CGS01KCFN2CK CGS01KCFN3CK CGS01KCFN4CK CHT01HL106H9 CKD05T3114BQ CKD05T3125BQ CKD05U3214BQ CKD05U3225BQ CKDD C CKDD214554NL CKDD C CKN01RL

Transcription

1 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 -102/01 ACS01VP004LL "LILY"3 WAY STOPCOCK" 怡安 " 輸液三通閥 7.8 ACY01NYC11GJ "JSM"Y CONNECTOR KIT W/INSERTION TOOL+TORQUE DEVICE" 吉 1065 生 "Y 型連接器組 ( 含導引支撐器 + 扭力控制器 ) BBU CA "COLOPLAST"SENSURA OSTOMY POUCH AND ACCESSORIES(NON- 91 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 CBC SB "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 CBC02ZFV61CK "COOK"ZILVER FLEX 35 VASCULAR STENTS(ILIAC ARTERY)8:10MM :140MM" 曲克 " 麗而服福雷斯血管支架 ( 腸骨血管支架 )* 給付規定請見備註欄 CBC05TX201CK "COOK"ZENITH TX2 DISSECTION ENDOVAS GRAFT W PTO FORM+INTRO SYS" 曲克 " 蘭尼思胸主動脈瘤支架 * 整組費用, 含門急診及當次住院置放支架 * 給付規定見備註 CBP SB "BOSTON SCIENTIFIC"OMEGA MONORAIL PTCR CORONARY STENT SYSTEM" 波士頓科技 " 亞美加單軌冠狀動脈支架系統 * 給付規定請見備註欄 CBP06ELUT5M4 "MEDTRONIC"RESOLUTE INTEGRITY ZOTAROLIMUS-ELUTING CORONARY STENT SYS" 美敦力 " 釋放型冠狀動脈支架 * 部分給付, 給付規定見備註, 並註明禁忌症勿用 CCC1400CSEHA " 漢尼帝克 " 依利特自體輸血系統管套 "HAEMONETICS" CELL SAVER 7307 ELITE SYSTEM DISPOSABLE SET-70,125,225ML BOWL * 給付規定請見備註欄 CDP01GPL00KQ 優式 導入 / 引流導管及其附件 ( 滅菌 ) URESIL INTRODUCTION/DRAINAGE CATHETER AND ACCESSORIES (STERILE) 1720 CDP01RLC38MR "MERIT"RESOLVE DRAINAGE CATHETERS(ONE STEP 含引流管及穿刺 1720 針組 )(STERILE)" 美瑞特 " 通用引流管 ( 滅菌 ) CFE02MBL01CK "COOK"4,6,10 SHOOTER SAEED MULTI-BAND LIGATOR " 曲克 " 多發 4000 型結紮器 給付規定請見備註欄 CFE02MBL02CK "COOK"SAEED MULTI-BAND LIGATOR(NON-STERILE)4;6;10 " 曲克 " 4000 結紮器 ( 未滅菌 ) 給付規定請見備註欄 CGDW17900JVQ "VOLCANO"PRIMEWIRE PRESSURE GUIDE WIRE" 火山 " 壓力偵測導線 給付規定請見備註欄 CGDW18185JVQ "VOLCANO"PRIMEWIRE PRESTIGE PRESSURE GUIDE WIRE" 火山 " 壓力 偵測導線 給付規定請見備註欄 CGPG1SC014Y7 " 伊維三 " 崔爾巴特支持導管 "EV3"TRAILBLAZER SUPPORT CATHETER 8715 CGPG385900VQ CGPG38590PVQ CGPG389000VQ CGS01ACUBASB CGS01KCFN1CK "VOLCANO"EAGLE EYE F/X 2.9F INTRAVASCULAR ULTRASOUND IMAGING CATHETER" 火山 " 血管內超音波影像導管 ( 彩色 ) 給付規定請見備註欄 "VOLCANO"EAGLE EYE PLATINUM DIGITAL IVUS CATHETER" 火山 " 數位式血管內超音波影像導管 ( 彩色 ) 給付規定請見備註欄 "VOLCANO"REVOLUTION ROTATIONAL IVUS IMAGING CATHETER" 火山 " 血管內超音波影像導管 給付規定請見備註欄 " 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) " 曲克 " 福來瑟橈動脈導入鞘組 "COOK"FLEXOR RADIAL INTRODUCER SHEATH SET 0.018" 5~7FR 7;13CM

2 CGS01KCFN2CK CGS01KCFN3CK CGS01KCFN4CK CHT01HL106H9 CKD05T3114BQ CKD05T3125BQ CKD05U3214BQ CKD05U3225BQ CKDD C CKDD214554NL CKDD C CKN01RLCTRMR CKUB2UNB01CK CKUB2UNB02CK CLPA119S20M0 CLPA12023A2C CLS04C1BESLL CLS04C1BSSLL CLS KG CLS KG CLS KG " 曲克 " 福來瑟橈動脈導入鞘組 "COOK"FLEXOR RADIAL INTRODUCER SHEATH SET 0.018" 5~7FR 23CM " 曲克 " 引導器 "COOK"FLEXOR INTRODUCER-FLEXOR CHECK FLO MICROPUNCTURE INTRODUCER SETS 0.018" 6~7FR 7;13CM " 曲克 " 引導器 "COOK"FLEXOR INTRODUCER-FLEXOR CHECK FLO MICROPUNCTURE INTRODUCER SETS 0.018" 6~7FR 23CM " 華億 " 體外循環管組 "HYM" HEART LUNGPACK( 含 ORGANIZER+PRE- BYPASS FILTER+SUCKER*2) "BIOTEQ"URETERAL STENT SET(W HYDROPHILIC)(LONG-TERM TYPE)(+PUSHER+CLAMP)" 邦特 " 輸尿管導管組 "BIOTEQ"URETERAL STENT SET(W HYDROPHILIC)(LONG-TERM TYPE)(+PUSHER+CLAMP)" 邦特 " 輸尿管導管組 "BIOTEQ"URETERAL STENT SET(W HYDROPHILIC)(LONG-TERM TYPE)(+PUSHER+CLAMP)" 邦特 " 輸尿管導管組 "BIOTEQ"URETERAL STENT SET(W HYDROPHILIC)(LONG-TERM TYPE)(+PUSHER+CLAMP)" 邦特 " 輸尿管導管組 "COVIDIEN"KENDALL ACUTE HEMODIALYSIS CATHETERS(DUAL LUMEN) KIT(C+N+G+D)" 柯惠 " 肯特利急性血液透析導管 "NAVILYST"VAXCEL PLUS CHRONIC DIALYSIS CATHETERS KIT(CATHETER+INTRODUCER KIT)" 娜維利斯特 " 斐克希長期透析用導管 "COVIDIEN"KENDALL PALINDROME CATHETER KIT AND SPORTPACK(CATH+INTRODUCER KIT)" 柯惠 " 肯特利沛霖卓導管組 ( 永植型 ) "MERIT"RESOLVE LOCKING DRAINAGE CATHETERS(HYDROPHILIC) SET( 引流管 +NX2+G+D+ 引流管袋 )(STERILE)" 美瑞特 " 通用引流管 ( 滅菌 ) "COOK"ULTRAXX NEPHROSTOMY BALLOON AND SETS(WITH SHEATH)" 曲克 " 奧創腎造口術氣球套組 "COOK"ULTRAXX NEPHROSTOMY BALLOON AND SETS(WITH SHEATH)" 曲克 " 腎造口術氣球套組 "MEDCOMP"VASCU-PICC PERIPHERALLY INSERTED CENTRAL VEIN ACCESS CATHETER(1 LUMEN)(C+N+G+D)" 美德康 " 週邊置入中央靜脈導管組 * 給付規定請見備註欄 " 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 "LILY"VOLUME METRIC ADMINISTRATION SET WITH VALVE 120ML 150ML" 怡安 " 精密輸液套 "LILY"VOLUME METRIC ADMINISTRATION SET WITH VALVE-NEEDLE FREE 120ML 150ML" 怡安 " 精密輸液套 - 免針式安全型 * 給付規定請見備註欄 "KABI"VOLUMAT LINE INFUSION SETS- STANDARD PUMP SET FOR INFUSION " 卡比 " 路美輸液組合套 - 一般幫浦輸液套 * 給付規定請見備註欄 "KABI"VOLUMAT LINE INFUSION SETS- PUMP DUAL SET FOR TRANSFUSION AND INFUSION " 卡比 " 路美輸液組合套 - 幫浦用 Y 型輸血套 "KABI"VOLUMAT LINE INFUSION SETS- PVC-FREE SET FOR INFUSION OF NTG AND DRUGS INCOMPATIBLE WITH PVC " 卡比 " 路美輸液組合套 -NTG 幫浦輸液套

3 CLS KG "KABI"VOLUMAT LINE INFUSION SETS- PVC-FREE PUMP SET FOR INFUSION OF LIGHT SENSITIVE DRUGS " 卡比 " 路美輸液組合套 - 幫浦用避光輸液套 CLS KG "KABI"VOLUMAT LINE INFUSION SETS- INFUSION PUMP SET WITH 150ML GRADUATED BURETTE " 卡比 " 路美輸液組合套 - 幫浦用精密輸液套 * 給付規定請見備註欄 CMV01HEADWMS "MICROVENTION"HEADWAY MICROCATHETER( 導管 + 止血閥 + 導引器 )" 麥新 " 前進微導管 * 給付規定請見備註欄 CMV04PC400UF "PENUMBRA"PENUMBRA COIL SYSTEM" 彼娜波 " 栓塞環系統 * 給付規定請見備註欄 CPC02CV782BS "BIOSENSORS"CENTRAL VENOUS CATHETER KIT 2LUMEN(CATH+NEEDLE+DILATOR+GUIDEWIRE+SYRINGE)" 拜爾生 " 中央靜脈導管組 CPC03CV783BS "BIOSENSORS"CENTRAL VENOUS CATHETER KIT 3LUMEN(CATH+NEEDLE+DILATOR+GUIDEWIRE+SYRINGE)" 拜爾生 " 中央靜脈導管組 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 CRT C " 柯惠 " 麥林可恰可舒氣切管 "COVIDIEN" MALLINCKRODT TRACHESOFT TRACHEOSTOMY CANNULAE CXE BA 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) CXE BA 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) CXE BA 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) CXE BA 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) FALSMAAB00A2 "AMO"SENSAR I-PIECE ACRYLIC IOL" 眼力健 " 勝視明單片型摺疊式人工水晶體 FALSMHBEC21E "AAREN"SINGLE-PIECE HYDROPHOBIC ACRYLIC POSTERIOR CHAMBAR IOL W/U.V ABS0RBER" 愛銳 " 單片型抗紫外線疏水性丙烯酸脂後房人工水晶體 FALSNMULTTA1 ACRYSOF IQ RESTOR MULITFOCAL TORIC IOL" 愛爾康 " 可舒視爾特智慧型非球面多焦點散光矯正單片軟式人工水晶體 ( 可過濾部分藍光 ) 部分給付項目 FALSNWAVE21E "AAREN"SINGLE-PIECE HYDROPHILIC ACRYLIC POSTERIOR CHAMBER IOL W/U.V ABSORBER(ASPHERIC)" 愛銳 " 單片型抗紫外線人工水晶體 ( 非球面 ), 部分給付項目 FBSF3XPDHTDP "DEPUY SPINE"EXPEDIUM SPINE SYSTEM:HOOK " 帝富脊椎 " 易配置脊椎系統 : 固定鉤 給付規定請見備註欄 FBSFARD1SNZ1 "ZIMMER"SPINE ARDIS INTERBODY SYSTEM(PEEK)" 捷邁 " 亞帝斯脊椎椎間穩定系統 ( 側開型每節椎體限置放 1 個 ) 給付規定請見備註欄 FBSFASN00PAE "AESCULAP"PROSPACE PEEK" 雅氏 " 博斯貝椎融間融合植入物 給付規定請見備註欄 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 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

4 FHPCL6947MM4 FHPHF368BPBK FHPL11646UST FHPL11888UST FHPL19288UST FPP Y2 FPP074202HY2 FPP Y2 FPS01291BSY2 FPS01301BSY2 FPS01311STY2 FSAE1TBRXXWH FSP ET FSP ET FSP ET FSP62P3DPAET HHF01H4R70KW HHF02H4RBCKW HHM01466F2CD HHM01S5030VS LEE011210H2C LEE011410Z2C LEE012255R2C LEE012266P2C 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 拜耳德尼克 可洛植入式雙極心導線 BIOTRONIK COROX OTW-L BP IMPLANTABLE CORONARY SINUS LEAD* 給付規定請見備註欄 聖猷達 心臟節律器導線 SJM ISOFLEX S LEAD* 需檢附心電圖報告專案報備使用 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 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 "SYNTEC"TITANIUM MESH PLATE" 亞太醫療 " 鈦合金網眼骨板 給付規定請見備註欄 "SYNTEC"TITANIUM MESH PLATE:STRAIGHT 2HOLE " 亞太醫療 " 鈦合金網眼骨板 : 直型骨板 給付規定請見備註欄 "SYNTEC"TITANIUM MESH PLATE" 亞太醫療 " 鈦合金網眼骨板 給付規定請見備註欄 "SYNTEC"TITANIUM MESH PLATE:SCREW " 亞太醫療 " 鈦合金網眼骨板 : 骨釘 給付規定請見備註欄 "SYNTEC"TITANIUM MESH PLATE:SCREW " 亞太醫療 " 鈦合金網眼骨板 : 骨釘 給付規定請見備註欄 "SYNTEC"TITANIUM MESH PLATE:SCREW " 亞太醫療 " 鈦合金網眼骨板 : 骨釘 給付規定請見備註欄 "TAEWOONG"NITI-S TRACHEOBRONCHIAL STENT" 泰悟 " 氣管支氣管支架 ( 含支架系統 )* 給付規定請見備註欄 "ETHICON"PROLENE POLYPROPYLENE MESH" 愛惜康 " 伯羅林不可吸收網 6X11CM "ETHICON"PROLENE POLYPROPYLENE MESH" 愛惜康 " 伯羅林不可吸收網 15CMX15CM "ETHICON"PROLENE POLYPROPYLENE MESH" 愛惜康 " 伯羅林不可吸收網 30CMX30CM "ETHICON"PROLENE(POLYPROPYLENE)3D PATCH" 愛惜康 " 伯羅倫 3D 修補網 芬沃 白血球過濾器 FENWAL SEPACELL PLATELET AND PLASMA COLLECTOR* 給付規定請見備註欄 芬沃 白血球過濾器 FENWAL SEPACELL LEUKOCYTE REDUCTION SET(1UNIT RED BLOOD CELL)* 給付規定請見備註欄 考迪斯 歐特易可回收血栓過濾網 CORDIS OPTEASE RETRIEVABLE VENA CAVA FILTER 法斯樂舒順 普倫特秀血栓清除導管 VASCULAR SOLUTIONS PRONTO-SHORT EXTRACTION CATHETER* 給付規定請見備註欄 " 柯惠 " 羅勒電極貼片 "COVIDIEN" LUDLOW MEDI-TRACE DEFIBRILLATION ELECTRODES " 柯惠 " 羅勒電極貼片 "COVIDIEN" LUDLOW MEDI-TRACE DEFIBRILLATION ELECTRODES " 柯惠 " 肯特利柯登斯去顫器電極貼片 "COVIDIEN" KENDALL MEDI- TRACE CADENCE ELECTRODES " 柯惠 " 肯特利柯登斯去顫器電極貼片 "COVIDIEN" KENDALL MEDI- TRACE CADENCE ELECTRODES ( 小兒用 )

5 LEE0160BWQJE 宜喜美 暫時性節律導線 - 四極 ECM TEMPORARY PACING WIRES-QUADOPOLAR NAN011430NBB "B.BRAUN"STERICAN SINGLE USE HYPODERMIC NEEDLE " 必勃朗 " 注射針 NBS07ZY3202M "IMAXEON"SALIENT SYRINGE KIT W/QUICK FILL TUBE" 愛美聖 " 注射筒套組 ( 含填充管 1 支 ) NBS07ZY3212M "IMAXEON"SALIENT SYRINGE KIT W/SPIKE" 愛美聖 " 注射筒套組 ( 含刺針 ) RRB TX 泰利福 誘發性肺量計 TELEFLEX INCENTIVE SPIROMETERS- TRIFLO* 給付規定請見備註欄 RRB TX 泰利福 誘發性肺量計 TELEFLEX INCENTIVE SPIROMETERS- VOLDYNE5000* 給付規定請見備註欄 RRB TX 泰利福 誘發性肺量計 TELEFLEX INCENTIVE SPIROMETERS- VOLDYNE2500* 給付規定請見備註欄 TKF01B5X20B9 "BAUSCH&LOMB"STELLARIS PC PROCEDURAL PACKS & ACCESSORIES:ILLUMINATION PROBE" 博士倫 " 曙光進階超音波乳化系統手術包及其配件 : 光纖導管 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 TSS G8 測利得血糖檢測系統 - 測利得血糖試片 BLOOD GLUCOSE TEST STRIP(25 50 片 / 盒, 片 / 單片包 )* 使用規定見備註 TSS QG 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 片 / 盒, 袋裝單片 10* 給付規定見備註 TSS G8 好贊血糖檢測系統 - 好贊血糖試片 BLOOD GLUCOSE TEST STRIP(25 50 片 / 盒, 片 / 單片包 )* 使用規定見備註 TSS BB 柏朗 貝優血糖測試系統 - 血糖試紙 B. BRAUN OMNITEST 3 GLUCOSE MONITORING SYSTEM-BLOOD GLUCOSE TEST STRIPS(25 片 / 罐 ) 給付規定請見備註欄 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 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 TSS01SELECFZ 穩擇血糖試紙 ONETOUCH SELECT TEST STRIPS(25 片 / 瓶,50 片 /2 瓶 )* 給付規定請見備註欄 WDD SN "SMITH&NEPHEW"REPLICARE ULTRA HYDROCOLLOID WOUND DRESSING(STERILE)10CMX10CM" 史耐輝 " 力普佳敷料 ( 滅菌 )* 給付規定請見備註欄 WDD SN "SMITH&NEPHEW"REPLICARE ULTRA HYDROCOLLOID WOUND DRESSING(STERILE)15CMX15CM" 史耐輝 " 力普佳敷料 ( 滅菌 )* 給付規定請見備註欄 WDD SN "SMITH&NEPHEW"REPLICARE ULTRA HYDROCOLLOID WOUND DRESSING(STERILE)20CMX20CM" 史耐輝 " 力普佳敷料 ( 滅菌 )* 給付規定請見備註欄 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

6 WDD081010AVH WDD081520AVH WDD083488AYD WDD083488BYD WDD08C1010QA WDD08C1515QA CBC TM CBC TM CBC03AAA02CK CBC03AAA02M4 CBC03AAA04CK CBC03AAA04M4 CBC03LEZT1CK CBC03PA23NGX CBC03PC12NGX CBC03PL10NGX CBC03RX101CK CBC03ZSLE1CK CBC04EX06CAN "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 "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 "BCT"ANTIMICROBIAL DRESSING(STERILE)5CMX5CM" 科云 " 抗菌敷料 ( 滅菌 )* 給付規定請見備註欄 "BCT"ANTIMICROBIAL DRESSING(STERILE)10CMX10CM" 科云 " 抗菌敷料 ( 滅菌 )* 給付規定請見備註欄 SIFOTEC HYDROCOLLOID DRESSING (STERILE) " 和豐 " 親水性敷料 ( 滅菌 ) 10CMX10CM SIFOTEC HYDROCOLLOID DRESSING (STERILE) " 和豐 " 親水性敷料 ( 滅菌 ) 15CMX15CM "TERUMO"ANACONDA AAA STENT GRAFT SYSTEM -AORTIC CUFF 腹主動脈人工血管支架系統 - 輔助配件 * 適應症請見備註欄 "TERUMO"ANACONDA AAA STENT GRAFT SYSTEM-ILIAC LEGS 安康達腹主動脈人工血管支架系統 - 輔助配件 * 適應症請見備註欄 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 "MEDTRONIC"TALENT AAA STENT GRAFT W THE XCELERANT HYDRO DELIVERY SYS(AORTIC,ILIAC EXT) 腹主動脈支架系統 ( 主動脈, 髂動脈延長段 )* 適應症見備註 "COOK"ZENITH AAA ENDOVASCULAR GRAFT W/H&L-B ONE-SHOT INTRO SYS 腹主動脈瘤支架暨輸送導引系統 - 輔助配件 * 適應症見備註 "MEDTRONIC"ENDURANT STENT GRAFT SYSTEM" 美敦力 " 茵德倫覆膜支架系統 ( 輔助配件 - 主動脈. 髂動脈延長段 )* 適應症請見備註欄 "COOK"ZENITH FLEX AAA ENDOVASCULAR GRAFT W Z-TRAK INTRO SYS" 曲克 " 蘭尼斯腹主動脈瘤支架暨輸送導引系統 - 輔助配件 ( 髂動脈延長段 )* 適應症見備註欄 "GORE"EXCLUDER AAA ENDOPROSTHESIS- AORTIC EXTENDER 易時固得腹主動脈瘤支架 ( 腹主動脈瘤主體延伸支架 )* 適應症請見備註欄 "GORE"EXCLUDER AAA ENDOPROSTHESIS(CONTRALATERAL LEG ENDOPROSTHESIS) 腹主動脈瘤支架輔助系統 ( 腹主動脈瘤對側腳支架 )* 適應症請見備註欄 "GORE"EXCLUDER AAA ENDOPROSTHESIS(ILIAC EXTENDER ENDOPROSTHESIS) 腹主動脈瘤支架輔助系統 ( 髂動脈分支延伸體 )* 適應症請見備註欄 "COOK"ZENITH RENU AAA ANCILLARY GRAFT WITH H&L-B ONE-SHOT INTRODUCTION SYS 腹主動脈瘤支架暨輸送導引系統 - 輔助配件 ( 延伸主體 )* 適應症請見備註欄 "COOK"ZENITH SPIRAL-Z AAA ILIAC LEG W/THE Z-TRAK INTRODUCTION SYS 腹主動脈瘤支架暨輸送系統 - 輔助配件 * 給付規定見備註 "ANGIOMED"BARD LIFESTENT VASCULAR STENT(DELIVERY SYS+STENT)" 安吉美爾德 " 巴德萊弗丹血管支架, 支架長 20:120MM* 適應症請見備註欄

7 CBC04EX12LAN CBC04EX15CAN CBC04EX20LAN CBC04MAR1SF2 CBC04PR120EY CBC04PR150EY CBC04SC210CD CBC04SN120CD CBC04SN150CD CBC04ZFV61CK "ANGIOMED"BARD LIFESTENT VASCULAR STENT(DELIVERY SYS+STENT)" 安吉美爾德 " 巴德萊弗丹血管支架, 支架長 20:120MM* 適應症請見備註欄 "ANGIOMED"BARD LIFESTENT VASCULAR STENT(DELIVERY SYS+STENT)" 安吉美爾德 " 巴德萊弗丹血管支架, 支架長 150:170MM* 適應症請見備註欄 "ANGIOMED"BARD LIFESTENT VASCULAR STENT(DELIVERY SYS+STENT)" 安吉美爾德 " 巴德萊弗丹血管支架, 支架長 150:200MM* 給付規定請見備註欄 "INVATEC"MARIS PERIPHERAL SELF-EXPANDING STENT SYSTEM" 英泰克 " 瑪瑞斯自膨式周邊血管支架系統 ( 淺股動脈血管支架 )L20:120MM D6:12MM* 適應症請見備註 "EV3"PROTEGE EVERFLEX SELF-EXPANDING BILIARY STENT SYS 20:120MM 5:8MM 波特捷自動擴張式膽道支架系統 - 淺股動脈 * 適應症請見備註欄 "EV3"PROTEGE EVERFLEX SELF-EXPANDING BILIARY STENT SYS 150MM 6:8MM 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 "CORDIS"S.M.A.R.T.CONTROL NITINOL STENT SYSTEM" 考迪斯 " 史瑪特鎳鈦支架系統 ( 淺股動脈血管支架 )20:100MM 6:10MM* 適應症請見備註欄 "CORDIS"S.M.A.R.T.NITINOL STENT SYSTEM" 考迪斯 " 史瑪特鎳鈦支架系統 ( 淺股動脈血管支架 )D 6:8MM L 120MM* 給付規定請見備註欄 "CORDIS"S.M.A.R.T.NITINOL STENT SYSTEM" 考迪斯 " 史瑪特鎳鈦支架系統 ( 淺股動脈血管支架 )D 6:8MM L 150MM* 給付規定請見備註欄 "COOK"ZILVER FLEX 35 VASCULAR STENTS" 曲克 " 麗而服福雷斯血管支架 ( 淺股動脈血管支架 )20:140MM 5:10MM* 適應症請見備註欄 CBC04ZFV62CK "COOK"ZILVER FLEX 35 VASCULAR STENTS" 曲克 " 麗而服福雷斯血管支架 ( 淺股動脈血管支架 )170:200MM 5-8MM CDCG20RCA1RC "RANFAC"INTRODUCTION DRAINAGE CATHETER" 仁斐 " 導入及引流導管 ( 術中膽管攝影導管 ) CDPN1UTPT1CK "COOK"WAYNE PNEUMOTHORAX SET( 含單向引流閥 + 豬尾導管 導線 + 擴張器 +3WAY+ 連接管 + 穿刺針 *2)" 曲克 " 威恩氣胸引流組 CFD04NJFT1CK "COOK"NASAL JEJUNAL FEEDING TUBE( 含導線 餵食管 鼻引導管 餵食管接頭 )" 曲克 " 經鼻腔空腸餵食管 適應症請見備註欄 1689 CFD BA "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 CFD BA "BARD"PONSKY PULL PEG DELUXE KIT (TUBE+WIRE+S+N+ADAP+BOL+SNARE+SCISSOR)" 巴德 " 經皮內視鏡胃造口組 ( 全套 ) 適應症請見備註欄 CFD BA "BARD"PONSKY PULL PEG KIT (TUBE+WIRE+S+N+ADAP+BOL)" 巴德 " 經皮內視鏡胃造口組 ( 半套 ) 適應症請見備註欄 CFD060640NK4 "KIMBERLY-CLARK"PEG KIT(TUBE+SNARE+ADAPTER+RING+NEEDLE+WIRE+CLAMP) 金百利克拉克 經皮內視鏡胃造廔組 ( 全套 ) 適應症請見備註欄

8 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 CFD060644NK4 "KIMBERLY-CLARK"PEG KIT(TUBE+ADAPTER+RING+NEEDLE+WIRE+CLAMP) 金百利克拉克 經皮內視鏡胃造廔組 ( 半套 ) 適應症請見備註欄 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 CFD0612LVNK4 "KIMBERLY-CLARK"GASTROSTOMY TUBE(SILICONE BALLOON TYPE) 金百利克拉克 胃造廔管 適應症請見備註欄 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 CFD CU " 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 ) CFD CU " 蔻沛 " 可福樂胃造口管組 "CORPAK"CORFLO GASTROSTOMY TUBE KIT(CORFLO-DUAL GT) 12~24FR CFD CU " 蔻沛 " 可福樂胃造口管組 "CORPAK"CORFLO GASTROSTOMY TUBE KIT(CORFLO-TRIPLE GT) 16~24FR CFD CU " 蔻沛 " 可福樂低板胃造口替換組套 "CORPAK"CORFLO-CUBBY LOW PROFILE GASTROSTOMY DEVICE KIT CFD FL 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 CFD VZ 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 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 CFD06BRT01CK "COOK"GASTROSTOMY DEVICES/ACCESSORIES BALLOON FEEDING TUBE " 曲克 " 胃造口術器材配件 /BALLOON 型替換管 適應症請見備註欄 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 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 CFD06PCK01CK GASTROSTOMY DEVICES/ACCESSORIES PATIENT CARE KIT 護理套組 適應症請見備註欄 CFD06PEG01CK PERCUTANEOUS ENDOSCOPIC GASTROSTOMY SYSTEM 胃造口術裝置組 ( 含 FEEDING TUBE+ 鬱金香形頭 + 藍色導線 +(ADAPTER+ NEEDLE+DILATOR) 適應症請見備註欄 CFD06PEGJ1CK "COOK"GASTROSTOMY DEVICES/ACCESSORIES JEJUNAL FEEDING TUBE " 曲克 " 胃造口術器材配件 / 空腸餵食管 適應症請見備註欄 CGDW10113NAN STAINLESS GUIDE WIRE 0.025~0.035" 125~150CM 311 CGDW10220NAN GUIDE WIRE 80CM:150CM 0.018":0.038" 泌尿科使用 313 CGDW10222NAN STAINLESS PTFE-COATED GUIDE WIRE 0.018~0.038" 80~100CM 277 CGDW10225NAN GUIDE WIRE 200CM:260CM 0.018":0.038"( 型號 0300, ) 437 泌尿科使用 CGDW10227NAN STAINLESS GUIDE WIRE PTFE-COATED 0.018~0.038"125CM

9 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 CGDW10233NAN STAINLESS GUIDE WIRE PTFE-COATED 0.018~0.038" 260~500CM 437 CGDW10252NCD EMERALD GUIDE WIRE FIXED-CORE STRAIGHT TIP 0.025" :0.038" :175CM CGDW10253NCD EMERALD GUIDE WIRE FIXED-CORE STRAIGHT TIP 0.025":0.038" :175CM CGDW10254NCD EMERALD GUIDE WIRE FIXED-CORE STRAIGHT TIP 0.025":0.038" :175CM CGDW102555CD EMERALD GUIDE WIRE FIXED-CORE STRAIGHT TIP 0.035" 260CM 437 CGDW102560CD EMERALD GUIDE WIRE FIXED-CORE STRAIGHT TIP 0.035" 150CM 313 CGDW102561CD EMERALD GUIDE WIRE FIXED-CORE STRAIGHT TIP 0.038" 150CM 313 CGDW102571CD EMRALD GUIDE WIRE MOVABLE-CORE J CURVE 0.035" 150CM 313 CGDW102580CD EMERALD GUIDE WIRE MOVABLE-CORE STRAIGHT TIP 0.038" 150CM 313 CGDW102586CD EMERALD GUIDE WIRE FIXED-CORE J CURVE 0.038" 150CM 313 CGDW102587CD EMERALD GUIDE WIRE FIXED-CORE J CURVE 0.035" 150CM 313 CGDW10430NAN STAINLESS GUIDE WIRE PTFE-COATED 0.018~0.038" 150CM 313 CGDW10541NAN NITINOL GUIDE WIRE 0.021~0.035" 145~200CM 751 CGDW10542NAN NITINOL GUIDE WIRE STIFF SHAFF 0.035" 145CM 779 CGDW10620NMV GUIDE WIRE(0.035" 0.038" 150CM) 313 CGDW108005ST " 聖猷達 " 海卓史蒂爾導引線 "ST.JUDE"HYDROSTEER GUIDEWIRE :0.038" 150CM,180CM( 鎳合金 ) CGDW108011ST " 聖猷達 " 海卓史蒂爾導引線 "ST.JUDE"HYDROSTEER 1359 GUIDEWIRE0.035:0.038" 260CM( 鎳合金 ) CGDW111011PB WORKER GUIDE WIRE 100CM STRAIGHT 277 CGDW111012PB WORKER GUIDE WIRE CM STRAIGHT( 型號 , , 自 92/7/1 生效 ) CGDW111013PB WORKER GUIDE WIRE CM STRAIGHT( 型號 自 /7/1 生效 ) CGDW111051PB WORKER GUIDE WIRE 100CM CURVE 277 CGDW111052PB WORKER GUIDE WIRE CM CURVE( 型號 , 自 /7/1 生效 ) CGDW111053PB WORKER GUIDE WIRE CM CURVE 437 CGDW111080C3 GUIDE WIRE 80CM 277 CGDW111400PB AMPLATZ GUIDE WIRE EXTRA STIFF 0.035" 90CM 779 CGDW111420PB AMPLATZ GUIDE WIRE EXTRA STIFF 0.035" 150CM 779 CGDW112511PB CANALIZER GUIDE WIRE 0.035" 150CM,180CM 751 CGDW112512PB CANALIZER GUIDE WIRE 0.035" 260CM 1359 CGDW112901PB CANALIZER GUIDE WIRE STIFF 0.035" 150CM,180CM 779 CGDW112902PB CANALIZER GUIDE WIRE STIFF 0.035" 260CM 1359 CGDW1145FSBA "BARD"UROLOGICAL CATHETER ACCESSORIES:HYDROGLIDE 313 GUIDEWIRES(STAINLESS STEEL)0.035" 145CM " 巴德 " 泌尿導管附件 : 親水性塗層導線 CGDW135153WT WATSON GUIDE WIRE STAINLESS WITH PTFE 150CM 0.021:0.038" 313 CGDW135225AG GUIDE WIRE 0.021,0.025,0.032" 150CM TF/FC/ST 313 CGDW135231AG GUIDE WIRE 0.035" 150CM STRAIGHT

10 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 CGDW135464AG GUIDE WIRE 0.018" 50CM 277 CGDW135470AG GUIDE WIRE 0.018" 150CM TF/FC/1.5MMJ 313 CGDW135522AG GUIDE WIRE 0.018:0.038" 260CM TF/ST 437 CGDW135523AG GUIDE WIRE 0.018:0.038" 125CM,150CM TF/FC/3MMJ 313 CGDW135541AG GUIDE WIRE 0.021" 50CM 277 CGDW135550AG GUIDE WIRE 0.025" 50CM 277 CGDW135585AG GUIDE WIRE 0.025" 260CM 437 CGDW135703AG GUIDE WIRE 0.035" 200CM EXCHANGE TF/ST 437 CGDW135787AG GUIDE WIRE J-TIP 0.035" 150CM 1.5MM 313 CGDW135817AG GUIDE WIRE 0.038" 200CM TF/3MMJ 437 CGDW135839AG GUIDE WIRE 0.032,0.035,0.038" 260CM TF/3MMJ 437 CGDW135963AG GUIDE WIRE 0.021" 260CM 437 CGDW135964AG GUIDE WIRE 0.018" 260CM 437 CGDW14652NMT AMPLATZ SUPER STIFF GUIDE WIRE 779 CGDW14652NSB " 波士頓科技 " 安普拉茲超硬導線 "BOSTON SCIENTIFIC"AMPLATZ 779 SUPER STIFF GUIDEWIRE 0.035/0.038" 145CM,180CM CGDW14656NSB " 波士頓科技 " 安普拉茲超硬導線 "BOSTON SCIENTIFIC"AMPLATZ 779 SUPER STIFF GUIDEWIRE 0.035/0.038" 75CM CGDW1465AMSB " 波士頓科技 " 安普拉茲超硬導線 "BOSTON SCIENTIFIC"AMPLATZ 923 SUPER STIFF GUIDEWIRE 0.035/0.038"X260CM CGDW149101SB STARTER GUIDE WIRE FIXED CORE STR TIP 3.5CM FIEXIBLE TIP , CM CGDW149110SB STARTER GUIDE WIRE MOVEABLE CORE STR TIP & J-CURVE TIP : CM CGDW149115SB STARTER GUIDE WIRE FIXED CORE J-CURVE 3.5CM FIEXIBLE TIP : CM CGDW14914NSB STARTER GUIDE WIRE NEW BENSON TYPE :180CM 313 CGDW149150SB STARTER GUIDE WIRE NEWTON & NEWTON(LLT)TYPE CM 313 CGDW149155SB STARTER GUIDE WIRE ROSEN HEAVY DUTY TYPE CM 313 CGDW149200LR STARTER GUIDEWIRE 0.018":0.038" 100:180CM( 產品型號含 313 M :81;2501:11) CGDW149200SB STARTER GUIDE WIRE FIXED CORE STR TIP 3.5CM FIEXIBLE TIP :0.032, CM CGDW149201LR STARTER GUIDEWIRE 0.025":0.035" 40CM,80CM 277 CGDW149201SB STARTER GUIDE WIRE FIXED CORE STR TIP 3.5CM FIEXIBLE TIP :0.035,40,80CM CGDW149212SB STARTER GUIDE WIRE FIXED CORE STR TIP 3.5CM FIEXIBLE TIP :0.038, CM CGDW149213LR STARTER GUIDEWIRE 0.035";0.038" 260CM 437 CGDW149213SB STARTER GUIDE WIRE FIXED CORE STR & 3CM J SHAPE 3.5CM 437 FLEXIBLE TIP 0.035, CM CGDW149220SB STARTER GUIDE WIRE DOUBLE END STR TIP& J CURVE TIP CM CGDW149221SB STARTER GUIDE WIRE FIXED CORE J-CURVE 3.5CM FIEXIBLE TIP 0.035, CM

11 CGDW149222SB STARTER GUIDE WIRE FIXED CORE J-CURVE 3.5CM FIEXIBLE TIP ,80CM CGDW149250SB STARTER GUIDE WIRE HEAVY DUTY TYPE CM 313 CGDW15024NCD GUIDE WIRE TEFLON 0.035";0.038" 260CM 437 CGDW15025NCD GUIDE WIRE TEFLON 0.021";0.038" 150CM;175CM 313 CGDW150270CD GUIDE WIRE TEFLON 0.035" 80CM 277 CGDW15027NCD GUIDE WIRE TEFLON 0.035";0.038" 150;180CM 313 CGDW15027XCD GUIDE WIRE TEFLON 0.035";0.038" 260CM 437 CGDW15410NAN NITINOL GUIDE WIRE 0.021~0.035" 220~400CM 1359 CGDW163541CK "COOK"URETERAL WIRE GUIDES " 曲克 " 輸尿管導線 145CM ;0.038 CGDW163845CK AMPLATZ STIFF WIRE GUIDE 145cm 779 CGDW172600PB NITINOL GUIDE WIRE 0.018" 80CM 653 CGDW1A2131BQ BIOTEQ URETERAL STENT SET DOUBLE J TYPE:GUIDE WIRE ":0.038" 120CM;150CM 邦特輸尿管導管組 ( 雙 J 型 ): 引導鋼線 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 CGDW1AES01CK "COOK"AMPLATZ EXTRA STIFF FIXED CORE WIRE GUIDE (PTFE 779 CODE)" 曲克 " 安培茲硬導線 0.025";0.035";0.038" 145CM CGDW1ANG11M4 " 美敦力 " 血管診斷攝影用導線 "MEDTRONIC"ANGIOGRAPHIC 313 GUIDEWIRES 0.025~0.038" 120~145CM PTFE CGDW1ANG12M4 " 美敦力 " 血管診斷攝影用導線 "MEDTRONIC"ANGIOGRAPHIC 313 GUIDEWIRES 0.025~0.038" 145~175CM PTFE CGDW1ANG13M4 " 美敦力 " 血管診斷攝影用導線 "MEDTRONIC"ANGIOGRAPHIC 923 GUIDEWIRES 0.035~0.038" 260CM PTFE EXTRA SUPPORT CGDW1ANG14M4 " 美敦力 " 血管診斷攝影用導線 "MEDTRONIC"ANGIOGRAPHIC 779 GUIDEWIRES 0.063" 160CM PTFE EXTRA SUPPORT 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 " 0.038" 260CM " 曲克 " 導線 CGDW1B1340BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE PTFE 0.018~0.045" ~100CM CGDW1B1341BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE PTFE 0.018~0.045" ~200CM CGDW1B1346BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE PTFE 0.018~0.045" ~500CM CGDW1B3450BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE HYDROPHILIC ~0.038" 40~100CM CGDW1B3551BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE HYDROPHILIC ~0.038" 120~200CM CGDW1B3557BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE HYDROPHILIC ~0.018" 120~200CM CGDW1B5250BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE PTFE AMPLATZ ~0.035" 90CM CGDW1B5251BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE PTFE AMPLATZ ~0.035" 145~180CM CGDW1B5252BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE PTFE AMPLATZ 0.025~0.035" 260CM

12 CGDW1B7361BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE PTFE 0.035~0.038" CM CGDW1BA344BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE 0.018~0.045" ~200CM CGDW1BC423BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE HYDROPHILIC ~0.038" 400~450CM CGDW1BC457BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE HYDROPHILIC ~0.038" 120~200CM CGDW1BC521BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE HYDROPHILIC ~0.038" 220~450CM CGDW1BC552BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE HYDROPHILIC ~0.038" 220~300CM CGDW1C6121BQ "BIOTEQ"DRAINAGE CATHETER & INTRODUCER SET:NITINOL GUIDE 653 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 CGDW1EMER1CD "CORDIS"GUIDE WIRE " 考迪斯 " 引導線 PTFE 125;150;175;180CM 313 CGDW1EMER2CD "CORDIS"GUIDE WIRE " 考迪斯 " 引導線 PTFE 220;260CM 437 CGDW1G002ACK GUIDE WIRE STRAIGHT 50CM,80CM 277 CGDW1G002NCK GUIDE WIRE STRAIGHT (100,125,145CM) 313 CGDW1G003ACK GUIDE WIRE AMPLATZ EXTRA-STIFF 145CM,180CM 779 CGDW1G003NCK GUIDE WIRE AMPLATZ EXTRA-STIFF 923 CGDW1G004NCK GUIDE WIRE COONS INTERVENTIONAL 313 CGDW1G005NCK TIP DEFLECTING GUIDE WIRE 822 CGDW1G006ACK GUIDE WIRE CURVED 50CM, 80CM 277 CGDW1G006NCK GUIDE WIRE CURVED 50:145CM(100,125,145CM) 313 CGDW1G007ACK GUIDE WIRE CURVED 180CM 313 CGDW1G007NCK GUIDE WIRE CURVED 180:260CM(260CM) 437 CGDW1G008ACK GUIDE WIRE CURVED 50CM, 80CM 277 CGDW1G008NCK GUIDE WIRE CURVED 50:145CM(100,125,145CM) 313 CGDW1G009ACK GUIDE WIRE CURVED 80CM 277 CGDW1G009NCK GUIDE WIRE CURVED (100,125,145CM) 313 CGDW1G011ACK TSF GUIDE WIRE STRAIGHT 50CM, 80CM 277 CGDW1G011NCK TSF GUIDE WIRE STRAIGHT 50:145CM(100,125,145CM) 313 CGDW1G012NCK GUIDE WIRE STRAIGHT 260CM 437 CGDW1G013NCK SOS INTERVENTIONAL GUIDE WIRE 145CM 952 CGDW1G016ACK GUIDE WIRE STRAIGHT 50CM,80CM 277 CGDW1G016NCK GUIDE WIRE STRAIGHT 50:145CM(100,125,145CM) 313 CGDW1G017NCK "COOK"GUIDE WIRE TEFCOR MOVABLE CURVED" 曲克 " 導線 313 CGDW1G018NCK GUIDE WIRE LUNDERQUIST EXCHANGE 120CM 787 CGDW1GAGSNTM RADIFOCUS GUIDEWIRE(SHAPEABLE TYPE 751 ANGLE,STRAIGHT)0.018":0.038"120:150CM CGDW1GKGLNTM RADIFOCUS GUIDEWIRE(SHAPEABLE TYPE 751 ANGLE,STRAIGHT)0.018":0.038"120:180CM CGDW1H1258GJ "JSM"GUIDE WIRE (HYDROPHILIC PVP PRE-COATED) "~0.038"120;150;180CM " 吉生 " 導引線 CGDW1H2630GJ "JSM"GUIDE WIRE (HYDROPHILIC PVP PRE-COATED) "~0.038" 260;300CM " 吉生 " 導引線 CGDW1HAHSNTM RADIFOCUS GUIDEWIRE HALFSTIFF(SHAPEABLE TYPE 779 ANGLE,STRAIGHT)0.018":0.038"120:180CM CGDW1HSF01CK LUNDERQUIST RING TORQUE GUIDE WIRE 變換金屬導線 787 CGDW1HW001CK HYDROPHILIC WIRE GUIDES 150CM,180CM 0.025" 0.035" 0.038"

13 CGDW1HW018CK HYDROPHILIC WIRE GUIDES 180CM 0.018" 2781 CGDW1HWA01CK HYDROPHILIC WIRE GUIDES 150CM,180CM 0.025" 0.035" 0.038" 751 CGDW1HWA02CK HYDROPHILIC WIRE GUIDES 260CM 0.025" 0.035" 0.038" 1359 CGDW1HWA18CK HYDROPHILIC WIRE GUIDES 150CM 180CM 0.018" 2781 CGDW1HWA28CK HYDROPHILIC WIRE GUIDES 260CM 0.018" 2800 CGDW1HWAS1CK HYDROPHILIC WIRE GUIDES EXTRA SUPPORT(STIFF SHAFT)150CM CM 0.035" 0.038" CGDW1HWAS2CK HYDROPHILIC WIRE GUIDES 260CM 0.035" 0.038" 1359 CGDW1HWS01CK HYDROPHILIC WIRE GUIDES EXTRA SUPPORT(STIFF SHAFT)150CM CM 0.035" 0.038" CGDW1LC181TM RADIFOCUS GUIDE WIRE M 0.018"~0.038"120CM,150CM,180CM 751 CGDW1LC182TM RADIFOCUS GUIDE WIRE M STIFF WIRE 0.025"~0.038" CM,180CM 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" CM,260CM,300CM CGDW1LC303TM RADIFOCUS GUIDE WIRE M STIFF WIRE 0.025",0.035" CM,300CM CGDW1LC30NTM RADIFOCUS GUIDE WIRE M 0.018"~0.038" 220CM,260CM,300CM 1359 CGDW1N405HST GUIDERIGHT GUIDEWIRE HEPARIN COATED FIXED CORE ",0.038" 150CM;180CM CGDW1N4568ST " 聖猷達 " 蓋瑞特導引線 "ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313 CGDW1N4577ST " 聖猷達 " 蓋瑞特導引線 "ST.JUDE " GUIDERIGHT GUIDEWIRE 260CM 437 CGDW1N458NST GUIDERIGHT GUIDEWIRE SUPER STIFF FIXED CODE 0.032",0.038" CM CGDW1N4610ST " 聖猷達 " 蓋瑞特導引線 "ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM CM CGDW1N4840ST " 聖猷達 " 蓋瑞特導引線 "ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313 CGDW1N4841ST " 聖猷達 " 蓋瑞特導引線 "ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313 CGDW1N4870ST " 聖猷達 " 蓋瑞特導引線 "ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313 CGDW1N4948ST " 聖猷達 " 蓋瑞特導引線 "ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313 CGDW1N4998ST " 聖猷達 " 蓋瑞特導引線 "ST.JUDE " GUIDERIGHT GUIDEWIRE 150CM 313 CGDW1N5018ST " 聖猷達 " 蓋瑞特導引線 "ST.JUDE " GUIDERIGHT GUIDEWIRE 260CM 437 CGDW1PA353TM " 泰爾茂 " 血管攝影用導線 "TERUMO"RADIFOCUS GUIDE WIRE M ":0.038" 80:180CM STIFF TYPE CGDW1PMG01CK COPE NITINOL MANDRIL WIRE GUIDE(PLATINUM TIP)0.018" CM 加蓋軸心鎳鉻合金導線 CGDW1PTGW1GJ STAINLESS STEEL GUIDE WIRE0.018"~0.038" 50CM;80CM W/PTFE 277 CGDW1PTGW1H9 STAINLESS W/PTFE GUIDE WIRE 0.018":0.038" 50CM:80CM 277 CGDW1PTGW2GJ STAINLESS STEEL GUIDE WIRE0.018"~0.038" 120CM;150CM;180CM 313 W/PTFE 403

14 CGDW1PTGW2H9 STAINLESS W/PTFE GUIDE WIRE 0.018":0.038" CM;150CM;180CM CGDW1PTGW3GJ STAINLESS STEEL GUIDE WIRE0.018"~0.038" 260CM;300CM 437 W/PTFE CGDW1PTGW3H9 STAINLESS W/PTFE GUIDE WIRE 0.018":0.038" 260CM;300CM 437 CGDW1R402NST GUIDERIGHT GUIDEWIRE HEPARIN COATED MOVABLE CORE ",0.038" 150CM CGDW1R455NST GUIDERIGHT GUIDEWIRE INTRODUCER ",0.025",0.032",0.035", CM,80CM CGDW1R45DDST GUIDERIGHT GUIDEWIRE DOUBLE DISTAL FIXED CORE ",0.038" 150CM,180CM CGDW1R45J2ST GUIDERIGHT GUIDEWIRE J TIP FIXED CORE 0.32",0.35",0.038" CM CGDW1R45NNST GUIDERIGHT GUIDEWIRE J TIP FIXED CORE ",0.25",0.30",0.32",0.35",0.038,0.65" 150CM,180CM CGDW1R4876ST GUIDERIGHT GUIDEWIRE SUPER STIFF FIXED CODE 0.038" 260CM 923 CGDW1R48NNST GUIDERIGHT GUIDEWIRE STRAIGHT FIXED CORE ",0.025",0.032",0.035",0.038" 150CM CGDW1R48SFST GUIDERIGHT GUIDEWIRE STRAIGHT FIXED CORE 0.035",0.038" CM CGDW1R4946ST GUIDERIGHT GUIDEWIRE J TIP MOVABLE CORE 0.035",0.038" CM CGDW1R4950ST GUIDERIGHT GUIDEWIRE STRAIGHT MOVABLE CORE 0.035",0.038" CM CGDW1R5018ST GUIDERIGHT GUIDEWIRE HEPARIN COATED FIXATED CORE 0.035" CM CGDW1RFPC1CK ROADRUNNER GUIDE WIRE 0.035",0.038" 145CM,180CM/TIP 7CM 751 CGDW1RFPC2CK ROADRUNNER GUIDE WIRE 0.035",0.038" 260CM/TIP 7CM 1359 CGDW1RFSP1CK ROADRUNNER WIRE GUIDE 0.035",0.038" 145CM,180CM 751 CGDW1RFSP2CK ROADRUNNER WIRE GUIDE 0.035",0.038" 260CM 1359 CGDW1RLPC1CK ROADRUNNER GUIDE WIRE 0.035",0.038" 145CM,180CM/TIP 16CM 751 CGDW1RLPC2CK ROADRUNNER GUIDE WIRE 0.035",0.038" 260CM/TIP 16CM 1359 CGDW1RPC1XCK ROADRUNNER GUIDE WIRE 0.035",0.038" 145CM,180CM/TIP 8CM 751 CGDW1RPC2XCK ROADRUNNER GUIDE WIRE 0.035",0.038" 260CM/TIP 8CM 1359 CGDW1S3515TM RADIOFOCUS GUIDE WIRE 0.035" 150CM (STRAIGHT) 751 CGDW1S3530TM RADIOFOCUS GUIDE WIRE 0.035" 300CM 1359 CGDW1SFA35C3 GUIDE WIRE 0.035" 150CM 313 CGDW1SFA38C3 GUIDE WIRE 0.038" 150CM 313 CGDW1THSF1CK GUIDE WIRE STAINLESS STEEL TFE COATING 0.035";0.038" CM CGDW1TSM01CK MOVABLE CORE STRAIGHT SAFELY GUIDE WIRE 安全導線 ,145CM(90/10/1 產品型號 TSM-32:38-80 另編代碼 ) CGDW1TSM0ACK MOVABLE CORE STRAIGHT SAFETY GUIDE WIRE 80CM 277 CGDW1UJAJNAS ASAHI UNIQUAL ANGIOGRAPHIC GUIDE WIRE 0.025":0.038" CM:200CM CGDW1UJBESAS ASAHI UNIQUAL ANGIOGRAPHIC GUIDE WIRE 0.025":0.038" CM:300CM CGDW1USAJNAS ASAHI UNIQUAL ANGIOGRAPHIC GUIDE WIRE 0.025":0.038" 150CM:200CM

15 CGDW1USBESAS ASAHI UNIQUAL ANGIOGRAPHIC GUIDE WIRE 0.025":0.038" CM:300CM CGDW1Z1P26SB ZIPWIRE HYDROPHILIC GUIDE WIRE STIFF/STANDARD ",0.035",0.038" 260CM 利博親水性導線 CGDW1ZSD58SB ZIPWIRE HYDROPHILIC GUIDE WIRE 0.025",0.035",0.038" CM,180CM 利博親水性導線 CGDW1ZSF58SB ZIPWIRE HYDROPHILIC GUIDE WIRE STIFF 0.025",0.035",0.038" CM,180CM 利博親水性導線 CGDW1ZSF80SB ZIPWIRE HYDROPHILIC GUIDE WIRE STIFF 0.035",0.038" 80CM 779 利博親水性導線 CGPW10462HAB HI-TORQUE BALANCE HEAVY WEIGHT GUIDE WIRE PTFE SUPPORT " 190CM CGPW10463HAB HI-TORQUE BALANCE HEAVY WEIGHT GUIDE WIRE PTFE SUPPORT " 300CM CGPW108001ST " 聖猷達 " 海卓史蒂爾導引線 "ST.JUDE"HYDROSTEER GUIDEWIRE " 150CM,180CM( 鎳合金 ) CGPW10S0L1RS REGATTA STEERABLE GUIDEWIRE 0.014" 195CM(COATING MICRO 2817 RIDGE) CGPW11048NAB HI-TORQUE PILOT 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 2430 GUIDE WIRE PTFE 0.014" 185CM CGPW112202SB " 波士頓科技 " 凱耐帝斯導引線 "BOSTON SCIENTIFIC"KINETIX 2587 GUIDE WIRE PTFE 0.014" 300CM CGPW114901SB PT GRAPHIX GUIDE WIRE 0.014" 182CM 2353 CGPW114913SB PT GRAPHIX GUIDE WIRE 0.014" 300CM 2587 CGPW11740NAB HI-TORQUE SUPER SUPPORT PTCA GUIDE WIRE 0.014" 190CM 2817 CGPW11741NAB HI-TORQUE ALL STAR PTCA GUIDE WIRE 0.014" 300CM 2870 CGPW11780NAB HI-TORQUE GUIDE WIRE EXTRA SUPPORT 190CM 2817 CGPW11782NAB HI-TORQUE GUIDE WIRE EXTRA SUPPORT 300CM 2870 CGPW11834HAB HI-TORQUE WHISPER EXTRA SUPPORT GUIDE WIRE 190CM 0.014" 2817 CGPW11835HAB HI-TORQUE WHISPER EXTRA SUPPORT GUIDE WIRE 300CM 0.014" 2870 CGPW118688TM RUNTHROUGH NS PTCA GUIDE WIRE W/PTFE 不鏽鋼 0.014" 150CM 2353 CGPW11S0L1RS REGATTA STEERABLE GUIDEWIRE 0.014" 300CM(COATING MICRO 2870 RIDGE) CGPW12224NAB HI-TORQUE EXTRE SUPPORT GUIDE WIRE 0.014" 190CM 2817 CGPW12234NAB HI-TORQUE EXTRA SUPPORT GUIDE WIRE 0.014" 300CM 2870 CGPW1223HNAB HI-TORQUE PTCA GUIDE WIRE W/HYDROCOAT 0.014" 190CM 2353 CGPW1223MNAB HI-TORQUE PTCA GUIDE WIRE W/MICROGLIDE COATING 0.014" CM CGPW12560NAB HI-TORQUE P.T.C.A GUIDE WIRE 0.010" 190CM 2353 CGPW128000AB HI-TORQUE GUIDE WIRE W/HYDROCOAT 0.014" 190CM EXTRA 2817 SUPPORT CGPW128001AB HI-TORQUE GUIDE WIRE W/HYDROCOAT 0.014" 300CM EXTRA 2870 SUPPORT CGPW13309NAB HI-TORQUE CROSS-IT PTCA GUIDE WIRE 0.014" 190CM 2353 CGPW13310NAB HI-TORQUE CROSS-IT PTCA GUIDE WIRE 0.014" 300CM 2587 CGPW1379MNAB HI-TORQUE PTCA GUIDE WIRE W/MICROGLIDE COATING 0.014" 300CM

16 CGPW138931SB PT2 GUIDEWIRE HYDROPHILIC COATING 0.014" 185CM 2353 CGPW138932SB PT2 GUIDEWIRE HYDROPHILIC COATING 0.014" 300CM 2587 CGPW138950SB IQ GUIDE WIRE 0.014" 185CM 2353 CGPW138951SB IQ GUIDE WIRE 0.014" 300CM 2587 CGPW14181ATM RUNTHROUGH NS PTCA GUIDE WIRE 嵐鍶路導引導線 2353 CGPW1418FATM RUNTHROUGH NS PTCA GUIDE WIRE HYDROPHILLIC COATING 180CM " CGPW1418XATM "TERUMO"RUNTHROUGH PTCA GUIDE WIRE(0.014" 180CM 2430 W/COATING)" 泰爾茂 " 嵐鍶路導引導線 CGPW1430RSTM PTCA GUIDE WIRE W/HYDROPHILIC COATING 0.014" 180:300CM 2353 CGPW144586AB HI-TORQUE ADVANCE LITE GUIDE WIRE W/HYDROCOAT HYDROPHILIC 2353 COATING 0.014" 190CM CGPW144587AB HI-TORQUE ADVANCE LITE GUIDE WIRE W/HYDROCOAT HYDROPHILIC 2587 COATING 0.014" 300CM CGPW144588AB HI-TORQUE ADVANCE GUIDE WIRE 190CM 0.014" 2353 CGPW144589AB HI-TORQUE ADVANCE GUIDE WIRE 300CM 0.014" 2587 CGPW146850SB V-18 CONTROL WIRE 0.018" CM 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 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 SMALL VESSAL PERIPHERAL GUIDE WIRE 180CM 2430 CGPW1503XNCD SMALL VESSEL PERIPHERAL GUIDE WIRE 300CM(90/10/1 型 2800 號 ,558,658,758-G 刪除 ) CGPW15072ACD STEERABLE GUIDE WIRE 0.014" STRAIGHT TIP 180CM 2353 CGPW15072NCD STABILIZER STEERABLE GUIDEWIRE 0.014" 180CM,300CM 2587 STRAIGHT TIP 加強型 (90/10/1 原 180CM 規格另編碼 ) CGPW15079ACD STEERABLE GUIDE WIRE 0.014" STRAIGHT TIP 3CM RADIOPAQUE 2353 TIP 180CM CGPW15079NCD STABILIZER STEERABLE GUIDEWIRE 0.014" 300CM STRAIGHT TIP 2587 (90/10/1 原 180CM 另編碼 ) CGPW15121ACD WIRE 0.014" 180CM STRAIGHT TIP 180CM 2353 CGPW15121NCD WIZDOM GUIDEWIRE 0.014",300CM STRAIGHT TIP (90/10/1 原 CM 規格另編碼 ) CGPW15132ACD GUIDE WIRE 0.014" 180CM STRAIGHT TIP MARKER WIRE 2353 CGPW15132NCD WIZDOM GUIDEWIRE 0.014" 300CM STRAIGHT TIP MARKER WIRE 2587 (90/10/1 原 180CM 規格另編碼 ) CGPW15179ACD STEERABLE GUIDE WIRE 0.014" 180CM STRAIGHT TIP MAKER WIRE 2353 CGPW15179NCD STABILIZER STEERABLE GUIDEWIRE 0.014" 300CM STRAIGHT TIP 2587 MARKER WIRE(90/10/1 原 180CM 另編碼 ) CGPW15279ACD STEERABLE GUIDE WIRE 0.014" 180CM STRAIGHT TIP EXTRA 2817 SUPPORT 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 CM (90/10/1 原 180CM 規格另編碼 ) 2587 CGPW1595M0CD ATW STEERABLE GUIDEWIRE(MARKER WIRE)0.014" 195CM

17 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 , J,X,Y,E-014 另編碼 ) CGPW15970ACD STEERABLE GUIDE WIRE 0.014" 180CM STRAIGHT TIP 25CM 2353 RADIOPAQUE TIP CGPW15970NCD STABILIZER STEERABLE GUIDEWIRE 0.014" 300CM STRAIGHT TIP 2587 (90/10/1 原 180CM 規格另編碼 ) CGPW19660NAB HI-TORQUE GUIDE WIRE EXTRA SUPPORT 190CM 2817 CGPW19661NAB HI-TORQUE GUIDE WIRE EXTRA SUPPORT 300CM 2870 CGPW196646AB HI-TORQUE BALANCE MIDDLEWEIGHT UNIVERSAL II GUIDE WIRE 2353 W/HYDROCOAT HYDROPHILIC COATING 0.014" 190CM CGPW196657AB HI-TORQUE BALANCE MIDDLEWEIGHT UNIVERSAL II GUIDE WIRE 2587 W/HYDROCOAT HYDROPHILIC COATING 0.014" 300CM CGPW1AG141AS PTCA GUIDE WIRE PTFE SOFT INTERMEDIATE ( 自 由 CM 改為 180CM) CGPW1AG143AS PTCA GUIDE WIRE STANDARD, STANDARD J, 2353 EXTENSION(AG 仍為 150CM, 其他型號自 由 175CM 改為 180CM) CGPW1AGH14AS NEO'S PTCA GUIDE WIRE EXTRA SUPPORT 0.014" ( 自 由 CM 改為 180CM) CGPW1AGH46AS "ASAHI"PTCA GUIDE WIRE EXTRA SUPPORT PTFE 0.014" 180CM " 2817 朝日 " 冠狀動脈導引線 CGPW1AGH47AS "ASAHI"PTCA GUIDE WIRE PTFE 0.014" 150CM;180CM " 朝日 " 冠狀 2353 動脈導引線 CGPW1AGM46AS "ASAHI"PTCA GUIDE WIRE EXTRA SUPPORT PTFE 0.014" 180CM " 2817 朝日 " 冠狀動脈導引線 CGPW1AGM47AS "ASAHI"PTCA GUIDE WIRE PTFE 0.014" 150CM;180CM " 朝日 " 冠狀 2353 動脈導引線 CGPW1AGP14AS PTCA GUIDE WIRE EXTRA SUPPORT( 自 由 175CM 改為 CM) CGPW1AGPFCAS PTCA GUIDE WIRE HYDROPHILIC COATING EXTRA SUPPORT 0.014" CM 180CM CGPW1AHWR3AS "ASAHI"PTCA GUIDE WIRE ASAHI SION 0.014" 300CM(PTFE 2587 COATING EXTRA SUPPORT)" 朝日 " 冠狀動脈導引線紫苑 CGPW1AHWRSAS "ASAHI"PTCA GUIDE WIRE ASAHI SION 0.014" 180CM (PTFE 2817 COATING EXTRA SUPPORT)"" 朝日 " 冠狀動脈導引線紫苑 CGPW1B8611BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE PTFE HEAVY DUTY 2828 STIFFNESS TIP 0.014" 180CM CGPW1B8612BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE PTFE HEAVY DUTY 2870 STIFFNESS TIP 0.014" 300CM 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 CGPW1BMWE9AB "ABBOTT"HI-TORQUE BALANCE MIDDLEWEIGHT ELITE GUIDE WIRE HYDROPHILIC COATING 0.014" 300CM " 亞培 " 高鐸格寶馬精英導線 "ABBOTT"HI-TORQUE BALANCE MIDDLEWEIGHT ELITE GUIDE WIRE HYDROPHILIC COATING 0.014" 190CM " 亞培 " 高鐸格寶馬精英導線 CGPW1CMW01CK APPROACH PRO LT MICRO WIRE GUIDE 0.014" 135CM,190CM 2828 CGPW1CMW02CK APPROACH PRO LT MICRO WIRE GUIDE 0.014" 300CM

18 CGPW1CMW03CK APPROACH PRO LT MICRO WIRE GUIDE 0.018" 135CM;190CM 2828 CGPW1CMW04CK APPROACH PRO LT MICRO WIRE GUIDE 0.018" 300CM 2870 CGPW1CT190M4 WIRE WORK GUIDE WIRES 190CM 0.014" NITINOL HYDROPHILLIC 2587 COATING CGPW1CT300M4 WIRE WORK GUIDE WIRES 300CM 0.014" NITINOL HYDROPHILLIC 2587 TEFLON COATING CGPW1D0CNNAB ACS 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 2587 親水性塗層微細導線 0.014" 300CM CGPW1HMW02CK APPROACH HYDRO ST MICRO WIRE GUIDE W/HYDROPHILIC COATING 2353 親水性塗層微細導線 0.014" 135,190CM CGPW1HYBGWM4 " 美敦力 " 艾坦導引導線 "MEDTRONIC" ATTAIN HYBRID GUIDE WIRE 2353 CGPW1JUN18SB "BOSTON SCIENTIFIC"JOURNEY GUIDEWIRE(W/HYDROCOAT 0.014" CM)" 波士頓科技 " 哲尼導引線 CGPW1JUN30SB "BOSTON SCIENTIFIC"JOURNEY GUIDEWIRE(W/HYDROCOAT 0.014" CM)" 波士頓科技 " 哲尼導引線 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 2587 格斯血管導線 CGPW1PRGW9AB ABBOTT HI-TORQUE PROGRESS GUIDE WIRE 0.014" 190CM 亞培博 2353 格斯血管導線 CGPW1PS180M4 WIRE WORK GUIDE WIRE W/COATING HYDRO-TRACK,PRO/PEL 180CM " 沃爾沃克導引導線 CGPW1PS300M4 WIRE WORK GUIDE WIRE W/COATING HYDRO-TRACK,PRO/PEL 300CM " 沃爾沃克導引導線 CGPW1PV1A1M4 "MEDTRONIC"PROVIA/INTUITION GUIDE WIRE W/COATING HYDRO- TRACK,PRO/PEL 180CM 0.014" " 美敦力 " 波維亞 / 英特迅導引導線 2353 CGPW1PV1A2M4 "MEDTRONIC"PROVIA/INTUITION GUIDE WIRE W/COATING HYDRO- TRACK,PRO/PEL 300CM 0.014" " 美敦力 " 波維亞 / 英特迅導引導線 2587 CGPW1PV1A3M4 "MEDTRONIC"PROVIA/INTUITION GUIDE WIRE W/COATING HYDRO TRACK,PRO/PEL EXTRA SUPPORT 180CM 0.014" " 美敦力 " 波維亞 / 英特迅導引導線 CGPW1RSTF0CK ROADRUNNER EXTRA-SUPPORT WIRE GUIDES 180,270,300CM 2817 CGPW1SK195F2 SKIPPER & SKIPPER RACE GUIDEWIRES PTFE 0.014" CM;195CM CGPW1SK1P1F2 "INVATEC"SKIPPER DEEP GUIDE WIRE W/COATING "250CM;300CM" 英泰克 " 賽艇帝普導引導絲 CGPW1SK1P2F2 "INVATEC"SKIPPER DEEP GUIDE WIRE W/COATING 0.014"195CM" 英 2817 泰克 " 賽艇帝普導引導絲 CGPW1SK300F2 SKIPPER & SKIPPER RACE GUIDEWIRES PTFE 0.014" 300CM 2587 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

19 CGPW1THDR2M4 CGPW1WNGW3AB CGPW1WNGW9AB CGPW1ZH180M4 CGPW1ZH300M4 CGS K0 CGS K0 CGS01MASNTMR CGS01MPS01CK CGS01MPS02CK CGS01MPS03CK WIRE WORK GUIDE WIRES 300CM 0.014" STAINLESS STEEL TEFLON(PRO/PEL) COATING EXTRA SUPPORT " 亞培 " 高鐸格威恩血管導線 "ABBOTT"HI-TORQUE WINN GUIDE WIRE 0.014" 300CM " 亞培 " 高鐸格威恩血管導線 "ABBOTT"HI-TORQUE WINN GUIDE WIRE 0.014" 190CM WIRE WORK GUIDE WIRES 180CM 0.014" STAINLESS STEEL HYDROPHILLIC COATING WIRE WORK GUIDE WIRES 300CM 0.014" STAINLESS STEEL HYDROPHILLIC COATING "KIMAL"ANGIOGATE INTRODUCER KIT(0.018"NITINOL GUIDEWIRE+4FR 5FR+21G NEEDLE)" 期茂 " 導引鞘組 : 微型導引器組 "KIMAL"ANGIOGATE INTRODUCER KIT(0.018"NITINOL GUIDEWIRE+4FR 5FR+21G NEEDLE)" 期茂 " 導引鞘組 : 微型導引器組 "MERIT" PRELUDE MINI ACCESS SHEATH INTRODUCERS(SHEATH+SIDEPORT+DILATOR+NITINOL GW+21G NEEDLE) " 美瑞特 " 福祿小血管導引鞘 "COOK"MICROPUNCTURE INTRODUCER SETS(W0.018 NITINOL GUIDE WIRE+4-5FR CATHETER+21G NEEDLE)" 曲克 " 微穿刺引導器組 "COOK"MICROPUNCTURE INTRODUCER SETS(W0.018 NITINOL GUIDE WIRE+4-5FR CATHETER+21G NEEDLE)" 曲克 " 微穿刺引導器組 "COOK"MICROPUNCTURE INTRODUCER SETS(W0.018 NITINOL GUIDE WIRE+4-5FR CATHETER+21G NEEDLE)" 曲克 " 微穿刺引導器組 CGS01PS18TMR "MERIT"PRELUDE SHORT SHEATH INTRODUCER(DILATOR+MARKER TIP 1308 SHEATH+STOPCOCK+0.018"GUIDE WIRE) " 美瑞特 " 福祿動靜脈廔管用導引鞘 CGS01PSSMTMR "MERIT"PRELUDE SHORT SHEATH INTRODUCER(DILATOR+MARKER TIP 1024 SHEATH+STOPCOCK) " 美瑞特 " 福祿動靜脈廔管用導引鞘 CKN01PNS01CK SAFE-T-J CURVED WIRE GUIDE 277 CLPA102000E5 SINGLE TITANIUM EPOXY PERITONEAL PORT(P+C+N) 限化學治療 7539 及癌症未期之疼痛治療使用 CLPA102000HJ PERITONEAL SYSTEM PORT-A-CATH (P+C+N) 適應症請見備註欄 7539 ( 含動脈, 腹膜及靜脈系統 ) CLPA105041AR 1 LUMEN PICC RADIOLOGY SELDINGER ACCESS SET(CATHETER+NEEDLE+DILATOR+GUIDE WIRE) 適應症請見備註欄 2884 CLPA105052AR DUAL LUMEN PICC RADIOLOGY SELDINGER ACCESS SET(C+G+I+T PORT) 適應症請見備註欄 CLPA10604NBA MRI SINGLE LUMEN IMPLANTED PORTS(PORT+C+N)* 適應症請見備註 7539 欄 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 CLPA108050E5 TI DUAL PORT (P+C+N) 型號 ,67 自 90/10/1 生效 限癌症化 7804 療及癌症未期之疼痛治療使用 CLPA108050HJ DUAL LUMEN TITANIUM PORT (P+C+N) 適應症請見備註欄

20 CLPA108052E5 DUAL LUMEN TITANIUM PORT (P+C+N+I) 限化學治療及癌症未期 7955 之疼痛治療使用 CLPA108052HJ DUAL LUMEN TITANIUM PORT (P+C+N+I) 適應症請見備註欄 7955 CLPA108066E5 TITANIUM DUAL LUMEN PORT-A SYSTEM(C+G+N+I+GRIPPER NEEDLE) 7955 適應症請見備註欄 CLPA108066HJ DUAL LUMEN TITANIUM PORT (P+C+N+I+GRIPPER NEEDLE) 適應 7955 症請見備註欄 CLPA11PS0TCK VITAL-PORT VASCULAR ACCESS SYSTEMS(P+C+N+I+GW) 適應症請 7712 見備註欄 CLPA C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE 7539 IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE) 適應症請見備註欄 CLPA C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE 7712 IMPLANTABLE DRUG DELIVERY SYSTEM(P+C+N+I) 適應症請見備註欄 CLPA C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE 7539 IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE) 適應症請見備註欄 CLPA C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE 7539 IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE) 適應症請見備註欄 CLPA C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE IMPLANTABLE DRUG DELIVERY SYSTEM(P+C+N) 適應症請見備註欄 7539 CLPA C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE 7539 IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE) 適應症請見備註欄 CLPA C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE 7539 IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE) 適應症請見備註欄 CLPA C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE 7539 IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE) 適應症請見備註欄 CLPA C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE 7712 IMPLANTABLE DRUG DELIVERY SYSTEM(P+C+N+I) 適應症請見備註欄 CLPA C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE 7539 IMPLANTABLE DRUG DELIVERY SYSTEM(PORT+CATH+NEEDLE) 適應症請見備註欄 CLPA12130NE5 SINGLE TITANIUM PORT-A CATHETER(P+C+N) 適應症請見備註欄 7539 CLPA130000BB CLPA130026BB CLPA130050BB CLPA130069BB CLPA13007NYP CLPA130085BB SINGLE TITANIUM MBS CELSITE PORT(PORT+CATH+NEEDLE) 適應症請見備註欄 SINGLE TITANIUM EPOXY CELSITE PORT(PORT+CATH+NEEDLE) 適應症請見備註欄, 型號 : 自 起刪除 SINGLE TITANIUM EPOXY CELSITE ARTERIAL PORT(P+C+N) 適應症請見備註欄 SINGLE TITANIUM EPOXY CELSITE PERITONEAL PORT(P+C+N) 適應症請見備註欄 "PEROUSE'POLYSITE IMPLANTABLE PORT(P+C+N+I) 全套式植入式血管輸注器 * 適應症請見備註欄 SINGLE TITANIUM EPOXY CELSITE PORT(PORT+CATH+NEEDLE) 適應症請見備註欄

21 CLPA13008NYP "PEROUSE"POLYSITE IMPLANTABLE PORT(PORT+CATH) 植入式血管輸 7470 注器 * 適應症請見備註欄 CLPA130092BB "B.BRAUN"CELSITE IMPLANTABLE PORTS 7712 (PORT+CATH+NEEDLE+INTRODUCER) 舒載皮下植入式注射座組 * 適應症請見備註欄, CLPA130100BB "B.BRAUN "CELSITE IMPLANTABLE DOUBLE PORTS 7955 (P+C+N+I+GRIPPER NEEDLE) 舒載皮下植入式雙槽注射座 * 適應症請見備註欄 CLPA130166HD HDC V-CATH SINGLE LUMEN PICC SET (C+N+D+G) 適應症請見備註 2884 欄 CLPA130395BB CELSITE IMPLANTABLE PORT,STANDARD (P+C+N+I)* 適應症請見備 7712 註欄 CLPA130893BB CELSITE IMPLANTABLE PORT,SMALL (P+C+N+I)* 適應症請見備註 7712 欄 ( 型號 文號 : )( 型號 自 起刪除 ) CLPA132045BB SINGLE TITANIUM MBS CELSITE 7712 PORT(PORT+CATH+NEEDLE+INTRODUCER) 適應症請見備註欄 CLPA133718BB CELSITE IMPLANTABLE PORT,STANDARD (P+C+N+I)* 適應症請見備 7712 註欄, 型號 : 自 起刪除 CLPA135000HD HDC V-CATH SINGLE LUMEN PICC SET (C+N+D+G) 適應症請見備註 2884 欄 CLPA135575HD HDC V-CATH SINGLE LUMEN PICC SET(C+N+D+G) 適應症請見備註欄 2884 CLPA136008HD HDC V-CATH SINGLE LUMEN PICC SET(C+N+D+G) 適應症請見備註欄 2884 CLPA138008HD HDC V-CATH SINGLE LUMEN PICC SET(C+N+D+G) 適應症請見備註欄 2884 CLPA139008HD HDC V-CATH DUAL LUMEN PICC SET(C+N+D+G) 適應症請見備註欄 3335 CLPA139266HD HDC V-CATH DUAL LUMEN PICC SET(C+N+D+G) 適應症請見備註欄 3335 CLPA139450HD HDC V-CATH DUAL LUMEN PICC SET(C+N+D+G) 適應症請見備註欄 3335 CLPA139550HD HDC V-CATH DUAL LUMEN PICC SET(C+N+D+G) 適應症請見備註欄 3335 CLPA140040HD HDC V-CATH SINGLE LUMEN PICC SET(C+N+D+G) 適應症請見備註欄 2884 CLPA14009NE5 SINGLE TITANIUM PORT-A CATHETER(PORT+C+N+I+GRIPPER 7712 NEEDLE) 適應症請見備註欄 CLPA14024NE5 TI SINGLE PORT-A(P+C+N) 型號 ,64,70,72,84 自 90/10/1 生 7539 效 限癌症化療及癌症未期之疼痛治療使用 CLPA14025NE5 SINGLE PORT-A CATH(P+C+N+I) ( 型號 ,63,65,85,3020 自 /10/01 生效 ) 適應症請見備註欄 CLPA14025NHJ TITANIUM PORT-A-CATH (P+C+N+I) 適應症請見備註欄 7712 CLPA14071NE5 TITANIUM SINGLE LUMEN PORT-A SYSTEM(C+G+N+I+GRIPPER 7712 NEEDLE) 適應症請見備註欄 CLPA14072NHJ "SMITHS"IMPLANTABLE ACCESS SYSTEM 內植用輸液管 7712 (P+C+N+I+GRIPPER NEEDLE)* 適應症請見備註欄 CLPA14130NBA SINGLE LUMEN PER-Q-CATHETER WITH GUIDWIRE 2.0:5.0FR 適應 2798 症請見備註欄 CLPA145213NL "NAVILYST"VAXCEL IMPLANTABLE PORTS/W PASV TECHNOLOGY (1 LUMEN)(P+C+N+I) 斐克希植入式輸液座 * 適應症請見備註欄

22 CLPA145455NL VAXCEL PERIPHERALLY INSERTED CENTRAL CATHETER(PICC)( LUMEN)/W PASV VALVE TECHNOLOGY 週邊導入中央靜脈導管 * 適應症見備註 CLPA145458NL "NAVILYST"VAXCEL PERIPHERALLY INSERTED CENTRAL 2884 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 CLPA145470NL VAXCEL PERIPHERALLY INSERTED CENTRAL CATHETER(PICC)( LUMEN)/W PASV VALVE TECHNOLOGY 週邊導入中央靜脈導管 * 適應症見備註 CLPA145478NL "NAVILYST"VAXCEL PERIPHERALLY INSERTED CENTRAL 3335 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 CLPA150120FM "FORTUNE"IMPLANTABLE VASCULAR ACCESS 7712 PORT(PORT+CATH+NEEDLE+INTRODUCER)" 富強 " 植入型血管輸液系統 * 適應症請見備註欄 CLPA150276HD HDC V-CATH DUAL LUMEN PICC SET(C+N+D+G) 適應症請見備註欄 3335 CLPA15105KHZ CLPA160260DV CLPA160284BA CLPA161548BA CLPA161635PF CLPA161636PF CLPA165750BA CLPA166041M0 CLPA166801M0 CLPA170754BA CLPA17505NBA CLPA176174BA CLPA17715NBA CLPA177255BA CLPA196001M0 CLPA1MS41NBD VORTEX VTX TITANIUM VASCULAR ACCESS PORTS(P+C+N+I)* 適應症請見備註欄 SINGLE PLASTIC HICKMAN PORT(PORT+CATH+NEEDLE) 適應症請見備註欄 SINGLE MRI PLASTIC PORT W/GROSHONG 3-WAY(P+C+N) ( 型號 自 91/07/01 生效 ) 適應症請見備註欄 MRI DUAL PORT W/GROSHONG CATHETER(PORT+CATH+NEEDLE) 適應症請見備註欄 ARTERIAL PORT-CATH(PORT+CATH+NEEDLE+INTRODUCER) 適應症請見備註欄 SINGLE LUMEN PFM VASCULAR ACCESS SYSTEM JET (C+G+N+I+GRIPPER NEEDLE)* 適應症請見備註欄 X-PORT ISP IMPLANTED PORT WITH MICROINTRODUCER KIT(P+C+N+I)* 適應正請見備註欄 "MEDCOMP"LOW PROFILE SHAPED CT PORTS AND ACCESSORIES(P+C+N+I) 薄型植入式輸液座與導管組 * 適應症請見備註欄 "MEDCOMP"MID-SIZE SHAPED CT PORTS AND ACCESSORIES(P+C+N+I) 中型植入式輸液座與導管組 * 適應症請見備註欄 X-PORT ISP IMPLANTED PORT WITH INTERMEDIATE KIT(P+C+N+I)* 適應正請見備註欄 "BARD"GROSHONG PERIPHERALLY INSERTED CENTRAL VENOUS DUAL- LUMEN W/INTRODUCER KIT* 適應症請見備註欄 "BARD"GROSHONG NXT CLEAR VUE 4FR.SINGLE LUMEN(PICC) 葛羅祥刻立回中央靜脈導管 * 適應症請見備註欄 SINGLE LUMEN GROSHONG PERIPHERALLY INSERT CENTRAL VENOUS CATH 3,4FR 適應症請見備註欄 DUAL LUMEN GROSHONG PERIPHERALLY INSERT CENTRAL VENOUS CATH 適應症請見備註欄 "MEDCOMP"PRO-FUSE AND ACCESSORIES(P+C+N+I) 普羅福斯植入式輸液座與導管組 * 適應症請見備註欄 1 LUMEN FIST PICC PROCEDURE KIT 3:5FRX65CM (C+G+I+T-PORT) 限癌症化療及癌症末期之疼痛治療使用

23 CLPA1P0R45SB "BOSTON SCIENTIFIC"VAXCEL IMPLANTABLE PORTS WITH PASV 7712 TECHNOLOGY (SINGLE LUMEN)(P+C+NX2+I) 斐克希植入式輸液座 * 適應症請見備註欄 CLPA1P1CC1CK TURBO-FLO PERIPHERALLY INSERTED CENTRAL VENOUS 2884 CATHETER(PICC) SET-ONE LUMEN (C+D+G+N)* 適應請見備註欄 CLPA1P1CC2CK TURBO-FLO PERIPHERALLY INSERTED CENTRAL VENOUS 2884 CATHETER(PICC) SET-ONE LUMEN (C+D+G+N)* 適應請見備註欄 CLPA1P1CC3CK TURBO-FLO PERIPHERALLY INSERTED CENTRAL VENOUS 3335 CATHETER(PICC) SET-TWOLUMEN (C+D+G+N)* 適應請見備註欄 CLPA1P1CC4CK TURBO-FLO PERIPHERALLY INSERTED CENTRAL VENOUS 3335 CATHETER(PICC) SET-TWOLUMEN (C+D+G+N)* 適應請見備註欄 CLPA1P1CC5CK TURBO-FLO OVER THE WIRE PERIPHERALLY INSERTED CENTRAL 2884 VENOUS CATHETER(PICC)SET(SINGLE LUMEN C+I+G)* 適應症請見備註欄 CLPA1P1CC6CK TURBO-FLO OVER THE WIRE PERIPHERALLY INSERTED CENTRAL 3335 VENOUS CATHETER(PICC)SET(DOUBLE LUMEN C+I+G)* 適應症請見備註欄 CLPA1P1CC7CK "COOK"TURBO-JECT PICC SET(CATH+INTRODUCER) 週邊導入中央靜 2884 脈導管組 ( 單腔 )* 適應症請見備註欄 CLPA1P1CC8CK "COOK"TURBO-JECT PICC SET(CATH+INTRODUCER) 週邊導入中央靜 3335 脈導管組 ( 雙腔 )* 適應症請見備註欄 CLPA1PD41NBD 2 LUMEN FIST PICC PROCEDURE KIT 65CM (C+G+I+T-PORT) 限癌 3335 症化療及癌症末期之疼痛治療使用 CLPA1PP1C1M0 "MEDCOMP"PRO-PICC PERIPHERALLY INSERTED CENTRAL VEIN 2884 CATHETER SET(SINGLE LUMEN C+N+G+D) 普羅匹克週邊導入中央靜脈導管組 * 適應症請見備註欄 CLPA1PP1C2M0 "MEDCOMP"PRO-PICC PERIPHERALLY INSERTED CENTRAL VEIN 3335 CATHETER SET(DOUBLE LUMEN C+N+G+D) 普羅匹克週邊導入中央靜脈導管組 * 適應症請見備註欄 CLPA1PS41NBD 1 LUMEN FIST PICC PROCEDURE KIT 1.9:5FRX65CM (C+G+I+T PORT) 限癌症化療及癌症末期之疼痛治療使用 CLPA1V1TA1CK "COOK"VITAL-PORT VASCULAR ACCESS SYSTEM 注射口組 (P+C+N+I) 7712 適應症請見備註欄 CLPA1VP100GH SINGLE PLASTIC VAS PORT (PORT+CATH+NEEDLE+INTRODUCER) 適 7712 應症請見備註欄 CLPA1VP150GH SINGLE PLASTIC VASPORT 7712 SYSTEM(PORT+CATH+NEEDLE+INTRODUCER)* 適應症請見備註欄 CLPA1VTXTRRH "RITA"VORTEX TR PORT SYSTEM(P+C+N+I) 植入型注射系統 * 適應症 7712 請見備註欄 CLPA202701WY ACCUFUSER DISPOSABLE SILICONE BALLOON INFUSER-CONTI 966 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 CLPA202702WY ACCUFUSER DISPOSABLE SILICONE BALLOON INFUSER-CONTI 997 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 CLPA205240W9 ACCUFLO ELASTOMERIC INFUSION DEVICE 安可復攜帶式微量輸液器 997 (2 日型 )( 雙層含外殼 )* 適應症請見備註欄 CLPA205275SG "SIGMA"BALLOON PUMP INFUSION SET(275ML-5ML/HR)" 十美牌 " 球 997 泵型微量輸液器 (2 日型 )( 雙層含外殼 )* 適應症請見備註欄 CLPA21009KBT 2 日型 INFUSOR 輸液器 ( 雙層含外殼 ) 適應症請見備註欄 997 CLPA210240W9 ACCUFLO ELASTOMERIC INFUSION DEVICE 安可復攜帶式微量輸液器 (1 日型 )( 雙層含外殼 )* 適應症請見備註欄

24 CLPA210275SG "SIGMA"BALLOON PUMP INFUSION SET(275ML-10ML/HR)" 十美牌 " 球泵型微量輸液器 (1 日型 )( 雙層含外殼 )* 適應症請見備註欄 966 CLPA21063KBT 1 日型 INFUSOR 輸液器 ( 雙層含外殼 ) 適應症請見備註欄 966 CLS040114NPW INFUSION SET W/BURETTE W/VALVE 100CC 41 CLS HR SOLUSET 100X60 PRECISION VOLUME IV SET W/100ML BURETTE 94.5 AND MICRODRIP CHAMBER 適應症請見備註欄 CLS040520VBB DOSIFIX VOLUME CONTROL ADMMINISTRATION SET 120ML WITH 41 VALVE CLS040708NPW PERFECT DISPOSABLE INFUSION SET(W/BURETTE W/VALVE) 41 CLS041VC01TZ VOLUME CONTROL I.V ADMINISTRATION SET 41 CLS041VPB3JS JMS INFUSION SET WITH BURET 100CC 41 CLS046369NPW INFUSION SET W/BURETTE W/VALVE 150CC,200CC 41 CLS04BR150SG VOLUME METERIC ADMINISTRATION SET W/FILTER 41 CLS04BRM08LL INFUSION SET WITH BURETTE 100CC 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 CLS04BUM08LL INFUSION SET WITH BURETTE( 雙路式 ) 41 CLS04BV100SG VOLUMEMMETRIC ADMINSTRATION SET 100ML WITH VALVE 41 CLS04BV150SG VOLUMEMMETRIC ADMINSTRATION SET 150ML WITH VALVE 41 CLS04C5894BT BURETROL IV SOLUTION ADMINISTRATION SET W/ VALVE 41 CLS04CSBACLL "LILY"VOLUME METERIC ADMINISTRATION SET W/VALVE 精密輸液套 41 CLS04CSBESLL "LILY"VOLUME METERIC ADMINISTRATION SET(W/VALVE)* 41 CLS04CSBRBLL VOLUME METERIC ADMINISTRATION SET 100ML 120ML 150ML 附過濾 41 網 CLS04CSBVFLL VOLUME METERIC ADMINISTRATION SET 100ML 120ML 150ML 附過濾 41 網 CLS04CSBVSLL VOLUME METERIC ADMINISTRATION SET 100ML 120ML 150ML 41 W/VALVE 附止水閥 附過濾網 CLS04IVC01TZ VOLUME CONTROL I.V ADMINISTRATION SET 41 CLS04IVPBFJS INFUSION SET PEDIATRIC 100ML BURET W/FLOAT VALVE 41 CLS04M270LTM TERUFUSION VOLUMETRIC SOLUTION ADMINISTRAION SET WITH 41 VALVE CLS04SBAFHLL VOLUME METERIC ADMINISTRATION SET 150CC W/VALVE 41 CLS04VB10LFP "MEDPRO"INFUSION SET 輸液套 41 CLS04VB10SFP "MEDPRO"INFUSION SET 輸液套 41 CLS04VB10YFP "MEDPRO"INFUSION SET WITH VALVE 輸液套 41 CLS HR PLUMSET I.V PUMP SET* 適應症請見備註欄 152 CLS HR PRIMARY IV PUMP SET* 適應症請見備註欄 152 CLS ZL "CARDINAL" ADMINSTRATION SET 適應症請見備註欄 152 CLS ZL "CARDINAL" ADMINSTRATION SET(0.2MICRO FILTER) 261 CLS ZL "CARDINAL" ADMINISTRATION SET 230 CLS ZL "CARDINAL" ADMINSTRATION SET 適應症請見備註欄 152 CLS05036EHM8 MEDITOP INFUSION SET FOR INFUSION PUMP (IV PUMP SET)* 適應 75 症請見備註欄 CLS05036SPBB "B.BRAUN"INFUSOMAT SPACE LINE 柏朗史倍司輸液套 * 適應症請見 152 備註欄 CLS HR IV PUMP SET* 適應症請見備註欄

25 CLS05037EHM8 MEDITOP INFUSION SET FOR INFUSION PUMP (IV PUMP SET)* 適應 75 症請見備註欄 CLS050800BTM "TERUMO"TERUFUSION SOLUTION ADMINISTRATION SET FOR 75 INFUSION PUMP(IV PUMP SET)" 泰爾茂 " 輸液套 * 給付規定請見備註欄 CLS050F825HR IV PUMP SET* 適應症請見備註欄 152 CLS051117ABT VOLUMETERIC PUMP SET( 型號 FNC1117B 自 090/07/01 起生效 ) 適 152 應症請見備註欄 CLS05130PUSG "SIGMA"INFUSION PUMP SET 幫浦輸液套 * 適應症請見備註欄 152 CLS052027HM8 "MEDITOP"INFUSION SET FOR INFUSION PUMP 輸液套 ( 輸液幫浦用 ) 75 CLS0526WEHM8 MEDITOP INFUSION SET FOR INFUSION PUMP (IV PUMP SET)* 適應 75 症請見備註欄 CLS05668SPBB INFUSOMAT SPACE LINE 柏朗史倍司輸液套 * 適應症請見備註欄 152 CLS05A200LTM TERUFUSION IV PUMP SET WITHOUT BAG 適應症請見備註欄 75 CLS05C0169BT COLLEAGUE PUMP SYRINGE ADAPTER SET * 適應症請見備註欄 54.2 CLS05C9604BT CONTINU-FLO PLUS SOLUTION ADMINISTRATION PUMP SET* 適應症 152 請見備註欄 CLS05T037HTP INFUSION PUMP SET 適應症請見備註欄 75 CLS HR SOLUSET 150ML BURETTE IV PUMP SET* 適應症請見備註欄 197 CLS HR HOSPIRA SPECIALTY PUMP SET(VENTED NITROGLYCERINE I V SET) 230 CLS ZL "CARDINAL" ADMINSTRATION SET 適應症請見備註欄 197 CLS HR PUMP SET(NITROGLYCERIN) 230 CLS06080PUSG "SIGMA"INFUSION PUMP SET WITH BURETTE 幫浦輸液套 * 適應症請 197 見備註欄 CLS060E798HR HOSPIRA IV PUMP SETS* 適應症請見備註欄 197 CLS060F821HR NTG PUMP SET-STERILE WITH LIGHT PROTECTIVE POLYETHYLENE 188 TUBING CLS060F826HR SOLUSET 150X60 PUMP SET BURETTE I V ADMINSTRATION SET* 適 152 應症請見備註欄 CLS060L217HR IV PUMP SET 188 CLS060L218HR NTG PUMP SET WITH LIGHT PROTECTIVE POLYETHYLENE 188 TUBINGING CLS HR BURETTE PUMP SET* 適應症請見備註欄 197 CLS HR PLUMSET IV PUMP SET W/FILTER 261 CLS06120PUSG "SIGMA"INFUSION PUMP SET LIGHT-RESISTANT 幫浦輸液套 ( 不透 188 光型 ) CLS06125SPBB INFUSOMAT SPACE LINE UV-PROTECT 史倍司輸液套 ( 不透光型 ) 188 CLS06294SPBB "B.BRAUN"INFUSOMAT SPACE LINE WITH BURETTE+NEEDLE-FREE ACCESS PORT 柏朗史倍司輸液套 ( 含儲藥筒 )* 適應症請見備註欄 197 CLS06731SPBB INFUSOMAT SPACE LINE PVC-FREE SET FOR THE ADMINISTRATION 188 OF CYTOTOXIC AGENTS 史倍司輸液套 CLS06C7552BT VENTED NITROGLYCERIN PUMP SET 230 CLS06C7553BT (NON-)VENTED PACLITAXEL SET W/0.22MICRON FILTER 261 CLS06C9644BT LIGHT SENSITIVE CLEARLINK SET 無針系統含過濾器避光輸液套 265 適應症請見備註欄 CLS06C9651BT BURETROL PUMP SET W/BURETTE 適應症請見備註欄 197 CLS06V9607BT "BAXTER"LIGHT SENSITIVE DRUGS SET 避光靜脈輸液管組 188 CLS070800BTM "TERUMO"TERUFUSION PLATELET ADMINISTRATION SET" 泰爾茂 " 血 17 小板輸液套 CLS071724NPW TRANSFUSION SET

26 CLS07A130NPW PERFECT DISPOSABLE TRANSFUSION (L TYPE ) 17 CLS07A200BTM BLOOD ADMINISTRATION SET 17 CLS07A200LTM BLOOD ADMINISTRATION SET 17 CLS07BT350JS BLOOD TRANSFUSION SET 17 CLS HR PUMP SET(NITROGLYCERIN) 230 CME02GL1DEV9 "MTI"OCCLUSION BALLOON SYSTEM(HYPERGLIDE)( 含 GUIDE WIRE 及 卡式注射器 )" 恩提愛 " 閉塞球囊系統 * 適應症請見備註欄 CVA M4 PROFLO ANGIOGRAPHIC CATHETER 6F,7F*100,110,125CM ( 衛署字 594 號 ) CVA011MG31SB IMAGER11 ANGIOGRAPHIC CATH( FRX40,65,90,100CM)0.035,0.038( 型號 M :M 自 92/7/1 生效 ) CVA01451XNCD "CORDIS"TEMPO ANGIOGRAPHIC CATHETER TEMPO4,TEMPO5 田布血管 594 造影導管 CVA014A00NM4 SITESEER CARDIOVASCULAR ANGIOGRAPHIC CATHETER 4FR 594 CVA01512HNMR IMPRESS ANGIOGRAPHIC CATHETERS 0.035",0.038" 100,125CM 映 594 象血管攝影導管 CVA01565CBMR IMPRESS ANGIOGRAPHIC CATHETERS 0.035",0.038" 65CM,100CM 594 映象血管攝影導管 CVA01565REMR IMPRESS ANGIOGRAPHIC CATHETERS 0.035",0.038" CM,65,80,100CM 映象血管攝影導管 CVA01565SMMR IMPRESS ANGIOGRAPHIC CATHETERS 0.035",0.038" 65CM,100CM 594 映象血管攝影導管 CVA01565VEMR IMPRESS ANGIOGRAPHIC CATHETERS 0.035",0.038" CM,100,125CM 映象血管攝影導管 CVA015A00NM4 SITESEER CARDIOVASCULAR ANGIOGRAPHIC CATHETER 5FR 594 CVA016A00NM4 SITESEER CARDIOVASCULAR ANGIOGRAPHIC CATHETER 6FR 594 CVA017779AMR PERFORMA DIAGNOSTIC RADIOLOGY CATHETERS 594 CVA01A80CMTM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 4FR CM 歐帝克血管攝影導管 CVA01B001NCK CEREBRAL CATHETER 594 CVA01H001NCK ANGIO CATHETER CEREBRAL CATHETER 594 CVA01H1234BQ ANGIOGRAPHIC CATHETER 4:5FR 100CM( 腦部血管用 ) 594 CVA01HN001CK ROYAL FLUSH PLUS HIGH FLOW ANGIOGRAPHIC FLUSH CATHETER , :6FR 70:110CM CVA01HNB01CK TORCON NB ANGIOGRAPHIC CATHETER 4.1FR 50:125CM(CEREBRAL 594 PULMONARY MUTIPURPOSE VISCERAL CATH) CVA01HNB02CK TORCON NB ANGIOGRAPHIC CATHETER 5.0,6.0FR :125CM(CEREBRAL PULMONARY MUTIPURPOSE VISCERAL CATH) CVA01HNB03CK TORCON NB ANGIOGRAPHIC CATHETER 4.1,5.0,6.0FR 70:110CM( 594 CORONARY CATH) 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 :110CM CORONARY CATH CVA01HNBR4CK TORCON NB ANGIOGRAPHIC CATHETER 594 CVA01HNBR5CK TORCON NB ANGIOGRAPHIC CATHETER 594 CVA01HNBR6CK "COOK" BEACON TIP TORCON NB ADVANTAGE CATHETER FR,40~100 CM " 曲克 " 遠端導引託鏗增益導管 CVA01HNBR7CK "COOK" BEACON TIP TORCON NB ADVANTAGE CATHETER FR,65~125CM " 曲克 " 遠端導引託鏗增益導管 CVA01HNBR8CK "COOK" BEACON TIP TORCON NB ADVANTAGE CATHETER 4.0 FR,80CM " 曲克 " 遠端導引託鏗增益導管

27 CVA01HNR01CK ROYAL FLUSH PLUS ANGIOGRAPHIC CATHETER 0.35" CM 594 CVA01HNR02CK ROYAL FLUSH PLUS ANGIOGRAPHIC CATHETER 0.035" 0.038" CM CVA01N001NCK ANGIO CATHETER VISCERAL CATHETER 65:100CM 594 CVA01NP4RCCY ANGIOGRAPHY CATHETER TYPE RC COBRA RH RLG SH HEAD-HUNTER 594 PIGTTAIL 4.2FR,5FR 65:100CM CVA01NP4RCGT "GOODTEC"ANGIOGRAPHY CATHETER " 固特克 " 血管攝影導管 594 CVA01P027NCK ANGIO CATHETER 50:110CM 594 CVA01RC123BQ ANGIOGRAPHIC CATHETER 4:5FR 65~80CM( 周邊血管用 ) 594 CVA024SP68TM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 594 PIGTAIL" 泰爾茂 " 歐帝克血管攝影導管 CVA TM "TERUMO"RADIOFOCUS YASHIRD ANGIOGRAPHIC CATHETER" 泰爾茂 " 594 血管攝影導管 CVA02AB441TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR COBRA 594 CVA02AC341TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR SHEPHERD 594 HOOK CVA02AD441TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR J CURVE 594 CVA02AE441TM "TERUMO"RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER" 泰爾 594 茂 " 歐帝克血管攝影導管 CVA02AG341TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4FR RH 594 CVA02AG941TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR YASHIRO 594 CVA02BB141TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR HEADHUNTER 594 CVA02BC141TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR NEWTON 594 CVA02BE141TM RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATH 4:5FR BENTSON 594 CVA02DB450TM RADIFOCUS COBRA ANGIOGRAPHIC CATHETER 5:6FR 65:100CM 594 CVA02DD450TM RADIFOCUS J CURVE ANGIOGRAPHIC CATHETER 5:7FR 65CM 594 CVA02DG350TM "TERUMO"RADIFOCUS RH ANGIOGRAPHIC CATHETER 5FR 65CM" 泰爾 594 茂 " 血管攝影導管 CVA02DG450TM RADIFOCUS RS ANGIOGRAPHIC CATHETER 5FR 65CM 594 CVA02EA150TM RADIFOCUS SIMMONS ANGIOGRAPHIC CATHETER 5:6FR 100CM 594 CVA02EB150TM RADIFOCUS HEADHUNTER ANGIOGRAPHIC CATHETER 5:7FR 100CM 594 CVA02EE150TM RADIFOCUS BENTSON ANGIOGRAPHIC CATHETER 5FR 100CM 594 CVA02RQ4FNTM OUTLOOK ANGIOGRAPHIC CATHETER 4FR 60CM:110CM ANY CURVE 594 ( 衛署字號 9685) CVA02RQ5FNTM OUTLOOK ANGIOGRAPHIC CATHETER 5FR 60CM:110CM ANY CURVE 594 ( 衛署字號 9685) CVC CD VISCERAL COBRA FEMORAL CATHETER 594 CVC CD ANGIO CATHETER FEMORAL AORTIC FLUSH (PIGTAIL) 594 CVC013241NCD ANGIO CATHETER FEMORAL VISCERAL (SIDEWINDER) 594 CVC CD ANGIO CATHETER FEMORAL AORTIC FLUSH (STRAIGH) 594 CVC013243NCD ANGIO CATHETER FEMORAL VISCERAL (BENTSON) 594 CVC013244NCD ANGIO CATHETER FEMORAL VISCERAL J CURVE (SHEPHERD HOOK) 594 CVC CD ANGIO CATHETER FEMORAL VISCERAL (HEADUNTER) 594 CVC CD ANGIO CATHETER FEMORAL VISCERAL (SHEPHERD HOOK) 594 CVC CD NIH CATHETER 5:8FR 80:100CM 594 CVC UV ALVISION CARDIOVASCULAR ANGIOGRAPHIC CATHETER 艾微視心血 594 管攝影導管 CVC014505NCD INFINITI DIAGNOSTIC CARDIOLOGY CATHETER 5FR 594 CVC015237NCD AMPLANTZ CATHETER LEFT/RIGHT 594 CVC01527XNCD AMPLANTZ TECH LEFT OR RIGHT CORONARY CATHETER 594 CVC015325NCD PIGTAIL CATHETER 5:8FR

28 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 CVC01AMK4JK0 CARDIAC CATHETER(AMPLATZ)4-6FR 100CM 594 CVC01CAPGTMR ANGIOGRAPHIC CATHETERS PIGTAIL CATHETER 594 CVC01HF456BK HYPERFLOW DIAGNOSTIC CATHETER 594 CVC01JKK4JK0 CARDIAC CATHETER(JUDKINS)4-6FR 100CM 594 CVC01JL235BQ ANGIOGRAPHIC CATHETER JL4,JL CVC01JR235BQ ANGIOGRAPHIC CATHETER JR4,JR CVC01MLK4JK0 CARDIAC CATHETER(MULTIPURPOSE)4-6FR 100CM 594 CVC01N001NCK ANGIO CATHETER CORONARY CATHETER 110:150CM 594 CVC01P1451BQ ANGIOGRAPHIC CATHETER 4:6FR 100~110CM( 冠狀動脈用 ) 594 CVC01P1K4JK0 CARDIAC CATHETER(PIGTAIL)4-6FR CM 594 CVC01PG155BQ ANGIOGRAPHIC CATHETER P155,P1G 594 CVC01RAK4JK0 CARDIAC CATHETER(INTERNAL MAMMARY, CORONARY BYPASS, 594 RADIAL)4-6FR 100CM CVC01RH001TM TERUMO RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 泰爾茂 594 歐帝克血管攝影導管 CVC01RH002TM TERUMO RADIFOCUS OPTITORQUE ANGIOGRAPHIC CATHETER 泰爾茂 594 歐帝克血管攝影導管 CVC01RHAL1TM OPTITORQUE ANGIOGRAPHIC CATHETER AMPLATZ LEFT 1:3,5:6FR CM CVC01RHAR1TM OPTITORQUE ANGIOGRAPHIC CATHETER AMPLATZ RIGHT 1-3 5:6FR CM CVC01RHJL4TM OPTITORQUE ANGIOGRAPHIC CATHETER JUDKINS LEFT 3.5:5.0MM 594 4:6FR 100CM CVC01RHJR4TM OPTITORQUE ANGIOGRAPHIC CATHETER JUDKINS RIGHT 3.5:5.0CM 594 4:6FR 100CM CVC01RHSP6TM OPTITORQUE ANGIOGRAPHIC CATHETER STRAIGHT PIGTAIL 4:6FR CM CXE04EACECST " 聖猷達 " 恩賽導管 "SJM" ENSITE ARRAY CATHETER* 適應症請見備 註欄 CXE04NS7TCWE 百歐森偉伯司特 藍星導管"BIOSENSE WEBSTER" NAVI-STAR CATHETER* 適應症請見備註欄 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 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 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 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 CXE05TCPBDST 聖猷達瑟爾皮庫爾帕斯雙向心臟電燒導管 SJM THERAPY COOL PATH BI-DIRECTIONAL ABLATION CATHETERS* 適應症請見備註欄 FBA SN KRACKOW HTO BLADE STAPLES ( 鈷鉻鉬 ) 2473 FBA022860NSN KRACKOW HTO BLADE STAPLE ( 鈷鉻鉬 )

29 FBA SN OSTEOTOMY FIXATION STAPLES( 鈷鉻鉬 ) 1637 FBA022867NSN OSTEOTOMY STAPLE( 鈷鉻鉬 ) 1637 FBA022868NSN TABLE FIXATION STAPLE( 鈷鉻鉬 ) 2005 FBA SN TABLE FIXATION STAPLES( 鈷鉻鉬 ) 2005 FBD00001NNY2 DCS PLATE 6:22HOLE 6748 FBD00001XNY2 DHS PLATE 135:150 度 2:12HOLE( 產品型號 :410,281540:560) FBD000095NZ1 VERSA-FX SUPRACONDYLAR FIXATION SYSTEM 6748 FBD000135NZ1 VERSA-FX FEMORAL FIXATION SYSTEM 6796 FBD Z1 VERSA-FX II SUPRACONDYLAR FIXATION SYSTEM 90,95 度 6748 (PLATEX1+LAG SCREWX1+COMP SCREWX1) FBD001193NZ1 VERSA-FX II FEMORAL FIXATION SYSTEM 130,135 度 (PLATEX1+LAG 6796 SCREWX1+COMP SCREWX1) FBD002412NSN COMPRESSION HIP SCREW SYSTEM (DHS) 6796 FBD V2 DHS PLATE SYSTEM (PLATE+SCREW)130~150 度 6796 FBD V2 DCS PLATE SYSTEM (PLATE+SCREW) 95 度 6748 FBD00281CNS1 "SYNTHES"BONE PLATE IMPLANT:COMPRESSION HIP 6796 SYSTEM(DHS) 度 " 信迪思 " 骨板植入物 : 動力髖螺釘骨板 FBD00281NNS1 DCS PLATE SYSTEM 95 度 6748 FBD003281NZ6 STAINLESS COMPRESSION HIP SCREW SYSTEM 95:140 度 (PX1+COM 6796 SCREWX1+LAG SCREWX1) FBD00401NNY2 TITANIUM DCS PLATE 6:22HOLE 7287 FBD00401XNY2 TITANIUM DHS PLATE 135:150 度 2:10HOLE 7339 FBD005963NS9 OMEGA II LOW PROFILE:CHS SYSTEM 度 (PLATEX1+LAG 6796 SCREWX1+COMPRESSION SCREWX1) FBD005966NS9 OMEGA II SYSTEM:SUPRACONDYLAR PLATE 95 度 (PLATE+LAG 6748 SCREW+COMPRESSION SCREW) FBD005970NS9 OMEGA3 HIP PLATE CHS SYSTEM 歐米加三固定系統 (PLATEX1+LAG 6796 SCREW+COMP SCREW) FBD005973NS9 OMEGA3 HIP PLATE SYSTEM 歐米加三固定系統 (PLATEX1+LAG 6748 SCREW+COMP SCREW) FBD00K004NAE COMPRESSION HIP SCREW(DHS) 6796 FBD01244XNSN DCS COMPRESSION TUBE PLATE SYSTEM(PLATE+LAG 6748 SCREW+COMPRESSING SCREW) FBN SN R-T RECONSTRUCTION NAIL 限股骨粗隆下骨折及股骨粗隆複合 6933 骨折患者申報 FBN04102XNU0 HUMERAL LOCKING SCREW 適應症請見備註欄 899 FBN SN R-T PROXIMAL SCREW 適應症請見備註欄 899 FBN SN FEMORAL LOCKING SCREW 適應症請見備註欄 899 FBN042252SZ1 M/DN RECONSTRUCTION SCREW 適應症請見備註欄 899 FBN042253SZ1 M/DN CORTICAL 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 899 欄 FBN04403SSY2 STAINLESS INTERLOCKING SCREW 骨髓內固定螺絲 適應症請見 899 備註欄 FBN04403STY2 TITANIUM KING BO INTERLOCKING SCREW 鈦合金骨髓內固定螺絲 970 適應症請見備註欄 FBN04520XNU0 NAIL LOCKING SCREW 適應症請見備註欄 899 FBN05002XNY2 HUMERAL NAIL 7.0:9.0X210:280 適應症請見備註欄 7890 FBN05003XNY2 FEMORAL NAIL 10:17,18,19,300:480,400:180 適應症請見備註 7890 欄 FBN05004XNY2 TIBIAL NAIL 9:13 255:420( 產品型號 :420,252280:420,253280:420) 適應症請見備註欄

30 FBN R1 FEMORAL NAIL SYSTEM 適應症請見備註欄 7890 FBN SN FEMORAL NAIL SYSTEM( 含 NAIL+SCREW) 適應症請見備註欄 7890 FBN R1 TIBIAL NAIL SYSTEM 適應症請見備註欄 7890 FBN SN 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 FBN052240SZ1 M/DN RETROGRADE FEMORAL NAIL( 反向股骨固定釘 ) 適應症請見 6933 備註欄 FBN052252SZ1 M/DN FEMORAL NAIL SYSTEM(NAIL+CORTICAL SCREW) 適應症請見 7890 備註欄 FBN052253SZ1 M/DN TIBIAL NAIL SYSTEM(NAIL+CORTICAL SCREW) 適應症請見 7890 備註欄 FBN052254SZ1 M/DN HUMERAL NAIL SYSTEM(NAIL+CORTICAL SCREW) 適應症請見 7890 備註欄 FBN052450NSN HUMERAL NAIL SYSTEM(NAIL+SCREW) 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 FBN053603NS3 FEMORAL NAIL SYSTEM 適應症請見備註欄 7890 FBN053603NS9 FEMORAL NAIL SYSTEM ( 原代碼 FBN053603NS3) 適應症請見備註 7890 欄 FBN053792NS3 TIBIAL NAIL SYSTEM 適應症請見備註欄 7890 FBN053792NS9 TIBIAL NAIL SYSTEM( 原代碼 FBN053792NS3) 適應症請見備註欄 7890 FBN05402XNY2 TITANIUM UNREAMED HUMERAL NAIL(NAILX1+LOCKING BOLTX4) 適 7879 應症請見備註欄 FBN05403FSY2 STAINLESS FEMUR INTERLOCKING NAIL(NAILX1+SCREWX3) 股骨髓內 7890 釘組 適應症請見備註欄 FBN05403FTY2 TITANIUM KING BO FEMUR INTERLOCKING NAIL 7879 SYSTEM(NAILX1+LOCKING BOLTX3) 鈦合金股骨髓內釘組 適應症請見備註欄 FBN05403HSY2 STAINLESS HUMERAL INTERLOCKING NAIL(NAILX1+SCREWX3) 肱骨髓 7890 內釘組 適應症請見備註欄 FBN05403HTY2 TITANIUM KING BO HUMERAL INTERLOCKING NAIL 7879 SYSTEM(NAILX1+LOCKING BOLTX3) 適應症請見備註欄 FBN05403TSY2 STAINLESS TIBIA INTERLOCKING NAIL(NAILX1+SCREWX3) 脛骨髓內 7890 釘組 適應症請見備註欄 FBN05403TTY2 TITANIUM TIBIA INTERLOCKING NAIL SYSTEM(NAILX1+LOCKING 7879 BOLTX3) 脛骨髓內釘組 適應症請見備註欄 FBN05403XNY2 TITANIUM UNREAMED FEMORAL NAIL(NAILX1+LOCKING BOLTX4) 適 7879 應症請見備註欄 FBN05404XNY2 TITANIUM UNREAMED TIBIAL NAIL(NAILX1+LOCKING BOLTX4) 適 7879 應症請見備註欄 FBN054102NH1 FEMORAL NAIL SYSTEM 適應症請見備註欄 7890 FBN05601XNU0 FEMORAL&TIBIAL NAIL SYSTEM(NX1+SX3)( 或 SCREW 型號 :1105) 適應症請見備註欄 FBN056091NH1 HUMERAL NAIL SYSTEM 適應症請見備註欄 7890 FBN056092NH1 TIBIAL NAIL SYSTEM 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 FBN07KA12NAE KIRSCHNER I.M. PIN FEMUR 1534 FBN07KC11NAE KIRSCHNER I.M.PIN HUMERUS/TIBIAL

31 FBN080481YM1 INTRAMEDULLARY TIBIA (KUNTSCHER) 下腿用骨髓內釘 1534 FBN084041NZ1 KUNTSCHER NAIL 14:15MM 1534 FBNG1273XNS1 PROXIMAL FEMORAL NAILS STAINLESS STEEL( : : : :960) 適應症請見備註欄 FBNG14003NS9 GAMMA3 SYSTEM STAINLESS STEEL 脛股骨固定系統 (NAILX1+SCREWX3) 適應症請見備註欄 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 FBNG1473XNS1 TI PROXIMAL FEMORAL NAIL 適應症請見備註欄 FBNG1511XNH1 GAMA LOCKING NAIL SYSTEM( 型號 :35, 自 /04/01 生效 ) 適應症請見備註欄 FBNG2148GSY2 "SYNTEC"KING BO HUMERAL INTERLOCKING NAILS SYSTEM:GAMMA SYSTEM:NAIL " 亞太醫療 " 金寶骨髓內釘系統 : 股骨頸髓內釘 適應症請見備註欄 FBNG22252SZ1 M/DN RECONTRUCTION NAIL 適應症請見備註欄 6933 FBNG24060NS9 GAMMA3 SYSTEM:NAIL 適應症請見備註欄 FBNG25113NH1 GAMA LOCKING NAIL :GAMA NAIL 適應症請見備註欄 FBNG3161GSY2 "SYNTEC"KING BO HUMERAL INTERLOCKING NAILS SYSTEM:GAMMA 865 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 FBNG3162GSY2 "SYNTEC"KING BO HUMERAL INTERLOCKING NAILS SYSTEM:GAMMA 1997 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 FBNG34003NS9 GAMMA3 SYSTEM:SET SCREW 適應症請見備註欄 865 FBNG34004NS9 GAMMA3 SYSTEM:LAG SCREW 適應症請見備註欄 1997 FBNG360822H1 GAMA LOCKING NAIL :SET SCREW 適應症請見備註欄 865 FBNG37120NH1 GAMA LOCKING NAIL :LAG SCREW 適應症請見備註欄 1997 FBP01007XNY2 4.5 SEMI-TUBULAR PLATE 2:12HOLE 500 FBP01008XNY /3 TUBULAR PLATE 2:12HOLE 441 FBP01009XNY /4 TUBULAR PLATE 2:8HOLE 380 FBP011403NSN ONE-THIRD TUBULAR PLATE 2:8HOLE,9:12HOLE 441 FBP011413NSN SEMI-TUBULAR PLATE 2:7HOLE,8:12HOLE 500 FBP011480NSN QUARTER TUBULAR PLATE 3:8HOLE 380 FBP V2 TUBULAR PLATE SEMI 2:12HOLE 500 FBP01222NNS1 SEMI-TUBULAR PLATE 2:12 HOLE 39:199MM 500 FBP V2 TUBULAR PLATE 1/3 3.5MM 2:12H 441 FBP012413NS1 "SYNTHES"ONE-THIRD TUBULAR PLATE 2:12HOLE 28:148MM" 信迪 441 思 " 三分之一管狀骨板 FBP V2 QUARTER TUBULAR PLATE 2.7 MM 3:8HOLE 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 FBP Z1 ONE-QUARTER TUBULAR PLATE 3:8HOLE 380 FBP Z1 ONE-THIRD TUBULAR PLATE 2:12HOLE 441 FBP Z1 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

32 FBP02010XNY2 4.5 BROAD DYNAMIC COMPRESSION PLATE 6:18HOLE 1782 FBP02011XNY2 4.5 BROAD LENGTHENING PLATE 8:10HOLE 1849 FBP02012XNY2 4.5 NARROW DYNAMIC COMPRESSION PLATE 2:17HOLE 1228 FBP02013XNY2 4.5 NARROW LENGTHENING PLATE 30:80MM 1849 FBP02015XNY2 2.0,2.7,3.5 DYNAMIC COMPRESSION PLATE 2:12HOLE( 產品型號 :580) FBP020559NS9 FEMORAL PLATE DISTAL 6-10HOLE( 配合 4.5MM,6.5MM SCREW 用 ) 3157 FBP021045NS9 L-BUTTRESS PLATE 67:339MM 3:20HOLE 2130 FBP021402NSN 3.5MM SMALL PLATE 2:12HOLE 952 FBP021412NSN 4.5MM BROAD PLATE 6:18HOLE 1782 FBP021414NSN 4.5MM NARROW PLATE 2:16HOLE,18:24HOLE 1228 FBP021460NSN 2.0MM STRAIGHT PLATE3:6HOLE 230 FBP022235NS1 LC-DCP 3.5 PLATE 4:12HOLE 977 FBP022245NS1 LC-DCP 4.5 NARROW PLATE 2:16HOLE 1228 FBP02224NNS1 NARROW DYNAMIC COMPRESSION PLATE DCP 2:18 HOLE 1228 FBP022265NS1 LC-DCP 4.5 BROAD PLATE 6:18HOLE 1782 FBP02226NNS1 BROAD DYNAMIC COMPRESSION PLATE DCP 6:18 HOLE 103:295MM 1782 FBP022278NS1 BROAD LENGTHENING PLATE 8 HOLE 135:165MM 1849 FBP02228NNS1 NARROW LENGTHENING PLATE 8 HOLE 135:185MM 1787 FBP022431NS1 MINI STRAIGHT PLATE 3:6 HOLE 17:35MM 230 FBP022435NS1 MINI DYNAMIC COMPRESSION PLATE DCP 4:8 HOLE 22:42MM 1173 FBP022440NS1 MINI DYNAMIC COMPRESSION PLATE 2:12 HOLE 20:100MM 1173 FBP022480NS1 DYNAMIC COMPRESSION PLATE DCP 2:12 HOLE 26:146MM 977 FBP023002NS9 SMALL COMPRESSION BONE PLATE ACP 2:30HOLE 1782 FBP023102NS9 SMALL T BONE PLATE ACP 3:4HOLE 952 FBP023205NS9 NARROW BONE PLATE 38:542MM 2:30HOLE 1228 FBP023215NS9 WIDE BONE PLATE ACP 4:30HOLE 1782 FBP02410XNY2 TITANIUM BROAD DYNAMIC COMPRESSION PLATE 4.5MM 6:18HOLE 1296 FBP02412XNY2 TITANIUM NARROW DYNAMIC COMPRESSION PLATE 4.5MM 2:16HOLE 924 FBP02415XNY2 TITANIUM DYNAMIC COMPRESSION PLATE 2.0MM:3.5MM 2:12HOLE 761 FBP Z1 2.0MM MINI COMPRESSION PLATE 4:12HOLE 1173 FBP Z1 2.0MM STRAIGHT PLATE 3:6HOLE 17:35MM 230 FBP Z1 2.7MM MINI COMPRESSION PLATE 2:12HOLE 977 FBP024935NZ1 3.5MM COMPRESSION PLATE 2:22HOLE 977 FBP Z1 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 FBP03019XNY2 4.5 COBRA HEAD PLATE 8:11HOLE 3892 FBP03021XNY2 4.5 CONDYLAR BUTTRESS PLATE 7:15HOLE

33 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 MM) FBP03028XNY2 "SYNTEC"SMALL PLATE:RECONSTRUCTION PLATE 5:22HOLE" 亞太醫 3487 療 " 小型骨板 : 重建骨板 (4HOLE 自 生效 ) FBP031005NSN STAINLESS LATERAL TIBIAL HEAD BUTTRESS PLATE 5:13HOLE :246MM FBP031179NZ1 RECONSTRUCTION PLATE 3487 FBP031400NSN 4.5MM RECONTRACTION PLATE 3:16HOLE 3487 FBP031406NSN CLOVERLEAF PLATE 3:6HOLE 1603 FBP031407NSN T-BUTTRESS PLATE 4:6HOLE,L-BUTTRESS PLATE TIBIAL 2130 FBP031415NSN SPOON PLATE 5:6HOLE 1762 FBP031416NSN T-PLATE 3:8HOLE 2130 FBP031418NSN COBRA HEAD PLATE 8:11HOLE 3892 FBP031704NSN HOOK PLATE 4HOLE 3151 FBP V2 DCP 4.5 NARROW DYNAMIC COMPRESSION PLATE 2:18HOLE 1228 FBP V2 DCP 4.5 BROAD DYNAMIC COMPRESSION PLATE 6:22HOLE 1782 FBP V2 RECONSTRUCTION PLATE 4.5MM 3:16HOLE 3487 FBP03229NNS1 PELVIC RECONSTRUCTION PLATE 3:16 HOLE 45:253MM 3487 FBP03229XNY2 STRAIGHT RECONSTRUCTION PLATE 4.5 3:16HOLE 3487 FBP V2 SPOON PLATE 4.5 5:6HOLE 1762 FBP032400NS1 SPOON PLATE 5:6:12 HOLE 100:120MM 1762 FBP V2 T PLATES 4.5MM 3:12HOLE 2130 FBP032401NS1 T PLATE 3:12 HOLE 2130 FBP V2 LATERAL TIBIAL HEAD PLATE-L/R 5:13HOLE 3157 FBP V2 T-BUTTRESS PLATE 4:6HOLE 2130 FBP032403NS1 SUPPORTING T PLATE 4:6 HOLE 81:112MM 2130 FBP V2 L-BUTTRESS PLATE 4.5 MM L/R 3:6HOLE 2130 FBP032404NS1 SUPPORTING PLATE(L-BUTTRESS PLATE) 3:6 HOLE 2130 FBP032405NS1 LATERAL TIBIAL BUTTRESS PLATE 5:13HOLE 3157 FBP V2 CONDYLAR BUTTRESS PLATE L/R 4.5 MM 7:15H 3493 FBP032407NS1 DISTAL FEMUR PLATE 7:15 HOLE (CONDYLAR BUTTRESS PLATE) 3493 FBP S1 HOOK PLATE 128MM 3151 FBP Y2 HOOK PLATE MM 3151 FBP V2 COBRA HEAD PLATE 4.5 8:11HOLE 3892 FBP032409NS1 COBRA HEAD PLATE 8:11 HOLE 3892 FBP V2 SMALL T-PLATE 3.5MM (3+3:4+8HOLE) 952 FBP032411NS1 SMALL T PLATE RIGHT ANGLE 3/3:6/4 HOLE 50:78MM 952 FBP V2 T PLATE OLIQUE 3.5MM (3+3;3+4;3+5HOLE) 952 FBP032412NS1 SMALL T PLATE OLIQUE ANGLE 3/3:5/3 HOLE 52:74MM 952 FBP V2 MULTIPLE FRAGMENT MINI PLATE (W-PLATE) 7HOLE 336 FBP V2 CALCANEAL Y-PLATE 3.5MM 3104 FBP032416NS1 CALCANEAL PLATE FBP V2 CLOVERLEAF PLATE 3.5MM 3:9HOLE 1603 FBP032418NS1 CLOVERLEAF PLATE 3:6 HOLE 1603 FBP V2 MINI L OBLIQUE PLATE L/R 2.7MM 336 FBP032423NS1 MINI L FINGER JOINT-HEAD PLATE 336 FBP V2 MINI T PLATE 2.0,2.7MM 336 FBP S1 MINI T FINGER JOINT-HEAD PLATE

34 FBP V2 ADAPTATION PLATE 100MM 20HOLE 2686 FBP V2 STRAIGHT MINI PLATE 3:6HOLE 230 FBP S1 MINI PLATE 1.5: FBP V2 MINI L PLATE L/R 2.0,2.7MM 336 FBP032433NS1 MINI L FINGER JOINT HEAD PLATE 336 FBP S1 MINI T FINGER JOINT HEAD PLATE 336 FBP S1 MINI PLATE 1.5: FBP V2 DCP MM 2:12HOLE(DYNAMIC,COMPRESSION PLATE) 977 FBP V2 RECONSTRUCTION PLATE 3.5MM 5:22HOLE 3487 FBP032451NS1 RECONSTRUCTION PLATE STRAIGHT 5:22 HOLE 58:262MM 3487 FBP V2 RECONSTRUCTION PLATE CURVED 3.5MM 6:18H 3487 FBP032453NS1 RECONSTRUCTION PLATE BENT 6:18 HOLE 70:214MM 3487 FBP03245XNY2 PELVIC RECONSTRUCTION PLATE 3.5 6:18HOLE 3487 FBP V2 STRAIGHT PLATE 1.5MM,2.0MM 20H 2686 FBP V2 H PLATE STRIGHT PLATE 1.5,2.0 4HOLE 336 FBP03246NNS1 MINI T-PLATE 1.5,2.0 9HOLE 2686 FBP033100NS9 OBLIQUE PLATE 3:8HOLE 952 FBP033104NS9 CLOVERLEAF PLATE 4/6 5/6HOLE 3:10HOLE 1603 FBP033110NS9 CALCANEAL PLATE 14HOLE 3104 FBP033220NS9 RECONSTRUCTION 4.5MM PLATE 3:30HOLE( 型號 : 自 /1/1 生效 ) FBP033310NS9 V-PLATE T-PLATE 63:335MM 3:20HOLE 2130 FBP033315NS9 T-PLATE 65:337MM 3:20HOLAE 3157 FBP03401XNSN 3.5MM RECONTRACTION PLATE 4:22HOLE,CURVED RECONTRACTION 3487 PLATE 6:18HOLE FBP03404XNSN SMALL T-PLATE PT ANGLE 3:6HOLE 952 FBP03405XNSN SMALL T-PLATE OBLIQUE 3:5HOLE 952 FBP03416XNY2 TITANIUM T-PLATE 4.5MM 3:8HOLE 1637 FBP03417XNY2 TITANIUM L/T BUTTRESS PLATE 4.5MM 3:6HOLE,L TIBIAL 2288 BUTTRESS PLATE 5:13HOLE 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 :70MM FBP03424XNY2 TITANIUM MINI T-PLATE 1.5MM:2.0MM 3:4HOLE,MINI L-PLATE MM,2.7MM FBP034256NS9 PELVIS AND ACETABULUM PLATES 2:30HOLE( 型號 : 自 93/1/1 生效 ) FBP03425XNY2 TITANIUM MINI CONDYLAR PLATE 1.5,2.0,2.7MM 2059 FBP03427NNY2 TITANIUM STRAIGHT MINI H-PLATE 1.5,2.0MM 20HOLE 2059 FBP03427XNY2 TITANIUM MINI H-PLATE 1.5,2.0MM 4HOLE 2059 FBP03428XNY2 TITANIUM RECONSTRUCTION PLATE 3.5MM 5:22HOLE 3463 FBP034301NS9 RECONSTRUCTION 4.5MM PLATE 2:30 HOLES 3487 FBP03440XNSN CALCANEAL Y-PLATE 9HOLE 3104 FBP03460XNSN 2.0MM T-PLATE,L-PLATE,H-PLATE( 型號 ,032,048 自 /1/1 起刪除 ) FBP Z1 1.5MM,2.0MM MINI STRAIGHT PLATE 20HOLE 2686 FBP034915NZ1 1.5MM,2.0MM MINI H-PLATE 4HOLE 2686 FBP Z1 2.0MM MINI L-PLATE 4HOLE 336 FBP Z1 2.7MM MINI L-PLATE 5HOLE 336 FBP Z1 2.7MM MULTIPLE FRAGMENT PLATE 7HOLE

35 FBP034927NZ1 2.7MM MINI T-PLATE 5HOLE 336 FBP Z1 3.5MM T-PLATE 3:4+3:8HOLE 952 FBP Z1 3.5MM OBLIQUE T-PLATE 3+3:5HOLE 952 FBP Z1 3.5MM CLOVERLEAF PLATE 3:10HOLE 1603 FBP Z1 3.5MM CALCANEAL PLATE 60:70MM 3104 FBP Z1 3.5MM CALCANEAL Y-PLATE 3104 FBP Z1 4.5MM T-PLATE 3:8HOLE 2130 FBP Z1 4.5MM T-BUTTRESS PLATE 4:6HOLE 2130 FBP Z1 4.5MM L-BUTTRESS PLATE 4HOLE 2130 FBP Z1 4.5MM SPOON PLATE 5:6HOLE 1762 FBP Z1 4.5MM COBRA HEAD PLATE 8:11HOLE 3892 FBP0349XXNZ1 1.5MM,2.0MM T-PLATE (3:4+9HOLE) 2686 FBP035020NSN STAINLESS MINI STRAIGHT PLATE 20HOLE 1.5MM 2686 FBP035030NSN 1.5MM H-PLATE 4HOLE 2686 FBP036030NSN 2.0MM T-PLATE 9HOLE 2686 FBP036048NSN 2.0MM H-PLATE 4HOLE 2686 FBP037012NSN MULTI FRAGMENT PLATE 7HOLE 230 FBP SN L-PLATE,T-PLATE 2.7MM 3HOLE 336 FBP03LM16NAE CLOVERLEAF PLATE 4.5 MM 3,4 HOLE 1603 FBP03LM17NAE L/T PLATE 4.5 MM 2130 FBP03LM18NAE T-BUTTRESS PLATE 4.5 MM 4,5,6 HOLE 2130 FBP03LM19NAE L-BUTTRESS PLATE 4.5 MM L/R 4 HOLE 2130 FBP03LM50NAE COBRA HEAD PLATE 3892 FBP03LM95NAE SPOON PLATE 4.5MM 5,6 HOLE 1762 FBP03LN02NAE L-PLATE 2.7 MM 336 FBP03LN15NAE RECONSTRUCTION PLATE 3.5 MM 3487 FBP03LN16NAE RECONSTRUCTION PLATE 2.7MM 3487 FBP03LN190AE Y-PLATE 3104 FBP03LN20NAE STRAIGHT/L PLATE 2.0 MM 230 FBP03LN225AE T-MINI FINGER PLATE 336 FBP03LN22NAE L-MINI PLATE 2.0MM 336 FBP03LN26NAE DCP 2.7 MM SMALL PLATE 1173 FBP03LN278AE MAXILLO-RECOSTRUCTION PLATE 2.0MM 3487 FBP03LN29NAE DCP PLATE 2.7MM 1173 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 FBP042372NS1 CONDYLAR PLATE 95 度 12 HOLE 50:80MM 3941 FBP042372NY2 CONDYLAR PLATE 95 度 FOR ADULTS AND 5:18HOLE 3941 FBP042375NS1 CONDYLAR PLATE 95 度 5 HOLE 50:80MM 3941 FBP042377NS1 CONDYLAR PLATE 95 度 7 HOLE 50:80MM 3941 FBP042379NS1 CONDYLAR PLATE 95 度 9 HOLE 50:80MM 3941 FBP04238NNS1 ANGLED BLADE PLATE 130 度 4:12 HOLE 50:110MM 2927 FBP04238NNY2 ANGLED BLADE PLATES 130 度 4:12HOLE 50:110MM 2927 FBP042392NS1 HIP PLATE 90:130 度 2927 FBP042392NY2 ANGLED BLADE PLATES FOR INTERTROCHANTERIC FEMORAL 2927 OSTEOTOMIES IN ADULTS FBP042436NS1 MINI CONDYLAR PLATE 2.0: FBP042466NS1 MINI CONDYLAR PLATE 2829 FBP04254XNSN ADULT CONDYLAR PLATE 95 度 5:16HOLE 3941 FBP04282XNS1 CONDYLAR PLATE

36 FBP04282XNY2 CONDYLAR PLATE 95 度 FOR SMALL ADULTS AND ADOLESCENTS 2927 FBP04283XNS1 ANGLED BLADE PLATE 130 度 4:9HOLE 2927 FBP04283XNY2 ANGLED BLADE PLATES 130 度 FOR SMALL STATURED ADULTS AND 2927 ADOLESCENTS 4:9HOLE FBP0449XXNZ1 1.5MM,2.0MM,2.7MM MINI CONDYLAR PLATE 7HOLE 2829 FBP045026NSN CONDYLAR PLATE 7HOLE 1.5MM RT,LT 2829 FBP046040NSN CONDYLAR PLATE 7HOLE 2.0MM RT,LT 2829 FBP04K012NAE CONDYLAR PLATE 95 度 4.5MM 3941 FBP04K021NAE ANGLED PLATE 90:130 度 4.5MM 2927 FBP04LM15NAE CONDYLAR BUTTRESS PLATE 4.5 MM 3493 FBPN10579NM1 STEINMANN PIN 180:230MM 184 FBPN12620NZ1 KIRSCHNER WIRE (K-PIN) WITH THREAD 2.5MM 255 FBPN12910NY2 STEINMANN PINS(SHANK)2.0MM:4.8MM *9"(230MM) 184 FBPN12915NY2 STEINMANN PINS(THREADED)2.0MM:4.8MM *9"(230MM) 279 FBPN12920NY2 STEINMANN PINS(SHANK)0.8MM:3.0MM *70MM 184 FBPN129210V2 STEINMANN PINS(SHANK) 0.8MM:5.0MM 184 FBPN12921NY2 STEINMANN PINS(SHANK)0.8MM:3.0MM *150MM 184 FBPN12922NY2 STEINMANN PINS(SHANK)0.8MM:3.0MM *280MM 184 FBPN12923NY2 STEINMANN PINS(SHANK)0.8MM:3.0MM *400MM 184 FBPN1292XNY2 STEINMANN PIN 70MM 150MM 184 FBPN129360V2 STEINMANN PIN WITH THREAD 279 FBPN12936NS1 STEINMANN PIN WITH THREAD 279 FBPN12936NY2 STEINMANN PIN W/MIDDLE THREADED 279 FBPN1293NNS1 STEINMANN PIN 184 FBPN1293NNY2 STEINMANN PIN W/TROCAR TIP 184 FBPN17011NZ1 STEINMANN PIN 1.8MM 184 FBPN17012NZ1 STEINMANN PIN 2.0MM,2.4MM 184 FBPN17013NZ1 STEINMANN PIN 2.8MM,3.2MM 184 FBPN17015NZ1 STEINMANN PIN 3.6MM,4.0MM 184 FBPN17017NZ1 STEINMANN PIN 4.8MM 184 FBPN1KX10NAE STEINMANN PIN 184 FBPN1KX30NAE STEINMANN PIN WITH THREAD 279 FBPN1LK30NXA STEINMANN PIN(THREADED)3.0;3.5;4.0;4.5;5.0;6.0MM 279 FBPN1MK30NXA STEINMANN PIN(NON-THREADED)3.0;3.5;4.0;4.5;5.0;6.0MM 184 FBPN1NK30NXA STEINMANN PIN(WITH TROCAR TIP)3.0;3.5;4.0;4.5;5.0;6.0MM 184 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 879 *2.5":6"(63.5MM:152.4MM) FBPN2KK28NXA KNOWLES PIN 2.8;3.2;4.0;4.8MM 879 FBPN30531YM1 MR-500 型髓內釘 (RUSH PIN) 722 FBPN31860NZ1 KIRSCHNER PIN 1.0MM:1.8MM 72 FBPN38111NZ1 RUSH MEDULLARY PIN 1/4" 722 FBPN38211NZ1 RUSH MEDULLARY PIN 3/16" 722 FBPN38310NZ1 RUSH MEDULLARY PIN 1/8" 722 FBPN38610NZ1 RUSH MEDULLARY PIN 3/32"

37 FBPN3KJ10NAE RUSH PIN 722 FBS01037XNY2 1.5,2.0,2.7,3.5 CORTEX SCREW( 產品型號 :040,204010:110) FBS01038XNY2 4.5 CORTEX SCREW( 產品型號 :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 :020,022:032, :024,26:40,10:50,55:115) FBS V2 CORTEX SCREW 1.5,2.0,2.7, FBS V2 CORTEX SCREW 3.5,4.5MM PART THREAD(SHATF SCREW) 145 FBS01210NNY2 STAINLESS CORTEX SCREW 1.5:3.5X6:110MM 145 FBS01211NNS1 CORTEX SCREW 1.5:4.0MM 145 FBS V2 CORTEX SCREW 4.5MM 161 FBS01214NNS1 CORTEX SCREW 4.5MM 161 FBS01225XNSN 4.5MM CORTEX SCREW 14:70MM,72:145MM 161 FBS01270XNSN CORTEX BONE SCREW 161 FBS013861NS9 SMALL CORTEX SCREW 2.0/2.7/3.5MM 145 FBS014000NS3 CORTEX SCREW 1.5:3.5MM 6:9MM 145 FBS014000NS9 "STRYKER"BONE SCREW 1.5:3.5MM 6:9MM" 史賽克 " 骨釘 ( 原代碼 145 FBS014000NS3) FBS014001NS3 CORTEX BONE SCREW 161 FBS014061NS9 CORTEX SCREW 4.5MM 14:150MM 161 FBS01410NNY2 TITANIUM CORTEX SCREW 1.5:3.5X6:110MM 183 FBS014148NY2 TITANIUM CORTEX SCREW 3.0:4.0X8:50MM 201 FBS01437XNY2 TITANIUM CORTEX SCREW 1.5MM:3.5MM ( 型號 :040,404010:110,404212:250) FBS01438XNY2 TITANIUM CORTEX SCREW 4.5MM 201 FBS014800NZ1 1.5:3.5MM CORTICAL SCREW( 型號 :50-01,02,03,482706:70-01,483510:150-01,-40:130-07,-16:50-04) 145 FBS014845NZ1 4.5MM CORTICAL SCREW 161 FBS01LA11NAE CORTEX SCREW 4.5MM 161 FBS01LB02NAE CORTEX SCREW 2.0MM 145 FBS01LB06NAE CORTEX SCREW 1.5MM 6:20MM 145 FBS01LB12NAE CORTEX SCREW 2.7MM 145 FBS01LB18NAE CORTEX SCREW 145 FBS02039XNY2 4.0 CANCELLOUS SCREW 144 FBS02040XNY2 6.5 CANCELLOUS SCREW( 產品型號 :150) 281 FBS V2 CANCELLOUS SCREW 4.0MM FULL,PART THREAD 144 FBS02207NNS1 CANCELLOUS BONE SCREW 3.5:4.0MM 144 FBS V2 CANCELLOUS SCREW 6.5MM 16,24,32MM,FULL THREAD 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 :8110,8115:8150,9025:9110,9115:9150) FBS022331NZ1 LONG CANCELLOUS SCREW FULLY THREAD 6.5MM 281 FBS024102NS3 CANCELLOUS BONE SCREW 281 FBS024103NS9 CANCELLOUS BONE SCREW 6.5MM(1/3) 115:150MM 281 FBS024203NS3 CANCELLOUS BONE SCREW 281 FBS024204NS9 CANCELLOUS BONE SCREW 6.5MM(2/3) 105:200M 281 FBS024302NS9 CANCELLOUS BONE SCREW 6.5MM 105:150M 281 FBS024303NS3 CANCELLOUS BONE SCREW 281 FBS02439XNY2 TITANIUM CANCELLOUS SCREW 4.0MM 144 FBS024402NU0 STAINLESS SELF-LOCKING SCREW 4.5MM 35:75MM

38 FBS02440XNY2 TITANIUM CANCELLOUS SCREW 6.5MM( 型號 :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 FBS028080NH1 CANCELLOUS BONE SCREW 4.0MM 144 FBS028120NH1 CANCELLOUS BONE SCREW 6.5MM DIA 281 FBS02LA33NAE THREAD CANCELLOUS SCREW 6.5MM 281 FBS02LB35NAE CANCELLOUS SCREW 4.0MM 144 FBS03041XNY2 4.5 MALLEOLAR SCREW 269 FBS030811NH1 MALLEOLAR SCREW 踝質釘 269 FBS V2 MALLEOLAR SCREW 4.5MM 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 FBS Z1 4.5MM MALLEOLAR SCREW 269 FBS03LA22NAE MALLEOLAR SCREW 20:110MM 269 FBS04042XNY2 3.5,4.5 CANNULATED SCREW( 產品型號 :472,214620:672) 1544 FBS04043XNY2 6.5 CANNULATED SCREW( 產品型號 :730) 1544 FBS04044XNY2 7.0,7.3 CANNULATED SCREW( 產品型號 :530,208830:950,209850:930) FBS041142NZ1 MINI MAGNA-FX CANNULATED SCREW 4.0MM,5.0MM 1544 FBS041146NZ1 MAGNA-FX CANNULATED SCREW 16MM,32MM 1544 FBS041155NZ1 HERBERT CANNULATED BONE SCREW 25:100MM 1544 FBS V2 CANNULATED SCREW 3.5,4.0, FBS04202NNS1 3.0 CANNULATED SCREW 1544 FBS04202NNY2 STAINLESS CANNULATED SCREW 3.4:4.0X8:50MM 1544 FBS WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:CANNULATED 1544 SCREW 3.5,4.0,4.5 威創骨釘骨板植入物 : 中空骨釘 FBS04205NNS1 3.5 CANNULATED SCREW 1544 FBS04207NNS1 4.0 CANNULATED SCREW 1544 FBS V2 CANNULATED SCREW 7.0, FBS WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:CANNULATED 1544 SCREW 7.0,7.3 威創骨釘骨板植入物 : 中空骨釘 FBS V2 CANNULATED SCREW FBS WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:CANNULATED 1544 SCREW 6.5 威創骨釘骨板植入物 : 中空骨釘 FBS04208NNS1 CANNULATED SCREW 7.0MM,7.3MM 1544 FBS04209NNS1 CANNULATED SCREW 7.0MM 32MM L45:130MM 1544 FBS V2 CANNULATED SCREW 2.4, FBS WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:CANNULATED 1544 SCREW 2.4,3.0 威創骨釘骨板植入物 : 中空骨釘 FBS04214NNS1 4.5 CANNULATED SCREW 1544 FBS SN CANNULATED HIP PIN SYSTEM(STAINLESS STEEL) 1544 FBS04216XNSN CANNULATED HIP PIN 1544 FBS042170NSN CANNULATED SCREW D 8,6.5,4MM( 產品型號 : ,222820:870) FBS SN CANNULATED SCREW(STAINLESS STEEL) 1544 FBS04218NNY2 STAINLESS CANNULATED SCREW 7.0:7.3X30:150MM

