第八十條附件三修正對照表

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第八十條附件三修正對照表

說明

修正年度；並明定保險人公告之依據。

特材代碼中英文名稱

支付點數 (108年1

月)

特材代碼中英文名稱支付點數

107/01 修正年度。

ACPD1MTC01M0 “美康”腹膜透析導管及配件：鈦金屬接頭“MEDCOMP

”

PERITONEAL DIALYSIS CATHETER AND ACCESSORIES

1482 本品項新增。

ACY01CFM01CK 曲克闕克芙爾導管轉接頭

“COOK”

CHECK-FLO PERFORMER ASSEMBLY

931 本品項刪除。

BBF03FB120SG “十美牌”餵食引導器 (未滅菌)-重力式餵食袋

“SIGMA”

FEED TUBE GUIDE (NON- STERILE)

現行規定修正規定

通則

1.本表所列屬不分廠牌別編列代碼之特殊材料者，藥物許可證之持有廠商或保險醫事服務機構無須向保險人建議收載；保險醫事服務機構按其所提供之特殊材料類別

，不分廠牌，依本標準所列代碼申報費用。

2.本表係一○八年一月份之給付品項及支付點數，依本標準第四條第八項規定，如有異動，以保險人最新公告為主。

通則

1.本表所列屬不分廠牌別編列代碼之特殊材料者，藥物許可證之持有廠商或保險醫事服務機構無須向保險人建議收載；保險醫事服務機構按其所提供之特殊材料類別

，不分廠牌，依本標準所列代碼申報費用。

2.本表係一○七年一月份之給付品項及支付點數，如有異動，以保險人最新公告為主。

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BBP0121132LK “福立克”可樂適造口術用袋及其附件 (未滅菌)-雙片式透明封口便袋32-70MM

“FLEXICARE

” COLOSET OSTOMY BAG AND

ACCESSORIES (NON-

STERILE)- CLOSED BAG，

COMFORT BACKING，

CLEAR FILM 32-70MM

30.7 本品項刪除。

BBP0121232LK “福立克”可樂適造口術用袋及其附件 (未滅菌)-雙片式透明封口便袋32- 70MM(不織布)

“FLEXICARE

ACCESSORIES (NON-

NON WOVEN BACKING ， CLEAR FILM 32-70MM

(3)

BBP0122132LK “福立克”可樂適造口術用袋及其附件 (未滅菌)-雙片式不透明封口便袋32- 70MM

“FLEXICARE

ACCESSORIES (NON-

COMFORT BACKING，

OPAQUE FILM 32-70MM

BBP0122232LK “福立克”可樂適造口術用袋及其附件 (未滅菌)-雙片式不透明封口便袋32- 70MM(不織布)

“FLEXICARE

ACCESSORIES (NON-

NON WOVEN BACKING ， OPAQUE FILM 32-70MM

(4)

BBP0411210LK 福立克”可樂適造口術用袋及其附件(未滅菌)-單片式便袋13- 64MM(含人工皮、不織布)

“FLEXICARE

”COLOSET OSTOMY BAG AND

ACCESSORIES (NON-

STERILE) –1 PCS CLOSED BAG， NON WOVEN BACKING，

13-64MM

BBP041776NA5 愛樂康造口術用袋及其附件(未滅菌)- 優護二件式開口便袋*限住院患者申報"ALCARE"

OSTOMY POUCH AND

ACCESSORIES (NON-

STERILE)- YOUCARE 2P TDF

30.7 本品項新增。

BBP0421615F4 康威新優穩舒柔單片墊高式造口袋 (未滅菌)-便袋*

限住院患者申報"CONVATEC"

ESTEEM + FLEX CONVEX POUCH (NON- STERILE)- OSTOMY POUCH

(5)

BBP0431132LK “福立克”可樂適造口術用袋及其附件 (未滅菌)-雙片式透明開口便袋32-70MM

“FLEXICARE

ACCESSORIES (NON-

STERILE)- DRAINABLE BAG，

COMFORT BACKING，

CLEAR FILM 32-70MM

BBP0431232LK “福立克”可樂適造口術用袋及其附件 (未滅菌)-雙片式透明開口便袋32- 70MM(不織布)

“FLEXICARE

ACCESSORIES (NON-

STERILE)- DRAINABLE BAG， NON WOVEN BACKING，

CLEAR FILM 32-70MM

(6)

BBP0432132LK “福立克”可樂適造口術用袋及其附件 (未滅菌)-雙片式不透明開口便袋32- 70MM

“FLEXICARE

ACCESSORIES (NON-

STERILE)- DRAINABLE BAG，

COMFORT BACKING，

OPAQUE FILM 32-70MM

BBP0432232LK “福立克”可樂適造口術用袋及其附件 (未滅菌)-雙片式不透明開口便袋32- 70MM(不織布)

