WIRE)"聖猷達"剝式

導管導引器

785

CGS01PA6CMST SJMPEEL-AWAY INTRODUCERS 6CM 4;5;6FR(SHEATH+NEEDLE)"聖猷達"

剝式導管導引器

785

CGS01PLD11MR PRELUDE SHEATH INTRODUCER 11CM

(W/SHEATH+SIDEPORT+VALVE+DILATOR+G.W)

537

CGS01PLD23MR PRELUDE SHEATH INTRODUCER 23CM

(W/SHEATH+SIDEPORT+VALVE+DILATOR+G.W)

953

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

834

CGS01PS11GMR PRELUDE SHEATH INTRODUCER 11CM

(W/SHEATH+SIDEPORT+VALVE+DILATOR+G.W+NEEDLE)

715

CGS01PS18TMR MERITPRELUDE 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

1306

CGS01PSS35MR MERITPRELUDE 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

1306

CGS01PSSMTMR MERITPRELUDE SHORT SHEATH INTRODUCER(DILATOR+MARKER TIP

SHEATH+STOPCOCK) "美瑞特"福祿動靜脈廔管用導引鞘

1022

CGS01QG110TA 天地合鞘管組"TARGET"DISPOSABLE INTRODUCER KIT 4:11FR

11CM(W/SHEATH，DILATOR，GUIDEWIRE，NEEDLE)

834

CGS01QG160TA 天地合鞘管組"TARGET"DISPOSABLE INTRODUCER KIT 4:11FR

16;24CM(W/SHEATH，DILATOR，GUIDEWIRE，NEEDLE)

1235

738


CGS01RCF01CK CHECK-FLO PERFORMER INTRODUCER SETS 25CM(SH+DI+SI+V+GW) 953

CGS01RCF02CK CHECK-FLO PERFORMER INTRODUCER SETS 30CM

W/RADIOLOGY(SH+DI+SI+V+GW)

1235

CGS01RCF04CK CHECK-FLO PERFORMER INTRODUCER SETS

5:13CM(S+D+GW+N+SV+SY+3WAY)0.021"，0.035"，0.038"

834

CGS01RCFN1CK COOKCHECK-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

834

CGS01RCFN2CK COOKCHECK-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

1235

CGS01RCFW1CK 曲克闕克芙爾引導器組"COOK"CHECK-FLO PERFORMER INTRODUCER

SETS 63~98CM(SHEATH+DILATOR+SIDEARM+VALVE+3WAY+RADIOPAQUE

BAND)

2726

CGS01S0025YZ 美力凱導引鞘組MEDIKIT INSERT SUPERSHEATH SET

25CM(SH+DI+GW+N+SI+V)

1067

CGS01S5711YZ 美力凱導引鞘組MEDIKIT INSERT SUPERSHEATH SET 4~7FR

5:11CM(SH+DI+GW+SI+V+N)

715

CGS01SC001CK SCHWARZ CATHETER INTRODUCTION SET 2200

CGS01SEA14ST SJMPEEL-AWAY INTRODUCERS 14CM

7:12FR(SHEATH+VALVE+DILATOR+SYRINGE+NEEDLE+GUIDE WIRE)"聖猷

達"剝式導管導引器

785

CGS01SHK1TGJ JSMSHEATH KIT "吉生"導引鞘組(SH+SIDEPORT+VALVE+DIL+G.W+N+IV

CATHETER+SYN)

715

CGS01SHKLAGJ JSMSHEATH 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"


537

CGS01SLE18BK 百多力勝能特套疊式冠狀竇導線運輸系統(包括配件)(引導導管+切割

工具+導線+輔助配件)"BIOTRONIK"SELECTRA TELESCOPIC CORONARY

SINUS LEAD DELIVERY SYSTEM

6528

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"


537

CGS01SUM11SB SUPER SHEATH INTRODUCER SHEATH 4-9FR 11CM 0.035"，0.038"


537

CGS01SUM25SB SUPER SHEATH INTRODUCER SHEATH 5-9FR 25CM 0.038"


953

CGS01SV12NGX 戈爾密封閥導鞘"GORE"DRYSEAL SHEATH

28CM(DILATOR+SIDEARM+VALVE+2WAY活栓*2+RADIOPAQUE MARKER)

887

CGS01TR482ST SJMENGAGE ENGAGE TR INTRODUCER(RADIA INTRODUCER)12CM

0.025"(SH+DIL+VALVE GUIDE WIRE+SIDEPORT 3WAY+NEEDLE)"聖猷達"


834




1235




834

CGS01Z9808AR 亞諾經皮導引鞘組"ARROW" PERCUTANEOUS SHEATH INTRODUCER

PRODUCT(S+D+G+N+S) 8FR 8.5FR 10CM

875

CGS0209880AR PERCUTANEOUS SHEATH 875

739


CGS0306018M9 DILATOR(FACIAL)6:18FR 23CM 153

CGS0311110BQ BIOTEQINTRODUCER 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) 430

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

2230

CGS06SRK18GJ “吉生”穿刺套組 -18FR以下“JSM” INSERTION KIT 832

CGS06SRK20GJ “吉生”穿刺套組 -20FR以上“JSM” INSERTION KIT 1128

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

CHA0175324DL PEDIATRIC STRAIGHT ARTERIAL CANNULA 18FR:24FR 565

CHA0188020DL ARTERIAL CANNULA 20:24FR 565

CHA01A085BED AORTIC PERFUSION CANNULAE(8-16F) 565

CHA01DLP77M4 美敦力兒童用動脈套管"MEDTRONIC"DLP ONE PIECE PEDIATRIC

ARTERIAL CANNULAE

3862

CHA031137CR5 索倫主動脈弓導管"SORIN" AORTIC ARCH CANNULAE(WIRE-REINFORCED

6，7，8MM/18，21，24FR)

790

CHA031206CR5 索倫主動脈弓導管"SORIN" AORTIC ARCH CANNULAE(W/WIRE

REINFORCED 6，7，8MM/18，21，24FR)

790

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

CHA03NA120R5 索倫主動脈弓導管"SORIN" AORTIC ARCH CANNULAE 565

CHA03NA343R5 索倫主動脈弓導管"SORIN" AORTIC ARCH CANNULAE(FLEXIBLE

STRAIGHT TIP WITH MOVABLE SUTURE RING NON-REINFORCED 6，7，

8MM/18，21，24FR)

565

CHA03RA213R5 索倫主動脈弓導管"SORIN" 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

CHAT1VCANNR5 索倫血管套管"SORIN"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

CHC01CA123R5 索倫心臟麻痺轉接器(Y轉接器)"SORIN" CARDIOPLEGIA ADAPTERS 329

CHC01CA410R5 索倫心臟麻痺轉接器(多功灌注轉接器)"SORIN" CARDIOPLEGIA

ADAPTERS(MULTIPLE PERFUSION ADAPTER)

657

740


CHC01CA420R5 索倫心臟麻痺轉接器(多功灌注轉接器-附排出線)"SORIN"

CARDIOPLEGIA ADAPTERS(MULTIPLE PERFUSION ADAPTER WITH VENT

LINE 15 INCH)

889

CHC01CA430R5 索倫心臟麻痺轉接器(多功灌注轉接器-附插管)"SORIN"

CARDIOPLEGIA ADAPTERS(MULTIPLE PERFUSION ADAPTER WITH VESSEL

CANNULA三條(VC-11000，VC-11010))

990

CHC01CA810R5 索倫心臟麻痺轉接器(順向/逆向灌注轉接器)"SORIN" CARDIOPLEGIA

ADAPTERS(CARDIOPLEGIA PERFUSION ADAPTERS WITH MONITORING

SET)

1035

CHC01CP110L5 CORONARY ARTERY PERFUSION CANNULAE 611

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 MEDTRONICCARPENTIER 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

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

CHF06EZFACR5 索倫動脈導管"SORIN" 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 MEDTRONICBIO-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

CHF06PT16AED 愛德華動脈灌注導管(含導引管組)"EDWARDS"OPTISITE ARTERIAL

PERFUSION CANNULA W/INTRODUCER

12404

CHF06RAPFVR5 索倫雷卜股靜脈導管"SORIN"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

CHG0294006M4 DLP RETROGRADE CORONARY SINUS PERFUSION CANNULA 3129

741


CHG02RCM14R5 索倫逆向心臟麻痺液灌注套管(手動型)"SORIN" RETROGRADE

CARDIOPLEGIA CANNULAE(15FR)

3129

CHG02RCS14R5 索倫逆向心臟麻痺液灌注套管(自動型)"SORIN" RETROGRADE


3129

CHG02RCS35R5 索倫逆向心臟麻痺液灌注套管(自動型)"SORIN" RETROGRADE


3129

CHH0112001DL LEFT HEART VENT CATHETER 13FR 568

CHH0112002DL VENT CATHETER 645

CHH0112008M4 DLP LEFT HEART VENT CATHETER 568

CHH01EE061ED EDWARDSLEFT VENTRICULAR VENT CATHETER左心室用導管 568

CHH01PE062ED LEFT VENTRICULAR VENT CATHETER 645

CHH01VT573R5 索倫心肺手術用引流導管"SORIN" 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

CHR01AR012ED AORTIC ROOT CANNULA主動脈根部套管 616

CHR01AR109L5 AORTIC ROOT CANNULAE 9:18GA 410

CHR01AR112R5 索倫動脈根部套管"SORIN" AORTIC ROOT CANNULAE(12:16GA) 410

CHR01AR212R5 索倫動脈根部套管(有排氣管)"SORIN" AORTIC ROOT

CANNULAE(12:16GA)

616

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

CHSU1160222C 柯惠肯特利亞羅臍脈導管 "COVIDIEN"KENDALL ARGYLE UMBILICAL

VESSEL CATHETER

170

CHSU1160352C 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

CHT0131601GJ 吉生體外循環管組"JSM"HEART LUNG PACK(TUBING+ORGANIZER+PRE-

BYPASS FILTER+SUCKER*2)

5218

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

CHT0147015GJ 吉生體外循環管組-塑膠管"JSM"HEART LUNG PACK-PVC TUBING 3748

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

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

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

742


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

CHT01TS100R5 索倫止血帶套環"SORIN" TOURNIQUET(TOURNIQUET KIT WITH SNARE) 255

CHT01TS130R5 索倫止血帶套環"SORIN" TOURNIQUET(TOURNIQUET KIT) 255

CHT0332401GJ “吉生”體外循環管組-預充管路組”JSM” HEART LUNG PACK-

PRIMING LINE

276

CHT0347016GJ 吉生體外循環管組-PHISIO塗層塑膠管"JSM"HEART LUNG PACK-PVC

TUBING WITH PHISIO COATING

3829

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*


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

CHV0166112M4 SINGLE STAGE VENOUS CANNULA 771

CHV0167312DL VENOUS CANNULAR 12，16，20，31FR (PEDIATRIC) 1002

CHV0168112M4 MEDTRONICSINGLE 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

CHV01LRD41R5 索倫二階靜脈引流導管"SORIN" DUAL STAGEVENOUS RETURN CANNULAE 803

CHV01RV110R5 索倫靜脈回流導管"SORIN" VENOUS RETURN CANNULAE(24，28，32

FR)

771

CHV01RV224R5 索倫靜脈回流導管"SORIN" VENOUS RETURN CANNULAE(WIRE-

REINFORCED)

771

CHV01TF008ED SINGLE STAGE VENOUS RETURN CANNULAE 靜脈引流導管 771

CHV01XRDS2L5 DUAL STAGE VENOUS RETURN CANNULAE 32:36FR 803

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



743



CKB0156116BA SUPRAPUBIC CATHETERISATION KIT 膀胱穿刺針組 16CH 590

CKB0160600AN VESICO SET 膀胱穿刺引流組 542

CKD006752L2X 百合一次性使用無菌血液透析導管及附件(雙腔)"BAIHE" DISPOSABLE

HEMODIALYSIS CATHETER & ACCESSORIES(2 LUMEN)

1388

CKD006753L2X 百合一次性使用無菌血液透析導管及附件(三腔)"BAIHE" DISPOSABLE

HEMODIALYSIS CATHETER & ACCESSORIES(3 LUMEN)

1738

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 COOKUNIVERSA 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 COOKUNIVERSA 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




CKD0380155MV CONTOUR SOFT PERCUFLEX STENTS W/HYDROPLUS

COATING+GUIDEWIRE+PUSHER+CLAMP

1416



1416



1416



1416

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

CKD03STRVLSB BOSTON SCIENTIFIC STRETCH VL STENT WITH HYDROPLUS "波士頓科

技"伸展輸尿管支架

1416

CKD0512135BQ BIOTEQURETERAL 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 BIOTEQURETERAL 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 BARDINLAY URETERAL STENT( WITH HYDROPLUS

COATING)+PUSHER+CLAMP"巴德"輸尿管導管組

1348

CKD0581125BQ 邦特輸尿管導管組"BIOTEQ" URETERAL STENT SET 1416

CKD0591125BQ 邦特輸尿管導管組"BIOTEQ" URETERAL STENT SET 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

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

744


CKD05J3114BQ BIOTEQURETERAL STENT SET(LONG-TERM TYPE) (STENT WITH

HYDROPHILIC+GUIDE WIRE+PUSHER)"邦特"輸尿管導管組(長效型)

1416

CKD05J3125BQ BIOTEQURETERAL STENT SET(LONG-TERM TYPE) (STENT WITH


1416

CKD05K3114BQ BIOTEQURETERAL STENT SET(LONG-TERM TYPE) (STENT WITH


1416

CKD05K3125BQ BIOTEQURETERAL STENT SET(LONG-TERM TYPE) (STENT WITH


1416

CKD05R3214BQ BIOTEQURETERAL STENT SET(LONG-TERM TYPE) (STENT WITH


1416

CKD05R3225BQ BIOTEQURETERAL STENT SET(LONG-TERM TYPE) (STENT WITH


1416

CKD05S3214BQ BIOTEQURETERAL STENT SET(LONG-TERM TYPE) (STENT WITH


1416

CKD05S3225BQ BIOTEQURETERAL STENT SET(LONG-TERM TYPE) (STENT WITH


1416

CKD05T3114BQ BIOTEQURETERAL STENT SET(W HYDROPHILIC)(LONG-TERM

TYPE)(+PUSHER+CLAMP)"邦特"輸尿管導管組

1348

CKD05T3125BQ BIOTEQURETERAL STENT SET(W HYDROPHILIC)(LONG-TERM


1348

CKD05U3214BQ BIOTEQURETERAL STENT SET(W HYDROPHILIC)(LONG-TERM


1348

CKD05U3225BQ BIOTEQURETERAL STENT SET(W HYDROPHILIC)(LONG-TERM


1348

CKD05USH01CK COOKUNIVERSA 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

CKDD112122AR LARGE-BORE MULTILUMEN HEMODIALYSIS CATHETER 1388

CKDD1135132C COVIDIENKENDALL 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


HEMODIALYSIS CATHETERS-MAHURKAR KIT，CURVED EXT.(C+N+G+D)

1388

CKDD1212132C 柯惠瑪護卡伊利急性雙腔導管組"COVIDIEN" MAHURKAR ELITE ACUTE

DUAL LUMEN CATHETER

1388

CKDD122122AR ARROWARROWGARD CATHETERS

SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR+SHEATH) 2 LUMEN "亞諾"抗

感染安全尖端導管

1388

CKDD122334BQ BIOTEQHEMODIALYSIS CATHETER KIT(2 LUMEN

CATHETER+NEEDLE+GUIDE WIRE+DILATOR)血液透析導管組

1388

745



SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR+SHEATH)2LUMEN"亞諾"抗感染

安全尖端導管

1388

CKDD124334BQ BIOTEQ2 LUMEN HEMODIALYSIS CATHETER KIT(C+N+G+D)血液透析導管

組

1388


HEMODIALYSIS CATHETERS-MAHURKAR DUAL LUMEN KIT(C+N+G+D)

1388

CKDD154334BQ BIOTEQHEMODIALYSIS 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


1388

CKDD1881SK2C 柯惠肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE


1388

CKDD1883CK2C 柯惠肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE


1388

CKDD1883SK2C 柯惠肯特利急性血液透析導管"COVIDIEN"KENDALL ACUTE


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

CKDD20450NBA HICKMAN HEMODIALYSIS CATHETER KIT(CATH+INTRODUCER KIT)永植型 3509

CKDD20452NBA HICKMAN HEMODIALYSIS CATHETER KIT(CATH+INTRODUCER KIT)永植型 3509


HEMODIALYSIS CATHETERS-MAHURKAR CATHETER

724


HEMODIALYSIS CATHETERS-MAHURKAR CATHETER，CURVED EXT.

724

CKDD214554NL NAVILYSTVAXCEL 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


HEMODIALYSIS CATHETERS-MAHURKAR CATHETER

724


HEMODIALYSIS CATHETERS-MAHURKAR CATHETER，CURVED EXT.

724

CKDD2450142C COVIDIENKENDALL PALINDROME CATHETER KIT AND

SPORTPACK(CATH+INTRODUCER KIT)"柯惠"肯特利沛霖卓導管組(永植

型)

3509


HEMODIALYSIS CATHETERS-PERMCATH CATHETER KIT

36~45CM(CATH+INTRODUCER KIT)

3509

CKDD256631BA HEMOGLIDE HEMODIALYSIS CATHETER KIT(CATH+INTRODUCER KIT)永植

型

3509

CKDD257331BA BARDHEMOSPLIT HEMODIALYSIS CATHETER(CATH+INTRODUCER KIT)"巴

德"思伯利特血液透析導管.永植型

3509

CKDD25833NBA BARDHemoStar HEMODIALYSIS CATHETER KITS(CATH+INTRODUCER KIT)

永植型

3509

CKDD260049BA HICKMAN HEMODIALYSIS CATHETER永植型 2603

746



HEMODIALYSIS CATHETERS-PERMCATH CATHETER KIT

28CM(CATH+INTRODUCER KIT)

3509

CKDD269033BA 巴德伊奎斯長期性血液透析導管"BARD" EQUISTREAM LONG-TERM

HEMODIALYSIS CATHETER

3509


HEMODIALYSIS CATHETERS-MAHURKAR MAXID 14.5FR.雙腔導管

(CATH+INTRODUCER KIT)

3509

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

CKDD2SL12PM0 MEDCOMPSILICONE 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 MEDCOMPHEMO-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 ARROWMULTI-LUMEN CENTRAL VENOUS CATHETERIZATION

SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR)"亞諾"多重輸液導管套

1738

CKDD3232132C 柯惠瑪護卡伊利急性三腔導管組"COVIDIEN" MAHURKAR ELITE ACUTE

TRIPLE LUMEN CATHETER

1738

CKDD323334BQ BIOTEQHEMODIALYSIS CATHETER KIT(3 LUMEN

CATHETER+NEEDLE+GUIDE WIRE+DILATOR)血液透析導管組

1738


SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR+SHEATH) 3 LUMEN "亞諾"抗

感染安全尖端導管

1738


HEMODIALYSIS CATHETERS-三腔透析導管(C+N+G+D)

1738

CKF0201237BA BARD75CC BARDEX LUBRICATH LATEX FOLEY CATHETER，2 WAY"巴德"

導尿管*給付規定請見備註欄

106

CKF0222630BA BARDBARDEX PEDIATRIC FOLEY CATHETER，LUBRICIOUS COATED，2

WAY 3CC導尿管*適應症請見備註欄

106

CKF0222656BA BARDFOLEY CATHETER二叉滑潤長期導尿管5CC，30CC*適應症請見備註

欄

106

CKF025118NUW UNOMEDICALFOLEY 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

CKF02M5118UM UNOMEDICALFOLEY 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


93.1

CKF030012NFM 2 WAY SILICONE FOLEY BALLOON CATHETER 5CC，30CC 12:26FR※適


93.1

CKF0300142R4 2 WAY ALL SILICONE FOLEY BALLOON CATHETER 5CC 12:24FR※適應

症請見備註欄

93.1

747


CKF0300212YN 2 WAY ALL SILICONE FOLEY BALLOON CATH 12:26FR 5CC※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



93.1

CKF0303207EW E-UP SILICONE FOLEY CATHETER FOR SINGLE USE(2 WAY 30ML)毅升


93.1

CKF0303308P2 SILICON 2 WAY FOLEY CATHETER*適應症請見備註欄 93.1

CKF0304822FM 富強導尿管"FORTUNE" UROLOGICAL CATHETER 93.1

CKF030512NFM 2 WAY SILICONE FOLEY BALLOON CATH W/X-RAY5CC，30CC 12:26FR※


93.1

CKF030513NCL SILICONE 2-WAY FOLEY CATHE 6:26FR ※適應症請見備註欄 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

CKF0312352BA BARDBARDIA 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

CKF03FL000EF 貝斯美德矽質導尿管(二叉)6FR:26FR "BESMED" SILICONE FOLEY

CATHETER(2 WAY)6FR:26FR

93.1

CKF03S2100WN SILICONE 2WAY FOLEY CATHE 3:50ML ※適應症請見備註欄 93.1



170



170

CKF0404307EW E-UP SILICONE FOLEY CATHETER FOR SINGLE USE(3 WAY 30ML)毅升


170

CKF040514NFM 3 WAY SILICONE FOLEY BALLOON CATHETER W/X-RAY 30CC 14:26FR※


170

CKF0412343BA BARDBARDIA 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 UNOMEDICALFOLEY 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

748


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 UNOMEDICALFOLEY 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

CKN0108000CK PERCUTANEOUS PIGTAIL NEPHROSTOMY SETS 6.0:10FR 15:30CM(標準

型)

2640

CKN0111245BQ BIOTEQDRAINAGE CATHETERAND INTRODUCER SET/KIT(C+N+G+D+引流管

袋+固定貼布)導管5-16FR 20-50CM

2580

CKN0113113BQ BIOTEQDRAINAGE 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


N+D+G+C)

2640


N+D+G+C)

2640

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

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

CKN0143117BQ 邦特引流導管及穿刺導入系統"BIOTEQ" DRAINAGE CATHETER &

INTRODUCER SET/KIT

2303

CKN0175030PB DRAINAGE SET AND ACCESSORIES導管(HYDROFEEL)+N+G+D+固定貼布 2580

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

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

CKN02NS001SG SIGMA NEPHROSTOMY CATHETER(SILICON)*適應症請見備註欄 331

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

749


CKN0410111MV PERCUTANEOUS NEPHROSTOMY CATHETER WITH LOOP LOCKING

RETENSION 豬尾巴導管

829

CKN0418572FM SILICONE NEPHROSTOMY PIGTAIL PATTERN CATHETER 12FR 331

CKN045522SAN ANGIOMEDINTRODUCTION/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 FORTUNESILICONE MALECOT CATHETER 14:36FR矽質梅花型引流管 885

CKN0583808CK COOKSILICONE 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

CKP010T2022C COVIDIENKENDALL PERITONEAL DIALYSIS CATHETERS(TENCKHOFF CATH

T202)"柯惠"肯特利腹膜液透析導管

1488

CKP0119671FA PD CATHETER 1488

CKP018812N2C COVIDIENKENDALL PERITONEAL DIALYSIS CATHETER"柯惠"肯特利腹膜

液透析導管系列

1488



1488



1488



1488

CKP018884N2C COVIDIENKENDALL PERITONEAL DIALYSIS CATHETERS(TENCKHOFF

PEDIATRIC)"柯惠"肯特利腹膜液透析導管

1488

CKP018888N2C COVIDIENKENDALL PERITONEAL DIALYSIS CATHETERS(TENCKHOFF

CATH)"柯惠"肯特利腹膜液透析導管

1488



1488

CKP0413836FA FRESENIUSPD ACCESSORIES SLEEP.SAFE SET/SET PLUS"費森尤斯"自

動腹膜透析管組

232

CKP04C4479BT HOMECHOICE AUTOMATED PD SET全自動腹膜透析導管組 224

CKP04C8303BT BaxterHOMECHOICE PEDIATRIC /LOW RECIRCULATION VOLUME APD SET

WITH CASSETTE小兒全自動腹膜透析導管組

224

CKS016020NAN ANGIOMEDURETERAL STENTS(STENT+GUIDE+PUSHER) 1117

CKS0257071CK COOKURETERAL 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 COOKURETERAL CATHETER輸尿管導管 153

CKU0336504BA URETERAL CATHETER (OLIVE TIP) 4:6FR 153

CKU0338008BA URETERAL CATHETER (CONE TIP) 8:12FR 153

CKU0362400AN 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 COOKURETEROSCOPY BALLOON CATHETER(CATHETER+GUIDE WIRE)輸尿管

氣球導管

5068

750


CKUB121810SB BOSTON SCIENTIFICPASSPORT 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

CKUB18884NBA UROFORCE BALLOON DILATION CATHETER 4032

CKUB1AUBS1CK COOK ASCEND AQ URETERAL DILATION BALLOON CATHETER 4CM:10CM 4032

CKUB2UNB01CK COOKULTRAXX 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 SCIENTIFICAMPLATZ 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

CKUD1VTD01CK 曲克安培茲腎臟擴張器組(單支)"COOK" AMPLATZ RENAL DILATOR SET

AND DILATORS(INDIVIDUAL)

953

CKUD200040AN PTFE DILATOR 4:9FR 110

CKUD200120AN PTFE DILATOR 12:14FR 154

CKUD20012DAN ANGIOMEDDILATATION SET 12FR擴張器組 154

CKUD200160AN PTFE DILATOR 16FR 220

CKUS22614NSB AMPLATZ TYPE RENAL SHEATH SET 818

CKUS26015NSB BOSTON SCIENTIFICAMPLATZ 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)


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 PEROUSEPOLYSITE IMPLANTABLE PORT(PORT+CATHETER)"普羅斯"植入

式動脈血管輸注器

9285

CLPA119S20M0 MEDCOMPVASCU-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


2884

CLPA11PS0TCK VITAL-PORT VASCULAR ACCESS SYSTEMS(P+C+N+I+GW)※適應症請見備

註欄

7712

751


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


IMPLANTABLE DRUG DELIVERY SYSTEM(P+C+N+I)※適應症請見備註欄

7712



見備註欄

7539



見備註欄

7539


IMPLANTABLE DRUG DELIVERY SYSTEM(P+C+N)※適應症請見備註欄

7539



見備註欄

7539



見備註欄

7539



見備註欄

7539


IMPLANTABLE DRUG DELIVERY SYSTEM(P+C+N+I)※適應症請見備註欄

7712



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 PEROUSEPOLYSITE 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 PEROUSEPOLYSITE IMPLANTABLE PORT(PORT+CATH)植入式血管輸注器*


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 SMITHSIMPLANTABLE 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 NAVILYSTVAXCEL 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

752


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

CLPA145458NL NAVILYSTVAXCEL 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 NAVILYSTVAXCEL 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



7712



7712



7712



7712



7712

CLPA150120FM FORTUNEIMPLANTABLE VASCULAR ACCESS

PORT(PORT+CATH+NEEDLE+INTRODUCER)"富強"植入型血管輸液系統*適


7712

CLPA15105KHZ HORIZENVORTEX VTX TITANIUM VASCULAR ACCESS PORTS(P+C+N+I)*給


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 MEDCOMPLOW 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 MEDCOMPMID-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 BARDGROSHONG PERIPHERALLY INSERTED CENTRAL VENOUS DUAL-LUMEN

W/INTRODUCER KIT*適應症請見備註欄

3335

CLPA176174BA BARDGROSHONG 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 MEDCOMPPRO-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

753


CLPA1ABRM1CK COOKSPECTRUM 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 COOKSPECTRUM 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 SCIENTIFICVAXCEL 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

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


CATHETER(PICC) SET-ONE LUMEN (C+D+G+N)*適應請見備註欄

2884


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


CATHETER(PICC) SET-TWOLUMEN (C+D+G+N)*適應請見備註欄

3335


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※適應症請見備註欄

3316


CATHETER(PICC) SET-TWOLUMEN (C+D+G+N)*適應請見備註欄

3335


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

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


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

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


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

CLPA1P1CC7CK COOKTURBO-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 COOKTURBO-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

CLPA1PWC01BA 巴德威力週邊置入中心導管(單腔)"BARD" POWER PICC (SINGLE

LUMEN)

2884

CLPA1PWC02BA 巴德威力週邊置入中心導管(雙腔)"BARD" POWER PICC (DUAL LUMEN) 3335

CLPA1V1TA1CK COOKVITAL-PORT VASCULAR ACCESS SYSTEM注射口組(P+C+N+I)適應症

請見備註欄

7712

CLPA1VPMNSM0 美德康週邊置入中央靜脈導管組-雙腔"MEDCOMP"VASCU-PICC

PERIPHERALLY INSERTED CENTRAL VEIN ACCESS CATHETER-DOUBLE

LUMEN(C+N+D+G+S)

3335

CLPA1VRXTRRH “瑞塔”植入型注射系統 “RITA” VORTEX TR PORT SYSTEM 8196

754


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

CLPA205241NR 尼普洛微量輸液器"NIPRO" SUREFUSER+ 920

CLPA205242NR 尼普洛微量輸液器"NIPRO" SUREFUSER+ 920

CLPA205275SG SIGMABALLOON 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 SIGMABALLOON 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

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

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

CLS040708NPW PERFECT DISPOSABLE INFUSION SET(W/BURETTE W/VALVE) 41

CLS041015B3B 康德萊滴定管式輸液器"KDL" INFUSION SETS WITH BURETTE 41

CLS041VC02TZ 善德定量型輸液套"SUNDER" VOLUME CONTROL I.V. ADMINISTRATION

SET

41

CLS041VC04Q4 尼得立斯定量型輸液套(免針式)"NEEDLELESS" VOLUME CONTROL I.V.

ADMINISTRATION SET(NEEDLELESS)

63.4

CLS041VC04TZ 善德定量型輸液套(免針式)"SUNDER" VOLUME CONTROL I.V.

ADMINISTRATION SET(NEEDLELESS)

63.4

CLS041VPB3JS JMS INFUSION SET WITH BURET 100CC 41

CLS046369NPW INFUSION SET W/BURETTE W/VALVE 150CC，200CC 41

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

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

CLS04BT165BQ 邦特精密輸液套(免針型)"BIOTEQ" PRECISION INFUSION SET

(NEEDLELESS)

63.4

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

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

CLS04CSBACLL LILYVOLUME METERIC ADMINISTRATION SET W/VALVE精密輸液套 41

CLS04CSBESLL LILYVOLUME METERIC ADMINISTRATION SET(W/VALVE)* 41

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

755


CLS04E010NPW INFUSION SET W/BURETTE W/VALVE W/SAFESITE NEEDLE-FREE

SYSTEM*適應症請見備註欄

63.4

CLS04IVPBFJS INFUSION SET PEDIATRIC 100ML BURET W/FLOAT VALVE 41

CLS04M270LTM TERUFUSION VOLUMETRIC SOLUTION ADMINISTRAION SET WITH VALVE 41

CLS04MS1002U 佳承輸液點滴套(免針型)"CHIA CHERNE"I.V. ADMINISTRATION SET 63.4

CLS04MS1202U 佳承輸液點滴套(免針型)"CHIA CHERNE"I.V. ADMINISTRATION SET 63.4

CLS04MS1502U 佳承輸液點滴套"CHIA CHERNE"I.V. ADMINISTRATION SET 63.4

CLS04MV1002U 佳承輸液點滴套(一般型)"CHIA CHERNE"I.V. ADMINISTRATION SET 41

CLS04MV1202U 佳承輸液點滴套(一般型)"CHIA CHERNE"I.V. ADMINISTRATION SET 41

CLS04MV1502U 佳承輸液點滴套"CHIA CHERNE"I.V. ADMINISTRATION SET 41

CLS04NB150SG SIGMA VOLUME METERIC ADMINISTRATION SET*適應症請見備註欄 63.4

CLS04NBSE2Q4 尼得立斯計量點滴輸液套"NEEDLELESS" VOLUME METERIC

ADMINISTRATION SET

63.4

CLS04NS120SG VOLUME METERIC ADMINISTRATION SET W/FREE SITE *適應症請見備

註欄

63.4

CLS04SBAFHLL VOLUME METERIC ADMINISTRATION SET 150CC W/VALVE 41

CLS04SBASSLL VOLUME METERIC ADMINISTRATIONN SET (安全型免針加藥)W/VALVE*


63.4

CLS0501648HR PLUMSET I.V 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


CLS05036SPBB B.BRAUNINFUSOMAT SPACE LINE柏朗史倍司輸液套*適應症請見備註欄 152

CLS050800BTM TERUMOTERUFUSION 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

CLS05087SPBB 柏朗史倍司輸液套INFUSOMAT SPACE LINE INFUSION PUMP

ADMINISTRATION SETS

152

CLS05095HUBB 柏朗史倍斯輸液套-FILTER"B. BRAUN" INFUSOMAT SPACE LINE 261

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 HOSPIRALIFESHIELD 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 SIGMAINFUSION PUMP SET 幫浦輸液套*適應症請見備註欄 152

CLS052027HM8 MEDITOPINFUSION SET FOR INFUSION PUMP輸液套(輸液幫浦用) 75

CLS05350HUBB 柏朗史倍斯輸液套WITHOUT BURETTE，卡榫式"B. BRAUN" INFUSOMAT

SPACE LINE

152

CLS0541950KG KABIVOLUMAT 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

756


CLS0543150KG KABIVOLUMAT 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 KABIVOLUMAT 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 KABIVOLUMAT 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 KABIVOLUMAT 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


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

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


CLS0602427HR PUMP SET(NITROGLYCERIN) 230

CLS06080PUSG SIGMAINFUSION 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 SIGMAINFUSION 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

CLS06125HUBB 柏朗史倍斯輸液套-避光藥品"B. BRAUN" INFUSOMAT SPACE LINE 188

CLS06125SPBB INFUSOMAT SPACE LINE UV-PROTECT史倍司輸液套(不透光型) 188

CLS06294SPBB B.BRAUNINFUSOMAT 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

CLS06437HUBB 柏朗史倍斯輸液套-避光藥品，FILTER，1個無針式接頭"B. BRAUN"

INFUSOMAT SPACE LINE

231

CLS06731SPBB INFUSOMAT SPACE LINE PVC-FREE SET FOR THE ADMINISTRATION OF

CYTOTOXIC AGENTS史倍司輸液套

188

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"


265

CLS06C9644BT LIGHT SENSITIVE CLEARLINK SET無針系統含過濾器避光輸液套※適


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

CLS070800BTM TERUMOTERUFUSION PLATELET ADMINISTRATION SET"泰爾茂"血小板輸

液套

17

CLS071724NPW TRANSFUSION SET 17

CLS07A130NPW PERFECT DISPOSABLE TRANSFUSION (L TYPE ) 17

757


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

CLS07C040TPW 普惠輸血套-免針安全型(L型)"PERFECT" DISPOSABLE TRANSFUSION

SET-SAFETY NEEDLE FREE(L　TYPE )

60.1

CLS08066HUBB 柏朗史倍斯輸液套-BLOOD TRANSFUSION"B. BRAUN" INFUSOMAT SPACE

LINE

230

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 SIGMAINFUSION PUMP SET BLOOD FILTER 幫浦輸血輸液套 230

CLS08150PUSG SIGMAINFUSION PUMP SET Y-SITE BLOOD FILTER Y 型幫浦輸血輸液

套

230

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

CLS0900BTYJS Y TYPE BLOOD TRANSFUSION 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

CLS09D030TPW 普惠輸血套-免針安全型(Y型)"PERFECT"　DISPOSABLE TRANSFUSION

SET- SAFETY NEEDLE FREE(Y　TYPE )

65.1

CLS1202427HR PUMP SET(NITROGLYCERIN) 230

CLS1400737BX BAXAEXACTA-MIX EVA CONTAINER 250ML"柏瑟"靜脈營養術灌注袋 101





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

CLS14B8084CT VIAFLEX TPN BAG 1000C.C. 125

CLS14B8112CT ALL-IN-ONE BAG 1000CC 127

CLS14B8122CT ALL-IN-ONE BAG 2000C.C. 149

CLS14B8132CT ALL-IN-ONE BAG 3000C.C. 149

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

758


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 GUIDEWIRE)*給付規定請見備註欄

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 MTIOCCLUSION 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 MTIOCCLUSION BALLOON SYSTEM(HYPERFORM)(含GUIDE WIRE及卡式注

射器)"恩提愛"閉塞球囊系統

35267

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

CMV0102636AS 朝日神經血管導引線 "ASAHI" NEUROVASCULAR GUIDE WIRE 4650

CMV0107056UF PENUMBRANEURON INTRACRANIAL ACCESS SYSTEM"彼娜波"紐諾顱內導

入系統(NEURON傳送導管)

12000

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

CMV0118298SB RENEGADE HI-FLO MICROCATHETER KIT(MICROCATH+G

WIRE+HEMASTATIC)*適應症請見備註欄

13810

CMV0120288S9 史賽克紐偌楓微細傳導支架系統(含穩定裝置)"STRYKER" NEUROFORM

MICRODELIVERY STENT SYSTEM(INCLUDE STABILIZER)

94000

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

CMV0149189SB EXCELSIOR PRE-SHAPED MICROCATHETER*適應症請見備註欄 7440

CMV016060NCM CODMANPROWLER INFUSION CATHETER"科特曼"保勒注射導管※適應症

請見備註欄

7440


請見備註欄

7440

CMV01606S1CM CODMANPROWLER LP&LP-ES INFUSION CATHETER"科特曼"保勒注射導管


7440

CMV01606S2CM CODMANPROWLER PLUS INFUSION CATHETER"科特曼"保勒注射導管※適


7440

CMV01606XNCM CODMANPROWLER INFUSION CATHETER"科特曼"保勒注射導管※適應症

請見備註欄

7440


請見備註欄

7440

CMV016FMLSUF 彼娜波紐諾邁克斯系統"PENUMBRA" NEURON MAX SYSTEM 12000

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

CMV01951052E 麥克思遠端導引導管"MICRUS" ENVOY DISTAL ACCESS GUIDING

CATHETER

12000

CMV01C44562E 麥克思中介導管"MICRUS" REVIVE INTERMEDIATE CATHETER 12000

CMV01E2710TM PROGREAT CATHETER(MICRO CATH+INTRODUCER

WIRE+COATING+HEMASTATIC)※適應症請見備註欄

13810

CMV01ECHL0V9 MTIECHELON MICRO CATHETERS "恩提愛"微導管(CATH+MICRO GUIDE


13810

CMV01FS135MR MERITFOUNTAIN INFUSION SYSTEM(CATH+GUIDE WIRE+HEMASTATIC)芳

登灌輸系統*適應症請見備註欄

13810

CMV01HEADWMS MICROVENTIONHEADWAY 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 COOKMULTI-SIDEPORT CATHETER INFUSION SET多側孔注射導管組*適


7440

CMV01MF251CK COOKMIRA-FLEX 18 MICROCATHETER*適應症請見備註欄 7440

759


CMV01MF252CK COOKCANTATA 2.5 AND CANTATA 2.8 MICROCATHETER"曲克"坎塔塔微

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


13810

CMV01MFS15CK COOK MICROFERRET-18 INFUSION CATHETER SET(CATH+GUIDE


13810

CMV01NARFX2C 奈維恩顱內支撐導管NAVIEN INTRACRANIAL SUPPORT CATHETER 12000

CMV01P2710TM PROGREAT CATHETER(MICRO CATH+INTERODUCER


13810

CMV01PC241TM PROGREAT CATHETER(MICRO CATH+INTRODUCER


13810

CMV01PX400UF PENUMBRAMICROCATHETER(導管+止血閥+導引器)"彼娜波"*微導管*給


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 SCIENTIFICRENEGADE 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


13810

CMV01SMAGXBL BALT MAGIC CATHETER SET ※適應症請見備註欄 18227

CMV01SQ135MR MERITFOUNTAIN INFUSION SYSTEM(CATH+GUIDE WIRE+HEMASTATIC)芳

登灌輸系統*適應症請見備註欄

13810

CMV01STD22AS “朝日”斯卓德微導管“ASAHI”STRIDE MICROCATHETER 7440

CMV020402XGT GOODTECBALLOON CATHETER-ARTERIAL EMBOLECTOMY CATHETER"固特

克"球型導管

995

CMV0205102S9 史賽克菲絲雀克灌注導管"STRYKER" FASTRACKER INFUSION CATHETER 7440

CMV020F20LQM MAQUETAXIUS CORONARY SHUNT"邁柯唯"艾齊克氏冠狀動脈分流管*適


2696

CMV0210042SB BOSTON SCIENTIFICGUIDER SOFTIP XF GUIDING CATHETER*適應症請

見備註欄

6535

CMV0210062SB BOSTON SCIENTIFICGUIDER 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

CMV021601SLW LEMAITREEMBOLECTOMY CATHETERS單腔式動脈血栓清除導管 995

CMV0216510LW LEMAITREEMBOLECTOMY 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 MICROVENTIONCHAPERON 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

