|
|
|
|
|
|
|
|
|
| 自費品項 |
| 【健保不給付】 |
| 項目 |
代碼 |
項目名稱 |
單位 |
XFE_UPRICE |
帳號 |
XFE_MTRM |
XFE_KIND |
單價 |
| 掛號費 |
A0010 |
掛號費(初診,複診) |
次 |
0 |
1 |
|
2 |
100 |
| 掛號費 |
A0011 |
急診掛號費 |
次 |
0 |
1 |
|
2 |
200 |
| 診斷書費 |
A02092 |
補開收據 |
張 |
0 |
2 |
|
2 |
10 |
| 診斷書費 |
A02101 |
重傷診診斷書(本院代辦) |
EA |
0 |
2 |
|
2 |
200 |
| 診斷書費 |
A02114 |
精神報告書撰寫費 |
EA |
0 |
2 |
|
2 |
2,500 |
| 診斷書費 |
A02115 |
精神鑑定費 |
EA |
0 |
2 |
|
2 |
4,500 |
| 診斷書費 |
A0221 |
英文診斷書 |
份 |
0 |
2 |
|
2 |
200 |
| 診斷書費 |
A1001 |
傷害診斷證明書(副本900元) |
份 |
0 |
2 |
|
2 |
1,800 |
| 診斷書費 |
A1002 |
一般診斷證明書(副本50元) |
份 |
0 |
2 |
|
2 |
100 |
| 診斷書費 |
A1003 |
勞保傷病證書 |
份 |
0 |
2 |
|
2 |
300 |
| 診斷書費 |
A1004 |
勞農保殘廢證書 |
份 |
0 |
2 |
|
2 |
500 |
| 診斷書費 |
A1005 |
出生證明書(三份)每加一份20元 |
份 |
0 |
2 |
|
2 |
120 |
| 診斷書費 |
A1006 |
死亡證明書(四份)每加一份20元 |
份 |
0 |
2 |
|
2 |
120 |
| 診斷書費 |
A10061 |
英文死亡證明書 |
份 |
0 |
2 |
|
2 |
200 |
| 診斷書費 |
A1008 |
重大傷病證明書 |
份 |
0 |
2 |
|
2 |
150 |
| 診斷書費 |
A1009 |
家庭聘外籍監護診斷書 |
份 |
0 |
2 |
|
2 |
1,000 |
| 診斷書費 |
A1010 |
義肢給付診斷書 |
份 |
0 |
2 |
|
2 |
200 |
| 診斷書費 |
A1011 |
流產診斷證明書 |
份 |
0 |
2 |
|
2 |
200 |
| 診斷書費 |
A1012 |
申請大陸地區配偶工作用診斷書 |
份 |
0 |
2 |
|
2 |
100 |
| 診斷書費 |
A1013 |
申請大陸地區配偶來台探病診斷書 |
份 |
0 |
2 |
|
2 |
100 |
| 診斷書費 |
A1014 |
英文出生證明書 |
份 |
0 |
2 |
|
2 |
200 |
| 診斷書費 |
A1015 |
電動代步車-電動輪椅評估報告 |
份 |
0 |
2 |
|
2 |
300 |
| 診斷書費 |
A1018 |
診斷書-巴氏量評估報告 |
份 |
0 |
2 |
|
2 |
200 |
| 診斷書費 |
A1020 |
國民年金保險身心障年金給付工作能力綜合評量表 |
份 |
0 |
2 |
|
2 |
1,000 |
| 診斷書費 |
A1021 |
就醫證明 |
份 |
0 |
2 |
|
2 |
20 |
| 診斷書費 |
A1103 |
勞農保傷病診斷證明書副本 |
份 |
0 |
2 |
|
2 |
150 |
| 診斷書費 |
A1104 |
兵役診斷證明書副本 |
份 |
0 |
2 |
|
2 |
250 |
| 診斷書費 |
A1105 |
診斷證明書影印手續費 |
份 |
0 |
2 |
|
2 |
10 |
| 診斷書費 |
A1107 |
死產證明書 |
份 |
0 |
2 |
|
2 |
100 |
| 診斷書費 |
A1108 |
家庭暴力及性侵害事件驗傷診斷書 |
份 |
0 |
2 |
|
2 |
300 |
| 診斷書費 |
A1110 |
輔具評估報告表 |
份 |
0 |
2 |
|
2 |
200 |
| 診斷書費 |
A3001 |
費用明細表 |
份 |
0 |
2 |
|
2 |
50 |
| 診斷書費 |
A3002 |
費用明細表 |
份 |
0 |
2 |
|
2 |
100 |
| 病房費補差額 |
30902 |
單套病房費補差額 |
天 |
0 |
3 |
|
2 |
2,000 |
| 病房費補差額 |
30903 |
雙套病房費補差額 |
天 |
0 |
3 |
|
2 |
1,000 |
| 診察費 |
10913 |
醫師出診費(在宅鑑定) |
次 |
0 |
4 |
|
2 |
1,000 |
| 診察費 |
10914 |
出診訪視費(在宅鑑定)巴氏量表 |
次 |
0 |
4 |
|
2 |
2,000 |
| 病歷複印 |
A9001 |
X-Copy 膠片(每張) |
張 |
0 |
4.1 |
|
2 |
200 |
| 病歷複印 |
A9002 |
X-Copy 光碟(X-RAY) |
份 |
0 |
4.1 |
|
2 |
200 |
| 病歷複印 |
A9003 |
X-Copy 光碟(CT) |
份 |
0 |
4.1 |
|
2 |
200 |
| 病歷複印 |
A9004 |
X-Copy 光碟(MRI) |
份 |
0 |
4.1 |
|
2 |
200 |
| 病歷複印 |
A9007 |
病歷複印行政處理費 |
EA |
0 |
4.1 |
|
2 |
120 |
| 病歷複印 |
A90071 |
病歷/報告單張 |
EA |
0 |
4.1 |
|
2 |
5 |
| 病歷複印 |
A9008 |
拍立得相片 |
EA |
0 |
4.1 |
|
2 |
100 |
| 處置費 |
571903 |
嬰兒洗澡費 |
EA |
0 |
5 |
|
2 |
200 |
| 處置費 |
57117A |
新生兒托嬰(診.護.床) |
EA |
0 |
5 |
|
2 |
1,100 |
| 處置費 |
A04011 |
衛生所補助差額-女性結紮(非產後) |
EA |
0 |
5 |
|
2 |
2,500 |
| 處置費 |
A04012 |
衛生所補助差額-男性結紮 |
EA |
0 |
5 |
|
2 |
600 |
| 藥品費 |
A0500 |
戒菸貼片藥品自付額(一週量) |
EA |
0 |
6 |
|
2 |
250 |
| 藥品費 |
A05001 |
戒菸嚼片自付額(一週量) |
EA |
0 |
6 |
|
2 |
110 |
| 藥品費 |
A050011 |
戒菸Champix 0.5mg
11#自付額 |
EA |
0 |
6 |
|
2 |
500 |
| 藥品費 |
A050012 |
戒菸Champix 1.0mg
14#自付額 |
EA |
0 |
6 |
|
2 |
710 |
| 藥品費 |
IACLA |
ACLASTA(骨力強)
5MG/100ML
|
Bot |
0 |
6 |
0 |
1 |
18,000 |
| 藥品費 |
IACTH |
ACT-HIB (B型嗜血桿菌)
|
Vial |
0 |
6 |
0 |
1 |
900 |
| 藥品費 |
IALF |
Taibilone
20ml(Alinamin-F)
|
Amp |
0 |
6 |
0 |
1 |
20 |
| 藥品費 |
IBOTO |
BOTOX 100U
|
Vial |
0 |
6 |
|
1 |
13,500 |
| 藥品費 |
IDPT41 |
# 四合一疫苗 |
Amp |
0 |
6 |
|
1 |
1,400 |
| 藥品費 |
IDPTC |
DPT-C |
Vial |
0 |
6 |
|
1 |
500 |
| 藥品費 |
IDYNA |
Dynastat
40mg/5ml/vial
|
Vial |
0 |
6 |
0 |
1 |
500 |
| 藥品費 |
IGARD |
Gardasil 0.5ml
|
vail |
0 |
6 |
|
1 |
3,500 |
| 藥品費 |
IGSP |
G.S.P 100ml
|
Vial |
0 |
6 |
0 |
1 |
4,500 |
| 藥品費 |
IHBVX |
B-型肝炎疫苗(大人)
|
Vial |
0 |
6 |
|
1 |
450 |
| 藥品費 |
INEPH |
Nepheosteril
250ml
|
Vial |
0 |
6 |
|
1 |
455 |
| 藥品費 |
IOSTE |
Ostenil 20mg/2ml
|
EA |
0 |
6 |
|
1 |
2,500 |
| 藥品費 |
IPNEU |
Pneumovax
(肺炎球菌疫苗)
|
Vial |
0 |
6 |
|
1 |
1,200 |
| 藥品費 |
IPREV1 |
PREVENAR 0.5ml |
Vial |
0 |
6 |
|
1 |
3,200 |
| 藥品費 |
ISNMC |
Stronger