39 FBS04402NNS1 TITANIUM 3.0 CANNULATED SCREW 1984 FBS04402NNY2 TITANIUM CANNULATED SCREW 3.0:4.0X8:50MM 1984 FBS WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:TITANIUM 1984 CANNULATED SCREW 3.5,4.0,4.5 威創骨釘骨板植入物 : 鈦合金中空骨釘 FBS04407NNS1 TITANIUM 4.0 CANNULATED SCREW 1984 FBS WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:TITANIUM CANNULATED SCREW 7.0,7.3 威創骨釘骨板植入物 : 鈦合金中空骨釘 1984 FBS WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:TITANIUM 1984 CANNULATED SCREW 6.5 威創骨釘骨板植入物 : 鈦合金中空骨釘 FBS04408NNS1 TITANIUM 7.3 CANNULATED SCREW 1984 FBS04408XNY2 TITANIUM CANNULATED SCREW 7.0X30:130MM 1984 FBS WG WILTROM BONE SCREW AND BONE PLATE IMPLANT:TITANIUM CANNULATED SCREW 2.4,3.0 威創骨釘骨板植入物 : 鈦合金中空骨釘 1984 FBS044144NY2 TITANIUM CANNULATED SCREW 4.5X20:72MM 1984 FBS04414NNS1 TITANIUM 4.5 CANNULATED SCREW 1984 FBS04418NNY2 TITANIUM CANNULATED SCREW 7.0:7.3X30:150MM 1984 FBS04442XNY2 TITANIUM CANNULATE SCREW 7.3MM 1984 FBS SN CANNULATED SCREW(TITANIUM) 1984 FBS051150NZ1 HERBERT MINI BONE SCREW 10:24MM 1544 FBS051151NZ1 HERBERT SCREW 16:30MM 1544 FBS051152NZ1 HERBERT WHIPPLE BONE SCREW 12:30MM 1544 FBS051154NZ1 HERBERT BONE SCREW 12:30MM 1544 FBS05602XNS3 TITANIUM CANNULATED SCREW(604610: 自 88/09/01 起生效 ) 1984 FBS05602XNS9 TITANIUM CANNULATED SCREW( 原代碼 FBS05602XNS3) 1984 FBS Z1 CORTICAL NUT 48 FBS07044XNY2 4.5,7.0,7.3 WASHER 66 FBS071430NSN WASHER 10,7,13MM OD 66 FBS V2 WASHER 4.5MM 7.0MM 13.0MM 66 FBS072199NS1 WASHER 66 FBS07219XNS1 WASHER/NUT 48 FBS074199NS1 WASHER FOR TITANIUM CANNULATE SCREW 84 FBS07444XNY2 TITANIUM WASHER 84 FBS074900NZ1 1.5MM:4.5MM WASHER 66 FBS076199NS3 WASHER FOR TCS SCREWS( 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 FBW M1 KIRSCHNER WIRE (K-PIN) 1.0:1.2MM 300MM 72 FBW M1 KIRSCHNER WIRE (K-PIN) 1.5:1.8MM 300MM 72 FBW M1 KIRSCHNER WIRE (K-PIN) 2.0MM 300MM 72 FBW M1 KIRSCHNER WIRE (K-PIN) 2.4MM 300MM 72 FBW M1 KIRSCHNER WIRE (K-PIN) 3.0MM 300MM 72 FBW011610NSN K-WIRE 0.6:1.6MM,2.0MM 72 FBW012900NY2 KIRSCHNER WIRES(SHANK)0.7MM,0.9MM,1.1MM,1.6MM 72 *4"(101.6MM) FBW Y2 KIRSCHNER WIRE 72 FBW012910NY2 KIRSCHNER WIRES(SHANK)0.7MM,0.9MM,1.1MM,1.6MM *9"(230MM)

40 FBW012911NY2 KIRSCHNER WIRES(SHANK)0.7MM,0.9MM,1.1MM,1.6MM *12"(300MM) 72 FBW012915NY2 KIRSCHNER WIRES(THREADED)0.9MM,1.1MM,1.6MM *9"(230MM) 255 FBW V2 K-PIN,GUIDEWIRE WITH THREAD 255 FBW012926NY2 KIRSCHNER WIRE W/THREADED 255 FBW012927NS1 K-PIN,GUIDEWIRE WITH THREAD 255 FBW01292NNS1 KIRSCHNER WIRE (K-PIN)0.6:3.0MM 72 FBW01294XNY2 KIRSCHNER WIRE WITH THREADED TIP 255 FBW01LX08NAE K-WIRE 0.8MM,1.0MMX310MM 72 FBW01LX08SAE KIRSCHNER WIRE (K-PIN)0.8MMx150MM 72 FBW01LX105AE K-WIRE 2.5MMx70MM 72 FBW01LX10SAE KIRSCHNER WIRE (K-PIN)1.0MMx150MM 72 FBW01LX12NAE K-WIRE 310MM,1.2:1.7MM 72 FBW01LX12SAE KIRSCHNER WIRE (K-PIN)1.2MMx150MM 72 FBW01LX14SAE KIRSCHNER WIRE (K-PIN)1.4MMx150MM 72 FBW01LX15SAE KIRSCHNER WIRE (K-PIN)1.5MMx150MM 72 FBW01LX16SAE KIRSCHNER WIRE (K-PIN)1.6MMx150MM 72 FBW01LX17SAE K-WIRE 150MM 1.7MM 72 FBW01LX18NAE K-WIRE 310MM,1.8MM 72 FBW01LX18SAE KIRSCHNER WIRE (K-PIN)1.8MMx150MM 72 FBW01LX20NAE K-WIRE 310MM,2.0MM 72 FBW01LX20SAE KIRSCHNER WIRE (K-PIN)2.0MMx150MM 72 FBW01LX22NAE K-WIRE 310MM,2.2MM 72 FBW01LX22SAE KIRSCHNER WIRE (K-PIN)2.2MMx150MM 72 FBW01LX25NAE K-WIRE 310MM,2.5MM 72 FBW01LX25SAE KIRSCHNER WIRE (K-PIN)2.5MMx150MM 72 FBW01LX28SAE KIRSCHNER WIRE (K-PIN)0.8MMx150MM 72 FBW01LX30NAE K-WIRE 210MM,1.0MM( 更改為 1.0X310MM) 72 FBW01LX30SAE KIRSCHNER WIRE (K-PIN)1.0MMx150MM 72 FBW01LX32NAE K-WIRE 310MM,1.2:1.6MM 72 FBW01LX32SAE KIRSCHNER WIRE (K-PIN)1.2MMx150MM 72 FBW01LX34SAE KIRSCHNER WIRE (K-PIN)1.4MMx150MM 72 FBW01LX35SAE KIRSCHNER WIRE (K-PIN)1.5MMx150MM 72 FBW01LX36SAE KIRSCHNER WIRE (K-PIN)1.6MMx150MM 72 FBW01LX37SAE KIRSCHNER WIRE 1.7MMx150MM 72 FBW01LX38NAE K-WIRE 310MM,1.8MM 72 FBW01LX38SAE KIRSCHNER WIRE (K-PIN)1.8MMx150MM 72 FBW01LX40NAE K-WIRE 310MM,2.0MM 72 FBW01LX40SAE KIRSCHNER WIRE (K-PIN)2.0MMx150MM 72 FBW01LX42NAE K-WIRE 310MM,2.2MM 72 FBW01LX42SAE KIRSCHNER WIRE (K-PIN)2.2MMx150MM 72 FBW01LX45NAE K-WIRE 310MM,2.5MM 72 FBW01LX45SAE KIRSCHNER WIRE (K-PIN)2.5MMx150MM 72 FBW01LX46SAE KIRSCHNER WIRE (K-PIN)3.0MMx150MM 72 FBW01LX47SAE KIRSCHNER WIRE 雅式鋼針 72 FBW01LX90NAE KIRSCHNER WIRE 雅式鋼針 72 FBW01LX915AE KIRSCHNER WIRE 雅式鋼針 72 FBW01LX91NAE KIRSCHNER WIRE 雅式鋼針 72 FBW01LX925AE KIRSCHNER WIRE 雅式鋼針 72 FBW01LX92NAE KIRSCHNER WIRE 雅式鋼針 72 FBW01LX955AE KIRSCHNER WIRE 雅式鋼針 72 FBW01LX95NAE KIRSCHNER WIRE 雅式鋼針 72 FBW01LX98SAE K-WIRE 0.8MM,1.0MMX70MM

41 FBW03C018NM1 KIRSCHNER WIRE( 田島 PIN) 0.7:1.5MM 100:120MM 72 FPP LE STRYKER LEIBINGER UNIVERSAL MANDIBLE SYSTEM:1.7MM MID FACE Y-PLATE 5 HOLES 適應症請見備註欄 FPP LE STRYKER LEIBINGER UNIVERSAL MANDIBLE SYSTEM:1.7MM MID FACE CURVED PLATE 4-10 HOLES 適應症請見備註欄 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 FPP M3 2HOLE MINI LOW PROFILE PLATE 適應症請見備註欄 975 FPP LE 0.6,1.0MM MINI BONE PLATE 5,6HOLE REGULAR STR 適應症請 975 見備註欄 FPP LE 0.6,1.0MM MINI BONE PLATE 8HOLE REGULAR STR 適應症請見備 1134 註欄 FPP LE 0.6,1.0MM MINI BONE PLATE 4 HOLE REGULAR STR 適應症請見 975 備註欄 FPP LE 0.6,1.0MM MINI L-PLATE REGULAR RIGHT 4HOLE 適應症請見備 1380 註欄 FPP LE L-PLATE LEFT 0.6MM 適應症請見備註欄 1380 FPP LE 0.6,1.0MM MINI L-PLATE LONG RIGHT 4HOLE 適應症請見備註 1380 欄 FPP LE 0.6,1.0MM MINI L-PLATE LONG LEFT 4HOLE 適應症請見備註欄 1380 FPP LE 0.6,1.0MM MINI L-PLATE REGULAR LEFT 4HOLE 適應症請見備 1380 註欄 FPP LE 0.6,1.0MM MINI T-PLATE REGULAR 90 度 6HOLE 適應症請見備 1885 註欄 FPP LE 0.6,1.0MM MINI T-PLATE LONG 90 度 5HOLE 適應症請見備註欄 1885 FPP LE 0.6,1.0MM MINI T-PLATE LONG 80 度 RIGHT 5HOLE 適應症請 1885 見備註欄 FPP LE 0.6,1.0MM MINI T-PLATE LONG 80 度 LEFT 5HOLE 適應症請見 1885 備註欄 FPP LE 0.6,1.0MM MINI DOUBLE T PLATE REGULAR 6HOLE 適應症請見 2270 備註欄 FPP LE 0.6,1.0MM MINI DOUBLE T LONG 90 度 4HOLE 適應症請見備註 2270 欄 FPP LE 0.6,1.0MM MINI Y PLATE(REGULAR LONG)5HOLE 適應症請見備 1743 註欄 FPP LE 0.6,1.0MM MINI DOUBLE Y PLATE LONG 6HOLE 適應症請見備註 2469 欄 FPP LE 0.6,1.0MM MINI DOUBLE Y PLATE LONG EXTENDED 8HOLE 適應 2469 症請見備註欄 FPP LE LOW PROFILE ORBITA PLATE CURVE 6,8 HOLE 0.6MM REGULAR 1562 適應症請見備註欄 FPP M3 TITANIUM 0.6MM MINI PLATE L SHAPE 適應症請見備註欄 1380 FPP LE 1.7 MID-FACE L-PLATE 5-6 HOLES 適應症請見備註欄 1380 FPP010677NLE MINI T PLATE 5 HOLE 適應症請見備註欄 1885 FPP M3 TITANIUM 0.6MM LOW PROFILE MINI PLATE ORBITA SHAPE 6, HOLES 適應症請見備註欄 FPP LE 2.0 MINI PLATE BAR 4-6 HOLES 適應症請見備註欄 975 FPP LE 1.0MM MINI BONE PLATE 16HOLE REGULAR STR 適應症請見備註 1565 欄 FPP010821NLE 2.0 MINI PLATE BAR 16 HOLES 適應症請見備註欄 1565 FPP LE 2.0 MINI PLATE L-PLATE 4-9 HOLES 適應症請見備註欄

42 FPP LE 2.0 MINI PLATE T-PLATE 6-8 HOLES 適應症請見備註欄 1885 FPP LE 2.0 MINI PLATE Y-PLATE 5-8 HOLES 適應症請見備註欄 1743 FPP LE 1.0MM MINI DOUBLE Y PLATE REGULAR 6HOLE 適應症請見備註 2469 欄 FPP LE 2.0 MINI PLATE CURVED PLATE 12 HOLES 適應症請見備註欄 1562 FPP EJ 2.0 MM MINI "L" PLATE 90 DEGREE, 4 HOLE 適應症請見備註 1380 欄 FPP EJ 2.0 MM MINI "L" PLATE 4 HOLE 適應症請見備註欄 1380 FPP EJ 2.0 MM MINI ZED PLATE 4 HOLE 適應症請見備註欄 1626 FPP EJ 2.0 MM MINI "Y" PLATE 7 HOLE 適應症請見備註欄 1743 FPP EJ 2.0 MM MINI L PLATE 4 HOLE 適應症請見備註欄 1380 FPP EJ 2.0 MM MINI ZED PLATE 4 HOLE 適應症請見備註欄 1626 FPP EJ 2.0 MM MINI Y PLATE 7 HOLE 適應症請見備註欄 1743 FPP EJ 2.0 MM MINI STRAIGHT PLATE 4 HOLE 適應症請見備註欄 975 FPP EJ 2.0 MM MINI STRAIGHT PLATE 10 HOLE 適應症請見備註欄 1134 FPP EJ 2.0 MM MINI STRAIGHT PLATE 16 HOLE 適應症請見備註欄 1565 FPP EJ 2.0 MM MINI T PLATE 5 HOLE 適應症請見備註欄 1885 FPP EJ 2.0 MM MINI LARGE BUR HOLE PLATE 6 HOLE 適應症請見備註 5873 欄 FPP LE 1.0MM MINI BONE PLATE 4HOLE LONG STR 適應症請見備註欄 975 FPP LE 0.6,1.0MM MINI BONE PLATE 6HOLE LONG STR 適應症請見備 1134 註欄 FPP EJ 2.0 MM MINI STRAIGHT PLATE 4 HOLE 適應症請見備註欄 975 FPP EJ 2.0 MM MINI STRAIGHT PLATE 10 HOLE 適應症請見備註欄 1134 FPP EJ 2.0 MM MINI I PLATE 4 HOLE 適應症請見備註欄 2270 FPP EJ 2.0 MM MINI Y PLATE 5 HOLE 適應症請見備註欄 1743 FPP011051NLE MINI PLATE 16 HOLE 適應症請見備註欄 1565 FPP011054NLE MINI PLATE 4 HOLE 適應症請見備註欄 975 FPP011056NLE MINI PLATE 6 HOLE 適應症請見備註欄 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 FPP EJ 2.0 MM MINI STRAIGHT PLATE 6 HOLE 適應症請見備註欄 1134 FPP EJ 2.0 MM MINI STRAIGHT PLATE 8 HOLE 適應症請見備註欄 1134 FPP EJ 2.0 MM MINI TR BSSO PLATE 4 HOLE 適應症請見備註欄 2270 FPP Y2 MINI PLATE 1.0MM 4HOLE STR 適應症請見備註欄 975 FPP Y2 MINI PLATE 1.0MM 8HOLE STR 適應症請見備註欄 1134 FPP Y2 MINI PLATE 1.0MM 16HOLE STR 適應症請見備註欄 1565 FPP Y2 MINI PLATE 1.0MM 4HOLE L-SHAPE 適應症請見備註欄 1380 FPP Y2 MINI PLATE 1.0MM 5HOLE T-SHAPE 80,90 度 適應症請見備註欄 1885 FPP Y2 MINI PLATE 1.0MM 5HOLE DOUBLE T-SHAPE 適應症請見備註欄 2270 FPP Y2 MINI PLATE 1.0MM 6HOLE Y-SHAPE 適應症請見備註欄 1743 FPP Y2 MINI NASAL BONE PLATE 1.0MM 適應症請見備註欄 4479 FPP S1 MINI PLATE 1.5/2.0 2:4HOLE 16:28MM 適應症請見備註欄 975 FPP S1 MINI PLATE 2.0 6HOLE 35:40MM 適應症請見備註欄 1134 FPP S1 2.0MM MANDIBLE MINI PLATE 6HOLE,70D( 轉 70 度 ) TWISTED 40MM 適應症請見備註欄

43 FPP S1 ADAPTION MINI PLATE 1.5,2.0 20HOLE STR 適應症請見備註欄 1565 FPP S1 ORBITAL RIM PLATE 1.5,2.0 CURVED 8:12 HOLES 適應症請見 1562 備註欄 FPP01475NNS1 L- PLATE 1.5,2.0 5:10 HOLES 適應症請見備註欄 1380 FPP S1 Y- PLATE 1.5,2.0 5:8 HOLES 適應症請見備註欄 1743 FPP S1 DOUBLE Y-PLATE 2.0 8HOLE 適應症請見備註欄 2469 FPP S1 X-PLATE 1.5,2.0 4 HOLES 適應症請見備註欄 2469 FPP S1 MINI H-PLATE 2.0 8:9 HOLES 適應症請見備註欄 4479 FPP S1 MINI BURR HOLE COVER 1.5,2.0 6 HOLES 適應症請見備註欄 5873 FPP M3 TITANIUM 0.6MM,1.0MM MINI PLATE 4 HOLES STR 適應症請見 975 備註欄 FPP M3 TITANIUM 0.6MM,1.0MM MINIP LATE 6 HOLES STR 適應症請見 1134 備註欄 FPP M3 TITANIUM 0.6MM,1.0MM MINIP LATE 8HOLE STR 適應症請見備 1134 註欄 FPP M3 TITANIUM 0.6MM,1.0MM MINI PLATE 16 HOLE STR 適應症請見 1565 備註欄 FPP M3 TITANIUM 1.0MM MINI PLATE L SHAPE 4 HOLE 適應症請見備註 1380 欄 FPP M3 TITANIUM 0.6MM,1.0MM MINI PLATE L SHAPE 4HOLE 適應症請 1380 見備註欄 FPP M3 TITANIUM0.6MM,1.0MM MINI PLATE 110 度 4HOLE 適應症請見 1380 備註欄 FPP M3 TITANIUM 0.6MM,1.0MM MIN IPLATE T SHAPE 90 度 4HOLE 適應 1885 症請見備註欄 FPP M3 TITANIUM 0.6MM,1.0MM MINI PLATE T SHAPE 80 度 4HOLE 適應 1885 症請見備註欄 FPP M3 TITANIUM 0.6MM,1.0MM MINI PLATE DOUBLE T SHAPE 90 度 ,6HOLE 適應症請見備註欄 FPP M3 TITANIUM0.6MM,1.0MM MINI PLATE Y SHAPE 5HOLE 適應症請 1743 見備註欄 FPP M3 TITANIUM 0.6MM,1.0MM MINI PLATE DOUBLE Y SHAPE 6HOLE 2469 適應症請見備註欄 FPP M3 TITANIUM 0.6MM,1.0MM MINI PLATE DOUBLE Y SHAPE 7HOLE 適 2469 應症請見備註欄 FPP M3 TITANIUM 0.6MM,1.0MM MINI PLATE H SHAPE 12HOLE 適應症請 4479 見備註欄 FPP MC TITANIUM 1MM MINI PLATE 4HOLE STR 適應症請見備註欄 975 FPP MC TITANIUM 1MM MINI PLATE 5HOLE STR 適應症請見備註欄 975 FPP MC TITANIUM 1MM MINI PLATE 6 HOLE STR 適應症請見備註欄 1134 FPP MC TITANIUM 1MM MINI PLATE 8 HOLE STR 適應症請見備註欄 1134 FPP MC TITANIUM 1MM MINI PLATE 4 HOLE 9MM STR 適應症請見備註欄 975 FPP MC FPP MC FPP MC FPP MC TITANIUM 1MM MINI PLATE 4 HOLE 12MM STR 適應症請見備註欄 "MEDICON"TITANIUM 1MM MINI L-PLATE LEFT 9MM 4 HOLE 鈦金屬顏面骨板系統 : 迷你骨板 適應症請見備註欄 TITANIUM 1MM MINI L-PLATE RIGHT 9MM 4 HOLE 適應症請見備註欄 TITANIUM 1MM MINI L-PLATE LEFT 9MM 4 HOLE 適應症請見備註欄

44 FPP MC TITANIUM 1MM MINI L-PLATE R 9MM 4 HOLE 適應症請見備註欄 1380 FPP MC TITANIUM 1MM MINI L-PLATE LEFT 12MM 4 HOLE 適應症請見備 1380 註欄 FPP MC TITANIUM 1MM MINI L-PLATE RIGHT 12MM 4 HOLE 適應症請見 1380 備註欄 FPP MC TITANIUM 1MM MINI L-PLATE LEFT 9MM 4 HOLE 適應症請見備 1380 註欄 FPP MC TITANIUM 1MM MINI Y PLATE 9MM 4 HOLE 適應症請見備註欄 1743 FPP MC TITANIUM 1MM MINI Y PLATE 12MM 4HOLE 適應症請見備註欄 1743 FPP MC TITANIUM 1MM MANDIBULAR ANGLE PLATE 4HOLE LEFT 適應症請 1626 見備註欄 FPP MC TITANIUM 1MM MINI MANDIBULAR ANGLE PLATE 4HOLE RIGHT 適 1626 應症請見備註欄 FPP MC TITANIUM 1MM MINI MANDIBULAR ANGLE PLATE 6HOLE LEFT 適 1836 應症請見備註欄 FPP MC TITANIUM 1MM MINI MANDIBULAR ANGLE PLATE 6HOLE RIGHT 適 1836 應症請見備註欄 FPP MC 1MM MINI TI-ORBITA PLATE 12MM 4HOLE 適應症請見備註欄 1562 FPP MC TITANIUM 1MM MINI PLATE 4 HOLE 10MM STR 適應症請見備註 975 欄 FPP MC TITANIUM MANDIBULAR RECONSTRUCTION PLATE STRAIGHT 100MM MM 適應症請見備註欄 FPP MC TITANIUM MANDIBULAR RECONSTRUCTION PLATE ANGLE 105MM 2MM HOLE R/L 適應症請見備註欄 FPP01A7072WR 0.6MM MINI L-PLATE 100 度 4-6 HOLE 1.5MM 適應症請見備註欄 1380 FPP01A7106WR MINI PREFORMED ORBITAL FLOOR PLATE 適應症請見備註欄 5778 FPP01A7345WR NEURO MINI PLATE STRAIGHT 2 HOLE 1.5MM 適應症請見備註欄 975 FPP01A8046WR 0.6MM MINI BONE PLATE, MEDIUM 2 HOLE STRAIGHT 2.0MM 適 975 應症請見備註欄 FPP01A8068WR MINI BURR HOLE PLATE 適應症請見備註欄 5873 FPP01A8081WR 0.6MM MINI Z PLATE 4 HOLE 適應症請見備註欄 1626 FPP01A9204WR 0.6,1.0MM MINI BONE PLATE 4 HOLE STRAIGHT 適應症請見備註 975 欄 FPP01A9206WR 0.6,1.0MM MINI BONE PLATE 6 HOLE STRAIGHT 適應症請見備註 1134 欄 FPP01A9207WR 0.6,1.0MM MINI BONE PLATE 6 HOLE LONG STRAIGHT 適應症請 1134 見備註欄 FPP01A9208WR 0.6,1.0MM MINI BONE PLATE 8 HOLE STRAIGHT 適應症請見備註 1134 欄 FPP01A9215WR 1.0MM MINI BONE PLATE, EXTRA LONG 4 HOLE STRAIGHT 2.0MM 975 適應症請見備註欄 FPP01A9216WR 0.6;1.0MM MINI BONE PLATE 16 HOLE STRAIGHT 適應症請見備 1565 註欄 FPP01A9226WR 0.6;1.0MM MINI ORBITAL PLATE 6:10HOLE 適應症請見備註欄 1562 FPP01A9228WR MINI PLATE, 6-8 HOLE ANGLE 2.0MM 適應症請見備註欄 1836 FPP01A9230WR 0.6;1.0MM MINI L-PLATE 4 HOLE 適應症請見備註欄 1380 FPP01A9240WR 0.6;1.0MM MINI T PLATE 5:7 HOLE 適應症請見備註欄 1885 FPP01A9250WR 0.6;1.0MM MINI Y PLATE 5 HOLE 適應症請見備註欄

45 FPP01A9264WR 0.6;1.0MM MINI L-PLATE 6 HOLE 適應症請見備註欄 1380 FPP01A9294WR 0.6;1.0MM MINI DOUBLE T-PLATE 4,6 HOLE 適應症請見備註欄 2270 FPP LE BRIDGING PLATE STR 6:10HOLE 2.8MM ( 型號 ,8, ,10 自 92/1/1 生效 ) 適應症請見備註欄 FPP LE BRIDGING PLATE STRAIGHT 11HOLE(4+3+4HOLE) 2.8MM 適應症 4230 請見備註欄 FPP LE BRIDGING PLATE STR 11:17 H 4230 ( :7,8003:11,3,9012:6, , :139 92/1/1 生效 ) 適應症見備註 FPP LE BRIDGING PLATE STRAIGHT 13HOLE(4+5+4HOE)2.8MM 適應症請 4230 見備註欄 FPP LE BRIDGING PLATE STRAIGHT 14HOLE(4+6+4HOLE)2.8MM 適應症請 4230 見備註欄 FPP LE BRIDGING PLATE STRAIGHT 15HOLE(4+7+4HOLE)2.8MM 適應症請 4230 見備註欄 FPP LE BRIDGING PLATE ANGLE LEFT 11HOLE(4+3+4HOLE)2.8MM ( 型號 自 92/1/1/ 生效 ) 適應症請見備註欄 FPP LE BRIDGING PLATE L-ANGLE 12:21H( 型號 :59,8025:87,9038:76 自 92/1/1 生效 ) 適應症請見備註欄 FPP LE BRIDGING PLATE ANGLE LEFT 15HOLE(4+7+4HOLE)2.8MM 適應症 6720 請見備註欄 FPP LE BRIDGING PLATE ANGLE LEFT 17HOLE (4+9+4HOLE)2.8MM 適應 6720 症請見備註欄 FPP LE BRIDGING PLATE ANGLE RIGHT 11HOLE(4+3+4HOLE)2.8MM 適應 6720 症請見備註欄 FPP LE BRIDGING PLATE ANGLE RIGHT 13HOLE(4+5+4HOLE)2.8MM 適應 6720 症請見備註欄 FPP LE BRIDGING PLATE ANGLE RIGHT 15HOLE(4+7+4HOLE)2.8MM 適應 6720 症請見備註欄 FPP LE BRIDGING PLATE ANGLE RIGHT 17HOE(4+9+4HOLE)2.8MM 適應症 6720 請見備註欄 FPP LE CONDYLAR IMPLANT LEFT 14MM 適應症請見備註欄 6874 FPP LE CONDYLAR IMPLANT RIGHT 14MM 適應症請見備註欄 6874 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION 6720 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 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION 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 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:RECONSTRUCTION PLATE FULL HOLE" 歐美特 " 下頷骨折重建系統, 重建骨板雙邊 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION 4230 SYSTEM:RECONSTRUCTION PLATE 14HOLE" 歐美特 " 下頷骨折重建系統, 重建直型骨板 14 洞 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION 4230 SYSTEM:RECONSTRUCTION PLATE 18HOLE" 歐美特 " 下頷骨折重建系統, 重建直型骨板 18 洞 FPP021552NLE ANGLE PLATE 6-10 HOLE 適應症請見備註欄 5573 FPP021591NLE RECON PLATE STRAIGHT HOLE 適應症請見備註欄 4230 FPP021592NLE RECON PLATE HEMI/FULL 適應症請見備註欄

46 FPP Y2 COMPRESSION PLATE 1.6MM 4,8HOLE STR 適應症請見備註欄 2722 FPP Y2 COMPRESSION PLATE 1.6MM 16HOLE STR 適應症請見備註欄 4230 FPP Y2 COMPRESSION PLATE 1.6MM 4HOLE STR/ 斜孔 適應症請見備註欄 2722 FPP Y2 TOTAL MANDIBULAR BRIDGING STR PLATE 3.0MM(4+9+4) HOLE 適應症請見備註欄 FPP Y2 MANDIBULAR BRIDGING STR PLATE 3.0MM(4+2+4) HOLE 適應症 2722 請見備註欄 FPP Y2 MANDIBULAR BRIDGING STR PLATE 3.0MM(4+3,4,5,6,7+4)HOLE 4230 適應症請見備註欄 FPP Y2 MANDIBULAR BRIDGING STR PLATE 3.0MM(4+3,5,7,9+4)HOLE 適 6720 應症請見備註欄 FPP M3 TITANIUM RECONSTRUCTION PLATE 8HOLE STR 適應症請見備註欄 2722 FPP M3 TITANIUM RECONSTRUCTION PLATE 10:14HOLE STR 適應症請見備 4230 註欄 FPP M3 TITANIUM RECONSTRUCTION PLATE 16,18HOLE STR 適應症請見備 4230 註欄 FPP M3 TITANIUM RECONSTRUCTION PLATE 5+8HOLE ANG 適應症請見備註 6720 欄 FPP M3 TITANIUM RECONSTRUCTION PLATE 5+12HOLE ANG 適應症請見備 6720 註欄 FPP M3 TITANIUM RECONSTRUCTION PLATE 5+16HOLE,5+20HOLE ANG 適應 6720 症請見備註欄 FPP M3 TITANIUM RECONSTRUCTION PLATE HOLE COMPLETE MANDIBLE 適應症請見備註欄 FPP024009KM3 TITANIUM CONDYLAR PROTHESIS W/2 FIXATION HOLES 適應症請 6874 見備註欄 FPP LE COMPRESSION PLATE ANGLE 4HOLE 適應症請見備註欄 5573 FPP S1 2.4MM RECONSTRUCTION PLATE STRAIGHT 12HOLE 95MM 適應症 4230 請見備註欄 FPP S1 2.4MM RECONSTRUCTION PLATE STRAIGHT 20:24HOLE 159MM 適 4230 應症請見備註欄 FPP024988NS1 2.4MM RECONSTRUCTION PLATE ANGLED 18:27HOLE 146MM 適應 6720 症請見備註欄 FPP025633NLE TOTAL BRIDGING PLATE 25:30HOLE( 型號含 :69) 適應症 請見備註欄 FPP MC TITANIUM MANDIBULAR RECONSTRACTION PLATE 14HOLE 適應症請 4230 見備註欄 FPP MC TITANIUM MANDIBULAR RECONSTRACTION PLATE ANGLE 12HOLE 適 6720 應症請見備註欄 FPP027051NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:ADAPTION PLATES PURE 4230 TITANIUMM 12 HOLES " 信迪思 " 下顎固定系統 : 連結骨板 FPP027171NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:PLATES PURE TITANIUMM HOLES STRAIGHT " 信迪思 " 下顎固定系統 : 直骨板 FPP02A4506WR 2.4 LOCKING RECON PLATES6,12 HOLE 適應症請見備註欄 4230 FPP02A4518WR 2.4 LOCKING RECON PLATES 18,24 HOLE 適應症請見備註欄 4230 FPP02A4540WR 2.4 LOCKING RECON 5+11 PLATES,ANGLE 適應症請見備註欄 6720 FPP02A4542WR 2.4 LOCKING RECON 5+22 PLATES,ANGLE 適應症請見備註欄 6720 FPP02A4544WR 2.4 LOCKING RECON PLATE,DOUBLE ANGLE 適應症請見備註欄 FPP LE FRACTURE PLATE 4:8HOLE 35MM 1.8MM( 型號 :064,081:084 自 92/1/1 生效 ) 適應症請見備註欄 FPP LE FRACTURE PLATE 4 HOLE 40MM 1.8MM 適應症請見備註欄

47 FPP LE FRACTURE PLATE 4 HOLE 50MM 1.8MM 適應症請見備註欄 2722 FPP LE FRACTURE PLATE 8 HOLE 60MM 1.8MM 適應症請見備註欄 2722 FPP LE FRACTURE PLATE 8 HOLE 70MM 1.8MM 適應症請見備註欄 2722 FPP LE MAND ANGLE PLATE 60 R "TS 1.8MM 適應症請見備註欄 3519 FPP LE FRACTURE PLATE 4H 35MM 1.8MM STR 適應症請見備註欄 2722 FPP LE FRACTURE PLATE 4H 40MM 1.8MM STR 適應症請見備註欄 2722 FPP LE FRACTURE PLATE 4H 50MM 1.8MM STR 適應症請見備註欄 2722 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:BSSO PLATE 4+6 HOLE" 歐美特 " 下頷骨折重建系統, 直型骨板 4+6 洞 2722 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION 2722 SYSTEM:FRACTURE PLATE 4:8 HOLE" 歐美特 " 下頷骨折重建系統, 骨折骨板 4;8 洞 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION 5573 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 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:RIGID 4230 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 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM: 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 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM: 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 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM: 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 FPP LE MANDIBULAR COMPRESSION PLATE 8HOLE 適應症請見備註欄 2722 FPP LE MANDIBULAR COMPRESSION PLATE 14HOLE 適應症請見備註欄 4230 FPP M3 MRS FRACTURE BONE PLATE 4:8HOLE STR 適應症請見備註欄 2722 FPP M3 MRS FRACTURE BONE PLATE 14HOLE STR 適應症請見備註欄 4230 FPP031550NLE COMPRESSION PLATE 2-10 HOLE 適應症請見備註欄 2722 FPP Y2 COMPRESSION PLATE 1.6MM 4HOLE STR/60 度 適應症請見備註欄 3519 FPP03434NNS1 2.0MM ZYGOMATIC DCP 4:6HOLE STR 適應症請見備註欄 2722 FPP S1 TENSION BAND PLATE 2.0,2.4 4:6HOLE STR 22:35MM 適應症請 2722 見備註欄 FPP S1 2.4MM LC-DCP STRAIGHT 4:6HOLE 36:52MM 適應症請見備註欄 2722 FPP S1 2.4MM LIMITED CONTACT-DCP ECCENTRIC 4:6HOLE 36:52MM 適 3519 應症請見備註欄 FPP S1 2.4MM LC-DCP CURVED 4:6HOLE 35:50MM 適應症請見備註欄 3519 FPP S1 UNIVERSAL FRACTURE PLATE 2.4 STRAIGHT 8 HOLES 適應症請 2722 見備註欄 FPP S1 UNIVERSAL FRACTURE PLATE 2.4 STRAIGHT 10 HOLES 適應症請 2722 見備註欄 FPP S1 UNIVERSAL FRACTURE PLATE 2.4 STRAIGHT 24 HOLES ( 自 /10/01 生效 ) 適應症請見備註欄 FPP034944NS1 UNIVERSAL FRACTURE PLATE 2.4 ANGLED 20:27 HOLES 適應症 6720 請見備註欄 FPP034984NS1 UNIVERSAL FRACTURE PLATE 2.4 ANGLED 6:10 HOLES 適應症請見備註欄

48 FPP035415NLE MANDIBULAR COMPRESSION PLATE 4:6HOLE 適應症請見備註欄 2722 FPP M3 MINIPLATE JALLUT GLIDING 4HOLE 適應症請見備註欄 2722 FPP037011NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:MINI TENSION BAND PLATES MM PURE TITANIUMM 4HOLE;6HOLE" 信迪思 " 下顎固定系統 : 迷你張力骨板 FPP037101NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:DCP PLATES PURE TITANIUM 2+2 OR 3+3 HOLES" 信迪思 " 下顎固定系統 : 動態加壓骨板 3519 FPP037111NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:PLATE(2+2HOLE)" 信迪思 " 下 2722 顎固定系統 : 下顎骨板 給付規定請見備註欄 FPP037131NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:DCP PLATES PURE TITANIUMM 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 FPP037151NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:PLATE(3+3HOLE)" 信迪思 " 下 2722 顎固定系統 : 下顎骨板 給付規定請見備註欄 FPP037211NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:DCP PLATES PURE TITANIUMM HOLES, CRESCENT OR ANGLED" 信迪思 " 下顎固定系統 : 新月型或曲型骨板 FPP MC 1.7MM MINI MANDIBULAR FRACTURE PLATE 4,6HOLE STR 適應症 2722 請見備註欄 FPP MC 1.7MM MINI MANDIBULAR FRACTURE PLATE 8HOLE STR 適應症請 2722 見備註欄 FPP MC 1.7MM MINI MANDIBULAR FRACTURE PLATE 16HOLE STR 適應症 4230 請見備註欄 FPP03A1060WR 2.4 FRACTURE PLATES 16 HOLE 適應症請見備註欄 4230 FPP03A1068WR 2.4 FRACTURE PLATES,6 HOLE CURVED 適應症請見備註欄 5573 FPP03A9282WR COMPRESSION STRAIGHT PLATE, 4,6,8 HOLE 適應症請見備註欄 2722 FPP03C1050WR 1.8MM FRACTURE PLATE, STRAIGHT 4,6,8 HOLE 適應症請見備註 2722 欄 FPP03C1064WR 1.8MM FRACTURE PLATE, 6,8 HOLE ANGLED 適應症請見備註欄 5573 FPP03C1068WR 1.8MM FRACTURE PLATE, 6 HOLE CURVED 適應症請見備註欄 1836 FPP060573NLE STRYKER LEIBINGER UNIVERSAL MANDIBLE SYSTEM:1.7MM MID FACE SET LOCKING 3-D PLATE 6X2 HOLES 適應症請見備註欄 FPP LE TITAN MINI 3-D BONE PLATE 2X2 HOLES SQUARE 0.6MM 適應症 3867 請見備註欄 FPP LE TITAN MINI 3-D BONE PLATE 2X2 HOLES RECTANGULAR SEGMENT MM 適應症請見備註欄 FPP060631NLE 2.0 MINI PLATE 3-D 2X2 HOLES 0.6MM 適應症請見備註欄 3867 FPP LE TITAN MINI 3-D BONE PLATE 3X2 HOLES SQUARE SEGMENT 0.6MM 4767 適應症請見備註欄 FPP LE TITAN MINI 3-D BONE PLATE 3X2 HOLES RECTANGULAR SEGMENT MM 適應症請見備註欄 FPP060632NLE 2.0 MINI PLATE 3-D 3X2 HOLES 0.6MM 適應症請見備註欄 4767 FPP LE TITAN 3-D BONE PLATE 4X2 HOLES RECTANGULAR SEGMENT 0.6MM 5211 適應症請見備註欄 FPP LE STRYKER LEIBINGER UNIVERSAL MANDIBLE SYSTEM:1.7MM MID FACE 3D PLATE 2X2 HOLES 適應症請見備註欄 FPP EJ 2.0 MM MINI SQUARE PLATE 4 HOLE 適應症請見備註欄

49 FPP LE TITAN MINI 3-D BONE PLATE 2X2 HOLES SQUARE SEGMENT 1.0MM 3867 適應症請見備註欄 FPP LE TITAN MINI 3-D BONE PLATE 2X2 HOLES RECTANGULAR SEGMENT MM 適應症請見備註欄 FPP LE TITAN MINI 3-D BONE PLATE 3X2 HOLES RECTANGULAR SEGMENT MM 適應症請見備註欄 FPP LE TITAN MINI 3-D BONE PLATE 4X2 HOLES SQUARE SEGMENT 1.0MM 5211 適應症請見備註欄 FPP LE TITAN MINI 3-D BONE PLATE 4X2 HOLES RECTANGULAR SEGMENT MM 適應症請見備註欄 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:MINI 5211 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 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:MINI LOCKING STRUT PLATE CURVED 2X6 HOLE" 歐美特 " 下頷骨折重建系統, 迷你鎖定矩陣型骨板弧狀 FPP EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:MINI LOCKING STRUT PLATE CURVED 2X8 HOLE" 歐美特 " 下頷骨折重建系統, 迷你鎖定矩陣型骨板弧狀 FPP LE 3 D PLATE 3X2 HOLE 適應症請見備註欄 4767 FPP LE 3 D PLATE 4X2 HOLE 適應症請見備註欄 5211 FPP LE 3 D PLATE 6X2 HOLE 適應症請見備註欄 FPP Y2 MINI H-SHAPE(3-D)PLATE 2X2 HOLE 適應症請見備註欄 3867 FPP Y2 MINI 1.0MM H-SHAPE(3-D)PLATE 3X2 HOLE 適應症請見備註欄 4767 FPP Y2 MINI 1.0MM H-SHAPE(3-D)PLATE 4X2 HOLE 適應症請見備註欄 5211 FPP Y2 MINI 1.0MM H-SHAPE(3-D)PLATE 2X2 HOLE 適應症請見備註欄 3867 FPP Y2 MINI 1.0MM H-SHAPE(3-D)PLATE 3X2 HOLE 適應症請見備註欄 4767 FPP Y2 MINI 1.0MM H-SHAPE(3-D)PLATE 4X2 HOLE 適應症請見備註欄 5211 FPP M3 MINI 2000 CAD 4 HOLE PLATE SQUARE,RECTANGULAR MM,1.0MM 適應症請見備註欄 FPP M3 MINI 2000 CAD 6 HOLE PLATE SQUARE,RECTANGULAR MM,1.0MM 適應症請見備註欄 FPP M3 MINI 2000 CAD 8 HOLE PLATE SQUARE,RECTANGULAR MM,1.0MM 適應症請見備註欄 FPP069001NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:PREFORMED RECONSTRUCTION PLATE" 信迪思 " 下顎固定系統 : 立體重建骨板 FPP06A7131WR NEURO SQUARE PLATE 適應症請見備註欄 3867 FPP06A7132WR NEURO TRIANGLE PLATE 適應症請見備註欄 3867 FPP06A7136WR 1.5MM MINI MATRIX PLATE 2X3 HOLE 適應症請見備註欄 4767 FPP06A7137WR 1.5MM MINI MATRIX PLATE 2X4 HOLE 適應症請見備註欄 5211 FPP06A7357WR 1.5MM NEURO PLATE,2X2 HOLE 適應症請見備註欄 3867 FPP06A9270WR 2.0MM MINI MATRIX,2X2 HOLE 適應症請見備註欄 3867 FPP06A9274WR 2.0MM MINI MATRIX,2X4 HOLE 適應症請見備註欄 5211 FPP06A9278WR 2.0MM MINI MATRIX,2X6 HOLE 適應症請見備註欄 FPP06A9281WR 2.0MM MINI MATRIX,2X8 HOLE 適應症請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 PLATE 4HOLE STR 限顏面骨折患者使用

50 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 PLATE 6HOLE STR 適應 2672 症請見備註欄 FPP M3 MICRO 1200 TITANIUM STR PLATE 6HOLE 7.5MM 適應症請見備註 2672 欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO HOLE PLATE STR 適應 2672 症請見備註欄 FPP M3 MICRO 1200 TITANIUM STR PLATE 4HOLE 6MM:9MM 適應症請見備 2498 註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO HOLE PLATE STR 適應 4246 症請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 L PLATE 5,8HOLE 適應 4085 症請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 L PLATE 4HOLE 適應症 4085 請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 L PLATE 5HOLE 適應症 4085 請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 T PLATE 7 HOLE 限顏面 4430 骨折患者使用 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 T PLATE 4 HOLE 適應症 4430 請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 H PLATE 9,14HOLE 限顏 4633 面骨折患者使用 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 Y PLATE 6 HOLE 適應症 4997 請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 X PLATE 6,7 HOLE 適應 5560 症請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 Y PLATE 4 HOLE 適應症 4997 請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 ORBITAL 8HOLE 適應症請 3883 見備註欄 FPP LE MICROPLUS BONE PLATE 0.55MM 4 HOLE STR 適應症請見備註欄 2498 FPP LE MICROPLUS BONE PLATE 0.55MM 6 HOLE STR 適應症請見備註欄 2672 FPP LE MICROPLUS BONE PLATE 0.55MM 8 HOLE STR 適應症請見備註欄 2672 FPP LE MICROPLUS BONE PLATE 0.55MM 12 HOLE STR 適應症請見備註 4246 欄 FPP LE MICROPLUS BONE PLATE 0.55MM 16HOLE STR 適應症請見備註欄 4246 FPP LE MICROPLUS BONE PLATE 0.55MM 24 HOLE STR 適應症請見備註 4246 欄 FPP LE MICROPLUS BONE PLATE 0.55MM L SHAPE 5 HOLE 適應症請見備 4085 註欄 FPP LE MICROPLUS BONE PLATE 0.55 MM L SHAPE 8 HOLE 適應症請見 4085 備註欄 FPP070622NLE MICRO STRAIGHT PLATE 24HOLE 適應症請見備註欄 4246 FPP070623NLE MICRO 3D PLATE 2X2 HOLE 適應症請見備註欄 3867 FPP LE MICROPLUS BONE PLATE 0.55MM T SHAPE 5 HOLE 90 DE 適應症 4430 請見備註欄 FPP LE MICROPLUS BONE PLATE 0.55MM T SHSPE 7 HOLE 90 DE 適應症請見備註欄

51 FPP LE MICROPLUS BONE PLATE 0.55MM DOUBLE T SHAPE 9 HOLE 適應 4633 症請見備註欄 FPP LE MICROPLUS BONE PLATE 0.55MM DOUBLE T SHAPE 14 HOLE 適應 4633 症請見備註欄 FPP LE MICROPLUS BONE PLATE 0.55MM DOUBLE T SHAPE 7 HOLE 適應 4633 症請見備註欄 FPP070624NLE MICRO DOUBLE Y PLATE 7HOLE 適應症請見備註欄 5560 FPP070625NLE MICRO ORBITA PLATE 4,10 HOLE 適應症請見備註欄 3883 FPP LE MICROPLUS BONE PLATE 0.55MM Y SHAPE 6 HOLE 適應症請見備 4997 註欄 FPP LE MICROPLUS BONE PLATE 0.55MM DOUBLE Y SHAPE 6 HOLE 適應 5560 症請見備註欄 FPP LE MICROPLUS BONE PLATE 0.55MM DOUBLE Y SHAPE 7 HOLE 適應 5560 症請見備註欄 FPP070626NLE MICRO L PLATE 8HOLE 適應症請見備註欄 4085 FPP LE MICROPLUS BURR 0.55MM H COVERING & BONE FLAP FIXATION 5873 PLATE 7,10,14MM 適應症請見備註欄 FPP070627NLE MICRO T PLATE 7HOLE 適應症請見備註欄 4430 FPP LE MICROPLUS BONE PLATE 0.55MM ORBITA PLATE 8 HOLE CURVED 3883 適應症請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 CAD PLATE 3 HOLE,4HOLE 3867 SQUARE 適應症請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 CAD PLATE 6HOLE 適應 5679 症請見備註欄 FPP M3 MONDEAL TITANIUM 0.6MM MICRO 1200 CAD PLATE 8HOLE 適應 6805 症請見備註欄 FPP070633NLE MICRO 3D PLATE 6X2 HOLE 適應症請見備註欄 FPP070637NLE MICRO MALLEABLE BURR HOLE COVER PLATE 7,10,14MM 適應症 5873 請見備註欄 FPP LE MICROPLUS BONE PLATE 0.55MM 4(2X2)HOLE SQUARE 3867 SEGMENTS,REGANG ULAR SEGMENT 適應症請見備註欄 FPP LE MICROPLUS BONE PLATE 0.55MM 6(3X2)HOLE SQUARE,RECTANG 5679 ULAR SEAGMENT 適應症請見備註欄 FPP LE MICROPLUS BONE PLATE 0.55MM 8(4X2)HOLE SQUARE,REGANG 6805 ULAR SEGMENT 適應症請見備註欄 FPP LE MICROPLUS BONE PLATE 0.55MM 16(4X4)HOLE SQUARE SEGMENTS 適應症請見備註欄 FPP LE TITANIUM MICRO 3-D PLATE 0.55MM 6X4HOLE 適應症請見備註欄 FPP M3 MICRO BURR HOLE COVER PLATE 7:14MM 適應症請見備註欄 5873 FPP EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.2MM HOLE CURVED PLAT 適應症請見備註欄 FPP EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.2MM HOLE STRAIGHT PLATE 適應症請見備註欄 FPP EJ M4 RIGID FIXATION SYSTEM 7, 11 HOLE Y PLATE, 0.5MM 適應 4997 症請見備註欄 FPP EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.2MM HOLE STRAIGHT PLATE 適應症請見備註欄 FPP EJ M4 RIGID FIXATION SYSTEM 6 HOLE LARGE, SMALL BUR HOLE 5873 PLATE, 0.5MM 適應症請見備註欄 FPP EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.2MM 2 HOLE STRAIGHT PLATE:MEDIUM,LONG 適應症請見備註欄

52 FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ FPP EJ M4 RIGID FIXATION SYSTEM 6 HOLE H PLATE, 0.5MM 適應症請見備註欄 M4 RIGID FIXATION SYSTEM 18 HOLE STRAIGHT PLATE, 0.55MM 適應症請見備註欄 M4 RIGID FIXATION SYSTEM 12 HOLE CURVED PLATE, 0.55MM 適應症請見備註欄 M4 RIGID FIXATION SYSTEM 5 HOLE STRAIGHT PLATE, 0.5MM 適應症請見備註欄 M4 RIGID FIXATION SYSTEM 10 HOLE STRAIGHT PLATE, 0.5MM 適應症請見備註欄 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 M4 RIGID FIXATION SYSTEM 4 HOLE 13, 16 MM LEFT, RIGHT L PLATE, 0.5MM 適應症請見備註欄 M4 RIGID FIXATION SYSTEM 2X4 HOLE QUAD PLATE, 0.5MM 適應症請見備註欄 M4 RIGID FIXATION SYSTEM 5 HOLE19 MM T PLATE, 0.5MM 適應症請見備註欄 M4 RIGID FIXATION SYSTEM 5 HOLE X PLATE, 0.5MM 適應症請見備註欄 M4 RIGID FIXATION SYSTEM ORBITAL FLOOR PLATE 0.35MM;0.25MM 適應症請見備註欄 M4 RIGID FIXATION SYSTEM MICRO 6 HOLE DOUBLE Y PLATE, 0.5MM 適應症請見備註欄 M4 RIGID FIXATION SYSTEM MICRO 4 HOLE STRAIGHT PLATE, 0.5MM 適應症請見備註欄 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 FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.2MM EXTENDED X PLATE 適應症請見備註欄 FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.2MM DOUBLE Y PLATE 適應症請見備註欄 FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.2MM BUR HOLE PLATE SMALL LARGE X-LARGE 適應症請見備註欄 FPP EJ 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 FPP EJ M4 RIGID FIXATION SYSTEM MICRO 6, 8 HOLE STRAIGHT PLATE, 0.5MM 適應症請見備註欄 FPP EJ "OSTEO MED"NEURO FIXATION SYSTEM 0.48MM(2HOLE PLATE X3+SCREW*6) " 歐特美 " 顱顏骨固定系統 : 含 2 HOLE PLATE X3+SCREWX6 適應症請見備註欄 FPP EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.6MM 5 HOLE STRAIGHT PLATE 適應症請見備註欄 FPP EJ "OSTEO MED"NEURO FIXATION SYSTEM0.48MM " 歐特美 " 顱顏骨固定系統 : 含 2 HOLE PLATE X2+SCREWX4 適應症請見備註欄 FPP EJ "OSTEO MED"NEURO FIXATION SYSTEM 0.48MM " 歐特美 " 顱顏骨固定系統 : 含 BURR HOLE X1+SCREWX6 適應症請見備註欄 FPP EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.6MM SQUARE PLATE 9MM 適應症請見備註欄 FPP EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.6MM 2 HOLE STRAIGHT PLATE:MEDIUM,LONG,SHORT 適應症請見備註欄

53 FPP EJ FPP EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.6MM DOUBLE Y PLATE 適應症請見備註欄 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 FPP EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.6MM HOLE STRAIGHT PLATE 適應症請見備註欄 FPP EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.6MM X3 HOLE QUAD PLATE 適應症請見備註欄 FPP EJ FAST-FLAP NEURO FIXATION SYSTEM 速固硬式固定系統 :1.6MM X4 HOLE QUAD PLATE 適應症請見備註欄 FPP S1 MICRO STRUT PLATE 16:22HOLE( 網狀 ) 適應症請見備註欄 FPP S1 MICRO 0.5MM ADAPTION PLATE 24HOLES( 型號 另編代碼 4246 FPP072010N) 適應症請見備註欄 FPP072010NS1 MICRO 0.5MM ADAPTION PLATE 34HOLE 適應症請見備註欄 4246 FPP Y2 MICRO PLATE 0.6MM 4HOLE STR 適應症請見備註欄 2498 FPP Y2 MICRO PLATE 0.6MM 6,8HOLE STR 適應症請見備註欄 2672 FPP Y2 MICRO PLATE 0.6MM 12,16,24HOLE STR 適應症請見備註欄 4246 FPP Y2 MICRO PLATE 0.6MM 5,8HOLE L-SHAPE 適應症請見備註欄 4085 FPP Y2 MICRO PLATE 0.6MM 5,7HOLE T-SHAPE 適應症請見備註欄 4430 FPP Y2 MICRO PLATE 0.6MM 6HOLE Y-SHAPE 適應症請見備註欄 4997 FPP Y2 MICRO PLATE 0.6MM 6,7HOLE DOUBLE Y-SHAPE 適應症請見備註 5560 欄 FPP Y2 MICRO ORBITA PLATE 0.6MM 8HOLE 適應症請見備註欄 3883 FPP Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 2X2 HOLE 適應症請見備註欄 3867 FPP Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 3X2 HOLE 適應症請見備註欄 5679 FPP Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 4X2 HOLE 適應症請見備註欄 6805 FPP Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 4X4 HOLE 適應症請見備註欄 FPP Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 6X4 HOLE 適應症請見備註欄 FPP Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 2X2 HOLE 適應症請見備註欄 3867 FPP Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 3X2 HOLE 適應症請見備註欄 5679 FPP Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 4X2 HOLE 適應症請見備註欄 6805 FPP Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 4X4 HOLE 適應症請見備註欄 FPP Y2 MICRO 0.6MM H-SHAPE(3-D)PLATE 6X4 HOLE 適應症請見備註欄 FPP072016NY2 MICRO BURR HOLES PLATE 0.6MM 7:14MM 適應症請見備註欄 5873 FPP S1 MICRO 0.5MM ORBITAL RIM PLATE CURVED 8:12HOLE 適應症請 3883 見備註欄 FPP07204NNS1 MICRO ORBITAL FLOOR PLATE UNIVERSAL/L/R ( ,044, 自 89/10/1 生效 ) 適應症請見備註欄 FPP07205NNS1 MICRO 0.5MM L-PLATE 5:9HOLE 適應症請見備註欄 4085 FPP S1 MICRO 0.5MM Y-PLATE 5:13HOLE 適應症請見備註欄 4997 FPP S1 MICRO 0.5MM DOUBLE Y-PLATE 6HOLE( 型號 ,069 自 89/10/1 生效 ) 適應症請見備註欄

54 FPP S1 MICRO 0.5MM T-PLATE 7:12HOLE 適應症請見備註欄 4430 FPP S1 MICRO 0.5MM X-PLATE 4HOLE 適應症請見備註欄 5560 FPP S1 MICRO 0.5MM H-PLATE 6:11HOLE 適應症請見備註欄 4633 FPP S1 TITANIUM MICRO BURR HOLE COVER 適應症請見備註欄 5873 FPP S1 MICRO 0.5MM PLATE 2:4HOLE STR 適應症請見備註欄 2498 FPP S1 MICRO BOX PLATE 4 HOLES 適應症請見備註欄 3867 FPP S1 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 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 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 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 FPP07503XNS1 UNIVERSAL ORBITAL FLOOR PLATE 0.4:0.5MM 適應症請見備註欄 FPP075403NLE ORBITAL FLOOR PLATE 適應症請見備註欄 FPP077071NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:STRUT PLATES PURE 3867 TITANIUMM 4 HOLES STRAIGHT" 信迪思 " 下顎固定系統 : 網狀 FPP077081NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:STRUT PLATES PURE 6805 TITANIUM 8 HOLES" 信迪思 " 下顎固定系統 : 網狀 FPP07801FNS1 PREFORMED ORBITAL PLATE 0.4MM 適應症請見備註欄 FPP EJ 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 FPP MC MICRO PLATE 4 HOLE 6.0,4.5MM 0.6MM STR 適應症請見備註欄 2498 FPP MC MICRO PLATE 6 HOLE 0.6MM STR 適應症請見備註欄 2672 FPP MC MICRO PLATE 8 HOLE 0.6MM STR 適應症請見備註欄 2672 FPP MC MICRO PLATE 4HOLE 7.5,9MM 0.6MM STR 適應症請見備註欄 2498 FPP MC MICRO PLATE 4HOLE 12MM 0.6MM STR 適應症請見備註欄 2498 FPP MC MICRO PLATE 6HOLE 7.5MM 0.6MM STR 適應症請見備註欄 2672 FPP MC MICRO PLATE 6HOLE 12MM 0.6MM STR 適應症請見備註欄 2672 FPP MC MICRO L-PLATE 4HOLE 7.5,9MM 0.6MM LEFT,RIGHT 適應症請見 4085 備註欄 FPP MC MICRO L-PLATE 6HOLE 12MM 0.6MM LEFT,RIGHT 適應症請見備 4085 註欄 FPP MC MICRO T-PLATE 4HOLE 7.5,9MM 0.6MM 適應症請見備註欄 4430 FPP MC MICRO T-PLATE 5HOLE 12MM 0.6MM 適應症請見備註欄 4430 FPP MC TITANIUM MICRO 0.6MM H-PLATE 9HOLE 限顏面骨折患者使用 4633 FPP MC TITANIUM 0.6MM MICRO Y-PLATE 4HOLE 8,12,15MM 適應症請 4997 見備註欄 FPP MC TITANIUM 0.6MM MICRO DOUBLE Y-PLATE 6,7HOLE 適應症請見備註欄

55 FPP MC TITANIUM MICRO 0.6MM ORBITAL PLATE 6,7HOLE 8,12,15MM 適 3883 應症請見備註欄 FPP MC 0.4MM TITANIUM BURR HOLES PLATE 6:13MM 適應症請見備註欄 5873 FPP MC 0.55MM MICRO CRANIO MAXILLO FACIAL TITANIUM PLATE 4HOLE 2498 STR 限顏面骨折患者使用 FPP MC 0.55MM MICRO CRANIO MAXILLO FACIAL TITANIUM PLATE 6HOLE 2672 STR 適應症請見備註欄 FPP MC 0.55MM MICRO CRANIO MAXILLO FACIAL TITANIUM PLATE 16HOLE 4246 STR 適應症請見備註欄 FPP MC 0.55MM MICRO CRANIO MAXILLO FACIAL TITANIUM H-PLATE 9HOLE 4633 限顏面骨折患者使用 FPP MC 0.55MM MICRO CRANIO MAXILLO FACIAL TITANIUM Y-PLATE 6HOLE 4997 適應症請見備註欄 FPP MC 0.55MM MICRO CRANIO MAXILLO FACIAL TITANIUM DOUBLE Y PLATE 6HOLE 適應症請見備註欄 FPP MC 0.55MM MICRO CRANIO MAXILLO FACIAL TITANIUM ORBITA PLATE HOLE 適應症請見備註欄 FPP07A7504WR MICRO STRAIGHT PLATE, 4-HOLE, REGULAR 適應症請見備註欄 2498 FPP07A7516WR MICRO STRAIGHT PLATE, 16 HOLE, REGULAR 適應症請見備註欄 4246 FPP07A7524WR MICRO STRAIGHT PLATE, 24-HOLE, ADAPTION 適應症請見備註欄 4246 FPP07A7530WR MICRO L-PLATE 5,8 HOLE 適應症請見備註欄 4085 FPP07A7540WR MICRO T-PLATE, 5-HOLE, REGULAR 適應症請見備註欄 4430 FPP07A7541WR MICRO T-PLATE, 7-HOLE, REGULAR 適應症請見備註欄 4430 FPP07A7548WR MICRO DOUBLE T-SHAPE, 11-HOLE REGULAR 適應症請見備註欄 4633 FPP07A7550WR MICRO Y-PLATE, 6-HOLE, REGULAR 適應症請見備註欄 4997 FPP07A7560WR MICRO DOUBLE Y-PLATE 6,7 HOLE 適應症請見備註欄 5560 FPP07A7568WR MICRO ORBITAL PLATE, 8-HOLE, CURVED 適應症請見備註欄 3883 FPP07A7570WR MICRO SQUARE PLATE 2X2 HOLE 1.0MM 適應症請見備註欄 3867 FPP07A7572WR MATRIX PLATE 2X3 HOLE 1.0MM 適應症請見備註欄 5679 FPP07A7574WR 1.0MM MICRO MATRIX PLATE 2X4 HOLE 適應症請見備註欄 6805 FPP07A7576WR MICRO BURR HOLE PLATE 適應症請見備註欄 5873 FPP07FM960AE 0.6MM MICRO PLATE STRAIGHT 2HOLE,4 HOLE 適應症請見備註欄 2498 FPP07FM964AE 0.6MM MICRO Y PLATE 5 HOLE 適應症請見備註欄 4997 FPP07FM965AE 0.6MM MICRO PLATE STRAIGHT 16 HOLE 適應症請見備註欄 4246 FPP07FM966AE 0.6MM MICRO DOUBLE Y PLATE 6 HOLE 適應症請見備註欄 5560 FPP07FM968AE MICRO BOX CAR PLATE 4 HOLE 適應症請見備註欄 3867 FPP07FM969AE 0.6MM MICRO BOX CAR PLATE 6 HOLE 適應症請見備註欄 5679 FPP07FM970AE 0.6MM MICRO BOX CAR PLATE 8 HOLE 適應症請見備註欄 6805 FPP07FM971AE 0.6MM MICRO BURR HOLE COVER PLATE 適應症請見備註欄 5873 FPP07FM973AE "AESCULAP"CRANIOPLATE SYSTEM:0.6MM MICRO MESH,MINIFEN PLATE" 雅氏 " 顱顏骨釘骨板系統 適應症請見備註欄 FPP LE TITANIUM LIGATURE WIRE 0.4MM 30CM 適應症請見備註欄 120 FPP LE TITANIUM LIGATURE WIRE 0.5MM 30CM 適應症請見備註欄 120 FPP LE TITANIUM LIGATURE WIRE 0.6MM 30CM 適應症請見備註欄 120 FPP LE 2.0 MINI CHIN PLATE BAR 6 HOLES 4-10MM 適應症請見備註欄 2700 FPP LE CHIN PLATE 4MM 適應症請見備註欄

56 FPP LE CHIN PLATE 6MM 適應症請見備註欄 2700 FPP LE CHIN PLATE 8MM 適應症請見備註欄 2700 FPP LE CHIN PLATE 10MM 適應症請見備註欄 2700 FPP LE CHIN PLATE 12MM 適應症請見備註欄 2700 FPP LE CHIN PLATE 14MM 適應症請見備註欄 2700 FPP Y2 SKULL TITANIUM WIRE 0.4:0.6MM 適應症請見備註欄 120 FPP094707NS1 TITANIUM MINI CHIN PLATE 2.0 DOUBLE BEND 5 HOLE 適應症 2700 請見備註欄 FPP M3 TIANIUM CHINPLATE 4HOLE 4:12MM 適應症請見備註欄 2700 FPP09A6471WR 2.0MM DUAL RAIL CHIN PLATES 適應症請見備註欄 2700 FPP FV BONAMATES BIOFIXATION SYSTEM:STR 4 HOLE X1.5MM,1.2X2.0MM,1.5X2.5MM 適應症請見備註欄 FPP FV BONAMATES BIOFIXATION SYSTEM:STR 6 HOLE X1.5MM,1.2X2.0MM,1.5X2.5MM 適應症請見備註欄 FPP FV BONAMATES BIOFIXATION SYSTEM:C 型 7 HOLE X1.5MM,1.2X2.0MM 適應症請見備註欄 FPP FV BONAMATES BIOFIXATION SYSTEM:Y 型 8 HOLE X1.5MM,1.2X2.0MM,1.5X2.5MM 適應症請見備註欄 FPP FV BONAMATES BIOFIXATION SYSTEM:L 型 8/10 HOLE X1.5MM,1.2X2.0MM,1.5X2.5MM 適應症請見備註欄 FPP FV BONAMATES BIOFIXATION SYSTEM:X 型 10 HOLE X1.5MM,1.2X2.0MM,1.5X2.5MM 適應症請見備註欄 FPP FV BONAMATES BIOFIXATION SYSTEM:STR 8 HOLE 1.5X2.5MM 適應 2672 症請見備註欄 FPS EJ "OSTEOMED"FAST-FLAP NEURO FIXATION SYSTEM:1.2MM AUTO DRIVE SCREW" 歐特美 " 速固硬式固定系統自攻螺絲 適應症請見備註欄 FPS EJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.3MM SAFETY SCREW " 歐美特 " 下頷骨折重建系統,2.3MM 安全骨釘 579 FPS EJ FPS EJ FPS EJ FPS EJ FPS EJ "OSTEOMED"FAST-FLAP NEURO FIXATION SYSTEM:1.5MM SAFETY SCREW" 歐特美 " 速固硬式固定系統安全螺絲 適應症請見備註欄 "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.7MM SCREW " 歐美特 " 下頷骨折重建系統,2.7MM 骨釘 "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.4MM SCREW " 歐美特 " 下頷骨折重建系統,2.4MM 骨釘 "OSTEOMED"FAST-FLAP NEURO FIXATION SYSTEM:1.6MM AUTO- DRIVE SCREW" 歐特美 " 速固硬式固定系統自攻螺絲 適應症請見備註欄 "OSTEOMED"FAST-FLAP NEURO FIXATION SYSTEM:1.9MM SAFETY SCREW" 歐特美 " 速固硬式固定系統安全螺絲 適應症請見備註欄 FPS010000NEJ "OSTEOMED"MANDIBULAR FRACTURE RECONSTRUCTION SYSTEM:2.0MM 298 SCREW " 歐美特 " 下頷骨折重建系統,2.0MM 骨釘 FPS010071NS1 1.5 MM CORTEX SCREW SELF-TAPPING 4:18 MM 適應症請見備 298 註欄 FPS0100NNNS1 1.0:1.3 MM MICRO,1.2:1.7 MM EMERGENCY SCREW 2:8MM 適應 1361 症請見備註欄 FPS010151NS1 2.4 MM,2.0MM CORTEX SCREW SELF-TAPPING 8:18 MM 適應症 579 請見備註欄 FPS010156NS1 2.7MM EMERGENCY SCREW 8:18MM 適應症請見備註欄

57 FPS LE MINI BONE SCREW 2.0X5MM( 型號 : 自 90/07/ 生效 ) 適應症請見備註欄 FPS LE MINI BONE SCREW 2.0x7MM 適應症請見備註欄 298 FPS LE MINI BONE SCREW 2.0x8MM/9MM 適應症請見備註欄 298 FPS LE MINI BONE SCREW 2.0x10MM/11MM 適應症請見備註欄 298 FPS LE MINI BONE SCREW 2.0x12MM/13MM 適應症請見備註欄 298 FPS LE MINI BONE SCREW 2.0x14MM/15MM 適應症請見備註欄 298 FPS LE MINI 2.0MM BONE SCREW 17MM 適應症請見備註欄 298 FPS LE MINI 2.3MM EMERGENCY BONE SCREW 9MM 適應症請見備註欄 298 FPS LE BRIFGING BONE SCREW 3.5X10MM 適應症請見備註欄 579 FPS LE BRIFGING BONE SCREW 3.5X12MM 適應症請見備註欄 579 FPS LE BRIFGING BONE SCREW 3.5X14MM 適應症請見備註欄 579 FPS LE BRIDGING BONE SCREW ( 型號 :822, :135,5108:5130 自 92/1/1 生效 ) 適應症請見備註欄 FPS LE BRIFGING BONE SCREW 3.5X18MM 適應症請見備註欄 579 FPS LE BRIFGING BONE SCREW 3.5X20MM 適應症請見備註欄 579 FPS LE BRIFGING BONE SCREW 3.5X25MM 適應症請見備註欄 579 FPS LE COMPREDSSION BONE SCREW SELF-TAPPING 2.7x10MM 適應症請 579 見備註欄 FPS LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x12MM 適應症請見 579 備註欄 FPS LE BONE SCREW SELF-TAPPING 2.7x14MM 適應症請見備註欄 579 FPS LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x16MM 適應症請見 579 備註欄 FPS LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x18MM 適應症請見 579 備註欄 FPS LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x20MM 適應症請見 579 備註欄 FPS LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x22MM 適應症請見 579 備註欄 FPS LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x24MM 適應症請見 579 備註欄 FPS LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x26MM 適應症請見 579 備註欄 FPS LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x28MM 適應症請見 579 備註欄 FPS LE COMPRESSION BONE SCREW SELF-TAPPING 2.7x30MM 適應症請見 579 備註欄 FPS LE COMPRESSION EMERGENCY BONE SCREW 3.2x12MM 適應症請見備 579 註欄 FPS LE EMERGENCY BONE SCREW 3.2x16MM 適應症請見備註欄 579 FPS LE COMPRESSION EMERGENCY BONE SCREW 3.2x20MM 適應症請見備 579 註欄 FPS LE COMPRESSION EMERGENCY BONE SCREW 3.2x24MM 適應症請見備 579 註欄 FPS01119NNS1 2MM MINI CORTEX 2.4MM,EMERGENCY SCREW SELF-TAPPING 適應 298 症請見備註欄 FPS LE MICROPLUS BONE SCREW SELF-TAPPING( 型號 :81409, :14111 自 90/07/01 生效 ) 適應症請見備註欄 1361 FPS LE MICROPLUS BONE SCREW SELF-TAPPING 1.2x4MM,1.2x5MM 適應症請見備註欄

58 FPS LE MICROPLUS BONE SCREW SELF-TSPPING 1.2x6MM:1.2x12MM 適應 1361 症請見備註欄 FPS011210NLE MICRO BONE SCREW 1.2MM 1.4MM 適應症請見備註欄 1361 FPS LE MICROPLUS EMERGENCY BONE SCREW SELF-TAPPING 1.4x3MM 適 1361 應症請見備註欄 FPS LE BONE SCREW 1.5x4MM 適應症請見備註欄 298 FPS LE LOW PROFILE BONE SCREW 1.5x5MM 適應症請見備註欄 298 FPS LE LOE PROFILE BONE SCREW 1.5x6MM 適應症請見備註欄 298 FPS LE LOW PROFILE BONE SCREW 1.5x7MM 適應症請見備註欄 298 FPS LE LOW PROFILE BONE SCREW 1.5x8MM 適應症請見備註欄 298 FPS LE LOW PROFILE BONE SCREW 1.5x9MM 適應症請見備註欄 298 FPS LE LOW PROFILE BONE SCREW 1.5x10MM 適應症請見備註欄 298 FPS LE BONE SCREW 1.5x11MM 適應症請見備註欄 298 FPS LE BONE SCREW 1.5x12MM 適應症請見備註欄 298 FPS LE BONE SCREW 1.5x13MM 適應症請見備註欄 298 FPS011700NLE MINI BONE SCREW 1.7MM,1.9MM 適應症請見備註欄 298 FPS M3 TITANIUM LOCK-DRIVE TRANSPLANT SCREW 2.0X7:17MM SELF- 579 CUTTING 適應症請見備註欄 FPS012009NLE TITANIUM FASTENING SCREW FOR TEMPORARY CONDYLAR 579 PROSTHESES 適應症請見備註欄 FPS012017NY2 MICRO BONE SCREW 1.2MM 2:12MM 適應症請見備註欄 1361 FPS EJ 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 FPS EJ M4 RIGID FIXATION SYSTEM MICRO SCREW 1.2MM(SCREW 1.2 X 2, , 4, 6, 8, 10, 12, 14MM) 適應症請見備註欄 FPS EJ M4 RIGID FIXATION SYSTEM MICRO SAFETY SCREW 1.5MM 適應症 1361 請見備註欄 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 FPS EJ M4 RIGID FIXATION SYSTEM 2.4MM MAXI FRACTURE SCREW 適應 579 症請見備註欄 FPS EJ M4 RIGID FIXATION SYSTEM 2.7MM MAXI FRACTURE SCREW 適應 579 症請見備註欄 FPS Y2 MANDIBULAR BONE SCREW 3.5MM 10:20MM 適應症請見備註欄 579 FPS LE 2.0 MINI BONE SCREW 適應症請見備註欄 298 FPS EJ M4 RIGID FIXATION SYSTEM 1.9MM SCREW 適應症請見備註欄 298 FPS EJ M4 RIGID FIXATION SYSTEM:AUTO-DRIVE SCREW 適應症請見備 1361 註欄 FPS EJ M4 RIGID FIXATION SYSTEM 1.6 MM SCREW 適應症請見備註欄 298 FPS EJ M4 RIGID FIXATION SYSTEM 2.0 MM SCREW 適應症請見備註欄 298 FPS014009SM3 TITANIUM CONDYLAR PROTHESIS FIXATION SCREW 適應症請見備 579 註欄 FPS014051NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:SCREWS,SELF-TAPPING SCREW MM 5-18MM" 信迪思 " 下顎固定系統 : 骨釘 FPS014651NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:EMERGENCY SELF-TAPPING 579 SCREW 2.7, 5-18MM" 信迪思 " 下顎固定系統 : 骨釘 FPS014668NS1 2.4MM UNILOCK SCREW 自攻牙鎖定骨釘 適應症請見備註欄

59 FPS01503CNS1 "SYNTHES"MATRIX MIDFACE SYSTEM:1.5MM SELF-TAPPING MICRO 1361 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 FPS01503DNS1 "SYNTHES"MATRIX MIDFACE SYSTEM:1.5MM SELF-DRILLING MICRO 1361 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 FPS01503ENS1 "SYNTHES"MATRIX MIDFACE SYSTEM:1.8MM EMERGENCY MICRO 1361 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 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 FPS M3 MRS TITANIUM SCREW 適應症請見備註欄 579 FPS016051NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:LOCK SCREWS SELF-TAPPING MM" 信迪思 " 下顎固定系統 : 骨釘 FPS016681NS1 "SYNTHES"MATRIX MANDIBLE SYSTEM:LOCK SCREWS SELF-TAPPING MM" 信迪思 " 下顎固定系統 : 骨釘 FPS017020NM3 MONDEAL TITANIUM 1.2MM MICRO LOCK DRIVE SCREW :8MM,1.5MMX4:6MM 適應症請見備註欄 FPS01702NNM3 TITANIUM 1.2MM MICRO LOCK DRIVE SCREW 適應症請見備註欄 1361 FPS M3 TITANIUM 2.0MM MINI STANDARD SCREW 5MM:19MM 適應症請見 298 備註欄 FPS M3 TITANIUM 2.0MM MINI LOCK-DRIVE SCREW 5MM:19MM 適應症請 298 見備註欄 FPS M3 TITANIUM 2.3MM MINI EMERGENCY SCREW 5MM:9MM 適應症請見 298 備註欄 FPS M3 TITANIUM 2.3MM MINI EMERGENCY LOCK-DRIVE SCREW 5MM:9MM 298 適應症請見備註欄 FPS018020NM3 MONDEAL TITANIUM 1.2MM MICRO CROSS FIT SCREW :8MM,1.5X4:6MM 適應症請見備註欄 FPS M3 CROSS-FIT,LOCK-DRIVE SCREW 2.0 4MM 適應症請見備註欄 298 FPS M3 TITANIUM 2.0MM MINI CROSS-FIT SCREW 5MM:19MM 適應症請見 298 備註欄 FPS M3 TITANIUM 2.3MM MINI EMERGENCY CROSS-FIT SCREW 5MM:9MM 298 適應症請見備註欄 FPS M3 TITANIUM LOCK-DRIVE SCREW 2.7X8:22MM SELF-CUTTING 適應症 579 請見備註欄 FPS M3 TITANIUM LOCK-DRIVE EMERGENCY SCREW 3.0X8:14MM SELF- 579 CUTTING 適應症請見備註欄 FPS MC TITANIUM 2MM MINI SCREW 5.5MM 適應症請見備註欄 298 FPS MC TITANIUM 2MM MINI SCREW 7MM 適應症請見備註欄 298 FPS MC TITANIUM 2MM MINI SCREW 9MM 適應症請見備註欄 298 FPS MC TITANIUM 2MM MINI SCREW 11MM 適應症請見備註欄 298 FPS MC "MEDICON"TITANIUM 2MM MINI SCREW 13MM 鈦金屬顏面骨板系統 : 298 迷你骨釘 適應症請見備註欄 FPS MC TITANIUM 2MM MINI SCREW 15MM 適應症請見備註欄 298 FPS MC MICRO SCREW 3.5X1.5MM 適應症請見備註欄 1361 FPS MC MICRO SCREW 5X1.5MM 適應症請見備註欄 1361 FPS MC MICRO SCREW 7X1.5MM 適應症請見備註欄 1361 FPS MC MICRO SCREW 9X1.5MM 適應症請見備註欄 1361 FPS MC MICRO SCREW 11X1.5MM 適應症請見備註欄 1361 FPS MC TITANIUM 1.5MM MICRO SCREW 13,15,16,17MM 適應症請見備註欄

60 FPS MC MICRO EMERGENCY SCREW 4X1.9MM 適應症請見備註欄 1361 FPS MC MICRO EMERGENCY SCREW 9X1.9MM 適應症請見備註欄 1361 FPS MC MICRO 1.2MM MAXILLO FACIAL TITANIUM SCREW 2:12MM 適應症 1361 請見備註欄 FPS MC "MEDICON"TITANIUM MANDIBULAR RECONSTRUCTION SCREWS X7MM 鈦金屬顏面骨板系統 : 下顎骨釘 適應症請見備註欄 FPS MC TITANIUM SCREWS 2.7X9MM 適應症請見備註欄 579 FPS MC TITANIUM SCREWS 2.7X11MM 適應症請見備註欄 579 FPS MC TITANIUM SCREWS 2.7X13MM 適應症請見備註欄 579 FPS MC TITANIUM SCREWS 2.7X15MM 適應症請見備註欄 579 FPS MC TITANIUM SCREWS 2.7X17MM 適應症請見備註欄 579 FPS MC TITANIUM SCREWS 2.7X19MM 適應症請見備註欄 579 FPS MC TITANIUM SCREWS 2.7X21MM 適應症請見備註欄 579 FPS MC TITANIUM SCREWS 2.7X23MM 適應症請見備註欄 579 FPS MC TITANIUM EMERGENCY SCREWS 3.2X9MM 適應症請見備註欄 579 FPS MC TITANIUM EMERGENCY SCREWS 3.2X13MM 適應症請見備註欄 579 FPS M3 NEWS S-DRIVE SELF-DRILLING SCREW(MINI 2000) 適應症請見備 298 註欄 FPS01A1803WR TITANIUM MINI EMERGENCY SCREW 1.5MM,1.8MM,2.3MM 適應症 298 請見備註欄 FPS01A2406WR MINI 2.4 TITANIUM SCREWS 適應症請見備註欄 579 FPS01A7002WR 1.5 MINI CROSS-DRIVE TITANIUM SCREWS 適應症請見備註欄 298 FPS01A7283WR 1.5 MINI CENTER-DRIVE TITANIUM SCREWS 適應症請見備註欄 298 FPS01A7372WR MICRO TITANIUM SCREWS 1.0MM 適應症請見備註欄 1361 FPS01A7383WR MICRO TITANIUM EMERGENCY SCREW 1.0MM 適應症請見備註欄 1361 FPS01A7604WR MINI CROSS-DRIVE TITANIUM SCREWS 2.0MM 適應症請見備註欄 298 FPS01A9474WR MINI CENTER-DRIVE TITANIUM SCREWS 2.0MM 適應症請見備註欄 298 FPS01FM940AE "AESCULAP"CRANIO PLATE SYSTEM:MICRO SCREW" 雅式 " 顱顏骨釘骨 1361 板系統 : 骨釘 適應症請見備註欄 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 FPS FV BONAMATES BIOFIXATION SYSTEM:SCREW 1.5X4.0~2.5X25MM( 單支 1361 包裝 ) 適應症請見備註欄 FPS FV BONAMATES BIOFIXATION SYSTEM:SCREW 1.5X4.0~2.5X25MM(2 支 / 2722 包 ) 適應症請見備註欄 FPS FV BONAMATES BIOFIXATION SYSTEM:SCREW 1.5X4.0~2.5X25MM(4 支 / 5444 包 ) 適應症請見備註欄 HHM MH 美樂得 第二代快取血栓清除導管 MEDRAD FETCH ASPIRATION CATHETER* 給付規定請見備註欄 HHM AB " 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 HHM01445TWSB FILTER WIRE EX SYETEM L 190CM,300CM* 適應症請見備註欄 HHM AB "ABBOTT"EMBOSHIELD PRO EMBOLIC PROTECTION SYSTEM 血管保護 盾 HHM SB FILTERWIRE EMBOLIC PROTECTION SYSTEM L190CM,300CM* 適應症請見備註欄

61 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 HHM01DV445F2 " 英泰克 " 戴芙血栓清除導管 "INVATEC"DIVER CE RAPID EXCHANGE CLOT EXTRACTION CATHETER* 適應症請見備註欄 HHM01DVMAXF2 " 英泰克 " 戴芙血栓清除導管加大型 "INVATEC" DIVER CE MAX CLOT EXTRACTIOM CATHETER HHM01ELNATTM 泰爾茂 艾密麗血栓清除導管 TERUMO ELIMINATE ASPIRATION CATHETER* 適應症請見備註欄 HHM01ENAV6AB " 亞培 " 第六代血栓防護盾系統 "ABBOTT" EMBOSHIELD NAV EMBOLIC PROTECTION SYSTEM(FILTRATION SYSTEM & RX RETRIEVAL CATH. PACK)* 適應症請見備註欄 HHM01EPSNNST " 聖猷達 " 栓塞防護系統 "SJM"PROXIS EMBOLIC PROTECTION SYSTEM* 適應症請見備註欄 HHM01EXPAPM4 美敦力 吸除導管 "MEDTRONIC" EXPORT AP ASPIRATION CATHETER* 適應症請見備註欄 HHM01EXPRTM4 美敦力 吸除導管 "MEDTRONIC" EXPORT XT ASPIRATION CATHETER* 適應症請見備註欄 HHM01FETCHF3 " 普希士 " 快取血栓清除導管 "POSSIS" FETCH ASPIRATION CATHETER* 適應症請見備註欄 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 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 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 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 HHM01SPDEREY 史派德栓塞防護系統 "EV3"SPIDER FX EMBOLIC PROTECTION DEVICE* 適應症請見備註欄 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 NBS LF OPTIVANTAGE DUAL-HEAD INJECTOR 200CC SYRINGE ( 注射筒 X1+ 吸 222 管 X1) NBS LF OPTIVANTAGE DUAL-HEAD INJECTOR 200CC SYRINGE ( 注射筒 X1+ 吸 313 管 X1+ 螺旋管 X1) NBS MH CONTRAST MEDIUM INJECTION SYRINGE 130,150CC( 型號 DSK130 自 /4/1 生效 ) NBS LF "LF"DISPOSABLE SYRINGE FOR DIGITAL INJECTION 130CC W/H- 222 FIL" 理博 " 高壓注射器用拋棄式針筒 NBS MH CONTRAST MEDIUM INJECTION SYRINGE 200CC 顯影劑注射筒 222 NBS070060QMH DISPOSABLE SYRINGE 60CC W/FILL TUBE 222 NBS N8 MRI SYRINGE SET 顯影劑注射筒 (60CC SYRINGEX1+25CC 435 SYRINGEX1+SPIKEX2+Y 型螺旋管 X1) NBS070125FMH DISPOSABLE SYRINGE 顯影劑注射筒 125CC 222 NBS070150QMH DISPOSABLE SYRINGE 150CC W/FILL TUBE 顯影劑注射筒 222 NBS N8 MRI SYRINGE SET 顯影劑注射筒 (60CC SYRINGEX2+SPIKEX2+Y 型螺 435 旋管 X1) NBS N8 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

62 NBS07065VSMH DISPOSABLE SYRINGE KIT 顯影劑注射筒 ( 注射筒 2+ 剌針 2+ 低壓螺 435 旋管與 T 型連接管 1) 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 435 旋管與 T 型連接管 1) NBS07125FQMH DISPOSABLE SYRINGE 125CC W/FILL TUBE 222 NBS07137NASD ANGIOGRAPHIC POWER SYRINGE 100ML 130ML W/J-CURVED FILL 222 TUBE NBS07137NCSD ANGIOGRAPHIC POWER SYRINGE 200ML W/J-CURVED FILL TUBE 222 NBS07137NESD ANGIOGRAPHIC POWER SYRINGE 150ML W/J-CURVED FILL TUBE 222 NBS07150AQMH DISPOSABLE SYRINGE 150CC W/FILL TUBE 顯影劑注射筒 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 NBS N8 DISPOSABLE SYRINGE SYSTEM WITH ACCESSORIES( 注射筒 + 吸管 ) 222 NBS MA OPTIRAY 320 IOVERSOL INJECTION SYRINGE 125ML 歐得利 320 造影 222 劑注射筒 NBS LF OPTIVANTAGE DUAL-HEAD INJECTOR( 注射筒 X1+ 吸管 X1+Y 型螺旋接 313 管 X1) NBS LF OPTIVANTAGE DUAL-HEAD INJECTOR( 注射筒 X2+ 吸管 X2+Y 型螺旋接 435 管 X1) NBS N8 DISPOSABLE SYRINGE SYSTEM WITH ACCESSORIES( 注射筒 + 吸管 + 螺 313 旋低壓連接管 ) NBS NL NAMIC ANGIOGRAPHIC CONTROL SYRINGES (8:20ML) 血管造影控制 174 注射系統 NBS LF 150ML SYRINGE W/HANDI-FIL 222 NBS LF 200ML FRONT LOADING SYRINGE W/HANDI-FIL 222 NBS N8 DISPOSABLE SYRINGE SYSTEM 150CC W/HANDI FIL LINDEN LUER 222 注射筒 + 吸管 NBS07AG115BQ ANGIOGRAPHIC SYRINGE ( 注射筒 X1+ 抽藥管 X1) 222 NBS07AG215BQ ANGIOGRAPHIC SYRINGE ( 注射筒 X1+ 抽藥管 X1) 222 NBS07C8536CC ANGIOGRAPHIC SYRINGE AND HAND-FILL SET 100~200ML 222 NBS07C8539CC ANGIOGRAPHIC SYRINGE CT PACK(SYRINGE+HAND-FILL ~200ML+ 螺旋連接管 ) NBS07CCS60MR CORONARY CONTROL SYRINGE 6CC 10CC 12CC 174 NBS07CT119BQ ANGIOGRAPHIC SYRINGE KIT ( 注射筒 X1+ 抽藥管 X1+ 螺旋管 X1) 313 NBS07CT129BQ ANGIOGRAPHIC SYRINGE KIT ( 注射筒 X2+ 抽藥管 X2+ 螺旋管 X1) 435 NBS07CT219BQ ANGIOGRAPHIC SYRINGE KIT ( 注射筒 X1+ 抽藥管 X1+ 螺旋管 X1) 313 NBS07CT229BQ ANGIOGRAPHIC SYRINGE KIT ( 注射筒 X2+ 抽藥管 X2+ 螺旋管 X1) 435 NBS07DCTPSMH DISPOSABLE 200 CC SYRINGE 二支 KIT( 注射筒 X2+SPIKE+ 連接管 435 +PRIME TUBE) NBS07MR123BQ ANGIOGRAPHIC SYRINGE KIT (60CC 注射筒 X2+ 抽藥管 X1+Y 螺旋管 435 X1) NBS07MR214BQ ANGIOGRAPHIC SYRINGE KIT (65CC 注射筒 X2+ 抽藥管 X1+Y 螺旋管 435 X1) NBS07SCTPQMH DISPOSABLE 200 CC SYRINGE KIT( 含吸管 + 連接管 +PRIME TUBE) 313 NBS07SCTPSMH DISPOSABLE 200 CC SYRINGE KIT( 含 SPIKE+ 連接管 +PRIME TUBE) 275 NBS07SSQFTMH DISPOSABLE 200 CC SYRINGE KIT( 含吸管 ) 222 NBS07SSSPKMH DISPOSABLE 200 CC SYRINGE KIT( 含 SPIKE) 222 NDN020112NBA HUBER PLUS NON-CORING NEEDLE SAFETY INFUSION SET W/TUBING 適應症請見備註欄

63 NDN HJ 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 64 備註欄 NDN BA STRAIGHT AND RIGHT-ANGLE NON-CORING NEEDLE 直式或直角無心 64 彎針 適應症請見備註欄 NDN BA PORT-A NON-CORING NEEDLE 限癌症化學治療及癌症未期之疼痛 64 治療使用 NDN BA WINGED INFUSION SET 蝴蝶彎針注射套組 適應症請見備註欄 64 NDN BA 蝴蝶彎針 WINGED INFUSION SET 適應症請見備註欄 64 NDN BB CYTOCAN NEEDLES FOR ACCESS PORT W/EXTENSION TUBING 適應 64 症請見備註欄 NDN BB SURECAN NON-CORING NEEDLE FOR PORT A 適應症請見備註欄 64 NDN BB SURECAN NON-CORING NEEDLE W/EXTENSION TUBE FOR ACCESS 64 PORTS 適應症請見備註欄 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 NDN02P1922KA PORT ACCESS INFUSION SET(NON-DEHP TUBING)19:22G 適應症請 64 見備註欄 NDN02PN001SG PORT ACCESS INFUSION SET 適應症請見備註欄 64 NES041218ABA "BARD"MONOPTY DISPOSABLE BIOPSY INSTRUMENT+TRUGUIDE 1380 COAXIAL BIOPSY NEEDLE 組織取樣針 + 同軸導引針 NES041MBS9ZM "MD TECH"SUPER-CORE II ADJUSTABLE BIOPSY INSTRUMENT+MD 1380 TECH CO-AXIAL INTRODUCER NEEDLE 切片針 + 同軸導引針 * 適應症請見備註欄 NES04ACNMFG5 "ANGIOTECH"ACN BIOPSY NEEDLES WITH CO-AXIAL NEEDLE 愛仕恩 1380 切片針 ( 同軸庫針組 )14-20G* 適應症請見備註欄 NES04CT14NJ6 "CAREFUSION"TEMNO BIOPSY NEEDLE + UNIVERSAL COAXIAL 1380 INTRODUCER NEEDLE" 卡弗迅 " 生檢針 + 同軸導引針 * 適應症請見備註欄 NES04MCTGABA "BARD"MAX-CORE DISPOSABLE BIOPSY INSTRUMENT+TRUGUIDE 1380 COAXIAL BIOPSY NEEDLE 組織取樣針 + 同軸導引針 NES04QCS01CK "COOK"COAXIAL QUICK-CORE BIOPSY SETS" 曲克 " 拋棄式取樣針 1380 ( 組 )( 同軸庫 )* 適應症請見備註欄 TKP ZM MD TECH BREAST LOCALIZATION NEEDLE(NEEDLE+HOOK WIRE) 984 美迪克 乳房定位針 TKP XL " 首馬特 " 乳房定位針 "SOMATEX"BREAST LOCALIZATION 984 NEEDLE(NEEDLE+HOOK WIRE) TKP04BLN00ZM MD TECH BREAST LOCALIZATION NEEDLE(NEEDLE+HOOK WIRE) 984 美迪克 乳房定位針 TKP04BREASBA "BARD"BREAST LOCALIZATION NEEDLE(NEEDLE+WIRE)" 巴德 " 乳房定 984 位針 TKP04DKBL1CK "COOK" DISPOSABLE (KOPANS)BREAST LESION LOCALIZATION 984 DEVICES(NEEDLES+WIRE)" 曲克 "DISPOSABLE 乳房病灶定位器材 TKP04EZN2X1G "E-Z-EM"PERCUGUIDE LESION MARKING SYSTEM(NEEDLE+HOOK 984 WIRE)" 易置 " 乳房定位針 TKP04REL01RC "RANFAC"BREAST MARKING SYSTEM:NEEDLE+HOOK WIRE( 乳房定位器 984 材組 ) TKP04SBS01RC "RANFAC"BREAST MARKING SYSTEM:NEEDLE+HOOK WIRE+STIFFENING 1123 CANNULA( 乳房定位器材組 ) TSS R 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

64 TSS G8 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 10.8 請見備註欄 TSS J1 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 10.8 / 罐 ) TSS XX 安倍賜血糖測試儀 - 安倍賜血糖試片 (25 片,50 片 / 盒 )* 使用規定請 10.8 見備註欄 TSS R 羅氏優勢血糖機組 - 羅氏優勢血糖試紙 ACCU-CHEK ADVANTAGE TEST 10.8 STRIPS((10 片,25 片,50 片 / 罐 )* 使用規定請見備註欄 TSS G8 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 10.8 請見備註欄 TSS J1 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, 片 / 罐 ) TSS R 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 10.8 規定請見備註欄 TSS G8 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 10.8 註欄 TSS J1 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 10.8,15 片 / 罐 ) TSS R 羅氏 GO 讚血糖機組 - 羅氏 GO 讚血糖試紙 ACCU-CHEK GO TEST 10.8 STRIPS((10 片,50 片 / 罐 )* 使用規定請見備註欄 TSS G8 日安血糖檢測系統 - 血糖試片 (50 片 / 盒 )* 使用規定請見備註欄 10.8 TSS R 羅氏整合型血糖機組 - 羅氏整合型血糖試紙 ACCU-CHEK INTEGRA 10.8 TEST STRIPS((17 片 / 捲,3 捲 / 盒 )* 使用規定請見備註欄 TSS G8 好贊血糖試紙 SO EASY BLOOD GLUCOSE TEST STRIP(25 片 50 片 10.8 單片鋁箔包 50 片 / 盒 )* 使用規定請見備註欄 TSS GV 樂適康血糖監測系統之血糖試紙 GLUCO PLUS GLUCOSE MONITORING 10.8 SYSTEM'S BLOOD TEST STRIP(25 片或 50 片 / 盒 )* 使用規定請見備註欄 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 10.8 見備註欄 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 10.8 見備註欄 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 10.8 見備註欄 TSS AB " 亞培 " 信妥血糖試紙 (50 片,100 片 / 罐 )PRECISION PCX PLUS BLOOD 10.8 GLUCOSE TEST STRIPS* 使用規定請見備註欄 TSS AB " 亞培 " 第二代醫療專用血糖試紙 OPTIUM POINT OF CARE TEST 10.8 STRIPS(25 片,50 片,100 片 / 罐 )* 使用規定請見備註欄 TSS G7 龍易血糖測試系統 - 血糖試紙 (50 片 / 盒 )* 使用規定請見備註欄 10.8 TSS AB " 亞培 " 歐騰血糖試紙 "ABBOTT" OPTIUM BLOOD GLUCOSE TEST 10.8 STRIPS(25 片,50 片 / 盒 )* 給付規定請見備註欄 TSS AB " 亞培 " 利舒坦優血糖試紙 "ABBOTT" FREESTYLE LITE BLOOD 10.8 GLUCOSE TEST STRIPS(50 片,100 片 / 罐 )* 使用規定請見備註欄 TSS013250BF9 福爾 2 合 1 血糖機之血糖試紙 * 使用規定請見備註欄 (25 片,50 片 / 10.8 盒 ) 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 / 10.8 盒 )* 使用規定請見備註欄 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 / 10.8 盒 )* 使用規定請見備註欄 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 / 10.8 盒 ) TSS014230DF9 福爾舒康血糖測試系統之血糖試紙 * 使用規定請見備註欄 (25 片, 50 片 / 盒 )

65 特材代碼 中英文名稱 支付點數 -102/01 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 / 10.8 盒 ) 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 / 10.8 盒 ) 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 10.8 備註欄 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 / 10.8 盒 ) 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 10.8 備註欄 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 10.8 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 TSS GK 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 TSS GK 歐克語音血糖監測系統 - 歐克語音血糖測試片 (25 片,50 片 / 盒 )* 使用規定請見備註欄 TSS GK 歐克免設碼血糖監測系統 - 歐克免設碼血糖試片 (25 片,50 片 / 盒 )* 使用規定請見備註欄 TSS GK 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 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 TSS01ACCP1FH 艾康血糖測試系統 - 血糖試紙 ACON ON CALL PLUS BLOOD GLUCOSE TEST STRIPS(50 片 / 盒,25 片 ( 單片鋁箔包 )/ 盒,1 片 ( 單片鋁箔包 ))* 使用規定請見備註欄 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 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 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 TSS01APVCCFT 愛彼德語音血糖測試系統 - 血糖測試片 AP VOICE BLOOD GLUCOSE MONITORING SYSTEM-BLOOD GLUCOSE TEST STRIPS(10 片,25 片 / 盒 )* 使用規定請見備註欄 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 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 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 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 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, 片,50 片,75 片,100 片 / 罐 ) 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 10.8 欄 TSS01EL001WB " 拜耳 " 易理測血糖測試試紙 ASCENSIA ELITE BLOOD GLUCOSE TEST 10.8 STRIPS(50 片 / 盒 )* 使用規定請見備註欄 TSS01EN001FY " 愛科來 " 葡萄糖檢測試紙 II(50 片 / 盒 ) * 使用規定請見備註欄 10.8 TSS01EN002FY " 愛科來 "X- 血糖檢測試紙 10 片,50 片 / 盒 * 適應症請見備註欄

66 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 10.8 見備註欄 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 10.8 備註欄 TSS01G421SVL 愛奧樂血糖測試儀專用試紙 * 使用規定請見備註欄 10.8 TSS01G423SVL 愛奧樂血糖測試系統專用試紙 * 使用規定請見備註欄 10.8 TSS01GE100JW GE 血糖監測系統 - 血糖測試片 GE BLOOD GLUCOSE MONITORING 10.8 SYSTEM-GE100 BLOOD GLUCOSE TEST STRIP(10 片 / 罐,25 片 / 罐 )* 給付規定請見備註欄 TSS01GM100FS 瑞特血糖監測系統 GM100- 瑞特血糖測試片 *(10 片,25 片,50 片, 片,200 片 / 盒 )* 使用規定請見備註欄 TSS01GM210FS 瑞特血糖監測系統 GM210- 瑞特血糖測試片 (10 片,25 片,50 片, 片,200 片 / 盒 )* 使用規定請見備註欄 TSS01GM300FS 瑞特血糖監測系統 GM300- 瑞特血糖測試片 *(10 片,25 片,50 片, 片 / 盒 )* 使用規定請見備註欄 TSS01GM550FS 瑞特血糖監測系統 GM550- 瑞特血糖測試片 (10 片,25 片,50 片, 片,200 片 / 盒 )* 使用規定請見備註欄 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 10.8 TSS01HHRRZFZ 隨手測血糖試紙 "ONETOUCH"HORIZON TM TEST STRIPS(25 片 / 盒 )* 10.8 使用規定請見備註欄 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 )* 10.8 使用規定請見備註欄 TSS01LT2255A 欣巧血糖測試片 GLUCOSURE LIGHT BLOOD GLUCOSE TEST STRIP 片 1 罐 / 盒,30 片 1 罐 / 盒,25 片 2 罐 / 盒,50 片 1 罐 / 盒 TSS01MAJHRFT 茂晶血糖測試系統 - 血糖試紙 (10 片,25 片 / 罐 )* 使用規定請見備註 10.8 欄 TSS01MAJJRFT 茂晶血糖測試系統 - 血糖試紙 (10 片,25 片 / 罐 )* 使用規定請見備註 10.8 欄 TSS01NM001JY 歐姆龍血糖監測系統 - 達健型 - 血糖試片 OMRON BLOOD GLUCOSE 10.8 MONITORING SYSTEM-HEA-230(25 片 /1 罐 )* 給付規定請見備註欄 TSS01QS2255A 佳盛時血糖測試片 QISSENSE BLOOD GLUCOSE TEST STRIP 25 片 1 罐 10.8 / 盒,30 片 1 罐 / 盒,25 片 2 罐 / 盒,50 片 1 罐 / 盒 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 10.8 用規定請見備註欄 TSS01SC001KJ 掌上靈血糖測試系統 - 血糖測試片 PALMLAB BLOOD GLUCOSE 10.8 MONITORING SYSTEM-BLOOD GLUCOSE TEST STRIP(25 片 / 罐 )* 給付規定請見備註欄 TSS01SE0505A 欣速血糖測試系統 - 欣速血糖測試片 SENSOREX G TEST STRIPS( 片 / 罐 )* 使用規定請見備註欄 TSS01SG103FX 易立測血糖試紙 (10 片,25 片,50 片 / 盒 )* 使用規定請見備註欄 10.8 TSS01SG105J4 易美測 I 血糖試紙 (25 片 / 盒 )* 適應症請見備註欄 10.8 TSS01SG106FX 易立測 II 血糖試紙 (10 片,25 片,50 片 / 盒 )* 使用規定請見備註欄 10.8 TSS01SG203FX 易立測血糖試紙 (25 片 *2 盒 )* 使用規定請見備註欄 10.8 TSS01SG205J4 易美測 I 血糖試紙 (25 片 *2 盒 )* 適應症請見備註欄 10.8 TSS01SG206FX 易立測 II 血糖試紙 (25 片 *2 盒 )* 使用規定請見備註欄 10.8 TSS01SMC00FT 適美捷血糖測試系統 - 血糖試紙 (10 片,25 片 / 罐 )* 使用規定請見備 10.8 註欄 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, 片 / 罐 )* 使用規定請見備註欄 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

67 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 10.8 請見備註欄 TSS01TB001F7 易速得 -168 血糖測試套組 - 易速得 -168 血糖測試片 (10 片,25 片, 片 / 罐 ;25 片 *2 罐 )* 使用規定請見備註欄 TSS01TB002F7 易速得 -606 血糖測試套組 - 易速得 -606 血糖測試片 (10 片,25 片, 片 / 罐 ;25 片 *2 罐 )* 使用規定請見備註欄 TSS01TB003F7 易速得 -608 血糖測試套組 - 易速得 -608 血糖測試片 (10 片,25 片, 片 / 罐 ;25 片 *2 罐 )* 使用規定請見備註欄 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 ; 片 *2 罐 )* 使用規定請見備註欄 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 ; 片 *2 罐 )* 使用規定請見備註欄 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 10.8 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 10.8 TSS01ULTRAFZ 穩豪血糖試紙 "ONETOUCH" ULTRA TEST STRIPS(25 片 / 罐,2 罐 / 10.8 盒 ;25 片 / 盒 生效 )* 使用規定請見備註欄 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 10.8 TSS01VV2255A 欣活血糖測試片 GLUCOSURE VIVO BLOOD GLUCOSE TEST STRIPS 片 1 罐 / 盒,30 片 1 罐 / 盒,25 片 2 罐 / 盒,50 片 1 罐 / 盒 ACA0100ABNPW IV CAP 3 ACA SG IV CAP 注射帽 3 ACA011PN01NQ INJECTION CAP 3 ACA011VCAPTP INJECTION CAP 3 ACA TZ IV LOCK 3 ACA012VCAPTP INJECTION CAP 3 ACA01AB00NPW IV LOCK 3 ACA01C1C02LL INJECTION CUP(IV LOCK) 3 ACA01NF005LL INJECTION CAP( 安全型 ) 適應症請見備註欄 43.1 ACC BT PLASTIC CONNECTOR 兩尖型 17.4 ACC BT PLASTIC CONNECTOR 一尖一平塑膠連接頭 17.4 ACC BT PLASTIC CONNECTOR 塑膠連接頭 17.4 ACC BT 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 ACM BB HIGH PRESSURE MANIFOLDS DOUBLE 35 BAR 221 ACM BB HIGH PRESSURE MANIFOLDS DOUBLE W/ROTABLE ADAPTER 35 BAR 221 ACM BB HIGH PRESSURE MANIFOLDS DOUBLE 70 BAR 221 ACM BB HIGH PRESSURE MANIFOLDS DOUBLE W/ROTABLE ADAPTER 70 BAR 221 ACM BB HIGH PRESSURE MANIFOLDS TRIPLE 35 BAR 263 ACM BB HIGH PRESSURE MANIFOLDS TRIPLE W/ROTABLE ADAPTER 35 BAR 263 ACM BB HIGH PRESSURE MANIFOLDS TRIPLE 70 BAR 263 ACM BB HIGH PRESSURE MANIFOLDS TRIPLE W/ROTABLE ADAPTER 70 BAR 263 ACM BB ANGIODYN HIGHT PRESSURE MANIFOLDS STOPCOCKS DOUBLE PORTS PSI 1000PSI ACM BB ANGIODYN HIGHT PRESSURE MANIFOLDS STOPCOCKS TRIPLE PORTS PSI 1000PSI ACM01202HFMR MANIFOLD 2-V 200PSI

68 ACM01253RXMR MANIFOLD 3 PORTS 200PSI;500PSI WITH HIGH PRESSURE TUBING 384 雙層 ( 可達 1200PSI) ACM012HFRXMR MANIFOLD 2-PORTS W/ HIGH PRESSURE TUBING( 雙層可達 1200PSI) 384 ACM012P640SB ANGIOGRAPHIC MANIFOLDS 2-PORTS 221 ACM012P700NL ANGIOGRAPHIC MANIFOLDS 2 PORTS 221 ACM013P640SB ANGIOGRAPHIC MANIFOLDS 3-PORTS 263 ACM013P700NL ANGIOGRAPHIC MANIFOLDS 3 PORTS 263 ACM014P700NL ANGIOGRAPHIC MANIFOLDS 4 PORTS 324 ACM01502RXMR MANIFOLD 2-PORTS 500 PSI 221 ACM01503RXMR MANIFOLD 3-PORTS 500 PSI 263 ACM01504RXMR MANIFOLD 4 PORTS 200PSI;500PSI WITH HIGH PRESSURE TUBING 384 雙層 ( 可達 1200PSI) ACM0154PRTMR "MERIT"MANIFOLD:4 PORTS 200PSI;500PSI" 美瑞特 " 多路水接頭 :4 324 連接頭 ACM019310NAG MANIFOLDS 2 PORTS 221 ACM01APMF2H9 ANGIO PACK:MANIFOLDS 2 PORT/ ACM01APMF3H9 ANGIO PACK:MANIFOLDS 3 PORT/ 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 ACM01M3P2HGJ "JSM" 3-PORTS MANIFOLDS (500PSI)+2 條 PRESSURE TUBING (PVC 可達 500PSI)+1 條 HIGH PRESSURE TUBING ( 雙層 PU 可達 1200PSI)" 吉生 " 多路引流器 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 ACM01M4P2HGJ "JSM" 4-PORTS MANIFOLDS (500PSI)+2 條 PRESSURE TUBING (PVC 可達 500PSI)+1 條 HIGH PRESSURE TUBING ( 雙層 PU 可達 1200PSI)" 吉生 " 多路引流器 ACM01MA2PTGJ MANIFOLDS (2 PORT 500PSI W/PVC PT) 多路引流器 ( 含 PVC 壓力連 251 接管 ) ACM01MA2PTH9 MANIFOLDS 2 PORTS W/ PVC TUBING 500PSI 251 ACM01MA2PUGJ "JSM"MANIFOLDS(2 PORT/500PSI W/PU 1200PSI)" 吉生 " 多路引流 384 器 ACM01MA2PVGJ "JSM"MANIFOLDS(2 PORT/500PSI W/PVC 1000PSI)" 吉生 " 多路引流 335 器 ACM01MA3PTGJ MANIFOLDS (3 PORT 500PSI W/PVC PT) 多路引流器 ( 含 PVC 壓力連 291 接管 ) ACM01MA3PTH9 MANIFOLDS 3 PORTS W/ PVC TUBING 500PSI 291 ACM01MA3PUGJ "JSM"MANIFOLDS(3 PORT/500PSI W/PU 1200PSI)" 吉生 " 多路引流 384 器 ACM01MA3PVGJ "JSM"MANIFOLDS(3 PORT/500PSI W/PVC 1000PSI)" 吉生 " 多路引流 335 器 ACM01MA4PTGJ MANIFOLDS (4 PORT 500PSI W/PVC PT) 多路引流器 ( 含 PVC 壓力連 372 接管 ) ACM01MA4PTH9 MANIFOLDS 4 PORTS W/ PVC TUBING 500PSI 372 ACM01MA4PUGJ "JSM"MANIFOLDS(4 PORT/500PSI W/PU 1200PSI)" 吉生 " 多路引流 384 器 ACM01MA4PVGJ "JSM"MANIFOLDS(4 PORT/500PSI W/PVC 1000PSI)" 吉生 " 多路引流 335 器 ACM01MAN12H9 MANIFOLDS 2PORTS 500PSI 221 ACM01MAN13H9 MANIFOLDS 3PORTS 500PSI

69 ACM01MAN14H9 MANIFOLDS 4PORTS 500PSI 324 ACM01MAN2PGJ MANIFOLDS (2 PORT 500PSI) 多路引流器 221 ACM01MAN3PGJ MANIFOLDS (3 PORT 500PSI) 多路引流器 263 ACM01MAN4PGJ MANIFOLDS (4 PORT 500PSI) 多路引流器 324 ACM01PT003CK 2-PORTS MANIFOLD 連接頭 250 ACM01TS520SG MANIFOLD 2 PORTS 221 ACM01TS530SG MANIFOLD 3 PORTS 263 ACM01TS540SG MANIFOLD 4 PORTS 324 ACP011000NDL Y TYPE ADAPTOR 346 ACP H9 " 華億 " 體外循環管組 "HYM"HEART LUNG PACK-Y & STRAIGHT & 88 REDUCER CONNECTOR(WITH LUER) ACP01CA123L5 " 加州 " 心臟麻痺轉接器 "CALIFORNIA" CARDIOPLEGIA ADAPTERS 88 ACP01EC210GH EXTRACORPOREAL TUBING Y CONNECTOR 88 ACP01EC212GH EXTRACORPOREAL TUBING STRAIGHT CONNECTOR 88 ACP01EC214GH EXTRACORPOREAL TUBING CONNECTORS REDUCER REDUCER /LUER 88 SPECIALTY ACP01ECTBSM6 EXTRACORPOREAL TUBING STRAIGHT CONNECTOR 88 ACP01ECTBYM6 EXTRACORPOREAL TUBING Y-CONNECTOR 88 ACP DL MULTIPURPOSE PERFUSION SET WITH VENT LINE 889 ACP DL 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 1514 CATHETER ACS BT 3-WAY STOPCOCK W/LUER LOCK 7.8 ACS BB 3 WAY STOPCOCK 7.8 ACS BB DISCOFIX C-3/-3 MULTIDIRECTIONAL STOPCOCKS" 柏朗 " 輸液轉換 7.8 閥 ACS TZ THREE WAY STOPCOCK SYSTEM 7.8 ACS0134MPATP PREDURA PRESSURE RESISTAN THREE WAY STOPCOCK 3.4MPA 360 度 PSI ACS013CAPSM8 3 WAY STOPCOCK 7.8 ACS TP 3 WAY STOPCOCK 7.8 ACS0168MPATP PREDURA PRESSURE RESISTAN THREE WAY STOPCOCK 1000PSI 70 ACS NL 3-WAY NAMIC MORSE STOPCOCK (200PSI) 7.8 ACS NL 3-WAY NAMIC MORSE STOPCOCK (400PSI) 34 ACS NL 3-WAY NAMIC MORSE STOPCOCK (1050PSI) 70 ACS01D010NPW DISPOSABLE INFUSION SET 3 WAY STOPCOCK 7.8 ACS01H3FLCMR MANIFOLD HIGH PRESSURE 3 WAY STOPCOCK (1050PSI)( 自 起廠牌碼由 ER 改為 MR) ACS01H3SNCMR MARQUIES SERIES STOPCOCKS 1050PSI 70 ACS01M3SNCMR MARQUIS SERIES STOPCOCK 500PSI 34 ACS01NCN3SNR 3 WAY STOPCOCK 塑膠三極栓 7.8 ACS01S3SNCMR MANIFOLD 3 WAY STOPCOCK W/LUER LOCK( 自 起廠牌碼由 34 ER 改為 MR) ACS01STP34H9 " 華億 " 體外循環管組 "HYM"HEART LUNG PACK-3 & 4 WAY 7.8 STOPCOCKS ACS01TS201SG 3 WAY STOPCOCK W/LOCK 7.8 ACS01V68MPTP PREDURA PRESSURE RESISTAN THREE WAY STOPCOCK V-TYPE PSI ACS03SMT01SG 1000PSI HIGH PRESSURE 3 WAY 70 ACVP105103B0 CSF CATHETER CONNECTOR,STRAIGHT 400 ACVP105104B0 CSF CATHETER CONNECTOR,RIGHT ANGLE 845 ACVP123048CM HAKIM STRAIGHT CONNECTOR

70 ACVP145103PM CONNECTOR 400 ACVP145104PM CONNECTOR L 型 845 ACVP182150CM ACCU-FLO STRAIGHT CONNECTORS(METAL,PLASTIC) 400 ACVP182151CM ACCU-FLO RIGHT ANGLE CONNECTORS(METAL,PLASTIC) 845 ACVP205105B0 CSF CATHETER CONNECTOR,3-WAY 1600 ACVP221520CM 3 WAY CONNECTOR 1600 ACVP245105PM 3 WAY CONNECTOR 1600 ACY010210NSD PTCA Y CONNECTOR 1065 ACY010210XSD MYSHELL LITE Y CONNECTORS 麥雪兒萊 Y 型接頭 1065 ACY AB COPILOT BLEEDBACK CONTROL VALVE Y ADAPTOR 1065 ACY010KAY2GG "GOODTEC"Y-CONNECTOR SET " 固德克 "Y 型連接器套組 1065 ACY016248VM4 ADJUSTABLE VALVE W/3-WAY STOPCOCK 1065 ACY NL NAMIC MORSE Y-ADAPTOR 1065 ACY SB NAMIC MORSE Y ADAPTOR 1065 ACY01KESU1NX Y-CONNECTOR(PTCA,PTA 用 ) 1065 ACY01MAP13MR MONIFOLD W/HEMOSTASIS VALVE 200PSI 單 Y 型 1065 ACY01MAP22MR ANGIOPLASTIC PACK & DOUBLE HEMOSTASIS VALVES 1155 ACY01MAP32MR HONOR HEMOSTASIS VALVE ANGIOPLASTY PACK 1065 ACY01MAP45MR "MERIT"ANGIOPLASTY PACKS & HEMOSTASIS VALVES" 美瑞特 " 血管 1065 成型術止血閥組 ACY01NYC00GJ "JSM"Y CONNECTOR KIT " 吉生 "Y 型連接器組 1065 ACY01NYC10GJ "JSM"Y CONNECTOR KIT W/INSERTION TOOL" 吉生 "Y 型連接器組含 1065 導引支撐器 ACY01PTBYCCK ADAPTERS PTCA 用 1065 ACY01YK100GJ "JSM"Y CONNECTOR KIT " 吉生 "Y 型連接器組 1065 ACY01YK110GJ "JSM"Y CONNECTOR KIT W/INSERTION TOOL " 吉生 "Y 型連接器組 1065 ( 含導引支撐器 ) ACY01YK111GJ "JSM"Y CONNECTOR KIT W/INSERTION TOOL+TORQUE DEVICE " 吉 1065 生 "Y 型連接器組 ( 含導引支撐器 + 扭力控制器 ) BBB01T060CTM TRANSFER BAG 600ML 60 BBB01T100BTM TRANSFER BAG 1000ML 60 BBF LL "LILY"FEEDING SET ACCESSORIES 雙袋機械 (PUMP) 式餵食袋 * 適應 110 症請見備註欄 BBF LL "LILY"FEEDING SET ACCESSORIES 雙袋重力式餵食袋 * 適應症請見 72 備註欄 BBF03223XXAB "ABBOTT"FLEXIFLOW PATROL 1 LITER TOP FILL BAG WITH 110 STOPCOCK AND UNIVERSAL ADAPTER 巡弋管灌餵食幫浦套管含餵食袋 * 適應症請見備註欄 BBF TZ FEEDING BAG 1200CC( 動力式 )* 適應症請見備註欄 72 BBF KD KENDALL KANGAROO ENTERAL FEEDING PUMP SETS*" 肯特利 " 袋鼠灌 110 食機用套組 * 給付規定請見備註欄 BBF KD "KENDALL"KANGAROO 924 PUMP SETS" 肯特利 " 袋鼠灌食機用套組 * 110 給付規定請見備註欄 BBF SH EASY CAP BAG 1000ML AND PUMP SET WITH FLUSH BAG 適應症 110 請見備註欄 BBF KD "KENDALL"KANGAROO EPUMP FEEDING SETS 袋鼠電子灌食機用灌食 110 套組 * 給付規定請見備註欄 BBF KG APPLIX SMART/VISION PUMP SET BAG 愛普仕管灌餵食管袋組合套 * 110 適應症請見備註欄 BBF03F1200SG FEEDING PUMP SET 適應症請見備註欄 110 BBF03FB030P2 "PAHSCO"FEEDING BAG 雙袋重力式餵食袋 * 適應症請見備註欄 72 BBF03FB040P2 "PAHSCO"FEEDING BAG 雙袋機械式餵食袋 * 適應症請見備註欄 110 BBF03FB600P2 PAHSC0 FEEDING BAG 重力式 600ML* 適應症請見備註欄

71 BBP CA POST OPERATION OPEN TRANSPARENT BAG 康便舒手術後便袋 * 限住 51 院患者申報 BBP F4 "CONVATEC"NATURA POUCH(NON-STERILE)" 康威 " 益舒穩造口袋 - 雙 43 片式不透明封口便袋 45-57MM( 未滅菌 )* 適應症請見備註欄 BBP F4 "CONVATEC"ESTEEM SYNERGY POUCH(NON-STERILE)" 康威 " 新易優穩 43 造口袋 - 雙片式 35-61MM( 未滅菌 )* 適應症請見備註欄 BBP F4 SUR-FIT NATURA POUCH 45/57MM 雙片式封口除臭便袋 * 限住院患者 43 申報 BBP HL CLOSED MINI POUCH 51MM 單片式封口便袋 * 限住院患者申報 11 BBP011680NA5 YOUCARE C 14:59MM* 限住院患者使用 51 BBP DD ONE PIECE SOLO MINI DRAINABLE POUCH 15:50MM( 含人工皮 不 55 織布 ) 限住院患者申報 BBP F4 "CONVATEC"NATURA POUCH(NON-STERILE)" 康威 " 益舒穩造口袋 - 雙 43 片式透明開口便袋 38-70MM( 未滅菌 )* 適應症請見備註欄 BBP F4 "CONVATEC"NATURA POUCH(NON-STERILE)" 康威 " 益舒穩造口袋 - 雙 43 片式不透明開口便袋 38-57MM( 未滅菌 )* 適應症請見備註欄 BBP F4 "CONVATEC"NATURA POUCH(NON-STERILE)" 康威 " 益舒穩造口袋 - 雙 43 片式不透明開口便袋 38-57MM( 未滅菌 )* 適應症請見備註欄 BBP F4 "CONVATEC"NATURA POUCH(NON-STERILE)" 康威 " 益舒穩造口袋 - 雙 74 片式透明開口便袋 100MM( 未滅菌 )* 適應症請見備註欄 BBP F4 "CONVATEC"ESTEEM POUCH(NON-STERILE)" 康威 " 新優穩造口袋 - 單 55 片 ( 含人工皮 不織布 )( 未滅菌 )* 適應症請見備註欄 BBP F4 "CONVATEC"ESTEEM SYNERGY POUCH(NON-STERILE)" 康威 " 新易優穩造口袋 - 雙片式透明開口 35-61MM( 未滅菌 )* 適應症請見備註欄 43 BBP DD SOLO DRAINABLE POUCHES(NON-STERILE) 10-40MM* 限住院患者申 43 報 BBP F4 SUR-FIT NATURA DRAINABLE POUCH 38:70MM 雙片式造口袋 * 限住院 43 患者申報 BBP F4 SUR-FIT NATURA DRAINABLE POUCH 100MM 雙片式造口袋 * 限住院患 74 者申報 BBP F4 "CONVATEC"LITTLE ONES 2 PIECE TRANSPARENT DRAINABLE POUCH 43 32/45MM 雙片式開口便袋 * 限住院患者申報 BBP HL POST OPERATION COMPACT DRAINABLE POUCH( 開口便袋 ) 限住院 55 患者申報 BBP HL DRAINABLE POUCH 44MM * 限住院患者申報 43 BBP HL DRAINABLE POUCH 102MM * 限住院患者申報 74 BBP HL DRAINABLE POUCH 38MM * 限住院患者申報 43 BBP HL OSTOMY TWO-PIECE WITH TRANSPARENT 57MM 中央點鎖式兩式便袋 43 * 限住院患者申報 BBP F4 "CONVATEC"ESTEEMSYNERGY DRAINABLE POUCH TRANSPARENT 43 35/48/61MM 雙片式造口袋 * 限住院患者申報 BBP F4 "CONVATEC"ESTEEMSYNERGY DRAINABLE POUCH OPAQUE 35/48MM 雙 43 片式造口袋 * 限住院患者申報 BBP F4 "CONVATEC"ESTEEMSYNERGY CLOSE POUCH OPAQUE 35/48/61MM 雙片 43 式造口袋 * 限住院患者申報 BBP F4 "CONVATEC"ESTEEMSYNERGY CLOSE POUCH OPAQUE MINI 35/48MM 雙 43 片式造口袋 * 限住院患者申報 BBP CA POST OPEN BAG 100MM* 限住院患者申報 74 BBP HL ONE-PIECE POUCH 51MM* 限住院患者申報 11 BBP HL STONINAL ONE PIECE POUCH 51MM 單片附人造皮便袋 * 限住院患者申報

72 BBP HL "HOLLISTER"OSTOMY POUCH AND ACCESSORIES(NON-STERILE)" 鶴 55 牌 " 造口術用袋及其附件 ( 未滅菌 )( 含人工皮 " 不織布 )* 適應症請見備註欄 BBP F4 "CONVATEC"ESTEEMSYNERGY CLOSE POUCH TRANSPARENT35/48/61MM 43 雙片式造口袋 * 限住院患者申報 BBP HL ONE PIECE PEDIATRIC DRAINABLE POUCH( 附人造皮 ) 限住院患 45 者申報 BBP CA "COLOPLAST"OSTOMY POUCH AND ACCESSORIES(NON-STERILE) 造口 43 術用袋及其附件 * 限住院患者申報 40MM:60MM BBP A5 PROCARE-2 DRAINABLE POUCH 30,40,50MM* 限住院患者申報 55 BBP A5 PROCARE-2 DRAINABLE POUCH 70MM* 限住院患者申報 43 BBP A5 LAPACK SUPER-G 人工肛門袋 G80* 限住院患者申報 11 BBP A5 LAPACK SUPER-G 人工肛門袋 G100* 限住院患者申報 11 BBP A5 LAPACK SUPER-G 人工肛門袋 G125* 限住院患者申報 11 BBP A5 LAPACK SUPER-C 100 人工肛門封口便袋 * 限住院患者申報 11 BBP A5 LAPACK SUPER F 簡易型夾鏈式開口便袋 * 限住院患者使用 11 BBP A5 POSPACK-B K 60,70MM* 限住院患者申報 55 BBP CA "COLOPLAST"ALTERNA FREE WITH HIDE-AWAY OUTLET OSTOMY 43 POUCH 40MM,50MM,60MM(TWO-PIECE) 崇尚型易關式開口袋 * 適應證請見備註欄 BBP041418NA5 YOUCARE D 14:50MM* 限住院患者使用 55 BBP A5 PEDIATRIC PROCARE 1 POST-OP * 限住院患者使用 45 BBP CA "COLOPLAST"EASIFLEX OSTOMY POUCH (NON-STERILE) 易利膚造口 43 術用袋 * 適應症請見備註欄 BBP041501KA5 "ALCARE"OSTOMY POUCH POSPACK-K 0-70MM( 含人工皮. 不織布 ) 造 55 口術用袋 * 限住院患者申報 BBP A5 POSPACK B 60MM 限住院患者使用 55 BBP041503NA5 POSPACK LIGHT 60MM 限住院患者使用 34 BBP A5 YOUCARE 2 POUCH DF 優護二件式開口便袋 * 限住院患者使用 43 BBP A5 YOUCARE 2 POUCH DF 優護二件式開口便袋 * 限住院患者使用 43 BBP A5 YOUCARE 2 POUCH DF 優護二件式開口便袋 * 限住院患者使用 43 BBP A5 YOUCARE 2 POUCH D 優護二件式開口便袋 * 限住院患者使用 43 BBP041662NA5 YOUCARE 2 POUCH D 優護二件式開口便袋 * 限住院患者使用 43 BBP A5 YOUCARE D 14:59MM* 限住院患者使用 55 BBP041678NA5 YOUCARE D 14:59MM* 限住院患者使用 55 BBP CA ILEOSTOMY BAG MAXI 40MM,50MM,60MM 限住院患者申報 43 BBP CA ALTERNA CHILDREN 雙片 OPEN TRANSPARENT BAG 40MM 限住院患 45 者申報 BBP HL "HOLLISTER"OSTOMY POUCH AND ACCESSORIES-NEW IMAGE LOCK'N ROLL DRAINABLE POUCH 新象便袋 102MM * 適應症請件備註欄 74 BBP HL NEW IMAGE DRAINABLE POUCH 2 PIECE 44:70MM * 限住院患者申報 43 BBP CA BBP F4 BBP F4 BBP CA "COLOPLAST"SENSURA OSTOMY POUCH AND ACCESSORIES(NON- STERILE)1-PIECE ( 含人工皮 不織布 )" 康樂保 " 善舒樂造口術用袋及其附件 * 給付規定請見備註欄 ACTIVE LIFE ONE-PIECE POUCH WITH SKIN BARRIER 50MM 雙片式造口袋 * 限住院患者申報 ACTIVE LIFE ONE-PIECE DRAINABLE POUCH 19/64MM 單片式造口袋 * 限住院患者申報 "COLOPLAST"ALTERNA ILEOSTOMY BAGS 10-70MM 愛特大迴腸造口袋 * 適應症請見備註欄

73 BBP CA ONE PIECE ALTERNA CHILDREN OPEN TRANSPARENT BAG 10:35MM 45 限住院患者申報 BBU HL FIRST CHOICE UROSTOMY POUCH WITH CUT-TO-FIT BARRIER( 含人 91 工皮 ) 限住院串者申報 BBU F4 SUR-FIT NATURA UROSTOMY POUCH 38:70MM 透明尿袋 * 限住院患者 77 申報 BBU HL UROSTOMY POUCH 38MM* 限住院患者申報 77 BBU HL CENTER POINT LOCK UROSTOMY POUCH 限住院患者申報 91 BBU CA "COLOPLAST"SENSURA OSTOMY POUCH AND ACCESSORIES(NON- 77 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 BBU A5 PROCARE-2 URINARY POUCH 30,40,50MM* 限住院患者申報 77 BBU A5 BIOURINE-B 50MM* 限住院患者申報 91 BBU A5 YOUCARE U 優護一件式尿袋 * 限住院患者使用 91 BBU011536NA5 YOUCARE U 優護一件式尿袋 * 限住院患者使用 91 BBU011666NA5 YOUCARE 2U 優護二件式尿袋 * 限住院患者使用 77 BBU CA COLOPLAST ALTERNA UROSTOMY BAG MAXI375ML 限住院患者申報 77 BBU CA ALTERNA CHILDREN TRANSPARENT URINE BAG 限住院患者申報 77 BBU HL NEW IMAGE UROSTOMY POUCH ( 不含人工皮 ) 44:70MM * 限住院患者 77 申報 BBU CA UROSTOMY BAG MAXI 375ML 限住院患者申報 91 BBU F4 "CONVATEC"ACTIVE LIFE ONE-PIECE UROSTOMY POUCH 19:45MM 單 91 片式尿袋 * 限住院患者申報 BBU CA ONE PIECE ALTERNA CHILDREN TRANSPARENT URINE BAG 91 10:35MM( 含人工皮 ) 限住院患者申報 BBW P2 P.C.N. BAG (S) 腎臟造廔引流袋 34 BBW P2 P.C.N. BAG (L) 腎臟造廔引流袋 34 BBW TZ PCN BAG 腎臟造口引流袋 34 BBW TZ PCN BAG 500ML 34 BBW P2 WOUND DRAINAGE SYSTEM BAG( 接真空傷口引流袋 ) 34 BBW PB PBN DRAINAGE BAG 34 CAE BB PERIFIX ONE EPIDURAL 427 ANAESTHESIA(NEEDLE+CATH+CONNECTOR+FILTER+LOR SYRINGE+SYRINGE) CAE H0 EPIDURAL ANESTHESIS SET 硬腦膜外醉套 362 CAE H0 EPIDURAL ANESTHESIS SET 硬腦膜外醉套 362 CAE BB EPIDURAL ANAESTHESIA SET(N+C)( 型號包含 , ) 241 CAE BB EPIDURAL ANAESTHESIA SET 16:18G(N+C+F+S)( 型號含 , :021,-200:307, :303) CAE BB EPIDURAL ANAESTHESIA CATHETER 103 CAE BB EPIDURAL ANAESTHESIA SET(N+C+S) 362 CAE BB EPIDURAL ANAESTHESIA SET(N+C+F) 362 CAE PX " 保德士 " 硬膜外腔麻醉針組 (1)"PORTEX"EPIDURAL MINIPACK 427 SYSTEMS(1) 16;18G(NEEDLE+CATHETER+FILTER+SYRINGE) CAE PX EPIDURAL MINIPACK SYSTEM 1 16G 80MM 427 CAE PX EPIDURAL MINIPACK SYSTEM 1 18G 80MM 427 CAE PX " 保德士 " 硬膜外腔麻醉針組 (4)"PORTEX"EPIDURAL MINIPACK 241 SYSTEMS(4) 16;18G(NEEDLE+CATHETER) CAE014014NBD PERISAFE EPIDURAL ANAESTHESIA KIT NEEDLE 17,18G CATH ,20G(N+C+FILTER+SYRINGE+GUIDE+CONNECTOR) CAE BB PERICAN EPIDURAL NEEDLE

74 CAE BB PERIFIX EPIDURAL SET 241 CAE BB PERIFIX EPIDURAL SET 241 CAE BB PERIFIX FOR CONTINUOUS EPIDURAL AND CAUDAL ANAESTHESIA SERIES CAE PX EPIDURAL MINIPACK SYSTEM 19G 硬脊膜穿刺麻醉針組 427 CAE01C1695TM CONNECTING EPIDURAL CATHETER 95CM 103 CAE01C1795TM CONNECTING EPIDURAL CATHETER 95CM 103 CAE01C1895TM CONNECTING EPIDURAL CATHETER 95CM 103 CAE01E5400AR NON-KINGKING EPIDURAL CATHETER 20GA 91.4CM,19GAX92CM 362 CAE01ENC16TM EPIDURAL NEEDLE 16G 110 CAE01ENC17TM EPIDURAL NEEDLE 17G 110 CAE01ENC18TM EPIDURAL NEEDLE 18G 110 CAE01PC383BB PERICAN NEEDLES FOR EPIDURAL ANAESTHESIA 背利安硬脊膜麻醉 110 穿刺針 CAE01SD150BB "B.BRAUN"PERIFIX CATHETERS FOR EPIDURAL 103 ANAESTHESIA(CATHETER)" 柏朗 " 脊椎硬膜麻醉用穿刺套 CAE01SD300BB "B.BRAUN"PERIFIX CATHETERS FOR EPIDURAL ANAESTHESIA" 柏朗 " 241 脊椎硬膜麻醉用穿刺套 (NEEDLE+CATHETER) CAE01SD301BB "B.BRAUN"PERIFIX CATHETERS FOR EPIDURAL ANAESTHESIA:MINI 362 SETS" 柏朗 " 脊椎硬膜麻醉用穿刺套 (NEEDLE+CATHETER+FILTER 或 SYRINGE) CAE01SD401BB "B.BRAUN"PERIFIX CATHETERS FOR EPIDURAL 427 ANAESTHESIA:FILTER SETS" 柏朗 " 脊椎硬膜麻醉用穿刺套 (NEEDLE+CATHETER+FILTER+SYRINGE) CAE HK EPIDURAL CATHETER 硬膜外針導管 103 CAE HK EPIDURAL CATHETER 硬膜外針導管 103 CAE PX EPIDURAL ANAESTHESIA CONDUCTION SET:EPIDURAL CATHETER 103 CAE HK EPIDURAL CATHETER 22G 103 CBA010502SAR INTRA AORTIC BALLOON CATHETER ( 型號 :IAB U,04240U,04250U,06830U,06840U,R950U 自 起生效 ) CBA010AB46M4 "MEDTRONIC"RELIANT STENT GRAFT BALLOON CATHETER" 美敦力 " 瑞 萊恩球囊導管 CBA QM "MAQUET"PEDIATRIC INTRA AORTIC BALLOON (PUMP)CATHETER FIDELITY 2.5CC 5CC 7CC 12CC 20CC" 邁柯唯 " 主動脈氣球導管 CBA QM "MAQUET"INTRA AORTIC BALLOON (PUMP) FIDELITY 8FR 25CC" 邁 柯唯 " 主動脈氣球導管 CBA QM "MAQUET"INTRA AORTIC BALLOON PUMP CATHETER 8FR 34CC" 邁柯 唯 " 主動脈氣球導管 CBA QM "MAQUET"INTRA-AORTIC (PUMP)BALLOON 8FR 34CC 40CC" 邁柯唯 " 主動脈氣球導管 CBA QM "MAQUET"INTRA AORTIC BALLOON(PUMP) CATHETER 7.5FR ;34;40CC" 邁柯唯 " 主動脈氣球導管 CBA014830UAR NARROWFLEX UNIVERSAL IAB CATHETER 8FR.30CC,40CC CBA ED "EDWARDS"FOGARTY OCCLUSION CATHETER(AORTIC) 堵塞用導管 CBA01B2640GX "GORE"TRI-LOBE BALLOON CATHETER(AORTIC) 三葉球囊導管 CBA01C0DA1CK "COOK"CODA BALLOON CATHETER (AORTIC) 科達球曩導管 CBA01C0DA2CK "COOK"CODA BALLOON CATHETER(AORTIC) 科達球囊導管 CBA01C0DA3CK "COOK"CODA 3G OCCLUSION BALLOON CATHETER" 曲克 " 柯達閉合球 囊導管 CBA01C0DA4CK "COOK"CODA LP BALLOON CATHETER" 曲克 " 科達艾皮球囊導管 CBA01REL46M4 "MEDTRONIC"RELIANT STENT GRAFT BALLOON CATHETER 瑞萊恩氣球導管

75 CBA01S730CAR REDIGUARD IAB CATHETER 7,8,9FR. 30CC,40CC CBA02F6830AR "ARROW"FIBER OPTIC INTRA-AORTIC BALLOON CATHETER 光纖感應 主動脈弓氣球導管 CBA02SEN7FQM "MAQUET"SENSATION 7FR INTRA-AORTIC BALLOON CATHETER" 邁柯 唯 " 光纖感應主動脈氣球導管 * 適應症請見備註欄 CBA LW " 樂脈 " 普特主動脈阻斷導管 "LEMAITRE"PRUITT AORTIC OCCLUSION 7638 CATHETER* 適應症請見備註欄 CBB SB ULTRA-THIN DIAMOND BALLOON DILATATION CATHETER 5822 CBB SB BLUW MAX BALLOON DILATATION CATHETERS 5822 CBB SB XXL BALLOON DILATATION CATHETER 5822 CBB L1 PTA BALLOON CATHETER 5822 CBB SB "BOSTON SCIENTIFIC"MUSTANG PTA BALLOON DILATATION 5822 CATHETERS D 3:10;12MM; L 20:100MM " 波士頓科技 " 瑪思丹氣球擴張導管 CBB N5 GHOST II PTA ANGIOPLASTY CATHETER 5FR. 3:10MM *1.5:10CM, ,75,120,150CM( 衛署字號 ) CBB SB "BOSTON SCIENTIFIC"STERLING BALLOON DILATATION CATHETERS D 3:8MM L 10:60MM C USABLE 80;135CM 氣球擴張導管 5822 CBB SB "BOSTON SCIENTIFIC"STERLING BALLOON DILATATION 5822 CATHETERS(OTW)D 4:10MM L 20:100MM C USABLE L40:135CM 氣球擴張導管 CBB SB "BOSTON SCIENTIFIC"STERLING BALLOON DILATATION 5822 CATHETERS(OTW) D 1.5:4MM L 20:40MM C USABLE 142;145CM 氣球擴張導管 CBB SB "BOSTON SCIENTIFIC"STERLING BALLOON DILATATION 5822 CATHETERS(Monorail) D 1.5:4MM L 20:40MM C USABLE 143;146CM 氣球擴張導管 CBB014020NCD POWER FLEX PTA CATHETER 5822 CBB014105NCD POWERFLEX PTA BALLOON CATHTER 5FR 5822 CBB014122NCD POWER FLEX PTA CATHETER 5FR 5822 CBB CD POWERFLEX PTA CATHETER 5822 CBB CD POWERFLEX PTA BALLOON 5822 CBB CD POWERFLEX PTA BALLOON 5822 CBB CD POWERFLEX PTA BALLOON 5822 CBB01420XNCD POWER FLEX PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY (PTA) 5822 CATHETER 3MM:12MM 40,80,135CM CBB01424NWCD "CORDIS"AVIATOR PLUS PERCUTANEOUS TRANSLUMINAL 5822 ANGIOPLASTY(PTA)BALLOON DILATATION CATHETER PTA 氣球擴張導管 4.0MM:6.0MM;7.0MM CBB014352XCD SAVVY PTA CATHETER 5FR 5822 CBB014353XCD SAVVY PTA CATHETER 5FR 5822 CBB014354XCD SAVVY PTA CATHETER 5FR 5822 CBB014355XCD SAVVY PTA CATHETER 5822 CBB014356XCD SAVVY PTA CATHETER 5822 CBB014357XCD SAVVY PTA CATHETER 5FR 5822 CBB014358XCD SAVVY PTA CATHETER 5FR 5822 CBB014359XCD SAVVY PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY(PTA)CATHETER 5822 CBB01435XXCD CORDIS SAVVY PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY(PTA) 5822 CATHETER 80;120;135;150CM CBB SB SMASH BALLOON DILATATION CATHETER 5822 CBB SC SMASH PTA BALLOON DILATION CATHETER 5FR 3.0:10MM

76 CBB SB WANDA PTA BALLOON DILATATION CATHETER 5822 CBB BQ "BIOTEQ"PTA BALLOON DILATATION CATHETER" 邦特 " 血管氣球擴張 5822 導管 CBB BQ "BIOTEQ"PTA BALLOON DILATATION CATHETER" 邦特 " 血管氣球擴張 5822 導管 CBB N5 HIGH FIVE PTA ULTRA HIGH PRESSURE CATHETER 5FR BALLOON 5822 DIA 3:10MM LENGTH 2:10CM CBB BQ "BIOTEQ"PTA BALLOON DILATATION CATHETER" 邦特 " 血管氣球擴張 5822 導管 CBB BQ "BIOTEQ"PTA BALLOON DILATATION CATHETER" 邦特 " 血管氣球擴張 5822 導管 CBB AB "ABBOTT"FOX SV PTA CATHETER 福斯深層周邊血管氣球導管 135CM MM:5.0MM CBB AB "ABBOTT"FOX SV PTA CATHETER 福斯深層周邊血管氣球導管 90CM MM:5.0MM CBB01ADM18F2 "INVATEC"ADMIRAL XTREME PTA BALLOON CATHETER 愛德米羅週邊 5822 血管氣球導管 3MM:12MM 20MM:120MM CBB01AP128AB FOX PLUS PTA CATHETER 5822 CBB01ARM35AB "ABBOTT"ARMADA 35/ARMADA 35LL PTA CATHETER" 亞培 " 阿曼達周 5822 邊血管球囊導管 CBB01AT751BA BARD ATLAS PTA BALLOON DILATATION CATHETER 75CM,120CM 5822 CBB01AT752BA "BARD"ATLAS PTA BALLOON DILATATION CATHETER 5822 CBB01ATB01CK ALL-TERRAIN BALLOON PTA DILATATION CATHETERS 5822 CBB01ATB02CK "COOK"ALL-TERRAIN BALLOON PTA DILATATION CATHETER 經皮穿刺 5822 血管成形術用氣球擴張導管 CBB01CQ120BA "BARD"CONQUEST PTA BALLOON DILATATION CATHETER 氣球擴張導 5822 管 CBB01CQ575BA CONQUEST PTA BALLOON DILATATION CATHETER( 型號 CQ-50; ;54;58 自 起生效, 文號 ) CBB01CYTESSB "BOSTON SCIENTIFIC"COYOTE ES OTW,MONORAIL PTA BALLOON 5822 DILATATION CATHETERS D 1.5:4MM; 20:40MM " 波士頓科技 " 凱優帝氣球擴張導管 CBB01F0XSVAB "ABBOTT"FOX SV PTA BALLOON CATHETER D 2:6MM L ,135,150CM 周邊血管氣球導管 CBB01FCPTAAB "ABBOTT"FOXCROSS PTA CATHETER 周邊血管氣球導管 5822 CBB01G11XXN5 "NUMED"GHOST II PTA CATHETER 40CM 75CM 120CM 135CM 150CM 5822 CBB01L2457KE "KANEKA"PTA BALLOON CATHETER 經皮穿腔成型術氣球導管 5822 CBB01MG1XXN5 NUMED MINI GHOST DILATATION CATHETER 2MM-6MM 2CM:4CM CM:150CM CBB01P5052VC OPTI-PLAST BALLOON DILATATION CATHETER 5.5FR 5822 CBB01PCF18F2 "INVATEC"PACIFIC XTREME PTA BALLOON CATHETER 派斯飛克血管 5822 治療導管 CBB01PTA14Y9 NANOCROSS.014 OTW PTA DILATATION CATHETER D 1.5:3.5MM L :120MM 導管長度 150CM 娜諾血管擴張氣球導管 CBB01PTA15Y9 NANOCROSS.014 OTW PTA DILATATION CATHETER D 4.0MM L MM;40MM;80MM 導管長度 90CM,150CM 娜諾血管擴張氣球導管 CBB01PTA18Y7 POWERCROSS.018 OTW PTA DILATATION CATHETER 包爾血管擴張氣 5822 球導管導管長度 90CM 150CM 球囊直徑 2MM:6MM 球囊長度 20MM:120MM CBB01PTA31K7 SD PTA DILATATION CATHETER 迅捷血管擴張氣球導管