760


CMV02403VBCD CORDISVISTA BRITE TIP INTRODUCER GUIDING "考迪斯"導引導管*適


6535

CMV02600XNCM CODMANTRANSIT 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 SYNOVISFLO-RESTER VESSEL OCCLUDERS血管閉塞器 2591

CMV02DEF68TM 泰爾茂諦思迪迅導引套"TERUMO" DESTINATION GUIDING SHEATH 6535

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 MICROVENTIONCHAPERON 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 SOLUTIONSGANDRAS 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

CMV02KCFW1CK COOKFLEXOR GUIDING CATHETERS 福雷色引導導管*適應症請見備註欄 6535

CMV02KCFW2CK COOKFLEXOR GUIDING CATHETERS "曲克"服來瑟引導導管 4.0~12.0FR

，30~110CM

6535

CMV02KCFW3CK COOKFLEXOR GUIDING CATHETERS "曲克"服來瑟引導導管 5.0~10.0FR

，55~90CM

6535

CMV02KCFW4CK COOKFLEXOR 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

CMV02KSAW3CK COOKFLEXOR GUIDING CATHETERS 5.0FR:8.0FR 0.018/0.038:0.038

40CM:90CM

6535

CMV02KSAW4CK COOKFLEXOR GUIDING CATHETERS弗萊色引導導管*適應症請見備註欄 6535

CMV02KSAW5CK COOKFLEXOR GUIDING CATHETERS弗萊色引導導管*適應症請見備註欄 6535

CMV02KSAW6CK COOKFLEXOR GUIDING CATHETERS5-8FR 55:110MM服來瑟引導導管*適


6535

CMV02MC150V9 恩提愛歐蕊恩微導管"MTI" ORION MICRO CATHETER 7440

CMV02MC172MS MICROVENTIONHEADWAY MICROCATHETER前進微導管*給付規定請見備註

欄

7440

CMV02NRHFMSB 波士頓科技神經系統用芮寧微導管"BOSTON SCIENTIFIC"NEURO

RENEGADE HI-FLO MICROCATHETER

7440

CMV02PNS13UF PENUMBRANEURON 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 CODMANAGILITY STEERABLE GUIDEWIRE"科特曼"愛捷第導引線※適應

症請見備註欄

4650

CMV03614XNCM CODMANAGILITY STEERABLE GUIDEWIRE"科特曼"愛捷第導引線※適應

症請見備註欄

4650

761


CMV03AMW01CK 曲克萊特超選擇微導線"COOK" ALIGHT SUPERSELECTIVE MICROWIRE

GUIDES

4650

CMV03FA509SB BOSTON SCIENTIFICFATHOM-16 STEERABLE GUIDEWIRE菲森可控式導線


4650

CMV03FWR45MR MERITFOUNTAIN INFUSION SYSTEM(GUIDE WIRE+TORQUE)芳登灌輸系統


4650

CMV03GW14XMS MICROVENTIONTRAXCESS GUIDE WIRE"麥新"翠克絲微導線*適應症請見

備註欄

4650

CMV03MT1GWV9 MTIGUIDEWIRE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

CMV03STM48AS ASAHI MICRO GUIDEWIRE 0.014" 0.018"*適應症請見備註欄 4650

CMV03STMGWAS ASAHISTREAMING MICRO GUIDEWIRE 0.014" 0.018"朝日"微導引線*給


4650

CMV03TPMG2CK COOKMICRO WIRE GUIDE 導線*適應症請見備註欄 4650

CMV03XCEGWV9 MTIX-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 波士頓科技白金纖維環"BOSTON SCIENTIFIC" FIBERED PLATINUM

COILS

2971

CMV04AX1UMV9 MTIAXIUM 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

CMV04BCS901L 布萊克博瑞凱栓塞圈系統"BLOCKADE" BARRICADE EMBOLIZATION COIL

SYSTEM

16876

CMV04DCS01CK DETACHABLE EMBOLIZATION COIL(機械式旋轉方式解離)*適應症請見

備註欄

13696

CMV04G26412E 麥克思微型線圈輸送系統"MICRUS" ORBIT GALAXY G2 MICROCOIL

DELIVERY SYSTEM

16876

CMV04GDC10SB BOSTON SCIENTIFICGDC 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

CMV04GDC11SB GDC DETACHALE COIL*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

CMV04M000TCK TORNADO EMBOLIZATION MICROCOIL 0.018，2:14CM 2:10MM※適應症

請見備註欄

2971

CMV04M003NCK TORNADO EMBOLIZATION MICROCOIL 0.035，0.038，3:14CM，3:10MM


2971

CMV04M005NCK 曲克犀厲彈簧栓塞"COOK" HILAL EMBOLIZATION MICROCOILS 2971

CMV04M007NCK COOK NESTER EMBOLIZATION COILS*適應症請見備註欄 2971

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

CMV04MCSVXMS MICROVENTIONMICROPLEX COIL SYSTEM微導線圈栓塞系統*適應症請見

備註欄

16876

CMV04MWCE1CK COOKMREYE 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

762


CMV04NEST2CK COOKNESTER EMBOLIZATION COILS(PLATINUM)"曲克"奈斯特彈簧栓塞*


2971

CMV04NEXUSV9 MTINEXUS DETACHABLE COILS SYSTEM 雷瑟斯分離式閉塞捲 *適應症

請見備註欄

18302

CMV04NYL0NV9 MTIAXIUM 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 PENUMBRAPENUMBRA COIL SYSTEM"彼娜波"栓塞環系統*給付規定請見

備註欄

16876

CMV04PGLACV9 MTIAXIUM 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

CMV04PR1MEV9 恩提愛艾欣波萊分離式閉塞捲"MTI" AXIUM PRIME DETACHABLE COIL 15780

CMV04SRCBP2E 麥克思微白金纖維環輸送系統“MICRUS” MICROCOIL DELIVERY

SYSTEM

16876

CMV04TARGTS9 史賽克塔吉特分離線圈"STRYKER" TARGET DETACHABLE COIL 16876

CMV0621029LW LEMAITREPRUITT IRRIGATION OCCLUSION CATHETER普特灌沖血管閉塞

導管

2396

CMV0621036LW LEMAITREPRUITT OCCLUSION CATHETER普特血管閉塞導管 2466

CMV070NYXXV9 MTIONYX LIQUID EMBOLIC SYSTEM歐尼斯液態栓塞系統 57467

CMV0755055V9 MTIMARATHON 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) 416

CPC0102005M0 SINGLE LUMEN INFUSION CATHETER SET 20G;24G(C+D+GW+N) 679

CPC0104301AR 亞諾單腔中央靜脈導管組(C+N+D+G+S)"ARROW" SINGLE-LUMEN

CENTRAL VENOUS CATHETERIZATION SET(C+N+D+G+S)

416

CPC0104706AR ARROWCENTRAL VEIN CATHETERIZATION SET I

LUMEN(CATH+NEEDLE+DILATOR+GUIDE WIRE+SYRING)"亞諾"中央靜脈導

管組

416

CPC01114G53D 福尼亞中心靜脈導管/單腔"FORNIA"DISPOSABLE CENTRAL VENOUS

CATHETER KITS/1LUMEN

416

CPC01116G53D 福尼亞中心靜脈導管/小兒用單腔"FORNIA"DISPOSABLE CENTRAL

VENOUS CATHETER KITS/PEDIATRIC 1LUMEN

679

CPC0124301AR 亞諾抗感染安全尖端導管-單腔 "ARROW" ARROWGARD CATHETERS-

SINGLE LUMEN(C+N+D+G+S))※適應症請見備註欄

548

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 416

CPC0147631AG CVP KIT MINI (含GUIDE WIRE， CATHETER， NEEDLE) 16FR 416

CPC0160004DV SINGLE LUMEN BROVIAC CATHETER 布羅斐式導管(用於化療患者)

2.7FR 90CM

2412

CPC016421L2X 百合一次性無菌中心靜脈導管組-單腔"BAIHE" DISPOSABLE CENTRAL

VENOUS CATHETER SET(1

LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE)

439

CPC016421P2X 百合一次性無菌中心靜脈導管組-小兒用單腔"BAIHE" DISPOSABLE

CENTRAL VENOUS CATHETER SET(PEDIATRIC 1


679

CPC016816NAG 愛琅中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-1 LUMEN

5:7FR (C+N+D+G+S)

416

CPC01A4301AR ARROWARROWGARD 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 ARROWCENTRAL VEIN CATHETERIZATION SET I

LUMEN(PEDIATRIC)(CATH+NEEDLE+DILATOR+GUIDE WIRE+SYRING)"亞

諾"中央靜脈導管組

679

763


CPC01B1161AG ARGONHYDROCATH 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) 416

CPC01C4400AR ARROWCENTRAL VEIN CATHETERIZATION SET I


管組

416

CPC01E4301AR ARROWCENTRAL VEIN CATHETERIZATION SET I


管組

416

CPC01E4700AR ARROWCENTRAL VEIN CATHETERIZATION SET(1

LUMEN)(CATHETER+NEEDLE+DILATOR+GUIDE WIRE+SYRINGE)"亞諾"中央

靜脈導管組

416

CPC01ECL11BB CERTOFIX CENTRAL VENOUS CATHETER (1

LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦單腔中

心靜脈導管組

416

CPC01H1056AG 愛琅中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-1 LUMEN

5:7FR(C+N+D+G+S)

416

CPC01M1142ED 1 LUMEN MULTI-MED CENTRAL CATHETER SET W/AMC THROMBOSHIELD※


548

CPC01M1162ED 1 LUMEN MULTI-MED CENTRAL CATHETER SET(C+N+GW+DIL+SY) 416

CPC01M1201ED 1 LUMEN CVP CATHETER W/AMC THROMBOSHIELD COATING(C+N+D+GW+S)


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

1440



症請見備註欄

1440



症請見備註欄

1440

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 ARROWARTERIAL 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

379

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)

416

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

CPC01SAC20AR 亞諾動脈導管組"ARROW"ARTERIAL CATHETERIZATION SET 379

CPC01STD11BB CERTOFIX CENTRAL VENOUS CATHETER(1

LUMEN)(CATHETER+DILATOR+GUIDEWIRE +NEEDLE+SYRINGE)舒鈦單腔中

心靜脈導管組

416

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)

416

764


CPC01SWL23W8 DOUBLE LUMEN CENTRAL VENOUS CATHETER SET


841

CPC01SWL33W8 TRIPLE LUMEN CENTRAL VENOUS CATHETER SET


850

CPC0214402AR ARROWMULTI-LUMEN CENTRAL VENOUS CATHETERIZATION SETS:2

LUMEN(C+N+GW+SY+D)" 亞諾"多重輸液導管

1568



841

CPC0222502AR ARROWARROWGARD 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

1787

CPC02245F53D 福尼亞中心靜脈導管/小兒用雙腔"FORNIA"DISPOSABLE CENTRAL


1568

CPC0225122AR 亞諾抗感染安全尖端導管-大管徑雙腔輸液導管組 "ARROW"

ARROWGARD CATHETERS-LARGE BORE TWO LUMEN HEMODIALYSIS

CATHETER(C+N+D+G+S)※適應症請見備註欄

1339

CPC0227702AR 亞諾抗感染安全尖端導管-雙腔 "ARROW" ARROWGARD CATHETERS-

DOUBLE LUMEN(C+N+D+G+S)※適應症請見備註欄

1339

CPC02278F53D 福尼亞中心靜脈導管/雙腔"FORNIA"DISPOSABLE CENTRAL VENOUS


841

CPC022L715M0 DOUBLE LUMEN INFUSION CATHETER SET (C+D+GW+N+SY) 841

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 2652

CPC026422L2X 百合一次性無菌中心靜脈導管組-雙腔"BAIHE" DISPOSABLE CENTRAL



951

CPC026422P2X 百合一次性無菌中心靜脈導管組-小兒用雙腔"BAIHE" DISPOSABLE

CENTRAL VENOUS CATHETER SET(PEDIATRIC 2


1568

CPC026817NAG 愛琅中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-2 LUMEN

7FR(C+N+D+G+S)

841

CPC02A7702AR ARROWARROWGARD 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

1339

CPC02B1150AG ARGONHYDROCATH 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※


1103

CPC02B1152AG 愛琅抑菌中心靜脈導管(2腔)"ARGON"HYDROCATH ASSURE HYDROPHILIC

ANTI-MICROBIAL CENTRAL VENOUS CATHETER 2 LUMEN(C+N+D+G+S)

1339

CPC02BCV22EE 2 LUMEN CVP CATHETER/SET 二腔中央靜脈導管組

(CATH+NEEDLE+DILATOR+GUIDEWIRE+SYRINGE)

841

CPC02C4402AR 亞諾中央靜脈導管套組-雙腔小兒用(C+N+D+G+S)"ARROW" CENTRAL

VENOUS CATHETERIZATION PRODUCT(C+N+D+G+S)"

1568

CPC02C6702AR 亞諾中央靜脈導管套組-雙腔成人用(C+N+D+G+S)"ARROW" CENTRAL

VENOUS CATHETERIZATION PRODUCT(C+N+D+G+S)

951

CPC02C7702AR 亞諾中央靜脈導管套組-雙腔成人用(C+N+D+G+S)"ARROW" CENTRAL


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

1339

CPC02CV782BS BIOSENSORSCENTRAL VENOUS CATHETER KIT

2LUMEN(CATH+NEEDLE+DILATOR+GUIDEWIRE+SYRINGE)"拜爾生"中央靜

脈導管組

841

765


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)

841

CPC02ECL12BB CERTOFIX CENTRAL VENOUS CATHETER (2 LUMEN)

(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+ SYRINGE)舒鈦雙腔中心靜脈

導管組

841



1339

CPC02M271SED 2 LUMEN MULTI-MED CENTRAL CATHETER SET(C+N+GW+DIL+SY) 841

CPC02M27S1ED 2 LUMEN CVP CATHETER W/AMC THROMBOSHIELD COATING(C+N+D+GW+S)


1339

CPC02N7702AR ARROWMULTI-LUMEN CENTRAL VENOUS CATHETERIZATION SETS:2


841


4:5FR(PEDIATRIC)(C+N+D+G+S)

1568

CPC02P2502AR 亞諾抗感染安全尖端導管-小兒雙腔 "ARROW" ARROWGARD CATHETERS-

PEDIATRIC DOUBLE LUMEN(C+N+D+G+S)※適應症請見備註欄

1787

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)


1787

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

1787

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

1787

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

1339

CPC02SDLM1CK SPECTRUM PEDIATRIC 2 LUMEN CVP CATHETER 4.0FR(C+N+D+G+S)※適


1787


LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦雙腔中

心靜脈導管組

841

CPC02SUDLMCK SPECTRUM 2 LUMEN CVP CATHETER(C+D+GW+N+S)※適應症請見備註欄 1339

CPC02SWL24W8 DOUBLE LUMEN CENTRAL VENOUS CATHETERIZATION SET(C+N+GW+S+D) 841

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

1339

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

1339

CPC02UDLM3CK 2 LUMEN SPECTRUM CENTERAL VENOUS CATHETER 抗感染導管※適應症

請見備註欄

1339

CPC0312123AR ARROWMULTI-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 ARROWMULTI-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 ARROWMULTI-LUMEN CENTRAL VENOUS CATHETERIZATION SETS:TRIPLE-

LUMEN C+N+GW+SY+D)" 亞諾"多重輸液導管

850

766




850

CPC0316553AR ARROWMULTI-LUMEN CENTRAL VENOUS CATHETERIZATION SETS:TRIPLE-

LUMEN (CATH+NEEDLE+DILATOR+GW+SYRING)5.5FR 13CM"亞諾"多重輸

液導管

2050

CPC0324703AR 亞諾抗感染安全尖端導管-三腔 "ARROW" ARROWGARD CATHETERS-

TRIPLE LUMEN(C+N+D+G+S)※適應症請見備註欄

1901

CPC0325123AR 亞諾抗感染安全尖端導管-大管徑三腔輸液導管組 "ARROW"

ARROWGARD CATHETERS-LARGE BORE TRIPLE LUMEN HEMODIALYSIS

CATHETER(C+N+D+G+S)※適應症請見備註欄

1901

CPC03345F53D 福尼亞中心靜脈導管/小兒用三腔"FORNIA"DISPOSABLE CENTRAL


2050

CPC03378F53D 福尼亞中心靜脈導管/三腔"FORNIA"DISPOSABLE CENTRAL VENOUS


850

CPC033L715M0 TRIPLE LUMEN INFUSION CATHETER SET (C+D+GW+N+SY) 850

CPC033LP58M0 TRIPLE LUMEN INFUSION CATHETER SET 5.5FR(C+D+GW+N+SY) 2050

CPC036423L2X 百合一次性無菌中心靜脈導管組-三腔"BAIHE" DISPOSABLE CENTRAL



1118

CPC036423P2X 百合一次性無菌中心靜脈導管組-小兒用三腔

(CATHETER+DILATOR+GUIDEWIRE+NEEDLE)"BAIHE" DISPOSABLE

CENTRAL VENOUS CATHETER SET(PEDIATRIC 3 LUMEN)

(CATHETER+DILATOR+GUIDEWIRE+NEEDLE)

2050

CPC0368172AG 愛琅中央靜脈導管組"ARGON"CENTRAL VENOUS CATHETERS-3 LUMEN

7FR(C+N+D+G+S)

850

CPC03A4703AR ARROWARROWGARD CATHETERS:ANTISEPTIC TRIPLE-LUMEN


1901

CPC03A5123AR ARROWARROWGARD CATHETERS:ANTISEPTIC LARGE BORE TRIPLE-LUMEN


1901

CPC03B1158AG 愛琅抑菌中心靜脈導管(3腔)"ARGON"HYDROCATH ASSURE HYDROPHILIC

ANTI-MICROBIAL CENTRAL VENOUS CATHETER(3LUMEN

1901

CPC03BCV31EE 3 LUMEN CVP CATHETER 三腔中央靜脈導管組

(CATHETER+GW+DILATOR+SYRINGE+NEEDLE)

850

CPC03C2123AR 亞諾中央靜脈導管套組-三腔大管徑(C+N+D+G+S)"ARROW" CENTRAL


1664

CPC03C4703AR 亞諾中央靜脈導管套組-三腔成人用(C+N+D+G+S)"ARROW" CENTRAL


1118

CPC03C5123AR 亞諾中央靜脈導管套組-三腔大管徑(C+N+D+G+S)"ARROW" CENTRAL


1664

CPC03C5703AR 亞諾中央靜脈導管套組-三腔成人用(C+N+D+G+S)"ARROW" CENTRAL


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

1901

CPC03CV783BS BIOSENSORSCENTRAL VENOUS CATHETER KIT

3LUMEN(CATH+NEEDLE+DILATOR+GUIDEWIRE+SYRINGE)"拜爾生"中央靜

脈導管組

850

CPC03ECL13BB CERTOFIX CENTRAL VENOUS CATHETER (3 LUMEN)

(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦三腔中心靜脈

導管組

850

CPC03HFL13BB CERTOFIX CENTRAL VENOUS CATHETER(3

LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦三腔中

心靜脈導管組

1664

767




1901

CPC03M371SED 3 LUMEN MULTI-MED CENTRAL CATHETER SET(C+N+GW+DIL+SY) 850

CPC03M37S1ED 3 LUMEN CVP CATHETER W/AMC THROMBOSHIELD COATING(C+N+D+GW+S)


1901


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


2127

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

1901


LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE)舒鈦三腔中

心靜脈導管組

850

CPC03SWL34W8 TRIPLE LUMEN CENTRAL VENOUS CATHETERIZATION SET(C+N+GW+S+D) 850

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)

850

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

1901

CPC03UTLM3CK 3 LUMEN SPECTRUM CENTERAL VENOUS CATHETER 抗感染導管※適應症

請見備註欄

1901

CPC03UTLMACK COOKSPECTRUM 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


1901

CPC03UTPE2CK SPECTRUM GLIDE CENTRAL VENOUS CATHETERS AND SETS 3 LUMEN

5FR(C+D+GW+N+S)※適應症請見備註欄

2127

CPC03UTPEDCK SPECTRUM AND SPECTRUM PEDIATRIC 3 LUMEN CVP CATHETER

5FR(C+N+D+G+S)※適應症請見備註欄

2127

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

2643

CPC089FHS1ED AVA ADVANCED VENOUS ACCESS DEVICES(AVA HF)(CVP KIT+保護套

+SHEATH)*適應症請見備註欄

2536

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※


5500

CPC0937700ED 愛德華裴迪亞特週邊血氧濃度導管-小兒由中央靜脈置

入"EDWARDS"PEDIASAT　OXIMETRY　CATHETER※適應症請見備註欄

8395

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

CPD011010DBD PRESSURE MONITOR DOME 154

CPD011011DBD DOME 154

CPD01BTR00GJ JSMPRESSURE MONITORING KIT: BIOTRANS DOME "吉生"血壓監視組合

套:DOME

154

CPD01BTR01BS PRESSURE MONITOR DOME 154

768


CPM01SC441SG CVP SCALE SYSTEM+3 WAY 114

CPM01VP001LL CVP SCALE SYSTEM(MONITOR+3 WAY) 114

CPM02BT481GJ JSMPRESSURE MONITORING KIT: 1 DOME PRESSURE MONITORING

KIT(DOME+FD+TUBING+3 WAYX2) "吉生"血壓監視組合套:1 DOME KIT

280

CPM02BT482GJ JSMPRESSURE 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

634

CPM02BT483GJ JSMPRESSURE 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)

634

CPM02BTR33BS 3 DOME 3WAY PRESSURE MONITORING KIT

3X(DOME+FLUSH+TUBING+3WAYX2)

978

CPM02BTR48BS 1DOME 3WAY PRESSURE MONITORING

KIT(DOME+DEVICE+TUBING+3WAYX2)

280

CPM02BTRDLGJ JSMPRESSURE 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

CPM02HP60RBD PRESSURE MONITORING KIT 1DOME 280

CPM030TNFRAG ARGONDISPOSABLE PRESSURE MONITOR:TRANSDUCER "愛琅"血壓監視組

合套:壓力轉換器

320

CPM0342584U2 ICUTRANSPAC IV MONITORING KIT(TRAN+FLUSH+TUBING+3WAYX2)"愛西

優"壓力監測套

320

CPM0342591U2 ICU3 TRANSPAC IV MONITORING KIT

3X(TRAN+FLUSH+TUBING+3WAYX2)"愛西優"壓力監測套

1014

CPM0342597HR TRANSPAC IV MONITORING KIT WITH 2 DISPOSABLE TRANSDUCER 870

CPM0342652U2 ICU2 TRANSPAC IV MONITORING KIT

2X(TRAN+FLUSH+TUBING+3WAYX2)"愛西優"壓力監測套

870

CPM034812DAG ARGONDISPOSABLE PRESSURE MONITOR KIT:2 TRANSDUCER

(TR+FL+TU+3WAYX4)"愛琅"血壓監視組合套

870

CPM034812TAG ARGONDISPOSABLE PRESSURE MONITOR KIT:3 TRANSDUCER


1014

CPM0352026BB COMBITRANS MONITORING SETS(FD+TR+3WAYX2+TUBING) 康比得壓力監

測組

320

CPM0352036BB COMBITRANS MONITORING SETS: DISPOSABLE TRANSDUCER 康比得壓力

監測組:壓力轉換器

320

CPM038603TSG PRESSURE MONITOR KIT 1 DOME WITH TRANSDUCER 320

CPM03ADP00GJ JSMPRESSURE MONITORING KIT(TRANSDUCER)"吉生"血壓監視組合套 320

CPM03ADP3WGJ JSMPRESSURE MONITORING KIT(TRANSDUCER+3WAY)"吉生"血壓監視組

合套

320

CPM03ADPT1GJ JSMPRESSURE MONITORING KIT :TRANSDUCER PRESSURE MONITORING

KIT(TR+FD+3WAYX2+TUBING)"吉生"血壓監視組合套:1TR

320

CPM03ADPT2GJ JSMPRESSURE MONITORING KIT: 2 TRANSDUCER PRESSURE MONITORING

KIT 2X(TR+FD+3WAYX2+TUBING)"吉生"血壓監視組合套:2TR

870

CPM03ADPT3GJ JSMPRESSURE MONITORING KIT: 3 TRANSDUCER PRESSURE MONITORING

KIT 3X(TR+FD+3WAYX2+TUBING)"吉生"血壓監視組合套:3TR

1014

769


CPM03ADPTDGJ JSMPRESSURE MONITORING KIT: TRANSDUCER PRESSURE MONITORING 2

WAY KIT (TR+FDX2+3WAYX4+TUBINGX2)"吉生"血壓監視組合套:1TR

2WAY

592

CPM03D2020AG ARGONDISPOSABLE PRESSURE MONITOR:TRANSDUCER W/FLUSH"愛琅"血

壓監視組合套:壓力轉換器

320

CPM03D4812AG ARGONDISPOSABLE PRESSURE MONITOR KIT:1 TRANSDUCER "愛琅"血壓

監視組合套

320

CPM03D4812HM DISPOSABLE PRESSURE MONITORING KIT WITH TRANSDUCER 320

CPM03DDL60AG ARGONDISPOSABLE PRESSURE MONITOR KIT:1 TRANSDUCER

2WAY(1TR+2(FL+TU+3WAYX2)"愛琅"血壓監視組合套

592

CPM03DNN12AG ARGONDISPOSABLE PRESSURE MONITOR KIT:1 TRANSDUCER


675

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 EDWARDSTRUWAVE NEONATAL PEDIATRIC DISPOSABLE PRESSURE

TRANSDUCER (1 TR) ( TR+FD+TUBING+3WAYX2)"愛德華"凸威壓力傳導

器:1TR 小兒

675

CPM03PX1X0ED EDWARDSTRUWAVE DISPOSABLE PRESSURE TRANSDUCER (1 TR 2WAY)

2X( TR+FD+TUBING+3WAYX2)"愛德華"凸威壓力傳導器:1TR 2WAY

592

CPM03PX260ED EDWARDSTRUWAVE DISPOSABLE PRESSURE TRANSDUCER (1 DOME)(

TR+FD+TUBING+3WAY)"愛德華"凸威壓力傳導器:1TR

320

CPM03PX2X2ED EDWARDSTRUWAVE DISPOSABLE PRESSURE TRANSDUCER (2 TR) 2X(

TR+FD+TUBING+3WAY)"愛德華"凸威壓力傳導器:2TR

870

CPM03PX3X7ED EDWARDSTRUWAVE DISPOSABLE PRESSURE TRANSDUCER (3 TR) 3X(

TR+FD+TUBING+3WAYX2)"愛德華"凸威壓力傳導器:3TR

1014

CPM03PX604ED EDWARDSTRUWAVE DISPOSABLE PRESSURE TRANSDUCER(FLUSH DEVICE

X1+ STOPCOCK 1)"愛德華"凸威壓力傳導器:1TR

320

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

CRB0116100RU 路希支氣管內管及配件"RUSCH" BRONCHIAL TUBES AND ACCESSORIES 1490

CRB0116400RU 路希崔西歐派特氣切管組"RUSCH"TRACHEOPART TRACHEOSTOMY TUBE

SET-FOR BRONCHIAL INTUBATION

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

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

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

CRE0111246RU 路希氣管內管 "RUSCH" PVC ENDOTRACHEAL TUBE 159

770


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

CRE0304201RU 路希路希費雷思加強型氣管內管"RUSCH"RUSCHFLEX ARMOURED

ENDOTRACHEAL TUBES

300

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

CRE03U00502C 柯惠麥林可加強型氣管內管"COVIDIEN" MALLINCKRODT SAFETY-FLEX

REINFORCED TRACHEAL TUBE

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

CRE0400181RU 路希氣管內管"RUSCH"ENDOTRACHEAL TUBE 188

CRE0411781RU 路希氣管內管"RUSCH"ENDOTRACHEAL TUBE 202

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


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

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

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

CRE0600180RU 路希氣管內管"RUSCH" ENDOTRACHEAL TUBE 143

CRE0611780RU 路希氣管內管"RUSCH" ENDOTRACHEAL TUBE 201

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

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，


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

771


CRE06ETPSU3G 以仁氣管內管(朝南型/無氣囊)"ELINE" ENDOTRACHEAL TUBE(SOUTH

POLAR PREFORMED)

143

CRE06M7ET2MU 華新氣管內管 MODERN ENDOTRACHEAL TUBE 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

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

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

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

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

CRT0154025VK 旭邦柔得多幼兒型氣切管 "VITALTEC" ROTA-TRACH PEDIATRIC

TRACHEOSTOMY TUBE

328

CRT0155050VK “旭邦”柔得多內管型氣切管“VITALTEC”ROTA-TRACH INNER

CANNULA TRACHEOSTOMY TUBE

865

CRT01T1000RU 路希克利斯多克利爾氣切管及配件"RUSCH" CRYSTALCLEAR PLUS

TRACHEOSTOMY TUBE AND ACCESSORIES

531

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

CRT01U1213RU 路希克利斯多克利爾氣切管及配件(無氣囊/有內管)"RUSCH" CRYSTAL

CLEAR PLUS TRACHEOSTOMY TUBE AND ACCESSORIES(UNCUFFED TYPE，

WITH INNER CANNULA)

525

CRT0212161RU 路希克利斯多克利爾氣切管(有氣囊) "RUSCH" CRYSTALCLEAR

TRACHEOSTOMY TUBE(CUFFED TYPE)

332

CRT0253050VK 旭邦柔得多幼兒型氣切管 "VITALTEC" ROTA-TRACH PEDIATRIC

TRACHEOSTOMY TUBE(CUFFED)

332

772


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

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

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

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

773


CRT02U0062UW 巫諾氣管切開套管"UNOMEDICAL" TRACHEOSTOMY TUBE 328

CRT02U0065MU 華新氣切套管MODERN TRACHEOSTOMY TUBE 332

CRT02U1217RU 路希克利斯多克利爾氣切管(無氣囊)"RUSCH" CRYSTALCLEAR

TRACHEOSTOMY TUBE(UNCUFFED TYPE)

328

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



3800



3800

CRT0512141RU 路希崔西歐氣切管及其配件 "RUSCH" TRACHEOFIX TRACHEOSTOMY

TUBE AND ACCESSORIES

865

CRT0512142RU 路希崔西歐氣切管及其配件 "RUSCH"TRACHEOFIX TRACHEOSTOMY TUBE

AND ACCESSORIES

850



865



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

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

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

CRT1021549TX 泰利福快速經皮氣切組及配件"TELEFLEX" PERCUQUICK SET 5365

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

774


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 ARROWBERMAN 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

CVA0135125MR 美瑞特迎晰血管攝影導管"MERIT"IMPRESS ANGIOGRAPHIC

CATHETERS(4-5FR，0.035"80:125CM)

594



594



594



594

CVA01451XNCD CORDISTEMPO ANGIOGRAPHIC CATHETER TEMPO4，TEMPO5田布血管造影

導管

594

CVA014A00NM4 SITESEER CARDIOVASCULAR ANGIOGRAPHIC CATHETER 4FR 594

CVA014FLNBMR 美瑞特迎晰血管攝影導管"MERIT"IMPRESS ANGIOGRAPHIC

CATHETERS(4FR，65:110CM;NON-BRAIDED)

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


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


594

CVA01565VEMR IMPRESS ANGIOGRAPHIC CATHETERS 0.035"，0.038" 65CM，100，

125CM 映象血管攝影導管

594


CVA015FLNBMR 美瑞特迎晰血管攝影導管"MERIT"IMPRESS ANGIOGRAPHIC

CATHETERS(5FR，65:110CM;NON-BRAIDED)

594


CVA017779AMR PERFORMA DIAGNOSTIC RADIOLOGY CATHETERS 594

CVA01A80CMTM TERUMORADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4FR 80CM 歐

帝克血管攝影導管

594

CVA01H001NCK ANGIO CATHETER CEREBRAL CATHETER 594

CVA01H1234BQ ANGIOGRAPHIC CATHETER 4:5FR 100CM(腦部血管用) 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

775


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

CVA01HNR02CK 曲克皇家血管攝影導管"COOK" ROYAL FLUSH PLUS ANGIOGRAPHIC

CATHETER 4.0/5.0FR 65-110CM

594

CVA01N001NCK ANGIO CATHETER VISCERAL CATHETER 65:100CM 594

CVA01NP4RCGT GOODTECANGIOGRAPHY 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

CVA01RFGC4TM 泰爾茂葛來血管攝影導管"TERUMO" REDIFOCUS GLIDECATH 594

CVA020TL0KTM 泰爾茂歐路克血管造影導管"TERUMO" OUTLOOK ANGIOGRAPHIC CATHER 594

CVA024SP68TM TERUMORADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER PIGTAIL"泰

爾茂"歐帝克血管攝影導管

594

CVA0250115BB 柏朗血管造影導管(4-6FRENCH)B.BRAUN ANGIODYN ANGIOGRAPHIC

CATHETER

594

CVA0295007TM TERUMORADIOFOCUS YASHIRD ANGIOGRAPHIC CATHETER"泰爾茂"血管攝

影導管

594

CVA02AB441TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR COBRA 594

CVA02ABCDGTM TERUMORADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-5FR 65-

80CM"泰爾茂"歐帝克血管攝影導管

594

CVA02AD441TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR J CURVE 594

CVA02AE441TM TERUMORADIFOCUS 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

CVA02APLPRTM TERUMORADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-6FR 80-


594

CVA02APRHLTM TERUMORADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-6FR 100-


594

CVA02BABCHTM TERUMORADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-5FR 65-


594

CVA02BB141TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR HEADHUNTER 594

CVA02BE141TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR BENTSON 594

CVA02CLRJRTM TERUMORADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-6FR 80-


594

CVA02CRFJRTM TERUMORADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4-6FR 80-


594

CVA02DADBETM TERUMORADIFOCUS 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 TERUMORADIFOCUS 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 TERUMORADIFOCUS RH ANGIOGRAPHIC CATHETER 5FR 65CM"泰爾茂"血

管攝影導管

594

CVA02DGEA9TM TERUMORADIFOCUS 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

776


CVA02EBCGJTM TERUMORADIFOCUS ANGIOGRAPHIC CATHETER 5FR 100CM"泰爾茂"血管

攝影導管

594

CVA02EE150TM RADIFOCUS BENTSON ANGIOGRAPHIC CATHETER 5FR 100CM 594

CVA02FGFKLTM TERUMORADIFOCUS ANGIOGRAPHIC CATHETER 5FR 6FR 65，

80;100;110CM"泰爾茂"血管攝影導管

594

CVA02RDTR9TM TERUMORADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 5-6FR 80-


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

CVC01532XNCD 考迪斯血管造影導管"CORDIS"SUPER TORQUE ANGIOGRAPHIC CATHETER 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

CVC015384XCD INFINITI DIAGNOSTIC CARDIOLOGY CATHETER 4FR 594

CVC01752F1MR ANGIO CATHETER 594

CVC018526NSB EXPO ANGIOGRAPHIC CATHETER 100:125CM 5F:7F 594

CVC01CAPGTMR ANGIOGRAPHIC CATHETERS PIGTAIL CATHETER 594

CVC01CRDPGMR 美瑞特普瑪豬尾巴導管"MERIT PERFORMA CARDIAC PIGTAIL

CATHETERS

594

CVC01JL235BQ ANGIOGRAPHIC CATHETER JL4，JL3.5 594

CVC01JR235BQ ANGIOGRAPHIC CATHETER JR4，JR3.5 594

CVC01N001NCK ANGIO CATHETER CORONARY CATHETER 110:150CM 594

CVC01P1451BQ ANGIOGRAPHIC CATHETER 4:6FR 100~110CM(冠狀動脈用) 594

CVC01PG155BQ ANGIOGRAPHIC CATHETER P155，P1G 594

CVC01RH001TM TERUMO RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 泰爾茂歐帝


594

CVC01RH002TM TERUMO RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 泰爾茂歐帝


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

777


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

CXE0132003BA 巴德歐比特診斷電極導管-十極"BARD" ORBITER ST DIAGNOSTIC

ELECTRODE CATHETERS

9882

CXE0140003BA VIKING DECAPOLAR ELECTRODE CATHETER400030:36，400070:71，

400074:75

9882

CXE014000NBA VIKING QUADPOLAR ELECTRODE CATHETER400001:12，400041:48，

400050:51，400091P，

7191

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

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

CXE01CRR04ST 聖猷達雷斯龐生理電極導管(四極)"SJM" RESPONSE

ELECTROPHYSIOLOGY CATHETERS(QUADRIPOLAR)

7191

CXE01CRR10ST 聖猷達雷斯龐生理電極導管(十極)"SJM" RESPONSE

ELECTROPHYSIOLOGY CATHETERS(DECAPOLAR)

9882

CXE01CRS04ST 聖猷達史普力米生理電極導管(四極)"SJM"SUPREME

ELECTROPHYSIOLOGY CATHETERS 4F，5F，6F QUADRIPOLAR

7191

CXE01CRS10ST 聖猷達史普力米生理電極導管(十極)"SJM"SUPREME

ELECTROPHYSIOLOGY CATHETERS(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

CXE01EPF13JV “日本來富恩”菲克斯固定彎電極導管“JAPAN LIFELINE”EPSTAR

FIX ELECTROPHYSIOLOGY CATHETER

16180

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

778


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

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

CXE02DP853YB 爾灣電生理診斷導管-十極"IBI"ELECTROPHYSIOLOGY DIAGNOSTIC

CATHETER

14154

779


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

CXE02QP854YB 爾灣電生理診斷導管-四極"IBI"ELECTROPHYSIOLOGY DIAGNOSTIC

CATHETER

12284

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

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

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

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

CXE0383351YB 爾灣除顫電極導管"IBI" THERAPY ABLATION CATHETERS 21479

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

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


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

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 ESTECHCOBRA SURGICAL PROBE "艾斯泰格"康柏拉電刀用電極*限心臟


40854

780


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

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

CXE03FLTRBWE 百歐森偉伯司特攝氏超延伸可調彎式雙向電燒/電生理導管"BIOSENSE

WEBSTER"CELSIUS FLTR BI-DIRECTIONAL CATHETER(8MM)

21479

CXE03LVW40ST 聖猷達除顫電燒導管"SJM"LIVEWIRE TC ABLATION 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


48097

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

70200

CXE0588050ST 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

70200

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

70200

CXE05CFLEXST 聖猷達瑟爾皮庫爾菲斯心臟電燒導管"SJM"THERAPY COOL FLEX

ABLATION CATHETERS

70200

CXE05CH1L1SB 波士頓科技奇利冷卻除顫系統"BOSTON SCIENTIFIC"CHILLI COOLED

ABLATION SYSTEM

70200

CXE05CH1L2SB 波士頓科技奇利液體冷卻除顫導管"BOSTON SCIENTIFIC" CHILLI II

COOLED ABLATION CATHETER

70200

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

70200

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

70200

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

70200

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

70200

781


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

70200

CXE05EECATM4 美敦力心臟冷凍消融導管"MEDTRONIC" FREEZOR CARDIAC

CRYOABLATION CATHETER

70200

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

70200

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

70200

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 Catheter

70200

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 Tip Catheter

70200

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

70200

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

70200

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

FAD0150201UX EX-PRESS GLAUCOMA FILTRATION DEVICE伊倍視青光眼房水調整裝置*


19900

FALSM95UVNSZ PMMA I.O.L. 1532

FALSMAAB00A2 AMOSENSAR I-PIECE ACRYLIC IOL"眼力健"勝視明單片型摺疊式人工

水晶體

2744

FALSMACRA11X CROMAACRYLIC 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 1532

FALSMCSFLXRY RAYNERINJECTABLE IOL SYSTEM PACK(HYDROPHILIC ACRYLIC)"銳能"

推注式人工水晶體系統包

2744

FALSMDL52NA2 DURALENS II IOL 1532

FALSMHAKR0ZX AKREOS FOLDABLE INTRAOCULAR LENSES(ACRYLIC W/UV FILTER) 2744

FALSMHBEC21E AARENSINGLE-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 1532

FALSMMA30BA1 ACRYSOF INTRAOCULAR LENSES 2744

FALSMMC71CA1 PMMA I.O.L. UV，UV+LASER 1532

FALSMMZ30BA1 ALCON CILCO INTRAOCULAR LENSES(PMMA)"愛爾康"視而卡人工水晶體 1532

FALSMNEFL1RQ NEO EYE FOLDABLE INTRAOCULAR LENS新視軟式人工水晶體 2744

FALSMNERP1RQ ROHTONEO EYE INTRAOCULAR LENS RP-11;RP12 "樂敦"新視人工水晶

體

1532

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) 1588

FALSMSL0004H 漢寧達視能球面親水性人工水晶體 "HANITA" SEELENS SPHERICAL

HYDROPHILIC INTRAOCULAR LENS

2744

FALSMSTEC1LS ACRYLIC INTRAOCULAR LENS 2744

782


FALSNCRYA0B9 BAUSCH&LOMBCRYSTALENS 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&LOMBCRYSTALENS 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