Neo-Minophag
|
Vial |
0 |
6 |
|
1 |
300 |
| 藥品費 |
ISPOR |
Spormin 500ml
|
Bot |
0 |
6 |
|
1 |
370 |
| 藥品費 |
IVAXI |
(自費)Vaxigrip
0.5ml
|
支 |
0 |
6 |
|
1 |
450 |
| 藥品費 |
IVAXI2 |
Vaxigrip
0.25(自費)
|
支 |
0 |
6 |
|
1 |
450 |
| 藥品費 |
IZOME |
ZOMETA POWDER FOR
SOL. FOR INFUSION |
Vial |
0 |
6 |
0 |
1 |
14,242 |
| 藥品費 |
OALF |
ALF 50mg (Johnvimin) |
Tab |
0 |
6 |
0 |
1 |
1 |
| 藥品費 |
OALUG |
Alugel 350mg
(Aluminum Hydroxide) |
Tab |
0 |
6 |
0 |
1 |
3 |
| 藥品費 |
OANTIB |
Antibiophilus Poeder
1500mg |
包 |
0 |
6 |
0 |
1 |
35 |
| 藥品費 |
OB2 |
B2 5mg(Riboflavin) |
Tab |
0 |
6 |
0 |
1 |
1 |
| 藥品費 |
OC |
Vit C 50mg (Ascorbic
Acid) |
Tab |
0 |
6 |
0 |
1 |
1 |
| 藥品費 |
OCALC |
Calcium carbonate
500mg |
Tab |
0 |
6 |
0 |
1 |
1 |
| 藥品費 |
OFANT5 |
Fanta 500ml |
Bot |
0 |
6 |
0 |
1 |
200 |
| 藥品費 |
OFLEE |
Fleet PHOSPO-SODA |
瓶 |
0 |
6 |
0 |
1 |
200 |
| 藥品費 |
OJUIC |
Juice HA 20mg/15ml |
SET |
0 |
6 |
|
1 |
3,000 |
| 藥品費 |
OLEDE |
Lederscon |
Tab |
0 |
6 |
0 |
1 |
3 |
| 藥品費 |
OLIVE1 |
(自費)Liver Favor 500mg |
SET |
0 |
6 |
|
1 |
3,600 |
| 藥品費 |
OLIVI |
Livial 2.5mg
(28Tab/盒) |
盒 |
0 |
6 |
0 |
1 |
1,100 |
| 藥品費 |
OMUCA |
Mucaine 10cc (Ulstal
suspension) |
包 |
0 |
6 |
0 |
1 |
15 |
| 藥品費 |
OPHYT |
Phyto Soyta 60tab/box |
盒 |
0 |
6 |
0 |
1 |
1,400 |
| 藥品費 |
OPROP |
Propecia 1mg
(Finasteride) |
Tab |
0 |
6 |
0 |
1 |
75 |
| 藥品費 |
OREDU |
Reductil
10mg(Sibutramine) |
盒 |
0 |
6 |
0 |
1 |
2,800 |
| 藥品費 |
OROTA |
Rotarix 1cc
(口服輪狀病毒疫苗) |
cc |
0 |
6 |
0 |
1 |
2,500 |
| 藥品費 |
OTAMI1 |
Tamiflu 75mg(自費) |
Cap |
0 |
6 |
0 |
1 |
110 |
| 藥品費 |
OVIAG1 |
Viagra
100mg(Sildenafil Citrate) |
Tab |
0 |
6 |
0 |
1 |
500 |
| 藥品費 |
OXENI84 |
Xenical(84顆/盒)
120mg(Orlistat) |
盒 |
0 |
6 |
0 |
1 |
3,200 |
| 藥品費 |
TBUTA |
Butaro Nasal Spray
10mg/ml |
Bot |
0 |
6 |
0 |
1 |
1,200 |
| 藥品費 |
TDERMA |
Dermatix 15g |
Tube |
0 |
6 |
0 |
1 |
1,950 |
| 藥品費 |
TDIFF |
Difflam Anti
Inflammatory Spray 1.5mg/ml |
Bot |
0 |
6 |
0 |
1 |
250 |
| 藥品費 |
TEVE220 |
舒摩兒潤澤凝露 |
SET |
0 |
6 |
|
1 |
220 |
| 藥品費 |
TEVE350 |
舒摩兒異敏舒緩防護露 |
SET |
0 |
6 |
|
1 |
350 |
| 藥品費 |
TEVE380 |
舒摩兒浴潔露 |
SET |
0 |
6 |
|
1 |
380 |
| 藥品費 |
TFORIK |
Froika Scar Gel
10ml(芙立康疤痕凝膠) |
Tube |
0 |
6 |
0 |
1 |
1,200 |
| 藥品費 |
TKING |
Kingistine 450gm |
瓶 |
0 |
6 |
0 |
1 |
390 |
| 藥品費 |
TMIAC1 |
Miacalcic Nasal Spray
200IU, 14dose |
Bot |
0 |
6 |
0 |
1 |
3,536 |
| 藥品費 |
TNEOM |
Neomycin 450gm |
罐 |
0 |
6 |
0 |
1 |
650 |
| 藥品費 |
TPOLYX |
Polyxal scar care
silicon gel 15g |
Tube |
0 |
6 |
0 |
1 |
1,890 |
| 藥品費 |
TPPP |
P.P Powder 1gm |
Pack |
0 |
6 |
0 |
1 |
5 |
| 注射技術費 |
39099 |
注射技射費 |
EA |
0 |
12 |
|
2 |
50 |
| 注射技術費 |
390901 |
注射技術費(針劑自備、預防注射、持連續注射卡) |
EA |
0 |
12 |
|
2 |
50 |
| 注射技術費 |
390915 |
流感疫苗技術費 |
EA |
0 |
12 |
|
2 |
150 |
| 特殊材料費 |
690901 |
(單腿施作)體內靜脈曲張雷射用光波導管 |
Each |
0 |
16 |
|
3 |
35,000 |
| 特殊材料費 |
690902 |
(雙腿施作)體內靜脈曲張雷射用光波導管 |
Each |
0 |
16 |
|
3 |
45,000 |
| 特殊材料費 |
690903 |
(每發)體外靜脈曲張雷射治療 |
Each |
0 |
16 |
|
3 |
20 |
| 特殊材料費 |
CA61001 |
替換式尿片30片/包 |
包 |
0 |
16 |
|
3 |
130 |
| 特殊材料費 |
CA70001 |
紙褲 |
包 |
0 |
16 |
|
3 |
45 |
| 特殊材料費 |
G011100 |
衛生紙120抽/包 |
Each |
0 |
16 |
|
3 |
20 |
| 特殊材料費 |
G020002 |
產墊一片 |
片 |
0 |
16 |
|
3 |
10 |
| 特殊材料費 |
G021001 |
替換式尿片(片) |
Each |
0 |
16 |
|
3 |
5 |
| 特殊材料費 |
G030101 |
紙尿褲(64片)Baby |
Each |
0 |
16 |
|
3 |
360 |
| 特殊材料費 |
G030203 |
成人尿褲(片) |
Each |
0 |
16 |
|
3 |
15 |
| 特殊材料費 |
G412011 |
鹼性電池(二個) |
Each |
0 |
16 |
|
3 |
35 |
| 特殊材料費 |
G901023 |
病人服 |
Each |
0 |
16 |
|
3 |
250 |
| 特殊材料費 |
G901024 |
床單 |
Each |
0 |
16 |
|
3 |
250 |
| 特殊材料費 |
K1Q0101 |
濕紙巾(ICU,7F) |
Each |
0 |
16 |
|
3 |
45 |
| 特殊材料費 |
K1Q0102 |
濕紙巾(Baby用) |
Each |
0 |
16 |
|
3 |
60 |
| 特殊材料費 |
K2B0201 |
血管區別帶 |
Each |
0 |
16 |
|
3 |
180 |
| 特殊材料費 |
K5B0001 |
樂母麗 |
Each |
0 |
16 |
|
3 |
360 |
| 特殊材料費 |
K5B0375 |
母體樂 |
Each |
0 |
16 |
|
3 |
360 |
| 特殊材料費 |
K5C0001 |
奶嘴 |
個 |
0 |
16 |
|
3 |
50 |
| 特殊材料費 |
K5D0001 |
臉盆 |
個 |
0 |
16 |
|
3 |
50 |
| 特殊材料費 |
K5E0001 |
吸痰球 |
Each |
0 |
16 |
|
3 |
100 |
| 特殊材料費 |
K5F0001 |
拋棄式鴨嘴(S) |