77 CBB01PTA35Y8 EVERCROSS.035 OTW PTA DILATATION CATHETER D 3.0:12.0MM L 15:120MM 導管長度 40,80,135CM 艾維血管擴張氣球導管 5822 CBB01PTA41CK "COOK"ADVANCED 18LP LOW PROFILE PTA BALLOON DILATATION 5822 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 CBB01PTA51CK "COOK"ADVANCED 35LP LOW PROFILE PTA BALLOON DILATION 5822 CATHETER 5-7 FR 80/135CM 艾德凡絲小剖面經皮穿刺血管成形術球囊 CBB01REU35F2 "INVATEC"REEF HP PTA BALLOON CATHETER D 4.0:8.0MM L :80MM USE LENGTH 50,80,120CM 週邊血管氣球導管 CBB01RV135BA "BARD"RIVAL PTA BALLOON DILATATION CATHETER 氣球擴張導管 5822 SHAFT 80&135CM D 4:10MM L 2:15CM CBB01SBR18F2 "INVATEC"SUBMARINE RAPIDO PTA BALLOON CATHETER 直徑 MM-7.00MM, 長度 20MM:40MM,60MM,80MM USE LENGTH:75CM,135CM 潛艇周邊血管治療導管 CBB01SF475KE "KANEKA"PTA CATHETER 血管擴張氣球導管 5822 CBB01SMTRYSB "BOSTON SCIENTIFIC"SYMMETRY BALLOON DILATATION CATHETER MM-6.0MM 2CM-10CM 對稱式氣球裝導管 CBB01SUP18F2 "INVATEC"SUBMARINE PLUS PTA CATHETER 潛艇週邊血管治療導管 5822 直徑 2.0MM:7.0MM 長度 20MM:120MM CBB01U7522VC ULTRAVERSE SMALL VESSEL BALLOON DILATATION CATHETER 3.5FR 5822 CBB01USSV1SB "BOSTON SCIENTIFIC"ULTRA-SOFT SV BALLOON DILATATION 5822 CATHETER4.0MM:7.0MM 1.5CM:2.0CM 3.1CM/3.1CM:3.4CM/3.1CM 90FR,150FR CBB01X5052VC OPTI-PLAST XT BALLOON DILATATION CATHETER 5.0FR 5822 CBB LW "LEMAITRE"DISTAL PERFUSION CATHETER" 樂脈 " 遠端灌流導管 7100 CBB SB "BOSTON SCIENTIFIC"MUSTANG PTA BALLOON DILATATION CATHETERS D 3:8MM; L 120:200MM " 波士頓科技 " 瑪思丹氣球擴張導管 * 適應症請見備註欄 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 CBB03AMD21F2 "INVATEC"AMPHIRION DEEP PTA BALLOON CATHETER D:2.0:4.00MM L:120:210MM" 英泰克 " 安菲允血管治療導管 * 適應症請見備註欄 CBB03AMD80F2 CBB03ARMA1AB CBB03ARMA2AB CBB03CYTLTSB CBB03CYTSTSB "INVATEC"AMPHIRION DEEP PTA BALLOON CATHETER D:1.5:4.00MM L:20:80MM" 英泰克 " 安菲允血管治療導管 * 適應症請見備註欄 "ABBOTT"ARMADA 14 PTA CATHETER D:1.5MM-4.0MM L:20MM:80MM" 亞培 " 阿曼達周邊血管球囊導管 * 適應症請見備註欄 "ABBOTT"ARMADA 14 PTA CATHETER D:1.5MM-4.0MM L:120MM:200MM" 亞培 " 阿曼達周邊血管球囊導管 * 適應症請見備註欄 "BOSTON SCIENTIFIC"COYOTE PTA BALLOON DILATATION CATHETERS D 2.0:4MM;L 120:220MM " 波士頓科技 " 凱優帝氣球擴張導管 * 適應症請見備註欄 "BOSTON SCIENTIFIC"COYOTE OTW.MONORAIL PTA BALLOON DILATATION CATHETERS D 1.5:4MM; 40:100MM " 波士頓科技 " 凱優帝氣球擴張導管 * 適應症見備註

78 CBB03PTAX1CK "COOK"ADVANCED 14LP LOW PROFILE PTA BALLOON DILATATION :4CM 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 CBB03PTAX2CK "COOK"ADVANCED 14LP LOW PROFILE PTA BALLOON DILATATION :4CM 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 CBB03STSL1SB "BOSTON SCIENTIFIC"STERLING PTA BALLOON DILATATION CATHETERS D:2.0:4.00MM L:120,150MM" 波士頓科技 " 施特靈氣球擴張導管 * 適應症請見備註欄 CBB03STSL8SB "BOSTON SCIENTIFIC"STERLING PTA BALLOON DILATATION 8733 CATHETERS D:2.0:4.00MM L:80,100MM" 波士頓科技 " 施特靈氣球擴張導管 * 適應症請見備註欄 CBB03SV435CD "CORDIS"SAVVY PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY ( PTA 8733 ) CATHETER D:2.0:6.0MM L:20:100MM" 考迪斯 " 沙維 PTA 擴張導管 * 給付規定請見備註欄 CBB04JS0S1CK "COOK"SOS BAKRI TAMPONADE BALLOON 500ML( 含 60ML 針筒 )" 曲克 " 7600 貝克利填塞氣球 * 適應症請見備註欄 CBC AB "ABBOTT"RX ACCULINK CAROTID STENT SYSTEM 亞科林頸動脈支架 系統 * 適應症請見備註欄 CBC01PCRXCCD "CORDIS"PRECISE PRO RX NITINOL STENT SYSTEM 普塞斯普羅鎳鈦 支架系統 ( 頸動脈支架 )* 適應症請見備註欄 CBC01PR0TEY7 "EV3"PROTEGE RX CAROTID STENT SYSTEMS STRAIGHT L:20:60MM D:6:10MM TAPERED L:30;40MM D:8X6;10X7MM 波特捷自動擴張式頸動脈支架系統 * 適應症見備註 CBC01SCH64SB OTW&MONORAIL CAROTID WALLSTENT D:6:10MM,L:30:50MM* 使用規 範請見備註欄 CBC01SCH65SB OTW&MONORAIL CAROTID WALLSTENT* 適應症請見備註欄 CBC01XRXSTAB "ABBOTT"XACT CAROTID STENT SYSTEM 頸動脈支架系統 * 適應症請 見備註欄 CBC BB "B.BRAUN"VASCUL FLEX SE SELF-EXPANDING PERIPHERAL STENT(ILIAC) 脈舒萊週邊血管支架 * 適應症請見備註欄 CBC SB "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 CBC SB BOSTON SCIENTIFIC WALLSTENT ILIAC ENDOPROSTHESIS WITH UNISTEP PLUS DELIVERY SYSTEM*" 波士頓科技 " 華斯登腸骨支架系統 * 適應症請見備註欄 CBC02ASSURM4 "MEDTRONIC"ASSURANT COBALT OVER THE WIRE ILIAC STENT SYSTEM 腸骨血管支架系統 * 適應症請見備註欄 CBC02C0810CD "CORDIS"S.M.A.R.T.CONTROL NITINOL STENT SYSTEM(ILIAC)" 考 迪斯 " 史瑪特鎳鈦支架系統 ( 腸骨支架 )* 適應症請見備註欄 CBC02C0MSEM4 "MEDTRONIC"COMPLETE SE ILIAC STENT SYSTEM D:4.0-10MM L:20:150MM CATHETER:80-130CM" 美敦力 " 康博立腸骨血管支架系統 * 適應症請見備註欄 CBC02GENESCD "CORDIS"PALMAZ GENESIS PERIPHERAL STENT AND DELIVERY SYSTEM " 考迪斯 " 帕瑪傑耐周邊血管支架及氣球輸送系統 ( 腸骨動脈支架 )* 適應症見備註欄 CBC02LUDUEAN "ANGIOMED" LUMINEXX VASCULAR STENT " 安吉美爾德 " 路明尼斯血 管支架直徑 4MM:9MM 10MM;12MM;14MM 長度 20MM:120MM 適應症請見備註欄 CBC02MP628F2 "INVATEC"MARIS PERIPHERAL SELF-EXPANDING STENT SYSTEM(ILIAC ARTERY) 瑪瑞斯自膨式週邊血管支架系統 * 適應症請見備註欄

79 CBC02P208MCD "CORDIS"PALMAZ BALLOON-EXPANDABLE STENT FOR THE ILIAC ARTERIES" 考迪斯 " 帕碼球狀腸骨動脈擴張導管 3.5MMX30MM"" 適應症請見備註欄 CBC02SCA35F2 "INVATEC"SCUBA PERIPHERAL STENT SYSTEM 80CM 130CM 腸骨血管支架系統 * 適應症請見備註欄 CBC02Z1V60CK "COOK"ZILVER VASCULAR STENT SYS(ILIAC ARTERY) " 曲克 " 麗而服血管支架系統 ( 腸骨動脈 )* 適應症請見備註欄 CBC02Z1V61CK "COOK"ZILVER VASCULAR STENT(ILIAC ARTERY)" 曲克 " 麗而服血管支架 * 適應症請見備註欄 CBC02Z1V62CK "COOK"ZILVER SELF EXPANDABLE VASCULAR STENTS(ILIAC ARTERY)" 曲克 " 麗而服自展性血管支架 * 適應症請見備註欄 CBC02Z1V63CK "COOK"ZILVER VASCULAR STENTS(ILIAC)6:10MMX20:80MM" 曲克 " 麗而服血管支架 ( 腸骨血管支架 )* 適應症請見備註欄 CBC02ZVM04AN "ANGIOMED"BARD E.LUMINEXX VASCULAR STENT" 安吉美爾德 " 巴德. 依路明尼斯血管支架 ( 腸骨血管支架 )* 適應症請見備註欄 CBC02ZVS04AN "ANGIOMED"BARD E.LUMINEXX VASCULAR STENT 巴德依. 路明尼斯血管支架 ( 腸骨血管支架 ) 直徑 4MM:10MM;12MM;14MM 長度 60CM;135CM* 適應症請見備註欄 CBC TM "TERUMO"ANACONDA AAA STENT GRAFT SYSTEM 安康達腹主動脈人工血管支架系統 ( 主體 + 分支體 *2)* 適應症請見備註欄 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 CBC03AAA01M4 "MEDTRONIC"TALENT AAA STENT GRAFT W THE XCELERANT HYDRO DELIVERY SYS 腹主動脈支架系統 ( 主體 + 分支體 )* 適應症請見備註欄 CBC03AAA03CK "COOK"ZENITH AAA ENDOVASCULAR GRAFT W/H&L-B ONE-SHOT INTRO SYS 腹主動脈瘤支架暨輸送導引系統 ( 主體 + 分支體 *2)* 適應症見備註 CBC03AAA03M4 "MEDTRONIC"ENDURANT STENT GRAFT SYSTEM" 美敦力 " 茵德倫覆膜支架系統 ( 主體 + 分支體 )* 適應症請見備註欄 CBC03AX101CK "COOK"ZENITH RENU AAA ANCILLARY GRAFT W/H&L-B ONE-SHOT INTRO SYS 腹主動脈瘤支架暨輸送導引系統 ( 主體 + 分支體 *2)* 適應症請見備註 CBC03AZT01CK "COOK"ZENITH FLEX AAA ENDOVASCULAR GRAFT /W Z-TRAK INTRO SYS 主動脈瘤支架暨輸送導引系統 ( 主體 + 分支體 *2)* 適應症見備註 CBC03PX23NGX "GORE"EXCLUDER AAA ENDOPROSTHESIS 易時固得腹主動脈支架 ( 腹主動脈瘤主體同測腳支架 + 對測腳支架 + 股動脈延伸支架 )* 適應症請見備註欄 CBC03ZFEN1CK "COOK"ZENITH FENESTRATED AAA ENDOVASCULAR GRAFT W/H&L-B ONE-SHOT INTRO SYS 腹主動脈瘤支架暨導引系統 ( 主體 + 分支體 *2)* 適應症見備註 CBC CK "COOK"ZENITH TX2 TAA ENDOVAS GRAFT W THE Z-TRAK PLUS INTRO SYS 胸主動脈支架手術出院後之滲漏特殊個案, 得申報需另修補之輔助配件 * 給付規定見備註 CBC GX "GORE" TAG THORACIC ENDOPROSTHESIS* 胸主動脈支架手術出院後之滲漏特殊個案, 得申報需另修補之輔助配件 * 給付規定請見備註欄 CBC L1 "BOLTON"RELAY PLUS THORAC STENT GRAFT W A TRANSPORT DELIVERY SYS 胸主動脈支架手術出院後之滲漏個案, 得申報需另修補之輔助配件 * 給付規定見備註

80 CBC M4 "MEDTRONIC"VALIANT THORA STENT GRAFT W CAPTIVIA DELIVERY SYS 胸主動脈支架手術出院後之滲漏特殊個案, 得申報需另修補之輔助配件 * 給付規定見備註 CBC05RE145L1 "BOLTON"RELAY PLUS THORAC STENT GRAFT W A TRANSPORT DELIVERY SYS 胸主動脈支架暨輸送系統 * 整組費用含門急診及當次住院所有置放支架 * 給付規定見備註 CBC05RELAYL1 "BOLTON"RELAY PLUS THORAC STENT GRAFT W A TRANSPORT DELIVERY SYS 胸主動脈支架暨輸送系統 * 整組費用含門急診及當次住院所有置放支架 * 給付規定見備註 CBC05TAA01CK "COOK"ZENITH TX2 TAA ENDOVASCULAR GRAFT W THE Z-TRAK PLUS INTRODUCTION SYS 胸主動脈支架 * 整組費用, 含門急診及當次住院所有置放支架 * 適應症見備註 CBC05TAA02CK "COOK"ZENITH TX2 TAA ENDOVASCULAR GRAFT W PTO-FORM" 曲克 " 蘭尼思胸主動脈瘤支架 * 整組費用, 含門急診及當次住院所有置放支架 * 適應症見備註欄 CBC05TG26NGX " 戈爾 " 胸主動脈瘤支架暨遞送系統 "GORE" TAG THORACIC ENDOPROSTHESIS* 整組費用, 含門急診及當次住院所有置放支架 * 給付規定請見備註欄 CBC05TT26NGX " 戈爾 " 胸主動脈瘤支架暨遞送系統 "GORE" TAG THORACIC ENDOPROSTHESIS* 整組費用, 含門急診及當次住院所有置放支架 * 給付規定請見備註欄 CBC05VLCAPM4 "MEDTRONIC"VALIANT THORACIC STENT GRAFT W THE CAPTIVIA DELIVERY SYS 范倫特胸主動脈支架系統 整組含門 急診及當次住院所有支架 * 給付規定見備註 CBC05VLTAAM4 "MEDTRONIC"VALIANT THORACIC STENT GRAFT W THE XCELERANT DELIVERY SYS 胸主動脈支架系統 * 整組費用, 含門急診及當次住院所有置放支架 * 適應症見備註 CBC06F0RX1CK "COOK"FORMULA 414 RENAL STENT SYSTEM 支架 5-7MMX12-24MM" 曲克 " 佛摩拉 414 腎臟血管支架系統 * 適應症請見備註欄 CBC06H1PP0F2 "INVATEC"HIPPOCAMPUS RENAL STENT SYSTEM :D:4-7MM L:10-24MM" 英泰克 " 海馬腎動脈支架系統 * 給付規定請見備註欄 CBC06H7493SB "BOSTON SCIENTIFIC"EXPRESS RENAL/BILIARY SD PREMOUNTED STENT SYS" 波士頓科技 " 極速腎臟 / 膽道用支架系統 ( 腎臟支架系統 )* 適應証見備註欄 CBC06HLELTAB "ABBOTT"RX HERCULINK ELITE PERIPHERAL STENT SYSTEM" 亞培 " 赫可林精英周邊血管支架系統 ( 腎動脈支架及輸送系統 )* 給付規定請見備註欄 CBC07VB10NGX "GORE"VIABAHN ENDOPROTHESIS D5:13MM.L10CM" 戈爾 " 威爾棒周邊血管支架 ( 含傳輸裝置 )* 給付規定請見備註欄 CBC07VB15NGX "GORE"VIABAHN ENDOPROTHESIS D5:10MM.L15CM" 戈爾 " 威爾棒周邊血管支架 ( 含傳輸裝置 )* 給付規定請見備註欄 CBC07VBC5NGX "GORE"VIABAHN ENDOPROTHESIS D5:8MM.L2.5CM,D5:13MM.L5CM" 戈爾 " 威爾棒周邊血管支架 ( 含傳輸裝置 )* 給付規定請見備註欄 CBP UZ CBP UZ CBP010MEGASB CBP01103TBRB TURQUOISE PTCA BALLOON DILATATION CATHETER D 1.5MM:2.75MM 綠松石冠狀動脈氣球擴張導管 TURQUOISE PTCA BALLOON DILATATION CATHETER D 3.0MM:4.5MM 綠松石冠狀動脈氣球擴張導管 "BOSTON SCIENTIFIC"OMEGA MONORAIL PTCR CORONARY STENT SYSTEM " 波士頓科技 "* 亞美加單軌冠狀動脈支架系統 * 適應症請見備註欄 "ORBUSNEICH"SAPPHIRE CORONARY DILATATION CATHETER 1.5MM:4.0MM 10MM:30MM 塞費爾冠狀動脈球曩擴張術導管

81 CBP01104TBRB "ORBUSNEICH"SAPPHIRE NC CORONARY DILATATION CATHETER 神飛 6843 冠狀動脈球囊擴張術導管 CBP01105TBRB "ORBUSNEICH"SAPPHIRE II CORONARY DILATATION CATHETER" 奧 6843 爾 " 第二代塞費爾冠狀動脈球曩擴張術導管 CBP01106TBRB "ORBUSNEICH"SAPPHIRE NC CORONARY DILATATION CATHETER" 奧 6843 爾 " 神飛冠狀動脈球囊擴張術導管 CBP UV INVADER CTO CORONARY ANGIOPLASTY BALLOON CATHETER 入侵者慢 6843 性全閉塞氣球擴張導管 CBP011NTEGM4 "MEDTRONIC"INTEGRITY RAPID EXCHANGE CORONARY STENT SYSTEM" 美敦力 " 英泰爾快速交換冠狀動脈血管支架系統 * 適應症請見備註欄 CBP01206FNJD JOSTENT FLEXMASTER(CORONARY STENT) W/DELIVERY SYSTEM 適 應症請見備註欄 CBP01210FMAB JOSTENT FLEXMASTER WITH DELIVERY SYSTEM * 適應症請見備註欄 CBP01210FNJD JOSTENT FLEXMASTER(CORONARY STENT) W/DELIVERY SYSTEM 適 應症請見備註欄 CBP01211FMAB ABBOTT JOSTENT FLEXMASTER WITH DELIVERY SYSTEM * 適應症請 見備註欄 CBP012535SHC HELISTENT CORONARY STENT W/DELIVERY SYSTEM * 適應症請見備 註欄 ( 原文號 ) CBP012540SHC HELISTENT CORONARY STENT W/DELIVERY SYSTEM * 適應症請見備 註欄 ( 原文號 ) CBP SB LIBERTE MONORAIL CORONARY STENT SYSTEM* 適應症請見備註欄 CBP BB COROFLEX CORONARY STENT SYSTEM(W/DELIVERY SYSTEM)* 適應症 請見備註欄 CBP BB COROFLEX CORONARY STENT SYSTEM(W/DELIVERY SYSTEM)* 適應症 請見備註欄 CBP BB "B.BRAUN"SEQUENT PTCA CATHETER 適可穩經皮穿刺汽球擴張導管 6843 CBP BB CBP BB CBP01563XNCD CBP AB CBP01AU729RB CBP01BL729RB CBP01BLUE1BB CBP01BLUE2BB CBP01CSUNATM CBP01DFX08JF COROFLEX CORONARY STENT SYSTEM(W/DELIVERY SYSTEM)* 適應症請見備註欄 COROFLEX CORONARY STENT SYSTEM(W/DELIVERY SYSTEM)* 適應症請見備註欄 NINJA PTCA DILATATION CATHETER 1.5:4.0MM 10:40MM( 自 改按條支付 ) ABBOTT FLEXMASTER F1 CORONARY STENT WITH DELIVERY SYSTEM 適應症請見備註欄 "ORBUSNEICH"AZULE CORONARY STENT DELIVERY SYSTEM" 奧爾 " 雅助冠狀動脈血管支架輸送系統 * 適應症請見備註欄 "ORBUSNEICH"BLAZER CORONARY STENT DELIVERY SYSTEM 布雷冠狀動脈血管支架輸送系統 * 適應症請見備註欄 "B.BRAUN"COROFLEX BLUE CORONARY STENT SYSTEM 普弩冠狀動脈血管支架系統 * 適應症請見備註欄 "B.BRAUN"COROFLEX BLUE CORONARY STENT SYSTEM 普弩冠狀動脈血管支架系統 * 適應症請見備註欄 TSUNAMI CORONARY STENT SYSTEM(WITH BALLOON)* 適應症請見備註欄 "DURAFLEX"CORONARY STENT SYSTEM" 杜拉佛克斯 " 冠狀動脈血管支架系統支架支架長度 8MM:25MM 支架內徑 2.5MM:4.0MM* 適應症請見備註欄

82 CBP01DRVNXM4 DRIVER RAPID EXCHANGE CORONARY STENT SYSTEM* 適應症請見備 註欄 CBP01DVW35AS "ASAHI"DOUVAN PTCA DILATATION CATHETER" 朝日 " 朵凡氣球擴張 6843 導管 CBP01FCBRVF2 "INVATEC"FALCON BRAVO PTCA BALLOON CATHETER 獵鷹柏拉弗冠狀 6843 動脈氣球導管直徑 1.5:4.0MM BALLOON LENGTH 10,14,20,30,40MM CATHETER LENGTH 145CM CBP01FF22BF2 "INVATEC"FALCON FORTE PTCA BALLOON CATHETER 冠狀動脈氣球導 6843 管直徑 2.00MM:4.00MM,4.50MM,5.00MM, 長度 145CM CBP01FLC10F2 "INVATEC"FALCON CTO PTCA BALLOON CATHETER 冠狀動脈氣球導管 6843 CBP01FLCBVF2 CBP01GAZ22BS CBP01GAZSTBS CBP01KANMETM CBP01ML8STAB CBP01MLVSTAB CBP01PR008CD CBP01PR023CD CBP01PWR25BS CBP01PWRLNBS CBP01R2252RB CBP01S103NAC CBP01S108NAC CBP01S115NAC CBP01S600NAC CBP01S915NAC CBP01S983NAB CBP01TRKNCAB CBP01TSUG2TM CBP01TSUG3TM "INVATEC"FALCON BRAVO PTCA BALLOON CATHETER 獵鷹柏拉弗冠狀動脈氣球導管直徑 2.0:4.0MM BALLOON LENGTH 10,14,20,30,40MM CATHETER LENGTH 145CM "BIOSENSORS"GAZELLE RAPID EXCHANGE CORONARY STENT SYSTEM 格希爾快速抽換冠狀動脈支架系統 * 適應症請見備註欄 "BIOSENSORS"GAZELLE CORONARY STENT SYSTEM 冠狀動脈內支架系統 * 適應症請見備註欄 "TERUMO"KANAME COBALT-CHROMIUM CORONARY STENT SYSTEM" 泰爾茂 " 凱樂鎂冠狀動脈血管支架系統 * 適應症請見備註欄 "ABBOTT"MULTI-LINK 8 CORONARY STENT SYSTEM" 亞培 " 第八代冠狀動脈支架系統 D 2.25:4.00MM L:8MM:38MM* 適應症請見備註欄 "ABBOTT"MULTI-LINK VISION RX CORONARY STENT SYSTEM 冠狀動脈支架系統 * 適應症請見備註欄 BX SONIC BALLOON EXPANDABLE STENT SYSTEM 適應症請見備註欄 BX SONIC BALLOON EXPANDABLE STENT SYSTEM 適應症請見備註欄 "BIOSENSORS"POWERLINE PTCA CATHETER 動源線冠狀動脈氣球擴張導管 "BIOSENSORS"POWERLINE PTCA CATHETER 經皮冠狀動脈成形術球囊導管 R-STENT EVOLUTION 2 CORONARY DELIVERY SYSTEM* 適應症請見備註欄 MULTI-LINK CORONARY STENT WITH STEP BALLOON DELIVERY SYSTEM * 適應症請見備註欄 MULTI-LINK DUET CORONARY STENT W/RX ROCKET BALLOON DELIVERY SYSTEM 適應症請見備註欄 MULTI-LINK CORONARY STENT WITH RX DELIVERY SYSTEM 3.0:4.0MMX15:35MM 適應症請見備註欄 MULTI-LINK STENT&BALLOON DELIVERY SYSTEM 3.0:3.75MM 適應症請見備註欄 MULTI-LINK HP CORONARY STENT/W HIGH PRESSURE BALL.DELI.SYS.3:4MMX15MM 適應症請見備註欄 "ABBOTT"MULTI-LINK CORONARY STENT SYSTEM 冠狀動脈擴張支架系統 * 適應症請見備註欄 "ABBOTT"NC TREK RX CORONARY DILATATION CATHETER" 亞培 " 恩希快克冠狀動脈氣球擴張導管 "TERUMO"TSUNAMI CORONARY STENT SYSTEM 冠狀動脈血管支架 * 適應症請見備註欄 "TERUMO"TSUNAMI CORONARY STENT SYSTEM 冠狀動脈血管支架系統 * 適應症請見備註欄

83 CBP01TSUGDTM CBP01TSUNATM CBP01V1S1NAB CBP01V7844AB CBP01VYGNCAB CBP01ZETANAB CBP02NCSP1M4 CBP02NCSPRM4 "TERUMO"TSUNAMI CORONARY STENT SYSTEM 冠狀動脈血管支架 * 適應症請見備註欄 TSUNAMI CORONARY STENT SYSTEM(WITH BALLOON)* 適應症請見備註欄 "ABBOTT"MULTI-LINK VISION RX CORONARY STENT SYSTEM2.75MM:4MM 8MM:28MM 適見冠狀動脈支架系統 * 適應症請見備註欄 "ABBOTT"MULTI-LINK VISION RX CORONARY STENT SYSTEM 2.75:4.00MM 8:28MM 冠狀動脈支架系統 * 適應症請見備註欄 "ABBOTT"VOYAGER NC CORONARY DILATATION CATHETER 航行家恩希冠狀動脈擴張導管 2.00MM:5.00MM 6MM:25MM "ABBOTT"MULTI-LINK RX ZETA CORONARY STENT SYSTEM 智達冠狀動脈支架系統 * 適應症請見備註欄 "MEDTRONIC"NC SPRINTER RAPID EXCHANGE BALLOON DILATATION CATHETER" 美敦力 " 史賓特高壓快速交換氣球擴張導管 "MEDTRONIC"NC SPRINTER RAPID EXCHANGE BALLOON DILATATION CATHETER" 美敦力 " 史賓特高壓快速交換氣球擴張導管 CBP02R5A85KE FORTIS II PTCA CATHETER 2.50MM:4.50MM 佛緹斯冠狀動脈成型術 6843 導管 CBP02R7R7FKE "KANEKA"IKAZUCHI RAPID EXCHANGE PTCA BALLOON CATHETER 雷快 6843 速抽換冠狀動脈氣球導管 CBP02SPR32M4 MEDTRONIC SPRINTER OVER-THE-WIRE BALLOON DILATATION 6843 CATHETER 1.5MM:4.0MM 6MM:30MM CBP02SPRL1M4 "MEDTRONIC"SPRINTER LEGEND RAPID EXCHANGE BALLOON 6843 DILATATION CATHETER 快速交換氣球擴張導管 CBP02SPRLGM4 "MEDTRONIC"SPRINTER LEGEND RAPID EXCHANGE BALLOON 6843 DILATATION CATHETER (D:1.25MM:4MM,L:6MM:30MM) CBP02SPRNTM4 SPRINTER RAPID EXCHANGE BALLOON DILATION CATHETER 6843 CBP02X2LNNVE EXTENSOR RAPID EXCHANGE BALLOON DILATATION CATHETER* 自 改按條支付 CBP02XW151BU BLUE MEDICAL XTRM-WAY PTCA DILATATION CATHETER 6843 CBP031016TTM "TERUMO"RYUJIN PLUS PTCA DILATATION CATHETER 琉均柏柆思冠 6843 狀動脈氣球擴張導管 CBP031215NTM RYUJIN PTCA DILATATION CATHETER RX CBP TM TERUMO RYUJIN PLUS PTCA DILATATION CATHETER 6843 CBP TM TERUMO RYUJIN PLUS PTCA DILATATION CATHETER 6843 CBP TM RYUJIN PLUS OTW PTCA DILATATION CATHETER 冠狀動脈氣球擴張 7809 導管 CBP032015NTM RYUJIN PTCA DILATATION CATHETER RX CBP SB "BOSTON SCIENTIFIC"MAVERICK XL MONORAIL PTCA DILATATION 6843 CATHETER 馬文瑞克氣球擴張導管 CBP SB QUANTUM MAVERICK MONORAIL DILATION CATHETER(PTCA BALLOON 6843 CATHETER) CBP SB "BOSTON SCIENTIFIC"QUANTUM MAVERICK PTCA DILATATION 7809 CATHETER D 2.0:5.0MM L8:30MM 冠狀動脈擴張導管 CBP SB MAVERICK 2 MONORAIL BALLOON CATHETER * 自 改按條支付 6843 CBP SB CBP SB "BOSTON SCIENTIFIC"APEX OTW PTCA DILATATION CATHETER 氣球擴張導管 "BOSTON SCIENTIFIC"APEX PTCA DILATATION CATHETER 氣球擴張導管

84 CBP03389XXSB CBP SB "BOSTON SCIENTIFIC"APEX MONORAIL PTCA DILATATION CATHETER D 1.50MM:5.0MM L8MM:40MM 艾佩斯單軌氣球擴張導管 "BOSTON SCIENTIFIC"NC QUANTUM APEX PTCA DILATATION CATHETER(MONORAIL) 康騰艾佩斯氣球擴張導管 2.0:5.0MM 6:30MM CBP SB "BOSTON SCIENTIFIC"NC QUANTUM APEX PTCA DILATATION 7809 CATHETER(OTW) 康騰艾佩斯氣球擴張導管 2.0:5.0MM 6:30MM CBP035265NAB "ABBOTT"CROSSSAIL CORONARY DILATATION CATHETER 可思爾冠狀 6843 動脈擴張導管 CBP0356F1XCD NINJA PTCA DILATATION CATHETER 10MM( 衛署字號 9349) 自 改按條支付 CBP0356F2XCD NINJA PTCA DILATATION CATHETER 15MM( 衛署字號 9349) 自 改按條支付 CBP0356F3XCD NINJA PTCA DILATATION CATHETER 18MM( 衛署字號 9349) 自 改按條支付 CBP0356F5XCD NINJA PTCA DILATATION CATHETER 20MM( 衛署字號 9349) 自 改按條支付 CBP0356F6XCD NINJA PTCA DILATATION CATHETER 25MM( 衛署字號 9349) 自 改按條支付 CBP0356F7XCD NINJA PTCA DILATATION CATHETER 30MM( 衛署字號 9349) 自 改按條支付 CBP035718NAB "ABBOTT"CORONARY DILATATION CATHETER 冠狀動脈擴張術氣球導 6843 管 CBP03701XNCD "CORDIS"DURA STAR RX PTCA DILATATION CATHETER 杜芮星冠狀動 6843 脈擴張導管 CBP03801XNCD "CORDIS"FIRE STAR RX PTCA DILATATION CATHETER 法爾星冠狀動 6843 脈擴張導管 CBP AB NC MERCURY PTCA CATHETER 適應症請見備註欄 7547 CBP03ACRHPY0 "ACROSTAK"ACROSS HP PTCA BALLOON CATHETER" 擴適達 " 高斯高壓 6843 冠狀動脈氣球導管 CBP03DCRK1TM "TERUMO"TAZUNA PTCA DILATATION CATHETER" 泰爾茂 " 鈦速納冠狀 6843 動脈氣球擴張導管 CBP03H1RU1TM "TERUMO"HIRYU PTCA DILATATION CATHETER 2.25:5.0MM 6:20MM 6843 冠狀動脈氣球擴張導管 CBP03M1115JD PTCA BALLOON CATHETER 自 改按條支付 6843 CBP03M2950AB JOCATH MAESTRO PTCA CATHETER( 原核文號 ) 6843 CBP03M3115AB JOCATH MERCURY PTCA CATHETER 6843 CBP03NCMERAB "ABBOTT"NC MERCURY PTCA CATHETER 馬克林冠狀動脈擴張導管 6843 CBP03R2A15KE KANEKA RX CATHETER AEROCROSS FIGHTER 1.5MM:4.0MM MM:20MM CBP03R4K15KE KANEKA RX CATHETER OTTIMO 1.5MM:4.0MM 10MM:20MM 6843 CBP03RAF25HC "HEXACATH"RAFALE PTCA DILATATION CATHETER 旋風冠狀動脈氣球 6843 擴張導管 CBP03SL0TWM4 "MEDTRONIC"SPRINTER LEGEND OVER-THE-WIRE BALLOON 7809 DILATATION CATHETER 同軸導線球囊擴張導管 CBP03TREK1AB "ABBOTT"TREK AND MINI TREK RX CORONARY DILATATION 6843 CATHETER" 亞培 " 快克 / 小快克冠狀動脈擴張導管 CBP03TREK2AB "ABBOTT"TREK AND MINI TREK OTW CORONARY DILATATION 7809 CATHETER" 亞培 " 快克 / 小快克冠狀動脈氣球擴張導管 CBP03V0TWNAB "ABBOTT"VOYAGER OTW CORONARY DILATATION CATHETER 莫雅佳甌第冠狀動脈擴張導管

85 CBP03V391NAB CBP05210CGAB CBP06ELUT1AB CBP06ELUT1BB CBP06ELUT1BS CBP06ELUT1HC CBP06ELUT1RB CBP06ELUT1SB CBP06ELUT1TM CBP06ELUT1YV CBP06ELUT2AB CBP06ELUT2BS CBP06ELUT2M4 CBP06ELUT2SB CBP06ELUT3AB CBP06ELUT3M4 CBP06ELUT3SB CBP06ELUT4M4 "ABBOTT"VOYAGER RX CORONARY DILATATION CATHETER 莫雅佳冠狀動脈擴張導管 "ABBOTT"JOSTENT GRAFTMASTER CORONARY STENT GRAFT(WITH DELIVERY SYSTEM)* 適應症請見備註欄. "ABBOTT"XIENCE V EVEROLIMUS ELUTING CORONARY STENT SYSTEM 艾諾莉茉斯冠狀動脈塗藥支架, 部分給付品項, 適應症見備註欄, 並註明其禁忌症勿使用 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 "BIOSENSORS"BIOMATRIX DRUG ELUTING CORONARY STENT SYS 釋放型冠狀動脈支架系統部分給付品項 * 適應症見備註, 並註明禁忌症不可使用 "HEXACATH"PREMOUNTED CORONARY STENT HELISTENT TITAN2" 海斯凱 " 泰坦 2( 塗層 ) 冠狀動脈血管支架 * 部分給付品項, 適應症見備註欄, 並註明禁忌症不可用 "ORBUS"GENOUS R STENT 傑納斯冠狀動脈血管支架輸送系統 2.5MM:4.0MM 9MM:33MM 部分給付品項. 適應症請見備註欄. 並註明其禁忌症不可使用. TAXUS EXPRESS PACLITAXEL-ELUTING CORONARY STENT SYSTEM 2.25:5.00MM 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 "TERUMO"NOBORI DRUG STENT SYSTEM 2.5MM:3.5MM 8MM:28MM 冠狀動脈塗藥支架部分給付品項 * 適應症請見備註, 並註明其禁忌症不可使用 "CID"JANUS OPTIMA CARBOSTENT W DELIVERY SYS" 喜安汀 " 真神奧普帝馬塗藥冠狀動脈血管支架, 部分給付品項 * 給付規定見備註欄, 並註明其禁忌症不可使用 "ABBOTT"PROMUS EVEROLIMUS ELUTING CORONARY STENT SYSTEM 冠狀動脈塗藥支架系統, 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 "BIOSENSORS"BIOMATRIX FLEX DRUG ELUTING CORONARY STENT SYS 拜美翠弗雷絲藥物釋放冠狀動脈支架, 部分給付品項 * 適應症見備註, 並註明禁忌症不可用 "MEDTRONIC"ENDEAVOR SPRINT ZOTAROLIMUS ELUTING CORONARY STENT SYSTEM 釋放型冠狀動脈支架, 部分給付品項 * 適應症見備註, 並註明其禁忌症不可使用 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 "ABBOTT"XIENCE PRIME EVEROLIMUS ELUTING CORONARY STENT SYSTEM 冠狀動脈塗藥支架系統部份給付品項 * 適應症請見備註欄, 並註明其禁忌症不可使用 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 "BOSTON SCIENTIFIC"TAXUS LIBERTE LONG MONORAIL PACLITAXEL-ELUTING CORONARY STENT SYS 紫杉醇釋放型冠狀動脈支架 * 適應證見備註 "MEDTRONIC"ENDEAVOR RESOLUTE ZOTAROLIMUS-ELUTING CORONARY STENT SYS 釋放型冠狀動脈支架系統 部分給付品項, 適應症見備註, 並註明其禁忌症勿用

86 CBP06ELUT4SB "BOSTON SCIENTIFIC"TAXUS ELEMENT PACLITAXEL-ELUTING CORONARY STENT SYS 冠狀動脈塗藥支架系統 * 部分給付品項, 適應症見備註, 並註明禁忌症不可用 CBP06ELUT5SB "BOSTON SCIENTIFIC"PROMUS ELEMENT EVEROLIMUS-ELUTING CORONARY STENT SYS 冠狀動脈塗藥支架系統 * 部分給付品項, 適應症見備註, 並註明禁忌症不可用 CBP BB "B.BRAUN"SEQUENT PLEASE PACLITAXEL-RELEASING RAPID EXCHANGE PTCA BALLOON CATHETER" 柏朗 " 喜寬普利斯紫杉醇釋放型冠狀動脈氣球導管 * 適應證見備註 CBS01RASHKM4 "MEDTRONIC"RASHKIND BALLOON SEPTOSTOMY CATHETER" 美敦力 " 球 9000 囊中膈切除術導管 CBS01SPTXXN5 "NUMED"Z-5 ATRIOSEPTOSTOMY CATHETER 9000 CBS029ASDAG6 "AGA"AMPLATZER SEPTAL OCCLUDER 4:20MM,22MM:38MM" 銨積維 " 安 普拉茲心房關閉器 * 給付規定請見備註欄 CBS029ASDNG6 "AGA"AMPLAATZER SEPTAL OCCLUDER WITH DELIVERY SYSTEM" 銨積 維 " 安普拉茲心房關閉器 給付規定請見備註欄 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 CBS029DEL5G6 "AGA"AMPLATZER DELIVERY SYSTEM 5-9FR* 安普拉茲遞送導管系統 * 給付規定請見備註欄 ( 自 起適應症代碼由 A213-4 更改為 A213-5) CBS029DEL9G6 "AGA"AMPLATZER DELIVERY SYSTEM 9FR,10FR,12FR" 銨積維 " 安普 拉茲遞送導管系統 * 給付規定請見備註欄 CBS029DELNG6 "AGA"AMPLATZER DELIVERY SYSTEM 6:8FR*" 銨積維 " 安普拉茲遞送 導管系統 * 給付規定請見備註欄 CBS029DELTG6 "AGA"AMPLATZER DELIVERY SYSTEM 安普拉茲遞送導管系統 5F:10F 12000,12F* 給付規定請見備註欄 CBS029SZB2G6 AMPLATZER SIZING BALLOON II 安普拉茲測量氣球導管 * 給付規定 請見備註欄 CBS02FASDNJ7 "OCCLUTECH"FIGULLA ASD OCCLUDERS" 奧圖 " 心房中隔補綴器 * 適應 症請見備註欄 CBS02PTSXXN5 PTS SIZING CATHETER 20:40MM 3:5CM 80CM 0.035" GUIDE WIRE 適應症請見備註欄 CBS039PDAAG6 "AGA"AMPLATZER DUCT OCCLUDER 開放性動脈導管關閉器 * 適應症請 見備註欄 CBS04407XXST " 聖猷達 " 房中膈穿刺針 "SJM" BRK TRANSSEPTAL NEEDLE 7230 CBS059AVP4G6 "AMPLATZER"VASCULAR PLUG&DELIVERY SYSTEM 4MM:8MM 血管塞含 遞送導管 * 給付規定請見備註欄 CBS059AVP9G6 "AMPLATZER"VASCULAR PLUG&DELIVERY SYSTEM 10MM:16MM 血管塞 含遞送導管 * 給付規定請見備註欄 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 CBT020712NAR ARROW BALLOON WEDGE-PRESSURE CATHETERS 4:8FR 60:110CM " 亞 1750 諾 " 肺動脈楔壓導管 ( 順流導管雙腔 ) CBT022014LPU PULSIOCATH CONTINUOUS CARDIAC OUTPUT THERMODILUTION 5775 CATHETER CBT022014NPU PULSIOCATH THERMODILUTION CATHETERS(PICCO2) 普新卡熱稀釋 5775 導管 ( 含 CATHETER+NITINOL GUIDE WIRE) CBT022015LPU "PULSION"PULSIOCATH THERMODILUTION CATHETER 5775 CBT AR "ARROW"BALLOONTHERMODILUTION CATHETERS(HEPARIN-COATED) 2710 FOUR LUMEN" 亞諾 " 熱稀釋順流導管 CBT AR "ARROW"BALLOONTHERMODILUTION CATHETERS(HEPARIN-COATED) 5 LUMEN" 亞諾 " 熱稀釋順流導管

87 CBT AR CBT AR CBT AR "ARROW" THERMODILUTION BALLOON CATHETER(4 LUMEN) 4FR 75CM " 亞諾 " 熱稀釋順流導管 ( 兒童 ) "ARROW"BALLOON THERMODILUTION CATHETER 4FRX75CM 5FRX80CM(HEPARIN COATED) 4 LUMENS " 亞諾 " 熱稀釋順流導管 "ARROW"BALLOON THERMODILUTION CATHETER 6FRX80CM;110CM 7FRX110CM(HEPARIN COATED) 4 LUMENS " 亞諾 " 熱稀釋順流導管 CBT AR "ARROW" THERMODILUTION BALLOON CATHETER(4 LUMEN) 7FR CM " 亞諾 " 熱稀釋順流導管 CBT04131HVED EDWARDS SWAN-GANZ THERMODILUTION CATHETER 4LUMEN FR,W/AMC THROMBOSHIELD COATING CBT04132F5ED "EDWARDS"SWAN-GANZ THERMODILUTION CATHETER 4LUMEN 5FR CM( 兒童用 ) 史望康熱稀釋導管 CBT041704HBS THERMODILUTION CATHETER 測輸量順流導管 ( 四腔 )7fr 110cm 1842 CBT04254NDBS THERMODILUTION CATHETER 5FR 4 LUMEN, 6FR 4 LUMEN,7FR LUMEN 順流導管 ( 四腔 ) CBT AG "ARGON"CRITICATH THERMODILUTION CATHETERS 4 LUMEN 5F CM" 愛琅 " 熱稀釋導管 CBT BD "B-D"CRITICATH THERMODILUTION CATHETERS 4 LUMEN 5F 80CM 熱 2162 稀釋導管 CBT AG "ARGON"CRITICATH THERMODILUTION CATHETERS 4 LUMEN 5F CM" 愛琅 " 熱稀釋導管 CBT BD "B-D"CRITICATH THERMODILUTION CATHETERS 4 LUMEN 5F 110CM 2162 熱稀釋導管 CBT045107SAG "ARGON"CRITICATH THERMODILUTION CATHETERS 4 LUMEN 7FR CM( 含保護套 )" 愛琅 " 熱稀釋導管 CBT045107SBD THERMODILUTION CATHETER FOUR LUMEN 7FR 110CM 1842 CBT ED SWAN-GANZ THERMODILUTION CATHETER FOUR LUMEN/AMC 2710 THROMBOSHIELD(HEPARIN) 熱稀釋導管 CBT04C144HED "EDWARDS"SWAN-GANZ THERMODILUTION CATHETER 4 LUMEN 7FR 2710 W/AMC THROMBOSHIELD COATING CBT04H5107AG "ARGON"CRITICATH THERMODILUTION CATHETERS 4 LUMEN 7FR CM" 愛琅 " 熱稀釋導管 CBT04H5107BD THERMODILUTION CATHETER FOUR LUMEN 7FR 110CM 1842 CBT05175HDBS THERMODILUTION CATHETER 7.5FR 5 LUMEN 2867 CBT U2 "ICU"FLOW-DIRECTED CATHETERS/ 測血氧 * 適應症請見備註欄 7148 CBT055507SAG "ARGON"CRITICATH THERMODILUTION CATHETERS 5 LUMEN 7FR CM" 愛琅 " 熱稀釋導管 CBT055507SBD THERMODILUTION CATHETER FIVE LUMEN 7.5FR 110CM 1341 CBT ED SWAN GANZ OXIMETRY AND VOLUMETRIC CATHETER* 適應症請見備註 7148 欄 CBT05831H7ED SWAN-GANZ 5 LUMEN THERMODILUTION CATHETER 1341 CBT05831HFED "EDWARDS"SWAN-GANZ THERMODILUTION CATHETERS 5 LUMEN 7FR 2867 W/AMC THROMBOSHIELD COATING 史望康熱稀釋管 CBT05831HVED EDWARDS SWAN-GANZ THERMODILUTION CATHETER 5LUMEN FR,W/AMC THROMBOSHIELD COATING CBT05834H7ED SWAN-GANZ 5 LUMEN THERMODILUTION CATHETER 1341 CBT E6 OXIMETRY SVO2 CATHETER 5LUMEN(PA,CVP,T,POTICAL,CONNECT,BALLOON INF)* 適應症見備註 7148 CBT ED CONTINUOUS CARDIAC OUTPUT THERMODILUTION CATHETER 6 LUMEN 7.5FR 適應症請見備註欄

88 CBT ED SWAN GANZ CONTINUOUS CARDIAC /END DIASTOLIC VOLUME 6200 THERMODILUTION CATHETER CCO/cEDV* 適應症請見備註欄 CBT U2 "ICU"FLOW-DIRECTED CATHETERS OPTI-Q SVO2/CCO CATHETER* 7052 適應症請見備註欄 CBT U2 "ICU"FLOW-DIRECTED CATHETERS* 適應症請見備註欄 6022 CBT ED CONTINUOUS CARDIAC OUTPUT THERMODILUTION CATHETER 7.5FR 7052 適應症請見備註欄 CBT06746F8ED SWAN GANZ CONTINUOUS CARDIAC /END DIASTOLIC VOLUME 7052 THERMODILUTION CATHETER CCO/SVO2/VIP* 適應症請見備註欄 CBT06757HFED SWAN GANZ CONTINUOUS CARDIAC /END DIASTOLIC VOLUME THERMODILUTION CATHETER CCO/SVO2/EDV/VIP* 適應症請見備註欄 7052 CBT ED "EDWARDS"SWAN GANZ CONTINUOUS CARDIAC OUTPUT/END 7052 DIASTOLIC VOLUME THERMODILUTION CATH CCO/SVO2/CEDV 熱稀釋導管 * 適應症見備註 CBT06777F8ED SWAN GANZ CONTINUOUS CARDIAC /END DIASTOLIC VOLUME 7052 THERMODILUTION CATHETER CCO/SVO2/CEDV/VIP* 適應症請見備註欄 CBT06831HFED "EDWARDS"SWAN-GANZ THERMODILUTION CATHETERS 6 LUMEN 7FR 3150 W/AMC THROMBOSHIELD COATING 史望康熱稀釋管 CBT07MHD68ED FLOTRAC SENSOR KIT W/60" OR 84" PRESSURE TUBING 弗羅威克感 6138 應器組 CBT07MHDAZED FLOTRAC SENSOR KIT W/60" PRESSURE TUBING & VAMP ADULT 6138 SYSTEM 弗羅威克感應器組附血液管理保護系統 CBV020MS2NTR PTMC BALLOON CATHETER CBV02PDCXXN5 PERCUTANEOUS TRANSLUMINAL VALVULOPASTY (PTV)CATHETER MM:30.0MM,2.0CM:8.0CM CBV02PDZXXN5 NUMED Z-MED II PERCUTANEOUS TRANSULUMINAL VALVULOPLASTY (PTV)CATHETER 4:30MM 2:10CM 100CM CBV02PTVNXN5 "NUMED"NUCLEUS PTV DILATATION CATHETER 二尖瓣及主動脈瓣氣 球擴張導管 CCC022180TBT CLOSED SYSTEM APHERESIS KIT 4336 CCC0300AT1VB AUTOTRANSFUSION SET 3160 CCC030980EHA THERAPEUTIC AND AUTOLOGOUS ERYTHROPHERESIS SET 3160 CCC030981EHA THERAPEUTIC AND AUTOLOGOUS ERYTHROPHERESIS SET 3160 CCC03BT271YT "SAFETRAN"BLOOD COMPONENTS APHERESIS" 笙創 " 血液成份分離器 3160 ( 離心杯 275CC+ 體外血液迴路管 ) CCC03BX051YT "SAFETRAN"BLOOD COMPONENTS APHERESIS" 笙創 " 血液成份分離器 3160 ( 離心杯 50CC+ 體外血液迴路管 ) CCC03BX221YT "SAFETRAN"BLOOD COMPONENTS APHERESIS" 笙創 " 血液成份分離器 3160 ( 離心杯 225CC+ 體外血液迴路管 ) CCC03BX371YT "SAFETRAN"BLOOD COMPONENTS APHERESIS" 笙創 " 血液成份分離器 3160 ( 離心杯 375CC+ 體外血液迴路管 ) CCC110971EHA PERIPHERAL BLOOD STEM CELLS SET 4336 CCC HA CELL SAVER COLLECTION RESERVOIR 適應症請見備註欄 3900 CCC1300ATRVB AUTOTRANSFUSION RESERVOIR* 適應症請見備註欄 3900 CCC M4 AUTOLOG RESERVOIR HOLDING BAG* 適應症請見備註欄 3900 CCC13BT894R5 "SORIN"AUTOTRANSFUSION RESERVOIR SET 自動輸血組儲血器 * 適應症請見備註欄 3900 CCC HA CELL SAVER 5 FAST PACK 225ML 體血液收集洗滌套 適應症請 7307 見備註欄 478

89 CCC HA " 漢尼帝克 " 自體血液回收系統管套 " HAEMONETICS " CELL SAVER 7307 SET FOR AUTOTRANSFUSION SYSTEM 70ML BOWL * 適應症請見備註欄 CCC1400ATFVB AUTOTRANSFUSION FAST START KIT(AUTOTRANSFUSION 7307 SET+AUTOTRANSFUSION RESERVOIR+ATS SUCTION LINE)* 適應症請見備註欄 CCC140156NHA CELL SAVER SET ( 術後自體血液回收單管回流式 ) 適應症請見 4000 備註欄 CCC M4 AUTOLOG WASH KIT* 適應症請見備註欄 7307 CCC CB BAYLOR RAPID AUTOLOGOUS TRANSFUSION SETS BRAT 2 PROCEDURE 7307 SET 適應症請見備註欄 CCC14745E5R5 "SORIN"AUTOTRANSFUSION KITS FOR ELECTA(WASH 7307 SET+AUTOTRANSFUSION RESERVOIR SET+LINE) 依雷塔專用自體輸血組 * 適應症請見備註欄 CCC1474E55R5 "SORIN"WASH SET 血液洗淨組 * 適應症請見備註欄 4000 CCC14EC243M4 ONE SOURCE PACK 自體輸血系統套裝組 適應症請見備註欄 含 7307 EL240 BP721 BT133 BTC93 型號:EC2S24 含 EL240 BP722 BT133 BTC93 自 生效 CCC AH "ATRIUM"OCEAN WATER SEAL CHEST DRAINS 海洋自體血液回收胸腔 4000 引流儲血器 ( 單管回流式 )* 適應症請見備註欄 CCC AH "ATRIUM"OCEAN WATER SEAL CHEST DRAINS 海洋自體血液回收胸腔 4467 引流儲血器 ( 雙管回流式 )* 適應症請見備註欄 CDCC243418PM C.S.F CARDIAC CATHETER REDUCED TIP BARIUM IMPREGNATED 2558 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 2000 PLEURAL/PNEUMOPERICARDIAL DRAINAGE SET 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 CDD P2 SILICON T DRAINGE TUBE 10FR:24FR 3MM:8MM 205 CDD012014NFM SILICONE Y DRAINAGE TUBE 14:24FR 205 CDD KK SILICON T-TUBE 5M/M:13M/M (TRACHEAL) 2825 CDD FM SILICONE ABDOMINAL SUMP DRAIN 14" 7MMX13MM 273 CDD FM SILICONE ABDOMINAL SUMP DRAIN 20" 7MMX13MM 273 CDD BA "BARD"NONPOWERED WOUND SUCTION DEVICES:SILICONE 3 LUMEN 1222 W/FILTER" 巴德 " 非動力式傷口抽吸器具 CDD M4 "MEDTRONIC"SUCTION TUBES " 美敦力 " 抽吸管 398 CDD H9 INTRACARDIAC SUCKER 398 CDD02SUCKEM6 EXTRACORPOREAL SUCKER 398 CDD ED PERICARDIAL SUMP(1/4") 431 CDD C8 JACKSON-PRATT SILICONE BULB RESERVOIR WITH TUBE KITS CC,400CC, 7MM/10MM/10FR/15FR/19FR 矽質真空傷口引流套 ( 儲液器 + 引流管 ) CDD ED SUCTION WAND(9F-22F) 431 CDD SA RIGID I-C SUCKER 431 CDD BA 400CC THREE-SPRING EVACUATOR KIT W/PVC ROUND DRAIN 271 CDD BA 400CC THREE-SPRING EVACUATOR KIT W/SILICONE ROUND DRAIN 455 CDD PC TLS BULB DRAINAGE SYSTEM 100CC 10.5FR( 球 + 管 ) 455 CDD P2 PVC VAC ( 球 + 管 ) 450CC 1/8",3/16",1/4" 271 CDD P2 SILICON VAC ( 球 + 管 ) 100CC,200CC 1/8",3/16",1/4"

90 CDD P2 MINIVAC WOUND DRAINAGE SYSTEM(PVC DRAIN 6FR WITH PVC 196 RESERVOIR 50ML) CDD P2 MINIVAC WOUND DRAINAGE SYSTEM(PVC DRAIN 6FR WITH PVC 196 RESERVOIR 20ML) CDD LL WOUND DRAINAGE SYSTEM 400ML 真空傷口引流套 (PVC 引流管 +PVC 吸 271 引球 + 穿刺針 ) CDD FM ALL SILICONE C.W.V SET(RESERVOIR 100CC+DRAIN 7MM,10MM) 455 CDD FM ALL SILICONE C.W.V SET(RESERVOIR 100CC+DRAIN 13MM) 455 CDD FM ALL SILICONE C.W.V SET(RESERVOIR 150CC+DRAIN 7MM,10MM) 455 CDD FM ALL SILICONE C.W.V SET(RESERVOIR 150CC+DRAIN 13MM) 455 CDD FM ALL SILICONE C.W.V SET(RESERVOIR 400CC+DRAIN 7MM,10MM) 455 CDD FM ALL SILICONE C.W.V SET(RESERVOIR 400CC+DRAIN 13MM) 455 CDD Z1 HEMOVAC 271 CDD042535NZ1 MINI SNYDER HEMOVAC SILICONE DRAIN 3/32 1/8",3/16",1/4" 455 SILICONE EVACUATOR 100ML( 球 + 管 + 針 ) CDD042541NZ1 400ML HEMOVAC COMPACT EVACUATOR KIT SILICONE DRAIN 417 1/8",3/16",1/4( 球 + 管 ) CDD042560NZ1 MINI SNYDER HEMOVAC SILICONE DRAIN 7MM,10MM SILICONE 455 EVACUATOR 100ML( 球 + 管 + 針 ) CDD042564NZ1 EVAC KITS 100ML FLAT DRAIN W/O TROCAR 7MM,10MM( 球 + 管 ) 455 CDD Z1 HEMOVAC 271 CDD Z1 PVC HEMOVAC COMPACT EVACUATOR KIT 3/32",3/16" 7,15FR 271 CDD P2 WOUND DRAINAGE SYSTEM (PAHSCO-VAC)450ML(BAG+TUBE+TROCAR) 271 CDD P2 WOUND DRAINAGE SYSTEM (PRE- 271 EVACUATOR)600ML,450ML(BAG+TUBE+TROCAR) CDD TZ VACUUM WOUND DRAINAGE SYSTEM(PVC 引流管 + 吸引球 ) 271 CDD P2 CLOSED WOUND DRAINAGE SYSTEM ML 球 PVC 管 SILICONE 417 ( 球 + 管 + 針 ) CDD P2 CLOSED WOUND DRAINAGE SYSTEM ML 球 + 管 455 SILICONE ( 球 + 管 + 針 ) CDD P2 CLOSED WOUND DRAINAGE SYSTEM 400ML 球 PVC 管 SILICONE ( 球 管 + 針 ) CDD P2 CLOSED WOUND DRAINAGE SYSTEM 450MLPVC ( 球 + 管 + 針 ) 271 CDD P2 CLOSED WOUND DRAINAGE SYSTEM 250ML PVC ( 球 + 管 + 針 ) 271 CDD045330NP2 CLOSED WOUND DRAINAGE SYSTEM 400ML PVC ( 球 + 管 + 針 ) 271 CDD P2 CLOSED WOUND DRAINAGE SYSTEMPVC WOUND DRAINAGE SYSTEM ML (BAG+TUBE+TROCAR) CDD P2 PVC WOUND DRAINAGE SYSTEM 30ML(BAG+TUBE+NEEDLE) 196 CDD P2 CLOSED WOUND DRAINAGE SYSTEMPVC WOUND DRAINAGE SYSTEM ML (BAG+TUBE+TROCAR) CDD P2 PVC WOUND DRAINAGES SYSTEM 600CC(BAG+CATH+TROCAR) 真空傷 271 口引俵套 CDD P2 PVC WOUND DRAINAGES SYSTEM 450CC(BAG+CATH+TROCAR) 真空傷 271 口引俵套 CDD P2 CLOSED WOUND DRAINAGE SYSTEM 200ML ( 罐 + 管 + 針 ) 271 CDD P2 CLOSED SYSTEM SUCTION DRAINAGE SET 800ML 1/4,1/8,3/ ( 球 100CC+ 管 + 針 ) CDD P2 CLOSED WOUND DRAINAGE SYSTEM 400CCPVC ( 球 + 管 + 針 ) 271 CDD P2 CLOSED SYSTEM SUCTION DRAINAGE SET ( 球 100CC+ 管 + 針 ) 271 CDD P2 CLOSED WOUND DRAINAGE SYSTEM 150MLPVC (BAG+ 管 + 針 ) 271 CDD P2 CLOSED WOUND DRAINAGE SYSTEM 150MLBAG PVC 管 SILICONE (BAG+ 管 + 針 )

91 CDD P2 CLOSED WOUND DRAINAGE SYSTEM 300MLPVC (BAG+ 管 + 針 ) 271 CDD P2 CLOSED WOUND DRAINAGE SYSTEM 300MLBAG PVC 管 SILICONE 417 (BAG+ 管 + 針 ) CDD P2 CLOSED WOUND DRAINAGE SYSTEM 450MLPVC (BAG+ 管 + 針 ) 271 CDD P2 CLOSED WOUND DRAINAGE SYSTEM 450MLBAG PVC 管 SILICONE 417 (BAG+ 管 + 針 ) CDD048410NM5 WOUND-EVC ET(EASY TOUCH)(PVC RESERVOIR 400ML,SILICONE 417 TUBING 1/8",3/16",1/4") CDD04CSB00LL "LILY"WOUND DRAINAGE SYSTEM(SILICONE)" 怡安 " 真空傷口引流套 455 / 套組 ( 矽質引流管 + 矽質吸引球 + 穿刺針 ) CDD04CWBSTSG "SIGMA" INTRODUCTION DRAINAGE CATHETER AND ACCESSORIES 455 (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 ) CDD04CWCV1EF SILICONE C.W.V SET(100CC,150CC,400CC+7MM,10MM,13MM) 矽質真 455 空傷口引流球 + 引流管 CDD04CWVS1SG SIGMA SILICONE C.W.V SET 100;125;150;400CC+7;10;13MM 十美 455 牌矽質真空引流球 + 矽質引流管組 CDD04HS2XXH0 "HOSMED"CLOSED WOUND VACUUM DRAINAGE SYSTEM:SILICONE CWV 455 RESERVOIR+DRAIN " 世新 " 密閉式真空傷口引流系統 : 矽質引流球 + 引流管 CDD04MB125SG SILICON MINI VACCUM BLUB 125CC(MB125)+FLAT TUBE OR ROUND 455 TUBE MD-118 7:9MM(HF107:9) CDD04PP400WN BAROVAC CLOSED WOUND DRAINAGE SYSTEMS (PVC DRAIN 271 3/32",1/8",3/16",1/4"WITH PVC RESERVOIR 400ML) CDD04PT503TM PORTABLE WOUND SUCTION UNIT( 球 + 管 ) 271 CDD04SS100WN ALL SILICONE CLOSED WOUND DRAINAGE SYSTEMS(SILICONE DRAIN 455 WITH RESERVOIR 100ML) CDD04SS200WN ALL SILICONE CLOSED WOUND DRAINAGE SYSTEMS 200ML(SILICONE 455 DRAIN WITH RESERVOIR 200ML) CDD04SU130C8 JACKSON PRATT WOUND DRAINAGE SYSTEM PVC 引流管 + 穿刺針 +PVC 271 吸引球 CDD L6 JACKSON-PRATT HEMADUCT SILICONE FLAT DRAINS W/O TROCAR 271 CDD L6 JACKSON-PRATT HEMADUCT SILICONE FLAT DRAINS W/TROCAR 271 CDD05000SMWN ALL SILICONE WOUND TUBINGW/TROCAR NEEDLE 3.2MM,4.8MM( 圓 271 型 ) CDD L6 JACKSON-PRATT HEMADUCT SILICONE ROUND DRAINS W/O TROCAR 271 CDD L6 JACKSON-PRATT HEMADUCT SILICONE ROUND DRAINS W/TROCAR 271 CDD0500SJPWN ALL SILICONE WOUND TUBINGW/TROCAR NEEDLE 4.8MM( 扁型 ) 271 CDD0500SMAWN " 世運 " 傷口引流套 ( 滅菌 )"SEWOON"CLOSED WOUND DRAINAGE 271 SYSTEM(STERILE)- 矽膠傷口引流管 ( 不附針 )3.2MM:13MM CDD0500SXLWN " 世運 " 傷口引流套 ( 滅菌 )"SEWOON"CLOSED WOUND DRAINAGE 271 SYSTEM(STERILE)- 矽膠傷口引流管 ( 附針 )6.4MM;13MM CDD SM EXTRA STRENGTH ROUND SUCTION DRAIN WITH TROCAR 10FR 271 CDD SM EXTRA STRENGTH ROUND SUCTION DRAIN 10FR 271 CDD C8 JACKSON-PRATT SILICONE DRAINS 7MM, 10MMJACKSON-PRATT 矽質 271 傷口引流管 CDD L6 JACKSON-PRATT HUBLESS FLAT SILICONE DRAINS W/O TROCAR 271 CDD L6 JACKSON-PRATT GOLD FLAT SILICONE DRAINS W/O TROCAR 271 CDD050132NL6 JACKSON-PRATT SILICONE ROUND DRAINS W/O TROCAR 271 CDD L6 JACKSON-PRATT GOLD SILICONE ROUND DRAINS W/O TROCAR 271 CDD FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON DRAINS TUBE 7MM" 富強 " 傷口引流系統 : 矽膠引流管

92 CDD FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON DRAINS TUBE 10MM" 富 271 強 " 傷口引流系統 : 矽膠引流管 CDD FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON DRAINS TUBE 13MM" 富 271 強 " 傷口引流系統 : 矽膠引流管 CDD L6 JACKSON-PRATT GOLD FLAT SILICONE DRAINS W/TROCAR 271 CDD FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON DRAINS TUBE 10:29FR " 271 富強 " 傷口引流系統 : 矽膠引流管 CDD050208NFM SILICONE ROUND DRAIN END PERFORATED 8,10,16,20FR 900MM 271 CDD FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON DRAINS TUBE+TROCAR " 271 富強 " 傷口引流系統 : 矽膠引流管 + 穿刺針 CDD05020XXH0 "HOSMED"CLOSED WOUND VACUUM DRAINAGE SYSTEM:SILICONE CWV 271 DRAIN " 世新 " 密閉式真空傷口引流系統 : 矽質引流管 CDD ET "ETHICON"J-VAC CLOSED WOUND DRAINAGE SYSTEM BLAKE SILICON 271 DRAINS WITH TROCAR 捷凡克封閉式引流系統 CDD ET "ETHICON"J-VAC CLOSED WOUND DRAINAGE SYSTEM BLAKE SILICON 298 DRAINS WITH TROCAR 捷凡克封閉式引流系統 CDD050308NFM SILICONE ROUND DRAIN MIDDLE PERFORATED 8,10,16,20FR MM CDD SM EXTRA STRENGTH FLAT SUCTION DRAIN 7MM 271 CDD SM EXTRA STRENGTH FLAT SUCTION DRAIN 10MM 271 CDD P2 SILICON VAC DRAINAGE & TROCAR 271 CDD P2 CLOSED WOUND DRAINAGE SYSTEMPVC VAC DRAINAGE 125 CDD P2 CLOSED WOUND DRAINAGE SYSTEMSILICONE VAC DRAINAGE 271 CDD052540NZ1 MINI-SNYDER HEMOVAC SILICONE DRAIN 3/32",1/8",3/16",1/4" 271 7MM,10MM W/TROCAR CDD052542NZ1 DRAIN ROUND W/O TROCAR 3/32",1/8",3/16",1/4 SILICONE( 管 ) 271 CDD052569NZ1 DRAIN FLAT W/O TROCAR 7MM,10MM SILICONE 271 CDD P2 CLOSED WOUND DRAINAGE SYSTEMPVC VAC DRAINAGE &TROCAR 125 CDD P2 CLOSED WOUND DRAINAGE SYSTEMSILICONE VAC DRAINAGE &TROCAR 271 CDD B0 SILICONE BULB DRAINAGE CATHETER 7MM 真空傷口引流管 271 CDD B0 SILICONE BULB DRAINAGE CATHETER 真空傷口引流管 271 CDD B0 SILICONE BULB RESERVOIR 100CC 真空傷口引流球 210 CDD B0 SILICONE BULB DRAINAGE CATHETER 10MM 真空傷口引流管 271 CDD B0 SILICONE BULB DRAINAGE CATHETER W/TROCAR 271 CDD B0 SILICONE BULB DRAINAGE CATHETER W/TROCAR (ROUND) 271 CDD B0 SILICONE BULBRESERVOIR 100CC W/CLIPS 210 CDD B0 SILICONE BULB DRAINAGE CATHETER W/TROCAR (FLAT) 271 CDD05CSC00LL LILY WOUND DRAINAGE SYSTEM:SILICON SUCTION DRAINAGE TUBE 271 怡安真空傷口引流套 : 矽質傷口引流管 CDD05CV110EF SILICONE C.W.V DRAIN 271 CDD05HRU86C8 JACKSON-PRATT HEMADUCT & HEMADUCT GOLD WOUND DRAINS FR,15FR,19FRHEMADUCT 矽質傷口引流管 CDD05MF104SG SILICONE SUCTION DRAINAGE TUBE(FLAT) 4,7,10MM 271 CDD05MFTR1SG "SIGMA" INTRODUCTION DRAINAGE CATHETER AND ACCESSORIES 271 (SILICONE) 7;10;13MM+TROCAR 十美牌導入 / 引流導管及其附件 ( 管 + 針 ) CDD FM SILICONE CLOSED WOUND VACUUM RESERVOIR 400CC 210 CDD C8 JACKSON-PRATT SILICONE BULB RESERVOIR 100CC & 400CC 矽質真 210 空傷口引流儲液器 CDD JJ J-VAC RESERVOIR SILICON 100CC 210 CDD JJ J-VAC RESERVOIR 150CC,450CC(PVC 球 )

93 CDD06021XXH0 "HOSMED"CLOSED WOUND VACUUM DRAINAGE SYSTEM:SILICONE CWV 210 RESERVOIR " 世新 " 密閉式真空傷口引流系統 : 矽質引流球 CDD SM SUCTION RESERVOIR 242 CDD P2 SILICON VAC RESERVOIR 100CC,200CC 210 CDD060S100WN ALL SILICONE BAROVAC RESERVOIR 100ML 210 CDD060S200WN ALL SILICONE BAROVAC RESERVOIR 200ML 210 CDD060S400WN " 世運 " 傷口引流套 ( 滅菌 )"SEWOON"CLOSED WOUND DRAINAGE 210 SYSTEM(STERILE)- 矽膠吸引球 400CC CDD FM "FORTUNE"C.W.V DRAIN SYSTEM:SILICON RESERVOIR 100CC,150CC 210 " 富強 " 傷口引流系統 : 矽膠真空吸球 CDD P2 太平洋真空傷口引流套 ( 滅菌 )PAHSCO WOUND DRAINAGE 210 SYSTEM(STERILE)-SILICONE EVACUATOR 125ML 200ML CDD P2 太平洋真空傷口引流套 ( 滅菌 )PAHSCO WOUND DRAINAGE SYSTEM(STERILE)-PVC PAHSCO-VAC 150ML 250ML 300ML 450ML 146 CDD Z1 SIKICONE MINI SNYDER HEMOVAC 100ML 210 CDD06CSB00LL LILY WOUND DRAINAGE SYSTEM:SILICON SURGICAL CWV 210 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 CDD06CW1S1EF SILICONE C.W.V RESERVOIR 100CC,150CC,400CC 210 CDD06CWVB1SG SIGMA SILICONE MINI BULB 100;125;150;400CC 十美牌矽質真空 210 引流球 CDD06MB125SG MINI BULB 125CC 真空吸引球 210 CDD P2 DIAMOND TIP THROACIC CANNULA 8:16FR 259 CDD P2 DIAMOND TIP THROACIC CANNULA 20:32FR 259 CDD MA " 麥林可 " 套針導管 MALLINCKRODT TROCAR CATHETER FR,12FR,16FR CDD MA " 麥林可 " 套針導管 MALLINCKRODT TROCAR CATHETER FR,24FR,28FR,32FR CDD AY " 肯麥斯 " 亞羅套針導管 "KENMEX" ARGYLE TROCAR CATHETER-8FR 259 CDD AY " 肯麥斯 " 亞羅套針導管 "KENMEX" ARGYLE TROCAR CATHETER :32FR CDD AY INGRAM TROCAR CATHETER 12FR,16FR 465 CDD AY INGRAM TROCAR CATHETER 12FR,16FR 膀胱穿刺針組 465 CDD PX " SMITHS"PORTEX CHEST DRAINAGE CATHETER" 史密斯 " 保德士胸腔 259 引流管 CDD10TDC10EE THORACIC DRAINAGE CATHETER W/TROCAR 259 CDD ET 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 刪除 ) 1595 CDD PA 安培 安全穿刺套管系統 APPLIED TROCAR SYSTEM KIT MM( 穿剌針 1+ 外管 1+ 內建可變式轉接頭 1) CDD U7 SURGICAL TROCAR SYSTEM 5-12MM ( 穿剌針 1+ 外管 1+ 內建可變式轉 1595 接頭 1) CDD ZH TROCAR KIT (5-12MM 穿刺針 X1+ 外管 X1+ 固定轉接頭 X1) 1329 CDD KM TROCAR KITS 內視鏡可轉換式安全穿刺套管組 5/10MM,5/12MM ( 穿 1595 剌針 1+ 外管 1+ 可變式轉接頭 1) CDD PA 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) 1595 CDD U7 SURGICAL TROCAR SYSTEM 5-12MM ( 穿剌針 1+ 外管 2+ 內建可變式轉接頭 2)

94 CDD ZH DETACHAPORT OBTURATOR AND SEAL SET:TROCAR SLEEVE(1 支外管 支固定轉接頭 ) CDD KM TROCAR KITS 內視鏡鈍型可轉換式安全穿刺套管組 5-10MM/ MM( 穿剌針 1+ 外管 1+ 可變式轉接頭 1+ 外管固定器 1) CDD PA TROCAR SYSTEM:SEPARATOR ACCESS SYSTEM11X100MM X100MM( 穿剌針 1+ 外管 1+ 內建可變式轉接頭 1) CDD ZH DETACHAPORT OBTURATOR AND SEAL SET:TROCAR KIT(1 支穿刺針 支外管 +2 支固定轉接頭 ) CDD KM "METROMED"TROCAR " 益鳴 " 穿刺套管 ( 穿剌針 1+ 外管 1+ 固定轉接頭 ) CDD PA SEPARATOR OBTURATOR 內視鏡手術剝離式穿刺針 638 CDD KM TROCAR KITS 內視鏡固定式安全穿刺套管組 5MM( 穿剌針 1+ 外管 固定式轉接頭 1) CDD PA CANNULAS WITH DISPOSABLE SEAL 內視鏡手術拋棄式套筒組 ( 穿刺 955 外管 + 可變式轉接頭 ) CDD U7 SURGICAL TROCAR SYSTEM 5-12MM ( 穿剌針 1+ 外管 1+ 內建可變式轉 1595 接頭 1) CDD KM TROCAR KITS 內視鏡可充氣式安全穿刺套管組 5MM ( 穿剌針 1+ 外 1963 管 2+ 固定式轉接頭 2) CDD PA DISPOSABLE TROCAR W/SHIELDED FLAT BLADE OBTURATOR 穿刺套管 1595 組 ( 穿剌針 1+ 外管 1+ 可變式轉接頭 1) CDD U7 SURGICAL TROCAR SYSTEM 5-12MM ( 穿剌針 1+ 外管 2+ 內建可變式轉 2658 接頭 2) CDD KM TROCAR KITS 內視鏡可充氣式安全穿刺套管組 5MM( 穿剌針 1+ 外管 固定式轉接頭 1) CDD PA PREMIUM DISPOSABLE TROCAR SYSTEM W/UNIVERSAL SEAL 通用孔道 1595 拋棄式穿刺系統 ( 穿剌針 1+ 外管 1+ 內建可變式轉接頭 1) CDD U7 SURGICAL TROCAR SYSTEM 5MM ( 穿剌針 1+ 外管 1+ 內建固定式轉接 1329 頭 1) CDD PA CANNULAS WITH DISPOSABLE SEAL 內視鏡手術拋棄式套筒組 ( 穿剌 638 針 ) CDD U7 SURGICAL TROCAR SYSTEM 5MM ( 穿剌針 1+ 外管 2+ 內建固定式轉接 1963 頭 2) CDD KM TROCAR KITS 內視鏡可轉換式安全穿刺套管組 5/10MM,5/12MM ( 穿 2658 剌針 1+ 外管 2+ 可變式轉接頭 2) CDD U7 SURGICAL TROCAR SYSTEM 5-12MM ( 穿剌針 1+ 外管 1+ 內建可變式轉 1595 接頭 1) CDD U7 SURGICAL TROCAR SYSTEM 5-12MM ( 穿剌針 1+ 外管 2+ 內建可變式轉 2658 接頭 2) CDD U7 SURGICAL TROCAR SYSTEM 5MM ( 穿剌針 1+ 外管 1+ 內建固定式轉接 1329 頭 1) CDD ET 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 ) CDD U7 SURGICAL TROCAR SYSTEM 5MM ( 穿剌針 1+ 外管 2+ 內建固定式轉接 1963 頭 2) CDD U7 SURGICAL TROCAR SYSTEM 5MM ( 穿剌針 1+ 外管 1+ 內建固定式轉接 1329 頭 1) CDD KM GYNECOLOGIC LAPAROSCOPE ACCESSORIES:TROCAR (1 支外管 +1 支 955 固定轉接頭 ) CDD110005NPA CANNULAS WITH DISPOSABLE SEAL 內視鏡手術拋棄式套筒組 ( 穿刺 955 外管 + 可變轉接頭 ) CDD KM "METROMED"TROCAR " 益鳴 " 穿刺套管 ( 穿剌針 1+ 外管 2+ 固定轉接頭 2)

95 CDD110007NPA CANNULAS WITH DISPOSABLE SEAL 內視鏡手術拋棄式套筒組 ( 穿剌 1595 針 + 穿刺外管 + 可變轉接頭 ) CDD KM TROCAR KITS 內視鏡固定式安全穿刺套管組 5MM ( 穿剌針 1+ 外管 固定式轉接頭 2) CDD1100K1TPA TROCAR KIT( 穿刺針 X1+ 外管 X2+ 可變轉接頭 X2) 2658 CDD L7 TROCAR KIT 10-12MM TROCAR AND CANULA 穿刺套管組 ( 防滑套管 支, 穿刺針 1 支, 多功能轉換器 1 組 ) CDD L7 TROCAR KIT 5-12MM TROCAR AND CANULA 穿刺套管組 ( 防滑套管 支, 穿刺針 1 支, 多功能轉換器 1 組 ) CDD L7 TROCAR KIT 5-12MM TROCAR AND CANULA 穿刺套管組 ( 防滑套管 支, 穿刺針 1 支, 多功能轉換器 2 組 ) CDD L7 TROCAR KIT 5-12MM TROCAR AND CANULA 穿刺套管組 ( 防滑套管 1 支 1595, 穿刺針 1 支, 多功能轉換器 1 組 ) CDD L7 TROCAR KIT 5-12MM TROCAR AND CANULA 穿刺套管組 ( 防滑套管 支, 穿刺針 1 支, 多功能轉換器 2 組 ) CDD110612AL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管 5-6MM( 穿刺套管 1 支 + 穿刺 1329 針 1 支 + 固定式轉接頭 1 支 ) CDD110612BL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管 5-12MM( 穿刺套管 1 支 + 穿 1595 刺針 1 支 + 可變式轉接頭 1 支 ) CDD110612CL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管 5-12MM( 穿刺套管 2 支 + 穿 1963 刺針 1 支 + 固定式轉接頭 2 支 ) CDD110612DL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管 5-6MM( 穿刺套管 1 支 + 穿刺 1329 針 1 支 + 固定式轉接頭 1 支 ) CDD110612EL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管 5-6MM( 穿刺套管 2 支 + 穿刺 1963 針 1 支 + 固定式轉接頭 2 支 ) CDD110612FL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管 5-6MM( 穿刺套管 1 支 + 固定 955 式轉接頭 1 支 ) CDD110612GL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管 5-12MM( 穿刺套管 2 支 + 穿 2658 刺針 1 支 + 可變式轉接頭 2 支 ) CDD110612HL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管 5-12MM( 穿刺套管 1 支 + 穿 1595 刺針 1 支 + 可變式轉接頭 1 支 ) CDD110612JL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管 5-12MM( 穿刺套管 1 支 + 可 955 變式轉接頭 1 支 ) CDD110612KL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管 5-6MM( 穿刺套管 3 支 + 穿刺 2918 針 1 支 + 固定式轉接頭 3 支 ) CDD110612LL7 LAGIS TROCAR KIT 內視鏡安全穿刺套管 5-12MM( 穿刺套管 2 支 + 穿 2658 刺針 1 支 + 可變式轉接頭 2 支 ) 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 ) 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 ) 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 ) CDD11090PF2C " 柯惠 " 可變徑式 V 型安全穿刺套管 "COVIDIEN" AUTOSUTURE 955 VERSAPORT PLUS V2 W/FIXATION CANNULA 11-12MM ( 外管 + 可變轉接頭 ) CDD11090PFUS AUTO SUTURE VERSAPORT PLUS V2 W/FIXATION CANNULA 11-12MM 955 ( 外管 + 可變轉接頭 ) CDD11095PF2C " 柯惠 " 可變徑式 V 型安全穿刺套管 "COVIDIEN" AUTOSUTURE 1595 VERSAPORT PLUS V2 W/FIXATION CANNULA 11-12MM ( 穿刺內管 + 外管 + 可變轉接頭 ) CDD11095PFUS AUTO SUTURE VERSAPORT PLUS V2 W/FIXATION CANNULA 11-12MM ( 穿刺內管 + 外管 + 可變轉接頭 )

96 CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 5MM 鈍頭 ( 穿刺針 1+ 外管 1+ 固定轉接頭 1) CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 5MM 鈍頭 ( 穿刺針 1+ 外管 2+ 固定轉接頭 2) CDD L9 ENDOSCOPIC INSTRUMENT 內視鏡器械 ( 含 : 穿刺針 *1+ 外管 *1+ 固定式轉接頭 *1) CDD L9 ENDOSCOPIC INSTRUMENT 內視鏡器械 ( 含 : 穿刺針 *1+ 外管 *2+ 固定式轉接頭 *2) CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 5MM 軟管 ( 穿刺針 1+ 外管 1+ 固定轉接頭 1) CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 5MM 軟管 ( 穿刺針 1+ 外管 2+ 固定轉接頭 2) CDD T SURGICAL TROCAR SET 5MM( 穿刺內管 X1+ 穿刺外管 X1+ 固定式轉接頭 X1) CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 5MM ( 穿刺針 1+ 外管 2+ 固定轉接頭 2) CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 5MM 尖頭硬管 ( 穿刺針 1+ 外管 1+ 固定轉接頭 1) CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 5MM ( 穿刺針 1+ 外管 2+ 固定轉接頭 2) CDD T SURGICAL TROCAR SET 5-10MM( 穿刺內管 X1+ 穿刺外管 X1+ 可變式轉接頭 X1) CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 10MM ( 穿刺針 1+ 外管 2+ 可變式轉接頭 2) CDD T SURGICAL TROCAR SET 5-12MM( 穿刺內管 X1+ 穿刺外管 X1+ 可變式轉接頭 X1) CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 12MM( 穿刺針 1+ 外管 2+ 可變式轉接頭 2) CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 5MM ( 穿刺針 1+ 外管 3+ 固定式轉接頭 3) CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 5MM ( 穿刺針 1+ 外管 4+ 固定式轉接頭 4) CDD T "TOPBOUND"SURGICAL TROCAR SET " 仁齊 " 穿刺器 (5MM: 穿刺針 1+ 外管 3+ 固定式轉接頭 3)+(10MM: 穿刺針 1+ 外管 1+ 可變式轉接頭 1) CDD114016SUS CDD114216KUS CDD117092F2C CDD117092FUS CDD C CDD US " 優施西 " 可充氣穿刺套管 "USSC" AUTO SUTURE THREADED TROCAR SLEEVES WITH WOODFORD SPIKE TROCAR AND INSUFFATION PORT( 穿剌針 1+ 外管 1+ 固定轉接頭 1) " 優施西 " 可充氣穿刺套管 "USSC" 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) " 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 ) AUTO SUTURE VERSAPORT PLUS V2 W/FIXATION CANNULA 5MM ( 外管 + 固定轉接頭 ) 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) VERSAPORT PLUS RPF SINGLE USE RADIOLUCENT TROCAR SLEEVE 5MM( 外管 + 固定式轉接頭 1)

97 CDD C " 柯惠 " 安全穿刺套管組 "COVIDIEN" AUTO SUTURE VERSAPORT 955 PLUS RPF TROCAR SYSTEM 5/10-12MM ( 外管 1+ 內建式可變轉接頭 1) CDD US VERSAPORT PLUS RPF SINGLE USE RADIOLUCENT TROCAR 955 SLEEVE5/10-12MM ( 外管 1+ 內建式可變轉接頭 1) CDD US " 優施西 " 可變式穿刺套管組 "USSC" VERSAPORT RPF SINGLE USE 2658 RADIOLUCENT TROCAR KIT 5/10MM( 穿剌針 1+ 外管 2+ 內建可變式轉接頭 2) CDD US " 優施西 " 可變式穿刺套管組 "USSC" VERSAPORT RPF SINGLE USE 1963 RADIOLUCENT TROCAR KIT 5MM( 穿剌針 1+ 外管 2+ 內建固定式轉接頭 2) CDD US " 優施西 " 腹腔穿刺套管 "USSC" AUTO SUTURE SURGISPIKE TROCAR MM( 穿剌針 1+ 外管 1+ 固定式轉接頭 1) CDD C " 柯惠 "V 型刀片穿刺套管 "COVIDIEN" AUTO SUTURE VERSAPORT V SINGLE USE WITH RADIOLUCENT TROCAR SLEEVE( 內管 + 外管 + 固定式接頭 ) CDD US AUTO SUTURE VERSAPORT V2 SINGLE USE W/RADIOLUCENT TROCAR 1329 SLEEVE ( 內管 + 外管 + 固定式接頭 ) CDD C " 柯惠 "V 型刀片穿刺套管 "COVIDIEN" AUTO SUTURE VERSAPORT V SINGLE USE WITH RADIOLUCENT TROCAR SLEEVE( 內管 + 外管 + 可變轉接頭 ) CDD US AUTO SUTURE VERSAPORT V2 SINGLE USE W/RADIOLUCENT TROCAR 1595 SLEEVE ( 內管 + 外管 + 可變轉接頭 ) CDD C " 柯惠 " 胸腔穿刺套管 "COVIDIEN" THORACOPORT TROCAR 1329 CDD US 優施西 胸腔穿刺套管 1329 CDD C " 柯惠 " 安全穿刺套管組 "COVIDIEN" AUTO SUTURE VERSAPORT PLUS RPF TROCAR SYSTEM 5MM ( 穿剌針 1+ 外管 1+ 固定式轉接頭 1) 1329 CDD US CDD119075P2C CDD119075PUS CDD119076P2C CDD119076PUS CDD119094F2C CDD119094FUS CDD C CDD US CDD119776P2C VERSAPORT PLUS RPF SINGLE USE RADIOLUCENT TROCAR 5MM 可變式安全穿刺套管 ( 穿剌針 1+ 外管 1+ 固定式轉接頭 1) " 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 ) CONVERTERLESS 5-12MM TROCAR 可變式鈍頭安全穿刺套管 ( 穿刺針 1+ 外管 1+ 可變式轉接頭 1+ 袋口結固定器 ) " 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) VERSAPORT PLUS RPF SINGLE USE RADIOLUCENT TROCAR5/10-12MM 可變式安全穿刺套管 ( 穿剌針 1+ 外管 1+ 內建可變式轉接頭 1) " 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 ) AUTO SUTURE VERSAPORT PLUS V2 W/FIXATION CANNULA 5MM ( 穿刺內管 + 外管 + 固定轉接頭 ) " 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) VERSAPORT PLUS RT SINGLE USE OBTURATORS(TROCAR) FOR USE WITH VERSAPORT RT REUSABLE CANNULAE 5MM( 穿剌針 1+ 外管 1+ 固定式轉接頭 1) " 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)

98 CDD119776PUS VERSAPORT PLUS RT SINGLE USE OBTURATORS(TROCAR) FOR USE 1010 W/VERSAPORT RT REUSABLE CANNULAE 10-12MM( 穿剌針 1+ 外管 1+ 內建可變式轉接頭 1) 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 1595 CDD11EPATHET "ETHICON"ENDOPATH XCEL TROCAR" 愛惜康 " 安德派思外科穿刺器 1595 ( 穿刺針 + 外管 + 可變式轉接頭 ) CDD11K1101PA TROCAR SYSTEM( 穿剌針 1+ 外管 1+ 可變式轉接頭 1) 1595 CDD11K1102PA APPLIED TROCAR SYSTEM 安培 安全穿刺套管系統 ( 穿剌針 外管 1+ 可變式轉接頭 1) CDD11K1103PA TROCAR SYSTEM( 穿剌針 1+ 外管 1+ 可變式轉接頭 1) 1595 CDD11K1104PA APPLIED TROCAR SYSTEM 安培 安全穿刺套管系統( 穿剌針 外管 1+ 可變式轉接頭 1) CDD11K1105PA APPLIED TROCAR SYSTEM 安培 安全穿刺套管系統( 穿剌針 外管 2+ 可變式轉接頭 2) CDD11K1106PA TROCAR SYSTEM( 穿剌針 1+ 外管 2+ 可變式轉接頭 2) 2658 CDD11K1107PA APPLIED TROCAR SYSTEM 安培 安全穿刺套管系統( 穿剌針 外管 2+ 可變式轉接頭 2) CDD11K1108PA APPLIED TROCAR SYSTEM 安培 安全穿刺套管系統( 外管 可變式轉接頭 1) CDD11K1109PA APPLIED TROCAR SYSTEM 安培 安全穿刺套管系統 ( 穿剌針 外管 1+ 可變式轉接頭 1) CDD11K1110PA "APPLIED"TROCAR SYSTEM(KII FIOS)" 安培 " 安全穿刺套管系統 ( 含 1900 外管 + 可變式轉接頭 + 內管 ( 附充氣功能 ) CDD11NB12F2C " 柯惠 " 無刀刃可變式穿刺套管 "COVIDIEN"VERSAPORT BLADELESS 1595 AND VERSAPORT PLUS BLADELESS SINGLE USE BLADELESS TROCAR( 內管 1+ 外管 1+ 可變轉接頭 1) CDD11NB12FUS " 優施西 " 無刀刃可變式穿刺套管 USS VERSAPORT BLADELESS AND 1595 VERSAPORT PLUS BLADELESS TROCAR( 穿刺內管 X1 穿刺外管 X1 可變轉接頭 X1) CDD11NBFCA2C " 柯惠 " 無刀刃可變式穿刺套管 "COVIDIEN"VERSAPORT BLADELESS 955 AND VERSAPORT PLUS BLADELESS SINGLE USE BLADELESS TROCAR( 外管 1+ 固定式轉接頭 1) CDD11NBFCAUS " 優施西 " 無刀刃可變式穿刺套管 "USS" VERSAPORT PLUS 955 BLADELESS SINGLE USE FIXATION CANNULA( 外管 TROCAR SLEEVE 1 支 + 固定式轉接頭 1 支 ) CDD11XCEL2ET 愛惜康 安德派思外科穿刺器雙外管 "ETHICON"ENDOPATH XCEL 2658 TROCAR CDD11XCELBET 愛惜康 安德派思外科穿刺器 "ETHICON"ENDOPATH XCEL 1595 TROCAR(BLADELESS) CDD11XCELLET 愛惜康 安德派思外科穿刺器 "ETHICON"ENDOPATH XCEL 1595 TROCAR CDD11XCELSET 愛惜康 安德派思外科穿刺器 - 外套管 + 固定式頭 "ETHICON" 955 TROCAR SLEEVE(BLADELESS) CDD11XCELVET 愛惜康 安德派思外科穿刺器 - 外套管 + 可變式頭 "ETHICON" 955 TROCAR SLEEVE(BLADELESS) CDD12K1109PA TROCAR SYSTEM 充氣式 ( 穿剌針 1+ 外管 1+ 可變式轉接頭 1) 3091 CDD12MSBT12C " 柯惠 " 腹腔鏡汽球固定式鈍頭穿刺套管組 "COVIDIEN" AUTO 3091 SUTURE BLUNT TIP TROCAR AND SYRINGE CDD12MSBT1US 優施西 腹腔鏡汽球固定式鈍頭穿刺套管組 3091 CDD12MSXB1US 優施西 可視式腹腔鏡汽球撐開式套管 2370 CDD12PDBS22C " 柯惠 " 腹腔鏡汽球撐開式套管 "COVIDIEN"PDB STERILE BALLOON

99 CDD12PDBS2US " 優施西 " 腹腔鏡汽球撐開式套管 2370 CDD13DGC01CK "COOK"JABCZENSKI DUCTOGRAM CANNULA 30 GAGE( 乳管攝影導管 ) 960 CDD13DGK00ZM "MD TECH"ANGIOTECH INTRODUCTION/DRAINAGE CATHETER " 美迪 960 克 " 安酋導入及引流導管 ( 乳管攝影導管 ) CDD13G1U30RC INTRODUCTION DRAINAGE CATHETER 導入及引流導管 ( 乳管攝影導 960 管 ) CDF M4 CSF FLOW CONTROL SHUNTS AND ACCESSORIES V-P-SHUNT 2870 RESERVOIR CDF CM ACCU-FLO SINGLE LUMEN RESERVOIR 2870 CDF01T4004BD DISPOSABLE FLOW/FLUSH DEVICE 140 CDF CM ACCU-FLO SINGLE LUMEN RESERVOIR 2870 CDF PM C.S.F. FLOW CONTROL VALVE STANDARD 6100 CDF B0 CSF VALVE BURR HOLE 6100 CDF B0 CSF VALVE BURR HOLE 6100 CDF CM ACCU-FLO DOUBLE LUMEN RESERVOIR(91/10/01 再重新生效, 刪除 ) CDF CM CODMAN HAKIM RIGHT ANGLE VALVES 6100 CDF PM C.S.F. FLOW CONTROL VALVE CONTOURED 6100 CDF PM C.S.F. FLOW CONTROL VALVE BURR HOLE 6100 CDLP106418B0 LUMBAR CATHETER SET( 腦室導管 + 貯水閥 +CONNECTOR+ 腹腔導管 ) 8120 CDLP144410PM C.S.F. LUMBOPERITONEAL CATHETER SYSTEM 8120 CDLP146418M4 EDM LUMBER CATHETER 24CM 2100 CDLP244513PM C.S.F. LUMBOPERITONEAL RESERVOIR 3305 CDP MV FLEXIMA NASOBILIARY CATH W/GUIDEWIRE(CATH+TRANSFER 5198 TUBE+DRAINAGE CANNECTOR TUBE+GUIDEWIRE) CDP SB FLEXIMA NASOBILIARY CATHETER (CATH+TRANSFER TUBE+DRAINAGE 5198 CONNECTOR TUBE+GUIDE WIRE) CDP010A001CK OASIS ONE ACTION STENT INTRODUCER SYSTEM 2000 CDP010ACL1CK OASIS PRE-LOADED STENT INTRODUCTION SYSTEM 4458 CDP010ACL2CK " 曲克 " 膽道支架暨支架引導組 "COOK"COTTON-LEUNG BILIARY 4458 STENT AND INTRODUCER SET CDP010ACL3CK " 曲克 " 膽道支架暨支架引導系統 "COOK" COTTON-LEUNG BILIARY 4458 STENTS AND INTRODUCERS CDP010ATS1CK 歐爾喜斯一步式支架引導系統膽道支架 "COOK"OASIS ONE ACTION 4458 STENT INTRODUCTION SYSTEM WITH ST-2 SOEHENDRA TANNENBAUM BILIARY STENT CDP CL P.T.C.D SET 矽質膽道膽囊穿刺套 2649 CDP CL P.T.C.D KIT (ONE STEP) 1720 CDP011STWNCY PERCUTANEOUS DIRECT ACCESS KIT 1720 CDP SB ACCUSTICK II PERCUTANEOUS INTRODUCER 2700 SYSTEM(NEEDLE+INTRODUCER+GUIDEWIRE*2) CDP SB ACCUSTICK II PERCUTANEOUS INTRODUCER 1666 SYSTEM(NEEDLE+INTRODUCER+GUIDEWIRE*1) CDP BQ "BIOTEQ"INTRODUCER SET" 邦特 " 穿刺導入系統組 ( 含穿刺針 INTRODUCER+0.018"GUIDE WIREX1 支 " 或 0.038"GUIDE WIREX1 支 ) CDP012633NC3 ULTRASONICALLY GUIDED ONE-STEP DRAINAGE SET 1720 CDP SB MICROVASIVE RAPID EXCHANGE BILIARY STENT SYSTEM( 含推進導 3929 管及導引導管 ) CDP PB INTRODUCER SET(NEEDLE+INTRODUCER+GUIDE WIREX2) 2700 CDP PB SKATER DRAINAGE CATHETER 6:16FR 25-35CM

100 CDP PB SKATER ONE STEP DRAINAGE CATHETER 6:16FR 20:25CM 1720 CDP PB 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 2033 BILIARY STENT CDP01ABSPLSB " 波士頓科技 " 阿德凡斯膽道支架 "BOSTON SCIENTIFIC"ADVANIX 4458 BILIARY STENT WITH NAVIFLEX RX DELIVERY SYSTEM CDP01BCLN1CK 曲克 多功能引流導管組 COOK MULTIPURPOSE DRAINAGE 1720 CATHETER SET CDP01BS001SB AMSTERDAM BILIARY STENT KIT ,8.5,10,11.5FRX5,7,10,12,15CM( 含推進導管及導引導管 ) CDP01BSK12SB AMSTERDAM BILIARY STENT KIT ( 含推進導管 ) 2401 CDP01BSK1TSB AMSTERDAM BILIARY STENT KIT 10,12FRX5,7,10,12,15CM( 含推進 4458 導管及導引導管 ) CDP01BTPD2BQ PIGTAIL DRAINAGE CATHETER SET (ONE SETP)7:14FR 19:39CM 含 1720 導管及穿刺針 CDP01BTPDABQ PIGTAIL DRAINAGE CATHETER SET(ONE STEP TYPE)( 含穿刺針組 引流管 ) CDP01BTPDBBQ PIGTAIL DRAINAGE CATHETER SET(ONE STEP TYPE)( 含穿刺針組 引流管 ) CDP01BTPDCBQ PIGTAIL DRAINAGE CATHETER SET(ONE STEP)( 含引流管及穿刺針 1720 組 ) CDP01BTPDDBQ PIGTAIL DRAINAGE CATHETER SET(ONE STEP)( 含引流管及穿刺針 1720 組 ) CDP01BTPDSBQ " 邦拓 " 豬尾巴引流導管組 ( 直接穿刺型 )"BIOTEQ"PIGTAIL 1720 DRAINAGE CATHETER SET(ONE STEP TYPE) CDP01CHB1NCK COTTON HUIBREGTSE BILIARY STENT SET 4458 CDP01CL120CK MAC-LOC BILIARY DRAINAGE CATH 12,14F 1720 CDP01CLB85CK " 曲克 " 經皮引流導管針組 ( 滅菌 ) "COOK" DRAINAGE CATHETER 1720 NEEDLE SET(STERILE) 6~16FR CDP01CLBS1CK 曲克 膽道支架暨支架引導組 COOK COTTON-LEUNG BILIARY 4458 STENT AND INTRODUCER SET CDP01CLBS2CK "COOK"COTTON-LEUNG BILIARY STENTS AND INTRODUCERS 5:14FR 4458 膽道支架暨支架引導系統 CDP01DTVN1CK 曲克 經皮引流導管針組 ( 滅菌 ) COOK DRAINAGE CATHETER 1720 NEEDLE SET(STERILE) CDP01DTVN2CK 曲克 經皮引流導管針組 COOK DRAINAGE CATHETER NEEDLE 1720 SET CDP01DTVN3CK 曲克 經皮引流導管針組 COOK DRAINAGE CATHETER NEEDLE 1720 SET CDP01E001NCK LIGUORY ENDOSCOPIC NASAL BILIARY DRAINAGE SET 5:7FR 5198 CDP01EC01NCK LIGUORY ENDOSCOPIC NASAL BILIARY DRAINAGE CATHETER 2333 CDP01EC02NCK NAGARAJA ENDOSCOPIC NASAL BILIARY DRAINAGE CATHETER 內視 730 鏡經膽道引流管 CDP01ENBD1CK " 曲克 " 鼻 - 膽道引流管組 "COOK" NASAL BILIARY DRAINAGE SET 5198 CDP01ENBD2CK " 曲克 " 鼻 - 膽道引流管 "COOK" NASAL BILIARY DRAINAGE 2200 CATHETER CDP01GEPD1CK PANCREATIC STENT SET( 含導入導引組 + 支架 ) 4815 CDP01GEPD2CK " 曲克 " 吉南胰管支架組 "COOK"GEENEN PANCREATIC STENT SET 4087 CDP01GEPD3CK " 曲克 " 胰管支架及引導器 "COOK" PANCREATIC STENTS AND 4087 INTRODUCERS CDP01GPPS1FG " 福萊克斯 " 支架放置套組 "ENDO-FLEX" STENT INTRODUCTION SET GPPS

101 CDP01K3076TP P.T.C.D SET 經皮穿肝膽道引流針組 1352 CDP01L001NCK COTTON LEUNG BILIARY STENT SET 4458 CDP01MAS18MR " 美瑞特 " 福祿小血管導引鞘 "MERIT" PRELUDE MINI ACCESS 1666 SHEATH INTRODUCERS(7,11CM SHEATH+SIDEPORT+VALVE+DILATOR+0.018GW+NEEDLE) CDP01MD102CK ULTRATHANE MULTIPUEPOSE DRAINAGE CATH 12,14F,25CM,18G 1720 CDP01MDC85CK ULTRATHANE MULTIPURPOSE DRAINAGE CATH 8.5,10.2F,25CM,18G 1720 CDP01MP1S1CK "COOK"MICROPUNCTURE INTRODUCER SETS 4F:5F 英吋 21G 1666 微穿刺引導器組 CDP01N0DNNBA OPTI-DRAIN MULTI-USE DRAINAGE CATHETER 8-12FR 1720 CDP01NNUNNBA DRAINAGE CATHETERS AND ACCESSORIES( 含穿刺針組 + 引流管 ) 1720 CDP01NPAS1CK "COOK"NEFF PERCUTANEOUS ACCESS SETS" 曲克 " 涅夫經皮引導組 FR 20CM CM CDP01NPAS2CK "COOK"NEFF PERCUTANEOUS ACCESS SETS" 曲克 " 涅夫經皮引導組 FR 20CM CM CDP01NPAS3CK "COOK"NEFF PERCUTANEOUS ACCESS SETS 4.0/7.0 20CM 22/15CM /6.0 20CM 21/15CM:22/15CM.018 CDP01NPDS1CK NASAL PANCREATIC DRAINAGE SET 5198 CDP01P001NCK "COOK"BILIARY DRAINAGE CATHETER" 曲克 " 膽道引流導管 800 CDP01P008NCK "COOK"BILIARY DRAINAGE CATHETER" 曲克 " 膽道引流導管 832 CDP01PAS30BA NAVARRE PERCUTANEOUS ACCESS SET 1666 CDP01PDD10BQ " 邦特 " 豬尾巴引流導管組 ( 直接穿刺型 ) "BIOTEQ" PIGTAIL 1720 DRAINAGE CATHETER SET(ONE STEP TYPE CDP01PDD2WBQ " 邦特 " 豬尾巴引流導管組 ( 直接穿刺型 ) "BIOTEQ" PIGTAIL 1720 DRAINAGE CATHETER SET(ONE STEP TYPE CDP01PDD30BQ " 邦特 " 豬尾巴引流導管組 ( 直接穿刺型 ) "BIOTEQ" PIGTAIL 1720 DRAINAGE CATHETER SET(ONE STEP TYPE CDP01PDD4WBQ " 邦特 " 豬尾巴引流導管組 ( 直接穿刺型 ) "BIOTEQ" PIGTAIL 1720 DRAINAGE CATHETER SET(ONE STEP TYPE CDP01PDS50BQ " 邦特 " 豬尾巴引流導管組 ( 直接穿刺型 ) "BIOTEQ" PIGTAIL 1720 DRAINAGE CATHETER SET(ONE STEP TYPE CDP01PDS6WBQ " 邦特 " 豬尾巴引流導管組 ( 直接穿刺型 ) "BIOTEQ" PIGTAIL 1720 DRAINAGE CATHETER SET(ONE STEP TYPE CDP01PDS70BQ " 邦特 " 豬尾巴引流導管組 ( 直接穿刺型 ) "BIOTEQ" PIGTAIL 1720 DRAINAGE CATHETER SET(ONE STEP TYPE CDP01PDS8WBQ " 邦特 " 豬尾巴引流導管組 ( 直接穿刺型 ) "BIOTEQ" PIGTAIL 1720 DRAINAGE CATHETER SET(ONE STEP TYPE CDP01U004NCK RING BILIARY DUCT DRAINAGE SET 2649 CDP01UC102CK ULTRATHANE UNIVERSAL CURVED DRAINAGE CATH 10.2F,25CM,18G 1720 CDP01UCD70CK ULTRATHANE UNIVERSAL CURVED DRAINAGE CATH 7,8.5F,25CM,18G 1720 CDP01UL120CK MAC-LOC ULTRATHANE DRAINAGE CATH 10.2,12F,25CM,18G 1720 CDP01UL140CK MAC-LOC MULTIPURPOSE DRAINAGE CATHETER 12,14F 25CM,18G 1720 CDP01ULT01CK " 曲克 " 經皮引流導管針組 "COOK" DRAINAGE CATHETER NEEDLE 1720 SET(BILIARY DRAINAGE CATHETERS) 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 1720 SET(STERILE)-MAC-LOC MULTIPURPOSE 8.5,10F-14F,25CM CDP01ZEBD1CK ZIMMON ENDOSCOPIC BILIARY STENT SET 5:7FR(STENT GUIDEWIRE INTRODUCER CATHETER)

102 CDP01ZEBD2CK 曲克 膽道留置管組 COOK BILIARY STENT SET 4458 CDP01ZEBD3CK 曲克 膽道支架暨支架引導系統 COOK ZIMMON BILIARY 4458 STENTS AND SET CDP01ZEBD4CK 曲克 膽道支架暨支架引導系統 COOK ZIMMON BILIARY 4458 STENTS AND INTRODUCERS CDP MV FLEXIMA NASOBILIARY CATH(NASOBILIRY CATH+NASAL TRANSFER 2200 TUBE+DRAINAGE CANNECTOR TUBE) CDP SB FLEXIMA NASOBILIARY CATHETER (CATH+TRANSFER TUBE+DRAINAGE 2200 CONNECTOR TUBE) CDP CL P.T.C.D. INTERNAL DRAINAGE TUBE (SILICON) 832 CDP02CHB1NCK COTTON HUIBREGTSE BILIARY STENT ONLY 2033 CDP02CLS01CK "COOK"COTTON-LEUNG BILIARY STENTS 5:14FR 膽道支架 2033 CDP02LS01NCK COTTON LEUNG BILIANY STENT ONLY 2033 CDP02PADBSSB AMSTERDAM BILIARY STENT 2033 CDP02PEBSTFG " 福萊克斯 " 膽道引流管 "ENDO-FLEX" BILIARY STENT 2033 CDP02PTFESFG " 福萊克斯 " 膽道引流管 "ENDO-FLEX" PTFE BILIARY STENT 2033 CDP02SPS11CK " 曲克 " 胰管支架及引導器 "COOK" PANCREATIC STENTS AND 2033 INTRODUCERS(STENT ONLY) CDP02SPS12CK " 曲克 " 西門胰管支架組 "COOK" ZIMMON PANCREATIC STENT SET 2033 CDP02TTS01CK ST-2 S0EHENDRA TANNENBAUM BILIARY STENT 8.5,10,11.5FR :12CM,15CM CDP02ZS001CK ZIMMON ENDOSCOPIC BILIARY STENT ONLY 5:7FR 4,7,10CM 2033 CDP02ZS002CK 曲克 膽道支架暨支架引導系統 COOK ZIMMON BILIARY 2033 STENTS AND SET(STENT ONLY) CDP02ZS003CK 曲克 膽道支架 COOK ZIMMON BILIARY STENT 2033 CDPC103105B0 PERITONEAL CATHETER 2075 CDPC121303CM ACCU-FLO BARIUM PISTAL SLIT VALVE PERITONEAL CATHETER 2320 CDPC123045CM HAKIM PERITONEAL CATHETER 2075 CDPC143103PM C.S.F CARDIAC/PERITONEAL CATHETER 2075 CDPC143209M4 CSF FLOW CONTROL SHUNTS AND 2075 ACCESSORIES(CARDIAC/PERITONEAL CATHETERS ) CDPC19007MM4 CSF FLOW CONTROL SHUNTS AND ACCESSORIES CSF CARDIAC 2320 PERITONEAL CATHETER WITH PRESSURE CDPN2TQTS1CK "COOK"THAL-QUICK CHEST TUBE SET 8~36FR 18~41CM( 穿刺針 + 擴 2000 張器 *3+ 導線 + 胸管插入器 + 胸管 )" 曲克 " 胸腔引流管組 CDSR104111B0 VENTRICULAR RESERVOIR 4710 CDSR123038M4 " 美敦力 " 腦脊髓液儲液囊 "MEDTRONIC" RESERVOIRS 4710 CDSR144102PM VENTRICULAR ACCESS DEVICE 18MM,28MM 4710 CDSR144111PM VENTRICULAR ACCESS DEVICE BURR HOLE 12MM 4710 CDSR244108M4 " 美敦力 " 腦脊髓液儲液囊 "MEDTRONIC"RESERVOIRS(CSF 4710 VENTRICULAR RESERVOIR 流液量 2.4ML) CDV CM EXTERNAL DRAINAGE COLLECTION KIT 腦室體外引流組 4850 CDV CM EXTERNAL DRAINAGE SYSTEM(E.D.S.) SET ( 不含 VENTRICULAR 4080 SET) CDV CM EXTERNAL DRAINAGE SYSTEM(E.D.S.) COLLECTION BAG 600 CDV CM EXTERNAL DRAINAGE SYSTEM(E.D.S.)VENTRICULAR SET ( 不含 2090 TUBING AND BAG) CDV CM EXTERNAL DRAINAGE SYSTEM EDSII (VENTRICULAR 4850 CATH+TUBING+BAG) CDV CM EXTERNAL DRAINAGE SYSTEM EDSII WITHOUT CATH(TUBING+BAG) 4080 CDV CM 柯特曼體外引流集液袋 "CODMAN" EDS CSF COLLECTION BAGS

103 CDV TP VENTRICULAR DRAINAGE KIT(VENTRICULAR CATH+TUBING+BAG) 4850 CDV B0 VENTRICULAR CATHETER 1200 CDV TP VENTRICULAR DRAINAGE KIT(VENTRICULAR CATH+TUBING+BAG) 4850 CDV TP VENTRICULAR DRAINAGE SET(TUBING+BAG) 4080 CDV TP VENTRICULAR DRAINAGE BAG 600 CDV B0 EDMS VENTRICULAR CATHETER 20CM W/STYLET 1200 CDV B0 EDMS DRAINAGE BAG 700ML 600 CDV B0 EDMS PATIENT CONNECTION LINE ASSEMBLY 162CM 1275 CDV B0 EXTERNAL DRAINAGE MONITORING SYSTEM 63X11CM 84CM 4080 CDV CM CODMAN EXTERNAL DRAINAGE SYSTEM 3 WITHOUT VENTRICULAR 4080 CATHETER CDV M4 EXACTA WITH PATIENT LINE(TUBING+Y-PORT+ANTI-REFLUX VALVE) 1275 CDV PM BECKER EDMS DRAINAGE BAG 700ML 600 CDV PM EDMS PATIENT CONNECTION LINE ASSEMBLY 1275 CDV PM I.C.P SHUNT BECKER 4080 CDV M4 EXTERNAL DRAINAGE AND MONITORING SYSTEM 4080 CDV M4 EXACTA DRAINAGE BAG 600ML 600 CDV02ND200TP VENTRICULAR CATH 1200 CDV B0 EDMS VENTRICULAR CATHETER 35CM W/STYLET+TROCAR 型 2090 號 :06118S 自 94 年 10 月 1 日起生效 ( 文號 ) CDV CM HAKIM VENTRICULAR CATHETER W/INTRODUCER 2090 CDV M4 " 美敦力 " 體外引流及監測用腦室導管 "MEDTRONIC" EXTERNAL 2090 DRAINAGE AND MONITORING VENTRICULAR CDV PM VENTRICULAR CATHETER WITH TROCAR 2090 CDV CM "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 CDV CM "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 CDVC121201CM ACCU-FLO VENTRICULAR CATHETER 1200 CDVC141101M4 EXTERNAL DRAINAGE AND MONITORING VENTRICULAR CATHETER 1200 CDVC141101PM VENTRICULAR CATHETER 1200 CDVP123011CM HAKIM PRECISION VALVE PRECHAMBER ONLY W/INTRODUCER 6100 CDVP128503CM UNI-SHUNT WITH RESERVOIR (CATHETER ONLY) 5100 CDVP128504CM UNI-SHUNT WITH RESERVOIR (CATHETER ONLY) 5100 CDVP128513CM UNI-SHUNT WITH RESERVOIR (CATHETER ONLY) 5100 CDVP128514CM UNI-SHUNT WITH RESERVOIR (CATHETER ONLY) 5100 CDVP128523CM UNI-SHUNT WITH RESERVOIR (CATHETER ONLY) 5100 CDVP128524CM UNI-SHUNT WITH RESERVOIR (CATHETER ONLY) 5100 CDVP128545CM UNI-SHUNT WITH RESERVOIR (CATHETER ONLY) 5100 CDVP19003AM4 CSF FLOW CONTROL SHUNTS AND ACCESSORIES V-PSHUNT KIT ( 腦 9120 室引流管 + 腹腔導管 +CTR RESERVOIR+CONX2) CDVP19003DM4 CSF FLOW CONTROL SHUNTS AND ACCESSORIES V-PSHUNT KIT ( 腦 9120 室引流管 + 腹腔導管 +CTR RESERVOIR+CONX2) CDVP19040BPM V-P SHUNT 腦室腹腔分流術導管組 9120 CDVP19040EPM V-P SHUNT 腦室腹腔分流術導管組 9120 CDVP323001CM HYDROCEPHALUS SHUNT SYSTEM 9120 CDVP323006CM VALVE UNIT+PERITONEAL C+VENTRICULAR 9120 C+ADAPTER+CONNECTOR+VALVE INTRODUCER CDVP323016CM VALVE UNIT+PERITONEAL C+VENTRICULAR C+ADAPTER+CONNECTOR+VALVE INTRODUCER

104 CDVP323281CM CODMAN HAKIM RIGHT ANGLE VALVES SYSTEM( 腦室導管 + 腹腔導管 定壓引流閥 ) CDVP328501CM UNI-SHUNT WITH ENLARGED DOME RESERVOIR 9120 CDVP346024PM C.S.F UNITIZED SHUNT KIT 9120 CEE010090NPW EXTENSION TUBE 6.3 CEE TP ANGIOGRAPHIC TUBE 142PSI 血管造影劑注入延長管 6.3 CEE010150CLL EXTENSION TUBE 90CM,100CM,120CM,150CM 6.3 CEE010150NPW EXTENSION TUBE 6.3 CEE010180NPW EXTENSION TUBE 6.3 CEE TP ANGIOGRAPHIC TUBE W/3 WAY 142PSI 血管造影劑注入延長管含三 17.3 路活栓 CEE P2 EXTENSION TUBE WITH Y 10CM 24.6 CEE P2 EXTENSION TUBE WITH SAMPLING PORT 60CM,70CM 6.3 CEE P2 EXTENSION TUBE WITH SAMPLING PORT 85CM:95CM 6.3 CEE P2 EXTENSION TUBE WITH T 15CM 14 CEE P2 IV EXTENSION TUBE 輸液延長管 45CM 6.3 CEE P2 IV EXTENSION TUBE 輸液延長管 60CM 6.3 CEE P2 EXTENSION TUBE 90CM 6.3 CEE P2 IV EXTENSION TUBE 輸液延長管 120CM 6.3 CEE P2 IV EXTENSION TUBE 輸液延長管 180CM 6.3 CEE01090ASLL EXTENSION TUBE (W/DOUBLE NEEDLE FREE) 輸液延長管 ( 安全型 ) 99 適應症請見備註欄 CEE010E877SG EXTENSION TUBE MALE-FEMALE LUER LUCK 100CM 6.3 CEE LL "LILY"EXTENSION TUBE 15CM" 怡安 " 輸液延長管 6.3 CEE LL "LILY"EXTENSION TUBE 15CM (NEEDLE FREE)" 怡安 " 輸液延長管 : 43.1 免針加藥座 CEE M8 EXTENSION TUBE 25:120CM 6.3 CEE CN 2 WAY Y CONNECTOR 24.6 CEE P2 EXTENSION TUBE WITH 3-WAY 15CM 17.3 CEE P2 EXTENSION TUBE WITH 3-WAY 192CM 17.3 CEE01A101NPW EXTENSION TUBE 6.3 CEE01A110NPW EXTENSION TUBE WITH T 14 CEE01B430BBQ "BIOTEQ"ANGIOGRAPHIC SYRINGE KIT(LOW PRESSURE TUBE)" 邦特 " 40 攝影導管用注射筒套組 ( 螺旋連接管 ) CEE01BTXDABQ "BIOTEQ"CONTRAST MEDIA DELIVERY SET " 邦特 " 顯影藥物輸液套 280 組 : 病人端輸液管 ( 含捲型幫浦輸液管 - 系統管 ) CEE01C1000U2 "ICU"CLAVE CONNECTOR AND ACCESSORIES DEVICES:CLAVE 43.1 NEEDLELESS CONNECTOR " 愛喜優 " 克萊福無針式接頭 適應症請見備註欄 CEE01C2000U2 "ICU"CLAVE NEEDLELESS CONNECTOR EXTENSION SET " 愛喜優 克 43.1 萊福無針式延長管 適應症請見備註欄 CEE01C4200U2 "ICU"CLAVE NEEDLELESS PIGGYBACK EXTENSION SET DUAL PORT " 愛喜優 " 克萊福無針式雙接頭延長管 適應症請見備註欄 99 CEE01C9190BT CEE01CH100U2 CEE01CH150U2 CATHETER EXTENSION SET 無針系統導管延長組 適應症請見備註欄 "ICU"CLAVE DRUG PREPARATION SYSTEM:ACCESS DEVICE IV BAG CLAVE CONNECTOR" 愛喜優 " 克萊福藥物準備系統組件 "ICU"CLAVE DRUG PREPARATION SYSTEM:IV BAG ACCESS SPIKE CLAVE CHECK VALVE)" 愛喜優 " 克萊福藥物準備系統組件 ( 玻璃瓶用 )

105 CEE01CH303U2 CEE01DCTPQUL "ICU"CLAVE DRUG PREPARATION SYSTEM:5" (13CM)BAG SPIKE ADAPTER W/SPIROS NON-DEHP TUBING" 愛喜優 " 克萊福藥物準備系統組件 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 ) CEE01E0085SG EXTENSION TUBE 6.3 CEE01ENT10SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE T-TYPE 43.1 EXTENSION TUBE" 十美牌 " 免針輸液接頭 T 型延長管 適應症請見備註欄 CEE01ENY10SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE Y EXTENSION 51.5 TUBE" 十美牌 " 免針輸液接頭 Y 延長管 適應症請見備註欄 CEE01ENY20SG " 十美牌 " 免針輸液接頭 "SIGMA"NEEDLELESS INJECTION ACCESS 99 DEVICE-Y 三路免針輸液接頭 * 適應症請見備註欄 CEE01ES107SG EXTENSION TUBE 6.3 CEE01ET015SG T-CONNECTOR 14 CEE01ET067BB SAFSITE NEEDLE FREE EXTENSION SET 適應症請見備註欄 43.1 CEE01ET112LL EXTENSION TUBE 6.3 CEE01ET116BB SAFSITE NEEDLE FREE EXTENSION SET 適應症請見備註欄 43.1 CEE01ET12CLL EXTENSION TUBE 6.3 CEE01ET20ULL 2 WAY EXTENSION TUBE 24.6 CEE01ET24ULL 4-WAY EXTENSION TUBE 48.3 CEE01ET33SBB SAFSITE NEEDLE FREE EXTENSION SET( 二個 NEEDLE FREE) 適應 99 症請見備註欄 CEE01ET60SLL SAFETY EXTENSION TUBE 適應症請見備註欄 23 CEE01ETA01NQ T-CONNECTOR(T-IV EXTENSION TUBE) 14 CEE01ETA03NQ IV EXTENSION TUBE+3 WAY 17.3 CEE01ETB05NQ Y-CONNECTOR(Y-IV EXTENSION TUBE) 24.6 CEE01ETC01NQ IV EXTENSION SET 6.3 CEE01ETN10SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE SINGLE 43.1 EXTENSION TUBE" 十美牌 " 免針輸液接頭延長管 適應症請見備註欄 CEE01ETN20SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE DOUBLE 99 EXTENSION TUBE" 十美牌 " 免針輸液接頭 2 路延長管 適應症請見備註欄 CEE01ETN51SG EXTENSION TUBE W/FREE SITE 無針式接頭 + 延長管 * 適應症請見備 43.1 註欄 CEE01H001NCK CONNECTING TUBE 314 CEE01H003NCK CONNECTING TUBE WITH DRAINAGE BAG CONNECTOR PCN 連接管 305 CEE01HPC03CK CONNECTING TUBE BRAIDED POLYETHYLENE 1200PSI 連接管雙層 314 CEE01LP160MH LOW PRESSURE COUNECTOR TUBE 300PSI( 螺旋連接管 ) 40 CEE01LRX50TP EXTENSION TUBE 50CM W/3 WAY STOPCOCK 17.3 CEE01LX1FLTP EXTENSION TUBE INJECTOR TYPE 213PSI 50CM,100CM 造影用延長 6.3 管 CEE01N8000SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE " 十美牌 " 免針輸 43.1 液接頭 適應症請見備註欄 CEE01NFEYSLL " 怡安 " 點滴輸液套 "LILY"INFUSION SET+NEEDLE FREE 適應症請 43.1 見備註欄 CEE01P8100SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE " 十美牌 " 免針 型輸液接頭 適應症請見備註欄

106 CEE01PET10SG CEE01PET20SG CEE01PEY10SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE SINGLE EXTENSION TUBE " 十美牌 " 免針 型輸液接頭延長管 適應症請見備註欄 "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE DOUBLE EXTENSION TUBE " 十美牌 " 免針 型輸液接頭 2 路延長管 適應症請見備註欄 "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE Y EXTENSION TUBE " 十美牌 " 免針 型輸液接頭 Y 延長管 適應症請見備註欄 CEE01PTT10SG "SIGMA"NEEDLELESS INJECTION ACCESS DEVICE T-TYPE 43.1 EXTENSION TUBE " 十美牌 " 免針 型輸液接頭 T 延長管 適應症請見備註欄 CEE01Q5100BD Q-SYTE LUER ACCESS SITE( 無針式接頭 ) 適應症請見備註欄 43.1 CEE01Q5101BD Q-SYTE LUER ACCESS SITE EXTENSION SETS 延長型無針式輸液 43.1 套接頭 適應症請見備註欄 CEE01Q5102BD Q-SYTE LUER ACCESS SITE EXTENSION SETS 延長型無針式輸液 43.1 套接頭 適應症請見備註欄 CEE01R1000BB SAFSITE VALVES AND ACCESSORIES 適應症請見備註欄 43.1 CEE01SF877SG EXTENSION TUBE SAFETY 15CM:50CM 適應症請見備註欄 23 CEE01T1100U2 "ICU"NON-DEHP MINIBORE EXT SET T-CONNECTOR AND BONDED 43.1 CLAVE CONNECTOR" 愛喜優 克萊福無針式 T 延長管 適應症請見備註欄 CEE01TC15NLL T-SITE CONNECTOR 14 CEE01VP003LL EXTENSION TUBE W/3 WAY 17.3 CEE01VP005LL "LILY"CVP-SACLE SYSTEM:3 WAY W/EXTENSION TUBE 17.3 CEP BS ARTERIAL PRESSURE TUBING 15CM,30CM,60CM 30.7 CEP P2 PRESSURE MONITOR LINES 24"-48" 30.7 CEP P2 PRESSURE MONITOR LINES 60"-72" 30.7 CEP010A01NPW EXTENSION TUBE 800PSI 高壓延長管 57 CEP011000PTP ANGIOGRAPHIC TUBE W/3 WAY 1000PSI 雙層血管造影劑注入延長 384 管含三路活栓 CEP BB 1200PSI ANGIODYN HIGH PRESSURE TUBINGS PUR( 雙層 ) 314 CEP BB 1000PSI ANGIODYN HIGH PRESSURE TUBINGS PVC 57 CEP011200PTP ANGIOGRAPHIC TUBE 1200PSI 雙層血管造影劑注入延長管 314 CEP BB 1000PSI ANGIODYN HIGH PRESSURE TUBINGS PVC 57 CEP012100DCD EXTENSION CATHETER 45CM,65CM,100CM (88/8/1 改按條給付 ) 314 CEP BS ARTERIAL PRESSURE TUBING 90CM 30.7 CEP AB ARTERIAL PRESSURE TUBING 30.7 CEP BS ARTERIAL PRESSURE TUBING 120CM 30.7 CEP BS ARTERIAL PRESSURE TUBING 150CM 30.7 CEP BS ARTERIAL PRESSURE TUBING 180CM 30.7 CEP01800PSTP ANGIOGRAPHIC TUBE 800PSI 雙層血管造影劑注入延長管 314 CEP BS ARTERIAL PRESSURE TUBING 210CM 30.7 CEP SB PRESSUREE MONITORING LINE 6":96" 30.7 CEP NL PRESSURE MONITORING LINE 6":96" 30.7 CEP NL CONTRAST INJECTION LINES (1200PSI 雙層 ) 顯影劑注射導線 314 CEP01A813ABQ 1200PSI HIGH PRESSURE CONNECTING TUBE ( 雙層 ) 314 CEP01A841ABQ 900PSI HIGH PRESSURE CONNECTING TUBE( 單層 ) 57 CEP01A851ABQ 1200PSI HIGH PRESSURE CONNECTING TUBE( 單層 ) 57 CEP01AL150SD "SEDAT"ALGAFLEX CONNECTION LINES 1200PSI(HIGH PRESSURE 314 LINE)" 西達 " 艾加非司壓力連接管 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

107 CEP01B330BBQ PRESSURE CONNECTING TUBE 500PSI 30.7 CEP01ETP01M6 PRESSURE TUBE 500PSI 30.7 CEP01ETP19M6 PRESSURE TUBE PSI 57 CEP01HP20EMR HIGH PRESSURE TUBING 20" 1200PSI( 雙層 ) 314 CEP01HP30EMR HIGH PRESSURE TUBING 30" 1200PSI( 雙層 ) 314 CEP01HP48EMR HIGH PRESSURE TUBING 48" 1200PSI( 雙層 ) 314 CEP01HP50EMR HIGH PRESSURE TUBING 500PSI( 雙層 ) 230 CEP01PT006AG "ARGON"DISPOSABLE PRESSURE MONITOR:PRESSURE TUBING" 愛琅 " 30.7 血壓監視組合套 : 壓力連接管 CEP01PT006BD ARTERIAL PRESSURE TUBING 30.7 CEP01PT012BD ARTERIAL PRESSURE TUBING 30.7 CEP01PT024BD ARTERIAL PRESSURE TUBING 30.7 CEP01PT036BD ARTERIAL PRESSURE TUBING 30.7 CEP01PT048AG "ARGON"DISPOSABLE PRESSURE MONITOR:PRESSURE TUBING" 愛琅 " 30.7 血壓監視組合套 : 壓力連接管 CEP01PT048BD ARTERIAL PRESSURE TUBING( 型號 PT84,PT12M:84M 自 89/04/01 起生 30.7 效 ) CEP01PT060BD ARTERIAL PRESSURE TUBING 30.7 CEP01PT072BD ARTERIAL PRESSURE TUBING 30.7 CEP01PT483GJ "JSM"PRESSURE TUBING " 吉生 " 壓力連接管 (500PSI PVC 每包 3 條 ) 92 CEP01PT500GJ PRESSURE TUBING 壓力連接管 (500PSI PVC) 30.7 CEP01PT500H9 PRESSURE TUBING 500PSI 壓力連接管 30.7 CEP01PT500SG ARTERIAL PRESSURE TUBING 500PSI 6":72" 30.7 CEP01PT501GJ "JSM"PRESSURE TUBING " 吉生 " 壓力連接管 (500PSI/PVC) 30.7 CEP01PTH12SG ARTERIAL PRESSURE TUBING 1200PSI 6":72" 57 CEP01PTHP1GJ "JSM"PRESSURE TUBING:HIGH PRESSURE TUBING" 吉生 " 壓力連接 314 管 (1200PSI PU 雙層 ) CEP01PTHPTGJ PRESSURE TUBING:HIGH PRESSURE TUBING 壓力連接管 (1200PSI 314 PU 雙層 ) CEP01PTHPTH9 PRESSURE TUBING 1200PSI 壓力連接管 ( 雙層 ) 314 CEP01PTPV1GJ "JSM"PRESSURE TUBING:HIGH PRESSURE TUBING 壓力連接管 57 (1000PSI/PVC) CEP01PTPVCGJ PRESSURE TUBING:HIGH PRESSURE TUBING 壓力連接管 (1000PSI 57 PVC) CEP01PTPVCH9 HIGH PRESSURE TUBING PVC 1000PSI 高壓力連接管 57 CET BB T-CONNECTOR 15CM 14 CET01B024NPW EXTENSION TUBE 6.3 CET01B032NPW EXTENSION TUBE W/T 14 CEV010KMS1TR PTMV( 經皮穿靜脈氣球導管二尖瓣成形術 )METAL TUBE 3615 CFD CU CORFLO ENTERAL FEEDING TUBE 36" 6FR;8FR;10FR( 含 STYLE) 限 450 G-I 手術後併 G-I TRACT 溢漏或吻合須 NPO 者 CFD CU CORFLO ENTERAL FEEDING TUBE 43" 8FR;10FR;12FR( 含 STYLE) 450 限 G-I 手術後併 G-I TRACT 溢漏或吻合須 NPO 者 CFD FL AG FREKA FEEDING TUBE SET 15FR. 100CM 艾極管灌餵食管袋組 450 合套 * 適應症請見備註欄 CFD01BSTPUEE ENTERAL FEEDING TUBE 8,10,12,14,16FGX125CM* 適應症請見備註 125 欄 CFD P2 ALL SILICON STOMACH TUBE* 適應症請見備註欄 86 CFD W6 SILICONE STOMACH TUBE 6FR:18FR* 適應症請見備註欄 86 CFD022020NFM ALL SILICONE STOMACH(GASTRIC)TUBE 4:20FR 適應症請見備註欄

108 CFD WN ALL SILICON LEVIN TUBE W/TAPER FUNNEL 2EYES 適應症請見備 86 註欄 CFD WN " 世運 " 矽質胃管附蓋子 "SEWOON"GASTROINTESTINAL TUBE AND 86 CATHETER(SILICONE) CFD WN ALL SILICON LEVIN TUBE W/TAPER FUNNEL 4EYES 適應症請見備 86 註欄 CFD022207NWN Silicon Levin Tube W/Taper Funnel 8:22FR 適應症請見備註 86 欄 CFD0276ST6MU ALL SILICONE STOMACH TUBE 適應症請見備註欄 86 CFD028000NCL ALL SILICONE STOMACH TUBE* 適應症請見備註欄 86 CFD SH KANGAROO ENTERNAL FEEDING TUBE 8,10,12FR 附導線 適應症 450 請見備註欄 CFD02G0101SG SILICONE GASTRIC TUBE* 適應症請見備註欄 86 CFD02GT001SG SIGMA GASTRIC TUBE(SILICON)* 適應症請見備註欄 86 CFD02GT101EW SILICONE GASTRIC DUODENAL LEVIN TUBE 適應症請見備註欄 86 CFD02GT301EW E-UP STOMACH TUBE(SILICON) 毅升一次性使用胃管 86 CFD02GT501EW E-UP GASTRIC DUODENAL LEVIN TUBE (SILICON) 08~18FR 毅升胃 86 管 CFD02ST000EF BESMED SILICONE STOMACH TUBING* 適應症請見備註欄 86 CFD04CNJFTCK COOK TIGER TUBE FRICTIONAL NASAL JEJUNAL FEEDING 4200 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 CFD05BPU08EE PU STOMACH CATHETER 聚胺酯胃管 適應症請見備註欄 115 CFD BA "BARD"DUAL PORT FEEDING ADAPTOR 經皮內視鏡胃造口組 : 雙座餵 212 食管接頭 適應症請見備註欄 CFD VZ FREKA PEG-SET GASTRIC 福胃可胃造口術胃管套組 : 餵食管接頭 212 適應症請見備註欄 CFD06BFA01CK PERCUTANEOUS ENDOSCOPIC GASTROSTOMY SYSTEM ADAPTER 餵食 212 管接頭 (TWO WAY OR ONE WAY) 適應症請見備註欄 CFD07WGS01CK "COOK"WILLS-OGLESBY PERCUTANEOUS GASTROSTOMY CATHETER( 餵 2700 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 CFE02SUPERSB BOSTON SCIENTIFIC SPEEDBAND SUPERVIEW SUPER7 MULTIPLE 4000 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 CGAP1AP212GJ " 吉生 " 心導管包 "JSM"ANGIO PACK- 基本包 ( 含穿刺針 + 導引鞘組 + 導 引線 /0.035"260CM+3PORT 多路引流器 *2+ 壓力連接管 500PSI*4+ 壓力連接管 1200PSI 雙層 ) CGAP1AP313GJ " 吉生 " 心導管包 "JSM"ANGIO PACK- 基本包 ( 含穿刺針 + 導引鞘組 + 導 引線 / 不鏽鋼 0.035"260CM+3PORT 多路引流器 *2+ 壓力連接管 500PSI*4+ 壓力連接管 1200PSI 雙層 ) CGAP1AP414GJ " 吉生 " 心導管包 "JSM"ANGIO PACK- 基本包 ( 含穿刺針 + 導引鞘組 + 導 引線 /0.035"150CM+3PORT 多路引流器 *2+ 壓力連接管 500PSI*4+ 壓力連接管 1200PSI 雙層 ) CGAP1AP515GJ " 吉生 " 心導管包 "JSM"ANGIO PACK- 基本包 ( 含穿刺針 + 導引鞘組 + 導 引線 / 不鏽鋼 0.035"150CM+3PORT 多路引流器 *2+ 壓力連接管 500PSI*4+ 壓力連接管 1200PSI 雙層 ) 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"260CM+3PORT 多路引流器 *2+ 壓力連接管 500PSI*4+ 壓力連接管 1200PSI 雙層 )

109 CGAP1AP721GJ " 吉生 " 心導管包 "JSM"ANGIO PACK- 基本包無導引鞘組 ( 穿刺針 + 導 引線 / 不鏽鋼 0.035"260CM+3PORT 多路引流器 *2+ 壓力連接管 500PSI*4+ 壓力連接管 1200PSI 雙層 ) CGAP1AP822GJ " 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"150CM+3PORT 多路引流器 *2+ 壓力連接管 500PSI*4+ 壓力連接管 1200PSI 雙層 ) CGAP1AP923GJ " 吉生 " 心導管包 "JSM"ANGIO PACK- 基本包無導引鞘組 ( 穿刺針 + 導 引線 / 不鏽鋼 0.035"150CM+3PORT 多路引流器 *2+ 壓力連接管 500PSI*4+ 壓力連接管 1200PSI 雙層 ) CGAP1APMAXGJ " 吉生 " 心導管包 "JSM"ANGIO PACK- 最大包 ( 含穿刺針 *2+ 導引鞘組 導引線 /0.035"260CM+4PORT 多路引流器 *2+ 壓力連接管 500PSI*4+ 壓力連接管 1200PSI 雙層 ) CGAP1HY100H9 HYM ANGIO PACK 心導管包 (GWX1+SHEATHX1+ARTERIAL 2413 NEEDLEX1+MANIFOLDX2+PRESSURE TUBINGX4+HIGHT PRESSURE TUBINGX1) CGAP1HY211H9 HYM ANGIO PACK " 華億 " 心導管包 (ARTERIAL 880 NEEDLEX1+MANIFOLDX1+PRESSURE TUBINGX2+HIGH PRESSURE TUBINGX1) CGBK1AFGV4LY " 奧林柏斯 " 單次用取石網 "OLYMPUS"SINGLE USE GRASPING FORCEPS CGBK1FSLX1CK "COOK"EXTRACTION BASKETS" 曲克 " 取石網 CGBK1MB501CK "COOK"EXTRACTION BASKETS" 曲克 " 取石網 CGBK1MSB01CK "COOK"EXTRACTION BASKETS" 曲克 " 取石網 CGBK1TRWRBSB "BOSTON SCIENTIFIC"TRAPEZOID RX WIREGUIDED RETRIEVAL BASKET" 波士頓科技 " 快速交換取石籃 CGDW10117NAN STAINLESS GUIDE WIRE 0.025~0.045" 40~100CM 140 CGDW101228CD MINI GUIDE WIRE 140 CGDW104435AR "ARROW"SPRING GUIDE WIRE 0.035" 60CM" 亞諾 導引線 140 CGDW10PNGWMW GUIDE WIRE 140 CGDW114735AR "ARROW SPRING WIRE GUIDE X 68CM 亞諾 導引線 140 CGDW116402AR "ARROW" SPRING GUIDE WIRE 0.018" 68CM (DUOFKEX)" 亞諾 導 140 引線 CGDW135206AG SPRING GUIDE WIRE 0.025",0.035",0.038" 40:65CM FIXED CORE 140 STRAIGHT CGDW135415AG SPRING GUIDE WIRE 0.025",0.032",0.035",0.038" 50,65CM 140 FIXED CORE,3MMJ STRAIGHT CGDW135451AG SPRING GUIDE WIRE 0.018",0.021" 25:80CM FIXED CORE 140 STRAIGHT CGDW135454AG SPRING GUIDE WIRE 0.018",0.021",0.025" 40,50CM FIXED 140 CORE,3MMJ CGDW135711AG GUIDE WIRE 75CM 140 CGDW135730AG SPRING GUIDE WIRE 0.018",0.021",0.025",50CM FIXED 140 CORE,6MMJ STRAIGHT CGDW135798AG SPRING GUIDE WIRE 0.035",0.038" 70,80CM FIXED CORE,3MMJ 140 CGDW135968AG SPRING GUIDE WIRE 0.028",0.032",0.035" 40,50CM FIXED 140 CORE,3MMJ CGDW135989AG GUIDE WIRE 0.028" 50CM 140 CGDW C " 柯惠 " 肯特利慢性血液透析導管 "COVIDIEN"KENDALL CHRONIC 140 HEMODIALYSIS CATHETERS-GUIDE WIRE 0.035" 0.038" 70CM CGDW196001KD J/STRAIGHT STAINLESS STEEL GUIDE WIRE 0.035" 0.038" 70CM

110 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 CGDW1BA340BQ " 邦特 " 血管內引導鋼線 "BIOTEQ"GUIDEWIRE 0.018~0.045" 40~100CM 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 CGDW1GW001G6 'AGA' AMPLATZER GUIDE WIRE (PDA OCCLUDER 用 ) 適應症請見 1600 備註欄 CGDW1MSU70MW GUIDE WIRE 股靜脈 鎖骨下靜脈導管 140 CGDW1SUPERG6 'AGA' AMPLATZER GUIDE WIRE (ASD OCCLUDER 用 ) 適應症請見 1600 備註欄 CGPG11001NAC VIKING CORONARY GUIDING CATHETER 6:10FR 自 改按條支 1744 付 CGPG11006NAC VIKING CORONARY GUIDING CATHETER* 自 改按條支付 1744 CGPG110264SB MACH 1 PERIPHERAL GUIDING CATHETER 6:8F 55,90CM 1744 CGPG134356SB MACH 1 GUIDE CATHETER 5:8FR 100CM ( 型號 H :6970) 自 改按條支付 CGPG138969SB RUNWAY GUIDE CATHETER 6FR 1744 CGPG1416TBRB LUMINA GUIDING CATHETER 1744 CGPG1417TBRB LUMINA GUIDING CATHETER 1744 CGPG1418TBRB LUMINA GUIDING CATHETER 1744 CGPG1419TBRB LUMINA GUIDING CATHETER 1744 CGPG151038ZF QUICK-CROSS SUPPORT2 CATHETERS ( 含 3 個探頭 )0.014" 135CM MM 0.018" 90CM 0.035"150CM 65MM 3FR 3.4FR 4.8FR CGPG15565FCD VISTABRITETIP GUIDING CATHETERS 5F 0.056(ALL CURVE STYLE) 1744 * 自 改按條支付 CGPG1564XNCD VISTABRITETIP GUIDING CATHETER 6FR 0.064" 自 改按條 1744 支付 CGPG1574XNCD VISTABRITETIP GUIDING CATHETER 7FR 0.074",0.078" 自 改按條支付 CGPG1586XNCD "CORDIS"VISTABRITETIP GUIDING CATHETER 8FR 0.086",0.088"" 1744 考迪斯 " 導引導管 自 改按條支付 CGPG158882CD VISTA BRITE TIP GUIDING CATHETER 8FR * 自 改按 1744 條支付 ( 型號 :2 自 92/7/1 生效 ) CGPG15888FCD PERIPHERAL GUIDING CATHETER 8FR 自 改按條支付 1744 CGPG159892CD VISTA BRITE TIP GUIDING CATHETER 9FR * 自 改按 1744 條支付 ( 型號 :2 自 92/7/1 生效 ) CGPG15989FCD PERIPHERAL GUIDING CATHETER 9FR 自 改按條支付 1744 CGPG16206NCD ENVOY GUIDING CATHETER 6FR 0.062" 90CM,100CM 自 改 1744 按條支付 CGPG16676FCD VISTABRITEIP GUIDING CATHETER 6FR 0.67(ALL CURVE STYLE) 1744 自 改按條支付 CGPG16706FCD VISTA BRITE TIP GUIDING CATHETER 6FR 0.70 ( 自 92/7/1 改按 1744 條支付 ) CGPG17787FCD VISTABRITETIP GUIDING CATHETERS 7F 0.078(ALL CURVE STYLE) 1744 * 自 改按條支付 CGPG1AB035BQ GUIDING CATHETER 1744 CGPG1AB131BQ GUIDING CATHETER 1744 CGPG1AB234BQ GUIDING CATHETER 1744 CGPG1CA031BQ GUIDING CATHETER