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

FALSNMULT14L 藍提視多焦點散光人工水晶體(多焦點型)"LENTIS" HYDROSMART

POSTERIOR CHAMBER INTRAOCULAR LENS WITH MULTIFOCAL TORIC

OPTIC(自付差額品項)

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

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

FALSNMULT2RY RAYNERSULCOFLEX 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

FALSNMULT3RY RAYNERM-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

FALSNMULTT4L 藍提視多焦點散光人工水晶體(多焦點散光型)"LENTIS" HYDROSMART


OPTIC

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)(自

付差額)

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)"ALCON"ACRYSOF IQ RESTOR MULTIFOCAL TORIC

INTRAOCULAR LENS

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


2744

FALSNPLSZ14N 尼德克預載式人工水晶體注入系統:非球面軟式人工水晶體(自付差

額)"NIDEK" PRE-LOADED IOL INJECTION SYSTEM

2744

783


FALSNSLAF04H 漢寧達愛視能非球面人工水晶體 (自付差額品項)"HANITA" SEELENS

AF ASPHERIC HYDROPHILIC INTRAOCULAR LENS

2744

FALSNSLAFE4H 漢寧達愛視預載式非球面人工水晶體(自付差額品項) "HANITA"

SEELENS AF EASY PRELOADED ASPHERIC HYDROPHILIC INTRAOCULAR

LENS

2744

FALSNSLHP04H 漢寧達必視能非球面疏水性人工水晶體(自付差額品項) "HANITA"

SEELENS HP ASPHERIC HYDROPHOBIC INTRAOCULAR LENS

2744

FALSNSLMF04H 漢寧達全視能非球面多焦點人工水晶體(自付差額品項) "HANITA"

SEELENS MF ASPHERIC MULTIFOCAL INTRAOCULAR LENS

2744

FALSNT0RC0A1 “愛爾康”可舒智慧型妥瑞明非球面散光矯正單片型軟式人工水晶體

(可濾部分藍光)(自付差額品項)

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 AMOTECNIS 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(自付差額)

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


2744

FALSNT0RC2RY RAYNERSULCOFLEX 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

FALSNT0RCA4L 藍提視多焦點散光人工水晶體(散光型)"LENTIS" HYDROSMART


OPTIC

2744

FALSNT0RCARY RAYNERT-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.SCHMIDTSILICONE 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.SCHMIDTSILICONE 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.SCHMIDTACRYLIC 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


2744

FALSNWAVE11E AARENHYDROPHILIC 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

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

FALSNWAVE11X CROMAPRELOADED 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

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

FALSNWAVE16C 愛視睫軟式疏水性人工水晶體 :非球面軟式人工水晶體(自付差

額)ASPICIO SOFT HYDROPHOBIC INTRAOCULAR LENS

2744

784


FALSNWAVE1A1 ACRYSOF ASPHERIC NATURAL IQ SINGLE PIECE IOL 非球面軟式+黃色

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 HOYAHOYA-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


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

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.SCHMIDTACRYLIC 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 AARENSINGLE-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 CROMABARRETT 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


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 RAYNERSULCOFLEX 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，


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

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

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

FALSNWAVE4RY 銳能非球面推注式人工水晶體系統 "RAYNER"ASPHERIC ACRYLIC IOL

WITH RAYSERT PLUS

2744

FALSNWAVE5A2 眼力健添視明單片型折疊式人工水晶體(非球面)"AMO" TECNIS 1-

PIECE ACRYLIC INTRAOCULAR LENS

2744

785


FALSNWAVE5B9 BAUSCH&LOMBAKREOS 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&LOMBAKREOS 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


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

1449

FAV01AP080B9 博士倫安視平人工玻璃體0.8ML"BAUSCH&LOMB"AMVISC PLUS

VISCOELASTIC

1605

FAV01AV050B9 博士倫安視可人工玻璃體0.5ML"BAUSCH&LOMB"AMVISC VISCOELASTIC 1449

FAV01AV080B9 博士倫安視可人工玻璃體0.8ML"BAUSCH&LOMB"AMVISC VISCOELASTIC 1605

FAV01B0050A1 0.5ML VISCOAT STERILE OCULAR VISCOELASTIC SOLUTION 玻離體替

代物

1449

FAV01B0075A1 0.75CC VISCOAT-STERILE OCULAR VISCOELASTIC SOLUTION 1605

FAV01BC1001X CROMA-PHARMA"BIOCORNEAL II 1CC"克洛法瑪"拜耳克尼人工玻璃體 1605

FAV01C0100R9 MEGACROM 1.8% 1CC 明佳人工玻璃體 1605

FAV01C0150R9 VISICROM 2% 1.5ML 2.5ML人工玻璃體 1605

FAV01C0200R9 CROMAEYEFILL HD VISCOELASTIC SOLUTION 2.5ML;1.5ML "寇瑪"艾飛

爾人工玻璃體

1605

FAV01C0300R9 CROMAEYEFILL M.B VISCOELASTIC SOLUTION 1.8% 0.55ML+1.4%

0.8ML "寇瑪"艾飛雙劑人工玻璃體

1605

FAV01C0400R9 CROMAEYEFILL S.C. VISCOELASTIC SOLUTION 0.9ML"寇瑪"艾飛人工

玻璃體

1605

FAV01D0100A1 DISCOVISC OPHTHALMIC VISCOSURGICAL DEVICE 1CC(人工玻璃體) 1605

FAV01D3540A1 0.75ML DUOVISC VISCOELASTIC SYSTEM 1605

FAV01E01003H 艾肯明妥見人工玻璃體"EYEKON"EYE COAT SH SODIUM HYALURONATE

VISCOELASTIC

1605

FAV01H0055A2 HEALON 0.55ML 1449

FAV01H0506A2 HEALON 5 0.6ML 1449

FAV01HGV55A2 HEALON GV 0.55ML 1449

FAV01HGV85A2 HEALON GV 0.85ML 1605

FAV01P0040A1 0.4ML PROVISC 玻離體替代物 707

FAV01P0055A1 0.55ML PROVISC 玻離體替代物 1449

FAV01P0085A1 0.85CC PROVISC 玻離體替代物 1605

FAV01PA001LB 護視安玻璃體替代物:0.55ML PREVISCAID OPHTHALMIC

VISCOELASTIC:0.55ML

1449


VISCOELASTIC:0.75ML

1605


VISCOELASTIC:1.0ML

1605

FAV01RN085RY RAYVISC OPHTHALMIC VISCOELASTIC 0.85ML 人工玻璃體 1605

FAV01VA08CLB VISCAID 0.8ML 1605

FAV01VA10CLB MBIVISCAID OPHTHALMIC VISCOELASTIC(1.0CC)"和康"維視愛眼科黏

彈劑

1605

FAV01VA204LB VISCAID OPHTHALMIC VISCOELASTIC 維視愛眼科黏彈劑(0.4CC 1.5%

SODIUM HYALURONATE)

707

786



SODIUM HYALURONATE)

1449


SODIUM HYALURONATE)

1605


SODIUM HYALURONATE)

1605

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

1605

FBA0110001H1 BONE CEMENT40GM 839

FBA011101NZ1 OSTEOBOND COPOLYMER BONE CEMENT 40G/20ML 839

FBA011102NZ1 DOUGH TYPE BONE CEMENT 40GM 839

FBA011103N6A 捷邁高抗力骨水泥(HFBC)"AAP BIOMATERIALS" HI-FATIGUE BONE

CEMENT(HFBC)-20G

420


CEMENT(HFBC)-40G

839


CEMENT(HFBC)-80G

1678

FBA011112NZ1 L.V.C BONE CEMENT 1285

FBA011200A2Z 泰瑞斯低黏性骨水泥CEMEX RX 40GM 839

FBA011200S2Z 泰瑞斯低黏性骨水泥"TECRES"CEMEX XL 839

FBA0131050CM CRANIOPLASTY BONE CEMENT (2PKG/BOX)頭顱整形術專用 3622

FBA01312204T 泰瑞斯蒙締客顱骨用成形骨泥"TECRES" MENDEC CRANIO 7181

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

FBA01HV040DP 帝富適髓骨水泥"DEPUY" SMARTSET HV BONE CEMENT 839

FBA0228673SN OSTEOTOMY FIXATION STAPLES(鈷鉻鉬) 1637

FBA0228675SN 史耐輝U型固定釘"SMITH&NEPHEW"FIXATION STAPLE/OSTEOTOMY

FIXATION STAPLES

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

FBA028690RSN 史耐輝U型固定釘"SMITH&NEPHEW"FIXATION STAPLE/REGULAR

FIXATION STAPLES

978

FBA028698TSN 史耐輝U型固定釘"SMITH&NEPHEW"FIXATION STAPLE/TABLE FIXATION

STAPLES

2005

FBA028720SSN 史耐輝U型固定釘"SMITH&NEPHEW"FIXATION STAPLE/SHORT LEG

FIXATION STAPLES

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


GRAFT 1CC

1923


GRAFT 5CC

4197


GRAFT 10CC

8457


GRAFT 20CC

12062

787


FBA0403G05BC BIOMATLANTEMBCP 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 WILTROMOSTEOCERA 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



4197

FBA040C05GWG WILTROMOSTEOCERA BONE GRAFT SUBSTITUTE顆粒(5.0CM3)"台微醫"康


4197



4197

FBA040C07GWG WILTROMOSTEOCERA BONE GRAFT SUBSTITUTE顆粒(7.0CM3)"台微醫"康


4197

FBA040C10BWG WILTROMOSTEOCERA 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

FBA040C10GWG WILTROMOSTEOCERA 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

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

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

FBA0410104FV 博納骨人工骨替代物(1G)BONAGRAFT SYNTHETIC BONE SUBSTITUTE 1923

FBA0410105FV 博納骨人工骨替代物(2.5G)BONAGRAFT SYNTHETIC BONE SUBSTITUTE 3150

FBA0410106FV 博納骨人工骨替代物(10G)BONAGRAFT SYNTHETIC BONE SUBSTITUTE 8457

FBA0410500M4 MEDTRONICMASTERGRAFT RESORBABLE CERAMIC GRANULES"美敦力"瑪斯

特可吸收性骨填充物5CC

4197



8457

FBA041142NZ0 TRIOSITE BONE SUBSTITUTES 2CC適應症請見備註欄 3150



10236

FBA041151NZ0 BIOMATLANTE TRIOSITE BONE SUBSTITUTES 10CC*適應症請見備註欄 8457



16100

FBA041300NZ0 TRIOSITE BONE SUBSTITUTES 2CC適應症請見備註欄 3150

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

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

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

788



註欄

8457


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

FBA04AG01RF8 FORMOSABONE 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 FORMOSABONE 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 FORMOSABONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER) 5 ML


4197

FBA04AG10RF8 FORMOSABONE 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



10236



12062

FBA04AX0A1HY 艾沛瓷骨移植替代物:塊狀:APACERAM BONE GRAFT SUBSTITUTE-TYPE

AX BLOCK

1923


AX BLOCK

3150


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


2.5CC *適應症請見備註欄

3150



4197



8457



12062



16100

FBA04B07143V 骨立活人工替代骨(滅菌)1CC VITOS M BONE GRAFT SUBSTITUTE

(STERILE)1CC

1923

FBA04B08153V 骨立活人工替代骨(滅菌)2.5CC VITOS M BONE GRAFT SUBSTITUTE

(STERILE)2.5CC

3150


(STERILE)5CC

4197


(STERILE)10CC

8457


(STERILE)20CC

12062


(STERILE)30CC

16100

FBA04BC02BWG WILTROMBICERA 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

789




4197

FBA04BC05GWG WILTROMBICERA BONE GRAFT SUBSTITUTE顆粒(5.0CM3)"台微醫"喜瑞


4197



4197



4197



8457



8457

FBA04CA01RF8 FORMOSABONE 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 FORMOSABONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER) 3 ML


3150



4197



8457



10236



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 MERRIESUNI-OSTEO "美瑞世"人工骨2GM(2CC)*適應症請見備註欄 3150




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


1923

FBA04FM02CLB 富瑞密骨骼填補顆粒FORAMIC BONE SUBSTITUTE GRANULES 2CC ※給


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

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 PURZERSINBONEHT BONE REPLACEMENT (7立方公分)生骨替代物二代*


4197

FBA04HT021PQ PURZERSINBONEHT BONE REPLACEMENT(1立方公分)*適應症請見備註欄 1923





4197

790




3150

FBA04MA001HY 艾沛瓷骨移植替代物:顆粒:APACERAM BONE GRAFT SUBSTITUTE，TYPE

AX GRANULE

1923


AX GRANULE

3150


AX GRANULE

4197


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 *


3150

FBA04SB050PQ PURZERSINBONE BONE REPLACEMENT 7.0CM3"瑞安"生骨替代物 3416

FBA04SB054PQ PURZERSINBONE 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)*


3416

FBA04TP0014R 瑞奇人工骨RICH BONE SUBSTITUTE(0.5CC-1CC) 1923

FBA04TP0024R 瑞奇人工骨RICH BONE SUBSTITUTE(2CC-2.5CC) 3150

FBA04TP0054R 瑞奇人工骨RICH BONE SUBSTITUTE-5CC 4197




FBA070942NH1 X-CHANGE MESH 5250

FBA101905NU0 U2 HIP STEM PLUG 7:16 1019

FBA101907NU0 聯合骨水泥式股骨柄:骨水泥式拋光股骨柄中心定位件與骨水泥止檔

件"UNITED"HIP SYSTEM:UCP CENTRALIZER WITH CEMENT RESTRICTOR

1019

FBA102002NW2 CEMENT CENTRALIZER 9:21MM 1019

FBA103005M5B 威力骨可吸收性磷酸鈣陶瓷MAXIBONE CALCIUM PHOSPHATE

CERAMIC(1.0-3.0MM GRANULES/5ML;0.5-1.0MM GRANULES/5ML)

4197

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

FBA143704NH1 DALL-MILES STAINLESS CABLE BONE PLATE ※適應症請見備註欄 7384

FBD00000955H 鴻君骨板骨釘系統/動態膝部加壓骨釘板組 (骨板+壓迫骨釘+拉力骨

釘)"HC"BONE PLATES AND SCREWS/OSTEO COMPRESS CONDYLE PLATE

SYSTEM (95°)(6:12 HOLE)

6748

FBD00001355H 鴻君骨板骨釘系統/動態髖部加壓骨釘板組 (骨板+壓迫骨釘+拉力骨

釘)"HC"BONE PLATES AND SCREWS/OSTEO COMPRESS HIP PLATE

SYSTEM (135°:150°)(2:12 HOLE)

6796

791


FBD00001NNY2 亞太醫療股骨壓迫性骨板系統(壓迫性骨板組)"SYNTEC"DYNAMIC

HIP/CONDYLAR SCREW PLATE SYSTEM-DYNAMIC CONDYLAR SCREW PLATE

SET(PLATE+DHS SCREW+COMP SCREW)

6748

FBD00001XNY2 DHS PLATE 135:150度 2:12HOLE(產品型號281420:410，281540:560) 6796

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 SYNTHESBONE 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 MICROWAREBONE 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 MICROWAREBONE 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 STRYKEROMEGA3 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

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 LAG SCREW COMPRESSION SCREW)

6796

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) ※


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 ※


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

792


FBEF127500R1 ILIZAROV External Fixator System :FEMORAL BASIC SET 股骨基本

組 ※適應症請見備註欄

18900

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 ※


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


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


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


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


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

793


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

FBEF32180NR1 ILIZAROV External Fixator System:ANKLE BASIC SET 踝骨基本組


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


17500

FBEF440001D1 TRAUMA-FIX EXTERNAL FIXTOR:HUMERAL BASIC SET 肱骨基本組 ※適


17500

FBEF440002D1 TRAUMA-FIX EXTERNAL FIXTOR:HUMERAL TRANSPORT FRAME 肱骨移位


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

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

FBEF500017D1 TELES CONNECTING ROD 341

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

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

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

FBEF5U1U2ND1 EXTERNAL FIXATOR SYSTEM:PIN CLAMP針夾(DIA.15:20MM) 3767

794


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

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

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

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

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

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

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

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



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



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

795


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

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

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 ZIMMERCOONRAD/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


24514

FBEU181053Z1 ZIMMERCOONRAD/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

FBFW14885NW2 SWANSON WRIST JOINT IMPLANT 11052

FBHB1103XNDP CUP ※適應症請見備註欄 10334

FBHB11503NU0 UNITEDHIP 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

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 DEPUYBIPOLAR 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

FBHBA1100NDP DEPUYCORAIL BIPOLAR HIP SYSTEM"帝富:可瑞雙極式人工髖關節組


35195

796


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 UNITEDHIP SYSTEM-U2 BIPOLAR IMPLANT "聯合"雙極半髖人工髖關節


35195

FBHBA3000TZ1 ZIMMERVERSYS HIP SYSTEM:BIPOLAR HIP SYSTEM "西美"威士人工髖

關節:雙極式人工髖關節組

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

FBHBA6000NZ1 CLS BIOPOLAR SYSTEM(STEM+HEAD+CUP)※適應症請見備註欄 35195

FBHBA7000NS2 好美得卡奧斯得寧愛克雷得髖關節系統-雙極式"HOWMEDICA

OSTEONICS"ACCOLADE FEMORAL HIP SYSTEM-BIPOLAR

35195

FBHBA8000TZ1 西美雙極式人工髖關節系統 BIPOLAR HIP SYSTEM(CUP+HEAD+STEM) 35195

FBHBAKTV1TZ1 ZIMMERKINECTIV 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


35195

FBHBCCERA1S2 CERAMIC BIPOLAR HIP SYSTEM※符合傳統雙極式髖關節組適應症者，



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


35195

FBHBCCERA1W2 CERAMIC BIPOLAR HIP SYSTEM※符合傳統雙極式髖關節組適應症者，



35195

FBHBCCERA1Z1 ZIMMERCERASUL POLY BACK OF CERAMIC LINER:BIPOLAR CERAMIC

SYSTEM"西美"西羅索高分子背架陶瓷髖臼植入物:陶瓷雙極式※自付

差額品項，超過部分由病患自付(符合傳統雙極式髖關節組給付規定

者使用)

35195

FBHBCCERA2AE CERAMIC BIPOLAR HIP SYSTEM※符合傳統雙極式髖關節組適應症者，



35195

FBHBCCERA2S2 STRYKERCERAMIC 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 ZIMMERKINECTIV 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 ZIMMERBIPOLAR BIOLOX DELTA HIP SYSTEM(CERAMIC)"捷邁"百優人工

髖關節系統:陶瓷雙極式人工髖關節組※自付差額品項，超過部分由

病患自付(符合傳統雙極式髖關節組給付規定者使用)

35195

FBHBCCERA4Z1 ZIMMERM/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

797


FBHBCCERA5U0 聯合人工髖關節組:陶瓷雙極式人工髖關節組※自付差額品項，超過

部分由病患自付"UNITED"CERAMIC BIPOLAR SYSTEM

35195

FBHBCCERA6S2 好美得卡奧斯得寧愛克雷得髖關節系統-陶瓷雙極式(自付差額品

項)"HOWMEDICA OSTEONICS"ACCOLADE FEMORAL HIP SYSTEM-CERAMIC

BIPOLAR

35195

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

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


45118

FBHBCCERR5Z1 ZIMMERBIOLOX CERAMIC FEMORAL HEADS:BIOLOX OPTION BIPOLAR HIP

SYSTEM"捷邁"百優人工髖關節系統:陶瓷雙極式人工髖關節組※自付

差額品項，超過部分由病患自付

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

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

FBHC13023NU0 UNITEDHIP SYSTEM(FULL XPE CUP)"聯合"骨水泥式髖臼杯:高耐磨全

聚乙烯式髖臼杯(含內襯)

14352

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

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

FBHC18755NZ1 ZIMMERALLOFIT IT ALLOCLASSIC ACETABULAR SHELL"捷邁"艾洛菲艾

提人工髖臼杯

10334

FBHC1DYNA2W2 WRIGHTDYNASTY 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 DEPUYPINNACLE HIP SYSTEM:CUP"帝富"必耐久人工髖臼系統:髖臼杯


10334

FBHC1P1NNADP PINNACLE ACETABULAR CUP全人工髖關節髖臼杯 10334

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 HOWMEDICAMODULAR REPLACEMENT SYSTEM -HIP※申報時應檢附該被保

險人之發票備查

187000

798


FBHCM6485NH1 HOWMEDICAMODULAR 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

FBHH101432DP DEPUYAML 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

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 DEPUYARTICUL/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

FBHHCCERA1S2 CERAMIC HIP SYSTEM：HEAD※凡只更換股骨頭者，如自願選用陶瓷股


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


4352

FBHHCCERA1Z1 CERAMIC HIP SYSTEM：HEAD※凡只更換股骨頭者，如自願選用陶瓷股


4352

FBHHCCERA2AE CERAMIC HIP SYSTEM:HEAD※凡只更換股骨頭者，如自願選用陶瓷股


4352

FBHHCCERA2S2 STRYKERTRIDENT 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 WRIGHTDYNASTY 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

FBHHCCERA2Z1 ZIMMERBIOLOX 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 WRIGHTDYNASTY 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 UNITEDCERAMIC 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

799


FBHHCCERA7U0 聯合襯套式陶瓷股小球"UNITED"BIOLOX OPTION CERAMIC FRMORAL

HEAD(自付差額品項)

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(UHMWPE)

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 WRIGHTLINEAGE 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)


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

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

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 DEPUYPINNACLE 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

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

800


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


付。

4018

FBHLCCERA1Z1 CERAMIC HIP SYSTEM：LINER※凡只更換髖臼杯內襯者，如自願選用


付。

4018

FBHLCCERA2Z1 ZIMMERBIOLOX 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


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

FBHMCBCEA6S2 好美得卡奧斯得寧愛克雷得髖關節系統-陶瓷MOORE雙極式(自付差額

品項)"HOWMEDICA OSTEONICS"ACCOLADE FEMORAL HIP SYSTEM-

CERAMIC MOORE BIPOLAR

7733

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

FBHMCBCER1S2 CERAMIC BIPOLAR HIP SYSTEM※凡符合使用MOORE規定者，如自願選


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


由病患自付。

7733

FBHMCBCER1Z1 CERAMIC BIPOLAR HIP SYSTEM※凡符合使用MOORE規定者，如自願選


由病患自付。

7733

FBHMCBCER2AE CERAMIC BIPOLAR HIP SYSTEM※凡符合使用MOORE規定者，如自願選


由病患自付。

7733

FBHMCBCER2S2 STRYKERCERAMIC 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 ZIMMERBIPOLAR 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 聯合人工髖關節組:陶瓷雙極式人工髖關節組※自付差額品項，超過

部分由病患自付"UNITED"CERAMIC BIPOLAR SYSTEM

7733

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

FBHMCPCEA5S2 好美得卡奧斯得寧愛克雷得人工髖關節系統-陶瓷頭+陶瓷內襯

MOOR(自付差額品項)"HOWMEDICA OSTEONICS"ACCOLADE FEMORAL HIP

SYSTEM-CERAMIC HEAD+CERAMIC LINER MOORE

7733

FBHMCPCEA6S2 好美得卡奧斯得寧愛克雷得人工髖關節系統-陶瓷頭MOORE(自付差額

品項)"HOWMEDICA OSTEONICS"ACCOLADE FEMORAL HIP SYSTEM-

CERAMIC HEAD MOORE

7733

801


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

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

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


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


付。

7733

FBHMCPCER2S2 STRYKERCERAMIC 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 ZIMMERBIOLOX 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 UNITEDCERAMIC 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 ZIMMERBIOLOX 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 ZIMMERBIOLOX 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


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

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

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

FBHMCRCER1S2 CERAMIC REVISION HIP SYSTEM※凡符合使用MOORE規定者，如自願選


由病患自付。

7733

FBHMCRCER1U0 CERAMIC REVISION HIP SYSTEM※凡符合使用MOORE規定者，如自願選


由病患自付。

7733

802


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


由病患自付。

7733

FBHMCRCER2S2 STRYKERCERAMIC REVISION HIP SYSTEM※符合使用MOORE規定，使用

陶瓷重建型，部分給付)

7733

FBHMCRCER2Z1 ZIMMERBIOLOX 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 ZIMMERREVISION 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 ZIMMERBIOLOX 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 UNITEDCERAMIC 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


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

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

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 "聯合"聯髖人工髖關節組 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

FBHPA2000NU0 UNITED U2 TOTAL HIP SYSTEM "聯合"聯髖人工髖關節組 39396

FBHPA2000TZ1 HA/TCP TOTAL HIP SYSTEM ※適應症請見備註欄 39396

FBHPA3000NU0 聯合聯髖人工髖關節組"UNITED" UNIQHIP TOTAL HIP SYSTEM 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

FBHPA6000NS2 好美得卡奧斯得寧愛克雷得髖關節系統"HOWMEDICA

OSTEONICS"ACCOLADE FEMORAL HIP SYSTEM

39396

803


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 ZIMMERKINECTIV 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 ZIMMERLONGEVITY IT TOTAL HIP SYSTEM (WITH KINECTIV)"捷邁"隆

傑艾提全人工髖關節組(搭配組合式股骨柄)

49319

FBHPAPMAMLDP DEPUYPINNACLE HIP SYSTEM"帝富"必耐久人工髖臼系統※適應症請見

備註欄

39396

FBHPAPMARADP DEPUYTOTAL HIP SYSTEM"帝富"全人工髖關節組※適應症請見備註欄 39396

FBHPAPRFMRW2 WRIGHTTOTAL 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


39396

FBHPCCERA1DP CERAMIC TOTAL HIP SYSTEM※凡符合傳統人工髖關節組之適應症者，



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，



39396

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，



39396

FBHPCCERA2AE CERAMIC TOTAL HIP SYSTEM※凡符合傳統人工髖關節組之適應症者，



39396

FBHPCCERA2S2 STRYKERCERAMIC 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


39396

804


FBHPCCERA2Z1 ZIMMERKINECTIV 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

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

FBHPCCERA3Z1 ZIMMERBIOLOX TOTAL HIP SYSTEM(CERAMIC)"捷邁"百優人工髖關節系

統:陶瓷HEAD+陶瓷LINER※自付差額品項，超過部分由病患自付(符合

傳統人工髖關節組給付規定者使用)

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 ZIMMERM/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)※自付差額項目，超過部分由病

患

49319

FBHPCCERA5S2 好美得卡奧斯得寧愛克雷得人工髖關節系統-陶瓷頭+陶瓷內襯(自付

差額品項)"HOWMEDICA OSTEONICS"ACCOLADE FEMORAL HIP SYSTEM-

CERAMIC HEAD+CERAMIC LINER

39396

FBHPCCERA5U0 UNITEDCERAMIC 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 ZIMMERBIOLOX DELTA CERAMIC TOTAL HIP SYSTEM"捷邁"百優人工髖

關節系統:陶瓷全人工髖關節組(陶瓷HEAD)※自付差額品項，超過部

分由病患自付(符合傳統人工髖關節組給付規定者使用)

39396

FBHPCCERA6S2 好美得卡奧斯得寧愛克雷得髖關節系統-陶瓷頭(自付差額品

項)"HOWMEDICA OSTEONICS"ACCOLADE FEMORAL HIP SYSTEM-CERAMIC

HEAD

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 ZIMMERBIOLOX DELTA CERAMIC TOTAL HIP SYSTEM"捷邁"百優人工髖

關節系統:陶瓷股骨柄組合式(陶瓷HEAD)※自付差額品項，超過部分

由病患自付(符合傳統人工髖關節組給付規定者使用)

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 ZIMMERBIOLOX CERAMIC FEMORAL HEADS:BIOLOX OPTION TOTAL HIP

SYSTEM"捷邁"百優人工髖關節系統:陶瓷HEAD+陶瓷LINER※自付差額

品項，超過部分由病患自付(符合傳統人工髖關節組給付規定者使用

39396

FBHPCCERE8Z1 ZIMMERBIOLOX CERAMIC FEMORAL HEADS:BIOLOX OPTION TOTAL HIP

SYSTEM(KINECTIV)"捷邁"百優人工髖關節系統:陶瓷全人工髖關節組

(陶瓷HEAD+陶瓷LINER)(搭配組合式股骨柄)※自付差額項目，超過部

分由病患自付

49319

FBHPCCERR7Z1 ZIMMERBIOLOX CERAMIC FEMORAL HEADS:BIOLOX OPTION TOTAL HIP

SYSTEM"捷邁"百優人工髖關節系統:陶瓷HEAD+陶瓷LINER※自付差額

品項，超過部分由病患自付(符合傳統人工髖關節組給付規定者使用)

39396

FBHPCCERR8Z1 ZIMMERBIOLOX CERAMIC FEMORAL HEADS "捷邁"百優人工髖關節系統:

陶瓷全人工髖關節組(陶瓷HEAD+陶瓷LINER)(搭配組合式股骨柄)※自

付差額項目，超過部分由病患自付

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

805


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，


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


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


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


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 ZIMMERKINECTIV 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)※


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

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


39396

FBHPMMETA2DP DEPUYPINNACLE 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 ZIMMERKINECTIV 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


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 ZIMMERM/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


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

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

806


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 UNITED U2 HIP STEM:U2 REVISION HIP SYSTEM"聯合"U2人工髖關節

股骨柄:U2重建型全人工髖關節組

52796

FBHRA6000NU0 UNITED”U-MOTION II REVISION TOTAL HIP SYSTEM聯合"優磨二代重

建型全髖關節組

52796

FBHRA6000TZ1 ZIMMERWAGNER 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

FBHRA8000TZ1 ZIMMERLONGEVITY IT REVISION TOTAL HIP SYSTEM"捷邁"隆傑艾提重

建型人工髖關節組

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 DEPUYPINNACLE 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 LINER

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

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 DELTA CERAMIC LINER(自付差額品項)

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


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



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



52796

FBHRCCERA2AE CERAMIC REVISION HIP SYSTEM※符合傳統重建型髖關節組適應症者



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

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

807


FBHRCCERA2Z1 ZIMMERBIOLOX CERAMIC FEMORAL HEADS:BIOLOX DELTA CERAMIC

REVISION HIP SYSTEM "捷邁"百優人工髖關節系統:重建型(陶瓷

HEAD)※自付差額品項，超過部分由病患自付(符合傳統重建型人工髖

關節組給付規定者使用)

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

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 ZIMMERREVISION 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


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 ZIMMERBIOLOX CERAMIC FEMORAL HEADS:BIOLOX DELTA CERAMIC

REVISION HIP SYSTEM"捷邁"百優人工髖關節系統:重建型(陶瓷HEAD)

※自付差額品項，超過部分由病患自付(符合重建型且骨缺損2度以上

給付規定者使用)

70099

FBHRCCERA5U0 UNITEDCERAMIC 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


52796

FBHRCCERA5Z1 ZIMMERBIOLOX DELTA CERAMIC REVISION HIP SYSTEM(ZMR)"捷邁"重

建型陶瓷人工髖關節(組合式股骨柄)※自付差額品項，超過部分由病

患自付

70099

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

FBHRCCERE5Z1 ZIMMERBIOLOX CERAMIC FEMORAL HEADS"捷邁"百優人工髖關節系統:

重建型(陶瓷HEAD+陶瓷LINER)※自付差額品項，超過部分由病患自付

(符合傳統重建型人工髖關節組給付規定者使用)

52796

FBHRCCERE6Z1 ZIMMERBIOLOX CERAMIC FEMORAL HEADS(ZMR)"捷邁"百優人工髖關節

系統:重建型(陶瓷HEAD+陶瓷LINER)※自付差額品項，超過部分由病

患自付(符合重建型且骨缺損2度以上給付規定者使用)

70099

FBHRCCERR5Z1 ZIMMERBIOLOX CERAMIC FEMORAL HEADS"捷邁"百優人工髖關節系統:


(符合傳統重建型人工髖關節組給付規定者使用)

52796

FBHRCCERR6Z1 ZIMMERBIOLOX CERAMIC FEMORAL HEADS"捷邁"百優人工髖關節系統:


(符合重建型且骨缺損2度以上給付規定者使用)

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

FBHS11107NU0 UNITEDHIP SYSTEM:UCP STEM CEMENTED"聯合"骨水泥式股骨柄:骨水

泥式拋光股骨柄

20692

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

FBHS1135XNDP AML STEM(87/7/7新增1554，1557-02:08，42:48，1345-20:27)※適


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

808


FBHS13708NW2 FEMORAL STEM (378X-XXXX自88/09/01起生效，385X，3793-XXXX自


20692

FBHS16010NZ1 ZIMMERAVENIR MULLER STEM"捷邁"艾文力穆勒人工股骨柄 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

FBHS16076NS2 HOWMEDICA-OSTEONICS OMNIFIT HFX HIP STEM "好美得卡-奧斯得寧"

人工髖關節股骨柄

20692

FBHS160ACNS2 好美得卡奧斯得寧愛克雷得髖關節系統-股骨柄"HOWMEDICA

OSTEONICS"ACCOLADE FEMORAL HIP SYSTEM-HIP STEM

20692

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

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 ZIMMERKINECTIV 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


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 WRIGHTPROFEMUR HIP SYSTEM:MODULAR STEM"瑞德"博菲莫人工髖關節

系統:組合式股骨柄

30615

FBHS1UTF1NU0 聯合楔形骨柄"UNITED”HIP SYSTEM:UTF STEM 20692

FBHS2130LNS2 HOWMEDICA-OSTEONICSOMNIFIT 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 ZIMMERWAGNER 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

FBHS31107RU0 UNITEDHIP SYSTEM:UCP LONG STEM CEMENTED HIGH OFFSET"聯合"骨

水泥式股骨柄:骨水泥式拋光長股骨柄高偏移型

34092

FBHS32000NW2 PERFECTA REVISION HIP STEM(NECK+BODY+STEM)※適應症請見備註欄 56371

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

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

FBHS5108XNU0 聯合二代大粗隆股骨柄"UNITED"HIP SYSTEM:GTF STEM II 24750

FBHS51108NU0 G.T.F HIP STEM大粗隆股骨柄※適應症請見備註欄 24750

809


FBHU110400Z1 捷邁人工肩關節系統:全肩關節"ZIMMER" ANATOMICAL SHOULDER

SYSTEM:TOTAL SHOULDER(STEM+HEAD+GLENOID)

52893

FBHU110401Z1 捷邁人工肩關節系統:半肩關節"ZIMMER" ANATOMICAL SHOULDER

SYSTEM:HEMI SHOULDER(STEM+HEAD)

38489

FBHU11040NZ1 捷邁人工肩關節系統:人工肱骨柄"ZIMMER" ANATOMICAL SHOULDER

SYSTEM:STEM

26932

FBHU11041NZ1 捷邁人工肩關節系統:人工肱骨頭"ZIMMER" ANATOMICAL SHOULDER

SYSTEM:HEAD(HUMERAL CUP)

11557

FBHU11042NZ1 捷邁人工肩關節系統:人工肩盂"ZIMMER" ANATOMICAL SHOULDER

SYSTEM:GLENOID(CUP INLAY)

14404

FBHU15300NS2 TOTAL SHOULDER SYSTEM(GLENOID+HEAD+STEM) 52893

FBHU15301NS2 SHOULDER SYSTEM(HEAD+STEM) 38489

FBHU15350NS2 SHOULDER HUMERAL HEAD(鈷鉻) 11557

FBHU15351NS2 SHOULDER HUMERAL STEM(TITANIUM) 26932

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※限用於膝關節再置換時使用 2989

FBKA25990TZ1 FEMORAL AUGMENTATION ※限用於膝關節再置換時使用 2989

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

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 HOWMEDICAGLOBAL 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 HOWMEDICAGLOBAL 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

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


5682

FBKE23000NW2 EXTENSION FEMORAL TIBIAL STEM※限用於人工膝關節再置換時使用 5682

FBKE25988NZ1 STEM EXTENSION ※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

810


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

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 WRIGHTADVANCE 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

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


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


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 DEPUYSIGMA 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

FBKF22105NU0 FEMUR COMPONENT 訂製型股骨植入物※適應症請見備註欄 89000

FBKF23000NW2 ADVANCE REVISION FEMORAL COMPONENT※適應症請見備註欄 18197

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

811


FBKF25926TZ1 ZIMMERGENDER 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※


40550

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


18197

FBKF26001NJJ PFC REVISION FEMORAL※適應症請見備註欄 18197

FBKF26430NH1 HOWMEDICAAVON 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

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

FBKFA5000TZ1 ZIMMERGENDER 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 HOWMEDICAAVON PATELLO-FEMORAL JOINT PROSTHESIS"好美得卡"阿文

股骨膝蓋人工關節

46894

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

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


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

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

FBKL1230XNU0 UNITED TIBIAL INSERT PLAINED※適應症請見備註欄 5348

FBKL13000NW2 WRIGHTADVANCE 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

FBKL17230NS2 TIBIAL INSERT※適應症請見備註欄 5348

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

812


FBKL25880NZ1 NEXGEN ROTATING HINGE KNEE ARTICULAR SURFACE※適應症請見備註

欄

11684

FBKL25994NZ1 NEXGEN TIBIAL ARTICULAR SURFACE(型號5994-022:042-10:33自


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

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 聯合聯膝人工膝關節:髕骨植入物"UNITED" UKNEE TOTAL KNEE

SYSTEM:PATELLA 26:44MM

5961

FBKP12403NU0 聯合聯膝人工膝關節:髕骨"UNITED" UKNEE TOTAL KNEE

SYSTEM:PATELLA

5961

FBKP1240XNU0 UNITEDUKNEE 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 HOWMEDICAAVON 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

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

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


43537

FBKPA1000PSN GENESIS II TOTAL KNEE SYSTEM(PS)※適應症請見備註欄 43537

FBKPA1100NDP DEPUYPFC SIGMA TOTAL KNEE

SYSTEM(TIBIAL+INSERT+PATELLA+FEMORAL)"帝富"全人工膝關節組※


43537

FBKPA1100NJJ PFC E KNEE SYSTEM※適應症請見備註欄 43537

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 WRIGHTADVANCE 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 ※


43537

813


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

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

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※


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

FBKPA8000TZ1 西美人工膝關節:全人工膝關節組(高彎曲度)NEXGEN LPS-FLEX

COMPLETE KNEE SYSTEM

51297

FBKPA8100NS2 SCORPIO NRG TOTAL KNEE SYSTEM※適應症請見備註欄 51297

FBKPA8100TZ1 西美人工膝關節:全人工膝關節組(高彎曲度)"ZIMMER" NEXGEN

COMPLETE KNEE SOLUTION:NEXGEN MIS COMPLETE KNEE SOLUTION

(LPS-FLEX)

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


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


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)


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


63204

FBKRA6475NH1 ROTATING HINGE TOTAL KNEE SYSTEM (FE+TI PLUG+PA+

BEARING+AXLE+BUMPER+BUSHINGX2)※適應症請見備註欄

117924

FBKS12703NU0 EXTENSION STRAIGHT STEM PSA TYPE※適應症請見備註欄 5682

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

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) ※


14031

FBKT11581NDP DEPUYSIGMA CO-CR TIBIAL TRAYS"帝富"人工膝關節脛骨盤※適應症

請見備註欄

14031

814


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


14031

FBKT12203NU0 U2 TOTAL KNEE SYSTEM：TIBIAL BASEPLATE※適應症請見備註欄 14031

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

FBKT1220XNU0 UNITED TIBIAL BASEPLATE WITH STEM(型號2201-3010:3060自


14031

FBKT1432RPJJ PFC SIGMA RP KNEE SYSTEM MOBILE BEARING TIBIA BASEPLATE※適


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

FBKT21872NW2 TIBIAL BASE WITH WEDGE ※限人工膝關節再置換時使用 16704

FBKT22203NU0 TIBIAL BASEPLATE PSA TYPE※適應症請見備註欄 14031

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

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

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 ZIMMERUNICOMPARTMENTAL HIGH-FLEX SYSTEM 155度(FEMORAL+TIBIAL

+SURFACE)※適應症請見備註欄

44983

815


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

FBM019138NH1 AUSTIN MOORE 7732

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 ※


970

FBN04520XNU0 NAIL LOCKING SCREW※適應症請見備註欄 899

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

FBN05403FSY2 STAINLESS FEMUR INTERLOCKING NAIL(NAILX1+SCREWX3)股骨髓內釘


7890

FBN05403HSY2 STAINLESS HUMERAL INTERLOCKING NAIL(NAILX1+SCREWX3)肱骨髓內

釘組※適應症請見備註欄

7890

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(NAILX1+SCREWX3)