Each |
0 |
16 |
|
3 |
50 |
| 特殊材料費 |
K5F0002 |
拋棄式鴨嘴(M) |
Each |
0 |
16 |
|
3 |
50 |
| 特殊材料費 |
K5G0001 |
生理沖洗壺 |
Each |
0 |
16 |
|
3 |
50 |
| 特殊材料費 |
K5H0003 |
刻度吸管3cc |
Each |
0 |
16 |
|
3 |
1 |
| 特殊材料費 |
K5I0001 |
布手套 |
付 |
0 |
16 |
|
3 |
50 |
| 特殊材料費 |
K5K0104 |
子宮頸抹片刷-排刷 |
Each |
0 |
16 |
|
3 |
50 |
| 特殊材料費 |
K5K0201 |
螢光抹片棒 |
Each |
0 |
16 |
|
3 |
800 |
| 特殊材料費 |
K5K0301 |
DigeneHPVDNATest護妳DNA抹片棒檢測 |
Each |
0 |
16 |
|
3 |
1,200 |
| 特殊材料費 |
K610101 |
肛溫計 |
Each |
0 |
16 |
|
3 |
30 |
| 特殊材料費 |
K610201 |
體溫計 |
Each |
0 |
16 |
|
3 |
30 |
| 特殊材料費 |
K610301 |
婦人體溫計 |
支 |
0 |
16 |
|
3 |
150 |
| 特殊材料費 |
K620101 |
肛溫計 |
Each |
0 |
16 |
|
3 |
30 |
| 特殊材料費 |
K630301 |
婦人體溫計 |
支 |
0 |
16 |
|
3 |
150 |
| 特殊材料費 |
K640001 |
耳溫套(一般大人) |
個 |
0 |
16 |
|
3 |
5 |
| 特殊材料費 |
K640002 |
耳溫套(小兒用) |
個 |
0 |
16 |
|
3 |
5 |
| 特殊材料費 |
K990101 |
Dlimaima(海草桿) |
Each |
0 |
16 |
|
3 |
250 |
| 特殊材料費 |
K990501 |
LoopOstomyRod(結腸支橕棒) |
Each |
0 |
16 |
|
3 |
180 |
| 特殊材料費 |
KA60070 |
灌食空針70cc(OR用) |
支 |
0 |
16 |
|
3 |
40 |
| 特殊材料費 |
KA70080 |
骨水泥塑膠筒80g(雷得) |
Each |
0 |
16 |
|
3 |
1,950 |
| 特殊材料費 |
KA70180 |
骨水泥注入器(互裕) |
Each |
0 |
16 |
|
3 |
2,160 |
| 特殊材料費 |
KA769Z1 |
CartridgeKit(Injector) |
Each |
0 |
16 |
|
3 |
1,871 |
| 特殊材料費 |
KB60100 |
RF Needle 100mm |
支 |
0 |
16 |
|
3 |
3,000 |
| 特殊材料費 |
KC60523 |
膀胱鏡注射針WilluamsCystoscopicInjectionNeedle |
支 |
0 |
16 |
|
3 |
2,160 |
| 特殊材料費 |
KE80001 |
石膏鞋 |
Each |
0 |
16 |
|
3 |
600 |
| 特殊材料費 |
KF40540 |
UrgoStrips(美容膠) |
Each |
0 |
16 |
|
3 |
100 |
| 特殊材料費 |
KF41542 |
MR1542免縫膠帶 |
包 |
0 |
16 |
|
3 |
120 |
| 特殊材料費 |
KGF3030 |
Gauze30*30(大紗) |
匹 |
0 |
16 |
|
3 |
520 |
| 特殊材料費 |
KGH0309 |
SUFUCIN人生舒膚淨紗布 |
Each |
0 |
16 |
|
3 |
20 |
| 特殊材料費 |
KGI3582 |
Tefaderm+Pad5*7 |
Each |
0 |
16 |
|
3 |
20 |
| 特殊材料費 |
KGI3584 |
Tefaderm+Pad6*10 |
Each |
0 |
16 |
|
3 |
30 |
| 特殊材料費 |
KGI3586 |
Tefaderm+Pad9*10 |
Each |
0 |
16 |
|
3 |
40 |
| 特殊材料費 |
KGI3589 |
Tefaderm+Pad9*15 |
Each |
0 |
16 |
|
3 |
60 |
| 特殊材料費 |
KGI3590 |
Tefaderm+Pad9*20 |
Each |
0 |
16 |
|
3 |
70 |
| 特殊材料費 |
KGI3591 |
Tefaderm+Pad9*25 |
Each |
0 |
16 |
|
3 |
80 |
| 特殊材料費 |
KHA1520 |
LumboperitonealShutT-Tuble脊髓空洞 |
Each |
0 |
16 |
|
3 |
15,000 |
| 特殊材料費 |
KHB3100 |
CHPV System with
Prechamber(可調VP Shunt |
Each |
0 |
16 |
|
3 |
60,000 |
| 特殊材料費 |
KHX0460 |
TracheaCannula氣切套管(鐵) |
Each |
0 |
16 |
|
3 |
1,500 |
| 特殊材料費 |
KJ66632 |
ICPMicrosensorICPBoltKit826632 |
Each |
0 |
16 |
|
3 |
24,000 |
| 特殊材料費 |
KJ70047 |
脊髓測壓器 |
Each |
0 |
16 |
|
3 |
936 |
| 特殊材料費 |
KJJ0050 |
Over-The Wire Graft
Cleaning Catheter 5Fr |
Each |
0 |
16 |
|
3 |
9,000 |
| 特殊材料費 |
KKM0018 |
Michel201-36818.0mm |
Each |
0 |
16 |
|
3 |
84 |
| 特殊材料費 |
KKM8037 |
ApposeULCDisposableskinstapler&stapleremove8037-12 |
Each |
0 |
16 |
|
3 |
420 |
| 特殊材料費 |
KKP1131 |
PCEEA31高級拋棄式灣型端對端自動縫合器31 |
Each |
0 |
16 |
|
3 |
12,000 |
| 特殊材料費 |
KKTPH33 |
環狀痔瘡切除器(PPH33mm) |
|
0 |
16 |
|
3 |
18,000 |
| 特殊材料費 |
KKU0001 |
多環食道靜脈曲張結紮器(拋棄式) |
Each |
0 |
16 |
|
3 |
5,200 |
| 特殊材料費 |
KL12132 |
Lapack12132人工肛門袋 |
個 |
0 |
16 |
|
3 |
55 |
| 特殊材料費 |
KL20001 |
Bedpan(便盆-塑膠) |
Each |
0 |
16 |
|
3 |
150 |
| 特殊材料費 |
KL21001 |
尿壺-塑膠 |
Each |
0 |
16 |
|
3 |
100 |
| 特殊材料費 |
KL22102 |
Lapack12102人工肛門膜 |
個 |
0 |
16 |
|
3 |
200 |
| 特殊材料費 |
KL23722 |
人工肛門膜44mm/3722 |
個 |
0 |
16 |
|
3 |
220 |
| 特殊材料費 |
KL23723 |
人工肛門膜57mm/3723 |
個 |
0 |
16 |
|
3 |
220 |
| 特殊材料費 |
KL23724 |
人工肛門膜70mm/3724 |
個 |
0 |
16 |
|
3 |
220 |
| 特殊材料費 |
KL23764 |
人工肛門膜3764(13-57mm) |
個 |
0 |
16 |
|
3 |
190 |
| 特殊材料費 |
KL70001 |
自動傷口沖洗器Pulsavacplusfanspraykit(ZIMMER) |
Each |
0 |
16 |
|
3 |
2,574 |
| 特殊材料費 |
KLA0250 |
血袋單袋250ML |
Each |
0 |
16 |
|
3 |
150 |
| 特殊材料費 |
KLD0002 |
Uridrop-尿套一卷 |
Each |
0 |
16 |
|
3 |
200 |
| 特殊材料費 |
KLD3060 |
Endobag3*6 |
Each |
0 |
16 |
|
3 |
1,620 |
| 特殊材料費 |
KLD5080 |
Endobag5*8 |
Each |
0 |
16 |
|
3 |
2,160 |
| 特殊材料費 |
KLG0250 |
EMPTYCONTAINER250cc |
組 |
0 |
16 |
|
3 |
1,500 |
| 特殊材料費 |
KLN1021 |
噴藥輔助器 |
個 |
0 |
16 |
|
3 |
600 |