“FLEXICARE

ACCESSORIES (NON-

STERILE)- DRAINABLE BAG， NON WOVEN BACKING，

OPAQUE FILM 32-70MM

(7)

BBU0121623F4 康威新優穩舒柔單片墊高式造口袋 (未滅菌)-尿袋*

限住院患者申報"CONVATEC"

ESTEEM + FLEX CONVEX POUCH (NON- STERILE)-URO POUCH(NON- STERILE)- OSTOMY POUCH

BBW01BAG01BQ 邦特導入/引流導管附件 (滅菌)-引流袋BIOTEQ INTRODUCER/D RAINAGE CATHETER ACCESSORIES(

STERILE)- DRAINAGE BAG

BBW01DB7504Q 康諾引流袋 (滅菌)-腎臟造廔引流袋"CONOD"

DRAINAGE BAG (STERILE)- PCN BAG

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

INTRODUCER/D RAINAGE CATHETER ACCESSORIES :P.C.N.

DRAINAGE BAG

(8)

BBW01LU800BQ 邦特導入/引流導管附件 (滅菌):腎臟造口引流袋 BIOTEQ

INTRODUCER/D RAINAGE CATHETER ACCESSORIES(

STERILE):

PCN DRAINAGE BAG

BBW01UB121BQ 邦特導入/引流導管附件 (滅菌):腎臟造口引流袋 BIOTEQ

DRAINAGE BAG

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

DRAINAGE BAG

CBA014300SLW 樂脈非氣球型閉塞導

管"LEMAITRE"

THE

UNBALLOON NON- OCCLUSIVE MODELING CATHETER

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

(9)

CBB0131555N5 GHOST II PTA ANGIOPLASTY CATHETER 5FR. 3:10MM

*1.5:10CM，

40，75，120

，150CM(衛署字號009069)

CBB018040N6K 博仕美雅其利周邊血管氣球擴張導管 (L:10-

100MM)"BROSM ED"ACHILLES NC PTA BALLOON DILATATION CATHETER

CBB018041N6K 博仕美雅其利周邊血管氣球擴張導管 (L:150MM)"BR OSMED"ACHILL ES NC PTA BALLOON DILATATION CATHETER

CBB018160N6K 博仕美卡斯特周邊血管氣球擴張導管 (L:10:100MM)

"BROSMED"CAS TOR NC PTA BALLOON DILATATION CATHETER

CBB018161N6K 博仕美卡斯特周邊血管氣球擴張導管 (L:150MM)"BR OSMED"CASTOR NC PTA

BALLOON DILATATION CATHETER

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CBB018200N6K 博仕美艾瑪仕周邊血管氣球擴張導管 (L:20:100MM)

"BROSMED"HER MES NC PTA BALLOON DILATATION CATHETER

CBB018201N6K 博仕美艾瑪仕周邊血管氣球擴張導管 (L:150MM)"BR OSMED"HERMES NC PTA

CBB01ATG35BA 巴德艾特斯格經皮穿刺血管成形術導管"BARD"ATLA S GOLD PTA DILATATION CATHETER L:20-60MM

CBB01BTFLRQC 清流班特弗洛里安經皮穿刺血管成形術導管

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

CBB01CPAC1QC CLEARSTREAMC LEARPAC 歐美加 PTA CATHETER"清流"清派歐美加經皮穿刺血管成形術導管

(11)

CBB01CPAC2QC CLEARSTREAMC LEARPAC 歐美加 PTA

CATHETER 120MM;150MM;

220MM"清流"

清派歐美加經皮穿刺血管成形術導管*給付規定請見備註欄

CBB01CQ40ABA 巴德康格斯特 40經皮穿刺血管成形術導管"BARD"CONQ UEST 40 PTA DILATATION CATHETER(>=4 0ATM)

CBB01DR035BA 巴德杜拉德經皮穿刺血管成形術氣球擴張導

管"BARD"DORA DO PTA

CBB01JK020EQ 優洛可優克經皮血管氣球擴張導管

(L20:80MM)"E UROCOR"JOKER 035 OVER THE WIRE (OTW) PTA BALLOON CATHETER

CBB01LYNX18R 雅瑟斯林可斯周邊血管氣球導

管"ARTHESYS"

LYNX PTA CATHETER L:10:200MM

(12)

CBB01PW035E7 優科德優科滑經皮球囊擴張導

管"EUCATECH"

EUCA PW PTA BALLOON CATHETER L20-100MM

CBB01TER155U 泰速-35氣球擴張導

管"TERSUS"0.