7890

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(NAILX1+SCREWX3)

7890

FBN05403TSY2 STAINLESS TIBIA INTERLOCKING NAIL(NAILX1+SCREWX3)脛骨髓內釘


7890

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

FBN07321004P 沛佳法斯樂-杜瓦伸縮式髓內釘系統"PEGA"FASSIER-DUVAL

TELESCOPIC IM SYSTEM

140000

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

816


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)


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

FBNG1473XNS1 TI PROXIMAL FEMORAL NAIL※適應症請見備註欄 18302

FBNG2148GSY2 SYNTECKING 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


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


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

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

FBP01102105H 鴻君骨板骨釘系統/管形骨板 (搭配4.5MM螺釘)"HC"BONE PLATES AND

SCREWS/SEMI-TUBULAR PLATE (2:10 HOLE)

500

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

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

FBP01222NNS1 SEMI-TUBULAR PLATE 2:12 HOLE 39:199MM 500


PLATE IMPLANT(TUBULAR PLATE3.5MM)

441

FBP012413NS1 SYNTHESONE-THIRD TUBULAR PLATE 2:12HOLE 28:148MM"信迪思"三分

之一管狀骨板

441


PLATE IMPLANT(TUBULAR PLATE 2.7MM)

380

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 MICROWAREBONE PLATE:SEMI-TUBULAR PLATE 4.5MM， 2:12 HOLE"全

微"骨板:半管型骨板

500

FBP01427NN2W MICROWAREBONE PLATE:LENGTHENING PLATE 4.5MM，8:10 HOLE，

BROAD，135:249MM"全微"骨板:寬加長型骨板

1849

FBP01441NN2W MICROWAREBONE PLATE:ONE-THIRD TUBULAR PLATE 3.5MM， 2:12

HOLE"全微"骨板:管型骨板

441

FBP014420N2W MICROWAREBONE 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

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

817


FBP02012XNY2 4.5 NARROW DYNAMIC COMPRESSION PLATE 2:17HOLE 1228

FBP02015305H 鴻君骨板骨釘系統/動態加壓骨板(小)(搭配3.5MM 螺釘)"HC"BONE

PLATES AND SCREWS/AUTO COMPRESSION PLATE-SMALL BONE

PLATE(3:10HOLE)

977

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

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

FBP022245NS1 LC-DCP 4.5 NARROW PLATE 2:16HOLE 1228

FBP02224NNS1 NARROW DYNAMIC COMPRESSION PLATE DCP 2:18 HOLE 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

FBP022265NS1 LC-DCP 4.5 BROAD PLATE 6:18HOLE 1782

FBP02226NNS1 BROAD DYNAMIC COMPRESSION PLATE DCP 6:18 HOLE 103:295MM 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

FBP022431NS1 MINI STRAIGHT PLATE 3:6 HOLE 17:35MM 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

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

FBP02404085H 鴻君骨板骨釘系統/加長延長窄型骨板 (搭配4.5MM螺釘)"HC"BONE

PLATSE AND SCREWS/LENGTHENING PLATE-NARROW PLATE (4:8HOLE)

1787

FBP02404155H 鴻君骨板骨釘系統/動態加壓窄型骨板(搭配4.5MM 螺釘)"HC"BONE

PLATES AND SCREWS/AUTO COMPRESSION NARROW PLATE (4:15HOLE)

1228

FBP02408085H 鴻君骨板骨釘系統/加長窄型骨板 (搭配4.5MM螺釘)"HC"BONE PLATES

AND SCREWS/LENGTHENING NARROW PLATE (8HOLE)

1787

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 MICROWAREBONE PLATE:DYNAMIC COMPRESSION PLATE 4.5MM， NARROW

，2:17 HOLE"全微"骨板:窄動態加壓骨板

1228

FBP02426NN2W MICROWAREBONE PLATE:DYNAMIC COMPRESSION PLATE 4.5MM， BROAD

，6:22 HOLE"全微"骨板:寬動態加壓骨板

1782

FBP024288N2W MICROWAREBONE PLATE:LENGTHENING PLATE 4.5MM，8 HOLES，NARROW

， 135:185MM"全微"骨板:窄加長型骨板

1787

818


FBP02448NN2W MICROWAREBONE PLATE:DYNAMIC COMPRESSION PLATE 2.0MM， 2.7MM

， 3.5MM， 2:12 HOLEMM"全微"骨板:動態加壓骨板

977

FBP02456165H 鴻君骨板骨釘系統/動態加壓-寬型骨板 (搭配4.5MM螺釘)"HC"BONE

PLATES AND SCREWS/AUTO COMPRESSION PLATE-WIDE PLATE

(6:16HOLE)

1782

FBP02458105H 鴻君骨板骨釘系統/加長寬型骨板 (搭配4.5MM螺釘)"HC"BONE PLATES

AND SCREWS/LENGTHENING WIDE PLATE (8:10HOLE)

1849

FBP0249203Z1 2.0MM STRAIGHT PLATE 3:6HOLE 17:35MM 230

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

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

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 SYNTECSMALL 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

FBP03123065H 鴻君骨板骨釘系統/T型小骨板 (搭配3.5MM螺釘)"HC"BONE PLATES

AND SCREWS/T-SMALL BONE PLATES (3:6 HOLE)

952

FBP03124065H 鴻君骨板骨釘系統/支撐-葉子型骨板 (搭配3.5MM螺釘)"HC"BONE

PLATES AND SCREWS/BUTTRESS-CLOVERLEAF PLATE (4:6 HOLE)

1603

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

FBP03156185H 鴻君骨板骨釘系統/可彎曲骨板15度 (搭配3.5MM螺釘)"HC"BONE

PLATES AND SCREWS/RECONSTRUCTION PLATE(LC-DCP) (6:18 HOLE)

3487

FBP03202065H 鴻君骨板骨釘系統/支撐 L 型骨板 (搭配4.5MM螺釘)"HC"BONE

PLATES AND SCREWS/BUTTRESS L PLATE(2:6 HOLE)

2130

FBP03203065H 鴻君骨板骨釘系統/支撐 V 型骨板 (搭配4.5MM螺釘)"HC"BONE

PLATES AND SCREWS/BUTTRESS V PLATE(3:6 HOLE)

2130

FBP03203085H 鴻君骨板骨釘系統/T型骨板 (搭配4.5MM螺釘)"HC"BONE PLATES AND

SCREWS/T BONE PLATES (2:8 HOLE)

2130

FBP03204085H 鴻君骨板骨釘系統/T型骨板 (搭配4.5MM螺釘)"HC"BONE PLATES AND

SCREWS/T BONE PLATES (4:8 HOLE)

2130

819


FBP03229NNS1 PELVIC RECONSTRUCTION PLATE 3:16 HOLE 45:253MM 3487

FBP03229XNY2 STRAIGHT RECONSTRUCTION PLATE 4.5 3:16HOLE 3487

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

FBP032400NS1 SPOON PLATE 5:6:12 HOLE 100:120MM 1762

FBP032401NS1 T PLATE 3:12 HOLE 2130

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

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

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

FBP032407NS1 DISTAL FEMUR PLATE 7:15 HOLE (CONDYLAR BUTTRESS PLATE) 3493

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

FBP032409NS1 COBRA HEAD PLATE 8:11 HOLE 3892

FBP032411NS1 SMALL T PLATE RIGHT ANGLE 3/3:6/4 HOLE 50:78MM 952

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

FBP032412NS1 SMALL T PLATE OLIQUE ANGLE 3/3:5/3 HOLE 52:74MM 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

FBP032416NS1 CALCANEAL PLATE 3.5 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

FBP032418NS1 CLOVERLEAF PLATE 3:6 HOLE 1603

FBP032423NS1 MINI L FINGER JOINT-HEAD PLATE 336

FBP0324241S1 MINI T FINGER JOINT-HEAD PLATE 336

FBP0324302V2 鐿鈦骨釘骨板植入物(重建骨板)"INTAI"BONE SCREW AND BONE PLATE

IMPLANT(RECONSTRUCTION PLATE)

3487

FBP0324319S1 MINI PLATE 1.5:2.0 2686

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

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

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

FBP03246NNS1 MINI T-PLATE 1.5，2.0 9HOLE 2686

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

FBP03253055H 鴻君"骨板骨釘系統/支撐Y型骨板 (搭配4.5MM螺釘)"HC"BONE PLATES

AND SCREWS/BUTTRESS Y FORK PLATE(3:5 HOLE)

2130

FBP03253065H 鴻君骨板骨釘系統/T型肱骨骨板(25度)(搭配4.5MM螺釘)"HC"BONE

PLATE AND SCREW/T HUMERAL PLATE

2130

820


FBP03254125H 鴻君骨板骨釘系統/支撐-骨盆骨板 (搭配3.5/4.0MM螺釘)"HC"BONE

PLATES AND SCREWS/PELEVIS AND ACETABULUM PLATE-SHERMAN TYPE

(4:12 HOLE)

2130

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

FBP033310NS9 V-PLATE T-PLATE 63:335MM 3:20HOLE 2130

FBP033315NS9 T-PLATE 65:337MM 3:20HOLAE 3157

FBP03355225H 鴻君骨板骨釘系統/可彎曲骨板 (搭配3.5MM螺釘)"HC"BONE PLATES

AND SCREWS/RECONSTRUCTION PLATE(LC-DCP) (5:22 HOLE)

3487

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

FBP03406095H 鴻君骨板骨釘系統/支撐-踝骨骨板 (搭配4.5MM螺釘)"HC"BONE

PLATES AND SCREWS/CONDYLAR BUTTRESS PLATE (6:9 HOLE)

3493

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

FBP03427NNY2 TITANIUM STRAIGHT MINI H-PLATE 1.5，2.0MM 20HOLE 2059

FBP03428XNY2 TITANIUM RECONSTRUCTION PLATE 3.5MM 5:22HOLE 3463

FBP034293N2W MICROWAREBONE PLATE:RECONSTRUCTION PLATE 4.5MM， STRAIGHT，

3:16 HOLE"全微"直線型重建骨板

3487

FBP034400N2W MICROWAREBONE PLATE:SPOON PLATE 4.5MM， 5:6 HOLE"全微"匙型骨

板

1762

FBP034403N2W MICROWAREBONE PLATE:T-BUTTRESS PLATE 4.5MM，4:6 HOLE"全微"T

型支撐骨板

2130

FBP03440502W MICROWAREBONE 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 MICROWAREBONE 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 MICROWAREBONE PLATE:CONDYLAR BUTTRESS PLATE 4.5MM，

LEFT/RIGHT，7:15 HOLE"全微"右邊型骨踝支撐骨板

3493

FBP034409N2W MICROWAREBONE PLATE:COBRA HEAD PLATE 4.5MM 8:11 HOLE"全微"眼

鏡蛇骨板

3892

FBP03440NN2W MICROWAREBONE 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 MICROWAREBONE PLATE:SMALL T-PLATE 3.5MM， RIGHT ANGLED，3:8

HOLE "全微" 3.5MM 右角T型骨板

952

FBP034412N2W MICROWAREBONE PLATE:SMALL T-PLATE 3.5MM， OBLIQUE ANGLED，

3:5 HOLE"全微" 3.5MM 斜角T型骨板

952

821


FBP034416N2W MICROWAREBONE PLATE:CALCANEAL PLATE 3.5MMT，60:70MM"全微"跟

骨骨板

3104

FBP034418N2W MICROWAREBONE PLATE:CLOVERLEAF PLATE 3.5MM， 3:9 HOLE"全微"

葉型骨板

1603

FBP03443312W MICROWAREBONE PLATE:MINI L-PLATE 2.0MM， 2.7MM， LEFT/RIGHT"

全微"L型骨板

336

FBP03443332W MICROWAREBONE PLATE:MINI L-PLATE 2.0MM， 2.7MM，LEFT/RIGHT，

OBLIQUE"全微"L型骨板

336

FBP034433N2W MICROWAREBONE PLATE:MINI T-PLATE 2.0MM， 2.7MM"全微" T型骨板 336

FBP034450N2W MICROWAREBONE PLATE:RECONSTRUCTION PLATE 3.5MM， STRAIGHT，

5:22 HOLE"全微"直線型重建骨板

3487

FBP034453N2W MICROWAREBONE PLATE:RECONSTRUCTION PLATE 3.5MM， CURVED，

6:18 HOLE"全微"弧線型重建骨板

3487

FBP03446192W MICROWAREBONE PLATE:MINI STRAIGHT PLATE 20 HOLE 1.5MM，

2.0MM"全微"直線骨板

2686

FBP034462N2W MICROWAREBONE 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 MICROWAREBONE PLATE:MINI H-PLATE 1.5MM， 2.0MM "全微" H型骨

板

336

FBP034466N2W MICROWAREBONE PLATE:CONDYLAR PLATE 1.5MM，2.0MM，2.7MM LEFT/

RIGHT"全微"左/右邊型骨踝骨板

2829

FBP03453165H 鴻君骨板骨釘系統/可彎曲骨板 (搭配4.5MM螺釘)"HC"BONE PLATES

AND SCREWS/RECONSTRUCTION PLATE(LC-DCP) (3:16 HOLE)

3487

FBP03460XNSN 2.0MM T-PLATE，L-PLATE，H-PLATE(型號7114-6030，032，048自

93/1/1起刪除)

336

FBP0349201Z1 2.0MM MINI L-PLATE 4HOLE 336

FBP0349271Z1 2.7MM MINI L-PLATE 5HOLE 336

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

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

FBP035020NSN STAINLESS MINI STRAIGHT PLATE 20HOLE 1.5MM 2686

FBP036030NSN 2.0MM T-PLATE 9HOLE 2686

FBP03903065H 鴻君骨板骨釘系統/T型脛骨骨板(90度)(搭配4.5MM螺釘)"HC"BONE

PLATES AND SCREWS/T TIBIA PLATE

2130

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

822


FBP03LN278AE MAXILLO-RECOSTRUCTION PLATE 2.0MM 3487

FBP03LN29NAE DCP PLATE 2.7MM 1173

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

FBP042356NS1 TEENAGER HIP PLATE 2315

FBP04236XNS1 BABY HIP PLATE 2315

FBP042372NS1 CONDYLAR PLATE 95度 12 HOLE 50:80MM 3941

FBP042372NY2 CONDYLAR PLATE 95度 FOR ADULTS AND 5:18HOLE 3941




FBP04238NNS1 ANGLED BLADE PLATE 130度 4:12 HOLE 50:110MM 2927

FBP042392NS1 HIP PLATE 90:130度 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

FBP04283XNS1 ANGLED BLADE PLATE 130度 4:9HOLE 2927

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




FBPN12936NS1 STEINMANN PIN WITH THREAD 279

FBPN1293NNS1 STEINMANN PIN 184

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

FBPN292001Y2 亞太醫療骨針系統/史氏骨針(無螺紋)"SYNTEC"PIN

SYSTEM/STEINMANN PINS(SHANK)

184

FBPN30531YM1 MR-500型髓內釘(RUSH PIN) 722

823


FBPN3KJ10NAE RUSH PIN 722

FBPS1000XN6H 創健體外組裝下肢義肢(未滅菌))/健保給付部分足義肢"INNOVATIVE

HEALTHCARE"EXTERNAL ASSEMBLED LOWER LIMB PROSTHESIS(NON-

STERILE)/PARTIAL FOOT PROSTHESIS

19000

FBPS1000XNX0 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢※適應症請見備註

欄.

19000


欄.

19000


欄.

19000


欄.

19000


欄.

19000


欄.

19000


欄.

19000


欄.

19000


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

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

FBPS1001XN6H 創健體外組裝下肢義肢(未滅菌)/健保給付珊姆式小腿義肢(踝關節離

斷)"INNOVATIVE HEALTHCARE"EXTERNAL ASSEMBLED LOWER LIMB

PROSTHESIS(NON-STERILE)/SYMES PROSTHESIS

24000

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


請見備註欄.

24000

824



請見備註欄.

24000


請見備註欄.

24000


請見備註欄.

24000


請見備註欄.

24000


請見備註欄.

24000


請見備註欄.

24000


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

FBPS1002XN6H 創健體外組裝下肢義肢(未滅菌)/健保給付膝關節離斷義

肢"INNOVATIVE HEALTHCARE"EXTERNAL ASSEMBLED LOWER LIMB

PROSTHESIS(NON-STERILE)/K/D PROSTHESIS

48000

FBPS1002XNX0 K/D PROSTHESIS 健保給付膝關節離斷義肢※適應症請見備註欄. 48000






825





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

FBPS1003XN6H 創健體外組裝下肢義肢(未滅菌)/健保給付膝上義肢"INNOVATIVE


STERILE)/A/K PROSTHESIS

48000

FBPS1003XNX0 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

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

826


FBPS1003XNXY A/K PROSTHESIS 健保給付膝上義肢 ※適應症請見備註欄 48000

FBPS1004XN6H 創健體外組裝下肢義肢(未滅菌)/健保給付膝下義肢"INNOVATIVE


STERILE)/B/K PROSTHESIS

34000

FBPS1004XNX0 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

FBPS1005XN6H 創健體外組裝下肢義肢(未滅菌)/健保給付髖關節離斷義


PROSTHESIS(NON-STERILE)/H/D&H/P PROSTHESIS

68000

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


欄.

68000


欄.

68000


欄.

68000


欄.

68000


欄.

68000


欄.

68000


欄.

68000


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

827


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

FBPS1006XN6H 創健體外肢體義肢用組件(未滅菌)/健保給付腕關節離斷義

肢"INNOVATIVE HEALTHCARE" EXTERNAL LIMB PROSTHETIC

COMPONENT(NON-STERILE)/W/D PROSTHESIS

42000

FBPS1006XNX0 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

828


FBPS1006XNXS W/D PROSTHESIS 健保給付腕關節離斷義肢※適應症請見備註欄. 42000

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

FBPS1007XN6H 創健體外肢體義肢用組件(未滅菌)/健保給付肘關節離斷義


COMPONENT(NON-STERILE)/E/D PROSTHESIS

62000

FBPS1007XNX0 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

FBPS1008XN6H 創健體外肢體義肢用組件(未滅菌)/健保給付肘上義肢"INNOVATIVE

HEALTHCARE" EXTERNAL LIMB PROSTHETIC COMPONENT(NON-

STERILE)/A/E PROSTHESIS

65000

FBPS1008XNX0 A/E PROSTHESIS 健保給付肘上義肢※適應症請見備註欄. 65000






829




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

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

FBPS1009XN6H 創健體外肢體義肢用組件(未滅菌)/健保給付肘下義肢"INNOVATIVE

HEALTHCARE" EXTERNAL LIMB PROSTHETIC COMPONENT(NON-

STERILE)/B/E PROSTHESIS

42000

FBPS1009XNX0 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

FBPS1010XN6H 創健體外肢體義肢用組件(未滅菌)/健保給付肩關節離斷義


COMPONENT(NON-STERILE)/S/D PROSTHESIS

65000

FBPS1010XNX0 S/D PROSTHESIS 健保給付肩關節離斷義肢 ※適應症請見備註欄. 65000







830



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

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

FBPS1011XN6H 創健體外肢體義肢用組件(未滅菌)/健保給付肩胛截除義


COMPONENT(NON-STERILE)/FOREQUATER PROSTHESIS

65000

FBPS1011XNX0 FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 ※適應症請見備註

欄.

65000


欄.

65000


欄.

65000


欄.

65000


欄.

65000


欄.

65000


欄.

65000


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

831


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

FBPS1012XN6H 創健體外肢體義肢用組件(未滅菌)/健保給付肘上美觀義


COMPONENT(NON-STERILE)/A/E COSMETIC PROSTHESIS

23000

FBPS1012XNX0 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 ※適應症請見備

註欄.

23000


註欄.

23000


註欄.

23000


註欄.

23000


註欄.

23000


註欄.

23000


註欄.

23000


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


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

832


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

FBPS1013XN6H 創健體外肢體義肢用組件(未滅菌)/健保給付肘下美觀義


COMPONENT(NON-STERILE)/B/E COSMETIC PROSTHESIS

14000

FBPS1013XNX0 B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢※適應症請見備註

欄.

14000


欄.

14000


欄.

14000


欄.

14000


欄.

14000


欄.

14000


欄.

14000


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

FBPS1014XN6H 創健體外肢體義肢用組件(未滅菌)/健保給付肩關節離斷美觀義


COMPONENT(NON-STERILE)/S/D COSMETIC PROSTHESIS

32300

FBPS1014XNX0 健保給付肩關節離斷美觀義肢 ※適應症請見備註欄. 32300



833


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





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

FBPS1015XN6H 創健體外肢體義肢用組件(未滅菌)/健保給付橫掌截肢美觀義


COMPONENT(NON-STERILE)/TRANS-CARPAL COSMETIC PROSTHESIS

7300

FBPS1015XNX0 健保給付橫掌截肢美觀義肢 ※適應症請見備註欄. 7300



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





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

FBPS1016XN6H 創健體外肢體義肢用組件(未滅菌)/健保給付手指截肢美觀義


COMPONENT(NON-STERILE)/PARTIAL FINGER COSMETIC PROSTHESIS

4800

FBPS1016XNX0 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



834




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


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

FBPS2000XN6H 創健體外組裝下肢義肢(未滅菌)/自付差額部分足義肢""INNOVATIVE


STERILE)/PARTIAL FOOT PROSTHESIS

19000

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



19000



19000



19000



19000



19000



19000



19000



19000

FBPS2000XNXB PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備註欄


19000

FBPS2000XNXC PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備註欄


19000

FBPS2000XNXD PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備註欄


19000

FBPS2000XNXE PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備註欄


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


19000

FBPS2000XNXH PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備註欄


19000

FBPS2000XNXJ PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備註欄


19000

FBPS2000XNXK PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備註欄


19000

835


FBPS2000XNXN PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備註欄


19000

FBPS2000XNXS PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備註欄


19000

FBPS2000XNXV PARTIAL FOOT PROSTHESIS 部分給付部分足義肢※適應症請見備註欄


19000

FBPS2001XN6H 創健體外組裝下肢義肢(未滅菌)/自付差額珊姆式小腿義肢(踝關節離

斷"INNOVATIVE HEALTHCARE"EXTERNAL ASSEMBLED LOWER LIMB

PROSTHESIS(NON-STERILE)/SYMES PROSTHESIS

24000

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




24000




24000




24000




24000




24000




24000




24000




24000

FBPS2001XNXB SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

FBPS2001XNXC SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

FBPS2001XNXD SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

FBPS2001XNXE SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

FBPS2001XNXF SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

FBPS2001XNXG SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

836


FBPS2001XNXH SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

FBPS2001XNXJ SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

FBPS2001XNXK SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

FBPS2001XNXN SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

FBPS2001XNXS SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

FBPS2001XNXV SYME"S PROSTHESIS 部分給付珊姆式小腿義肢(踝關節離斷)※適應症



24000

FBPS2002XN6H 創健體外組裝下肢義肢(未滅菌)/自付差額膝關節離斷義


PROSTHESIS(NON-STERILE)/K/D PROSTHESIS

48000

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



48000



48000



48000



48000



48000



48000



48000



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


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


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


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


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


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


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


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


48000

837


FBPS2002XNXK K/D PROSTHESIS 部分給付膝關節離斷義肢※適應症請見備註欄，按


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


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


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


48000

FBPS2003XN6H 創健體外組裝下肢義肢(未滅菌)/自付差額膝上義肢"INNOVATIVE


STERILE)/A/K PROSTHESIS

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



48000



48000



48000



48000



48000



48000



48000



48000



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


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


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


48000

FBPS2003XNXE A/K PROSTHESIS 部分給付膝上義肢 ※適應症請見備註欄，按健保給


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


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


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


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


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


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


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


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


48000

838


FBPS2004XN6H 創健體外組裝下肢義肢(未滅菌)/自付差額膝下義肢"INNOVATIVE


STERILE)/B/K PROSTHESIS

34000

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



34000



34000



34000



34000



34000



34000



34000



34000



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


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


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


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


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


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


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


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


34000

FBPS2004XNXK B/K PROSTHESIS 部分給付膝下義肢※適應症請見備註欄，按健保給


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


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


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


34000

FBPS2005XN6H 創健體外組裝下肢義肢(未滅菌)/自付差額髖關節離斷義


PROSTHESIS(NON-STERILE)/H/D&H/P PROSTHESIS

68000

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

839




68000



68000



68000



68000



68000



68000



68000



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


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


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


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


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


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


68000

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


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


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


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


68000

840


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


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


68000

FBPS2006XN6H 創健體外肢體義肢用組件(未滅菌)/自付差額腕關節離斷義


PROSTHESIS(NON-STERILE)/W/D PROSTHESIS

42000

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



42000



42000



42000



42000



42000



42000



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


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


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


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


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


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


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


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


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


42000

FBPS2006XNXS W/D PROSTHESIS 部分給付腕關節離斷義肢※適應症請見備註欄，按


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


42000

FBPS2007XN6H 創健體外肢體義肢用組件(未滅菌)/自付差額肘關節離斷義


PROSTHESIS(NON-STERILE)/E/D PROSTHESIS

62000

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

841




62000



62000



62000



62000



62000



62000



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


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


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


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


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


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


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


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


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


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


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


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


62000

FBPS2008XN6H 創健體外肢體義肢用組件(未滅菌)/自付差額肘上義肢"INNOVATIVE


STERILE)/A/E PROSTHESIS

65000

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



65000



65000



65000



65000



65000



65000

842




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


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


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


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


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


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


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


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


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


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


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


65000

FBPS2009XN6H 創健體外肢體義肢用組件(未滅菌)/自付差額肘下義肢"INNOVATIVE


STERILE)/B/E PROSTHESIS

42000

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



42000



42000



42000



42000



42000



42000



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


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


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


42000

FBPS2009XNXE B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄，按健保給


42000

843


FBPS2009XNXF B/E PROSTHESIS 部分給付肘下義肢 ※適應症請見備註欄，按健保給


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


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


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


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


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


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


42000

FBPS2010XN6H 創健體外肢體義肢用組件(未滅菌)/自付差額肩關節離斷義


PROSTHESIS(NON-STERILE)/S/D PROSTHESIS

65000

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



65000



65000



65000



65000



65000



65000



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


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


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


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


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


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


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


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


65000

844


FBPS2010XNXN S/D PROSTHESIS 部分給付肩關節離斷義肢 ※適應症請見備註欄，按


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


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


65000

FBPS2011XN6H 創健體外肢體義肢用組件(未滅菌)/自付差額肩胛截除義


PROSTHESIS(NON-STERILE)/FOREQUATER PROSTHESIS

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



65000



65000



65000



65000



65000



65000



65000

FBPS2011XNXB FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備註


65000

FBPS2011XNXC FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備註


65000

FBPS2011XNXD FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備註


65000

FBPS2011XNXE FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備註


65000

FBPS2011XNXF FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備註


65000

FBPS2011XNXG FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備註


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

845


FBPS2011XNXJ FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備註


65000

FBPS2011XNXK FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備註


65000

FBPS2011XNXN FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備註


65000

FBPS2011XNXS FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備註


65000

FBPS2011XNXV FOREQUATER PROSTHESIS 部分給付肩胛截除義肢 ※適應症請見備註


65000

FBPS2012XN6H 創健體外肢體義肢用組件(未滅菌)/自付差額肘上美觀義


PROSTHESIS(NON-STERILE)/A/E COSMETIC PROSTHESIS

23000

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



23000



23000



23000



23000



23000



23000



23000

FBPS2012XNXB A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見備


23000

FBPS2012XNXC A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見備


23000

FBPS2012XNXD A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見備


23000

FBPS2012XNXE A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見備


23000

846


FBPS2012XNXF A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見備


23000

FBPS2012XNXG A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見備


23000

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


23000

FBPS2012XNXK A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見備


23000

FBPS2012XNXN A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見備


23000

FBPS2012XNXS A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見備


23000

FBPS2012XNXV A/E COSMETIC PROSTHESIS 部分給付肘上美觀義肢 ※適應症請見備


23000

FBPS2013XN6H 創健體外肢體義肢用組件(未滅菌)/自付差額肘下美觀義


PROSTHESIS(NON-STERILE)/B/E COSMETIC PROSTHESIS

14000

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



14000



14000



14000



14000



14000



14000



14000

FBPS2013XNXB B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見備註


14000

847


FBPS2013XNXC B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見備註


14000

FBPS2013XNXD B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見備註


14000

FBPS2013XNXE B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見備註


14000

FBPS2013XNXF B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見備註


14000

FBPS2013XNXG B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見備註


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


14000

FBPS2013XNXK B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見備註


14000

FBPS2013XNXN B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見備註


14000

FBPS2013XNXS B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見備註


14000

FBPS2013XNXV B/E COSMETIC PROSTHESIS 部分給付肘下美觀義肢※適應症請見備註


14000

FBPS2014XN6H 創健體外肢體義肢用組件(未滅菌)/自付差額肩關節離斷美觀義


PROSTHESIS(NON-STERILE)/S/D COSMETIC PROSTHESIS

32300

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



32300



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



32300



32300



32300



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


32300

848


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


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


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


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


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


32300

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


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


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


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


32300

FBPS2015XN6H 創健體外肢體義肢用組件(未滅菌)/自付差額橫掌截肢美觀義


PROSTHESIS(NON-STERILE)/TRANS-CARPAL COSMETIC PROSTHESIS

7300

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



7300



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



7300



7300



7300



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


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


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


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


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


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


7300

849


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


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


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


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


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


7300

FBPS2016XN6H 創健體外肢體義肢用組件(未滅菌)/自付差額手指截肢美觀義


PROSTHESIS(NON-STERILE)/PARTIAL COSMETIC PROSTHESIS

4800

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



4800



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



4800



4800



4800



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


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


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


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


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


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


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


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


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


4800

850


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


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


4800

FBS01000355H 鴻君骨板骨釘系統/皮質骨釘"HC"BONE PLATES AND SCREWS/CORTEX

SCREW(3.5MM)

145

FBS01000455H 鴻君骨板骨釘系統/皮質骨釘"HC"BONE PLATES AND SCREWS/CORTEX

SCREW(4.5MM)

161

FBS01000655H 鴻君骨板骨釘系統/海綿骨釘"HC"BONE PLATES AND

SCREWS/CANCELLOUS SCREW(6.5MM)

281

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

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

FBS0120421V2 鐿鈦骨釘骨板植入物(皮質骨釘3.5MM)"INTAI"BONE SCREW AND BONE

PLATE IMPLANT(CORTEX SCREW3.5MM)

145

FBS012042N2W MICROWAREBONE SCREW:SHAFT SCREW 3.5MM， 4.5MM， 12:115MM"全

微"骨釘:軸骨釘

145

FBS012100N2W MICROWAREBONE 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

FBS0121420V2 鐿鈦骨釘骨板植入物(皮質骨釘4.5MM)"INTAI"BONE SCREW AND BONE

PLATE IMPLANT(CORTEX SCREW4.5MM)

161

FBS01214NN2W MICROWAREBONE 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

FBS014000NS3 CORTEX SCREW 1.5:3.5MM 6:9MM 145

FBS014000NS9 STRYKERBONE 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

FBS0141006V2 鐿鈦骨釘骨板植入物(皮質骨釘鈦1.5/2.0/2.7/3.5MM)"INTAI"BONE

SCREW AND BONE PLATE IMPLANT(CORTEX SCREW T6A14V)

183

FBS0141440V2 鐿鈦骨釘骨板植入物(皮質骨釘鈦4.5MM)"INTAI"BONE SCREW AND

BONE PLATE IMPLANT(CORTEX SCREW T6A14V4.5MM)

201

FBS01437XNY2 TITANIUM CORTEX SCREW 1.5MM:3.5MM (型號402006:040，

404010:110，404212:250)

183

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

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

851


FBS02000405H 鴻君骨板骨釘系統/海綿骨釘"HC"BONE PLATES AND

SCREWS/CANCELLOUS SCREW(4.0MM)

144

FBS02039XNY2 4.0 CANCELLOUS SCREW 144

FBS02040XNY2 6.5 CANCELLOUS SCREW(產品型號217045:150) 281

FBS022060N2W MICROWAREBONE 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

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



281

FBS0221801V2 鐿鈦骨釘骨板植入物(海綿骨釘6.5MM)"INTAI"BONE SCREW AND BONE

PLATE IMPLANT(CANCELLOUS SCREW6.5MM)

281

FBS02218NN2W MICROWAREBONE 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

FBS024102NS3 CANCELLOUS BONE SCREW 281

FBS024103NS9 CANCELLOUS BONE SCREW 6.5MM(1/3) 115:150MM 281

FBS0241601V2 鐿鈦骨釘骨板植入物(海綿骨釘鈦6.5MM)"INTAI"BONE SCREW AND

BONE PLATE IMPLANT(CANCELLOUS SCREW TI6A14V6.5MM)

259

FBS0241602V2 鐿鈦骨釘骨板植入物(海綿骨釘鈦4.0MM)"INTAI"BONE SCREW AND

BONE PLATE IMPLANT(CANCELLOUS SCREW TI6A14V4.0MM)

144


FBS024204NS9 CANCELLOUS BONE SCREW 6.5MM(2/3) 105:200M 281

FBS024302NS9 CANCELLOUS BONE SCREW 6.5MM 105:150M 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

FBS03000455H 鴻君骨板骨釘系統/踝螺釘"HC"BONE PLATES AND SCREWS/MALLEOLAR

SCREW(4.5MM)

269

FBS03041XNY2 4.5 MALLEOLAR SCREW 269

FBS030811NH1 MALLEOLAR SCREW 踝質釘 269

FBS032150N2W MICROWAREBONE 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

FBS04040705H 鴻君骨板骨釘系統/中空螺釘"HC"BONE PLATES AND

SCREWS/CANNULATED SCREW(4.5:7.0MM)

1544

852


FBS04042XNY2 3.5，4.5 CANNULATED SCREW(產品型號214420:472，214620:672) 1544

FBS04044XNY2 7.0，7.3 CANNULATED SCREW(產品型號209420:530，208830:950，

209850:930)

1544

FBS04202NNS1 3.0 CANNULATED SCREW 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 MICROWAREBONE SCREW:CANNULATED SCREW 3.5MM， 4.0MM， 4.5MM，

10:72MM"全微"骨釘:中空骨釘

1544




7.0，7.3威創骨釘骨板植入物:中空骨釘

1544


6.5威創骨釘骨板植入物:中空骨釘

1544

FBS04208NN2W MICROWAREBONE 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


2.4，3.0威創骨釘骨板植入物:中空骨釘

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

FBS04286NN2W MICROWAREBONE 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


CANNULATED SCREW 7.0，7.3威創骨釘骨板植入物:鈦合金中空骨釘

1984


CANNULATED SCREW 6.5威創骨釘骨板植入物:鈦合金中空骨釘

1984

FBS04408XNY2 TITANIUM CANNULATED SCREW 7.0X30:130MM 1984


CANNULATED SCREW 2.4，3.0威創骨釘骨板植入物:鈦合金中空骨釘

1984

FBS0441801Y2 亞太醫療骨釘/7.0及7.3中空骨釘"SYNTEC"BONE SCREW/CANNULATED

SCREW

1984

FBS0488701Y2 亞太醫療鈦合金骨釘/7.3中空骨釘"SYNTEC"TITANIUM BONE

SCREW/CANNULATED SCREW

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

FBS07000015H 鴻君骨板骨釘系統/墊圈"HC"BONE PLATES AND SCREWS/WASHER 66

853


FBS07044XNY2 4.5，7.0，7.3 WASHER 66

FBS071430NSN WASHER 10，7，13MM OD 66

FBS072199NS1 WASHER 66

FBS07219XNS1 WASHER/NUT 48

FBS072971N2W MICROWAREBONE 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

FBS0800234S2 史賽克前十字韌帶界面固定螺釘"STRYKER"ACL INTERFERENCE SCREW 4023

FBS0801768SN SMITH&NEPHEWBIOSURE 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

4023

FBS081120MLV 靈威特傑耐斯可吸收性螺釘"LINVATEC"GENESYS MATRYX

INTERFERENCE SCREW

4023

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 4023

FBS081370TAW 艾思瑞斯介面骨螺絲釘"ARTHREX"CANNULATED INTERFERENCE SCREW 4023

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

FBS08222FNT1 邁特軟組織固定錨"MITEK"ANCHOR SYSTEM-FOR SOFT TISSUE

REATTACHMENT

3268

FBS082545NT1 ABSOLUTE ABSORBABLE INTERFERENCE SCREW※限實施十字韌帶重建手

術患者使用

4023

FBS082870CKL 卡爾斯特美卡菲士可吸收複合式韌帶螺釘"KARL STORZ" MEGAFIX-C

BIOABSORBABLE COMPOSITE INTERFERENCE SCREW

4023

FBS083512NLA LIGAMENT CANULATED SCREW※限十字韌帶重建手術使用 4023

FBS085015TLV CONMED LINVATECMATRYX 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

4023


INTERFERENCE SCREW

4023

FBS086101HLV LINVATECREVO 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 LINVATECSUPER REVO-FT SUTURE ANCHOR "靈威特"軟組織縫合錨釘

(肩關節)

3413

FBS08623MS2R ORTHOMEDMISBIO BIOABSORBABLE INTERFERENCE SCREWS"奧圖曼"可吸

收介面骨釘※給付規定請見備註欄

4023

FBS08718HE2R ORTHOMEDINTERFERENCE SCREWS"奧圖曼"介面螺釘※給付規定請見備

註欄

4023

FBS0872070SN SOFTSILK TM SCREW SYSTEM(型號含7207256:7207264)※限實施十字

韌帶重建手術使

4023

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

4023

854


FBS087207NSN TITANIUM RCI SCREW 固定螺釘※限實施十字韌帶重建手術使用。 4023

FBS0872091SN 史耐輝軟組織錨釘"SMITH ＆ NEPHEW" TWINFIX TI SUTURE ANCHOR 3268

FBS0872200SN 史耐輝縫合錨釘及附件"SMITH ＆ NEPHEW" TWINFIX SUTURE ANCHORS

AND ACCESSORIES

3268


INTERFERENCE SCREW

4023

FBS088059NLV LINVATECENDOPEARL BIOABSORBABLE SOFT TISSUE FIXATION DEVICE

"靈威特"恩皮爾軟組織固定器

4079

FBS088320NLV LINVATEC CANNULATED INTEREFERENCE SCREW ※限實施十字韌帶重建

術患者使用

4023

FBS08ACL417H 銀聯生物可吸收性前/後十字韌帶螺釘INION HEXALON BIODEGRADABLE

ACL/PCL SCREW

4023

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

3413

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

4023

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

4023

FBS08CPV10BC BIOMATLANTEOSTEOTWIN RESORBABLE COMPOSITE INTERFERENCE

SCREW"瑪蘭尼"使得挺吸收性複合式螺絲 7:10MM/25;30MM

4023

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



144

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

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

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

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

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

FBSF110002U0 UNITEDCENTURY 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 UNITEDCENTURY 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

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

855


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

FBSF11302NB0 TITANIUM SPINAL FIXATION SYSTEM 脊椎固定系統二節(SX4+RX2) ※


23358

FBSF11303NB0 TITANIUM SPINAL FIXATION SYSTEM 脊椎固定系統三節(SX6+RX2) ※


34118

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

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

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

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

FBSF16201NS9 TITANIUM SPINAL IMPLANT (DIAPASON)(SX4+RX2)脊椎人工置換組：

二節(免事前審查)

13816

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

FBSF162200S9 TITANIUM ROD PLATE SPINE SYSTEM二節(RX2+SX4+BLOCKERX4) 13816

FBSF162300S9 TITANIUM ROD PLATE SPINE SYSTEM三節(RX2+SX6+BLOCKERX6) 20044

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

856


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

FBSF16301NS9 TITANIUM SPINAL IMPLANT (DIAPASON)(SX6+RX2)脊椎人工置換組：

三節(免事前審查)

20044

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

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

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

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

FBSF1800023F 泰德腰椎內固定系統:三節TEND LUMBAR FIXATION SYSTEM:3

LEVEL(SX6+RX2)

34118

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

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

FBSF1821XNDA TITANIUM ZPLATE ANTERIOR SPINAL SYSTEM (PLATEX1+SCREWX4)※適

應症請見備註欄，須事前審查

23886

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

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

FBSF186001RK TITANIUM SPINAL SYSTEM (SX4 + RX2) 二節免事前審查 13816

FBSF1860023F 泰德腰椎內固定系統:三節(免事前審查)TEND LUMBAR FIXATION


20044

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

857


FBSF1865P2M4 BASIS SPINAL SYSTEM 二節(ATL PLATE SYSTEM)(PX1+SX4)※適應症

請見備註欄

23358

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


23358

FBSF188003RK 瑞寶億腰椎內固定系統:三節REBORN ESSENCE LUMBAR FIXATION


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

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

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

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

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

FBSF1ASAT1AQ TITANIUM ANTERIOR SPINAL SYSTEM(PX1+SX4)※適應症請見備註欄 23886

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

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

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

858


FBSF1BAR121S SCIENT'XISOBAR 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'XISOBAR 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