| 特殊材料費 |
KM40201 |
可調式頸圈Selectolar) |
Each |
0 |
16 |
|
3 |
1,200 |
| 特殊材料費 |
KM40202 |
頸圈-小(可調式) |
Each |
0 |
16 |
|
3 |
700 |
| 特殊材料費 |
KM41200 |
頸圈(藍)MJ |
Each |
0 |
16 |
|
3 |
2,400 |
| 特殊材料費 |
KM42001 |
頸圈(白)S |
Each |
0 |
16 |
|
3 |
1,200 |
| 特殊材料費 |
KM44000 |
Vista六段式可調頸圈(#984000) |
EA |
0 |
16 |
|
3 |
4,800 |
| 特殊材料費 |
KM70001 |
助行器 |
Each |
0 |
16 |
|
3 |
1,500 |
| 特殊材料費 |
KM70002 |
四腳拐 |
Each |
0 |
16 |
|
3 |
800 |
| 特殊材料費 |
KM70038 |
枴杖 |
付 |
0 |
16 |
|
3 |
600 |
| 特殊材料費 |
KM81002 |
軟背架 |
個 |
0 |
16 |
|
3 |
750 |
| 特殊材料費 |
KM83010 |
QUIK DRAW 護腰 |
EA |
0 |
16 |
|
3 |
5,500 |
| 特殊材料費 |
KOD0102 |
自費簡診手套M |
Box |
0 |
16 |
|
3 |
150 |
| 特殊材料費 |
KP61028 |
電極片L-102-8鈕扣式 |
包 |
0 |
16 |
|
3 |
350 |
| 特殊材料費 |
KR30001 |
Dermatomeblade(取皮刀片) |
Each |
0 |
16 |
|
3 |
1,500 |
| 特殊材料費 |
KR30010 |
Dermatomeblade植皮刀片 |
Each |
0 |
16 |
|
3 |
1,500 |
| 特殊材料費 |
KSA0104 |
Spinecath intradiscal
cather4pin+introducerNeedlestandard |
Each |
0 |
16 |
|
3 |
57,600 |
| 特殊材料費 |
KU10001 |
黃疸眼罩 |
個 |
0 |
16 |
|
3 |
150 |
| 特殊材料費 |
KU10101 |
FACEMASK |
盒 |
0 |
16 |
|
3 |
100 |
| 特殊材料費 |
KU71002 |
AmbuDispossible |
個 |
0 |
16 |
|
3 |
990 |
| 特殊材料費 |
KV20001 |
臍護包 |
包 |
0 |
16 |
|
3 |
80 |
| 特殊材料費 |
KV40980 |
Side Fiber SF 980 DL |
Each |
0 |
16 |
|
3 |
150,000 |
| 特殊材料費 |
KV41900 |
TUNATherapyAccessories1900 |
Each |
0 |
16 |
|
3 |
57,600 |
| 特殊材料費 |
KV43128 |
輸尿管氣化切除用雷射光纖 |
Each |
0 |
16 |
|
3 |
75,000 |
| 特殊材料費 |
KV43213 |
攝護腺氣化切除用雷射光纖 |
Each |
0 |
16 |
|
3 |
150,000 |
| 特殊材料費 |
KV44291 |
開顱大單E附過濾篩集水袋BC4291E |
Each |
0 |
16 |
|
3 |
480 |
| 特殊材料費 |
KV45220 |
膀胱鏡檢包BC5220FC(拋棄式) |
Each |
0 |
16 |
|
3 |
450 |
| 特殊材料費 |
KV46236 |
NSD產包DeliveryPeck |
Each |
0 |
16 |
|
3 |
150 |
| 特殊材料費 |
KV49012 |
骨科基本防水防護系統 9012A |
Each |
0 |
16 |
|
3 |
2,100 |
| 特殊材料費 |
KWB0100 |
ArtificalLigamentAC |
Each |
0 |
16 |
|
3 |
64,000 |
| 特殊材料費 |
KWB0110 |
ArtificalLigamentPPLY110 |
Each |
0 |
16 |
|
3 |
64,000 |
| 特殊材料費 |
KWB06NF |
12062.5mm*6mmScrew |
Each |
0 |
16 |
|
3 |
2,436 |
| 特殊材料費 |
KWB07NF |
12072.5mm*8mmScrew |
Each |
0 |
16 |
|
3 |
2,436 |
| 特殊材料費 |
KWB10DP |
CerviFix Screw |
Each |
0 |
16 |
|
3 |
13,230 |
| 特殊材料費 |
KWB20DP |
CerviFix Rod summit |
Each |
0 |
16 |
|
3 |
7,560 |
| 特殊材料費 |
KWB24NF |
12242.0mm*7mmscrew(5)+2.5*8mm(1)screw |
包 |
0 |
16 |
|
3 |
15,084 |
| 特殊材料費 |
KWB25NF |
12252.0mm*7mmscrew(5)+2.5*8mm(1)screw |
包 |
0 |
16 |
|
3 |
15,084 |
| 特殊材料費 |
KWB26NF |
12263.1mm*10mmScrew |
Each |
0 |
16 |
|
3 |
7,200 |
| 特殊材料費 |
KWB27NF |
12273.1mm*12mmScrew |
Each |
0 |
16 |
|
3 |
7,200 |
| 特殊材料費 |
KWB28NF |
12283.1mm*14mmScrew |
Each |
0 |
16 |
|
3 |
7,200 |
| 特殊材料費 |
KWB29NF |
12293.1mm*16mmScrew |
Each |
0 |
16 |
|
3 |
7,200 |
| 特殊材料費 |
KWB30NF |
12303.1mm*18mmScrew |
Each |
0 |
16 |
|
3 |
7,200 |
| 特殊材料費 |
KWB4503 |
Matrix Neuro Screw |
Vial |
0 |
16 |
|
3 |
1,950 |
| 特殊材料費 |
KWB90NF |
12902.5mm10/12/14/16/18mmscrew |
包 |
0 |
16 |
|
3 |
11,400 |
| 特殊材料費 |
KWB94NF |
12942.5mm*10/12/14/16/18mm |
包 |
0 |
16 |
|
3 |
11,400 |
| 特殊材料費 |
KWB97NF |
12972.8mm*10/12/14/16/18mmscrew |
包 |
0 |
16 |
|
3 |
11,400 |
| 特殊材料費 |
KWC5360 |
395.360ScoketWrnch |
Each |
0 |
16 |
|
3 |
3,500 |
| 特殊材料費 |
KWC5520 |
395.520OpenClamp |
Each |
0 |
16 |
|
3 |
9,334 |
| 特殊材料費 |
KWC5530 |
395.530CliseClamp |
Each |
0 |
16 |
|
3 |
9,334 |
| 特殊材料費 |
KWC5560 |
395.560Clamp4.0/2.5mm |
Each |
0 |
16 |
|
3 |
5,730 |
| 特殊材料費 |
KWC5570 |
395.570Clampdiam.4.0/4.0mm |
Each |
0 |
16 |
|
3 |
5,730 |
| 特殊材料費 |
KWC5700 |
395.700ConnectingBars |
Each |
0 |
16 |
|
3 |
400 |
| 特殊材料費 |
KWC5710 |
395.710ConnectingBars |
Each |
0 |
16 |
|
3 |
400 |
| 特殊材料費 |
KWC5720 |
395.720ConnectingBars |
Each |
0 |
16 |
|
3 |
400 |
| 特殊材料費 |
KWC5730 |
395.730ConnectingBars |
Each |
0 |
16 |
|
3 |
400 |
| 特殊材料費 |
KWC5740 |
395.740ConnectingBars |
Each |
0 |
16 |
|
3 |
400 |
| 特殊材料費 |
KWC5750 |
395.750ConnectingBars |
Each |
0 |
16 |
|
3 |
400 |
| 特殊材料費 |
KWC5760 |
395.760ConnectingBars |
Each |
0 |
16 |
|
3 |
634 |