035"PTA BALLOON DILATATION CATHETER

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

PERIPHERAL DILATATION CATHETER

CBB03BTK225R 泰速-14氣球擴張導管 (D:2- 4MM;L:150- 220MM)"TERSU S-14"BTK PTA BALLOON DILATATION CATHETER

CBB03BTK805R 泰速-14氣球擴張導管 (D:2- 4MM;L:20- 100MM)"TERSU S-14"BTK PTA BALLOON DILATATION CATHETER

(13)

CBB03DR035BA 巴德杜拉德經皮穿刺血管成形術氣球擴張導管(下肢血管)"BARD"DOR ADO PTA BALLOON DILATATION CATHETER L:120-200MM

(L100MM)"EUR OCOR"JOKER 035 OVER THE WIRE (OTW) PTA BALLOON CATHETER

(L:120;150MM )"EUROCOR"JO KER 035 OVER THE WIRE (OTW) PTA BALLOON CATHETER

CBB03LYNX28R 雅瑟斯林可斯周邊血管氣球導管(下肢血管)"ARTHESYS

"LYNX PTA CATHETER L:10:100MM

CBB03LYNX38R 雅瑟斯林可斯周邊血管氣球導管(下肢血管)"ARTHESYS

"LYNX PTA CATHETER L:120:200MM

(14)

CBB03PCELLM4 美敦力派斯飛克普拉斯周邊血管治療導管-

L:120:150MM"

MEDTRONIC"PA CIFIC PLUS PTA CATHETER

CBB03PCESSM4 美敦力派斯飛克普拉斯周邊血管治療導管-

L:20:80MM"ME DTRONIC"PACI FIC PLUS PTA CATHETER

CBB03PCFLLF2 INVATECPACIF IC XTREME PTA BALLOON CATHETER"英泰克"派斯飛克血管治療導管(下肢血管治療導

管)L:120MM:3 00MM

CBB03PR0205F 艾拉維派威 018周邊血管氣球擴張導管 (L:20:100MM)

"ARRAVASC"PI ROUETTE 018 PTA CATHETER

CBB03PR1505F 艾拉維派威 018周邊血管氣球擴張導管 (L:150:300MM )"ARRAVASC"P IROUETTE 018 PTA CATHETER

CBB03PWL35E7 優科德優科滑經皮球囊擴張導管(下肢血管)"EUCATECH

"EUCA PW PTA BALLOON CATHETER L120-200MM

(15)

CBB03PWSV1E7 優科德優科滑絲經皮球囊擴張導管(下肢血

管)"EUCATECH

"EUCA PWSV PTA BALLOON CATHETER L:20-80MM

CBB03PWSV2E7 優科德優科滑絲經皮球囊擴張導管(下肢血

管)"EUCATECH

"EUCA PWSV PTA BALLOON CATHETER L:120-150MM

CBC01SCH64SB OTW&MONORAIL CAROTID WALLSTENT D:6:10MM，

L:30:50MM*使用規範請見備註欄

CBC02MP628F2 INVATECMARIS PERIPHERAL SELF- EXPANDING STENT

SYSTEM(ILIAC ARTERY)瑪瑞斯自膨式週邊血管支架系統

*適應症請見備註欄

CBC02PWSBEE7 優科德優科滑絲周邊血管支架系統(腸骨血管支

架)"EUCATECH

"EUCA PWS PTA STENT SYSTEM(ILIAC STENT)

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CBC02RSTLCE7 優科德里斯周邊血管支架系統(腸骨血管支

架)"EUCATECH

"RESISTANT SELF- EXPANDABLE STENT

SYSTEM(ILIAC STENT)

CBC03AAA01CK ZENITH FLEX AAA

ENDOVASCULAR GRAFT W/THE H&L-B ONE- SHOT INTRO SYS腹主動脈瘤支架暨輸送系統(主體+分支體*2)*適應症見備註

405000 本品項刪除。

CBC03AAA03CK COOKZENITH AAA

ENDOVASCULAR GRAFT W/H&L- B ONE-SHOT INTRO SYS腹主動脈瘤支架暨輸送導引系統(主體+分支體*2)*適應症見備註

405000 本品項刪除。

CBC03ZSLE1CK COOKZENITH SPIRAL-Z AAA ILIAC LEG W/THE Z-TRAK INTRODUCTION SYS腹主動脈瘤支架暨輸送系統-輔助配件*給付規定見備註

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CBC04FCLP1G9 法西里-比比自膨式支架 (淺股動脈支架L:20- 120MM)FACILE -PP SELF EXPANDING STENT