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

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)


23358

FBSF1HUTR3GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX6)際仁脊椎固定系統(三節)


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

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

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)


23358

FBSF1LSTR3GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX6)際仁脊椎固定系統(三節)


34118

FBSF1LUTR2GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX4)際仁脊椎固定系統二節※


23358

FBSF1LUTR3GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX6)際仁脊椎固定系統三節※


34118

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

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 MERRIESPROT 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 MERRIESPROT 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

FBSF1PCS01V2 INTAISPINAL FIXATION SYSTEM(RX2+SX4)"鐿鈦"脊椎固定系統:二節

(免事前審查)

13816

FBSF1PCS01WG WILTROMSPINAL FIXATION SYSTEM(RX2+SX4)"威創"脊椎固定系統二節

(免事前審查)

13816

FBSF1PCS02V2 INTAISPINAL FIXATION SYSTEM(RX2+SX6)"鐿鈦"脊椎固定系統:三節

(免事前審查)

20044

859


FBSF1PCS02WG WILTROMSPINAL FIXATION SYSTEM(RX2+SX6)"威創"脊椎固定系統三節

(免事前審查)

20044

FBSF1PCS03V2 INTAISPINAL 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 INTAISPINAL FIXATION SYSTEM(RX2+SX6)"鐿鈦"脊椎固定系統:三節


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 WILTROMSPINAL FIXATION SYSTEM(RX2+SX4)"威創"脊椎固定系統:二

節※給付規定請見備註欄

23358

FBSF1PCS06WG WILTROMSPINAL 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

FBSF1RF002RX RF SPINAL SYSTEM二節(SX4+RX2)(免事前審查) 13816

FBSF1RF003RX RF SPINAL SYSTEM三節(SX6+RX2)(免事前審查) 20044

FBSF1SW200AE AESCULAPTITANIUM 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 AESCULAPTITANIUM 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

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

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

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

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

FBSF21502NS1 TITANIUM UNIVERSAL SPINAL ROD 免事前審查 679

FBSF21534NS1 TITANIUM UNIVERSAL SPINAL ROD LONG 免事前審查 1419

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

860


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

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

FBSF22040NS9 XIA TITANIUM SPINAL ROD 40:60MM(免事前審查) 679

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

FBSF265041S9 TITANIUM SPINAL IMPLANT (DIAPASON)：ROD 40:60MM 脊椎人工置換

組：固定桿(免事審查)

679

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

FBSF26511NS9 TITANIUM SPINAL (DIAPASON)ROD 26:40CM脊椎人工置換組：固定桿


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

FBSF277004Y2 TITANIUM SPINAL ROD 6X50:100MM 短節(免術前審查) 679

FBSF277011Y2 TITANIUM SPINAL ROD 6X110:300MM 長節固定四節以上(免術前審查) 1419

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

FBSF2820NSY2 TITANIUM SPINAL ROD 2:11CM 短節免事前審查 679

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

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

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

FBSF2860NSY2 ROD 連結棒-短節 679

FBSF286540M4 BASIS SPINAL TITANIUM ROD 51CM(免事前審查) 679

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 SYNTECCOLISEUM 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

861


FBSF2911NSY2 SYNTECCOLISEUM 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

FBSF2913CLY2 SYNTECCOLISEUM 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 SYNTECCOLISEUM 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

FBSF2AS001AQ TITANIUM SPINAL ROD 5:10CM免術前審查 679

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

FBSF2ASNR1AQ TITANIUM SMARTLOC SPINAL ROD 40:100MM免事前審前 679

FBSF2ASNR2AQ TITANIUM SMARTLOC SPINAL ROD 110:450MM免事前審前 1419

FBSF2ASYR1AQ TITANIUM SMARTLOC SPINAL ROD 40:100MM(短節)※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

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

FBSF2B0001RK TITANIUM SPINAL ROD 40:100 MM(短節) 免事前審查 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

FBSF2B0002RK TITANIUM SPINAL ROD 110：480MM(長節)免事前審查 1419

FBSF2BA0013F 泰德腰椎內固定系統:固定桿(標準桿)TEND LUMBAR FIXATION

SYSTEM:STANDARD ROD

919

FBSF2BA001RK TITANIUM SPINAL ROD 40:100MM(短節)※適應症請見備註 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

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'XISOBAR 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

FBSF2BAR2S1S SCIENT'XISOBAR 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 UNITEDCENTURY 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

FBSF2LR001GZ SPINAL ROD 脊椎固定桿短節免事前審查 679

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

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

862


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

FBSF2PR040B0 TITANIUM SPINAL ROD 40MM:100MM免事前審查 679

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 UNITEDCENTURY 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

FBSF2RD01TV2 INTAISPINAL FIXATION SYSTEM:ROD 25:100MM"鐿鈦"脊椎固定系統:

連接桿(免事前審查)

679

FBSF2RD01TWG WILTROMSPINAL 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

FBSF2RD02TV2 INTAISPINAL 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 WILTROMSPINAL 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 INTAISPINAL 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 WILTROMSPINAL FIXATON SYSTEM:TITANIUM ROD 25:100MM "威創"脊

椎固定系統:連接桿

919

FBSF2RD04TV2 INTAISPINAL 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 WILTROMSPINAL 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

FBSF2RF00SRX RF SPINAL ROD 40:100MM(免事前審查) 679

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

FBSF2RY63NXA Y TYPE POSTERIOR TITANIUM SPINAL ROD 5:10CM(免事前審查) 679

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 AESCULAPTITANIUM 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 AESCULAPTITANIUM 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

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

863


FBSF2TS01TJA TITANIUM SPINAL ROD 30:100MM(免事前審查) 679

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

FBSF301020B0 長安脊頸椎內固定系統:骨鉤"BMI"SPINAL FIXATION

SYSTEM:TITANIUM SPINAL HOOK

3311

FBSF30559NDP M-M TITANIUM HOOK※適應症請見備註欄 3311

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

FBSF3140XNTD TITANIUM TREND SPINAL HOOK※適應症請見備註欄 3311

FBSF340051WG WILTROMSPINAL FIXATION SYSTEM:HOOK"威創"脊椎固定系統:椎弓鉤


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


3311

FBSF34983NS1 TITANIUM UNIVERSAL SPINAL HOOK ※適應症請見備註欄，須事前審

查

3311

FBSF36132NY2 TITANIUM CERVICAL CLAMP(配合FBSF46132NY2使用) 4110

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

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


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

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 ※


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 SPINEEXPEDIUM 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

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

FBSF4010RNZ6 TITANIUM SPINAL SCREW※適應症請見備註欄 5380

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

FBSF4110XNTD TITANIUM TREND SPINAL SCREW※適應症請見備註欄 5380

864


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

FBSF41300NB0 TITANIUM SPINAL FIXATION SYSTEM：SCREW 脊椎固定螺絲 ※適應症

請見備註欄

5380

FBSF41600NB0 BMISPINAL 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

FBSF44002TWG WILTROMSPINAL 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 WILTROMSPINAL 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

FBSF44005TWG WILTROMSPINAL 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

FBSF44006TV2 INTAISPINAL 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 WILTROMSPINAL 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 WILTROMSPINAL 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

FBSF44008TWG WILTROMSPINAL 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 WILTROMSPINAL 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 WILTROMSPINAL 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 INTAISPINAL 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 WILTROMSPINAL 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 INTAISPINAL 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 WILTROMSPINAL 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 STRYKERXIA 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


5380

FBSF448233S9 STRYKER XIA 3 SPINAL SYSTEM:SCREW"史賽克"喜爾三脊椎系統:骨釘


5380

865


FBSF44985NS1 SYNTHESUNIVERSAL SPINAL SYSTEM:TITANIUM SCREW "信迪思"廣用型

脊椎系統:固定螺釘

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

FBSF44995NS1 TITANIUM CLICK'X PEDICLE SCREW (免事前審查) 3114

FBSF455030B0 TITANIUM SPINAL SCREW(免事前審查) 3114

FBSF46132NY2 TITANIUM CERVICAL SCREW(配合FBSF36132NY2使用) 2100

FBSF46201NS1 TITANIUM PANGEA PEDICLE SCREW※適應症請見備註欄 5380

FBSF464001S9 TITANIUM SPINAL (DIAPASON)SCREW脊椎人工置換組：骨釘(免事前審

查)

3114

FBSF46400NS9 TITANIUM SPINAL(DIAPASON)SCREW 脊椎人工置換組：骨釘※適應症

請見備註欄

5380

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

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

FBSF4769NNY2 TITANIUM SPINAL PEDICLE SCREW 4.5:8，30:55MM 3114

FBSF4770NNY2 TITANIUM SPINAL PEDICLE SCREW(免術前審查) 3114

FBSF4774NNY2 TITANIUM O TYPE SPINAL FIXATION SCREW※適應症請見備註欄 5380

FBSF4781NNY2 ARTEST SPINAL FIXATION SYSTEM：TITANIUM SPINAL POLYAXIAL

PEDICLE SCREW(免事前審查)

3114

FBSF48010TY2 SYNTECARTEST 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


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

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

FBSF4807TMDA TITANIUM CD HORIZON SPINAL SCREW ※適應症請見備註欄 5380

FBSF481405Y2 SYNTECLATILS 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 SYNTECLATILS 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

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

FBSF4884CHY2 POLYAXIAL SCREW 多軸骨釘 ※適應症請見備註欄 5380

FBSF4886NNY2 MONOAXIAL SCREW 單軸骨釘 3114

FBSF4895NNY2 MONOAXIAL SCREW 單軸骨釘 3114

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

FBSF4AS001AQ TITANIUM SPINAL SCREW免術前審查 3114

FBSF4AS002AQ TITANIUM SPINAL FIXATION SYSTEM:SCREW 免事前審查 3114

FBSF4ASLS1AQ TITANIUM SPINAL SCREW※適應症請見備註欄 5380

FBSF4ASNS1AQ TITANIUM SMARTLOC SPINAL SCREW免事前審查 3114

866


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

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

FBSF4B0001RK TITANIUM SPINAL SCREW免事前審查 3114

FBSF4B0009RK REBORN ESSENCELUMBAR FIXATION SYSTEM:MULTI SCREW"瑞寶億"腰椎

內固定系統:萬向螺釘(免事前審查)

3114

FBSF4BA0013F 泰德腰椎內固定系統:脊椎螺釘TEND LUMBAR FIXATION

SYSTEM:SPINAL SCREW

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

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

FBSF4BA007RK TITANIUM SPINAL SCREW ※適應症請見備註欄 5380

FBSF4BA008RK REBORN ESSENCELUMBAR 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 ESSENCELUMBAR 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

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

FBSF4BA012RK REBORN ESSENCELUMBAR 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

FBSF4BAN4ARK 瑞寶億諾瓦脊椎固定系統:萬向螺釘REBORN ESSENCE NOVA SPINAL

FIXATION SYSTEM:POLY AXIAL SCREW

5380

FBSF4BAR4S1S SCIENT'XISOBAR 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 MERRIESCANNULATED SPINAL SYSTEM:CANNULATED PEDICLE SCREW "美

瑞世"中空螺釘脊椎固定系統

12960

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


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

FBSF4LC004GZ 際仁脊椎固定系統:固定釘(免事前審查)GEZEN SPINAL

FIXATION:SPINAL SCREW

3114

867


FBSF4LS004GZ GEZEN SPINAL FIXATION SYSTEM:SCREW 際仁脊椎固定系統:骨釘※適


5380

FBSF4LU004GZ GEZEN SPINAL FIXATION SYSTEM:SCREW 際仁脊椎固定系統:固定釘※


5380

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

FBSF4MM58MDP 帝富脊椎鈦質莫斯邁阿密脊椎系統-螺釘"DEPUY SPINE"TITANIUM

MOSS MIAMI SPINAL SYSTEM:MONOAXIAL SCREW

3114

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

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

FBSF4P2PSPZ6 MERRIESPROT 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 美瑞世普生二代後方脊椎固定器:固定螺釘"MERRIES"PROT II

POSTERIOR SPINE SYSTEM:SCREW

5380

FBSF4R382NS9 XIA REDUCTION SCREW※適應症請見備註欄 5380

FBSF4RF001RX RF SPINAL SCREW(免事前審查) 3114

FBSF4S3101U0 UNITEDCENTURY 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

FBSF4S8655M4 TITANIUM CD TULIP SCREW(免術前審查) 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

FBSF4S9603M4 TITANIUM CD REDUCTION SCREW(免術前審查) 3114

FBSF4SW70NAE AESCULAPTITANIUM 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

FBSF4SX07NAE TITANIUM SPINE SCREW (96年10月1日起免事前審查) 3114

FBSF4TL01TJA TITANIUM SPINAL PEDICLE SCREW※適應症請見備註欄 5380

FBSF4TS01TJA TITANIUM SPINAL PEDICLE SCREW(免事前審查) 3114

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

FBSF4YP04NXA Y TYPE POSTERIOR TITANIUM SPINAL PEDICLE SCREW(免事前審查) 3114

FBSF5000051A MONT BLANC SPINAL TRANSVERSE CONNECTOR※適應症請見備註欄 6108

FBSF50001TV2 INTAISPINAL 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 WILTROMSPINAL 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 INTAISPINAL 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

868


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

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

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

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

FBSF5B0001RK TITANIUM SPINAL LINK 免事前審查 2661

FBSF5BA0013F 泰德腰椎內固定系統:橫向連結器TEND LUMBAR FIXATION

SYSTEM:TRANSVERSE LINK

6108

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 UNITEDCENTURY 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

869


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

FBSF5P2CLKZ6 PROT II POSTERIOR SPINE CROSS LINK※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

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

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

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

FBSFA00002RK TITANIUM INTERVERTEBRAL CAGE 椎間融合器※適應症請見備註欄 13116

FBSFA000033F 泰德高分子腰椎椎間融合器:後開型TEND PEEK LUMBAR INTERBODY

FUSION CAGE

21971

FBSFA00003RK PEEK LUMBAR INTERVERTEBRAL CAGE 高分子材料腰椎椎間融合器(後


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

870


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


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

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

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 UNITEDEXPRESS 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

FBSFA45271Y2 亞太醫療和祥前方頸椎椎間融合器:聚醚醚酮"SYNTEC" ANTERIOR

CERVICAL INTERBODY CAGE:PEEK

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

FBSFA6730SS9 STRYKEROIC PEEK CAGE(STERILE)"史賽克"後開腰椎護架系統(滅菌) 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

FBSFA6731SS9 STRYKEROGIVAL 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

FBSFA6741NS9 SOLIS CERVICAL CAGE SYSTEM 梭利斯椎頸護架系統(頸椎PEEK CAGE)


21971

FBSFA6741SS9 STRYKERSOLIS CERVICAL CAGE SYSTEM(STERILE)(PEEK)"史賽克"梭利

斯椎頸護架系統(滅菌)

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

FBSFA6742SS9 STRYKERSOLIS AS PEEK SPACER(STERILE)"史賽克"椎間融合器(滅菌) 21971

FBSFA6760NS9 OIC PL PEEK SPACER 椎間融合器(後開型)※適應症請見備註欄 21971

FBSFA6760SS9 STRYKEROIC PEEK CAGE(STERILE)"史賽克"後開腰椎護架系統(滅菌) 21971

FBSFA706NNY2 TITANIUM VETEBRAL INTERBODY CAGE 高9:14MM長20:24※適應症請見

備註欄

13116

FBSFA7091NY2 TITANIUM VETEBRAE INTERBODY CAGE 9:14MMX20:24MM※適應症請見

備註欄

13116

871


FBSFA82501Y2 SYNTECPEEK 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 SYNTECBARNANA 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

FBSFA8380SS9 STRYKERAVS 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

FBSFA8984NS1 PLIVIOS IMPLANTS PEEK CAGE 腰椎椎間融合器(後開型)※適應症請

見備註欄

21971

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

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

FBSFA939MNM4 MEDTRONICCRESCENT 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

FBSFAALS02AQ TITANIUM VIGOR CERVICAL DISC SPACER ※適應症請見備註欄 12110

FBSFAAP002AQ A-SPINEPOLYMER 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-SPINEVIGOR 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 SPINEFIDJI CERVICAL CAGES (PEEK)"捷邁"頸椎椎間融合器


21971

FBSFAC001NZ1 ZIMMER SPINALFIDJI CERVICAL CAGES(PEEK)"捷邁"頸椎椎間融合器


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


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

872


FBSFACH11NXA TITANIUM CERVICAL CAGE 鈦合金頸椎椎間融合器※適應症請見備註

欄

12110

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

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

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

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

FBSFAF00023F 泰德高分子腰椎椎間融合器:後開型TEND PEEK LUMBAR INTERBODY

FUSION CAGE

21971

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

FBSFAF00033F 泰德高分子頸椎椎間融合器TEND PEEK CERVICAL INTERBODY FUSION

CAGE

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

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 AESCULAPTSPACE 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 SPINEARTJULIET 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

FBSFAN0SDSL2 阿伐泰克諾歐椎間融合器:聚醚醚酮(側開型每節椎體限置放1

個)"ALPHATEC"NOVEL SD SPINAL SPACER SYSTEM(PEEK TLIF)

43943

FBSFAN0VSDL2 ALPHATECNOVEL 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 ALPHATECNOVEL 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 INTAIINTERBODY 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 WILTROMINTERBODY 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 JOPEEK 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 JOPEEK 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 WILTROMINTERBODY 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

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

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

873


FBSFAPTG01WG WILTROMINTERBODY 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

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

FBSFARD1SNZ1 ZIMMERSPINE 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'XANTERIOR 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 AESCULAPPROSPACE 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 INTAIINTERBODY 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



43943



43943

FBSFATRYKC1C SPINEARTCERVICAL IMPLANTS(PEEK)"司佰特"頸椎椎間植入物 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

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

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

FBSFC014XNS1 SYNTHESVECTRA SYSTEM(P*1+S*4)"信迪思"頸椎固定系統(二節)※適


18623

FBSFC04CTSS1 信迪思枕頸椎融合系統:枕頸椎螺釘"SYNTHES" OCCIPITO CERVICAL

FUSION SYSTEM:OCCIPITAL SCREW

8260

FBSFC07189S1 信迪思辛納思脊椎固定系統:頸椎骨鉤環"SYNTHES" SYNAPSE

SYSTEM:LAMINA HOOK

5375

FBSFC10002U0 UNITEDSLIMFIT 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 UNITEDSLIMFIT 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

FBSFC10108AD TITANIUM SLIM-LOC ANTERIOR CERVICAL SCREW※適應症請見備註欄 984

FBSFC11CTSDP 帝富脊椎桑明脊椎系統-枕骨固定組(枕骨用)-枕骨固定螺絲"DEPUY

SPINE" SUMMIT SPINAL SYSTEM-OCCIPITAL SCREW&NUT-OCCIPITAL

BONE SCREW

8260

FBSFC128XNS1 SYNTHESVECTRA SYSTEM(P*1+S*6)"信迪思"頸椎固定系統(三節)※適


20591

FBSFC1792SDP TITANIUM SLIM-LOC ANTERIOR CERVICAL PLATE 二節※適應症請見備

註欄

18623

874


FBSFC1793SDP TITANIUM SLIM-LOC ANTERIOR CERVICAL PLATE 三節※適應症請見備

註欄

20591

FBSFC20002U0 UNITEDBOOSTER 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 UNITEDBOOSTER 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 STRYKERREFLEX 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

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

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

FBSFC3402NZ1 西美提尼卡前方頸椎板系統-骨釘"ZIMMER"TRINICA AND TRINICA

SELECT ANTERIOR CERVICAL PLATE SYSTEM-SCREW

984

FBSFC34563DP 帝富脊椎桑明脊椎系統-固定桿(長)"DEPUY SPINE" SUMMIT SPINAL

SYSTEM-ROD

3700

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

FBSFC3637HDP 帝富脊椎桑明脊椎系統-骨鉤"DEPUY SPINE" SUMMIT SPINAL SYSTEM-

HOOK AND INNER SCREW

5375

FBSFC3869NS9 STRYKERREFLEX 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

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

FBSFC4020NS9 REFLEX HYBRID ANTERIOR CERVICAL SCREW 芮菲斯前置頸椎骨釘 ※


984

FBSFC40609S1 信迪思艾可索固定植入物:頸椎骨鉤環"SYNTHES" AXON

IMPLANTS:HOOK

5375

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

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(3節以內，25-40MM)"STRYKER"

OASYS SYSTEM-PLATE

1950

FBSFC4805NS9 史賽克頸椎後側固定系統-短固定桿(3節以內，25-40MM)"STRYKER"

OASYS SYSTEM-ROD

1950

875


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(4節以，上50-350MM"STRYKER"

OASYS SYSTEM-PLATE

3700

FBSFC4809NS9 史賽克頸椎後側固定系統-長固定桿(4節以，上50-350MM)"STRYKER"

OASYS SYSTEM-ROD

3700

FBSFC4869NS9 STRYKERREFLEX 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

FBSFC51314S1 信迪思辛納思脊椎固定系統:頸部橫向連結器"SYNTHES" SYNAPSE

SYSTEM:CERVICAL TRANSVERSE CONNECTOR

7208

FBSFC612XNS1 SYNTHESVECTRA 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

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

FBSFC94043S1 信迪思頸椎固定植入物:頸椎固定鉤"SYNTHES" CERVIFIX

IMPLANTS:CERVICAL HOOKS

5375

FBSFC95051S1 信迪思頸椎固定植入物:頸椎固定夾"SYNTHES"CERVIFIX

IMPLANTS:LAMINA CLAMPS

5375

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

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

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

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

FBSFCASP01AQ TITANIUM CERVICAL PLATE (免事前審查) 3588

FBSFCASS02AQ TITANIUM CERVICAL SCREW(免事前審查) 180

876


FBSFCB0003RK TITANIUM CERVICAL SCREW 免事前審查 180

FBSFCB0004RK TITANIUM CERVICAL PLATE 免事前審查 3588

FBSFCBA001RK 瑞寶億頸椎前路骨板系統:二節(PX1+SX4)REBORN ESSENCE ANTERIOR

CERVICAL PLATE SYSTEM:TITANIUM(PX1+SX4)※適應症請見備註欄

18623

FBSFCBA002RK 瑞寶億頸椎前路骨板系統:三節(PX1+SX6)REBORN ESSENCE ANTERIOR

CERVICAL PLATE SYSTEM:TITANIUM(PX1+SX6)※適應症請見備註欄

20591

FBSFCBA003RK 瑞寶億頸椎前路骨板系統:頸椎螺絲REBORN ESSENCE ANTERIOR

CERVICAL PLATE SYSTEM:CERVICAL SCREW

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 SYNTECDYNAMIC 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

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

FBSFCPC108RK 瑞寶億頸椎後路固定系統-頸椎固定螺釘REBORN ESSENCE POSTERIOR

CERVICAL FIXATION SYSTEM-CERVICAL FIXATION SCREW

8260

FBSFCPC32BRK 瑞寶億頸椎後路固定系統-雙直徑連接桿300MM(長;4節以上)REBORN

ESSENCE POSTERIOR CERVICAL FIXATION SYSTEM-CONNECT ROD

3700

FBSFCPC604RK 瑞寶億頸椎後路固定系統-枕骨板(一體成型)REBORN ESSENCE

POSTERIOR CERVICAL FIXATION SYSTEM-OCCIPITAL ROD PLATE

7400

FBSFCPC700RK 瑞寶億頸椎後路固定系統-橫向(萬向)連結器REBORN ESSENCE

POSTERIOR CERVICAL FIXATION SYSTEM-TRANSVERSE(UNIVERSAL)LINK

7208

FBSFCPCLSRRK 瑞寶億頸椎後路固定系統-平滑桿40:120MM(長;4節以上)REBORN

ESSENCE POSTERIOR CERVICAL FIXATION SYSTEM-SMOOTH ROD(LONG)

3700

FBSFCPCSSRRK 瑞寶億頸椎後路固定系統-平滑桿30MM(短)REBORN ESSENCE

POSTERIOR CERVICAL FIXATION SYSTEM-SMOOTH ROD

1950

877


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 UNITEDSLIMFIT 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

FBSFCS3104U0 UNITEDBOOSTER 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

FBSFCSR956S1 信迪思頸椎固定植入物:枕骨固定骨桿(240MM)"SYNTHES"CERVIFIX

IMPLANTS:OCCIPUT ROD

3700

FBSFCSR957S1 信迪思辛納思脊椎固定系統:頸椎骨桿(240MM)"SYNTHES" SYNAPSE

SYSTEM:CERVICAL ROD

3700

FBSFCSW005BB 雅氏雅士弗頸椎固定系統-連接器"AESCULAP”S4 CERVICAL SYSTEM-

CROSS CONNECTOR

7208

FBSFCSW126BB 雅氏雅士弗頸椎固定系統-枕骨固定釘"AESCULAP”S4 CERVICAL

SYSTEM-OCCIPITAL SCREW

8260

FBSFCSW194BB 雅氏雅士弗頸椎固定系統-固定桿30MM(短)"AESCULAP”S4 CERVICAL

SYSTEM-ROD(SHORT)

1950

FBSFCSW198BB 雅氏雅士弗頸椎固定系統-固定桿(長)4節以上"AESCULAP”S4

CERVICAL SYSTEM-ROD(LONG)

3700

FBSFCTRYC21C SPINEART CERVICAL IMPLANTS 二節(PX1+SX4)司佰特頸椎間植入物※


18623

FBSFCTRYC31C SPINEART CERVICAL IMPLANTS 三節(PX1+SX6)司佰特頸椎間植入物※


20591

FBSFCTRYCS1C SPINEART CERVICAL IMPLANTS:SCREW司佰特頸椎間植入物:骨釘※適


984

FBSFR49816S1 信迪思第二代延展式肋骨支撐架-平行連結器/延展連結器(整組使用

者不得申報，只適用於組件單獨使用者申報)"SYNTHES"VEPTR

VERTICAL EXPANDABLE PROSTHETIC TITANIUM RIB II-PARALLEL

CONNECTOR EXTENSION CONNECTOR

14824

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，只適用於組件單獨使用者申報)

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用者申報)

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)(整組使用者不得申報，只適用於組件單獨使用者

申報)

64148

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


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


申報)

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


申報)

88048

878


FBSFR6411LS1 SYNTHESVEPTR 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 SYNTHESVEPTR 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 SYNTHESVEPTR 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 SYNTHESVEPTR 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 SYNTHESVEPTR: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

300221

FBSFR9703LS1 SYNTHESVEPTR: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 SYNTHESVEPTR: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 SYNTHESVEPTR: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 SYNTHESVEPTR: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 SYNTHESVEPTR: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 SYNTHESVEPTR: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 SYNTHESVEPTR: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 SYNTHESVEPTR: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 SYNTHESVEPTR:EXTENSION CONNECTOR"信迪思"延展連接器(整組使用

者不得申報，只適用於組件單獨使用者申報)

14824

FBSFR97257S1 SYNTHESVEPTR: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 SYNTHESVEPTR: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 SYNTHESVEPTR: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

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

FBT01020MS4M 速普新關節內注射劑SUPLASYN STERILE SODIUM HYALURONATE

SOLUTION(2ML/注射筒裝)

709

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

FBT01025MLR7 雅節關節內注射劑(每次療程注射三次)ARTZ/ARTZ DISPO 709

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

879


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)


421

FBT01SA25CLB SYNOAID INTRA-ARTICULAR INJECTION欣節益關節內注射劑※適應症

請見備註欄

425

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

FBUF11001NW2 UNICOMPARTMENTAL KNEE FEMORAL COMPONENT※適應症請見備註欄 23268

FBUF15842NZ1 ZIMMERUNICOMPARTMENTAL HIGH-FLEX FEMORAL COMPONENT※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 ZIMMERUNICOMPARTMENTAL HIGH-FLEX ARTICULAR SURFACE※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 ZIMMERUNICOMPARTMENTAL HIGH-FLEX PRECOAT TIBIAL PLATE※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 ZIMMERUNICOMPARTMENTAL HIGH-FLEX ALL POLYETHYLENE TIBIAL

BASEPLATE(TIBIAL+SURFACE)※適應症請見備註欄

21709

FBW01000155H 鴻君骨板骨釘系統/克氏骨針"HC"BONE PLATES AND

SCREWS/KIRSCHNER WIRE (K-PIN) (DIAMETER1.0:5.0MM X70:200)

72

FBW0106321M1 KIRSCHNER WIRE (K-PIN) 1.0:1.2MM 300MM 72

FBW0106324M1 KIRSCHNER WIRE (K-PIN) 1.5:1.8MM 300MM 72

FBW0106325M1 KIRSCHNER WIRE (K-PIN) 2.0MM 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

880


FBW012915NY2 KIRSCHNER WIRES(THREADED)0.9MM，1.1MM，1.6MM *9"(230MM) 255

FBW012926NY2 KIRSCHNER WIRE W/THREADED 255

FBW012927NS1 信迪思骨科用K氏鋼絲(螺紋尖)"SYNTHES" K WIRE(THREAD TIP) 255

FBW01292NNS1 信迪思骨科用K氏鋼絲(針狀尖/雙頭尖)"SYNTHES" K

WIRE(TROCAR/DOUBLE TIP)

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


FBW01LX12NAE K-WIRE 310MM，1.2:1.7MM 72





FBW01LX17SAE K-WIRE 150MM 1.7MM 72

FBW01LX18NAE K-WIRE 310MM，1.8MM 72









FBW01LX30NAE K-WIRE 210MM，1.0MM(102.01.01更改為1.0X310MM) 72


FBW01LX32NAE K-WIRE 310MM，1.2:1.6MM 72





FBW01LX37SAE KIRSCHNER WIRE 1.7MMx150MM 72










FBW01LX47SAE KIRSCHNER WIRE 雅式鋼針 72

FBW01LX90NAE KIRSCHNER WIRE 雅式鋼針 72

FBW01LX915AE 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

881


FEP0456210XT MCGEE MODIFIED LOOP PISTON 1250



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

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

FHFCD32354ST 聖猷達優你法植入式心律去顫器"SJM" UNIFY IMPLANTABLE

CARDIOVERTER DEFIBRILLATOR

565882

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 MEDTRONICPROTECTA 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

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


565882

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


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

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 DEFIBRILLATORS(HF-T)*給

付規定見備註

591468

882


FHFCDLUXHFBK 百多力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 ENVIRONMENT(HF-T)

591468

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

FHFCDQ3367ST 聖猷達克卓亞速拉植入式心律去顫器-四極"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


609212

FHFCDQMP33ST 聖猷達克卓亞速拉多點式植入式心律去顫器"SJM"QUADRA ASSURA MP


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


591468

FHFCDTBAD4M4 美敦力長青植入式心臟去顫器""MEDTRONIC"VIVA XT/S CRT-D


591468

FHFCDTBAQQM4 美敦力長青植入式心臟去顫器"MEDTRONIC"VIVA QUAD CRT-D


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

FHFCDUA32MST 聖猷達優你法亞速拉植入式心律去顫器"SJM" UNIFY ASSURA


565882

FHFCDUA33MST 聖猷達優你法亞速拉植入式心律去顫器"SJM"UNIFY ASSURA


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 3304

FHG110401CMP CARBOFLO GRAFT，STRAIGHT，10CM 卡邦人工血管 3304





FHG1106020MP STRAIGHT GRAFT 6，8MM 20CM 6170




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


FHG1106050SB EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT 4:8MMX50CM型

號381056，57，58自92.10.1生效

10990




FHG1106S50TM TERUMO SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES

STRAIGHT GRAFT 50CM*6，7，8，10MM

10990

883



FHG1116040QM 邁柯唯人工血管"MAQUET" EXXCEL SOFT EPTFE VASCULAR GRAFT 5-

8MM*40CM

10795

FHG1130S06BA 印帕聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR GRAFT(STRAIGHT

6MM*30CM)

8563

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 10990

FHG11D500CBA 巴德迪斯塔人工血管"BARD" DISTAFLO BYPASS GRAFTS 10990


FHG11D600CBA 巴德迪斯塔人工血管"BARD" DISTAFLO BYPASS GRAFTS 60CM 14524





FHG11V106CMP VENAFLO GRAFT，STRAIGHT，10CM維那人工血管 3304





FHG11VL100MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS-STRAIGHT GRAFT(6，7MM，

10CM)維那人工血管直式

3304



6170



8563



10795



10990

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 3304







FHG1230STWBA 印帕聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR GRAFT(STRAIGHT

THINWALL 6MM*30CM)

8563

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



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

FHG1406545GX RINGED GRAFT 5CM 6MM 45CM 13162

FHG140657NGX RINGED GRAFT 50CM 6MM，8MM 70CM 21700

884


FHG1406C40QM 邁柯唯人工血管"MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT

6MM*45CM

13162

FHG1406C40SB EXXCEL SOFT EPTFE GRAFT STRAIGHT CENTRALLY SUPPORTED

6MM/40CM，45CM/5CM

13162


VASCULAR GRAFTS STANDARD WALL-CENTER HELIX，6MM* 45CM

13162

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

FHG1506660SB EXXCEL SOFT EPTFE GRAFT THIN WALL STRAIGHT EXTERNALLY

SUPPORTED 6MM/60CM/60CM

20116


8MM*70CM

22269


SUPPORTED 6MM，8MM，10MM/70CM/70CM

22269


SUPPORTED 6MM，8MM/80CM/80CM

25266

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 22269

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

FHG1606670GX REMOVABLE RINGED THIN WALLED GRAFT 60CM 6MM 70CM 22269


8MM*80CM

25266

FHG1606880SB EXXCEL SOFT EPTFE GRAFT STRAIGHT EXTERNALLY SUPPORTED 6MM，

8MM/80CM/80CM

25266


FULL SUPPORT STRAIGHT GRAFT 20CM*6，7，8，10MM

7973

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


FULL SUPPORT STRAIGHT GRAFT 80CM*6，7，8，10MM

25266

FHG16CF604MP CARBOFLO GRAFT，CENTERFLEX，40CM 卡邦人工血管 13162

FHG16CF605MP CARBOFLO GRAFT，CENTERFLEX，50CM 卡邦人工血管 16654

FHG16CV604MP VENAFLO GRAFT，CENTERFLEX，40CM維那人工血管 13162

FHG16CV605MP VENAFLO GRAFT，CENTERFLEX，50CM維那人工血管 16654

FHG16CVL40MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS CENTERFLEX(6-7MM，40CM)

印帕維那人工血管中間螺旋式

13162

FHG16CVL50MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS CENTERFLEX(6MM，50CM)印

帕維那人工血管中間螺旋式

16654

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

885



SMALL BEADING 60CM

20116


SMALL BEADING 60CM

20116


SMALL BEADING 70CM

22269


SMALL BEADING 70CM

22269


SMALL BEADING 80CM

25266


SMALL BEADING 80CM

25266

FHG16F0640MP FLEX GRAFT 6，7，8，10MM 40CM 14920


6MM*30CM)

11414


7;8;10MM*40CM)

14920

FHG16F401TMP CARBOFLO GRAFT，FLEX THINWALL SMALL BEADING，10CM 卡邦人工血

管

4214


管

22269

FHG16F601CMP CARBOFLO GRAFT，STRAIGHT FLEX，10CM 卡邦人工血管 4214


管

11414




管

16948



管

20116




管

25266

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)

22099


VASCULAR GRAFTS THIN WALL-HELIX SUPPORTED，6MM 7MM 8MM* 70CM

22269


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

14657

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



26400



28330

886


FHG1825130AH 亞翠恩福立心人工血管"ATRIUM" FLIXENE VASCULAR GRAFTS 30CM 14629



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

8771

FHG2106030TM TERUMOGELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR

PROSTHESES GELSEAL STRAIGHT GRAFTS6:10MM 30CM

8169

FHG2112025TM 泰爾茂傑斯弗特加強型人工血管"TERUMO"GELSOFT PLUS GELATIN

SEALED POLYESTER VASCULAR PROSTHESES 18MM 25CM

7854

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

9553

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

FHG2112051TM TERUMO GELSEAL GELATIN SEALED POLYESTER VASCULAR PROSTHESES

GELSEAL TRIAXIAL，GELSOFT STRAIGHT 12:18MM 50，60CM

10190


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

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


SPECIAL FOUR BRANCH(PLEXUS)40CM*4@15CM*適應症請見備註欄

56028

FHG21GK041V8 MAQUET INTERGARD KNITTED VASCULAR GRAFTS邁柯唯英特佳針織系列

人工血管12-24MM，40CM

10190

FHG21GK100V8 MAQUET INTERGARD KNITTED VASCULAR GRAFTS邁柯唯英特佳針織系列

人工血管8MM，100CM

18737

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


VASCULAR GRAFT AND PATCH 12-24MM，20CM

7888



10234



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



9312


VASCULAR GRAFT AND PATCH 6-8MM*20CM

5723

887


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


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

20311


VASCULAR GRAFT AND PATCH(徑向支撐型)8MM*100CM

25266

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

FHG21KUT4HQM 邁柯唯英特佳肝素膠原塗層人工血管MAQUET INTERGARD HEPARIN


10795

FHG21KUT7HQM 邁柯唯英特佳肝素膠原塗層人工血管MAQUET INTERGARD HEPARIN


16800

FHG21W1407V8 MAQUET INTERGARD WOVEN VASCULAR GRAFTS邁柯唯英特佳編織系列人

工血管14-24MM，50CM

15287

FHG21W2050TM TERUMO GELWEAVE GELATIN SEALED POLYESTER VASCULAR PROSTHESES

GELWEAVE STRAIGHT VASCULAR GRAFTS 50CM*20-34MM

12362

FHG21WK015V8 MAQUET INTERGARD WOVEN VASCULAR GRAFTS邁柯唯英特佳編織系列人


4588



5563



8169



9553



11630



14835

FHG3140A64BA 印帕聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR GRAFT(SHORT

TAPERED 6，7-4MM*40CM)

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


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

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

888


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

15601

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)

15601

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

15601

FHG3147040GX TAPERED GRAFT 4-7MM 40CM 12527

FHG3147S45MP STEPPED GRAFT 4-7MM 45CM 12527

FHG3164A40MP CARBOFLO GRAFT，SHORT TAPERED，40CM 卡邦人工血管 12527

FHG316CF50MP CENTER FLEX 6:8MM 50CM 16654

FHG31T4645MP CARBOFLO GRAFT，STEPPED，45CM 卡邦人工血管 12527

FHG31T4750MP CARBOFLO GRAFT，STEPPED，50CM 卡邦人工血管 14714

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

6645



7530



12527

FHG31VT246MP VENAFLO GRAFT，STEPPED，20/25CM維那人工血管 6645

FHG31VT346MP VENAFLO GRAFT，STEPPED，30CM維那人工血管 7530

FHG3274070MP CARBOFLO GRAFT，TAPERED THINWALL，70CM 卡邦人工血管 18207


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 13162

FHG3425145AH 亞翠恩福立心人工血管"ATRIUM"FLIXENE VASCULAR GRAFTS 三層錐型

4-6:5-8X45CM

18630

FHG3447S45MP CENTERFLEX STEPPED GRAFT 4-7MM，5-8MM 45CM 14150

FHG34CF40ABA 印帕聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR GRAFT(SHORT

TAPERED CENTERFLEX 6，7-4MM*40CM)

14150

FHG34CFT40BA 印帕聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR GRAFT(STEPPED

CENTERFLEX 4-7MM*40CM)

14150


VASCULAR GRAFTS(SHORT TAPER CENTER HELIX STANDARD 4-

7MM*45CM)

15601

FHG3630A74BA 印帕聚四氟乙烯人工血管"IMPRA" EPTFE VASCULAR GRAFT(SHORT

TAPERED 7-4MM*30CM)

7530

FHG3647145GX TAPERED GRAFT WITH REMOVAL RINGED 15601

FHG3674A40MP CARBOFLO GRAFT，SHORT TAPERED CENTERFLEX，40CM 卡邦人工血管 15601

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

14150

FHG36F7407MP CARBOFLO GRAFT，FLEX THINWALL TAPERED SMALL BEADING，70CM 卡

邦人工血管

21795

889


FHG36T4740MP CARBOFLO GRAFT，STEPPED CENTERFLEX，40/45CM 卡邦人工血管 15601

FHG36T4750MP CARBOFLO GRAFT，STEPPED CENTERFLEX，50CM 卡邦人工血管 16090

FHG36VT454MP VENAFLO GRAFT，STEPPED CENTERFLEX，45CM維那人工血管 15601

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 TERUMOGELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR

PROSTHESES BIFURCATION WOVEN GRAFTS12:24*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