| 特殊材料費 |
KWC5770 |
395.770ConnectingBars |
Each |
0 |
16 |
|
3 |
634 |
| 特殊材料費 |
KWE0423 |
3.5 LC-LCP
423.541-441.861 |
Each |
0 |
16 |
|
3 |
36,000 |
| 特殊材料費 |
KWE0424 |
4.5 LC-LCP
424.541-440.461 |
Each |
0 |
16 |
|
3 |
36,000 |
| 特殊材料費 |
KWE0439 |
LCP Anterolateral
Distal Tibia Plate 441.444~441.445.453,439 |
Each |
0 |
16 |
|
3 |
78,000 |
| 特殊材料費 |
KWE0441 |
LCP Anterolateral
Distal Tibia Plate 441.444~441.445.453,439 |
Each |
0 |
16 |
|
3 |
58,000 |
| 特殊材料費 |
KWE05NF |
10051.5mmCPS4holePlate |
Each |
0 |
16 |
|
3 |
9,144 |
| 特殊材料費 |
KWE06NF |
10061.5mmCPS6holePlate |
Each |
0 |
16 |
|
3 |
10,188 |
| 特殊材料費 |
KWE1062 |
AOHookPlate241.062 |
Each |
0 |
16 |
|
3 |
22,500 |
| 特殊材料費 |
KWE1063 |
241.063CLAVICLEHOOKPLATE3.54H |
Each |
0 |
16 |
|
3 |
22,500 |
| 特殊材料費 |
KWE1064 |
241.064CLAVICLEHOOKPLATE3.54H |
Each |
0 |
16 |
|
3 |
22,500 |
| 特殊材料費 |
KWE13NF |
10132.0mmCPS4holePlate |
Each |
0 |
16 |
|
3 |
8,364 |
| 特殊材料費 |
KWE14NF |
10142.0mmCPS4holePlate,extended |
Each |
0 |
16 |
|
3 |
9,144 |
| 特殊材料費 |
KWE16NF |
10162.0mmCPS10holePlate |
Each |
0 |
16 |
|
3 |
16,440 |
| 特殊材料費 |
KWE23NF |
10232.5mmCPS4holePlate |
Each |
0 |
16 |
|
3 |
6,540 |
| 特殊材料費 |
KWE24NF |
10242.5mmCPS4holePlate,extended |
Each |
0 |
16 |
|
3 |
6,804 |
| 特殊材料費 |
KWE25NF |
10252.5mmCPS6holePlate |
Each |
0 |
16 |
|
3 |
8,364 |
| 特殊材料費 |
KWE26NF |
10262.5mmCPS6holePlate,extended |
Each |
0 |
16 |
|
3 |
8,616 |
| 特殊材料費 |
KWE27NF |
10272.5mmCPS8holePlate |
Each |
0 |
16 |
|
3 |
10,188 |
| 特殊材料費 |
KWE36NF |
10362.5mmCPS10holePlate |
Each |
0 |
16 |
|
3 |
12,000 |
| 特殊材料費 |
KWE38NF |
10382.0mmCPS6holePlate,Orthognathic |
Each |
0 |
16 |
|
3 |
9,144 |
| 特殊材料費 |
KWE45DP |
CerviFix Occiput Rod
31mm:45mm |
Each |
0 |
16 |
|
3 |
35,280 |
| 特殊材料費 |
KWH62Z1 |
超耐磨墊片 |
Each |
0 |
16 |
|
3 |
55,000 |
| 特殊材料費 |
KWO1NZ1 |
TibialHalfWedge金屬墊片 |
Each |
0 |
16 |
|
3 |
5,000 |
| 特殊材料費 |
KWO2232 |
卡伯拉利鋼索固定針Cable Pin |
Each |
0 |
16 |
|
3 |
33,000 |
| 特殊材料費 |
KWP0512 |
人工髓核SOLO-5H:5mm；W:12mm |
Vial |
0 |
16 |
|
3 |
120,000 |
| 特殊材料費 |
KWP07W2 |
陶瓷對陶瓷人工髖關節(健保差額) |
Each |
0 |
16 |
|
3 |
72,000 |
| 特殊材料費 |
KWQ0015 |
布恩頸椎人工關節15MM221-07041 |
組 |
0 |
16 |
|
3 |
280,000 |
| 特殊材料費 |
KWQ00DP |
CerviFix Link(summit) |
Each |
0 |
16 |
|
3 |
18,900 |
| 特殊材料費 |
KWQ00M8 |
CDHorizonM8SextantPercutaneousSpinalSystem |
組 |
0 |
16 |
|
3 |
72,000 |
| 特殊材料費 |
KWQ0101 |
DynesysSpinalSystem一節 |
組 |
0 |
16 |
|
3 |
32,000 |
| 特殊材料費 |
KWQ0102 |
DynesysSpinalSystem二節 |
組 |
0 |
16 |
|
3 |
76,000 |
| 特殊材料費 |
KWQ0103 |
DynesysSpinalSystem三節 |
組 |
0 |
16 |
|
3 |
98,000 |
| 特殊材料費 |
KWQ0170 |
Dynesys
Universal Spacer 01.03706.045 |
BOX |
0 |
16 |
|
3 |
18,000 |
| 特殊材料費 |
KWQ0173 |
Dynesys Cord
01.03731.100:200 |
BOX |
0 |
16 |
|
3 |
24,000 |
| 特殊材料費 |
KWQ0176 |
Dynesys Pedicle Screw
01.03760:72.035:055 |
BOX |
0 |
16 |
|
3 |
18,000 |
| 特殊材料費 |
KWQ01M8 |
SEXTANT 3節 |
組 |
0 |
16 |
|
3 |
96,000 |
| 特殊材料費 |
KWQ0202 |
(K-Rod 2 Level)Thend
Spinal Fixation System |
組 |
0 |
16 |
|
3 |
76,000 |
| 特殊材料費 |
KWQ0203 |
(K-Rod 3 Level)Thend
Spinal Fixation System |
組 |
0 |
16 |
|
3 |
98,000 |
| 特殊材料費 |
KWQ0204 |
(K-Rod 4 Level)Thend
Spinal Fixation System |
組 |
0 |
16 |
|
3 |
130,000 |
| 特殊材料費 |
KWQ0302 |
PEEK RODS Spinal
System 二節 |
組 |
0 |
16 |
|
3 |
76,000 |
| 特殊材料費 |
KWQ0303 |
PEEK RODS Spinal
System 3節 |
組 |
0 |
16 |
|
3 |
98,000 |
| 特殊材料費 |
KWQ08DP |
OPAL椎間盤支架Oplique
Posterior Atraumatic Lumbar Cage syste |
組 |
0 |
16 |
|
3 |
78,000 |
| 特殊材料費 |
KWQ15AE |
雅氏頸椎人工關節15MM |
組 |
0 |
16 |
|
3 |
280,000 |
| 特殊材料費 |
KWQ15DP |
(信迪思)人工椎間盤ProdiscL/Prodisc-C |
組 |
0 |
16 |
|
3 |
280,000 |
| 特殊材料費 |
KWQ20DP |
3.00mm*120mmRod(summit) |
Each |
0 |
16 |
|
3 |
7,560 |
| 特殊材料費 |
KWQ84M4 |
"長安"腰椎間融合器BMI
Lumbar Spinal Cage |
組 |
0 |
16 |
|
3 |
78,000 |
| 特殊材料費 |
KWS18B0 |
C1-C2 Cervical
Fixation System |
Each |
0 |
16 |
|
3 |
52,000 |
| 特殊材料費 |
KWT01AB |
杏捷CAGE |
Each |
0 |
16 |
|
3 |
39,000 |
| 特殊材料費 |
KWT01DP |
Plivios/Cervios
Cage(鼎邦) |
Each |