CBC04FCLP2G9 法西里-比比自膨式支架 (淺股動脈支架

L:150MM)FACI LE-PP SELF EXPANDING STENT

CBC04MAR1SF2 INVATECMARIS PERIPHERAL SELF- EXPANDING STENT

SYSTEM"英泰克"瑪瑞斯自膨式周邊血管支架系統(淺股動脈血管支架)L20:120MM D6:12MM*適應症請見備註

CBC04RTS01E7 優科德里斯周邊血管支架系統(淺股動脈血管支

架)"EUCATECH

SYSTEM(L:20- 120MM)

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CBC04RTS02E7 優科德里斯周邊血管支架系統(淺股動脈血管支

架)"EUCATECH

SYSTEM(L:150 -200MM)

CBC05TBRANCK 曲克蘭尼思T 分支型胸腹主動脈內支架"COOK"ZENI TH T-BRANCH THORACOABDOM INAL

ENDOVASCULAR GRAFT

305007 本品項新增。

CBC07BG5106X 潷葛睿孚周邊覆膜支架系統 (D:5-10MM;遞送系統

75:120CM)"BE GRAFT"PERIPH ERAL STENT GRAFT SYSTEM

CBC07CV100AN 安吉美爾德柯維拉血管覆膜支架:含傳輸裝置(長度:100MM直徑:6:10MM)"A NGIOMED"COVE RA VASCULAR COVERED STENT

CBC07CV380AN 安吉美爾德柯維拉血管覆膜支架:含傳輸裝置(長度:30;40;60;

80MM直

徑:6:10MM)"A NGIOMED"COVE RA VASCULAR COVERED STENT

(19)

CBC07VH05NGX 戈爾威爾棒周邊血管支架- 含生物表面肝素塗層

(L:2.5;5.0CM )"GORE"VIABA HN

ENDOPROSTHES IS-HEPARIN BIOACTIVE SURFACE

(L:10CM)"GOR E"VIABAHN ENDOPROSTHES IS-HEPARIN BIOACTIVE SURFACE

(L:15CM)"GOR E"VIABAHN ENDOPROSTHES IS-HEPARIN BIOACTIVE SURFACE

100980 本品項新增。

CBP01103TBRB ORBUSNEICHSA PPHIRE

CORONARY DILATATION CATHETER 1.5MM:4.0MM 10MM:30MM塞費爾冠狀動脈球曩擴張術導管

CBP01802NC6K 博仕美阿波羅冠狀動脈氣球擴張導

管"BROSMED"A POLLO PTCA BALLOON DILATATION CATHETER

(20)

CBP01AARPC7X 阿受斯皮可冠狀動脈支架系統(冠狀動脈支架)ARTHOS PICO STENT IMPLANTATION SYSTEM

CBP01EUCA6E7 優科德優科第六代冠狀動脈氣球擴張導管"EUCATECH"

EUCA VI PTCA BALLOON CATHETER

CBP01RD3ZEKE 卡內卡經皮穿刺冠狀動脈導管KANEKA PTCA CATHETER

CBP03389XXSB BOSTON

SCIENTIFICAP EX MONORAIL PTCA

DILATATION CATHETER D 1.50MM:5.0MM L8MM:40MM艾佩斯單軌氣球擴張導管

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

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

CBP03ERUNCXW 朗迪優霸恩喜冠狀動脈氣球導

管"RONTIS"EU ROPA ULTRA NC PTCA BALLOON CATHETER

(21)

CBP03RAF25HC HEXACATHRAFA LE PTCA DILATATION CATHETER旋風冠狀動脈氣球擴張導管

CBP06ELUT13X 上海微創火鷹雷帕黴素冠狀動脈塗藥支架系統(自付差額"SHANGHAI MICROPORT"FI REHAWK

RAPAMYCIN TARGET ELUTING CORONARY STENT SYSTEM)

CBP06ELUT1AB ABBOTTXIENCE V EVEROLIMUS ELUTING CORONARY STENT SYSTEM 艾諾莉茉斯冠狀動脈塗藥支架，部分給付品項，適應症見備註欄，並註明其禁忌症勿使用。

CBP06ELUT1BB COROFLEX PLEASE PACLITAXEL- ELUTING CORONARY STENT SYSTEM 部分給付品項紫杉醇釋放型冠狀動脈血管支架*適應症見備註，並註明其禁忌症勿使用。

(22)

CBP06ELUT1RB ORBUSGENOUS R STENT傑納斯冠狀動脈血管支架輸送系統

2.5MM:4.0MM 9MM:33MM 部分給付品項.

適應症請見備註欄.並註明其禁忌症不可使用.