111 CGPG1CA131BQ GUIDING CATHETER 1744 CGPG1CA214BQ GUIDING CATHETER 1744 CGPG1CAS31BQ GUIDING CATHETER 1744 CGPG1CGC58MR "MERIT" CONCIERGE GUIDING CATHETER(5~8F)" 美瑞特 " 康捷導引 1744 導管 CGPG1CNCRGMR "MERIT" CONCIERGE GUIDING CATHETER(5~8F)" 美瑞特 " 康捷導引 1744 導管 CGPG1CX101CK CXI SUPPORT CATHETER( 含 4 個不透線標記 ) 西斯艾支持導管 8715 CGPG1CX102CK CXI SUPPORT CATHETER( 含 4 個不透射線標記 ) 西斯艾支持導管 8715 CGPG1CXC01CK "COOK" CROSSCATH SUPPORT CATHETER ( 單腔含 3 個探 8715 頭 )3.0~4.8FR 90~150CM" 曲克 " 庫斯凱支持導管 CGPG1EGA8NCY GUIDING CATHETER 8FR 100CM TYPE:JR,JL,AR,AL,HS,SC 自 改按條支付 CGPG1GCF60TM HEARTRAIL PTCA GUIDING CATHETER 5:8FR 100CM 哈得睿兒導引 1744 導管 CGPG1GCF70TM HEARTRAIL PTCA GUIDING CATHETER 5:8FR 100CM 哈得睿兒導引 1744 導管 CGPG1GCF90TM HEARTRAIL II PTCA GUIDING CATHETER 哈得睿兒導引導管第二代 1744 CGPG1GCH60TM HEARTRAIL PTCA GUIDING CATHETER STANDARD TYPE 5:8FR 1744 CGPG1JLJRAAS "ASAHI" ZENYTEEX PTCA GUIDING CATHETER " 朝日 " 辛尼堤經皮冠 1744 狀動脈成型術導引導管 CGPG1KMF4AKE CRUSADE CORONARY ANGIOPLASTY CATHETER 2 LUMEN 140CM FR( 冠狀動脈成型術探測導管 ) CGPG1LA006M4 LAUNCHER GUIDE CATHETER 6FR 1744 CGPG1LA501M4 LAUNCHER GUIDE CATHETER 5FR 1744 CGPG1LA502M4 LAUNCHER GUIDE CATHETER 5FR 1744 CGPG1LA701M4 LAUNCHER GUIDE CATHETER 7FR 1744 CGPG1LA702M4 LAUNCHER GUIDE CATHETER 7FR 1744 CGPG1LA801M4 LAUNCHER GUIDE CATHETER 8FR 1744 CGPG1LA802M4 LAUNCHER GUIDE CATHETER 8FR 1744 CGPG1MSC57VS MINNIE SUPPORT CATHETER( 含 3 個探頭 ) 8715 CGPG1PBSMPAS "ASAHI" ZENYTEEX PTCA GUIDING CATHETER " 朝日 " 辛尼堤經皮冠 1744 狀動脈成型術導引導管 CGPG1SCBR1CK SLIP-CATH GUIDING CATHETERS 4.0FR 40:150CM 1744 CGPG1SCBR2CK SLIP-CATH GUIDING CATHETERS 4.5:6.5FR 75:135CM 1744 CGPG1SCBR3CK SLIP-CATH GUIDING CATHETERS 5.0FR 40:125CM 1744 CGPG1SCBR4CK SLIP-CATH GUIDING CATHETERS 5.0FR 65:90CM 1744 CGPG1SELE2M4 " 美敦力 " 艾坦賽勒傳送導管系統 "MEDTRONIC"ATTAIN SELECT II 1744 DELIVERY CATHETER SYSTEM CGPG1SHA01M4 SHERPA NX ACTIVE GUIDE CATHETERS 5:6F 1744 CGPG1SHA02M4 SHERPA NX ACTIVE GUIDE CATHETERS 5:6F 1744 CGPG1SHA03M4 SHERPA NX ACTIVE GUIDE CATHETERS 5:6F 1744 CGPG1SHB01M4 SHERPA NX BALANCED GUIDE CATHETERS 6:8F 1744 CGPG1SHB02M4 SHERPA NX BALANCED GUIDE CATHETERS 6:8F 1744 CGPG1SHB03M4 SHERPA NX BALANCED GUIDE CATHETERS 6:8F 1744 CGPG1SW510VS SKYWAY SUPPORT CATHETER 0.014" 138CM( 多功能 ) 8715 CGPG1Z2007M4 Z2 CORONARY GUIDING CATHETER 7FR,8FR 自 改按條支付 1744 CGPG1Z27PUM4 Z2 GUIDING CATHETER 1744 CGPG1Z28PUM4 Z2 GUIDING CATHETER 1744 CGPG2CFLNRVS VASCULAR SOLUTIONS GUIDELINER CATHETER " 法斯樂舒順 " 冠連導管 適應症請見備註欄

112 CGPG338942SB "BOSTON SCIENTIFIC"ATLANTIS SR CORONARY IMAGING CATHETER W/SLED" 波士頓 " 亞蘭提斯冠狀動脈攝影導管 - 血管內超音波導管及橇型板 適應症請見備註欄 CGS VE PERCUTANEOUS CATHETER INTRODUCERS W/DILATOR,GUIDEWIRE CM 5:9FR CGS VE PERCUTANEOUS CATHETER INTRODUCERS W/DILATOR 23CM 6:9FR 887 CGS010037AVE PERCUTANEOUS CATHETER INTRODUCERS 23CM(6F:9F), WITH 977 DILATOR,GUIDE WIRE CGS K0 ANGIOGATE HV INTRODUCER KIT 12CM (S+D+GW+3WAY+SI) 583 CGS AR HI-FLOW TRUAMA SET 700 CGS ST " 聖猷達 " 剝式導管導引器 "SJM"PEEL-AWAY INTRODUCER 14CM 864 5:16FR(S+D+SY+N+G.W) CGS010511MCD " 考迪斯 " 皮膜鞘導引器 "CORDIS"BRITE TIP INTERVENTIONAL 820 SHEATH 5.5; 11CM(DILATOR+SIDEARM+VALVE+GUIDEWIRE+3WAY+RADIOPAQUE BRITETIP) CGS010512TK0 ANGIOGATE TRANSRADIAL INTRODUCER KIT 12CM 715 (S+D+N+GW+3WAY+SI) CGS ST " 聖猷達 " 剝式導管導引器 "SJM" PEEL-AWAY INTRODUCER 864 CGS010519TK0 ANGIOGATE TRANSRADIAL INTRODUCER KIT 19CM,24CM 1067 (S+D+N+GW+3WAY+SI) CGS ST " 聖猷達 " 剝式導管導引器 "SJM"PEEL-AWAY INTRODUCER 23CM 864 9:14FR(S+D+G.W) CGS ST " 聖猷達 " 剝式導管導引器 "SJM"PEEL-AWAY INTRODUCER 6CM 864 4:6FR(SHEATH+NEEDLE) CGS ST " 聖猷達 " 剝式導管導引器 "SJM"PEEL-AWAY INTRODUCER 14CM 864 5:16FR(SHEATH+DILATOR) CGS010601NBA "BARD"PTFE PEEL-APART PERCUTANEOUS INTRODUCER KITS" 巴德 " 864 剝撕式經皮導引套組 CGS010610NST " 聖猷達 " 費思凱斯導管導引器 "SJM"FAST-CATH HEMOSTASIS 875 INTRODUCER 12CM(S+D+SV+GW+SY+N+ 保護套 ) CGS ST " 聖猷達 " 麥克斯導管導引器 "SJM"MAXIMUM HEMOSTASIS 583 INTRODUCER 12CM 4:9FR 0.025:0.038"(W/S+D+V+G.W+SI) CGS ST " 聖猷達 " 麥克斯導管導引器 "SJM"MAXIMUM HEMOSTASIS 583 INTRODUCER 8.5CM 4:7FR 0.021:0.025"(W/SHEATH+DILATOR+VALVE+G.W+SIDEPORT) CGS ST " 聖猷達 " 麥克斯導管導引器 "SJM"MAXIMUM HEMOSTASIS 583 INTRODUCER 5CM 4:6FR 0.021"(W/SHEATH+DILATOR+VALVE+G.W+SIDEPORT) CGS010658NBA "BARD"PTFE PEEL-APART PERCUTANEOUS INTRODUCER 864 KITS"(MICROINTRODUCER) 巴德 " 剝撕式經皮導引套組 CGS ST " 聖猷達 " 麥克斯導管導引器 "SJM"MAXIMUM HEMOSTASIS 1067 INTRODUCER 23CM 5:8FR 0.038"(W/S+D+G.W+SI+V+N) CGS ST " 聖猷達 " 麥克斯導管導引器 "SJM"MAXIMUM HEMOSTASIS 715 INTRODUCER 12CM CGS ST " 聖猷達 " 麥克斯導管導引器 "SJM"MAXIMUM HEMOSTASIS 1067 INTRODUCER 23CM CGS010674NST " 聖猷達 " 費思凱斯導管導引器 "SJM"FAST-CATH HEMOSTASIS 1400 INTRODUCERS 45CM 30 度 (S+D+SV+3WAY) CGS ST " 聖猷達 " 剝式導管導引器 "SJM"PEEL-AWAY INTRODUCER 14CM 7:12FR(S+D+SY+N+G.W+V)

113 CGS ST CGS010768NST CGS ST CGS ST CGS ST CGS ST CGS ST CGS AR CGS AR " 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) " 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) " 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) " 聖猷達 " 雅帝明導管導引器 "SJM"ULTIMUM INTRODUCER SET (S+H+V+G+SIDEPORT) " 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) " 聖猷達 " 雅帝明導管導引器 "SJM"ULTIMUM INTRODUCER SETW/HEMOSTASIS VALVE 12CM (S+H+V+G+SIDEPORT) " 聖猷達 " 雅帝明導管導引器 "SJM"ULTIMUM INTRODUCER SET W/HEMOSTASIS VALVE 23CM (S+H+V+G+SIDEPORT) "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM 4FR X 7.5CM (S+D+GW+SV+3WAY+N) 亞諾 經皮導引鞘組 "ARROW"PERCUTANEOUS SHEATH WITH SPRING WIRE GUIDE( S+D+G+SV+3 WAY)4:6FR 7.5CM;5:9FR 11CM" 亞諾 " 經皮導引鞘組 CGS VE MULLINS TRANSSEPTAL INTRODUCER SET PRDIATRIC 44CM 6:8FR 1400 CGS VE MULLINS TRANSSEPTAL INTRODUCER SET AUDLT 59CM 6:8FR 1400 CGS AR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SET 7:8FR CM(S+D+SV+GW+N+SY+3WAY)" 亞諾 " 經皮導引鞘組 CGS AR PERCUTANEOUS INTRODUCER SYSTEM KIT 6FR 11CM 875 CGS AR PERCUTANEOUS INTRODUCER SYSTEM KIT 715 8FR(SHE+DIL+SIDEPORT+G.W+NE+ 一般空針 ) CGS AR PERCUTANEOUS INTRODUCER SYSTEM KIT 8FR 11CM 875 CGS AR PERCUTANEOUS SHEATH INTRODUCER SET 8.5FR 875 CGS011101AVE PERCUTANEOUS CATHETER INTRODUCERS 11CM(5F:9F),WITH 583 DILATOR, GUIDE WIRE CGS ED INTRO-FLEX PERCUTANEOUS SHEATH INTRODUCER SET 10CM(S+SV WAY+D+GW+N+ 保護套 ) CGS011389HED INTRO-FLEX PERCUTANEOUS SHEATH INTRODUCER SET 10CM 875 W/COATING(S+SV+4 WAY+D+GW+N+ 保護套 ) CGS C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE 864 IMPLANTABLE DRUG DELIVERY SYSTEM-9 FR PEEL-AWAY SHEATH INTRODUCER KIT CGS US CHEMOSITE 9 FR PEEL-AWAY SHEATH INTRODUCER KIT 864 CGS C " 柯惠 " 植入型注射系統 "COVIDIEN"AUTO SUTURE CHEMOSITE 864 IMPLANTABLE DRUG DELIVERY SYSTEM -7 FR PEEL-AWAY SHEATH INTRODUCER KIT CGS US CHEMOSITE 7 FR PEEL-AWAY SHEATH INTRODUCER KIT 864 CGS ST FAST-CATH HEMOSTASIS INTRODUCER 費思凱絲止血導管導引器 583 CGS012335MCD " 考迪斯 " 皮膜鞘導引器 "CORDIS"BRITE TIP INTERVENTIONAL 887 SHEATH 23;35CM(DILATOR+SIDEARM+VALVE+3WAY+RADIOPAQUE BRITETIP) CGS ED INTRO-FLEX PERCUTANEOUS SHEATH INTRODUCER SET 8.5FR 10CM(S+D+SI+V+GW+N+ 保護套 +SY)

114 CGS ED INTRO-FLEX PERCUTANEOUS SHEATH INTRODUCER SET AMC COATED FR 10CM(S+D+SI+V+GW+N+ 保護套 ) CGS BB INTRODUCER KIT,7F,9F,11F * 適應症請見備註欄 864 CGS BK " 拜耳德尼克 " 思考導線引入裝置系統 "BIOTRONIK"SCOUTPRO 6528 CORONARY SINUS LEAD DELIVERY SYSTEM* 適應症請見備註欄 CGS AG P.T.C.A LONG SHEATH 23CM 887 CGS01402ANCD AVANTI PLUS SHEATH INTRODUCER 11CM(4:11FR WITHOUT 470 GUIDEWIRE) CGS01402RNCD AVANTI PLUS SHEATH INTRODUCER 5CM(4:8FR WITHOUT 470 GUIDEWIRE) CGS014065NST " 聖猷達 " 麥克斯導管導引器 "SJM" MAXIMUM HEMOSTASIS 835 INTRODUCER CGS ST ULTIMUM INTRODUCER WITH HEMOSTASIS VALVE) SHEATH; 583 DILATOR;HEMOSTASIS VALVE;GUIDEWIRE; SIDEPORT ( 3WAY) 12CM 0.035" CGS ST ULTIMUM INTRODUCER WITH HEMOSTASIS VALVE) SHEATH; 977 DILATOR;HEMOSTASIS VALVE;GUIDEWIRE; SIDEPORT ( 3WAY) 23CM 0.035" CGS014076NST ULTIMUM INTRODUCER WITH HEMOSTASIS VALVE) SHEATH; 583 DILATOR;HEMOSTASIS VALVE;GUIDEWIRE; SIDEPORT ( 3WAY) 5CM 0.035" CGS C " 柯惠 " 肯特利慢性血液透析導管 "COVIDIEN"KENDALL CHRONIC 864 HEMODIALYSIS CATHETERS-PULL-APART INTRODUCER SET(10,12,14,16FR)(C+D+GW+N+SY) CGS KD QUINTON PULL-APART INTRODUCER SET(7,10,12,14,16FR)( 含 864 C+D+GW+N+SY) CGS C " 柯惠 " 肯特利慢性血液透析導管 "COVIDIEN"KENDALL CHRONIC 864 HEMODIALYSIS CATHETERS-OVAL PULL-APART INTRODUCER SET(PEEL-AWAY)(SH+DIL+GW+SYR+NE) CGS KD OVAL PULL-APART INTRODUCER SET(PEEL- 864 AWAY)(SH+DIL+GW+SYR+NE) CGS014555MCD " 考迪斯 " 皮膜鞘導引器 "CORDIS"BRITE TIP INTERVENTIONAL 1400 SHEATH 45;55CM(DILATOR+SIDEARM+VALVE+3WAY+RADIOPAQUE BRITETIP) CGS AG SHEATH INTRODUCER 5:9FR 583 CGS AG PEDIATRIC INTRODUCER KIT(SHEATH+DILATOR+GUIDE WIRE) 583 CGS AG SHEATH INTRODUCER 583 CGS AG ONE PIECE TUOHY-BORST INTRODUCER 5:9FR(INTRODUCER+GUIDE 583 WIRE+DILATOR) CGS AG INTRODUCER KIT 583 CGS AG SHEATH INTRODUCER 7FR 583 CGS AG SHEATH INTRODUCER 8FR 583 CGS AG INTRODUCER KIT(SHEATH,DILATOR,SIDE PORT,3 WAY,GUIDE WIRE) 583 CGS CD CGS CD CGS01504PNCD CGS01504TNCD AVANTI PLUS CATHETER SHEATH INTRODUCER TRANSRADIAL KIT 11CM AVANTI PLUS CATHETER SHEATH INTRODUCER TRANSRADIAL KIT 23CM AVANTI PLUS SHEATH INTRODUCER 5CM(4:8FR WITH GUIDEWIRE,DILATOR) AVANTI PLUS SHEATH INTRODUCER 23CM(4:11FR WITHOUT GUIDEWIRE)

115 CGS01504XNCD AVANTI PLUS SHEATH INTRODUCER 11CM(4:11FR WITH 583 GUIDEWIRE,DILATOR) CGS0158F38MR " 美瑞特 " 動脈導引鞘 "MERIT"PRELUDE SHEATH INTRODUCER 583 CGS016014NDV HICKMAN INTRODUCER 864 CGS016031NBA INTRO-EZE PERCUTANEOUS INTRODUCER KIT 5:15FR :16CM(SH+DI+GW+SY+N) CGS016207DM4 DUAL CHAMBER PERCUTANEOUS LEAD INTRODUCER CM(2SH+2D+2GW+N+SY) CGS016207NM4 PERCUTANEOUS LEAD INTRODUCER 60CM(SH+D+GW+N+SY) 864 CGS016207SM4 PERCUTANEOUS LEAD INTRODUCER 60CM(SH+D+GW+N+SY) 864 CGS0162BTKM4 PERCUTANEOUS LEAD INTRODUCER 60CM(SH+D+GW+N+SY) 864 CGS GQ " 葛貝可 " 可剝式導入管工具組 "GREATBATCH" PTFE PEELABLE 864 INTRODUCER KIT(S+D+SY+N+G.W) CGS016890MCD " 考迪斯 " 皮膜鞘導引器 "CORDIS"BRITE TIP INTERVENTIONAL 2850 SHEATH 90CM(DILATOR+SIDEARM+VALVE+3WAY+RADIOPAQUE BRITETIP) CGS M0 "MEDCOMP"CENTRAL VENOUS CATHETERS AND 864 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 ) CGS01A1MDSST "SJM" CPS AIM SL SLITTABLE INNER CATHETER(CATHETER+SIDE 1810 PORT+TOOL)" 聖猷達 " 縱裂式內導管 CGS01A1MWSST "SJM" CPS AIM SL SLITTABLE INNER CATHETER( 1810 CATHETER+TOOL)" 聖猷達 " 縱裂式內導管 CGS01A40GNTM RADIOFOCUS INTRODUCER II 16CM 4:6FR WITH 0.025" GUIDE 1262 WIRE CGS01A40K1TM RADIFOCUS INTRODUCER II 4FR CM(W/SHEATH,DILATOR,GUIDEWIRE,NEEDLE) CGS01A40K2TM RADIFOCUS INTRODUCER II 4:11FR CM(W/SHEATH,DILATOR,GUIDEWIRE,NEEDLE) CGS01AL191TM " 泰爾茂 " 攝影引導管 "TERUMO" RADIFOCUS INTRODUCER II FR,16;25CM 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 835 II(WITH NEEDLE/SYRINGE) CGS01AS073TM " 泰爾茂 " 血管攝影引導管 "TERUMO" RADIFOCUS INTRODUCER II FR 7CM,10CM CGS01AS091TM " 泰爾茂 " 攝影引導管 "TERUMO" RADIFOCUS INTRODUCER II FR,5-10CM CGS01ATTANM4 美敦力 安坦左心室傳送系統 MEDTRONIC IRELAND ATTAIN 6528 LEFT-HEART DELIVERY SYSTEM* 適應症請見備註欄 CGS01ATTCSM4 " 美敦力 " 艾坦左心室傳送系統 "MEDTRONIC" ATTAIN COMMAND LEFT 6528 HEART DELIVERY SYSTEM * 適應症請見備註欄 CGS01AVK11TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR MM)" 泰爾茂 " 835 血管攝影引導套 ( 鞘 + 擴張器 + 導線 + 針筒 + 導入針 SIDEARM W/VALVE) CGS01AVK12TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR MM)" 泰爾茂 " 835 血管攝影引導套 ( 鞘 + 擴張器 + 導線 + 針筒 + 導入針 SIDEARM W/VALVE) CGS01AVK13TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR MM)" 泰爾茂 " 血管攝影引導套 ( 鞘 + 擴張器 + 導線 + 針筒 + 導入針 SIDEARM W/VALVE)

116 CGS01AVK14TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR MM)" 泰爾茂 " 835 血管攝影引導套 ( 鞘 + 擴張器 + 導線 + 針筒 + 導入針 SIDEARM W/VALVE) CGS01AVK21TM "TERUMO"RADIFOCUS INTRODUCER II(4-10FR MM)" 泰爾茂 " 1262 血管攝影引導套 ( 鞘 + 擴張器 + 導線 + 針筒 + 導入針 SIDEARM W/VALVE) CGS01AVK22TM "TERUMO"RADIFOCUS INTRODUCER II(4-10FR MM)" 泰爾茂 " 1262 血管攝影引導套 ( 鞘 + 擴張器 + 導線 + 針筒 + 導入針 SIDEARM W/VALVE) CGS01B11MQTM RADIFOCUS INTRODUCER II 11FR 0.035"(GW+SH+SD) 不含 NEEDLE 820 CGS01B40G7TM RADIFOCUS INTRODUCER II 7CM 4:5FR 835 CGS01B50N1TM RADIFOCUS INTRODUCER II AND WIRE 10CM 5:11FR 835 CGS01B50N2TM RADIFOCUS INTRODUCER II 25CM 5:11FR AND WIRE 1098 CGS01BL073TM " 泰爾茂 " 血管攝影引導管 "TERUMO" RADIFOCUS INTRODUCER II FR 7CM,10CM CGS01BL191TM " 泰爾茂 " 攝影引導管 "TERUMO" RADIFOCUS INTRODUCER II FR,25,40CM CGS01BL192TM " 泰爾茂 " 攝影引導管 "TERUMO" RADIFOCUS INTRODUCER II FR,16,25CM CGS01BS073TM " 泰爾茂 " 血管攝影引導管 "TERUMO" RADIFOCUS INTRODUCER II FR 25CM,40CM CGS01BS091TM " 泰爾茂 " 攝影引導管 "TERUMO" RADIFOCUS INTRODUCER II FR,7;10CM CGS01BS092TM " 泰爾茂 " 攝影引導管 "TERUMO" RADIFOCUS INTRODUCER II FR,7;10CM CGS01BVK11TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR MM)" 泰爾茂 " 820 血管攝影引導套 ( 鞘 + 擴張器 + 導線 SIDEARM W/VALVE) CGS01BVK12TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR MM)" 泰爾茂 " 820 血管攝影引導套 ( 鞘 + 擴張器 + 導線 SIDEARM W/VALVE) CGS01BVK13TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR MM)" 泰爾茂 " 820 血管攝影引導套 ( 鞘 + 擴張器 + 導線 SIDEARM W/VALVE) CGS01BVK14TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR MM)" 泰爾茂 " 820 血管攝影引導套 ( 鞘 + 擴張器 + 導線 SIDEARM W/VALVE) CGS01BVK21TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR MM)" 泰爾茂 " 1098 血管攝影引導套 ( 鞘 + 擴張器 + 導線 SIDEARM W/VALVE) CGS01BVK22TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR MM)" 泰爾茂 " 1098 血管攝影引導套 ( 鞘 + 擴張器 + 導線 SIDEARM W/VALVE) CGS01BVK23TM "TERUMO"RADIFOCUS INTRODUCER II(4-11FR MM)" 泰爾茂 " 1098 血管攝影引導套 ( 鞘 + 擴張器 + 導線 SIDEARM W/VALVE) CGS01BVK31TM "TERUMO"RADIFOCUS INTRODUCER II(7FR 450MM)" 泰爾茂 " 血管攝 1400 影引導套 ( 鞘 + 擴張器 + 導線 SIDEARM W/VALVE) CGS01C407NST ULTIMUM INTRODUCER WITH HEMOSTASIS VALVE(SHEATH; 835 DILATOR;HEMOSTASIS VALVE;GUIDEWIRE;NEEDLE)12CM TRANSRADIAL KITS CGS01C4852ST "SJM"ENGAGE ENGAGE TR INTRODUCER (FEMORAL)25CM "0.038"(SH+DIL+VALVE+GUIDE WIRE+SIDEPORT 3WAY)" 聖猷達 " 茵給桔導管導引器 CGS01C485NST "SJM"ENGAGE ENGAGE TR INTRODUCER (FEMORAL)12CM 0.035"0.038"(SH+DIL+VALVE+GUIDE WIRE+SIDEPORT 3WAY)" 聖猷達 " 茵給桔導管導引器

117 CGS01CL724AR CGS01CL735AR CGS01CL745AR CGS01CL765AR CGS01CL775AR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM (SUPER ARROW-FLEX NON-KINKING)5:10FR 24CM 亞諾 經皮導引鞘組 ( 可彎折式 ) "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM (SUPER FLEX)35CM(S+D+SV+3 AWY) 亞諾 經皮導引鞘組 ( 可彎折式 ) "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM (SUPER ARROW-FLEX NON-KINKING)5:8FR,10FR 45CM 亞諾 經皮導引鞘組 ( 可彎折式 ) "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM (SUPER ARROW-FLEX NON-KINKING) 6,7,9,10FR 65CM 亞諾 經皮導引鞘組 ( 可彎折式 ) "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM(SUPER FLEX) 65:100CM(S+D+SV+3 AWY) 亞諾 經皮導引鞘組 ( 可彎折式 ) CGS01CP711AR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM(SUPER ARROW FLEX NON-KINKING)5:10FR 11CM 亞諾 經皮導引鞘組 ( 可彎折式 ) CGS01CPSAMST " 聖猷達 " 內導管 "SJM" CPS AIM INNER CATHETER 1810 CGS01CPSDSST "SJM"CPS DIRECT SL II SLITTABLE OUTER GUIDE CATHETER " 聖 6528 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 CGS01CPSPLST 縱裂式外導引導管 CPS DIRECT PL PEELABLE OUTER CATHETER( 導 6528 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 CGS01CPSSLST 縱裂式外導引導管 CPS DIRECT SL OUTER CATHETER( 導管 + 擴張器 + 止血閥接合器 ( 含導引絲 )+ 止血閥旁縱裂器 ) 適應症請見備註欄 6528 CGS01CS11NYZ SUPERSHEATH INTRODUCER SET 11CM(SH+DI+GW+N+SI+V) 715 CGS01CS25NYZ SUPERSHEATH INTRODUCER SET 25CM(SH+DI+GW+N+SI+V) 1067 CGS01CW08NAR "ARROW"PERCUTANEOUS SHEATH INTRODUCER SYSTEM 790 5,7,9FRX7.5,11CM (S+D+SV+W+N+SY+3 WAY) 亞諾 經皮導引鞘組 CGS01DUH25SB SUPER SHEATH INTRODUCER SHEATH 25CM 5-9FR 0.035",0.038" 977 (SHEATH+DILATOR+SIDEARM+VALVE,GUIDEWIRE) 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 CGS01EX124BD CGS01EX132AG CGS01EX132BD CGS01EX134AG CGS01EX134BD CGS01MPCN4M0 CGS01N6100ST CGS01N6123ST PERCUTANEOUS SHEATH INTRODUCER KIT 6:9FR(W/DILATOR,GUIDE WIRE,NEEDLE, 保護套 ) " 愛琅 " 前引導組 "ARGON"PERCUTANEOUS SHEATH INTRODUCER KIT- LINK KITS 6:9FR(W/DILATOR,GUIDE WIRE,NEEDLE) PERCUTANEOUS SHEATH INTRODUCER KIT 6:9FR(W/DILATOR,GUIDE WIRE,NEEDLE) " 愛琅 " 前引導組 "ARGON"PERCUTANEOUS SHEATH INTRODUCER KIT- POPULAR KITS 6:9FR(W/DILATOR,GUIDE WIRE,NEEDLE) PERCUTANEOUS SHEATH INTRODUCER KIT 6:9FR(W/DILATOR,GUIDE WIRE,NEEDLE) " 美德康 " 微穿刺引導器組 "MEDCOMP" MICRO-STICK INTRODUCER SET " 聖猷達 " 費思凱絲導管導引器 "SJM" FAST-CATH HEMOSTASIS INTRODUCERS WITH HEMOSTASIS VALVE 12CM SHEATH " 聖猷達 " 費思凱絲導管導引器 "SJM" FAST-CATH HEMOSTASIS INTRODUCERS WITH HEMOSTASIS VALVE 12CM SHEATH

118 CGS01N6138ST " 聖猷達 " 費思凱絲導管導引器 "SJM" FAST-CATH HEMOSTASIS 977 INTRODUCERS WITH HEMOSTASIS VALVE 23CM SHEATH CGS01N6151ST " 聖猷達 " 費思凱絲導管導引器 "SJM" FAST-CATH HEMOSTASIS 583 INTRODUCERS WITH HEMOSTASIS VALVE 12CM SHEATH CGS01N6159ST " 聖猷達 " 費思凱絲導管導引器 "SJM" FAST-CATH HEMOSTASIS 583 INTRODUCERS WITH HEMOSTASIS VALVE 5CM SHEATH CGS01N6160ST " 聖猷達 " 費思凱絲導管導引器 "SJM" FAST-CATH HEMOSTASIS 583 INTRODUCERS WITH HEMOSTASIS VALVE 5CM SHEATH CGS01N6560ST " 聖猷達 " 費思凱絲導管導引器 "SJM" FAST-CATH HEMOSTASIS 2850 INTRODUCERS WITH HEMOSTASIS VALVE 70CM SHEATH CGS01N6656ST " 聖猷達 " 麥克斯導管導引器 "SJM" MAXIMUM HEMOSTASIS 1262 INTRODUCER CGS01N6700ST " 聖猷達 " 費思凱絲導管導引器 "SJM" FAST-CATH HEMOSTASIS 583 INTRODUCERS WITH HEMOSTASIS VALVE 12CM SHEATH CGS01N6773ST " 聖猷達 " 費思凱絲導管導引器 "SJM" FAST-CATH HEMOSTASIS 2850 INTRODUCERS WITH HEMOSTASIS VALVE 98CM SHEATH CGS01N6784ST " 聖猷達 " 費思凱絲導管導引器 "SJM" FAST-CATH HEMOSTASIS 1400 INTRODUCERS WITH HEMOSTASIS VALVE 40CM SHEATH CGS01PA140ST "SJM"PEEL-AWAY INTRODUCERS 14CM 5:16FR(SHEATH+DILATOR)" 聖 864 猷達 " 剝式導管導引器 CGS01PA14NST "SJM"PEEL-AWAY INTRODUCERS 14CM 864 5:16FR(SHEATH+DILATOR+SYRINGE+NEEDLE+GUIDE WIRE)" 聖猷達 " 剝式導管導引器 CGS01PA230ST "SJM"PEEL-AWAY INTRODUCERS 23CM 864 7:14FR(SHEATH+DILATOR+SYRINGE+NEEDLE+GUIDE WIRE)" 聖猷達 " 剝式導管導引器 CGS01PA6CMST "SJM"PEEL-AWAY INTRODUCERS 6CM 4;5;6FR(SHEATH+NEEDLE)" 聖 864 猷達 " 剝式導管導引器 CGS01PLD11MR PRELUDE SHEATH INTRODUCER 11CM 583 (W/SHEATH+SIDEPORT+VALVE+DILATOR+G.W) CGS01PLD23MR PRELUDE SHEATH INTRODUCER 23CM 977 (W/SHEATH+SIDEPORT+VALVE+DILATOR+G.W) CGS01PS11GMR PRELUDE SHEATH INTRODUCER 11CM 715 (W/SHEATH+SIDEPORT+VALVE+DILATOR+G.W+NEEDLE) CGS01RCF01CK CHECK-FLO PERFORMER INTRODUCER SETS 25CM(SH+DI+SI+V+GW) 977 CGS01RCF02CK CHECK-FLO PERFORMER INTRODUCER SETS 30CM 1262 W/RADIOLOGY(SH+DI+SI+V+GW) CGS01RCF03CK CHECK-FLO PERFORMER INTRODUCER SETS 45CM 1262 W/RADIOLOGY(SH+DI+SI+V+GW) CGS01RCF04CK CHECK-FLO PERFORMER INTRODUCER SETS 835 5:13CM(S+D+GW+N+SV+SY+3WAY)0.021",0.035",0.038" CGS01RCFN1CK "COOK"CHECK-FLO PERFORMER INTRODUCER SETS 4.0:9.0 FR :13 CM(SHEATH,DILATOR,SIDE+V,RADIOLOGY GW,NEEDLE)" 曲克 " 闕克芙爾引導器組 CGS01RCFN2CK "COOK"CHECK-FLO PERFORMER INTRODUCER SETS 4.0:9.0 FR CM(SHEATH,DILATOR,SIDE+V,RADIOLOGY GW,NEEDLE)" 曲克 " 闕克芙爾引導器組 CGS01RPDCAGU 雷必多可切開式導管組合系統 RAPIDO CUT-AWAY GUIDING 6528 CATHETER SYSTEM(CATHETER+FINISH WIRE+CUTTER+RHV+BCV) 適應症請見備註欄 CGS01SC001CK SCHWARZ CATHETER INTRODUCTION SET

119 CGS01SEA14ST "SJM"PEEL-AWAY INTRODUCERS 14CM 864 7:12FR(SHEATH+VALVE+DILATOR+SYRINGE+NEEDLE+GUIDE WIRE)" 聖猷達 " 剝式導管導引器 CGS01SHK1TGJ "JSM"SHEATH KIT " 吉生 " 導引鞘組 715 (SH+SIDEPORT+VALVE+DIL+G.W+N+IV CATHETER+SYN) CGS01SHKLAGJ "JSM"SHEATH KIT " 吉生 " 導引鞘組 875 (SH+SIDEPORT+VALVE+DIL+G.W+N+IV CATHETER+SYN+ 保護套 ) CGS01SHSH7SB SUPER SHEATH INTRODUCER SHEATH 4-9FR 7CM 0.035",0.308" 583 (SHEATH+DILATOR+SIDEARM+VALVE,GUIDEWIRE) CGS01SPTSWYZ 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" 583 (SHEATH+DILATOR+SIDEARM+VALVE,GUIDEWIRE) CGS01SUM11SB SUPER SHEATH INTRODUCER SHEATH 4-9FR 11CM 0.035",0.038" 583 (SHEATH+DILATOR+SIDEARM+VALVE,GUIDEWIRE) CGS01SUM25SB SUPER SHEATH INTRODUCER SHEATH 5-9FR 25CM 0.038" 977 (SHEATH+DILATOR+SIDEARM+VALVE,GUIDEWIRE) CGS01TR482ST "SJM"ENGAGE ENGAGE TR INTRODUCER(RADIA INTRODUCER)12CM "(SH+DIL+VALVE GUIDE WIRE+SIDEPORT 3WAY+NEEDLE)" 聖猷達 " 茵給桔導管導引器 CGS01TR485ST "SJM"ENGAGE ENGAGE TR INTRODUCER(RADIA INTRODUCER)25CM "(SH+DIL+VALVE GUIDE WIRE+SIDEPORT 3WAY+NEEDLE)" 聖猷達 " 茵給桔導管導引器 CGS01TR487ST "SJM"ENGAGE ENGAGE TR INTRODUCER(RADIA INTRODUCER)7CM "(SH+DIL+VALVE GUIDE WIRE+SIDEPORT 3WAY+NEEDLE)" 聖猷達 " 茵給桔導管導引器 CGS01TS20NGX "GORE"INTRODUCER SHEATH WITH SILICONE PINCH 887 VALVE(W/DILATOR)30CM 20:24FR 帶矽膠夾管閥導鞘 CGS AR PERCUTANEOUS SHEATH 875 CGS M9 DILATOR(FACIAL)6:18FR 23CM 153 CGS BQ "BIOTEQ"INTRODUCER SET:DILATOR 4:16FR 5:30CM" 邦特 " 穿刺導 153 入系統組 : 引流用擴張管 CGS PB DILATOR 5:8FR 20CM 153 CGS PB DILATOR 4:8FR 0.035:0.038" 20:35CM 153 CGS PB DILATOR 9:18FR 0.038:0.052" 25CM 153 CGS03J001NCK " 曲克 " 擴張器 "COOK"DILATORS 153 CGS03JCD01CK DILATOR 153 CGS03JCD03CK DILATOR 擴張器 (JCD20:24-45:52-20 自 生效 ) 449 CGS04C304SM4 " 美敦力 " 賽勒克可調彎導管系統 "MEDTRONIC"SELECTSITE 2257 DEFLECTABLE CATHETER SYSTEM* 適應症請見備註欄 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 CHA TM AORTIC ARCH CANNULA 6.5MM 20FR 585 CHA TM AORTIC ARCH CANNULA 8MM 24FR 585 CHA AY " 肯特利 " 亞羅主動脈灌流導管 "Kendall" Argyle Thi Aortic 585 Perfusion Cannula CHA TM AORTIC ARCH CANNULA 8MM 24FR 790 CHA DL PEDIATRIC STRAIGHT ARTERIAL CANNULA 18FR:24FR 585 CHA DL ARTERIAL CANNULA 20:24FR 585 CHA01A085BED AORTIC PERFUSION CANNULAE(8-16F) 585 CHA01AS202ED AORTIC PERFUSION CANNULA

120 CHA TM SOFT-FLOW AORTIC ARCHCANNULAE W/WIRE REINFORCED 7MM,8MM FR,24FR CHA TM SOFT-FLOW AORTIC ARCH CANNULA 7MM,8MM 21FR,24FR 585 CHA TM SOFT-FLOW AORTIC ARCH CANNULAE WITH WIRE REINFORCED 790 CHA TM SOFT-FLOW AORTIC ARCH CANNULAE WITHOUT REINFORCED 515 CHA031137CL5 AORTIC ARCH CANNULAE WIRE-REINFORCED 6,7,8MM/18,21,24FR 790 CHA031206CL5 AORTIC ARCH CANNULA W/WIRE REINFORCED 6:24FR 790 CHA TM HIGH FLOW AORTIC ARCH CANNULA 585 CHA TM FLEXIBLE ARTERIAL CANNULA 20:24FR 585 CHA0320STAED " 愛德華 " 動脈灌注導管 "EDWARDS" AORTIC PERFUSION CANNULAE 790 CHA M4 DLP ARTERIAL CANNULAE WIREWOUND BODY 20FR,22FR,24FR 790 CHA03NA120L5 AORTIC ARCH CANNULAE 585 CHA03NA343L5 AORTIC ARCH CANNULAE FLEXIBLE STRAIGHT TIP WITH MOVABLE 585 SUTURE RING NON-REINFORCED 6,7,8MM/18,21,24FR CHA03RA213L5 AORTIC ARCH CANNULAE STRAIGHT TIP WIRE-REINFORCED 790 6,7,8MM/18,21,24FR CHAT100009ED CARDIOPLEGIA DELIVERY SETS(9F) 135 CHAT110016S6 AORTA/VEIN PUNCH 4:6MM 918 CHAT131001DL IMA CANNULA 內乳動脈導管 567 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 CHAT1AP425M4 AORTIC PUNCH 918 CHAT1AP525M4 AORTIC PUNCH 918 CHAT1DP48KTX " 特立菲斯 " 主動脈打孔器 "TELEFLEX"AORTIC PUNCH 918 CHAT1VCANNL5 " 加州 " 血管套管 "CALIFORNIA" VESSEL CANNULAE 135 CHC ED CARDIOPLEGIA DELIVERY SETS(2 LINES) 346 CHC ED CARDIOPLEGIA DELIVERY SETS(3 LINES) 657 CHC M4 ADAPTERS 轉接器 ( 結合心肺繞道手術使用 ) 346 CHC M4 " 美敦力 " 順行 / 逆行性結合選擇開關 "MEDTRONIC" ARISS 1088 ANTEGRADE/RETROGRADE INTEGRAL SELECTOR SWITCH CHC M4 " 美敦力 " 多重灌流組 "MEDTRONIC" DLP MULTIPLE PERFUSION SETS 990 CHC DL CORONARY CANNULA 10:14FR 611 CHC DL CORONARY SOFT TIP 611 CHC01CA123L5 " 加州 " 心臟麻痺轉接器 CALIFORNIA CARDIOPLEGIA ADAPTERS 346 CHC01CA410L5 MULTIPLE PERFUSION ADAPTER 657 CHC01CA420L5 MULTIPLE PERFUSION ADAPTER WITH VENT LINE 15 INCH 適應症 889 請見備註欄 CHC01CA430L5 MULTIPLE PERFUSION ADAPTER WITH VESSEL CANNULA 三條 (VC ,VC-11010) CHC01CA810L5 CARDIOPLEGIA PERFUSION ADAPTERS WITH MONITORING SET* 適應 1088 症請見備註欄 CHC01CP110L5 CORONARY ARTERY PERFUSION CANNULAE 611 CHC01CP212L5 CORONARY ARTERY PERFUSION CANNULAE WITH BALLOON 611 CHC01MS001ED CARDIOPLEGIA DELIVERY SETS(MONITORING SET) 1088 CHF M4 BIO-MEDICUS CANNULA 套管及導管 (ADULT)23:29FR* 使用參考請見備註欄

121 CHF M4 CHF M4 CHF06CB965M4 CHF06CB966M4 CHF06D008VED CHF06EBSAXTM CHF06EBSCATM CHF06EBSCVTM CHF06EBSVXTM CHF06ELS88QM CHF06FEM08ED BIO-MEDICUS CANNULA 套管及導管 (ADULT)15:21FR* 使用參考請見備註欄 BIO-MEDICUS CANNULA 套管及導管 (PEDIATRIC)8:14FR* 使用參考請見備註欄 ARTERIAL PERCUTANEOUS CANNULA KIT W/INTRODUCER SET 使用參考請見備註欄 ( 型號 :CB ,CB 自 生效, 文號 :W ) VENOUS PERCUTANEOUS CANNULA KIT W/INTRODUCER SET 使用參考請見備註欄 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 " 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 ARTRIAL CAPIOX EBS CANNULATION KIT W/INTRODUCER SET 13.5,15,16.5FR 使用參考請見備註欄 VENOUS CAPIOX EBS CANNULATION KIT W/INTRODUCER SET 18,19.5,21FR 使用參考請見備註欄 " 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 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 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 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 CHF06HLSCAQM " 邁柯唯 " 動靜脈導管 - 股動脈導管 "MAQUET" HLS CANNULAE /BIOLINE COATING/ 含 INTRODUCER SET CHF06HLSCVQM " 邁柯唯 " 動靜脈導管 - 股靜脈導管 "MAQUET" HLS CANNULAE /BIOLINE COATING/ 含 INTRODUCER SET CHF06MED1CM4 "MEDTRONIC"BIO-MEDICUS FEMORAL ARTERIAL/VENOUS CANNULA :29FR" 美敦力 " 股動 / 靜脈套管 * 適應症請見備註欄 CHF06MEFKAML FEMORAL CANNULAE 股動靜脈導管 適應症請見備註欄 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 CHG TM RETROGRADE CARDIOPLEGIA CANNULAE MANUAL INFLATE 13FR,17FR 3184 CHG TM RETROGRADE CARDIOPLEGIA CANNULA 3184 CHG M4 DLP RETROGRADE CORONARY SINUS PERFUSION CANNULA 3184 CHG M4 RETROGRADE CORONARY SINUS PERFUSION CANNULA WITH MANUAL 3147 INFLATING CUFF AND SILICONE BODY CHG02RCM14L5 RETROGRADE CARDIOPLEGIA CANNULAE 6,10,13,15FR 3184 CHG02RCS14L5 RETROGRADE CARDIOPLEGIA CANNULAE 13,14,15FR 3184 CHG02RCS35L5 RETROGRADE CARDIOPLEGIA CANNULAE 13FR,14FR,15FR 逆向心臟 3184 麻痺液灌注套管 CHG02SGK14QM RETROGRADE CARDIOPLEGIA CANNULA 3184 CHH DL LEFT HEART VENT CATHETER 13FR 568 CHH DL VENT CATHETER

122 CHH M4 DLP LEFT HEART VENT CATHETER 568 CHH L4 MALLEABLE VENT CATHETER 18FR 568 CHH01EE061ED "EDWARDS"LEFT VENTRICULAR VENT CATHETER 左心室用導管 568 CHH01PE062ED LEFT VENTRICULAR VENT CATHETER 685 CHH01VT218L4 MALLEABLE VENT CATHETER 12FR,18FR 568 CHH025902MAY 肯特利 左心室導管 "Kendall" Argyle Left Ventricular 568 Sump Vent Catheters CHR RM AORTIC ROOT CANNULA 635 CHR010014VED AORTIC PERFUSION CANNULAE(14G) 797 CHR DL AORTIC ROOT CANNULA 9FR:18FR 635 CHR DL AORTIC CANNULA 12:18G 410 CHR TM AORTIC CANNULA 24FR 加強型動脈導管 797 CHR M4 "MEDTRONIC DLP"CARDIOPLEGIA CANNULA DOUBLE LUMEN" 美敦力 " 797 雙管腔心臟麻痺套管 CHR01AR012ED AORTIC ROOT CANNULA 主動脈根部套管 635 CHR01AR109L5 AORTIC ROOT CANNULAE 9:18GA 410 CHR01AR112L5 AORTIC ROOT CANNULAE 12:16GA 410 CHR01AR209L5 AORTIC ROOT CANNULAE WITH VENT LINE 9:18G 635 CHR01AR212L5 AORTIC ROOT CANNULAE WITH VENT LINE 12:16G 635 CHR01CA16VQM ANTEGRADE CARDIOPLEGIA CANNULAE W/VENT 順行性心臟麻醉導管 635 CHR01CAS16QM ANTEGRADE CARDIOPLEGIA CANNULAE 順行性心臟麻醉導管 410 CHR M4 AORTIC ROOT CANNULAE WITH VENT LINE 635 CHR DL AORTIC ROOT CANNULA WITH VENT LINE 635 CHR ED RETROGRADE CARDIOPLEGIA CANNULAE(14F) 3184 CHR03RC014ED RETROGRADE CARDIOPLEGIA CANNULAE 3184 CHR03RC301ED RETROGRADE CARDIOPLEGIA CANNULAE 3184 CHSU116022AY 肯特利 亞羅臍脈導管 "Kendall" Argyle Umbilical Vessel 170 Catheter CHSU116035KD 肯特利 亞羅臍脈導管 "Kendall" Argyle Umbilical Vessel 170 Catheter CHT TM CONDUCER CARDIOPLEGIA SET W/MP-4 1:1,4:1,8: CHT TM CONDUCER CARDIOPLEGIA SSET W/MP-4 AND BRIDGE 4: CHT TM CONDUCER CARDIOPLEGIA SET 4:1,2:1 BLOOD MIXING 2884 CHT TM CONDUCER CARDIOPLEGIA SET( 含 DOMEXI,ARTERIAL PRESSURE 3173 TUBINGX3,3-WAY STOPCOCKX1) CHT DL PEDIATRIC TOURNIQUET KIT 258 CHT01A32NSH9 HEART LUNG PACK:A32 CUSTOMER PACK(TUBING+ORGANIZER+PRE BYPASS FILTER) CHT01CAP40GH POSTOPERATIVE CONVERSION PACKS For Cardiotomy 1528 /Autotransfusion /Pleural Drainage Reservoir cap35 CHT01CH207H9 HEART LUNG PACK( 含 PRE-BYPASS FILTER) 4137 CHT01CHX30QM PLEGIOX CARDIOPLEGIA HEAT EXCHANGER( 含 DIA-CONN,PVC SH,PUMP CONN,SILICONE,PVC-70SH,Y-CONN,ONE WAY VALVE,DIA-CONN/BL) CHT01CSS01TV CSS PERFUSION TUBING SET ( 含 TUBING+PRE-BYPASS FILTER ORGANIZER+SUCKER X 2) CHT01CSS02TV CSS PERFUSION TUBING SET ( 含 TUBING+PRE-BYPASS 5252 FILTER+SUCKER X 2) CHT01CSS03TV CSS PERFUSION TUBING SET ( 含 TUBING+PRE-BYPASS FILTER) 4137 CHT01CSS04TV CSS PERFUSION TUBING SET ( 只含 TUBING) 3829 CHT01ECTB1M6 EXTRACORPOREAL TUBING PACK( 含 PRE-BYPASS FILTER+SUCKERX2+ORGANIZER)

123 CHT01ECTBSM6 EXTRACORPOREAL TUBING PACK( 含 PRE-BYPASS FILTER) 4137 CHT01HS101H9 HEART LUNG PACK( 含 ORGANIZER+PRE-BYPASS FILTER+SUCKERX2) 5500 CHT01HTA12H9 HEART LUNG PACK HSIN TUNG A12 ADULT( 含 ORGANIZER+PRE BYPASS FILTER+SUCKER X2+ARTERIAL FILTER) CHT01MY100M4 MYOTHERMXP CARDIOPLEGIA DELIVERY SYSTEM(BLOOD 3173 MIXING+CONDUCER+COIL TUBING+MP4) CHT01P0201QM BLOOD CARDIOPLEGIA SET W/PLEGIOX 具自動熱交換功能 ( 含 DIA CONN,PVC-75SH,PUMP CONN,SILICONE,PVC-70SH,Y-CONN,ONE WAY VALVE,DIA-CONN/BL) CHT01TS100L5 TOURNIQUET KIT WITH SNARE 258 CHT01TS130L5 TOURNIQUET KIT 258 CHT01VBC4CGH VISION BLOOD CARDIOPLEGIA(BLOOD MIXING+CONDUCER+COIL 3173 TUBING+MP4) 具熱交換功能 CHT01VBCBRGH VISION BLOOD CARDIOPLEGIA SYSTEM(BLOOD 2884 MIXING+CONDUCER+COIL TUBING) CHT03A25PLH9 HEART LUNG PACK:A25 PRIME LINE(TUBING 49"+ Y CONNECTOR) 291 CHT H9 HEART LUNG PACK:FLOW PROBE CONNECTOR 914 CHT H9 HEART LUNG PACK:STATSAT CONNECTOR 1/4;3/8;1/2 氧分壓測定接 914 頭 * 適應症請見備註欄 CHT TM CDI HEMATOCRIT SATURATION CUVETTE 血氧感知器 914 CHT05TMC25M4 TMC TRI-OPTIC MEASUREMENT CELL 914 CHV ED SINGLE STAGE VENOUS RETURN CANNULAE(12:40FR/ 直 ) 771 CHV ED SINGLE STAGE VENOUS RETURN CANNULAE 771 CHV ED SINGLE STAGE VENOUS RETURN CANNULAE(12:40FR/ 彎 ) 771 CHV TM MALLEABLE VENOUS RETURN CATHETER REINFORCED 24FR 1029 CHV TM 2 STAGE VENOUS RETURN CANNULA 803 CHV TM VENOUS RETURN CAHTTER W/WIRE REINFORCED 803 CHV M4 SINGLE STAGE VENOUS CANNULA 771 CHV DL VENOUS CANNULAR 12,16,20,31FR (PEDIATRIC) 1034 CHV M4 "MEDTRONIC"SINGLE STAGE VENOUS CANNULA" 美敦力 " 單孔型靜脈 1029 套管 12:40FR CHV DL VENOUS CANNULAR 12:31FR (HIGH FLOW) 1034 CHV DL VENOUS CANNULAR 12:31FR (ADULT) 1034 CHV M4 TWO STAGE VENOUS CANNULA 803 CHV01LRD32L5 DUAL STAGE VENOUS RETURN CANNULAE 32FR 803 CHV01LRD41L5 "CALIFORNIA" DUAL STAGEVENOUS RETURN CANNULAE 803 CHV01RV110L5 WIRE REINFORCED VENOUS RETURN CANNULAE24,28,32,34,36, CHV01RV222L5 WIRE REINFORCED VENOUS RETURN CANNULAE(STREIGHT)20:40FR 771 CHV01RV224L5 VENOUS RETURN CANNULAE(WIRE-REINFORCED) 靜脈回流導管 771 CHV01TF008ED SINGLE STAGE VENOUS RETURN CANNULAE 靜脈引流導管 771 CHV01XRDS2L5 DUAL STAGE VENOUS RETURN CANNULAE 32:36FR 803 CHV TM 2 STAGE VENOUS CANNULA 32FR 550 CHV ED DUAL STAGE VENOUS RETURN CANNULAE(29/37F) 1034 CHV ED DUAL STAGE VENOUS RETURN CANNULAE(36/46F) 1034 CHV DL SINGLE 2 STAGE VENOUS CANNULA 803 CHV03TF334ED " 愛德華 " 二階靜脈引流導管 "EDWARDS" DUAL STAGE VENOUS 1034 RETURN CANNULAE CHV03TR283ED DUAL STAGE VENOUS RETURN CANNULA 803 CHV03TRF29ED DUAL STAGE VENOUS CANNULAE

124 CKB BB CYSTOFIX 10:15FR 8:12CM 542 CKB BB CYSTOFIX 10:15FR 8:12CM 542 CKB BB CYSTOFIX 10:15FR 8:12CM 542 CKB BB CYSTOFIX 10:15FR 8:12CM 542 CKB BA SUPRAPUBIC CATHETERISATION KIT 膀胱穿刺針組 16CH 590 CKB AN VESICO SET 膀胱穿刺引流組 542 CKD CK DOUBLE PIGTAIL(J)STENT SET 4.7:8.2FR(stent+guide 1570 wire+pusher) CKD01BTDJ2BQ DOUBLE J URETERAL STENT SET(STENT+GUIDE+PUSHER) 1117 CKD01US101CK "COOK"UNIVERSA FIRM AND SOFT URETERAL STENT SET( 雙 1570 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 CKD01US102CK "COOK"UNIVERSA FIRM AND SOFT URETERAL STENT SET( 雙 1570 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 CKD030472NAN DOUBLE J-STENT 4,7FR 24CM:7FR 32CM 1570 CKD035550NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1570 CKD035572NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1570 CKD035591NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1570 CKD035610NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1570 CKD035704NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1570 CKD035723NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1570 CKD035921NAN URETERAL STENTS(STENT+GUIDE WIRE+PUSHER) 1570 CKD MV CONTOUR SOFT PERCUFLEX STENTS W/HYDROPLUS 1698 COATING+GUIDEWIRE+PUSHER+CLAMP CKD MV CONTOUR SOFT PERCUFLEX STENTS W/HYDROPLUS 1698 COATING+GUIDEWIRE+PUSHER+CLAMP CKD MV CONTOUR SOFT PERCUFLEX STENTS W/HYDROPLUS 1698 COATING+GUIDEWIRE+PUSHER+CLAMP CKD MV CONTOUR SOFT PERCUFLEX STENTS W/HYDROPLUS 1698 COATING+GUIDEWIRE+PUSHER+CLAMP CKD BQ "BIOTEQ"URETERAL STENT SET(DOUBLE J TYPE)( W/HYDROPHILIC COATING+GUIDE WIRE+PUSHER+CLIP)" 邦特 " 輸尿管導管組 ( 雙 J 型 ) 1698 CKD BQ CKD057774NBA CKD BA CKD05BTDJ3BQ CKD05DSHFNGT CKD05DUSPNGT CKD05DUTWNGT CKD05J3114BQ "BIOTEQ"URETERAL STENT SET(DOUBLE J TYPE)( W/HYDROPHILIC COATING+GUIDE WIRE+PUSHER+CLIP)" 邦特 " 輸尿管導管組 ( 雙 J 型 ) URETERAL STENT WITH HYDROPLUS COATING+GUIDE WIRE+PUSHER+CLAMP "BARD"INLAY URETERAL STENT( WITH HYDROPLUS COATING)+PUSHER+CLAMP" 巴德 " 輸尿管導管組 URETERAL STENT(DOUBLE J TYPE)(STENT WITH HYDROPHILIC COATING+GUIDE WIRE+PUSHER+CLIP) DOUBLE PIGTAIL URETERAL STENT SET(stent with hydromer+guide wire+pusher) DOUBLE PIGTAIL URETERAL STENT SET(stent with hydromer+guide wire+pusher) DOUBLE PIGTAIL URETERAL STENT SET(stent with hydromer+guide wire+pusher) "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH HYDROPHILIC+GUIDE WIRE+PUSHER)" 邦特 " 輸尿管導管組 ( 長效型 )

125 CKD05J3125BQ CKD05K3114BQ CKD05K3125BQ CKD05PSHFNGT CKD05R3214BQ CKD05R3225BQ CKD05S3214BQ CKD05S3225BQ "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH HYDROPHILIC+GUIDE WIRE+PUSHER)" 邦特 " 輸尿管導管組 ( 長效型 ) "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH HYDROPHILIC+GUIDE WIRE+PUSHER)" 邦特 " 輸尿管導管組 ( 長效型 ) "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH HYDROPHILIC+GUIDE WIRE+PUSHER)" 邦特 " 輸尿管導管組 ( 長效型 ) DOUBLE PIGTAIL URETERAL STENT SET(stent with hydromer+guide wire+pusher) "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH HYDROPHILIC+GUIDE WIRE+PUSHER)" 邦特 " 輸尿管導管組 ( 長效型 ) "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH HYDROPHILIC+GUIDE WIRE+PUSHER)" 邦特 " 輸尿管導管組 ( 長效型 ) "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH HYDROPHILIC+GUIDE WIRE+PUSHER)" 邦特 " 輸尿管導管組 ( 長效型 ) "BIOTEQ"URETERAL STENT SET(LONG-TERM TYPE) (STENT WITH HYDROPHILIC+GUIDE WIRE+PUSHER)" 邦特 " 輸尿管導管組 ( 長效型 ) CKD05USH01CK "COOK"UNIVERSA STENT FIRM AQ AND SOFT AQ SET (STENT-WITH 1698 HYDROPHILIC COATING+GUIDE WIRE+PUSHER) 由尼維莎輸尿管內置支架組 CKD BA SILICON FLOURO-4 URETERAL STENT(stent+introducer kit) 2325 CKDD112122AR LARGE-BORE MULTILUMEN HEMODIALYSIS CATHETER 1392 CKDD115122AR ARROW-HOWES LARGE-BORE MULTI-LUMEN HEMODIALYSIS CATHETER 900 雙腔輸液導管組 CKDD C " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE 1392 HEMODIALYSIS CATHETERS-MAHURKAR KIT(C+N+G+D) CKDD117005KD "KENDALL"DUAL LUMEN HEMODIALYSIS CATHETER KIT(C+N+G+D) 雙 1392 腔透析導管 CKDD C " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE HEMODIALYSIS CATHETERS-MAHURKAR KIT,CURVED EXT.(C+N+G+D) 1392 CKDD117009KD CKDD122122AR CKDD122334BQ CKDD123122AR CKDD124334BQ CKDD C "KENDALL"DUAL LUMEN HEMODIALYSIS CATHETER KIT(C+N+G+D) 雙腔透析導管 "ARROW"ARROWGARD CATHETERS SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR+SHEATH) 2 LUMEN " 亞諾 " 抗感染安全尖端導管 "BIOTEQ"HEMODIALYSIS CATHETER KIT(2 LUMEN CATHETER+NEEDLE+GUIDE WIRE+DILATOR) 血液透析導管組 "ARROW"ARROWGARD CATHETERS SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR+SHEATH) 2 LUMEN " 亞諾 " 抗感染安全尖端導管 "BIOTEQ"2 LUMEN HEMODIALYSIS CATHETER KIT(C+N+G+D) 血液透析導管組 " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE HEMODIALYSIS CATHETERS-MAHURKAR DUAL LUMEN KIT(C+N+G+D)

126 特材代碼 中英文名稱 支付點數 -102/01 CKDD139003KD "KENDALL"DUAL LUMEN HEMODIALYSIS CATHETER KIT(C+N+G+D) 雙 1392 腔透析導管 CKDD154334BQ "BIOTEQ"HEMODIALYSIS CATHETER KIT" 邦特 " 血液透析導管組 ( 雙 900 腔 ) CKDD15553NBA DUAL-LUMEN NIAGARA SLIM CATH DIALYSIS CATH KIT(C+N+G+D) 1392 CKDD15554NBA DUAL-LUMEN NIAGARA SLIM CATH DIALYSIS CATH KIT(C+N+G+D) 1392 CKDD1881CK2C " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE HEMODIALYSIS CATHETERS-MAHURKAR KIT,CURVED EXT.(C+N+G+D) 1392 CKDD1881CKKD DUAL LUMEN HEMODIALYSIS CATHETER KIT CURVE(C+N+G+D) 1392 CKDD1881SK2C " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE 1392 HEMODIALYSIS CATHETERS-MAHURKAR KIT(C+N+G+D) CKDD1881SKKD DUAL LUMEN HEMODIALYSIS CATHETER KIT STR(C+N+G+D) 1392 CKDD1883CK2C " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE HEMODIALYSIS CATHETERS-MAHURKAR KIT,CURVED EXT.(C+N+G+D) 1392 CKDD1883CKKD DUAL LUMEN HEMODIALYSIS CATHETER KIT CURVE(C+N+G+D) 1392 CKDD1883SK2C " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE 1392 HEMODIALYSIS CATHETERS-MAHURKAR KIT(C+N+G+D) CKDD1883SKKD DUAL LUMEN HEMODIALYSIS CATHETER KIT STRAIGHT(C+N+G+D) 1392 CKDD193009KD CURVED AND STRAIGHT DUAL LUMEN CATHETER KITS(C+N+G+D) 1392 CKDD1K3500VC DIALYSIS CATHETERS KIT(CATH+DILATOR+GUIDE 1392 WIRE+NEEDLE)12.5CM:24CM( 自 起型號更改為 文號 CKDD1K4065VC 雙頭管路 DIALYSIS CATHTER KIT(C+N+G+D)( 自 起型號更改 1392 為 文號 ) CKDD1KDLS4VC 雙頭管路 DIALYSIS CATHETER KIT(C+N+G+D) 1392 CKDD20450NBA HICKMAN HEMODIALYSIS CATHETER KIT(CATH+INTRODUCER KIT) 永 3509 植型 CKDD20452NBA HICKMAN HEMODIALYSIS CATHETER KIT(CATH+INTRODUCER KIT) 永 3509 植型 CKDD C " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE 900 HEMODIALYSIS CATHETERS-MAHURKAR CATHETER CKDD214001KD DUAL LUMEN CATHETER 雙頭血液透析管路 900 CKDD C " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE 900 HEMODIALYSIS CATHETERS-MAHURKAR CATHETER,CURVED EXT. CKDD214002KD DUAL LUMEN CATHETER 雙頭血液透析管路 900 CKDD C " 柯惠 " 肯特利慢性血液透析導管 "COVIDIEN"KENDALL CHRONIC 3509 HEMODIALYSIS CATHETERS-MAHURKAR 13.5FR CUFFED CATHETER KIT CKDD233074KD HEMODIALYSIS CATHETER(C+N+G+D) 3509 CKDD C " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE 900 HEMODIALYSIS CATHETERS-MAHURKAR CATHETER CKDD242005KD DUAL LUMEN CATHETER 雙頭血液透析管路 900 CKDD C " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE 900 HEMODIALYSIS CATHETERS-MAHURKAR CATHETER,CURVED EXT. CKDD245007KD DUAL LUMEN CATHETER 雙頭血液透析管路 900 CKDD C " 柯惠 " 肯特利慢性血液透析導管 "COVIDIEN"KENDALL CHRONIC HEMODIALYSIS CATHETERS-PERMCATH CATHETER KIT 36~45CM(CATH+INTRODUCER KIT)

127 CKDD248001KD PERMCATH DUAL LUMEN CATHETER KITS(CATH+INTRODUCER KIT) 永 3509 植型 CKDD256631BA HEMOGLIDE HEMODIALYSIS CATHETER KIT(CATH+INTRODUCER KIT) 3509 永植型 CKDD257331BA "BARD"HEMOSPLIT HEMODIALYSIS CATHETER(CATH+INTRODUCER 3509 KIT)" 巴德 " 思伯利特血液透析導管. 永植型 CKDD25833NBA "BARD"HemoStar HEMODIALYSIS CATHETER KITS(CATH+INTRODUCER 3509 KIT) 永植型 CKDD260049BA HICKMAN HEMODIALYSIS CATHETER 永植型 2623 CKDD266606BA HICKMAN HEMODIALYSIS CATHETER KIT(CATH+INTRODUCER KIT) 永 3509 植型 CKDD C " 柯惠 " 肯特利慢性血液透析導管 "COVIDIEN"KENDALL CHRONIC 3509 HEMODIALYSIS CATHETERS-PERMCATH CATHETER KIT 28CM(CATH+INTRODUCER KIT) CKDD269001KD "KENDALL"CHRONIC HEMODIALYSIS CATHETERS(DUAL LUMEN 3509 CATHETER+INTRODUCER KIT) 永植型慢性血液透析導管 CKDD C " 柯惠 " 肯特利慢性血液透析導管 "COVIDIEN"KENDALL CHRONIC 3509 HEMODIALYSIS CATHETERS-MAHURKAR MAXID 14.5FR. 雙腔導管 (CATH+INTRODUCER KIT) CKDD288145KD "KENDALL"CHRONIC HEMODIALYSIS CATHETER KITS(DUAL LUMEN 3509 CATH+INTRODUCER KIT) 永植型 CKDD288155KD DUAL LUMEN CATHETER 直式雙頭血液透析管路 900 CKDD294009KD CURVED EXTENSION DUAL LUMEN CATHETER 900 CKDD2D3500BA DOUBLE LUMEN SUBCLAVIAN CANNULA 12.5CM(C+N+G+D)( 自 起型號更改為 文號 CKDD2D4000BA DOUBLE LUMEN SUBCLAVIAN CANNULA 15CM(C+N+G+D)(( 自 起 1392 型號更改為 文號 ) CKDD2D4400BA DOUBLE LUMEN SUBCLAVIAN CANNULA 20CM(C+N+G+D)(( 自 起 1392 型號更改為 文號 ) CKDD2J0KADJ0 DOUBLE LUMEN CATHETERS 900 CKDD2K4400BA DOUBLE LUMEN SUBCLAVIAN CANNULA 20(C+N+G+D)(CM( 自 起 1392 型號更改為 文號 ) CKDD2L4424VC 雙頭管路 DIALYSIS CATHETER( 自 起型號更改為 文 900 號 ) CKDD2SL12PM0 "MEDCOMP"SILICONE DOUBLE LUMEN CATHETERS AND 3509 ACCESSORIES(CATHETER+NEEDLE+GUIDE WIRE+DILATOR)" 美德康 " 矽質血液透析導管與配件 CKDD2SL18PM0 "MEDCOMP"HEMO-CATH LONG TERM DIALYSIS CATHETERS (DOUBLE 3509 LUMEN )AND ACCESSORIES(CATHETER+INTRODUCER KIT)" 美德康 " 長期矽質血液透析導管與配件 CKDD312123AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR)" 亞諾 " 多重輸液導管套 1738 CKDD323334BQ CKDD325123AR CKDD C CKDD345603KD "BIOTEQ"HEMODIALYSIS CATHETER KIT(3 LUMEN CATHETER+NEEDLE+GUIDE WIRE+DILATOR) 血液透析導管組 "ARROW"ARROWGARD CATHETERS SETS(CATH+NEEDLE+GUIDEWIRE+DILATOR+SHEATH) 3 LUMEN " 亞諾 " 抗感染安全尖端導管 " 柯惠 " 肯特利急性血液透析導管 "COVIDIEN"KENDALL ACUTE HEMODIALYSIS CATHETERS- 三腔透析導管 (C+N+G+D) "KENDALL"TRIPLE LUMEN HEMODIALYSIS CATHETERS(C+N+G+D) 三腔透析導管

128 CKF BA "BARD"BARDEX PEDIATRIC FOLEY CATHETER,LUBRICIOUS COATED,2 115 WAY 3CC 導尿管 * 適應症請見備註欄 CKF BA "BARD"FOLEY CATHETER 二叉滑潤長期導尿管 5CC,30CC* 適應症請 115 見備註欄 CKF025118NUW "UNOMEDICAL"FOLEY CATHETERS(HYDROPHILIC 2-WAY)3CC-30CC" 巫 115 諾 " 導尿管 * 適應症請見備註欄 CKF02H2265BA BIOCATH HYDROGEL COATING 2 WAY FOLED 8:24FR 5CC,30CC 適 115 應症請見備註欄 CKF02L0165BA LUBRICATH 2 WAY FOLED 8:26FR 3CC,5CC 適應症請見備註欄 115 CKF02M5118UM "UNOMEDICAL"FOLEY CATHETERS(HYDROPHILIC 2-WAY)3CC-30CC" 巫 115 諾 " 親水性雙叉導尿管 * 適應性請見備註欄 CKF FM 2 WAY SILICONE FOLEY BALLOON CATH 1.5CC 6FR,3CC 8:10FR 117 適應症請見備註欄 CKF030012NFM 2 WAY SILICONE FOLEY BALLOON CATHETER 5CC,30CC 12:26FR 117 適應症請見備註欄 CKF R4 2 WAY ALL SILICONE FOLEY BALLOON CATHETER 5CC 12:24FR 適 117 應症請見備註欄 CKF YN 2 WAY ALL SILICONE FOLEY BALLOON CATH 12:26FR 5CC 適應症 117 請見備註欄 CKF R4 2 WAY ALL SILICONE FOLEY BALLOON CATHETER 30CC 16:26FR 117 適應症請見備註欄 CKF FM " 富強 " 導尿管 "FORTUNE"UROLOGICAL CATHETER(ALL SILICON WAY 3CC)* 適應症請見備註欄 CKF W6 ALL SILICONE 2 WAY FOLEY CATHETER 6FR:26FR* 適應症請見備註 117 欄 CKF P2 SILICON 2 WAY FOLEY CATHETER* 適應症請見備註欄 117 CKF030512NFM 2 WAY SILICONE FOLEY BALLOON CATH W/X-RAY5CC,30CC 12:26FR 117 適應症請見備註欄 CKF030513NCL SILICONE 2-WAY FOLEY CATHE 6:26FR 適應症請見備註欄 117 CKF RU "RUSCH"SILICONE 2 WAY FOLEY CATHETER 5-15ML" 路西 " 導尿管 * 117 適應症請見備註欄 CKF0376SF6MU MODERN ALL SILICONE FOLEY CATHETER 導尿管 * 適應症請見備註欄 117 CKF03F0101SG SILICONE 2 WAY FOLEY CATHETER* 適應症請見備註欄 117 CKF03FC001SG SILICON FOLEY BALLOON CATHETER* 適應症請見備註欄 117 CKF03S2100WN SILICONE 2WAY FOLEY CATHE 3:50ML 適應症請見備註欄 117 CKF040514NFM 3 WAY SILICONE FOLEY BALLOON CATHETER W/X-RAY 30CC :26FR 適應症請見備註欄 CKF041426NFM SILICONE 3 WAY FOLEY CATHETER 14:26FR 適應症請見備註欄 170 CKF042103NWN CKF045518NUW CKF04H1875BA CKF04H2267BA CKF04L1630BA CKF04M5118UM SILICONE 3 WAY FOLEY CATHETER 5CC,30CC 16:26FR 適應症請見備註欄 "UNOMEDICAL"FOLEY CATHETERS(HYDROPHILIC 3-WAY)5CC-30CC" 巫諾 " 導尿管 * 適應症請見備註欄 LUBRICATH 3 WAY FOLEY CATHETER 75CC 18:24FR 適應症請見備註欄 BIOCATH 3 WAY FOLEY CATHETER 30:50CC 18:24FR 適應症請見備註欄 HYDROGEL 3 WAY FOLEY CATHETER 30CC 16:26FR 適應症請見備註欄 "UNOMEDICAL"FOLEY CATHETERS(HYDROPHILIC 3-WAY)5CC-30CC" 巫諾 " 親水性三叉導尿管 * 適應性請見備註欄

129 CKF04Y0630GC 三叉矽質導尿管 * 適應症請見備註欄 170 CKN CK PERCUTANEOUS PIGTAIL NEPHROSTOMY SETS 6.0:10FR 15:30CM( 標 2716 準型 ) CKN BQ "BIOTEQ"DRAINAGE CATHETERAND INTRODUCER SET/KIT(C+N+G+D 引流管袋 + 固定貼布 ) 導管 5-16FR 20-50CM CKN BQ "BIOTEQ"DRAINAGE CATHETER&INTRODUCER 2975 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 CKN011450NC3 PERCUTANEOUS NEPHROSTOMY SET PIGTAIL TYPE(chiba N+initial 2716 N+D+G+C) CKN011460NC3 PERCUTANEOUS NEPHROSTOMY SET PIGTAIL TYPE(chiba N+initial 2716 N+D+G+C) CKN011470NC3 PERCUTANEOUS NEPHROSTOMY SET PIGTAIL TYPE(chiba N+initial 2716 N+D+G+C) CKN011897SAN "ANGIOMED"INTRODUCTION/DRAINAGE CATHETER AND 1720 ACCESSORIES(STERILE)SOFT-DRAIN DIRECT PUNCTURE SET(ONE- STEP)" 安吉美爾德 " 導入 / 引流導管及其附件 CKN MV PCN NEPHROSTOMY SET 8FR 30CM(C+N+D+G+cannecting tube) 2651 CKN SB PERCUTANEOUS NEPHROSTOMY SET-PIGTAIL DESIGN(C+N+D+G) 2716 CKN CL PCN NEPHROSTOMY KIT WITH SILICON WALECOT 10FR:14FR(C+ 穿刺 3312 N+ 顯影 N+G+D+ 引流管 ) CKN015500PAN "ANGIOMED"INTRODUCTION/DRAINAGE CATHETER AND 2671 ACCESSORIES:PERCUT NEPHROSTOMY SET(C+CHIBA N+INITIAL N+D+G+ 固定盤 ) 導入 / 引流導管及附件 CKN015520PAN "ANGIOMED"INTRODUCTION/DRAINAGE CATH AND 2716 ACCESSORIES:NEPHROPUR NEPHROSTOMY SET(C+CHIBA N+INITIAL N+D+G+ 引流管袋 + 固定盤 ) 導入 / 引流導管及附件 CKN015521LAN "ANGIOMED"INTRODUCTION/DRAINAGE CATH AND 2716 ACCESSORIES:NEPHROPUR NEPHROSTOMY SET(C+CHIBA N+INITIAL N+D+G+ 引流管袋 + 固定盤 ) 導入 / 引流導管及附件 CKN015522SAN "ANGIOMED"INTRODUCTION/DRAINAGE CATHETER AND 2651 ACCESSORIES:NEPHROSTOMY SET(C+INITIAL N+D+G+ 引流管袋 )" 安吉美爾德 " 導入 / 引流導管及附件 CKN PB DRAINAGE SET AND ACCESSORIES 導管 (HYDROFEEL)+N+GX2+D+CO AXIAL D) CKN PB DRAINAGE SET AND ACCESSORIES 導管 (HYDROFEEL)+N+G+D+ 引流管 2975 袋 + 固定貼布 CKN PB DRAINAGE SET AND ACCESSORIES 導管 (HYDROFEEL)+N+G+D+ 固定貼 2930 布 CKN PB DRAINAGE SET AND ACCESSORIES 導管 (HYDROFEEL)+CHIBA 2975 N+N+G+D+ 引流管袋 CKN PB PIGTAIL NEPHROSTOMY SET( 自 起增加型號 文號 ) CKN PB PIGTAIL NEPHROSTOMY SET W/SAFETY STRING LOCK SYSTEM( 自 起增加型號 文號 ) 導管 (HYDROFEEL)+STIFFENER+GX2+D+ 固定貼布 CKN01PNPDLCY PIGTAIL NEPHROSTOMY SET 6:10FR 40CM 2651 CKN FM SILICONE 2WAY NEPHROSTOMY BALLOON CATHETER X-RAY OPEN TIP 338 8:24FR CKN FM SILICONE 3WAY NEPHROSTOMY BALLOON CATHETER X-RAY OPEN TIP :24FR CKN FM SILICONE 2WAY NEPHROSTOMY BALLOON CATHETER TIEMANN TIP 338 CKN FM SILICONE 3WAY NEPHROSTOMY BALLOON CATHETER TIEMANN TIP

130 CKN CL SILICON NEPHROSTOMY BALLOON CATHETER 8:10FR 球型腎臟造廔 338 管 CKN CL SILICON NEPHROSTOMY BALLOON CATHETER 12:24FR 球型腎臟造廔 338 管 CKN CL SILICON 3 WAY FOLEY CATHETER 16:26FR 適應症請見備註欄 170 CKN02N2108YN ALL SILICONE NEPHROSTOMY BALLOON CATHETER 8:24FR1.5:5CC 338 CKN02NS001SG SIGMA NEPHROSTOMY CATHETER(SILICON)* 適應症請見備註欄 338 CKN02S0101SG SILICONE 2 WAY NEPHROSTOMY CATHETER 338 CKN FM SILICONE NEPHROSTOMY CATHETER WITH DETACHABLE FUNNEL :24FR CKN CL SILICON NEPHROSTOMY BALLOON CATHETER W/REMOVABLE 12:24FR 530 可分離式腎臟造廔管 CKN MV PERCUTANEOUS NEPHROSTOMY CATHETER WITH LOOP LOCKING 829 RETENSION 豬尾巴導管 CKN FM SILICONE NEPHROSTOMY PIGTAIL PATTERN CATHETER 12FR 338 CKN045522SAN "ANGIOMED"INTRODUCTION/DRAINAGE CATHETER AND 530 ACCESSORIES:NEPHROSTOMY SLIM SET " 安吉美爾德 " 導入 / 引流導管及附件 CKN04BTPDSBQ NEPHROSTOMY CATHETER(WITH STYLET&FLEXIBLE CANNULA) 829 CKN CK MALECOT CATHETER 885 CKN051111NWN MALECOT CATHETER 4 WING 12:40FR 273 CKN CL SILICON 4 WING MALECOT 10:26FR 梅花型腎臟造廔管 885 CKN051840NFM "FORTUNE"SILICONE MALECOT CATHETER 14:36FR 矽質梅花型引流 885 管 CKN BA MALECOT NEPHROSTOMY TUBE 16:36FR 273 CKN059106NRU MALECOT CATHETER 4 WING " 造廔管 "4 葉 273 CKN FM SILICONE 2WAY NEPHROSTOMY CATHETER X-RAY OPAQUE TIP 338 8:24FR CKN FM SILICONE 3WAY NEPHROSTOMY CATHETER X-RAY OPAQUE TIP :24FR CKP010T2022C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETERS(TENCKHOFF CATH T202)" 柯惠 " 肯特利腹膜液透析導管 1505 CKP010T202KD PERITONEAL DIALYSIS CATHETER(TENCKHOFF 2 CUFF)T CKP FA PD CATHETER 1505 CKP018812N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETER" 柯惠 " 肯特 1505 利腹膜液透析導管系列 CKP018812NKD "KENDALL" PERITONEAL DIALYSIS CATHETER" 肯特利 " 腹膜液透析 1505 導管系列 CKP018814N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETER" 柯惠 " 肯特 1505 利腹膜液透析導管系列 CKP018814NKD "KENDALL" PERITONEAL DIALYSIS CATHETER" 肯特利 " 腹膜液透析 1505 導管系列 CKP018817N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETER" 柯惠 " 肯特 1505 利腹膜液透析導管系列 CKP018817NKD "KENDALL" PERITONEAL DIALYSIS CATHETER" 肯特利 " 腹膜液透析 1505 導管系列 CKP018880N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETER" 柯惠 " 肯特 1505 利腹膜液透析導管系列 CKP018880NKD "KENDALL" PERITONEAL DIALYSIS CATHETER" 肯特利 " 腹膜液透析導管系列

131 CKP018884N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETERS(TENCKHOFF PEDIATRIC)" 柯惠 " 肯特利腹膜液透析導管 1505 CKP018884NKD PERITONEAL DIALYSIS CATHETER 1505 CKP018888N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETERS(TENCKHOFF 1505 CATH)" 柯惠 " 肯特利腹膜液透析導管 CKP018888NKD PERITONEAL DIALYSIS CATHETER 1505 CKP018890N2C "COVIDIEN"KENDALL PERITONEAL DIALYSIS CATHETER" 柯惠 " 肯特 1505 利腹膜液透析導管系列 CKP018890NKD "KENDALL" PERITONEAL DIALYSIS CATHETER" 肯特利 " 腹膜液透析 1505 導管系列 CKP FA "FRESENIUS"PD ACCESSORIES SLEEP.SAFE SET/SET PLUS" 費森尤 232 斯 " 自動腹膜透析管組 CKP04C4479BT HOMECHOICE AUTOMATED PD SET 全自動腹膜透析導管組 232 CKP04C8303BT HOMECHOICE PEDIATRIC /LOW RECIRCULATION VOLUME A PD SET 小 232 兒全自動腹膜透析導管組 CKS016020NAN "ANGIOMED"URETERAL STENTS(STENT+GUIDE+PUSHER) 1117 CKS PB URETERAL PIGTAIL STENT SET HYDROFEEL 1570 STEERABLE(STENT+G+SHEATH+CLIP) CKS PB URETERAL PIGTAIL STENT SET HYDROFEEL 1698 STANDARD(STENT+G+SHEATH+CLIP) CKS PB URETERAL PIGTAIL STENT SET HYDROFEEL 1698 STANDARD(STENT+G+SHEATH+CLIP) CKS PB URETERAL PIGTAIL STENT SET HYDROFEEL 1698 PEDIATRIC(STENT+G+SHEATH+CLIP) CKS PB URETERAL PIGTAIL STENT SET HYDROFEEL 1698 STEEERABLE(STENT+G+SHEATH+CLIP) CKS PB URETERAL PIGTAIL STENT SET HYDROFEEL 1698 STEEERABLE(STENT+G+SHEATH+CLIP) CKU P2 URETERAL CATHETER STRAIGHT TIP 3:7FR 75CM 166 CKU CK "COOK"URETERAL CATHETER 輸尿管導管 166 CKU BA URETERAL CATHETER (OLIVE TIP) 4:6FR 166 CKU BA URETERAL CATHETER (SPIRAL) 4:6FR 166 CKU BA URETERAL CATHETER (CONE TIP) 8:12FR 166 CKU AN URETERAL CATHETER 166 CKU AN URETERAL CATHETER 166 CKU036243NAN URETERAL CATHETER 166 CKU AN URETERAL CATHETER 166 CKU036245NAN URETERAL CATHETER 166 CKU AN URETERAL CATHETER 166 CKU036251NAN URETERAL CATHETER CYLINDERAL 4:8CH 70CM 斑馬線導管 166 CKU AN URETERAL CATHETER 166 CKU036313NAN URETERAL CATHETER 166 CKUB101000CK URETeRAL BALLOON dilator CATHETER 65CM 5FR,7FR 4032 CKUB101415CK BALLOON URETERAL(UREThERAL 自 起改為 URETERAL) DILATOR 5068 SETS 5:7FR 65CM(CATH+GUIDE WIRE) CKUB107835CK "COOK"URETEROSCOPY BALLOON CATHETER(CATHETER+GUIDE WIRE) 5068 輸尿管氣球導管 CKUB121810SB "BOSTON SCIENTIFIC"PASSPORT UROLOGICAL BALLOON DILATATION 5068 CATHETER WITH HYDRO PLUS BONDED HYDROGEL COATING" 波士頓科技 " 帕斯泌尿科氣球擴張導管 CKUB122510MV UROMAX ULTRA HIGH PRESSURE URETERAL CATHETER W/SHEATH

132 CKUB128005CK "COOK" UPJ OCCLUSION BALLOON CATHETER SETS(CATH+GUIDE 5068 WIRE)" 曲克 " 優皮傑閉合氣球導管組 CKUB18884NBA UROFORCE BALLOON DILATION CATHETER 4032 CKUB1AUBS1CK COOK ASCEND AQ URETERAL DILATION BALLOON CATHETER CM:10CM CKUD126100SB BOSTON SCIENTIFIC AMPLATZ TYPE GRADUATED RENAL DILATOR 953 SET CKUD126120SB "BOSTON SCIENTIFIC"AMPLATZ TYPE GRADUATED RENAL 695 STYLET/SHEATH CKUD160300AN RENAL DILATOR W/SHEATH 695 CKUD200008CL SILICON NEPHROSTOMY DILATOR 腎擴張造廔導管 117 CKUD200012CL SILICON NEPHROSTOMY DILATOR 腎擴張造廔導管 164 CKUD200016CL SILICON NEPHROSTOMY DILATOR 腎擴張造廔導管 234 CKUD200040AN PTFE DILATOR 4:9FR 117 CKUD200120AN PTFE DILATOR 12:14FR 164 CKUD20012DAN "ANGIOMED"DILATATION SET 12FR 擴張器組 164 CKUD200160AN PTFE DILATOR 16FR 234 CKUS22614NSB AMPLATZ TYPE RENAL SHEATH SET 820 CKUS26015NSB "BOSTON SCIENTIFIC"AMPLATZ TYPE RENAL SHEATH 820 SET/INDIVIDUAL SHEATHS CKUS2AMPV1CK TFE SHEATHS FOR AMPLATZRENAL DILATORS 10:36FR,16:40CM 820 CLPA120020US SINGLE TITANIUM CHEMOSITE VENOUS PORT(PORT+CATH+NEEDLE) 9370 適應症請見備註欄 CLPA120021US SINGLE TITANIUM CHEMOSITE LOW PROFILE PORT 9FR(P+C+N+I) 適應症請見備註欄 CLPA120022US SINGLE TITANIUM CHEMOSITE LOW PROFILE 9370 PORT(PORT+CATH+NEEDLE) 適應症請見備註欄 CLPA120023US SINGLE TITANIUM CHEMOSITE LOW PROFILE 9370 PORT(PORT+CATH+NEEDLE) 適應症請見備註欄 CLPA120024US SINGLE TITANIUM CHEMOSITE LOW-PROFILE PORT(P+C+N) 適應症 9370 請見備註欄 CLPA120026US SINGLE TITANIUM CHEMOSITE LOW-PROFILE 9370 PORT(PORT+CATH+NEEDLE) 適應症請見備註欄 CLPA120027US SINGLE TITANIUM CHEMOSITE LOW-PROFILE 9370 PORT(PORT+CATH+NEEDLE) 適應症請見備註欄 CLPA120044US SINGLE TITANIUM CHEMOSITE PORT(PORT+CATH+NEEDLE) 適應症 9370 請見備註欄 CLPA120045US SINGLE TITANIUM CHEMOSITE PORT 9FR(P+C+N+I) 適應症請見備 註欄 CLPA120085US SINGLE TITANIUM CHEMOSITE VENOUS PORT(PORT+CATH+NEEDLE) 9370 適應症請見備註欄 CLPA1ABRM1CK "COOK"SPECTRUM TURBO-JECT PICC SETS 4-5FR CM(CATH+INTRODUCER) " 曲克 " 史派純特波傑特周邊血管導入套組 ( 單腔 ) CLPA1ABRM2CK "COOK"SPECTRUM TURBO-JECT PICC SETS 4-5FR 50CM 4100 (CATH+INTRODUCER)" 曲克 " 史派純特波傑特周邊血管導入套組 ( 雙腔 ) CLS BB DOSIFIX W/SAFESITE NEEDLE-FREE SYSTEM W/VALVE 120ML( 自 更改功能類別 )* 適應症請見備註欄 CLS BB DOSIFIX W/SAFESITE NEEDLE-FREE SYSTEM W/VALVE 150ML( 自 起更改功能類別 )* 適應症請見備註欄 CLS04A260NPW PERFECT DISPOSABLE INFUSION SET(W/BURETTE W/VALVE W/SAFESITE NEEDLE SYSTEM )* 適應症請見備註欄

133 CLS04E010NPW INFUSION SET W/BURETTE W/VALVE W/SAFESITE NEEDLE-FREE 74 SYSTEM* 適應症請見備註欄 CLS04NB150SG SIGMA VOLUME METERIC ADMINISTRATION SET* 適應症請見備註欄 74 CLS04NS120SG VOLUME METERIC ADMINISTRATION SET W/FREE SITE * 適應症請見 74 備註欄 CLS04SBASSLL VOLUME METERIC ADMINISTRATIONN SET ( 安全型免針加 74 藥 )W/VALVE* 適應症請見備註欄 CLS06M270LTM TERUFUSION IV PUMP SET WITH BAG 100CC 適應症請見備註欄 CLS08066SPBB INFUSOMAT SPACE LINE TRANSFUSION WITH 200UM BLOOD FILTER 230 史倍司輸血套 CLS HR Y-TYPE BLOOD SET WITH PUMP 230 CLS HR Y-TYPE BLOOD PLUMSET 230 CLS08140PUSG "SIGMA"INFUSION PUMP SET BLOOD FILTER 幫浦輸血輸液套 230 CLS08150PUSG "SIGMA"INFUSION PUMP SET Y-SITE BLOOD FILTER Y 型幫浦輸血 230 輸液套 CLS0900BTYJS Y TYPE BLOOD TRANSFUSION SET 22 CLS TM Y TYPE ADMINISTRATION SET 22 CLS TM Y TYPE ADMINISTRATION SET 22 CLS09A140NPW PERFECT DISPOSABLE TRANSFUSION (Y TYPE ) 22 CLS09B140NPW Y TYPE BLOOD TRANSFUSION SET 22 CLS BX "BAXA"EXACTA-MIX EVA CONTAINER 250ML" 柏瑟 " 靜脈營養術灌注 101 袋 CLS BX "BAXA"EXACTA-MIX EVA CONTAINER 500ML" 柏瑟 " 靜脈營養術灌注 101 袋 CLS BX "BAXA"EXACTA-MIX EVA CONTAINER 1000ML" 柏瑟 " 靜脈營養術灌注 127 袋 CLS BX "BAXA"EXACTA-MIX EVA CONTAINER 2000ML" 柏瑟 " 靜脈營養術灌注 156 袋 CLS BX "BAXA"EXACTA-MIX EVA CONTAINER 3000ML" 柏瑟 " 靜脈營養術灌注 156 袋 CLS BB NUTRIENT MIXING BAG-NUTRIMIX 156 CLS BB TPN BAG 3000CC 156 CLS14B8082CT VIAFLEX TPN BAG 250C.C. 96 CLS14B8083CT VIAFLEX TPN BAG 500C.C. 96 CLS14B8084CT VIAFLEX TPN BAG 1000C.C. 125 CLS14B8086BT EMPTY VIAFLEX CONTAINER WITH CONNECTOR 2000ML 156 CLS14B8087BT EMPTY VIAFLEX CONTAINER WITH CONNECTOR 3000ML 156 CLS14B8112CT ALL-IN-ONE BAG 1000CC 127 CLS14B8122CT ALL-IN-ONE BAG 2000C.C. 156 CLS14B8132CT ALL-IN-ONE BAG 3000C.C. 156 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 CME01MABDXBL MAGIC CATHETER WITH BALLOON EMBOLIZATION SET(BALLOON+MICRO CATH+MANDRIA) 適應症請見備註欄 CMV SB RENEGADE HI-FLO MICROCATHETER KIT(MICROCATH+G WIRE+HEMASTATIC)* 適應症請見備註欄 CMV SB SPINNAKER ELITE FLOW DIRECTED INFUSION CATHETER SET(INFUSION CATH+MICRO GUIDEWIRE+HEMASTATIC )* 適應症請見備註欄

134 特材代碼 中英文名稱 支付點數 -102/01 CMV TA SPINNAKER INFUSION CATHTER(CATH+GUIDEWIRE+HEMASTATIC) 適 應症請見備註欄 CMV SB EXCELSIOR MICROCATHETER LENGTH 150/6 TIP CONFIGURATION ,2 MARKER * 適應症請見備註欄 CMV SB EXCELSIOR PRE-SHAPED MICROCATHETER* 適應症請見備註欄 7440 CMV SB FAS TRACKER INFUSON CATHETER KIT(CATH+GUIDE WIRE+HEMASTATIC)* 適應症請見備註欄 CMV016060NCD "CORDIS"PROWLER INFUSION CATHETER" 考迪斯 " 保勒注射導管 適 7440 應症請見備註欄 CMV016060NCM "CODMAN"PROWLER INFUSION CATHETER" 科特曼 " 保勒注射導管 適 7440 應症請見備註欄 CMV016061NCD "CORDIS"PROWLER INFUSION CATHETER" 考迪斯 " 保勒注射導管 適 7440 應症請見備註欄 CMV016061NCM "CODMAN"PROWLER INFUSION CATHETER" 科特曼 " 保勒注射導管 適 7440 應症請見備註欄 CMV01606S1CD "CORDIS"PROWLER SELECT LP&LP-ES INFUSION CATHETER 保勒注射 7440 導管 * 適應症請見備註欄 CMV01606S1CM "CODMAN"PROWLER LP&LP-ES INFUSION CATHETER" 科特曼 " 保勒注 7440 射導管 適應症請見備註欄 CMV01606S2CD "CORDIS"PROWLER SELECT PLUS INFUSION CATHETER 保勒注射導管 7440 * 適應症請見備註欄 CMV01606S2CM "CODMAN"PROWLER PLUS INFUSION CATHETER" 科特曼 " 保勒注射導 7440 管 適應症請見備註欄 CMV01606XNCD "CORDIS"PROWLER INFUSION CATHETER 保勒注射導管 * 適應症請見 7440 備註欄 CMV01606XNCM "CODMAN"PROWLER INFUSION CATHETER" 科特曼 " 保勒注射導管 適 7440 應症請見備註欄 CMV016251NCD "CORDIS"PROWLER INFUSION CATHETER 保勒注射導管 * 適應症請見 7440 備註欄 CMV016251NCM "CODMAN"PROWLER INFUSION CATHETER" 科特曼 " 保勒注射導管 適 7440 應症請見備註欄 CMV01E2710TM PROGREAT CATHETER(MICRO CATH+INTRODUCER WIRE+COATING+HEMASTATIC) 適應症請見備註欄 CMV01ECHL0V9 "MTI"ECHELON MICRO CATHETERS 微導管 (CATH+MICRO GUIDE WIRE+HEMASTATIC)* 適應症請見備註欄 CMV01FS135MR "MERIT"FOUNTAIN INFUSION SYSTEM(CATH+GUIDE WIRE+HEMASTATIC) 芳登灌輸系統 * 適應症請見備註欄 CMV01MC11XCY COSMO MICRO CATHETER KIT(CATH+GUIDEWIRE+Y CONNECTOR+TORQUE DEVICE) 適應症請見備註欄 CMV01MC1S2CK "COOK"MULTI-SIDEPORT CATHETER INFUSION SET 多側孔注射導管 7440 組 * 適應症請見備註欄 CMV01MF251CK "COOK"MIRA-FLEX 18 MICROCATHETER* 適應症請見備註欄 7440 CMV01MF252CK "COOK"CANTATA 2.5 AND CANTATA 2.8 MICROCATHETER" 曲克 " 坎塔 7440 塔微導管 * 適應症請見備註欄 CMV01MFNT1CK "COOK"MIRAFLEX MICROCATHETER 麥拉菲微導管 * 適應症請見備註欄 7440 CMV01MFNT2CK "COOK"MIRAFLEX MICROCATHETER 2.5FR 100:150CM 麥拉菲微導管 * 適應症請見備註欄 CMV01MFS01CK MICROFERRET-21 HIGH FLOW INFUSION CATH SET(C+G+CONNE.+TOR.DEVICE) 適應症請見備註欄 CMV01MFS11CK COOK MICROFERRET-18 INFUSION CATHETER SET(CATH+GUIDE WIRE+HEMASTATIC)* 適應症請見備註欄

135 CMV01MFS15CK COOK MICROFERRET-18 INFUSION CATHETER SET(CATH+GUIDE WIRE+HEMASTATIC)* 適應症請見備註欄 CMV01P2710TM PROGREAT CATHETER(MICRO CATH+INTERODUCER WIRE+COATING+HEMASTATIC) 適應症請見備註欄 CMV01PC241TM PROGREAT CATHETER(MICRO CATH+INTRODUCER WIRE+COATING+HEMASTATIC) 適應症請見備註欄 CMV01PX400UF "PENUMBRA"MICROCATHETER( 導管 + 止血閥 + 導引器 )" 彼娜波 "* 微導 管 * 給付規定請見備註欄 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 CMV01RENFASB "BOSTON SCIENTIFIC"RENEGADE HI-FLO FATHOM KIT (CATH+GUIDE WIRE+HEMASTATIC)AND SYSTEM " 波士頓科技 " 瑞能蓋高流動探測組 * 適應症請見備註欄 CMV01SCR3NCK "COOK"MULTI-SIDEPORT CATHETER INFUSION SET 多側孔注射導管 7440 組 * 適應症請見備註欄 CMV01SCWHVMR "MERIT"FOUNTAIN INFUSION SYSTEM(CATH+GUIDE WIRE+HEMASTATIC) 芳登灌輸系統 * 適應症請見備註欄 CMV01SMAGXBL BALT MAGIC CATHETER SET 適應症請見備註欄 CMV01SQ135MR "MERIT"FOUNTAIN INFUSION SYSTEM(CATH+GUIDE WIRE+HEMASTATIC) 芳登灌輸系統 * 適應症請見備註欄 CMV01STDATAS ASAHI MICRO CATHETER * 適應症請見備註欄 7440 CMV020402XCY CIC BALLOON CATHETER FOR EMBOLECTOMY CATHETER 2:8FR 1071 CMV020402XGT "GOODTEC"BALLOON CATHETER-ARTERIAL EMBOLECTOMY CATHETER" 1071 固特克 " 球型導管 CMV SB FAS TRACKER INFUSON CATHETER* 適應症請見備註欄 7440 CMV TA TARGET FASTRACKER INFUSION CATHETER 適應症請見備註欄 7440 CMV020F150QM AXIUS CORONARY SHUNT* 適應症請見備註欄 2771 CMV020F20LQM "MAQUET"AXIUS CORONARY SHUNT" 邁柯唯 " 艾齊克氏冠狀動脈分流 2771 管 * 適應症請見備註欄 CMV SB "BOSTON SCIENTIFIC"GUIDER SOFTIP XF GUIDING CATHETER* 適應 6923 症請見備註欄 CMV SB "BOSTON SCIENTIFIC"GUIDER SOFTIP XF GUIDING CATHETER* 適應 6923 症請見備註欄 CMV02120FFED EDWARDS FOGARTY ARTERIAL EMBOLECTOMY CATHETER 1071 CMV02120XNED FORGATY ARTERIAL EMBOLECTOMY CATHETER 2:7FR 40:80MM 1071 CMV021240NBT FORGATY EMBOLECTOMY CATHETER 1071 CMV021280NBT FORGATY EMBOLECTOMY CATHETER 1071 CMV0212TLWED FOGARTY THRU-LUMEN EMBOLECTOMY CATHETER(2 LUMEN CATH) 1895 CMV SB TRACKER EXCEL-14 MICROCATHETER* 適應症請見備註欄 7440 CMV TA TARGET THERAPEUTICS TRACKER EXCEL-14 MICROCATHETER* 適應症 7440 請見備註欄 CMV02142NNTA TARGET THERAPEUTICS TRACKER EXCEL-14 MICROCATHETER* 適應症 7440 請見備註欄 CMV021601SLW "LEMAITRE"EMBOLECTOMY CATHETERS 單腔式動脈血栓清除導管 1071 CMV LW "LEMAITRE"EMBOLECTOMY CATHETERS 導引線式動脈血栓清除導管 1895 ( 雙腔 ) CMV021801LLW "LEMAITRE"EMBOLECTOMY CATHETERS 單腔式動脈血栓清除導管 1071 CMV SB RENEGADE MICROCATHETER* 適應症請見備註欄 7440 CMV TA RENAGADE FIBER BRAIDED MICRO CATH PROXIMAL/DISTAL 3F/2.5F ,150CM 適應症請見備註欄 CMV SB RENEGADE HI-FLO MICROCATHETER OD=3.0F/2.8F ID=0.027/0.027 L80/150CM * 適應症請見備註欄

136 CMV SB RENEGADE HI-FLO MICROCATHETER O.D 3.0,2.8F I.D L ,150CM * 適應症請見備註欄 CMV021CXXXMS "MICROVENTION"CHAPERON GUIDING CATHETER SYSTEM" 麥新 " 護航 6923 導引導管系統 * 給付規定請見備註欄 CMV021VS12ED ANASTA FLO INTRAVASCULAR SHUNT* 適應症請見備註欄 2771 CMV M4 CLEARVIEW INTRACORONARY SHUNT* 適應症請見備註欄 2771 CMV ED FORGATY VENOUS THROMBECTOMY CATHETER 1071 CMV02403VBCD "CORDIS"VISTA BRITE TIP INTRODUCER GUIDING " 考迪斯 " 導引導 6923 管 * 適應症請見備註欄 CMV02600XNCD "CORDIS"TRANSIT INFUSION CATHETER 3FR/2.5FR ,90,105,140,155,175CM 適應症請見備註欄 CMV02600XNCM "CODMAN"TRANSIT INFUSION CATHETER" 科特曼 " 微細血管注射導管 7440 * 適應症請見備註欄 CMV02A4400A4 SYNTEL ARTERIAL EMBOLECTOMY CATHETER 3:7FR/40,50,80CM 1071 CMV02A4E09A4 PYTHON DUAL LUMEN EMBOLECTOMY CATHETER(CATH+GUIDE 2565 WIRE+INTRODUCER) CMV02A4F00A4 SYNTEL ARTERIAL EMBOLECTOMY CATHETER 2:7FR 40,60,80CM 1071 CMV02C1254B2 FLORESTER CORONARY ARTERY OCCLUDER 冠狀動脈血管阻塞棒 2591 CMV02C5015S7 "SYNOVIS"FLO-RESTER VESSEL OCCLUDERS 血管閉塞器 2591 CMV02EL134BS ARTERIAL EMBOLECTOMY CATHETER 1071 CMV02EL326BS EMBOLECTOMY CATHETER 1071 CMV02FT012B2 FLO-THRU INTRALUMINAL SHUNT 血管通路器 * 適應症請見備註欄 2771 CMV02FT012S7 FLO-THRU INTRALUMINAL SHUNT 血管通路器 * 適應症請見備註欄 2771 CMV02FT10XCY INTRACEREBRAL BRAIDED GUIDING CATHETER HYDROPHILIC 5FR,6FR 100CM 適應症請見備註欄 CMV02GCXXXMS "MICROVENTION"CHAPERON GUIDING CATHETER SYSTEM" 麥新 " 護航導引導管系統 * 給付規定請見備註欄 CMV02GNDRAVS "VASCULAR SOLUTIONS"GANDRAS INTRAVASCULAR CATHETER(INFUSION)" 法斯樂舒順 " 恩德拉血管內導管 * 適應症請見備註欄 CMV02GSFK1TM "TERUMO"DESTINATION GUIDING SHEATH" 泰爾茂 " 諦思迪迅導引套 * 給付規定請見備註欄 CMV02KCFW1CK "COOK"FLEXOR GUIDING CATHETERS 福雷色引導導管 * 適應症請見備註欄 CMV02KCFW2CK "COOK"FLEXOR GUIDING CATHETERS " 曲克 " 服來瑟引導導管 4.0~12.0FR,30~110CM CMV02KCFW3CK "COOK"FLEXOR GUIDING CATHETERS " 曲克 " 服來瑟引導導管 5.0~10.0FR,55~90CM CMV02KCFW4CK "COOK"FLEXOR GUIDING CATHETERS " 曲克 " 福雷色引導導管 4.0~12.0FR,40~110CM CMV02KSAW1CK "COOK "FLEXOR GUIDING CATHETERS " 曲克 " 服來瑟引導導管 * 適應症請見備註欄 CMV02KSAW2CK COOK FLEXOR GUIDING CATHETERS 0.038" 70:90CM* 適應症請見備註欄 CMV02KSAW3CK "COOK"FLEXOR GUIDING CATHETERS 5.0FR:8.0FR 0.018/0.038: CM:90CM CMV02KSAW4CK "COOK"FLEXOR GUIDING CATHETERS 弗萊色引導導管 * 適應症請見備註欄 CMV02KSAW5CK "COOK"FLEXOR GUIDING CATHETERS 弗萊色引導導管 * 適應症請見備註欄

137 CMV02KSAW6CK "COOK"FLEXOR GUIDING CATHETERS5-8FR 55:110MM 服來瑟引導導 6923 管 * 適應症請見備註欄 CMV02LMGN1CK "COOK"NORTHSTAR LUMAX FLEX GUIDING CATHETERS 諾斯達盧馬福 6923 雷司導引導管 * 適應症請見備註欄 CMV02LMGN2CK "COOK"WHITE LUMAX GUIDING CATHETERS 懷特盧馬導引導管 * 適應 6923 症請見備註欄 CMV02MC172MS "MICROVENTION"HEADWAY MICROCATHETER 前進微導管 * 給付規定請 7440 見備註欄 CMV02MF001CK MICROFERRET-18 INFUSION CATHETER SET 3FR * 適應症請見備註 7440 欄 CMV02PNS13UF "PENUMBRA"NEURON INTRACRANIAL ACCESS SYSTEM-SELECT 7440 CATHETER 顱內導入系統導管 * 適應症請見備註欄 CMV02RFGC4TM RADIFOCUS GLIDECATH 4FR 65:100CM ALL CURVE 1071 CMV02V3064B2 FLORESTER VASCULAR OCCLUDER 週邊動脈血管阻塞棒 2591 CMV SB TRANSEND GUIDE WIRE * 適應症請見備註欄 4650 CMV CD "CORDIS"AGILITY STEERABLE GUIDEWIRE 0.014" 165,205,350CM" 4650 考迪斯 " 愛捷第導引線 適應症請見備註欄 CMV CM "CODMAN"AGILITY STEERABLE GUIDEWIRE" 科特曼 " 愛捷第導引線 4650 適應症請見備註欄 CMV CD "CORDIS"AGILITY STEERABLE GUIDEWIRE " 考迪斯 " 愛捷第導引線 4650 適應症請見備註欄 CMV CM "CODMAN"AGILITY STEERABLE GUIDEWIRE" 科特曼 " 愛捷第導引線 4650 適應症請見備註欄 CMV03614XNCD "CORDIS"AGILITY STEERABLE GUIDEWIRE CM( 型號 自 91/07/01 生效 ) 適應症請見備註欄 CMV03614XNCM "CODMAN"AGILITY STEERABLE GUIDEWIRE" 科特曼 " 愛捷第導引線 4650 適應症請見備註欄 CMV03FA509SB "BOSTON SCIENTIFIC"FATHOM-16 STEERABLE GUIDEWIRE 菲森可控 4650 式導線 * 適應症請見備註欄 CMV03FWR45MR "MERIT"FOUNTAIN INFUSION SYSTEM(GUIDE WIRE+TORQUE) 芳登灌 4650 輸系統 * 適應症請見備註欄 CMV03GW14XMS "MICROVENTION"TRAXCESS GUIDE WIRE" 麥新 " 翠克絲微導線 * 適應 4650 症請見備註欄 CMV03MT1GWV9 "MTI"GUIDEWIRE 導引線 ( 親水性導入線 + 扭轉器 + 導入線導入鞘 )* 適 4650 應症請見備註欄 CMV03S0RXXBL "BALT"SORCERER GUIDEWIRE 魔術師導線 * 適應症請見備註欄 4650 CMV03STM48AS ASAHI MICRO GUIDEWIRE 0.014" 0.018"* 適應症請見備註欄 4650 CMV03TPMG1CK MICRO GUIDE WIRE 0.14INCH * 適應症請見備註欄 4650 CMV03TPMG2CK "COOK"MICRO WIRE GUIDE 導線 * 適應症請見備註欄 4650 CMV03XCEGWV9 "MTI"X-CELERATOR GUIDEWIRE 0.010",0.014"300CM " 恩提愛 " 愛 4650 克西亞導引線 ( 親水性導引線 + 扭轉器 + 導入線導入鞘 ) CMV TA FIBERED PLATINUM COIL 適應症請見備註欄 3122 CMV TA FIBERED PLATINUM COIL2:30MMX2:100MM 適應症請見備註欄 3122 CMV SB GDC-SYNERG OCCLUSION COIL* 適應症請見備註欄 ( 型號 : SR 自 起生效 ) CMV SB GDC-SYNERG OCCLUSION COIL* 適應症請見備註欄 CMV TA VASCULAR PLATINUM COIL 適應症請見備註欄 3122 CMV SB FIBERED PLATINUM COILS* 適應症請見備註欄 3122 CMV04AX1UMV9 "MTI"AXIUM DETACHABLE COILS SYSTEM 西恩分離式閉塞捲 MM:25MM,1CM:50CM* 適應症請見備註欄 CMV04C0SM0MS "MICROVENTION"MICROPLEX COIL SYSTEM COSMOS COMPLEX COILS(10,18 SYSTEM)" 麥新 " 微導線圈栓塞系統 * 適應症請見備註欄

138 CMV04DCS01CD CMV04DCS01CK CMV04DCS01CM CMV04DCS02CD CMV04DCS02CM CMV04DCS03CD CMV04DCS03CM CMV04GDC04TA CMV04GDC10SB "CORDIS"TRUFILL DCS DETACHABLE CIOL SYSTEM 楚菲爾分離式白金纖維環系統 * 適應症請見備註欄 DETACHABLE EMBOLIZATION COIL( 機械式旋轉方式解離 )* 適應症請見備註欄 "CODMAN"TRUFILL DCS DETACHABLE COIL SYSTEM" 柯特曼 " 楚菲爾分離式白金纖維環系統 * 適應症請見備註欄 "CORDIS"TRUFILL DCS DETACHABLE CIOL SYSTEM 楚菲爾分離式白金纖維環系統 * 適應症請見備註欄 "CODMAN"TRUFILL DCS DETACHABLE COIL SYSTEM" 柯特曼 " 楚菲爾分離式白金纖維環系統 * 適應症請見備註欄 "CORDIS"TRUFILL DCS DETACHABLE COIL SYSTEM 楚菲爾分離式白金纖維環系統 * 適應症請見備註欄 "CODMAN"TRUFILL DCS DETACHABLE COIL SYSTEM" 柯特曼 " 楚菲爾分離式白金纖維環系統 * 適應症請見備註欄 GDC-SYNER G OCCLUSION COILS( 產品型號包括 SR4:344715SR4) 適應症請見備註欄 "BOSTON SCIENTIFIC"GDC DETACHABLE COIL 2,2.5,3,4,5,6,7MM 古利艾美分離式閉塞捲 * 適應症請見備註欄 CMV04GDC10TA GDC OCCLUSION COILS(OD 2:20MM 1:30CM) 適應症見備註 ( ,10: 生效 ) CMV04GDC11SB GDC DETACHALE COIL* 適應症請見備註欄 CMV04GDC12SB GDC DETACHALE COIL* 適應症請見備註欄 CMV04GDC18SB GDC DETACHALE COIL* 適應症請見備註欄 CMV04GDC19SB GDC DETACHALE COIL* 適應症請見備註欄 CMV04H2HSVMS "MICROVENTION"HYDROCOIL(HYDROSOFT HELICAL) EMBOLIC SYSTEM(10 COIL SIZE)1.5MM:10MM 2CM:30CM 親水性線圈栓塞系統 * 適應症請見備註欄 CMV04HCSVXMS "MICROVENTION"MICROPLEX COIL SYSTEM 微導線圈栓塞系統 * 適應 症請見備註欄 CMV04HESVXMS HYDROCOIL EMBOLIC SYSTEM (HES) 親水性線圈栓塞系統 * 適應症請 見備註欄 CMV04HFRMVMS "MICROVENTION"HYDROCOIL EMBOLIC SYSTEM(HES) D:3MM:8MM L:6CM:33CM;" D:6MM:20MM L:19CM:48CM 麥新 " 親水性線圈栓塞系統 * 適應症請見備註欄 CMV04M000TCK TORNADO EMBOLIZATION MICROCOIL 0.018,2:14CM 2:10MM 適應 3122 症請見備註欄 CMV04M001NCK "COOK"EMBOLIZATION COILS" 曲克 : 栓塞環 * 適應症請見備註欄 2019 CMV04M002NCK "COOK"EMBOLIZATION COILS" 曲克 : 栓塞環 * 適應症請見備註欄 2019 CMV04M003NCK TORNADO EMBOLIZATION MICROCOIL 0.035,0.038,3:14CM,3:10MM 3122 適應症請見備註欄 CMV04M005NCK HILAL EMBOLIZATION MICROCOILS* 適應症請見備註欄 3122 CMV04M006NCK EMBOLIZATION COILS * 適應症請見備註欄 2019 CMV04M007NCK COOK NESTER EMBOLIZATION COILS* 適應症請見備註欄 3122 CMV04M008NCK COOK MREYE EMBOLIZATION COILS AND DETACHABLE COILS 英吋.1:5 公分 英吋.1:20 公分 英吋.1:20 公分 * 適應請見備註欄 CMV04MAX05SB MATRIX2 DETA.COIL D:2-24MM L:2-40CM 360 度 COMP SHAPE-360 度 FIRM.360 度 STANDARD SR.360 度 SOFT SR.HELICAL SHAPE-HELICAL ULTRA SOFT SR* 適應症見備註 CMV04MAX06SB MATRIX COIL D:2-20MM L:4:30CM 3D OMEGA SHAPE-3D OMEGA FIRM;STANDARD HELICAL SHAPE-2DFIRM;STANDARD SR;SOFT SR;HELICAL SOFT SR* 適應症見備註

139 CMV04MCSVXMS CMV04MWCE1CK CMV04NEST2CK CMV04NEXUSV9 CMV04NYL0NV9 CMV04PGLACV9 "MICROVENTION"MICROPLEX COIL SYSTEM 微導線圈栓塞系統 * 適應症請見備註欄 "COOK"MREYE EMBOLIZATION COILS 密絲特艾栓塞線圈, 伸展之栓塞長度 1:20 公分, 線圈狀栓塞直徑 2:25 公厘 * 適應症請見備註欄 "COOK"NESTER EMBOLIZATION COILS(PLATINUM)" 曲克 " 奈斯特彈簧栓塞 * 適應症請見備註欄 "MTI"NEXUS DETACHABLE COILS SYSTEM 雷瑟斯分離式閉塞捲 * 適應症請見備註欄 "MTI"AXIUM NYLON DETACHABLE COILS SYSTEM" 恩提愛 " 艾司恩分離式閉塞捲,D 1.5MM-10MM,L 1CM-30CM* 適應症請見備註欄 "MTI"AXIUM PGLA DETACHABLE COILS SYSTEM" 恩提愛 " 艾恩斯分離式閉塞捲, 直徑 1.5MM-10MM, 長度 1CM-30CM* 適應症請見備註欄 CMV04TARGTSB "BOSTON SCIENTIFIC"TARGET DETACHABLE COIL " 頓士頓科技 " 塔 吉特分離線圈 * 適應症請見備註欄 CMV LW "LEMAITRE"PRUITT IRRIGATION OCCLUSION CATHETER 普特灌沖血 2466 管閉塞導管 CMV LW "LEMAITRE"PRUITT OCCLUSION CATHETER 普特血管閉塞導管 2466 CMV070NYXXV9 "MTI"ONYX LIQUID EMBOLIC SYSTEM 歐尼斯液態栓塞系統 CMV V9 "MTI"MARATHON FLOW DIRECTED MICRO CATHETERS 梅洛森微導管 CPC BB 1 LUMEN PEDIATRIC CVP CATHETER(C+N+D+G+S) 679 CPC BB 1 LUMEN CVP CATHETER(C+N+D+G+S) 439 CPC M0 SINGLE LUMEN INFUSION CATHETER SET(C+D+GW+N) 439 CPC M0 SINGLE LUMEN INFUSION CATHETER SET 20G;24G(C+D+GW+N) 679 CPC AR "ARROW"CENTRAL VEIN CATHETERIZATION SET I 439 LUMEN(CATH+NEEDLE+DILATOR+GUIDE WIRE+SYRING)" 亞諾 " 中央靜脈導管組 CPC BA SILICONE PER-Q CATHETER(PICC)(CATH W/STYLET,INTRODUCER 1043 NEEDLE)2,3FR 28CM,60CM CPC014132NBA SINGLE LUMEN SILICONE PER-Q CATHETER BASIC TRAY 2FR 1043 CPC AG CVP KIT MINI ( 含 GUIDE WIRE, CATHETER, NEEDLE) 16FR 439 CPC AG CVP KIT MINI ( 含 GUIDE WIRE, CATHETER, NEEDLE) 16FR 439 CPC DV SINGLE LUMEN BROVIAC CATHETER 布羅斐式導管 2.7FR 90CM 2412 CPC016816NAG " 愛琅 " 中央靜脈導管組 "ARGON"CENTRAL VENOUS CATHETERS LUMEN 5:7FR (C+N+D+G+S) CPC016816NBD SINGLE LUMEN CVP CATHETER(CATH+N+DIL+GW+SYR) 439 CPC01A4301AR "ARROW"ARROWGARD CATHETERS:ANTISEPTIC SINGLE LUMEN CVP 548 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 CPC01A4650AR "ARROW"CENTRAL VEIN CATHETERIZATION SET I 679 LUMEN(PEDIATRIC)(CATH+NEEDLE+DILATOR+GUIDE WIRE+SYRING)" 亞諾 " 中央靜脈導管組 CPC01B1161AG "ARGON"HYDROCATH ASSURE HYDROPHILIC ANTI-MICROBIAL 548 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 CPC01B1161BD ANTIMICROBIAL SINGLE LUMEN CVP CATHETER(C+N+D+G+S) 適應 548 症請見備註欄 CPC01BCV11EE 1 LUMEN CVP CATHETER(CATHETER+GW+DILATOR+SYRINGE)

140 CPC01C4400AR "ARROW"CENTRAL VEIN CATHETERIZATION SET I 439 LUMEN(CATH+NEEDLE+DILATOR+GUIDE WIRE+SYRING)" 亞諾 " 中央靜脈導管組 CPC01E4301AR "ARROW"CENTRAL VEIN CATHETERIZATION SET I 439 LUMEN(CATH+NEEDLE+DILATOR+GUIDE WIRE+SYRING)" 亞諾 " 中央靜脈導管組 CPC01E4700AR "ARROW"CENTRAL VEIN CATHETERIZATION SET(1 439 LUMEN)(CATHETER+NEEDLE+DILATOR+GUIDE WIRE+SYRINGE)" 亞諾 " 中央靜脈導管組 CPC01ECL11BB CERTOFIX CENTRAL VENOUS CATHETER (1 439 LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE) 舒鈦單腔中心靜脈導管組 CPC01H1056AG " 愛琅 " 中央靜脈導管組 "ARGON"CENTRAL VENOUS CATHETERS LUMEN 5:7FR(C+N+D+G+S) CPC01H1056BD SINGLE LUMEN CVP CATHETER 439 SET(CATH+NEEDLE+DILATOR+G.WIRE+SYRINGE) CPC01M1142ED 1 LUMEN MULTI-MED CENTRAL CATHETER SET W/AMC 548 THROMBOSHIELD 適應症請見備註欄 CPC01M1162ED 1 LUMEN MULTI-MED CENTRAL CATHETER SET(C+N+GW+DIL+SY) 439 CPC01M1201ED 1 LUMEN CVP CATHETER W/AMC THROMBOSHIELD 548 COATING(C+N+D+GW+S) 適應症請見備註欄 CPC01P1051AG " 愛琅 " 中央靜脈導管組 "ARGON"CENTRAL VENOUS CATHETERS LUMEN 2.5:4FR(PEDIATRIC)(C+N+D+G+S) CPC01P1051BD 1 LUMEN CVP CATH SET 18G,20G,22G(PEDIATRIC)(C+N+D+G+S) 679 CPC01PED01BB CERTOFIX CENTRAL VENOUS CATHETER(PEDIATRIC LUMEN)(CATHETER+GUIDEWIRE+NEEDLE+SCALPEL+3 WAY) 舒鈦單腔小兒用中心靜脈導管組 CPC01PMS01CK "COOK" FEMORAL DISTAL AORTIC PRESSURE MONITORING SET :5.0 FR. " 曲克 " 動脈壓力監測組 (CATHETER+WIRE+NEEDLE+SYRINGE) 適應症請見備註欄 CPC01PMS02CK "COOK" FEMORAL DISTAL AORTIC PRESSURE MONITORING SET :5.0 FR. " 曲克 " 動脈壓力監測組 (CATHETER+WIRE+NEEDLE+SYRINGE) 適應症請見備註欄 CPC01PMS03CK "COOK" FEMORAL DISTAL AORTIC PRESSURE MONITORING SET :5.0 FR. " 曲克 " 動脈壓力監測組 (CATHETER+WIRE+NEEDLE+SYRINGE) 適應症請見備註欄 CPC01PTT11BB CERTOFIX CENTRAL VENOUS CATHETER(PROTECT 1 LUMEN) 548 (CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE) 舒鈦抗感染單腔中心靜脈導管組 CPC01R4020AR "ARROW"ARTERIAL CATHETERIZATION SET(RA ,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 CPC01STD11BB CERTOFIX CENTRAL VENOUS CATHETER(1 439 LUMEN)(CATHETER+DILATOR+GUIDEWIRE +NEEDLE+SYRINGE) 舒鈦單腔中心靜脈導管組 CPC01SWL11W8 SINGLE LUMEN PEDIATRIC CENTRAL VENOUS CATHETER SET 679 4FR(C+N+S+GW+D+ INJECTION CAP) CPC01SWL12W8 SINGLE LUMEN PEDIATRIC CENTRAL VENOUS CATHETER SET 679 5FR(C+N+S+GW+D+ INJECTION CAP) CPC01SWL13W8 SINGLE LUMEN CENTRAL VENOUS CATHETER SET 6FR(C+N+S+GW+D+INJECTION CAP)

141 CPC01SWL14W8 SINGLE LUMEN CENTRAL VENOUS CATHETER SET 439 7FR(C+N+S+GW+D+INJECTION CAP) CPC01SWL21W8 DOUBLE LUMEN INFANT CENTRAL VENOUS CATHETER SET FR(C+N+S+GW+D+ INJECTION CAP) CPC01SWL22W8 DOUBLE LUMEN PEDIATRIC CENTRAL VENOUS CATHETER SET FR(C+N+S+GW+D+ INJECTION CAP) CPC01SWL23W8 DOUBLE LUMEN CENTRAL VENOUS CATHETER SET 951 7FR(C+N+S+GW+D+INJECTION CAP) CPC01SWL33W8 TRIPLE LUMEN CENTRAL VENOUS CATHETER SET FR(C+N+S+GW+D+INJECTION CAP) CPC BB 2 LUMEN PEDIATRIC CVP CATHETER(C+N+D+G+S) 1568 CPC BB 2 LUMEN CVP CATHETER(C+N+D+G+S)( 型號包括 :9685) 951 CPC AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION SETS: LUMEN ( 早產兒 ) 4FR 13CM" 亞諾 " 多重輸液導管 CPC AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION SETS:2 951 LUMEN(C+N+GW+SY+D)" 亞諾 " 多重輸液導管 CPC AR "ARROW"ARROWGARD CATHETERS:ANTISEPTIC PEDIATRIC DOUBLE 1835 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 CPC022L715M0 DOUBLE LUMEN INFUSION CATHETER SET (C+D+GW+N+SY) 951 CPC022LP35M0 DOUBLE LUMEN INFUSION CATHETER SET 4FR,5FR(C+D+GW+N+SY) 1568 CPC DV DUAL LUMEN HICKMAN CATHETER 2743 CPC026817NAG " 愛琅 " 中央靜脈導管組 "ARGON"CENTRAL VENOUS CATHETERS LUMEN 7FR(C+N+D+G+S) CPC026817NBD 2 LUMEN CVP CATHETER(CATH+N+DIL+GW+SYR) 951 CPC02A7702AR "ARROW"ARROWGARD CATHETER (DOUBLE LUMEN )14FR X CM(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 CPC02B1150AG "ARGON"HYDROCATH ASSURE HYDROPHILIC ANTI-MICROBIAL 1141 CENTRAL VENOUS CATHETER:2 LUMEN(C+N+D+G)" 愛琅 " 抑菌中心靜脈導管 :2 腔 適應症請見備註欄 CPC02B1150BD "BD"ANTIMICROBIAL 2 LUMEN CVP CATHETER(C+N+D+G)" 必帝 " 抑菌 1141 雙腔中心靜脈導管組 適應症請見備註欄 CPC02B1152AG "ARGON"HYDROCATH ASSURE HYDROPHILIC ANTI-MICROBIAL 1428 CENTRAL VENOUS CATHETER:2 LUMEN(C+N+D+G+S)" 愛琅 " 抑菌中心靜脈導管 :2 腔 適應症請見備註欄 CPC02B1152BD "BD"ANTIMICROBIAL 2 LUMEN CVP CATHETER(C+N+D+G+S)" 必帝 " 抑 1428 菌雙腔中心靜脈導管組 適應症請見備註欄 CPC02BCV22EE 2 LUMEN CVP CATHETER/SET 二腔中央靜脈導管組 951 (CATH+NEEDLE+DILATOR+GUIDEWIRE+SYRINGE) CPC02CUDLMCK 2 LUMEN SPECTRUM AND SPECTRUM GLIDE CENTRAL VENOUS 1428 CATHETERS AND SETS(C+N+D+GW+SY) 適應症請見備註欄 CPC02ECL12BB CERTOFIX CENTRAL VENOUS CATHETER (2 LUMEN) 951 (CATHETER+DILATOR+GUIDEWIRE+NEEDLE+ SYRINGE) 舒鈦雙腔中心靜脈導管組 CPC02M2716ED 2 LUMEN CVP CATHETER W/AMC THROMBOSHIELD 1428 COATING(C+N+D+GW+S) 適應症請見備註欄 CPC02M271SED 2 LUMEN MULTI-MED CENTRAL CATHETER SET(C+N+GW+DIL+SY) 951 CPC02M27S1ED 2 LUMEN CVP CATHETER W/AMC THROMBOSHIELD COATING(C+N+D+GW+S) 適應症請見備註欄

142 CPC02N7702AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION SETS:2 951 LUMEN(C+N+GW+SY+D)" 亞諾 " 多重輸液導管 CPC02P1065AG " 愛琅 " 中央靜脈導管組 "ARGON"CENTRAL VENOUS CATHETERS LUMEN 4:5FR(PEDIATRIC)(C+N+D+G+S) CPC02P1065BD 2 LUMEN CVP CATH SET 4,5FR(PEDIATRIC)(C+N+D+G+S) 1568 CPC02PED02BB CERTOFIX CENTRAL VENOUS CATHETER (PEDIATRIC LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE) 舒鈦雙腔小兒用中心靜脈導管組 CPC02PEDSUCK SPECTRUM PEDIATRIC 2 LUMEN CVP CATHETER FR,5FR(C+D+GW+N+S) 適應症請見備註欄 CPC02PEDUDCK 2 LUMEN SPECTRUM GLIDE CENTRAL VENOUS CATHETERS AND SETS FR 8CM 小兒用 (C+N+D+G+S) 抗感染導管 適應症請見備註欄 CPC02PEUD1CK SPECTRUM AND SPECTRUM PEDIATRIC 2 LUMEN CVP CATHETER ~5.0FR(C+N+D+G+S) 適應症請見備註欄 CPC02PTT12BB CERTOFIX CENTRAL VENOUS CATHETER (PROTECT 2 LUMEN) 1428 (CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE) 舒鈦抗感染雙腔中心靜脈導管組 CPC02SDLM1CK SPECTRUM PEDIATRIC 2 LUMEN CVP CATHETER 4.0FR(C+N+D+G+S) 1835 適應症請見備註欄 CPC02STD12BB CERTOFIX CENTRAL VENOUS CATHETER(2 951 LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE) 舒鈦雙腔中心靜脈導管組 CPC02SUDLMCK SPECTRUM 2 LUMEN CVP CATHETER(C+D+GW+N+S) 適應症請見備註 1428 欄 CPC02SWL24W8 DOUBLE LUMEN CENTRAL VENOUS CATHETERIZATION 951 SET(C+N+GW+S+D) CPC02UDL81CK 2 LUMEN SPECTRUM GLIDE CENTRAL VENOUS CATHETERS AND SETS 8.0FR 15CM (C+N+D+G+S) 抗感染導管 適應症請見備註欄 1428 CPC02UDLM2CK SPECTRUM AND SPECTRUM 2 LUMEN CVP CATHETER FR(C+N+D+G+S) 適應症請見備註欄 CPC02UDLM3CK 2 LUMEN SPECTRUM CENTERAL VENOUS CATHETER 抗感染導管 適 1428 應症請見備註欄 CPC BB 3 LUMEN PEDIATRIC CVP CATHETER(C+N+D+G+S) 2050 CPC BB 3 LUMEN CVP CATHETER(C+N+D+G+S) 1118 CPC AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION 1664 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 ) CPC AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION 2050 SETS:PEDATRIC 3 LUMEN CVP SET 5.5FR 30CM(C+N+GW+SY+D)" 亞諾 " 多重輸液導管 CPC AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION 1118 SETS:TRIPLE-LUMEN C+N+GW+SY+D)" 亞諾 " 多重輸液導管 CPC AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION 1118 SETS:TRIPLE-LUMEN (CATH+NEEDLE+DILATOR+GW+SYRING)" 亞諾 " 多重輸液導管 CPC AR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION 2050 SETS:TRIPLE-LUMEN (CATH+NEEDLE+DILATOR+GW+SYRING)5.5FR 13CM" 亞諾 " 多重輸液導管 CPC033L715M0 TRIPLE LUMEN INFUSION CATHETER SET (C+D+GW+N+SY) 1118 CPC033LP58M0 TRIPLE LUMEN INFUSION CATHETER SET 5.5FR(C+D+GW+N+SY) 2050 CPC TZ 3 LUMEN CENTRAL VENOUS CATHETER(CATH+NEE+DILA+GW+SY)

143 CPC AG " 愛琅 " 中央靜脈導管組 "ARGON"CENTRAL VENOUS CATHETERS LUMEN 7FR(C+N+D+G+S) CPC BD 3 LUMEN CVP CATHETER(CATH+N+DIL+GW+SYR) 1118 CPC03A4703AR "ARROW"ARROWGARD CATHETERS:ANTISEPTIC TRIPLE-LUMEN 1905 (C+N+D+G+S)" 亞諾 " 抗感染安全尖端導管 適應症請見備註欄 CPC03A5123AR "ARROW"ARROWGARD CATHETERS:ANTISEPTIC LARGE BORE TRIPLE LUMEN (C+N+D+G+S)" 亞諾 " 抗感染安全尖端導管 適應症請見備註欄 CPC03B1158AG "ARGON"HYDROCATH ASSURE HYDROPHILIC ANTI-MICROBIAL 1905 CENTRAL VENOUS CATHETER: 3 LUMEN(C+N+D+G+S)" 愛琅 " 抑菌中心靜脈導管 :3 腔 適應症請見備註欄 CPC03B1158BD ANTIMICROBIAL 3 LUMEN CVP CATHETER(C+N+D+G+S) 適應症請見 1905 備註欄 CPC03BCV31EE 3 LUMEN CVP CATHETER 三腔中央靜脈導管組 1118 (CATHETER+GW+DILATOR+SYRINGE+NEEDLE) CPC03CUTLMCK 3 LUMEN SPECTRUM AND SPECTRUM GLIDE CENTRAL VENOUS 1905 CATHETERS AND SETS(C+N+D+GW+SY) 適應症請見備註欄 CPC03ECL13BB CERTOFIX CENTRAL VENOUS CATHETER (3 LUMEN) 1118 (CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE) 舒鈦三腔中心靜脈導管組 CPC03M3716ED 3 LUMEN CVP CATHETER W/AMC THROMBOSHIELD 1905 COATING(C+N+D+GW+S) 適應症請見備註欄 CPC03M371SED 3 LUMEN MULTI-MED CENTRAL CATHETER SET(C+N+GW+DIL+SY) 1118 CPC03M37S1ED 3 LUMEN CVP CATHETER W/AMC THROMBOSHIELD 1905 COATING(C+N+D+GW+S) 適應症請見備註欄 CPC03P1139AG " 愛琅 " 中央靜脈導管組 "ARGON"CENTRAL VENOUS CATHETERS LUMEN 5FR(PEDIATRIC)(C+N+D+G+S) CPC03P1139BD 3 LUMEN CVP CATH SET 5FR(PEDIATRIC)(C+N+D+G+S) 2050 CPC03PED03BB CERTOFIX CENTRAL VENOUS CATHETER (PEDIATRIC LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE) 舒鈦三腔小兒用中心靜脈導管組 CPC03PEDUTCK SPECTRUM PEDIATRIC 3 LUMEN CVP CATHETER 5FR(C+D+GW+N+S) 2200 適應症請見備註欄 CPC03PTT13BB CERTOFIX CENTRAL VENOUS CATHETER(PROTECT 3 LUMEN) 1905 (CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE) 舒鈦抗感染三腔中心靜脈導管組 CPC03STD13BB CERTOFIX CENTRAL VENOUS CATHETER( LUMEN)(CATHETER+DILATOR+GUIDEWIRE+NEEDLE+SYRINGE) 舒鈦三腔中心靜脈導管組 CPC03SWL34W8 TRIPLE LUMEN CENTRAL VENOUS CATHETERIZATION 1118 SET(C+N+GW+S+D) CPC03UTLM1CK SPECTRUM AND SPECTRUM 3 LUMEN CVP CATHETER FR(C+N+D+G+S) 適應症請見備註欄 CPC03UTLM3CK 3 LUMEN SPECTRUM CENTERAL VENOUS CATHETER 抗感染導管 適 1905 應症請見備註欄 CPC03UTLMACK "COOK"SPECTRUM AND SPECTRUM GLIDE 3 LUMEN CVP CATHETER FR,7FR(C+D+GW+N+S)" 曲克 " 史派純和史派純革來得中央靜脈導管組 適應症請見備註欄 CPC03UTPE2CK SPECTRUM GLIDE CENTRAL VENOUS CATHETERS AND SETS 3 LUMEN FR(C+D+GW+N+S) 適應症請見備註欄 CPC03UTPEDCK SPECTRUM AND SPECTRUM PEDIATRIC 3 LUMEN CVP CATHETER 5FR(C+N+D+G+S) 適應症請見備註欄

144 CPC05S1000AG " 愛琅 " 中央靜脈導管組 "ARGON"CENTRAL VENOUS CATHETERS-CVP 210 CATHETER 14G:18G 90MM:160MM CPC05S1000BD CVP CATHETER 14G:18G 90MM:160MM 210 CPC0885HS1ED AVA ADVANCED VENOUS ACCESS DEVICES(AVA 3XI)(CVP KIT+ 保護 2734 套 +SHEATH+SIDE ARM)* 適應症請見備註欄 CPC089FHS1ED AVA ADVANCED VENOUS ACCESS DEVICES(AVA HF)(CVP KIT+ 保護套 SHEATH)* 適應症請見備註欄 CPC PU CEVOX CENTRAL VENOUS OXYGEN SATURATION MONITORING 5500 SYSTEM:FIBROPTIC PROBE CATHETER 中央靜脈血氧飽和度 : 光纖探針導管 適應症請見備註欄 CPC ED 3 LUMEN PRESEP CENTRAL VENOUS OXIMETRY CATHETER 7300 SET(CVPC+PROBE+N+GW+D+SY) 適應症請見備註欄 CPC09X3820ED PRESEP OXIMETRY CATHETER 3LUMEN (PROBE+3 LUMEN CVP 7300 KIT(CATHETER+DILATOR+GUIDE WIRE+NEEDLE+SYRINGE) 裴瑟週邊血氧濃度導管 CPD011010DBD PRESSURE MONITOR DOME 154 CPD011010DHM DOME 154 CPD011011DBD DOME 154 CPD01BTR00GJ "JSM"PRESSURE MONITORING KIT: BIOTRANS DOME " 吉生 " 血壓監 154 視組合套 :DOME CPD01BTR01BS PRESSURE MONITOR DOME 154 CPD01BTR01H9 BIOTRANS DOME 154 CPM BB CVP MONITOR+3 WAY 114 CPM01SC441SG CVP SCALE SYSTEM+3 WAY 114 CPM01VP001LL CVP SCALE SYSTEM(MONITOR+3 WAY) 114 CPM020460TBD 1DOME PRESSURE MONITORING KIT 310 CPM021560TBD 1 DOME PRESSURE MONITORING KIT 310 CPM BD PRESSURE MONITORING KIT 1 DOME 310 CPM HM 1DOME PRESSURE MONITORING KIT 310 CPM021712BBD 1 DOME PRESSURE MONITORING KIT 310 CPM021712SBD PRESSURE MONITORING KIT 1 DOME 310 CPM021712SHM 1 DOME PRESSURE MONITORING KIT 310 CPM BB 1 DOME COMBIDYN PRESSURE MONITORING SETS 310 CPM028603NSG PRESSURE MONITORING KIT 1DOME 310 CPM02BT481GJ "JSM"PRESSURE MONITORING KIT: 1 DOME PRESSURE MONITORING 310 KIT(DOME+FD+TUBING+3 WAYX2) " 吉生 " 血壓監視組合套 :1 DOME KIT CPM02BT482GJ "JSM"PRESSURE MONITORING KIT :2 DOME 3WAY PRESSURE 664 MONITORING KIT 2X(DOME+FD+3WAYX2+TUBING)" 吉生 " 血壓監視組合套 :2 DOME KIT CPM02BT483GJ "JSM"PRESSURE MONITORING KIT :3 DOME 3WAY PRESSURE 978 MONITORING KIT 3X(DOME+FD+3WAYX2+TUBING)" 吉生 " 血壓監視組合套 :3 DOME KIT CPM02BTR24BS 2 DOME 3WAY PRESSURE MONITORING KIT 664 2X(DOME+FLUSH+TUBING+3WAYX2) CPM02BTR24H9 2 DOME 3WAY PRESSURE MONITORING KIT 664 2X(DOME+DEVICE+TUBING+3 WAYX2) CPM02BTR33BS 3 DOME 3WAY PRESSURE MONITORING KIT 978 3X(DOME+FLUSH+TUBING+3WAYX2) CPM02BTR33H9 3 DOME 3WAY PRESSURE MONITORING KIT 978 3X(DOME+DEVICE+TUBING+3 WAYX2) CPM02BTR48BS 1DOME 3WAY PRESSURE MONITORING KIT(DOME+DEVICE+TUBING+3WAYX2)

145 CPM02BTR48H9 1 DOME 3WAY PRESSURE MONITORING KIT(DOME+DEVICE+TUBING WAYX2) CPM02BTRDLGJ "JSM"PRESSURE MONITORING KIT :1 DOME 3WAY PRESSURE 369 MONITORING KIT 1X(DOME+FDX2+3WAYX4+TUBINGX2)" 吉生 " 血壓監視組合套 :1 DOME 2WAY KIT CPM02DL418BS 1DOME 2WAY PRESSURE MONITORING KIT 369 1X(DOME+FLUSH+TUBINGX2+3WAYX4) CPM02DL418H9 1 DOME 2WAY PRESSURE MONITORING KIT 369 1X(DOME+DEVICE+TUBINGX2+3 WAYX4) CPM02HP60RBD PRESSURE MONITORING KIT 1DOME 310 CPM02VGH2QBD PRESSURE MONITORING KIT 2 DOME 664 CPM02VGH2QHM PRESSURE MONITORING KIT (2 DOME) 664 CPM02VGH3QBD PRESSURE MONITORING KIT 3 DOME 978 CPM02VGH3QHM PRESSURE MONITORING KIT (3 DOME) 978 CPM030TNFRAG "ARGON"DISPOSABLE PRESSURE MONITOR:TRANSDUCER " 愛琅 " 血壓 369 監視組合套 : 壓力轉換器 CPM030TNFRBD PRESSURE MONITOR TRANSDUCER 369 CPM HR TRANSPAC IV MONITORING KIT(TRAN+FLUSH+TUBING+3WAYX2) 369 CPM U2 "ICU"TRANSPAC IV MONITORING 369 KIT(TRAN+FLUSH+TUBING+3WAYX2)" 愛西優 " 壓力監測套 CPM HR TRIFURCATED KITS WITH 3 DISPOSABLE TRANSDUCER 1105 CPM U2 "ICU"3 TRANSPAC IV MONITORING KIT X(TRAN+FLUSH+TUBING+3WAYX2)" 愛西優 " 壓力監測套 CPM HR TRANSPAC IV MONITORING KIT WITH 2 DISPOSABLE TRANSDUCER 915 CPM HR TRANSPAC IV MONITORING KIT WITH 1 DISPOSABLE TRANSDUCER 644 CPM HR TRANSPAC IV MONITORING KIT 369 CPM HR TRANSPAC IV MONITORING KIT WITH 2 DISPOSABLE TRANSDUCER 915 CPM U2 "ICU"2 TRANSPAC IV MONITORING KIT 915 2X(TRAN+FLUSH+TUBING+3WAYX2)" 愛西優 " 壓力監測套 CPM034812DAG "ARGON"DISPOSABLE PRESSURE MONITOR KIT:2 TRANSDUCER 915 (TR+FL+TU+3WAYX4)" 愛琅 " 血壓監視組合套 CPM034812DBD 2 TRANSDUCER DISPOSABLE PRESSURE MONITOR 915 KIT(TR+FL+TU+3WAYX4) CPM034812TAG "ARGON"DISPOSABLE PRESSURE MONITOR KIT:3 TRANSDUCER 1105 (TR+FL+TU+3WAYX6)" 愛琅 " 血壓監視組合套 CPM034812TBD 3 TRANSDUCER DISPOSABLE PRESSURE MONITOR 1105 KIT(TR+FL+TU+3WAYX6) CPM BB COMBITRANS MONITORING SETS(FD+TR+3WAYX2+TUBING) 康比得壓 369 力監測組 CPM BB COMBITRANS MONITORING SETS: DISPOSABLE TRANSDUCER 康比得 369 壓力監測組 : 壓力轉換器 CPM038603ASG DISPOSABLE PRESSURE MONITOR KIT 1 DOME 369 W/TRANSDUCER(TR+FLU+TUB+3WAYX2) CPM038603BSG DISPOSABLE PRESSURE MONITOR KIT 2 DOME W/TRANSDUCER 915 2(TR+FLU+TUB+3WAYX2) CPM038603CSG DISPOSABLE PRESSURE MONITOR KIT 3 DOME W/TRANSDUCER (TR+FLU+TUB+3WAYX2) CPM038603TSG PRESSURE MONITOR KIT 1 DOME WITH TRANSDUCER 369 CPM03ADP00GJ "JSM"PRESSURE MONITORING KIT(TRANSDUCER)" 吉生 " 血壓監視組合套