0 |
16 |
|
3 |
39,000 |
| 特殊材料費 |
KWT01JJ |
AcroMedI/FCAGE |
Each |
0 |
16 |
|
3 |
39,000 |
| 特殊材料費 |
KWT01M4 |
"Medtronic"Cornerstone-SR
Cage System |
Each |
0 |
16 |
|
3 |
39,000 |
| 特殊材料費 |
KWT01S9 |
PeekCAGE |
Each |
0 |
16 |
|
3 |
39,000 |
| 特殊材料費 |
KWT01Z8 |
先鴻CAGE |
Each |
0 |
16 |
|
3 |
39,000 |
| 特殊材料費 |
KWT02Z8 |
BodyCage-Hollowtube冠亞 |
Each |
0 |
16 |
|
3 |
65,000 |
| 特殊材料費 |
KWT0NZ1 |
TM-100 Spinal System |
Each |
0 |
16 |
|
3 |
54,000 |
| 特殊材料費 |
KWT30DP |
SynMeshImplants椎間植入物1節 |
Each |
0 |
16 |
|
3 |
72,000 |
| 特殊材料費 |
KWT31DP |
2節(31mm)SynMeshImplants椎間植入物 |
Each |
0 |
16 |
|
3 |
108,000 |
| 特殊材料費 |
KWT5NZ1 |
TM-500 Spinal System |
Each |
0 |
16 |
|
3 |
83,000 |
| 特殊材料費 |
KXC04RW |
人工代用骨(浦登仕4cc) |
Each |
0 |
16 |
|
3 |
57,500 |
| 特殊材料費 |
KXC05RW |
人工代用骨(艾羅麥5cc) |
Each |
0 |
16 |
|
3 |
72,000 |
| 特殊材料費 |
KXC0601 |
人工代用骨(艾羅麥1cc) |
Each |
0 |
16 |
|
3 |
18,000 |
| 特殊材料費 |
KXC10RW |
人工代用骨(浦登仕10cc) |
Each |
0 |
16 |
|
3 |
85,000 |
| 特殊材料費 |
KXG0005 |
Floseal伏血凝止血劑5ml
Hemostatic Matrix |
SET |
0 |
16 |
RA |
3 |
16,400 |
| 特殊材料費 |
KXJ0303 |
Mesh Plate |
Vial |
0 |
16 |
|
3 |
20,750 |
| 特殊材料費 |
KXJ0304 |
防止沾粘片3*4(intrceed) |
Vial |
0 |
16 |
|
3 |
6,000 |
| 特殊材料費 |
KXJ1010 |
Mesh P1 1.3 10CM*10CM |
Vial |
0 |
16 |
|
3 |
76,960 |
| 特殊材料費 |
KXK0010 |
復凝合劑Tissucol Duo
Quick"Baxter" |
Vial |
0 |
16 |
|
3 |
21,000 |
| 特殊材料費 |
KXK1010 |
皮膚超薄型敷料10*10cm |
Each |
0 |
16 |
|
3 |
110 |
| 特殊材料費 |
KXK10SQ |
AQUACEL HYDROFIBER
DRESSING WTIH SILVER 15X15CM |
Each |
0 |
16 |
RA |
3 |
648 |
| 特殊材料費 |
KXK1515 |
皮膚超薄型敷料15*15cm |
Each |
0 |
16 |
|
3 |
198 |
| 特殊材料費 |
KXQ01DP |
Cement 低溫健伸自費骨水泥_健伸 |
Each |
0 |
16 |
|
3 |
20,000 |
| 特殊材料費 |
KXQ01JJ |
Cement 締克自費 |
Each |
0 |
16 |
|
3 |
20,000 |
| 特殊材料費 |
KXQ01M4 |
維克疏骨自費 |
Each |
0 |
16 |
|
3 |
72,000 |
| 特殊材料費 |
KXQ2001 |
DISC-O-TECHCEMENT |
Each |
0 |
16 |
|
3 |
72,000 |
| 膳食費 |
051901 |
早餐一餐 |
EA |
0 |
28 |
|
2 |
35 |
| 膳食費 |
051902 |
午餐或晚餐 |
EA |
0 |
28 |
|
2 |
50 |
| 膳食費 |
051906 |
(治療伙食)早餐 |
EA |
0 |
28 |
|
2 |
35 |
| 膳食費 |
051907 |
(治療伙食)午餐 |
EA |
0 |
28 |
|
2 |
70 |
| 膳食費 |
051908 |
(治療伙食)晚餐 |
EA |
0 |
28 |
|
2 |
70 |
| 救護車費 |
C437 |
救護車費-基本費(5公里內)EMT1技術員另計 |
EA |
0 |
29 |
|
2 |
500 |
| 救護車費 |
|
救護車費_超過5公里(每一公里) |
EA |
|
29 |
|
|
20 |
| 手術費 |
80699 |
輸卵管輸卵管吻合術 |
EA |
0 |
32 |
|
2 |
30,000 |
| 手術費 |
81004 |
自行要求剖腹產 |
EA |
0 |
32 |
|
2 |
12,482 |
| 手術費 |
649903 |
Palatoplasty--secondary
repair |
EA |
0 |
32 |
|
2 |
20,000 |
| 手術費 |
784901 |
陰莖重度彎曲矯正術 |
EA |
0 |
32 |
RA |
2 |
14,000 |
| 手術費 |
790901 |
男性輸精管結紮 |
EA |
0 |
32 |
RA |
2 |
5,000 |
| 手術費 |
806901 |
輸卵管結紮術(剖腹產後並行) |
EA |
0 |
32 |
|
2 |
4,500 |
| 手術費 |
806902 |
輸卵管結紮術(自然產後或單純結紮) |
EA |
0 |
32 |
|
2 |
5,250 |
| 手術費 |
806903 |
輸卵管結紮術(腹腔鏡)含腹腔穿刺針 |
EA |
0 |
32 |
|
2 |
9,000 |
| 手術費 |
810901 |
人工流產衛生所補助 |
EA |
0 |
32 |
|
2 |
1,000 |
| 麻醉費 |
96991 |
無痛分娩(日間) |
EA |
0 |
33 |
|
2 |
4,500 |
| 麻醉費 |
96992 |
表面麻醉 EMLA |
EA |
0 |
33 |
|
2 |
250 |
| 麻醉費 |
96993 |
Epidural
block(硬脊膜下麻醉阻斷術) |
EA |
0 |
33 |
|
2 |
3,000 |
| 麻醉費 |
96999 |
麻醉術後止痛術(PCA 另計) |
EA |
0 |
33 |
|
2 |
4,000 |
| 麻醉費 |
960901 |
無痛分娩(日間) |
EA |
0 |
33 |
|
2 |
4,500 |
| 麻醉費 |
960902 |
無痛分娩(小夜) |
EA |
0 |
33 |
|
2 |
5,500 |
| 麻醉費 |
960903 |
無痛分娩(大夜) |
EA |
0 |
33 |
|
2 |
7,000 |
| 麻醉費 |
960904 |
表面麻醉EMLA |
EA |
0 |
33 |
|
2 |
250 |
| 麻醉費 |
960905 |
麻醉術後止痛術 |
EA |
0 |
33 |
|
2 |
4,000 |
| 麻醉費 |
960906 |
麻醉自費差額 |
EA |
0 |
33 |
|
2 |
3,505 |
| 麻醉費 |
969992 |
麻醉術後止痛術(EPOPC) |
EA |
0 |
33 |
|
2 |
4,000 |
| 麻醉費 |
96027C |
PCA(五天以內) |
EA |
0 |
33 |
|
2 |
4,500 |
| 麻醉費 |
96991E |
無痛分娩(小夜) |
EA |
0 |
33 |
|
2 |
5,500 |
| 麻醉費 |
96991N |
無痛分娩(大夜) |
EA |
0 |
33 |
|
2 |
7,000 |
| 麻醉費 |
KD60001 |
PCA Set |
組 |
0 |
33 |
|
3 |
2,000 |
| 檢查費 |
320901 |
健檢：腰椎X光檢查 |
EA |
0 |
35 |
|
2 |
250 |
| 檢查費 |
320902 |
健檢：胸部X光檢查 |
EA |
0 |
35 |
|
2 |
200 |
| 檢查費 |
32001CA |
Chest PA(健檢用) |
EA |
0 |
35 |
|
2 |
200 |
| 檢查費 |
32006CA |
K.U.B.(健檢用) |
EA |
0 |
35 |
|
2 |
200 |
| 檢查費 |
33064B1 |
健檢:X光骨骼密度測定 |