CBP06ELUT3RB 奧爾康博進階釋放型冠狀動脈支架(自付差額品

項)"ORBUSNEI CH"COMBO PLUS DUAL THERAPY STENT

CBP06ELUT3TM 泰爾茂阿提瑪斯特丹誠冠狀動脈塗藥支架系統(自付差額)"TERUMO"

ULTIMASTER TANSEI SIROLIMUS ELUTING CORONARY STENT SYSTEM

CBP06FB2EL3X 上海微創法爾貝德冠狀動脈塗藥支架系統 (自付差額品項)"SHANGHAI MICROPORT"FI REBIRD2 RAPAMYCIN- ELUTING CORONARY COCR STENT SYSTEM

(23)

CBP07SUPTCE7 優科德石坡息經皮穿刺塗藥冠狀動脈導管"EUCATECH"

SUPPORT C PACLITAXEL- ELUTING PTCA CATHETER

CBS029ASDNG6 AGAAMPLAATZE R SEPTAL OCCLUDER WITH DELIVERY SYSTEM"銨積維"安普拉茲心房關閉器※

給付規定請見備註欄

143762 本品項刪除。

CBS029DEL9G6 AGAAMPLATZER DELIVERY SYSTEM 9FR，

10FR，12FR"

銨積維"安普拉茲遞送導管系統*給付規定請見備註欄

CBS029DELNG6 AGAAMPLATZER DELIVERY SYSTEM 6:8FR*"銨積維"安普拉茲遞送導管系統

*給付規定請見備註欄

CBS02CRASDG6 安普拉茲心房關閉器

AMPLATZER SEPTAL OCCLUDER

138000 本品項新增。

CBS04D1400WE 百歐森偉伯司特摩比卡斯心房中膈穿刺針"BIOSENSE WEBSTER"

MOBICATH TRANSSEPTAL NEEDLE

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CBV02TF0XXBA 巴德楚芙瓣膜成形術灌注導管(主動脈瓣氣球導

管)"BARD"TRU E FLOW

VALVULOPLAST Y PERFUSION CATHETER

CDD0401201ED PERICARDIAL SUMP(1/4")

CDD0403300ED SUCTION WAND(9F-22F)

CDD0455192P2 “太平洋”密閉式真空傷口引流套(滅菌)

“PAHSCO”

CLOSED WOUND DRAINAGE SYSTEM(STERI LE) 125、

200ML球PVC、

管

SILICONE(球+

管+針)

CDD10211102C 柯惠亞羅穿刺導管10FR，

12FR，

16FR"COVIDIE N" ARGYLE TROCAR CATHETER 10FR，12FR，

16FR

CDD10211202C 柯惠亞羅穿刺導管20FR，

24FR，28FR，

32FR"COVIDIE N" ARGYLE TROCAR CATHETER 20FR，24FR，

28FR，32FR

CDD110612YL7 大吉士穿刺套管(穿刺內管 X1+穿刺外管 X1+可變式轉接頭X1)LAGIS TROCAR

(25)

CDD11091PF2C 柯惠可變徑式 V型安全穿刺套管

"COVIDIEN"

VERSAPORT PLUS

AUTOSUTURE V2

W/FIXATION CANNULA 5- 11~12MM (外管+可變轉接頭)

CDD11096PF2C 柯惠可變徑式 V型安全穿刺套管

"COVIDIEN"VE RSAPORT PLUS AUTOSUTURE V2

W/FIXATION CANNULA 5- 12MM (穿刺內管+外管+可變轉接頭)

CDD110NB1N2C “柯惠”溫莎安可視式腹腔鏡穿刺器 (穿刺針1+外管1+

可變轉接頭1)

“COVIDIEN”

VERSAONE OPTICAL TROCAR

CDD110NB5S2C “柯惠”溫莎安可視式腹腔鏡穿刺器 (穿刺針1+外管2+

固定轉接頭2)

“COVIDIEN”

(26)

CDD110NB5X2C “柯惠”溫莎安可視式腹腔鏡穿刺器(穿刺針1+外管1+

固定轉接頭1)

“COVIDIEN”

CDD114216U2C 柯惠可充氣穿刺套

管"COVIDIEN"

AUTO SUTURE THREADED TROCAR

SLEEVES WITH WOODFORD SPIKE TROCAR AND

INSUFFATION PORT(穿剌針 1+外管2+固定轉接頭2)

CDD117093F2C 柯惠可變徑式 V型安全穿刺套管

"COVIDIEN"

VERSAPORT PLUS

AUTOSUTURE V2

W/FIXATION CANNULA 5MM (外管+固定轉接頭)