15188

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


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

FHP011NGMRSB 波士頓科技迎吉心臟節律器"BOSTON SCIENTIFIC"INGENIO MRI

PACEMAKER

81477

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

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


64214

FHP01ACSRMST 聖猷達愛森心臟節律器(單腔)"SJM"ACCENT PULSE GENERATOR(SR) 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

FHP01ADVMRSB 波士頓科技艾凡緹心臟節律器"BOSTON SCIENTIFIC"ADVANTIO MRI

PACEMAKER

81477

FHP01ADVSRSB “波士頓科技”艾凡緹心臟節律器“BOSTON SCIENTIFIC”ADVANTIO

PACEMAKER

64214

FHP01ASSRMST 聖猷達安速拉第心臟節律器(單腔)"SJM" ASSURITY PULSE

GENERATOR(SR)

64214

FHP01ASSRUST 聖猷達安速拉第心臟節律器-單腔"SJM"ASSURITY PULSE

GENERATOR(SR)

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

890


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


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


ACCESSORIES-EFFECTA S

61910

FHP01ELUSRBK 百多力艾路納核磁共振植入式心律調節器 -單腔"BIOTRONIK"ELUNA 8

IMPLANTABLE PACEMAKER SYSTEM WITH A CONDITIONAL INTENDED USE

IN A MRI ENVIRONMENT(SR)

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

FHP01EN1SRM4 美敦力安信諾核磁共振植入式心臟節律器(單腔)"MEDTRONIC" ENSURA

MRI SURESCAN IMPLANTABLE PACEMAKER(SR)

81477

FHP01ENDRMST 聖猷達恩德拉第心臟節律器(單腔)"SJM" ENDURITY PULSE

GENERATOR(SR)

64214

FHP01ENDRUST 聖猷達恩德拉第心臟節律器-單腔"SJM"ENDURITY PULSE

GENERATOR(SR)

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

FHP01EVASTBK 百多力艾維亞植入式心律調節器"BIOTRONIK"EVIA IMPLANTABLE

CARDIAC PACEMAKERS

64214

FHP01MR224ST 聖猷達艾森核磁共振心臟節律器"SJM"ACCENT MRI PULSE GENERATOR 81477

FHP01MR24MST 聖猷達愛森核磁共振心臟節律器(單腔)"SJM" ACCENT MRI PULSE

GENERATOR(SR)

81477

FHP01MR62UST 聖猷達恩德拉第心臟節律器-單腔"SJM"ENDURITY PULSE GENERATOR-

SR(MRI)

81477

FHP01MR72UST 聖猷達安速拉第心臟節律器"SJM"ASSURITY PULSE GENERATOR(MRI) 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

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

891


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


64214


PACEMAKER *適應症見備註欄

64214


PACEMAKER *需檢附心電圖報告專案報備使用

64214



64214

FHP01SSS20SB 波士頓科技歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 20


56540

FHP01SX134ST 聖猷達撒司坦植入式心臟節律器(單腔)"SJM" SUSTAIN IMPLANTABLE

CARDIAC PULSE GENERATOR(SSI)

61910

FHP01SX136ST 聖猷達撒司坦植入式心臟節律器(單腔)"SJM" SUSTAIN IMPLANTABLE

CARDIAC PULSE GENERATOR(SSIR)

64214

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

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

FHP01VSR1UST 聖猶達植入式心臟節律器(單腔)"SJM"IMPLANTABLE CARDIAC PULSE

GENERATOR(SR)

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

FHP01ZESRMST 聖猷達神風植入式心臟節律器(單腔)"SJM"ZEPHYR IMPLANTABLE

CARDIAC PULSE GENERATOR(SR)

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

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

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


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


93833

FHP02ACDRMST 聖猷達愛森心臟節律器(雙腔自付差額)"SJM" ACCENT PULSE

GENERATOR(DDDR)

93833

FHP02ACSDRST 聖猷達艾森艾斯特心臟節律器(雙腔)"SJM" ACCENT ST PULSE



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

892


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

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

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

FHP02ASSRMST 聖猷達安速拉第心臟節律器(雙腔自付差額)"SJM" ASSURITY PULSE

GENERATOR(DDDR)

93833

FHP02ASSRUST 聖猷達安速拉第心臟節律器(雙腔自付差額)"SJM"ASSURITY PULSE

GENERATOR(DDDR)

93833

FHP02DDD2SST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR *


93833

FHP02DDD2UST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR *


93833

FHP02DDD32GU 內植用雅密特心臟整律器GUIDANT INSIGNIA I AVT PULSE


93833

FHP02DDD50SB 波士頓科技歐超心臟整律器"BOSTON SCIENTIFIC" ALTRUA 50


93833

FHP02DDD6SST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR *


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


93833

FHP02DDR31GU 內植用雅密特心臟整律器GUIDANT INSIGNIA I AVT PULSE



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 *


自付。

93833




93833

FHP02DDR41GU 因施尼亞心臟整律器GUIDANT INSIGNIA I ULTRA PULSE GENERATOR*


自付。

93833




93833

FHP02DDR5SST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR *


自付。

93833




93833

893


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

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


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


93833

FHP02ELUDRBK 百多力艾路納核磁共振植入式心律調節器-雙腔(自付差

額)"BIOTRONIK"ELUNA 8 IMPLANTABLE PACEMAKER SYSTEM WITH A

CONDITIONAL INTENDED USE IN A MRI ENVIRONMENT(DDDR)

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

FHP02ENDRMST 聖猷達恩德拉第心臟節律器(雙腔自付差額)"SJM" ENDURITY PULSE

GENERATOR(DDDR)

93833

FHP02ENDRUST 聖猷達恩德拉第心臟節律器(雙腔自付差額)"SJM"ENDURITY PULSE

GENERATOR-DDDR

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

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

FHP02MR12MST 聖猷達愛森核磁共振心臟節律器(雙腔自付差額)"SJM" ACCENT MRI

PULSE GENERATOR(DDDR)

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

FHP02MR22MST 聖猷達愛森核磁共振心臟節律器(雙腔自付差額)"SJM" ACCENT MRI

PULSE GENERATOR(DDDR)

93833

FHP02MR62UST 聖猷達恩德拉第心臟節律器(雙腔自付差額)"SJM"ENDURITY PULSE

GENERATOR-DDDR(MRI)

93833

FHP02MR72UST 聖猷達安速拉第心臟節律器-雙腔(自付差額)"SJM"ASSURITY PULSE

GENERATOR(DDDR)-MRI

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

894


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

FHP02SX234ST 聖猷達撒司坦植入式心臟節律器(雙腔)"SJM" SUSTAIN IMPLANTABLE

CARDIAC PULSE GENERATOR(DDD)

93833

FHP02SX236ST 聖猷達撒司坦植入式心臟節律器(雙腔自付差額)"SJM" SUSTAIN

IMPLANTABLE CARDIAC PULSE GENERATOR(DDDR)

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 *


93833

FHP02VDR1UST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR *


93833

FHP02VDR4SST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR *


93833

FHP02VDR4UST 雙腔型心臟節律器"SJM" IMPLANTABLE CARDIAC PULSE GENERATOR *


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


93833

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


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


12*12CM

8322


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


FABRICS(1.0*15.2CM)(2.1*5.1CM)

281


FABRICS(2.5CM*10.2CM)

563


FABRICS(5.1*10.2CM)

1697


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


10.2*10.2CM

2319


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

895



2.5*10.2CM，5.1*5.1CM

563


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


443350

FHPCD214VMM4 美敦力思格拉植入式心臟去顫器(單腔)"MEDTRONIC" SECURA VR


330345

FHPCD354DMM4 MEDTRONICPROTECTA XT DR IMPLANTABLE CARDIOVERTER


註欄

483701

FHPCD354VMM4 MEDTRONICPROTECTA XT VR IMPLANTABLE CARDIOVERTER


註欄

342335

FHPCDA155DGU 佳騰維達艾維塔植入型心律去顫器"GUIDANT" VITALITY AVT ICD*適


383267

FHPCDA44VRSB 波士頓科技侒諾偵植入式心律去顫器(單腔)"BOSTON

SCIENTIFIC"ENERGEN IMPLANTABLE CARDIOVERTER DEFIBRILLATOR

(ICD)(VR)

315795

FHPCDA46VRSB 波士頓科技英賽特植入式心律去顫器(單腔)"BOSTON

SCIENTIFIC"INCEPTA IMPLANTABLE CARDIOVERTER DEFIBRILLATOR

(ICD)(VR)

315795

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


315795

FHPCDD234DM4 美敦力思格拉植入式心臟去顫器“MEDTRONIC”SECURA DR


443350

FHPCDD234VM4 美敦力思格拉植入式心臟去顫器“MEDTRONIC”SECURA VR


330345

FHPCDD284DM4 美敦力麥思蒙植入式心臟去顫器(雙腔)"MEDTRONIC" MAXIMO II DR


383267

FHPCDD284VM4 美敦力麥思蒙植入式心臟去顫器(單腔)"MEDTRONIC" MAXIMO II VR


315795

FHPCDD354DM4 MEDTRONICPROTECTA XT DR IMPLANTABLE CARDIOVERTER


註欄

483701

FHPCDD354VM4 MEDTRONICPROTECTA XT VR IMPLANTABLE CARDIOVERTER


註欄

342335

FHPCDD364DM4 美敦力博特多植入式心臟去顫器"MEDTRONIC" PROTECTA DR


383267

896


FHPCDD364VM4 美敦力博特多植入式心臟去顫器"MEDTRONIC" PROTECTA VR


315795

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

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

FHPCDDR359ST 聖猷達幅地法亞速拉植入式心律去顫器((射頻雙腔型)"SJM"FORTIFY

ASSURA 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

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

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


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

FHPCDDRF2MST 聖猷達植入式心律去顫器-雙腔"SJM" FORTIFY IMPLANTABLE


443350

FHPCDDRFSMST 聖猷達幅地法艾斯特植入式心律去顫器-雙腔"SJM" FORTIFY ST


443350

FHPCDDRPLSST “聖猷達”克侖特普拉斯植入式心律去顫器-雙腔SJM”CURRENT+


383267

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

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


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)*


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


342335

FHPCDLUXDRBK 百多力路麥斯核磁共振植入式心臟去顫器(DR-T)"BIOTRONIK" LUMAX


INTENDED USE IN A MRI ENVIRONMENT(DR-T)

483701

FHPCDLUXVDBK 百多力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 ENVIRONMENT(VR-T DX)

342335

897


FHPCDLUXVRBK 百多力路麥斯核磁共振植入式心臟去顫器(VR-T)"BIOTRONIK" LUMAX


INTENDED USE IN A MRI ENVIRONMENT(VR-T)

342335

FHPCDPD26NST 聖猷達植入式雙腔型心臟去顫器"SJM"PHONTON DR IMPLANTABLE


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

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


383267

FHPCDRFVD2ST 聖猷達克侖特植入式心律去顫器 "SJM" CURRENT IMPLANTABLE


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

FHPCDVR359ST 聖猷達幅地法亞速拉植入式心律去顫器(射頻單腔型)"SJM"FORTIFY

ASSURA IMPLANTABLE CARDIOVERTER DEFIBRILLATOR

342335

FHPCDVR36QST 聖猷達植入式心律去顫器"SJM" CURRENT ACCEL IMPLANTABLE


330345

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

FHPCDVRCD2ST 聖猷達植入式心律去顫器"SJM" CURRENT ACCEL IMPLANTABLE


330345

FHPCDVRF1MST 聖猷達植入式心律去顫器-單腔"SJM" FORTIFY IMPLANTABLE


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


330345

FHPCDVRFSMST 聖猷達幅地法艾斯特植入式心律去顫器-單腔"SJM" FORTIFY ST


330345

FHPCDVRPLSST “聖猷達”克侖特普拉斯植入式心律去顫器-單腔SJM”CURRENT+


315795

FHPCL06935M4 美敦力史賓特導管"MEDTRONIC" SPRINT QUATTRO SECURE S LEAD*適


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

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. ACCESSORIES

76664

898


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

FHPCL6935MM4 “美敦力”史賓特植入式導線“MEDTRONIC”SPRINT QUATTRO SECURE

IMPLANTABLE LEAD

76664

FHPCL693MRM4 美敦力史賓特核磁共振植入式電極導線-三極(主動式固

定)"MEDTRONIC"SPRINT QUATTRO SECURE MRI SURESCAN IMPLANTABLE

LEAD

76664

FHPCL6946MM4 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

FHPCL694MRM4 美敦力史賓特核磁共振植入式電極導線-四極(主動式固

定)"MEDTRONIC"SPRINT QUATTRO SECURE MRI SURESCAN IMPLANTABLE

LEAD

76664

FHPCL6996SM4 美敦力皮下導線系統"MEDTRONIC" SUBCUTANEOUS LEAD SYSTEM 87034

FHPCLAF157GU 安達植入式去顫器電極導線ENDOTAK RELIANCE IMPLANTABLE LEAD*適


76664

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 GUIDANTENDOTAK 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


75682

FHPCLB0184GU 佳騰安達集植入式電極導線"GUIDANT" ENDOTAK RELIANCE G


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


75682

FHPCLLDA22ST 聖猷達亞提旭心臟導線(主動式固定)"SJM"OPTISURE LEADS(FOR ICD) 76664

FHPCLLDP22ST 聖猷達亞提旭心臟導線(非主動固定)"聖猷達""SJM"OPTISURE

LEADS(FOR ICD)

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

FHPCLR704NST 聖猷達經靜脈心搏過速導線※適應症見備"SJM”TRANSVENOUS

TACHYARRHYTHMIA LEAD

75682

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

899


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

FHPCLTD359BK 百多力保心護心內除顫器植入式四極被動導線(包括附

件)"BIOTRONIK" PROTEGO TD IMPLANTABLE DEFIBRILLATOR LEADS

INCL. ACCESSORIES

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

FHPHF04X98M4 美敦力艾坦卓越電極導線"MEDTRONIC"ATTAIN PERFORMA LEAD 22311

FHPHF08042M4 美敦力因信可心房同步雙心室節律器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

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

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

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

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

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

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

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

FHPHFPM312ST 聖猷達安路心臟再同步節律器"SJM" ALLURE CARDIAC

RESYNCHRONIZATION THERAPY PULSE GENERATOR

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

900


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


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

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


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*


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

FHPL127319SB 波士頓科技迎吉電極導線(含配件)"BOSTON SCIENTIFIC"INGEVITY

LEAD

7434

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*


7434

FHPL1PPT99ST 聖猷達亞提仙司心臟導線"SJM" OPTISENSE LEAD *應檢附心電圖報


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

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

15410

901


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

15410

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


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

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

FHPL2LPAMRST 聖猷達核磁共振植入式心臟節律器導線"SJM"TENDRIL MRI

IMPLANTABLE CARDIAC PACING LEADS

15410

FHPL2LPAMYST 聖猷達核磁共振心臟節律器導線(主動固定式)"SJM"TENDRIL MRI

PACING LEADS(ACTIVE FIXATION)

15410

FHPL2M5076M4 美敦力蓋普夏固定諾比核磁共振電極導線"MEDTRONIC" CAPSUREFIX

NOVUS MRI SURESCAN LEAD

15410

FHPL2M5086M4 美敦力蓋普夏核磁共振固定導線"MEDTRONIC" CAPSUREFIX MRI

SURESCAN LEAD

15410

FHPL2MR174M4 美敦力蓋普夏核磁共振導線"MEDTRONIC"CAPSURE SENSE MRI

SURESCAN LEAD

15410

FHPL2SAF37BK 百多力莎費歐核磁共振植入式電極導線"BIOTRONIK" SAFIO S MR

CONDITIONAL BIPOLAR PACING LEAD WITH ACTIVE FIXATION

15410

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

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

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

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

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

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

902


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

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(PERIMOUNT AORTIC VALVE，2800TFX

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(PERIMOUNT MITRAL VALVE，6900PTFX)

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

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

FHVR1A2636R5 索林康保瓣膜成形術環"SORIN"CARBOMEDICS ANNULOPLASTY RING 20100

FHVR1GC638M4 美敦力瓣膜成型帶(26:38MM)"MEDTRONIC"CG FUTURE ANNULOPLASTY

BAND

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

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

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

FHX0211644E8 艾斯泰格穩定器與定位器(滅菌)-亞特萊心臟牽引器"ESTECH"

STABILIZER AND POSITIONER(STERILE)-ATLAS POSITIONER

27721

903


FHX0215128TM 泰爾茂穩定器與定位器(滅菌)-亞特萊心臟牽引

器"TERUMO"STABILIZER AND POSITIONER(STERILE)-ATLAS

POSITIONER

27721

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

FHX0250700R5 索倫英派爾氧合器(氧合器)"SORIN" INSPIRE

OXYGENATORS(OXYGENATOR)

12913

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

FHX02AP170CX 雀斯緯博心臟血管外科器械(滅菌)-定位器"CHASE" VIPER

CARDIOVASCULAR SURGICAL INSTRUMENTS (STERILE)-VIPER II

APICAL LIFT

27721

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


34805

FHX02E4031TM 泰爾茂穩定器與定位器(滅菌)-心臟不停跳冠狀動脈繞道手術用穩定

器"TERUMO"STABILIZER AND POSITIONER(STERILE)-TITAN

STABILIZER

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(人工心肺及動脈過濾器)"TERUMO"CAPIOX

FX(OXYGENATOR WITHOUT RESERVOIR WITH HYDROPHILIC POLYMER

COATED AND ARTERIAL FILTER*適應症請見備註欄

20703

FHX02LAVAGGJ 吉生噴射灌洗器(滅菌)"JSM" JET LAVAGE(STERILE)*適應症請見備註

欄

2178

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)


2178

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

FHX02TS250M4 美敦力心臟血管外科器械(滅菌)-穩定器"MEDTRONIC"

CARDIOVASCULAR SURGICAL INSTRUMENTS (STERILE)-STABILIZER

44002

FHX02UM900QM ACROBAT VACUUM OFF PUMP SYSTEM(ACCESS RAIL

PLATFORM+STABILIZER+VACCUM TUBING SET)

44002

904


FHX02UR297M4 美敦力穩定器及定位器系統(滅菌)-定位器"MEDTRONIC"STABILIZER

AND POSITIONER SYSTEM(STERILE)-POSITIONER

27721

FHX02URHP3M4 美敦力心臟血管外科器械(滅菌)-定位器"MEDTRONIC"

CARDIOVASCULAR SURGICAL INSTRUMENTS(STERILE)-POSITIONER

27721

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

FHX02XP350QM 邁柯唯阿克貝埃心臟不停跳穩定器系統(滅菌)-定位器"MAQUET"

ACROBAT I OFF-PUMP SYSTEM(STERILE)-POSITIONER

27721

FHX02XP400QM 邁柯唯阿克貝心臟不停跳穩定器系統(滅菌)-定位器"MAQUET"

ACROBAT OFF-PUMP SYSTEM (STERILE)-POSITIONER

27721

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

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

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

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

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

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

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


14409

FHX03A5410M4 AFFINITY NT HOLLOW FIBER OXYGENATOR WITH TRILLIUM BIOPASSIVE

SURFACE AND INTEGRATED CVR NT

12124

905


FHX03A541TM4 AFFINITY NT HOLLOW FIBER OXYGENATOR W/RESERVOIR (TRILLIUM

COATED)※適應症請見備註欄

12368

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 RESERVOIR

16542

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

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(OXYGENATOR WITH COATING AND RESERVOIR

WITH COATING)

22284

FHX03BPX80M4 BIO-PUMP PLUS CENTRIFUGAL BLOOD PUMP *適應症請見備註欄 9062

FHX03CPRVPR5 索倫離心幫浦"SORIN"CENTRIFUGAL PUMP REVOLUTION 9062

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(人工心肺、動脈過濾器及硬殼貯血

槽)"TERUMO"CAPIOX FX(OXYGENATOR WITH RESERVOIR WITH

HYDROPHILIC POLYMER COATED AND ARTERIAL FILTER*適應症請見備

註欄

24000

FHX03FX251TM 泰爾茂菲斯膜型人工心肺(人工心肺及動脈過濾器)"TERUMO"CAPIOX

FX

15046

FHX03FX25RTM 泰爾茂菲斯膜型人工心肺(人工心肺、動脈過濾器及硬殼貯血

槽)"TERUMO"CAPIOX FX

16730

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

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 COATING(PEDIATRIC，INFANT)

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

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 TERM， RHEOPARIN COATING)

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


350000

FHX03PMAG2T8 索羅格小兒血液幫浦"THORATEC" PEDIVAS BLOOD PUMP 350000

906


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

FHX03RX05RTM CAPIOX RX HOLLOW FIBER OXYGENATOR WITH RESERVOIR BY X-

COATING

22284

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

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


WITH SOFTLINE COATING WITH VENOUS HARDSHELL RESERVOIR

ARTERIAL*適應症備註欄

14409


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” HEART LUNG PACK

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


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

907


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

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

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

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

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

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

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， INFANT)

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

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

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


IMPLANT(7.5CM*7.5CM)

10110


IMPLANT(10CM*12.5CM)

21448

FNP9102010BB NEURO PATCH 2X10CM 3171

FNP910205XGX DURA SUBSTITUTE 2CMX5CM 1862

FNP9102575N7 DURAGEN DURAL GRAFT MATRIX 2.5CMX7.5CM 3213


908




FNP9105006GX DURA SUBSTITUTE 5CMX6CM(代用人工腦膜) 5865



FNP9106008S7 司諾維思腦膜補片"SYNOVIS"DURA-GUARD DURAL REPAIR PATCH WITH

APEX PROCESSING 6CM*8CM

9211



FNP9107575N7 DURAGEN DURAL GRAFT MATRIX 7.5CMX7.5CM 10110


APEX PROCESSING8CM*14CM

19427


APEX PROCESSING 10CM*16CM

22394

FNP9110125N7 DURAGEN DURAL GRAFT MATRIX 10CMX12.5CM 21448


FNP9112014BB B.BRAUNNEURO-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




FNP9166102AE 雅氏雷歐普代用腦膜 "AESCULAP" LYOPLANT 1.5CM*3CM 848


FNP91CDUR1CK 曲克拜爾迪賽硬腦膜替代物"COOK" BIODESIGN DURAL GRAFT 2CM*3CM 1039

FNP91CDUR2CK 曲克拜爾迪賽硬腦膜替代物"COOK" BIODESIGN DURAL GRAFT 4CM*7CM 4183

FNP91DUR01CK 曲克拜爾迪賽硬腦膜替代物"COOK" BIODESIGN DURAL GRAFT 7CM×

10CM

13404

FNP91DUR02CK 曲克拜爾迪賽硬腦膜替代物"COOK" BIODESIGN DURAL GRAFT 7CM×

20CM

21749

FPM0119603HH 優美加微植皮擴皮墊(滅菌)"HUMECA" MICROGRAFT

GAUZES(STERILE)1:3

1663

FPM0119604HH MICROGRAFT GAUZE WITH CORKPLATE 1:4※適應症請見備註欄 1663



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


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

909


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

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


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※


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

910


FPP0110030EJ 2.0 MM MINI STRAIGHT PLATE 4 HOLE ※適應症請見備註欄 975


FPP0110039EJ 2.0 MM MINI LARGE BUR HOLE PLATE 6 HOLE ※適應症請見備註欄 5873

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


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



FPP0120211Y2 MINI PLATE 1.0MM 4HOLE STR※適應症請見備註欄 975

FPP0120213Y2 亞太醫療鈦合金顏面骨釘骨板系統:迷你直型骨板6-8洞"Syntec"

Titanium Facial Bone Screw/Plate System-Mini Straight

Plate6-8holes

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 亞太醫療鈦合金顏面骨釘骨板系統:T型骨板80-90度；5-6洞"Syntec"

Titanium Facial Bone Screw/ Plate System- T-Shape Plate；5-6

holes

1885

FPP0120241Y2 MINI PLATE 1.0MM 5HOLE DOUBLE T-SHAPE ※適應症請見備註欄 2270

FPP0120246Y2 亞太醫療鈦合金顏面骨釘骨板系統:Y型骨板5洞"Syntec" Titanium

Facial Bone Screw/Plate System-Y-Shape Plate 5holes

1743

FPP0120251Y2 MINI PLATE 1.0MM 6HOLE DOUBLE Y-SHAPE ※適應症請見備註欄 2469

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

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


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


SYSTEM:MINI BONE PLATE，PURE TITANIUM L-TYPE 4:5HOLE

1380

911


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

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 ※


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 DRAINAGE ，5HOLE

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

912


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

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


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

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

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

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 史賽克雷賓格爾下頷骨系統:下頷髁骨植入物"Stryker Leibinger"

Universal Mandible System: Temporary Condylar Prostheses

Left

6874

FPP0208771LE 史賽克雷賓格爾下頷骨系統:下頷髁骨植入物"Stryker Leibinger"

Universal Mandible System: Temporary Condylar Prostheses

Right

6874

FPP0214201EJ OSTEOMEDMANDIBULAR 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


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


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


SYSTEM:RECONSTRUCTION PLATE 14HOLE"歐美特"下頷骨折重建系統，

重建直型骨板14洞

4230


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

913


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

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

FPP0240080M3 TITANIUM RECONSTRUCTION PLATE 5+20+5HOLE COMPLETE MANDIBLE


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;16HOLE;18HOLE

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 SYNTHESMATRIX 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

FPP027051NS1 SYNTHESMATRIX MANDIBLE SYSTEM:ADAPTION PLATES PURE TITANIUMM

12;20 HOLES "信迪思"下顎固定系統:連結骨板

4230

FPP027171NS1 SYNTHESMATRIX 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




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

914


FPP0308674LE FRACTURE PLATE 4H 50MM 1.8MM STR ※適應症請見備註欄 2722

FPP0314080EJ OSTEOMEDMANDIBULAR 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 OSTEOMEDMANDIBULAR 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 OSTEOMEDMANDIBULAR 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

FPP0314222EJ OSTEOMEDMANDIBULAR 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 OSTEOMEDMANDIBULAR 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


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


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

LEIBINGER” UNIVERSAL MANDIBLE SYSTEM COMPRESSION PLATE 2-10

HOLE

2722

FPP03434NNS1 2.0MM ZYGOMATIC DCP 4:6HOLE STR ※適應症請見備註欄 2722

FPP034503NS1 SYNTHESMATRIX 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


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 SYNTHESMATRIX 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

915


FPP037101NS1 SYNTHESMATRIX 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 SYNTHESMATRIX 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

FPP037131NS1 SYNTHESMATRIX 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 SYNTHESMATRIX 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 SYNTHESMATRIX 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 ※


4767



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 ※


5211


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



3867



3867



4767



5211



5211

FPP0610501EJ OSTEOMEDMANDIBULAR 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


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


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



FPP0620261Y2 MINI H-SHAPE(3-D)PLATE 2X2 HOLE※適應症請見備註欄 3867

916


FPP0626201Y2 亞太醫療鈦合金顏面骨釘骨板系統/H型迷你骨板/厚1.0MM/3×2

孔"SYNTEC" TITANIUM FACIAL BONE SCREW/PLATE SYSTEM/MINI H-

SHAPE PLATE

4767



SHAPE PLATE

5211



SHAPE PLATE

3867

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



3*2HOLE

4767



4*2HOLE

5211



4*2HOLE

10383



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




4767




5211




10383




10711

FPP0657710M3 MINI 2000 CAD 4 HOLE PLATE SQUARE ，RECTANGULAR 0.6MM，1.0MM


3867



4767



5211

FPP069001NS1 SYNTHESMATRIX MANDIBLE SYSTEM:PREFORMED RECONSTRUCTION

PLATE"信迪思"下顎固定系統:立體重建骨板

10711

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

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

917


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

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




FPP0706210LE MICROPLUS BONE PLATE 0.55MM 16HOLE 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

918


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

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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

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4HOLE;10 HOLE

3883

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

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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


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

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

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

919


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


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



4246

FPP0712006EJ M4 RIGID FIXATION SYSTEM 6 HOLE LARGE， SMALL BUR HOLE PLATE

， 0.5MM※適應症請見備註欄

5873


HOLE STRAIGHT PLATE:MEDIUM，LONG ※適應症請見備註欄

2498

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

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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※


10437

FPP0712104EJ M4 RIGID FIXATION SYSTEM MICRO 6 HOLE DOUBLE Y PLATE， 0.5MM


5560

FPP0712130EJ M4 RIGID FIXATION SYSTEM MICRO 4 HOLE STRAIGHT PLATE， 0.5MM


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


EXTENDED X PLATE ※適應症請見備註欄

5560


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

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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

FPP0715301Y2 亞太醫療鈦合金顏面骨釘骨板系統/H微型骨板/厚0.6MM/4×4

孔"SYNTEC" TITANIUM FACIAL BONE SCREW/PLATE SYSTEM/MICRO H

PLATE

10383

FPP0715302Y2 亞太醫療鈦合金顏面骨釘骨板系統/H微型骨板/厚0.6MM/6×4

孔"SYNTEC" TITANIUM FACIAL BONE SCREW/PLATE SYSTEM/MICRO H

PLATE

11325

FPP0718001EJ OSTEO MEDNEURO 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



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 MEDNEURO 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

920


FPP0718005EJ OSTEO MEDNEURO 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

FPP0718006EJ 歐特美顱顏骨固定系統/2洞骨板*3+骨釘*6"OSTEOMED" NEUROPACK

STERILE NEURO FIXATION SYSTEM/PLATE + SCREW

15882

FPP0718007EJ 歐特美顱顏骨固定系統/2洞骨板*2+骨釘*4"OSTEOMED" NEUROPACK

STERILE NEURO FIXATION SYSTEM/PLATE + SCREW

10587

FPP0718008EJ 歐特美顱顏骨固定系統/骨板*1+骨釘*6"OSTEOMED" NEUROPACK

STERILE NEURO FIXATION SYSTEM/BURR HOLE PLATE + SCREW

14133

FPP0718009EJ 歐特美顱顏骨固定系統/骨板*1+骨釘*6"OSTEOMED" NEUROPACK

STERILE NEURO FIXATION SYSTEM/BURR HOLE GROOVE SHUNT PLATE +

SCREW

14133


SQUARE PLATE 9MM ※適應症請見備註欄

3867


HOLE STRAIGHT PLATE:MEDIUM，LONG，SHORT※適應症請見備註欄

2498


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



2672



5679



6805

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






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

921


FPP07204NNS1 MICRO ORBITAL FLOOR PLATE UNIVERSAL/L/R (421.040，044，045自


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


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

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

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

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


SYSTEM: MICRO BONE PLATE TITANIUM L-TYPE 4HOLE;5HOLE;8HOLE

4085

FPP0742025Y2 SYNTECTITANIUM MESH PLATE"亞太醫療"鈦合金網眼骨板※給付規定

請見備註欄

10437

FPP074202HY2 SYNTECTITANIUM 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 SYNTECTITANIUM MESH PLATE"亞太醫療"鈦合金網眼骨板※給付規定

請見備註欄

10437


SYSTEM: MICRO BONE PLATE TITANIUM L-TYPE 4HOLE;5HOLE;8HOLE

4085

FPP07421FFY2 SYNTECFLAPFIX 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


SYSTEM:MICRO BONE PLATE，PURE TITANIUM L-TYPE 4:5HOLE

4085

922


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

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


SYSTEM:COMBINE CMF MICRO BONE PLATE，PURE TITANIUM，SQUARE

，3*2HOLE

5679



，4*2HOLE

6805



，4*2HOLE

10383



，6*4HOLE

11325


SYSTEM:COMBINE CMF MICRO BONE PLATE，PURE TITANIUM，


3867

FPP0748121XU 合碩顱顏骨固定系統:矩形骨板3*2洞"CUSMED"CMF FIXATION



5679




6805




10383




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

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

923


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 DRAINAGE ，5HOLE

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

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

FPP0756208LE 史賽克雷賓格爾下頷骨系統/1.2MM8孔骨板(厚度0.6MM)"STRYER

LEIBINGER"UNIVERSAL MANDIBLE SYSTEM/1.2MM 8HOLES PLATE

2672

FPP0760101M4 MEDTRONICINVISX 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 SYNTHESMATRIX MANDIBLE SYSTEM:STRUT PLATES PURE TITANIUMM 4

HOLES STRAIGHT"信迪思"下顎固定系統:網狀

3867

FPP077081NS1 SYNTHESMATRIX 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

FPP07812474B 拜普雷固定系統/6洞花瓣型骨板"BIOPLATE"FIXATION SYSTEM/6 HOLE

FLEXIBLE BURR HOLE COVER/厚度0.023英吋/18MM

5873

FPP07813204B 拜普雷固定系統/2洞及4洞直型骨板"BIOPLATE"FIXATION

SYSTEM/STRAIGHT PLATE/厚度0.023英吋/15-20MM

2498

FPP07813294B 拜普雷固定系統/5洞Y型骨板"BIOPLATE"FIXATION SYSTEM/Y PLATE/

厚度0.023英吋/19MM

4997

924


FPP07813304B 拜普雷固定系統/6洞X型骨板"BIOPLATE"FIXATION SYSTEM/X PLATE/


5560

FPP07813314B 拜普雷固定系統/5洞T型骨板"BIOPLATE"FIXATION SYSTEM/T PLATE/


4430

FPP07813344B 拜普雷固定系統/4洞方格型骨板"BIOPLATE"FIXATION SYSTEM/BOXCAR

PLATE/厚度0.023英吋

3867



5679



6805

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

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 信迪思顱骨固定系統:皮瓣固定夾"SYNTHES"FLAPFIX

SYSTEM:FLAPFIX(PURE TITANIUM)

4000

FPP07FF490AE AESCULAPCRANIOFIX 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 AESCULAPCRANIOPLATE 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 MICROFIXATIONRAPIDFLAP 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



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






FPP094707NS1 TITANIUM MINI CHIN PLATE 2.0 DOUBLE BEND 5 HOLE ※適應症請見

備註欄

2700

925


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，


4085

FPP1101507FV BONAMATES BIOFIXATION SYSTEM：X 型 10 HOLE 1.0X1.5MM，


5560

FPP1101509FV 維綱博納力可吸收性骨固定系統/骨板"BTO"BONAMATES BIOFIXATION

SYSTEM/BONAPLATE

2672

FPS0100001EJ OSTEOMEDFAST-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 OSTEOMEDMANDIBULAR 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 OSTEOMEDFAST-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


SCREW "歐美特"下頷骨折重建系統，2.7MM 骨釘

579



579

FPS0100006EJ OSTEOMEDFAST-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 OSTEOMEDFAST-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 OSTEOMEDMANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.0MM


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

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

FPS0108405LE MINI BONE SCREW 2.0X5MM(型號52-17012:52-82308自 90/07/01生


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




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

926


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


註欄

579


註欄

579


註欄

579


註欄

579


註欄

579


註欄

579


註欄

579


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



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/微骨釘"STRYKER LEIBINGER"

UNIVERSAL MANDIBLE SYSTEM/MICRO BONE SCREW/1.2MM;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








FPS011700NLE 史賽克雷賓格爾下頷骨系統/迷你骨釘"STRYKER LEIBINGER"

UNIVERSAL MANDIBLE SYSTEM/MINI BONE SCREW/1.7MM;1.9MM

298

FPS0120013M3 TITANIUM LOCK-DRIVE TRANSPLANT SCREW 2.0X7:17MM SELF-CUTTING


579

927


FPS012009NLE 史賽克雷賓格爾下頷骨系統:下頷髁骨骨釘"Stryker Leibinger"

Universal Mandible System: Condyle Fastening Screw

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

FPS0120624EJ M4 RIGID FIXATION SYSTEM 2.4MM MAXI FRACTURE SCREW ※適應症

請見備註欄

579

FPS0120704LE 史賽克雷賓格爾下頷骨系統/迷你骨釘"STRYKER LEIBINGER"

UNIVERSAL MANDIBLE SYSTEM/MINI BONE SCREW/2.0MM

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

FPS012340NLE 史賽克雷賓格爾下頷骨系統/迷你骨釘"STRYKER LEIBINGER"

UNIVERSAL MANDIBLE SYSTEM/MINI BONE SCREW/2.3MM;2.7MM

579

FPS01291BSY2 SYNTECTITANIUM 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 SYNTECTITANIUM MESH PLATE:SCREW "亞太醫療"鈦合金網眼骨板:骨


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

928


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


ALLOY

1361

FPS013115LXU 合碩顱顏骨固定系統:骨釘，自攻"CUSMED"CMF FIXATION


ALLOY

298

FPS013115TXU 合碩顱顏骨固定系統:骨釘，自攻"CUSMED"CMF FIXATION


ALLOY

579

FPS01311STY2 SYNTECTITANIUM MESH PLATE:SCREW "亞太醫療"鈦合金網眼骨板:骨


1361

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


TITANIUM ALLOY

298

FPS013125WXU 合碩顱顏骨固定系統:骨釘，應急自攻"CUSMED"CMF FIXATION


TITANIUM ALLOY

579

FPS014009SM3 TITANIUM CONDYLAR PROTHESIS FIXATION SCREW※適應症請見備註欄 579

FPS014051NS1 SYNTHESMATRIX 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 SYNTHESMATRIX 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 SYNTHESMATRIX 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 SYNTHESMATRIX 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 SYNTHESMATRIX 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 SYNTHESMATRIX MANDIBLE SYSTEM:LOCK SCREWS SELF-TAPPING 2.0-

2.4MM"信迪思"下顎固定系統:骨釘

579

FPS016681NS1 SYNTHESMATRIX 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

929


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


298

FPS018020NM3 MONDEAL TITANIUM 1.2MM MICRO CROSS FIT SCREW 2:8MM，

1.5X4:6MM※適應症請見備註欄

1361

FPS01812694B 拜普雷固定系統/自鑽骨釘"BIOPLATE"FIXATION SYSTEM/SELF

DRILLING SCREWS/直徑1.9MM/長度4-5MM

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

FPS0183012M3 TITANIUM LOCK-DRIVE EMERGENCY SCREW 3.0X8:14MM SELF-CUTTING


579

FPS0192004M3 NEWS S-DRIVE SELF-DRILLING SCREW(MINI 2000)※適應症請見備註

欄

298

FPS01FM940AE AESCULAPCRANIO 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)


2722

FPS1150402FV BONAMATES BIOFIXATION SYSTEM：SCREW 1.5X4.0~2.5X25MM(4支/包)


5444

FPT0120789L0 SILIMEDTISSUE EXPANDER "賜妳媚"組織擴張器※給付規定請見備註

欄

11229

FPT0135054NW MENTORTISSUE EXPANDER"曼陀"組織擴張器 11229

FPT01SC088A2 ALLERGAN TISSUE EXPANDERS"愛力根"組織擴張器※適應症請見備註

欄

11229

FSAE1GTBXXQS 博娜氣管及支氣管支架"BONASTENT" TRACHEAL/BRONCHIAL STENT*適


32122

FSAE1GTBXXSB BOSTON SCIENTIFICULTRAFLEX 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 TAEWOONGNITI-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

FSAE3DSTD1NV 杜門氣管與支氣管支架系統-直型 TRACHEOBRONXANE DUMON STENT-

STRAIGHT

26290

FSAE3DSY02NV 杜門氣管與支氣管支架系統-Y型 TRACHEOBRONXANE DUMON STENT-Y 54285

FSP6100611ZQ SOFRADIMPARIETENE POLYPROPYLENE MESHES"舒法定"帕瑞挺人工聚丙

烯編網06X11CM

922

FSP6101170BA BARDSOFT MESH柔軟修補網7.5CMX15CM 10CMX15CM (15CMX15CM自

970401起刪除)

1541

FSP6101171BA BARDSOFT MESH柔軟修補網5CMX10CM 4.5CMX10CM 6CMX13.7CM 922

FSP6101177BA BARDSOFT MESH"巴德" 柔軟修補網15CMX15CM 1603

FSP6101510ZQ SOFRADIMPARIETENE POLYPROPYLENE MESHES"舒法定"帕瑞挺人工聚丙

烯編網15X10CM

1541

FSP6101515ZQ SOFRADIMPARIETENE POLYPROPYLENE MESHES 15X15CM"舒法定"帕瑞挺

人工聚丙烯編網

1603

930




2848

FSP6106011ET ETHICONPROLENE POLYPROPYLENE MESH"愛惜康"伯羅林不可吸收網

6X11CM

922

FSP6106011JJ PROLENE POLYPROPYLENE MESH PMS，6*11CM 922



922

FSP6110650BB B.BRAUNOPTILENE MESH 歐特靈網片5CMX10CM 4.5CMX10CM 6CMX14CM 922

FSP6110651BB B.BRAUNOPTILENE MESH 歐特靈網片7.5CMX15CM 10CMX15CM 1541

FSP6110652BB B.BRAUNOPTILENE MESH 歐特靈網片15CMX15CM 1603

FSP6110653BB B.BRAUNOPTILENE 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



1541

FSP6115015BB PREMILENE MESH 7.5X15CM，15X15CM，5X30CM，10X15CM 1541


15CMX15CM

1603

FSP6115015JJ PROLENE POLYPROPYLENE MESH PMM，15*15CM 1603

FSP6130030BB PREMILENE MESH 30X30CM，26X36CM 2848


30CMX30CM

2848

FSP6130030JJ PROLENE POLYPROPYLENE MESH PML，30*30CM 2848

FSP6130714AH ATRIUMPROLITE P0LYPROPYLENE MESH普來聚丙烯網片(7.5CMX15CM，

10CMX15CM)

1541

FSP6130717AH ATRIUMPROLITE P0LYPROPYLENE MESH普來聚丙烯網片(15CMX15CM) 1603

FSP6130720AH ATRIUMPROLITE P0LYPROPYLENE MESH普來聚丙烯網片(25.4CMX35.5CM

，30CMX30CM)

2848

FSP61PL609AH ATRIUMPROLITE POLYPROPYLENE MESH PROLITE(15X23CM)普來聚丙烯

網片

2019

FSP61S00352C COVIDIENSYNETURE SURGIPRO MESH 3"X5" "柯惠"舒耐久聚丙烯編網 922

FSP61S01492C COVIDIENSYNETURE SURGIPRO MESH 14"X9" "柯惠"舒耐久聚丙烯編網 2848

FSP6201127DV DAVOLBARD 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

FSP62P3DPAET ETHICONPROLENE(POLYPROPYLENE)3D PATCH"愛惜康"伯羅倫3D修補網 3800

FSP62TECRTZQ SOFRADIMPARIETEX MESHES-PLUGS"舒法定"帕瑞得人工編網-立體錐形

塞編網

3800

FSP63CHM01CK COOKBIODESIGN INGUINAL HERNIA GRAFT"曲克"拜爾迪賽腹股溝疝氣

支撐物10CMX15CM.6CMX13CM.8CMX15CM.*適應症請見備註欄

8621

FSP7103657AM AMSSPARC 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 AMSMONARC 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

931


FSP710BTR2SB “波士頓科技”歐碧翠系統(2個輸送裝置+1個網狀結構)“BOSTON

SCIENTIFIC” OBTRYX II SYSTEM

13680

FSP710BTRXSB BOSTON SCIENTIFICOBTRYX 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 ETHICONTENSION-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 BARDALIGN URETHRAL SUPPORT SYSTEM(含INTRODUCER+MESH

ASSEMBLY)艾萊尿道支撐系統

13680

FSP71KDM015N 尼奧麥迪克金系統(2支穿引器+一條聚丙烯懸吊帶) "NEOMEDIC"

CONTASURE KIM

13680

FSP71SAF01QN 博美敦蘇菲可調式懸吊帶系統(懸吊帶+置入針)"PROMEDON"SAFYRE 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 GYNECARETVTEXACT 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

FUK02HEF2XGA 衛寶血液濾過器(小兒用)"GAMBRO" HEMOFILTER 2305

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

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

FUK030300CGA ADSORBA 300GM 9982

FUK03300KTGA GAMBROPRISMAFLEX 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

FUK05DF030FN 英弗梅血液過濾器(小兒用)"INFOMED"HEMOFILTER(CVVH) 4095

FUK05DF080FN INFOMEDCVVH HEMOFILTER 0.8M平方血液過濾器*適應症請見備註欄 3596

FUK05DF140FN INFOMEDCVVH HEMOFILTER 1.4M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

FUK05FHF20GA 衛寶普利司馬弗列克斯套組(小兒用)"GAMBRO" PRISMAFLEX SET

(CVVH)

5286

932


FUK05FM100GA PRISMAFLEX SET(CVVH TUBING+HEMOFILTER)0.9M平方*適應症請見備

註欄

5102

FUK05FM150GA GAMBROPRISMAFLEX 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

FUK05HD150E9 美蒂佳血液濾過器(小兒用)"MEDICA" HEMOFILTERS(CVVH) 4095

FUK05HD300E9 CVVH HEMOFILTER*適應症請見備註欄 4002

FUK05PF150GA GAMBROPRISMAFLEX SET*適應症請見備註欄 5102

FUK05PFXSTGA GAMBROPRISMAFLEX SET(CVVH TUBING+HEMOFILTER)膜面積1M平方*適

應症請見備註欄.