EA |
0 |
35 |
|
2 |
800 |
| 檢查費 |
A233902 |
全球人壽-Chest PA(健檢用) |
EA |
0 |
35 |
|
2 |
300 |
| 檢查費 |
A233903 |
全球人壽-子宮抹片檢查 |
EA |
0 |
35 |
|
2 |
350 |
| 檢查費 |
A233905 |
全球人壽-尿液檢查 |
EA |
0 |
35 |
|
2 |
70 |
| 檢查費 |
12999 |
Gonozyme |
EA |
0 |
37 |
|
2 |
600 |
| 檢查費 |
65902 |
Amphetamine (定量) |
EA |
0 |
37 |
|
7 |
600 |
| 檢查費 |
65904 |
Morphine(定量) |
EA |
0 |
37 |
|
7 |
600 |
| 檢查費 |
65908 |
Cannabis(定量) |
EA |
0 |
37 |
|
7 |
600 |
| 檢查費 |
65909 |
MDMA(定性) |
EA |
0 |
37 |
|
7 |
800 |
| 檢查費 |
90901 |
先天性腎上腺增生症 |
EA |
0 |
37 |
|
7 |
100 |
| 檢查費 |
90902 |
罕見先天性代謝異常疾病篩檢 |
EA |
0 |
37 |
|
7 |
300 |
| 檢查費 |
91901 |
VIT-D |
EA |
0 |
37 |
|
7 |
2,000 |
| 檢查費 |
91902 |
VIT-E |
EA |
0 |
37 |
|
7 |
1,000 |
| 檢查費 |
108901 |
Ketamine (K他命) |
EA |
0 |
37 |
|
7 |
2,100 |
| 檢查費 |
120901 |
CA72-4 |
EA |
0 |
37 |
|
7 |
800 |
| 檢查費 |
120902 |
NSE |
EA |
0 |
37 |
|
7 |
1,000 |
| 檢查費 |
120904 |
Cord Blood IgE
(臍帶血免疫球蛋白E) |
EA |
0 |
37 |
|
7 |
400 |
| 檢查費 |
120905 |
健檢：CA153 |
EA |
0 |
37 |
|
7 |
500 |
| 檢查費 |
120906 |
健檢：NT-pro BNP |
EA |
0 |
37 |
|
2 |
1,500 |
| 檢查費 |
120907 |
SMA基因檢測 |
EA |
0 |
37 |
|
7 |
3,200 |
| 檢查費 |
120908 |
Down Syndrome 四指標 |
EA |
0 |
37 |
|
7 |
2,400 |
| 檢查費 |
120909 |
健檢：CA153 |
EA |
0 |
37 |
|
7 |
500 |
| 檢查費 |
130901 |
健檢：胃幽門桿菌抽血檢測 |
EA |
0 |
37 |
|
2 |
500 |
| 檢查費 |
130902 |
C.difficile toxin
A&B |
EA |
0 |
37 |
|
2 |
600 |
| 檢查費 |
130903 |
G.B.S B型鏈球菌DNA檢查 |
EA |
0 |
37 |
|
2 |
1,800 |
| 檢查費 |
130904 |
Cyfra 21-1 |
EA |
0 |
37 |
|
2 |
1,000 |
| 檢查費 |
140901 |
Hepatitis C
RNA,quantitative(自費) |
EA |
0 |
37 |
|
7 |
2,800 |
| 檢查費 |
140902 |
HCV-genotype(自費) |
EA |
0 |
37 |
|
7 |
3,000 |
| 檢查費 |
140903 |
Hepatitis B,DNA
quantitive(自費) |
EA |
0 |
37 |
|
7 |
1,500 |
| 檢查費 |
140906 |
Hepatitis E,HEV IgG |
EA |
0 |
37 |
|
7 |
600 |
| 檢查費 |
140907 |
Hepatitis E,HEV IgM |
EA |
0 |
37 |
|
7 |
800 |
| 檢查費 |
300902 |
過敏體質檢測-55項 |
EA |
0 |
37 |
|
2 |
2,200 |
| 檢查費 |
305903 |
Vitamin D |
EA |
0 |
37 |
|
2 |
2,000 |
| 檢查費 |
305904 |
一般親子鑑定(2人) |
EA |
0 |
37 |
|
2 |
15,000 |
| 檢查費 |
305905 |
法律親子鑑定(2人) |
EA |
0 |
37 |
|
2 |
18,000 |
| 檢查費 |
306901 |
自費檢驗-貧血檢查 |
EA |
0 |
37 |
|
2 |
640 |
| 檢查費 |
306902 |
自費檢驗-肝炎檢查 |
EA |
0 |
37 |
|
2 |
900 |
| 檢查費 |
306903 |
自費檢驗-肝膽功能檢查 |
EA |
0 |
37 |
|
2 |
770 |
| 檢查費 |
306904 |
自費檢驗-腎功能檢查 |
EA |
0 |
37 |
|
2 |
240 |
| 檢查費 |
306905 |
自費檢驗-血糖檢查 |
EA |
0 |
37 |
|
2 |
80 |
| 檢查費 |
306906 |
自費檢驗-心臟血管檢查 |
EA |
0 |
37 |
|
2 |
2,025 |
| 檢查費 |
306907 |
自費檢驗-性安全檢查 |
EA |
0 |
37 |
|
2 |
915 |
| 檢查費 |
306908 |
自費檢驗-甲狀腺功能檢查 |
EA |
0 |
37 |
|
2 |
840 |
| 檢查費 |
306909 |
自費檢驗-男性癌症篩檢 |
EA |
0 |
37 |
|
2 |
2,510 |
| 檢查費 |
306910 |
自費檢驗-女性癌症篩檢 |
EA |
0 |
37 |
|
2 |
2,700 |
| 檢查費 |
306911 |
醫療服務部健檢 |
EA |
0 |
37 |
|
2 |
8,000 |
| 檢查費 |
306912 |
自費檢驗-Ostase |
EA |
0 |
37 |
|
2 |
500 |
| 檢查費 |
306913 |
自費檢驗-尿液 |
EA |
0 |
37 |
|
2 |
90 |
| 檢查費 |
306914 |
自費檢驗-ABO血型測定 |
EA |
0 |
37 |
|
2 |
45 |
| 檢查費 |
306916 |
Semen analysis(自費檢驗) |
EA |
0 |
37 |
|
2 |
400 |
| 檢查費 |
306918 |
自費檢驗-血型+RH |
EA |
0 |
37 |
|
2 |
180 |
| 檢查費 |
332901 |
健檢：64切心血管電腦斷層掃瞄 |
EA |
0 |
37 |
|
2 |
16,000 |
| 檢查費 |
332902 |
健檢：磁核共振攝(頭部、脊椎、頸部三選一) |
EA |
0 |
37 |
|
2 |
6,000 |
| 檢查費 |
332903 |
健檢：乳房攝影 |
EA |
0 |
37 |
|
2 |
1,500 |
| 檢查費 |
609001 |
Urine OB(健檢) |
EA |
0 |
37 |
|
2 |
15 |
| 檢查費 |
1209041 |
D1+F2 (臍帶血免疫球蛋白E) |
EA |
0 |
37 |
|
7 |
400 |
| 檢查費 |
3308481 |
健檢：MRI(腦部) 不打顯影劑 |
EA |
0 |
37 |
|
2 |
10,000 |
| 檢查費 |
3308482 |
健檢：MRI(頸椎) 不打顯影劑 |
EA |
0 |
37 |
|
2 |
10,000 |
| 檢查費 |
3308483 |
健檢：MRI(胸椎) 不打顯影劑 |
EA |
0 |
37 |
|
2 |
10,000 |
| 檢查費 |
3308484 |
健檢：MRI(腰椎) 不打顯影劑 |
EA |
0 |
37 |
|
2 |
10,000 |
| 檢查費 |
3308485 |
健檢：MRI(腹部) 不打顯影劑 |
EA |
0 |
37 |
|
2 |
10,000 |
| 檢查費 |
3308486 |
健檢：MRI(頸椎專案) 不打顯影劑 |
EA |
0 |
37 |
|
2 |
4,000 |
| 檢查費 |
3308487 |
健檢：MRI(腰椎專案) 不打顯影劑 |
EA |
0 |
37 |
|
2 |
4,000 |
| 檢查費 |
3308581 |
健檢：(MRI)腦瘤磁振造影檢查 |
EA |
0 |
37 |
|
2 |
32,000 |
| 檢查費 |
3308582 |
健檢：(MRI)頭部磁振造影檢查 |
EA |
0 |
37 |
|
2 |
7,000 |
| 檢查費 |
3308583 |
健檢：(MRI)心臟磁振造影檢查 |