CDD11790942C 柯惠V型刀片穿刺套管

"COVIDIEN"VE RSAPORT AUTO SUTURE PLUS V2/V2 BLADED TROCAR (內管 +外管+固定式接頭)

(27)

CDD11790962C 柯惠V型刀片穿刺套管

"COVIDIEN"VE RSAPORT AUTO SUTURE PLUS V2/V2 BLADED TROCAR(內管+

外管+可變轉接頭)

CDD11906892C 柯惠安全穿刺套管組

"COVIDIEN"

AUTO SUTURE VERSAPORT PLUS RPF TROCAR SYSTEM 5MM (穿剌針1+外管1+固定式轉接頭1)

CDD119093F2C 柯惠可變徑式 V型安全穿刺套管

"COVIDIEN"VE RSAPORT PLUS AUTOSUTURE V2

W/FIXATION CANNULA 5MM (穿刺內管+外管+固定轉接頭)

CDD11NB12S2C 柯惠無刀刃可變式穿刺套管"COVIDIEN"

VERSAPORT BLADELESS AND

VERSAPORT PLUS BLADELESS SINGLE USE BLADELESS TROCAR(內管 1+外管1+可變轉接頭1)

(28)

CDD11NB15S2C “柯惠”無刀刃可變式穿刺套管 15MM(穿刺內管1+外管 1+可變式轉接頭2+5MM轉接頭

1)"COVIDIEN"

VERSAPORT PLUS BLADELESS SINGLE USE BLADELESS TROCAR 15MM

CDD11NBFCS2C 柯惠無刀刃可變式穿刺套管"COVIDIEN"

VERSAPORT PLUS BLADELESS SINGLE USE BLADELESS TROCAR(外管 1+固定式轉接頭1)

CDD11UNC122C “柯惠”溫莎安通用外套管 (穿刺套管1支 +可變式轉接頭1支)

“COVIDIEN”

VERSAONE UNIVERSAL CANNULA

CDD11UNCA52C “柯惠”溫莎安通用外套管 (穿刺套管1支 +固定式轉接頭1支)

“COVIDIEN”

VERSAONE UNIVERSAL CANNULA

(29)

CDDC1PG5007N “凱瑞斯”

PVA負壓泡綿傷口敷料及其配件(滅菌)- 引流罐

“CURATIOS”

PVA NEGATIVE PRESSURE WOUND

DRESSING AND ACCESSORIES(

STERILE)500M L、750ML

CDDF1P15107N “凱瑞斯”

PVA負壓泡綿傷口敷料及其配件(滅菌)

“CURATIOS”

STERILE)10*1 0、10*15CM

CDDF1P20157N “凱瑞斯”

PVA負壓泡綿傷口敷料及其配件(滅菌)

“CURATIOS”

STERILE)15*1 5、20*10、

20*15CM

CDF0242104PM C.S.F. FLOW CONTROL VALVE STANDARD

CDLP244513PM C.S.F.

LUMBOPERITON EAL

RESERVOIR

(30)

CDP0107551AG “史凱特”引流管

“SKATER”

DRAINAGE CATHETER

CDP01299304G 美迪格單次使用胰管引流支架(含1支推送管及1支單獨引流支架)"MEDI- GLOBE"PANCRE ATIC

DRAINAGE STENT

(SINGLE USE)

CDP01302224G “美迪格”單次使用膽道引流支架(膽道支架套組:含推送管*1+膽道支架*1)

“MEDI-GLOBE

” BILIARY DRAINAGE STENT (SINGLE USE)(BILIARY STENT SET)

CDP01BCLN1CK 曲克多功能引流導管

組"COOK”

MULTIPURPOSE DRAINAGE CATHETER SET

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)

(31)

CDP01BTPDCBQ PIGTAIL DRAINAGE CATHETER SET(ONE STEP)(含引流管及穿刺針組)

CDP01BTPDDBQ PIGTAIL DRAINAGE CATHETER SET(ONE STEP)(含引流管及穿刺針組)

CDP01BTPDSBQ 邦拓豬尾巴引流導管組（直接穿刺

型）"BIOTEQ"

PIGTAIL DRAINAGE CATHETER SET

（ONE STEP TYPE）

CDP01CLB85CK 曲克經皮引流導管針組 (滅菌)

"COOK"

DRAINAGE CATHETER NEEDLE

SET(STERILE) 6~16FR

CDP01MDC85CK ULTRATHANE MULTIPURPOSE DRAINAGE CATH 8.5，

10.2F，25CM

，18G

CDP01PD001BQ 邦特豬尾巴引流導管組 (直接穿刺型)

"BIOTEQ"

PIGTAIL DRAINAGE CATHETER SET(ONE STEP TYPE

(32)