146 CPM03ADP3WGJ "JSM"PRESSURE MONITORING KIT(TRANSDUCER+3WAY)" 吉生 " 血壓監 369 視組合套 CPM03ADPT1GJ "JSM"PRESSURE MONITORING KIT :TRANSDUCER PRESSURE 369 MONITORING KIT(TR+FD+3WAYX2+TUBING)" 吉生 " 血壓監視組合套 :1TR CPM03ADPT2GJ "JSM"PRESSURE MONITORING KIT: 2 TRANSDUCER PRESSURE 915 MONITORING KIT 2X(TR+FD+3WAYX2+TUBING)" 吉生 " 血壓監視組合套 :2TR CPM03ADPT3GJ "JSM"PRESSURE MONITORING KIT: 3 TRANSDUCER PRESSURE 1105 MONITORING KIT 3X(TR+FD+3WAYX2+TUBING)" 吉生 " 血壓監視組合套 :3TR CPM03ADPTDGJ "JSM"PRESSURE MONITORING KIT: TRANSDUCER PRESSURE 644 MONITORING 2 WAY KIT (TR+FDX2+3WAYX4+TUBINGX2)" 吉生 " 血壓監視組合套 :1TR 2WAY CPM03AT148H9 PRESSURE MONITORING KIT(TR+FD+3 WAYX2+TUBING) 369 CPM03AT1DLH9 PRESSURE MONITORING KIT (TR+FDX2+3 WAYX2+TUBINGX2) 644 CPM03AT248H9 PRESSURE MONITORING KIT 2X(TR+FD+3 WAYX2+TUBING) 915 CPM03AT348H9 PRESSURE MONITORING KIT 3X(TR+FD+3 WAYX2+TUBING) 1105 CPM03ATF30H9 PRESSURE MONITORING KIT(TR+FD+3 WAYX2+TUBING) 369 CPM03D2020AG "ARGON"DISPOSABLE PRESSURE MONITOR:TRANSDUCER W/FLUSH" 愛 369 琅 " 血壓監視組合套 : 壓力轉換器 CPM03D2020BD TRANSDUCER W/FLUSH 369 CPM03D4812AG "ARGON"DISPOSABLE PRESSURE MONITOR KIT:1 TRANSDUCER " 愛 369 琅 " 血壓監視組合套 CPM03D4812BD DISPOSABLE PRESSURE MONITORING KIT W/1 TRANSDUCER 369 CPM03D4812HM DISPOSABLE PRESSURE MONITORING KIT WITH TRANSDUCER 369 CPM03DDL60AG "ARGON"DISPOSABLE PRESSURE MONITOR KIT:1 TRANSDUCER 644 2WAY(1TR+2(FL+TU+3WAYX2)" 愛琅 " 血壓監視組合套 CPM03DDL60BD DISPOSABLE PRESSURE MONITORING 1 TRANSDUCER(2 WAY) 644 CPM03DNN12AG "ARGON"DISPOSABLE PRESSURE MONITOR KIT:1 TRANSDUCER 734 (TR+FL+TU+3WAYX2)" 愛琅 " 血壓監視組合套 CPM03DNN12BD PEDIATRIC 1 TRANSDUCER DISPOSABLE PRESSURE MONITORING KIT 734 CPM03DP240H9 2 TRANSDUCER PRESSURE MONITORING KIT 2X(TR+FD WAYX2+TUBING) CPM03DP340H9 3 TRANSDUCER PRESSURE MONITORING KIT 3X(TR+FD WAYX2+TUBING) CPM03DPT24H9 TREANSDUCER PRESSURE MONITORING KIT(TR+FD+3 WAYX2+TUBING) 369 CPM03DPT30H9 PRESSURE MONITORING KIT(TR+FD+3 WAYX2+TUBING) 369 CPM03DPTDLH9 TRANSDUCER PRESSURE MONITORING 2WAY KIT (TR+FD WAYX2+TUBINGX2) CPM03DTL60BD DISPOSABLE PRESSURE MONITORING 3 WAY KIT(2 TRANSDUCER) 818 CPM03MER12MR MERITRANS DISPOSABLE PRESSURE MONITORING TRANSDUCER 369 W/3WAY 電子式壓力轉換器 CPM03PV800PU PCCO MONITORING KIT 30CM,100CM,150CM(TX1+FX1+TX WAYX2)( 含溫度感應器, 與 CBT022014LPU 及 CBT022015LPU 搭配使用 ) CPM03PX12NED "EDWARDS"TRUWAVE NEONATAL PEDIATRIC DISPOSABLE PRESSURE TRANSDUCER (1 TR) ( TR+FD+TUBING+3WAYX2)" 愛德華 " 凸威壓力傳導器 :1TR 小兒

147 CPM03PX1X0ED "EDWARDS"TRUWAVE DISPOSABLE PRESSURE TRANSDUCER (1 TR 644 2WAY) 2X( TR+FD+TUBING+3WAYX2)" 愛德華 " 凸威壓力傳導器 :1TR 2WAY CPM03PX260ED "EDWARDS"TRUWAVE DISPOSABLE PRESSURE TRANSDUCER (1 DOME)( 369 TR+FD+TUBING+3WAY)" 愛德華 " 凸威壓力傳導器 :1TR CPM03PX2X2ED "EDWARDS"TRUWAVE DISPOSABLE PRESSURE TRANSDUCER (2 TR) 915 2X( TR+FD+TUBING+3WAY)" 愛德華 " 凸威壓力傳導器 :2TR CPM03PX3X7ED "EDWARDS"TRUWAVE DISPOSABLE PRESSURE TRANSDUCER (3 TR) X( TR+FD+TUBING+3WAYX2)" 愛德華 " 凸威壓力傳導器 :3TR CPM03PX604ED "EDWARDS"TRUWAVE DISPOSABLE PRESSURE TRANSDUCER(FLUSH 369 DEVICE X1+ STOPCOCK 1)" 愛德華 " 凸威壓力傳導器 :1TR CRB C " 柯惠 " 麥林可雙腔支氣管內管 "COVIDIEN" MALLINCKRODT 1490 BRONCHO-CATH ENDOBROCHIAL TUBE CRB MA 2 LUMEN BRONCO-CATHETER LEFT/RIGHT 28:39FR 1490 CRB03AEBS1CK ARNDT ENDOBRONCHIAL BLOCKER SET 9.0FR. 78CM * 給付規定請 3675 見備註欄 CRB03AEBS2CK 曲克 支氣管內管阻隔管組 ARNDT ENDOBRONCHIAL BLOCKER SET FR. 65CM * 給付規定請見備註欄 CRB03AEBS3CK 曲克 支氣管內管阻隔管組 ARNDT ENDOBRONCHIAL BLOCKER SET FR. 50CM,65CM * 給付規定請見備註欄 CRB03BBTAEDZ 大研 支氣管閉鎖導管 DAIKEN COOPDECH ENDOBRONCHIAL 3675 BLOCKER TUBE 給付規定請見備註欄 CRE01C00402C " 柯惠 " 麥林可顯微喉手術氣管插管 "COVIDIEN" MALLINCKRODT 159 MLT MICROLARYNGEAL TUBE CRE01C0040MA ENDOTRACHEAL TUBE MLT 4:6FR 處置使用可申報, 手術使用不 159 另給付 型號 自 刪除 CRE01C4050UW " 花瑪 " 氣管內管 PHARMA ENDOTRACHEAL TUBES CUFF 5:8.5MM * 處 300 置使用可申報, 手術使用不另給付. CRE01C4060EU NON-KINKING ENDOTRACHEAL TUBE ARMOURED CUFF 6.0:8.5MM 300 處置使用可申報手術使用不另給付 CRE01C6121UW " 巫諾 " 氣管內管 "UNOMEDICAL" ENDOTRACHEAL TUBES( 增強型 300 CUFF,ID5:9MM)* 處置使用可申報, 手術使用不另給付 CRE01U0030EU NON-KINKING ENDOTRACHEAL TUBE ARMOURED UNCUFF 3.0:5.5MM 328 處置使用可申報手術使用不另給付 CRE01U6113UW " 巫諾 " 氣管內管 "UNOMEDICAL" ENDOTRACHEAL TUBES( 增強型 328 UNCUFFED,ID2.5:9MM)* 處置使用可申報, 手術使用不另給付 CRE C " 柯惠 " 麥林可加強型氣管內管 "COVIDIEN" MALLINCKRODT SAFETY- 300 FLEX REINFORCED TRACHEAL TUBE* 處置使用可申報, 手術使用不另給付 CRE MA REINFORCED ENDOTRACHEAL TUBE NON-KINKING 加強型氣管內管 * 處 300 置使用可申報, 手術使用不另給付 CRE03C055NFM SILICONE ENDOTRACHEAL TUBE W/CUFF 5.5:10.0MM 處置使用可 300 申報手術使用不另給付 CRE03U00502C " 柯惠 " 麥林可加強型氣管內管 "COVIDIEN" MALLINCKRODT SAFETY- 328 FLEX REINFORCED TRACHEAL TUBE CRE03U0050MA REINFORCED ENDOTRACHEAL TUBE (NON-KINKING) 處置使用可申 328 報, 手術使用不另給付 CRE03U025NFM SILICONE ENDOTRACHEAL TUBE W/WIRE WITHOUT CUFF 2.5:5.0MM 328 處置使用可申報手術使用不另給付 CRE04C0035RU AGT-TUBE,NASAL TRACHEAL TUBE W/LOW-PRESSURE CUFF,ID 3.5MM 4.5MM 7.0MM 7.5MM 處置使用可申報, 手術使用不另給付

148 CRE04C00402C CRE04C0040MA CRE04C0060PP CRE04C0060PX CRE04C0060UW CRE04C6131UW CRE04U030N2C CRE04U030NMA CRE04U3030UW CRE04U6133UW CRE06C0035RU CRE06C00402C CRE06C0040MA CRE06C0040UW CRE06C0050MU CRE06C0050PX CRE06C0453W6 CRE06C3060UW CRE06U0030PX CRE06U0030RU CRE06U0030UW CRE06U0304W6 CRE06U045N2C CRE06U045NMA CRE06U6123UW CRE07C00452C " 柯惠 " 麥林可彎型氣管內管 "COVIDIEN" MALLINCKRODT RAE ORAL AND NASAL TRACHEAL TUBE- 鼻彎有氣囊 RAE NASAL TRACHEAL TUBE W/CUFF 4.5:8MM 鼻彎 處置使用可申報手術用不另給付 NASAL CURVED W/CUFF ENDOTRACHEAL TUBE 6:8MM 處置使用可申報, 手術使用不另給付 PORTEX TRACHEAL TUBES POLAR PERFORMED TRACHEAL TUBE IVORY PVC CUFF 6:8MM NASAL TYPE( 擴增 5:9MM) 處置使用可申報手術使用不另給付 " 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 " 巫諾 " 氣管內管 "UNOMEDICAL" ENDOTRACHEAL TUBES( 鼻彎型 CUFF ID6:8MM)* 處置使用可申報, 手術使用不另給付 " 柯惠 " 麥林可彎型氣管內管 "COVIDIEN" MALLINCKRODT RAE ORAL AND NASAL TRACHEAL TUBES- 鼻彎無氣囊 RAE PREFORMED ENDOTRACHEAL TUBE (NASAL TYPE) 氣管內管 ( 處置使用可申報手術使用不另給付 ) " 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 " 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 AGT-TUBE, ORAL TRACHEAL TUBE W/LOW-PRESSURE CUFF, ID 3.5:9.0MM 處置使用可申報, 手術使用不另給付 " 柯惠 " 麥林可彎型氣管內管 "COVIDIEN" MALLINCKRODT RAE ORAL AND NASAL TRACHEAL TUBES- 口彎有氣囊 RAE ORAL TRACHEAL TUBES(W/CUFF)* 處置使用可申報, 手術使用不另給付 " 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 MODERN ENDOTRACHEAL TUBE(CUFFED) 華新氣管內管 * 處置使用可申報 手術使用不另申報 POLAR PERFORMED TRACHEAL TUBE CLEAR PVC CUFF 5:9MM ORAL TYPE 處置使用可申報手術使用不另給付 ENDOTRACHEAL TUBE (WITH/CUFF)* 處置使用可申報, 手術使用不另給付. " 巫諾 " 氣管內管 "UNOMEDICAL" ENDOTRACHEAL TUBES( 口彎型 CUFF,ID4:9MM)* 處置使用可申報, 手術使用不另給付 POLAR PERFORMED TRACHEAL TUBE CLEAR PVC UNCUFF 3:7.5MM ORAL TYPE 處置使用可申報手術使用不另給付 AGT-TUBE, ORAL TRACHEAL TUBE WITHOUT CUFF,ID 3.0:7.0MM 處置使用可申報, 手術使用不另給付 " 巫諾 " 氣管內管 "UNOMEDICAL" ENDOTRACHEAL TUBES 處置使用可申報, 手術使用不另給付 ENDOTRACHEAL TUBE (WITHOUT/CUFF) 處置使用可申報, 手術使用不另給付. " 柯惠 " 麥林可彎型氣管內管 "COVIDIEN" MALLINCKRODT RAE ORAL AND NASAL TRACHEAL TUBES- 口彎無氣囊 RAE PREFORMED ENDOTRACHEAL TUBE WITHOUT CUFF 口彎型 處置使用可申報, 手術使用不另給付 " 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 " 柯惠 " 麥林可鐳射氣管內管 COVIDIEN MALLINCKRODT LASER-FLEX TRACHEAL TUBES

149 CRE07C0045MA CRG010168NHU " 麥林可 " 鐳射氣管內管 "MALLINCKRODT"LASER-FLEX TRACHEAL TUBE " 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 CRG010169NHU " 哈德森 " 嬰兒型連續正壓氣道給氧管路 - 半套 "HUDSON" INFANT 654 CPAP CANNULAS(SET) NO.0:N0.5 適應症請見備註欄 CRG011630NAY ARGYLE CPAP NASAL CANNULA KIT ARGYLE 小兒專用連續正壓鼻導 654 管組 適應症請見備註欄 CRG01407NNW7 " 嬰克 " 嬰兒經鼻式氧氣鼻套管 "INCA" INFANT NASAL OXYGEN CPAP 654 CANNULA* 適應症請見備註欄 CRG01427NNW7 " 嬰克 " 嬰兒經鼻式氧氣鼻套管 "INCA" INFANT NASAL OXYGEN CPAP 1120 CANNULA* 適應症請見備註欄 CRN NU NASAL NASOPHARYNX APPLICATION 後荷式咽插管 2960 CRT01TTLPCS5 雪莉氣切套管及其附件 SHILEY TRACHEOSTOMY CANNULAE AND 865 ACCESSORIES 有氣囊 無開窗 /LONG TERM CARE 使用 ) CRT01U0025ZG " 富齡 " 氣切管 "ALLY" TRACHEOSTOMY TUBE(UNCUFF, ID MM) CRT01U0060WN TEFLON TRACHEOSTOMY TUBE(DOUBLE TUBE)6:12MM 外徑 525 CRT KK " 高研 " 氣管套管 "KOKEN" TRACHEAL CANNULA 525 CRT KK " 高研 " 比比氣管套管 "KOKEN" TRACHEAL CANNULA PP 493 CRT VK " 旭邦 " 柔得多標準型氣切管 ( 一次使用型 )"VITALTEC" ROTA- 332 TRACH STANDARD TRACHEOSTOMY TUBE CRT C " 柯惠 " 麥林可恰可舒氣切管 COVIDIEN MALLINCKRODT 361 TRACHESOFT TRACHEOSTOMY CANNULAE- 標準型無氣囊 CRT MA 麥林可 恰可舒氣切管 "MALLINCKRODT"TRACHESOFT 361 TRACHEOSTOMY CANNULAE CRT02C0030UW " 花瑪 " 氣切套管 PHARMA TRACHEOSTOMY TUBE UNCUFF 3:10MM 361 CRT02C00502C " 柯惠 " 麥林可恰可舒氣切管 COVIDIEN MALLINCKRODT 332 TRACHESOFT TRACHEOSTOMY CANNULAE- 可調整型 CRT02C0050MA TRACHEOSTOMY TUBE CUFF 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 577 內徑產品型號 :100 自 生效 CRT02C0060PX PROFILE CUFFED TRACHEOSTOMY 332 CRT02C0060UW TRACHEOSTOMY TUBE,REGULAR HVLP CUFF,ID 6:10MM 氣切套管 ( 有 332 閥 ) CRT02C0060ZG " 富齡 " 氣切管 "ALLY" TRACHEOSTOMY TUBE(W/CUFF, ID MM) 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 332 TRACHESOFT TRACHEOSTOMY CANNULAE- 標準型 CRT02C0080MA STANDARD TRACHEOSTOMY CANNULAE TRACHEOSTOMY TUBE CUFF 332 CRT02C0793W6 TRACHEOSTOMY TUBE (WITH/CUFF) 332 CRT02C0800PX " 保德士 " 氣切套管 "PORTEX" TRACHEOSTOMY TUBE-BLUE LINE 332 ULTRA TRACHEOSTOMY TUBE 低壓氣囊氣切套管 CRT02C1560FM 氣切套管 FORTUNE TRACHEOSTOMY TUBE ID2.0MM:12.0MM( 普通球 )

150 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 332 TRACHEOSTOMY TUBE-WITH ADJUSTABLE FLANGE (TTAF) WITH HVLP CUFF, ID 6:11MM CRT02CP050YN ALL SILICONE TRACHEOSTOMY TUBE W/CUFF 5.0:10.0MM(PRE- 577 FORMED TYPE) CRT02TT016SG SIGMA TRACHEOSTOMY TUBE 332 CRT02TT046SG SIGMA TRACHEOSTOMY TUBE(SILICON) 577 CRT02U0025WN ALL SILICONE TRACHEOSTOMY TUBE WITHOUT CUFF 12:42FR :10.0MM 內徑 CRT02U0030PX PLAIN TRACHEOSTOMY TUBE 3:5MM 361 CRT02U0030UW TRACHEOSTOMY TUBE,PLAIN,UNCUFF,ID 3:10MM 氣切套管 ( 無閥 ) 361 CRT02U0030YN ALL SILICONE TRACHEOSTOMY TUBE UNCUFF 3.0:10.0MM(PLAIN 460 TYPE) CRT02U0045S5 雪莉氣切套管 SHILEY TRACHEOSTOMY CANNULAE 小兒用 ( WITH 893 OBTURATION) CRT02U0060PX PLAIN TRACHEOSTOMY TUBE 6:10MM 361 CRT02U0062UW " 巫諾 " 氣管切開套管 "UNOMEDICAL" TRACHEOSTOMY TUBE 361 CRT02U0065MU 華新氣切套管 MODERN TRACHEOSTOMY TUBE 332 CRT02U1561FM 氣切套管 FORTUNE TRACHEOSTOMY TUBE ID2.0MM:12.0MM( 無球型 ) 460 CRT02U5060UW CRT04C678MHJ CRT04C750MHJ CRT04C850MHJ CRT05BC060PX CRT05BC870PX CRT05BU060PX CRT05C0050S5 CRT05C7271UW CRT05C7272UW CRT05U0050S5 巫諾 氣管切開套管 - 無閥 UNOMEDICAL TRACHEOSTOMY TUBE-PLAIN (WITHOUT CUFF), ID 3:10MM " 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 " 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 " 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 BLUE LINE ULTRA TUBE KIT FENESTRATED PROFILE SOFT-SEAL CUFF AND INNER CANNULAE 6:10MM(LONG TERM CARE 使用 ) " 史密斯 " 保德士氣切套管 "SMITHS"PORTEX TRACHEOSTOMY TUBE(BLUE LINE ULTRA SUCTIONAID TUBE WITH PROFILE SOFT- SEAL CUFF AND INNER CANNULAE BLUE LINE ULTRA UNCUFFED FENESTRATED TUBE KIT W/ INNER CANNULAE 6:10MM 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 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 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 使用雪莉氣切套管 SHILEY TRACHEOSTOMY CANNULAE 無氣囊 開窗 /LONG TERM CARE 使用

151 CRT05U7273UW CRT06U0060PX CRT09C6262UW CRT09U6264UW CRT PX CRT10PTS01CK CRT10PTS02CK CVA AR 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 DOOUBLE FENESTRATED TRACHEOSTOMY TUBES PVC UNCUFF WITH 15MM CONNECTOR 6:10MM 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) 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) " 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 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 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 "ARROW"BERMAN ANGIOGRAPHIC BALLOON CATHETERS(REVERSE)5FR 80CM;7FR 110CM" 亞諾 " 帕曼心臟血管攝影用導管 ( 反逆流式 ) CVA AR "ARROW"BERMAN ANGIOGRAPHIC CATHETER(PEDIATRIC) 4:8FR :110CM 亞諾 帕曼心臟血管攝影用導管 CXE BA " 巴德 " 歐文四極診斷電極導管 "BARD"WOVEN DIAGNOSTIC 8090 ELECTRODE CATHETER CXE BA TRIPOLAR ELECTRODE 6:7FR 125CM 8060 CXE BA QUADPOLAR ELECTRODE 6FR 110CM 1CM 8090 CXE BA WOVEN TRIPOLAR ELECTRODE CATHETER 8060 CXE BA NBIH BIPOLAR PACING ELECTRODE 5:7FR 100:125CM 6600 CXE BA QUADPOLAR ELECTRODE 6FR 120CM 8090 CXE BA " 巴德 " 歐文診斷電極導管 "BARD" WOVEN DIAGNOSTIC ELECTRODE 8090 CATHETERS 四極 CXE BA WOVEN QUADPOLAR ELECTRODE 8090 CATH200150:3,200055P,56,56E,57P,58,58E,59P,60,60E,61P,62E,63P,64P CXE BA WOVEN QUADPOLAR ELECTRODE CATHETER201400,200066:69,202,203,472,473,574,578,582:586, 8090 CXE BA WOVEN DECAPOLAR ELECTRODE CATHETER CXE BA " 巴德 " 歐文診斷電極導管 "BARD" WOVEN DIAGNOSTIC ELECTRODE CATHETERS 十極 CXE BA OPEN-LUMEN QUADPOLAR ELECTRODE 6FR 110CM 1CM 7700 CXE BA OPEN-LUMEN QUADPOLAR ELECTRODE 6FR 110CM 5MM 7700 CXE BA QUADPOLAR OPEN LUMEN ELECTRODE 7FR 0.038" 120CM 1CM 7700 CXE BA WOVEN PENTAPOLAR ELECTRODE CATHETER 8090 CXE BA VIKING DECAPOLAR ELECTRODE CATHETER400030:36,400070:71,400074:75 CXE014000NBA VIKING QUADPOLAR ELECTRODE 8090 CATHETER400001:12,400041:48,400050:51,400091P, CXE BA " 巴德 " 維克診斷電極導管 "BARD" VIKING DIAGNOSTIC ELECTRODE CATHETER 十極

152 CXE BA " 巴德 " 維克診斷電極導管 "BARD" VIKING DIAGNOSTIC ELECTRODE 8090 CATHETER 四極 CXE BA VIKING SOFT TIP QUADPOLAR ELECTRODE CATHETER :512,400541:542 CXE BA VIKING SOFT TIP DECAPOLAR ELECTRODE CATHETER400530:536,400570:571 CXE BA " 巴德 " 探戈診斷電極導管 "BARD" TANGO DIAGNOSTIC ELECTRODE 8090 CATHETERS 四, 五極 CXE BA " 巴德 " 探戈診斷電極導管 "BARD" TANGO DIAGNOSTIC ELECTRODE CATHETERS 十極 CXE01CDFNNYB " 爾灣 " 電生理診斷導管 "IBI"ELECTROPHYSIOLOGY DIAGNOSTIC CATHETER-INQUIRY FIXED SOFT TIP DIAGNOSTIC CATH.- DECAPOLAR CXE01EPEXDSB " 波士頓科技 " 診斷電極導管 "BOSTON SCIENTIFIC" EXPLORER FIXED CURVE DIAGNOSTIC CATHETER 十極 CXE01EPEXQSB " 波士頓科技 " 診斷電極導管 "BOSTON SCIENTIFIC" EXPLORER 8090 FIXED CURVE DIAGNOSTIC CATHETER 四極 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 ) CXE01F0400CV ELECTRODE CATH.4 極, 型號 F4:6,65-QA,D,E,F,H,K,L-2,5,10, RT;F5,6- CXE01F0401CV ELECTRODE CATH.QUADPOLAR, 型號 F5,6-ST,C,S-QF,A,D CXE01F1000CV ELECTRODE CATH.DECAPOLAR, 型號 F5A-DP-282,P10-RT;F6-DA, F,G,P- CXE01F1001CV ELECTRODE CATH.DECAPOLAR, 型號 F6A-DP-282-RT;F7LA-DP-P RT CXE01F5120JV " 日本來富恩 " 菲克斯固定彎電極導管 "JAPAN LIFELINE" EPSTAR 8090 FIX ELECTROPHYSIOLOGY CATHETER(4,5FR./5 電極 ) CXE01F7LDGCV ELECTROPHYSIOLOGY CATHETER FIXED CURVE LUMEN CATHETER(DECAPOLAR 固定式十極 ) CXE01LUMENST 雷斯龐生理電極導管 RESPONSE ELECTROPHYSIOLOGY CATHETERS CXE01Q0405YB " 爾灣 " 電生理診斷導管 "IBI"ELECTROPHYSIOLOGY DIAGNOSTIC 8090 CATHETER-INQUIRY 4F FIXED DIAGNOSTIC CATH.-QUADRAPOLAR CXE01RDECAST 雷斯龐生理電極導管 RESPONSE ELECTROPHYSIOLOGY CATHETERS F,7F,DECAPOLAR CXE01RQUADST 雷斯龐生理電極導管 RESPONSE ELECTROPHYSIOLOGY CATHETERS F,6F,QUADRIPOLAR CXE01SDECAST 聖猷達 史普力米生理電極導管 SJM SUPREME ELECTROPHYSIOLOGY CATHETER 十極 CXE01SQUADST 聖猷達 史普力米生理電極導管 SJM SUPREME 8090 ELECTROPHYSIOLOGY CATHETER - 四極 CXE BA DYNAMIC XT STEERABLE DECAPOLAR ELECTRODE CATHETER CXE BA DYNAMIC XT STEERABLE QUADPOLAR ELECTRODE CATHETER 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 ) CXE022005NBA CXE JV CXE02557XSSB EP.XT STEERABLE QUADPOLAR ELECTRODE CATH :527: 735:737:741:769:770:898 " 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 ) " 波士頓科技 " 診斷用導管 "BOSTON SCIENTIFIC" POLARIS DX STEERABLE DIAGNOSTIC CATHETER

153 CXE02567STYB " 爾灣 " 電生理診斷導管 "IBI"ELECTROPHYSIOLOGY DIAGNOSTIC CATHETER-INQUIRY SOFT TIP STEERABLE DIAGNOSTIC CATH.- DECAPOLAR CXE YB " 爾灣 " 電生理診斷導管 "IBI" ELECTROPHYSIOLOGY DIAGNOSTIC CATHETER( 十極 ) CXE028478NYB " 爾灣 " 電生理診斷導管 "IBI" ELECTROPHYSIOLOGY DIAGNOSTIC CATHETER-QUADRIPOLAR STEERABLE 5F CXE02848STYB " 爾灣 " 電生理診斷導管 "IBI" ELECTROPHYSIOLOGY DIAGNOSTIC CATHETER( 四極 ) CXE02849STYB " 爾灣 " 電生理診斷導管 "IBI" ELECTROPHYSIOLOGY DIAGNOSTIC CATHETER( 四極 ) CXE02D0400CV ELECTRODE CATH. 可彎式四極, 型號 D5S-270L-B2-RT;D5S-AL RT;D5S-270L- CXE02D0401CV ELECTRODE CATH. 四極可彎, 型號 D6,7-DR-5,10,252-RT;D6, AGALBGBLCGCLDGDL CXE02D1000CV ELECTRODE CATH. 可彎十極,6,7-10DR,FR-2,5,P10, RT; CXE02D6DR2CV SMALL DOME DEFLECTABLE QUADRAPOLAR EP CATHETER ( 可彎式四 極 ) CXE02LVW04ST 聖猷達 可控式生理電極導管 SJM LIVEWIRE STEERABLE ELECTROPHYSIOLOGY CATHETER-4 極 CXE02LVW10ST 聖猷達 可控式生理電極導管 SJM LIVEWIRE STEERABLE ELECTROPHYSIOLOGY CATHETER-10 極 CXE02QSNSTYB " 爾灣 " 電生理診斷導管 "IBI"ELECTROPHYSIOLOGY DIAGNOSTIC CATHETER-INQUIRY SOFT TIP STEERABLE DIAGNOSTIC CATH.- QUADRAPOLAR CXE BA " 巴德 " 史汀格除顫電極導管 "BARD"STINGER ABLATION CATHETERS CXE BA " 巴德 " 天蠍電燒電極導管 "BARD"SCORPION ABLATION CATHETER CXE033100TBA " 巴德 " 天蠍電燒電極導管 "BARD" SCORPION ABLATION CATHETER CXE034500TSB CXE035086TSB CXE M4 CXE038336NYB CXE038337NYB CXE038344NYB CXE038372NYB CXE03ASU23FW CXE03BD74LWE CXE03BD78LWE " 波士頓科技 " 布雷瑟心臟除顫系統 "BOSTON SCIENTIFIC" BLAZER II XP CARDIAC ABLATION SYSTEM " 波士頓科技 " 布雷瑟除顫電極導管 "BOSTON SCIENTIFIC" BLAZER II/BLAZER II HTD ABLATION CATHETER 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 ) " 爾灣 " 除顫電極導管 "IBI"ABLATION ELECTROPHYSIOLOGY CATHETER " 爾灣 " 瑟爾皮除顫電極導管 "IBI"THERAPY DUAL-8 ABLATION CATHETER " 爾灣 " 瑟爾皮熱阻電燒導管 "IBI" THERAPY 8MM TIP THERMISTOR ABLATION CATHETER " 爾灣 " 除顫電極導管 "IBI" ABLATION ELECTROPHYSIOLOGY CATHETER " 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 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 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

154 CXE03BPLARE8 CXE03CBBRAE8 " 艾斯泰格 " 康柏拉電雙極套 "ESTECH"COBRA BIPOLAR INSERTS** 限心臟外科手術時使用並附 AF 心電圖報告術前術中或術後 " 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 CXE03CRYCSFW " 艾科 " 冷凍治療儀專用探針 "ATRICURE" CRYO1 CRYO-ABLATION PROBE* 使用規定請見備註欄 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 CXE03CS927E8 "ESTECH"COBRA SURGICAL PROBE " 艾斯泰格 " 康柏拉電刀用電極 * 限心臟外科手術時使用並附 AF 心電圖報告術前術中或術後 CXE03EMR23FW " 艾科 " 外科手術剝離夾鉗 "ATRICURE" ISOLATOR SURGICAL ABLATION CLAMPS* 適應症請見備註欄 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) 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 CXE03LVWTCST " 聖猷達 " 除顫電燒導管 "SJM" LIVEWIRE TC ABLATION CATHETER CXE03MARNXM4 美敦力瑪林射頻電燒導管 MEDTRONIC MARINR STEERABLE ABLATION CATHETER CXE03P4500SB " 波士頓科技 " 布雷瑟除顫電極導管 "BOSTON SCIENTIFIC" BLAZER PRIME TEMPERATURE ABLATION CATHETER CXE03P5031SB " 波士頓科技 " 布雷瑟除顫電極導管 "BOSTON SCIENTIFIC" BLAZER PRIME TEMPERATURE ABLATION CATHETER CXE03SAFFRST " 聖猷達 " 雙向電燒導管 "SJM" SAFIRE BI-DIRECTIONAL ABLATION CATHETER 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 CXE03WULP2ER " 愛匹克 " 心臟燒灼系統 "EPICOR" CARDIAC ABLATION SYSTEM* 適 應症請見備註欄 FAD01000S2ZJ AHMED GLAUCOMA VALVE 壓滅青光眼用舒壓導流瓣膜 * 適應症請見備 註欄 FAD UX "OPTONOL"EX-PRESS MINIATURE GLAUCOMA SHUNT AND ACCESSORIES(EDS)" 歐能 " 伊倍視小型眼房水調整閥及其配件 * 適應症請見備註欄 FAD UX EX-PRESS GLAUCOMA FILTRATION DEVICE 伊倍視青光眼房水調整裝 置 * 給付規定請見備註欄 FALSM95UVNSZ PMMA I.O.L FALSMACRA11X "CROMA"ACRYLIC INTRAOCULAR LENS" 克洛瑪 " 人工水晶體 2744 FALSMAR40NA2 "AMO" SENSAR ACRYLIC POSTERIOR CHAMBER INTRAOCULAR LENS " 2744 艾米歐 " 勝色人工水晶體眼球 FALSMCLRFLA2 CLARIFLEX SILICONE IOL 2744 FALSMCR5BUA1 PMMA I.O.L 1555 FALSMCSFLXRY "RAYNER"INJECTABLE IOL SYSTEM PACK(HYDROPHILIC ACRYLIC)" 2744 銳能 " 推注式人工水晶體系統包 FALSMDL52NA2 DURALENS II IOL 1555 FALSMHAKR0ZX AKREOS FOLDABLE INTRAOCULAR LENSES(ACRYLIC W/UV FILTER)

155 FALSMHBEC11B OII HYDROPHOBIC ACRYLIC POSTERIOR CHAMBER INTRAOCULAR 2744 LENS W/U.V. ABSORBER 艾絲抗紫外線疏水性丙烯酸脂後房人工水晶體 FALSMHBEC11E "AAREN"HYDROPHOBIC ACRYLIC POSTERIOR CHAMBER INTRAOCULAR 2744 LENS W/U.V. ABSORBER " 愛銳 " 抗紫外線疏水性丙烯酸脂後房人工水晶體 FALSMLS100LS INTRAOCULAR LENS 1555 FALSMMA30BA1 ACRYSOF INTRAOCULAR LENSES 2744 FALSMMC71CA1 PMMA I.O.L. UV,UV+LASER 1555 FALSMMZ30BA1 "ALCON" CILCO INTRAOCULAR LENSES(PMMA)" 愛爾康 " 視而卡人工 1555 水晶體 FALSMNEFL1RQ NEO EYE FOLDABLE INTRAOCULAR LENS 新視軟式人工水晶體 2744 FALSMNERP1RQ "ROHTO"NEO EYE INTRAOCULAR LENS RP-11;RP12 " 樂敦 " 新視人工 1555 水晶體 FALSMSA30AA1 ACRYSOF SINGLE-PIECE FOLDABLE ACRYLIC POSTERIOR CHAMBER 2744 INTRAOCULAR LENSES FALSMSA60AA1 ACRYSOF SINGLE PIECE INTRAOCULAR LENS" 愛爾康愛爾蘭廠 " 可舒 2744 單片型軟式人工水晶體 FALSMSFLEXB9 SILICONE SOFLEX(SOFLEX SE) INTRAOCULAR LENS( 可折疊式矽膠 ) 2744 FALSMSTEC1LS ACRYLIC INTRAOCULAR LENS 2744 FALSNCRYA0B9 "BAUSCH&LOMB"CRYSTALENS ASPHERIC OPTIC ACCOMMODATING 2744 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 FALSNCRYHDB9 "BAUSCH&LOMB"CRYSTALENS ACCOMMODATING INTRAOCULAR LENS " 2744 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 FALSNMULT1A2 REZOOM ACRYLIC MULTIFOCAL IOL 多焦點軟式人工水晶體, 按一般 2744 功能人工水晶體價格給付, 超過部分由病患自付 FALSNMULT1LS TETRAFLEX INTRAOCULAR LENS 多焦點軟式人工水晶體, 按一般功 2744 能人工水晶體價格給付, 超過部分由病患自付 FALSNMULT1RY M-FLEX MULTIFOCAL INJECTABLE ACRYLIC LENS INJECTION 2744 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 FALSNMULT2A1 ACRYSOF IQ RESTOR MULTI FOCAL INTRAOCULAR LENS 可舒銳視妥 2744 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 FALSNMULT2RY "RAYNER"SULCOFLEX HYDROPHILIC INTRAOCULAR LENSES" 銳能 " 視 2744 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 FALSNMULT3A2 TECNIS MULTIFOCAL IOL 多焦點人工水晶體, 按一般功能人工水晶 2744 體價格給付, 超過部分由病患自付 FALSNNATU1A1 ACRYSOF NATURAL STERILE UV-ABSORBING ACRYLIC FOLDABLE 2744 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 FALSNNATU2A1 ACRYSOF NATURAL SINGLE PIECE IOL " 愛爾康愛爾蘭廠 " 可舒視然 2744 單片型軟式人工水晶體 ( 可過濾部分藍光 ), 按一般功能人工水晶體給付, 超過部分由病患自付 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

156 FALSNT0RC1A2 FALSNT0RC1RY FALSNT0RC2A1 FALSNT0RC2RY FALSNT0RCARY FALSNT0RTU1D FALSNT0RTY1D FALSNWAVE11D FALSNWAVE11E FALSNWAVE11K FALSNWAVE11X FALSNWAVE1A1 FALSNWAVE1B9 FALSNWAVE1HY "AMO"TECNIS TORIC I-PIECE SOFT ACRYLIC LENS" 眼力健 " 添視明散光矯正單片型折疊式人工水晶體, 按一般功能人工水晶體價格給付, 超過部分由病患自付 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 ACRYSOF IQ TORIC SINGLE PIECE NATURAL IOL " 愛爾康 " 可舒智慧型妥瑞明非球面散光矯正軟式人工水晶體, 按一般功能人工水晶體給付, 超過部分由病患自付 "RAYNER"SULCOFLEX HYDROPHILIC INTRAOCULAR LENSES" 銳能 " 視飛克斯人工水晶體 ( 散光型 ) 按一般功能人工水晶體價格給付, 超過部分由病患自付 "RAYNER"T-FLEX ASPHERIC HYDROPHILIC INTRAOCULAR LENSES" 銳能 " 散光非球面人工晶體, 按一般功能人工水晶體價格給付, 超過部分由病患自付 "DR.SCHMIDT"SILICONE INTRAOCULAR LENS MICROSIL TORIC" 史密舒 " 散光人工水晶體, 按一般功能人工水晶體價格給付, 超過部分由病患自付 "DR.SCHMIDT"SILICONE INTRAOCULAR LENS MICROSIL TORIC" 史密舒 " 散光人工水晶體, 按一般功能人工水晶體價格給付, 超過部分由病患自付 "DR.SCHMIDT"ACRYLIC INTRAOCULAR LENS MICROCRYL " 史密舒 " 單片型軟式人工水晶體體 ( 非球面 ), 按一般功能人工水晶體價格給付, 超過部分由病患自付 "AAREN"HYDROPHILIC ACRYLIC INTRAOCULAR LENS W/U.V ABSORBER(ASPHERIC)" 愛銳 " 抗紫外線人工水晶體 ( 非球面 ), 按一般功能水晶體給付, 超過部分民眾自付 "XCELENS"IDEA INTRAOCULAR LENS(ASPHERIC)" 愛瑟樂視 " 人工水晶體 非球面軟式人工水晶體, 按一般功能人工水晶體價格給付, 超過部分由病患自付 "CROMA"PRELOADED ACRYLIC INTRAOCULAR LENS " 克洛瑪 " 植入器預載式人工水晶體 ( 非球面 ), 按一般功能水晶體給付, 超過部分由民眾自付 ACRYSOF ASPHERIC NATURAL IQ SINGLE PIECE IOL 非球面軟式人工水晶體, 按一般功能人工水晶體價格給付, 超過部分由病患自付 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 "HOYA"HOYA-PS AF-I(UY)INTRAOCULAR LENS" 豪雅 " 植入器預載式人工水晶體 非球面過瀘藍光人工水晶體, 超過部分由病患自付 FALSNWAVE1LS ASPHERIC IOL 非球面人工水晶體, 按一般功能人工水晶體價格給付, 超過部分由病患自付 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 FALSNWAVE21D "DR.SCHMIDT"ACRYLIC INTRAOCULAR LENS MICROCRYL " 史密舒 " 單片型軟式人工水晶體 ( 非球面藍光防護 ), 按一般功能人工水晶體給付, 超過部分由病患自付 FALSNWAVE21X "CROMA"BARRETT ACRYLIC INTRAOCULAR LENS ASPHERIC" 克洛瑪 " 植入器預載式非球面人工水晶體, 按一般功能水晶體給付, 超過部分由民眾自付

157 FALSNWAVE2A1 ACRYSOF RESTOR APODIZED DIFFRACTIVE ASPHERIC IOL 非球面軟 2744 式人工水晶體 ( 含多焦點及可過濾藍光 ) 按一般功能人工水晶體價格給付, 超過部分由病患自付 FALSNWAVE2A2 TECNIS FOLDABLE ACRYLIC IOL 非球面軟式人工水晶體, 按一般 2744 功能人工水晶體價格給付, 超過部分由病患自付 FALSNWAVE2B9 AKREOS ADVANCED OPTICS ASPHERIC INTRAOCULAR LENS 非球面軟 2744 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 FALSNWAVE2RY "RAYNER"SULCOFLEX HYDROPHILIC INTRAOCULAR LENSES" 銳能 " 視 2744 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 FALSNWAVE3A1 ACRYSOF IQ ASPHERIC NATURAL SINGLE PIECE IOL 可舒愛視明智 2744 慧型非球面單片型軟式人工水晶體 ( 可濾部分藍光 ), 按一般功能給付, 超過部分由病患自付 FALSNWAVE3A2 TECNIS CL FOLDABLE INTRAOCULAR LENS 非球面軟式人工水晶體 2744, 按一般功能人工水晶體價格給付, 超過部分由病患自付 FALSNWAVE3B9 SOF PORT AO W/VIOLET SHIELD ADVANCED OPTICS LENS 非球面軟 2744 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 FALSNWAVE4A2 TECNIS 1 PIECE ACRYLIC INTRAOCULAR LENS 非球面, 按一般功 2744 能人工水晶體價格給付, 超過部分由病患自付 FALSNWAVE4B9 AKREOS AO MICRO INCISION LENS 非球面軟式人工水晶體, 按一 2744 般功能人工水晶體價格給付, 超過部分由病患自付 FALSNWAVE5B9 "BAUSCH&LOMB"AKREOS INTRAOCULAR LENS " 博士倫 優視非球面 2744 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 FALSNWAVE6B9 "BAUSCH&LOMB"AKREOS AO MICRO INCISION LENS" 博士倫 優視微 2744 切口人工水晶體 非球面人工水晶體, 按一般功能人工水晶體給付, 超過部分由病患自付 FAV01100CCSZ OCUCOAT 1CC 玻璃體替代物 1785 FAV01B0050A1 0.5ML VISCOAT STERILE OCULAR VISCOELASTIC SOLUTION 玻離體 1564 替代物 FAV01B0075A1 0.75CC VISCOAT-STERILE OCULAR VISCOELASTIC SOLUTION 1785 FAV01BC1001X CROMA-PHARMA"BIOCORNEAL II 1CC" 克洛法瑪 " 拜耳克尼人工玻璃 1785 體 FAV01C0090R9 OCULOCROM 2% 0.9CC 歐奇樂人工玻璃體 1785 FAV01C0100R9 MEGACROM 1.8% 1CC 明佳人工玻璃體 1785 FAV01C0150R9 VISICROM 2% 1.5ML 2.5ML 人工玻璃體 2021 FAV01C0200R9 "CROMA"EYEFILL HD VISCOELASTIC SOLUTION 2.5ML;1.5ML " 寇 2021 瑪 " 艾飛爾人工玻璃體 FAV01C0300R9 "CROMA"EYEFILL M.B VISCOELASTIC SOLUTION 1.8% 0.55ML+1.4% ML " 寇瑪 " 艾飛雙劑人工玻璃體 FAV01C0400R9 "CROMA"EYEFILL S.C. VISCOELASTIC SOLUTION 0.9ML" 寇瑪 " 艾飛 1785 人工玻璃體 FAV01D0100A1 DISCOVISC OPHTHALMIC VISCOSURGICAL DEVICE 1CC( 人工玻璃體 ) 1785 FAV01D3540A1 0.75ML DUOVISC VISCOELASTIC SYSTEM 1785 FAV01H0055A2 HEALON 0.55ML 1564 FAV01H0506A2 HEALON 5 0.6ML 1564 FAV01HGV55A2 HEALON GV 0.55ML 1564 FAV01HGV85A2 HEALON GV 0.85ML 1785 FAV01P0040A1 0.4ML PROVISC 玻離體替代物 1415 FAV01P0055A1 0.55ML PROVISC 玻離體替代物

158 FAV01P0085A1 0.85CC PROVISC 玻離體替代物 1785 FAV01RN085RY RAYVISC OPHTHALMIC VISCOELASTIC 0.85ML 人工玻璃體 1785 FAV01VA04CLB VISCAID 0.4ML 1415 FAV01VA05CLB VISCAID 0.55ML 1564 FAV01VA08CLB VISCAID 0.8ML 1785 FAV01VA10CLB "MBI"VISCAID OPHTHALMIC VISCOELASTIC(1.0CC)" 和康 " 維視愛眼 1785 科黏彈劑 FBA H1 BONE CEMENT40GM 906 FBA011101NZ1 OSTEOBOND COPOLYMER BONE CEMENT 40G/20ML 906 FBA011102NZ1 DOUGH TYPE BONE CEMENT 40GM 906 FBA011112NZ1 L.V.C BONE CEMENT 1429 FBA CM CRANIOPLASTY BONE CEMENT (2PKG/BOX) 頭顱整形術專用 3903 FBA DP CRANIOPLASTIC (POWDER 30G+LIQUID 16.17G/20 分鐘 ) 頭顱整形泥 8000 FBA0133CMWDP CMW BONE CEMENT 40GM( 粉末 + 液體 ) 906 FBA01ER307DP ENDURANCE BONE CEMENT 40GM WITH LIQUID 906 FBA0217XXNLV TITANIUM STAPLIZER POWERED METAPHYSEAL STAPLE 546 FBA022291NZ1 BONE STAPLE 368 FBA SN REGULAR FIXATION STAPLES( 鈷鉻鉬 ) 978 FBA022869NSN BONE STAPLE( ㄇ型 )( 鈷鉻鉬 ) 978 FBA SN SHORT LEG FIXATION STAPLES( 鈷鉻鉬 ) 978 FBA022872NSN BONE STAPLE IRREGULAR/SHORT FIXATION STAPLE( ㄇ型 )( 鈷鉻 978 鉬 ) FBA024060NZ1 EPIPHYSEAL STAPLE 978 FBA024061NZ1 FRACTURE STAPLE 978 FBA024064NZ1 STAPLE 978 FBA M4 MASTERGRAFT RESORBABLE CERAMIC GRANULES 5CC* 適應症請見備 5467 註欄 FBA M4 MASTERGRAFT RESORBABLE CERAMIC GRANULES10CC* 適應症請見備 8791 註欄 FBA M4 MASTERGRAFT RESORBABLE CERAMIC GRANULES15CC* 適應症請見備 註欄 FBA M4 MASTERGRAFT RESORBABLE CERAMIC GRANULES30CC* 適應症請見備 註欄 FBA040053NZ0 TRIOSITE BONE SUBSTITUTES 5CC * 適應症請見備註欄 5467 FBA0402B04BC MBCP BONE SUBSTITUTE 2CC * 適應症請見備註欄 4179 FBA0403G05BC "BIOMATLANTE"MBCP BONE SUBSTITUTE GRANULES 2-3MM 5CC" 瑪蘭 5467 尼 " 博萌得多孔雙相人工替代物 * 適應症請建備註欄 FBA040C02BWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE 塊材 (2.0CM3)" 台微 4179 醫 " 康骨益人工骨替代物 * 適應症請見備註欄 FBA040C05BFQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE 塊材 (5.0CM3) 紐創康骨 5467 益人工骨替代物 * 適應症請見備註欄 FBA040C05BWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE 塊材 (5.0CM3)" 台微 5467 醫 " 康骨益人工骨替代物 * 適應症請見備註欄 FBA040C05GWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE 顆粒 (5.0CM3)" 台微 5467 醫 " 康骨益人工骨替代物 * 適應症請見備註欄 FBA040C07BFQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE 塊材 (7.0CM3) 紐創康骨 5467 益人工骨替代物 * 適應症請見備註欄 FBA040C07BWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE 塊材 (7.0CM3)" 台微 5467 醫 " 康骨益人工骨替代物 * 適應症請見備註欄 FBA040C07GFQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE 顆粒 (7.0CM3) 紐創康骨益人工骨替代物 * 適應症請見備註欄

159 FBA040C07GWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE 顆粒 (7.0CM3)" 台微 5467 醫 " 康骨益人工骨替代物 * 適應症請見備註欄 FBA040C10BFQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE 塊材 (10.0CM3) 紐創康骨 8791 益人工骨替代物 * 適應症請見備註欄 FBA040C10BWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE 塊材 (10.0CM3)" 台 8791 微醫 " 康骨益人工骨替代物 * 適應症請見備註欄 FBA040C10GFQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE 顆粒 (10.0CM3) 紐創康骨 8791 益人工骨替代物 * 適應症請見備註欄 FBA040C10GWG "WILTROM"OSTEOCERA BONE GRAFT SUBSTITUTE 顆粒 (10.0CM3)" 台 8791 微醫 " 康骨益人工骨替代物 * 適應症請見備註欄 FBA040CB01FQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE STICK 5X5X20MM(2CM3) 4179 人工骨替代物 * 適應症請見備註欄 FBA040CB02FQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE STICK 5X5X10MM(2CM3) 4179 人工骨替代物 * 適應症請見備註欄 FBA040CG01FQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE GRANULE 2-3MM(5CM3) 5467 人工骨替代物 * 適應症請見備註欄 FBA040CG02FQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE GRANULE 1-2MM(5CM3) 5467 人工骨替代物 * 適應症請見備註欄 FBA040CG03FQ NANO OSTEOCERA BONE GRAFT SUBSTITUTE GRANULE MM(5CM3) 人工骨替代物 * 適應症請見備註欄 FBA041000NS1 CHRON OS GRANULE,60%POROSITY,1.0CC * 適應症請見備註欄 2565 FBA041001NS1 CHRON OS GRANULE,60%POROSITY,5.0CC* 適應症請見備註欄 5467 FBA041002NS1 CHRON OS GANULE,60%POROSITY,10CC* 適應症請見備註欄 8791 FBA S1 CHRON OSTM BLOCK,70%POROSITY,12.5X12.5X10MM* 適應症請見備 3922 註欄 FBA S1 CHRON OS BLOCK,70%POROSITY,20X20X10MM* 適應症請見備註欄 5142 FBA FV BONAGRAFT SYNTHETIC BONE SUBSTITUTE 1GM(1CC) 博納骨人工骨 2565 替代物 * 適應症請見備註欄 FBA FV BONAGRAFT SYNTHETIC BONE SUBSTITUTE 2.5GM(2.5CC) 博納骨人 4179 工骨替代物 * 適應症請見備註欄 FBA FV BONAGRAFT SYNTHETIC BONE SUBSTITUTE 5GM(5CC) 博納骨人工骨 5467 替代物 * 適應症請見備註欄 FBA M4 "MEDTRONIC"MASTERGRAFT RESORBABLE CERAMIC GRANULES" 美敦 5467 力 " 瑪斯特可吸收性骨填充物 5CC FBA M4 "MEDTRONIC"MASTERGRAFT RESORBABLE CERAMIC GRANULES" 美敦 8791 力 " 瑪斯特可吸收性骨填充物 10CC FBA041142NZ0 TRIOSITE BONE SUBSTITUTES 2CC 適應症請見備註欄 4179 FBA M4 "MEDTRONIC"MASTERGRAFT RESORBABLE CERAMIC GRANULES" 美敦 力 " 瑪斯特可吸收性骨填充物 15CC FBA041151NZ0 BIOMATLANTE TRIOSITE BONE SUBSTITUTES 10CC* 適應症請見備註 8791 欄 FBA M4 "MEDTRONIC"MASTERGRAFT RESORBABLE CERAMIC GRANULES" 美敦 力 " 瑪斯特可吸收性骨填充物 30CC FBA041300NZ0 TRIOSITE BONE SUBSTITUTES 2CC 適應症請見備註欄 4179 FBA044020RW2 OSTEOSET BONE VOID FILLER 4.8MM 20 PELLETS(2CC) 適應症 4179 請見備註欄 FBA044050RW2 OSTEOSET BONE VOID FILLER 4.8MM 50 PELLETS(5CC) 適應症 5467 請見備註欄 FBA044050TW2 OSTEOSET T BONE VOID FILLER W/TOBRAMYCIN 4.8MM 50 顆 5CC 限骨感染需補骨時使用, 適應症見備註欄 FBA046184NH1 BONESAVE SYNTHETIC BONE SUBSTITUTE(20CC)* 適應症請見備註欄

160 FBA Z8 STIMULAN CALCIUM SULPHATEBONE GRAFT 3.0MM 5CC* 適應症請見 5467 備註欄 FBA Z8 STIMULAN CALCIUM SULPHATEBONE GRAFT 3.0MM 10CC* 適應症請見 8791 備註欄 FBA Z8 STIMULAN CALCIUM SULPHATEBONE GRAFT 4.8MM 10CC* 適應症請見 8791 備註欄 FBA Z8 STIMULAN CALCIUM SULPHATEBONE GRAFT 4.8MM 20CC* 適應症請見 備註欄 FBA Z8 ALLOGRAN-N BONE GRAFT SUBSTITUTE 10CC * 適應症請見備註欄 8791 FBA Z8 ALLOGRAN-N BONE GRAFT SUBSTITUTE 35CC * 適應症請見備註欄 FBA Z8 ALLOGRAN-R BONE VOID FILLER 5CC * 適應症請見備註欄 5467 FBA Z8 ALLOGRAN-R BONE VOID FILLER 10CC * 適應症請見備註欄 8791 FBA Z8 ALLOGRAN-R BONE VOID FILLER 20CC * 適應症請見備註欄 FBA048110JSN JAX BONE VOID FILLER 10CC * 適應症請見備註欄 8791 FBA0490G01BC MBCP BONE SUBSTITUTE 1CC* 適應症請見備註欄 2565 FBA0490G02BC MBCP BONE SUBSTITUTE 2CC* 適應症請見備註欄 4179 FBA0490G10BC MSCP BONE SUBSTITUTE 10CC* 適應症請見備註欄 8791 FBA0490G16BC MSCP BONE SUBSTITUTE 16CC* 適應症請見備註欄 FBA049512JSN JAX BONE VOID FILLER 2CC * 適應症請見備註欄 4179 FBA049513JSN JAX BONE VOID FILLER 5CC * 適應症請見備註欄 5467 FBA DP CONDUIT TCP(TRICALCIUM PHOSPHATE)GRANULES 5CC 適應症請見 5467 備註欄 FBA DP CONDUIT TCP(TRICALCIUM PHOSPHATE)GRANULES 10CC 適應症請 8791 見備註欄 FBA DP CONDUIT TCP(TRICALCIUM PHOSPHATE)GRANULES 15CC 適應症請 見備註欄 FBA DP CONDUIT TCP(TRICALCIUM PHOSPHATE)GRANULES 30CC(2X15CC) 適應症請見備註欄 FBA04A2Q05RJ "GRAFTYS"RESORBABLE BONE VOID FILLER 5CC 可吸收性骨填充物 * 5467 適應症請見備註欄 FBA04A2Q10RJ "GRAFTYS"RESORBABLE BONE VOID FILLER 10CC 可吸收性骨填充物 8791 * 適應症請見備註欄 FBA04A3Q10RJ "GRAFTYS"RESORBABLE BONE VOID FILLER 10CC 可吸收性骨填充物 8791 * 適應症請見備註欄 FBA04AG01RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID 2565 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 FBA04AG03RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER) 3 ML 人工代用骨 ( 再吸收骨填充物 )* 適應症請見備註欄 4179 FBA04AG05RF8 FBA04AG10RF8 FBA04AG15RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER) 5 ML 人工代用骨 ( 再吸收骨填充物 )* 適應症請見備註欄 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER)10ML" 台塑生醫 " 人工代用骨 ( 再吸收骨填充物 )* 適應症請見備註欄 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER)15ML" 台塑生醫 " 人工代用骨 ( 再吸收骨填充物 )* 適應症請見備註欄

161 FBA04AG20RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER)20ML" 台塑生醫 " 人工代用骨 ( 再吸收骨填充物 )* 適應症請見備註欄 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 FBA04B02151U 尼諾斯人工替代骨 ( 滅菌 )NUROS BONE GRAFT SUBSTITUTE(STERILE)-2.5CC * 適應症請見備註欄 FBA04B03161U 尼諾斯人工替代骨 ( 滅菌 )NUROS BONE GRAFT SUBSTITUTE(STERILE)-5CC * 適應症請見備註欄 FBA04B04171U 尼諾斯人工替代骨 ( 滅菌 )NUROS BONE GRAFT SUBSTITUTE(STERILE)-10CC * 適應症請見備註欄 FBA04B05181U 尼諾斯人工替代骨 ( 滅菌 )NUROS BONE GRAFT SUBSTITUTE(STERILE)-20CC * 適應症請見備註欄 FBA04B06191U 尼諾斯人工替代骨 ( 滅菌 )NUROS BONE GRAFT SUBSTITUTE(STERILE)-30CC * 適應症請見備註欄 FBA04BC02BWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE 塊材 (2.0CM3)" 台微醫 " 喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BC05BFQ NANO BICERA BONE GRAFT SUBSTITUTE 塊狀 (5.0CM3) 紐創喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BC05BWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE 塊材 (5.0CM3)" 台微醫 " 喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BC05GWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE 顆粒 (5.0CM3)" 台微醫 " 喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BC07BFQ NANO BICERA BONE GRAFT SUBSTITUTE 塊狀 (7.0CM3) 紐創喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BC07BWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE 塊材 (7.0CM3)" 台微醫 " 喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BC07GFQ NANO BICERA BONE GRAFT SUBSTITUTE 顆粒 (7.0CM3) 紐創喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BC07GWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE 顆粒 (7.0CM3)" 台微醫 " 喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BC10BFQ NANO BICERA BONE GRAFT SUBSTITUTE 塊狀 (10.0CM3) 紐創喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BC10BWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE 塊材 (10.0CM3)" 台微醫 " 喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BC10GFQ NANO BICERA BONE GRAFT SUBSTITUTE 顆粒 (10.0CM3) 紐創喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BC10GWG "WILTROM"BICERA BONE GRAFT SUBSTITUTE 顆粒 (10.0CM3)" 台微醫 " 喜瑞骨人工骨替代物 * 適應症請見備註欄 FBA04BCB01FQ NANO BICERA BONE GRAFT SUBSTITUTE GRANULE 5X5X20MM(2 CM3) 人工骨替代物 * 適應症請見備註欄 FBA04BCB02FQ NANO BICERA BONE GRAFT SUBSTITUTE GRANULE 5X5X10MM(2 CM3) 人工骨替代物 * 適應症請見備註欄 FBA04BCG01FQ NANO BICERA BONE GRAFT SUBSTITUTE GRANULE2-3MM(5.0 CM3) 人工骨替代物 * 適應症請見備註欄 FBA04BCG02FQ NANO BICERA BONE GRAFT SUBSTITUTE GRANULE 1-2MM(5.0 CM3) 人工骨替代物 * 適應症請見備註欄 FBA04BCG03FQ NANO BICERA BONE GRAFT SUBSTITUTE GRANULE 0.5-1MM(5.0 CM3) 人工骨替代物 * 適應症請見備註欄 FBA04CA01RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER)1ML" 台塑生醫 " 人工代用骨 ( 再吸收骨填充物 )* 適應症請見備註欄

162 FBA04CA03RF8 FBA04CA05RF8 FBA04CA10RF8 FBA04CA15RF8 FBA04CA20RF8 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER) 3 ML 人工代用骨 ( 再吸收骨填充物 )* 適應症請見備註欄 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER) 5 ML 人工代用骨 ( 再吸收骨填充物 )* 適應症請見備註欄 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER) 10 ML 人工代用骨 ( 再吸收骨填充物 )* 適應症請見備註欄 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER) 15 ML 人工代用骨 ( 再吸收骨填充物 )* 適應症請見備註欄 "FORMOSA"BONE GRAFT-CALTRIX(RESORBABLE BONE VOID FILLER) 20 ML 人工代用骨 ( 再吸收骨填充物 )* 適應症請見備註欄 FBA04CS001Z6 UNI-OSTEO 1CC* 適應症請見備註欄 2565 FBA04CS002Z6 UNI-OSTEO 2CC* 適應症請見備註欄 4179 FBA04CS003Z6 UNI-OSTEO 3CC* 適應症請見備註欄 5142 FBA04CS005Z6 UNI-OSTEO 5CC* 適應症請見備註欄 5467 FBA04CS010Z6 UNI-OSTEO 10CC* 適應症請見備註欄 8791 FBA04CS020Z6 UNI-OSTEO 20CC* 適應症請見備註欄 FBA04CS102Z6 "MERRIES"UNI-OSTEO " 美瑞世 " 人工骨 2GM(2CC)* 適應症請見備註 4179 欄 FBA04CS105Z6 "MERRIES"UNI-OSTEO " 美瑞世 " 人工骨 5GM(5CC)* 適應症請見備註 5467 欄 FBA04CS110Z6 "MERRIES"UNI-OSTEO " 美瑞世 " 人工骨 10GM(10CC)* 適應症請見備 8791 註欄 FBA04CS120Z6 "MERRIES"UNI-OSTEO " 美瑞世 " 人工骨 20GM(20CC)* 適應症請見備 註欄 FBA04FM01CLB 1CC BONE SUBSTITUTE GRANULES 骨骼填補顆粒 適應症請見備 2565 註欄 FBA04FM02CLB 2CC BONE SUBSTITUTE GRANULES 骨骼填補顆粒 適應症請見備 4179 註欄 FBA04FM05CLB FORAMIC BONE GRAFT SUBSTITUTE 5CC* 適應症請見備註欄 5467 FBA04FM10CLB FORAMIC BONE GRAFT SUBSTITUTE 10CC* 適應症請見備註欄 8791 FBA04FM20CLB FORAMIC BONE GRAFT SUBSTITUTE 20CC* 適應症請見備註欄 FBA04HS114Z6 MERRIES K-PHATE BONE SUBSTITUTE BLOCK(5X5X10MM),4 塊 / 2565 包,1CC/ 包 * 適應症請見備註欄 FBA04HS122Z6 MERRIES K-PHATE BONE SUBSTITUTE BLOCK(5X5X20MM),2 塊 / 2565 包,1CC/ 包 * 適應症請見備註欄 FBA04HS124Z6 MERRIES K-PHATE BONE SUBSTITUTE BLOCK(5X5X20MM),4 塊 / 4179 包,2CC/ 包 * 適應症請見備註欄 FBA04HS201Z6 K-PHATE BONE SUBSTITUTE 1CC 適應症請見備註欄 2565 FBA04HS202Z6 K-PHATE BONE SUBSTITUTE 2CC 適應症請見備註欄 4179 FBA04HS205Z6 MERRIES K-PHATE BONE SUBSTITUTE 5CC* 適應症請見備註欄 5467 FBA04HS208Z6 MERRIES K-PHATE BONE SUBSTITUTE 8CC* 適應症請見備註欄 5467 FBA04HS210Z6 K-PHATE BONE SUBSTITUTE 10CC 適應症請見備註欄 8791 FBA04HS220Z6 K-PHATE BONE SUBSTITUTE 20CC 適應症請見備註欄 FBA04HT020PQ "PURZER"SINBONEHT BONE REPLACEMENT (7 立方公分 ) 生骨替代物 5467 二代 * 適應症請見備註欄 FBA04HT021PQ "PURZER"SINBONEHT BONE REPLACEMENT(1 立方公分 )* 適應症請見備註欄

163 FBA04HT022PQ "PURZER"SINBONEHT BONE REPLACEMENT(2 立方公分 )* 適應症請見 4179 備註欄 FBA04HT023PQ "PURZER"SINBONEHT BONE REPLACEMENT(5 立方公分 )* 適應症請見 5467 備註欄 FBA04HT024PQ "PURZER"SINBONEHT BONE REPLACEMENT (10 立方公分 ) 生骨替代物 8791 二代 * 適應症請見備註欄 FBA04HT040PQ "PURZER"SINBONEHT BONE REPLACEMENT (7 立方公分 ) 生骨替代物 5467 二代 * 適應症請見備註欄 FBA04HT041PQ "PURZER"SINBONEHT BONE REPLACEMENT(1 立方公分 )* 適應症請見 2565 備註欄 FBA04HT042PQ "PURZER"SINBONEHT BONE REPLACEMENT(2 立方公分 )* 適應症請見 4179 備註欄 FBA04HT043PQ "PURZER"SINBONEHT BONE REPLACEMENT(5 立方公分 )* 適應症請見 5467 備註欄 FBA04HT050PQ "PURZER"SINBONEHT BONE REPLACEMENT (7 立方公分 ) 生骨替代物 5467 二代 * 適應症請見備註欄 FBA04HT051PQ "PURZER"SINBONEHT BONE REPLACEMENT (1 立方公分 ) 生骨替代物 2565 二代 * 適應症請見備註欄 FBA04HT052PQ "PURZER"SINBONEHT BONE REPLACEMENT (2 立方公分 ) 生骨替代物 4179 二代 * 適應症請見備註欄 FBA04HT053PQ "PURZER"SINBONEHT BONE REPLACEMENT (5 立方公分 ) 生骨替代物 5467 二代 * 適應症請見備註欄 FBA04HT054PQ "PURZER"SINBONEHT BONE REPLACEMENT (10 立方公分 ) 生骨替代物 8791 二代 * 適應症請見備註欄 FBA04HT091PQ "PURZER"SINBONEHT BONE REPLACEMENT(1 立方公分 )* 適應症請見 2565 備註欄 FBA04HT092PQ "PURZER"SINBONEHT BONE REPLACEMENT(2 立方公分 )* 適應症請見 4179 備註欄 FBA04HT093PQ "PURZER"SINBONEHT BONE REPLACEMENT(5 立方公分 )* 適應症請見 5467 備註欄 FBA04P6922BZ SBM BIOSORB BONE SUBSTITUTES 2CC* 適應症請見備註欄 4179 FBA04P6944BZ SBM BIOSORB BONE SUBSTITUTES 5CC* 適應症請見備註欄 5467 FBA04P6946BZ SBM BIOSORB BONE SUBSTITUTES 15CC* 適應症請見備註欄 ( 產品型 號 :P 自 起生效 ) FBA04PB005YG OSTEO-G BONE VOID FILLER DEVICE 6G 奧斯吉骨填充裝置 * 適應 5467 症請見備註欄 FBA04PB103YG OSTEO-G BONE VOID FILLER DEVICE 3 CC 奧斯吉骨填充裝置 * 適應 4179 症請見備註欄 FBA04PB106YG OSTEO-G BONE VOID FILLER DEVICE 6 CC 奧斯吉骨填充裝置 * 適應 5467 症請見備註欄 FBA04SB050PQ SINBONE BONE REPLACEMENT 7.0CM3* 適應症請見備註欄 5467 FBA04SB054PQ SINBONE BONE REPLACEMENT 10CM3* 適應症請見備註欄 8791 FBA04SB0X0PQ SINBONE BONE REPLACEMENT (SB020:5MM*5MM*5MM 7.0 CM3) 3416 (SB010 自 起將 5MM*5MM*40MM 7.0 CM3 變更為 5MM*5MM*20MM 7.0 CM3)* 適應症請見備註欄 FBA070942NH1 X-CHANGE MESH 5250 FBA100900NH1 HIP STEM PLUG 8:14MM 1041 FBA101109NZ1 POLY PLUG INTRAMEDULLARY PLUGS 1041 FBA101905NU0 U2 HIP STEM PLUG 7: FBA102002NW2 CEMENT CENTRALIZER 9:21MM 1041 FBA105460RDP C-STEM CEMENT RESTRICTOR 1041 FBA Z1 CABLE-READY COBALT CHROME CABLE+SLEEVE 適應症請見備註欄

164 FBA Z1 STAINLESS CABLE-READY PLATE 6:8HOLE 適應症請見備註欄 7384 FBA Z1 TITANIUM CABLE-READY GRIP(SHORT) 適應症請見備註欄 4975 FBA142232NZ1 STAINLESS CABLE-READY+SLEEVE 1.3MM,1.8MM 適應症請見備註 3341 欄 FBA142300NH1 DALL-MILES STAINLESS CABLE 適應症請見備註欄 1287 FBA142301NH1 DALL-MILES STAINLESS CABLE GRIP 適應症請見備註欄 4586 FBA142305NH1 DALL-MILES STAINLESS CABLE SLEEVE( 纜線套 ) 適應症請見備 1784 註欄 FBA S1 WIRE MOUNT 骨板固定鈕 適應症請見備註欄 1784 FBA143704NH1 DALL-MILES STAINLESS CABLE BONE PLATE 適應症請見備註欄 7384 FBEF100002RK FBEF100003RK FBEF110001D1 FBEF110002D1 FBEF110003D1 FBEF127500R1 FBEF135000R1 FBEF141800R1 FBEF1D0001RK FBEF1D0002RK FBEF1D0003RK FBEF200004RK FBEF2199XNS1 FBEF220001D1 FBEF220002D1 FBEF220003D1 FBEF220004D1 REBORN ESSENCE EXTERNAL FIXATION SYSTEM-UNI-LENGTHENING 瑞寶億骨外固定系統 - 單邊延長組 (PIN CLAMPX2+DISTR&COMP RODX1) 適應症請見備註欄 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 TRAUMA-FIX EXTERNAL FIXTOR:FEMORAL BASIC FRAME 股骨基本組 適應症請見備註欄 TRAUMA-FIX EXTERNAL FIXTOR:FEMORAL LENGTHENING FRAME 股骨延長組 適應症請見備註欄 TRAUMA-FIX EXTERNAL FIXTOR:FEMORAL BONE TRANSPORT FRAM 股骨移位組 適應症請見備註欄 ILIZAROV External Fixator System :FEMORAL BASIC SET 股骨基本組 適應症請見備註欄 ILIZAROV External Fixator System :FEMORAL LENGTHENING SET 股骨延長組 適應症請見備註欄 ILIZAROV External Fixator System :FEMORAL DOUBLE LENGTHENING SET 股骨雙層延長組 適應症請見備註欄 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 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 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 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 DISPOFIX SYSTEM(EXTERNAL FIXATOR)(SELDRILLX4+CLAMPX4+RODX1+BARX1) 適應症請見備註欄 TRAUMA-FIX EXTERNAL FIXTOR:TIBIAL BASIC FRAME 脛骨基本組 適應症請見備註欄 TRAUMA-FIX EXTERNAL FIXTOR:TIBIAL BONE TRANSPORT FRAM 脛骨移位組 適應症請見備註欄 TRAUMA-FIX EXTERNAL FIXTOR:SINGLE LEVEL TIBIAL LENGTHENING FRAM 適應症請見備註欄 TRAUMA-FIX EXTERNAL FIXTOR:DOUBLE LEVEL TIBIAL LENGTHENING FRAM 適應症請見備註欄

165 FBEF220005D1 TRAUMA-FIX EXTERNAL FIXTOR:TIBIAL DEFORMITY FRAM 適應症 請見備註欄 FBEF22010NZ6 HUMERUS FRAME SET( 美瑞世肱骨外固定器組 ) 一支連接桿 + 二支多 8755 向球 ) 適應症請見備註欄 FBEF223000R1 ILIZAROV External Fixator System :TIBIAL BASIC SET 脛骨基 本組 適應症請見備註欄 FBEF228750R1 ILIZAROV External Fixator System :TIBIAL BONE TRANSPORT SET 脛骨移位組 適應症請見備註欄 FBEF231900R1 ILIZAROV External Fixator System :TIBIAL LENGTHENING SET 脛骨延長組 適應症請見備註欄 FBEF241400R1 ILIZAROV External Fixator System :TIBIAL DOUBLE LENGTHENING SET 脛骨雙層延長組 適應症請見備註欄 FBEF2D0004RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM 瑞寶億骨外固定系 統 - 脛骨基本組 ( 全環 + 半環 + 連結桿 + 螺栓 + 螺帽 + 溝槽墊片 + 桿座 )* 適應症見備註欄 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 FBEF2D0006RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM 瑞寶億骨外固定系 統 - 脛骨延長組 ( 全環 + 半環 + 連結桿 + 螺栓 + 延長桿 + 溝槽墊片 + 桿座 )* 適應症見備註欄 FBEF2D0007RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM 瑞寶億骨外固定系 統 - 脛骨雙層延長組 ( 全環 + 半環 + 連結桿 + 螺栓 + 螺帽 + 延長桿 + 溝槽墊片 + 桿座 )* 適應症見備註欄 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 FBEF32180NR1 ILIZAROV External Fixator System:ANKLE BASIC SET 踝骨基本 組 適應症請見備註欄 FBEF330001D1 TRAUMA-FIX EXTERNAL FIXTOR:ANKLE BASIC SET 踝骨基本組 適應症請見備註欄 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 FBEF421800R1 ILIZAROV External Fixator System :HUMERAL BASIC SET 肱骨 基本組 適應症請見備註欄 FBEF440001D1 TRAUMA-FIX EXTERNAL FIXTOR:HUMERAL BASIC SET 肱骨基本組 適應症請見備註欄 FBEF440002D1 TRAUMA-FIX EXTERNAL FIXTOR:HUMERAL TRANSPORT FRAME 肱骨移 位組 適應症請見備註欄 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 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 FBEF500001RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-PIN HOLDER CLAMP 704 瑞寶億骨外固定系統 - 針夾 適應症請見備註欄 FBEF500017D1 TELES CONNECTING ROD 341 FBEF500018D1 CONNECTING ROD 106 FBEF50001ND1 UNIVERSAL BALL JOINT 714 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

166 FBEF50001NZ6 5HOLE UNIVERSAL BALL JOINT( 美瑞世五洞外固定器 ) 714 FBEF50001XD1 EXTERNAL FIXATOR SYSTEM:PIN HOLDER CLAMP(WITH ONE:TWO 704 DIA.8MM ROD, WITH ONE:TWO DIA.5MM ROD) 針夾 FBEF50008ND1 EXTERNAL FIXATOR SYSTEM:ARTICULATION 301 COUPLING(DIA.5:8MM*DIA.3:8MM) 結合器 FBEF50013ND1 ARTICULING COUPING 301 FBEF50014NZ6 ARTICULATION COUPLING 8X3,8X4,8X5MM( 美瑞世多向外固定 301 器 )( 規格 8*3 更正為 8*8MM) FBEF50018ND1 EXTERNAL FIXATOR SYSTEM:CONNECTING ROD 連結桿 106 FBEF50018NRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-CONNECTING ROD 瑞 106 寶億骨外固定系統 - 連結桿 適應症請見備註欄 FBEF50018NZ6 CONNECTING ROD 200,250,300MM( 美瑞世骨外連接管 ) 106 FBEF50019ND1 EXTERNAL FIXATOR SYSTEM:ADJUSTABLE TELESCOPICCONNECTING 1692 ROD 調整桿 FBEF50019NRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-ADJUSTABLE 1692 TELESCOPIC CONNECTING ROD 瑞寶億骨外固定系統 - 調整桿 適應症請見備註欄 FBEF50020NZ6 COLLES FRAME SET( 美瑞世一支連接桿 + 二支多向球 ) 限橈骨和尺 4201 骨雙骨折使用 FBEF500S2ND1 EXTERNAL FIXATOR SYSTEM:COLLES-FOREARM FRAME 手腕組 4201 (L170MM) FBEF54601NU0 UNITED EXTERNAL FIXATOR WITHOUT PIN( 手腕骨外固定器組 ) 限 4201 撓骨和尺骨雙骨折使用 FBEF55150NZ6 STAINLESS HALP PIN 5MM 798 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 4201 FBEF5U1U2ND1 EXTERNAL FIXATOR SYSTEM:PIN CLAMP 針夾 (DIA.15:20MM) 3767 FBEF5U1U2NRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-PIN CLAMP 瑞寶億 3767 骨外固定系統 - 針夾 適應症請見備註欄 FBEF5U3U4ND1 EXTERNAL FIXATOR SYSTEM:SMOOTH ROD 連結桿 866 (DIA.20MM*L200:300MM) FBEF5U3U4NRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-CONNECTING ROD 瑞 866 寶億骨外固定系統 - 連結桿 適應症請見備註欄 FBEF5U5LEND1 EXTERNAL FIXATOR SYSTEM:DISTRACTION&COMPRESSION ROD 伸縮 3192 桿 (250+50MM) 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 FBEF5U6U7ND1 EXTERNAL FIXATOR SYSTEM:ROD CONNECTOR 桿連結器 3971 (DIA.8:20MM*DIA.20MM) FBEF5U6U7NRK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-ROD CONNECTOR 瑞 3971 寶億骨外固定系統 - 桿連結器 適應症請見備註欄 FBEFP02101SN ILIZAROV WIRE 1.5MM 適應症請見備註欄 475 FBEFP02102SN ILIZAROV WIRE 1.8MM 適應症請見備註欄 475 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 :400MM 適應症請見備註欄 FBEFP0666ND1 EXTERNAL FIXATION SYSTEM:WIRE 1.5MM 2.0MM 300:400MM 適 475 應症請見備註欄 FBEFP0M30NRT EXTERNAL FIXATOR CORTICAL SCREW 1520 FBEFP1010NRT EXTERNAL FIXATOR CORTICAL SCREW

167 FBEFP1012NRT CANCELLOUS SCREW(10.130:4,10.180:4 自 90/04/01 起刪除 ) 1520 FBEFP2482NSN SKELETAL TRACTION HALF PIN 3MM (COVE POINT PIN) 599 FBEFP24831SN HALF PIN 4MM 615 FBEFP2483NSN SKELETAL TRACTION HALF PIN 5MM (COVE POINT PIN) 798 FBEFP248XNSN SKELETAL TRACTION FULL PIN ALL SIZE (COVE POINT PIN) 1191 FBEFP294NNS1 SCHANZ SCREW (FOR EXTERNAL FIXATION ) 459 FBEFP294XNY2 SKELETAL TRACTION PIN 319 FBEFP295XNY2 HALF PIN 319 FBEFP296XNY2 TRANSFIXING PIN 319 FBEFP29771S1 "MATHYS" SCHANZ SCREW (SELDRILL) 4.0/3.0MM 1039 FBEFP29774S1 "MATHYS" SCHANZ SCREW(SELDRILL) DIA MM 1039 FBEFP29782S1 "MATHYS" SCHANZ SCREW(SELDRILL) DIA MM 1102 FBEFP29792S1 SELDRILL 6.0MM 1146 FBEFP297XNY2 SCHANZ SCREW( 型號 ,294520:70,294620:40)(90/04/01 起 459 型號 刪除, 新增 ) FBEFP3059NZ6 STAINLESS FULL PIN 4-5MM( 兩截全針 ) 1191 FBEFP3070NZ6 TITANIUM HALF PIN 2.5-3MM,3-4MM( 兩截半針 ) 1424 FBEFP3070SZ6 STAINLESS HALF PIN 2.5-3,3-4MM 80:150CM( 粗細兩截 ) 1039 FBEFP3090NZ6 STAINLESS HALF PIN 4-5MM,5-6MM( 兩截半針 ) 1102 FBEFP3109NZ6 TITANIUM HALF PIN 3MM 554 FBEFP3109SZ6 STAINLESS HALF PIN 3MM 80:110CM 599 FBEFP4021NU0 HALF PIN 3,4MM 599 FBEFP4031NZ6 TITANIUM HALF PIN 4MM 622 FBEFP4031SZ6 STAINLESS HALF PIN 4MM 120:180CM 615 FBEFPA4001RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-HALF PIN DIA.3MM 599 瑞寶億骨外固定系統 - 半骨針 適應症請見備註欄 FBEFPA5002RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-HALF PIN DIA.4MM 615 瑞寶億骨外固定系統 - 半骨針 適應症請見備註欄 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 1102 FBEFPA9003RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-HALF PIN DIA.5MM 798 瑞寶億骨外固定系統 - 半骨針 適應症請見備註欄 FBEFPAB004RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-HALF PIN DIA MM;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 FBEFPAC006RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-FULL PIN DIA MM 瑞寶億骨外固定系統 - 全骨針 適應症請見備註欄 FBEFPFUP1ND1 EXTERNAL FIXATOR SYSTEM:FULL PIN 全針 (DIA :6MM*L200:300MM) FBEFPHAP1ND1 EXTERNAL FIXATOR SYSTEM:HALF PIN 半針 (DIA.2:3MM*L45:90MM) 507 FBEFPKX36NAE SCHANZ SCREW 459 FBEFPLX34NAE SCHANZ" SCREW SCHRAUBEN HALF PIN 798 FBEFPLX74NAE SMALL EF SCHANZE SCREW AND PIN 1056 FBEFPP1N56D1 EXTERNAL FIXATOR SYSTEM: HALF PIN 半針 (DIA.5-6MM*L150:180MM) 702 FBEFPPN040D1 EXTERNAL FIXATOR SYSTEM: HALF PIN 半針 615 (DIA.4MM*L150:180MM) FBEFPPN234D1 EXTERNAL FIXATOR SYSTEM:HALF PIN 半針 (DIA2:4MM*L70:150MM)

168 FBEFPPN456D1 EXTERNAL FIXATOR SYSTEM:HALF PIN 半針 1102 (DIA.4:6MM*L150:180MM) FBEFPW0001RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-WIRE 瑞寶億骨外固 475 定系統 - 針 * 適應症見備註欄 FBEFPW0002RK REBORN ESSENCE EXTERNAL FIXATION SYSTEM-OLIVE WIRE 瑞寶億 1337 骨外固定系統 - 橄欖針 * 適應症見備註欄 FBEH14111NH1 TOTAL ELBOW :HUMERAL 適應症請見備註欄 FBEH15000NS2 TOTAL ELBOW SYSTEM 適應症請見備註欄 FBEH15005NS2 TOTAL ELBOW:HUMERAL COMPONENT 適應症請見備註欄 FBEH18006NZ1 TOTAL ELBOW SYSTEM(HUMERAL+ULNAR) 適應症請見備註欄 FBEH181051Z1 COONRAD/MORREY HUMERAL COMPONENT( 型號 : 自 90/07/01 生效 ) 適應症請見備註欄 FBEH18105NZ1 "ZIMMER"COONRAD/MORREY TOTAL ELBOW SYSTEM(HUMERAL+ULNAR)" 捷邁 " 人工肘關節組 適應症請見備註欄 FBEU14112NH1 TOTAL ELB0W :ULNAR 適應症請見備註欄 FBEU15005NS2 TOTAL ELBOW:ULNA COMPONENT 適應症請見備註欄 FBEU181052Z1 COONRAD/MORREY ULNAR COMPONENT( 型號 : 自 90/07/01 生效 ) 適應症請見備註欄 FBEU181053Z1 "ZIMMER"COONRAD/MORREY TOTAL ELBOW SYSTEM:ULNAR" 捷邁 " 人工 肘關節組 : 尺骨件 適應症請見備註欄 FBFJ11234NDP NEUFLEX FINGER IMPLANTS(SILICON) 3712 FBFJ1G470NW2 SWANSON FINGER JOINT( 含鈦合金指套 ) FBFW14885NW2 SWANSON WRIST JOINT IMPLANT FBHB1103XNDP CUP 適應症請見備註欄 FBHB1126XNSN SYNERGY CONVENE BIPOLAR CUP SHELL 適應症請見備註欄 7680 FBHB11503NU0 "UNITED"HIP SYSTEM-U2 BIPOLAR IMPLANT:CUP+LINER " 聯合 " 雙 極半髖人工髖關節 : 髖臼杯 + 內襯 適應症請見備註欄 FBHB11700NW2 BIPOLAR CUP 適應症請見備註欄 7680 FBHB13110NW2 BIOPOLAR CUP&CUP INSERT 適應症請見備註欄 FBHB1501XNU0 UNITED BIPOLAR CUP 聯髖半髖外帽 適應症請見備註欄 7680 FBHB15264NH1 P.C.A. CUP 適應症請見備註欄 FBHB15984NZ1 BIPOLAR CUP 適應症請見備註欄 FBHB1NK04NAE BICONTACT BIPOLAR CUP 適應症請見備註欄 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 FBHB21700NW2 BIPOLAR INSERT 適應症請見備註欄 3472 FBHB2601XNU0 UNITED BIPOLAR CUP LINER 聯髖半髖內襯 適應症請見備註欄 3472 FBHB27139NSN SYNERGY CONVENE BIPOLAR CUP LINER 適應症請見備註欄 3472 FBHBA0580NH1 EXTER BIPOLAR SYSTEM 適應症請見備註欄 FBHBA1000NAE BICONTACT BIPOLAR HIP SYSTEM 適應症請見備註欄 FBHBA1000NDP "DEPUY"BIPOLAR HIP SYSTEM" 帝富 " 雙極式人工髖關節組 適應症 請見備註欄 FBHBA1000NSN SYNERGY CONVENE BIPOLAR SYSTEM 適應症請見備註欄 FBHBA1000NU0 UNITED BIPOLAR SYSTEM 適應症請見備註欄 FBHBA1000NW2 BIOPOLAR HIP SYSTEM 適應症請見備註欄 FBHBA1000TZ1 BIPOLAR HIP SYSTEM 適應症請見備註欄 FBHBA1100NDP "DEPUY"CORAIL BIPOLAR HIP SYSTEM" 帝富 : 可瑞雙極式人工髖關 節組 適應症請見備註欄 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

169 FBHBA2000NU0 UNITED U2 BIPOLAR SYSTEM 適應症請見備註欄 FBHBA3000NU0 "UNITED"HIP SYSTEM-U2 BIPOLAR IMPLANT " 聯合 " 雙極半髖人工 髖關節 適應症請見備註欄 FBHBA3000TZ1 VERSYS BIPOLAR SYSTEM 適應症請見備註欄 FBHBA4120NH1 ABG HA BIPOLAR SYSTEM 適應症請見備註欄 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 FBHBA5500NS2 ACCOLADE BIPOLAR HIP SYSTEM(STEM+CUP+HEAD) 適應症請見備 註欄 FBHBA6000NS2 BIPOLAR HIP SYSTEM 適應症請見備註欄 FBHBA6000NZ1 CLS BIOPOLAR SYSTEM(STEM+HEAD+CUP) 適應症請見備註欄 FBHBA8000TZ1 BIPOLAR HIP SYSTEM(CUP+HEAD+STEM) 適應症請見備註欄 FBHBA9101NH1 P.C.A. BIPOLAR HIP SYSTEM 適應症請見備註欄 FBHBA9610NDP C-STEM BIPOLAR HIP SYSTEM 適應症請見備註欄 FBHBA9979NDP SUMMIT BIPOLAR HIP STEM(STEM+CUP+HEAD) 適應症請見備註欄 FBHBAKTV1TZ1 "ZIMMER"KINECTIV M/L TAPER BIPOLAR HIP PROSTHESIS SYSTEM" 西美 " 組合式股骨柄可旋式雙極式全人工股骨修補系統 適應症請見備註欄 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 FBHBCCERA1AE CERAMIC BIPOLAR HIP SYSTEM 符合傳統雙極式髖關節組適應症者, 如自願選用陶瓷雙極式人工髖關節組, 則按傳統雙極式髖關節組給付, 超過部分由病患自付 FBHBCCERA1DP CERAMIC BIPOLAR HIP SYSTEM 符合傳統雙極式髖關節組適應症者, 如自願選用陶瓷雙極式人工髖關節組, 則按傳統雙極式髖關節組給付, 超過部分由病患自付 FBHBCCERA1S2 CERAMIC BIPOLAR HIP SYSTEM 符合傳統雙極式髖關節組適應症者, 如自願選用陶瓷雙極式人工髖關節組, 則按傳統雙極式髖關節組給付, 超過部分由病患自付 FBHBCCERA1U0 CERAMIC BIPOLAR SYSTEM 符合傳統雙極式髖關節組適應症者, 如自願選用陶瓷雙極式人工髖關節組, 則按傳統雙極式髖關節組給付, 超過部分由病患自付 FBHBCCERA1W2 CERAMIC BIPOLAR HIP SYSTEM 符合傳統雙極式髖關節組適應症者, 如自願選用陶瓷雙極式人工髖關節組, 則按傳統雙極式髖關節組給付, 超過部分由病患自付 FBHBCCERA1Z1 BIPOLAR CERAMIC SYSTEM 符合傳統雙極式髖關節組適應症者, 如自願選用陶瓷雙極式人工髖關節組, 則按傳統雙極式髖關節組給付, 超過部分由病患自付 FBHBCCERA2AE CERAMIC BIPOLAR HIP SYSTEM 符合傳統雙極式髖關節組適應症者, 如自願選用陶瓷雙極式人工髖關節組, 則按傳統雙極式髖關節組給付, 超過部分由病患自付 FBHBCCERA2S2 "STRYKER"CERAMIC BIPOLAR SYSTEM 符合傳統雙極式髖關節適應症, 自願選用陶瓷 HEAD, 則按傳統雙極式髖關節組給付, 超過部分由病患自付 FBHBCCERA2Z1 "ZIMMER"KINECTIV M/L TAPER CERAMIC BIPOLAR HIP PROSTHESIS SYSTEM" 西美 " 組合式股骨柄可旋式雙極式陶瓷人工股骨系統 ( 部分給付 ) 適應症請見備註欄 FBHBCCERA3Z1 "ZIMMER"BIPOLAR BIOLOX DELTA HIP SYSTEM(CERAMIC) 符合傳統雙極式適應症者, 如自願選用陶瓷雙極式, 按傳統髖關節組給付, 超過部分由病患自付

170 FBHBCCERA4Z1 "ZIMMER"M/L TAPER BIPOLAR HIP PROSTHESIS W/KINECTIV TECHNOLOGY" 捷邁 " 康內特人工髖關節 ( 雙極式陶瓷組合式股骨柄, 部分給付 ) 適應症請見備註欄 FBHBCCERA5U0 "UNITED"CERAMIC BIPOLAR SYSTEM 符合傳統雙極式髖關節組適 應症者, 如自願選用陶瓷雙極式人工髖關節組, 則按健保局給付, 超過部分由病患自付 FBHBCCERAZW2 "WRIGHT" CERAMIC BIPOLAR HIP SYSTEM( 搭配組合式股骨柄 ) " 瑞 德 " 陶瓷雙極式人工髖關節系統 ( 部分給付項目, 超過部分由病患自付 ) 適應症請見備註欄 FBHC10581NH1 ACETABULAR CUPS 適應症請見備註欄 FBHC11246NDP AML CUP+AML INSERT 適應症請見備註欄 FBHC1124XNDP AML CUP( 型號 :80,24-09:10,50,51, :153 自 /4/1 生效 ) 適應症請見備註欄 FBHC11455NDP DURALOC HIP IMPLANT:ACETABULAR CUP 適應症請見備註欄 FBHC11599NDP DURALOC ACETABULAR CUP SYSTEM 適應症請見備註欄 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 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 FBHC1301XNU0 UNITED ACETABULAR CUP( 型號 :5062 自 92/4/1 生效 ) 適應症請見備註欄 FBHC1302XNU0 TOTAL HIP CUP+LINER 適應症請見備註欄 FBHC1303XNU0 TITANIUM U2 ACETABULAR CUP 適應症請見備註欄 FBHC13671NW2 HIP CUP (1808,3000,398-XXXX 自 88/10/1 生效,3631,41, : :80 自 93/1/1 生效 ) 適應症請見備註欄 FBHC14000NH1 ABG HA OUTERSHELL 42:74MM 適應症請見備註欄 FBHC14262NZ1 ALLOFIT CUP SYSTEM 適應症請見備註欄 FBHC14930NH1 ACETABULAUM CUP 適應症請見備註欄 FBHC15000NZ1 MULTIPOLAR BIPOLAR CUP 雙極式人工半髖臼杯 ( 型號 5001 自 /1/1 生效 ) 適應症請見備註欄 FBHC154NXNS2 ACETABULUM CUP 適應症請見備欄 FBHC16200NZ1 TRILOGY ACETABULAR CUP(40:80MM) 適應症請見備註欄 FBHC16304NS2 ACETABULUM CUP(CUP+INSERT 一體成型 ) 適應症請見備註欄 FBHC16528NZ1 CUP WITH LINER 適應症請見備註欄 FBHC16532NZ1 HARRIS GALANTE CUP WITH LINER 適應症請見備註欄 FBHC17133NSN SYNERGY TOTAL HIP REFLECTION SHELL 適應症請見備註欄 FBHC17504NH1 P.C.A.DEEP SOCKET SHELL 適應症請見備註欄 FBHC18005NZ1 ZCA ALL-POLY ACETABULAR CUP+INSERT 適應症請見備註欄 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 FBHC1DYNA2W2 "WRIGHT"DYNASTY ACETABULAR CUP SYSTEM:CUP" 瑞德 " 戴內斯帝髖 臼杯系統 適應症請見備註欄 FBHC1NA64NAE BICONTACT CUP 44:64MM( 型號 NH044T:068T 自 92/4/1 生效 ) 適應 症請見備註欄 FBHC1NK810AE PE-ACETABULAR CUP+INSERT 適應症請見備註欄 FBHC1P1CUPDP "DEPUY"PINNACLE HIP SYSTEM:CUP" 帝富 " 必耐久人工髖臼系統 : 髖 臼杯 適應症請見備註欄 FBHC1P1NNADP PINNACLE ACETABULAR CUP 適應症請見備註欄 FBHC26728NZ1 LINER 適應症請見備註欄 4336 FBHC27504NH1 P.C.A. UNIVERSAL CUP(SHELL) 適應症請見備註欄

171 FBHCM1100NU0 CUSTOM MADE FEMORAL PROXIMAL TUMOR PROTHSIS SYSTEM(H+I+C+S) 申報費用時應檢附發票備查 FBHCM2475NH1 "HOWMEDICA"MODULAR REPLACEMENT SYSTEM -HIP 申報時應檢附 該被保險人之發票備查 FBHCM6485NH1 "HOWMEDICA"MODULAR REPLACEMENT SYSTEM -HIP 申報費用應檢 附發票備查 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 FBHH101432DP "DEPUY"AML TOTAL HIP SYSTEM:FEMORAL HEAD" 帝富 " 全人工髖關 4696 節系統 : 股骨頭 ) 適應症請見備註欄 FBHH10586NH1 FEMORAL HEAD 適應症請見備註欄 4696 FBHH1101XNDP AML FEMORAL HEAD(87/7/ :60,136501:03,11: ,21:25,29:30,43:48, :13 適應症見備註 FBHH11260NS2 "HOWMEDICA-OSTEONICS" OMNIFIT HIP SYSTEM: HA FEMORAL HEAD 4696 " 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 FBHH11261NS2 "HOWMEDICA-OSTEONICS" OMNIFIT HIP SYSTEM: HA FEMORAL HEAD 4696 " 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 FBHH11262NS2 "BG" EXETER TOTAL HIP SYSTEM: HA FEMORAL HEAD " 必吉 " 愛克 4696 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 FBHH11840NDP CORAIL FEMORAL HEAD 適應症請見備註欄 4696 FBHH1201XNU0 UNITED FEMORAL HEAD (BIPOLAR)( 型號 :1828 自 92//4/ 生效 ) 適應症請見備註欄 FBHH13611NW2 FEMORAL HEAD 適應症請見備註欄 4696 FBHH14003NH1 P.C.A.FEMORAL HEAD 適應症請見備註欄 4696 FBHH15220RDP S-ROM FEMORAL HEAD 適應症請見備註欄 4696 FBHH16260NH1 V40/PCA FEMORAL HEAD 適應症請見備註欄 4696 FBHH16260NS2 HA FEMORAL HEAD 適應症請見備註欄 4696 FBHH16530NH1 ABG HA FEMORAL HEAD 22.22:32MM(TOTAL AND BIPOLAR) 適應 4696 症請見備註欄 FBHH17130NSN SYNERGY TOTAL HIP FEMORAL HEAD 適應症請見備註欄 4696 FBHH18018NZ1 FEMORAL HEAD 適應症請見備註欄 ( :05 自 刪除 ) FBHH19262NZ1 FEMORAL HEAD 適應症請見備註欄 4696 FBHH1962XNDP C-STEM HIP HEAD 適應症請見備註欄 4696 FBHH1ARTHDDP "DEPUY"ARTICUL/EZE HEADS " 帝富 " 股骨頭系統 適應症請見備註 4696 欄 FBHH1NK33NAE FEMORAL HEAD 適應症請見備註欄 4696 FBHH1NK46NAE BICONTACT FEMORAL HEAD 28,32MM(NK330K:533K,NJ111K-134K 自 /4/1 生效 ) 適應症請見備註欄 FBHHC6565NH1 CERAMIC HEAD 凡只更換股骨頭者, 如自願選用陶瓷股骨頭時, 4696 則按傳統股骨頭給付, 超過部分由病患自付 FBHHCCERA1AE CERAMIC HIP SYSTEM:HEAD 凡只更換股骨頭者, 如自願選用陶瓷 4696 股骨頭時, 則按傳統股骨頭給付, 超過部分由病患自付 FBHHCCERA1DP CERAMIC HIP SYSTEM:HEAD 凡只更換股骨頭者, 如自願選用陶 4696 瓷股骨頭時, 則按傳統股骨頭給付, 超過部分由病患自付 FBHHCCERA1S2 CERAMIC HIP SYSTEM:HEAD 凡只更換股骨頭者, 如自願選用陶 4696 瓷股骨頭時, 則按傳統股骨頭給付, 超過部分由病患自付 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

172 FBHHCCERA1W2 CERAMIC HIP SYSTEM:HEAD 凡只更換股骨頭者, 如自願選用陶 4696 瓷股骨頭時, 則按傳統股骨頭給付, 超過部分由病患自付 FBHHCCERA1Z1 CERAMIC HIP SYSTEM:HEAD 凡只更換股骨頭者, 如自願選用陶 4696 瓷股骨頭時, 則按傳統股骨頭給付, 超過部分由病患自付 FBHHCCERA2AE CERAMIC HIP SYSTEM:HEAD 凡只更換股骨頭者, 如自願選用陶瓷 4696 股骨頭時, 則按傳統股骨頭給付, 超過部分由病患自付 FBHHCCERA2S2 "STRYKER"TRIDENT POLY ACETABULAR SYSTEM:CERAMIC HEAD 凡 4696 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 FBHHCCERA2W2 "WRIGHT"DYNASTY ACETABULAR CUP SYSTEM:CERAMIC HEAD 陶瓷股 4696 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 FBHHCCERA2Z1 "ZIMMER"BIOLOX DELTA TAPER HEAD(CERAMIC) 符合傳統髖關節 4696 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 FBHHCCERA5U0 "UNITED"CERAMIC FEMORAL HEAD DELTA 凡只更換股骨頭者, 如 4696 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 FBHL11241NDP DURALOC HIP IMPLANT:ENDURON LINER 適應症請見備註欄 4336 FBHL11260NS2 HA HIP INSERT( 型號 2041C-26XX,28XX 自 91/01/01 生效 ) 適應症 4336 請見備註欄 FBHL11284NH1 ABG HA INSERT 42:74MM 適應症請見備註欄 4336 FBHL1241XNDP AML HIP INSERT(87/7/7 新增產品型號 :24,48:64) 適應 4336 症請見備註欄 FBHL13646NH1 P.C.A.HIP INSERT 適應症請見備註欄 4336 FBHL13820NW2 HIP CUP INSERT (3X15,5X00,5X15-XXXX 自 88/10/1 生效,3641: :4006 自 93/1/1 生效 ) 適應症請見備註欄 FBHL13830NW2 "WRIGHT"LINEAGE INTERSEAL HIP SYSTEM:A-CLASS ACETABLAR LINER" 瑞德 " 尼盈聚髖關節系統 : 髖白杯內櫬 適應症請見備註欄 4336 FBHL1401XNU0 UNITED ACETABULAR CUP LINER( 型號 :5062 自 92/4/1 生 4336 效 ) 適應症請見備註欄 FBHL1403XNU0 U2 ACETABULAR LINER 適應症請見備註欄 4336 FBHL16161NZ1 ACETABULAR CUP LINER(40:80MM) 適應症請見備註欄 4336 FBHL16200NS2 INSERT CUP 適應症請見備註欄 4336 FBHL16305NZ1 LONGEVITY ACETABULAR CUP LINER 適應症請見備註欄 4336 FBHL16352NH1 SYSTEM 12 ACETABULAR INSERT 適應症請見備註欄 4336 FBHL16567NZ1 ACETABULAR CUP LINER 42:70MM 適應症請見備註欄 4336 FBHL1717XNSN SYNERGY TOTAL HIP ACETABULAR LINER 適應症請見備註欄 4336 FBHL1NK17NAE BICONTACT INSERT 28,30MM( 型號 NA278:NA291 自 92/1/1 生 4336 效,NH171:476 自 92/4/1 生效 ) 適應症請見備註欄 FBHL1P1NPLDP "DEPUY"PINNACLE HIP SYSTEM:LINER " 帝富 " 必耐久人工髖臼系 4336 統 : 襯墊 FBHL1PNNPEDP "DEPUY" PINNACLE ACETABULAR SYSTEM " 帝富 " 可耐髖人工髖臼杯 4336 系統 適應症請見備註欄 FBHLC4936NH1 CERAMIC 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 4336 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

173 FBHLCCERA1DP FBHLCCERA1S2 FBHLCCERA1U0 FBHLCCERA1W2 FBHLCCERA1Z1 FBHLCCERA2Z1 FBHMCBCER1AE FBHMCBCER1DP FBHMCBCER1S2 FBHMCBCER1U0 FBHMCBCER1W2 FBHMCBCER1Z1 FBHMCBCER2AE FBHMCBCER2S2 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 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 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 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 CERAMIC HIP SYSTEM:LINER 凡只更換髖臼杯內襯者, 如自願選用陶瓷髖臼杯內襯時, 則按傳統髖臼杯內襯給付, 超過部分由病患自付 "ZIMMER"BIOLOX DELTA TAPER LINER(CERAMIC) 符合傳統髖關節髖臼內杯適應症者, 如自願選用陶瓷髖臼內杯, 按傳統髖關節組給付, 超過部分由病患自付 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 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 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 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 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 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 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 "STRYKER"CERAMIC BIPOLAR 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 FBHMCBCER3Z1 "ZIMMER"BIPOLAR BIOLOX DELTA HIP SYSTEM(CERAMIC) 符合 MOORE 規定者, 如自願選用陶瓷雙極式, 按傳統髖關節組給付, 超過部分由病患自付 FBHMCBCER5U0 "UNITED"CERAMIC BIPOLAR SYSTEM 凡符合使用 MOORE 規定者, 如自願選用本陶瓷單極式人工髖關節組, 則按健保局核價部份給付, 超過部分由病患自付 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

174 FBHMCPCER1DP CERAMIC TOTAL HIP SYSTEM 凡符合使用 MOORE 規定者, 如自願選用陶瓷人工髖關節組, 則按 MOORE 人工髖關節給付, 超過部分由病患自付 FBHMCPCER1S2 CERAMIC HIP SYSTEM 凡符合使用 MOORE 者, 自願選用陶瓷人工髖關節組, 按 MOORE 給付, 超過部分由病患自付 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 FBHMCPCER1W2 CERAMIC TOTAL HIP SYSTEM 凡符合使用 MOORE 規定者, 如自願選用陶瓷人工髖關節組, 則按 MOORE 人工髖關節給付, 超過部分由病患自付 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, 則按 MOORE 人工髖關節給付, 超過部分由病患自付 FBHMCPCER2AE CERAMIC TOTAL HIP SYSTEM 凡符合使用 MOORE 規定者, 如自願選用陶瓷人工髖關節組, 則按 MOORE 人工髖關節給付, 超過部分由病患自付 FBHMCPCER2S2 "STRYKER"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 FBHMCPCER3Z1 FBHMCPCER5U0 FBHMCPCER5Z1 FBHMCPCER6Z1 FBHMCRCER1AE FBHMCRCER1DP FBHMCRCER1S2 FBHMCRCER1U0 FBHMCRCER1W2 FBHMCRCER1Z1 FBHMCRCER2AE "ZIMMER"BIOLOX DELTA TOTAL HIP SYSTEM(CERAMIC) 符合 MOORE 規定者, 如自願選用陶瓷全人工髖關節組, 按 MOORE 給付, 超過部分由病患自付 "UNITED"CERAMIC HIP SYSTEM 凡符合使用 MOORE 規定者, 如自願選用本陶瓷雙極式人工髖關節組, 則按健保局核價部份給付, 超過部分由病患自付 "ZIMMER"BIOLOX DELTA CERAMIC TOTAL HIP SYSTEM 符合使用 MOORE 規定者, 如自願選用陶瓷 HEAD, 則按 MOORE 給付, 超過部分由病患自付 "ZIMMER"BIOLOX DELTA CERAMIC TOTAL HIP SYSTEM 符合使用 MOORE 規定者, 如自願選用陶瓷 HEAD( 組合式股骨柄 ), 則按 MOORE 給付, 超過部分由病患自付 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 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 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 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 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 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 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

175 FBHMCRCER2S2 "STRYKER"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 8493 FBHMCRCER2Z1 "ZIMMER"BIOLOX DELTA CERAMIC REVISION HIP SYSTEM 符合使 8493 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 FBHMCRCER3Z1 "ZIMMER"REVISION BIOLOX DELTA HIP SYSTEM(CERAMIC) 符合 8493 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 FBHMCRCER4Z1 "ZIMMER"BIOLOX DELTA CERAMIC REVISION HIP SYSTEM 符合使 8493 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 FBHMCRCER5U0 "UNITED"CERAMIC REVISION HIP SYSTEM 凡符合使用 MOORE 規定 8493 者, 如自願選用本重建型人工髖關節組, 則按健保局核價部份給付, 超過部分由病患自付 FBHMMLDH01W2 BIG FEMORAL HEAD TOTAL HIP SYSTEM( 含固定樁 ) 符合使用 8493 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 FBHMMLDH01Z1 LDH TOTAL HIP SYSTEM 符合使用 MOORE 規定者, 如使用 LDH 人工 8493 髖關節組, 按 MOORE 給付, 超過部分由病患自付 FBHMMLDH02W2 BIG FEMORAL HEAD TOTAL HIP SYSTEM( 不含固定樁 ) 符合使用 8493 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 FBHMMLDH02Z1 MMC CUP NON-HA VERSION (LDH TOTAL HIP SYSTEM) 符合使用 8493 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 FBHMMMETA1DP PINNACLE METAL ON METAL TOTAL HIP SYSTEM 符合 MOORE 者, 如 8493 自願選用金屬人工髖關節組, 按 MOORE 髖關節組給付, 超過部分由病患自付 FBHMMMETA1Z1 METAL ON METAL TOTAL HIP SYSTEM 符合使用 MOORE 規定者, 如 8493 使用 METAL ON METAL 人工髖關節組, 按 MOORE 給付, 超過部分由病患自付 FBHMMMETA2Z1 "ZIMMER" METAL ON METAL TOTAL HIP SYSTEM 符合使用 MOORE 8493 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 FBHPA0580NH1 EXETER TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA1000NAE BICONTACT TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA1000NDP AML TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA1000NS2 HA TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA1000NU0 UNITED TOTAL HIP SYSTEM 聯髖人工髖關節 適應症請見備註欄 FBHPA1000NW2 TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA1000TZ1 HARRIS GALANTE TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA1100NDP CORAIL TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA2000NS2 TOTAL HIP SYSTEM(STEM+CUP+INSERT+HEAD) 適應症請見備註欄 FBHPA2000NU0 UNITED U2 TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA2000TZ1 HA/TCP TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA3000NU0 TOTAL HIP SYSTEM ( 型號 : : :1726) 適應症請見備註欄 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

176 FBHPA4000TZ1 VERSYS TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA4120NH1 ABG HA TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA4845NH1 ABG TOTAL HIP SYSTEM (STEM+CUP+HEAD+INSERT) 愛必吉全人工髖 關節組 適應症請見備註欄 FBHPA5000NS2 TOTAL HIP SYSTEM(STEM+CUP+HEAD+INSERT) 適應症請見備註欄 FBHPA5500NS2 ACCOLADE TOTAL HIP SYSTEM(STEM+CUP+INSERT+HEAD) 適應症請 見備註欄 FBHPA6000NZ1 CLS SPOTORNO SYSTEM(STEM+LINER+HEAD+ACETABULAR CUP) 適應 症請見備註欄 FBHPA7000NSN SYNERGY TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA8000TZ1 TOTAL HIP SYSTEM(CUP+LINER+HEAD+STEM) 適應症請見備註欄 FBHPA9101NH1 P.C.A.TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA9610NDP C-STEM TOTAL HIP SYSTEM 適應症請見備註欄 FBHPA9979NDP SUMMIT TOTAL HIP SYSTEM(STEM+HEAD+CUP+INSERT) 適應症請見 備註欄 FBHPAKTV1TZ1 "ZIMMER"KINECTIV M/L TAPER TOTAL HIP PROSTHESIS SYSTEM" 西美 " 組合式股骨柄可旋式全人工股骨修補系統 適應症請見備註欄 FBHPAPMAMLDP FBHPAPMARADP FBHPAPRFMRW2 FBHPC4845NH1 FBHPCCERA1AE FBHPCCERA1DP FBHPCCERA1S2 FBHPCCERA1U0 FBHPCCERA1W2 FBHPCCERA1Z1 FBHPCCERA2AE FBHPCCERA2S2 "DEPUY"PINNACLE HIP SYSTEM" 帝富 " 必耐久人工髖臼系統 適應症請見備註欄 "DEPUY"TOTAL HIP SYSTEM" 帝富 " 全人工髖關節組 適應症請見備註欄 "WRIGHT"TOTAL HIP SYSTEM ( 搭配組合式股骨柄 )" 瑞德 " 全人工髖關節系統 適應症請見備註欄 ABG 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, 按傳統人工髖關節組給付, 超過部分由病患自付 CERAMIC TOTAL HIP SYSTEM 凡符合傳統人工髖關節組之適應症者, 如自願選用陶瓷人工髖關節組時, 則按傳統人工髖關節組給付, 超過部分由病患自付 CERAMIC TOTAL HIP SYSTEM 凡符合傳統人工髖關節組之適應症者, 如自願選用陶瓷人工髖關節組時, 則按傳統人工髖關節組給付, 超過部分由病患自付 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 CERAMIC TOTAL HIP SYSTEM 凡符合傳統人工髖關節組之適應症者, 如自願選用陶瓷人工髖關節組時, 則按傳統人工髖關節組給付, 超過部分由病患自付 CERAMIC TOTAL HIP SYSTEM 凡符合傳統人工髖關節組之適應症者, 如自願選用陶瓷人工髖關節時, 則按傳統人工髖關節組給付, 超過部分由病患自付 CERAMIC TOTAL HIP SYSTEM 凡符合傳統人工髖關節組之適應症者, 如自願選用陶瓷人工髖關節組時, 則按傳統人工髖關節組給付, 超過部分由病患自付 CERAMIC TOTAL HIP SYSTEM 凡符合傳統人工髖關節組之適應症者, 如自願選用陶瓷人工髖關節組時, 則按傳統人工髖關節組給付, 超過部分由病患自付 "STRYKER"CERAMIC TOTAL HIP SYSTEM 符合傳統人工髖關節適應症者, 自願選用陶瓷 HEAD, 則按傳統人工髖關節組給付, 超過部分由病患自付

177 FBHPCCERA2W2 CERAMIC TOTAL HIP SYSTEM 凡符合傳統人工髖關節組之適應症者, 如自願選用陶瓷人工髖關節時, 則按傳統人工髖關節組給付, 超過部分由病患自付 FBHPCCERA2Z1 "ZIMMER"KINECTIV M/L TAPER CERAMIC TOTAL HIP PROSTHESIS SYSTEM" 西美 " 組合式股骨柄可旋式陶瓷全人工股骨修補系統 ( 部分給付項目 ) 適應症請見備註欄 FBHPCCERA3Z1 "ZIMMER"BIOLOX TOTAL HIP SYSTEM(CERAMIC) 符合傳統髖關節組適應症者, 如自願選用陶瓷全人工髖關節組, 按傳統髖關節組給付, 超過部分由病患自付 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 FBHPCCERA4Z1 "ZIMMER"M/L TAPER HIP PROSTHESIS W/KINECTIV TECHNOLOGY" 捷邁 " 康內特人工髖關節 ( 陶瓷, 組合式股骨柄, 部分給付項目, 超過部分自付 ) 適應症請見備註欄 FBHPCCERA5U0 "UNITED"CERAMIC TOTAL HIP SYSTEM 凡符合傳統人工髖關節組之適應症者, 如自願選用陶瓷人工髖關節組, 則按健保給付, 超過部分由病患自付 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 FBHPCCERA5Z1 "ZIMMER"BIOLOX DELTA CERAMIC TOTAL HIP SYSTEM 符合傳統人工髖關節適應症者, 自願選用陶瓷 HEAD, 則按傳統人工髖關節組給付, 超過部分由病患自付 FBHPCCERA6Z1 "ZIMMER"BIOLOX DELTA CERAMIC TOTAL HIP SYSTEM 符合傳統人工髖關節適應症, 選用陶瓷 HEAD, 則按傳統人工髖關節組給付 ( 組合式 STEM), 超過病患自付 FBHPMLDH01W2 BIG FEMORAL HEAD TOTAL HIP SYSTEM ( 含固定樁 ) 符合傳統髖關節組適應症者, 如自願選用 BFH 人工髖關節組, 按傳統髖關節組給付, 超過部分由病患自付 FBHPMLDH01Z1 LARGE DIAMETER HEAD (LDH))TOTAL HIP SYSTEM 符合傳統髖關節組適應症者, 如自願選用 LDH 人工髖關節組, 按傳統髖關節組給付, 超過部分由病患自付 FBHPMLDH02W2 BIG FEMORAL HEAD TOTAL HIP SYSTEM( 不含固定樁 ) 符合傳統髖關節組適應症者, 如自願選用 BFH 人工髖關節組, 按傳統髖關節組給付, 超過部分由病患自付 FBHPMLDH02Z1 MMC CUP NON-HA VERSION (LDH TOTAL HIP SYSTEM) 符合傳統髖關節組適應症者, 如自願選用 LDH 人工髖關節組, 按傳統髖關節組給付, 超過部分由病患自付 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 FBHPMLDH03Z1 "ZIMMER"KINECTIV M/L TAPER LDH TOTAL HIP PROSTHESIS SYSTEM" 西美 " 組合式股骨柄可旋式巨頭全人工股骨修補系統 ( 部分給付項目 ) 適應症請見備註欄 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 FBHPMMETA1DP PINNACLE METAL ON METAL TOTAL HIP SYSTEM 符合傳統髖關節組適應症者, 如自願選用金屬人工髖關節組, 按傳統髖關節組給付, 超過部分由病患自付

178 FBHPMMETA1W2 "WRIGHT"TOTAL HIP SYSTEM(METAL ON METAL) 符合傳統髖關節 組適應症者, 如自願選用金屬人工髖關節組, 按傳統髖關節組給付, 超過部分由病患自付 FBHPMMETA1Z1 METASUL METAL ON METAL TOTAL HIP SYSTEM 符合傳統髖關節組 適應症者, 如自願選用金屬人工髖關節組, 按傳統髖關節組給付, 超過部分由病患自付 FBHPMMETA2DP "DEPUY"PINNACLE METAL ON METAL TOTAL HIP SYSTEM 符合傳統 髖關節適應症者, 如自願選用 PINNACLE, 按傳統髖關節組給付, 超過部分由病患自付 FBHPMMETA2W2 "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 ) 適應症請見備註欄 FBHPMMETA2Z1 "ZIMMER"KINECTIV M/L TAPER METASUL TOTAL HIP PROSTHESIS SYSTEM" 西美 " 組合式股骨柄可旋式金屬對金屬 ( 部分給付項目 ) 適應症請見備註欄 FBHPMMETA3W2 "WRIGHT"TOTAL HIP SYSTEM(METAL ON METAL) 符合傳統髖關節 組適應症者, 如自願選用金屬人工髖關節組, 按傳統髖關節組給付, 超過部分由病患自付 FBHPMMETA3Z1 "ZIMMER" METAL ON METAL TOTAL HIP SYSTEM 符合傳統髖關節 組適應症者, 如自願選用金屬人工髖關節組, 按傳統髖關節組給付, 超過部分由病患自付 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 ) 適應症請見備註欄 FBHPMMETA4Z1 "ZIMMER"M/L TAPER HIP PROSTHESIS W/KINECTIV TECHNOLOGY" 捷 邁 " 康內特人工髖關節組 ( 金屬對金屬, 組合式股骨柄, 部分給付項目 ) 適應症請見備註欄 FBHRA0580NH1 EXTER REVISION TOTAL HIP SYSTEM 適應症請見備註欄 FBHRA1000NDP AML REVISION TOTAL HIP SYSTEM 適應症請見備註欄 FBHRA1000NW2 REVISION TOTAL HIP SYSTEM 適應症請見備註欄 FBHRA1000TZ1 REVISION TOTAL HIP SYSTEM 適應症請見備註欄 FBHRA10099DP C-STEM REVISION TOTAL HIP SYSTEM 適應症請見備註欄 FBHRA1100NH1 P.C.A.REVISION TOTAL HIP SYSTEM 適應症請見備註欄 FBHRA2000NW2 PERFECTA REVISION TOTAL HIP SYSTEM(NECK+BODY+STEM+HEAD+CUP+INSERT) 適應症請見備註欄 FBHRA2000TZ1 VERSYS REVISION TOTAL HIP SYSTEM 適應症請見備註欄 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 FBHRA3000TZ1 VERSYS CEMENTED REVISION/CALCAR TOTAL HIP SYSTEM 適應症 請見備註欄 FBHRA4000TZ1 ZMR REVISION HIP SYSTEM(BODY+STEM+HEAD+CUP+INSERT) 適應 症請見備註欄 FBHRA5000NS2 TOTAL HIP REVISION SYSTEM(STEM+CUP+INSERT+HEAD) 適應症請 見備註欄 FBHRA5000NU0 U2 REVISION HIP SYSTEM 適應症請見備註欄 FBHRA5000TZ1 CPT REVISION HIP SYSTEM(CUP+LINER+HEAD+STEM) 捷奔特髖關節 組 適應症請見備註欄 FBHRA5200RDP S-ROM TOTAL HIP SYSTEM(STEM+SLEEVES+HEAD+CUP+INSERT) 適 應症請見備註欄 FBHRA6000TZ1 "ZIMMER"WAGNER SL REVISION HIP SYSTEM" 捷邁 " 衛格能重建型髖關節組 適應症請見備註欄

179 FBHRA6260NH1 RESTORATION REVISION HIP SYSTEM 適應症請見備註欄 FBHRANK20NAE BICONTACY REVISION HIP SYSTEM(STEM+HEAD+CUP+INSERT) 適應 症請見備註欄 FBHRAP1REVDP "DEPUY"PINNACLE HIP SYSTEM:REVISION" 帝富 " 必耐久人工髖臼系 統 : 重建式 適應症請見備註欄 FBHRCCERA1AE CERAMIC REVISION HIP SYSTEM 符合傳統重建型髖關節組適應症 者, 如自願選用陶瓷重建型人工髖關節組, 按傳統重建型髖關節組給付, 超過部分由病患自付 FBHRCCERA1DP CERAMIC REVISION HIP SYSTEM 符合傳統重建型髖關節組適應症 者, 如自願選用陶瓷重建型人工髖關節組, 按傳統重建型髖關節組給付, 超過部分由病患自付 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 FBHRCCERA1U0 CERAMIC REVISION HIP SYSTEM 符合傳統重建型髖關節組適應症 者, 如自願選用陶瓷重建型人工髖關節組, 按傳統重建型髖關節組給付, 超過部分由病患自付 FBHRCCERA1W2 CERAMIC REVISION HIP SYSTEM 符合傳統重建型髖關節組適應症 者, 如自願選用陶瓷重建型人工髖關節組, 按傳統重建型髖關節組給付, 超過部分由病患自付 FBHRCCERA1Z1 REVISION CERAMIC HIP SYSTEM 符合傳統重建型髖關節組適應症 者, 如自願選用陶瓷重建型人工髖關節組, 按傳統重建型髖關節組給付, 超過部分由病患自付 FBHRCCERA2AE CERAMIC REVISION HIP SYSTEM 符合傳統重建型髖關節組適應症 者, 如自願選用陶瓷重建型人工髖關節組, 按傳統重建型髖關節組給付, 超過部分由病患自付 FBHRCCERA2S2 "STRYKER"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 HEAD, 則按傳統重建型髖關節組給付, 超過部分由病患自付 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 FBHRCCERA2Z1 "ZIMMER"BIOLOX DELTA CERAMIC REVISION HIP SYSTEM 符合傳 統重建型髖關節適應症, 選用陶瓷 HEAD, 則按傳統重建型髖關節組給付, 超過病患自付 FBHRCCERA3Z1 "ZIMMER"REVISION BIOLOX DELTA HIP SYSTEM(CERAMIC) 符合傳 統重建型適應症者, 如自願選用陶瓷重建型, 按傳統髖關節組給付, 超過部分由病患自付 FBHRCCERA4Z1 "ZIMMER"BIOLOX DELTA CERAMIC REVISION HIP SYSTEM 符合重 建型 ( 骨缺損 2 度以上 ) 髖關節適應症, 選用陶瓷 HEAD, 按傳統重建髖關節給付, 超過病患自付 FBHRCCERA5U0 "UNITED"CERAMIC REVISION HIP SYSTEM 符合傳統重建型髖關節 組適應症者, 如自願選用陶瓷重建型人工髖關節組, 則按健保局給付, 超過部分由病患自付 FBHS10580NH1 FEMORAL STEM 適應症請見備註欄 FBHS1101XNU0 UNITED PRIMARY HIP STEM (BIPOLAR STEM) 適應症請見備註欄 FBHS11104NU0 UNITED U2 HIP STEM" 聯合 "U2 人工髖關節股骨柄 適應症請見備 註欄 FBHS11104RU0 U2 REVISION HIP SYSTEM:STEM 適應症請見備註欄 FBHS1110XNU0 TOTAL HIP STEM(CEMENT STEM) 適應症請見備註欄 FBHS11170NS2 HA PRIMARY STEM 適應症請見備註欄 FBHS11200NS2 EXETER PRIMARY STEM 適應症請見備註欄

180 FBHS11300NS2 ACCOLADE PRIMARY STEM 適應症請見備註欄 FBHS1135XNDP AML STEM(87/7/7 新增 1554, :08,42:48, :27) 適 應症請見備註欄 FBHS12900NZ1 CLS SPOTORNO STEM 適應症請見備註欄 FBHS13708NW2 FEMORAL STEM (378X-XXXX 自 88/09/01 起生效,385X,3793-XXXX 自 /10/1 生效 ) 適應症請見備註欄 FBHS14120NH1 ABG HA FEMORAL STEM 1#:9# (TOTAL AND BIPOLAR) 適應症請 見備註欄 FBHS14845NH1 ABG TOTAL HIP SYSTEM:STEM 股骨柄 適應症請見備註欄 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 FBHS16260NH1 RESTORATION P/S LONG STEM 適應症請見備註欄 FBHS16521NZ1 HARRIS GALANTE PRIMARY STEM 適應症請見備註欄 FBHS16578NZ1 VERSYS HA/TCP FIBER METAL TAPER STEM 適應症請見備註欄 FBHS1713XNSN SYNERGY TOTAL HIP STEM ( : 自 88/10/1 生效 ) 適應症請見備註欄 FBHS17711NZ1 M/L TAPER HIP PROSTHESIS(STEM) 適應症請見備註欄 FBHS17841NZ1 VERSYS FIBER METAL MIDCOAT HIP STEM(COLLARED) 適應症請見 備註欄 FBHS17850NZ1 VERSYS ADVOCATE CEMENTED STEM 適應症請見備註欄 FBHS17853NZ1 VERSYS CEMENTED TOTAL HIP STEM( :17-01:21 自 89/04/ 起生效 ) 適應症請見備註欄 FBHS17854NZ1 VERSYS CEMENTED HIP CT STEM 適應症請見備註欄 FBHS17857NZ1 VERSYS HERITAGE CDH:FEMORAL STEM 適應症請見備註欄 FBHS17862NZ1 VERSYS FIBER METAL TAPER HIP STEM 適應症請見備註欄 FBHS19101NH1 P.C.A. PRIMARY STEM 適應症請見備註欄 FBHS1925XNDP CORAIL FEMORAL STEM 適應症請見備註欄 FBHS1961XNDP C-STEM HIP STEM( 自 92/7/1 生效 ) ( ,01500,02500 自 92/10/1 生效 ) 適應症請見備註欄 FBHS19979NDP SUMMIT HIP STEM 適應症請見備註欄 FBHS1KTV1NZ1 "ZIMMER"KINECTIV M/L TAPER HIP PROSTHESIS SYSTEM:STEM" 西美 " 可旋式人工股骨修補系統 : 組合式股骨柄 適應症請見備註欄 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 FBHS1PRFMRW2 "WRIGHT"PROFEMUR HIP SYSTEM:MODULAR STEM" 瑞德 " 博菲莫人工 髖關節系統 : 組合式股骨柄 適應症請見備註欄 FBHS2130LNS2 "HOWMEDICA-OSTEONICS"OMNIFIT HIP SYSTEM:OMNIFIT CEMENTED LONG STEM" 好美得卡 - 奧斯得寧 " 人工髖關節系統 : 股骨柄 適應症請見備註欄 FBHS21445NS2 EXETER HIP LONG STEM 適應症請見備註欄 FBHS23730NW2 REVISION HIP LONG STEM 適應症請見備註欄 ( 型號 XXXX,3784-XXXX 自 89/10/1 生效 ) 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 FBHS30102NZ1 "ZIMMER"WAGNER SL REVISION HIP SYSTEM:STEM" 捷邁 " 衛格能重 建型髖關節組 : 股骨柄 適應症請見備註欄 FBHS30580NH1 FEMORAL LONG STEM 適應症請見備註欄 FBHS310099DP C-STEM REVISION HIP STEM 適應症請見備註欄 FBHS31100NH1 P.C.A. LONG STEM 適應症請見備註欄

181 FBHS32000NW2 PERFECTA REVISION HIP STEM(NECK+BODY+STEM) 適應症請見備 註欄 FBHS3354XNDP AML LONG STEM(87/11/2 起 :90-000, : ) 適應症請見備註欄 FBHS35500RDP S-ROM ZTT SLEEVES( 近端套筒 ) 適應症請見備註欄 FBHS35600RDP S-ROM FEMORAL STEM( 型號含 L:424R,526514L:684) 適應 症請見備註欄 FBHS37846NZ1 VERSYS BEADED FULLCOAT PLUS REVISION STEM 200MM( :20-08 自 89/04/01 起生效 ) 適應症請見備註欄 FBHS37855NZ1 VERSYS CEMENTED REVISION STEM 200:260MM 適應症請見備註欄 FBHS37871NZ1 VERSYS CEMENTED REVISION/CALCAR STEM 適應症請見備註欄 FBHS38114NZ1 CPT REVISION HIP SYSTEM:STEM 捷奔特髖關節系統 ( 股骨柄 ) 適應症請見備註欄 FBHS39980NZ1 ZMR REVISION HIP STEM 適應症請見備註欄 FBHS39990NZ1 ZMR REVISION HIP STEM BODY 適應症請見備註欄 FBHS3NK21NAE REVISION HIP STEM 適應症請見備註欄 FBHS51108NU0 G.T.F HIP STEM 大粗隆股骨柄 適應症請見備註欄 FBHU111281DP GLOBAL SHOULDER IMPLANTS STEM 12MM FBHU111340DP HUMERAL ASSEMBLY STEM FBHU111344DP HUMERAL HEAD FBHU111348DP FINNED GLENDOID HYLAMER POLLYMER PEGGED GLENOID FBHU11134NDP GLOBAL HUMERAL STEM FBHU111378DP GLOBAL PEGGED GLENOID FBHU1113NNDP GLOBAL HUMERAL HEAD FBHU143000Z1 BIGLIANI/FLATOW TOTAL SHOULDER(STEM+HEAD+CUP) FBHU143001Z1 BIGLIANI/FLATOW HEMI SHOULDER(STEM+HEAD) FBHU143002Z1 BIGLIANI/FLATOW MONOBLOCK SHOULDER(STEM+HEAD) FBHU14300NZ1 BIGLIANI/FLATOW HUMERAL STEMS FBHU14301NZ1 BIGLIANI/FLATOW MODULAR HEAD FBHU14302NZ1 BIGLIANI/FLATOW GLENOID(PU CUP) FBHU15300NS2 TOTAL SHOULDER SYSTEM(GLENOID+HEAD+STEM) FBHU15301NS2 SHOULDER SYSTEM(HEAD+STEM) FBHU15350NS2 SHOULDER HUMERAL HEAD( 鈷鉻 ) FBHU15351NS2 SHOULDER HUMERAL STEM(TITANIUM) FBHU15362NS2 SOLAR TOTAL SHOULDER SYSTEM:SHOULDER GLENOID COMP(PLASTIC) FBKA21872NW2 FEMORAL BUILD(WEDGE) 限用於人工膝關節再置換時使用 3006 FBKA22600NU0 FEMORAL AUGMENT SET( 後端遠側 - 整塊 ) 適應症請見備註欄 6510 FBKA22603NU0 FEMORAL AUGMENT SET 適應症請見備註欄 3006 FBKA22803NU0 TIBIAL AUGMENT SET 適應症請見備註欄 3006 FBKA23000NW2 REVISION FEMORAL WEDGE 限用於人工膝關節再置換時使用 3006 FBKA23001NW2 REVISION TIBIAL WEDGE 限用於人工膝關節再置換時使用 3006 FBKA25988NZ1 TIBIAL WEDGE 須事前審查限用於膝關節再置換時使用 3006 FBKA25990TZ1 FEMORAL AUGMENTATION 須事前審查限用於膝關節再置換時使用 3006 FBKA27510NS2 FBKA296080JJ FBKB21759NW2 "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 TC3 PFC REVISION FEMORAL AUGMENTATION 限用於人工膝關節再置換時使用 WHITESIDE ORTHOLOC REVISION TIBIAL STEM 5CM,6.25CM 適應症請見備註欄

182 FBKB21870NW2 REVISION TIBIAL LONG STEM 7.5CM,15CM 限用於人工膝關節再 5710 置換時使用 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 FBKCM2475NH1 "HOWMEDICA"GLOBAL MODULAR REPLACEMENT SYSTEM -KNEE 適應 症請見備註欄, 申報費用時應附發票備查 FBKCM6485NH1 "HOWMEDICA"GLOBAL MODULAR REPLACEMENT SYSTEM -KNEE 申報 費用應檢附發票備查 FBKCMXXXXNW2 CUSTOM-MADE TOTAL KNEE PROTHESIS 適應症請見備註欄, 申報 費用檢附發票 FBKE21859NW2 WHITESIDE ORTHOLOC REVISION FEMORAL STEM 5CM 適應症請見 1350 備註欄 FBKE21890NW2 REVISION FEMORAL LONG STEM 10CM,15CM 限用於人工膝關節再 5710 置換時使用 FBKE22700NU0 CURVED EXTENSION STEM( 型號 :38;041:48;5132:38;42:48;5231:37;41:47 自 生效 ) 適應症請見備註欄 FBKE23000NW2 EXTENSION FEMORAL TIBIAL STEM 限用於人工膝關節再置換時使 5710 用 FBKE25988NZ1 STEM EXTENSION 須事前審查限用於膝關節再置換時使用 5710 FBKE26478NS2 EXTENSION STEM 80MM:155MM 限用於人工膝關節再置換時使用 5710 FBKE28640NH1 DURACON TIBIAL FEMORAL EXTENSION STEM ( 自 /10/1 生效 ) 限用於人工膝關節再置換時使用 FBKE286960JJ REVISION STEM EXTENSION(96-07,17-20,21,31,32 自 89/04/01 生 5710 效 ) 限用於人工膝關節再置換時使用 FBKF10000CSN GENESIS II TOTAL KNEE SYSTEM:FEMORAL COMPONENTS 適應症 請見備註欄 FBKF10011NH1 FEMORAL COMPONENT EXTRA EXTRA-SMALL:LARGE 適應症請見備 註欄 FBKF10096PSN GENESIS II TOTAL KNEE SYSTEM(PS):FEMORAL COMPONENTS 適 應症請見備註欄 FBKF10208NH1 DURACON PS FEMORAL COMPONENT 適應症請見備註欄 FBKF10410NJJ PFC FEMORAL 適應症請見備註欄 FBKF1179NNDP LCS FEMORAL COMPONENT( 型號 自 90/01/01 生效 ) 適應症 請見備註欄 FBKF11880NW2 WHITESIDE ORTHOLOC FEMORAL COMPONENT( XX;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 FBKF11890NW2 "WRIGHT"ADVANCE TOTAL KNEE SYSTEM FEMORAL " 瑞德 " 艾德凡斯 人工膝關節系統 : 股骨 適應症請見備註欄 FBKF12000NW2 PSL FEMORAL COMPONENT 適應症請見備註欄 FBKF12101NU0 FEMORAL COMPONENT(PS) 適應症請見備註欄 FBKF12103MU0 U2 TOTAL KNEE SYSTEM:FEMORAL 適應症請見備註欄 FBKF12103NU0 U2 TOTAL KNEE SYSTEM:FEMORAL CRUCIATE RETAINING 適應症 請見備註欄 FBKF1210XNU0 UNITED FEMORAL COMPONENT 適應症請見備註欄 FBKF15500NH1 TRIATHLON FEMORAL COMPONENT 適應症見備註欄 FBKF15950TZ1 NEXGEN CR-FLEX FEMORAL COMPONENT 適應症請見備註欄 FBKF15964TZ1 NEXGEN LPS-FLEX FEMORAL COMPLETE 適應症請見備註欄 FBKF15970NZ1 FEMORAL COMPONENT 適應症請見備註欄 FBKF15996TZ1 NEXGEN FEMORAL COMPONENT(LPS) 適應症請見備註欄 FBKF16630NH1 DURACON TOTAL KNEE FEMORAL 適應症請見備註欄

183 FBKF17030NS2 "HOWMEDICA OSTEONICS" SCORPIO TOTAL KNEE SYSTEM: CR FEMORAL COPMONENT " 好美得卡 - 奧斯得寧 " 斯高比歐人工膝關節系統 : 股骨 適應症請見備註欄 FBKF17130NS2 "HOWMEDICA OSTEONICS" SCORPIO TOTAL KNEE SYSTEM: FEMORAL COPMONENT" 好美得卡 - 奧斯得寧 " 斯高比歐人工膝關節系統 : 股骨 適應症請見備註欄 FBKF18000NS2 "HOWMEDICA OSTEONICS" SCORPIO NRG TOTAL KNEE SYSTEM: FEMORAL COMPONENT" 好美得卡 - 奧斯得寧 " 斯高比歐人工膝關節系統 : 股骨 適應症請見備註欄 FBKF18110NH1 PCA FEMORAL 適應症請見備註欄 FBKF19600NDP PFC SIGMA CRUCIATE RETAINING FEMORAL COMPONENT 適應症請 見備註欄 FBKF19600NJJ PFC E CURCIATE RETAINING FEMORAL 適應症請見備註欄 ( :58 自 89/7/1 收,93/1/1 由 FBKF296008JJ 調來 ) FBKF1N050NAE E.MOTION FEMORAL COMPONENT 適應症請見備註欄 FBKF1S1G1RDP "DEPUY" SIGMA PS FEMORAL COMPONENTS" 帝富 " 膝格瑪股骨組件 適應症請見備註欄 FBKF1S1GUSDP "DEPUY"SIGMA PS FEMORAL KNEE SYSTEM:FEMORAL" 帝富 " 膝格瑪人 工股骨膝關節系統 : 股骨 適應症請見備註欄 FBKF2179NNDP LCS REVISION FEMORAL COMPONENT 適應症請見備註欄 FBKF21850NW2 WHITESIDE ORTHOLOC REVISION FEMORAL COMPONENT 適應症請 見備註欄 FBKF21857NW2 WHITESIDE ORTHOLOC P.S.L REVISION FEMORAL COMPONENT 適應 症請見備註欄 FBKF22026NH1 DURACON REVISION FEMORAL COMPONENT 適應症請見備註欄 FBKF22103NU0 FEMORAL COMPONENT PSA TYPE 適應症請見備註欄 FBKF22105NU0 FEMUR COMPONENT 訂製型股骨植入物 適應症請見備註欄 FBKF23000NW2 ADVANCE REVISION FEMORAL COMPONENT 適應症請見備註欄 FBKF25393NH1 ROTATINGE HINGE TOTAL KNEE SYSTEM:FEMORAL COMPONENT 適應 症請見備註欄 FBKF25880TZ1 NEXGEN ROTATING HINGE KNEE FEMORAL COMPONENT 適應症請見 備註欄 FBKF25926TZ1 "ZIMMER"GENDER SOLUTION PATELLOFEMORAL JOINT SYSTEM:FEMORAL COMPONENT " 捷邁 " 皮富捷髕骨股骨人工關節 : 髕股骨關節股骨組件 適應症請見備註欄 FBKF25976NZ1 NEXGEN FEMORAL COMPONENT(CRA) 適應症請見備註欄 FBKF25994TZ1 NEXGEN FEMORAL COMPONENT(LCCK) 適應症請見備註欄 FBKF26000NS2 HOWMEDICA OSTEONICS" SCORPIO TOTAL KNEE SYSTEM: FEMORAL COPMONENT" 好美得卡 - 奧斯得寧 " 斯高比歐人工膝關節系統 : 股骨 適應症請見備註欄 FBKF26001NJJ PFC REVISION FEMORAL 適應症請見備註欄 FBKF296008JJ TC3 PFC REVISION FEMORAL COMPONENTS ( : 自 /01/01 轉至 FBKF19600NJJ) 適應症請見備註欄 FBKFA5000TZ1 "ZIMMER"GENDER SOLUTION PATELLOFEMORAL JOINT SYSTEM " 捷 邁 " 皮富捷髕骨股骨人工關節 適應症請見備註欄 FBKL10460NDP PFC INSERT 適應症請見備註欄 8309 FBKL10460NJJ PFC INSERT ( : 自 89/07/01 生效 ) 適應症請見備 8309 註欄 FBKL10480CSN GENESIS II TOTAL KNEE SYSTEM:TIBIAL ARTICULAR COMPONENTS 8309 適應症請見備註欄 FBKL10802PSN GENESIS II TOTAL KNEE SYSTEM(PS):TIBIAL ARTICULAR 8309 COMPONENTS 適應症請見備註欄 FBKL11030NS2 OMNIFIT TIBIAL INSERT 適應症請見備註欄

184 FBKL11501PSN PS HIGH FLEXION ARTICULAR INSERT 適應症請見備註欄 FBKL11531CSN CR DEEP FLEXION ARTICULAR INSERT 適應症請見備註欄 FBKL11770NW2 WHITESIDE ORTHOLOC TIBIAL INSERT( 型號 KITC,KIMP-XXXX 自 /01/01 生效 ) 適應症請見備註欄 FBKL1178NNDP LCS MENISCAL BEARINGS INSERT( 型號 : 自 90/01/01 生效 ) 適應症請見備註欄 FBKL12000NW2 PSL TIBIAL INSERT 適應症請見備註欄 8309 FBKL12301NU0 TIBIAL INSERT(PS) 適應症請見備註欄 8309 FBKL123033U0 U2 TOTAL KNEE SYSTEM:TIBIAL INSERT 適應症請見備註欄 8309 FBKL12303NU0 U2 TOTAL KNEE SYSTEM:TIBIAL INSERT CRUCIATE RETAINING 8309 適應症請見備註欄 FBKL1230XNU0 UNITED TIBIAL INSERT PLAINED 適應症請見備註欄 8309 FBKL13000NW2 "WRIGHT"ADVANCE TOTAL KNEE SYSTEM:INSERT(DOUBLE HIGH)" 瑞 德 " 艾德凡斯人工膝關節系統 : 脛骨襯墊 適應症請見備註欄 FBKL15500NH1 TRIATHLON TIBIA INSERT 適應症見備註欄 FBKL15960NZ1 NEXGEN LPS-FLEX TIBIAL ARTICULAR SURFACE 適應症請見備 註欄 FBKL15971NZ1 ARTICULAR SURFACE 適應症請見備註欄 8309 FBKL15981NZ1 ARTICULAR SURFACE 適應症請見備註欄 8309 FBKL15996NZ1 NEXGEN TIBIAL ARTICULAR SURFACE 適應症請見備註欄 8309 FBKL16644NH1 DURACON TOTAL KNEE TIBIAL 適應症請見備註欄 8309 FBKL17109NH1 DURACON TIBIAL PS INSERT( :425 自 91/10/1 生效 ) 適 8309 應症請見備註欄 FBKL17220NS2 SCORPIO CR INSERT COMPONENT 適應症請見備註欄 8309 FBKL17230NS2 TIBIAL INSERT 適應症請見備註欄 8309 FBKL17250NS2 SCORPIO SUPERFLEX PS TIBIAL INSERT 適應症請見備註欄 FBKL18130NH1 PCA TIBIAL INSERT 適應症請見備註欄 8309 FBKL18200NS2 SCORPIO NRG TIBIAL INSERT 適應症請見備註欄 FBKL19059NZ1 NEXGEN CR-FLEX TIBIAL ARTICULAR SURFACE 適應症請見備註 欄 FBKL19602NDP PFC E CURCIATE RETAINING TIBIAL INSERT 適應症請見備註欄 8309 FBKL19602NJJ PFC E CURCIATE RETAINING TIBIAL INSERT 適應症請見備註欄 8309 FBKL1962RPJJ PFC SIGMA RP KNEE SYSTEM ROTATING PLATFORM INSERT 適應症 請見備註欄 FBKL1N064NAE E.MOTION TIBIA INSERT 適應症請見備註欄 FBKL21658NW2 P.S.L REVISION TIBIAL INSERT( 型號 KIPS-0114:2625,KIRV S,M:630S,M 自 93/1/1 生效 ) 適應症請見備註欄 FBKL22303NU0 TIBIAL INSERT PSA TYPE 適應症請見備註欄 FBKL25880NZ1 NEXGEN ROTATING HINGE KNEE ARTICULAR SURFACE 適應症請見 備註欄 FBKL25970NZ1 NEXGEN TIBIAL ARTICULAR SURFACE(CRA) 適應症請見備註欄 FBKL25994NZ1 NEXGEN TIBIAL ARTICULAR SURFACE( 型號 :042-10:33 自 /10/01 生效 ) 適應症請見備註欄 FBKL26000NS2 TIBIAL BEARING COMPONENT 適應症請見備註欄 FBKL26040NJJ PFC REVISION INSERT 適應症請見備註欄 FBKL27493NS2 SERIES 7000 TIBIAL INSERT 適應症請見備註欄 FBKL296050JJ TC3 PFC REVISION TIBIAL INSERT 適應症請見備註欄 FBKP10205NH1 PATELLA COMPONENT METAL BACK,ALL PLASTIC( :2645 自 /04/01 生效 ) 適應症請見備註欄 FBKP10417NDP PFC PATELLA 適應症請見備註欄