5102

FUK05PR100GA GAMBROPRISMA SET (CVVH TUBING+HEMOFILTER)1.15M平方*適應症請

見備註欄

5102

FUK05PST60GA GAMBROPRISMAFLEX SET(CVVH TUBING+HEMOFILTER)膜面積0.6M平方*

適應症請見備註欄.

4579

FUK05RHF6SGA GAMBROCVVH HEMOFILTER(0.6M平方)血液過濾器*適應症請見備註欄 3596

FUK05ST100GA GAMBROPRISMA 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 GAMBROPRISMA SET連續式血液透析器及迴路管套*適應症請見備註欄 4579

FUK05TS201K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUITS-CVVH英禾美體外血液迴

路管-血液濾過

1393

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

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

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

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

FUK05TS413FN 英弗梅體外血液迴路管-小兒連續靜靜脈血液透析INFOMED

EXTRACORPOREAL BLOOD CIRCUITS-PEDIATRIC CVVHD

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

FUK05U1000FA FRESENIUSPOLYSULFONE 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 FRESENIUSPOLYSULFONE HAEMOFILTERS(CVVH FILTER 0.7M平方)人工


3596

FUK05U600SFA FRESENIUSPOLYSULFONE HAEMOFILTERS(CVVH FILTER 1.4M平方)人工


4002

FUS0100411AM AMS800 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

FUS0126477WZ 賽菲爾人工尿道括約肌"ZEPHYR" ARTIFICIAL URINARY SPHINCTER 155000

FUT01CYST12L 邁蘭喜仕膀胱灌注液"MYLAN" CYSTISTAT STERILE SODIUM

HYALURONATE SOLUTION

4819

HEF0146092H9 華億體外循環管組"HYM"HEART LUNG PACK-ARTERIAL FILTER 3/8"

ADULT 20 MICRO

1573

933


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

HEF0150538R5 索倫滴得可動脈過濾器"SORIN" DIDECO KIDS ARTERIAL FILTERS 1716

HEF01ARF40H9 華億體外循環管組-動脈過濾器"HYM" HEART LUNGPACK-ARTERIAL

FILTER 40MICRO

1573

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

HEF02A3510M4 AFFINITY ARTERIAL FILTER 1573

HEF02AF001TM ARTERY FILTER ADULT 1573

HEF02AF002TM ARTERY FILTER PEDIATRIC 1573

HEF02AF125TM CAPIOX ARTERIAL FILTER 1573

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

HEF03EVAFXKA 川澄化工血漿成分分離器"KAWASUMI LABORATORIES" PLASMA

FRACTIONATOR EVAFLUX

4296

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

HEF03P1DRYFA 費森尤斯血漿過濾器"FRESENIUS" PLASMAFILTER 4296

HEF03PLA40E9 MEDICA PLASMAFILTERS 0.35平方公尺 4296

HEF03PRFPEGA GAMBROPRISMAFLEX SET血漿透析器及血液迴路管 6000

HEF03PRLPEGA GAMBROPRISMAFLEX SET 血液透析器及迴路管套 6000

HEF03PRTPEGA GAMBROPRISMA 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

934


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

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

HFF02EF010SG TPN FILTER SET 0.22UM 68.3

HFF02EF15YSG TPN FILTER SET 0.22UM 68.3

HHF010PL1BHA 漢尼帝克去除白血球高效率血小板專用過濾器"HAEMONETICS" PL

HIGH EFFICIENCY LEUKOCYTE REDUCTION FILTER FOR A SINGLE UNIT

OF PLATELET CONCENTRATE

1162

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

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

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

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

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

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

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

HHM0103048WU “優樂”高佳輸血過濾器“EUROSETS” GOCCIA BLOOD FILTER 305

935


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

HHM010VX6HQL 克力玫抽吸導管"QUALIMED"EMAX ASPIRATION CATHETER 14123

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

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

HHM01ADVANM4 美敦力先鋒血栓吸除導管(6F)"MEDTRONIC" EXPORT ADVANCE

ASPIRATION CATHETER(6F)

14123

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

HHM01CPT01CK 曲克色列克特白金腔靜脈過濾器組"COOK" CELECT PLATINUM VENA

CAVA FILTER SET

33528

HHM01DL950BA 巴德迪耐立腔靜脈過濾器"BARD" DENALI VENA CAVA FILTER 33528

HHM01ELNATTM “泰爾茂”艾密麗血栓清除導管“TERUMO” ELIMINATE ASPIRATION


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


14123

HHM01EXPRTM4 美敦力”吸除導管"MEDTRONIC" EXPORT XT ASPIRATION CATHETER*適


14123

HHM01FETCHF3 普希士快取血栓清除導管 "POSSIS" FETCH ASPIRATION CATHETER*適


14123

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


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

936


HHM01M13X1F2 英泰克莫瑪極致腦血管保護裝置"INVATEC" MO.MA ULTRA CEREBRAL

PROTECTION DEVICE

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

HHM01P5030VS 法斯樂舒順普倫特秀血栓清除導管"VASCULAR SOLUTIONS"PRONTO-

SHORT EXTRACTION CATHETER

14123

HHM01PNTV4VS 法斯樂舒順普威血栓清除導管"VASCULAR SOLUTIONS" PRONTO V4

EXTRACTION CATHETER

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

HHM01SCACTNX 尼瓦西斯血栓吸除導管"MINVASYS"STEMICATH THROMBOASPIRATION

CATHETER

14123

HHM01SPDEREY 史派德栓塞防護系統"EV3"SPIDER FX EMBOLIC PROTECTION DEVICE*


33371

HHM01SQ40SHA 漢尼帝克篩選微集合體之輸血過濾器"HAEMONETICS" BLOOD

TRANSFUSION FILTER

305

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

HHM01TULP1CK 曲克剛特圖利浦腔靜脈濾器"COOK" GUNTHER TULIP VENA CAVA

FILTER

33528

HHM01VCFLT4A 亞倫腔靜脈過濾器"ALN" OPTIONAL VENA CAVA FILTER 33528

LEE0106500M4 TEMPORARY MYOCARDIAL PACING LEAD 1036

LEE0107154AR 亞諾心律調整導管"ARROW" PACING CATHETERS 2846

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

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

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

LEE01AP518G2 PEDIATRIC DEFIB ELECTRODES體外心律調節器貼片 1050

LEE01AP919G2 MARGUETTE DEFIBRILLATION PACING MONITORING PADS 652

LEE01B1LAR5M 美喜宜暫時性節律導線(雙極)"MCE"TEMPORARY PACING

WIRES(BIPOLAR WIRE)

2076

LEE01BP250BS BIPOLAR PACING CATHETER 5F，110CM(BALLOON CATHETER，ADAPTOR

，PEEL-AWAY SHEATH)

2846

LEE01BPX25BS BIPOLAR PACING CATHETER 5F，110CM 2249

937


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

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

LEE01M1749HP DEFIB PACING PADS ADULT (2EA/SET) 652

LEE01M1LAR5M 美喜宜暫時性節律導線(單極)"MCE"TEMPORARY PACING

WIRES(MONOPOLAR WIRE)

1036

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

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 SYSTEM RTS ELECTRODES

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.BRAUNSTERICAN 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

NAN011830N3C 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

NAN011830NTM 泰爾茂亞加尼針頭"TERUMO"AGANI NEEDLE 0.5

NAN01ECL01BD BD 安全遮蔽防護式注射針BD ECLIPSE NEEDLE 1

NAN01SAGLNBD BD滑蓋式安全注射針 BD SAFETY GLIDE NEEDLE 1

NAN02002903W 一協紀胰島素注射筆專用針"ARTSANA" INSUPEN INSULIN PEN NEEDLE 3.2

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 BDPEN NEEDLE"必帝"注射筆專用針(胰島素筆型針頭) 3.2

NAN020032NBD BD注射筆專用針:31~32G，4~8MM BD MICRO-FINE PEN NEEDLE:31~32G

，4~8MM

3.2

938


NAN02003303W 一協紀胰島素注射筆專用針"ARTSANA" INSUPEN INSULIN PEN NEEDLE 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

NAN03ATSH1BD BD AUTOSHIELD DUO PEN NEEDLE BD安全式注射筆專用針(胰島素專

用)

5.1

NAN03ATSH2BD BD AUTOSHIELD DUO PEN NEEDLE BD安全式注射筆專用針(胰島素專

用)

5.1

NAN041823NNR IC NEEDLE心肌長針 4.9

NAN0601823TP 特浦造影針"TOP"P.T.C. NEEDLE 102

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 104

NAN1121200AG AMC/4 ARTERIAL NEEDLE 21Gx2"(5.1CM)導線導引針 104

NAN11A1820GJ JSMINTRODUCER NEEDLE"吉生"穿刺針 59.4

NAN11AP1NEH9 ANGIO PACK ：INTRODUCER NEEDLE(單針) 59.4

NAN141822NCK DISPOSABLE ONE PART NEEDLE 導線導引針 104

NAN1418275AG AMC/4 ARTERIAL NEEDLE WITH FIXED WINGS 18Gx23/4"(7.0CM) 導線

導引針

104

NAN1421100AG AMC/3 ARTERIAL NEEDLE 21Gx1"(2.5CM)導線導引針 104

NAN145312NAG 雅客特殊針頭:動脈針AMC/3 ARTERIAL NEEDLE 18GX7CM，3.8CM

19GX3.8CM

104

NAN1521500C3 DISPOSABLE SELDING NEEDLE 18G 7.5CM 124

NAN1550400PB PUNCTURE NEEDLE W/STYLET雙針(外套管+內針) 124

NAN155324NAG PERCUTANEOUS ENTRY NEEDLE 16GX7.3CM，18GX7.3CM，19GX3.8，

7.3CM，21GX3.8CM

124

NAN155324NAR ARROWMULTI-LUMEN CENTRAL VENOUS CATHETERIZATION:INTRODUCER

NEEDLE (外套管+內針)

124

NAN15ADVANMR ADVANCE ANGIOGRAPHIC NEEDLES 高昇血管攝影穿刺針(外管+內針) 124

NAN15AN72SMR MAJESTIK SERIES ANGIOGRAPHY NEEDLES 16-21G(雙針) 124

NAN15DCM18CK 曲克拋棄式經皮穿刺針"COOK"DISPOSABLE PERCUTANEOUS ENTRY

NEEDLES 18:22G 2.5:9.0CM

124

NAN165341NAG 雅客特殊針頭:導引穿刺針(三針)"ARGON" SPECIALTY

NEEDLE:ARTERIAL CATHETER NEEDLE

200

NAN16AN18TMR MAJESTIK SERIES ANGIOGRAPHY NEEDLES 18G 7CM(3-PART)(外管+內

針+填充器)

200

NBS010001NBD 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

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

NBS010003S3C “千禧光”安全注射器3CC(不附針)SOL-CARE LUER LOCK SAFETY

SYRINGE 3CC(WITHOUT NEEDLE)

1.8

939



NEEDLE

1

NBS010003SYL 宇壽一次性使用回縮型自毀注射器:3 ML不附針"YUSHOU" SAFETY

SYRINGE:3 ML WITHOUT NEEDLE

1.8

NBS010003VPW 3CC SYRINGE WITHOUT NEEDLE 1


NBS010005NFR FAIRYSYRINGE 5CC WITHOUT NEEDLE"樺萊"塑膠注射筒(不附針) 1.4




SYRINGE 5CC (WITHOUT NEEDLE)

2.6


NEEDLE

1.4



2.6



NBS010010NFR 10 CC SYRINGE WITHOUT NEEDLE 2.4

NBS010010NPW 10CC SYRINGE WITHOUT NEEDLE 2.4

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





4


NEEDLE

2.4



4


NBS010020NBD 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



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




6.6


NEEDLE

2.9









940




NEEDLE

6.6

NBS010030TTM TERUMODISPOSABLE SYRINGE:30CC WITHOUT NEEDLE"泰爾茂"注射針

筒:30CC不附針

6.6



NBS010050NFR 50CC SYRINGE WITHOUT NEEDLE 9.5





9.5



NBS010050NUY 60CC SYRINGE WITHOUT/NEEDLE 9.5



NEEDLE

9.5



NBS010060TTM TERUMODISPOSABLE 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



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

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


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


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

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



2.6

NBS01A005VPW 普惠塑膠注射筒不附針:5CC(安全型)"PERFECT" DISPOSABLE SYRINGE


2.6



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


6.6

941


NBS01A020VPW 普惠塑膠注射筒不附針:20CC(安全型)"PERFECT"DISPOSABLE SYRINGE


6.6

NBS01EME05BD BD注射筒(不含注射針)5CC BD EMERALD SYRINGE WITHOUT NEEDLE 1.4



NBS01EME23BD BD注射筒(不含注射針)2CC;3CC BD EMERALD SYRINGE WITHOUT

NEEDLE

1

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

NBS0700103LF LFDISPOSABLE ASSOCIATED W/POWER INJECTORS"理博"注射筒及配件:

顯影劑注射筒含吸管

222

NBS0700150MH CONTRAST MEDIUM INJECTION SYRINGE 130，150CC(型號DSK130自

91/4/1生效)

222

NBS0700172LF LFDISPOSABLE SYRINGE FOR DIGITAL INJECTION 130CC W/H-FIL"理

博"高壓注射器用拋棄式針筒

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

NBS0701801LF LFDISPOSABLE ASSOCIATED:MRI SYRINGE"理博"注射筒及配件:顯影劑

注射筒

222

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

NBS070539D3N NEMOTODISPOSABLE SYRINGE KIT"根本"顯影注射筒組套(100ML注射筒

+60"螺旋管+填充管)

313

NBS070539E3N NEMOTODISPOSABLE SYRINGE KIT"根本"顯影注射筒組套(200ML注射筒

+60"螺旋管+填充管)

313

NBS070539F3N NEMOTODISPOSABLE SYRINGE KIT"根本"顯影注射筒組套(200ML注射筒

+填充管+100ML注射筒+60"螺旋Y型管)

435

NBS070539G3N NEMOTODISPOSABLE SYRINGE KIT"根本"顯影注射筒組套(200ML注射筒

2支+填充管+60"螺旋Y型管)

435

NBS070539H3N NEMOTODISPOSABLE SYRINGE KIT"根本"顯影注射筒組套(100ML注射筒

2支+填充管+60"螺旋Y型管)

435

NBS070539J3N 根本顯影注射筒套組:50;100;150;200CC注射筒 1支+填充

管"NEMOTO"DISPOSABLE SYRINGE KIT:SYRINGE*1+J TUBE

222

NBS070539K3N 根本顯影注射筒套組:注射筒+60"螺旋管+填充管"NEMOTO"DISPOSABLE

SYRINGE KIT:SYRINGE+COILED LINE+J TUBE

313

942


NBS070539L3N 根本顯影注射筒套組:注射筒2支+60"螺旋Y管+填充

管"NEMOTO"DISPOSABLE SYRINGE KIT:SYRINGE*2+COILED LINE+J

TUBE

435

NBS070539N3N 根本顯影注射筒套組:注射筒50;100;150;200CC"NEMOTO"DISPOSABLE

SYRINGE KIT:SYRINGE

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

NBS07137NE5P 普魯斯血管顯影劑注射筒及其附件:造影藥劑注射筒(含吸

管)"PEROUSE" SYRINGES FOR ANGIOGRAPHY AND ACCESSORIES

222

NBS0714158MR MERITMEDALLION SERIES SYRINGES"美瑞特"馬德廉注射筒1CC 174

NBS07150AQMH DISPOSABLE SYRINGE 150CC W/FILL TUBE顯影劑注射筒 222

NBS07150EQ2M IMAXEONSYRINGE 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

NBS0732377MA OPTIRAY 320 IOVERSOL INJECTION SYRINGE 125ML歐得利320造影劑

注射筒

222

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

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

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 MEDRADDISPOSABLE SYRINGE KIT"美樂得"注射筒組套:拋棄式注射筒

及填充管

222

NBS0780099LF 理博注射筒及配件:注射筒+延長管+抽藥管"LF"DISPOSABLE

ASSOCIATED W/POWER INJECTORS:CT 9000 ADV-CT MULTIPACK

313

NBS0780180LF 理博注射筒及配件:注射筒2支+Y型延長管"LF"DISPOSABLE

ASSOCIATED W/POWER INJECTORS:OPTISTAR-MR SYRINGE MULTIPACK

435

NBS0784402LF 理博注射筒及配件:注射筒2支+Y型延長管+抽藥管"LF"DISPOSABLE

ASSOCIATED W/POWER INJECTORS:OPTIVANTAGE-SYRINGE-DUAL PACK

200ML

455

NBS0784422LF 理博注射筒及配件:注射筒2支+Y型螺旋接管+抽藥管2

支"LF"DISPOSABLE ASSOCIATED W/POWER INJECTORS:OPTIVANTAGE-

SYRINGE-DUAL PACK 200ML

435

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

NBS07AC115BQ 邦特攝影導管用注射筒套組:造影藥劑注射筒+吸管+雙層高壓

(1200PSI)附M-F接頭連接管"BIOTEQ"ANGIOGRAPHIC SYRINGE KIT

W/HIGH PRESSURE TUBING

536

943


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 TUBE+SPIKE

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+COILED T TUBE WITH 1 CHECK VALVE+2X

SPIKES

435

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

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

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 IMAXEONSALIENT SYRINGE KIT W/QUICK FILL TUBE"愛美聖"注射筒套

組(含填充管1支)

222

NBS07ZY3212M IMAXEONSALIENT 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

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

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

NCS010001NRW 勤達一次性使用無菌注射器帶針1CC"TEAM POWER"DISPOSABLE

SYRINGE 1CC

2

NCS010001NSH 1 CC SYRINGE 2

NCS010001NTM 1 CC SYRINGE 2

NCS010001NTP 1 CC SYRINGE 2

NCS010001NUU 1CC RETRACTABLE SAFETY SYRINGE W/NEEDLE※適應症請見備註欄 4.9

NCS010001NUY 1 CC SYRINGE W/NEEDLE 2

NCS010001NV4 1CC SYRINGE W/NEEDLE 2

NCS010001PTM 1CC SYRINGE W/NEEDLE 2

NCS010001S1M 濟翔自動回縮式安全針筒:1CC附針MYSAFETY SYRINGE:1CC WITH

NEEDLE

4.9

NCS010001S3S 磐宇一次性使用無菌可抽回式自毀注射器(帶針):1 ML"SUNWELL"

AUTO-DISABLE STERILE SAFETY SYRINGE FOR SINGLE USE:1 ML

4.9

NCS010001SB8 普康注射筒 1CC 附針頭"BU KWANG"DISPOSABLE SYRINGE WITH

NEEDLE

2

NCS010001VPW 1CC SYRINGE W/NEEDLE 2

944


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


SYRINGE W/NEEDLE

1.4

NCS010003N3C 千禧光安全注射器:3CC附針SOL-CARE LUER LOCK SAFETY

SYRINGE:3CC WITH NEEDLE

4.9

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



SYRINGE 3CC W/NEEDLE

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

NCS010003S1M MEDICAL CHAINMY SAFETY SYRINGE 3CC "濟翔"自動回縮式安全針筒


4.9



4.9


NEEDLE

1.4

NCS010003SYF 3CC DISPOSABLE SYRINGE W/NEEDLE (SAFETY) ※適應症請見備註欄 4.9

NCS010003SYL 宇壽一次性使用回縮型自毀注射器:3 ML附針"YUSHOU" SAFETY

SYRINGE:3 ML WITH NEEDLE

4.9

NCS010003VPW 3CC SYRINGE W/NEEDLE 1.4


SYRINGE W/NEEDLE

1.8

NCS010005N3C 千禧光安全注射器:5CC附針SOL-CARE LUER LOCK SAFETY

SYRINGE:5CC WITH NEEDLE

4.9









1.8




NCS010005NUY 5CC SYRINGE W/NEEDLE 1.8

NCS010005NV4 5CC SYRINGE W/NEEDLE 1.8


945





4.9


NEEDLE

1.8

NCS010005SYF 5CC DISPOSABLE SYRINGE W/NEEDLE (SAFETY) ※適應症請見備註欄 4.9



4.9


NCS010010N3B 康德萊一次性使用無菌注射器附針10ML"KDL"FOR SINGLE USE


2.5

NCS010010N3C “千禧光”安全注射器10CC(附針)SOL-CARE LUER LOCK SAFETY

SYRINGE 10CC (WITH NEEDLE)

4.9









2.5








NEEDLE

2.5

NCS010010SYF YUE PFONGDISPOSABLE SYRINGE W/NEEDLE"裕豐"塑膠注射筒附針安全

型10CC

4.9



4.9


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

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

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



3.1

NCS010020N3C 千禧光安全注射器:20ML附針SOL-CARE LUER LOCK SAFETY

SYRINGE:20ML WITH NEEDLE

7.1

NCS010020NBD 20 CC SYRINGE (附針) 3.1



NCS010020NNR 20 CC SYRINGE(附針) 3.1


NCS010020NPW 20CC SYRINGE W/NEEDLE 3.1



3.1

946


NCS010020NTM 20 CC SYRINGE (附針) 3.1

NCS010020NTP 20CC SYRINGE W/NEEDLE 3.1



NCS010020NYF 20 CC SYRINGE (附針) 3.1


NEEDLE

3.1



SYRINGE W/NEEDLE

1.4



4.9



5.2






NEEDLE

5.2




4.9


SYRINGE W/NEEDLE

1.4



4.9



8.5




NCS010050NTM TERUMODISPOSABLE SYRINGE W/NEEDLE 50CC"泰爾茂"注射針筒含針頭 8.5




NEEDLE

8.5




4.9


SYRINGE W/NEEDLE

1.8



4.9

NCS010060NTM TERUMODISPOSABLE 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

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



4.9

947



SYRINGE W/NEEDLE

2.5



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

NCS010302SSG SIGMA SYRINGE WITH NEEDLE 3CC 十美牌注射筒附針3CC 1.4

NCS010304SSG SIGMA SYRINGE WITH NEEDLE SAFETY 3CC 十美牌注射筒附針安全型


4.9




4.9




4.9

NCS01A003NPW 3CC SYRINGE W/NEEDLE(附安全護套)※適應症請見備註欄 4.9

NCS01A003VPW 普惠塑膠注射筒附針3CC(安全型)"PERFECT"DISPOSABLE SYRINGE

3CC/NEEDLE(SAFETY)

4.9

NCS01A005NPW PERFECT5CC 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


5CC/NEEDLE(SAFETY)

4.9

NCS01A010NPW PERFECT10CC DISPOSABLE SYRINGE(SAFETY) W/NEEDLE"普惠"塑膠注

射筒附針(安全型)

4.9


10CC/NEEDLE(SAFETY)

4.9

NCS01A020NPW PERFECT20CC DISPOSABLE SYRINGE(SAFETY) W/NEEDLE"普惠"塑膠注

射筒附針(安全型)

7.1


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


W/SYRINGE 3CC

4.9


W/SYRINGE 5CC

4.9


W/SYRINGE 10CC

4.9

NCS01EME05BD BD注射筒(含注射針)5CC BD EMERALD SYRINGE W/NEEDLE 1.8



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



4.9



4.9



4.9

948


NCS01SAG10BD BD滑蓋式安全注射筒附針10CC BD SYRINGE WITH SAFETYGLIDE

NEEDLE 10CC

4.9

NCS01SAG1CBD BD滑蓋式安全注射筒附針1CC BD SYRINGE WITH SAFETYGLIDE NEEDLE

1CC

4.9


5CC

4.9


3CC

4.9

NCS01SNS012P 嘉鎂一次性使用無菌注射器帶針(護蓋式)1CC EWNL DISPOSABLE

SYRINGE W/NEEDLE(SAFETY NEEDLE)

4.9



4.9



4.9



4.9



7.1



7.1



7.1

NCS030000NUU RETRACTABLE SAFETY INSULIN SYRINGE W/NEEDLE※適應症請見備註

欄

6

NCS0300100NR INSULIN SYRINGE 1CC 3.7

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

NCS030310N3B 康德萊一次性使用無菌胰島素注射器"KDL"DISPOSABLE INSULIN

SYRINGE

3.7

NCS030310NFB 桂台胰島素注射筒附針"FEELJECT"DISPOSABLE INSULIN SYRINGES

WITH NEEDLE

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

NCS030510VPW 普惠塑膠注射筒:胰島素空針"PERFECT"DISPOSABLE SYRINGE:INSULIN

SYRINGE

3.7

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

NDN0100022GW SCALP VEIN SET 22:25G 3.9

NDN01023XNPW SCALP NEEDLE 3.9

NDN011827NFR SCALP NEEDLE 3.9

NDN011827NJS SCALP NEEDLE 3.9

NDN011827NM8 MEDITOPTOP SCALP VEIN SET"邁迪特浦"特浦翼狀針 3.9

NDN011827NNR SCALP NEEDLE 3.9

NDN011827NTP SCALP NEEDLE 3.9

949


NDN011828N3B 康德萊頭皮針"KDL" SCALP VEIN SET 3.9

NDN011925NLL SCALP頭皮針 3.9

NDN011925NTM SCALP NEEDLE 3.9

NDN01A010NPW SCALP VEIN SET 16:27G 3.9

NDN020112NBA BARDHUBER 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 BARDHUBER 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※給付規定請見備註欄

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

NDN0222052BA 蝴蝶彎針WINGED INFUSION SET※適應症請見備註欄 64

NDN0227600HJ SMITHSGRIPPER 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 SMITHSGRIPPER 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


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

NDN02A430NPW PERFECTWINGED CORE RESISTANT NEEDLE SETS(SAFETY)"普惠"蝴蝶彎

針(安全型)

91.5

NDN02A450NPW PERFECTSAFETY WINGED CORE RESISTANT NEEDLE SETS"普惠"安全型

蝴蝶彎針

91.5

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 BIOCIVI.V. CATHETER(TPU)"百仕韋"靜脈留置針 9.7

NDN040024CBB INTROCAN CERTO-IV CATHETER 24G(PU) 9.7

NDN0404000HJ SMITHSJELCO 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

9.7

NDN041422CBB INTROCAN CERTO-IV CATHETER 14:22G (PU)(產品型號0405-5756，64

，72，6272，99)

9.7

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 9.7

NDN041424STM SURFLO IV CATHETER 14G:24G(ETFE) 9.5

NDN041622NBD IV CATHETER(TEFLON) 9.5

NDN041622NNR IV CATHETER(TEFLON) 9.5

950


NDN041622NTM IV CATHETER(TEFLON) 9.5

NDN041624N2F 美德芙靜脈留置針"MEDIFIRST"CATH PRO I.V CATHETER(PU) 9.7

NDN041627NTM IV CATHETER 16:27G (PU) 9.7

NDN041824ATM SURSHIELD SURFLO II安全靜脈留置針※適應症請見備註欄 21.1

NDN041824N2F 美德芙靜脈留置針"MEDIFIRST"CATH PRO I.V CATHETER(PU) 9.7

NDN041824NTP IV CATHETER MN(TEFLON) 9.5

NDN042400NBB IV CATHETER(TEFLON) 9.5

NDN042400NNR IV CATHETER(TEFLON) 9.5

NDN042456NBD BD 回縮式安全靜脈導管:小兒用24GX0.56 BD INSYTE AUTOGUARD

SHIELDED I.V. CATHETER:24GX0.56

21.1

NDN043818ABD INSYTE AUTOGUARD SHIELDED IV CATHETER 回縮式安全靜脈導管　※


21.1

NDN0442511BB 柏朗第三代安全靜脈留置針"B.BRAUN" INTROCAN SAFETY 3 CLOSED

I.V. CATHETER

26.4

NDN0442603BB VASOFIX SAFETY I.V. CANNULAE 菲適免針加藥安全靜脈留置針※適


29.1

NDN0442689BB VASOFIX I.V. CANNULAE 菲適免針加藥靜脈留置針 14.4

NDN0442CWSBB INTROCAN CERTO SAFETY PU 18:24G安全靜脈留置針※適應症請見備

註欄

21.1

NDN0451SNW2K 欣意安全靜脈留置針"MASTER&FRANK"SAFETY IV CATHETER 21.1

NDN04BC001BD BD INSYTE AUTOGUARD BC SHIELD IV CATHETER 16:24G BD 安全性靜

脈留置針-血液控制

26.4

NDN04FEP03BB INTROCAN SAFETY IVC CANNULAE ※適應症請見備註欄 21.1

NDN04FEP03NR 尼普洛安全靜脈留置針NIPRO SAFETOUCH CATH 21.1

NDN04NEXV1BD BD密閉式靜脈留置導管系統:安全型靜脈留置導管+Y型管+2個安全無

針式接頭"BD"NEXIVA CLOSED IV CATHETER SYSTEM:DUAL PORT Y

W/Q-SYTE

85

NDN04PUR03BB INTROCAN SAFETY IVC CANNULAE ※適應症請見備註欄 21.1

NDN04S1424BD INSYTE IV CATHETER(VIALON) 9.7

NDN04SC5J1YZ “美迪克”安全性靜脈留置針"MEDIKIT” SUPERCATH 5 SAFETY

I.V.CATHETER

21.1

NDN04SC5V1YZ 美迪克安全性靜脈留置針"MEDIKIT" SUPERCATH 5 SAFETY I.V.

CATHETER

21.1

NDN04SR01NTM SURFLO I.V CATHETER 14G:24G 9.5

NDN050024WBB INTROCAN CERTO IV CATHETER W/WING 24G(PU) 9.7

NDN050024WBD IV CATHETER 24G(TEFLON) 9.5

NDN051422WBB INTROCAN CERTO IV CATHETER W/WING (PU) 14:22G(產品型號0405-

6280，5780，5799，6264，7802)

9.7

NDN051622WBD IV CATHETER 16:22G(TEFLON) 9.5

NES010201NBA MAX-CORE DISPOSABLE BIOPSY INSTRUMENT 14:20G(自動式) 633

NES0102300CD BIOPSY FORCEPS(88/08/1再生效，300L，302L自88/08/01起生效) 6402

NES010804TAG 亞康恩迪洛骨髓活體組織切片針"ARGON" T-LOK BONE MARROW BIOPSY

NEEDLES

598

NES0114070HK SONO GUIDE BIOPSY NEEDLE 14G 16G 70CM ，170CM 358

NES0115011AG 亞康恩骨髓活體組織切片針"ARGON" BONE MARROW BIOPSY NEEDLE-

BONE MARROW ASPIRATION NEEDLE

529

NES0117070HK SONO GUIDE BIOPSY NEEDLE 17G 18G 70CM ，170CM 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

NES0118015AG 亞康恩骨髓活體組織切片針"ARGON"BONE MARROW BIOPSY NEEDLE-

PEDIATRIC BONE MARROW NEEDLE

598

951


NES011815NHK HAKKOPTC CHIBA NEEDLE肝膽穿刺針150MM:250MM 358

NES015043NCD BIOPSY FORCEPS FOR ENDOMYOCADIAL BIOPSIES 6402

NES0182000ZM MD TECH SNARELOK BONE MARROW BIOPSY TRAY AND ACCESSORIES 598

NES01AM18NGP BONE MARROW ASPIRATION NEEDLE 529

NES01BM00XGP GALLINIBIOMID 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

NES01BMHN1AG 亞康恩骨髓活體組織切片針"MD TECH" BONE MARROW BIOPSY NEEDLE-

BONE MARROW HARVEST NEEDLE WITH SIDE HOLE

529

NES01BN160AG 亞康恩骨髓活體組織切片針"MD TECH" BONE MARROW BIOPSY NEEDLE-

OSTY CORE BONE BIOPSY NEEDLE

598

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

NES01M1806AG 亞康恩穿刺針"ARGON" FINE NEEDLE ASPIRATION (FNA) BIOPSY

NEEDLES

358


NEEDLES

358


NEEDLES

358


NEEDLES

358

NES01MN120BA MAGNUM BIOPSY NEEDLE 633

NES01ST00NJ6 CAREFUSIONSTERNUM TEMNO DEVICE"卡弗迅"骨髓抽吸針 623

NES01TC00XJ6 CAREFUSIONT-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 CAREFUSIONILLINOIS STERNAL/ILIAC BONE MARROW ASPIRATION

NEEDLES"卡弗迅"伊利諾胸骨/腸骨骨髓抽取針

529

NES0218150TP TOPASPIRATION BIOPSY NEEDLE (18GX150MM)吸引生檢針 618


NES0221150TP ASPIRATION BIOPSY NEEDLE (MAJIMA NEEDLE) 150MM 618


NES0307650AG 亞康恩剖美克組織切片針"ARGON"PRO-MAG BIOPSY NEEDLES 633

NES0310800AG 亞康恩拜爾賓全組織切片器 "ARGON"BIOPINCE FULL-CORE BIOPSY

INSTRUMENT 10CM

633

NES0312182BA BARDMONOPTY BIOPSY INSTRUMENT組織取樣針 633

NES031406NJ6 CAREFUSIONTEMNO BIOPSY NEEDLES "卡弗迅"生檢針 611


INSTRUMENT 15CM

633


INSTRUMENT 20CM

633

NES03315SDJU PAJUNKDELTA CUT BIOPSY SYSTEM生檢穿刺套管組14:20G 611

NES0370111AG 亞康恩舒普克半自動組織切片器"ARGON" SUPER CORE SEMI-

AUTOMATIC BIOPSY INSTRUMENT

611

NES0370111ZM SUPER-CORE II ADJUSTABLE BIOPSY INSTRUMENT 彈簧組織切片針 611

NES0376260ZN 奧特亞組織取樣針（滅菌）ULTRA CORE BIOPSY NEEDLE (STERILE) 633

NES0376311AG 亞康恩楚克自動組織切片器"ARGON" TRU-CORE II AUTOMATIC BIOPSY

INSTRUMENT

633

NES0376311ZR TRU-CORE II AUTOMATIC DISPOSABLE BIOPSY DEVICE 633

NES0376330ZM 楚克切片針"TRU-CORE" I BIOPSY NEEDLES 633

952


NES0376501ZM PRO-MAG AUTOMATIC BIOPSY NEEDLE 633



NES03G14162N 捷太史樂賓組織切片針"GTA" SLB DISPOSABLE SEMI-AUTOMATIC

BIOPSY NEEDLE

611

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 BARDMONOPTY DISPOSABLE BIOPSY INSTRUMENT+TRUGUIDE COAXIAL

BIOPSY NEEDLE組織取樣針+同軸導引針

1380

NES041356NJ6 CAREFUSIONUNIVERSAL 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 TECHSUPER-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

NES0470121AG 亞康恩舒普克半自動組織切片器"ARGON" SUPER CORE SEMI-

AUTOMATIC BIOPSY INSTRUMENT

1380

NES04ACNMFG5 ANGIOTECHACN 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 BARDBIOPSY 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 CAREFUSIONTEMNO 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

NES04M7011AG 亞康恩舒普克半自動組織切片器+同軸導引針"ARGON" SUPER CORE

SEMI-AUTOMATIC BIOPSY INSTRUMENT+CO-AXIAL INTRODUCER NEEDLE*


1380

NES04MCTGABA BARDMAX-CORE DISPOSABLE BIOPSY INSTRUMENT+TRUGUIDE COAXIAL

BIOPSY NEEDLE組織取樣針+同軸導引針

1380

NES04MCXS0AG 亞康恩同軸導引針 "ARGON" CO-AXIAL INTRODUCER NEEDLE*適應症請

見備註欄

889

NES04MCXS1AG 亞康恩同軸導引針 "ARGON" CO-AXIAL INTRODUCER NEEDLE*適應症請

見備註欄

889

NES04QCS01CK COOKCOAXIAL 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

RRB01TB000EF 貝斯美德誘發型肺量計"BESMED" INCENTIVE SPIROMETER 140


VOLDYNE5000*給付規定請見備註欄

140


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

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


2459

953


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

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

SAS03PCEAC2C “柯惠”彎型端對端自動縫合器“COVIDIEN” PREMIUM PLUS CEEA

SINGLE USE CIRCULAR STAPLER

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

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

SAS06548872C 柯惠可拆除式皮膚縫合釘(滅菌) "COVIDIEN" REMOVABLE SKIN

STAPLE (STERILE))

210

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

SAS06803522C 柯惠可拆除式皮膚縫合釘(滅菌) "COVIDIEN" REMOVABLE SKIN

STAPLE (STERILE)

173

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

SAS06TS35RQW 台灣先進可拆除式皮膚縫合釘(滅菌) "TAIWAN SURGICAL" REMOVABLE

SKIN STAPLE (STERILE)