CDP01PDD30BQ 邦特豬尾巴引流導管組 (直接穿刺型)

"BIOTEQ"

CDP01PDD4WBQ 邦特豬尾巴引流導管組 (直接穿刺型)

"BIOTEQ"

CDP01PDS70BQ 邦特豬尾巴引流導管組 (直接穿刺型)

"BIOTEQ"

CDP01PV630LY “奧林柏斯”

單次用膽道引流支架(膽道支架套組:含推送管*1+膽道支架*1)

“OLYMPUS”

SINGLE USE BILIARY DRAINAGE STENT V

CDP01UC102CK ULTRATHANE UNIVERSAL CURVED DRAINAGE CATH 10.2F，

25CM，18G

(33)

CDP01UL120CK ULTRATHANE UNIVERSAL CURVED DRAINAGE CATH 10.2F，

25CM，18G

CDP01UL140CK ULTRATHANE UNIVERSAL CURVED DRAINAGE CATH 10.2F，

25CM，18G

CDP01ULT01CK 曲克經皮引流導管針

組"COOK"

DRAINAGE CATHETER NEEDLE SET(BILIARY DRAINAGE CATHETERS)

CDP01ULT50CK MAC-LOC ULTRATHANE DRAINAGE CATH 5，6F，

25CM，23，

20G

CDP01ULT70CK MAC-LOC ULTRATHANE DRAINAGE CATH

CDP01ULT85CK 曲克經皮引流導管針

組"COOK"DRAI NAGE

CATHETER NEEDLE

SET(STERILE) -MAC-LOC MULTIPURPOSE 8.5，10F-14F

，25CM

CDPN2A3601WU 優樂胸腔引流瓶(滅

菌)"EUROSETS

" CHEST DRAINAGE SYSTEM (STERILE)

(34)

CDVPA55123CM 柯特曼貝特斯分流

器"CODMAN"

BACTISEAL UNIVERSAL SHUNT

CEE010544H3N “根本”高壓延長管

“NEMOTO”

PRESSURE TUBE

CEE012000EJ6 CAREFUSIONSM ARTSITE NEEDLE FREE VALVE

EXTENSION SETS AND COMPONENTS "

卡爾費森"無針輸注閥組及配件:無針輸注閥※適應症請見給付規定

38 CEE012000EJ6 CAREFUSIONSM ARTSITE NEEDLE FREE VALVE

卡爾費森"無針輸注閥組及配件:無針輸注閥※適應症請見給付規定

27.4 依據本標準相關規定調整價格。

CEE0120039J6 CAREFUSIONSM ARTSITE NEEDLE FREE VALVE

卡爾費森"無針輸注閥組及配件-無針輸注閥延長管※

適應症請見給付規定

38 CEE0120039J6 CAREFUSIONSM ARTSITE NEEDLE FREE VALVE

卡爾費森"無針輸注閥組及配件-無針輸注閥延長管※

適應症請見給付規定

33.7 依據本標準相關規定調整價格。

CEE01A152VPW 普惠靜注延長管-免針安全型"PERFECT"E XTENSION TUBE-NEEDLE FREE

CEE01BV701BQ “邦特”輸液套※適應症請見備註欄

“BIOTEQ”

INTRAVENOUS SET (I.V.

SET)

(35)

CEE01CH510U2 “愛西優”可來福藥物準備系統組件-可來福藥瓶轉接頭“ICU”

CHEMOCLAVE DRUG

PREPARATION SYSTEM- UNIVERSAL VENTED VIAL SPIKE，

CLAVE

CEE01CH720U2 “愛西優”可來福藥物準備系統組件-可來福藥瓶轉接頭“ICU”

CHEMOCLAVE DRUG

PREPARATION SYSTEM

CEE01CL100U2 “愛西優”化療樂扣藥物準備系統-化療樂扣接頭

“ICU”

CHEMOLOCK DRUG

PREPARATION SYSTEM - BAG SPIKE

CHEMOLOCK CONNECTOR

CEE01CL140U2 “愛西優”化療樂扣藥物準備系統-化療樂扣接頭+輸液袋接頭

“ICU”

CHEMOLOCK DRUG

PREPARATION SYSTEM- ACCESS DEVICE IV BAG

CHEMOLOCK CONNECTOR

(36)

CEE01CL303U2 “愛西優”化療樂扣藥物準備系統-輸液管轉接頭注射調節頭“ICU

” CHEMOLOCK DRUG

PREPARATION SYSTEM

CEE01CL318U2 “愛西優”化療樂扣藥物準備系統-輸液管含無針密閉接頭+輸液線含SPIKE*1

“ICU”