185 FBKP10417NJJ PFC PATELLA 適應症請見備註欄 6344 FBKP10566NSN GENESIS II TOTAL KNEE SYSTEM:PARELLAR COMPONENTS 適應症 6344 請見備註欄 FBKP11670NW2 WHITESIDE ORTHOLOC PATELLA( 型號 KPRC,KPON-XXXX 自 91/01/01 生 6344 效 ) 適應症請見備註欄 FBKP1179NNDP LCS PATELLAR COMPONENT( 型號 :86, : 自 /01/01 生效 ) 適應症請見備註欄 FBKP12401NU0 TOTAL KNEE PATELLA 26:44MM 適應症請見備註欄 6344 FBKP12403NU0 UKNEE TOTAL KNEE SYSTEM:PATELLA 適應症請見備註欄 6344 FBKP1240XNU0 UNITED PATELLA 適應症請見備註欄 6344 FBKP13420NS2 OMNIFIT PATELLA COMPONENT 適應症請見備註欄 6344 FBKP15500NH1 TRIATHLON PATELLA 適應症見備註欄 6344 FBKP15973NZ1 PATELLA COMPONENT 適應症請見備註欄 6344 FBKP17331NS2 SCORPIO CR PATELLA 適應症請見備註欄 6344 FBKP19601NDP PFC SIGMA CRUCIATE RETAINING OVAL-DOME PATELLA 適應症請 6344 見備註欄 FBKP19601NJJ PFC SIGMA CURCIATE RETAINING OVAL-DOME PATELLA ( 型號 :0122 自 90/10/01 生效 ) 適應症請見備註欄 FBKP1N048NAE E.MOTION PATELLA 適應症請見備註欄 6344 FBKP21190NH1 ROTATINGE HINGE TOTAL KNEE SYSTEM :DOME PATELLAR ( 型號 ,39,59-15 自 93/4/1 生效 ) 適應症請見備註欄 FBKP26035NJJ PFC REVISION PATELLA 適應症請見備註欄 6344 FBKPA0012NH1 DURACON TOTAL KNEE SYSTEM 適應症請見備註欄 FBKPA0208NH1 DURACON PS TOTAL KNEE SYSTEM 適應症請見備註欄 FBKPA1000CSN GENESIS II TOTAL KNEE SYSTEM(CR) 適應症請見備註欄 FBKPA1000NDP LCS TOTAL KNEE SYSTEM 適應症請見備註欄 FBKPA1000NJJ PFC TOTAL KNEE SYSTEM 適應症請見備註欄 FBKPA1000NU0 UNITED TOTAL KNEE SYSTEM 適應症請見備註欄 FBKPA1000NW2 WHITESIDE ORTHOLOC TOTAL KNEE SYSTEM 瑞德人工膝關節系統 適應症請見備註欄 FBKPA1000PSN GENESIS II TOTAL KNEE SYSTEM(PS) 適應症請見備註欄 FBKPA1100NDP "DEPUY"PFC SIGMA TOTAL KNEE SYSTEM(TIBIAL+INSERT+PATELLA+FEMORAL)" 帝富 " 全人工膝關節組 適應症請見備註欄 FBKPA1100NJJ PFC E KNEE SYSTEM 適應症請見備註欄 FBKPA129RPJJ PFC SIGMA RP KNEE SYSTEMW/ROTATING PLATFORM 適應症請見備 註欄 FBKPA2000CSN GENESIS II TOTAL KNEE SYSTEM(CR-FLEX) 高彎曲度全人工膝關 節系統 適應症請見備註欄 FBKPA2000NU0 TOTAL KNEE SYSTEM(PS) 適應症請見備註欄 FBKPA2000NW2 PSL TOTAL KNEE SYSTEM 適應症請見備註欄 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 FBKPA3000NW2 "WRIGHT"ADVANCE TOTAL KNEE SYSTEM(DOUBLE HIGH) " 瑞德 " 艾德 凡斯人工膝關節系統 ( 高彎曲度 ) 適應症請見備註欄 FBKPA5000NU0 U2 TOTAL KNEE SYSTEM-CRUCIATE RETAINING 適應症請見備註欄 FBKPA5000TZ1 NEXGEN COMPLETE KNEE (CR)SYSTEM 適應症請見備註欄 FBKPA5100TZ1 NEXGEN MIS COMPLETE KNEE SOLUTION (CR) 微創全人工膝關節組 適應症請見備註欄 FBKPA5500NH1 TRIATHLON TOTAL KNEE SYSTEM( 含 TIBIA INSERT+FEMORAL+TIBIA TRAY+PATELLA) 適應症見備註欄

186 FBKPA6000NU0 U2 TOTAL KNEE SYSTEM-POSTERIOR STABILIZED 適應症請見備註 欄 FBKPA6000TZ1 NEXGEN COMPLETE KNEE (PS)SYSTEM 適應症請見備註欄 FBKPA7000TZ1 NEXGEN COMPLETE KNEE SOLUTION (LPS) 適應症請見備註欄 FBKPA7100NS2 SCORPIO TOTAL KNEE SYSTEM(PS) 適應症請見備註欄 FBKPA7100TZ1 NEXGEN MIS COMPLETE KNEE SOLUTION (LPS) 微創全人工膝關節組 適應症請見備註欄 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 FBKPA7300NS2 SCORPIO TOTAL KNEE SYSTEM 適應症請見備註欄 FBKPA7800NS2 "HOWMEDICA"SCORPIO MOBILE BEARING KNEE SYSTEM" 好美得卡 - 奧 斯得寧 " 人工膝關節系統 適應症請見備註欄 FBKPA8000TZ1 NEXGEN LPS-FLEX COMPLETE KNEE SYSTEM 適應症請見備註欄 FBKPA8100NS2 SCORPIO NRG TOTAL KNEE SYSTEM 適應症請見備註欄 FBKPA8100TZ1 NEXGEN MIS COMPLETE KNEE SOLUTION (LPS-FLEX) 微創全人工膝 關節組 適應症請見備註欄 FBKPA9000TZ1 NEXGEN CR-FLEX COMPLETE KNEE SOLUTION 適應症請見備註欄 FBKPA9100TZ1 NEXGEN MIS COMPLETE KNEE SOLUTION (CR-FLEX) 微創全人工膝關 節組 適應症請見備註欄 FBKPAN000NAE E.MOTION KNEE SYSTEM FOLATING KNEE 適應症請見備註欄 FBKRA1000NJJ PFC REVISION KNEE SYSTEM 適應症請見備註欄 FBKRA1000NW2 WHITESIDE ORTHOLOC LONG STEM REVISION TOTAL KNEE SYSTEM 適應症請見備註欄 FBKRA1000TZ1 M/G REVISION KNEE SYSTEM 適應症請見備註欄 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 FBKRA11000JJ TC3 PFC REVISION KNEE SYSTEM 適應症請見備註欄 FBKRA1100NU0 U2 REVISION TOTAL KNEE SYSTEM(FEMORAL+TIBIAL+INSERT+PATELLA) 適應症請見備註欄 FBKRA2000NDP LCS REVISION TOTAL KNEE SYSTEM 適應症請見備註欄 FBKRA2000NW2 WHITESIDE ORTHOLOC P.S.L.TOTAL KNEE SYSTEM 適應症請見備 註欄 FBKRA2026NH1 DURACON REVISION KNEE SYSTEM 適應症請見備註欄 FBKRA3000NW2 ADVANCE REVISION TOTAL KNEE SYSTEM 適應症請見備註欄 FBKRA3000TZ1 NEXGEN COMPLETE KNEE SOLUTION(LCCK) 適應症請見備註欄 FBKRA4000TZ1 NEXGEN COMPLETE KNEE SOLUTION(CRA) 適應症請見備註欄 FBKRA5000TZ1 NEXGEN ROTATING HINGE KNEE SYSTEM 適應症請見備註欄 FBKRA6000NS2 HOWMEDICA OSTEONICS" SCORPIO TOTAL KNEE SYSTEM:REVISION SYSTEM 好美得卡 - 奧斯得寧 " 斯高比歐人工膝關節系統 : 再置換 適應症請見備註欄 FBKRA6475NH1 ROTATING HINGE TOTAL KNEE SYSTEM (FE+TI PLUG+PA BEARING+AXLE+BUMPER+BUSHINGX2) 適應症請見備註欄 FBKS12703NU0 EXTENSION STRAIGHT STEM PSA TYPE 適應症請見備註欄 5710 FBKS129051U0 SEGMENT PART 訂製型脛骨中段延伸件 適應症請見備註欄 FBKS12905NU0 STEM 訂製型脛骨下段延伸件 適應症請見備註欄 FBKT10160NSN GENESIS II TOTAL KNEE SYSTEM:TIBIAL COMPONENTS 適應症請 見備註欄 FBKT10224CSN GENESIS II TOTAL KNEE SYSTEM:TIBIAL+CRTICULAR COMPONENTS 適應症請見備註欄

187 FBKT10411NDP PFC TIBIAL(PRIMARY 或 REVISION) 適應症請見備註欄 FBKT10411NJJ PFC TIBIAL(PRIMARY 或 REVISION)( 型號 :9 自 89/1/1 生效 ) 適應症請見備註欄 FBKT11581NDP "DEPUY"SIGMA CO-CR TIBIAL TRAYS" 帝富 " 人工膝關節脛骨盤 適 應症請見備註欄 FBKT1179NNDP LCS TIBIAL 適應症請見備註欄 FBKT11870NW2 WHITESIDE ORTHOLOC TIBIAL BASE 脛骨基座 適應症請見備註 欄 FBKT11871NW2 TIBIAL BASE 適應症請見備註欄 FBKT11885NW2 CF TIBIAL STEM+TIBIAL BASE( 型號 KTCO,KTCC,KTTI-XXXX 自 /01/01 生效 ) 適應症請見備註欄 FBKT12203NU0 U2 TOTAL KNEE SYSTEM:TIBIAL BASEPLATE 適應症請見備註欄 FBKT1220XNU0 UNITED TIBIAL BASEPLATE WITH STEM( 型號 :3060 自 /10/1 生效 ) 適應症請見備註欄 FBKT12330NH1 TIBIAL BASEPLATE CURCIFORM S1:L2,SCREW FIX S1:L2 適應症 請見備註欄 FBKT1432RPJJ PFC SIGMA RP KNEE SYSTEM MOBILE BEARING TIBIA BASEPLATE 適應症請見備註欄 FBKT15500NH1 TRIATHLON TIBIA TRAY 適應症見備註欄 FBKT15950NZ1 NEXGEN MIS TIBIAL PLATE 微創人工莖骨板 適應症請見備註欄 FBKT15972NZ1 TIBIAL PLATE 適應症請見備註欄 FBKT15982NZ1 TIBIAL PLATE 適應症請見備註欄 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 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 FBKT1AP0LYDP PFC SIGMA KNEE SYSTEM:ALL POLYETHYLENE TIBIAL+INSERT 適應症請見備註欄 FBKT1N062NAE E.MOTION TIBIA FOLATING PLATE 適應症請見備註欄 FBKT2179NNDP LCS REVISION ROTATING TIBIAL PLATEAU 適應症請見備註欄 FBKT21872NW2 TIBIAL BASE WITH WEDGE 限人工膝關節再置換時使用 FBKT22203NU0 TIBIAL BASEPLATE PSA TYPE 適應症請見備註欄 FBKT222059U0 TIBIAL BEARING COMPONENT 訂製型脛骨連接件 適應症請見備註 欄 FBKT22205NU0 TIBIAL COMPONENT 訂製型脛骨植入物 適應症請見備註欄 FBKT22360NH1 DURACON REVISION TIBIAL BASEPLATE 適應症請見備註欄 FBKT253933H1 ROTATINGE HINGE TOTAL KNEE SYSTEM:TIBIAL BEARING COMPONENT( 型號 自 93/4/1 生效 適應症請見備註欄 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 自 93/4/1 生效 適應症請見備註欄 FBKT253944H1 ROTATINGE HINGE TOTAL KNEE SYSTEM:BUSHING ( 型號 自 93/4/1 生效 ) 適應症請見備註欄 FBKT25394NH1 ROTATINGE HINGE TOTAL KNEE SYSTEM:TIBIAL PLUG ( 型號 :2421 自 93/4/1 生效 適應症請見備註欄 FBKT25880NZ1 NEXGEN ROTATING HINGE KNEE TIBIAL PLATE 適應症請見備註欄

188 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 FBKT286000JJ TC3 PFC REVISION TIBIAL TRAY 適應症請見備註欄 FBKUA1000NAE SEARCH UNICOMPARTMENTAL KNEE SYSTEM(FEMORAL+TIBIA+INSERT) 適應症請見備註欄 FBKUA1000TH1 EIUS UNICOMPARTMENTAL KNEE SYSTEM( 含 FEMORAL+TIBIAL+INSERT) 適應症請見備註欄 FBKUA1000TW2 UNICOMPARTMENTAL KNEE SYSTEM(FEMORAL+TIBIAL+INSERT) 適應 症請見備註欄 FBKUA1000USN GENESIS UNICOMPARMENTAL KNEE SYSTEM 適應症請見備註欄 FBKUA10277DP PRESERVATION UNICOMPARTMENTAL KNEE SYSTEM(FEMORAL+TIBIAL+INSERT) 適應症請見備註欄 FBKUA2000TZ1 UNICOMPARTMENTAL HIGH-FLEX SYSTEM 155 度 (FEMORAL+TIBIAL SURFACE) 適應症請見備註欄 FBKUA9600NJJ PFC SIGMA UNICOMPARTMENTAL KNEE SYSTEM 人工半膝關節組 適 應症請見備註欄 FBKW2280XNU0 TIBIAL WEDGE 限用於人工膝關節再置換時使用 3006 FBKW25220NZ1 TIBIAL WEDGE 限用於人工膝關節再置換時使用 3006 FBKW286010JJ TC3 PFC REVISION TIBIAL WEDGE 限用於人工膝關節再置換時 3006 使用 FBM011109NU0 MOORE HIP SYSTEM 8493 FBM01203XNR1 MOORE PROSTHESIS (41:52MM,HEAD) 8493 FBM01203XNSN MOORE PROSTHESES 8493 FBM014006NZ1 "ZIMMER"MOORE HIP PROSTHESIS " 西美 " 莫爾人工髖關節 8493 FBM019138NH1 AUSTIN MOORE 8493 FBNG13120NS9 GAMMMA3 TI SYSTEM 鈦合金股骨固定系統 (NX1+SX3) FBNG1403GTY2 TITANIUM KING BO GAMMA LOCKING NAIL SYSTEM(NAILX1+LOCKING BOLTX3) 適應症請見備註欄 FBP042351NS1 HIP DCP PLATE CHILD 2315 FBP042351NY2 ANGLED BLADE PLATES FOR INTERTROCHANTERIC FEMORAL 2315 OSTEOTOMIES IN CHILDREN FBP042356NS1 TEENAGER HIP PLATE 2315 FBP04236NNY2 ANGLED BLADE PLATES FOR INTERTROCHANTERIC FEMORAL 2315 OSTEOTOMIES IN SMALL ADULTS FBP04236XNS1 BABY HIP PLATE 2315 FBP04236XNY2 ANGLED BLADE PLATES 90 度 FOR INTERTROCHANTERIC FEMORAL 2315 OSTEOTOMIES IN INFANT FBP094102NU0 STAINLESS ANATOMIC FEMUR PLATE 4:8HOLE 限 EPIPHYSIS 8744 METAPHYSIS 骨折使用 FBP09510SNY2 STAINLESS ANATOMICAL PLATE (TIBIAL,FEMUR,FIBULAR) 適應 8744 症請見備註欄 FBPS1000XNX0 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備 註欄. FBPS1000XNX1 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備 註欄. FBPS1000XNX2 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備 註欄. FBPS1000XNX4 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備 註欄. FBPS1000XNX5 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄

189 FBPS1000XNX6 FBPS1000XNX7 FBPS1000XNX8 FBPS1000XNX9 FBPS1000XNXB FBPS1000XNXC FBPS1000XNXD FBPS1000XNXE FBPS1000XNXF FBPS1000XNXG FBPS1000XNXH FBPS1000XNXJ FBPS1000XNXK FBPS1000XNXN FBPS1000XNXS FBPS1000XNXV FBPS1000XNXY FBPS1001XNX0 FBPS1001XNX1 FBPS1001XNX2 FBPS1001XNX4 FBPS1001XNX5 FBPS1001XNX6 FBPS1001XNX7 FBPS1001XNX8 FBPS1001XNX9 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給寸部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄 PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄. PARTIAL FOOT PROSTHESIS 健保給付部分足義肢 適應症請見備註欄 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. 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. 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. 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. 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. 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. 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. 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. 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

190 特材代碼 中英文名稱 支付點數 -102/01 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. 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. 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. 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. 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. 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. 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. 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. 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. FBPS1001XNXN SYME"S PROSTHESIS 珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見 備註欄 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. 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. 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 FBPS1002XNX0 K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNX1 K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNX2 K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNX4 K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNX5 K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNX6 K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNX7 K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNX8 K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNX9 K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXB K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXC K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXD K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXE K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄

191 FBPS1002XNXF K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXG K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXH K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXJ K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXK K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXN K/D PROSTHESIS 膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXS K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXV K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1002XNXY K/D PROSTHESIS 健保給付膝關節離斷義肢 適應症請見備註欄 FBPS1003XNX0 A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNX1 A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNX2 A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNX3 A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNX4 A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNX5 A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNX6 A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNX7 A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNX8 A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNX9 A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXB A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXC A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXD A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXE A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXF A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXG A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXH A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXJ A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXK A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXN A/K PROSTHESIS 膝上義肢 適應症請見備註欄 FBPS1003XNXS A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXV A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1003XNXY A/K PROSTHESIS 健保給付膝上義肢 適應症請見備註欄 FBPS1004XNX0 B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNX1 B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNX2 B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNX3 B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNX4 B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNX5 B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNX6 B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNX7 B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNX8 B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNX9 B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNXB B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNXC B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNXD B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄

192 FBPS1004XNXE B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNXF B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNXG B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNXH B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNXJ B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNXK B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNXN B/K PROSTHESIS 膝下義肢 適應症請見備註欄 FBPS1004XNXS B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNXV B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 FBPS1004XNXY B/K PROSTHESIS 健保給付膝下義肢 適應症請見備註欄 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. FBPS1005XNX1 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 適應症請見備 註欄. FBPS1005XNX2 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 適應症請見備 註欄. FBPS1005XNX4 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 適應症請見備 註欄. FBPS1005XNX5 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 適應症請見備 註欄. FBPS1005XNX6 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 適應症請見備 註欄. FBPS1005XNX7 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 適應症請見備 註欄. FBPS1005XNX8 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 適應症請見備 註欄. FBPS1005XNX9 H/D&H/P PROSTHESIS 健保給付髖關節離斷義肢 適應症請見備 註欄. 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. 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. 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. 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. 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. 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. 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. 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. 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. FBPS1005XNXN H/D&H/P PROSTHESIS 髖關節離斷義肢 適應症請見備註欄 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. 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. 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

193 特材代碼 中英文名稱 支付點數 -102/01 FBPS1006XNX0 W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNX1 W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNX2 W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNX4 W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNX5 W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNX6 W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNX7 W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNX9 W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXB W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXC W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXD W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXE W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXF W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXG W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXH W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXJ W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXK W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXS W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXV W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1006XNXY W/D PROSTHESIS 健保給付腕關節離斷義肢 適應症請見備註欄 FBPS1007XNX0 E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNX1 E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNX2 E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNX4 E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNX5 E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNX6 E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄

194 FBPS1007XNX7 E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNX9 E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXB E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXC E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXD E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXE E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXF E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXG E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXH E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXJ E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXK E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXS E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXV E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1007XNXY E/D PROSTHESIS 健保給付肘關節離斷義肢 適應症請見備註欄 FBPS1008XNX0 A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNX1 A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNX2 A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNX4 A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNX5 A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNX6 A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNX7 A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNX9 A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNXB A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNXC A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNXD A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNXE A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNXF A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNXG A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 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 FBPS1008XNXJ A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNXK A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNXS A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNXV A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1008XNXY A/E PROSTHESIS 健保給付肘上義肢 適應症請見備註欄 FBPS1009XNX0 B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNX1 B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNX2 B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNX4 B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNX5 B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄

195 FBPS1009XNX6 B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNX7 B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNX9 B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNXB B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNXC B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNXD B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNXE B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNXF B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNXG B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNXH B/E PROSTHESIS 健保給付肘下功能性義肢 適應症請見備註欄 FBPS1009XNXJ B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNXK B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNXS B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNXV B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1009XNXY B/E PROSTHESIS 健保給付肘下義肢 適應症請見備註欄 FBPS1010XNX0 S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNX1 S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNX2 S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNX4 S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNX5 S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNX6 S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNX7 S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNX9 S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNXB S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNXC S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNXD S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNXE S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNXF S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNXG S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 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 FBPS1010XNXJ S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNXK S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNXS S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄

196 FBPS1010XNXV S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1010XNXY S/D PROSTHESIS 健保給付肩關節離斷義肢 適應症請見備註欄 FBPS1011XNX0 FBPS1011XNX1 FBPS1011XNX2 FBPS1011XNX4 FBPS1011XNX5 FBPS1011XNX6 FBPS1011XNX7 FBPS1011XNX9 FBPS1011XNXB FBPS1011XNXC FBPS1011XNXD FBPS1011XNXE FBPS1011XNXF FBPS1011XNXG FBPS1011XNXH FBPS1011XNXJ FBPS1011XNXK FBPS1011XNXS FBPS1011XNXV FBPS1011XNXY FBPS1012XNX0 FBPS1012XNX1 FBPS1012XNX2 FBPS1012XNX4 FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄 FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄. FOREQUATER PROSTHESIS 健保給付肩胛截除義肢 適應症請見備註欄 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見備註欄. A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見備註欄. A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見備註欄. A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見備註欄

197 特材代碼 中英文名稱 支付點數 -102/01 FBPS1012XNX5 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNX6 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNX7 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNX9 A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNXB A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNXC A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNXD A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNXE A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNXF A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNXG A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNXH A/E COSMETIC PROSTHESIS 健保給付美觀性肘關節以上截肢義肢 適應症請見備註欄 FBPS1012XNXJ A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNXK A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見 備註欄. FBPS1012XNXN A/E COSMETIC PROSTHESIS 肘上美觀義肢 適應症請見備註欄 FBPS1012XNXS FBPS1012XNXV FBPS1012XNXY FBPS1013XNX0 FBPS1013XNX1 FBPS1013XNX2 FBPS1013XNX4 FBPS1013XNX5 FBPS1013XNX6 FBPS1013XNX7 FBPS1013XNX9 FBPS1013XNXB A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見備註欄. A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見備註欄. A/E COSMETIC PROSTHESIS 健保給付肘上美觀義肢 適應症請見備註欄 B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見備註欄. B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見備註欄. B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見備註欄. B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見備註欄. B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見備註欄. B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見備註欄. B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見備註欄. B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見備註欄. B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見備註欄

198 FBPS1013XNXC B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見 備註欄. FBPS1013XNXD B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見 備註欄. FBPS1013XNXE B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見 備註欄. FBPS1013XNXF B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見 備註欄. FBPS1013XNXG B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見 備註欄. 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 FBPS1013XNXJ B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見 備註欄. FBPS1013XNXK B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見 備註欄. FBPS1013XNXN B/E COSMETIC PROSTHESIS 肘下美觀義肢 適應症請見備註欄 FBPS1013XNXS B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見 備註欄. FBPS1013XNXV B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見 備註欄. FBPS1013XNXY B/E COSMETIC PROSTHESIS 健保給付肘下美觀義肢 適應症請見 備註欄 FBPS1014XNX0 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNX1 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNX2 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNX4 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNX5 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNX6 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNX7 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNX9 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNXB 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNXC 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNXD 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNXE 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNXF 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNXG 健保給付肩關節離斷美觀義肢 適應症請見備註欄 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 FBPS1014XNXJ 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNXK 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNXS 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNXV 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1014XNXY 健保給付肩關節離斷美觀義肢 適應症請見備註欄 FBPS1015XNX0 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNX1 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNX2 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNX4 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNX5 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNX6 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNX7 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNX9 健保給付橫掌截肢美觀義肢 適應症請見備註欄

199 FBPS1015XNXB 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNXC 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNXD 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNXE 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNXF 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNXG 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNXH TRANS-CARPAL COSMETIC PROSTHESIS 健保給付橫掌截肢義肢 適 7300 應症請見備註欄 FBPS1015XNXJ 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNXK 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNXS 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNXV 健保給付橫掌截肢美觀義肢 適應症請見備註欄 FBPS1015XNXY 健保給付橫掌截肢美觀義肢 適應症請見備註欄 7300 FBPS1016XNX0 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNX1 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNX2 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNX4 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNX5 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNX6 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNX7 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNX9 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNXB 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNXC 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNXD 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNXE 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNXF 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNXG 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNXH PARTIAL FINGER COSMETIC PROSTHESIS 健保給付手指截肢義肢 4800 適應症請見備註欄 FBPS1016XNXJ 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNXK 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNXS 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNXV 健保給付手指截肢美觀義肢 適應症請見備註欄 FBPS1016XNXY 健保給付手指截肢美觀義肢 適應症請見備註欄 4800 FBPS2000XNX0 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢 適應症請見備 註欄, 按健保給付之部分足義肢給付, 超過部分由病患自付. FBPS2000XNX1 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢 適應症請見備 註欄, 按健保給付之部分足義肢給付, 超過部分由病患自付. FBPS2000XNX2 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢 適應症請見備 註欄, 按健保給付之部分足義肢給付, 超過部分由病患自付. FBPS2000XNX4 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢 適應症請見備 註欄, 按健保給付之部分足義肢給付, 超過部分由病患自付. FBPS2000XNX5 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢 適應症請見備 註欄, 按健保給付之部分足義肢給付, 超過部分由病患自付. FBPS2000XNX6 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢 適應症請見備 註欄, 按健保給付之部分足義肢給付, 超過部分由病患自付. FBPS2000XNX7 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢 適應症請見備 註欄, 按健保給付之部分足義肢給付, 超過部分由病患自付. FBPS2000XNX8 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢 適應症請見備 註欄, 按健保給付之部分足義肢給付, 超過部分由病患自付. FBPS2000XNX9 PARTIAL FOOT PROSTHESIS 部分給付部分足義肢 適應症請見備註欄, 按健保給付之部分足義肢給付, 超過部分由病患自付

200 FBPS2000XNXB FBPS2000XNXC FBPS2000XNXD FBPS2000XNXE FBPS2000XNXF FBPS2000XNXG FBPS2000XNXH FBPS2000XNXJ FBPS2000XNXK FBPS2000XNXN FBPS2000XNXS FBPS2000XNXV FBPS2001XNX0 FBPS2001XNX1 FBPS2001XNX2 FBPS2001XNX4 FBPS2001XNX5 FBPS2001XNX6 FBPS2001XNX7 FBPS2001XNX8 FBPS2001XNX9 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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

201 FBPS2001XNXB SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. FBPS2001XNXC SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. FBPS2001XNXD SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. FBPS2001XNXE SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. FBPS2001XNXF SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. FBPS2001XNXG SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. FBPS2001XNXH SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. FBPS2001XNXJ SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. FBPS2001XNXK SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. FBPS2001XNXN SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. FBPS2001XNXS SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. FBPS2001XNXV SYME"S PROSTHESIS 部分給付珊姆式小腿義肢 ( 踝關節離斷 ) 適應症請見備註欄, 按健保給付之珊姆式小腿義肢 ( 踝關節離斷 ) 給付, 超過部分由病患自付. 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. FBPS2002XNX1 K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNX2 K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNX4 K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNX5 K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNX6 K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNX7 K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNX8 K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付

202 FBPS2002XNX9 K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXB K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXC K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXD K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXE K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXF K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXG K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXH K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXJ K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXK K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXN K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXS K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. FBPS2002XNXV K/D PROSTHESIS 部分給付膝關節離斷義肢 適應症請見備註欄, 按健保給付之膝關節離斷義肢給付, 超過部分由病患自付. 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. FBPS2003XNX1 A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付. FBPS2003XNX2 A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付. FBPS2003XNX3 A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付. FBPS2003XNX4 A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付. FBPS2003XNX5 A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付. FBPS2003XNX6 A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付. FBPS2003XNX7 A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付. FBPS2003XNX8 A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付. FBPS2003XNX9 A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付. FBPS2003XNXB A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付. FBPS2003XNXC A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付. FBPS2003XNXD A/K PROSTHESIS 部分給付膝上義肢 適應症請見備註欄, 按健保給付膝上義肢給付, 超過部分由病患自付

203 FBPS2003XNXE FBPS2003XNXF FBPS2003XNXG FBPS2003XNXH FBPS2003XNXJ FBPS2003XNXK FBPS2003XNXN FBPS2003XNXS FBPS2003XNXV FBPS2004XNX0 FBPS2004XNX1 FBPS2004XNX2 FBPS2004XNX3 FBPS2004XNX4 FBPS2004XNX5 FBPS2004XNX6 FBPS2004XNX7 FBPS2004XNX8 FBPS2004XNX9 FBPS2004XNXB FBPS2004XNXC FBPS2004XNXD FBPS2004XNXE FBPS2004XNXF FBPS2004XNXG FBPS2004XNXH 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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

204 FBPS2004XNXJ FBPS2004XNXK FBPS2004XNXN FBPS2004XNXS FBPS2004XNXV FBPS2005XNX0 FBPS2005XNX1 FBPS2005XNX2 FBPS2005XNX4 FBPS2005XNX5 FBPS2005XNX6 FBPS2005XNX7 FBPS2005XNX8 FBPS2005XNX9 FBPS2005XNXB FBPS2005XNXC FBPS2005XNXD FBPS2005XNXE FBPS2005XNXF 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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

205 FBPS2005XNXG FBPS2005XNXH FBPS2005XNXJ FBPS2005XNXK FBPS2005XNXN FBPS2005XNXS FBPS2005XNXV H/D&H/P PROSTHESIS 部分給付髖關節離斷義肢 適應症請見備註欄, 按健保給付之髖關節離斷義肢給付, 超過部分由病患自付. 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. 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. 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. 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. 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. 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 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. FBPS2006XNX1 W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNX2 W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNX4 W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNX5 W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNX6 W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNX7 W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNX9 W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNXB W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNXC W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNXD W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNXE W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNXF W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNXG W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. 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. FBPS2006XNXJ W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付

206 FBPS2006XNXK W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNXN W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNXS W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. FBPS2006XNXV W/D PROSTHESIS 部分給付腕關節離斷義肢 適應症請見備註欄, 按健保給付之腕關節離斷義肢給付, 超過部分由病患自付. 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. FBPS2007XNX1 E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNX2 E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNX4 E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNX5 E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNX6 E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNX7 E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNX9 E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXB E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXC E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXD E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXE E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXF E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXG E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXH E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXJ E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXK E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXN E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXS E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. FBPS2007XNXV E/D PROSTHESIS 部分給付肘關節離斷義肢 適應症請見備註欄, 按健保給付之肘關節離斷義肢給付, 超過部分由病患自付. 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. FBPS2008XNX1 A/E PROSTHESIS 部分給付肘上義肢 適應症請見備註欄, 按健保給付之肘上義肢給付, 超過部分由病患自付

207 FBPS2008XNX2 FBPS2008XNX4 FBPS2008XNX5 FBPS2008XNX6 FBPS2008XNX7 FBPS2008XNX9 FBPS2008XNXB FBPS2008XNXC FBPS2008XNXD FBPS2008XNXE FBPS2008XNXF FBPS2008XNXG FBPS2008XNXH FBPS2008XNXJ FBPS2008XNXK FBPS2008XNXN FBPS2008XNXS FBPS2008XNXV FBPS2009XNX0 FBPS2009XNX1 FBPS2009XNX2 FBPS2009XNX4 FBPS2009XNX5 FBPS2009XNX6 FBPS2009XNX7 FBPS2009XNX9 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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

208 FBPS2009XNXB B/E PROSTHESIS 部分給付肘下義肢 適應症請見備註欄, 按健保給付之肘下義肢給付, 超過部分由病患自付. FBPS2009XNXC B/E PROSTHESIS 部分給付肘下義肢 適應症請見備註欄, 按健保給付之肘下義肢給付, 超過部分由病患自付. FBPS2009XNXD B/E PROSTHESIS 部分給付肘下義肢 適應症請見備註欄, 按健保給付之肘下義肢給付, 超過部分由病患自付. FBPS2009XNXE B/E PROSTHESIS 部分給付肘下義肢 適應症請見備註欄, 按健保給付之肘下義肢給付, 超過部分由病患自付. FBPS2009XNXF B/E PROSTHESIS 部分給付肘下義肢 適應症請見備註欄, 按健保給付之肘下義肢給付, 超過部分由病患自付. FBPS2009XNXG B/E PROSTHESIS 部分給付肘下義肢 適應症請見備註欄, 按健保給付之肘下義肢給付, 超過部分由病患自付. 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. FBPS2009XNXJ B/E PROSTHESIS 部分給付肘下義肢 適應症請見備註欄, 按健保給付之肘下義肢給付, 超過部分由病患自付. FBPS2009XNXK B/E PROSTHESIS 部分給付肘下義肢 適應症請見備註欄, 按健保給付之肘下義肢給付, 超過部分由病患自付. FBPS2009XNXN B/E PROSTHESIS 部分給付肘下義肢 適應症請見備註欄, 按健保給付之肘下義肢給付, 超過部分由病患自付. FBPS2009XNXS B/E PROSTHESIS 部分給付肘下義肢 適應症請見備註欄, 按健保給付之肘下義肢給付, 超過部分由病患自付. FBPS2009XNXV B/E PROSTHESIS 部分給付肘下義肢 適應症請見備註欄, 按健保給付之肘下義肢給付, 超過部分由病患自付. 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. FBPS2010XNX1 S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNX2 S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNX4 S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNX5 S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNX6 S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNX7 S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNX9 S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNXB S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNXC S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNXD S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNXE S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNXF S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付. FBPS2010XNXG S/D PROSTHESIS 部分給付肩關節離斷義肢 適應症請見備註欄, 按健保給付之肩關節離斷義肢給付, 超過部分由病患自付

209 FBPS2010XNXH FBPS2010XNXJ FBPS2010XNXK FBPS2010XNXN FBPS2010XNXS FBPS2010XNXV FBPS2011XNX0 FBPS2011XNX1 FBPS2011XNX2 FBPS2011XNX4 FBPS2011XNX5 FBPS2011XNX6 FBPS2011XNX7 FBPS2011XNX9 FBPS2011XNXB FBPS2011XNXC FBPS2011XNXD FBPS2011XNXE FBPS2011XNXF 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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

210 FBPS2011XNXG FBPS2011XNXH FBPS2011XNXJ FBPS2011XNXK FBPS2011XNXN FBPS2011XNXS FBPS2011XNXV FBPS2012XNX0 FBPS2012XNX1 FBPS2012XNX2 FBPS2012XNX4 FBPS2012XNX5 FBPS2012XNX6 FBPS2012XNX7 FBPS2012XNX9 FBPS2012XNXB FBPS2012XNXC 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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

211 FBPS2012XNXD FBPS2012XNXE FBPS2012XNXF FBPS2012XNXG FBPS2012XNXH FBPS2012XNXJ FBPS2012XNXK FBPS2012XNXN FBPS2012XNXS FBPS2012XNXV FBPS2013XNX0 FBPS2013XNX1 FBPS2013XNX2 FBPS2013XNX4 FBPS2013XNX5 FBPS2013XNX6 FBPS2013XNX7 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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

212 FBPS2013XNX9 FBPS2013XNXB FBPS2013XNXC FBPS2013XNXD FBPS2013XNXE FBPS2013XNXF FBPS2013XNXG FBPS2013XNXH FBPS2013XNXJ FBPS2013XNXK FBPS2013XNXN FBPS2013XNXS FBPS2013XNXV FBPS2014XNX0 FBPS2014XNX1 FBPS2014XNX2 FBPS2014XNX4 FBPS2014XNX5 FBPS2014XNX6 FBPS2014XNX7 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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

213 FBPS2014XNX9 FBPS2014XNXB FBPS2014XNXC FBPS2014XNXD FBPS2014XNXE FBPS2014XNXF FBPS2014XNXG FBPS2014XNXH FBPS2014XNXJ FBPS2014XNXK FBPS2014XNXS FBPS2014XNXV FBPS2015XNX0 FBPS2015XNX1 FBPS2015XNX2 FBPS2015XNX4 FBPS2015XNX5 FBPS2015XNX6 FBPS2015XNX7 FBPS2015XNX9 FBPS2015XNXB FBPS2015XNXC FBPS2015XNXD FBPS2015XNXE FBPS2015XNXF FBPS2015XNXG 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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

214 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. FBPS2015XNXJ 部分給付橫掌截肢美觀義肢 適應症請見備註欄, 按健保給付之橫掌截肢美觀義肢給付, 超過部分由病患自付. FBPS2015XNXK 部分給付橫掌截肢美觀義肢 適應症請見備註欄, 按健保給付之橫掌截肢美觀義肢給付, 超過部分由病患自付. FBPS2015XNXN 部分給付橫掌截肢美觀義肢 適應症請見備註欄, 按健保給付之橫掌截肢美觀義肢給付, 超過部分由病患自付. FBPS2015XNXS 部分給付橫掌截肢美觀義肢 適應症請見備註欄, 按健保給付之橫掌截肢美觀義肢給付, 超過部分由病患自付. FBPS2015XNXV 部分給付橫掌截肢美觀義肢 適應症請見備註欄, 按健保給付之橫掌截肢美觀義肢給付, 超過部分由病患自付. 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. FBPS2016XNX1 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNX2 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNX4 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. FBPS2016XNX5 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNX6 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNX7 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNX9 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNXB 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNXC 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNXD 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNXE 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNXF 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNXG 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. 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. FBPS2016XNXJ 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNXK 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNXN 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付. FBPS2016XNXS 部分給付手指截肢美觀義肢 適應症請見備註欄, 按健保給付之手指截肢美觀義肢給付, 超過部分由病患自付

215 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 4800 手指截肢美觀義肢給付, 超過部分由病患自付. FBS SN "SMITH&NEPHEW"BIOSURE HA INTERFERENCE SCREW " 史耐輝 " 可吸 4234 收性固定螺絲 限十字韌帶重建手術使用 FBS NF BIODEGRADABLE MINI PLATING SYSTEM:ACL/PCL SCREW 限實施 4234 十字韌帶重建手術患者使用 FBS081322SAW FASTAK SUTURE ANCHOR 2.4MM 縫合錨釘 限肩關節韌帶手術患者 3268 使用 FBS081370BAW BIO-INTERFERENCE SCREW 限實施十字韌帶重建手術患者使用 4234 FBS081370TAW CANNULATED INTERFERENCE SCREW 限實施十字韌帶重手術使用 4113 FBS081915SAW SUTURE ANCHOR 限肩關節韌帶手術患者使用 3268 FBS082123NT1 MITEK ROTATOR CUFF ANCHOR 限肩關節韌帶手術患者使用 3268 FBS082165NT1 SOFT TISSUE ANCHOR(G II SNAP-PAK MINI QUICK ANCHER) 限肩 3268 關節韌帶手術患者使用 FBS082221NT1 FASTIN SOFT TISSUE ANCHOR 限肩關節韌帶手術患者使用 3268 FBS082225NT1 FASTIN ANCHOR 限肩關節韌帶手術患者使用 3268 FBS082545NT1 ABSOLUTE ABSORBABLE INTERFERENCE SCREW 限實施十字韌帶重 4234 建手術患者使用 FBS082870BKL MEGAFIX BIOABSORBABLE INTERFERENCE SCREW 可吸收性韌帶螺釘 4234 限用於十字韌帶重建手術者 FBS082870TKL MEGAFIX-T INTERFERENCE SCREW 限實施十字韌帶重手術使用 4113 FBS083512NLA LIGAMENT CANULATED SCREW 限十字韌帶重建手術使用 4113 FBS085015TLV "CONMED LINVATEC"MATRYX INTERFERENCE SCREW " 康美靈威特 " 固 4234 定螺釘 ( 可吸收 ) 限十字韌帶重建手術使用 FBS086101HLV "LINVATEC"REVO SOFT TISSUE ANCHOR" 靈威特 " 軟組織固定錨釘 3268 限肩關節韌帶手術患者使用 FBS086101NLV REVO SUTURE ANCHOR(CANCELLOUS SCREW)2.7,4MM (C6140,C 自 91/10/01 生效 ) 限肩關節韌帶手術患者使用 FBS086140HLV "LINVATEC"SUPER REVO-FT SUTURE ANCHOR " 靈威特 " 軟組織縫合 3268 錨釘 ( 肩關節 ) FBS SN SOFTSILK TM SCREW SYSTEM( 型號含 : ) 限實施十 4113 字韌帶重建手術使 FBS SN BIORCI SCREW SYSTEM RCI 可吸收性介面固定螺絲 限十字韌帶重 4234 建手術使用 FBS087207NSN TITANIUM RCI SCREW 固定螺釘 限實施十字韌帶重建手術使用 4113 FBS SN TWINFIX SUTURE ANCHOR(TI) 軟組織錨釘 限肩關節韌帶手術患 3268 者使用 FBS SN TWINFIX SUTURE ANCHORS AND ACCESSORIES 3268 FBS088059NLV "LINVATEC"ENDOPEARL BIOABSORBABLE SOFT TISSUE FIXATION 4100 DEVICE " 靈威特 " 恩皮爾軟組織固定器 FBS088320NLV LINVATEC CANNULATED INTEREFERENCE SCREW 限實施十字韌帶 4113 重建術患者使用 FBS088321NLV LINVATEC PROPEL CANNULATED INTERFERENCE SCREW 限實施十 4113 字韌帶重建術患者使用 FBS08ARWSFAW SUTURE ANCHOR W/FIBER WIRE 縫合錨釘含高鋼性縫線 限肩關節 3918 韌帶手術患者使用 FBS08C8000LV LINVATEC ABSORBABLE INTERFERENCE SCREW ( 型號 C8030:39 自 /7/1 生效 ) 限實施十字韌帶重建手術患者使用 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

216 FBS08CPV10BC "BIOMATLANTE"OSTEOTWIN RESORBABLE COMPOSITE INTERFERENCE SCREW" 瑪蘭尼 " 使得挺吸收性複合式螺絲 7:10MM/25;30MM 4234 FBSCM1103NU0 CUSTOM MADE HUMERAL TUMOR PROSTHESIS 申報費用時應檢附該 被保險人之發票備查 FBSCM6487NH1 CASTOM MADE HUMERAL PROTHESIS 申報費用應檢附發票備查 FBSF A MONT BLANC SPINAL SYSTEM 二節 (RX2+SX4) 適應症請見備註欄 FBSF100002ZV VIMAX SPINAL SYSTEM 二節 (SX4+RX2) 適應症請見備註欄 FBSF A MONT BLANC SPINAL SYSTEM 三節 (RX2+SX6) 適應症請見備註欄 FBSF100003ZV VIMAX SPINAL SYSTEM 三節 (SX6+RX2) 適應症請見備註欄 FBSF100012ZV VIM SPINAL SYSTEM 二節 (SX4+RX2 或 SX4+PX2) 適應症請見備註 欄 FBSF100013ZV VIM SPINAL SYSTEM 三節 (SX6+RX2) 適應症請見備註欄 FBSF100022ZV VIMAX SPINAL SYSTEM 二節 (SX4+RX2) 免事前審查 FBSF100023ZV VIMAX SPINAL SYSTEM 三節 (SX6+RX2) 免事前審查 FBSF10002TDP TITANIUM ISOLA SPINAL SYSTEM 二節 適應症請見備註欄 FBSF10003TDP TITANIUM ISOLA SPINAL SYSTEM 三節 適應症請見備註欄 FBSF1000F21A "SPINEWAY" MONT BLANC SPINE SYSTEM (SX4+RX2)" 施百威 脊椎 固定系統二節 ( 免事前審查 ) FBSF1000F31A "SPINEWAY" MONT BLANC SPINE SYSTEM (SX6+RX2)" 施百威 脊椎 固定系統三節 ( 免事前審查 ) FBSF101625B0 TITANIUM SPINAL SYSTEM(PX2+SX4) 適應症請見備註欄 FBSF101626B0 TITANIUM SPINAL SYSTEM(RX2+SX4) 適應症請見備註欄 FBSF101635B0 TITANIUM SPINAL SYSTEM(RX2+SX6 或 RX2+SX4+HX2) 適應症請見 備註欄 FBSF101640B0 TITANIUM LUMBAR SPINAL SYSTEM 二節 (PX2+SX4) FBSF101641B0 TITANIUM LUMBAR SPINAL SYSTEM 三節 (PX2+SX6) FBSF101642B0 TITANIUM LUMBAR SYSTEM 二節 (SX4+RX2) 免事前審查 FBSF101643B0 TITANIUM LUMBAR SYSTEM 三節 (SX6+RX2) 免事前審查 FBSF1082TMDA TITANIUM TSRH SPINAL SYSTEM( 二節 ) 適應症請見備註欄 FBSF1083TMDA TITANIUM TSRH SPINAL SYSTEM( 三節 ) 適應症請見備註欄 FBSF110001TT TITANIUM SPINAL SYSTEM 二節 (RX2+SX4)( 免事前審查 ) FBSF110002TT TITANIUM SPINAL SYSTEM 三節 (RX2+SX6)( 免事前審查 ) FBSF110002U0 "UNITED"CENTURY SPINAL SYSTEM (S*4+R*2) " 聯合 " 世紀脊椎固 定系統二節 適應症請見備註欄 FBSF110003U0 "UNITED"CENTURY SPINAL SYSTEM (S*6+R*2) " 聯合 " 世紀脊椎固 定系統 ( 三節 ) 適應症請見備註欄 FBSF11002LTD TITANIUM TREND SPINAL SYSTEM 二節 (SX4+RX2) 適應症請見備註 欄 FBSF11003LTD TITANIUM TREND SPINAL SYSTEM 三節 (SX6+RX2) 適應症請見備註 欄 FBSF11302NB0 TITANIUM SPINAL FIXATION SYSTEM 脊椎固定系統二節 (SX4+RX2) 適應症請見備註欄 FBSF11303NB0 TITANIUM SPINAL FIXATION SYSTEM 脊椎固定系統三節 (SX6+RX2) 適應症請見備註欄 FBSF13800NS9 TITANIUM XIA SPINAL SCREW( 免事審查 ) 3114 FBSF13802NS9 TITANIUM XIA SPINAL SYSTEM( 二節 SX4+RX2)( 免事審查 ) FBSF13803NS9 TITANIUM XIA SPINAL SYSTEM( 三節 SX6+RX2)( 免事審查 ) FBSF13820NS9 TITANIUM XIA SPINAL SYSTEM 二節前置脊椎固定 (SX4+RX2) 適應症請見備註欄

217 FBSF140001RK TITANIUM ANTERIOR SPINAL SYSTEM(PX1+SX4) 適應症請見備註 欄 FBSF148144S9 XIA 4.5 TITANIUM SPINAL IMPLANTS (SX4+RX2) 二節 適應症請 見備註欄 FBSF148145S9 XIA 4.5 TITANIUM SPINAL IMPLANTS (SX6+RX2) 三節 適應症請 見備註欄 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 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 FBSF1495XNS1 TITANIUM CLICK'X SPINAL SYSTEM 上開式三節 (SX6+RX2) 適應 症請見備註欄 FBSF14981NS1 TITANIUM UNIVERSAL SPINAL SYSTEM ( 二節 SCREWX4+RODX2) 適 應症請見備註欄, 須事前審查 FBSF14982NS1 VENTROFIX ANTERIOR SPINAL SYSTEM(RODX2+ 或 X1+SCREWX4) 適 應症請見備註欄 FBSF14985NS1 TITANIUM CLICK'X SPINAL SYSTEM 上開式二節 (SX4+RX2) 適應 症請見備註欄 FBSF1498XNS1 TITANIUM UNIVERSAL SPINAL SYSTEM ( 三節 SCREWX6+RODX2) 適 應症請見備註欄, 須事前審查 FBSF14994NS1 TITANIUM SPINAL SYSTEM 三節 (SX6+RX2) 免事前審查 FBSF14995NS1 TITANIUM SPINAL SYSTEM 二節 (SX4+RX2) 免事前審查 FBSF16200NDX TITANIUM SPINAL IMPLANT(RX2+SX4) 二節型號 :9060,XL 自 90/07/01 生效 適應症請見備註欄 FBSF16200NS9 TITANIUM SPINAL IMPLANT(DIAPASON)(RX2+SX4) 脊椎人工置換 組 : 二節 適應症請見備註欄 FBSF16201NS9 TITANIUM SPINAL IMPLANT (DIAPASON)(SX4+RX2) 脊椎人工置換 組 : 二節 ( 免事前審查 ) FBSF16202NS1 TITANIUM PANGEA SPINAL SYSTEM(SX4+RX2) 適應症請見備註欄 FBSF16203NS1 TITANIUM PANGEA SPINAL SYSTEM(SX6+RX2) 適應症請見備註欄 FBSF162200S9 TITANIUM ROD PLATE SPINE SYSTEM 二節 (RX2+SX4+BLOCKERX4) FBSF162300S9 TITANIUM ROD PLATE SPINE SYSTEM 三節 (RX2+SX6+BLOCKERX6) 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 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 FBSF16300NDX TITANIUM SPINAL IMPLANT 三節 (SX6+RX2) 型號 :9060,XL 自 90/07/01 生效 適應症請見備註欄 FBSF16300NS9 TITANIUM SPINAL IMPLANT(DIAPASON)(RX2+SX6) 脊椎人工置換 組 : 三節 適應症請見備註欄 FBSF16301NS9 TITANIUM SPINAL IMPLANT (DIAPASON)(SX6+RX2) 脊椎人工置換 組 : 三節 ( 免事前審查 ) FBSF16720NS9 TITANIUM OPUS SPINAL FIXATION 二節 (SX4+RX2) FBSF16730NS9 TITANIUM OPUS SPINAL FIXATION 三節 (SX6+RX2) FBSF17200NDX OPUS SPINAL FIXATION 二節 (SCREWX4+RODX2) 適應症請見備註欄 FBSF17300NDX OPUS SPINAL FIXATION 三節 (SCREWX6+RODX2) 適應症請見備註欄 FBSF1765P2Y2 TITANIUM SPINAL SYSTEM 二節 (RX2+SX4) 適應症請見備註欄

218 FBSF1765P3Y2 TITANIUM SPINAL SYSTEM 三節 (RX2+SX6) 適應症請見備註欄 FBSF176902Y2 TITANIUM POSTERIOR SPINAL FIXATION SYSTEM 二節 (RX2+SX4)( 原 產品型號 : :930) FBSF176903Y2 TITANIUM POSTERIOR SPINAL FIXATION SYSTEM 三節 (RX2+SX6)( 原 產品型號 : :930) FBSF177002Y2 TITANIUM C TYPE SPINAL FIXATION SYSTEM 二節 (RX2+SX4)( 免術 前審查 ) FBSF177003Y2 TITANIUM C TYPE SPINAL FIXATION SYSTEM 三節 (RX2+SX6)( 免術 前審查 ) FBSF177202Y2 TITANIUM SPINAL SYSTEM(RX2+SX4) 二節 適應症請見備註欄 FBSF177203Y2 TITANIUM SPINAL SYSTEM(RX2+SX6) 三節 適應症請見備註欄 FBSF177402Y2 TITANIUM O TYPE SPINAL SYSTEM 二節 (RX2+SX4) 適應症請見備 註欄 FBSF177403Y2 TITANIUM O TYPE SPINAL SYSTEM 三節 (RX2+SX6) 適應症請見備 註欄 FBSF180001RK TITANIUM SPINAL SYSTEM (SX4+RX2) 二節 適應症請見備註欄 FBSF180002RK TITANIUM SPINAL SYSTEM (SX6+RX2) 三節 適應症請見備註欄 FBSF180003RK TITANIUM SPINAL SYSTEM 二節 (SX4+RX2) 適應症請見備註欄 FBSF180004RK TITANIUM SPINAL SYSTEM 三節 (SX6+RX2) 適應症請見備註欄 FBSF180005RK TITANIUM SPINAL SYSTEM 二節 (SX4+RX2) 適應症請見備註欄 FBSF180006RK TITANIUM SPINAL SYSTEM 三節 (SX6+RX2) 適應症請見備註欄 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 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 FBSF181NP2Y2 BRIDGE SPINAL FIXATION SYSTEM 二節 (RX2+SX4) 免事前審查 FBSF181NP3Y2 BRIDGE SPINAL FIXATION SYSTEM 三節 (RX2+SX6) 免事前審查 FBSF1821XNDA TITANIUM ZPLATE ANTERIOR SPINAL SYSTEM (PLATEX1+SCREWX4) 適應症請見備註欄, 須事前審查 FBSF1822MNM4 ZPLATE II ANTERIOR FIXATION SYSTEM(PX1+SX4) 二節 適應症請 見備註欄 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 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 FBSF186001RK TITANIUM SPINAL SYSTEM (SX4 + RX2) 二節免事前審查 FBSF186002RK TITANIUM SPINAL SYSTEM (SX6+RX2) 三節免事前審查 FBSF1865N2M4 BASIS SPINAL SYSTEM TITANIUM 二節 (SX4+RX2)( 免事前審查 ) FBSF1865N3M4 BASIS SPINAL SYSTEM TITANIUM 三節 (SX6+RX2)( 免事前審查 ) FBSF1865P2M4 BASIS SPINAL SYSTEM 二節 (ATL PLATE SYSTEM)(PX1+SX4) 適應 症請見備註欄 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 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 FBSF188NP2Y2 "SYNTEC" COLISEUM SPINAL FIXATION SYSTEM " 亞太醫療 " 高立捷脊椎固定系統二節 (RX2+SX4)

219 FBSF188NP3Y2 "SYNTEC" COLISEUM SPINAL FIXATION SYSTEM " 亞太醫療 " 高立捷 脊椎固定系統三節 (RX2+SX6) FBSF1A3EHNXA A3 POSTERIOR TITANIUM SPINAL EVOLUTION HOOK(SCREWX2+HOOKX2+NUTX2) FBSF1A3N2NXA A3 POSTERIOR TITANIUM SPINAL SYSTEM 二節 (RX2+SX4) 適應症 請見備註欄 FBSF1A3N3NXA A3 POSTERIOR TITANIUM SPINAL SYSTEM 三節 (RX2+SX6) 適應症 請見備註欄 FBSF1AAS2NXA TITANIUM SPINAL SYSTEM 二節 (RX2+SX4) 適應症請見備註欄 FBSF1AAS8NXA TITANIUM SPINAL SYSTEM 三節 (RX2+SX6) 適應症請見備註欄 FBSF1AS001AQ TITANIUM SPINAL OC-FIX SCREW SYSTEM 二節 (RX2+SX4) 免術前審 查 FBSF1AS002AQ TITANIUM SPINAL OC-FIX SCREW SYSTEM 三節 (RX2+SX6) 免術前審 查 FBSF1AS003AQ TITANIUM SPINAL FIXATION SYSTEM (SX4+RX2) 二節免事前審查 FBSF1AS004AQ TITANIUM SPINAL FIXATION SYSTEM (SX6+RX2) 三節免事前審查 FBSF1ASAT1AQ TITANIUM ANTERIOR SPINAL SYSTEM(PX1+SX4) 適應症請見備註 欄 FBSF1ASN01AQ TITANIUM SMARTLOC SPINAL SYSTEM(SX4+RX2) 免事前審前 FBSF1ASN02AQ TITANIUM SMARTLOC SPINAL SYSTEM(SX6+RX2) 免事前審前 FBSF1ASPL1AQ TITANIUM SPINAL SYSTEM 二節 (RX2+SX4) 適應症請見備註欄 FBSF1ASPL2AQ TITANIUM SPINAL SYSTEM 二節 (PX2+SX4) 適應症請見備註欄 FBSF1ASPL3AQ TITANIUM SPINAL SYSTEM 三節 (RX2+SX6) 適應症請見備註欄 FBSF1ASPL4AQ TITANIUM SPINAL SYSTEM 三節 (PX2+SX6) 適應症請見備註欄 FBSF1ASY01AQ TITANIUM SMARTLOC SPINAL SYSTEM 二節 (SX4+RX2) 適應症請見 備註欄 FBSF1ASY02AQ TITANIUM SMARTLOC SPINAL SYSTEM 三節 (SX6+RX2) 適應症請見 備註欄 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 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 FBSF1AYS2NXA Y TYPE POSTERIOR TITANIUM SPINAL SYSTEM 二節 (RX2+SX4)( 免事 前審查 ) FBSF1AYS8NXA Y TYPE POSTERIOR TITANIUM SPINAL SYSTEM 三節 (RX2+SX6)( 免 事前審查 ) FBSF1CD2S2M4 TITANIUM CD SPINAL SYSTEM 二節 (SX4+RX2)( 免術前審查 ) FBSF1CD2S3M4 TITANIUM CD SPINAL SYSTEM 三節 (SX6+RX2)( 免術前審查 ) FBSF1CDH2TDA TITANIUM CD HORIZON SPINAL SYSTEM 二節 (SCREWX4+RODX2) 適 應症請見備註欄 FBSF1CDH3TDA TITANIUM CD HORIZON SPINAL SYSTEM 三節 (SCREWX6+RODX2) 適 應症請見備註欄 FBSF1CENTAS9 TITANIUM CENTAUR ANTERIOR SYSTEM( 二節 1P+4S 或 2L+4S) 適應 症請見備註欄 FBSF1GS12NG0 GSS TITANIUM SPINAL SYSTEM 二節 (RX2+SX4) 適應症請見備註 欄 FBSF1GS13NG0 GSS TITANIUM SPINAL SYSTEM 三節 (RX2+SX6) 適應症請見備註 欄 FBSF1HUTR2GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX4) 際仁脊椎固定系統 ( 二節 ) 適應症請見備註欄

220 FBSF1HUTR3GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX6) 際仁脊椎固定系統 ( 三 節 ) 適應症請見備註欄 FBSF1JAVA2JA TITANIUM SPINAL SYSTEM 二節 (RX2+SX4) 適應症請見備註欄 FBSF1JAVA3JA TITANIUM SPINAL SYSTEM 三節 (RX2+SX6) 適應症請見備註欄 FBSF1LCLR2GZ SPINAL SYSTEM (RX2+SX4) 脊椎系統二節免事前審查 FBSF1LCLR3GZ SPINAL SYSTEM (RX2+SX6) 脊椎系統三節免事前審查 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 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 FBSF1LSTR2GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX4) 際仁脊椎固定系統 ( 二 節 ) 適應症請見備註欄 FBSF1LSTR3GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX6) 際仁脊椎固定系統 ( 三 節 ) 適應症請見備註欄 FBSF1LUTR2GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX4) 際仁脊椎固定系統二節 適應症請見備註欄 FBSF1LUTR3GZ GEZEN SPINAL FIXATION SYSTEM(RX2+SX6) 際仁脊椎固定系統三節 適應症請見備註欄 FBSF1M2SP2Z6 TITANIUM SPINAL SYSTEM 二節 (PX2+SX4 或 RX2+SX4) FBSF1M2SP3Z6 M2 SPINAL POSTERIOR SYSTEM 三節 (ROD 2+SCREW 6 或 PLATE SCREW 6)M2 脊椎後方固定系統免事前審查 FBSF1M3SP2Z6 TITANIUM M3 SPINAL POSTERIOR SYSTEM 二節 (RX2+SX4) 適應症 請見備註欄 FBSF1M3SP3Z6 TITANIUM M3 SPINAL POSTERIOR SYSTEM 三節 (RX2+SX6) 適應症 請見備註欄 FBSF1M8RS2M4 TITANIUM CD HORIZON M8 SPINAL SYSTEM(RX2+SX4) 二節 適應症 請見備註欄 FBSF1M8RS3M4 TITANIUM CD HORIZON M8 SPINAL SYSTEM(RX2+SX6) 三節 適應症 請見備註欄 FBSF1MES2NZ6 TITANIUM SPINAL SYSTEM 二節 (RODX2 或 PLATEX2+SCREWX4) 適應 症請見備註欄 FBSF1MES3NZ6 TITANIUM SPINAL SYSTEM 三節 (RODX2 或 PLATEX2+SCREWX6) 適應 症請見備註欄 FBSF1P2SP2Z6 "MERRIES"PROT II POSTERIOR SPINE SYSTEM(RX2+SX4) " 美瑞世 " 普生二代後方脊椎固定器二節 適應症請見備註欄 FBSF1P2SP3Z6 "MERRIES"PROT II POSTERIOR SPINE SYSTEM (RX2+SX6) " 美瑞 世 " 普生二代後方脊椎固定器三節 適應症請見備註欄 FBSF1PCS01WG "WILTROM"SPINAL FIXATION SYSTEM(RX2+SX4)" 威創 " 脊椎固定系 統二節 ( 免事前審查 ) FBSF1PCS02WG "WILTROM"SPINAL FIXATION SYSTEM(RX2+SX6)" 威創 " 脊椎固定系 統三節 ( 免事前審查 ) 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 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 FBSF1R200NS9 XIA REDUCTION IMPLANTS 二節 (RX2+SX4) 適應症請見備註欄 FBSF1R300NS9 XIA REDUCTION IMPLANTS 三節 (RX2+SX6) 適應症請見備註欄 FBSF1RF002RX RF SPINAL SYSTEM 二節 (SX4+RX2)( 免事前審查 ) FBSF1RF003RX RF SPINAL SYSTEM 三節 (SX6+RX2)( 免事前審查 ) FBSF1S200NS9 SR90D RODDING SYSTEM 二節 (RODX2+SCREWX4) 適應症請見備註 欄 FBSF1S300NS9 SR90D RODDING SYSTEM 三節 (RODX2+SCREWX6) 適應症請見備註欄

221 FBSF1SA1T2Y2 TITANIUM UNIVERSAL ANTERIOR SPINAL FIXATION SYSTEM(SX4+PX1) 適應症請見備註欄 FBSF1SA2T2Y2 TITANIUM UNIVERSAL ANTERIOR SPINAL FIXATION SYSTEM(SX4+BLOCKX2+RODX2) 適應症請見備註欄 FBSF1SW200AE "AESCULAP"TITANIUM S4 SPINAL SYSTEM 二節 (SX4+RX2)" 雅氏 " 雅 士弗脊椎固定系統 適應症請見備註欄 FBSF1SW300AE "AESCULAP"TITANIUM S4 SPINAL SYSTEM 三節 (SX6+RX2)" 雅氏 " 雅 士弗脊椎固定系統 適應症請見備註欄 FBSF1SX002AE TITANIUM SPINE SYSTEM EVOLUTION 二節 (SCREWX4+LODX2)(96 年 月 1 日起免事前審查 ) FBSF1SX003AE TITANIUM SPINE SYSTEM EVOLUTION 三節 (SCREWX6+LODX2)(96 年 月 1 日起免事前審查 ) FBSF1T2552DP M-M TITANIUM SPINAL SYSTEM( 二節 ) 適應症請見備註欄 FBSF1T3553DP M-M TITANIUM SPINAL SYSTEM( 三節 ) 適應症請見備註欄 FBSF1TS002JA TITANIUM SPINAL SYSTEM 二節 (RX2+SX4)( 免事前審查 ) FBSF1TS003JA TITANIUM SPINAL SYSTEM 三節 (RX2+SX6)( 免事前審查 ) FBSF1VSP2TDP TITANIUM VSP SPINAL SYSTEM 二節 適應症請見備註欄 FBSF1VSP3TDP TITANIUM VSP SPINAL SYSTEM 三節 適應症請見備註欄 FBSF1X200NS9 XIA TITANIUM SPINAL IMPLANTS 二節 (SX4+RX2)( :860, :760 自 92/4/1 生效 ) 適應症請見備註欄 FBSF1X300NS9 XIA TITANIUM SPINAL IMPLANTS 三節 (SX6+RX2)( :860, :760 自 92/4/1 生效 ) 適應症請見備註欄 FBSF A MONT BLANC SPINAL ROD 短 適應症請見備註欄 1089 FBSF200002ZV VIMAX SPINAL ROD 40:100MM 適應症請見備註欄 1089 FBSF A MONT BLANC SPINAL ROD 長 適應症請見備註欄 3218 FBSF200004ZV VIMAX SPINAL ROD 110:450MM 適應症請見備註欄 3218 FBSF200012ZV VIM SPINAL ROD PLATE 40:100MM 35MM 適應症請見備註欄 1089 FBSF200014ZV VIM SPINAL ROD 110:300MM 適應症請見備註欄 3218 FBSF200022ZV VIMAX SPINAL ROD 40:100MM 免事前審查 679 FBSF200024ZV VIMAX SPINAL ROD 110:150MM 免事前審查 1851 FBSF2000F21A "SPINEWAY" MONT BLANC SPINE SYSTEM:ROD 40:64MM" 施百威 脊 679 椎固定系統 : 固定桿 ( 免事前審查 ) FBSF2000F41A "SPINEWAY" MONT BLANC SPINE SYSTEM:ROD 132:158MM" 施百威 1851 脊椎固定系統 : 固定桿 ( 免事前審查 ) FBSF20572NDP M-M TITANIUM ROD 30CM,48CM 適應症請見備註欄 3218 FBSF20574NDP M-M TITANIUM ROD 12CM 適應症請見備註欄 1089 FBSF2080TMDA TITANIUM TSRH SPINAL ROD( 短節 ) 適應症請見備註欄 1089 FBSF2081TMDA TITANIUM TSRH SPINAL ROD( 長節 ) 適應症請見備註欄 3218 FBSF210001TT TITANIUM SPINAL ROD 50:100MM( 免事前審查 ) 679 FBSF210002TT TITANIUM SPINAL ROD 110MM:450MM( 免事前審查 ) 1851 FBSF210B2NZ6 TITANIUM SPINAL ROD 4.5:10.5CM 適應症請見備註欄 1089 FBSF210B5NZ6 TITANIUM SPINAL ROD 12.5:20CM 適應症請見備註欄 3218 FBSF21502NS1 TITANIUM UNIVERSAL SPINAL ROD 免事前審查 679 FBSF21534NS1 TITANIUM UNIVERSAL SPINAL ROD LONG 免事前審查 1851 FBSF21600LTD TITANIUM TREND SPINAL ROD 110:300MM 適應症請見備註欄 3218 FBSF21600STD TITANIUM TREND SPINAL ROD 適應症請見備註欄 1089 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 ) 1851 FBSF248147S9 XIA TITANIUM SPINAL ROD 40:100MM( 短節 ) 適應症請見備註欄

222 FBSF248148S9 XIA TITANIUM SPINAL ROD 110:600MM ( 長節 ) 適應症請見備註 3218 欄 FBSF248232S9 "STRYKER" XIA 3 SPINAL SYSTEM:ROD 30:100MM " 史賽克 " 喜爾三 1089 脊椎系統 : 固定桿短節 適應症請見備註欄 FBSF248233S9 "STRYKER" XIA 3 SPINAL SYSTEM:ROD 11:600MM " 史賽克 " 喜爾三 3218 脊椎系統 : 固定桿長節 適應症請見備註欄 FBSF24981NS1 TITANIUM UNIVERSAL SPINAL ROD 適應症請見備註欄 1089 FBSF24985NS1 TITANIUM PANGEA ROD 35:85MM 適應症請見備註欄 1089 FBSF2498XNS1 TITANIUM UNIVERSAL SPINAL ROD LONG 適應症請見備註欄, 應 3218 事前審查 FBSF254040B0 TITANIUM SPINAL ROD 40MM:110MM( 短節 ) 適應症請見備註欄 1089 FBSF254047B0 TITANIUM SPINAL ROD 120MM:200MM( 長節 ) 適應症請見備註欄 3218 FBSF26051NB0 TITANIUM SPINAL PLATE 適應症請見備註欄 1089 FBSF26202NS1 TITANIUM PANGEA ROD MM 適應症請見備註欄 3218 FBSF265041S9 TITANIUM SPINAL IMPLANT (DIAPASON):ROD 40:60MM 脊椎人工 679 置換組 : 固定桿 ( 免事審查 ) FBSF26504NDX TITANIUM DIAPASON SPINAL ROD 40:100MM 適應症請見備註欄 1089, 須事前審查 FBSF26504NS9 TITANIUM SPINAL IMPLANT(DIAPASON):ROD 70:100MM 脊椎人工 1089 置換組 : 固定桿 適應症請見備註欄 FBSF265111S9 TITANIUM SPINAL IMPLANT(DIAPASON):ROD 110:250MM 脊椎人工 1851 置換組 : 固定桿 ( 免事前審查 ) FBSF26511NDX TITANIUM DIAPASON SPINAL ROD 11:40CM 適應症請見備註欄, 3218 須事前審查 FBSF26511NS9 TITANIUM SPINAL (DIAPASON)ROD 26:40CM 脊椎人工置換組 : 固定 3218 桿 適應症請見備註欄 FBSF26702NDX OPUS SPINAL FIXATION PLATE 適應症請見備註欄 1089 FBSF26710NDX OPUS SPINAL FIXATION ROD 40:100MM 適應症請見備註欄 1089 FBSF26711NDX OPUS SPINAL FIXATION ROD 110:400MM 適應症請見備註欄 3218 FBSF26714NS9 TITANIUM OPUS SPINAL FIXATION ROD( 免事前審查 ) 1851 FBSF276590Y2 TITANIUM SPINAL ROD 5:10CM 適應症請見備註欄 1089 FBSF27659NY2 TITANIUM SPINAL ROD 12:30CM 適應症請見備註欄 3218 FBSF277004Y2 TITANIUM SPINAL ROD 6X50:100MM 短節 ( 免術前審查 ) 679 FBSF277006Y2 TITANIUM SPINAL ROD 短節 適應症請見備註欄 1089 FBSF277011Y2 TITANIUM SPINAL ROD 6X110:300MM 長節固定四節以上 ( 免術前審 1851 查 ) FBSF277071Y2 TITANIUM SPINAL FIXATION PLATE 45:80MM 適應症請見備註欄 1089 FBSF277104Y2 STAINLESS SPINAL ROD 4:10CM 短節 ( 免術前審查 ) 558 FBSF277111Y2 STAINLESS SPINAL ROD 11:30CM 長節 ( 免術前審查 ) 558 FBSF2785NLY2 ARTEST SPINAL FIXATION SYSTEM:ROD 115:450MM 亞力士脊椎固 3218 定系統長節連接管 適應症請見備註欄 FBSF2785NSY2 ARTEST SPINAL FIXATION SYSTEM:ROD 20:110MM 亞力士脊椎固 1089 定系統短節連接管 適應症請見備註欄 FBSF2820NLY2 TITANIUM SPINAL ROD 11.5:45CM 長節免事前審查 1851 FBSF2820NSY2 TITANIUM SPINAL ROD 2:11CM 短節免事前審查 679 FBSF28280NM4 TITANIUM SPINAL ROD 51CM 適應症請見備註欄 3218 FBSF2839NLY2 "SYNTEC" AREIKEN SPINAL FIXATION SYSTEM:ROD " 亞太醫療 " 亞 1851 力健脊椎固定系統 : 連結棒 ( 長節 )11.5~45CM, 免事前審查 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

223 FBSF2855LTDA TITANIUM CD HORIZON SPINAL ROD( 長節 ) 適應症請見備註欄 3218 FBSF2855STDA TITANIUM CD HORIZON SPINAL ROD( 短節 ) 適應症請見備註欄 1089 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 1851 FBSF2887CLY2 ROD 連結棒 - 長節 適應症請見備註欄 3218 FBSF2887CSY2 ROD 連結棒 - 短節 適應症請見備註欄 1089 FBSF2911NLY2 "SYNTEC"COLISEUM SPINAL FIXATION SYSTEM:ROD 120:450MM" 亞 1851 太醫療 " 高立捷脊椎固定系統 : 連接桿 ( 長節 ) 免事前審查 FBSF2911NSY2 "SYNTEC"COLISEUM SPINAL FIXATION SYSTEM:ROD 40:100MM" 亞太 679 醫療 " 高立捷脊椎固定系統 : 連接桿 ( 短節 ) 免事前審查 FBSF2913CLY2 "SYNTEC"COLISEUM SPINAL FIXATION SYSTEM:ROD 120:450MM" 亞太醫療 " 高立捷脊椎固定系統 : 連接桿 ( 長節 ) 適應症請見備註欄 3218 FBSF2913CSY2 "SYNTEC"COLISEUM SPINAL FIXATION SYSTEM:ROD 40:100MM" 亞太醫療 " 高立捷脊椎固定系統 : 連接桿 ( 短節 ) 適應症請見備註欄 1089 FBSF2A3R1NXA A3 POSTERIOR TITANIUM SPINAL ROD 4:10CM 適應症請見備註欄 1089 FBSF2A3R2NXA A3 POSTERIOR TITANIUM SPINAL ROD 11:50CM 適應症請見備註 3218 欄 FBSF2AS001AQ TITANIUM SPINAL ROD 5:10CM 免術前審查 679 FBSF2ASLP1AQ TITANIUM SPINAL PLATE 適應症請見備註欄 1089 FBSF2ASLR1AQ TITANIUM SPINAL ROD 20:90MM 適應症請見備註欄 1089 FBSF2ASLR2AQ TITANIUM SPINAL ROD 110:450MM 適應症請見備註欄 3218 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 1851 FBSF2ASYR1AQ TITANIUM SMARTLOC SPINAL ROOD 40:100MM 適應症請見備註欄 1089 FBSF2ASYR2AQ TITANIUM SMARTLOC SPINAL ROOD 110:480MM 適應症請見備註欄 3218 FBSF2ASYR3AQ TITANIUM SMARTLOC EVOLUTION SPINAL ROD 40MM:100MM 適應 1089 症請見備註欄 FBSF2ASYR4AQ TITANIUM SMARTLOC EVOLUTION SPINAL ROD 110:600MM 適應症 3218 請見備註欄 FBSF2B0001RK TITANIUM SPINAL ROD 40:100 MM( 短節 ) 免事前審查 679 FBSF2B0002RK TITANIUM SPINAL ROD 110:480MM( 長節 ) 免事前審查 1851 FBSF2BA001RK TITANIUM SPINAL ROD 40:100MM( 短節 ) 適應症請見備註 1089 FBSF2BA002RK TITANIUM SPINAL ROD 110:450MM( 長節 ) 適應症請見備註欄 3218 FBSF2BA003RK TITANIUM SPINAL PLATE 適應症請見備註欄 1089 FBSF2GS21NG0 GSS TITANIUM SPINAL ROD MM 適應症請見備註欄 1089 FBSF2GS22NG0 GSS TITANIUM SPINAL ROD MM 適應症請見備註欄 3218 FBSF2L3401U0 "UNITED"CENTURY SPINAL SYSTEM:ROD 11:51CM " 聯合 " 世紀脊椎 3218 固定系統固定桿 ( 長節 ) 適應症請見備註欄 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 1851 桿長節免事前審查 FBSF2M2PLTZ6 M2 SPINAL POSTERIOR SYSTEM:PLATE M2 脊椎後方固定系統 : 骨 679 板免事前審查 FBSF2M2SRNZ6 TITANIUM SPINAL ROD 4.5:10.5CM

224 FBSF2M3LRDZ6 TITANIUM M3 SPINAL POSTERIOR ROD 125:300MM 適應症請見備 3218 註欄 FBSF2M3SRDZ6 TITANIUM M3 SPINAL POSTERIOR ROD 45:105MM 適應症請見備註 1089 欄 FBSF2P2LRDZ6 PROT II POSTERIOR SPINE ROD 12.5:20CM 適應症請見備註欄 3218 FBSF2P2SRDZ6 PROT II POSTERIOR SPINE ROD 4.5:10.5CM 適應症請見備註欄 1089 FBSF2PR040B0 TITANIUM SPINAL ROD 40MM:100MM 免事前審查 679 FBSF2PR041B0 TITANIUM SPINAL ROD 110MM:450MM 免事前審查 1851 FBSF2R063NXA TITANIUM SPINAL ROD 4:11CM 適應症請見備註欄 1089 FBSF2R068NXA TITANIUM SPINAL ROD 13:40CM 適應症請見備註欄 3218 FBSF2R1797DP DEPUY SPINE MOSS MIAMI SPINE SYSTEM:ROD 帝富脊椎莫斯邁阿 1089 密脊椎系統 : 固定桿 適應症請見備註欄 FBSF2R3401U0 "UNITED"CENTURY SPINAL SYSTEM:ROD 3:10CM " 聯合 " 世紀脊椎固 1089 定系統固定桿 ( 短節 ) 適應症請見備註欄 FBSF2R482NS9 XIA REDUCTION ROD 30:90MM 適應症請見備註欄 1089 FBSF2R8550M4 TITANIUM CD HORIZON M8 SPINAL ROD 20"( 免術前審查 ) 1851 FBSF2R855LM4 TITANIUM CD HORIZON M8 SPINAL ROD 長節 50.4CM 適應症請見 3218 備註欄 FBSF2R869SM4 TITANIUM CD HORIZON M8 SPINAL ROD 短節 3CM,8CM 適應症請見 1089 備註欄 FBSF2RADLTDP TITANIUM ISOLA SPINAL ROD 10:46CM 適應症請見備註欄 3218 FBSF2RD01TWG "WILTROM"SPINAL FIXATION SYSTEM:TITANIUM SPINAL ROD :100MM" 威創 " 脊椎固定系統 : 連接桿 50:100MM( 免事前審查 ) FBSF2RD02TWG "WILTROM"SPINAL FIXATION SYSTEM:TITANIUM SPINAL ROD 125:500MM" 威創 " 脊椎固定系統 : 連接桿 125:500MM( 免事前審查 ) 1851 FBSF2RD03TWG WILTROM SPINAL FIXATON SYSTEM:TITANIUM ROD 25:100MM 威創 1089 脊椎固定系統 : 連接桿 適應症請見備註欄 FBSF2RD04TWG WILTROM SPINAL FIXATON SYSTEM:TITANIUM ROD 125:500MM 威創 3218 脊椎固定系統 : 連接桿 適應症請見備註欄 FBSF2RF00LRX RF SPINAL ROD 110:150MM( 免事前審查 ) 1851 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 3218 FBSF2RS869M4 "MEDTRONIC" CD HORIZON LEGACY SPINAL SYSTEM:ROD MM " 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 1089 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 ) 1851 FBSF2S192NS9 SR90D RODDING SYSTEM ROD 110:600MM 適應症請見備註欄 3218 FBSF2S812NS9 SR90D RODDING SYSTEM ROD 30:90MM 適應症請見備註欄 1089 FBSF2SR125Z6 TITANIUM SPINAL ROD 125MM:200MM( 免事前審查 ) 1851 FBSF2SW35NAE "AESCULAP"TITANIUM S4 SPINAL SYSTEM:ROD 35MM:120MM" 雅氏 " 1089 雅士弗脊椎固定系統 : 支撐桿 適應症請見備註欄 FBSF2SW50NAE "AESCULAP"TITANIUM S4 SPINAL SYSTEM:ROD 150MM:500MM" 雅 3218 氏 " 雅士弗脊椎固定系統 : 支撐桿 適應症請見備註欄 FBSF2SX10NAE TITANIUM SPINE ROD MM (96 年 10 月 1 日起免事前審查 ) 679 FBSF2SX12NAE TITANIUM SPINE ROD MM (96 年 10 月 1 日起免事前審查 )

225 FBSF2T1FRMCM TI-FRAME TITANIUM( 後頸椎固定架 ) 適應症請見備註欄 7607 FBSF2TL01TJA TITANIUM SPINAL ROD 30:100MM 適應症請見備註欄 1089 FBSF2TL02TJA TITANIUM SPINAL ROD 120:800MM 適應症請見備註欄 3218 FBSF2TR001GZ GEZEN SPINAL FIXATION SYSTEM:ROD 40:105 MM 際仁脊椎固定系 1089 統 : 固定桿 ( 短 ) 適應症請見備註欄 FBSF2TR002GZ GEZEN SPINAL FIXATION SYSTEM:ROD MM 際仁脊椎固定 3218 系統 : 固定桿 ( 長 ) 適應症請見備註欄 FBSF2TS01TJA TITANIUM SPINAL ROD 30:100MM( 免事前審查 ) 679 FBSF2TS02TJA TITANIUM SPINAL ROD MM( 免事前審查 ) 1851 FBSF2X204NS9 XIA TITANIUM SPINAL ROD 70:100MM 適應症請見備註欄 1089 FBSF2X211NS9 XIA TITANIUM SPINAL ROD 360:600MM 適應症請見備註欄 3218 FBSF A MONT BLANC SPINAL HOOK 適應症請見備註欄 5375 FBSF300003ZV VIMAX SPINAL HOOK 適應症請見備註欄 5375 FBSF300013ZV VIM SPINAL HOOK 適應症請見備註欄 5375 FBSF301020B0 TITANIUM SPINAL HOOK 適應症請見備註欄 5375 FBSF30559NDP M-M TITANIUM HOOK 適應症請見備註欄 5375 FBSF3080TMDA TITANIUM TSRH SPINAL HOOK 適應症請見備註欄 5375 FBSF308XXNDA STANLESS TSRH SPINAL IMPLANT SYSTEM HOOK 適應症請見備註 4424 欄 FBSF3140XNTD TITANIUM TREND SPINAL HOOK 適應症請見備註欄 5375 FBSF340051WG "WILTROM"SPINAL FIXATION SYSTEM:HOOK" 威創 " 脊椎固定系統 : 椎 5375 弓鉤 適應症請見備註欄 FBSF348150S9 XIA TITANIUM SPINAL HOOK 適應症請見備註欄 5375 FBSF348232S9 "STRYKER" XIA 3 SPINAL SYSTEM:HOOK" 史賽克 " 喜爾三脊椎系統 : 5375 骨鉤 適應症請見備註欄 FBSF34983NS1 TITANIUM UNIVERSAL SPINAL HOOK 適應症請見備註欄, 須事前 5375 審查 FBSF35911NDX TITANIUM DIAPASON SPINAL HOOK 適應症請見備註欄, 須事前 5375 審查 FBSF36132NY2 TITANIUM CERVICAL CLAMP( 配合 FBSF46132NY2 使用 ) 4110 FBSF36201NS1 TITANIUM PANGEA SPINAL HOOK 適應症請見備註欄 5375 FBSF375504Y2 STAINLESS SPINAL HOOK 適應症請見備註欄 4424 FBSF376504Y2 TITANIUM SPINAL HOOK 適應症請見備註欄 5375 FBSF377041Y2 TITANIUM SPINAL HOOK( 免術前審查 ) 2420 FBSF386520M4 BASIS SPINAL TITANIUM HOOK( 免事前審查 ) 2420 FBSF3961TMDA TITANIUM CD HORIZON SPINAL HOOK 適應症請見備註欄 5375 FBSF39970SDP STAINLESS ISOLA SPINAL SYSTEM HOOK 適應症請見備註欄 4424 FBSF39970TDP TITANIUM ISOLA SPINAL SYSTEM HOOK 適應症請見備註欄 5375 FBSF3A3H1NXA A3 POSTERIOR TITANIUM SPINAL HOOK 適應症請見備註欄 5375 FBSF3ASLH1AQ TITANIUM SPINAL HOOK 適應症請見備註欄 5375 FBSF3ASYH1AQ TITANIUM SMARTLOC SPINAL HOOK 適應症請見備註欄 5375 FBSF3ASYH2AQ SMARTLOC EVOLUTION SYSTEM:HOOK 史麥特艾爾脊椎固定系統 : 固 5375 定鉤 適應症請見備註欄 FBSF3BA001RK TITANIUM SPINAL HOOK 適應症請見備註欄 5375 FBSF3H212NXA TITANIUM SPINAL PEDICLE HOOK 適應症請見備註欄 5375 FBSF3H754PM4 "MEDTRONIC" CD HORIZON LEGACY SPINAL SYSTEM:HOOK " 美敦力 " 5375 雷格斯脊椎矯正系統 : 骨鉤 適應症請見備註欄 FBSF3H8415M4 TITANIUM CD REDUCTION SCREW CONNECTOR HOOK( 免術前審查 ) 2420 FBSF3H859PM4 TITANIUM CDH M8 PEDIATRIC HOOK 適應症請見備註欄 5375 FBSF3H859SM4 TITANIUM CD HORIZON M8 SPINAL HOOK 適應症請見備註欄 5375 FBSF3H869RM4 TITANIUM CDH M8 REDUCTION SPINAL HOOK 適應症請見備註欄 5375 FBSF3HAAKNDP STANLESS ISOLA SPINAL HOOK 鉤 適應症請見備註欄

226 FBSF3HAAKTDP TITANIUM ISOLA SPINAL HOOK 適應症請見備註欄 5375 FBSF3HK01NZ6 TITANIUM SPINAL HOOK 適應症請見備註欄 5375 FBSF3HY12NXA Y TYPE POSTERIOR TITANIUM SPINAL HOOK( 免事前審查 ) 2420 FBSF3LK003GZ GEZEN SPINAL FIXATION SYSTEM:HOOK 際仁脊椎固定系統 : 固定鉤 5375 適應症請見備註欄 FBSF3M3SHKZ6 TITANIUM M3 SPINAL POSTERIOR HOOK 適應症請見備註欄 5375 FBSF3R382NS9 XIA REDUCTION HOOK 適應症請見備註欄 5375 FBSF3S600NS9 SR90D RODDING SYSTEM HOOK 適應症請見備註欄 5375 FBSF3SX30NAE TITANIUM SPINE HOOK 適應症請見備註欄 5375 FBSF3X600NS9 XIA TITANIUM SPINAL HOOK 適應症請見備註欄 ( :20215; ;20221;20230;20231 自 生效 ) 5375 FBSF A MONT BLANC SPINAL SCREW 適應症請見備註欄 6381 FBSF400004ZV VIMAX SPINAL SCREW 適應症請見備註欄 6381 FBSF400014ZV VIM SPINAL SCREW 適應症請見備註欄 6381 FBSF400024ZV VIMAX SPINAL SCREW 免事前審查 3114 FBSF4000F41A "SPINEWAY" MONT BLANC SPINE SYSTEM:SCREW " 施百威 脊椎固 3114 定系統 : 固定釘 ( 免事前審查 ) FBSF4010RNZ6 TITANIUM SPINAL SCREW 適應症請見備註欄 6381 FBSF40536NDP M-M TITANIUM SCREW MONO( 型號 :29155 自 92/1/1 生效 ) 6381 適應症請見備註欄 FBSF40543NDP M-M TITANIUM SCREW POLY( 型號 :37155 自 92/1/1 生效 ) 6381 適應症請見備註欄 FBSF4080TMDA TITANIUM TSRH SPINAL SCREW 適應症請見備註欄 6381 FBSF409099DP TITANIUM MOSS MIAMI SPINAL SCREW 適應症請見備註欄 6381 FBSF410001TT TITANIUM SPINAL SCREW( 免事前審查 ) 3114 FBSF4110XNTD TITANIUM TREND SPINAL SCREW 適應症請見備註欄 6381 FBSF41300NB0 TITANIUM SPINAL FIXATION SYSTEM:SCREW 脊椎固定螺絲 適 6381 應症請見備註欄 FBSF41600NB0 "BMI"SPINAL FIXATION SYSTEM:OPS TITANIUM SPINAL SCREW " 長 安 " 脊頸椎內固定系統 : 脊椎骨質疏鬆內固定釘 適應症請見備註欄 FBSF41797CDP DEPUY SPINE SARL MOSS MIAMI SPINE SYSTEM:SCREW 帝富脊椎莫 6381 士邁阿密脊椎系統 : 固定釘 適應症請見備註欄 FBSF41797UDP DEPUY SPINE MOSS MIAMI SPINE SYSTEM:SCREW 帝富脊椎莫斯邁 6381 阿密脊椎系統 : 固定釘 適應症請見備註欄 FBSF42236NDP TITANIUM PEDICLE SCREW 適應症請見備註欄 6381 FBSF44002TWG "WILTROM"SPINAL FIXATION SYSTEM:PEDICLE SCREW U TYPE" 威 3114 創 " 脊椎固定系統 : 脊椎骨釘 U 型 ( 免事前審查 ) FBSF44004TWG "WILTROM"SPINAL FIXATION SYSTEM:PEDICLE SCREW REDUCTION U TYPE" 威創 " 脊椎固定系統 : 脊椎骨釘 U 型折斷 ( 免事前審查 ) 3114 FBSF44005TWG FBSF44006TWG FBSF44007TWG FBSF44008TWG "WILTROM"SPINAL FIXATION SYSTEM:CANNULATED REDUCTION PEDICLE SCREW U TYPE" 威創 " 脊椎固定系統 : 脊椎骨釘中空折斷 U 型 適應症請見備註欄 "WILTROM"SPINAL FIXATION SYSTEM:PEDICLE SCREW AXIAL U TYPE" 威創 " 脊椎固定系統 : 脊椎骨釘 U 型多軸向 ( 免事前審查 ) "WILTROM"SPINAL FIXATION SYSTEM:PEDICLE SCREW POLY-AXIAL REDUCTION U TYPE" 威創 " 脊椎固定系統 : 脊椎骨釘 U 型多軸向折斷 ( 免事前審查 ) "WILTROM"SPINAL FIXATION SYSTEM:CANNULATED PEDICLE SCREW POLY-AXIAL U TYPE" 威創 " 脊椎固定系統 : 脊椎骨釘中空 U 型多軸向 適應症請見備註欄

227 FBSF44009TWG "WILTROM"SPINAL FIXATION SYSTEM:CANNULATED PEDICLE SCREW 6381 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 FBSF44010TWG "WILTROM"SPINAL FIXATION SYSTEM:CANNULATED PEDICLE SCREW 6381 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 FBSF448146S9 XIA 4.5 TITANIUM SPINAL SCREW 適應症請見備註欄 6381 FBSF448231S9 "STRYKER"XIA SPINAL SYSTEM:TITANIUM CANNULATED SCREW" 史賽 克 " 喜爾脊椎系統 : 中空螺釘 給付規定請見備註欄 FBSF448232S9 "STRYKER" XIA 3 SPINAL SYSTEM:SCREW" 史賽克 " 喜爾三脊椎系 6381 統 : 骨釘 適應症請見備註欄 FBSF448233S9 "STRYKER" XIA 3 SPINAL SYSTEM:SCREW" 史賽克 " 喜爾三脊椎系 6381 統 : 骨釘 適應症請見備註欄 FBSF44985NS1 TITANIUM UNIVERSAL SPINAL SCREW 適應症請見備註欄 6381 FBSF44988NS1 TITANIUM CLICK'X SPINAL SCREW 適應症請見備註欄 6381 FBSF44989NS1 TITANIUM CLICK'X SPINAL SCREW 適應症請見備註欄 6381 ( V:507V;520V:527V 自 刪除 ) FBSF44995NS1 TITANIUM CLICK'X PEDICLE SCREW ( 免事前審查 ) 3114 FBSF455030B0 TITANIUM SPINAL SCREW( 免事前審查 ) 3114 FBSF46121NY2 STAINLESS CERVICAL SCREW 17:24MM 188 FBSF461221Y2 STAINLESS SPINAL RESCUABLE SCREW(FBSF46121NY2 失敗時用, 配 188 合 FBSF661202Y2 用 ) FBSF461321Y2 TITANIUM SPINAL RESCUABLE SCREW(FBSF66131NY2 失敗時用, 配合 194 FBSF661302Y2 用 ) FBSF46132NY2 TITANIUM CERVICAL SCREW( 配合 FBSF36132NY2 使用 ) 2400 FBSF46201NS1 TITANIUM PANGEA PEDICLE SCREW 適應症請見備註欄 6381 FBSF464001S9 TITANIUM SPINAL (DIAPASON)SCREW 脊椎人工置換組 : 骨釘 ( 免事 3114 前審查 ) FBSF46400NDX TITANIUM DIAPASON SPINAL SCREW 型號 :9060,XL 自 /07/01 生效 適應症請見備註欄 FBSF46400NS9 TITANIUM SPINAL(DIAPASON)SCREW 脊椎人工置換組 : 骨釘 適應 6381 症請見備註欄 FBSF46700NDX OPUS SPINAL FIXATION SCREW 適應症請見備註欄 6381 FBSF4670BNS9 TITANIUM OPUS SPINAL FIXATION SCREW( 免事前審查 ) 3114 FBSF471545B0 TITANIUM SPINAL SCREW( 型號含 :45) 適應症請見備註 6381 欄 FBSF4765NNY2 TITANIUM SPINAL SCREW 適應症請見備註欄 6381 FBSF4769NNY2 TITANIUM SPINAL PEDICLE SCREW 4.5:8,30:55MM 3114 FBSF4770NNY2 TITANIUM SPINAL PEDICLE SCREW( 免術前審查 ) 3114 FBSF477253Y2 TITANIUM SPINAL OSTEOPOROTIC SCREW( 免術前審查 ) 3114 FBSF4772NNY2 TITANIUM SPINAL SCREW 適應症請見備註欄 6381 FBSF4774NNY2 TITANIUM O TYPE SPINAL FIXATION SCREW 適應症請見備註欄 6381 FBSF4780NNY2 ARTEST SPINAL FIXATION SYSTEM:TITANIUM SPINAL PEDICLE 3114 SCREW( 免事前審查 ) FBSF4781NNY2 ARTEST SPINAL FIXATION SYSTEM:TITANIUM SPINAL POLYAXIAL 3114 PEDICLE SCREW( 免事前審查 ) FBSF4782NNY2 PEDICLE SCREW( 免事前審查 ) 3114 FBSF4790NNY2 ARTEST SPINAL FIXATION SYSTEM:TITANIUM SPINAL CANNULATED 3114 PEDICLE SCREW( 免事前審查 ) FBSF4791NNY2 ARTEST SPINAL FIXATION SYSTEM:TITANIUM SPINAL CANNULATED POLYAXIAL PEDICLE SCREW( 免事前審查 )

228 FBSF4803NNY2 ARTEST SPINAL FIXATION SYSTEM:PEDICLE SCREW 亞力士脊椎固 6381 定系統 : 骨釘 適應症請見備註欄 FBSF4804NNY2 ARTEST SPINAL FIXATION SYSTEM:CANNULATED PEDICLE SCREW 6381 亞力士脊椎固定系統 : 骨釘 適應症請見備註欄 FBSF4806NNY2 ARTEST SPINAL FIXATION SYSTEM:POLYAXIAL PEDICLE SCREW 亞 6381 力士脊椎固定系統 : 骨釘 適應症請見備註欄 FBSF4807NNY2 ARTEST SPINAL FIXATION SYSTEM:CANNULATED POLYAXIAL 6381 PEDICLE SCREW 亞力士脊椎固定系統骨釘 適應症請見備註欄 FBSF4807TMDA TITANIUM CD HORIZON SPINAL SCREW 適應症請見備註欄 6381 FBSF4816NNY2 REDUCTION PEDICLE SCREW 免事前審查 3114 FBSF4818NNY2 POLYAXIAL PEDICLE SCREW 免事前審查 3114 FBSF4827MNM4 TITANIUM MULTI AXIAL SPINAL SCREW 適應症請見備註欄 6381 FBSF4832NNY2 "SYNTEC" AREIKEN SPINAL FIXATION SYSTEM:MONOAXIAL SCREW" 3114 亞太醫療 " 亞力健脊椎固定系統單軸骨釘, 免事前審查 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 6381 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 6381 FBSF4A3S1NXA A3 POSTERIOR TITANIUM SPINAL SCREW 適應症請見備註欄 6381 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 6381 FBSF4ASNS1AQ TITANIUM SMARTLOC SPINAL SCREW 免事前審查 3114 FBSF4ASYS1AQ TITANIUM SMARTLOC SPINAL SCREW 適應症請見備註欄 6381 FBSF4ASYS3AQ TITANIUM SMARTLOC EVOLUTION SPINAL SCREW 適應症請見備註 6381 欄 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 FBSF4ASYS7AQ SMARTLOC EVOLUTION SYSTEM: SPINAL SCREW 史麥特艾爾脊椎固 6381 定系統 : 骨釘 適應症請見備註欄 FBSF4B0001RK TITANIUM SPINAL SCREW 免事前審查 3114 FBSF4B0009RK "REBORN ESSENCE"LUMBAR FIXATION SYSTEM:MULTI SCREW" 瑞寶 3114 億 " 腰椎內固定系統 : 萬向螺釘 ( 免事前審查 ) FBSF4BA001RK TITANIUM SPINAL SCREW 適應症請見備註欄 6381 FBSF4BA002RK TITANIUM SPINAL SCREW 適應症請見備註欄 6381 FBSF4BA005RK TITANIUM SPINAL SCREW 適應症請見備註欄 6381 FBSF4BA006RK TITANIUM SPINAL SCREW 適應症請見備註欄 6381 FBSF4BA007RK TITANIUM SPINAL SCREW 適應症請見備註欄 6381 FBSF4BA008RK "REBORN ESSENCE"LUMBAR FIXATION SYSTEM:PEDICLE LONG SCREW" 瑞寶億 " 腰椎內固定系統 : 椎弓根螺釘 適應症請見備註欄 6381 FBSF4BA011RK FBSF4BA012RK FBSF4CSSCWZ6 FBSF4CU004GZ "REBORN ESSENCE"LUMBAR FIXATION SYSTEM:POLY AXIAL SCREW" 瑞寶億 " 腰椎內固定系統 : 萬向螺釘 適應症請見備註欄 "REBORN ESSENCE"LUMBAR FIXATION SYSTEM:CANNULATED POLY AXIAL SCREW" 瑞寶億 " 腰椎內固定系統 : 中空萬向螺釘 給付規定請見備註欄 "MERRIES"CANNULATED SPINAL SYSTEM:CANNULATED PEDICLE SCREW " 美瑞世 " 中空螺釘脊椎固定系統 適應症請見備註欄 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 FBSF4GS41NG0 GSS TITANIUM SPINAL PEDICLE SCREW 適應症請見備註欄

229 FBSF4HU004GZ GEZEN SPINAL FIXATION SYSTEM:SCREW 際仁脊椎固定系統 : 骨釘 6381 適應症請見備註欄 FBSF4LB05NAE STANLESS SPONGIOSA CERVICAL CASPAR SCREW 3.5MM WIDE 188 THREAD 10MM:19MM FBSF4LB06NAE STANLESS SPONGIOSA CERVICAL CASPAR SCREW 3.5MM WIDE 228 THREAD 20MM 以上 FBSF4LC004GZ SPINAL SCREW 脊椎固定釘免事前審查 3114 FBSF4LS004GZ GEZEN SPINAL FIXATION SYSTEM:SCREW 際仁脊椎固定系統 : 骨釘 6381 適應症請見備註欄 FBSF4LU004GZ GEZEN SPINAL FIXATION SYSTEM:SCREW 際仁脊椎固定系統 : 固定 6381 釘 適應症請見備註欄 FBSF4M2PCNZ6 M2 SPINAL POSTERIOR SYSTEM:SCREW M2 脊椎後方固定系統 : 骨 3114 釘免事前審查 FBSF4M2PWNZ6 TITANIUM SPINAL SCREW 3114 FBSF4M3SSEZ6 TITANIUM M3 SPINAL POSTERIOR SCREW 適應症請見備註欄 6381 FBSF4P2PSPZ6 "MERRIES"PROT II POSTERIOR SPINE SYSTEM:SCREW " 美瑞世 " 普 6381 生二代後方脊椎固定器 " 固定釘 適應症請見備註欄 FBSF4P2SCWZ6 PROT II POSTERIOR SPINE SCREW 適應症請見備註欄 6381 FBSF4R382NS9 XIA REDUCTION SCREW 適應症請見備註欄 6381 FBSF4RF001RX RF SPINAL SCREW( 免事前審查 ) 3114 FBSF4S3101U0 "UNITED"CENTURY SPINAL SYSTEM:SCREW " 聯合 " 世紀脊椎固定系 6381 統骨螺絲 適應症請見備註欄 FBSF4S475NS9 SR90D RODDING SYSTEM SCREW 適應症請見備註欄 6381 FBSF4S754MM4 "MEDTRONIC" CD HORIZON LEGACY SPINAL SYSTEM:SCREW " 美敦 6381 力 " 雷格斯脊椎矯正系統 : 骨釘 適應症請見備註欄 FBSF4S859FM4 TITANIUM CD HORIZON M8 SPINAL SCREW 適應症請見備註欄 6381 FBSF4S8655M4 TITANIUM CD TULIP SCREW( 免術前審查 ) 3114 FBSF4S869MM4 TITANIUM CDH M8 MULTIAXIAL SCREW 適應症請見備註欄 6381 FBSF4S9603M4 TITANIUM CD REDUCTION SCREW( 免術前審查 ) 3114 FBSF4SW70NAE "AESCULAP"TITANIUM S4 SPINAL SYSTEM:TRANSPEDICULAR BONE SCREW" 雅氏 " 雅士弗脊椎固定系統 : 螺釘 適應症請見備註欄 6381 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 6381 FBSF4TS01TJA TITANIUM SPINAL PEDICLE SCREW( 免事前審查 ) 3114 FBSF4UP04NXA TITANIUM SPINAL SCREW 適應症請見備註欄 6381 FBSF4X380NS9 XIA TITANIUM SPINAL SCREW( 型號 :860, :760 自 92/4/1 生效 ) 適應症請見備註欄 6381 FBSF4YP04NXA Y TYPE POSTERIOR TITANIUM SPINAL PEDICLE SCREW( 免事前審 3114 查 ) FBSF A MONT BLANC SPINAL TRANSVERSE CONNECTOR 適應症請見備註欄 7208 FBSF500005ZV VIMAX SPINAL TRANSVERSE LINK 適應症請見備註欄 7208 FBSF500015ZV VIM SPINAL TRANSVERSE LINK 適應症請見備註欄 7208 FBSF50001TWG "WILTROM"SPINAL FIXATION SYSTEM:CROSS LINK" 威創 " 脊椎固定 3331 系統 : 橫向連接鉤 ( 免事前審查 ) FBSF A MONT BLANC SPINAL TRANSVERSE LINK 免事前審查 3331 FBSF500025ZV VIMAX SPINAL LINK 免事前審查 3331 FBSF50002TWG WILTROM SPINAL FIXATION SYSTEM:CROSS-LINK HOOK 威創脊椎固 7208 定系統 : 橫向連接鉤組合 給付規定請見備註欄 FBSF50055TJA TITANIUM SPINAL TRANSVERSE CONNECTOR 適應症請見備註欄 7208 FBSF5010TNZ6 TITANIUM SPINAL TRANSVERSE LINK 適應症請見備註欄

230 FBSF50380NS9 XIA SPINAL SYSTEM:CROSS LINK ( 免事前審查 ) 3331 FBSF50382NS9 XIA TITANIUM CROSS CONNECTOR 適應症請見備註欄 7208 FBSF50565NDP M-M TITANIUM TRANSVERSE CONNECTOR 適應症請見備註欄 7208 FBSF5080TMDA TITANIUM TSRH SPINAL CROSSLINK PLATE 適應症請見備註欄 7208 FBSF510001TT TITANIUM SPINAL TRANSVERSE LINK( 免事前審查 ) 3331 FBSF5170XNTD TITANIUM TREND TRANSVERSE LINK 適應症請見備註欄 7208 FBSF518010B0 TITANIUM TRANSVERSE LINK 適應症請見備註欄 7208 FBSF518012B0 TITANIUM TRANSVERSE LINK( 免事前審查 ) 3331 FBSF52230TDP TITANIUM ISOLA TRANSVERSE ROD CONNECTOR 適應症請見備註 7208 欄 FBSF54107NS9 MAC TATINIUM TRANSVERSE LINK 適應症請見備註欄 7208 FBSF548149S9 XIA 4.5 TITANIUM SPINAL CROSSLINK 適應症請見備註欄 7208 FBSF548232S9 "STRYKER" XIA 3 SPINAL SYSTEM:MONOBLOCK CONNECTOR " 史賽 7208 克 " 喜爾三脊椎系統 : 結合器組 適應症請見備註欄 FBSF548233S9 "STRYKER" XIA 3 SPINAL SYSTEM:CROSS CONNECTOR " 史賽克 " 喜 7208 爾三脊椎系統 : 結合器組 適應症請見備註欄 FBSF54977NS1 TITANIUM TRANSVERSE CONNECTORS 免事前審查 3331 FBSF54981NS1 TITANIUM UNIVERSAL SPINAL CROSS LINK 適應症請見備註欄, 7208 須事前審查 FBSF56201NS1 TITANIUM TRANSVERSE CONNECTORS 適應症請見備註欄 7208 FBSF56452NDX TITANIUM DIAPASON TRANSVERSE LINK 適應症請見備註欄 7208 ( :100 自 86/11/17 生效 ) FBSF57200NS9 TITANIUM TRANSVERSE LINKS( 免事審查 ) 3331 FBSF57651NY2 TITANIUM SPINAL CROSS-LINK 適應症請見備註欄 7208 FBSF577003Y2 TITANIUM SPINAL TRANSVERSE LINK( 免術前審查 ) 3331 FBSF5811XNDA TATINIUM TSRH LOW PROFILE CROSSLINK PLATE 適應症請見備 7208 註欄 FBSF5821NHY2 BRIDGE TRANSVERSE LINK 免事前審查 3331 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 3331 FBSF5886CCY2 "SYNTEC" TRANSVERSE LINK " 亞太醫療 " 高立捷橫向連結器 適 7208 應症請見備註欄 FBSF5886NCY2 "SYNTEC" TRANSVERSE LINK " 亞太醫療 " 高立捷橫向連結器 3331 FBSF5A3C1NXA A3 POSTERIOR TITANIUM SPINAL CROSSLINK HOOK 適應症請見 7208 備註欄 FBSF5AS001AQ TITANIUM SPINAL LINK 免術前審查 3331 FBSF5ASLL1AQ TITANIUM SPINAL LINK 適應症請見備註欄 7208 FBSF5ASNL1AQ TITANIUM SMARTLOC TRANSVERSE LINK 免事前審前 3331 FBSF5ASYL1AQ TITANIUM SMARTLOC TRANSVERSE LINK 適應症請見備註欄 7208 FBSF5ASYL2AQ TITANIUM SMARTLOC EVOLUTION TRANSVERSE LINK 適應症請見備 7208 註欄 FBSF5ASYL3AQ SMARTLOC EVOLUTION SYSTEM:TRANSVERSE LINK 史麥特艾爾脊椎 7208 固定系統 : 橫向連接器 適應症請見備註欄 FBSF5B0001RK TITANIUM SPINAL LINK 免事前審查 3331 FBSF5BA001RK TITANIUM SPINAL TRANSVERSE LINK 適應症請見備註欄 7208 FBSF5BT001GZ GEZEN SPINAL FIXATION SYSTEM:TRANSVERSE LINK 際仁脊椎固定 7208 系統 : 橫向連結組 適應症請見備註欄 FBSF5C111NXA TITANIUM SPINAL CROSS LINK 適應症請見備註欄 7208 FBSF5C3201U0 "UNITED"CENTURY SPINAL SYSTEM:CROSSLINK " 聯合 " 世紀脊椎固 7208 定系統交叉連桿 適應症請見備註欄 FBSF5CY11NXA Y TYPE POSTERIOR TITANIUM SPINAL LINK( 免事前審查 )

231 FBSF5DTT4TDA TITANIUM CD HORIZON SPINAL D.T.T#4( 橫向固定桿 ) 適應症請 7208 見備註欄 FBSF5GS51NG0 GSS TITANIUM SPINAL TRANSVERSE LINK 適應症請見備註欄 7208 FBSF5L8414M4 TITANIUM CD DTT #4 TRANSVERSE LINK( 免術前審查 ) 3331 FBSF5LT001GZ GEZEN SPINAL FIXATION SYSTEM:TRANSVERSE LINK 際仁脊椎固定 7208 系統 : 橫向連結器 適應症請見備註欄 FBSF5LT005GZ GEZEN SPINAL FIXATION SYSTEM:TRANSVERSE LINK 際仁脊椎固定 3331 系統 : 脊椎橫向連結器免事前審查 FBSF5M2TKNZ6 TITANIUM SPINAL TRANSVERSE LINK 3331 FBSF5M3SLKZ6 TITANIUM M3 SPINAL POSTERIOR TRANSVERSE LINK 適應症請見 7208 備註欄 FBSF5P2CLKZ6 PROT II POSTERIOR SPINE CROSS LINK 適應症請見備註欄 7208 FBSF5P2CNTZ6 PROT II POSTERIOR SPINE ROD CONNECTOR 適應症請見備註欄 7208 FBSF5P2TLKZ6 PROT II POSTERIOR SPINE TRANSVERSE LINK 適應症請見備註欄 7208 FBSF5R382NS9 XIA REDUCTION CROSS LINK 適應症請見備註欄 7208 FBSF5RF001RX RF SPINAL LINK( 免事前審查 ) 3331 FBSF5S500NS9 SR90D RODDING SYSTEM CROSS LINK 適應症請見備註欄 7208 FBSF5SW69NAE AESCULAP"TITANIUM S4 SPINAL SYSTEM:CROSS CONNECTOR" 雅氏 " 7208 雅士弗脊椎固定系統 : 連接器 適應症請見備註欄 FBSF5SX17NAE TITANIUM SPINE CROSSLINK (96 年 10 月 1 日起免事前審查 ) 3331 FBSF5TS55TJA TITANIUM SPINAL TRANSVERSE CONNECTOR( 免事前審查 ) 3331 FBSF5X380NS9 XIA TITANIUM SPINAL CROSS LINK 適應症請見備註欄 7208 FBSF610001TT TITANIUM CERVICAL PLATE( 免術前審查 ) 4046 FBSF610002TT TITANIUM CERVICAL SCREW( 免術前審查 ) 194 FBSF62225NDP TITANIUM VSP PLATE 適應症請見備註欄 1089 FBSF661202Y2 STAINLESS CERVICAL PLATE 28:72CM 3747 FBSF661302Y2 TITANIUM CERVICAL PLATE 28:72MM 4046 FBSF66131NY2 TITANIUM CERVICAL SCREW 17:24MM 194 FBSF6613NNY2 TITANIUM DYNAMIC CERVICAL FIXATION SYSTEM 194 FBSF6CPU16XA TITANIUM CERVICAL PLATE ( 免術前審查 ) 4046 FBSF6CPU20XA TITANIUM CERVICAL PLATE ( 免術前審查 ) 4046 FBSF6CSA35XA TITANIUM CERVICAL SCREW ( 免術前審查 ) 194 FBSF6CSB35XA TITANIUM CERVICAL SCREW ( 免術前審查 ) 194 FBSF6FF930AE STANLESS CASPAR OSTEOSYNTH CERVICAL PLATE 28:33MM LONG 3747 FBSF6FF934AE STANLESS CASPAR OSTEOSYNTH CERVICAL PLATE 37:46MM LONG 4098 FBSF6FF939AE STANLESS CASPAR OSTEOSYNTH.CERVICAL PLATE.48:54MM LONG 4273 FBSF6FF944AE STANLESS CASPAR OSTEOSYNTH CERVICAL PLATE 60MM LONG 4536 FBSF6FF946AE STANLESS CASPAR OSTEOSYNTH CERVICAL PLATE 66MM LONG 5128 FBSF6FF947AE STANLESS CASPAR OSTEOSYNTH CERVICAL PLATE 72MM LONG 5763 FBSF A MONT BLANC SPINAL HOOK SCREW SYSTEM(SX2+HX2+RX2) 免事前審 查 FBSF700027ZV VIMAX SPINAL HOOK SCREW SYSTEM(SX2+HX2+RX2) 免事前審查 FBSF7295NNS1 STANLESS STEEL HOOK SCREW SYSTEM(SCREWX2+HOOKX2+NUTX4+SPRINGX2) FBSF7804NHY2 BRIDGE SPINAL HOOK SCREW SYSTEM(HX2+SX4+NX2) 免事前審查 FBSF7SX25NAE TITANIUM SPINE EVOLUTION HOOK SYSTEM(SCREWX2+HOOKX2+NUTX2) FBSF8T1SFWCM TITANIUM CABLE SOFWIRE( 後頸椎固定軟鋼絲索 ) 適應症請見備 8000 註欄 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

232 特材代碼 中英文名稱 支付點數 -102/01 FBSFA00001RK TITANIUM INTERVERTEBRAL CAGE 椎間融合器 適應症請見備註欄 FBSFA00002RK TITANIUM INTERVERTEBRAL CAGE 椎間融合器 適應症請見備註欄 FBSFA00003RK PEEK LUMBAR INTERVERTEBRAL CAGE 高分子材料腰椎椎間融合器 ( 後開型 ) 適應症請見備註欄 FBSFA0001NS1 TRAVIOS IMPLANTS PEEK( 側開型每節椎體限置放 1 個 ) 適應症請 見備註欄 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 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 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 FBSFA22001XP II-TYPE INTERVERTEBRAL SPACER PEEK CAGE 錐頭式椎間填充塊 ( 後開型 ) 適應症請見備註欄 FBSFA22002XP II-TYPE INTERVERTEBRAL SPACER PEEK( 側開型每節椎體限置放 個 ) 適應症請見備註欄 FBSFA2740LB0 TITANIUM LUMBAR SPINAL CAGE 腰椎椎間融合器 適應症請見備 註欄 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 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 FBSFA3605LU0 "UNITED"EXPRESS LUMBAR CAGE SYSTEM(PLIF PEEK)" 聯合 " 快捷腰 椎融合器系統 ( 後開型 ) 適應症請見備註欄 FBSFA420MNM4 TELAMON FUSION DEVICE PEEK CAGE 泰拉蒙融合器 ( 後開型 ) 適 應症請見備註欄 FBSFA6720NS9 TITANIUM OIC CAGE SYSTEM 9:13MMX20:25MM 適應症請見備註 欄 FBSFA6730NS9 OIC CAGE SYSTEM-PEEK IMPLANTS 椎體護架系統 ( 後開型 ) 適應 症請見備註欄 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 FBSFA6741NS9 SOLIS CERVICAL CAGE SYSTEM 梭利斯椎頸護架系統 ( 頸椎 PEEK CAGE) 適應症請見備註欄 FBSFA6742NS9 "STRYKER" SOLIS AS PEEK SPACER " 史賽克 " 椎間融合器 ( 頸椎 ) 適應症請見備註欄 FBSFA6760NS9 OIC PL PEEK SPACER 椎間融合器 ( 後開型 ) 適應症請見備註欄 FBSFA706NNY2 FBSFA7074NY2 FBSFA7091NY2 FBSFA7092NY2 FBSFA82501Y2 TITANIUM VETEBRAL INTERBODY CAGE 高 9:14MM 長 20:24 適應症請見備註欄 TITANIUM VETEBRAE INTERBODY CAGE:ANTERIOR CERVICAL INTERBODY CAGE 鈦合金椎籠 : 前方頸椎間融合器 適應症請見備註欄 TITANIUM VETEBRAE INTERBODY CAGE 9:14MMX20:24MM 適應症請見備註欄 TITANIUM VETEBRAE INTERBODY CAGE 9:14MMX20:24MM 適應症請見備註欄 "SYNTEC"PEEK VERTEBRAE INTERBODY CAGE" 亞太醫療 " 春菊聚醚醚酮椎籠 ( 腰椎後開型 ) 適應症請見備註欄

233 FBSFA82526Y2 "SYNTEC"BARNANA PEEK TLIF VERTEBRA INTERBODY CAGE" 亞太醫 療 " 巴拿馬腰椎椎間融合器 ( 側開型每節椎體限置放 1 個 ) 適應症請見備註欄 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 FBSFA8984NS1 PLIVIOS IMPLANTS PEEK CAGE 腰椎椎間融合器 ( 後開型 ) 適應症 請見備註欄 FBSFA8992NS1 CERVIOS IMPLANTS WEDGE-SHAPED PEEK CAGE 頸椎椎間融合器 適應症請見備註欄 FBSFA8993NS1 CERVIOS IMPLANTS CURVED PEEK CAGE 頸椎椎間融合器 適應症 請見備註欄 FBSFA908MNM4 TELAMON FUSION DEVICE 適應症請見備註欄 FBSFA919MNM4 VERTE-STACK CRESCENT VERTEBRAL BODY SPACER:TLIF PEEK SPACER( 側開型每節椎體限置放 1 個 ) 適應症請見備註欄 FBSFA939MNM4 "MEDTRONIC"CRESCENT SPINAL SYSTEM:SPACER(PEEK)" 美敦力 " 克 里森脊椎系統 : 椎體護架 ( 側開型每個椎體限置放 1 個 ) 適應症請見備註欄 FBSFA9501NS1 TITANIUM CONTACT FUSION CAGE 9:15MM X8:11MM 適應症請見備 註欄 FBSFAALS01AQ TITANIUM LUMBAR DISC SPACER 適應症請見備註欄 FBSFAALS01TT TITANIUM LUMBAR DISC SPACER 適應症請見備註欄 FBSFAALS02AQ TITANIUM VIGOR CERVICAL DISC SPACER 適應症請見備註欄 FBSFAAP002AQ "A-SPINE"POLYMER LUMBAR DISC SPACER(PEEK)" 冠亞 " 高分子複合 材料腰椎椎間融合器 ( 後開型 )* 適應症請見備註欄 FBSFAAP003AQ "A-SPINE"VIGOR PEEK CERVICAL DISC SPACER" 冠亞 " 偉戈高分子 複合材料頸椎椎間融合器 * 適應症請見備註欄 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 FBSFAC000NZ1 "ZIMMER SPINE"FIDJI CERVICAL CAGES (PEEK)" 捷邁 " 頸椎椎間融 合器 給付規定請見備註欄 FBSFAC001NZ1 "ZIMMER SPINAL"FIDJI CERVICAL CAGES(PEEK)" 捷邁 " 頸椎椎間融 合器 適應症請見備註欄 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 FBSFACA11NXA TITANIUM VERTEBRAL FUSION CAGE 20:24MMX8:15MM 適應症請見 備註欄 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 FBSFACCAGE1A "SPINEWAY" AYERS ROCK CERVICAL CAGES"(PEEK) 施百威 " 頸椎融 合器 適應症請見備註欄 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 FBSFACE11NXA CERVICAL CAGE 頸椎椎間融合器 ( 頸椎 PEEK CAGE) 適應症請見備 註欄 FBSFACG11NXA TITANIUM CERVICAL CAGE 鈦合金頸椎椎間融合器 適應症請見備 註欄 FBSFACG15NZ6 TITANIUM SPINAL SPACER 5:11MMX7:13MM 適應症請見備註欄 FBSFACH11NXA TITANIUM CERVICAL CAGE 鈦合金頸椎椎間融合器 適應症請見備 註欄 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

234 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 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 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 FBSFAFJ00NAE "AESCULAP"TSPACE PEEK TLIF SYSTEM " 雅氏 " 樹脂椎間盤支撐架 植入物 ( 側開型, 每節椎體置放 1 個 ) 適應症請見備註欄 FBSFAJUL0L1C "SPINEART"JULIET OL LUMBAR CAGE(PEEK)" 司佰特 " 茱麗葉腰椎融 合器 ( 側開型每節椎體限置放 1 個 ) 適應症請見備註欄 FBSFAJULPL1C SPINEART JULIET LUMBAR CAGE(PLIF)" 司佰特 " 腰椎融合器 適應 症請見備註欄 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 FBSFALCAGEZV GOALIE LUMBAR INTERVERTEBRAL CAGE 適應症請見備註欄 FBSFAPCAGEZV VITAL PEEK LUMBAR INTERVERTEBRAL CAGE 威拓高分子材料腰椎 椎間融合器 ( 後開型 ) 適應症請見備註欄 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 FBSFAPCG01V2 "INTAI"INTERBODY FUSION SYSTEM(CERVICAL PEEK CAGE)" 鐿鈦 " 高分子複合椎間融合器 ( 頸椎椎籠 ) 適應症請見備註欄 FBSFAPCG01WG "WILTROM"INTERBODY FUSION SYSTEM:CERVICAL PEEK CAGE" 威創 " 高分子複合椎間融合器系統 : 頸椎椎籠 適應症請見備註欄 FBSFAPLCNNJZ "JO"PEEK LUMBAR CAGE " 傑奎 " 高分子腰椎椎間融合器 ( 後開型 ) 適應症請見備註欄 FBSFAPPG00V2 "INTAI"INTERBODY FUSION SYSTEM(PLIF PEEK CAGE)" 鐿鈦 " 高分 子複合椎間融合器 ( 胸腰椎椎籠 ) 適應症請見備註欄 FBSFAPPG01WG "WILTROM"INTERBODY FUSION SYSTEM:PLIF PEEK CAGE" 威創 " 高分 子複合椎間融合器系統 : 胸腰椎椎籠 適應症請見備註欄 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 FBSFAPTG01WG "WILTROM"INTERBODY FUSION SYSTEM:TLIF PEEK CAGE" 威創 " 高分 子複合椎間融合器系統 ( 側開型腰椎椎籠, 每節椎體限置放 1 個 ) 給付規定請見備註欄 FBSFASAMRY1S "SCIENT'X"ANTERIOR CAGE SAMARYS(PEEK) " 賽恩司 " 莎美莉前路 頸椎融合器 適應症請見備註欄 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 FBSFATCAGEZV VITAL PEEK LUMBAR INTERVERTEBRAL CAGE( 側開型每節椎體限置 放 1 個 ) 適應症請見備註欄 FBSFATPG00V2 "INTAI"INTERBODY FUSION SYSTEM(TLIF PEEK)" 鐿鈦 " 高分子複合椎間融合系統 ( 側開型每節椎體置放 1 個 ) 適應症請見備註欄 FBSFATPG04V2 FBSFATPG08V2 "INTAI"INTERBODY FUSION SYSTEM(TLIF PEEK)" 鐿鈦 " 高分子複合椎間融合系統 ( 側開型每節椎體置放 1 個 ) 適應症請見備註欄 "INTAI"INTERBODY FUSION SYSTEM(TLIF PEEK)" 鐿鈦 " 高分子複合椎間融合系統 ( 側開型每節椎體置放 1 個 ) 適應症請見備註欄 FBSFATRYKC1C SPINEART CERVICAL IMPLANTS(PEEK) 司佰特頸椎椎間植入物 適應症請見備註欄

235 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 FBSFAWS16CB0 CERVICAL CAGE(PEEK) 頸椎椎間融合器 適應症請見備註欄 FBSFAWS41LB0 LUMBAR SPINAL CAGE PEEK CAGE 腰椎椎間融合器 ( 後開型 ) 適應 症請見備註欄 FBSFC014XNS1 "SYNTHES"VECTRA SYSTEM(P*1+S*4)" 信迪思 " 頸椎固定系統 ( 二節 ) 適應症請見備註欄 FBSFC10002U0 "UNITED"SLIMFIT ANTERIOR CERVICAL PLATE SYSTEM (P*1+S*4)" 聯合 " 史令飛頸前路骨板系統二節 適應症請見備註欄 FBSFC10003U0 "UNITED"SLIMFIT ANTERIOR CERVICAL PLATE SYSTEM (P*1+S*6)" 聯合 " 史令飛頸前路骨板系統三節 適應症請見備註欄 FBSFC10030AD TITANIUM PEAK ANTERIOR CERVICAL SCREW( 型號含 :13026) 適應症請見備註欄 FBSFC10108AD TITANIUM SLIM-LOC ANTERIOR CERVICAL SCREW 適應症請見備註欄 FBSFC128XNS1 "SYNTHES"VECTRA SYSTEM(P*1+S*6)" 信迪思 " 頸椎固定系統 ( 三節 ) 適應症請見備註欄 FBSFC1742SDP TITANIUM PEAK ANTERIOR CERVICAL PLATE 二節 適應症請見備註欄 FBSFC1743SDP TITANIUM PEAK ANTERIOR CERVICAL PLATE 三節 適應症請見備註欄 FBSFC1792SDP TITANIUM SLIM-LOC ANTERIOR CERVICAL PLATE 二節 適應症請見備註欄 FBSFC1793SDP TITANIUM SLIM-LOC ANTERIOR CERVICAL PLATE 三節 適應症請見備註欄 FBSFC20002U0 "UNITED"BOOSTER ANTERIOR CERVICAL PLATE SYSTEM (P*1+S*4) " 聯合 " 普斯特頸前路骨板系統二節 適應症請見備註欄 FBSFC20003U0 "UNITED"BOOSTER ANTERIOR CERVICAL PLATE SYSTEM (P*1+S*6) " 聯合 " 普斯特頸前路骨板系統三節 適應症請見備註欄 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 FBSFC27551B0 TITANIUM CERVICAL SPINAL SYSTEM(PX1+SX4) 適應症請見備註 欄 FBSFC27553B0 TITANIUM CERVICAL SPINAL SYSTEM(PX1+SX6) 適應症請見備註 欄 FBSFC27555B0 TITANIUM CERVICAL SCREW 適應症請見備註欄 1125 FBSFC27556B0 TITANIUM CERVICAL PLATE 24:90MM( 免術前審查 ) 4046 FBSFC27557B0 TITANIUM CERVICAL SCREW( 免術前審查 ) 194 FBSFC2869NS9 "STRYKER"REFLEX HYBRID ANTERIOR CERVICAL PLATE:SYSTEM(PX1+SX4) " 史賽克 " 芮菲斯前置頸椎骨板系統 : 二節 適應症請見備註欄 FBSFC2Z86NS9 REFLEX ZERO PROFILE ANTERIOR CERVICAL PLATING SYSTEM 二節 (PLATE X1+SCREW X 4) 適應症請見備註欄 FBSFC3400NZ1 TRINICA AND TRINICA SELECT ANTERIOR CERVICAL PLATE SYSTEM 二節 (PX1+SX4) 適應症請見備註欄 FBSFC3401NZ1 TRINICA AND TRINICA SELECT ANTERIOR CERVICAL PLATE SYSTEM 三節 (PX1+SX6) 適應症請見備註欄 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

236 FBSFC3869NS9 "STRYKER"REFLEX HYBRID ANTERIOR CERVICAL PLATE:SYSTEM(PX1+SX6) " 史賽克 " 芮菲斯前置頸椎骨板系統 : 三節 適應症請見備註欄 FBSFC3Z86NS9 REFLEX ZERO PROFILE ANTERIOR CERVICAL PLATING SYSTEM 三節 (PLATE X1+SCREW X 6) 適應症請見備註欄 FBSFC4020NS9 REFLEX HYBRID ANTERIOR CERVICAL SCREW 芮菲斯前置頸椎骨釘 1125 適應症請見備註欄 FBSFC4030NS9 RELFEX ZERO PROFILE ANTERIOR CERVICAL SCREW 適應症請見備 1125 註欄 FBSFC450XNS1 CERVICAL SPINE SOLID EXPANSION HEAD SCREW 4.0/4.35MM 擴張 1125 頭實心骨釘 適應症請見備註欄 FBSFC4869NS9 "STRYKER"REFLEX HYBRID ANTERIOR CERVICAL PLATE:SCREW " 史 1125 賽克 " 芮菲斯前置頸椎骨板系統 : 骨釘 適應症請見備註欄 FBSFC4871NS1 TITANIUM CERVICAL SPINE LOCKING PLATE SYSTEM 二節 適應症 請見備註欄 FBSFC487XNS1 TITANIUM CERVICAL SPINE LOCKING PLATE SYSTEM 三節 適應症 請見備註欄 FBSFC6113NY2 TITANIUM CERVICAL SPINE SCREW 適應症請見備註欄 1125 FBSFC612XNS1 "SYNTHES"VECTRA SYSTEM:CERVICAL SPINE SCREW" 信迪思 " 頸椎固定系統 : 多角度動態自攻牙頸椎骨螺釘 適應症請見備註欄 1125 FBSFC8340NY2 TITANIUM CERVICAL PLATE FIXATION SYSTEM 三節 (PX1+SX6) 適應症請見備註欄 FBSFC834NNY2 TITANIUM CERVICAL PLATE FIXATION SYSTEM 二節 (PX1+SX4) 適應症請見備註欄 FBSFC835NNY2 TITANIUM CERVICAL BONE LOCKING SCREW 適應症請見備註欄 1125 FBSFC8792NM4 ZEPHIR ANTERIOR CERVICAL SCREW 適應症請見備註欄 1125 FBSFC879N2M4 ZEPHIR ANTERIOR CERVICAL SYSTEM 二節 (SX4+PX1) 適應症請 見備註欄 FBSFC879N3M4 ZEPHIR ANTERIOR CERVICAL SYSTEM 三節 (SX6+PX1) 適應症請 見備註欄 FBSFCASC01AQ TITANIUM CERVICAL PLATE SYSTEM 二節 (PX1+SX4) 適應症請見備 註欄 FBSFCASC02AQ TITANIUM CERVICAL PLATE SYSTEM 三節 (PX1+SX6) 適應症請見備 註欄 FBSFCASC03AQ TITANIUM WINLOC CERVICAL PLATE SYSTEM 二節 (PX1+SX4) 適應 症請見備註欄 FBSFCASC04AQ TITANIUM WINLOC CERVICAL PLATE SYSTEM 三節 (PX1+SX6) 適應 症請見備註欄 FBSFCASCS1AQ TITANIUM CERVICAL SCREW 適應症請見備註欄 1125 FBSFCASCS2AQ TITANIUM CERVICAL SCREW 適應症請見備註欄 1125 FBSFCASP01AQ TITANIUM CERVICAL PLATE ( 免事前審查 ) 4046 FBSFCASS02AQ TITANIUM CERVICAL SCREW( 免事前審查 ) 194 FBSFCB0003RK TITANIUM CERVICAL SCREW 免事前審查 194 FBSFCB0004RK TITANIUM CERVICAL PLATE 免事前審查 4046 FBSFCBA001RK TITANIUM CERVICAL PLATE SYSTEM (PX1+SX4) 二節 適應症請 見備註欄 FBSFCBA002RK TITANIUM CERVICAL PLATE SYSTEM (PX1+SX6) 三節 適應症請見 備註欄 FBSFCBA003RK TITANIUM CERVICAL SCREW 適應症請見備註欄 1125 FBSFCCPCN2XA TITANIUM CERVICAL PLATE SYSTEM(PX1+SX4) 二節 適應症請見備註欄

237 FBSFCCPCN3XA TITANIUM CERVICAL PLATE SYSTEM(PX1+SX6) 三節 適應症請見 備註欄 FBSFCCSC35XA TITANIUM CERVICAL SCREW 適應症請見備註欄 1125 FBSFCCSD35XA TITANIUM CERVICAL SCREW 適應症請見備註欄 1125 FBSFCCSF12Y2 TITANIUM CERVICAL SPINE FIXATION SYSTEM 二節 (PX1+SX4) 適 應症請見備註欄 FBSFCCSF13Y2 TITANIUM CERVICAL SPINEFIXATION SYSTEM 三節 (PX1+SX6) 適 應症請見備註欄 FBSFCFG2XNAE TITANIUM CASPAR CERVICAL SYSTEM 二節 (PLATEX1+SCREWX4) 適 應症請見備註欄, 須事前審查 FBSFCFG3XNAE TITANIUM CASPAR CERVICAL SYSTEM 三節 (PLATEX1+SCREWX6) 適 應症請見備註欄, 須事前審查 FBSFCFG4XNAE CASPAR EVOLUTION CERVICAL SYSTEM( 型號含 LA017T:028T) 二節 (PLATEX1+SCREWX4) 適應症請見備註欄 FBSFCFG4XXAE CASPAR EVOLUTION CERVICAL SYSTEM ANTERIOR( 型號含 LA017T:028T) 三節 (PX1+SX6) 適應症請見備註欄 FBSFCFJ700AE TITANIUM ABC ANTERIOR CERVICAL PLATING SYSTEM(PX1+SX4) 適應症請見備註欄 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 FBSFCFJ790AE ABC TITANIUM CERVICAL SCREW 適應症請見備註欄 1125 FBSFCFJ800AE TITANIUM ABC ANTERIOR CERVICAL PLATING SYSTEM(PX1+SX6) 適應症請見備註欄 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 FBSFCFJ900AE "AESCULAP" ABC CERVICAL SCREW" 雅氏 " 前方頸椎骨釘 適應症請 1125 見備註欄 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 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 FBSFCS3102U0 "UNITED"SLIMFIT ANTERIOR CERVICAL PLATE SYSTEM:SCREW " 聯 1125 合 " 史令飛頸前路骨板系統 : 自攻螺絲 適應症請見備註欄 FBSFCS3104U0 "UNITED"BOOSTER ANTERIOR CERVICAL PLATE SYSTEM:SCREW " 聯 1125 合 " 普斯特頸前路骨板系統 : 骨螺絲 適應症請見備註欄 FBSFCSCREW1A SPINE WAY BLUE MOUNTAIN CERVICAL SYSTEM:SCREW 施百威藍山頸 1125 椎固定系統 適應症請見備註欄 FBSFCTRYC21C SPINEART CERVICAL IMPLANTS 二節 (PX1+SX4) 司佰特頸椎間植入 物 適應症請見備註欄 FBSFCTRYC31C SPINEART CERVICAL IMPLANTS 三節 (PX1+SX6) 司佰特頸椎間植入 物 適應症請見備註欄 FBSFCTRYCS1C SPINEART CERVICAL IMPLANTS:SCREW 司佰特頸椎間植入物 : 骨釘 1125 適應症請見備註欄 FBSFR9701LS1 "SYNTHES"VEPTR RIB TO LUMBAR LAMINA(CRS*1+L*3+EB*1+ER*1+H*1+FR*1)" 信迪思 " 延展式肋骨支撐架 : 肋骨至板狀腰椎組合 適應症請見備註欄 FBSFR9702LS1 "SYNTHES"VEPTR:RIB TO ILIUM(CRS*1+CHR*1+DL*3+EB*1+LER*1+AH*1+EC*1+FR*1)" 信迪思 " 延展式肋骨支撐架 : 肋骨至髂骨組合 適應症請見備註欄 FBSFR9703LS1 "SYNTHES"VEPTR:RIB TO RIB(CRS*1+CRS*1+CHR*2+DL*4+EB*1+FR*1)" 信迪思 " 延展式肋骨支撐架 : 肋骨至肋骨組合 適應症請見備註欄

238 FBSFR9704LS1 "SYNTHES"VEPTR:DISTRACTION LOCKS" 信迪思 " 延展式肋骨支撐架 : 延展用鎖 適應症請見備註欄 ( 整組使用者不得申報, 只適用於組件單獨使用者申報 ) FBSFR97057S1 "SYNTHES"VEPTR:CRANIAL RIB SUPPORT " 信迪思 " 延展式助骨支撐架 ( 頭位肋骨支架 ) 適應症請見備註欄 ( 整組使用者不得申報, 只適用於組件單獨使用者申報 ) FBSFR97065S1 "SYNTHES"VEPTR:CAUDAL RIB SUPPORT" 信迪思 " 延展式助骨支撐架 : 尾位直式肋骨支架 適應症請見備註欄 ( 整組使用者不得申報, 只適用於組件單獨使用者申報 ) FBSFR97103S1 "SYNTHES"VEPTR:EXTENSION BAR" 信迪思 " 延展橫槓 適應症請見備註欄 ( 整組使用者不得申報, 只適用於組件單獨使用者申報 ) FBSFR97126S1 "SYNTHES"VEPTR:CLOSING HALF-RING FOR RIB SUPPORT" 信迪思 " 閉鎖半圓環 適應症請見備註欄 ( 整組使用者不得申報, 只適用於組件單獨使用者申報 ) FBSFR97127S1 "SYNTHES"VEPTR:ROD" 信迪思 " 橫槓 適應症請見備註欄 ( 整組使用者不得申報, 只適用於組件單獨使用者申報 ) FBSFR97131S1 "SYNTHES"VEPTR:LUMBAR EXTENSION ROD" 信迪思 " 板狀腰椎延展橫槓 適應症請見備註欄 ( 整組使用者不得申報, 只適用於組件單獨使用者申報 ) FBSFR97167S1 "SYNTHES"VEPTR:EXTENSION CONNECTOR" 信迪思 " 延展連接器 適應症請見備註欄 ( 整組使用者不得申報, 只適用於組件單獨使用者申報 ) FBSFR97257S1 "SYNTHES"VEPTR:ALA HOOK " 信迪思 " 薦骨翼鉤 適應症請見備註欄 ( 整組使用者不得申報, 只適用於組件單獨使用者申報 ) FBSFR97261S1 "SYNTHES"VEPTR:LAMINIA HOOK " 信迪思 " 板狀椎弓鉤 適應症請見備註欄 ( 整組使用者不得申報, 只適用於組件單獨使用者申報 ) FBSFR98910S1 "SYNTHES"VEPTR:FIXATION RING FOR RODS" 信迪思 " 橫槓固定環 適應症請見備註欄 ( 整組使用者不得申報, 只適用於組件單獨使用者申報 ) 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 FBT01020MSHE SUPLASYN STERILE SODIUM HYALURONATE SOLUTION(2ML/ 注射筒裝 ) 每次療程注射三次 適應症請見備註欄 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 FBT01025MLN0 "NISSIN"LUMISTERON DISPO (2.5ML/SYRINGE)" 日新 " 倍利骨關節腔注射劑 ( 每次療程注射五次 ) 適應症請見備註欄 FBT01025MLR7 ARTZ/ARTZDISPO 雅節關節內注射劑 ( 每次療程注射五次 ) 適應症請見備註欄 FBT01025MLU5 UNIHYLON DISPO 2.5ML W/SYRINGE( 每次療程注射五次 ) 適應症請見備註欄 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 FBT01AA25CLB ARTIAID INTRA-ARTICULAR INJECTION( 每次療程注射 5 次 ) 適應症請見備註欄 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 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 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

239 FBT01HY002FD HYALGAN INTRA-ARTICULAR INJECTOR WITHOUT/SYRINGE( 自 97 年 月 1 日起改每次療程注射 3 次 ) 適應症請見備註欄 FBT01HYRANLJ HYRUAN PLUS INJ. 瀚樂骨關節腔注射液, 每次療程注射三次 適應 1099 症請見備註欄 FBT01N25MLR7 ARTZ/ARTZDISPO 2.5ML 25MG WITHOUT SYRINGE( 每次療程注射五 655 次 ) 適應症請見備註欄 FBT01SA25CLB SYNOAID INTRA-ARTICULAR INJECTION 欣節益關節內注射劑 適應 659 症請見備註欄 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 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 FBUF11001NW2 UNICOMPARTMENTAL KNEE FEMORAL COMPONENT 適應症請見備註欄 FBUF110277DP PRESERVATION UNICOMPARTMENTAL KNEE FEMORAL COMPONENT 適 應症請見備註欄 FBUF15842NZ1 UNICOMPARTMENTAL HIGH-FLEX FEMORAL COMPONENT 適應症請見 備註欄 FBUF16636NH1 UNICOMPARTMENTAL KNEE FEMORAL 適應症請見備註欄 FBUF172500SN UNICOMPARMENTAL KNEE FEMORAL 適應症請見備註欄 FBUF19671NJJ PFC SIGMA UNICOMPARTMENTAL FEMORAL COMPONENT 人工半膝關節 股骨元件 適應症請見備註欄 FBUL15842NZ1 UNICOMPARTMENTAL HIGH-FLEX ARTICULAR SURFACE 適應症請見 7277 備註欄 FBUL171248SN UNICOMPARMENTAL KNEE TIBIAL INSERT 適應症請見備註欄 7277 FBUL19672NJJ PFC SIGMA(PFC)UNICOMPARTMENTAL TIBIAL INSERT COMPONENT 半 7277 膝關節襯墊 適應症請見備註欄 FBUT11002NW2 UNICOMPARTMENTAL KNEE TIBIAL+INSERT COMPONENT 適應症請見 備註欄 FBUT110277DP PRESERVATION UNICOMPARTMENTAL KNEE TIBIAL+INSERT COMPONENT 適應症請見備註欄 FBUT15842NZ1 UNICOMPARTMENTAL HIGH-FLEX PRECOAT TIBIAL PLATE 適應症請 見備註欄 FBUT16636NH1 UNICOMPARTMENTAL KNEE TIBIAL+INSERT 適應症請見備註欄 FBUT171242SN UNICOMPARMENTAL KNEE ALL-POLY TIBIAL+INSERT 適應症請見備 註欄 FBUT172610SN UNICOMPARMENTAL KNEE TIBIAL BASES 適應症請見備註欄 FBUT19670NJJ PFC SIGMA(PFC)UNICOMPARTMENTAL TIBIAL TRAY COMPONENT 半膝 關節脛骨元件 適應症請見備註欄 FBUT25842NZ1 UNICOMPARTMENTAL HIGH-FLEX ALL POLYETHYLENE TIBIAL BASEPLATE(TIBIAL+SURFACE) 適應症請見備註欄 FEP XT WIRE PISTON 2811 FEP XT WIRE PISTON 2811 FEP XT FISCH TEF-WIRE PISTON 1365 FEP XT MCGEE MODIFIED LOOP PISTON 1250 FEP XT MCGEE MODIFIED LOOP PISTON 1250 FEP XT MCGEE MODIFIED LOOP PISTON 1250 FES XT FISCH SPANDER II TOTAL WITH FOOTPLATE SHOE 全聽 2742 FES XT AUSTIN MODIFIED TOTAL OSSICULAR REPLACEMENT 2742 FES GS MICRON ALL TITANIUM TORP 全鈦全人工聽小骨置換物 2742 FES XT AUSTIN MODIFIED PARTIAL OSSICULAR REPLACEMENT 3500 FES XT AUSTIN MODIFIED PARTIAL OSSICULAR REPLACEMENT

240 FES GS 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 FHFCD07298M4 " 美敦力 " 因信可植入式去纖維顫動器 * 適應症請見備註欄 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 FHFCD32454ST FHFCD354TMM4 FHFCDAHF37ST FHFCDC174AM4 FHFCDCD321ST FHFCDCD323ST FHFCDCD40QST FHFCDCDPLSST FHFCDCRT19GU FHFCDD214MM4 FHFCDD234TM4 FHFCDD284TM4 FHFCDD354TM4 FHFCDD364TM4 FHFCDDRF32ST FHFCDLUMHFBK FHFCDP1068SB 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 "MEDTRONIC"PROTECTA XT CRT-D IMPLANTABLE CARDIOVERTER DEFIBRILLATOR" 美敦力 " 博特多艾緹植入式心臟去顫器 * 適應症請見備註欄 " 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 " 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 " 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 " 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 " 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 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 " 佳騰 " 康達克心臟再同步治療用去顫器 "GUIDANT"CONTAK RENEWAL 4&4 HE CARDIAC RESYNCHRONIZATION THERAPY* 適應症請見備註欄 " 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 " 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 " 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 " 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 " 美敦力 " 博特多植入式心臟去顫器 "MEDTRONIC" PROTECTA CRT-D IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 " 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 拜耳德尼克 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 " 波士頓科技 " 康格斯心臟再同步治療用去顫器 "BOSTON SCIENTIFIC" COGNIS 100 HE CRT-D* 適應症請見備註欄