173

954


SAS06TS35RTS 台灣先進可拆除式皮膚縫合釘(滅菌) "TAIWAN SURGICAL" REMOVABLE


173

SAS06TS35WQW 台灣先進可拆除式皮膚縫合釘(滅菌) "TAIWAN SURGICAL" REMOVABLE


210

SAS06TS35WTS 台灣先進可拆除式皮膚縫合釘(滅菌) "TAIWAN SURGICAL" REMOVABLE


210

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



註欄

2036



註欄

2153



註欄

2293



註欄

2293



註欄

2041



註欄

2036



註欄

2036



註欄

2153

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

SAU01TA30L2C 柯惠 TA自動手術縫合器及縫合釘 "COVIDIEN" TA STAPLERS AND

LOADING UNITS

2293


LOADING UNITS

2036


LOADING UNITS

2036


LOADING UNITS

2153

SAU01TRH90JJ ETHICONDISPOSABLE 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 ※適


2293

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

SAU01XR60BJJ PROXIMATE RELOADABLE LINEAR STAPLER 60MM 3.5LEG，4.8LEG ※適


2036

955


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

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

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


2244

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


2239

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

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



4000



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

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

SAU07304532C 柯惠GIA自動手術縫合器-旋轉式釘匣(45MM)"COVIDIEN" AUTO SUTURE


CARTRIDGE-45MM STAPLE

4900

SAU07304562C 柯惠GIA自動手術縫合器-旋轉式釘匣(60MM)"COVIDIEN" AUTO SUTURE


CARTRIDGE-60MM STAPLE

5956

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 UNITS - LOADING UNITS

4000

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


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


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


STAPLE

4000

956


SAU07CFC45J8 南京邁迪欣一次性使用旋轉切割吻合器-45MM縫合釘匣" Nanjing


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


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

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


(中) 6;24 CLIPS/排(M)

17.9


(中-大) 6;24 CLIPS/排(M-L)

20.2

SCV010412LV7 維達力克鈦金屬血管夾系統(大)"VITALITEC" SLS-CLIP TITANIUM

HEMOSTATIC CLIP SYSTEM

35


(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

SCV011500NS6 “司堅倫”單次用哈巴狗血管夾“SCANLAN”SINGLE-USE BULLDOG

CLAMP

192

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

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

957


SCV01FD870TX 泰利芙斯血管夾"Teleflex Medical" Hemoclip-TITANIUM(LARGE) 35

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

SCV01LT400JJ TITANIUM LIGA CLIP (L) 6 CLIP/排 35

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

SCV029380NM1 瑞穗腦動脈瘤夾，"MIZUHO"SUGITA ANEURYSM CLIP 2897

SCV029400NM1 SUGITA ANEURYSM CLIP (STANDARD TYPE) 2256

SCV029401NM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801


SCV029404NM1 SUGITA ANEURYSM CLIP (FENESTRATED LARGE TYPE) 2897

SCV029404SM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801

SCV0294050M1 瑞穗腦動脈瘤夾，"MIZUHO"SUGITA ANEURYSM CLIP 2801

SCV029405NM1 SUGITA ANEURYSM CLIP (TEMPORARY TYPE) 2778

SCV0294069M1 瑞穗腦動脈瘤夾，"MIZUHO"SUGITA ANEURYSM CLIP 2256

SCV029406NM1 SUGITA ANEURYSM CLIP (STANDARD TYPE) 2256

SCV029406SM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801


SCV029407SM1 SUGITA ANEURYSM CLIP (FENESTRATED LARGE TYPE) 2897

SCV029408SM1 SUGITA ANEURYSM CLIP (MINI TYPE) 2908

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

SCV03CA500PA 安培腹腔鏡血管夾系統"APPLIED"EPIX UNIVERSAL CLIP APPLIER 175

SCV03EL5MLET 愛惜康5毫米腹腔鏡多釘縫合器"ETHICON"LIGAMAX5 5MM ENDOSCOPIC

MULTIPLE CLIP APPLIER

200

SCV03TDC10QW 台灣先進拋棄式血管夾"TAIWAN SURGICAL"DISPOSABLE CLIP APPLIER

20釘

175

SCV2023703TX 泰利芙斯希瑪克力普血管夾"Teleflex Medical" Hemoclip

Automatic Clip Applier With Clips-M20

98.7

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



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

958




113

SCV20340512C 柯惠自動連發式血管夾 "COVIDIEN" AUTO SUTURE PREMIUM

SURGICLIP APPLIER WITH CLIPS

98.7

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

TBCT10023TVR EAGLE LABSMANUAL 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 LABSMANUAL OPHTHALMIC SURGICAL INSTRUMENT-LACRIMAL

INTUBATION SET"老鷹"手動式眼科手術器械-鼻淚管通條

1773

TBCT109600W5 CRAWFORD LARCRIMAL INTUBATION SET鼻淚管通條 1773

TBCT1105491Z FCI MONOKA LACRIMAL INTUBATION SETS"佛朗惜眼" 蒙那卡矽質淚管 6816

TBCT1205981Z FCI AUTOSTABLE BICANALICULUS INTUBATION SET II"佛朗惜眼"自動

固定淚管支架

7327

TBCT1L1S27QT QUESTMANUAL OPHTHALMIC SURGICAL INSTRUMENT:LACRIMAL

INTUBATION SET"可思透"手動式眼科手術器械:鼻淚管通條

1773

TBCT1S12301Z FCI MONOKA LACRIMAL INTUBATION SETS"佛朗惜眼" 蒙那卡矽質淚

管-輔助通條

6816

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

TBS01S19825L 雷?森視網膜植入物-海綿"LABTICIAN" RETINAL IMPLANTS-SPONGE 2500

TBS01S29695L 雷?森視網膜植入物(條)"LABTICIAN" RETINAL IMPLANTS-BAND 960

TBS01S30175L 雷?森視網膜植入物(輪)"LABTICIAN" RETINAL IMPLANTS-TIRE 1080

TBS01S51001Z 佛朗惜眼鞏膜環扣物(條)"FCI "SCLERAL BUCKLING IMPLANTS-BAND 960

TBS01S52301Z 佛朗惜眼鞏膜環扣物(輪)"FCI "SCLERAL BUCKLING IMPLANTS-TIRE 1080

TBS01S56301Z 佛朗惜眼鞏膜環扣物(海綿)"FCI "SCLERAL BUCKLING IMPLANTS-

SPONGE

2500

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

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

TKP0113713WF EHL 3.5FR 電擊線 3477

TKP012280NWF LITHOTRIPTER:RIWOLITH PROBES 2280.XXX 3477

959


TKP012708NKL EHL PROBE電擊碎石線 3477

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

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*


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 STARMEDELECTROSURGICAL 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 RFRADIOFREQUENCY 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 MEDSPHEREELECTROSURGICAL RF ELECTRODES "邁德斯菲爾"電外科電

極 ※適應症請見備註欄

18800

TKP03STAR2XM STARMEDSTAR RF ELECTRODE-FIXED"史達美克"史達射頻電極-固定式


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

TKP0423103AG 亞康恩乳房定位針 (滅菌)"ARGON" BREAST LOCALIZATION NEEDLE

(STERILE)

953

TKP0425000AG ARGON BREAST LOCALIZATION NEEDLE(NEEDLE+HOOK WIRE)"亞康恩"乳

房定位針(滅菌)

953

TKP0425303AG 亞康恩乳房定位針 (滅菌)"ARGON" BREAST LOCALIZATION NEEDLE

(STERILE)

953

TKP0427100XL 首馬特乳房定位針"SOMATEX"BREAST LOCALIZATION

NEEDLE(NEEDLE+HOOK WIRE)

953

TKP0427160XL 首馬特乳房定位針"SOMATEX"BREAST LOCALIZATION NEEDLE 953

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

NEEDLE(NEEDLE+WIRE)

953

TKP04BLN00AG ARGON BREAST LOCALIZATION NEEDLE(NEEDLE+HOOK WIRE"亞康恩"乳

房定位針(滅菌)

953

TKP04BREASBA BARDBREAST LOCALIZATION NEEDLE(NEEDLE+WIRE)"巴德"乳房定位針 953

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)

953

TKP04DKBL1CK COOK DISPOSABLE (KOPANS)BREAST LESION LOCALIZATION

DEVICES(NEEDLES+WIRE)"曲克"DISPOSABLE乳房病灶定位器材

953

TKP04DKBL2CK COOK DISPOSABLE BREAST LESION LOCALIZATION DEVICES(可與MRI相

容)"曲克"拋棄式乳房病灶定位器材

1287

TKP04EZMB21G E-Z-EMPERCUGUIDE LESION MARKING SYSTEM(可與MRI相容)"易置"乳

房定位針

1287

TKP04EZN2X1G E-Z-EMPERCUGUIDE LESION MARKING SYSTEM(NEEDLE+HOOK WIRE)"易

置"乳房定位針

953

TKP04GTSMRBA BARD BREAST LOCALIZATION NEEDLE-MR BEADED BREAST

LOCALIZATION WIRE "巴德"乳房定位針-磁振造影賈拉堤絲珠狀乳房

定位線

1287

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

960


TKVC12405CZS 米睿玻璃體切割系統配件(切除刀）(自103.08.01起支付標準醫令代

碼86207B、86409B、86410B及86411B使用者已內含不得另外申報)

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


申報)

4950

TKVC141018A1 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

TKVC201006A1 ANTERIOR ADVANCE TECHNOLOGY IRRIGATION OCUTOME PROBE

(ATOP)((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

TKVC208012A1 ANTERIOR VITRECTOMY 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

TKVC244006B9 博士倫曙光超音波乳化儀:前房玻璃體切除刀(自103.08.01起支付標


申報)

4497

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

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


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

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

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

961


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，50PCS/VIAL)

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

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 ALUMINUM FOIL(SIDE TYPE)(50 PCS)

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

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 GLUCOSE TEST STRIP

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

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

TSS01011014W 舒易測血糖監測系統-血糖試紙(25片、50片/盒) GLUCOEXPERT BLOOD

GLUCOSE MONITORING SYSTEM-TEST STRIPS

8.1

TSS01052286B 衡欣索洛專業型血糖測試系統-血糖測試試紙"BTM"SOLUS PRO BLOOD

GLUCOSE MONITORING SYSTEM-BLOOD GLUCOSE TEST STRIPS

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

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

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

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

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

TSS0126840AB 輔理善越佳型血糖試紙(25片/盒、50片/盒)FREESTYLE OPTIUM BLOOD

GLUCOSE TEST STRIPS

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

962


TSS01400014D 糖博士優測血糖監測系統-糖博士優測血糖試紙(25*2/盒)GLUCODR

AUTO BLOOD GLUCOSE MONITORING SYSTEM-GLUCODR AUTO TEST

STRIPS

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

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

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


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


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

TSS01700PRFS 瑞特定點照護連線型血糖監測系統GM700PRO:瑞特血糖測試片(10片、

25片、50片、75片、100片、200片/盒)RIGHTEST POCT BLOOD

GLUCOSE MONITORING SYSTEM GM700PRO: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

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)


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))*


8.1

TSS01ACCV1FH 樂康血糖測試系統血糖測試片(25片/瓶、50片/盒(25片/瓶，2瓶

裝)、100片/盒(25片/瓶，4瓶裝)、25片/盒(單片鋁箔包))ON CALL

VIVID BLOOD GLUCOSE MONITORING SYSTEM TEST STRIPS

8.1

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

963


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)*


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*25、50 PCS/VIAL)

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/BOX)

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

TSS01EN003FY 愛科來SIGMA血糖試紙(25片/盒，50片/盒)"ARKRAY"GLUCOCARD SIGMA

TEST STRIPS

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

TSS01G700SFS 瑞特血糖監測系統GM700S:瑞特血糖測試片(10片、25片、50片、75

片、100片、200片/盒)RIGHTEST BLOOD GLUCOSE MONITORING SYSTEM

GM700S:BLOOD GLUCOSE TEST STRIP

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


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

964


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 GLUCOSE TEST STRIP

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 GLUCOSE TEST STRIP

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

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

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-BLOOD GLUCOSE TEST STRIP

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


8.1

TSS01HL5221J 帝寶血糖試紙(25片/盒、50片/盒)TIPOCARE BLOOD GLUCOSE TEST

STRIP

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


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

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

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

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


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

TSS01SELECFZ 穩擇血糖試紙ONETOUCH SELECT TEST STRIPS(25片/瓶，50片/2瓶)*


8.1

TSS01SG105J4 易美測I血糖試紙(25片/盒)*適應症請見備註欄 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

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

965


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

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



8.1



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

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

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

WBB0402050C7 ELASTIC BANDAGE※適應症請見備註欄 5.3

WBB0402050EX ELASTIC BANDAGE※適應症請見備註欄 5.3

WBB0402050F0 FOR CARE ELASTIC BANDAGE*適應正請見備註欄 5.3

WBB0402050GM ELASTIC BANDAGE※適應症請見備註欄 5.3

WBB0402050KF ELASTIC BANDAGE※適應症請見備註欄 5.3

WBB0402050MG I-Ming BANDAGE ELASTIC "愛民"彈性繃帶2"x5Y※適應症請見備註欄 5.3

WBB0402050UQ U.A.TOPELASTIC BANDAGE(NON-STERILE)2"X5Y"優亞特"彈性繃帶(未

滅菌*適應症請見備註欄)

5.3

WBB0402050YS ELASTIC BANDAGE 2"X5Y※適應症請見備註欄 5.3

WBB0403050C7 ELASTIC BANDAGE※適應症請見備註欄 11

WBB0403050EX ELASTIC BANDAGE※適應症請見備註欄 11

WBB0403050EZ ELASTIC BANDAGE 3"x5Y *適應症請見備註欄 11

WBB0403050F0 FOR CARE ELASTIC BANDAGE*適應正請見備註欄 11

WBB0403050FF ELASTIC BANDAGE※適應症請見備註欄 11

WBB0403050GM ELASTIC BANDAGE※適應症請見備註欄 11

WBB0403050KF ELASTIC BANDAGE※適應症請見備註欄 11

WBB0403050MG I-Ming BANDAGE ELASTIC "愛民"彈性繃帶3"x5Y※適應症請見備註欄 11

WBB0403050RL RE-ORDERELASTIC BANDAGE(NON-STERILE)3吋X5碼彈性繃帶*適應症

請見備註欄

11

966




11

WBB0403050YS ELASTIC BANDAGE 3"x5Y※適應症請見備註欄 11

WBB0403050ZB ELASTIC BANDAGE*適應症請見備註欄 11

WBB0404050C7 ELASTIC BANDAGE※適應症請見備註欄 11

WBB0404050EX ELASTIC BANDAGE※適應症請見備註欄 11

WBB0404050EZ ELASTIC BANDAGE 4"x5Y *適應症請見備註欄 11

WBB0404050F0 FOR CARE ELASTIC BANDAGE*適應正請見備註欄 11

WBB0404050FF ELASTIC BANDAGE※適應症請見備註欄 11

WBB0404050GM ELASTIC BANDAGE※適應症請見備註欄 11

WBB0404050KF ELASTIC BANDAGE※適應症請見備註欄 11

WBB0404050MG I-Ming BANDAGE ELASTIC "愛民"彈性繃帶4"x5Y※適應症請見備註欄 11


請見備註欄

11



11

WBB0404050YS ELASTIC BANDAGE 4"x5Y※適應症請見備註欄 11

WBB0404050ZB ELASTIC BANDAGE*適應症請見備註欄 11

WBB0406050C7 ELASTIC BANDAGE※適應症請見備註欄 17.7

WBB0406050EX ELASTIC BANDAGE※適應症請見備註欄 17.7

WBB0406050EZ ELASTIC BANDAGE 6"x5Y *適應症請見備註欄 17.7

WBB0406050F0 FOR CARE ELASTIC BANDAGE*適應症請見備註欄 17.7

WBB0406050FF ELASTIC BANDAGE※適應症請見備註欄 17.7

WBB0406050GM ELASTIC BANDAGE※適應症請見備註欄 17.7

WBB0406050KF ELASTIC BANDAGE※適應症請見備註欄 17.7

WBB0406050MG I-Ming BANDAGE ELASTIC "愛民"彈性繃帶6"x5Y※適應症請見備註欄 17.7


請見備註欄

17.7



17.7

WBB0406050YS ELASTIC BANDAGE 6"x5Y※適應症請見備註欄 17.7

WBB0406050ZB ELASTIC BANDAGE*適應症請見備註欄 17.7

WBB0703030A5 CAST BANDAGE 21.9

WBB0703030C7 CSDPLASTER OF PAIRS BANDAGE (non-sterile)3"X3Y"中衛"石膏繃帶

(未滅菌)

21.9

WBB0703030NJ PLASTER BANDAGE 3"X3Y 21.9

WBB0703030QP POPPLASTER OF PARIS BANDAGE(NON-STERILE)3"X3Y"披歐披"石膏繃

帶(未滅菌)

21.9

WBB0703030U6 PLASTER OF PARIS BANDAGE 3"X3Y 21.9

WBB0703030ZD DUK-IN PLASTER BANDAGE 21.9

WBB0703031NS NOK-SAN CAST PLASTER BANDAGE石膏繃帶3"X3Y 21.9

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

21.9

WBB0703050C7 CAST BANDAGE 30.9

WBB0703050JX ANJI JIXIANGPLASTER OF PARIS BANDAGES(NON-STERILE)"安吉吉祥"

石膏繃帶(未滅菌)3"X5Y

30.9


帶(未滅菌)

30.9


WBB0704030C7 中衛石膏繃帶(未滅菌)"CSD"PLASTER OF PAIRS BANDAGE (NON-

STERILE)

24.2



967


WBB0704040ZD DUK-IN PLASTER BANDAGE 34.1

WBB0704050A5 CAST BANDAGE 38.1


(未滅菌)

38.1



38.1


WBB0704050NS NOK-SAN CAST PLASTER BANDAGE 10CMX4.5M(4"X5Y) 38.1


帶(未滅菌)

38.1


WBB0704051A5 ALCAREP&O PLASTER OF PARIS BANDAGE 4"X5Y(10CMX4.5M)"愛樂康"

石膏繃帶

38.1



38.1



帶(未滅菌)

48.8



48.8


WBB0706040U6 PLASTER OF PARIS BANDAGE 6"X4Y 47

WBB0706040ZD DUK-IN PLASTER BANDAGE 47

WBB0706050A5 Alcarecasting 6"x5y 50.1


(未滅菌)

50.1



50.1


WBB0706050NS NOK-SAN CAST PLASTER BANDAGE 15CMX4.5M(6"X5Y) 50.1


帶(未滅菌)

50.1


WBB0706051A5 ALCAREP&O PLASTER OF PARIS BANDAGE 6"X5Y(15CMX4.5M)"愛樂康"

石膏繃帶

50.1



50.1

WBB0801020KB KOBKOBRA 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)

69.8

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

105

WBB0802040C7 中衛樹脂石膏繃帶 (未滅菌)"CSD" ORTHOPEDIC CASTING TAPE (NON-

STERILE)

69.8

WBB0802040K3 KANGDAORTHOPEDIC CASTING TAPE樹脂石膏繃帶(玻璃纖維)2吋4碼*適


105


註欄

196

WBB0802040Q5 S&FROBO 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

69.8

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

69.8

WBB0802040Q8 OPTIMA CASTORTHOPAEDIC 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

105

968


WBB0802040YK CONNECTORTHOPEDIC 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

69.8

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

105

WBB0802041HZ HORIZONORTHOPEDIC 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

105

WBB0802041NJ POLYESTER CAST TAPE聚脂纖維石膏繃帶2吋X4Y*使用規範請見備註欄 69.8

WBB08030402B 瑪迪安納樹脂石膏繃帶(未滅菌) "MEDIANA" CASTING TAPE (NON-

STERILE)

75


見備註欄

105


STERILE)

75

WBB0803040HZ HORIZONORTHOPEDIC 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

75



105


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

105

WBB0803040Q3 DONG HAEORTHOPEDIC CASTING TAPE輕石膏(玻璃纖維)3吋X4碼*適應

症請見備註欄

105


請見備註欄

75



75



105

WBB0803040Q9 TOMATOORTHOPAEDIC CASTING TAPE(NON-STERILE)玻璃纖維石膏繃帶3

吋X4碼*適應症請見備註欄

105



75


症請見備註欄

105



105

WBB0803041NJ POLYESTER CAST TAPE聚脂纖維石膏繃帶3吋X4Y*使用規範請見備註欄 75


STERILE)

107


見備註欄

123


STERILE)

107



107



123


註欄

265

969



欄

123


症請見備註欄

123


請見備註欄

107



107



123



123



107


症請見備註欄

123



123



STERILE)

117


見備註欄

137


STERILE)

117



117



137


註欄

334


欄

137


症請見備註欄

137


請見備註欄

117



117



137



137



117


症請見備註欄

137



137


970



STERILE)

126


症請見備註欄

160


請見備註欄

126



126

WBB0806040YK CONNECTORTHOPEDIC CASTING TAPE6"X4Y(15.0CMX360CM)(NON-


126

WBB0817942A5 聚脂纖維石膏繃帶3吋X4碼*使用規範請見備註欄 75



WBB0820400Q5 S&FROBO 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

105

WBB0830400HZ HORIZONORTHOPEDIC CASTING TAPE(NON-STERILE)樹脂石膏繃帶(玻璃


105



123



137

WBB0850400Q5 S&FROBO 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

137

WBP0102030YK CONNECTCAST 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 SHUNCOTTON BANDAGES(NON-STERILE) 2"X4Y"銓順"石膏棉捲

(未滅菌)

11

WBP0103030C7 CSD ORTHOPAEDIC CAST COTTON PADDING 13

WBP0103030YK CONNECTCAST 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 JIXIANGUNDERCAST PADDING BANDAGE(NON-STERILE) 3"X4Y"安

吉吉祥"棉捲(未滅菌)

12.8

WBP0103040KF ORTHOPEDIC COTTON BANDAGE 12.8


(未滅菌)

12.8


WBP0104030YK CONNECTCAST COTTON PADDING(NON-STERILE)4"X3Y(10CMX270CM)"可


12.8

WBP0104040BP B.P.I UNDER CAST PADDING BANDAGE COTTON 17.3







17.3


WBP0104040NJ ORTHOPEDIC COTTON BANDAGE 17.3


(未滅菌)

17.3

971




WBP0106030C7 CSD ORTHOPAEDIC CAST COTTON PADDING 24



24

WBP0106040BP B.P.I UNDER CAST PADDING BANDAGE COTTON 25.6







25.6


WBP0106040NJ ORTHOPEDIC COTTON BANDAGE 25.6


(未滅菌)

25.6

WBP0106050A5 ORTHOPEDIC COTTON BANDAGE 31.5




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

WDD0800020SN 史耐輝索羅特傷口清創修護凝膠(未滅菌)"SMITH & NEPHEW"

SOLOSITE WOUND GEL (NON-STERILE) 20G

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&NEPHEWALLEVYN 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&NEPHEWALLEVYN 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



327



395



345

WDD0800073SN SMITH&NEPHEWALLEVYN 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



320



459


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

972




586



224



406



612

WDD0800248SN SMITH&NEPHEWALLEVYN 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



註欄

225



註欄

243



註欄

364

WDD0800270SN SMITH & NEPHEWALLEVYN 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


DRESSING(STERILE)12.5X12.5CM"史耐輝"矽膠愛力膚敷料(滅菌)*適


225


DRESSING(STERILE)17.5X17.5CM"史耐輝"矽膠愛力膚敷料(滅菌)*適


364

WDD0800434SN SMITH&NEPHEWREPLICARE 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



請見備註欄

116



請見備註欄

192

WDD0800451SN SMITH&NEPHEWALLEVYN 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&NEPHEWALLEVYN 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

WDD080078CSN 史耐輝愛力膚銀親水性抗菌敷料"SMITH&NEPHEW"ALLEVYN AG

HYDROCELLULAR ANTIMICROBIAL DRESSING 12.5CMX12.5CM

320

973


WDD080081CSN 史耐輝愛力膚銀親水性抗菌敷料"SMITH&NEPHEW"ALLEVYN AG

HYDROCELLULAR ANTIMICROBIAL DRESSING 17.5CMX17.5CM

459

WDD0801008J9 TRONJENHYDROCOLLOID DRESSING(STERILE)10CMX10CM"中鎮"親水性敷

料(滅菌)*適應症請見備註欄

119

WDD08010102H 赫麗敷藻酸鈣鹽敷料(滅菌)HERADERM ALGINATE WOUND DRESSING

(STERILE)10X10CM

112



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 TRONJENHYDROCOLLOID 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


得"膠原藻酸纖維敷料(滅菌)※適應症請見備註欄

112



得"膠原藻酸纖維敷料(滅菌)10*20CM

125

WDD0801044P1 保立美含銀敷料(非黏著性)POLYMEM QUADRAFOAM SILVER NON-

ADHESIVE PAD DRESSING 10.8X10.8cm

184

WDD0801212SN HYDROCELLULAR ADHESIVE DRESSING 12.5X12.5CM※適應症請見備註

欄

177

WDD0801313SN 史耐輝必膚膜"SMITH & NEPHEW" BIOBRANE TEMPORARY WOUND

DRESSING 13CMX13CM

2400

WDD0801338SN 史耐輝必膚膜"SMITH & NEPHEW" BIOBRANE TEMPORARY WOUND

DRESSING 13CMX38CM

4500

WDD0801419BB B.BRAUNASKINA GEL，15G 雅膚清創凝膠*適應症請見備註欄 140



116


欄

327



欄

395

WDD080270CSN 史耐輝矽膠愛力膚敷料(滅菌)"SMITH & NEPHEW"ALLEVYN GENTLE

BORDER DRESSING(STERILE)10CM×10CM

119


BORDER DRESSING (STERILE)12.5CM×12.5CM

225


BORDER DRESSING (STERILE)17.5CM×17.5CM

364

WDD0803410CA COLOPLAST BIATAIN FOAM DRESSING(STERILE)-NON-ADHESIVE "康樂

保"平而坦泡綿敷料(滅菌)-非黏性10X10CM

119


保"平而坦泡綿敷料(滅菌)-非黏性15X15CM

245


保"平而坦泡綿敷料(滅菌)-非黏性20CMX20CM

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



327

WDD0803470CA COLOPLAST BIATAIN FOAM DRESSING(STERILE)-SOFT-HOLD "康樂保"

平而坦泡綿敷料(滅菌)-自黏10CMX10CM

119

974




245



245

WDD0803708F4 CONVATECAQUACEL 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 CONVATECAQUACEL 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

WDD08037115T 賜爾膚含銀藻酸鈣鹽敷料(滅菌)SILVERLAP AG ALGINATE DRESSING

(STERILE)5CMX5CM

56.4

WDD0803711F4 CONVATECAQUACEL 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


(STERILE)10CMX10CM

224

WDD0803712F4 CONVATECAQUACEL AG HYDROFIBER DRESSING 2X45CM *適應症請見備

註欄

198


(STERILE)15CMX15CM

406


(STERILE)20CMX20CM

612


(STERILE)5CMX20CM

224

WDD0803760CA COLOPLAST SEASORB AG DRESSING 康樂保藻膠銀離子敷料10CMX10CM*


224

WDD0803771F4 CONVATECAQUACEL 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*


224

WDD0803786F4 康威愛康膚銀燒傷親水性纖維敷料"CONVATEC"AQUACEL AG BURN

HYDROFIBER DRESSING 13CM×10CM

224



432



920



3060



3060


HYDROFIBER DRESSING-含銀手套2.54CMX4.5CM

56.4



56.4



198



224



406

WDD080451CSN SMITH&NEPHEWALLEVYN 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

975


WDD0805101YY CORELEADERHYDROCOLLOID DRESSING(STERILE)"康力得"親水性敷料

(滅菌)5CMX10CM*適應症請見備註欄

41.1

WDD0805200GM 卓和創傷敷料(滅菌)"GMTH"WOUND DRESSING(STERILE)5×20CM 53.2



53.2

WDD080520A3T 騰森親水性膠體敷料(滅菌)"TENSENSE"HYDROCOLLOID

DRESSING(STERILE)5cmX20cm

53.2

WDD080700CSN SMITH&NEPHEWALLEVYN 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

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 COLOPLASTBIATAIN 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 COLOPLASTBIATAIN AG FOAM DRESSING "康樂保"平而坦銀離子泡綿


406

WDD0809801KD ULTEC PRO ALGINATE HYDROCOLLOID DRESSING 4X4(10.16X10.16CM)


112

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

WDD0809939HL RESTORE CALCICARE WOUND CARE DRESSING STERILE 10X20CM ※適應

症請見備註欄

125

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

WDD0809955HL RESTORE PLUS WOUND CARE DRESSING STERILE 20X20CM※適應症請見

備註欄

395

WDD0810100GM 卓和創傷敷料(滅菌)"GMTH"WOUND DRESSING(STERILE)10×10CM 53.2

WDD0810100YY CORELEADERALGINATE 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



53.2



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



125

WDD0810607F4 ConvaTecVERSIVA 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


康威"威吸寶敷料(滅菌)-非粘性*給付規定請見備註欄。

243

WDD0810609F4 ConvaTecVERSIVA 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

976




225



409

WDD0810612F4 ConvaTecVERSIVA 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



507


康威"威吸寶敷料(滅菌)-非自粘性*給付規定請見備註欄。

364



364

WDD0811010F4 CONVATECDUO 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



224


愛康膚-銀手術覆蓋敷料(滅菌)9×25cm

406



459



395



689

WDD0815150GM 卓和創傷敷料(滅菌)"GMTH"WOUND DRESSING(STERILE)15×15CM 116



167



116



116

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 ALCARESI-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 ALCARESI-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

WDD0818754A5 愛樂康矽膠泡棉敷料(滅菌)"ALCARE" SI-AID SILICONE-FACED

DRESSING(STERILE)20X30cm

619

WDD0818755A5 愛樂康矽膠泡棉敷料(滅菌)"ALCARE" SI-AID SILICONE-FACED


880

WDD0819921HL 鶴牌超薄型癒合片(滅菌)"HOLLISTER" RESTORE EXTRA THIN WOUND

CARE DRESSING (STERILE)10X10CM(薄)

53.2

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

977


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

WDD0820627F4 康威愛康膚-銀泡棉敷料"CONVATEC" AQUACEL AG FOAM DRESSING

12.5X12.5CM

317


17.5X17.5CM

559


21X21CM

633

WDD0820633F4 “康威”愛康膚泡棉敷料 (滅菌):非黏性“CONVATEC” AQUACEL


119



243



364



326


5X5CM

55.3


10X10CM

184


15X15CM

368


20X20CM

633

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



119



245

WDD0820674F4 〝康威〞愛康膚強化吸收親水性纖維敷料 (滅菌) 〝CONVATEC〞


143


10X10CM

184


8X8CM

115


15X20CM

559


25X30CM

974

WDD082100SBB B.BRAUNASKINA SORB CALCIUM ALGINATE DRESSING(STERILE)

6CMX6CM雅膚藻酸鈣敷料*適應症請見備註欄

20.4



112



167


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

978




243

WDD083488AYD BCTANTIMICROBIAL DRESSING(STERILE)5CMX5CM"科云"抗菌敷料(滅

菌)*給付規定請見備註欄

56.4

WDD083488BYD BCTANTIMICROBIAL DRESSING(STERILE)10CMX10CM"科云"抗菌敷料(滅


224

WDD083488CYD BCTANTIMICROBIAL DRESSING(STERILE)2.5CMX10CM"科云"抗菌敷料

(滅菌)*給付規定請見備註欄

56.4

WDD083488DYD BCTANTIMICROBIAL DRESSING(STERILE)2.5CMX20CM"科云"抗菌敷料

(滅菌)*給付規定請見備註欄

198

WDD083488EYD BCTANTIMICROBIAL DRESSING(STERILE)5CMX20CM"科云"抗菌敷料(滅


224

WDD083488FYD BCTANTIMICROBIAL DRESSING(STERILE)20CMX20CM"科云"抗菌敷料(滅


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 COLOPLASTCOMFEEL 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


WDD0835421CA COLOPLASTCOMFEEL 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


WDD0835481CA COLOPLASTCOMFEEL 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


料(滅菌) 15X15CM

245

WDD083736AYD BCTCALCIUM ALGINATE DRESSING(STERILE) 10CMX10CM"科云"藻酸鈣

敷料(滅菌)*給付規定請見備註欄

112


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

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 10x10cm

184




460




368



FOAM DRESSING 10x30 cm

559

WDD0840001BB 博坦舒傷口凝膠"B.BRAUN"PRONTOSAN WOUND GEL 30ML 550

WDD0841010BB B.BRAUNASKINA FOAM WOUND DRESSING(STERILE)10CMX10CM雅膚泡棉

敷料*適應症請見備註欄

119

WDD0841210BB B.BRAUNASKINA FOAM WOUND DRESSING(STERILE)0CMX20CM雅膚泡棉敷

料*適應症請見備註欄

245

979


WDD0842005BB B.BRAUNASKINA 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



406



224

WDD0860924P8 TENDERWET 10X10CM※適應症請見備註欄 119

WDD0862110BB B.BRAUNASKINA 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.BRAUNASKINA CALGITROL AG雅膚凱奇樂藻酸銀敷料15CMX15CM*適應

症請見備註欄

406

WDD0862120BB B.BRAUNASKINA CALGITROL AG"柏朗"雅膚凱奇樂藻酸銀敷料

20CMX20CM*適應症請見備註欄

612

WDD0862415BB 柏朗舒膚朗凱奇樂藻酸銀軟膏"B.BRAUN"ASKINA CALGITRO PASTE

15GM

280

WDD0868212F4 ConvaTecKALTOSTAT 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 ConvaTecKALTOSTAT 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 ConvaTecKALTOSTAT 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.BRAUNASKINA HYDRO 10CMX10CM雅膚親水膠敷料*適應症請見備註欄 119



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.BRAUNASKINA TRANSORBENT "柏朗"雅膚多聚泡棉敷料10X10CM ※適


119

WDD0872790BB B.BRAUNASKINA TRANSORBENT"柏朗雅膚多聚泡綿敷料" 15X15CM ※適


245

WDD0872791BB ASKINA TRANSORBENT 20X20CM 柏朗雅膚多聚泡綿敷料※適應症請見

備註欄

395

WDD087335CSN 史耐輝愛力膚親水性敷料(滅菌)"SMITH＆NEPHEW"ALLEVYN NON-

ADHESIVE DRESSING (STERILE) 10X20CM

225



119



364

WDD0877901F4 ConvaTecAQUACEL 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 ConvaTecAQUACEL 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

980


WDD0877903F4 ConvaTecAQUACEL 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 MOLNLYCKEMEPILEX 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 CONVATECDUODERM 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

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*


116

WDD08900283M 3M TEGASORB THIN HYDROCOLLOID DRESSING 20CMX20CM親水性敷料*


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


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



119



245



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

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




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

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 MOLNLYCKEMEPILEX 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


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

981



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

WDD0899571HN HARTMANNATRAUMAN AG SILVER DRESSING(10X10CM)含銀軟膏膚料*適

應證請見備註欄

224

WDD0899572HN HARTMANNATRAUMAN AG SILVER DRESSING(10X20CM)含銀軟膏膚料*適

應證請見備註欄

406

WDD0899581P8 HARTMANNHYDROPHILIC WOUND DRESSING(THIN)(STERILE)HYDROTUL

5X5CM親水性創傷覆蓋材*適應症請見備註欄

26

WDD0899583P8 HARTMANNHYDROPHILIC WOUND DRESSING(THIN)(STERILE)HYDROTUL

10X12CM親水性創傷覆蓋材*適應症請見備註欄

53.2

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&NEPHEWALGISITE M CALCIUM ALGINATE DRESSING"史耐輝"海藻

酸鈣敷料10X10CM*適應症請見備註欄

112



177



41.8

WDD08A1111QY SYSTAGENIXACTISORB 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


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


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 SAVDERMBIOCELLULOSE FILM (6CMX6CM)"舒膚貼"生物合成纖維膜*適


108

WDD08B0211ZW SAVDERMBIOCELLULOSE FILM (10CMX8CM) "舒膚貼"生物合成纖維膜 *


275

WDD08B0308ZW SAVDERMBIOCELLULOSE FILM (16CMX10CM)"舒膚貼" 生物合成纖維膜


438

WDD08B0409ZW SAVDERMBIOCELLULOSE FILM (21CMX16CM)"舒膚貼"生物合成纖維膜*


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

WDD08C0501ZW 舒膚貼抗菌親水性敷料(滅菌)SAVDERM ANTISEPTIC HYDROCOLLOIDS

THIN DRESSING (STERILE)5×5cm

56.4


THIN DRESSING (STERILE)10CMX10CM*給付規定請見備註欄

224

WDD08C0506SN SMITH&NEPHEWCUTINOVA HYDRO DRESSING新世代人工皮膚5CMX6CM*適


29.3


THIN DRESSING (STERILE) 5.5×8.5CM

56.4


THIN DRESSING (STERILE)5X20cm

224

982



DRESSING (STERILE)5x5cm

56.4



224



612



406

WDD08C1010QA SIFOTEC HYDROCOLLOID DRESSING (STERILE) "和豐"親水性敷料 (滅

菌) 10CMX10CM

53.2

WDD08C1010SN SMITH&NEPHEWCUTINOVA HYDRO DRESSING 10X10CM*適應症請見備註欄 119


DRESSING (STERILE)5.5x8.5cm

56.4



224


DRESSING (STERILE)5X5CM(厚)

56.4



224


DRESSING (STERILE)5.5X8.5CM(厚)

56.4



224



406



612

WDD08C1515QA SIFOTEC HYDROCOLLOID DRESSING (STERILE) "和豐"親水性敷料 (滅

菌) 15CMX15CM

116

WDD08C1520SN SMITH&NEPHEWCUTINOVA HYDRO DRESSING 15X20CM*適應症請見備註欄 327

WDD08D0245SN SMITH&NEPHEWDURAFIBER 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



定請見備註欄

73



定請見備註欄

83.8



定請見備註欄

143



定請見備註欄

29.3


DRESSING(STERILE)10CMX10CM"史耐輝"愛爾膚纖維敷料(滅菌)*給付


119


DRESSING(STERILE)15CMX15CM"史耐輝"愛爾膚纖維敷料(滅菌)*給付


245

983


WDD08E1405K6 EUROMEDSURESKIN 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




395




245


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




395

WDD08E2412K6 EUROMEDSURESKIN 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




245

WDD08E2432K6 EUROMEDSURESKIN 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


DRESSING(STERILE)(THIN)10X10CM"優而美"舒肌親水性傷口敷料*適


53.2


DRESSING(STERILE)(THIN)15X15CM"優而美"舒肌親水性傷口敷料*適


116


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

WDD08F0101ZW 舒膚貼泡棉敷料 (滅菌)"SAVDERM"FOAM DRESSING (STERILE)5×5CM 29.3

WDD08F0102ZW SAVDERMFOAM DRESSING (STERILE)10X10CM泡棉敷料*適應症請見備註

欄

119

WDD08F0103ZW 舒膚貼泡棉敷料 (滅菌)"SAVDERM"FOAM DRESSING (STERILE)10×20CM 225

WDD08F0104ZW 舒膚貼泡棉敷料 (滅菌)"SAVDERM"FOAM DRESSING (STERILE)20×20CM 364

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

WDD08H0106ZW 舒膚貼親水性敷料 (滅菌)SAVDERM HYDROCOLLOIDS THIN DRESSING

(STERILE)15×15CM

116


(STERILE)5×20CM

53.2


(STERILE)10×10CM

53.2


(STERILE)20X20cm

192

984



(STERILE)10X10cm(厚)

119

WDD08HC0802H 赫麗敷超薄型親水性敷料(滅菌)HERADERM HYDROCOLLOID THIN

DRESSING (STERILE)10X10CM

53.2

WDD08HD0802H 赫麗敷親水性敷料(滅菌)HERADERM HYDROCOLLOID DRESSING

(STERILE)10X10CM

119

WDD08HDGE12H 赫麗敷清創凝膠(滅菌) HERADERM GEL (STERILE)40GM 276

WDD08NG415QY SYSTAGENIXNU-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 SYSTAGENIXNU-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 SYSTAGENIXTIELLE 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 INCSURESKIN 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




612




406

WDD08T0709QY SYSTAGENIXTIELLE 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 POWERHYDROPHILIC 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



註。

143



註。

245



註。

327

WDD08T2020RW TEAM POWERHYDROPHILIC WOUND DRESSING (STERILE) 親水性創傷敷

料(滅菌)20X20CM*(薄型)*適應症請見備註欄

192

WDD08X1111QY SYSTAGENIXTIELLE 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 SYSTAGENIXTIELLE 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

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15X20CM

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

985


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

986

附件三 特殊材料給付品項暨支付標準表™„件三_特殊... · 37.1 bbp0100774f4...

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附件三特殊材料給付品項暨支付標準表™„件三_特殊... · 37.1 bbp0100774f4...