CHEMOLOCK DRUG

PREPARATION SYSTEM

CEE01CL325U2 “愛西優”化療樂扣藥物準備系統-4路輸液管含無針密閉接頭+輸液線含SPIKE*1

“ICU”

CHEMOLOCK DRUG

PREPARATION SYSTEM

“ICU”

CHEMOLOCK DRUG

PREPARATION SYSTEM

(37)

“ICU”

CHEMOLOCK DRUG

PREPARATION SYSTEM

CEE01CL620U2 “愛西優”化療樂扣藥物準備系統-化療樂扣藥瓶轉接頭“ICU”

CHEMOLOCK DRUG

PREPARATION SYSTEM- CHEMOLOCK VIAL SPIKE，

13MM

CEE01CTU154Q 康諾連接管 (滅

菌)"CONOD"

CONNECTING TUBES (STERILE)

CEE01NF010LL “怡安”無針輸液連接頭- 無針輸液連接頭+三通閥

“LILY”

NEEDLELESS CONNECTOR WITH 3WAY STOPCOCK

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

SET/NEEDLELE SS FEMALE ADAPTOR

(38)

CEE01NVC12Q4 “尼得立斯”

藥物準備系統輸液接頭-一對一安全輸液管

“NEEDLELESS

” DRUG PREPARATION SYSTEM AND NEEDLELESS INJECTION ACCESS DEVICE- ONE WAY SAFETY INFUSION SET

藥物準備系統輸液接頭- 一對二安全輸液管

“NEEDLELESS

” DRUG PREPARATION SYSTEM AND NEEDLELESS INJECTION ACCESS DEVICE- TWO WAYS SAFETY INFUSION SET

藥物準備系統輸液接頭- 一對三安全輸液管

“NEEDLELESS

” DRUG PREPARATION SYSTEM AND NEEDLELESS INJECTION ACCESS DEVICE- THREE WAYS SAFETY

INFUSION SET

(39)

藥物準備系統輸液接頭- 取藥針(氣孔)

“NEEDLELESS

” DRUG PREPARATION SYSTEM AND NEEDLELESS INJECTION ACCESS DEVICE-VIAL ACCESS DEVICE (VENT)

CEE01R1000BB SAFSITE VALVES AND ACCESSORIES

※適應症請見備註欄

CEE01S2000BD BD無針輸注閥組及配件-無針輸注閥BD SMARTSITE NEEDLE FREE VALVE

EXTENSION SETS AND COMPONENTS- NEEDLE FREE VALVE

CEE01S2000J6 “卡爾費森”

無針輸注閥組及配件-無針輸注閥※適應症請見備註欄"CAREFUSIO N"SMARTSITE NEEDLE FREE VALVE

EXTENSION SETS AND COMPONENTS- NEEDLE FREE VALVE

(40)

CEE01S2019BD BD無針輸注閥組及配件-無針輸注閾+多路延長管BD SMARTSITE NEEDLE FREE VALVE

EXTENSION SETS AND COMPONENTS- NEEDLE FREE VALVE AND MULTIPLE WAY EXTENSION SETS

CEE01S2019J6 卡爾費森無針輸注閥組及配件-無針輸注閥+多路延長管※適應症請見備註

欄"CAREFUSIO N"SMARTSITE NEEDLE FREE VALVE

EXTENSION SETS AND COMPONENTS- NEEDLE FREE VALVE AND MULTIPLE WAY EXTENSION SETS

CEE01S2028BD BD無針輸注閥組及配件-無針輸注閥+延長管(含 DEHP)BD SMARTSITE NEEDLE FREE VALVE

EXTENSION SETS AND COMPONENTS- NEEDLE FREE VALVE AND EXTENSION SETS(WITH DEHP)

(41)

CEE01S2028J6 卡爾費森無針輸注閥組及配件-無針輸注閥+延長管(含 DEHP)※適應症請見備註欄"CAREFUSIO N"SMARTSITE NEEDLE FREE VALVE

EXTENSION SETS AND COMPONENTS- NEEDLE FREE VALVE AND EXTENSION SETS(WITH DEHP)

CEE01S2039BD BD無針輸注閥組及配件-無針輸注閥+T型延長管BD SMARTSITE NEEDLE FREE VALVE

EXTENSION SETS AND COMPONENTS- NEEDLE FREE VALVE AND EXTENSION SETS

CEE01S2039J6 卡爾費森無針輸注閥組及配件?無針輸注閥+T型延長管

※適應症請見備註

欄"CAREFUSIO N"SMARTSITE NEEDLE FREE VALVE

EXTENSION SETS AND COMPONENTS- NEEDLE FREE VALVE AND EXTENSION SETS