241 FHFCDSYN72M4 因信可植入式去纖維顫動器 MEDTRONIC INSYNC ICD * 適應症 請見備註欄 FHG110304NGX STRAIGHT VASCULAR PROSTHESIS 3MM,4MM,5MM,6MM,7MM,8MM,10MM CM FHG110307NGX STRAIGHT VASCULAR PROSTHESIS 3MM,4MM,5MM,6MM,7MM,8MM,10MM CM FHG MP STRAIGHT GRAFT 4MM 10CM 3363 FHG110401CMP CARBOFLO GRAFT,STRAIGHT,10CM 卡邦人工血管 3363 FHG MP STRAIGHT GRAFT 4MM 40CM FHG110404CMP CARBOFLO GRAFT,STRAIGHT,40CM 卡邦人工血管 FHG110405CMP CARBOFLO GRAFT,STRAIGHT,50CM 卡邦人工血管 FHG110503NGX GORE-TEX VASCULAR GRAFTS 5MM,6MM,8MMX30CM 8714 FHG MP STRAIGHT GRAFT 5MM 40CM FHG MP STRAIGHT GRAFT 6,8MM 20CM 6279 FHG QM " 邁柯唯 " 人工血管 "MAQUET"EXXCEL SOFT EPTFE VASCULAR 6279 GRAFT(STANDARD WALL STRAIGHT4-8MM*20CM FHG SB EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT ,6,8MMX20CM 型號 ,28 自 生效 FHG110602CMP CARBOFLO GRAFT,STRAIGHT,20CM 卡邦人工血管 6279 FHG110603CMP CARBOFLO GRAFT,STRAIGHT,30CM 卡邦人工血管 8714 FHG MP STRAIGHT GRAFT 6MM 40CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT MM*40CM FHG SB EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT 4:8MMX40CM 型號 ,47,48 自 生效 FHG MP STRAIGHT GRAFT 6MM 50CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT MM*50CM FHG SB EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT 4:8MMX50CM 型號 ,57,58 自 生效 FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL STRAIGHT 6MM*60CM FHG SB EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT 6MMX60CM 型 號 自 生效 FHG MP STRAIGHT GRAFT 6MM 70CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL STRAIGHT 4-8MM*70CM FHG SB EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT 4:8MMX70CM 型號 ,77,78 自 生效 FHG110607CMP CARBOFLO GRAFT,STRAIGHT,70CM 卡邦人工血管 FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL STRAIGHT 4-8MM*80CM FHG SB EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT ,5,6,8MMX80CM 型號 ,88 自 生效 FHG110608CMP CARBOFLO GRAFT,STRAIGHT,80CM 卡邦人工血管 FHG SB EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT 6MMX90CM FHG1106S10TM FHG1106S20TM FHG1106S30TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES STRAIGHT GRAFT 10CM*6,7,8,10MM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES STRAIGHT GRAFT 20CM*6,7,8,10MM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES STRAIGHT GRAFT 30CM*6,7,8,10MM

242 FHG1106S40TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES STRAIGHT GRAFT 40CM*6,7,8,10MM FHG1106S50TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES STRAIGHT GRAFT 50CM*6,7,8,10MM FHG1106S60TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES STRAIGHT GRAFT 60CM*6,7,8,10MM FHG1106S70TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES STRAIGHT GRAFT 70CM*6,7,8,10MM FHG1106S80TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES STRAIGHT GRAFT 80CM*6,7,8,10MM FHG MP STRAIGHT GRAFT 7MM 40CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCEL SOFT EPTFE VASCULAR GRAFT MM*40CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL STRAIGHT 5-8MM*50CM FHG AH " 亞翠恩 " 艾德凡達聚四氟乙烯人工血管 "ATRIUM" ADVANTA PTFE 3363 VASCULAR GRAFTS STANDARD WALL-STRAIGHT,6MM 10CM FHG1130S06BA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR 8714 GRAFT(STRAIGHT 6MM*30CM) FHG1140S08BA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR GRAFT(STRAIGHT 3.5,8,10MM*40CM) FHG11D5008BA " 巴德 " 迪斯塔人工血管 "BARD"DISTAFLO BYPASS GRAFTS 50CM FHG11D500CBA " 巴德 " 迪斯塔人工血管 "BARD" DISTAFLO BYPASS GRAFTS FHG11D6008BA " 巴德 " 迪斯塔人工血管 "BARD"DISTAFLO BYPASS GRAFTS 60CM FHG11D600CBA " 巴德 " 迪斯塔人工血管 "BARD" DISTAFLO BYPASS GRAFTS 60CM FHG11D7008BA " 巴德 " 迪斯塔人工血管 "BARD"DISTAFLO BYPASS GRAFTS 70CM FHG11D700CBA " 巴德 " 迪斯塔人工血管 "BARD" DISTAFLO BYPASS GRAFTS 70CM FHG11D8008BA " 巴德 " 迪斯塔人工血管 "BARD"DISTAFLO BYPASS GRAFTS 80CM FHG11D800CBA " 巴德 " 迪斯塔人工血管 "BARD" DISTAFLO BYPASS GRAFTS 80CM FHG11V106CMP VENAFLO GRAFT,STRAIGHT,10CM 維那人工血管 3363 FHG11V206CMP VENAFLO GRAFT,STRAIGHT,20CM 維那人工血管 6279 FHG11V306CMP VENAFLO GRAFT,STRAIGHT,30CM 維那人工血管 8714 FHG11V406CMP VENAFLO GRAFT,STRAIGHT,40CM 維那人工血管 FHG11V506CMP VENAFLO GRAFT,STRAIGHT,50CM 維那人工血管 FHG11VL100MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS-STRAIGHT 3363 GRAFT(6,7MM,10CM) 維那人工血管直式 FHG11VL200MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS-STRAIGHT 6279 GRAFT(6,7MM,20CM) 維那人工血管直式 FHG11VL300MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS-STRAIGHT 8714 GRAFT(6,7MM,30CM) 維那人工血管直式 FHG11VL400MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS-STRAIGHT GRAFT(6,7MM,40CM) 維那人工血管直式 FHG11VL500MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS-STRAIGHT GRAFT(6,7MM,50CM) 維那人工血管直式 FHG120304NGX THIN WALLED VASCULAR GRAFT 3MM,4MM,5MM,6MM,7MM,8MM,10MM CM FHG120307NGX THIN WALLED VASCULAR GRAFT 3MM,4MM,5MM,6MM,7MM,8MM,10MM CM FHG120401TMP CARBOFLO GRAFT,STRAIGHT THINWALL,10CM 卡邦人工血管 3363 FHG120405TMP CARBOFLO GRAFT,STRAIGHT THINWALL,50CM 卡邦人工血管 FHG120407TMP CARBOFLO GRAFT,STRAIGHT THINWALL,70CM 卡邦人工血管 FHG120508TMP CARBOFLO GRAFT,STRAIGHT THINWALL,80CM 卡邦人工血管

243 FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR 6279 GRAFT(THIN WALL STRAIGHT 6-8MM*20CM FHG SB EXXCEL SOFT EPTFE VASCULAR THIN WALL GRAFT 6,8MMX20CM 型 6279 號 ,28 自 生效 FHG120602TMP CARBOFLO GRAFT,STRAIGHT THINWALL,20CM 卡邦人工血管 6279 FHG120603TMP CARBOFLO GRAFT,STRAIGHT THINWALL,30CM 卡邦人工血管 8714 FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT 6-10MM*40CM FHG SB EXXCEL SOFT EPTFE VASCULAR THIN WALL GRAFT 6,8,10MMX40CM 型號 ,48,41 自 生效 FHG120604TMP CARBOFLO GRAFT,STRAIGHT THINWALL,40CM 卡邦人工血管 FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT 6-10MM*50CM FHG SB EXXCEL SOFT EPTFE VASCULAR THIN WALL GRAFT 6,8,10MMX50CM 型號 ,51 自 生效 FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT 6MM*60CM FHG SB EXXCEL SOFT EPTFE VASCULAR THIN WALL GRAFT 6MMX60CM 型號 自 生效 FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT 5-10MM*70CM FHG SB EXXCEL SOFT EPTFE VASCULAR THIN WALL GRAFT ,5,6,7,8,10MMX70CM FHG TM "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELSOFT PLUS EXTERNALLY REINFORCED STRAIGHT GRAFTS6:10MM 75CM FHG TM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELSEAL EXTERNALLY REINFORCEED STRAIGHT 6:10MM 75CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT 5-10MM*80CM FHG SB EXXCEL SOFT EPTFE VASCULAR THIN WALL GRAFT ,5,6,7,8,10MMX80CM 型號 :88,81 自 生效 FHG SB EXXCEL SOFT EPTFE VASCULAR THIN WALL GRAFT 6MMX90CM FHG AH " 亞翠恩 " 艾德凡達聚四氟乙烯人工血管 "ATRIUM" ADVANTA PTFE VASCULAR GRAFTS THIN WALL-STRAIGHT,6MM 7MM 8MM *70CM FHG1230STWBA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR 8714 GRAFT(STRAIGHT THINWALL 6MM*30CM) FHG1240STWBA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR GRAFT(STRAIGHT THINWALL 3,6,8MM*40CM) FHG12F0470MP P.T.F.E FLEX GRAFT 4:10MM 70CM FHG12F0650MP FLEX GRAFT 6:10MM 50CM FHG12F0660MP FLEX GRAFT 6:10MM 60CM FHG12F0680MP FLEX GRAFT 6:10MM 80CM FHG130504NGX STANDARD STREATCH GRAFT 5MM,6MM,7MM,8MM,10MM 40CM FHG130507NGX STANDARD STRETCH GRAFT 5MM,6MM,7MM,8MM 70CM FHG AH " 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) FHG AH " 亞翠恩 " 艾德凡達聚四氟乙烯人工血管 "ATRIUM" ADVANTA PTFE VASCULAR GRAFTS(STANDARD 4-8MM;10MM*50CM) FHG AH " 亞翠恩 " 艾德凡達聚四氟乙烯人工血管 "ATRIUM" ADVANTA PTFE VASCULAR GRAFTS(STANDARD 4:8MM,10MM 70CM)

244 FHG AH " 亞翠恩 " 艾德凡達聚四氟乙烯人工血管 "ATRIUM" ADVANTA PTFE VASCULAR GRAFTS(STANDARD 6MM*60CM) FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL STRAIGHT EXTERNALLY SUPPORTED 6-8MM*70CM*20-50CM FHG SB EXXCEL SOFT EPTFE GRAFT STRAIGHT EXTERNALLY SUPPORTED MM,8MM/70CM/20-50CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL STRAIGHT EXTERNALLY SUPPORTED 6-8MM*80CM*20-50CM FHG SB EXXCEL SOFT EPTFE GRAFT STRAIGHT EXTERNALLY SUPPORTED MM,8MM/80CM/20-50CM FHG140623NGX " 戈爾 " 戈爾特賜內植人工血管 "GORE" GORE-TEX VASCULAR GRAFTS MM,8MMX(20CM 環 )X30CM FHG140624NGX " 戈爾 " 戈爾特賜內植人工血管 "GORE" GORE-TEX VASCULAR GRAFTS MM,8MMX(20CM 環 )X40CM FHG GX RINGED GRAFT 5CM 6MM 45CM FHG140657NGX RINGED GRAFT 50CM 6MM,8MM 70CM FHG140677NGX " 戈爾 " 戈爾特賜內植人工血管 "GORE" GORE-TEX VASCULAR GRAFTS MM,8MM,10MMX(70CM 環 )X70CM FHG1406C40QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT MM*45CM FHG1406C40SB EXXCEL SOFT EPTFE GRAFT STRAIGHT CENTRALLY SUPPORTED MM/40CM,45CM/5CM FHG1406C50QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL STRAIGHT CENTRALLY SUPPORTED 6MM*50CM*5CM FHG1406C50SB EXXCEL SOFT EPTFE GRAFT STRAIGHT CENTRALLY SUPPORTED MM/50CM/5CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL STRAIGHT EXTERNALLY SUPPORTED 8MM*30CM*12CM FHG SB EXXCEL SOFT EPTFE GRAFT STRAIGHT EXTERNALLY SUPPORTED MM/30CM/12CM FHG GX " 戈爾 " 戈爾特賜內植人工血管 "GORE" GORE-TEX VASCULAR GRAFTS MMX(30CM 環 )X30CM FHG1416C40QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL STRAIGHT CENTRALLY SUPPORTED 6MM*40CM*5CM FHG AH " 亞翠恩 " 艾德凡達聚四氟乙烯人工血管 "ATRIUM" ADVANTA PTFE VASCULAR GRAFTS STANDARD WALL-CENTER HELIX,6MM* 45CM FHG QM FHG SB FHG QM FHG SB " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6-8MM*40CM*20-30CM EXXCEL SOFT EPTFE GRAFT THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6MM,8MM/40CM/20-30CM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT 5MM*70CM EXXCEL SOFT EPTFE GRAFT THIN WALL STRAIGHT EXTERNALLY SUPPORTED 5MM,6MM,8MM/70CM/20-60CM

245 FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6-8MM*80CM*30-70CM FHG SB EXXCEL SOFT EPTFE GRAFT THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6MM,8MM/80CM/30-60CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6MM*40CM*40CM FHG SB EXXCEL SOFT EPTFE GRAFT THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6MM/40CM/40CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT MM*50CM FHG SB EXXCEL SOFT EPTFE VASCULAR THIN WALL GRAFT WITH EXTERNALLY RING SUPPORTED 6MM,10MMX50CM/RING50CM FHG150657NGX RINGED THIN WALLED GRAFT 50CM 6MM,8MM,10MM 70CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT MM*60CM FHG SB EXXCEL SOFT EPTFE GRAFT THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6MM/60CM/60CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT MM*70CM FHG SB EXXCEL SOFT EPTFE GRAFT THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6MM,8MM,10MM/70CM/70CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT MM*80CM FHG SB EXXCEL SOFT EPTFE GRAFT THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6MM,8MM/80CM/80CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED 8MM*30CM*12CM FHG SB EXXCEL SOFT EPTFE GRAGT THIN WALL STRAIGHT EXTERNALLY SUPPORTED 8MM/30CM/12CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6-8MM*70CM*20-30CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED 10MM*50CM*50CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(THIN WALL STRAIGHT EXTERNALLY SUPPORTED 6MM*80CM*80CM FHG154515NGX RINGED THIN WALLED GRAFT 5CM 4MM,5MM 15CM 4289 FHG15F30TWBA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR GRAFT(FLEX THINWALL 6MM*30CM) FHG15F4007BA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR GRAFT(FLEX THINWALL 6,8MM*40CM) FHG15F408SBA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR GRAFT(FLEX SMALL BEADING 8MM*40CM) FHG160577NGX REMOVABLE RINGED THIN WALLED GRAFT 70CM 5MM,6MM,8MM 70CM FHG160623NGX REMOVABLE RINGED THIN WALLED GRAFT 20CM RS 30CM,6MM,8MM FHG160634NGX REMOVABLE RINGED THIN WALLED GRAFT 8MM 40CM

246 FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL STRAIGHT EXTERNALLY SUPPORTED 6-8MM*50CM*50CM FHG SB EXXCEL SOFT EPTFE GRAFT STRAIGHT EXTERNALLY SUPPORTED MM,8MM/50CM/50CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT MM*70CM FHG SB EXXCEL SOFT EPTFE GRAFT STRAIGHT EXTERNALLY SUPPORTED MM/60CM/60CM FHG GX REMOVABLE RINGED THIN WALLED GRAFT 60CM 6MM 70CM FHG GX REMOVABLE RINGED THIN WALLED GRAFT 60CM RS 80CM,6MM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT MM*70CM FHG SB EXXCEL SOFT EPTFE GRAFT STRAIGHT EXTERNALLY SUPPORTED MM,8MM/70CM/70CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT MM*80CM FHG SB EXXCEL SOFT EPTFE GRAFT STRAIGHT EXTERNALLY SUPPORTED MM,8MM/80CM/80CM FHG1606C40TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES CENTRAL SUPPORT STRAIGHT GRAFT 40CM*6,7,8,10MM FHG1606C50TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES CENTRAL SUPPORT STRAIGHT GRAFT 50CM*6,7,8,10MM FHG1606E50TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES END SUPPORT STRAIGHT GRAFT 50CM*6,7,8,10MM FHG1606S10TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR 4289 PROSTHESES FULL SUPPORT STRAIGHT GRAFT 10CM*6,7,8,10MM FHG1606S20TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR 8114 PROSTHESES FULL SUPPORT STRAIGHT GRAFT 20CM*6,7,8,10MM FHG1606S30TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES FULL SUPPORT STRAIGHT GRAFT 30CM*6,7,8,10MM FHG1606S40TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES FULL SUPPORT STRAIGHT GRAFT 40CM*6,7,8,10MM 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 FHG1606S60TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES FULL SUPPORT STRAIGHT GRAFT 60CM*6,7,8,10MM FHG1606S70TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES FULL SUPPORT STRAIGHT GRAFT 70CM*6,7,8,10MM FHG1606S80TM "TERUMO" SEALPTFE GELATIN SEALED EPTFE VASCULAR PROSTHESES FULL SUPPORT STRAIGHT GRAFT 80CM*6,7,8,10MM FHG GX REMOVABLE RINGED THIN WALLED GRAFT 70CM RS 80CM,8MM FHG16CF604MP CARBOFLO GRAFT,CENTERFLEX,40CM 卡邦人工血管 FHG16CF605MP CARBOFLO GRAFT,CENTERFLEX,50CM 卡邦人工血管 FHG16CV604MP VENAFLO GRAFT,CENTERFLEX,40CM 維那人工血管 FHG16CV605MP VENAFLO GRAFT,CENTERFLEX,50CM 維那人工血管 FHG16CVL40MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS CENTERFLEX( MM,40CM) 印帕維那人工血管中間螺旋式 FHG16CVL50MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS CENTERFLEX(6MM,50CM) 印帕維那人工血管中間螺旋式

247 FHG16DF508BA " 巴德 " 迪斯塔人工血管 "BARD"DISTAFLO BYPASS GRAFTS WITH FLEX SMALL BEADING 50CM FHG16DF5SCBA " 巴德 " 迪斯塔人工血管 "BARD" DISTAFLO BYPASS GRAFTS WITH FLEX SMALL BEADING 50CM FHG16DF600BA " 巴德 " 迪斯塔人工血管 "BARD"DISTAFLO BYPASS GRAFTS WITH FLEX SMALL BEADING 60CM FHG16DF6SCBA " 巴德 " 迪斯塔人工血管 "BARD" DISTAFLO BYPASS GRAFTS WITH FLEX SMALL BEADING 60CM FHG16DF700BA " 巴德 " 迪斯塔人工血管 "BARD"DISTAFLO BYPASS GRAFTS WITH FLEX SMALL BEADING 70CM FHG16DF7SCBA " 巴德 " 迪斯塔人工血管 "BARD" DISTAFLO BYPASS GRAFTS WITH FLEX SMALL BEADING 70CM FHG16DF800BA " 巴德 " 迪斯塔人工血管 "BARD"DISTAFLO BYPASS GRAFTS WITH FLEX SMALL BEADING 80CM FHG16DF8SCBA " 巴德 " 迪斯塔人工血管 "BARD" DISTAFLO BYPASS GRAFTS WITH FLEX SMALL BEADING 80CM FHG16F0640MP FLEX GRAFT 6,7,8,10MM 40CM FHG16F3006BA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR GRAFT(FLEX MM*30CM) FHG16F4007BA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR GRAFT(FLEX ;8;10MM*40CM) FHG16F401TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,10CM 卡邦人工 4289 血管 FHG16F507TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,70CM 卡邦人工 血管 FHG16F601CMP CARBOFLO GRAFT,STRAIGHT FLEX,10CM 卡邦人工血管 4289 FHG16F603TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,30CM 卡邦人工 血管 FHG16F604CMP CARBOFLO GRAFT,STRAIGHT FLEX,40CM 卡邦人工血管 FHG16F605CMP CARBOFLO GRAFT,STRAIGHT FLEX,50CM 卡邦人工血管 FHG16F605TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,50CM 卡邦人工 血管 FHG16F606CMP CARBOFLO GRAFT,STRAIGHT FLEX,60CM 卡邦人工血管 FHG16F606TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,60CM 卡邦人工 血管 FHG16F607CMP CARBOFLO GRAFT,STRAIGHT FLEX,70CM 卡邦人工血管 FHG16F608CMP CARBOFLO GRAFT,STRAIGHT FLEX,80CM 卡邦人工血管 FHG16F608TMP CARBOFLO GRAFT,FLEX THINWALL SMALL BEADING,80CM 卡邦人工 血管 FHG170534NGX " 戈爾 " 戈爾特賜內植人工血管 "GORE" GORE-TEX VASCULAR GRAFTS(STRETCH VASCULAR GRAFT WITH REMOVABLE RINGS 5MM,6MM,8MM*30CM RS*40CM FHG170577NGX " 戈爾 " 戈爾特賜內植人工血管 "GORE" GORE-TEX VASCULAR GRAFTS(STRETCH VASCULAR GRAFT WITH REMOVABLE RINGS 5MM,6MM,8MM*70CM RS*70CM FHG170645NGX " 戈爾 " 戈爾特賜內植人工血管 "GORE" GORE-TEX VASCULAR GRAFTS(STRETCH VASCULAR GRAFT WITH REMOVABLE RINGS 6MM,8MM*40CM RS*50CM FHG AH " 亞翠恩 " 艾德凡達聚四氟乙烯人工血管 "ATRIUM" ADVANTA PTFE VASCULAR GRAFTS(STANDARD WALL-HELIX SUPPORTED 4:8MM,70CM)

248 FHG AH " 亞翠恩 " 艾德凡達聚四氟乙烯人工血管 "ATRIUM" ADVANTA PTFE VASCULAR GRAFTS THIN WALL-HELIX SUPPORTED,6MM 7MM 8MM* 70CM FHG AH " 亞翠恩 " 艾德凡達聚四氟乙烯人工血管 "ATRIUM" ADVANTA PTFE VASCULAR GRAFTS(WALL-HELIX SUPPORTED STANDARD 5MM:8MM*50CM) FHG GX " 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 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 FHG180606NGX " 戈爾 " 戈爾特賜內植人工血管 ( 內環伸展性薄壁人工血管 )"GORE" GORE-TEX VASCULAR GRAFTS(INTERING GRAFT)6MM,7MM,8MM X 60CM FHG180608NGX " 戈爾 " 戈爾特賜內植人工血管 ( 內環伸展性薄壁人工血管 )"GORE" GORE-TEX VASCULAR GRAFTS(INTERING GRAFT)6MM,7MM,8MM X 80CM FHG AH "ATRIUM" FLIXENE VASCULAR GRAFTS" 亞翠恩 " 福立心人工血管 FHG GX FHG GX FHG TM FHG TM FHG TM FHG TM FHG TM FHG211203NGX FHG TM FHG TM FHG211752PQM " 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 5CM X 20CM " 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 "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELSEAL STRAIGHT GRAFTS6:10MM 30CM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELSEAL TRIAXIAL,GELSOFT STRAIGHT 6:10MM 30CM "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELSEAL STRAIGHT GRAFTS6:10MM 60CM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELSEAL TRIAXIAL,GELSOFT STRAIGHT 6:10MM 60CM "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELSEAL STRAIGHT GRAFTS12:18MM 25,30CM " 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 "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELSEAL STRAIGHT GRAFTS12:18MM 60CM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELSEAL TRIAXIAL,GELSOFT STRAIGHT 12:18MM 50,60CM " 邁柯唯 " 白金雙重絲絨人工血管 "MAQUET"HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT6-10MM*30CM FHG211752PSB HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT 6-10MM*30CM FHG QM " 邁柯唯 " 白金雙重絲絨人工血管 "MAQUET"HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT20:38MM*30CM

249 FHG SB FHG211754PQM FHG211754PSB FHG TM FHG TM FHG212003NGX FHG TM FHG TM FHG QM FHG SB FHG QM FHG QM FHG SB FHG QM FHG QM FHG SB HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT 20-38MM*30CM " 邁柯唯 " 白金雙重絲絨人工血管 "MAQUET"HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT12:18MM*30CM HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT 12-18MM*30CM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELSEAL TRIAXIAL,GELSOFT STRAIGHT 20:38MM 20,25CM " 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 " 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 "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR PROSTHESES SPECIAL FOUR BRANCH(PLEXUS)40CM*4@15CM* 適應症請見備註欄 "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR PROSTHESES SPECIAL FOUR BRANCH(PLEXUS)40CM*4@15CM * 適應症請見備註欄 " 邁柯唯 " 白金雙重絲絨人工血管 "MAQUET"HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT8-10MM*60CM " 波士頓科技 " 白金雙重絲絨人工血管 "BOSTON SCIENTIFIC"HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT 60CM " 邁柯唯 " 白金雙重絲絨人工血管 "MAQUET" HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR GRAFT 6-7MM*60CM " 邁柯唯 " 白金雙重絲絨人工血管 "MAQUET"HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT20:28MM*60CM " 波士頓科技 " 白金雙重絲絨人工血管 "BOSTON SCIENTIFIC"HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT 60CM " 邁柯唯 " 白金雙重絲絨人工血管 "MAQUET"HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT24:38MM*60CM " 邁柯唯 " 白金雙重絲絨人工血管 - 四分支 "MAQUET"HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT 4 BRANCH " 波士頓科技 " 四分支白金雙重絲絨人工血管 HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT* 適應症請見備註欄 FHG21GK020V8 "INTERVASCULAR"INTERGARD KNITTED VASCULAR GRAFTS" 英特維 " 英特佳針織系列人工血管 6-10MM,20CM FHG21GK021V8 "INTERVASCULAR"INTERGARD KNITTED VASCULAR GRAFTS" 英特維 " 英特佳針織系列人工血管 12-24MM,20CM FHG21GK040V8 "INTERVASCULAR"INTERGARD KNITTED VASCULAR GRAFTS" 英特維 " 英特佳針織系列人工血管 6-10MM,40CM FHG21GK041V8 "INTERVASCULAR"INTERGARD KNITTED VASCULAR GRAFTS" 英特維 " 英特佳針織系列人工血管 12-24MM,40CM

250 FHG21GK070V8 "INTERVASCULAR"INTERGARD KNITTED VASCULAR GRAFTS" 英特維 " 英特佳針織系列人工血管 6-10MM,70CM FHG21GK100V8 "INTERVASCULAR"INTERGARD KNITTED VASCULAR GRAFTS" 英特維 " 英特佳針織系列人工血管 8MM,100CM FHG21GKRS1V8 " 英特維 " 英特佳針織系列人工血管 "INTERVASCULAR" INTERGARD KNITTED VASCULAR GRAFTS RADIALLY SUPPORTED 6-8MM,70CM,R15-30CM FHG21GKRS2V8 " 英特維 " 英特佳針織系列人工血管 "INTERVASCULAR" INTERGARD KNITTED VASCULAR GRAFTS RADIALLY SUPPORTED ULTRA THIN 6MM,85CM,R45CM FHG21GKUT1V8 " 英特維 " 英特佳 "INTERVASCULAR" INTERGARD KNITTED VASCULAR GRAFTS ULTRA THIN 5-8MM,70CM FHG21GKUT2V8 " 英特維 " 英特佳 "INTERVASCULAR" INTERGARD KNITTED VASCULAR GRAFTS ULTRA THIN 5-8MM,40CM FHG21GKUT3V8 " 英特維 " 英特佳 "INTERVASCULAR" INTERGARD KNITTED VASCULAR GRAFTS ULTRA THIN 6-8MM,20CM FHG21HEWAAV8 "INTERVASCULAR"INTERGARD WOVEN VASCULAR GRAFTS" 英特維 " 英特佳編織系列四分叉主動脈弓人工血管 20-34MM*8-10MM,50CM FHG21K1206V8 "INTERVASCULAR"INTERGARD KNITTED VASCULAR GRAFTS" 英特維 " 英特佳針織系列雙叉人工血管 12-24MM,50CM FHG21W0630TM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS 30CM*6,8,10MM FHG21W0660TM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS 60CM*6-10MM FHG21W1230TM FHG21W1260TM FHG21W1407V8 FHG21W2030TM FHG21W2050TM FHG21WK015V8 FHG21WK016V8 FHG21WK030V8 FHG21WK031V8 FHG21WK032V8 FHG21WK060V8 "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS 30CM*12-18MM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS 60CM*12-18MM "INTERVASCULAR"INTERGARD WOVEN VASCULAR GRAFTS" 英特維 " 英特佳編織系列人工血管 14-24MM,50CM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS 30CM*20-38MM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR PROSTHESES GELWEAVE STRAIGHT VASCULAR GRAFTS 50CM*20-34MM "INTERVASCULAR"INTERGARD WOVEN VASCULAR GRAFTS" 英特維 " 英特佳編織系列人工血管 12-24MM,15CM "INTERVASCULAR"INTERGARD WOVEN VASCULAR GRAFTS" 英特維 " 英特佳編織系列人工血管 26-36MM,15CM "INTERVASCULAR"INTERGARD WOVEN VASCULAR GRAFTS" 英特維 " 英特佳編織系列人工血管 6-10MM,30CM "INTERVASCULAR"INTERGARD WOVEN VASCULAR GRAFTS" 英特維 " 英特佳編織系列人工血管 12-18MM,30CM "INTERVASCULAR"INTERGARD WOVEN VASCULAR GRAFTS" 英特維 " 英特佳編織系列人工血管 20-38MM,30CM "INTERVASCULAR"INTERGARD WOVEN VASCULAR GRAFTS" 英特維 " 英特佳編織系列人工血管 22-32MM,60CM

251 FHG3140A64BA FHG GX FHG QM FHG SB FHG TM FHG TM FHG QM FHG SB FHG GX FHG QM FHG SB FHG3146S30TM FHG3146S40TM FHG3146S41TM FHG3146S45TM FHG3146S46TM FHG3146S50TM FHG3146W40TM FHG3146W41TM FHG3146W45TM FHG TM " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR GRAFT(SHORT TAPERED 6,7-4MM*40CM) " 戈爾 " 戈爾特賜內植人工血管 "GORE"GORE-TEX VASCULAR GRAFTS- TAPERED GRAFT 4-6MM*40CM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL SHORT TAPER 4-7MM*40-45CM EXXCEL SOFT EPTFE GRAFT SHORT TAPER,STEP 4-6MM,4-7MM*40CM,45CM 型號 , 自 生效 " 泰爾茂 " 特普弗人工血管 "TERUMO" TAPERFLO GELATIN SEALED EPTFE VASCULAR PROSTHESES SHORT TAPER GRAFT40,45CM 4-6,4-7MM " 泰爾茂 " 麥斯弗人工血管 "TERUMO" MAXIFLO EXPANDED EPTFE VASCULAR PROSTHESES(SHORT TAPER GRAFT40,50CM*4-6:4-7MM) " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT 4-7MM*45CM EXXCEL SOFT EPTFE VASCULAR STANDARD WALL GRAFT(STEP)4-6MM,4-7MMX45CM 型號 ,57 自 生效 " 戈爾 " 戈爾特賜內植人工血管 "GORE"GORE-TEX VASCULAR GRAFTS- TAPERED GRAFT 4-6MM*50CM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL SHORT TAPER 4-7MM*50CM EXXCEL SOFT EPTFE GRAFT SHORT TAPER 4-6MM,4-7MM/50CM 型號 ,47 自 生效 " 泰爾茂 " 特普弗人工血管 TAPERFLO GELATIN SEALED EPTFE VASCULAR PROSTHESES GELATIN SEALED STEPPED TAPER GRAFT 30,35CM 4-6:5-8MM " 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 " 泰爾茂 " 麥斯弗人工血管 "TERUMO" MAXIFLO EXPANDED EPTFE VASCULAR PROSTHESES(STEPPED TAPER GRAFT40,45CM*4-6:5-8MM) " 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 " 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) " 泰爾茂 " 特普弗人工血管 TAPERFLO GELATIN SEALED EPTFE VASCULAR PROSTHESES GELATIN SEALED STEPPED TAPER CENTRAL SUPPORT GRAFT 50CM 4-7MM 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 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 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 " 泰爾茂 " 特普弗人工血管 "TERUMO" TAPERFLO GELATIN SEALED EPTFE VASCULAR PROSTHESES SHORT TAPER GRAFT 30CM 4-7MM

252 FHG GX TAPERED GRAFT 4-7MM 40CM FHG3147S45MP STEPPED GRAFT 4-7MM 45CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL STEP 4-6MM*45CM FHG3164A40MP CARBOFLO GRAFT,SHORT TAPERED,40CM 卡邦人工血管 FHG316CF50MP CENTER FLEX 6:8MM 50CM FHG3174T40MP TAPERED GRAFT 7-4MM 40CM FHG31T4645MP CARBOFLO GRAFT,STEPPED,45CM 卡邦人工血管 FHG31T4750MP CARBOFLO GRAFT,STEPPED,50CM 卡邦人工血管 FHG31VLT20MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS STEPPED GRAFT(4-6, MM,20CM,25CM) 印帕維那人工血管階級式 FHG31VLT30MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS STEPPED GRAFT(4-6, MM,30CM,35CM) 印帕維那人工血管階級式 FHG31VLT40MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS STEPPED GRAFT(4-6, MM,40CM,45CM) 印帕維那人工血管階級式 FHG31VT246MP VENAFLO GRAFT,STEPPED,20/25CM 維那人工血管 6762 FHG31VT346MP VENAFLO GRAFT,STEPPED,30CM 維那人工血管 9040 FHG MP CARBOFLO GRAFT,TAPERED THINWALL,70CM 卡邦人工血管 FHG AH " 亞翠恩 " 艾德凡達聚四氟乙烯人工血管 "ATRIUM" ADVANTA PTFE VASCULAR GRAFTS(SHORT TAPER STANDARD WALL 4-6MM,4-7MM*40CM,45CM) FHG GX " 戈爾 " 戈爾特賜內植人工血管 "GORE"GORE-TEX VASCULAR GRAFTS TAPERED STRETCH GRAFT 4-6MM*45CM FHG GX TAPERED STRETCH VASCULAR GRAFT 4:7MMX40CM FHG336CF40MP CENTER FLEX GRAFT 6:10MM 40CM FHG QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT(STANDARD WALL SHORT TAPER CENTRALLY SUPPORTED 4-7MM*40-45CM*5-10CM FHG3447C40QM " 邁柯唯 " 人工血管 "MAQUET" EXXCELSOFT EPTFE VASCULAR GRAFT MM*45CM FHG3447C40SB EXXCEL SOFT EPTFE GRAFT SHORT TAPER,STEP CENTRALLY SUPPORTED 4-7MM/40CM,45CM/5-15CM FHG3447S45MP CENTERFLEX STEPPED GRAFT 4-7MM,5-8MM 45CM FHG34CF40ABA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR GRAFT(SHORT TAPERED CENTERFLEX 6,7-4MM*40CM) FHG34CFT40BA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR GRAFT(STEPPED CENTERFLEX 4-7MM*40CM) FHG AH " 亞翠恩 " 艾德凡達聚四氟乙烯人工血管 "ATRIUM" ADVANTA PTFE VASCULAR GRAFTS(SHORT TAPER CENTER HELIX STANDARD 4-7MM*45CM) FHG3630A74BA " 印帕 " 聚四氟乙烯人工血管 "IMPRA" EPTFE VASCULAR 9040 GRAFT(SHORT TAPERED 7-4MM*30CM) FHG GX TAPERED GRAFT WITH REMOVAL RINGED FHG3674A40MP CARBOFLO GRAFT,SHORT TAPERED CENTERFLEX,40CM 卡邦人工血管 FHG36CVLT4MP IMPRA VENAFLO EPTFE VASCULAR GRAFTS STEPPED CENTERFLEX( MM,45CM) 印帕維那人工血管階級中間螺旋式 FHG36F7407MP CARBOFLO GRAFT,FLEX THINWALL TAPERED SMALL BEADING,70CM 卡邦人工血管 FHG36T4740MP CARBOFLO GRAFT,STEPPED CENTERFLEX,40/45CM 卡邦人工血管 FHG36T4750MP CARBOFLO GRAFT,STEPPED CENTERFLEX,50CM 卡邦人工血管 FHG36VT454MP VENAFLO GRAFT,STEPPED CENTERFLEX,45CM 維那人工血管

253 FHG GX " 戈爾 " 戈爾特賜內植人工血管 ( 錐狀內環伸展性人工血管 )"GORE" GORE-TEX VASCULAR GRAFTS(INTERING GRAFT)4-6MM X 45CM FHG GX 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 FHG421664PQM " 邁柯唯 " 白金雙重絲絨人工血管 "MAQUET"HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT(BIFURCATIONS)14:24MM* 7:12MM*40CM FHG421664PSB HEMASHIELD PLATINUM WOVEN DOUBLE VELOUR VASCULAR GRAFT BIFURCATIONS 12-24MM*6-12MM*40CM FHG TM "TERUMO"GELSOFT PLUS GELATIN SEALED POLYESTER VASCULAR PROSTHESES BIFURCATION WOVEN GRAFTS12:24*6:12MM 45CM FHG TM "TERUMO" GELSEAL GELATIN SEALED POLYESTER VASCULAR PROSTHESES BIFURCATION WOVEN GRAFT 12:24*6:12MM 45CM 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 FHG43W1245TM "TERUMO" GELWEAVE GELATIN SEALED POLYESTER VASCULAR PROSTHESES BIFURCATION WOVEN GRAFT 12:24*6:12MM 45CM FHP0100KSRM4 KAPPA SR PULSE GENERATOR 須檢附心電圖報告專案報備使用 FHP ST SINGLE CHAMBER PULSE GENERATOR SSIR* 須檢附心電圖報告專案 報備使用 FHP0110SS1M4 SIGMA SSI PACEMAKER WITHOUT LEAD 須檢附心電圖報告專案報 備使用 FHP GU " 佳騰 " 因施尼亞心律調節器 "GUIDANT" INSIGNIA I PLUS GENERATOR* 適應症請見備註欄 FHP PR REGENCY SR+SSIR PULSE GENERATOR W/AUTOCAPTURE 須檢附心電 圖報告專案報備使用 FHP PR REGENCY SC+SSIC PULSE GENERATOR W/AUTOCAPTURE 須檢附心電 圖報告專案報備使用 FHP PR REGENCY/MICRONY SSIR PULSE GENERATOR 須附心電圖報告專案報 備使用 ( 不須事前審查 ) FHP011SS1RM4 SIGMA SSIR PACEMAKER WITHOUT LEAD 須檢附心電圖報告專案 報備使用 FHP012404NPR REGENCY SR SSIR PULSE GENERATOR WITHOUT LEAD 須檢附心電 圖報告專案報備使用 FHP012406NPR REGENCY SC/SCX SSI PULSE GENERATOR WITHOUT LEAD 須檢附心 電圖報告專案報備使用 FHP BK BIOTRONIK IMPLANTABLE PACEMAKER-PHILOS II 拜耳德尼克 植入式心律調整器(VVIR) 需檢附心電圖報告專案報備使用 FHP BK BIOTRONIK IMPLANTABLE PACEMAKER-PHILOS II 拜耳德尼克 植入式心律調整器(VVI) 需檢附心電圖報告專案報備使用 FHP01ACCPMST " 聖猷達 " 艾森心臟節律器 (ACCENT IMPLANTABLE CARDIAC PULSE GENERATOR) * 適應症請見備註欄 FHP01ACCRMST " 聖猷達 " 艾森心臟節律器 ((ACCENT IMPLANTABLE CARDIAC PULSE GENERATOR) * 適應症請見備註欄 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 FHP01ACCVRST " 聖猷達 " 艾森艾斯特心臟節律器 ( 單腔 )"SJM" ACCENT ST PULSE GENERATOR* 適應症請見備註欄 FHP01ADAPSM4 "MEDTRONIC" ADAPTA PACING SYSTEM" 美敦力 " 黛拉心臟節律系統 * 適應症請見備註欄

254 FHP01ADD1SM4 FHP01ADSRSM4 FHP01ADVDSM4 FHP01AVTSRGU " 美敦力 " 黛拉心臟節律器 "MEDTRONIC" ADAPTA PACEMAKER-DDD* 使用規定請見備註欄 " 美敦力 " 黛拉心臟節律器 "MEDTRONIC" ADAPTA PACEMAKER- AAI/VVI* 使用規定請見備註欄 " 美敦力 " 黛拉心臟節律器 "MEDTRONIC" ADAPTA PACEMAKER-VDD* 使用規定請見備註欄 " 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 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 FHP01DDD20SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA PACEMAKER * 適應症見備註欄 FHP01ESS1RM4 ENPULSE PACING GENERATOR 須檢附心電圖報告專案報備使用 FHP01EVASRBK " 拜耳德尼克 " 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 FHP01K9KSRM4 KAPPA PULSE GENERATOR 須檢附心電圖報告專案報備使用 FHP01KAKSRM4 KAPPA PULSE GENERATOR (SSIR) * 須檢附心電圖報告專案報備使 用 FHP01S1195GU INSIGNIA I ENTRA PULSE GENERATOR 須檢附心電圖報告專案報 備使用 FHP01S484NGU INSIGNIA I ENTRA PULSE GENERATOR 須檢附心電圖報告專案報 備使用 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 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 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 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 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 FHP01SSR20SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA PACEMAKER * 適應症見備註欄 FHP01SSR40SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA PACEMAKER * 適應症見備註欄 FHP01SSR50SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA PACEMAKER * 需檢附心電圖報告專案報備使用 FHP01SSR60SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA PACEMAKER * 需檢附心電圖報告專案報備使用 FHP01SSS20SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA PACEMAKER * 適應症見備註欄 FHP01TA245BK 拜耳德尼克 塔洛斯心搏徐緩治療節律裝置 BIOTRONIK TALOS BRADYCARDIA THERAPY PACEMAKER(DDD)* 須檢附心電圖報告專案報備使用 FHP01TA248BK 拜耳德尼克 塔洛斯心搏徐緩治療節律裝置 BIOTRONIK TALOS PACEMAKER(DDDR)* 適應症請見備註欄按同類近似特材支付點數 點支付超過部分由病人支付 FHP01TA250BK 拜耳德尼克 塔洛斯心搏徐緩治療節律裝置 BIOTRONIK TALOS PACEMAKER(VVI/AAI)* 須檢附心電圖報告專案報備使用

255 FHP01TA252BK FHP01TA254BK FHP01UTASRGU 拜耳德尼克 塔洛斯心搏徐緩治療節律裝置 BIOTRONIK TALOS BRADYCARDIA THERAPY PACEMAKER(VDDR)* 須檢附心電圖報告專案報備使用拜耳德尼克 塔洛斯心搏徐緩治療節律裝置 BIOTRONIK TALOS BRADYCARDIA THERAPY PACEMAKER(VVIR/AAIR)* 須檢附心電圖報告專案報備使用 " 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 FHP01V56SRST " 聖猷達 " 維奇植入式心臟節律器 "SJM" VICTORY IMPLANTABLE CARDIAC PULSE GENERATOR * 須檢附心電圖報告專案報備使用 FHP01VDSS5SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA PACEMAKER * 適應症見備註欄 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 FHP01VERSCST 植入式心臟節律器 IMPLANTABLE CARDIAC PULSE GENERATOR 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 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 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 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付 FHP02ACSDRST " 聖猷達 " 艾森艾斯特心臟節律器 ( 雙腔 )"SJM" ACCENT ST PULSE GENERATOR* 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付 FHP02DDD12GU 因施尼亞內植用心律調節器 GUIDANT INSIGNIA I ENTRA PULSE GENERATOR* 適應症請見備註欄 FHP02DDD18BK 雙腔型心臟節律器 "BIOTRONIK" IMPLANTABLE PACEMAKERS-PHILOS II D* 適應症請見備註欄 FHP02DDD2SST 雙腔型心臟節律器 "SJM" IMPLANTABLE CARDIAC PULSE GENERATOR * 適應症請見備註欄 FHP02DDD2UST 雙腔型心臟節律器 "SJM" IMPLANTABLE CARDIAC PULSE GENERATOR * 適應症請見備註欄 FHP02DDD32GU 內植用雅密特心臟整律器 GUIDANT INSIGNIA I AVT PULSE GENERATOR* 適應症請見備註欄 FHP02DDD50SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA 50 PACEMAKER * 需檢附心電圖報告專案報備使用

256 FHP02DDD6SST 雙腔型心臟節律器 "SJM" IMPLANTABLE CARDIAC PULSE GENERATOR * 適應症請見備註欄 FHP02DDD6UST 雙腔型心臟節律器 "SJM" IMPLANTABLE CARDIAC PULSE GENERATOR * 適應症請見備註欄 FHP02DDDADM4 美敦力黛拉心臟節律器 MEDTRONIC ADAPTA PACING GENERATOR* 適 應症請見備註欄 FHP02DDDENM4 美敦力心臟節律系統 MEDTRONIC ENPULSE PACING GENERATOR* 適應 症請見備註欄 FHP02DDDKKM4 美敦力卡帕人工心律調節器 MEDTRONIC KAPPA PULSE GENERATOR* 適應症請見備註欄 FHP02DDDSEM4 美敦力賽亞心臟節律器 MEDTRONIC SENSIA PACING GENERATOR* 適 應症請見備註欄 FHP02DDDSGM4 希格瑪人工心律調節器 * 適應症請見備註欄 FHP02DDR11GU 因施尼亞內植用心律調節器 GUIDANT INSIGNIA I ENTRA PULSE GENERATOR* 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 FHP02DDR20SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA PACEMAKER * 適應症見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 FHP02DDR21BK 雙腔型心臟節律器 "BIOTRONIK" IMPLANTABLE PACEMAKERS-PHILOS II* 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 FHP02DDR21GU 因施尼亞心律調節器 GUIDANT INSIGNIA I PLUS PULSE GENERATOR* 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 FHP02DDR31GU 內植用雅密特心臟整律器 GUIDANT INSIGNIA I AVT PULSE GENERATOR* 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付 FHP02DDR3UST 雙腔型心臟節律器 "SJM" IMPLANTABLE CARDIAC PULSE GENERATOR * 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 FHP02DDR40SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA PACEMAKER * 適應症見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 FHP02DDR41GU 因施尼亞心臟整律器 GUIDANT INSIGNIA I ULTRA PULSE GENERATOR* 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 FHP02DDR50SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA PACEMAKER * 適應症見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 FHP02DDR5SST 雙腔型心臟節律器 "SJM" IMPLANTABLE CARDIAC PULSE GENERATOR * 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 FHP02DDR5UST 雙腔型心臟節律器 "SJM" IMPLANTABLE CARDIAC PULSE GENERATOR * 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 FHP02DDR60SB " 波士頓科技 " 歐超心臟整律器 "BOSTON SCIENTIFIC" ALTRUA 60 PACEMAKER * 適應症見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付

257 FHP02DDR7SST FHP02DDR7UST FHP02DDR8SST FHP02DDR8UST FHP02DDRADM4 FHP02DDRENM4 FHP02DDRKKM4 FHP02DDRSEM4 FHP02DDRSGM4 FHP02DDRTHM4 FHP02DDRVEM4 FHP02EVADRBK FHP02MR224ST FHP02MR226ST FHP02PM234ST FHP02PM236ST FHP02SDR1SM4 FHP02VDDADM4 雙腔型心臟節律器 "SJM" DUAL CHAMBER PULSE GENERATOR * 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付 維奇植入式心臟節律器 "SJM"VICTORY IMPLANTABLE CARDIAC PULSE GENERATOR 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付雙腔型心臟節律器 "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 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付 美敦力心臟節律系統 MEDTRONIC ENPULSE PACING GENERATOR* 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 美敦力卡帕人工心律調節器 MEDTRONIC KAPPA PULSE GENERATOR* 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 美敦力賽亞心臟節律器 MEDTRONIC SENSIA PACING GENERATOR* 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 希格瑪人工心律調節器 * 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付 美敦力維莎心臟節律器 MEDTRONIC VERSA PACING GENERATOR* 適應症請見備註欄, 按同類近似特材支付點數 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付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 點支付, 超過部分由病患自付 " 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 點支付, 超過部分由病患支付 " 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 點支付, 超過部分由病患自付 美敦力黛拉心臟節律器 MEDTRONIC ADAPTA PACING GENERATOR* 適應症請見備註欄

258 FHP02VDDENM4 美敦力心臟節律系統 MEDTRONIC ENPULSE PACING GENERATOR* 適應 症請見備註欄 FHP02VDDKKM4 美敦力卡帕人工心律調節器 MEDTRONIC KAPPA PULSE GENERATOR* 適應症請見備註欄 FHP02VDDSGM4 希格瑪人工心律調節器 * 適應症請見備註欄 FHP02VDR16BK 雙腔型心臟節律器 "BIOTRONIK" IMPLANTABLE PACEMAKERS-PHILOS II SLR* 適應症請見備註欄 FHP02VDR1SST 雙腔型心臟節律器 "SJM" IMPLANTABLE CARDIAC PULSE GENERATOR * 適應症請見備註欄 FHP02VDR1UST 雙腔型心臟節律器 "SJM" IMPLANTABLE CARDIAC PULSE GENERATOR * 適應症請見備註欄 FHP02VDR4SST 雙腔型心臟節律器 "SJM" IMPLANTABLE CARDIAC PULSE GENERATOR * 適應症請見備註欄 FHP02VDR4UST 雙腔型心臟節律器 "SJM" IMPLANTABLE CARDIAC PULSE GENERATOR * 適應症請見備註欄 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 點支付, 超過部分由病患自付 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 點支付, 超過部分由病患自付 FHP ED CVS DIVISION PERICARDIAL PATCH 10X15CM 7838 FHP GX " 戈爾 " 普瑞得福心包膜代用膜 "GORE" PRECLUDE PRECARDIAL 4310 MEMBRANE 6*12CM FHP GX " 戈爾 " 普瑞得福心包膜代用膜 "GORE" PRECLUDE PRECARDIAL 8322 MEMBRANE 12*12CM FHP GX " 戈爾 " 普瑞得福心包膜代用膜 "GORE" PRECLUDE PRECARDIAL MEMBRANE 15*20CM FHP11XA400ED EQUINE PERICARDIAL PATCH 10*10 CM 7838 FHP41V1017VW " 維喜 " 人工血管接環 "VASORING" VASCULAR RING CONNECTOR FHP BA " 巴德 " 心血管補片 "BARD"CARDIOVASCULAR PATCH-CARDIOVASCULAR 4935 FABRICS(15.2*15.2CM) FHP BA " 巴德 " 心血管補片 "BARD"CARDIOVASCULAR PATCH-CARDIOVASCULAR 281 FABRICS(1.0*15.2CM)(2.1*5.1CM) FHP BA " 巴德 " 心血管補片 "BARD"CARDIOVASCULAR PATCH-CARDIOVASCULAR 563 FABRICS(2.5CM*10.2CM) FHP BA " 巴德 " 心血管補片 "BARD"CARDIOVASCULAR PATCH-CARDIOVASCULAR 1697 FABRICS(5.1*10.2CM) FHP BA " 巴德 " 心血管補片 "BARD"CARDIOVASCULAR PATCH-CARDIOVASCULAR 2319 FABRICS(10.2*10.2CM) FHP BA " 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 FHP BA FHP BA FHP BA FHP BA " 巴德 " 心血管補片 "BARD" CARDIOVASCULAR PATCH-SURGICAL FELTS 10.2*10.2CM " 巴德 " 心血管補片 "BARD" CARDIOVASCULAR PATCH-SURGICAL FELTS 15.2*15.2CM " 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 " 巴德 " 心血管補片 "BARD" CARDIOVASCULAR PATCH-SURGICAL FELTS 2.5*10.2CM,5.1*5.1CM

259 FHP BA FHP AE FHP SB FHP SB FHP SB FHPCD1870VGU FHPCD1871DGU FHPCD214DMM4 FHPCD214VMM4 FHPCD354DMM4 FHPCD354VMM4 FHPCDA155DGU FHPCDC164AM4 FHPCDD164VM4 FHPCDD234DM4 FHPCDD234VM4 FHPCDD284DM4 FHPCDD284VM4 FHPCDD354DM4 " 巴德 " 心血管補片 "BARD" CARDIOVASCULAR PATCH-SURGICAL FELTS 2.5*15.2CM " 雅氏 " 人工血管補片 "AESCULAP" VASCULAR PATCH(2*9CM,1*7CM,3*4CM) " 波士頓科技 " 美洛思心臟血管移植彌補片及止血帶 "BOSTON SCIENTIFIC"MEADOX CARDIOVASCULAR FABRICS & TAPES 5.1CM*10.2CM " 波士頓科技 " 美洛思心臟血管移植彌補片及止血帶 "BOSTON SCIENTIFIC"MEADOX CARDIOVASCULAR FABRICS & TAPES 10.2CM*10.2CM " 波士頓科技 " 美洛思心臟血管移植彌補片及止血帶 "BOSTON SCIENTIFIC"MEADOX CARDIOVASCULAR FABRICS & TAPES 15.2CM*15.2CM GUIDANT VITALITY AICD 維達自動植入型心律去顫器 * 適應症請見備註欄 GUIDANT VITALITY AICD 維達自動植入型心律去顫器 * 適應症請見備註欄 " 美敦力 " 思格拉植入式心臟去顫器 ( 雙腔 )"MEDTRONIC" SECURA DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 使用規定請見備註欄 " 美敦力 " 思格拉植入式心臟去顫器 ( 單腔 )"MEDTRONIC" SECURA VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 使用規定請見備註欄 "MEDTRONIC"PROTECTA XT DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR" 美敦力 " 博特多艾緹植入式心臟去顫器 * 適應症請見備註欄 "MEDTRONIC"PROTECTA XT VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR" 美敦力 " 博特多艾緹植入式心臟去顫器 * 適應症請見備註欄 " 佳騰 " 維達艾維塔植入型心律去顫器 "GUIDANT" VITALITY AVT ICD* 適應症請見備註欄 " 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 " 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 " 美敦力 " 思格拉植入式心臟去顫器 MEDTRONIC SECURA DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR * 適應症請見備註欄 " 美敦力 " 思格拉植入式心臟去顫器 MEDTRONIC SECURA VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR * 適應症請見備註欄 " 美敦力 " 麥思蒙植入式心臟去顫器 ( 雙腔 )"MEDTRONIC" MAXIMO II DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 " 美敦力 " 麥思蒙植入式心臟去顫器 ( 單腔 )"MEDTRONIC" MAXIMO II VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 "MEDTRONIC"PROTECTA XT DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR" 美敦力 " 博特多艾緹植入式心臟去顫器 * 適應症請見備註欄

260 FHPCDD354VM4 FHPCDD364DM4 FHPCDD364VM4 FHPCDDR36QST FHPCDDRCD2ST FHPCDDRF22ST FHPCDDRF23ST FHPCDDRPLSST FHPCDF102DSB FHPCDF110DSB FHPCDLUMDRBK FHPCDLUMDXBK FHPCDLUMVRBK FHPCDP0230ST FHPCDPD232ST FHPCDPD236ST FHPCDPD240ST FHPCDPD243ST FHPCDPD255ST FHPCDPD258ST "MEDTRONIC"PROTECTA XT VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR" 美敦力 " 博特多艾緹植入式心臟去顫器 * 適應症請見備註欄 " 美敦力 " 博特多植入式心臟去顫器 "MEDTRONIC" PROTECTA DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 " 美敦力 " 博特多植入式心臟去顫器 "MEDTRONIC" PROTECTA VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 " 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 "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 " 聖猷達 " 弗帝法艾斯特植入式心律去顫器 "SJM" FORTIFY ST IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 " 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 聖猷達 克侖特普拉斯植入式心律去顫器 - 雙腔 SJM CURRENT+ IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 使用規定請見備註欄 " 波士頓科技 " 泰利均植入型心律去顫器 "BOSTON SCIENTIFIC" TELIGEN 100 HE ICD* 適應症請見備註欄 " 波士頓科技 " 泰利均植入型心律去顫器 "BOSTON SCIENTIFIC" TELIGEN 100 HE ICD* 適應症請見備註欄 拜耳德尼克 路麥斯植入式心臟除顫器 - 雙腔 BIOTRONIK LUMAX TACHYARRHYTHMIA THERAPY IMPLANTABLE DEFIBRILLATORS- DR-T* 給付規定請見備註欄 拜耳德尼克 路麥斯植入式心臟除顫器 - 單腔 BIOTRONIK LUMAX TACHYARRHYTHMIA THERAPY IMPLANTABLE DEFIBRILLATORS- VR-T DX* 給付規定請見備註欄 拜耳德尼克 路麥斯植入式心臟除顫器 - 單腔 BIOTRONIK LUMAX TACHYARRHYTHMIA THERAPY IMPLANTABLE DEFIBRILLATORS- VR-T* 給付規定請見備註欄 PHOTON DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 PHOTON DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 EPIC PLUS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR 適應症請見備註欄 PHOTON DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR 適應症請見備註欄 PHONTON DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR 植入式雙腔型心臟去顫器 * 適應症請見備註欄 " 聖猷達 " 艾匹克雙腔型植入式去纖維顫動器 "SJM" EPIC PLUS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 " 聖猷達 " 艾匹克雙腔型植入式去纖維顫動器 "SJM" EPIC PLUS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄

261 FHPCDPD26NST FHPCDPD27NST FHPCDPS158ST " 聖猷達 " 植入式雙腔型心臟去顫器 "SJM"PHONTON DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 " 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 " 聖猷達 " 艾匹克單腔型植入式去纖維顫動器 "SJM" EPIC PLUS VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 FHPCDPS168ST " 聖猷達 " 植入式心律去顫器 "SJM"IMPLANTABLE CARDIOVERTER DEFIBRILLATORS* 適應症請見備註欄 FHPCDPS193ST 植入性心律去顫器 IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適 應症請見備註欄 FHPCDPS196ST EPIC PLUS VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR 適應 症請見備註欄 FHPCDPS199ST IMPLANTABLE CARDIOVERTER DEFIBRILLATOR 適應症請見備註欄 FHPCDPVRC7ST FHPCDRFD22ST FHPCDRFVD2ST FHPCDT167DGU FHPCDT177DGU FHPCDVR36QST FHPCDVRCD2ST FHPCDVRF23ST FHPCDVRF35ST FHPCDVRPLSST " 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 " 聖猷達 " 克侖特植入式心律去顫器 "SJM" CURRENT IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 " 聖猷達 " 克侖特植入式心律去顫器 "SJM" CURRENT IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 " 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 " 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 " 聖猷達 " 植入式心律去顫器 "SJM" CURRENT ACCEL IMPLANTABLE CARDIOVERTER/DEFIBRILLATOR* 適應症請見備註欄 " 聖猷達 " 植入式心律去顫器 "SJM" CURRENT ACCEL IMPLANTABLE CARDIOVERTER/DEFIBRILLATOR* 適應症請見備註欄 " 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 " 聖猷達 " 弗帝法艾斯特植入式心律去顫器 ( 單腔 )"SJM" FORTIFY ST IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 適應症請見備註欄 聖猷達 克侖特普拉斯植入式心律去顫器 - 單腔 SJM CURRENT+ IMPLANTABLE CARDIOVERTER DEFIBRILLATOR* 使用規定請見備註欄 FHPCL06935M4 " 美敦力 " 史賓特導管 "MEDTRONIC" SPRINT QUATTRO SECURE S LEAD* 適應症請見備註欄 FHPCL06944M4 SPRINT LEAD(ICD)* 適應症請見備註欄 FHPCL06947M4 史賓特導線 SPRINT LEAD 58,65,75,100CM * 適應症請見備註欄 FHPCLAF157GU 安達植入式去顫器電極導線 ENDOTAK RELIANCE IMPLANTABLE LEAD* 適應症請見備註欄 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 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

262 FHPCLB0170GU "GUIDANT"ENDOTAK RELIANCE SG IMPLANTABLE LEAD* 適應症請見 備註欄 FHPCLB0174GU " 佳騰 " 安達集植入式電極導線 "GUIDANT" ENDOTAK RELIANCE G IMPLANTABLE LEAD* 適應症請見備註欄 FHPCLB0184GU " 佳騰 " 安達集植入式電極導線 "GUIDANT" ENDOTAK RELIANCE G IMPLANTABLE LEAD* 適應症請見備註欄 FHPCLD712QST " 聖猷達 " 德拉多心臟導線 "SJM" DURATA LEAD(FOR ICD)* 適應症 請見備註欄 FHPCLD717QST " 聖猷達 " 德拉多心臟導線 "SJM" DURATA LEAD(FOR ICD)* 適應症 請見備註欄 FHPCLDU723ST " 聖猷達 " 德拉多心臟導線 "SJM" DURATA LEAD FHPCLDU7SWST " 聖猷達 " 德拉多心臟導線 "SJM" DURATA LEAD * 適應症請見備註 欄 FHPCLE0147GU 安達植入式去顫器電極導線 ENDOTAK RELIANCE IMPLANTABLE LEAD* 適應症請見備註欄 FHPCLKX345BK " 拜耳德尼克 " 植入式心內除顫器導線 "BIOTRONIK" ICD LEAD(KENTROX RV-S65,SL-S65/16,SL-S65/18-STEROID)* 適應症請見備註欄 FHPCLKX348BK " 拜耳德尼克 " 植入式心內除顫器導線 "BIOTRONIK" ICD LEAD(KENTROX RV65;75,SL65/16;18,SL75/16;18,SL100/16;18- STEROID)* 適應症請見備註欄 FHPCLKX633BK FHPCLLN337BK FHPCLLN350BK FHPCLLN351BK FHPCLLN352BK " 拜耳德尼克 " 肯特心內除顫器導線 "BIOTRONIK" KENTROX A+ ICD LEADS* 適應症請見備註欄 " 拜耳德尼克 " 霖納思植入式心內除顫器導線 BIOTRONIK LINOX TD ICD LEADS* 適應症請見備註欄 " 拜耳德尼克 " 霖納思植入式心內除顫器導線 BIOTRONIK LINOX SD IMPLANTABLE DEFIBRILLATOR LEADS* 適應症請見備註欄 " 拜耳德尼克 " 霖納思植入式心內除顫器導線 BIOTRONIK LINOX S ICD LEADS* 適應症請見備註欄 " 拜耳德尼克 " 霖納思植入式心內除顫器導線 BIOTRONIK LINOX T IMPLANTABLE DEFIBRILLATOR LEADS* 適應症請見備註欄 FHPCLR1ATAST TRANSVENOUS TACHYARRHYTHMIA LEAD 適應症請見備註欄 ( 產品型 號 RIATA1560:1562,1590:1592 自 生效使用 ) FHPCLR700NST " 聖猷達 " 經靜脈心搏過速導線 "SJM" TRANSVENOUS TACHYARRHYTHMIA LEAD* 適應症請見備註欄 FHPCLR704NST " 聖猷達 經靜脈心搏過速導線 SJM TRANSVENOUS TACHYARRHYTHMIA LEAD* 適應症請見備註欄 FHPHF04193M4 ATTAIN OTW LEAD 艾坦插入式導線 適應症請見備註欄 FHPHF04194M4 " 美敦力 " 艾坦插入式導線 "MEDTRONIC"ATTAIN OTW LEAD* 適應症請 見備註欄 FHPHF04195M4 " 美敦力 " 艾坦史塔菲導線 "MEDTRONIC" ATTAIN STARFIX LEAD* 適 應症請見備註欄 FHPHF04196M4 " 美敦力 " 艾坦艾比利導線 "MEDTRONIC" ATTAIN ABILITY LEAD* 適 應症請見備註欄 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 FHPHF08042M4 INSYNC III ATRIAL SYNCHRONOUS PACING DEVICE 適應症請見備註欄

263 FHPHF0C2TRM4 FHPHF1056NST " 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 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 生效 ) FHPHF1058NST " 聖猷達 " 左心室心臟節律器導線 "SJM" LEFT VENTRICULAR LEAD* 適應症請見備註欄 FHPHF11568ST " 聖猷達 " 左心導線 "SJM" QUICKFLEX LEAD* 適應症請見備註欄 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 FHPHF14001BK " 拜耳德尼克 " 可洛植入式雙極心導線 "BIOTRONIK" COROX OTW ENDOCARDIAL LEAD* 適應症請見備註欄 FHPHF14002BK " 拜耳德尼克 " 可洛植入式心導線 "BIOTRONIK" COROX OTW LEAD* 適 應症請見備註欄 FHPHF32374ST " 聖猷達 " 夸特左心導線 SJM QUARTET LEFT HEART LEAD* 使用規 定請見備註欄 FHPHF33820BK " 拜耳德尼克 " 璽特司植入式心臟同步治療心律調節 器 "BIOTRONIK"STRATOS IMPLANTABLE CARDIAC PACEMAKER* 適應症請見備註欄 FHPHF96CRTST SJM BIVENTRICULAR STIMULATION DEVICE 聖猷達 雙心室心 臟節律器 * 適應症請見備註欄 FHPHFACUTYGU " 佳騰 " 雅各易導型電極導管 "GUIDANT"ACUITY STEERABLE LEAD* 適 應症請見備註欄 FHPHFEASY2GU " 佳騰 " 易導型第二代雙電極導管 "GUIDANT"EASYTRAK 2 IS PACING LEAD* 適應症請見備註欄 FHPHFEASY3GU " 佳騰 " 易導型第 3 代冠狀靜脈電極導線 "GUIDANT"EASYTRAK CORONARY VENOUS LEAD* 適應症請見備註欄 FHPHFEASYTGU 佳騰 易導型電極導線 GUIDANT EASYTRAK 2 PACING LEAD* 適應症請見備註欄 FHPHFH1401GU " 佳騰 " 控達刻脈搏產生器 "GUIDANT" CONTAK RENEWAL CRT-P PULSE GENERATOR* 適應症請見備註欄 FHPHFKX346BK " 拜耳德尼克 " 可洛植入式心導線 "BIOTRONIK"COROX OTW LEAD* 適 應症請見備註欄 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 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 FHPL104067M4 CAPSURE FIX LEAD * 須檢附心電圖報告專案報備使用 7951 FHPL104073M4 CAPSURE SENSE LEAD 蓋普夏導線 須附心電圖報告專案報備使用 7610 FHPL104074M4 "MEDTRONIC" CAPSURE SENSE LEAD " 美敦力 " 蓋普夏導線 * 需檢附 7610 心電圖報告專案報備使用 FHPL104088GU " 佳騰 " 伸縮性雙極之心內膜心房電極導線 "GUIDANT" FLEXTEND 7951 PACING LEAD* 須檢附心電圖報告專案報備使用 FHPL104965M4 CAPSURE EPICARDIA LEAD STEROID ELUTING 須檢附心電圖專案 7924 報備使用 FHPL104968M4 CAPSURE EPICARDIAL LEAD * 須檢附心電圖報告專案報備使用 7924 FHPL105038M4 CAPSURE VDD LEAD * 須檢附心電圖報告專案報備使用 7610 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

264 FHPL105076M4 FHPL105594M4 FHPL11368NST FHPL11388NST FHPL11488NST FHPL11646TST FHPL11688NST FHPL117882ST FHPL11888NST FHPL140335GU FHPL140535GU FHPL140634GU FHPL151121GQ FHPL19288NST FHPL1B4456GU FHPL1PPT99ST FHPL1S9F4NST FHPL1S9F4UST FHPL1SE362BK FHPL1SR346BK FHPL1SS350BK FHPL1VDD43GU FHPL203830M4 FHPL205038M4 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 ) CAPSURE SP NOVUS ENDOCARDIAL LEAD,STEROID ELUTING* 須附心電圖報告專案報備使用 IMPLANTABLE CARDIAC VDD PACING LEAD 52CM,58CM,65CM * 須檢附心電圖報告專案報備使用 PACESETTER TENDRIL IMPLANTABLE CARDIAC PACING LEAD 須檢附心電圖報告專案報備使用 PACESETTER TENDRIL IMPLANTABLE CARDIAC PACING LEDA * 須檢附心電圖報告專案報備使用 IMPLANTABLE CARDIAC PACING LEAD 須檢附心電圖報告專案報備使用 1646T,1642T IMPLANTABLE CARDIAC PACING LEADS 須附心電圖報告專案報備使用 " 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 " 聖猷達 " 心臟節律器導線 "SJM" IMPLANTABLE CARDIAC PACING LEADS* 適應症請見備註欄 GUIDANT SELUTE PICOTIP PACING 沖提心內膜心房電極導線 * 適應症請見備註欄 GUIDANT SWEET PICOTIP RX STEROID ELUTING POSITIVE- FIXATION POROUS TIP PACING LEAD 史威類固醇沖提正極固定多孔尖端電極導線 * 適應症請見備註欄 SELUTE ATRIAL-J PICOTIP PACING LEAD 須檢附心電圖報告專案報備使用 " 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 " 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 " 佳騰 " 纖幼植入式起搏電極導線 "GUIDANT" FINELINE II PACING LEAD* 適應症請見備註欄 " 聖猷達 " 亞提仙司心臟導線 "SJM" OPTISENSE LEAD * 應檢附心電圖報告專案報備使用 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 " 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 拜耳德尼克 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 " 拜耳德尼克 " 植入式心律調節器電極導線 "BIOTRONIK" SELOX ST/SELOX JT ENDOCARDIAL LEAD(SELOX ST 60,53; JT 53,45)* 需檢附心電圖報告專案報備使用 " 拜耳德尼克 " 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 " 佳騰 " 類固醇 (VDD 型 ) 心內膜心房電極導線 "GUIDANT"SELUTE PICOTIP VDD PACING LEADS* 應檢附心電圖報告專案報備使用 " 美敦力 " 賽西兒導線 "MEDTRONIC"SELECTSURE LEAD* 適應症請見備註欄 美敦力 蓋普夏整律導管"METRONIC" CAPSURE VDD-2 LEAD* 適應症請見備註欄

265 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 FHPL2SLX65BK " 拜耳德尼克 " 世樂植入式電極導線 "BIOTRONIK" SOLOX IMPLANTABLE ENDOCARDIAL LEAD* 適應症請見備註欄 FHV010019AST AORTIC VALVE FHV010025MST " 聖猷達 " 人工機械瓣膜 "ST.JUDE" MECHANICAL HEART VALVE FHV0117AHPST AORTIC VALVE FHV01A1927ST REGENT MECHANICAL HEART VALVE 瑞珍機械性心臟瓣膜 FHV01A1929F6 " 翁克斯 " 人工心瓣膜 "ON-X" PROSTHETIC HEART VALVE 19:29MM FHV01A19LNR5 SORIN BICARBON ARTIFICIAL AORTIC HEART VALVE 17:31MM FHV01AMHPJST MECHANICAL HEART VALVE 人工機械瓣膜 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 FHV01ART19R5 " 索林 " 百康保雙葉式人工心臟瓣膜 "SORIN" BICARBON ARTIFICIAL HEART VALVE 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 FHV01CNNFVF6 " 翁克斯 " 人工心瓣膜 "ON-X" PROSTHETIC HEART VALVE FHV01DPMHVM4 美敦力 心臟瓣膜 MEDTRONIC OPEN PIVOT HEART VALVE FHV01EZ770M4 HALL EASY-FIT PROSTHETIC HEART VALVE FHV01M19LSR5 SORIN BICARBON ARTIFICIAL MITRAL HEART VALVE 19:33MM FHV01M2333F6 " 翁克斯 " 人工心瓣膜 "ON-X" PROSTHETIC HEART VALVE 23:33MM FHV01MTR19R5 " 索林 " 百康保雙葉式人工心臟瓣膜 "SORIN" BICARBON ARTIFICIAL HEART VALVE 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 FHV M4 FREESTYLE AORTIC ROOT BIOPROSTHESIS(19MM:27MM) 適應症請 見備註欄 FHV022500PED PRIMA PLUS STENTLESS BIOPROSTHESIS 適應症請見備註欄 FHV M4 THE PRESTYLED FREESTYLE BIOPROSTHESIS FHV02A2625ED CARPENTIER-EDWARDS BIOPROSTHESES FHV02A2650ED " 愛德華 " 卡本特愛德華人工心臟瓣膜 "EDWARDS"CARPENTIER EDWADRS S.A.V. BIOPROSTHESIS FHV02B10AMST PORCIN HEART VALVE (AORTIC 21MM:29MM,MITRAL 25MM:35MM) FHV02B2933ST " 聖猷達 " 豬組織瓣膜 "SJM"PORCINE VALVE FHV02ELEAMST SJM EPIC VALVE AORTIC-21A-31A MITRAL-25M-35M FHV02EPSAMST " 聖猷達 " 豬組織瓣膜 "SJM" EPIC VALVE FHV02T505TM4 HANCOCK II BIOPROSTHETIC HEART VALVE(AORTIC :29MM,MITRAL 25:33MM) FHVR104100ED 卡本特 - 麥卡錫亞當二尖瓣修補環 "EDWARDS"CARPENTIER MCCARTHY-ADMA IMR ETLOGIX ANNULOPLASTY RING24MM:34MM FHVR104450ED C/E PHYSIO ANNULOPLASTY RING(24:40MM) FHVR104600ED COSGROVE-EDWARDS ANNULOPLASTY SYSTEM(26:38MM) FHVR1AFR23ST " 聖猷達 " 愛調環狀成形術環 "SJM" ATTUNE FLEXIBLE ADJUSTABLE ANNULOPLASTY RING FHVR1CG638M4 COLVIN-GALLOWAY FUTURE ANNULOPLASTY BAND 瓣膜成型帶 FHVR1M4900ED " 愛德華 " 三尖瓣環成形術系統 "EDWARDS"MC3 TRICUSPID ANNULOPLASTY SYSTEM FHVR1RSARNST " 聖猷達 " 環狀成形術環 "SJM" RIGID SADDLE RING FHVR1SARNNST 環狀成形術環 SEGUIN ANNULOPLASTY RING FHVR1SARPNST 環狀成形術環 SEGUIN ANNULOPLASTY RING

266 FHVR1T4528ED CARPENTIER-EDWARDS CLASSIC ANNULOPLASTY RING(26:36MM) FHVR1TARNNST SJM TAILOR ANNULOPLASTY RING(25MM:35MM) FHVR1TARPNST TAILOR ANNULOPLASTY RING 泰勒環狀成形術環 FHX M4 MINIMAX PLUS OXYGENATOR FHX M4 OCTOPUS 4 TISSUE STABILIZER SYSTEM ( 產品型號 自 94 年 月 1 日生效 )29700&29800 自 95 年 9 月 1 日刪除給付 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 FHX02CB100QM " 邁柯唯 " 噴射灌洗器 ( 滅菌 )"MAQUET" JET LAVAGE(STERILE)* 適應 2425 症請見備註欄 FHX02E4012E8 SYNERGY ATTACHMENT * 心臟不停跳冠狀動脈繞道手術用吸引式穩 定器 FHX02E401SE8 CORONARY ARTERY STABILIZER * 心臟不停跳冠狀動脈繞道手術用 穩定器 FHX02E4031E8 艾斯泰格 穩定器與定位器 - 心臟不停跳冠狀動脈繞道手術用穩 定器 ESTECH STABILIZER AND POSITIONER-TITAN STABILIZER* 給付規定請見備註欄 FHX02E4210E8 艾斯泰格 穩定器與定位器 - 噴射灌洗器 ( 滅菌 ) ESTECH 2425 STABILIZER AND POSITIONER-BLOW MISTER (STERILE) FHX02FX15RTM " 泰爾茂 " 菲斯膜型人工心肺 "TERUMO"CAPIOX FX(OXYGENATOR WITHOUT RESERVOIR WITH HYDROPHILIC POLYMER COATED AND ARTERIAL FILTER* 適應症請見備註欄 FHX02HMM50QM " 邁柯唯 " 微孔膜氧合器 "MAQUET" QUADROX-I SMALL ADULT MICROPOROUS MEMBRANE OXGENATOR* 適應症請見備註欄 FHX02HMS70QM " 邁柯唯 " 微孔膜氧合器 "MAQUET" OXYGENATOR QUADROX-I WITH SOFTLINE COATING * 適應症請見備註欄 FHX02LAVAGGJ " 吉生 " 噴射灌洗器 ( 滅菌 )"JSM" JET LAVAGE(STERILE)* 適應症請 2425 見備註欄 FHX02MBSTRM4 " 美敦力 " 噴射灌洗器 "MEDTRONIC" BLOWER/MISTER(WITH TUBING 2425 SET) FHX02MT222L5 加州 灌洗器 CALIFORNIA BLOWER/MISTER(WITH TUBING 2425 SET) * 適應症請見備註欄 FHX02RX050TM CAPIOX RX HOLLOW FIBER OXYGENATOR WITHOUT RESERVOIR BY X COATING FHX02RX150TM 泰爾茂 膜型人工心肺 RX TERUMO CAPIOX RX OXYGENATOR(WITHOUT RESERVOIR)* 適應症請見備註欄 FHX02RX250TM CAPIOX RX OXYGENATOR WITHOUT/RESERVOIR W/HYDROPHILIC POLYMER COATED 適應症請見備註欄 ( 二 )( 產品型號 CX*RX25W,CX*RX25E 自 94 年 10 月 1 日生效 ) 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 FHX02UM600GU ACROBAT OFF-PUMP SYSTEM STABILIZER WITH BLADES 心臟不停跳 穩定器 FHX02UM900QM ACROBAT VACUUM OFF PUMP SYSTEM(ACCESS RAIL PLATFORM+STABILIZER+VACCUM TUBING SET) FHX M4 MINIMAX PLUS OXYGENATOR WITH RESERVOIR FHX TM 丟棄式離心幫浦 "TERUMO" DISPOSABLE CENTRIFUGUAL PUMP 適應症 9528 請見備註欄 FHX030BP80M4 BIO-PUMP 適應症請見備註欄 9528 FHX030DP38M4 BIO-PROBE INSERT 適應症請見備註欄

267 FHX M4 艾克模薄膜式人工心肺 MEDTRONIC ECMO SILICON MEMBRANE OXGENATOR* 適應症請見備註欄 FHX R5 " 索倫 " 康倍佛進化成人氧合器 "SORIN" DIDECO COMPACTFLO EVOLUTION ADULT OXYGENATOR(WITH HARDSHELL VENOUS RESERVOIR) FHX R5 " 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) FHX R5 " 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 FHX R5 " 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 FHX R5 " 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 FHX R5 " 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 FHX03541TTM4 AFFINITY NT HOLLOW FIBER OXYGENATOR WITH TRILLIUM BIOPASSIVE SURFACE AND INTEGRATED CVR NT 含心臟切開術靜脈貯槽之人工心肺 * 適應症請見備註欄 FHX03A5410M4 AFFINITY NT HOLLOW FIBER OXYGENATOR WITH TRILLIUM BIOPASSIVE SURFACE AND INTEGRATED CVR NT FHX03A541TM4 AFFINITY NT HOLLOW FIBER OXYGENATOR W/RESERVOIR (TRILLIUM COATED) 適應症請見備註欄 FHX03BPX80M4 BIO-PUMP PLUS CENTRIFUGAL BLOOD PUMP * 適應症請見備註欄 9528 FHX03CB511M4 AFFINITY HOLLOW FIBER OXYGENATOR BIOACTIVE SURFACE 適應 症請見備註欄 FHX03FC038TM 泰爾茂 血液幫浦 - 流量接頭 TERUMO CAPIOX SP PUMP-FLOW 914 CONNECTOR* 適應症請見備註欄 FHX03FS038TM CAPIOX SP BLOOD FLOW SENSOR 適應症請見備註欄 914 FHX03FX15RTM " 泰爾茂 " 菲斯膜型人工心肺 "TERUMO"CAPIOX FX(OXYGENATOR WITH RESERVOIR WITH HYDROPHILIC POLYMER COATED AND ARTERIAL FILTER* 適應症請見備註欄 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 FHX03HMM71QM " 邁柯唯 " 微孔膜氧合器 "MAQUET" QUADROX-I ADULT MICROPOROUS MEMBRANE OXYGENATOR* 適應症請見備註欄 FHX03ME002ML HOLLOW FIBER OXYGENATOR WITH RESERVOIR,RHEOPARIN COATED(HILITE 7000ADULT/HILITE 2800PEDIATRIC/HILITE 1000INFANT) 適應症請見備註欄 FHX03ME062ML HOLLOW FIBER OXYGENATOR WITH RESERVOIR,(HILITE ADULT/HILITE 2800PEDIATRIC/HILITE 1000INFANT) FHX03MECL6ML " 美德思 " 人工心肺 "MEDOS"OXYGENATOR* 適應症請見備註欄 FHX03MEDP2ML " 美德思 " 血液幫浦系統 "MEDOS"DELTASTREAM BLOOD PUMP SYSTEM* 9528 適應症請見備註欄 FHX03PHEADH9 " 華億 " 體外循環管組 "HYM" HEART LUNG PACK(PUMP HEAD)* 適應症 9528 請見備註欄 FHX03PMAG1T8 索羅格 善翠美血液幫浦 THORATEC CENTRIMAG BLOOD PUMP* 適應症請見備註欄 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

268 FHX03RX05RTM CAPIOX RX HOLLOW FIBER OXYGENATOR WITH RESERVOIR BY X COATING FHX03RX15RTM 泰爾茂 膜型人工心肺 RX TERUMO CAPIOX RX OXYGENATOR* 適 應症請見備註欄 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 生效 ) FHX03SP045TM CAPIOX SP PUMP HEAD 適應症請見備註欄 9528 FHX03SX10RTM CAPIOX SX MEMBRANE OXYGENATOR WITH HARD-SHELL RESERVOIR (PEDIATRIC) FHX03SX18RTM CAPIOX SX MEMBRANE OXYGENATOR WITH HARD-SHELL RESERVOIR (ADULT) 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 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 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 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 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 FHX03VKM55QM " 邁柯唯 " 微孔膜氧合器附靜脈硬殼式儲血槽 OXYGENATOR QUADROX I WITH SOFTLINE COATING WITH VENOUS HARDSHELL RESERVOIR ARTERIAL* 適應症備註欄 FHX03VKM71QM " 邁柯唯 " 微孔膜氧合器附靜脈硬殼式儲血槽 OXYGENATOR QUADROX I WITH SOFTLINE COATING WITH VENOUS HARDSHELL RESERVOIR+FILTER* 適應症見備註欄 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 FHX04A20E1H9 "HYM" HEART LUNG PACK(W/OXYGENATOR+PUMP HEAD+FLOW PROBE+TUBING SET 等 ) 適應症請見備註欄 FHX04A21E1H9 "HYM" HEART LUNG PACK(W/OXYGENATOR+FLOW PROBE+TUBING SET 等 ) 適應症請見備註欄 FHX04A31CPH9 HEART LUNG PACK 適應症備註 PRE BYPASS FILTER+ORGANIZER+SUCKER*2+ARTERIAL FILTER+TRANSDUCER+PROBE CONNECTOR+SATURATION CUVETTE+PUMP HEAD FHX04CB1V9M4 BLOOD TUBING PACK 血液套裝組 (OXYGENATOR+BIO-PUMP+TUBING SET+DISPOSABLE PROBE) 型號 CB1Q91R4,CB2503R1 自 生效 FHX04CB4P7M4 " 美敦力 " 血液套裝組 MEDTRONIC BLOOD TUBING PACK(WITHOUT OXYGENATOR)* 適應症請見備註欄 FHX04CBCCSM4 ECMO CLOSE CHEST SUPPORT CIRCUIT W/OXYGENATOR+BIO PUMP+TUBING SET 使用參考見備註欄 CB2506 於 擴增 FHX04CXESLTM CAPIOX EBS OXYGENATOR KIT(HP) 人工心肺套 /OXYGENATOR+SP- PUMP+TUBING SET 使用參考請見備註欄

269 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 FHX04ME620ML ECMO LT SYSTEM(OXGENATOR+TUBING,A-V LOOP,ADAPTOR,ACCESSORY+PUMP HEAD) 適應症請見備註欄 FHX04ME623ML ECMO LT SYSTEM WITHOUT PUMPHEAD 適應症請見備註欄 FHX04METUBML " 美德思 " 管路組 "MEDOS" TUBING SETS(ECMO)* 適應症請見備註欄 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 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 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 FHXR200321M4 AFFINITY VENOUS RESERVOIR BAG 3297 FHXR20CR40TM CARDIOTOMY RESERVOIR 4000CC 3297 FHXR2CAPDFGH CARDIOTOMY RESERVOIR/AUTOTRANSFUSION/PLEURAL DRAINAGE 3596 RESERVOIR 適應症請見備註欄 FHXR2EL400M4 CARDIOTOMY RESERVOIR* 適應症請見備註欄 3596 FHXR2RV500M4 VENOUS RESERVOIR 1820 FHXR2VHK11QM " 邁柯唯 " 靜脈硬殼式儲血槽 "MAQUET" VENOUS HARDSHELL 3596 CARDIOTOMY RESERVOIR 適應症請見備註欄 FHXR2VHK20QM " 邁柯唯 " 開心術靜脈硬殼式儲血槽 "MAQUET" VENOUS HARDSHELL 3297 CARDIOTOMY RESERVOIR FNP CM " 柯特曼 " 人工腦膜 "CODMAN"DURAFORM DURAL GRAFT 3443 IMPLANT(2.5CM*7.5CM) FNP CM " 柯特曼 " 人工腦膜 "CODMAN"DURAFORM DURAL GRAFT 4403 IMPLANT(5CM*5CM) FNP CM " 柯特曼 " 人工腦膜 "CODMAN"DURAFORM DURAL GRAFT IMPLANT(7.5CM*7.5CM) FNP CM " 柯特曼 " 人工腦膜 "CODMAN"DURAFORM DURAL GRAFT IMPLANT(10CM*12.5CM) FNP BB NEURO PATCH 2X10CM 3486 FNP GX DURA SUBSTITUTE 2CMX10CM( 代用人工腦膜 ) 3486 FNP910205XGX DURA SUBSTITUTE 2CMX5CM 2000 FNP910210XGX DURA SUBSTITUTE 2CMX10CM 3486 FNP N7 DURAGEN DURAL GRAFT MATRIX 2.5CMX7.5CM 3443 FNP BB NEURO PATCH 4X5CM 3486 FNP BB NEURO PATCH 4X10CM 6797 FNP910404XGX DURA SUBSTITUTE 4CMX4CM 2979 FNP GX DURA SUBSTITUTE 5CMX6CM( 代用人工腦膜 ) 6011 FNP910506XGX DURA SUBSTITUTE 5CMX6CM 6011 FNP BB NEURO PATCH 6X8CM 7819 FNP S7 " 司諾維思 " 腦膜補片 "SYNOVIS"DURA-GUARD DURAL REPAIR PATCH 9725 WITH APEX PROCESSING 6CM*8CM FNP GX DURA SUBSTITUTE 6CMX10CM( 代用人工腦膜 ) FNP BB NEURO PATCH 6X14CM FNP910610XGX DURA SUBSTITUTE 6CMX10CM FNP N7 DURAGEN DURAL GRAFT MATRIX 7.5CMX7.5CM FNP S7 " 司諾維思 " 腦膜補片 "SYNOVIS"DURA-GUARD DURAL REPAIR PATCH WITH APEX PROCESSING8CM*14CM

270 FNP GX DURA SUBSTITUTE 10CMX12CM( 代用人工腦膜 ) FNP S7 " 司諾維思 " 腦膜補片 "SYNOVIS"DURA-GUARD DURAL REPAIR PATCH WITH APEX PROCESSING 10CM*16CM FNP N7 DURAGEN DURAL GRAFT MATRIX 10CMX12.5CM FNP911012XGX DURA SUBSTITUTE 10CMX12CM FNP BB "B.BRAUN"NEURO-PATCH 12CMX14CM FNP BB NEURO PATCH 1.5X3CM 750 FNP T0 WIRE MESH 10X10CM 263 FNP AE " 雅氏 " 雷歐普代用腦膜 "AESCULAP" LYOPLANT 6CM*14CM FNP AE " 雅氏 " 雷歐普代用腦膜 "AESCULAP" LYOPLANT 4CM*10CM 8000 FNP AE " 雅氏 " 雷歐普代用腦膜 "AESCULAP" LYOPLANT 4CM*5CM 4000 FNP AE " 雅氏 " 雷歐普代用腦膜 "AESCULAP" LYOPLANT 2CM*10CM 4000 FNP AE " 雅氏 " 雷歐普代用腦膜 "AESCULAP" LYOPLANT 1.5CM*3CM 900 FNP AE " 雅氏 " 雷歐普代用腦膜 "AESCULAP" LYOPLANT 6CM*8CM 9600 FNP91CDUR1CK "COOK"DURASIS DURAL SUBSTITUTE" 曲克 " 硬腦膜替代物 2CM*3CM 1102 FNP91CDUR2CK "COOK"DURASIS DURAL SUBSTITUTE" 曲克 " 硬腦膜替代物 4CM*7CM 4403 FNP91DUR01CK " 曲克 " 硬腦膜替代物 "COOK" DURASIS DURAL SUBSTITUTE 7CM CM FNP91DUR02CK " 曲克 " 硬腦膜替代物 "COOK" DURASIS DURAL SUBSTITUTE 7CM CM FPM HH MICROGRAFT GAUZE WITH CORKPLATE 1:4 適應症請見備註欄 1700 FPM HH MICROGRAFT GAUZE WITH CORKPLATE 1:6 適應症請見備註欄 1700 FPM HH MICROGRAFT GAUZE WITH CORKPLATE 1:9 適應症請見備註欄 1700 FPP LE STRYKER LEIBINGER UNIVERSAL MANDIBLE SYSTEM:1.7MM MID- FACE SET LOCKING DOUBLE Y PLATE 7 HOLES 適應症請見備註欄 2469 FPP010574NLE MINI DOUBLE Y PLATE 7 HOLE 適應症請見備註欄 2469 FPP M3 0.6MM,1.0MM TIANIUM LOW PROFILE MINI PLATE DOUBLE Y 6HOLE 2469 適應症請見備註欄 FPP010826NLE 2.0 MINI PLATE DOUBLE Y-PLATE 適應症請見備註欄 2469 FPP EJ 2.0 MM MINI X PLATE 4 HOLE 適應症請見備註欄 2469 FPP EJ 2.0 MM MINI DOUBLE Y PLATE 6 HOLE 適應症請見備註欄 2469 FPP Y2 MINI PLATE 1.0MM 6HOLE DOUBLE Y-SHAPE 適應症請見備註欄 2469 FPP MC TITANIUM 1MM MINI DOUBLE Y PLATE 9MM 6HOLE 適應症請見備 2469 註欄 FPP01A7120WR MINI X-PLATE REGULAR 4 HOLE 適應症請見備註欄 2469 FPP01A9260WR 0.6,1.0MM MINI DOUBLE Y PLATE 6:8HOLE 適應症請見備註欄 2469 FPP07421FFY2 "SYNTEC"FLAPFIX SYSTEM" 亞太醫療 " 顱骨固定系統 適應症請見 4000 備註欄 FPP07FF460S1 "SYNTHES"FLAPFIX SYSTEM:FLAPFIX(PURE TITANIUM)" 信迪思 " 顱 4000 骨固定系統 : 皮瓣固定夾 給付規定請見備註欄 FPP07FF490AE "AESCULAP"CRANIOFIX 2 TITANIUM CLAMP " 雅氏 " 第二代鈦合金頭 4000 骨固定夾 適應症請見備註欄 FPP07SF12FJL JEIL SPEEDY FLAP CRANIOPLASTY PLATE 偕猷 顱骨板固定 4000 系統 適應症請見備註欄 FPP W2 TENDON SPACER 3:6MM 2500 FPT L0 TISSUE EXPANDER 1CC~1000CC 適應症請見備註欄 9000 FPT01SC088A2 "ALLERGAN" TISSUE EXPANDERS" 愛力根 " 組織擴張器 適應症請見備註欄

271 FSAE171000SB TRACHEOBRONCHIAL WALLSTENT UNISTEP DELIVERY SYS. STENT5: *20:90MM 適應症見備註 M :390 FSAE1GTBXXQS " 博娜 " 氣管及支氣管支架 "BONASTENT" TRACHEAL/BRONCHIAL STENT* 適應症請見備註欄 FSAE1GTBXXSB "BOSTON SCIENTIFIC"ULTRAFLEX TRACHEOBRONCHIAL STENT SYSTEM 歐超福雷斯氣管和支氣管支架系統 * 適應症請見備註欄 FSP ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES" 舒法定 " 帕瑞挺人 1072 工聚丙烯編網 06X11CM FSP BA "BARD"SOFT MESH 柔軟修補網 7.5CMX15CM 10CMX15CM (15CMX15CM 1672 自 起刪除 ) FSP BA "BARD"SOFT MESH 柔軟修補網 5CMX10CM 4.5CMX10CM 6CMX13.7CM 1072 FSP BA "BARD"SOFT MESH" 巴德 " 柔軟修補網 15CMX15CM 1710 FSP ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES" 舒法定 " 帕瑞挺人 1672 工聚丙烯編網 15X10CM FSP ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES 15X15CM" 舒法定 " 1710 帕瑞挺人工聚丙烯編網 FSP ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES 30X30CM" 舒法定 " 3108 帕瑞挺人工聚丙烯編網 FSP BB PREMILENE MESH 2.5X10CM,5X10CM 1072 FSP610510MGX GORE-TEX MYCROMESH 5CMX10CM 1072 FSP610515MGX GORE-TEX MYCROMESH 5CMX15CM 1072 FSP JJ PROLENE POLYPROPYLENE MESH PMS,6*11CM 1072 FSP611015MGX GORE-TEX MYCROMESH 10CMX15CM 1672 FSP ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES 6X11CM" 舒法定 " 帕 1072 瑞挺人工聚丙烯編網 FSP BB "B.BRAUN"OPTILENE MESH 歐特靈網片 5CMX10CM 4.5CMX10CM CMX14CM FSP BB "B.BRAUN"OPTILENE MESH 歐特靈網片 7.5CMX15CM 10CMX15CM 1672 FSP BB "B.BRAUN"OPTILENE MESH 歐特靈網片 15CMX15CM 1710 FSP BB "B.BRAUN"OPTILENE MESH 歐特靈網片 26CMX36CM 30CMX30CM 3108 FSP DV MARLEX MESH 1"X4"X0.6MM( 自 起改為 BARD MESH FLAT 1072 SHEET1"X4") FSP DV MARLEX MESH 10"X14"( 自 起改為 BARD MESH FLAT 3108 SHEET10"X14") FSP DV MARLEX MESH 2"X12"( 自 起改為 BARD MESH FLAT 1672 SHEET2"X12") FSP DV MARLEX MESH 3"X6" (2PCS/BOX)( 自 起改為 BARD MESH FLAT 1672 SHEET3"X6") FSP ZQ "SOFRADIM"PARIETENE POLYPROPYLENE MESHES 15X10CM" 舒法定 " 1672 帕瑞挺人工聚丙烯編網 FSP BB PREMILENE MESH 7.5X15CM,15X15CM,5X30CM,10X15CM 1672 FSP JJ PROLENE POLYPROPYLENE MESH PMM,15*15CM 1710 FSP QM "MAQUET"MESH 內植用網 2.5CMX10.2CM 1072 FSP SB MESH 內植用網 2.5CMX10.2CM 1072 FSP QM "MAQUET"MESH 內植用網 5.1CMX30.5CM,7.6CMX15.2CM 1672 FSP SB MESH 內植用網 5.1CMX30.5CM 1672 FSP QM "MAQUET"MESH 內植用網 25.4CMX35.6CM 3108 FSP SB MESH 內植用網 25.4CMX35.6CM 3108 FSP QM "MAQUET"MESH 內植用網 15.2CMX15.2CM 1710 FSP SB MESH 內植用網 15.2CMX15.2CM 1710 FSP BB PREMILENE MESH 30X30CM,26X36CM 3108 FSP JJ PROLENE POLYPROPYLENE MESH PML,30*30CM

272 FSP AH FSP AH FSP AH FSP AH FSP AH FSP AH FSP61PL212AH FSP61PL609AH FSP61S00352C FSP61S0035US FSP61S01492C FSP61S0149US FSP DV FSP63CHM01CK FSP AM FSP AM FSP ET FSP71BRD16BA FSP71TVT0MYM FSP71TVTRLYM FSP AM "ATRIUM"PROLITE P0LYPROPYLENE MESH 普來聚丙烯網片 (2.5CMX10CM,5CMX10CM) "ATRIUM"PROLITE P0LYPROPYLENE MESH 普來聚丙烯網片 (7.5CMX15CM,10CMX15CM) "ATRIUM"PROLITE P0LYPROPYLENE MESH 普來聚丙烯網片 (15CMX15CM) "ATRIUM"PROLITE POLYPROPYLENE MESH PROLITE ULTRA(20X25.4CM) 普來聚丙烯網片 "ATRIUM"PROLITE POLYPROPYLENE MESH PROLITE ULTRA(25.4X25.4CM) 普來聚丙烯網片 "ATRIUM"PROLITE P0LYPROPYLENE MESH 普來聚丙烯網片 (25.4CMX35.5CM,30CMX30CM) "ATRIUM"PROLITE P0LYPROPYLENE MESH 普來聚丙烯網片 (5CMX30CM) "ATRIUM"PROLITE POLYPROPYLENE MESH PROLITE(15X23CM) 普來聚丙烯網片 "COVIDIEN"SYNETURE SURGIPRO MESH 3"X5" " 柯惠 " 舒耐久聚丙烯編網 "USS"SYNETURE SURGIPRO MESH 3"X5" " 優施西 " 舒耐久聚丙烯編網 "COVIDIEN"SYNETURE SURGIPRO MESH 14"X9" " 柯惠 " 舒耐久聚丙烯編網 "USS"SYNETURE SURGIPRO MESH 14"X9" " 優施西 " 舒耐久聚丙烯編網 "DAVOL"BARD MESH PERFIX PLUG" 德柏 " 巴德修補網 : 珀菲斯塞子 ( 高 / 直徑 1"/1.35" 1.3"/1.55" 1.6"/1.9" 1.6"/2.0") "COOK"BIODESIGN SURGISIS INGUINAL HERNIA GRAFT" 曲克 " 拜爾迪賽瑟集喜司腹股溝疝氣支撐物 10CMX15CM.6CMX13CM.8CMX15CM.* 適應症請見備註欄 "AMS"SPARC SLING SYSTEM 懸吊手術系統 ( 兩支不銹鋼彎曲弓狀穿引針 ( 不需再使用 INTRODUCER)+ 一條聚丙烯懸帶 ) "AMS"MONARC SUBFACIAL HAMMOCK 懸吊手術系統 ( 兩支不銹鋼彎曲弓狀穿引針 ( 不需再使用 INTRODUCER)+ 一條聚丙烯懸帶 ) "ETHICON"TENSION-FREE VAGINAL TAPE(TVT)DEVICE 含 INTRODUCER 及 RIGID CATHETER GUIDE "BARD"ALIGN URETHRAL SUPPORT SYSTEM( 含 INTRODUCER+MESH ASSEMBLY) 艾萊尿道支撐系統 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 ) "GYNECARE"TVTEXACT CONTINENCE SYSTEM" 蓋那客 " 尿失禁手術用懸吊帶依捷特系統 ( 含放置環 螺旋型導針 無創帶翼導引器 ) "AMS"ADVANCE MALE SLING SYSTEM" 艾梅斯 " 艾得滿適男性尿道懸吊帶系統 (2 支植入穿引針 +1 條網膜懸吊帶 )* 適應症請健備註欄 FUK02CA101NV EXTRACORPOREAL TUBING SET(CAVH TUBING SET) 730 FUK02HEF2XGA GAMBRO HEMOFILTER 2252 FUK02PAN06AS CAVH HEMOFILTER( 產品型號 PAN-03,PAN-10 自 94 年 10 月 1 日起生效, 2252 文號 ) FUK02TS013FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS(CAVH TUBING SET) 英 730 弗梅體外血液迴路管 FUK0300HP1KU HEMOPERFUSION CARTRIDGE

273 FUK030300CGA ADSORBA 300GM FUK03300KTGA "GAMBRO"PRISMAFLEX ADSORBA 300KIT " 衛寶 " 吸附器套組 ( 灌注器 體外血液迴路管 ) FUK03TS205FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS-HEMOPERFUSION 英弗梅 1393 體外血液迴路管 - 血液灌流 FUK03TS206FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS-PEDIATRIC 1393 HEMOPERFUSION 英弗梅體外血液迴路管 - 小兒血液灌流 FUK03TS407FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS-HEMOPERFUSION 英弗梅 1393 體外血液迴路管 - 血液灌流 FUK03TS408FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS-PEDIATRIC 1393 HEMOPERFUSION 英弗梅體外血液迴路管 - 小兒血液灌流 FUK04AV60SGA GAMBRO KIT FOR CAVH&CAVHD 4221 FUK04PAN10AS HEMOFILTER 2252 FUK0500M60GA PRISMA SET(CVVH TUBING+HEMOFILTER) 膜面積 0.6M 平方, 連續式血 4847 液透析器及迴路套管 * 適應症請見備註欄 FUK GA PRISMAFLEX SET(CVVH TUBING+HEMOFILTER) 膜面積 1.1M 平方 * 適應 5400 症請見備註欄 FUK GA PRISMAFLEX SET(CVVH TUBING+HEMOFILTER) 膜面積 1.4M 平方 * 適應 5400 症請見備註欄 FUK050M100GA PRISMA SET(CVVH TUBING+HEMOFILTER) 膜面積 0.9M 平方, 連續式血 5400 液透析器及迴路套管 * 適應症請見備註欄 FUK05DF030FN "INFOMED"CVVH HEMOFILTER 0.3M 平方新生兒血液過濾器 * 適應症 3645 請見備註欄 FUK05DF080FN "INFOMED"CVVH HEMOFILTER 0.8M 平方血液過濾器 * 適應症請見備 3645 註欄 FUK05DF140FN "INFOMED"CVVH HEMOFILTER 1.4M 平方血液過濾器 * 適應症請見備 4095 註欄 FUK05DF190FN "INFOMED"CVVH HEMOFILTER 1.9M 平方血液過濾器 * 適應症請見備 4095 註欄 FUK05F0M60GA PRISMAFLEX SET(CVVH TUBING+HEMOFILTER)0.6M 平方 * 適應症請見 4847 備註欄 FUK05FHF20GA "GAMBRO"PRISMAFLEX SET(CVVH TUBING+HEMOFILTER)0.2M 平方普 4847 利司馬弗列克斯套組 * 適應症請見備註欄 FUK05FM100GA PRISMAFLEX SET(CVVH TUBING+HEMOFILTER)0.9M 平方 * 適應症請見 5400 備註欄 FUK05FM150GA "GAMBRO"PRISMAFLEX SET(CVVH TUBING+HEMOFILTER 膜面積 1.5M 平 5400 方 ) 普利司馬弗列克斯套組 * 適應症請見備註欄 FUK05HD150E9 CVVH HEMOFILTER* 適應症請見備註欄 3645 FUK05HD200E9 CVVH HEMOFILTER* 適應症請見備註欄 3645 FUK05HD300E9 CVVH HEMOFILTER* 適應症請見備註欄 4095 FUK05PF150GA "GAMBRO"PRISMAFLEX SET* 適應症請見備註欄 5400 FUK05PFXSTGA "GAMBRO"PRISMAFLEX SET(CVVH TUBING+HEMOFILTER) 膜面積 1M 平 5400 方 * 適應症請見備註欄. FUK05PR100GA "GAMBRO"PRISMA SET (CVVH TUBING+HEMOFILTER)1.15M 平方 * 適應 5400 症請見備註欄 FUK05PST60GA "GAMBRO"PRISMAFLEX SET(CVVH TUBING+HEMOFILTER) 膜面積 0.6M 4847 平方 * 適應症請見備註欄. FUK05RHF6SGA "GAMBRO"CVVH HEMOFILTER(0.6M 平方 ) 血液過濾器 * 適應症請見備 3645 註欄 FUK05ST100GA "GAMBRO"PRISMA SET(CVVH TUBING+HEMOFILTER) 膜面積 1.0M 平方 5400 連續式血液透析器及迴路管套 * 適應症請見備註欄 FUK05ST60PGA "GAMBRO"PRISMA SET 連續式血液透析器及迴路管套 * 適應症請見備註欄

274 FUK05TS002FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS FOR CF200-PEDIATRIC 1393 CVVH 英弗梅體外血液迴路管 * 適應症請見備註欄 FUK05TS200FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS FOR CF200- CVVH 英弗 1393 梅體外血液迴路管 * 適應症請見備註欄 FUK05TS201K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUITS-CVVH 英禾美體外血 1393 液迴路管 - 血液濾過 FUK05TS202K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUITS-CVVH(PEDIATRIC) 英 1393 禾美體外血液迴路管 - 小兒血液濾過 FUK05TS400FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS-CVVH 英弗梅體外血液 1393 迴路管 * 適應症請見備註欄 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 FUK05TS405K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT-PEDIATRIC 1393 CONTINUOUS VENO-VENOUS HEMOFILTRATION (CVVH)HF400/HF440 用英禾美體外血液迴路管 - 小兒血液濾過 FUK05TS504FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS-PEDIATRIC CVVH 英弗 1393 梅體外血液迴路管 * 適應症請見備註欄 FUK05U1000FA "FRESENIUS"POLYSULFONE HAEMOFILTERS(CVVH FILTER 1.8M 平方 4095 ) 人工合成膜血液過濾器 * 適應症請見備註欄 FUK05U400SFA "FRESENIUS"POLYSULFONE HAEMOFILTERS(CVVH FILTER 0.7M 平方 ) 3645 人工合成膜血液過濾器 * 適應症請見備註欄 FUK05U600SFA "FRESENIUS"POLYSULFONE HAEMOFILTERS(CVVH FILTER 1.4M 平方 ) 4095 人工合成膜血液過濾器 * 適應症請見備註欄 FUS AM "AMS"800 URINARY CONTROL SYSTEM(CONTROL PUMP+PRESSURE REGULATING BALLOON+BELT CUFFS+800 ACCESSORY KIT )" 艾梅斯 " 尿控系統 * 適應症請見備註欄 FUT01CYST1ZP "BIONICHE"CYSTISTAT STERILE SODIUM HYALURONATE SOLUTION 4819 喜仕膀胱灌注液 * 適應症請見備註欄 HEF H9 " 華億 " 體外循環管組 "HYM"HEART LUNG PACK-ARTERIAL FILTER /8" ADULT 20 MICRO HEF H9 HEART LUNG PACK:ARTERIAL FILTER WITH HEPARIN 1716 COATING(ADULT;PEDIATRIC;INFANT)* 體外循環 120 分以上用 HEF01AFS40GH BLOOD ARTERIAL FILTER 40 MICRO WITH INTEGRATED BYPSS WITH 1629 INLET TUBING ATTACHED* 適應症請見備註欄 HEF01ARF40H9 " 華億 " 體外循環管組 - 動脈過濾器 "HYM" HEART LUNGPACK ARTERIAL FILTER 40MICRO HEF01GAF25GH HEPARIN COATED 25 MICRON WITH INTEGRATED BYPASS AND INLET 1716 TUBING ATTACHED* 限體外循環超過 120 分鐘患者使用 HEF01GAF2BGH 25 MICRON WITHOUT INTEGRATED BYPASS AND INLET TUBING 1629 ATTACHED HEF01GAF40GH ARTERIAL FILTER 40 MICRO W/INTEGRATED BYPASS,INLET 1716 TUBING* 體外循環 120 分以上用 ( 生效 ) HEF M4 PEDIATRIC ARTERY FILTER 1629 HEF02A3510M4 AFFINITY ARTERIAL FILTER 1629 HEF02AF001TM ARTERY FILTER ADULT 1629 HEF02AF002TM ARTERY FILTER PEDIATRIC 1629 HEF02AF125TM CAPIOX ARTERIAL FILTER 1629 HEF02E3840P3 EXTRA CORTOREAL FILTER 體外循環血液過濾器 ( 開心用 ) 1629 HEF02HBF14QM " 邁柯唯 " 動脈過濾器 "MAQUET" QUART ARTERIAL FILTER 1629 HEF02S4104M4 " 美敦力 " 艾芬你堤兒童動脈過濾器 "MEDTRONIC"AFFINITY 1629 PEDIATRIC ARTERIAL FILTER HEF030P005AS PLASMAFLO

275 HEF030P008AS PLASMAFLO(PLASMA FILTER) 4500 HEF030PS06KU PVA FILTER,PLASMACURE 4500 HEF030PS08KU 固拉力血漿分離器 KURARAY PLASMACURE PE PLASMA SEPARATOR 4500 HEF032011NF5 MJ BLOOD LINE SET FOR BLOOD PURIFICATION 邁捷血液淨化迴路 1500 導管 HEF03EC030AS " 旭 " 血漿成分分離器 "ASAHI" CASCADEFLO EC PLASMA COMPONENT 4500 SEPARATOR HEF03EVACLKA " 川澄化工 " 膜型血漿分離器 "KAWASUMI LABORATORIES" PLASMA 4500 SEPARATOR EVACLIO HEF03EVACUKA EVACURE PLASMA SEPARATOR 4500 HEF03EVAFLKA EVAFLUX 血液成份分離器加血液迴路管組 6000 HEF03EVAFXKA " 川澄化工 " 血漿成分分離器 "KAWASUMI LABORATORIES" PLASMA 4500 FRACTIONATOR EVAFLUX HEF03HD400E9 雙重濾過血液濾過器 HEMOFILTER 6000 HEF03HD500E9 雙重濾過血液濾過器 HEMOFILTER 6000 HEF03KPD80KA " 川澄 " 血漿交換用血液迴路管 "KAWASUMI" BLOOD TUBING LINE 1500 FOR PLASMA EXCHANGE HEF03KPE88KA "KAWASUMI LABORATORIES" BLOOD TUBING LINE FOR PLASMA 1500 EXCHANGE " 川澄化工 " 血漿交換用血液迴路導管 HEF03LF030FN " 英弗梅 " 血漿過濾器 "INFOMED"PLASMAFILTER 4500 HEF03LF050FN " 英弗梅 " 血漿過濾器 "INFOMED"PLASMAFILTER 4500 HEF03LF070FN " 英弗梅 " 血漿過濾器 "INFOMED"PLASMAFILTER 4500 HEF03P1DRYFA " 費森尤斯 " 血漿過濾器 "FRESENIUS" PLASMAFILTER 4500 HEF03PLA20E9 MEDICA PLASMAFILTERS 0.15 平方公尺 4500 HEF03PLA40E9 MEDICA PLASMAFILTERS 0.35 平方公尺 4500 HEF03PLA60E9 MEDICA PLASMAFILTERS 0.55 平方公尺 4500 HEF03PRFPEGA "GAMBRO"PRISMAFLEX SET 血漿透析器及血液迴路管 6000 HEF03PRLPEGA "GAMBRO"PRISMAFLEX SET 血液透析器及迴路管套 6000 HEF03PRTPEGA "GAMBRO"PRISMA SET 連續式血液透析器及迴路管套 6000 HEF03PS08SKA 川澄化工血漿分離器 KAWASUMI LABORATORIES PLASMACURE PE 4500 PLASMA SEPARATOR HEF03PS08TKU 固拉力血漿分離器及血液迴路管 KURARAY PLASMA SEPARATOR & 6000 BLOOD TUBING LINE HEF03TS203FN 英弗梅體外血液迴路管 INFOMED EXTRACORPOREAL BLOOD 1500 CIRCUITS(FOR CF200 PLASMA EXCHANGE) HEF03TS203K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT FOR CF200-PLASMA 1500 EXCHANGE 英禾美 CF200 用體外血液迴路管 - 血漿置換 HEF03TS204FN 英弗梅體外血液迴路管 INFOMED EXTRACORPOREAL BLOOD 1500 CIRCUITS(FOR CF200-PEDIATRIC PLASMA EXCHANGE) HEF03TS204K5 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT FOR CF PEDIATRIC PLASMA EXCHANGE 英禾美 CF200 用體外血液迴路管 - 小兒血漿置換 HEF03TS401FN 英弗梅體外血液迴路管 INFOMED EXTRACORPOREAL BLOOD CIRCUITS 1500 HEF03TS401K5 HEF03TS402K5 HEF03TS406K5 HEF03TSP02FN HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT-DOUBLE FILTRATION HF400/HF440 用英禾美體外血液迴路管 - 雙重濾過 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT-PLASMA EXCHANGE 體外血液迴路管 - 血漿置換 HEMOSCIEN EXTRACORPOREAL BLOOD CIRCUIT-PEDIATRIC PLASMA EXCHANGE 英禾美體外血液迴路管 - 小兒血漿置換英弗梅體外血液迴路管 INFOMED EXTRACORPOREAL BLOOD CIRCUITS(FOR PLASMA EXCHANGE)

276 HEF03TSP06FN 英弗梅體外血液迴路管 INFOMED EXTRACORPOREAL BLOOD 1500 CIRCUITS(PEDIATRIC PLASMA EXCHANGE) HEF05CPS02P3 PALL EXTRACORPOREAL CIRCUIT FILTER* 適應症請見備註欄 722 HEF05VBT16QM " 邁柯唯 " 氣泡過濾器 "MAQUET" VENOUS BUBBLE TRAP 722 HEF060BC1BP3 PALL EXTRACORPOREAL CIRCUIT FILTER 限開心手術使用於 2995 BLOOD CARDIOPIEGIA SOLUTION 時申報 HEH01511SLTM HEMOCONCENTRATOR W/HEMODIALYSIS OR HEMOCARE TUBING SET 4600 適應症請見備註欄 HEH01HF53TFA " 比孚 " 血液濃縮器 "B.V."HEMOCONCENTRATORS(WITH TUBING)* 適應 4600 症請見備註欄 HEH01HPHJUMY " 米得克 " 血液濃縮器 "MINNTECH" HEMOCOR 3300 HEMOCONCENTRATOR( 小兒使用 )* 適應症請見備註欄 HEH01HPHTSMY " 米得克 " 血液濃縮器 "MINNTECH" HEMOCOR HEMOCONCENTRATOR* 4600 適應症請見備註欄 HEH01M1N1TMY HEMOCONCENTRATOR WITH CONNECTOR PACKAGE,TUBING" 米得克 " 血 3300 液濃縮器 * 適應症請見備註欄 HFF01096NTP3 TPN FILTER 0.2UUM 80 HFF BB STERIFIX INFUSION FILTER 00.2UM(T.P.N) 80 HFF02C8363BT TPN 0.22 MICRO FILTER 80 HFF02E25YFLL TPN FILTER W/EXTENSION TUBE 80 HFF02EF010SG TPN FILTER SET 0.22UM 80 HFF02EF15YSG TPN FILTER SET 0.22UM 80 HFF02ET15FLL TPN FILTER W/EXTENSION TUBE 80 HHF01P1ASDTM LEUKOCYTE REMOVAL FILTER IMUGARD III-PL* 適應症請見備註欄 1400 HHF01P214YTM LEUKOCYTE REMOVAL FILTER IMUGARD III-PL 12UNIT Y TYPE 適 1400 應症請見備註欄 HHF01PL110WX " 雙威 " 單次使用濾除白血球過濾器 ( 血小板用 )"SHUANGWEI" 1400 LEUKOCYTE REDUCTION FILTER FOR BLOOD HHF01PL210WX " 雙威 " 單次使用濾除白血球過濾器 ( 血小板用 )"SHUANGWEI" 1400 LEUKOCYTE REDUCTION FILTER FOR BLOOD HHF01PL310WX " 雙威 " 單次使用濾除白血球過濾器 ( 血小板用 )"SHUANGWEI" 1400 LEUKOCYTE REDUCTION FILTER FOR BLOOD HHF01PLX10AS SEPACELL LEUKOCYTE REMOVAL FILTER( 血小板專用 ) 過濾 12 UNIT* 1400 適應症請見備註欄 HHF01PPBBFFA LENKOCYTE REMOVAL FILTER FOR PLATELET CONCENTRATES* 適應症 1400 請見備註欄 HHF01PPBSFFA LENKOCYTE REMOVAL FILTER FOR PLATELET CONCENTRATES* 適應症 1400 請見備註欄 HHF01PXL8YP3 LEUKOCYTE REMOVAL FILTER FOR PLATELATE 適應症請見備註欄 1400 HHF01R0250JH 笙創白血球過濾器 SAFETRAN LEUKOCYTE REDUCTION FILTER/ 紅血 615 球濃厚液 1UNIT* 給付規定請見備註欄 HHF02R0500JH 笙創白血球過濾器 SAFETRAN LEUKOCYTE REDUCTION FILTER/ 紅血 820 球濃厚液 2UNIT* 給付規定請見備註欄 HHF02R204YTM LEUKOCYTE REMOVAL FILTER IMUGARD III-RC 500CC Y TYPE 適 615 應症請見備註欄 HHF02R500AAS SEPACELL LEUKOCYTE REMOVAL FILTER 1000CC( 紅血球專用 ) 適 820 應症請見備註欄 HHF02R602ETM IMUGARD III-RC LEUKOCYTE REMOVAL FILTER* 適應症請見備註欄

277 HHF02RC101WX " 雙威 " 單次使用濾除白血球過濾器 ( 全血及紅血球 615 用 )"SHUANGWEI" LEUKOCYTE REDUCTION FILTER FOR BLOOD(500CC) HHF02RC102WX " 雙威 " 單次使用濾除白血球過濾器 ( 全血及紅血球 820 用 )"SHUANGWEI" LEUKOCYTE REDUCTION FILTER FOR BLOOD(1000CC) HHF02RC201WX " 雙威 " 單次使用濾除白血球過濾器 ( 全血及紅血球 615 用 )"SHUANGWEI" LEUKOCYTE REDUCTION FILTER FOR BLOOD(500CC) HHF02RC202WX " 雙威 " 單次使用濾除白血球過濾器 ( 全血及紅血球 820 用 )"SHUANGWEI" LEUKOCYTE REDUCTION FILTER FOR BLOOD(1000CC) HHF02RCL1YP3 LEUKOCYTE REMOVAL FILTER FOR RBC 適應症請見備註欄 615 HHF02RM1N1FA LENKOCYTE REMOVAL FILTER FOR RED CELL CONCENTRATES* 適應症 615 請見備註欄 HHF02RPBB2FA LEUKOCYTE REMOVAL FILTER FOR RED CELL CONCENTRATE 過濾 CC* 適應症請見備註欄 HHF02RPBBFFA LENKOCYTE REMOVAL FILTER FOR RED CELL CONCENTRATES* 適應症 615 請見備註欄 HHF02RPBS2FA LEUKOCYTE REMOVAL FILTER FOR RED CELL CONCENTRATE 過濾 CC* 適應症請見備註欄 HHF02RPBSFFA LENKOCYTE REMOVAL FILTER FOR RED CELL CONCENTRATES* 適應症 615 請見備註欄 HHF02T1000JH 笙創白血球過濾器 SAFETRAN LEUKOCYTE REDUCTION FILTER/ 血小 1400 板用 12U* 給付規定請見備註欄 HHF04500A3AS SEPACELL LEUKOCYTE REMOVAL FILTER FOR RBC 2 UNIT 適應症 820 請見備註欄 HHF04R500AAS LEUKOCYTE REMOVAL FILTER( 紅血球專用 ) 過濾 1000CC 適應症請 820 見備註欄 HHM010040SP3 BLOOD TRANSFUSION FILTER 40UM 1500CC 305 HHM BB " 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) 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 HHM01466XNCD TRAPEASE PERMANENT VENA CAVA FILTER AND INTRODUCTION KIT HHM01500TWSB GREENFIELD VENA CAVA FILTER SET(INTRODUCER+FILTER+SHEATH/DILATOR+ADAPTER) HHM SB GREENFIELD VENA CAVA FILTER SYSTEM(INTRODUCER+FILTER+SHEATH/DILATOR+ADAPTER) HHM SB GREENFIELD VENA CAVA FILTER SYSTEM(INTRODUCER+FILTER+SHEATH/DILATOR+ADAPTER) HHM01AEGSYJQ " 先健 " 腔靜脈過濾器 "LIFETECH" AEGISY VENA CAVA FILTER SYSTEM(INTRODUCER CATH WITH FILTER,SHEATH/DILATOR) HHM01CELE1CK " 曲克 " 色列克特腔靜脈濾器組 "COOK" CELECT VENA CAVA FILTER SET HHM01CELECCK " 曲克 " 色列克特腔靜脈濾器 "COOK" CELECT VENA CAVA FILTER HHM01G146SM4 GUARDWIRE PLUS TEMPORARY OCCLUSION AND ASPIRATION SYSTEM* 適應症請見備註欄 HHM01RF400BA " 巴德 " 腔靜脈過濾器 "BARD"G2 X VENA CAVA FILTER (FILTER+INTRO+DILA+DELIVERY KIT+ADAPTER)

278 HHM01TUL1PCK COOK GUNTHER TULIP VENA CAVA MREYE FILTER SET(INTRODUCER+FILTER+SHEATH/DILATOR+ADAPTER) HHM01TULIPCK COOK GUNTHER TULIP VENA CAVA MREYE FILTER SET(INTRODUCER+FILTER+SHEATH/DILATOR+ADAPTER) HHM01TULP1CK " 曲克 " 剛特圖利浦腔靜脈濾器 "COOK" GUNTHER TULIP VENA CAVA FILTER HHM02040SNP3 BLOOD TRANSFUSION FILTER 40UM 移除微血栓輸血過濾器 ( 小兒科 305 專用 ) LEE M4 TEMPORARY MYOCARDIAL PACING LEAD 1038 LEE AR " 亞諾 " 心律調整導管 "ARROW" PACING CATHETERS 2902 LEE011210HG1 MEDI-TRACE DEFIBRILLATION ELECTRODES 652 LEE011410ZG1 MEDI-TRACE DEFIBRILLATION ELECTRODES 2EA/SET 652 LEE012255RKD 肯特利柯登斯去顫器電極貼片 KENDALL MEDI-TRACE CADENCE 652 ELECTRODES LEE012266PKD 肯特利柯登斯去顫器電極貼片 KENDALL MEDI-TRACE CADENCE 1050 ELECTRODES ( 小兒用 ) LEE A9 " 奧圖 " 心肌導線 "ALTO" Myo/Wire Temporary Cardiac Pacing 420 Wire LEE ST " 聖猷達 " 電極導線 "SJM" PACEL BIPOLAR PACING CATHETERS BALLOON CATH. LEE014017AST " 聖猷達 " 電極導線 "SJM" PACEL BIPOLAR PACING CATHETERS 2291 LEE014017VST " 聖猷達 " 電極導線 "SJM" PACEL BIPOLAR PACING CATHETERS 2291 LEE JE " 宜喜美 " 暫時性節律導線 - 雙極 ECM TEMPORARY PACING WIRES BIPOLAR LEE016025SJE " 宜喜美 " 暫時性節律導線 "ECM"TEMPORARY PACING WIRES 1038 LEE016173PBA " 巴德 " 暫時性電極導管 "BARD"TEMPORARY BALLOON PACING 2902 ELECTRODE CATHETER LEE016221PBA " 巴德 " 暫時性電極導管 "BARD"SEMI-FLOATING BIPOLAR PACING 2291 ELECTRODE CATHETER LEE018153PBA " 巴德 " 暫時性電極導管 "BARD"SPECIAL CARE BIPOLAR PACING 2291 ELECTRODE CATHETER LEE ED " 愛德華 " 史望康雙極心律導管組 EDWARDS SWAN-GANZ BIPOLAR 2902 CATHETER KIT LEE01AP518G2 PEDIATRIC DEFIB ELECTRODES 體外心律調節器貼片 490 LEE01AP919G2 MARGUETTE DEFIBRILLATION PACING MONITORING PADS 652 LEE01BP250BS BIPOLAR PACING CATHETER 5F,110CM(BALLOON 2902 CATHETER,ADAPTOR,PEEL-AWAY SHEATH) LEE01BPX25BS BIPOLAR PACING CATHETER 5F,110CM 2291 LEE01KL180JC " 耐倫科技 " 哈特普拉斯自動體外心臟去顫電擊器 - 電極 652 片 "NANOOMTECH" HEARTPLUS AUTOMATED EXTERNAL DEFIBRILLATORS-ELECTRODE PAD LEE01M1749HP DEFIB PACING PADS ADULT (2EA/SET) 652 LEE01M3501HP MULTIFUNCTION ADULT DEFIB ELECTRODES 652 LEE01M3504HP MULTIFUNCTION PEDIATRIC DEFIB ELECTRODES 490 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 652 透型 LEE01M3717HP MULTIFUNCTION PEDIATRIC PLUS PADS 多功能兒童用電擊貼片 490 LEE01M3870HP INFANT/CHILD PADS 多功能嬰幼兒用電擊貼片 490 LEE01N1749HP DEFIB PACING PADS CHILD (2 EA/SET)

279 LEE01P0510KT " 日本光電 " 心臟電極蘇復器 - 體外電極貼片 "NIHON KOHDEN" 652 DEFIBRILLATOR-EXTERNAL PACING ELECTRODES LEE01P0512KT " 日本光電 " 心臟電極蘇復器 - 體外電極貼片 "NIHON KOHDEN" 1050 DEFIBRILLATOR-EXTERNAL PACING ELECTRODES(CHILD) LEE01PADSTZ2 " 佐爾 " 電擊去顫器 - 電擊貼片 "ZOLL" DEFIBRILLATOR-ADULT 652 MULTI-FUNCTION PACING/DEFIBRILLATION STAT PADZ LEE01TBJFSKH 奧斯卡 暫時型心律調節器導線 OSCOR TB TEMPORARY 2291 BIPOLAR PACING LEAD MA NH 特殊材料管理費用 1500 NAN011627NBB NEEDLE 0.5 NAN011826NV4 DISPOSABLE NEEDLE 18G:26G 0.5 NAN011827NBD NEEDLE 0.5 NAN011827NFE SAFETY NEEDLE 適應症請見備註欄 1 NAN011827NNR NEEDLE 0.5 NAN011827NTM NEEDLE 0.5 NAN011827NTP NEEDLE 0.5 NAN011827NUY NEEDLE 0.5 NAN011923NBN NEEDLE 0.5 NAN020031NBD "BD"PEN NEEDLE" 必帝 " 注射筆專用針 ( 胰島素筆型針頭 ) 3.2 NAN020050NNR NOVOFINE NEEDLE 30G 胰島素筆型注射器針頭 3.2 NAN020632GNR NIPRO NOVOFINE NEEDLE 32G 尼普爾諾和筆注射針 3.2 NAN BB OMNICAN FINE NEEDLES 29:31G 胰島素注射筆專用針頭 3.2 NAN041823NNR IC NEEDLE 心肌長針 4.9 NAN TP P.T.C.D 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 NAN TP P.T.C.D NEEDLE 102 NAN TP P.T.C.D NDDELE 102 NAN TP P.T.C.D NEEDLE 102 NAN TP P.T.C.D NEEDLE 23GX150MM 102 NAN AG AMC/4 ARTERIAL NEEDLE 18Gx23/4"(7.0CM) 導線導引針 105 NAN AG AMC/4 ARTERIAL NEEDLE 21Gx2"(5.1CM) 導線導引針 105 NAN115324NAR "ARROW"MULTI-LUMEN CENTRAL VENOUS CATHETERIZATION 60 SETS:INTRODUCER NEEDLE( 單針 )" 亞諾 " 多重輸液導管 ( 單針 ) NAN11A1820GJ "JSM"INTRODUCER NEEDLE" 吉生 " 穿刺針 60 NAN11AP1NEH9 ANGIO PACK :INTRODUCER NEEDLE( 單針 ) 60 NAN141822NCK DISPOSABLE ONE PART NEEDLE 導線導引針 105 NAN AG AMC/4 ARTERIAL NEEDLE WITH FIXED WINGS 18Gx23/4"(7.0CM) 105 導線導引針 NAN AG AMC/3 ARTERIAL NEEDLE 21Gx1"(2.5CM) 導線導引針 105 NAN BS ARTERIAL NEEDLE FOR PERCUTANEOUS ENTRY ( 單針 ) 60 NAN145312NAG AMC/3 ARTERIAL NEEDLE 18GX7CM,3.8CM 19GX3.8CM 105 NAN C3 DISPOSABLE SELDING NEEDLE 18G 7.5CM 128 NAN BS ARTERIAL NEEDLE FOR PERCUTANEOUS ENTRY ( 外管 + 內針 ) 128 NAN BS ARTERIAL NEEDLE FOR PERCUTANEOUS ENTRY ( 外管 + 內針 ) 128 NAN PB PUNCTURE NEEDLE W/STYLET 雙針 ( 外套管 + 內針 ) 128 NAN155324NAG PERCUTANEOUS ENTRY NEEDLE GX7.3CM,18GX7.3CM,19GX3.8,7.3CM,21GX3.8CM NAN155324NAR "ARROW"MULTI-LUMEN CENTRAL VENOUS 128 CATHETERIZATION:INTRODUCER NEEDLE ( 外套管 + 內針 ) NAN15ADVANMR ADVANCE ANGIOGRAPHIC NEEDLES 高昇血管攝影穿刺針 ( 外管 + 內針 )

280 NAN15AN72SMR MAJESTIK SERIES ANGIOGRAPHY NEEDLES 16-21G( 雙針 ) 128 NAN15DCM18CK DISPOSABLE PERCUTANEOUS ENTRY THINWALL NEEDLES 18:22G :9.0CM NAN BS ARTERIAL NEEDLE FOR PERCUTANEOUS ENTRY ( 外管 + 內針 +STYLE) 203 NAN165341NAG ARTERIAL CATHETER NEEDLE 16GX6.4CM,18GX6.4CM,20GX3.8CM 203 NAN16AN18TMR MAJESTIK SERIES ANGIOGRAPHY NEEDLES 18G 7CM(3-PART)( 外管 內針 + 填充器 ) NBS010001KBD 1CC SAFTI DISPOSABLE SYRINGE WITHOUT/NEEDLE 1CC 注射筒不附 1.9 針 NBS010001NBD 1CC SYRINGE WITHOUT NEEDLE 1.9 NBS010001NSP 1CC SYRINGE WITHOUT NEEDLE 1.9 NBS010001NV4 1 CC SYRINGE WITHOUT NEEDLE 1.9 NBS010001PTM 1CC SYRINGE WITHOUT/NEEDLE 1.9 NBS010001VPW 1CC SYRINGE WITHOUT NEEDLE 1.9 NBS010002NSP 2-3CC SYRINGE WITHOUT NEEDLE 1 NBS010003KBD 3CC SAFTI DISPOSABLE SYRINGE WITHOUT/NEEDLE 3CC 注射筒不附 1 針 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 NBS010003VPW 3CC SYRINGE WITHOUT NEEDLE 1 NBS010005KBD 5CC SAFTI DISPOSABLE SYRINGE WITHOUT/NEEDLE 5CC 注射筒不附 1.4 針 NBS010005NBD 5CC SYRINGE WITHOUT NEEDLE 1.4 NBS010005NSP 5CC SYRINGE WITHOUT NEEDLE 1.4 NBS010005NV4 5 CC SYRINGE WITHOUT NEEDLE 1.4 NBS010005PTM 5CC SYRINGE WITHOUT/NEEDLE 1.4 NBS010005VPW 5CC SYRINGE WITHOUT NEEDLE 1.4 NBS010010KBD 10CC SAFTI DISPOSABLE SYRINGE WITHOUT/NEEDLE 10CC 注射筒不 2.4 附針 NBS010010NBD 10CC SYRINGE WITHOUT NEEDLE 2.4 NBS010010NFR 10 CC SYRINGE WITHOUT NEEDLE 2.4 NBS010010NPW 10CC SYRINGE WITHOUT NEEDLE 2.4 NBS010010NSP 10CC SYRINGE WITHOUT NEEDLE 2.4 NBS010010NUY 10CC SYRINGE WITHOUT/NEEDLE 2.4 NBS010010NV4 10 CC SYRINGE WITHOUT NEEDLE 2.4 NBS010010PTM 10CC SYRINGE WITHOUT/NEEDLE 2.4 NBS010010VPW 10CC SYRINGE WITHOUT NEEDLE 2.4 NBS010020KBD 20CC SAFTI DISPOSABLE SYRINGE WITHOUT/NEEDLE 20CC 注射筒不 2.9 附針 NBS010020NBB 20 CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020NBD 20 CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020NBN 20 CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020NFR 20 CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020NNR 20 CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020NPD 20CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020NPW 20 CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020NSP 20CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020NTM 20 CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020NTP 20 CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020NUY 20CC SYRINGE WITHOUT/NEEDLE

281 NBS010020NV4 20CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020NYF 20 CC SYRINGE WITHOUT NEEDLE 2.9 NBS010020PTM 20CC SYRINGE WITHOUT/NEEDLE 2.9 NBS010020VPW 20CC SYRINGE WITHOUT NEEDLE 2.9 NBS010025NPW 25CC SYRINGE WITHOUT NEEDLE 2.9 NBS010030KBD 30CC SAFTI DISPOSABLE SYRINGE WITHOUT/NEEDLE 30CC 注射筒不 6.6 附針 NBS010030NBB 30 CC SYRINGE WITHOUT NEEDLE 6.6 NBS010030NBD 30 CC SYRINGE WITHOUT NEEDLE 6.6 NBS010030NBN 30 CC SYRINGE WITHOUT NEEDLE 6.6 NBS010030NFR 30 CC SYRINGE WITHOUT NEEDLE 6.6 NBS010030NNR 30 CC SYRINGE WITHOUT NEEDLE 6.6 NBS010030NPW 30 CC SYRINGE WITHOUT NEEDLE 6.6 NBS010030NSH 30 CC SYRINGE WITHOUT NEEDLE 6.6 NBS010030NSP 30CC SYRINGE WITHOUT NEEDLE 6.6 NBS010030NTM 30 CC SYRINGE WITHOUT NEEDLE 6.6 NBS010030NTP 30 CC SYRINGE WITHOUT NEEDLE 6.6 NBS010030NUY 30CC SYRINGE WITHOUT/NEEDLE 6.6 NBS010030NV4 30CC SYRINGE WITHOUT NEEDLE 6.6 NBS010030TTM "TERUMO"DISPOSABLE SYRINGE:30CC WITHOUT NEEDLE" 泰爾茂 " 注 6.6 射針筒 :30CC 不附針 NBS010030VPW 30CC SYRINGE WITHOUT NEEDLE 6.6 NBS01003SSFE 3CC RETRACTABLE SAFETY SYRINGE WITHOUT NEEDLE 適應症請見 1.8 備註欄 NBS010050KBD 50CC SAFTI DISPOSABLE SYRINGE WITHOUT/NEEDLE 50CC 注射筒不 9.5 附針 NBS010050NBB 50 CC SYRINGE WITHOUT NEEDLE 9.5 NBS010050NBD 50 CC SYRINGE WITHOUT NEEDLE 9.5 NBS010050NBN 50 CC SYRINGE WITHOUT NEEDLE 9.5 NBS010050NFR 50CC SYRINGE WITHOUT NEEDLE 9.5 NBS010050NNR 50 CC SYRINGE WITHOUT NEEDLE 9.5 NBS010050NPW 50 CC SYRINGE WITHOUT NEEDLE 9.5 NBS010050NSP 50CC,60CC SYRINGE WITHOUT NEEDLE 9.5 NBS010050NTM 50 CC SYRINGE WITHOUT NEEDLE 9.5 NBS010050NTP 50 CC SYRINGE WITHOUT NEEDLE 9.5 NBS010050NUY 60CC SYRINGE WITHOUT/NEEDLE 9.5 NBS010050NV4 50CC SYRINGE WITHOUT NEEDLE 9.5 NBS010050VPW 50CC SYRINGE WITHOUT NEEDLE 9.5 NBS01005SSFE 5CC RETRACTABLE SAFETY SYRINGE WITHOUT NEEDLE 適應症請見 2.6 備註欄 NBS010060NPW 60CC SYRINGE WITHOUT NEEDLE 9.5 NBS010060TTM "TERUMO"DISPOSABLE SYRINGE:60CC WITHOUT NEEDLE" 泰爾茂 " 注 9.5 射針筒 :60CC 不附針 NBS0100N20BD PLASTIPAK SYRINGE 20CC WITHOUT NEEDLE 2.9 NBS0100N30BD PLASTIPAK SYRINGE 30CC WITHOUT NEEDLE 6.6 NBS0100N50BD PLASTIPAK SYRINGE 50CC WITHOUT NEEDLE 9.5 NBS01010SSFE 10CC RETRACTABLE SAFETY SYRINGE WITHOUT/NEEDLE 適應症請 4 見備註欄 NBS01020SSFE 20CC RETRACTABLE SAFETY SYRINGE WITHOUT/NEEDLE 適應症請 6.6 見備註欄 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

282 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 2.6 針安全型 5CC 適應症請見備註欄 NBS011001SSG SIGMA SYRINGE WITHOUT NEEDLE 10CC 十美牌注射筒不附針 10CC 2.4 NBS011003SSG SIGMA SYRINGE WITHOUT NEEDLE SAFETY 10CC 十美牌注射筒不附 4 針安全型 10CC 適應症請見備註欄 NBS012001SSG SIGMA SYRINGE WITHOUT NEEDLE 20CC 十美牌注射筒不附針 20CC 2.9 NBS012003SSG SIGMA SYRINGE WITHOUT NEEDLE SAFETY 20CC 十美牌注射筒不附 6.6 針安全型 20CC 適應症請見備註欄 NBS NN NOVOPEN 4 WITHOUT NEEDLE( 筆型胰島素注射筒 ) 每支以使用三 900 年以上為原則 NBS NN NOVOPEN 4 WITHOUT NEEDLE( 筆型胰島素注射筒 ) 每支以使用三 900 年以上為原則 NBS NN "NOVOPEN ECHO" 諾和筆易兒樂 ( 筆型胰島素注射筒 ) 每支以使用 900 三年以上為原則 NBS02M9662HQ INSULIN DELIVERY DEVICE 胰島素注射筆, 每支以使用三年以上為 900 原則 適應症請見備註欄 NBS02M9673HQ HUMAPEN LUXURA HD INSULIN DELIVERY DEVICE 胰島素注射筆, 每 900 支以使用三年以上為原則 適應症請見備註欄 NBS LF "LF"OPTIVANTAGE DUAL-HEAD INJECTOR" 理博 " 雙驅動自動注射系 455 統 ( 注射筒 X2+ 吸管 X2+Y 型螺旋接管 X1) NBS07DCTPQMH DISPOSABLE 200 CC SYRINGE 二支 KIT( 注射筒 X2+ 吸管 + 連接管 455 +PRIME TUBE) NCS010001KBD 1CC SAFTI DISPOSABLE SYRINGE W/NEEDLE 1CC 注射筒附針 2 NCS010001NBD 1 CC SYRINGE 2 NCS010001NBN 1 CC SYRINGE 2 NCS010001NCG 1CC RETRACTABLE SAFETY SYRINGE W/NEEDLE 克銳回拉式安全注 3.9 射器附針 適應症請見備註欄 NCS010001NDD 1CC SYRINGE 2 NCS010001NFR 1 CC SYRINGE 2 NCS010001NNR 1 CC SYRINGE 2 NCS010001NPD 1CC SYRINGE W/NEEDLE 2 NCS010001NPW 1 CC SYRINGE 2 NCS010001NSH 1 CC SYRINGE 2 NCS010001NSP 1CC SYRINGE W/NEEDLE 2 NCS010001NTM 1 CC SYRINGE 2 NCS010001NTP 1 CC SYRINGE 2 NCS010001NUU 1CC RETRACTABLE SAFETY SYRINGE W/NEEDLE 適應症請見備註欄 3.9 NCS010001NUY 1 CC SYRINGE W/NEEDLE 2 NCS010001NV4 1CC SYRINGE W/NEEDLE 2 NCS010001PTM 1CC SYRINGE W/NEEDLE 2 NCS010001VPW 1CC SYRINGE W/NEEDLE 2 NCS010002NPW 2 CC SYRINGE 1.4 NCS010002NSP 2-3CC SYRINGE W/NEEDLE 1.4 NCS010003KBD 3CC SAFTI DISPOSABLE SYRINGE W/NEEDLE 3CC 注射筒附針 1.4 NCS010003NBB 3 CC SYRINGE 1.4 NCS010003NBD 3 CC SYRINGE 1.4 NCS010003NBN 3 CC SYRINGE 1.4 NCS010003NCG 3CC RETRACTABLE SAFETY SYRINGE W/NEEDLE 適應症請見備註欄

283 NCS010003NDD 3CC SYRINGE 1.4 NCS010003NFR 3CC SYRINGE W/NEEDLE 1.4 NCS010003NNR 3 CC SYRINGE 1.4 NCS010003NPD 3CC SYRINGE W/NEEDLE 1.4 NCS010003NPW 3 CC SYRINGE 1.4 NCS010003NSH 3 CC SYRINGE 1.4 NCS010003NTM 3 CC SYRINGE 1.4 NCS010003NTP 3 CC SYRINGE 1.4 NCS010003NUU 3CC RETRACTABLE SAFETY SYRINGE W/NEEDLE 適應症請見備註欄 2.8 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 CHAIN"MY SAFETY SYRINGE 3CC " 濟翔 " 自動回縮式安全 2.8 針筒 適應症請見備註欄 NCS010003SYF 3CC DISPOSABLE SYRINGE W/NEEDLE (SAFETY) 適應症請見備註 2.8 欄 NCS010003VPW 3CC SYRINGE W/NEEDLE 1.4 NCS010005KBD 5CC SAFTI DISPOSABLE SYRINGE W/NEEDLE 5CC 注射筒附針 1.8 NCS010005NBB 5 CC SYRINGE 1.8 NCS010005NBD 5 CC SYRINGE 1.8 NCS010005NBN 5 CC SYRINGE 1.8 NCS010005NCG 5CC RETRACTABLE SAFETY SYRINGE W/NEEDLE 適應症請見備註欄 3.9 NCS010005NDD 5CC SYRINGE 1.8 NCS010005NFR 5CC SYRINGE W/NEEDLE 1.8 NCS010005NNR 5 CC SYRINGE 1.8 NCS010005NPD 5CC SYRINGE W/NEEDLE 1.8 NCS010005NPW 5 CC SYRINGE 1.8 NCS010005NSP 5CC SYRINGE W/NEEDLE 1.8 NCS010005NTM 5 CC SYRINGE 1.8 NCS010005NTP 5 CC SYRINGE 1.8 NCS010005NUU 5CC RETRACTABLE SAFETY SYRINGE W/NEEDLE 適應症請見備註欄 3.9 NCS010005NUY 5CC SYRINGE W/NEEDLE 1.8 NCS010005NV4 5CC SYRINGE W/NEEDLE 1.8 NCS010005NYF 5 CC SYRINGE 1.8 NCS010005PTM 5CC SYRINGE W/NEEDLE 1.8 NCS010005SYF 5CC DISPOSABLE SYRINGE W/NEEDLE (SAFETY) 適應症請見備註 3.9 欄 NCS010005VPW 5CC SYRINGE W/NEEDLE 1.8 NCS010006NSH 6 CC SYRINGE 1.8 NCS010010KBD 10CC SAFTI DISPOSABLE SYRINGE W/NEEDLE 10CC 注射筒附針 2.5 NCS010010NBB 10 CC SYRINGE 2.5 NCS010010NBD 10 CC SYRINGE 2.5 NCS010010NBN 10 CC SYRINGE 2.5 NCS010010NCG 10CC RETRACTABLE SAFETY SYRINGE W/NEEDLE 適應症請見備註 4.2 欄 NCS010010NDD 10CC SYRINGE 2.5 NCS010010NFR 10CC SYRINGE W/NEEDLE 2.5 NCS010010NNR 10 CC SYRINGE 2.5 NCS010010NPD 10CC SYRINGE W/NEEDLE

284 NCS010010NPW 10 CC SYRINGE 2.5 NCS010010NSP 10CC SYRINGE W/NEEDLE 2.5 NCS010010NTM 10 CC SYRINGE 2.5 NCS010010NTP 10 CC SYRINGE 2.5 NCS010010NUY 10CC SYRINGE W/NEEDLE 2.5 NCS010010NV4 10CC SYRINGE W/NEEDLE 2.5 NCS010010NYF 10 CC SYRINGE 2.5 NCS010010PTM 10CC SYRINGE W/NEEDLE 2.5 NCS010010VPW 10CC SYRINGE W/NEEDLE 2.5 NCS01001SAFE 1CC RETRACTABLE SAFETY SYRINGE W/NEEDLE FOR ALLERGY 適應 3.9 症請見備註欄 NCS01001SSFE 1 CC SYRINGE W/NEEDLE( 附安全護套 ) 適應症請見備註欄 3.9 NCS010020KBD 20CC SAFTI DISPOSABLE SYRINGE W/NEEDLE 20CC 注射筒附針 3.1 NCS010020NBD 20 CC SYRINGE ( 附針 ) 3.1 NCS010020NBN 20CC SYRINGE W/NEEDLE 3.1 NCS010020NDD 20CC SYRINGE 3.1 NCS010020NFR 20CC SYRINGE W/NEEDLE 3.1 NCS010020NNR 20 CC SYRINGE( 附針 ) 3.1 NCS010020NPD 20CC SYRINGE W/NEEDLE 3.1 NCS010020NPW 20CC SYRINGE W/NEEDLE 3.1 NCS010020NSP 20CC SYRINGE W/NEEDLE 3.1 NCS010020NTM 20 CC SYRINGE ( 附針 ) 3.1 NCS010020NTP 20CC SYRINGE W/NEEDLE 3.1 NCS010020NUY 20CC SYRINGE W/NEEDLE 3.1 NCS010020NV4 20CC SYRINGE W/NEEDLE 3.1 NCS010020NYF 20 CC SYRINGE ( 附針 ) 3.1 NCS010020VPW 20CC SYRINGE W/NEEDLE 3.1 NCS010030KBD 30CC SAFTI DISPOSABLE SYRINGE W/NEEDLE 30CC 注射筒附針 5.2 NCS010030NFR 30CC SYRINGE W/NEEDLE 5.2 NCS010030NPD 30CC SYRINGE W/NEEDLE 5.2 NCS010030NPW 30CC SYRINGE W/NEEDLE 5.2 NCS010030NSP 30CC SYRINGE W/NEEDLE 5.2 NCS010030NUY 30CC SYRINGE W/NEEDLE 5.2 NCS010030NV4 30CC SYRINGE W/NEEDLE 5.2 NCS010030VPW 30CC SYRINGE W/NEEDLE 5.2 NCS01003SSFE 3CC SYRINGE W/NEEDLE( 附安全護套 ) 適應症請見備註欄 2.8 NCS010050KBD 50CC SAFTI DISPOSABLE SYRINGE W/NEEDLE 50CC 注射筒附針 8.5 NCS010050NBN DISPOSABLE SYRINGE 50CC W/NEEDLE 8.5 NCS010050NFR 50CC SYRINGE W/NEEDLE 8.5 NCS010050NPD 50CC SYRINGE W/NEEDLE 8.5 NCS010050NPW 50CC SYRINGE W/NEEDLE 8.5 NCS010050NSP 50CC,60CC SYRINGE W/NEEDLE 8.5 NCS010050NTM "TERUMO"DISPOSABLE SYRINGE W/NEEDLE 50CC" 泰爾茂 " 注射針筒 8.5 含針頭 NCS010050NUY 60CC SYRINGE W/NEEDLE 8.5 NCS010050NV4 50CC SYRINGE W/NEEDLE 8.5 NCS010050VPW 50CC SYRINGE W/NEEDLE 8.5 NCS TZ ROTATABLE RETRACTABLE SAFETY SYRINGE 3CC 適應症請見備註 2.8 欄 NCS01005SSFE 5CC SYRINGE W/NEEDLE( 附安全護套 ) 適應症請見備註欄 3.9 NCS010060NTM "TERUMO"DISPOSABLE SYRINGE W/NEEDLE 60CC" 泰爾茂 " 注射針筒 8.5 含針頭 NCS010102SSG SIGMA SYRINGE WITH NEEDLE 1CC 十美牌注射筒附針 1CC 2 674

285 NCS010104SSG SIGMA SYRINGE WITH NEEDLE 1CC SAFETY 十美牌注射筒附針安全 3.9 型 1CC 適應症請見備註欄 NCS01010SSFE 10CC RETRACTABLE SAFETY SYRINGE W/NEEDLE 適應症請見備註 4.2 欄 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 2.8 型 3CC 適應症請見備註欄 NCS010502SSG SIGMA SYRINGE WITH NEEDLE 5CC 十美牌注射筒附針 5CC 1.8 NCS010504SSG SIGMA SYRINGE WITH NEEDLE SAFETY 5CC 十美牌注射筒附針安全 3.9 型 5CC 適應症請見備註欄 NCS011002SSG SIGMA SYRINGE WITH NEEDLE 10CC 十美牌注射筒附針 10CC 2.5 NCS011004SSG SIGMA SYRINGE WITH NEEDLE SAFETY 10CC 十美牌注射筒附針安 4.2 全型 10CC 適應症請見備註欄 NCS TZ 1CC SAFETY SYRINGE 適應症請見備註欄 3.9 NCS TZ 3CC SAFETY SYRINGE 適應症請見備註欄 2.8 NCS TZ 5CC SAFETY SYRINGE 適應症請見備註欄 3.9 NCS TZ 10CC SAFETY SYRINGE 適應症請見備註欄 4.2 NCS01A003NPW 3CC SYRINGE W/NEEDLE( 附安全護套 ) 適應症請見備註欄 2.8 NCS030000NUU RETRACTABLE SAFETY INSULIN SYRINGE W/NEEDLE 適應症請見備 6 註欄 NCS NR INSULIN SYRINGE 1CC 3.7 NCS03001S1FE 1CC RETRACTABLE SAFETY INSULIN SYRINGE W/NEEDLE 適應症請 6 見備註欄 NCS030310NSP INSULIN SYRINGE W/NEEDLE 3.7 NCS030510NBB 0.3:1.0CC INSULIN SYRINGE W/NEEDLE 3.7 NCS030510NBD INSULIN SYRINGE(30G 自 87/12/23 起生效 ) 3.7 NCS030510NBN INSULIN SYRINGE 100UNIT 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 3.7 SS30M;05M3009(A) 自 生效 ) NCS KD INSULINE SYRINGE W/NEEDLE( ,145,350,368,1358,1366,600700,800,601600) NCS BB OMNICAN INSULIN SYRINGES W/NEEDLE 0.5/1.0ML 3.7 NCS BB INSULIN SYRINGE 3.7 NDD04N8008SG INJECTION CAP W/FREE SITE 無針式接頭 * 適應症請見備註欄 43.1 NDN GW SCALP VEIN SET 22:25G 3.9 NDN01023XNPW SCALP NEEDLE 3.9 NDN011825NV4 SCALP SET 18G:25G 3.9 NDN011827NFR SCALP NEEDLE 3.9 NDN011827NJS SCALP NEEDLE 3.9 NDN011827NM8 "MEDITOP"TOP SCALP VEIN SET" 邁迪特浦 " 特浦翼狀針 3.9 NDN011827NNR SCALP NEEDLE 3.9 NDN011827NTP SCALP NEEDLE 3.9 NDN011925NLL SCALP 頭皮針 3.9 NDN011925NTM SCALP NEEDLE 3.9 NDN01A010NPW SCALP VEIN SET 16:27G 3.9 NDN N "BIOCIV"I.V. CATHETER(TPU)" 百仕韋 " 靜脈留置針 10.5 NDN040024CBB INTROCAN CERTO-IV CATHETER 24G(PU) 10.5 NDN HJ "SMITHS"JELCO IV CATHETER TEFLON 14:24G " 史密斯 " 杰可靜脈留置針

286 NDN HJ "SMITHS" OPTIVA IV CATHETER PU 14:24G " 史密斯 " 奧迪發靜脈 10.5 留置針 NDN041214NAY IV CATHETER(TEFLON) 9.5 NDN041422CBB INTROCAN CERTO-IV CATHETER 14:22G (PU)( 產品型號 ,64,72,6272,99) NDN041422NBB IV CATHETER(TEFLON) 9.5 NDN041422NBN IV CATHETER(TEFLON) 9.5 NDN041424ABD INSYTE AUTOGUARD INTRAVASCULAR CATHETER 安全性靜脈導管 適 27.5 應症請見備註欄 NDN041424NBD IV CATHETER(TEFLON) 9.5 NDN041424NTM IV CATHETER(TEFLON) 9.5 NDN041424STM SURFLO IV CATHETER 14G:24G(ETFE) 9.5 NDN041622NBD IV CATHETER(TEFLON) 9.5 NDN041622NNR IV CATHETER(TEFLON) 9.5 NDN041622NTM IV CATHETER(TEFLON) 9.5 NDN041624ABD IV CATHETER(PU) 10.5 NDN041627NTM IV CATHETER 16:27G (PU) 10.5 NDN041824ATM SURSHIELD SURFLO II 安全靜脈留置針 適應症請見備註欄 27.5 NDN041824NTP IV CATHETER MN(TEFLON) 9.5 NDN042400NBB IV CATHETER(TEFLON) 9.5 NDN042400NNR IV CATHETER(TEFLON) 9.5 NDN043818ABD INSYTE AUTOGUARD SHIELDED IV CATHETER 回縮式安全靜脈導管 27.5 適應症請見備註欄 NDN BB VASOFIX SAFETY I.V. CANNULAE 菲適免針加藥安全靜脈留置針 33.8 適應症請見備註欄 NDN BB VASOFIX I.V. CANNULAE 菲適免針加藥靜脈留置針 16.8 NDN0442CWSBB INTROCAN CERTO SAFETY PU 18:24G 安全靜脈留置針 適應症請見 27.5 備註欄 NDN0442NWSBB INTROCAN CERTO SAFETY TEF 18:24G 安全靜脈留置針 適應症請 27.5 見備註欄 NDN04FEP03BB INTROCAN SAFETY IVC CANNULAE 適應症請見備註欄 27.5 NDN04PUR03BB INTROCAN SAFETY IVC CANNULAE 適應症請見備註欄 27.5 NDN04S1424BD INSYTE IV CATHETER(VIALON) 10.5 NDN04SR01NTM SURFLO I.V CATHETER 14G:24G 9.5 NDN04T1424BD INSYTE IV CATHETER(PU/VIALON) 10.5 NDN04W1624BD INSYTE-W IV CATHETER(PU/VIALON) 10.5 NDN050024WBB INTROCAN CERTO IV CATHETER W/WING 24G(PU) 10.5 NDN050024WBD IV CATHETER 24G(TEFLON) 9.5 NDN051422WBB INTROCAN CERTO IV CATHETER W/WING (PU) 14:22G( 產品型號 ,5780,5799,6264,7802) NDN051622NBB VASOCAN IV CATHETER(TEFLON)( 蠂翼靜脈留置針 ) 9.5 NDN051622WBD IV CATHETER 16:22G(TEFLON) 9.5 NES010201NBA MAX-CORE DISPOSABLE BIOPSY INSTRUMENT 14:20G( 自動式 ) 633 NES CD BIOPSY FORCEPS(88/08/1 再生效,300L,302L 自 88/08/01 起生效 ) 6474 NES010804TZM "MD TECH"T-LOK BONE MARROW BIOPSY NEEDLES 迪洛骨髓活體組織 598 切片針 NES HK SONO GUIDE BIOPSY NEEDLE 14G 16G 70CM,170CM 400 NES ZM BONE MARROW ASPIRATION NEEDLE 529 NES HK SONO GUIDE BIOPSY NEEDLE 17G 18G 70CM,170CM 400 NES01174LNAN UNI-CUT NEEDLES 16G:18G 200MM 400 NES01174NNAN UNI-CUT NEEDLES 14G:18G 75:150MM 400 NES011762LAN VACU-CUT BIOPSY NEEDLES 18G:19.5G 200MM

287 NES011762NAN VACU-CUT BIOPSY NEEDLES 18G:19.5G 100:150MM 663 NES01176LNAN VACU-CUT BIOPSY NEEDLES 21G,22G 200MM 663 NES01176NNAN VACU-CUT BIOPSY NEEDLES 21G,22G 100:150MM 663 NES ZM PEDIATRIC BONE MARROW NEEDLE 598 NES011815NHK "HAKKO"PTC CHIBA NEEDLE 肝膽穿刺針 150MM:250MM 400 NES015043NCD BIOPSY FORCEPS FOR ENDOMYOCADIAL BIOPSIES 6474 NES ZM MD TECH SNARELOK BONE MARROW BIOPSY TRAY AND ACCESSORIES 598 NES01AM18NGP BONE MARROW ASPIRATION NEEDLE 529 NES01AM18NHK QUICUT BONE MARROW ASPIRATION NEEDLE 15:18G 45:60MM 八光快 529 切骨髓抽吸生檢針 NES01BM00XGP "GALLINI"BIOMID DISPOSABLE BONE MARROW ASPIRATION BIOPSY 623 NEEDLE" 格利尼 " 可丟棄式骨髓吸取針 NES01BM13NGP BONE MARROW BIOPSY NEEDLE 598 NES01BM13NHK QUICKCUT BIOPSY FOR BONE MARROW 7:13G,10CM:15CM 598 NES01BMHN1ZM BONE MARROW HARVEST NEEDLE WITH SIDE HOLE 529 NES01BN160ZM OSTY CORE BONE BIOPSY NEEDLE 598 NES01BV00NC8 BONE BEVEL BIOPSY NEEDLE(BV SERIES) 骨髓切片或抽吸針 623 NES01M1806ZM SOFT TISSUE BIOPSY NEEDLE 18G,9:15CM 400 NES01M1808ZM SOFT TISSUE BIOPSY NEEDLE 18G,20CM 400 NES01M2006ZM SOFT TISSUE BIOPSY NEEDLE 19:22G,9:15CM 400 NES01M2008ZM SOFT TISSUE BIOPSY NEEDLE 19:22G,20CM 400 NES01MN120BA MAGNUM BIOPSY NEEDLE 633 NES01ST00NC8 STERNUM TEMNO DEVICE 骨髓抽吸針 623 NES01ST00NJ6 "CAREFUSION"STERNUM TEMNO DEVICE" 卡弗迅 " 骨髓抽吸針 623 NES01TC00XC8 T-HANDLE JAMSHIDI BONE MARROW BIOPSY /ASPIRATION NEEDLES 623 NES01TC00XJ6 "CAREFUSION"T-HANDLE JAMSHIDI BONE MARROW 623 BIOPSY/ASPIRATION NEEDLES" 卡弗迅 " 介入體骨髓切片 / 組織抽取針 NES01TN00XC8 ILLINOIS STERNAL/ILIAC BONE MARROW ASPIRATION NEEDLES 529 NES01TN00XJ6 "CAREFUSION"ILLINOIS STERNAL/ILIAC BONE MARROW ASPIRATION 529 NEEDLES" 卡弗迅 " 伊利諾胸骨 / 腸骨骨髓抽取針 NES TP "TOP"ASPIRATION BIOPSY NEEDLE (18GX150MM) 吸引生檢針 663 NES TP "TOP"ASPIRATION BIOPSY NEEDLE (18GX200MM) 吸引生檢針 663 NES TP ASPIRATION BIOPSY NEEDLE (MAJIMA NEEDLE) 150MM 663 NES TP "TOP"ASPIRATION BIOPSY NEEDLE (21GX200MM) 吸引生檢針 663 NES02B152NHK BIOPSY NEEDLE QUICKCUT 1B15G:18G 200MM:470MM 400 NES02B154NHK BIOPSY NEEDLE QUICKCUT 1B15G:18G 40MM:150MM 400 NES02B192NHK BIOPSY NEEDLE QUICKCUT 1B19G:22G 200MM:470MM 663 NES02B194NHK BIOPSY NEEDLE QUICKCUT 1B19G:22G 40MM:150MM 663 NES02B234NHK BIOPSY NEEDLE QUICKCUT 1B23G 40MM:470MM 663 NES ZM "MD TECH"BIOPINCE FULL CORE BIOPSY INSTRUMENT 10CM" 美迪 633 克 " 拜爾賓全組織切片器 NES BA "BARD"MONOPTY BIOPSY INSTRUMENT 組織取樣針 633 NES031406NC8 CARDINAL TEMNO BIOPSY NEEDLES 14G:16G;18G:20G;22G 611 NES031406NJ6 "CAREFUSION"TEMNO BIOPSY NEEDLES " 卡弗迅 " 生檢針 611 NES ZM BIOPINCE FULL CORE BIOPSY INSTRUMENT 15CM" 美迪克 " 拜爾賓全 633 組織切片器 NES ZM BIOPINCE FULL CORE BIOPSY INSTRUMENT 20CM" 美迪克 " 拜爾賓全 633 組織切片器 NES03315SDJU "PAJUNK"DELTA CUT BIOPSY SYSTEM 生檢穿刺套管組 14:20G

288 NES ZM SUPER-CORE II ADJUSTABLE BIOPSY INSTRUMENT 彈簧組織切片針 611 NES ZN ULTRA CORE BIOPSY NEEDLE FOR USE WITH BARD MAGNUM BIOPSY 633 INSTRUMENT(AUTOMATIC) NES ZR TRU-CORE II AUTOMATIC DISPOSABLE BIOPSY DEVICE 633 NES ZM PRO-MAG AUTOMATIC BIOPSY NEEDLE 633 NES ZM PRO-MAG AUTOMATIC BIOPSY NEEDLE 633 NES ZM PRO-MAG AUTOMATIC BIOPSY NEEDLE 633 NES03TM14NGP SPRING LOADED BIOPSY NEEDLE( 自動彈簧切片針 ) 611 NES03TM16NGP SPRING LOADED BIOPSY NEEDLE( 自動彈簧切片針 ) 611 NES03TZ14NGP SPRING LOADED BIOPSY NEEDLE( 自動彈簧切片針 ) 611 NES03TZ16NGP SPRING LOADED BIOPSY NEEDLE( 自動彈簧切片針 ) 611 NES041356NJ6 "CAREFUSION"UNIVERSAL COAXIAL INTRODUCER NEEDLE(STERILE)" 卡弗迅 " 同軸導引針 ( 滅菌 )* 給付規定請見備註欄 889 NES04C12ABBA "BARD"BIOPSY NEEDLE SYSTEM-TRUGUIDE COAXIAL BIOPSY 889 NEEDLE" 巴德 " 組織取樣針 - 同軸組織取樣針 * 適應證請見備註欄 NES04CT14NC8 "CARDINAL"BIOPSY NEEDLES 14G:22G+UNIVERSAL COAXIAL 1380 INTRODUCER NEEDLE 生檢針 + 同軸導引針 * 適應症請見備註欄 NES04MCXS0ZM "MD TECH"CO-AXIAL INTRODUCER NEEDLE" 美迪克 " 同軸導引針 * 適 889 應症請見備註欄 NES04MCXS1ZM "MD TECH"CO-AXIAL INTRODUCER NEEDLE" 美迪克 " 同軸導引針 * 適 889 應症請見備註欄 RRB HU HUDSON INCENTIVE SPIROMETER TRIFLO II INSPIRATORY 190 EXERCISER* 適應症請見備註欄 RRB HU HUDSON INCENTIVE SPIROMETER VOLDYNE 5000* 適應症請見備註欄 140 RRB HU HUDSON INCENTIVE SPIROMETER VOLDYNE 2500* 適應症請見備註欄 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 190 INCENTIVE SPIROMETER AND ACCESSORY* 適應症請見備註欄 RRB EF " 貝斯美德 " 誘發型肺量計 "BESMED" INCENTIVE SPIROMETER 190 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 SAS026025SUS SAS02MLC60J8 SAS02MLC80J8 SAS02NTLC5ET SAS02NTLC7ET SAS02TCT55JJ " 優施西 "GIA 自動手術縫合器 + 釘 "USSC"AUTO SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLER* 適應症請見備註欄 " 南京邁迪欣 " 一次性使用直線型切割吻和器和釘倉 "NANJING MAIDIXIN" DISPOSABLE LINEAR CUTTER AND CARTRIDGE* 適應症請見備註欄 " 南京邁迪欣 " 一次性使用直線型切割吻和器和釘倉 "NANJING MAIDIXIN" DISPOSABLE LINEAR CUTTER AND CARTRIDGE* 適應症請見備註欄 " 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) " 愛惜康 " 直線形切割縫合器和可調節釘匣 "ETHICON ENDO- SURGERY"LINEAR CUTTER 75MM AND SELECTABLE CARTRIDGE/RELOADS(75MM) LINEAR CUTTER SAFETY LOCKOUT 55MM 腸胃自動縫合器 適應症請見備註欄

289 SAS02TLC55JJ SAS02TLC75JJ SAS02TLHNNJJ SAS03CDHXAET SAS03CDHXXET SAS03EEA252C SAS03EEA25US SAS03MCS21J8 SAS03PCEAT2C SAS03PCEATUS SAS03PCEEA2C SAS03PCEEAUS SAS03SDH21JJ SAS03SDHXAET SAS TX SAS TX SAS US SAS DG SAS TY SAS TY SAS DG TITANIUM LINEAR CUTTER 55MM 腸胃自動縫合器 55MM 適應症請見備註欄 LINEAR CUTTER SAFETY LOCKOUT 75MM 腸胃自動縫合器 適應症請見備註欄 TITANIUM LINEAR STAPLE 30,60,90MM ( 自動縫合器 + 釘 ) 適應症請見備註欄愛惜康彎型管腔吻合器 ETHICON ENDO-SURGERY CURVED INTRALUMINAL STAPLERS(ILS)21,25,29,33MM " 愛惜康 " 普克美釘合器 "ETHICON"PROXIMATE ILS INTRALUMINAL STAPLER* 適應症請見備註欄 " 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 " 優施西 " 一次性彎形端對端縫合器 "USSC" AUTO SUTURE CEEA SINGLE USE STAPLERS* 適應症請見備註欄 " 南京邁迪欣 " 一次性使用管型消化道吻和器 "NANJING MAIDIXIN" DISPOSABLE CIRCULAR STAPLER* 適應症請見備註欄 " 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 " 優施西 " 自動手術縫合器及縫合釘 "USS"PREMIUM PLUS CEEA SINGLE USE STAPLER* 適應症請見備註欄 " 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 " 優施西 " 自動手術縫合器及縫合釘 "USSC"AUTO SUTURE EEA STAPLING INSTRUMENTS AND DISPOSABLE LOADING UNITS* 適應症請見備註欄 CIRCULAR STAPLE 消化道自動吻合器 + 釘 21,25,29,33MM 適應症請見備註欄愛惜康直線型管腔吻合器 ETHICON ENDO-SURGERY STRAIGHT INTRALUMINAL STAPLERS(ILS)21,25,29,33MM " 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 " 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 " 優施西 " 可拆除式皮膚縫合釘及縫合器 ( 滅菌 )"USS"DISPOSABLE SKIN STAPLER AND LOADING UNITS(STERILE) 35W 適應症請見備註欄 泰科 拋棄式自動縫合鬆開皮膚縫合器( 滅菌 )"TYCO" APPOSE DISPOSABLE SKIN STAPLER(STERILE) 25R 適應症請見備註欄 泰科 拋棄式自動縫合鬆開皮膚縫合器 ( 滅菌 )"TYCO" APPOSE DISPOSABLE SKIN STAPLER(STERILE) 25R 適應症請見備註欄 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 泰科 拋棄式自動縫合鬆開皮膚縫合器 ( 滅菌 )"TYCO" APPOSE DISPOSABLE SKIN STAPLER(STERILE) 25W 適應症請見備註欄

290 SAS TY SAS DG SAS TY 泰科 拋棄式自動縫合鬆開皮膚縫合器 ( 滅菌 )"TYCO" APPOSE DISPOSABLE SKIN STAPLER(STERILE) 25W 適應症請見備註欄 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 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 SAS06PMR35JJ REGULAR 35R MULTI-DIRECTION SKIN STAPLER 適應症請見備註 183 欄 SAS06PMW35JJ WIDE 35W MULTI-DIRECTION SKIN STAPLER 適應症請見備註欄 231 SAU010TR30JJ "ETHICON"DISPOSABLE STAPLER-PROXIMATE LINEAR RELOADING 2293 UNIT( TITANIUM)30MM 適應症請見備註欄 SAU010TR60JJ "ETHICON"DISPOSABLE STAPLER-PROXIMATE LINEAR RELOADING 2063 UNIT( TITANIUM)60MM 適應症請見備註欄 SAU C " 柯惠 "TA 自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA 2293 DISPOSABLE SURGICAL STAPLER AND LOADING UNIT 適應症請見備註欄 SAU US PERMIUM MULTIFIRE TA DLU 30 適應症請見備註欄 2293 SAU C " 柯惠 "TA 自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA 2063 DISPOSABLE SURGICAL STAPLER AND LOADING UNIT 適應症請見備註欄 SAU US PERMIUM MULTIFIRE TA DLLU 60 適應症請見備註欄 2063 SAU C " 柯惠 "TA 自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA 2153 DISPOSABLE SURGICAL STAPLER AND LOADING UNIT 適應症請見備註欄 SAU US PERMIUM MULTIFIRE TA DLU 90 適應症請見備註欄 2153 SAU C " 柯惠 "TA 自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA 2293 DISPOSABLE SURGICAL STAPLER AND LOADING UNIT 適應症請見備註欄 SAU US TA 30 P-3.5 DLU 胸腹器吻合釘 TA30 3.5MM 適應症請見備註 2293 欄 SAU C " 柯惠 "TA 自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA 2293 DISPOSABLE SURGICAL STAPLER AND LOADING UNIT 適應症請見備註欄 SAU US TA 30 P-4.8 DLU 胸腹器吻合釘 TA30 4.8MM 適應症請見備註 2293 欄 SAU C " 柯惠 "TA 自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA 2294 DISPOSABLE SURGICAL STAPLER AND LOADING UNIT 適應症請見備註欄 SAU US TA 30 P-V3 DLU 胸腹器吻合釘 TA30P-V 2.5MM 適應症請見備 2294 註欄 SAU C " 柯惠 "TA 自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA 2063 DISPOSABLE SURGICAL STAPLER AND LOADING UNIT 適應症請見備註欄 SAU US TA 55 P-3.5 DLU 胸腹器吻合釘 TA55P 3.5MM 適應症請見備註 2063 欄 SAU C " 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

291 SAU US TA 55 P-4.8 DLU 胸腹器吻合釘 TA55P 4.8MM 適應症請見備註 2063 欄 SAU C " 柯惠 "TA 自動手術縫合器及縫合釘 "COVIDIEN" AUTO SUTURE TA 2153 DISPOSABLE SURGICAL STAPLER AND LOADING UNIT 適應症請見備註欄 SAU US TA 90 P-3.5,4.8 DLU 胸腹器吻合釘 TA90P 3.5MM,4.8MM 適 2153 應症請見備註欄 SAU01MLSA3J8 " 南京邁迪欣 " 一次性使用直線型吻和器和釘倉 "NANJING 2293 MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 30* 適應症請見備註欄 SAU01MLSA6J8 " 南京邁迪欣 " 一次性使用直線型吻和器和釘倉 "NANJING 2063 MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 60* 適應症請見備註欄 SAU01MLSA9J8 " 南京邁迪欣 " 一次性使用直線型吻和器和釘倉 "NANJING 2153 MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 90* 適應症請見備註欄 SAU01MLSC3J8 " 南京邁迪欣 " 一次性使用直線型吻和器和釘倉 "NANJING 2293 MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 30* 適應症請見備註欄 SAU01MLSC6J8 " 南京邁迪欣 " 一次性使用直線型吻和器和釘倉 "NANJING 2063 MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 60* 適應症請見備註欄 SAU01MLSC9J8 " 南京邁迪欣 " 一次性使用直線型吻和器和釘倉 "NANJING 2153 MAIDIXIN" DISPOSABLE LINEAR STAPLER AND CARTRIDGE 90* 適應症請見備註欄 SAU01TA30L2C " 柯惠 " TA 自動手術縫合器及縫合釘 "COVIDIEN" TA STAPLERS 2293 AND LOADING UNITS SAU01TA30LUS " 優施西 " TA 自動手術縫合釘 "USSC" TA LOADING UNITS 30MM 2293 SAU01TA45L2C " 柯惠 " TA 自動手術縫合器及縫合釘 "COVIDIEN" TA STAPLERS 2063 AND LOADING UNITS SAU01TA45LUS " 優施西 " TA 自動手術縫合釘 "USSC" TA LOADING UNITS 45MM 2063 SAU01TA60L2C " 柯惠 " TA 自動手術縫合器及縫合釘 "COVIDIEN" TA STAPLERS 2063 AND LOADING UNITS SAU01TA60LUS " 優施西 " TA 自動手術縫合釘 "USSC" TA LOADING UNITS 60MM 2063 SAU01TA90L2C " 柯惠 " TA 自動手術縫合器及縫合釘 "COVIDIEN" TA STAPLERS 2153 AND LOADING UNITS SAU01TA90LUS " 優施西 " TA 自動手術縫合釘 "USSC" TA LOADING UNITS 90MM 2153 SAU01TRH90JJ "ETHICON"DISPOSABLE STAPLER-PROXIMATE LINEAR RELOADING 2153 UNIT( TITANIUM)90MM 適應症請見備註欄 SAU01XR30BJJ PROXIMATE RELOADABLE LINEAR STAPLER 30MM 3.5LEG,4.8LEG 2293 適應症請見備註欄 SAU01XR30RJJ PROXIMATE RELOADABLE LINEAR STAPLER 30MM VASCULAR 適應 2294 症請見備註欄 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 2294 SAU01XR60BJJ PROXIMATE RELOADABLE LINEAR STAPLER 60MM 3.5LEG,4.8LEG 適應症請見備註欄 SAU US AUTO SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLERS 適應症請見備註欄 SAU C " 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

292 SAU US GIA 50P DLU 腸胃吻合釘 適應症請見備註欄 2272 SAU US AUTO SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLERS 適應症請見備註欄 SAU US AUTO SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLERS 適應症請見備註欄 SAU US AUTO SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLERS 適應症請見備註欄 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 SAU026025LUS SAU DG SAU TY SAU02MLCCCJ8 SAU02SSR55ET SAU02SSR75ET SAU02TCRNNJJ SAU02TRD75ET SAU02TRT55JJ SAU02TRT75JJ SAU C SAU US SAU C " 優施西 "GIA 自動手術縫合器 "USSC"AUTO SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLER* 適應症請見備註欄 VALTRAC BIOFRAGMENTABLE ANASTOMOSIS RING 1.5:2.5MMX25:34MM 適應症請見備註欄 " 優施西 " 生化可吸收性腸吻合環 "USS" VALTRAC DEVICES 適應症請見備註欄 " 南京邁迪欣 " 一次性使用直線型切割吻和器和釘倉 "NANJING MAIDIXIN" DISPOSABLE LINEAR CUTTER AND CARTRIDGE* 適應症請見備註欄 " 愛惜康 " 直線形切割縫合器和可調節釘匣 - 可調節釘匣 "ETHICON ENDO-SURGERY"LINEAR CUTTER 55/75MM AND SELECTABLE CARTRIDGE/RELOADS(55MM) " 愛惜康 " 直線形切割縫合器和可調節釘匣 - 可調節釘匣 "ETHICON ENDO-SURGERY"LINEAR CUTTER 55/75MM AND SELECTABLE CARTRIDGE/RELOADS(75MM) RELOAD LINEAR CUTTER 55MM,75MM 腸胃自動縫合釘 適應症請見備註欄 " 愛惜康 " 普克美縫合釘 "ETHICON" PROXIMATE LINEAR CUTTERS & RELOAD UNITS * 適應症請見備註欄 RELOAD LINEAR CUTTER 55MM 腸胃自動縫合釘 適應症請見備註欄 RELOAD LINEAR CUTTER 75MM 腸胃自動縫合釘 適應症請見備註欄 " 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 EEA 25,28,31 DLU 腸道 食道縫合釘 25,28,31MM 適應症請見備註欄 " 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 SAU US 優施西 GIA 自動手術縫合器 60MM 5956 SAU C " 柯惠 "GIA 自動手術縫合器 "COVIDIEN"AUTO SUTURE MULTIFIRE 4000 GIA DISPOSABLE SURGICAL STAPLER * 適應症請見備註欄 SAU US 優施西 GIA 自動手術縫合器 30MM 4000 SAU C " 柯惠 "GIA 自動手術縫合器 "COVIDIEN"AUTO SUTURE MULTIFIRE 4900 GIA DISPOSABLE SURGICAL STAPLER * 適應症請見備註欄 SAU US 優施西 GIA 自動手術縫合器 45MM 4900 SAU C " 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

293 SAU C " 柯惠 "GIA 自動手術縫合器 - 旋轉式釘匣 (45MM)"COVIDIEN" AUTO 4900 SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLER- ROTICULATOR CARTRIDGE-45MM SAU C " 柯惠 "GIA 自動手術縫合器 - 旋轉式釘匣 (60MM)"COVIDIEN" AUTO 5956 SUTURE MULTIFIRE GIA DISPOSABLE SURGICAL STAPLER- ROTICULATOR CARTRIDGE-60MM SAU07CFC30J8 "NANJING MAIDIXIN" DISPOSABLE LINEAR CUTTER FOR ENDOSCOPE 4000 USE(30MM) SAU07CFC45J8 "NANJING MAIDIXIN" DISPOSABLE LINEAR CUTTER FOR ENDOSCOPE 4900 USE(45MM) SAU07CFC60J8 "NANJING MAIDIXIN" DISPOSABLE LINEAR CUTTER FOR ENDOSCOPE 5956 USE(60MM) SAU07ECR45ET " 愛惜康 " 愛喜龍 45 安德派思縫合釘 "ETHICON" ECHELON ENDOPATH ENDOSCOPIC LINER CUTTERS AND RELOADS SAU07ECR60ET " 愛惜康 " 愛喜龍安德派思縫合釘 "ETHICON" ECHELON 60 ENDOPATH 5756 STAPLER CARTRIDGE SAU07TR45BET " 愛惜康 " 安德派思切割縫合釘 "ETHICON" ENDOPATH ENDOSCOPIC 4802 LINEAR CUTTER RELOADING UNIT SAU07TR60BET " 愛惜康 " 安德派思切割縫合釘 "ETHICON" ENDOPATH ENDOSCOPIC 5756 LINEAR CUTTER RELOADING UNIT 60MM SCS CM RANEY SCALP CLIP 頭皮夾 20 排 / 盒 10 支 / 排 13 SCS P2 " 太平洋 " 頭皮夾 "PAHSCO" SCALP CLIP 13 SCS01FF15PAE RANEY SCALP CLIPS 13 SCV010412LV7 " 維達力克 " 鈦金屬血管夾系統 ( 大 )"VITALITEC" SLS-CLIP 35 TITANIUM HEMOSTATIC CLIP SYSTEM SCV010912LV7 " 維達力克 " 鈦金屬血管夾 ( 大 )"VITALITEC" NINE CLIP TITANIUM 35 HEMOSTATIC CLIP SYSTEM(LARGE) SCV01B218MV7 " 維達力克 " 鈦金屬血管夾系統 ( 中 )"VITALITEC" SLS-CLIP 19 TITANIUM HEMOSTATIC CLIP SYSTEM(MEDIUM) SCV01B918MV7 " 維達力克 " 鈦金屬血管夾 ( 小 )"VITALITEC" NINE CLIP TITANIUM 19 HEMOSTATIC CLIP SYSTEM(MEDIUM) SCV01FD100WK HEMO CLIP (M) 每盒 10 排, 每排 25CLIP 15 SCV01FD135WK HEMO CLIP (S) 每盒 12 排, 每排 25CLIP 13 SCV01FD160WK HEMO CLIP (M.L) 每盒 20 排, 每排 10CLIP 19 SCV01FD170WK HEMO CLIP (L) 每盒 10 排, 每排 15CLIP 30 SCV01FD300WK HEMO CLIP (M) 每盒 20 排, 每排 10CLIP 15 SCV01FD335WK HEMO CLIP (S) 每盒 24 排, 每排 10CLIP 13 SCV01FD360WK HEMO CLIP (ML) 每盒 16 排, 每排 10CLIP 19 SCV01FD370WK HEMO CLIP (L) 每盒 12 排, 每排 10CLIP 30 SCV01FD800WK TITANIUM HEMOCLIP(MEDIUM) 19 SCV01FD835WK TITANIUM HEMOCLIP(SMALL) 17 SCV01FD860WK TITANIUM HEMOCLIP(MEDIUM-LARGE) 22 SCV01FD870WK TITANIUM HEMOCLIP(LARGE) 35 SCV01J118SV7 " 維達力克 " 鈦金屬血管夾系統 ( 小 )"VITALITEC" SLS-CLIP 17 TITANIUM HEMOSTATIC CLIP SYSTEM(SMALL) SCV01J918SV7 " 維達力克 " 鈦金屬血管夾 ( 小 )"VITALITEC" NINE CLIP TITANIUM 17 HEMOSTATIC CLIP SYSTEM(SMALL) SCV01LT100JJ TITANIUM LIGA CLIP (S) 6 CLIP/ 排 17 SCV01LT200JJ TITANIUM LIGA CLIP (M) 6 CLIP/ 排 19 SCV01LT300JJ TITANIUM LIGA CLIP (M-L) 6 CLIP/ 排 22 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)

294 SCV01V912MV7 " 維達力克 " 鈦金屬血管夾 ( 中大 )"VITALITEC" NINE CLIP 22 TITANIUM HEMOSTATIC CLIP SYSTEM(MEDIUM/LARGE) SCV029380NM1 SUGITA ANEURYSM CLIPS(FENESTRATED LARGE TYPE)NO.7,9,12, SCV029400NM1 SUGITA ANEURYSM CLIP (STANDARD TYPE) 2256 SCV029401NM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801 SCV029402NM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801 SCV029404NM1 SUGITA ANEURYSM CLIP (FENESTRATED LARGE TYPE) 3000 SCV029404SM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801 SCV M1 SURGITA ANEURYSM CLIPS LARGE TYPE N SCV029405NM1 SUGITA ANEURYSM CLIP (TEMPORARY TYPE) 3000 SCV M1 SURGITA ANEURYSM CLIPS STANDARD TYPE N SCV029406NM1 SUGITA ANEURYSM CLIP (STANDARD TYPE) 2256 SCV029406SM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801 SCV M1 SURGITA ANEURYSM CLIPS LARGE TYPE N SCV029407NM1 SUGITA ANEURYSM CLIP (LARGE TYPE) 2801 SCV029407SM1 SUGITA ANEURYSM CLIP (FENESTRATED LARGE TYPE) 3000 SCV029408SM1 SUGITA ANEURYSM CLIP (MINI TYPE) 3000 SCV02FE60NAE ANEURYSM CLIP 2602 SCV ET 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 175 MULTI-FIRE RATCHETED REUSABLE CLIP APPLIER-DISPOSABLE 19 TITANIUM CLIP SCV031113LQX " 麥克嵐潘特斯 " 傑尼多發式血管夾 "MICROLINE PENTAX" GEMINI 175 MULTI-FIRE LARGE CLIP APPLIER 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 175 CLIP APPLIER SCV03615MLUS ENDO CLIP APPLIER M/L CLIPS 內視鏡自動血管夾 175 SCV03625LL2C 柯惠 內視鏡自動血管夾 "COVIDIEN" ENDO CLIP SINGLE USE 200 CLIP APPLIER SCV03625LLUS ENDO CLIP APPLIER M/L CLIPS 內視鏡自動血管夾 200 SCV WK HEMOCLIP AUTOMATIC CLIP APPLIER WITH CLIPS S SCV WK HEMOCLIP AUTOMATIC CLIP APPLIER WITH CLIPS M SCV US SURGI-CLIP M-9.5 ( 每支 20 CLIP) 104 SCV US SURGI-CLIP M-11 ( 每支 20 CLIP) 104 SCV C " 柯惠 " 拋棄式自動血管夾 "COVIDIEN" AUTO SUTURE DISPOSABLE 104 AUTOMATIC CLIP APPLIER SCV US PREMIUM SURGI-CLIP ( 每支 20 CLIP) M SCV C " 柯惠 " 拋棄式自動血管夾 "COVIDIEN" AUTO SUTURE DISPOSABLE 104 AUTOMATIC CLIP APPLIER SCV US PREMIUM SURGI-CLIP M9.75 ( 每支 15 CLIP) 104 SCV C " 柯惠 " 拋棄式自動血管夾 "COVIDIEN" AUTO SUTURE DISPOSABLE 102 AUTOMATIC CLIP APPLIER SCV US PREMIUM SURGI-CLIP ( 每支 20 CLIP) S SCV C " 柯惠 " 拋棄式自動血管夾 "COVIDIEN" AUTO SUTURE DISPOSABLE 122 AUTOMATIC CLIP APPLIER SCV US PREMIUM SURGI-CLIP L-13.0 ( 每支 15 CLIP) 122 SCV C " 柯惠 " 自動連發式血管夾 "COVIDIEN" AUTO SUTURE PREMIUM 104 SURGICLIP APPLIER WITH CLIPS SCV US AUTO SUTURE DISPOSABLE AUTOMATIC CLIP APPLIER PREMIUM SURGICLIP II(M-9.75)

295 SCV C " 柯惠 " 自動連發式血管夾 "COVIDIEN" AUTO SUTURE PREMIUM 104 SURGICLIP APPLIER WITH CLIPS SCV US AUTO SUTURE DISPOSABLE AUTOMATIC CLIP APPLIER PREMIUM 104 SURGICLIP II(M-11.5) SCV CH CONMED DISPOSABLE CLIP APPLIER 拋棄式血管夾 104 SCV20MCL20JJ MULTIPLE CLIPS APPLIER (20 CLIP/PC) 122 SCV20MCM20JJ MULTIPLE CLIP APPLIER (20 CLIP/PC) 104 SCV20MCM30JJ MULTIPLE CLIP APPLIER (30 CLIP/PC) 104 SCV20MCS20JJ MULTIPLE CLIP APPLIER (20 CLIP/PC) 102 TBCT10023TVR "EAGLE LABS"MANUAL OPHTHALMIC SURGICAL INSTRUMENT LACRIMAL INTUBATION SET" 老鷹 " 手動式眼科手術器械 - 鼻淚管通條 TBCT10027TVR "EAGLE LABS"MANUAL OPHTHALMIC SURGICAL INSTRUMENT LACRIMAL INTUBATION SET" 老鷹 " 手動式眼科手術器械 - 鼻淚管通條 TBCT102836HV " 艾伯特海斯 " 手動式眼科手術器械 - 鼻淚管通條 "ALBERT 1773 HEISS"MANUAL OPHTHALMIC SURGICAL INSTRUMENT-LACHRYMAL INTUBATION SET TBCT109600W5 CRAWFORD LARCRIMAL INTUBATION SET 鼻淚管通條 1773 TBCT1L1S27QT "QUEST"MANUAL OPHTHALMIC SURGICAL INSTRUMENT:LACRIMAL 1773 INTUBATION SET" 可思透 " 手動式眼科手術器械 : 鼻淚管通條 TBS Z FCI SCLERAL BUCKLING IMPLANTS-BAND " 佛朗惜眼 " 鞏膜環扣物 463 TBS Z FCI SCLERAL BUCKLING IMPLANTS-TIRE " 佛朗惜眼 " 鞏膜環扣物 661 TKC K2 SUPERBLADE TREPHINE VACUUM 2350 TKC028260NJM "JEDMED"HESSBURG-BARRON VACUUM TREPHINE " 捷德 " 漢氏伯手動 2350 環鉅 TKF A1 LIGHT GUIDE 20G 1450 TKF ZT FIBER OPTIC ENDOILLUMINATOR PROBE 後房手術用光纖 1450 TKF01DP602B9 ILLUMINATORS 眼科手術儀用光纖導管 1450 TKF01MVS01B9 ILLUMINATORS 眼科手術儀用光纖導管 1450 TKP WF EHL 9FR 電擊線 3477 TKP WF EHL 3.5FR 電擊線 3477 TKP WF EHL 5FR 電擊線 3477 TKP012280NWF LITHOTRIPTER:RIWOLITH PROBES 2280.XXX 3477 TKP012708NKL EHL PROBE 電擊碎石線 3477 TKP03ACT102C " 柯惠 " 威利雷柏酷迪波無線電頻率電刀系統 - 冷循環式射頻燒灼電 極針組 "COVIDIEN" VALLEYLAB COOL-TIP RF SYSTEM-RF ELECTRODE KIT* 給付規定請見備註欄 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 TKP03RFA01XM "STARMED"ELECTROSURGICAL SYSTEM AND ACCESSORIES:RF COAGULATION ELECTRODES" 史達美克 " 電燒系統及附件 : 凝血電極針 ( 冷卻式 ) 適應症請見備註欄 TKP03RFA20RX "RF"RADIOFREQUENCY ELECTROSURGICAL CAUTERY APPARATUS AND ACCESSORIES" 愛爾發 " 電子燒灼機及其附件 : 凝血電極針 ( 水冷式 ) TKP03RFATA1H "MEDSPHERE"ELECTROSURGICAL RF ELECTRODES " 邁德斯菲爾 " 電外 科電極 適應症請見備註欄 TKVC105064QQ POSTERIOR VITRECTOMY CUTTERS 30PSI 20GA( 後房玻璃體切除刀 )

296 TKVC10506NQQ "MICRO VISION"MANUAL OPHTHALMIC SURGICAL 4409 INSTRUMENT:ACCURUS VITRECTOMY PROBE" 麥可威視 " 手動式眼科手術器械 : 玻璃體切除探頭 TKVC105124QQ "MICRO VISION"MANUAL OPHTHALMIC SURGICAL 4950 INSTRUMENT:ACCURUS VITRECTOMY PROBE 2500 切 " 麥可威視 " 手動式眼科手術器械 : 玻璃體切除探頭 TKVC107402A1 STANDALONE ACCURUS PROBE 4497 TKVC12405CZS "MID LABS"VITREOUS CUTTER W/TUBING SET " 米睿 玻璃體切割 4409 系統配件 ( 切除刀 ) TKVC141018A1 ACCURUS 2500 VITRECTOMY PROBE 玻璃體切除探頭 4950 TKVC1CX408B9 HIGH SPEED VITRECTOMY CUTTER TIPS 高速玻璃體切割頭 次 / 分 TKVC201006A1 ANTERIOR ADVANCE TECHNOLOGY IRRIGATION OCUTOME PROBE 4497 (ATOP) TKVC208012A1 ANTERIOR VITRECTOMY PROBE 4497 TKVS1D4801B9 VITREOUS ASPIRATION AND CUTTING INSTRUMENT PACKS:VENTURI 4500 BASIC POSTERIOR VITRECTOMY ( 含盒子 ) TKVS1D4801SZ BASIC POSTERIOR VITRECTOMY PACK 4500 TKVS1D4803B9 VITREOUS ASPIRATION AND CUTTING INSTRUMENT PACKS: 4500 POSTERIOR VITRECTOMY CUTTER PACKS( 不含盒子 ) TKVS1D4803SZ MICROVIT VITRECTOMY CUTER POSTERIOR 4500 WBB C7 ELASTIC BANDAGE 適應症請見備註欄 10.6 WBB EX ELASTIC BANDAGE 適應症請見備註欄 10.6 WBB EZ ELASTIC BANDAGE 2"x5Y * 適應症請見備註欄 10.6 WBB F0 FOR CARE ELASTIC BANDAGE* 適應正請見備註欄 10.6 WBB GM ELASTIC BANDAGE 適應症請見備註欄 10.6 WBB KB DURELASTIC-M 5CMx4.5M * 適應症請見備註欄 10.6 WBB KF ELASTIC BANDAGE 適應症請見備註欄 10.6 WBB MG "I-Ming" BANDAGE ELASTIC " 愛民 " 彈性繃帶 2"x5Y 適應症請見 10.6 備註欄 WBB RL "RE-ORDER"ELASTIC BANDAGE(NON-STERILE)2 吋 X5 碼彈性繃帶 * 適 10.6 應症請見備註欄 WBB UQ "U.A.TOP"ELASTIC BANDAGE(NON-STERILE)2"X5Y" 優亞特 " 彈性繃 10.6 帶 ( 未滅菌 * 適應症請見備註欄 ) WBB YS ELASTIC BANDAGE 2"X5Y 適應症請見備註欄 10.6 WBB YU YU CHUNG ELASTIC BANDAGE (NON-STERILE)* 適應症請見備註欄 10.6 WBB Z5 S.S BANDAGE 2x5* 適應症請見備註欄 10.6 WBB ZB ELASTIC BANDAGE* 適應症請見備註欄 10.6 WBB C7 ELASTIC BANDAGE 適應症請見備註欄 11 WBB EX ELASTIC BANDAGE 適應症請見備註欄 11 WBB EZ ELASTIC BANDAGE 3"x5Y * 適應症請見備註欄 11 WBB F0 FOR CARE ELASTIC BANDAGE* 適應正請見備註欄 11 WBB FF ELASTIC BANDAGE 適應症請見備註欄 11 WBB GM ELASTIC BANDAGE 適應症請見備註欄 11 WBB KB DURELASTIC-M 7.5CMx4.5M * 適應症請見備註欄 11 WBB KF ELASTIC BANDAGE 適應症請見備註欄 11 WBB MG "I-Ming" BANDAGE ELASTIC " 愛民 " 彈性繃帶 3"x5Y 適應症請見 11 備註欄 WBB RL "RE-ORDER"ELASTIC BANDAGE(NON-STERILE)3 吋 X5 碼彈性繃帶 * 適 11 應症請見備註欄 WBB TW ELASTIC BANDAGE* 適應症請見備註欄

297 WBB UQ "U.A.TOP"ELASTIC BANDAGE(NON-STERILE)3"X5Y" 優亞特 " 彈性繃 11 帶 ( 未滅菌 * 適應症請見備註欄 ) WBB YS ELASTIC BANDAGE 3"x5Y 適應症請見備註欄 11 WBB YU YU CHUNG ELASTIC BANDAGE (NON-STERILE)* 適應症請見備註欄 11 WBB Z5 S.S BANDAGE 3x5* 適應症請見備註欄 11 WBB ZB ELASTIC BANDAGE* 適應症請見備註欄 11 WBB C7 ELASTIC BANDAGE 適應症請見備註欄 13.2 WBB EX ELASTIC BANDAGE 適應症請見備註欄 13.2 WBB EZ ELASTIC BANDAGE 4"x5Y * 適應症請見備註欄 13.2 WBB F0 FOR CARE ELASTIC BANDAGE* 適應正請見備註欄 13.2 WBB FF ELASTIC BANDAGE 適應症請見備註欄 13.2 WBB GM ELASTIC BANDAGE 適應症請見備註欄 13.2 WBB KB DURELASTIC-M 10CMx4.5M * 適應症請見備註欄 13.2 WBB KF ELASTIC BANDAGE 適應症請見備註欄 13.2 WBB MG "I-Ming" BANDAGE ELASTIC " 愛民 " 彈性繃帶 4"x5Y 適應症請見 13.2 備註欄 WBB RL "RE-ORDER"ELASTIC BANDAGE(NON-STERILE)4 吋 X5 碼彈性繃帶 * 適 13.2 應症請見備註欄 WBB TW ELASTIC BANDAGE* 適應症請見備註欄 13.2 WBB UQ "U.A.TOP"ELASTIC BANDAGE(NON-STERILE)4"X5Y" 優亞特 " 彈性繃 13.2 帶 ( 未滅菌 * 適應症請見備註欄 ) WBB YS ELASTIC BANDAGE 4"x5Y 適應症請見備註欄 13.2 WBB YU YU CHUNG ELASTIC BANDAGE (NON-STERILE)* 適應症請見備註欄 13.2 WBB ZB ELASTIC BANDAGE* 適應症請見備註欄 13.2 WBB C7 ELASTIC BANDAGE 適應症請見備註欄 18 WBB EX ELASTIC BANDAGE 適應症請見備註欄 18 WBB EZ ELASTIC BANDAGE 6"x5Y * 適應症請見備註欄 18 WBB F0 FOR CARE ELASTIC BANDAGE* 適應症請見備註欄 18 WBB FF ELASTIC BANDAGE 適應症請見備註欄 18 WBB GM ELASTIC BANDAGE 適應症請見備註欄 18 WBB KB DURELASTIC-M 15CMx4.5M * 適應症請見備註欄 18 WBB KF ELASTIC BANDAGE 適應症請見備註欄 18 WBB MG "I-Ming" BANDAGE ELASTIC " 愛民 " 彈性繃帶 6"x5Y 適應症請見 18 備註欄 WBB RL "RE-ORDER"ELASTIC BANDAGE(NON-STERILE)6 吋 X5 碼彈性繃帶 * 適 18 應症請見備註欄 WBB TW ELASTIC BANDAGE* 適應症請見備註欄 18 WBB UQ "U.A.TOP"ELASTIC BANDAGE(NON-STERILE)6"X5Y" 優亞特 " 彈性繃 18 帶 ( 未滅菌 * 適應症請見備註欄 ) WBB YS ELASTIC BANDAGE 6"x5Y 適應症請見備註欄 18 WBB YU YU CHUNG ELASTIC BANDAGE (NON-STERILE)* 適應症請見備註欄 18 WBB ZB ELASTIC BANDAGE* 適應症請見備註欄 18 WBB AZ "M&A"POP PLASTER OF PARIS BANDAGE EXTRA FAST SETTING 20 2"X3Y 石膏繃帶 WBB AZ PLASTER OF PARIS BANDAGE 2"x5Y 22.7 WBB JN "JOIN"OPTIMA POP PLASTER OF PARIS BANDAGE2"X5Y 歐替瑪石膏 22.7 繃帶 WBB A5 CAST BANDAGE 22.7 WBB AZ "M&A"POP PLASTER OF PARIS BANDAGE EXTRA FAST SETTING 3"X3Y 石膏繃帶

298 WBB C7 "CSD"PLASTER OF PAIRS BANDAGE (non-sterile)3"x3y" 中衛 " 石 22.7 膏繃帶 ( 未滅菌 ) WBB NJ PLASTER BANDAGE 3"X3Y 22.7 WBB U6 PLASTER OF PARIS BANDAGE 3"X3Y 22.7 WBB ZD DUK-IN PLASTER BANDAGE 22.7 WBB NS NOK-SAN CAST PLASTER BANDAGE 石膏繃帶 3"X3Y 22.7 WBB U6 PLASTER OF PARIS BANDAGE 3"X4Y 24.4 WBB AZ PLASTER OF PARIS BANDAGE 3"X5Y 30.9 WBB C7 CAST BANDAGE 30.9 WBB JN "JOIN"OPTIMA POP PLASTER OF PARIS BANDAGE3"X5Y 歐替瑪石膏 30.9 繃帶 WBB JX "ANJI JIXIANG"PLASTER OF PARIS BANDAGES(NON-STERILE)" 安吉 30.9 吉祥 " 石膏繃帶 ( 未滅菌 )3"X5Y WBB U6 PLASTER OF PARIS BANDAGE 3"X5Y 30.9 WBB DQ PLASTER OF PARIS BANDAGE B.P 24.4 WBB U6 PLASTER OF PARIS BANDAGE 4"X3Y 24.4 WBB U6 PLASTER OF PARIS BANDAGE 4"X4Y 34.1 WBB ZD DUK-IN PLASTER BANDAGE 34.1 WBB A5 CAST BANDAGE 38.1 WBB AZ PLASTER OF PARIS BANDAGE 4"X5Y 38.1 WBB C7 "CSD"PLASTER OF PAIRS BANDAGE (non-sterile)4"x5y" 中衛 " 石 38.1 膏繃帶 ( 未滅菌 ) WBB JN "JOIN"OPTIMA POP PLASTER OF PARIS BANDAGE4"X5Y 歐替瑪石膏 38.1 繃帶 WBB JX "ANJI JIXIANG"PLASTER OF PARIS BANDAGES(NON-STERILE)" 安吉 38.1 吉祥 " 石膏繃帶 ( 未滅菌 )4"X5Y WBB NJ PLASTER BANDAGE 4"X5Y 38.1 WBB NS NOK-SAN CAST PLASTER BANDAGE 10CMX4.5M(4"X5Y) 38.1 WBB U6 PLASTER OF PARIS BANDAGE 4"X5Y 38.1 WBB A5 "ALCARE"P&O PLASTER OF PARIS BANDAGE 4"X5Y(10CMX4.5M)" 愛 38.1 樂康 " 石膏繃帶 WBB AZ "M&A"POP PLASTER OF PARIS BANDAGE EXTRA FAST SETTING "X5Y 石膏繃帶 WBB JN "JOIN"OPTIMA POP PLASTER OF PARIS BANDAGE5"X5Y 歐替瑪石膏 48.8 繃帶 WBB NJ PLASTER BANDAGE 5"X5Y 48.8 WBB U6 PLASTER OF PARIS BANDAGE 5"X5Y 48.8 WBB U6 PLASTER OF PARIS BANDAGE 6"X3Y 38 WBB U6 PLASTER OF PARIS BANDAGE 6"X4Y 47 WBB ZD DUK-IN PLASTER BANDAGE 47 WBB A5 "Alcare"casting 6"x5y 50.1 WBB AZ PLASTER OF PARIS BANDAGE 6"X5Y 50.1 WBB C7 "CSD"PLASTER OF PAIRS BANDAGE (non-sterile)6"x5y" 中衛 " 石 50.1 膏繃帶 ( 未滅菌 ) WBB JN "JOIN"OPTIMA POP PLASTER OF PARIS BANDAGE6"X5Y 歐替瑪石膏 50.1 繃帶 WBB JX "ANJI JIXIANG"PLASTER OF PARIS BANDAGES(NON-STERILE)" 安吉 50.1 吉祥 " 石膏繃帶 ( 未滅菌 )6"X5Y WBB NJ PLASTER BANDAGE 6"X5Y 50.1 WBB NS NOK-SAN CAST PLASTER BANDAGE 15CMX4.5M(6"X5Y) 50.1 WBB U6 PLASTER OF PARIS BANDAGE 6"X5Y 50.1 WBB A5 "ALCARE"P&O PLASTER OF PARIS BANDAGE 6"X5Y(15CMX4.5M)" 愛樂康 " 石膏繃帶

299 WBB AZ PLASTER OF PARIS BANDAGE 8"X5Y 68.3 WBB JN "JOIN"OPTIMA POP PLASTER OF PARIS BANDAGE8"X5Y 歐替瑪石膏 68.3 繃帶 WBB KB "KOB"KOBRA CAST 易速石膏繃帶 ( 聚脂石膏繃帶 )1 吋 X2 碼 * 適應症 85 請見備註欄 WBB Q9 "TOMATO"ORTHOPAEDIC CASTING TAPE(NON-STERILE) 玻璃纖維石膏 50 繃帶 1 吋 X2 碼 * 適應症請見備註欄 WBB M SCOTCHCAST PLUS CASTING TAPE 玻璃纖維石膏繃帶 2 吋 X4 碼 * 適應 120 症請見備註欄 WBB HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE) 樹脂石膏繃帶 120 ( 聚脂纖維 )2 吋 X4.4 碼 * 適應症請見備註欄 WBB K3 "KANGDA"ORTHOPEDIC CASTING TAPE 樹脂石膏繃帶 ( 玻璃纖維 )2 吋 碼 * 適應症請見備註欄 WBB KB "KOB"KOBRA CAST 易速石膏繃帶 ( 聚脂石膏繃帶 )2 吋 X4 碼 * 適應症 196 請見備註欄 WBB NJ FIBERGLASS CAST TAPE 玻璃纖維石膏繃帶 2 吋 X4Y* 使用規範請見備 120 註欄 WBB Q3 "DONG HAE"ORTHOPEDIC CASTING TAPE 輕石膏 ( 玻璃纖維 )2 吋 X4 碼 * 120 適應症請見備註欄 WBB Q5 "S&F"ROBO CASTING TAPE 若玻樹脂石膏繃帶 ( 聚脂纖維 )2 吋 X4 碼 * 120 適應症請見備註欄 WBB Q6 NEMOA CAST ORTHOPAEDIC CASTING TAPE(POLYESTER) 米尼亞聚脂 120 繃帶 2 吋 X4 碼 * 使用規範請見備註欄 WBB Q7 "KJC"PP-BAND CASTING TAPE 必庇綁樹脂石膏 ( 聚脂纖維 )2 吋 X4 碼 * 120 適應症請見備註欄 WBB Q8 "OPTIMA CAST"ORTHOPAEDIC CASTING TAPE(NON-STERILE) 樹脂石 120 膏繃帶 ( 玻璃纖維 )2 吋 X4 碼 * 適應症請見備註欄 WBB Q9 "TOMATO"ORTHOPAEDIC CASTING TAPE(NON-STERILE) 玻璃纖維石膏 120 繃帶 2 吋 X4 碼 * 適應症請見備註欄 WBB YK "CONNECT"ORTHOPEDIC CASTING TAPE 2"X4Y(5.0CMX360CM)(NON- STERILE)" 可耐特 " 樹脂石膏繃帶 ( 未滅菌 )* 適應症請見備註欄 120 WBB M SCOTCHCAST PREMIUM CASTING TAPE 玻璃纖維石膏繃帶 2 吋 X4 碼 * 適應症請見備註欄 WBB HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NEAL CAST FIBERGLASS ALPHA TYPE) 樹脂石膏繃帶 ( 玻璃纖維 )2 吋 X4.4 碼 * 適應症請見備註欄 WBB NJ POLYESTER CAST TAPE 聚脂纖維石膏繃帶 2 吋 X4Y* 使用規範請見備註欄 WBB M SCOTCHCAST PLUS CASTING TAPE 玻璃纖維石膏繃帶 3 吋 X4 碼 * 適應症請見備註欄 WBB HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE) 樹脂石膏繃帶 ( 聚脂纖維 )3 吋 X4.4 碼 * 適應症請見備註欄 WBB K3 "KANGDA"ORTHOPEDIC CASTING TAPE 樹脂石膏繃帶 ( 玻璃纖維 )3 吋 4 碼 * 適應症請見備註欄 WBB KB "KOB"KOBRA CAST 易速石膏繃帶 ( 聚脂石膏繃帶 )3 吋 X4 碼 * 適應症請見備註欄 WBB NJ FIBERGLASS CAST TAPE 玻璃纖維石膏繃帶 3 吋 X4Y* 使用規範請見備註欄 WBB Q3 "DONG HAE"ORTHOPEDIC CASTING TAPE 輕石膏 ( 玻璃纖維 )3 吋 X4 碼 * 適應症請見備註欄 WBB Q5 "S&F"ROBO CASTING TAPE 若玻樹脂石膏繃帶 ( 聚脂纖維 )3 吋 X4 碼 * 適應症請見備註欄

300 WBB Q6 NEMOA CAST ORTHOPAEDIC CASTING TAPE(POLYESTER) 米尼亞聚脂繃帶 3 吋 X4 碼 * 使用規範請見備註欄 WBB Q7 "KJC"PP-BAND CASTING TAPE 必庇綁樹脂石膏 ( 聚脂纖維 )3 吋 X4 碼 * 適應症請見備註欄 WBB Q8 "OPTIMA CAST"ORTHOPAEDIC CASTING TAPE(NON-STERILE) 樹脂石膏繃帶 ( 玻璃纖維 )3 吋 X4 碼 * 適應症請見備註欄 WBB Q9 "TOMATO"ORTHOPAEDIC CASTING TAPE(NON-STERILE) 玻璃纖維石膏繃帶 3 吋 X4 碼 * 適應症請見備註欄 WBB YK "CONNECT"ORTHOPEDIC CASTING TAPE 3"X4Y(7.5CMX360CM)(NON- STERILE)" 可耐特 " 樹脂石膏繃帶 ( 未滅菌 )* 適應症請見備註欄 WBB M SCOTCHCAST PREMIUM CASTING TAPE 玻璃纖維石膏繃帶 3 吋 X4 碼 * 適應症請見備註欄 WBB HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NEAL CAST FIBERGLASS ALPHA TYPE) 樹脂石膏繃帶 ( 玻璃纖維 )3 吋 X4.4 碼 * 適應症請見備註欄 WBB NJ POLYESTER CAST TAPE 聚脂纖維石膏繃帶 3 吋 X4Y* 使用規範請見備註欄 WBB M SCOTCHCAST PLUS CASTING TAPE 玻璃纖維石膏繃帶 4 吋 X4 碼 * 適應症請見備註欄 WBB HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE) 樹脂石膏繃帶 ( 聚脂纖維 )4 吋 X4.4 碼 * 適應症請見備註欄 WBB K3 "KANGDA"ORTHOPEDIC CASTING TAPE 樹脂石膏繃帶 ( 玻璃纖維 )4 吋 4 碼 * 適應症請見備註欄 WBB KB "KOB"KOBRA CAST 易速石膏繃帶 ( 聚脂石膏繃帶 )4 吋 X4 碼 * 適應症請見備註欄 WBB NJ FIBERGLASS CAST TAPE 玻璃纖維石膏繃帶 4 吋 X4Y* 使用規範請見備註欄 WBB Q3 "DONG HAE"ORTHOPEDIC CASTING TAPE 輕石膏 ( 玻璃纖維 )4 吋 X4 碼 * 適應症請見備註欄 WBB Q5 "S&F"ROBO CASTING TAPE 若玻樹脂石膏繃帶 ( 聚脂纖維 )4 吋 X4 碼 * 適應症請見備註欄 WBB Q6 NEMOA CAST ORTHOPAEDIC CASTING TAPE(POLYESTER) 米尼亞聚脂繃帶 4 吋 X4 碼 * 使用規範請見備註欄 WBB Q7 "KJC"PP-BAND CASTING TAPE 必庇綁樹脂石膏 ( 聚脂纖維 )4 吋 X4 碼 * 適應症請見備註欄 WBB Q8 "OPTIMA CAST"ORTHOPAEDIC CASTING TAPE(NON-STERILE) 樹脂石膏繃帶 ( 玻璃纖維 )4 吋 X4 碼 * 適應症請見備註欄 WBB Q9 "TOMATO"ORTHOPAEDIC CASTING TAPE(NON-STERILE) 玻璃纖維石膏繃帶 4 吋 X4 碼 * 適應症請見備註欄 WBB YK "CONNECT"ORTHOPEDIC CASTING TAPE 4"X4Y(10.0CMX360CM)(NON- STERILE)" 可耐特 " 樹脂石膏繃帶 ( 未滅菌 )* 適應症請見備註欄 WBB M WBB HZ WBB NJ WBB M SCOTCHCAST PREMIUM CASTING TAPE 玻璃纖維石膏繃帶 4 吋 X4 碼 * 適應症請見備註欄 "HORIZON"ORTHOPEDIC CASTING TAPE(NEAL CAST FIBERGLASS ALPHA TYPE) 樹脂石膏繃帶 ( 玻璃纖維 )4 吋 X4.4 碼 * 適應症請見備註欄 POLYESTER CAST TAPE 聚脂纖維石膏繃帶 4 吋 X4Y* 使用規範請見備註欄 SCOTCHCAST PLUS CASTING TAPE 玻璃纖維石膏繃帶 5 吋 X4 碼 * 適應症請見備註欄

301 WBB HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE) 樹脂石膏繃帶 ( 聚脂纖維 )5 吋 X4.4 碼 * 適應症請見備註欄 WBB K3 "KANGDA"ORTHOPEDIC CASTING TAPE 樹脂石膏繃帶 ( 玻璃纖維 )5 吋 4 碼 * 適應症請見備註欄 WBB KB "KOB"KOBRA CAST 易速石膏繃帶 ( 聚脂石膏繃帶 )5 吋 X4 碼 * 適應症請見備註欄 WBB NJ FIBERGLASS CAST TAPE 玻璃纖維石膏繃帶 5 吋 X4Y* 使用規範請見備註欄 WBB Q3 "DONG HAE"ORTHOPEDIC CASTING TAPE 輕石膏 ( 玻璃纖維 )5 吋 X4 碼 * 適應症請見備註欄 WBB Q5 "S&F"ROBO CASTING TAPE 若玻樹脂石膏繃帶 ( 聚脂纖維 )5 吋 X4 碼 * 適應症請見備註欄 WBB Q6 NEMOA CAST ORTHOPAEDIC CASTING TAPE(POLYESTER) 米尼亞聚脂繃帶 5 吋 X4 碼 * 使用規範請見備註欄 WBB Q7 "KJC"PP-BAND CASTING TAPE 必庇綁樹脂石膏 ( 聚脂纖維 )5 吋 X4 碼 * 適應症請見備註欄 WBB Q8 "OPTIMA CAST"ORTHOPAEDIC CASTING TAPE(NON-STERILE) 樹脂石膏繃帶 ( 玻璃纖維 )5 吋 X4 碼 * 適應症請見備註欄 WBB Q9 "TOMATO"ORTHOPAEDIC CASTING TAPE(NON-STERILE) 玻璃纖維石膏繃帶 5 吋 X4 碼 * 適應症請見備註欄 WBB YK "CONNECT"ORTHOPEDIC CASTING TAPE 5"X4Y(12.5CMX360CM)(NON- STERILE)" 可耐特 " 樹脂石膏繃帶 ( 未滅菌 )* 適應症請見備註欄 WBB M SCOTCHCAST PREMIUM CASTING TAPE 玻璃纖維石膏繃帶 5 吋 X4 碼 * 適應症請見備註欄 WBB HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NEAL CAST FIBERGLASS ALPHA TYPE) 樹脂石膏繃帶 ( 玻璃纖維 )5 吋 X4.4 碼 * 適應症請見備註欄 WBB NJ POLYESTER CAST TAPE 聚脂纖維石膏繃帶 5 吋 X4Y* 使用規範請見備註欄 WBB K3 "KANGDA"ORTHOPEDIC CASTING TAPE 樹脂石膏繃帶 ( 玻璃纖維 )6 吋 4 碼 * 適應症請見備註欄 WBB Q3 "DONG HAE"ORTHOPEDIC CASTING TAPE 輕石膏 ( 玻璃纖維 )6 吋 X4 碼 * 適應症請見備註欄 WBB Q5 "S&F"ROBO CASTING TAPE 若玻樹脂石膏繃帶 ( 聚脂纖維 )6 吋 X4 碼 * 適應症請見備註欄 WBB Q6 NEMOA CAST ORTHOPAEDIC CASTING TAPE(POLYESTER) 米尼亞聚脂繃帶 6 吋 X4 碼 * 使用規範請見備註欄 WBB Q9 "TOMATO"ORTHOPAEDIC CASTING TAPE(NON-STERILE) 玻璃纖維石膏繃帶 6 吋 X4 碼 * 適應症請見備註欄 WBB YK "CONNECT"ORTHOPEDIC CASTING TAPE6"X4Y(15.0CMX360CM)(NON- STERILE)" 可耐特 " 樹脂石膏繃帶 ( 未滅菌 )* 適應症請見備註欄 WBB A5 玻璃纖維石膏繃帶 2 吋 X4 碼 * 使用規範請見備註欄 120 WBB A5 玻璃纖維石膏繃帶 3 吋 X4 碼 * 使用規範請見備註欄 140 WBB A5 玻璃纖維石膏繃帶 4 吋 X4 碼 * 使用規範請見備註欄 160 WBB A5 玻璃纖維石膏繃帶 5 吋 X4 碼 * 使用規範請見備註欄 180 WBB A5 聚脂纖維石膏繃帶 2 吋 X4 碼 * 使用規範請見備註欄 120 WBB A5 聚脂纖維石膏繃帶 3 吋 X4 碼 * 使用規範請見備註欄 140 WBB A5 聚脂纖維石膏繃帶 4 吋 X4 碼 * 使用規範請見備註欄 160 WBB A5 聚脂纖維石膏繃帶 5 吋 X4 碼 * 使用規範請見備註欄 180 WBB HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE) 樹脂石膏繃帶 ( 玻璃纖維 )2 吋 X4.4 碼 * 適應症請見備註欄

302 WBB Q5 "S&F"ROBO CASTING TAPE 若玻樹脂石膏繃帶 ( 玻璃纖維 )2 吋 X4 碼 * 120 適應症請見備註欄 WBB HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE) 樹脂石膏繃帶 140 ( 玻璃纖維 )3 吋 X4.4 碼 * 適應症請見備註欄 WBB Q5 "S&F"ROBO CASTING TAPE 若玻樹脂石膏繃帶 ( 玻璃纖維 )3 吋 X4 碼 * 140 適應症請見備註欄 WBB HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE) 樹脂石膏繃帶 160 ( 玻璃纖維 )4 吋 X4.4 碼 * 適應症請見備註欄 WBB Q5 "S&F"ROBO CASTING TAPE 若玻樹脂石膏繃帶 ( 玻璃纖維 )4 吋 X4 碼 * 160 適應症請見備註欄 WBB HZ "HORIZON"ORTHOPEDIC CASTING TAPE(NON-STERILE) 樹脂石膏繃帶 180 ( 玻璃纖維 )5 吋 X4.4 碼 * 適應症請見備註欄 WBB Q5 "S&F"ROBO CASTING TAPE 若玻樹脂石膏繃帶 ( 玻璃纖維 )5 吋 X4 碼 * 180 適應症請見備註欄 WBB Q5 "S&F"ROBO CASTING TAPE 若玻樹脂石膏繃帶 ( 玻璃纖維 )6 吋 X4 碼 * 200 適應症請見備註欄 WBP YK "CONNECT"CAST COTTON PADDING(NON- 8 STERILE)2"X3Y(5CMX270CM)" 可耐特 " 石膏棉捲 ( 未滅菌 ) WBP JN OPTIMA PAD 石膏棉捲 11 WBP QB "CHUAN SHUN"COTTON BANDAGES(NON-STERILE) 2"X4Y" 銓順 " 石膏 11 棉捲 ( 未滅菌 ) WBP C7 CSD ORTHOPAEDIC CAST COTTON PADDING 13.5 WBP DQ SABHARWAL'S BANDAGE ORTHOPAEDIC CAST PADDING 13.5 WBP YK "CONNECT"CAST COTTON PADDING(NON STERILE)3"X3Y(7.5CMX270CM)" 可耐特 " 石膏棉捲 ( 未滅菌 ) WBP C7 CSD ORTHOPAEDIC CAST COTTON PADDING 14 WBP FC ORTHOPEDIC COTTON BANDAGE 14 WBP JN OPTIMA PAD 石膏棉捲 14 WBP JX "ANJI JIXIANG"UNDERCAST PADDING BANDAGE(NON-STERILE) 14 3"X4Y" 安吉吉祥 " 棉捲 ( 未滅菌 ) WBP KF ORTHOPEDIC COTTON BANDAGE 14 WBP QB "CHUAN SHUN"COTTON BANDAGES(NON-STERILE) 3"X4Y" 銓順 " 石膏 14 棉捲 ( 未滅菌 ) WBP C7 CSD ORTHOPAEDIC CAST COTTON PADDING 14 WBP YK "CONNECT"CAST COTTON PADDING(NON- 14 STERILE)4"X3Y(10CMX270CM)" 可耐特 " 石膏棉捲 ( 未滅菌 ) WBP DQ ORTHOPAEDIC CAST PADDING 14 WBP BP B.P.I UNDER CAST PADDING BANDAGE COTTON 18.3 WBP C7 CSD ORTHOPAEDIC CAST COTTON PADDING 18.3 WBP FC ORTHOPEDIC COTTON BANDAGE 18.3 WBP JN OPTIMA PAD 石膏棉捲 18.3 WBP JX "ANJI JIXIANG"UNDERCAST PADDING BANDAGE(NON-STERILE) "X4Y" 安吉吉祥 " 棉捲 ( 未滅菌 ) WBP KF ORTHOPEDIC COTTON BANDAGE 18.3 WBP NJ ORTHOPEDIC COTTON BANDAGE 18.3 WBP QB "CHUAN SHUN"COTTON BANDAGES(NON-STERILE) 4"X4Y" 銓順 " 石膏 18.3 棉捲 ( 未滅菌 ) WBP C7 CSD ORTHOPAEDIC CAST COTTON PADDING 24.3 WBP C7 CSD ORTHOPAEDIC CAST COTTON PADDING 24.3 WBP C7 CSD ORTHOPAEDIC CAST COTTON PADDING 24 WBP YK "CONNECT"CAST COTTON PADDING(NON- 24 STERILE)6"X3Y(15CMX270CM)" 可耐特 " 石膏棉捲 ( 未滅菌 ) WBP DQ ORTHOPAEDIC CAST PADDING

303 WBP BP B.P.I UNDER CAST PADDING BANDAGE COTTON 27.5 WBP C7 CSD ORTHOPAEDIC CAST COTTON PADDING 27.5 WBP FC ORTHOPEDIC COTTON BANDAGE 27.5 WBP JN OPTIMA PAD 石膏棉捲 27.5 WBP JX "ANJI JIXIANG"UNDERCAST PADDING BANDAGE(NON-STERILE) "X4Y" 安吉吉祥 " 棉捲 ( 未滅菌 ) WBP KF ORTHOPEDIC COTTON BANDAGE 27.5 WBP NJ ORTHOPEDIC COTTON BANDAGE 27.5 WBP QB "CHUAN SHUN"COTTON BANDAGES(NON-STERILE) 6"X4Y" 銓順 " 石膏 27.5 棉捲 ( 未滅菌 ) WBP A5 ORTHOPEDIC COTTON BANDAGE 34.4 WBP C7 CSD ORTHOPAEDIC CAST COTTON PADDING 34.4 WBP YK "CONNECT"CAST COTTON PADDING(NON STERILE)8"X3Y(20CMX270CM)" 可耐特 " 石膏棉捲 ( 未滅菌 ) WDD SN INTRASITE GEL 8GM * 適應症請見備註欄 87 WDD M 3M TEGADERM HYDROGEL WOUND FILLER(STERILE) 15GM 水解凝膠 * 162 適應症請見備註欄 WDD SN INTRASITE GEL 15GM * 適應症請見備註欄 162 WDD M 3M TEGADERM HYDROGEL WOUND FILLER(STERILE)25GM 水解凝膠 * 適 276 應症請見備註欄 WDD SN INTRASITE GEL 25GM * 適應症請見備註欄 276 WDD SN "SMITH&NEPHEW"ALLEVYN ADHESIVE 73 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 WDD SN "SMITH&NEPHEW"ALLEVYN ADHESIVE 177 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 WDD SN "SMITH&NEPHEW"ALLEVYN ADHESIVE 327 DRESSING(STERILE)17.5CMX17.5CM" 史耐輝 " 愛力膚親水性自黏敷料 ( 滅菌 )* 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN ADHESIVE 400 DRESSING(STERILE)22.5CMX22.5CM" 史耐輝 " 愛力膚親水性自黏敷料 ( 滅菌 )* 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL 198 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 WDD SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL 320 DRESSING 12.5CMX12.5CM" 史耐輝 " 愛力膚銀親水性抗菌敷料 * 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL 459 DRESSING 17.5CMX17.5CM" 史耐輝 " 愛力膚銀親水性抗菌敷料 * 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL 57 DRESSING 5CMX5CM" 史耐輝 " 愛力膚銀親水性抗菌敷料 * 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL 228 DRESSING 10CMX10CM" 史耐輝 " 愛力膚銀親水性抗菌敷料 * 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL DRESSING 15CMX15CM" 史耐輝 " 愛力膚銀親水性抗菌敷料 * 適應症請見備註欄

304 WDD SN "SMITH&NEPHEW"ALLEVYN AG HYDROCELLULAR ANTIMICROBIAL 612 DRESSING 20CMX20CM" 史耐輝 " 愛力膚銀親水性抗菌敷料 * 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN GENTLE SOFT GEL ADHESIVE 119 HYDROCELLULAR DRESSING 10CMX10CM" 史耐輝 " 柔膠愛力膚敷料 ( 滅菌 )* 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN GENTLE SOFT GEL ADHESIVE 225 HYDROCELLULAR DRESSING 10CMX20CM" 史耐輝 " 柔膠愛力膚敷料 ( 滅菌 )* 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN GENTLE SOFT GEL ADHESIVE 250 HYDROCELLULAR DRESSING 15CMX15CM" 史耐輝 " 柔膠愛力膚敷料 ( 滅菌 )* 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN GENTLE SOFT GEL ADHESIVE 364 HYDROCELLULAR DRESSING 20CMX20CM" 史耐輝 " 柔膠愛力膚敷料 ( 滅菌 )* 適應症請見備註欄 WDD SN "SMITH & NEPHEW"ALLEVYN GENTLE BORDER 119 DRESSING(STERILE)10X10CM" 史耐輝 " 矽膠愛力膚敷料 ( 滅菌 )* 適應症請見備註欄 WDD SN "SMITH & NEPHEW"ALLEVYN GENTLE BORDER 225 DRESSING(STERILE)12.5X12.5CM" 史耐輝 " 矽膠愛力膚敷料 ( 滅菌 )* 適應症請見備註欄 WDD SN "SMITH & NEPHEW"ALLEVYN GENTLE BORDER 364 DRESSING(STERILE)17.5X17.5CM" 史耐輝 " 矽膠愛力膚敷料 ( 滅菌 )* 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN DRESSING(SACRUM)22CMX22CM 愛力膚親水 400 性的聚乙烯膚料 * 適應症請見備註欄 WDD F4 DUODERM EXTRA THIN CGF DRESSING 5X10CM 超薄型親水性敷料 * 適 43 應症請見備註欄 WDD F4 DUODERM EXTRA THIN CGF DRESSING 5X20CM 超薄型親水性敷料 * 適 55 應症請見備註欄 WDD P8 HYDROCOLL CONCAVE 6X14CM 適應症請見備註欄 86 WDD SN "SMITH&NEPHEW"ALLEVYN DRESSING 愛力膚親水性的聚乙烯敷料 123 (LITE 10CMX10CM)* 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN DRESSING 愛力膚親水性的聚乙烯敷料 255 (LITE 10CMX20CM)* 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN DRESSING(SACRUM)17CMX17CM 愛力膚親水 327 性的聚乙烯膚料 * 適應症請見備註欄 WDD SN HYDROCELLULAR ADHESIVE DRESSING 7.5X7.5CM 適應症請見備註 73 欄 WDD J9 "TRONJEN"HYDROCOLLOID DRESSING(STERILE)10CMX10CM" 中鎮 " 親 123 水性敷料 ( 滅菌 )* 適應症請見備註欄 WDD F4 DUODERM EXTRA THIN CGF DRESSING 10X10CM 超薄型親水性敷料 * 55 適應症請見備註欄 WDD J9 "TRONJEN"HYDROCOLLOID DRESSING(STERILE)10X10CM " 中鎮 " 親水 55 性敷料 ( 滅菌 )( 超薄 )* 適應症請見備註欄 WDD SN HYDROPHILIC POLYURETHANE DRESSING 10X10CM 適應症請見備註 123 欄 WDD SN HYDROPHILIC POLYURETHANE DRESSING 10X20CM 適應症請見備註 255 欄 WDD SN HYDROCELLULAR ADHESIVE DRESSING 12.5X12.5CM 適應症請見備註欄

305 WDD UG WDD UG WDD UG "URGO"ALGOPLAQUE HYDROCOLLOID DRESSING(STERILE)10CMX10CM 悠可平親水性敷料 * 適應症請見備註欄 "URGO"ALGOPLAQUE HYDROCOLLOID DRESSING(STERILE)15CMX15CM 悠可平親水性敷料 * 適應症請見備註欄 "URGO"ALGOPLAQUE HYDROCOLLOID DRESSING(STERILE)20CMX20CM 悠可平親水性敷料 * 適應症請見備註欄 WDD UG "URGO"ALGOPLAQUE FILM/THIN HYDROCOLLOID 43 DRESSING(STERILE)5CMX10CM 悠可平薄型親水性敷料 * 適應症請見備註欄 WDD UG "URGO"ALGOPLAQUE FILM/THIN HYDROCOLLOID 55 DRESSING(STERILE)5CMX20CM 悠可平薄型親水性敷料 * 適應症請見備註欄 WDD UG "URGO"ALGOPLAQUE FILM/THIN HYDROCOLLOID 55 DRESSING(STERILE)10CMX10CM 悠可平薄型親水性敷料 * 適應症請見備註欄 WDD UG "URGO"ALGOPLAQUE FILM/THIN HYDROCOLLOID 121 DRESSING(STERILE)15CMX15CM 悠可平薄型親水性敷料 * 適應症請見備註欄 WDD UG "URGO"ALGOPLAQUE FILM/THIN HYDROCOLLOID 196 DRESSING(STERILE)20CMX20CM 悠可平薄型親水性敷料 * 適應症請見備註欄 WDD UG "URGO"URGOSORB ALGINATE HYDROCOLLOID ABSORBENT 130 DRESSING(STERILE)5CMX30CM 悠可吸藻酸鹽親水性敷料 * 適應症請見備註欄 WDD UG "URGO"URGOSORB ALGINATE HYDROCOLLOID ABSORBENT 23 DRESSING(STERILE)5CMX5CM 悠可吸藻酸鹽親水性敷料 * 適應症請見備註欄 WDD UG "URGO"URGOSORB ALGINATE HYDROCOLLOID ABSORBENT 121 DRESSING(STERILE)10CMX10CM 悠可吸藻酸鹽親水性敷料 * 適應症請見備註欄 WDD UG "URGO"URGOSORB ALGINATE HYDROCOLLOID ABSORBENT 139 DRESSING(STERILE)10CMX20CM 悠可吸藻酸鹽親水性敷料 * 適應症請見備註欄 WDD BB "B.BRAUN"ASKINA GEL,15G 雅膚清創凝膠 * 適應症請見備註欄 162 WDD F4 DUODERM EXTRA THIN CGF DRESSING 15X15CM 超薄型親水性敷料 * 121 適應症請見備註欄 WDD UG "URGO"HYDROGEL(STERILE)15G/TUBE 水性凝膠 * 適應症請見備註欄 162 WDD SN WDD SN WDD SN WDD CA WDD F4 WDD F4 HYDROCELLULAR ADHESIVE DRESSING 17.5X17.5CM 適應症請見備註欄 HYDROPHILIC POLYURETHANE DRESSING 20X20CM 適應症請見備註欄 HYDROCELLULAR ADHESIVE DRESSING 22.5X22.5CM 適應症請見備註欄 "COLOPLAST"BIATAIN DRESSING(STERILE)15CMX15CM 平而坦傷口敷料 ( 滅菌 )* 適應症請見備註欄 "CONVATEC"AQUACEL AG HYDROFIBER DRESSING 10X10CM * 適應症請見備註欄 "CONVATEC"AQUACEL AG HYDROFIBER DRESSING 15X15CM * 適應症請見備註欄

306 WDD F4 "CONVATEC"AQUACEL AG HYDROFIBER DRESSING 20X30CM * 適應症 920 請見備註欄 WDD F4 "CONVATEC"AQUACEL AG HYDROFIBER DRESSING 2X45CM * 適應症請 198 見備註欄 WDD CA COLOPLAST SEASORB AG DRESSING 康樂保藻膠銀離子敷料 CMX10CM* 適應症請見備註欄 WDD F4 "CONVATEC"AQUACEL AG HYDROFIBER DRESSING 2X45CM * 適應症請 198 見備註欄 WDD CA COLOPLAST SEASORB AG DRESSING 康樂保藻膠銀離子敷料 228 3CMX44CM* 適應症請見備註欄 WDD YY "CORELEADER"HYDROCOLLOID DRESSING(STERILE)" 康力得 " 親水性 43 敷料 ( 滅菌 )5CMX10CM* 適應症請見備註欄 WDD YY "CORELEADER"HYDROCOLLOID DRESSING(STERILE)" 康力得 " 親水性 55 敷料 ( 滅菌 )5CMX20CM* 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN DRESSING 愛力膚親水性的聚乙烯敷料 177 (HEEL 10.5CMX13.5CM)* 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN DRESSING 愛力膚親水性的聚乙烯敷料 86 (TRACHE0STOMY 9CMX9CM)* 適應症請見備註欄 WDD M 3MTEGASORB HYDROCOLLOID DRESSING 親水性敷料 10CMX10CM* 適應 123 症請見備註欄 WDD M 3MTEGASORB HYDROCOLLOID DRESSING 親水性敷料 15CMX15CM* 適應 255 症請見備註欄 WDD KD CURASORB CALCUIUM ALIGINATE DRESSINGS 5.08X5.08CM 給付 23 規定請見備註欄 WDD KD CURASORB CALCUIUM ALIGINATE DRESSINGS 10.16X10.16CM 給 121 付規定請見備註欄 WDD KD CURASORB CALCUIUM ALIGINATE DRESSINGS 20.32X10.16CM 給 139 付規定請見備註欄 WDD KD CURASORB CALCUIUM ALIGINATE DRESSINGS 15.24X25.4CM 給付 269 規定請見備註欄 WDD KD CURASORB CALCUIUM ALIGINATE DRESSINGS 10.16X13.97CM 給 130 付規定請見備註欄 WDD KD CURASORB CALCUIUM ALIGINATE DRESSINGS 30.48X60.96CM 給 1425 付規定請見備註欄 WDD KD CURASORB CALCUIUM ZINC ALIGINATE DRESSINGS 5.08X5.08CM 23 給付規定請見備註欄 WDD KD CURASORB CALCUIUM ZINC ALIGINATE DRESSINGS 10.16X10.16CM 121 給付規定請見備註欄 WDD KD CURASORB CALCUIUM ZINC ALIGINATE DRESSINGS 10.16X20.32CM 139 給付規定請見備註欄 WDD CA "COLOPLAST"BIATAIN AG FOAM DRESSING " 康樂保 " 平而坦銀離子 228 泡綿敷料 10CMX10CM* 適應症請見備註欄 WDD CA "COLOPLAST"BIATAIN AG FOAM DRESSING " 康樂保 " 平而坦銀離子 413 泡綿敷料 15CMX15CM* 適應症請見備註欄 WDD KD ULTEC PRO ALGINATE HYDROCOLLOID DRESSING 121 4X4(10.16X10.16CM) 給付規定請見備註欄 WDD KD ULTEC PRO ALGINATE HYDROCOLLOID DRESSING 188 6X6(15.24X15.24CM) 給付規定請見備註欄 WDD KD ULTEC PRO ALGINATE HYDROCOLLOID DRESSING 269 8X8(20.32X20.32CM) 給付規定請見備註欄 WDD HL RESTORE EXTRA THIN 10CMMX10CM 適應症請見備註欄 55 WDD HL RESTORE EXTRA THIN 15.2CMMX20.3CM 適應症請見備註欄

307 WDD HL RESTORE CALCICARE WOUND CARE DRESSING STERILE 10X10CM 121 適應症請見備註欄 WDD HL RESTORE CALCICARE WOUND CARE DRESSING STERILE 5X5CM 適 23 應症請見備註欄 WDD HL RESTORE CALCICARE WOUND CARE DRESSING STERILE 10X20CM 139 適應症請見備註欄 WDD HL RESTORE PLUS WOUND CARE DRESSING STERILE 10X10CM 適應症 123 請見備註欄 WDD HL RESTORE PLUS WOUND CARE DRESSING STERILE 20X20CM 適應症 400 請見備註欄 WDD HL RESTORE PLUS TAPERED EDGE WOUND CARE DRESSING STERILE X10CM 適應症請見備註欄 WDD YY "CORELEADER"ALGINATE FIBER WOUND 121 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 WDD YY "CORELEADER"HYDROCOLLOID DRESSING(STERILE)" 康力得 " 親水性 55 敷料 ( 滅菌 )10CMX10CM* 適應症請見備註欄 WDD081010TSN REPLICARE ULTRA 10X10CM 適應症請見備註欄 55 WDD YY "CORELEADER"ALGINATE FIBER WOUND 139 DRESSING(STERILE)10CMX20CM" 康力得 " 藻酸鹽纖維傷口敷料 ( 滅菌 )* 適應症請見備註欄 WDD F4 "CONVATEC"VERSIVA XC DRESSING(STERILE)11CMX11CM 威吸寶敷料 143 * 適應症請見備註欄 WDD F4 "CONVATEC"VERSIVA XC DRESSING(STERILE)15CMX15CM 威吸寶敷料 250 * 適應症請見備註欄 WDD F4 "CONVATEC"VERSIVA XC DRESSING(STERILE)10CMX10CM 威吸寶敷料 119 * 適應症請見備註欄 WDD F4 "CONVATEC"VERSIVA XC DRESSING(STERILE)14CMX14CM 威吸寶敷料 225 * 適應症請見備註欄 WDD F4 "CONVATEC"VERSIVA XC DRESSING(STERILE)22CMX22CM 威吸寶敷料 419 * 適應症請見備註欄 WDD F4 "CONVATEC"VERSIVA XC DRESSING(STERILE)18.5CMX20.5CM 威吸寶 364 敷料 * 適應症請見備註欄 WDD F4 "CONVATEC"VERSIVA XC DRESSING(STERILE)21CMX25CM 威吸寶敷料 512 * 適應症請見備註欄 WDD F4 "CONVATEC"VERSIVA XC DRESSING(STERILE)20CMX20CM 威吸寶敷料 364 * 適應症請見備註欄 WDD F4 "CONVATEC"VERSIVA XC DRESSING(STERILE)19CMX19CM 威吸寶敷料 364 * 適應症請見備註欄 WDD F4 "CONVATEC"DUO DERM CGF CONTROL GEL FORMULA DRESSING X10CM 親水性 CGF 敷料 * 適應症請見備註欄 WDD F4 "CONVATEC"DUO DERM CGF CONTROL GEL FORMULA DRESSING X20CM 親水性 CGF 敷料 * 適應症請見備註欄 WDD F4 "CONVATEC"DUO DERM CGF CONTROL GEL FORMULA DRESSING X30CM 親水性 CGF 敷料 * 適應症請見備註欄 WDD YY "CORELEADER"ALGINATE FIBER WOUND 188 DRESSING(STERILE)15CMX15CM" 康力得 " 藻酸鹽纖維傷口敷料 ( 滅菌 )* 適應症請見備註欄 WDD YY "CORELEADER"HYDROCOLLOID DRESSING(STERILE)" 康力得 " 親水性 121 敷料 ( 滅菌 )15CMX15CM* 適應症請見備註欄 WDD081515TSN REPLICARE ULTRA 15X15CM 適應症請見備註欄 121 WDD A5 KARAYAHESIVE HYDROCOLLOID WOUND DRESSING 37.5CM2, 親水性敷料 * 適應症請見備註欄

308 WDD A5 KARAYAHESIVE HYDROCOLLOID WOUND DRESSING 75CM2, 親水性敷 43 料 * 適應症請見備註欄 WDD A5 KARAYAHESIVE HYDROCOLLOID WOUND DRESSING 113CM2, 親水性敷 55 料 * 適應症請見備註欄 WDD A5 KARAYAHESIVE HYDROCOLLOID WOUND DRESSING 150CM2, 親水性敷 55 料 * 適應症請見備註欄 WDD081518TSN REPLICARE ULTRA 15X18CM 適應症請見備註欄 121 WDD A5 KARAYAHESIVE HYDROCOLLOID WOUND DRESSING 25CM2, 親水性敷 26 料 * 適應症請見備註欄 WDD A5 KARAYAHESIVE HYDROCOLLOID WOUND DRESSING 100CM2, 親水性敷 55 料 * 適應症請見備註欄 WDD A5 "ALCARE"SI-AID SILICONE-FACED DRESSING(STERILE)10CMX10CM" 愛樂康 " 矽膠泡棉敷料 ( 滅菌 ) 親水性創傷覆蓋材 123 WDD A5 "ALCARE"SI-AID SILICONE-FACED DRESSING(STERILE)10CMX20CM" 愛樂康 " 矽膠泡棉敷料 ( 滅菌 ) 親水性創傷覆蓋材 255 WDD082020TSN REPLICARE ULTRA 20X20CM 適應症請見備註欄 196 WDD082100SBB "B.BRAUN"ASKINA SORB CALCIUM ALGINATE DRESSING(STERILE) 23 6CMX6CM 雅膚藻酸鈣敷料 * 適應症請見備註欄 WDD082101SBB WDD082102SBB WDD082105SBB "B.BRAUN"ASKINA SORB CALCIUM ALGINATE DRESSING(STERILE) 10CMX10CM 雅膚藻酸鈣敷料 * 適應症請見備註欄 "B.BRAUN"ASKINA SORB CALCIUM ALGINATE DRESSING(STERILE) 15CMX15CM 雅膚藻酸鈣敷料 * 適應症請見備註欄 "B.BRAUN"ASKINA SORB CALCIUM ALGINATE DRESSING(STERILE) 2.7CMX34CM 雅膚藻酸鈣敷料 * 適應症請見備註欄 WDD LN MELGISORB ABSORBENT CALCIUM SODIUM ALGINATE 23 DRESSING(5CMX5CM)* 適應症請見備註欄 WDD LN MELGISORB ABSORBENT CALCIUM SODIUM ALGINATE 121 DRESSING(10CMX10CM)* 適應症請見備註欄 WDD LN MELGISORB ABSORBENT CALCIUM SODIUM ALGINATE 139 DRESSING(10CMX20CM)* 適應症請見備註欄 WDD LN MELGISORB ABSORBENT CALCIUM SODIUM ALGINATE 72 DRESSING(32CMX2.2CM)* 適應症請見備註欄 WDD CA COMFEEL PLUS ULCER DRESSING 10X10CM 適應症請見備註欄 123 WDD CA COMFEEL PLUS ULCER DRESSING 15X15CM 適應症請見備註欄 255 WDD CA COMFEEL PLUS ULCER DRESSING 20X20CM 適應症請見備註欄 400 WDD CA COMFEEL PLUS ULCER DRESSING 4X6CM 適應症請見備註欄 30 WDD CA "COLOPLAST"BIATAIN NON-ADHESIVE DRESSING 10X10CM 平而坦非 123 黏性泡綿敷料 * 適應症請見備註欄 WDD CA "COLOPLAST"BIATAIN NON-ADHESIVE DRESSING 15X15CM 平而坦非 255 黏性泡綿敷料 * 適應症請見備註欄 WDD CA "COLOPLAST"BIATAIN DRESSING NON-ADHESIVE 20CMX20CM 平而坦 400 傷口敷料 * 適應症請見備註欄 WDD CA "COLOPLAST"BIATAIN ADHESIVE DRESSING 12X12CM 平而坦黏性泡 177 綿敷料 * 適應症請見備註欄 WDD CA "COLOPLAST"BIATAIN ADHESIVE DRESSING 18X18CM 平而坦黏性泡綿敷料 * 適應症請見備註欄

309 WDD CA "COLOPLAST"BIATAIN DRESSING SOFT-HOLD 10CMX10CM 平而坦傷口 123 敷料 * 適應症請見備註欄 WDD CA "COLOPLAST"BIATAIN DRESSING SOFT-HOLD 10CMX20CM 平而坦傷口 255 敷料 * 適應症請見備註欄 WDD CA "COLOPLAST"BIATAIN DRESSING SOFT-HOLD 15CMX15CM 平而坦傷口 255 敷料 * 適應症請見備註欄 WDD CA COMFEEL PLUS TRANSPARENT DRESSING 5X7CM 適應症請見備註欄 26 WDD CA COMFEEL PLUS TRANSPARENT DRESSING 10X10CM 適應症請見備註 55 欄 WDD CA COMFEEL PLUS TRANSPARENT DRESSING 15X15CM 適應症請見備註 121 欄 WDD CA COMFEEL PLUS TRANSPARENT DRESSING 20X20CM 適應症請見備註 196 欄 WDD CA COMFEEL SEASORB DRESSING 10X10CM 適應症請見備註欄 123 WDD CA COMFEEL SEASORB DRESSING 15X15CM 適應症請見備註欄 255 WDD083736AYD "BCT"CALCIUM ALGINATE DRESSING(STERILE) 10CMX10CM" 科云 " 藻 121 酸鈣敷料 ( 滅菌 )* 給付規定請見備註欄 WDD CA "COLOPLAST"SEASORB SOFT 130 DRESSING(ALGINATE)(FILLER)3CMX44CM 軟性敷料 * 適應症請見備註欄 WDD CA COMFEEL PURILON GEL 15GM* 適應症請見備註欄 162 WDD CA COMFEEL PURILON GEL 25GM* 適應症請見備註欄 276 WDD BB "B.BRAUN"ASKINA FOAM WOUND DRESSING(STERILE)10CMX10CM 雅膚 123 泡棉敷料 * 適應症請見備註欄 WDD BB "B.BRAUN"ASKINA FOAM WOUND DRESSING(STERILE)0CMX20CM 雅膚 255 泡棉敷料 * 適應症請見備註欄 WDD BB "B.BRAUN"ASKINA FOAM WOUND DRESSING(STERILE)20CMX20CM 雅 400 膚泡棉敷料 * 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN DRESSING 愛力膚親水性的聚乙烯敷料 55 (THIN 10CMX10CM)* 適應症請見備註欄 WDD SN "SMITH&NEPHEW"ALLEVYN DRESSING 愛力膚親水性的聚乙烯敷料 145 (THIN 15CMX20CM)* 適應症請見備註欄 WDD BB "B.BRAUN"ASKINA THINSITE DRESSING(STERILE)10CMX10CM* 適應 55 症請見備註欄 WDD BB ASKINA THINSITE 15CMX15CM* 適應症請見備註欄 121 WDD BB ASKINA THINSITE 20CMX20CM* 適應症請見備註欄 196 WDD BB ASKINA THINSITE 5CMX20CM* 適應症請見備註欄 55 WDD LN MOLNLYCKE MELGISORB AG ANTIMICROBIAL ALGINATE DRESSING 美 228 尼克美極收銀抗菌海藻鹽敷料 10CMX10CM* 適應症請見備註欄 WDD LN MOLNLYCKE MELGISORB AG ANTIMICROBIAL ALGINATE DRESSING 美 413 尼克美極收銀抗菌海藻鹽敷料 15CMX15CM* 適應症請見備註欄 WDD LN MOLNLYCKE MELGISORB AG ANTIMICROBIAL ALGINATE DRESSING 美 228 尼克美極收銀抗菌海藻鹽敷料 3CMX44CM* 適應症請見備註欄 WDD P8 TENDERWET 7.5X7.5CM 適應症請見備註欄 73 WDD P8 TENDERWET 10X10CM 適應症請見備註欄 123 WDD P8 TENDERWET 10X10CM 適應症請見備註欄 123 WDD LN MOLNLYCKE HYPERGEL 15GM* 適應症請見備註欄 162 WDD BB "B.BRAUN"ASKINA CALGITROL AG" 柏朗 " 雅膚凱奇樂藻酸銀敷料 CMX10CM* 適應症請見備註欄 WDD BB "B.BRAUN"ASKINA CALGITROL AG 雅膚凱奇樂藻酸銀敷料 15CMX15CM* 適應症請見備註欄

310 WDD BB "B.BRAUN"ASKINA CALGITROL AG" 柏朗 " 雅膚凱奇樂藻酸銀敷料 CMX20CM* 適應症請見備註欄 WDD F4 KALTOSTAT ALGINATE WOUND DRESSING 5X5CM 藻酸鈣鈉鹽傷口敷 23 料 * 適應症請見備註欄 WDD F4 KALTOSTAT ALGINATE WOUND DRESSING 7.5X12CM 藻酸鈣鈉鹽傷口 72 敷料 * 適應症請見備註欄 WDD F4 KALTOSTAT ALGINATE WOUND DRESSING 10X20CM 藻酸鈣鈉鹽傷口 139 敷料 * 適應症請見備註欄 WDD F4 KALTOSTAT ALGINATE WOUND DRESSING 15X25CM 藻酸鈣鈉鹽傷口 269 敷料 * 適應症請見備註欄 WDD LN NORMLGEL 15GM* 適應症請見備註欄 162 WDD BB "B.BRAUN"ASKINA HYDRO 10CMX10CM 雅膚親水膠敷料 * 適應症請見 123 備註欄 WDD BB "B.BRAUN"ASKINA HYDRO 15CMX15CM 雅膚親水膠敷料 * 適應症請見 255 備註欄 WDD BB "B.BRAUN"ASKINA HYDRO 20CMX20CM 雅膚親水膠敷料 * 適應症請見 400 備註欄 WDD BB ASKINA BS,BP,BT 10X10CM,5X20CM 適應症請見備註欄 123 WDD BB ASKINA BS,BP,BT 15X15CM 適應症請見備註欄型號 F F72015 自 刪除 WDD BB ASKINA BS,BT 20X20CM 適應症請見備註欄 400 WDD BB "B.BRAUN"ASKINA TRANSORBENT " 柏朗 " 雅膚多聚泡棉敷料 10X10CM 123 適應症請見備註欄 WDD BB "B.BRAUN"ASKINA TRANSORBENT" 柏朗雅膚多聚泡綿敷料 " 15X15CM 255 適應症請見備註欄 WDD BB ASKINA TRANSORBENT 20X20CM 柏朗雅膚多聚泡綿敷料 適應症請 400 見備註欄 WDD SH ULTEC HYDROCOLLOID DRESSING 10X10CM 適應症請見備註欄 123 WDD F4 AQUACEL HYDROFIBER DRESSING5CMX5CM* 適應症請見備註欄 30 WDD F4 AQUACEL HYDROFIBER DRESSING 10CMX10CM* 適應症請見備註欄 123 WDD F4 AQUACEL HYDROFIBER DRESSING 15CMX15CM* 適應症請見備註欄 255 WDD LN "MOLNLYCKE"MEPILEX LITE SAFETAC ABSORBENT SOFT SILICONE 250 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 WDD LN MEPILEX AG ANTIMICROBIAL SOFT SILICONE FOAM DRESSING 美皮蕾銀抗菌軟性矽膠泡棉敷料 12.5CM*12.5CM* 適應症請見備註欄 327 WDD LN MEPILEX AG ANTIMICROBIAL SOFT SILICONE FOAM DRESSING 美皮蕾銀抗菌軟性矽膠泡棉敷料 17.5CM*17.5CM* 適應症請見備註欄 576 WDD F4 "CONVATEC"DUODERM HYDROACTIVE GEL 30GM 多愛膚親水性凝膠 * 276 適應症請見備註欄 WDD F4 "CONVATEC"DUODERM HYDROACTIVE GEL 15GM 多愛膚親水性凝膠 * 162 適應症請見備註欄 WDD M TEGASORB THIN HYDROCOLLOID DRESSING 5CMX10CM* 適應症請見備 43 註欄 WDD M HYDROCOLLOID DRESSING 10X10CM( 薄 ) 適應症請見備註欄 55 WDD M 3M TEGASORB THIN HYDROCOLLOID DRESSING 15CMX15CM 親水性敷 121 料 * 適應症請見備註欄 WDD M 3M TEGASORB THIN HYDROCOLLOID DRESSING 20CMX20CM 親水性敷 196 料 * 適應症請見備註欄 WDD M TEGASORB THIN HYDROCOLLOID DRESSING 10CMX10CM * 適應症請見備註欄

311 WDD M 3M TEGASORB THIN HYDROCOLLOID DRESSING 5CMX20CM* 適應症請 55 見備註欄 WDD M 3M TEGADERM HIGH INTEGRITY ALGINATE DRESSING(STERILE) 海藻 121 酸鹽敷料 10CMX10CM* 適應症請見備註欄 WDD M 3M TEGADERM HIGH GELLING ALGINATE DRESSING(STERILE) 海藻酸 121 鹽敷料 10CMX10CM* 適應症請見備註欄 WDD LN Mepitel 5cm x 7.5cm * 適應症請見備註欄 66 WDD M 3M HYDROPHILIC WOUND DRESSING 親水性創傷覆蓋材 (TEGADERM 30 FOAM 5CMX5CM)* 適應症請見備註欄 WDD M 3M HYDROPHILIC WOUND DRESSING 親水性創傷覆蓋材 (TEGADERM 123 FOAM 10CMX10CM)* 適應症請見備註欄 WDD M 3M HYDROPHILIC WOUND DRESSING 親水性創傷覆蓋材 (TEGADERM 255 FOAM 10CMX20CM)* 適應症請見備註欄 WDD M 3M HYDROPHILIC WOUND DRESSING 親水性創傷覆蓋材 (TEGADERM 400 FOAM 20CMX20CM)* 適應症請見備註欄 WDD P8 HYDROCOLL 10X10CM 適應症請見備註欄 123 WDD P8 HYDROCOLL 15X15CM 適應症請見備註欄 255 WDD P8 HYDROCOLL 20X20CM 適應症請見備註欄 400 WDD P8 HYDROCOLL SACRAL 15X18CM 適應症請見備註欄 327 WDD P8 HYDROCOLL TRANSPARENT 10X10CM( 薄 ) 適應症請見備註欄 55 WDD P8 HYDROCOLL TRANSPARENT 15X15CM( 薄 ) 適應症請見備註欄 121 WDD LN Mepitel 7.5cm x10cm* 適應症請見備註欄 98 WDD LN MEPITEL 10cm x18cm* 適應症請見備註欄 ( 型號更正為 ) 207 WDD LN Mepitel 20cm x30cm* 適應症請見備註欄 674 WDD LN MEPILEX STERILE 10CMX10CM 適應症請見備註欄 119 WDD LN MEPILEX STERILE 10CMX20CM 適應症請見備註欄 225 WDD LN MEPILEX STERILE 15CMX15CM 適應症請見備註欄 250 WDD LN MEPILEX STERILE 20CMX20CM 適應症請見備註欄 364 WDD LN MEPILEX BORDER SAFETAC SILICON FOAM DRESSING 7.5X7.5CM* 適 68 應症請見備註欄 WDD LN MEPILEX BORDER SAFETAC SILICON FOAM DRESSING 10X10CM* 適應 119 症請見備註欄 WDD LN MEPILEX BORDER SAFETAC SILICON FOAM DRESSING 15X15CM* 適應 250 症請見備註欄 WDD LN MEPILEX BORDER SAFETAC SELF-ADHERENT SOFT SILICONE FOAM 326 DRESSING 15CMX20CM* 適應症請見備註欄 WDD LN "MOLNLYCKE"MEPILEX AG ANTIMICROBIAL SOFT SILICONE FOAM 327 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 WDD LN "MOLNLYCKE"MEPILEX AG ANTIMICROBIAL SOFT SILICONE FOAM 576 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 WDD LN "MOLNLYCKE"MEPILEX AG ANTIMICROBIAL SOFT SILICONE FOAM 1072 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 WDD HN "HARTMANN"ATRAUMAN AG SILVER DRESSING(5X5CM) 含銀軟膏膚料 * 57 適應證請見備註欄 WDD HN "HARTMANN"ATRAUMAN AG SILVER DRESSING(10X10CM) 含銀軟膏膚 228 料 * 適應證請見備註欄 WDD HN "HARTMANN"ATRAUMAN AG SILVER DRESSING(10X20CM) 含銀軟膏膚料 * 適應證請見備註欄

312 WDD P8 "HARTMANN"HYDROPHILIC WOUND 26 DRESSING(THIN)(STERILE)HYDROTUL 5X5CM 親水性創傷覆蓋材 * 適應症請見備註欄 WDD P8 "HARTMANN"HYDROPHILIC WOUND 55 DRESSING(THIN)(STERILE)HYDROTUL 10X12CM 親水性創傷覆蓋材 * 適應症請見備註欄 WDD P8 "HARTMANN"HYDROPHILIC WOUND 145 DRESSING(THIN)(STERILE)HYDROTUL 15X20CM 親水性創傷覆蓋材 * 適應症請見備註欄 WDD P8 SORBALGON 10X20CM 適應症請見備註欄 255 WDD P8 SORBALGON 10X10CM 適應症請見備註欄 123 WDD P8 SORBALGON 5X5CM 適應症請見備註欄 30 WDD08A0112ZW SAVDERM ALGINATE DRESSING 舒膚貼藻酸鈣鹽敷料 (5.5CMX8.5CM) 47 WDD08A0202ZW SAVDERM ALGINATE DRESSING 舒膚貼藻酸鈣鹽敷料 (10CMX10CM) 121 WDD08A0520SN WDD08A0521SN WDD08A0522SN WDD08B0110ZW WDD08B0211ZW WDD08B0308ZW WDD08B0409ZW WDD08C0113ZW WDD08C0220ZW WDD08C0506SN WDD08C1010SN WDD08C1520SN WDD08E1405K6 WDD08E1407K6 WDD08E1416K6 WDD08E2405K6 "SMITH&NEPHEW"ALGISITE M CALCIUM ALGINATE DRESSING" 史耐輝 " 海藻酸鈣敷料 10X10CM* 適應症請見備註欄 "SMITH&NEPHEW"ALGISITE M CALCIUM ALGINATE DRESSING" 史耐輝 " 海藻酸鈣敷料 15X20CM* 適應症請見備註欄 "SMITH&NEPHEW"ALGISITE M CALCIUM ALGINATE DRESSING" 史耐輝 " 海藻酸鈣敷料 2X30CM* 適應症請見備註欄 "SAVDERM"BIOCELLULOSE FILM (6CMX6CM)" 舒膚貼 " 生物合成纖維膜 * 適應症請見備註欄 "SAVDERM"BIOCELLULOSE FILM (10CMX8CM) " 舒膚貼 " 生物合成纖維膜 * 適應症請見備註欄 "SAVDERM"BIOCELLULOSE FILM (16CMX10CM)" 舒膚貼 " 生物合成纖維膜 * 適應症請見備註欄 "SAVDERM"BIOCELLULOSE FILM (21CMX16CM)" 舒膚貼 " 生物合成纖維膜 * 適應症請見備註欄 SAVDERM HYDROGEL(STERILE)30G 舒膚貼清創修護凝膠 ( 滅菌 )* 適應症請見備註欄 SAVDERM HYDROGEL(STERILE)25GM 舒膚貼清創修護凝膠 ( 滅菌 )* 適應症請見備註欄 "SMITH&NEPHEW"CUTINOVA HYDRO DRESSING 新世代人工皮膚 5CMX6CM* 適應症請見備註欄 "SMITH&NEPHEW"CUTINOVA HYDRO DRESSING 10X10CM* 適應症請見備註欄 "SMITH&NEPHEW"CUTINOVA HYDRO DRESSING 15X20CM* 適應症請見備註欄 "EUROMED"SURESKIN HYDROCOLLOID WOUND DRESSING(STERILE)(STANDARD)10X10CM" 優而美 " 舒肌親水性傷口敷料 * 適應症請健備註欄 "EUROMED"SURESKIN HYDROCOLLOID WOUND DRESSING(STERILE)(STANDARD)20X20CM" 優而美 " 舒肌親水性傷口敷料 * 適應症請健備註欄 "EUROMED"SURESKIN HYDROCOLLOID WOUND DRESSING(STERILE)(STANDARD)15X15CM" 優而美 " 舒肌親水性傷口敷料 * 適應症請健備註欄 "EUROMED"SURESKIN HYDROCOLLOID WOUND DRESSING(STERILE)(BORDER)10X10CM" 優而美 " 舒肌親水性傷口敷料 * 適應症請健備註欄

313 WDD08E2407K6 WDD08E2412K6 WDD08E2416K6 WDD08E2432K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND DRESSING(STERILE)(BORDER)20X20CM" 優而美 " 舒肌親水性傷口敷料 * 適應症請健備註欄 "EUROMED"SURESKIN HYDROCOLLOID WOUND DRESSING(STERILE)(BORDER-SACRAL)15X18CM" 優而美 " 舒肌親水性傷口敷料 * 適應症請健備註欄 "EUROMED"SURESKIN HYDROCOLLOID WOUND DRESSING(STERILE)(BORDER)15X15CM" 優而美 " 舒肌親水性傷口敷料 * 適應症請健備註欄 "EUROMED"SURESKIN HYDROCOLLOID WOUND DRESSING(STERILE)(BORDER-SACRAL LARGE BUTTERFLY)15X18CM" 優而美 " 舒肌親水性傷口敷料 * 適應症請健備註欄 WDD08E3205K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND DRESSING(STERILE)(THIN)10X10CM" 優而美 " 舒肌親水性傷口敷料 * 適應症請健備註欄 WDD08E3216K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND DRESSING(STERILE)(THIN)15X15CM" 優而美 " 舒肌親水性傷口敷料 * 適應症請健備註欄 WDD08E3515K6 "EUROMED"SURESKIN HYDROCOLLOID WOUND DRESSING(STERILE)(THIN)5X15CM" 優而美 " 舒肌親水性傷口敷料 * 適應症請健備註欄 WDD08F0102ZW "SAVDERM"FOAM DRESSING (STERILE)10X10CM 泡棉敷料 * 適應症請見備註欄 WDD08F0203ZW "SAVDERM"FOAM DRESSING(STERILE)10CM*20CM 泡棉敷料 ( 滅菌 )* 適應症請見備註欄 WDD08F0301ZW "SAVDERM"FOAM DRESSING(STERILE)(5CMX5CM) 泡棉敷料 ( 滅菌 )* 適應症請見備註欄 WDD08F0404ZW "SAVDERM"FOAM DRESSING(STERILE)(20CMX20CM) 泡棉敷料 ( 滅菌 )* 適應症請見備註欄 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 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 WDD08H0102ZW SAVDERM HYDROCOLLOIDS THIN DRESSING(STERILE)10X10CM 親水性敷料 ( 滅菌 )* 適應症請見備註欄 WDD08H0206ZW SAVDERM HYDROCOLLOIDS THIN DRESSING(STERILE)15X15CM 親水性敷料 ( 滅菌 )* 適應症請見備註欄 WDD08H0307ZW SAVDERM HYDROCOLLOIDS THIN DRESSING(STERILE)5X20CM 親水性敷料 ( 滅菌 )* 適應症請見備註欄 WDD08S0101ZW "SAVDERM"SELF-ADHESIVE FOAM DRESSING(STERILE) 自黏性泡棉敷料 5X5CM* 適應症請見備註欄 WDD08S0202ZW "SAVDERM"SELF-ADHESIVE FOAM DRESSING(STERILE) 自黏性泡棉敷料 10X10CM* 適應症請見備註欄 WDD08S0303ZW "SAVDERM"SELF-ADHESIVE FOAM DRESSING(STERILE) 自黏性泡棉敷料 10X20CM* 適應症請見備註欄 WDD08S0404ZW "SAVDERM"SELF-ADHESIVE FOAM DRESSING(STERILE) 自黏性泡棉敷料 20X20CM* 適應症請見備註欄 WDD08S2405K6 "EUROMED INC"SURESKIN SLIVER HYDROCOLLOID DRESSING 10CMX10CM(BORDER)" 優而美 " 舒肌親水性含銀離子傷口敷料 ( 滅菌 )( 固定型 )* 適應症請見備註欄

314 WDD08S2407K6 "EUROMED INC"SURESKIN SLIVER HYDROCOLLOID DRESSING CMX20CM(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 WDD08S2416K6 "EUROMED INC"SURESKIN SLIVER HYDROCOLLOID DRESSING CMX15CM(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 WDD08T0510RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創 43 傷敷料 ( 滅菌 )5X10CM*( 薄型 )* 適應症請見備註欄 WDD08T0520RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創 55 傷敷料 ( 滅菌 )5X20CM*( 薄型 )* 適應症請見備註欄 WDD08T1010RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創 55 傷敷料 ( 滅菌 )10X10CM*( 薄型 )* 適應症請見備註欄 WDD08T1515RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創 121 傷敷料 ( 滅菌 )15X15CM*( 薄型 )* 適應症請見備註欄 WDD08T2020RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創 196 傷敷料 ( 滅菌 )20X20CM*( 薄型 )* 適應症請見備註欄 WDD08W0505RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創 30 傷敷料 ( 滅菌 )5X5CM* 適應症請見備註欄 WDD08W1010RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創 123 傷敷料 ( 滅菌 )10X10CM* 適應症請見備註欄 WDD08W1020RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創 255 傷敷料 ( 滅菌 )10X20CM* 適應症請見備註欄 WDD08W2020RW "TEAM POWER"HYDROPHILIC WOUND DRESSING (STERILE) 親水性創 400 傷敷料 ( 滅菌 )20X20CM* 適應症請見備註欄 ACA01B1596BN INJECTION PORT CAP(IV LOCK) 0 ACM AB HIGH PRESSURE STOPCOCK MANIFOLD FIVE-STATION 600PSI 0 ACM AB HIGH PRESSURE STOPCOCK MANIFOLD TWO-STATION 600PSI 0 ACM AB HIGH PRESSURE STOPCOCK MANIFOLD THREE-STATION 600PSI 0 ACM AB HIGH PRESSURE STOPCOCK MANIFOLD FOUR-STATION 600PSI 0 ACS01B1702BD STOPCOCKS W/LUER-LOCK 0 CBP SB EXPRESS MONORAIL CORONARY STENT WITH DELIVERY SYSTEM * 適 0 應症請見備註欄 CBP SB EXPRESS MONORAIL CORONARY STENT DELIVERY SYSTEM * 適應症請 0 見備註欄 CBP01PN341BK "BIOTRONIK"PLEON PTCA CATHETER 0 CBP01VFP01CK CORONARY STENT W/BALLOON DELIVERY SYSTEM 適應症請見備註 0 欄 CBP02R5825KE "KANEKA"FORTIS PTCA CATHETER 2.50MM:4.50MM 8MM:18MM 0 CBP03A1540EQ EUROCOR AMADEUS SUPERCROSS RX-CORONARY BALLOON DILATATION 0 CATHETER 1.5MM:4.0MM 10MM:40MM CBP03V400NAB "ABBOTT"VOYAGER RX CORONARY DILATATION CATHETER 茉亞嘉冠狀 0 動脈擴張導管 CBP06ELUT1M4 MEDTRONIC ENDEAVOR ELUTING CORONARY STENT SYSTEM MM:4.0MM 8MM:30MM 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. CBP06ELUT2CD "CORDIS"CYPHER SELECT+SIROLIMUS-ELUTING CORONARY STENT :3.50MM 8:33MM 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. CDDC1M008CKC CANISTER W/ GEL 真空罐含接頭及引管 適應症請見備註欄 0 CDDF1M001SKC DRESSING PU FOAM 100X75X32MM (S SIZE) 適應症請見備註欄 0 CDDF1M002MKC DRESSING PU FOAM 180X125X32MM (M SIZE) 適應症請見備註欄 0 704

315 CDDF1M003LKC DRESSING PU FOAM 256X150X32MM (L SIZE) 適應症請見備註欄 0 CGS01P7983ST " 聖猷達 " 導管傳送系統 "SJM"APEEL CS PLUS CATHETER DELIVERY 0 SYSTEM* 適應症請見備註欄 CHH TM LEFT HEAT VENT CATHETER 20FR 0 CHH TM VENT CATHETER 18FR 0 CHT017903SU8 TOURNIQUET KIT WITH SNARE(1 紅 2 藍 3 白 ) 導管綁帶組附鐵線 0 CKD CK "COOK"DOUBLE PIGTAIL STENT SET(URETERAL STENT/(SILICONE 0 POLYURETHANE)+GUIDE WIRE+PUSHER) 雙豬尾型輸尿管內置導管組 4.7-8FR 22-32CM CKD CK "COOK"DOUBLE PIGTAIL STENT SET(URETERAL STENT/(SILICONE 0 POLYURETHANE)+GUIDE WIRE+PUSHER) 雙豬尾型輸尿管內置導管組 4.7-8FR 12-30CM CKN013873NAN SOFT DRAIN DRAINAGE SET( 針 + 雙腔引流管 +3way+ 固定盤 + 細菌過 0 濾網 + 尖刀 ) CLPA104150HJ PROPORT IMPLANTABLE VENOUS ACCESS SYSTEMS(P+C+N) 適應症 0 請見備註欄 CLPA104151HJ PROPORT IMPLANTABLE VENOUS ACCESS 0 SYSTEMS(P+C+N+I+GW+GRIPPER NEEDLE) 適應症請見備註欄 CLS04VB12CBB B.BRAUN IV-FIX BURETTE INFUSION SET WITH VALVE 0 CLS04VBNAPBB "B.BRAUN"IV-FIX BURETTE INFUSION SET( 免針加藥 )* 適應症請見 0 備註欄 CLS07C5896BT BLOOD ADMINISTRATION SET 0 CLS BX Exacta-Mix EVA Container TPN Bag 250ML 0 CLS BX Exacta-Mix EVA Container TPN Bag 500ML 0 CLS BX Exacta-Mix EVA Container TPN Bag 1000ML 0 CLS BX Exacta-Mix EVA Container TPN Bag 2000ML 0 CLS BX Exacta-Mix EVA Container TPN Bag 3000ML 0 CVA01SCB01CK SLIP-CATH SELECTIVE ANGIOGRAPHIC CATHETER 5F 40CM:100CM 0 CXE ST CXE ST CXE010189NST CXE ST CXE01N1130ST CXE01N1381ST CXE01N1863ST CXE02019NNST CXE02N1575ST CXE02N15NNST "SJM"SUPREME ELECTROPHYSIOLOGY CATHETER-5F,6F QUADRIPOLAR FIXED CURVE CATHETER" 聖猷達 " 史普力米生理電極導管 "SJM"SUPREME ELECTROPHYSIOLOGY CATHETER-4F DECAPOLAR CSL CATHETER" 聖猷達 " 史普力米生理電極導管 "SJM"SUPREME ELECTROPHYSIOLOGY CATHETER-4F QUADRIPOLAR FIXED CURVE CATHETER" 聖猷達 " 史普力米生理電極導管 " 聖猷達 " 雷斯龐生理電極導線 "SJM" RESPONSE ELECTROPHYSIOLOGY CATHETERS 5F,6F QUADRIPOLAR " 聖猷達 " 雷斯龐生理電極導線 "SJM" RESPONSE ELECTROPHYSIOLOGY CATHETERS 7F,DECAPOLAR " 聖猷達 " 雷斯龐生理電極導線 "SJM" RESPONSE ELECTROPHYSIOLOGY CATHETERS 6F,DECAPOLAR " 聖猷達 " 史普力米生理電極導管 "SJM" SUPREME ELECTROPHYSIOLOGY CATHETER 5F,DECAPOLAR "SJM"STEERABLE ELECTROPHYSIOLOGY CATHETER " 聖猷達 " 可控式生理電極導管 ( 十極 ) " 聖猷達 " 可控式生理電極導管 "SJM" STEERABLE ELECTROPHYSIOLOGY CATHETER 6F,DECAPOLAR " 聖猷達 " 可控式生理電極導管 "SJM" STEERABLE ELECTROPHYSIOLOGY CATHETER 7F,QUADRIPOLAR

316 CXE02N1600ST CXE02N1601ST CXE03402XXST CXE03CMBRASB " 聖猷達 " 可控式生理電極導管 "SJM" STEERABLE ELECTROPHYSIOLOGY CATHETER 6F,QUADRIPOLAR " 聖猷達 " 可控式生理電極導管 "SJM" STEERABLE ELECTROPHYSIOLOGY CATHETER 6F,QUADRIPOLAR "SJM"STEERABLE ELECTROPHYSIOLOGY CATHETER " 聖猷達 " 可控式生理電極導管 ( 雙溫控可控式燒灼導管 LIVEWIRE TC ABLATION CATHETER) 康柏拉電刀用電極 BOSTON SCIENTIFIC 廠牌 COBRA SURGICAL PROBE 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 CXE03SA402ST " 聖猷達 " 雙向電燒導管 "SJM"BI-DIRECTIONAL ABLATION 0 CATHETER FALSM3LENSHB FOLDABLE INTRAOCULAR LENS(HYDROPHILLIC ACRYLIC) 摺疊式人 0 工水晶體 FALSMH60MMB9 HYDROVIEW INTRAOCULAR LENS 0 FBD009501NS3 OHS SYSTEM (COMPRESSION HIP SCREW) 0 FBD009501NS9 OHS SYSTEM 度 (COMPRESSION HIP SCREW)( 原代碼 0 FBD009501NS3) FBD S3 COMPRESSION TUBE PLATE OCS 0 FBD S9 COMPRESSION TUBE PLATE HIP SYSTEM OCS 95 度 ( 原代碼 0 FBD S3) FBHS1PRFMNW2 PROFEMUR HIP SYSTEM:FEMORAL STEM ( 含 NECK) 適應症請見備 0 註欄 FBKA20610NH1 DURACON TOTAL KNEE TIBIAL WEDGE 限用於人工膝關節再置換時 0 使用 FBKA22510NH1 DURACON TOTAL KNEE FEMORAL SPACER DISTAL 限用於人工膝關 0 節再置換時使用 FBKL10100NH1 TIBIAL INSERT EXTRA-SMALL:LARGE 9MM:16MM( :7125 自 0 89/4/1 生效 ) 適應症請見備註欄 FBKL22410NH1 DURACON REVISION TIBIAL INSERT 適應症請見備註欄 0 FBKP1G442NSN GENESIS PATELLA COMPONENT 適應症請見備註欄 0 FBKPAG1000SN GENESIS TOTAL KNEE SYSTEM 適應症請見備註欄 0 FBKRAG1000SN GENESIS REVISION TOTAL KNEE SYSTEM 適應症請見備註欄 0 FBP012360NZ1 1/3 TUBULAR PLATE 2:8HOLE 0 FBP012367NZ1 SEMI-TUBULAR PLATE 4:7HOLE( 自 88/1/12 生效 ) 0 FBP012460NZ1 QUARTER TUBULAR PLATE 3:8HOLE 0 FBP014050NS9 SEMI-TUBULAR PLATE 2:10 HOLE 39:167MM( 原代碼 FBP014050NS3) 0 FBP014071NS9 ONE THIRD TUBULAR PLATE 2:8 HOLE 25:97MM( 原代碼 0 FBP014071NS3) FBP021010NS9 SMALL BONE PLATES4:10 HOLES; 52:120MM(ULNA AND RADIUS)( 原 0 代碼 FBP021010NS3) FBP021024NS3 SMALL BONE PLATE 0 FBP021024NS9 SMALL BONE PLATE ACP 4-8 HOLE( 原代碼 FBP021024NS3) 0 FBP021044NS9 L-PLATES R/L3/2:6/2 HOLES; 68:116MM TIBIA( 原代碼 0 FBP021044NS3) FBP021046NS3 SMALL BONE PLATE 3.5 SCREW 0 FBP022420NZ1 STRAIGHT MINI PLATE 0 FBP022429NZ1 FOREARM PLATE 5:12HOLE( 型號 自 91/10/01 生效 ) 0 FBP022463NZ1 BROAD SELF COMPRESSION PLATE 5:14HOLE(SCP) 0 FBP022470NZ1 NARROW SELF COMPRESSION PLATE 12HOLE(SCP)( :11 自 88/1/11 生效 ) 0 706

317 FBP023000NS9 NARROW BONE PLATES4:15 HOLES; 72.5:277MM TIBIA AND 0 ULNA( 原代碼 FBP023000NS3) FBP023100NS9 WIDE BONE PLATES6:16 HOLES; 105:296MM HUMERUS AND 0 TIBIA( 原代碼 FBP023100NS3) FBP023300NS3 Y-FORK PLATE ACP L/R 0 FBP023300NS9 Y-FORK PLATE ACP L/R 3:5 HOLE( 原代碼 FBP023300NS3) 0 FBP023500NS3 T PLATE FEMORAL L/R 0 FBP023500NS9 HUMERAL PLATE ACP L/R 3-6 HOLE( 原代碼 FBP023500NS3) 0 FBP025055NS9 PLATE FOR CONDYLAR-FRAGMENT R/L 7/6:9/6 HOLES 0 172:210MM( 原代碼 FBP020559NS3) FBP025062NS3 SMALL BONE PLATE ACP 4:6 HOLE 27:40MM 0 FBP025062NS9 SMALL BONE PLATE ACP 4-6 HOLE( 原代碼 FBP025062NS3) 0 FBP025103NS3 SMALL BONE PLATE ACP 4:10HOLE 35:95MM 0 FBP025103NS9 SMALL BONE PLATE ACP L/R 4:10 HOLE( 原代碼 FBP025103NS3) 0 FBP02510XNS9 SMALL BONE PLATE ACP 3-5 HOLE( 原代碼 FBP02510XNS3) 0 FBP025804NS3 CONDYLAR PLATE ACP 90 (ANGLED) 0 FBP025804NS9 ADUL OSTEOTOMY PLATE ACP 90( 原代碼 FBP025804NS3) 0 FBP027005NS3 CONDYLAR PLATE ACP 95 0 FBP027005NS9 CONDYLAR PLATE ACP 95 6/8/10 HOLE( 原代碼 FBP027005NS3) 0 FBP028003NS3 CONDYLAR PLATE ACP 90 (ANGLED) 0 FBP028003NS9 CHILDREN OSTEOTOM PLATES ACP 90 4 HOLE( 原代碼 0 FBP028003NS3) FBP028192NH1 STRAIGHT WIDE PLATE 0 FBP031013NS3 V.T.L.PLATE 0 FBP031034NS3 T PLATE 0 FBP031432NS3 T PLATE 0 FBP031432NS9 FORMA PLATE L/R 4/3,6/3,8/3 HOLE( 原代碼 FBP031432NS3) 0 FBP Z1 MINI EPIPHYSIS PLATE T L/R 0 FBP032419NZ1 MINI EPIPHYSIS PLATE OBLIQUE L/R 0 FBP Z1 L-BUTTRESS PLATE 4 HOLE 0 FBP Z1 T-BUTTRESS PLATE 5:6 HOLE 0 FBP03244XNZ1 CONDYLAR BUTTRESS PLATES 7HOLE,9HOLE 157CM,189CM 0 FBP Z1 SPOON PLATE 5HOLE 0 FBP032451NZ1 T-PLATE 4:8HOLE 0 FBP Z1 CLOVERLEAF PLATE 3HOLE 0 FBP032454NZ1 SMALL T-PLATE 3:5HOLE 0 FBP032455NZ1 SMALL STRAIGHT PLATE 3:8HOLE 0 FBP032456NZ1 MULTIPLE FRAGMENT PLATE 0 FBP032458NZ1 PLATE 0 FBP032459NZ1 EPIPHYSIS PLATE 0 FBP03245XNZ1 T-PLATES 3HOLE 67CM 0 FBP034102NS3 CLOVER LEAF PLATE 4/6:5/6 HOLE 88:104MM 0 FBP034250NS9 PELVIS AND ACETABULUM PLATES4:12 HOLES; 65:184MM( 原代碼 0 FBP034250NS3) FBP035600NH1 PROXIMAL TIBIAL PLATE 3:7 HOLE 0 FBP038300NH1 STRAIGHT PLATE FOR SMALL FRAGMENT 0 FBP038310NH1 PLATE FOR MULTIPLE FRAGMENT 7 HOLE 0 FBP038350NH1 MINI STRAIGHT PLATE 0 FBP038360NH1 MINI EPIPHYSEAL PLATE 0 FBP048202NH1 CONDYLAR PLATE ANGLE 95 度 (312) 0 FBS012306NZ1 CORTICAL SCREW 4.5MM 0 FBS012320NZ1 CORTICAL SCREW 2.0MM 0 FBS012324NZ1 2.7MM CORTICAL SCREW 6:24MM 0 707

318 FBS Z1 3.5MM CORTICAL SCREW 10:50MM 0 FBS012350NZ1 1.5MM CORTICAL SCREW 6:16MM 0 FBS022322NZ1 4.0MM CANCELLOUS SCREW PARTIAL THREAD 10:50MM 0 FBS022330NZ1 CANCELLOUS SCREW 0 FBS Z1 6.5MM CANCELLOUS SCREW FULLY THREADED 25:40MM 0 FBS022332NZ1 CANCELLOUS SCREW 0 FBS022340NZ1 4.0MM CANCELLOUS SCREW FULLY THREADED 14:60MM 0 FBS032323NZ1 MALLEOLAR SCREW 0 FBS032334NZ1 MALLEOLAR SCREW 0 FBS064304NSN NUT FOR 4.5MM CORTEX SCREW 0 FBS072344NZ1 WASHERS 0 FBSF1KASRNAD TITANIUM KANEDA SR ANTERIOR SPINAL SYSTEM(SX4+RX2) 適應 0 症請見備註欄 FBSF1KAT12DP KANEDA SR-ANTERIOR TITANIUM SPINAL SYSTEM 二節 0 FBSF1KAT13DP KANEDA SR-ANTERIOR TITANIUM SPINAL SYSTEM 三節 0 FBSF232102DP KANEDA SR-ANTERIOR TITANIUM SPINAL ROD 0 FBSF250001DP STAINLESS ANTERIOR ISOLA SPINAL ROD 0 FBSF452102DP KANEDA SR-ANTERIOR TITANIUM SPINAL SCREW 0 FBSF53210NAD TITANIUM KANEDA SR ANTERIOR TRANSVERSE SMOOTH ROD 0 COUPLERS 適應症請見備註欄 FBSF53210NDP KANEDA SR-ANTERIOR TITANIUM SPINAL LINK 0 FBSFC2486NS9 TI REFLEX ANTERIOR CERVICAL PLATE SYSTEM 二節 ( 型號 :522 自 92/4/1 生效 ) 適應症請見備註欄 FBSFC3486NS9 TI REFLEX ANTERIOR CERVICAL PLATE SYSTEM 三節 ( 型號 :522 自 92/4/1 生效 ) 適應症請見備註欄 FBSFC4010NS9 REFLEX ANTERIOR CERVICAL SCREW 適應症請見備註欄 0 FHG AH ULTRAMAX VASCULAR GRAFT STRAIGHT 12MM:18MM 30CM 0 FHG AH ULTRAMAX VASCULAR GRAFT STRAIGHT 20MM:30MM 30CM 0 FHG4108R10AH ULTRAMAX VASCULAR GRAFT AXILLO-BIFEMORAL 0 8MM,10MM,100X60CM FHG AH ULTRAMAX VASCULAR GRAFT BIFURCATES-STANDARD,ANATOMICAL 0 40CM FHP BK " 拜耳德尼克 " 璽洛植入式心律調節器 "BIOTRONIK"CYLOS 0 IMPLANTABLE CARDIAC PACEMAKERS* 適應症請見備註欄 FHP02DDR34BK 雙腔型心律調節器 "BIOTRONIK" CYLOS IMPLANTABLE CARDIAC 0 PACEMAKERS* 適應症請見備註欄, 按同類近似特材支付點數 點給付超過部分由病患自付 FHPCLKX341BK " 拜耳德尼克 " 植入式心內除顫器導線 "BIOTRONIK" ICD LEAD* 適應 0 症請見備註欄 FHX036000SGH GISH IBC FLOPUMP WITH GBS COATING* 適應症請見備註欄 0 FUK05TS403FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS TUBING SET FOR 0 HF400-HEMOFILTRATION(CVVH)* 適應症請見備註欄 FUK05TS405FN INFOMED EXTRACORPOREAL BLOOD CIRCUITS TUBING SET FOR 0 HF400-PEDIATRIC HEMOFILTRATION(CVVH)* 適應症請見備註欄 HEF03AC177AS PLASMA FILTER 附血液迴路管 0 HEF03TS402FN "INFOMED"EXTRACORPOREAL BLOOD CIRCUITS TUBING SET FOR 0 HF400-PLASMA EXCHANGE 體外血液循環管路 - 血漿置換 HEH011000TMY HEMOCONCENTRATOR WITH TUBING 適應症請見備註欄 0 HEH01400TSMY HEMOCONCENTRATOR WITH TUBING 適應症請見備註欄 0 LEE M4 " 美敦力 " 電極片 "MEDTRONIC" ELECTRODES 0 LEE01P1199M4 " 美敦力 " 電極片 "MEDTRONIC" ELECTRODES 0 NBS AB ANGIOGRAPHIC SYRINGE 10,12CC 0 708

319 SCV V7 " 威坦鐵克 " 鈦金屬血管夾 "VITALITEC" SLS-CLIP TITANIUM 0 HEMOSTATIC CLIP 大型 SCV01B2180V7 " 威坦鐵克 " 鈦金屬血管夾 "VITALITEC" SLS-CLIP TITANIUM 0 HEMOSTATIC CLIP 中型 SCV01J1180V7 " 威坦鐵克 " 鈦金屬血管夾 "VITALITEC" SLS-CLIP TITANIUM 0 HEMOSTATIC CLIP 小型 SCV01V3120V7 " 威坦鐵克 " 鈦金屬血管夾 "VITALITEC" SLS-CLIP TITANIUM 0 HEMOSTATIC CLIP 中型 / 大型 TBS MZ SCLERAL BUCKLING COMPONENTS:SILICON BAND 0 TBS MZ SCLERAL BUCKLING COMPONENTS:SILICON BAND 0 TBS MZ SCLERAL BUCKLING COMPONENTS:SILICON BAND 0 TBS MZ SCLERAL BUCKLING COMPONENTS:SILICON TIRE 0 TBS MZ SCLERAL BUCKLING COMPONENTS:SILICON TIRE 0 TBS MZ SCLERAL BUCKLING COMPONENTS:SILICON TIRE 0 TBS MZ SCLERAL BUCKLING COMPONENTS:SILICON SPONGE 0 TBS MZ SCLERAL BUCKLING COMPONENTS:SILICON SPONGE 0 TBS MZ SCLERAL BUCKLING COMPONENTS:SILICON SPONGE 0 TBS MZ SCLERAL BUCKLING COMPONENTS:SILICON SPONGE 0 TBS MZ SCLERAL BUCKLING COMPONENTS:SILICON SPONGE 0 709