EA |
0 |
37 |
|
2 |
8,000 |
| 檢查費 |
3308584 |
健檢：(MRI)乳房磁振造影檢查(女性) |
EA |
0 |
37 |
|
2 |
12,000 |
| 檢查費 |
3308585 |
健檢：(MRI)下肢血管磁振造影檢查 |
EA |
0 |
37 |
|
2 |
12,000 |
| 檢查費 |
12020B1 |
自費Mycoplasma
pneumonia Ab test(IgM) |
EA |
0 |
37 |
|
2 |
800 |
| 檢查費 |
33084B1 |
健檢：MRI 不打顯影劑 |
EA |
0 |
37 |
|
2 |
6,000 |
| 檢查費 |
33085B1 |
健檢：MRI 打顯影劑 |
EA |
0 |
37 |
|
2 |
11,000 |
| 檢查費 |
A04004 |
Amniocentesis |
EA |
0 |
37 |
|
2 |
8,000 |
| 檢查費 |
A04005 |
Amniocentesis |
EA |
0 |
37 |
|
2 |
6,000 |
| 檢查費 |
A040051 |
衛生局補助羊膜穿刺術 |
EA |
0 |
37 |
|
2 |
2,500 |
| 檢查費 |
A04006 |
Anti-phosphlipid
antibody/Lupus anticoag |
EA |
0 |
37 |
|
2 |
700 |
| 檢查費 |
A04007 |
Lecithin/Sphingomycelin(L/S) |
EA |
0 |
37 |
|
2 |
1,500 |
| 檢查費 |
A04016 |
Chromsome |
EA |
0 |
37 |
|
2 |
4,000 |
| 檢查費 |
A04017 |
Chromsome(補助) |
EA |
0 |
37 |
|
2 |
1,200 |
| 檢查費 |
A04030 |
Down's
Syndrome(B-HCG+AFP) |
EA |
0 |
37 |
|
2 |
800 |
| 檢查費 |
A04032 |
妊娠糖尿病篩檢 |
EA |
0 |
37 |
|
2 |
200 |
| 檢查費 |
A04037 |
孕婦海洋性貧血篩檢檢查 |
EA |
0 |
37 |
|
2 |
2,000 |
| 檢查費 |
A04038 |
海洋性貧血篩檢檢查(胎兒) |
EA |
0 |
37 |
|
2 |
3,500 |
| 檢查費 |
H1N1 |
H1N1病毒抗原檢驗 |
EA |
0 |
37 |
|
2 |
450 |
| 檢查費 |
L080A01 |
貧血檢查(CBC、Fe/TIBC) |
EA |
0 |
37 |
|
2 |
400 |
| 檢查費 |
L090A01 |
高級健檢-肝功能檢查 |
EA |
0 |
37 |
|
2 |
250 |
| 檢查費 |
L090A02 |
高級健檢-腎功能檢查 |
EA |
0 |
37 |
|
2 |
100 |
| 檢查費 |
L090A03 |
高級健檢-心臟循環檢查 |
EA |
0 |
37 |
|
2 |
300 |
| 檢查費 |
L090A04 |
肝膽功能檢查 |
EA |
0 |
37 |
|
2 |
350 |
| 檢查費 |
L090A05 |
腎功能檢查 |
EA |
0 |
37 |
|
2 |
120 |
| 檢查費 |
L090A06 |
血糖檢查(飯前、飯後) |
EA |
0 |
37 |
|
2 |
100 |
| 檢查費 |
L090A07 |
心臟血管檢查 |
EA |
0 |
37 |
|
2 |
450 |
| 檢查費 |
L090A08 |
甲狀腺功能檢查 |
EA |
0 |
37 |
|
2 |
400 |
| 檢查費 |
L090A09 |
門診減重自費檢驗 |
EA |
0 |
37 |
|
2 |
500 |
| 檢查費 |
L12015 |
高級健檢-CRP |
EA |
0 |
37 |
|
2 |
100 |
| 檢查費 |
L12078 |
高級健檢CA-153乳癌 |
EA |
0 |
37 |
|
2 |
300 |
| 檢查費 |
L12080 |
高級健檢Anti-SCC |
EA |
0 |
37 |
|
2 |
300 |
| 檢查費 |
L120901 |
CA72-4 |
EA |
0 |
37 |
|
2 |
800 |
| 檢查費 |
L120902 |
NSE |
EA |
0 |
37 |
|
2 |
1,200 |
| 檢查費 |
L120A01 |
高級健檢-特殊檢查(男性) |
EA |
0 |
37 |
|
2 |
1,000 |
| 檢查費 |
L120A02 |
高級健檢-特殊檢查(女性) |
EA |
0 |
37 |
|
2 |
1,000 |
| 檢查費 |
L120A03 |
高級健檢-重要癌症指標檢查 |
EA |
0 |
37 |
|
2 |
2,900 |
| 檢查費 |
L120A04 |
性安全檢查(RPR、HIV) |
EA |
0 |
37 |
|
2 |
350 |
| 檢查費 |
L120A05 |
男性癌篩檢(PSA、SCC、CEA、AFP、CA199) |
EA |
0 |
37 |
|
2 |
1,600 |
| 檢查費 |
L14032 |
高級健檢-HBs Ag B型肝炎抗原 |
EA |
0 |
37 |
|
2 |
200 |
| 檢查費 |
L14033 |
高級健檢-HBs Ab B型肝炎抗體 |
EA |
0 |
37 |
|
2 |
200 |
| 檢查費 |
L14040 |
高級健檢Anti HAV(A型肝炎抗體) |
EA |
0 |
37 |
|
2 |
250 |
| 檢查費 |
L14046 |
高級健檢-EB-IgA EB |
EA |
0 |
37 |
|
2 |
300 |
| 檢查費 |
L14049 |
高級健檢-愛滋抗體檢驗 |
EA |
0 |
37 |
|
2 |
400 |
| 檢查費 |
L14051 |
高級健檢-C型肝炎 |
EA |
0 |
37 |
|
2 |
250 |
| 檢查費 |
L140A01 |
肝炎檢查(HBsAG、HBsAb、HCV) |
EA |
0 |
37 |
|
2 |
550 |
| 檢查費 |
L27001 |
高級健檢-三碘甲狀腺素 |
EA |
0 |
37 |
|
2 |
250 |
| 檢查費 |
L27004 |
高級健檢-甲狀腺功能TSH |
EA |
0 |
37 |
|
2 |
250 |
| 檢查費 |
LA |
高級健檢項(全身生化項目) |
EA |
0 |
37 |
|
2 |
2,000 |
| 檢查費 |
LA02 |
安泰胸部X光檢查 |
EA |
0 |
37 |
|
2 |
300 |
| 檢查費 |
LA03 |
安泰靜止心電圖檢查 |
EA |
0 |
37 |
|
2 |
200 |
| 檢查費 |
LA04 |
安泰靜止及運動心電圖檢查 |
EA |
0 |
37 |
|
2 |
450 |
| 檢查費 |
LA05 |
安泰肝功能檢查 |
EA |
0 |
37 |
|
2 |
1,040 |
| 檢查費 |
LA06 |
安泰Gamma-GT |
EA |
0 |
37 |
|
2 |
150 |
| 檢查費 |
LA07 |
安泰血液常規檢查 |
EA |
0 |
37 |
|
2 |
250 |
| 檢查費 |
LA08 |
安泰血清檢查VDRL |
EA |
0 |
37 |
|
2 |
100 |
| 檢查費 |
LA09 |
安泰尿酸檢查(Uric Acid) |
EA |
0 |
37 |
|
2 |
70 |
| 檢查費 |
LA10 |
安泰甲狀腺檢查(T4) |
EA |
0 |
37 |
|
2 |
350 |
| 檢查費 |
LA11 |
安泰腎功能檢查(Blood Urea
Nitrogen.Creatinine) |
EA |
0 |
37 |
|
2 |
140 |
| 檢查費 |
LA12 |
安泰血液十五項檢查 |
EA |
0 |
37 |
|
2 |
1,820 |
| 檢查費 |
LA13 |
安泰HIV Test |
EA |
0 |
37 |
|
2 |
310 |
| 檢查費 |
LA14 |
安泰(Cholesterol,Triglyceride) |
EA |
0 |
37 |
|
2 |
320 |
| 檢查費 |
LA15 |
安泰G.T.T |
EA |
0 |
37 |
|
2 |
450 |
| 檢查費 |
LA16 |
安泰血糖檢查 |
EA |
0 |
37 |
|
2 |
70 |
| 檢查費 |
LA17 |
安泰糖化血色素(HbA1c) |
EA |
0 |
37 |
|
2 |
300 |
| 檢查費 |
LA18 |
安泰紅血球沉降速率(HbA1c) |
EA |
0 |
37 |
|
2 |
80 |
| 檢查費 |
LA19 |
安泰上腸胃道攝影(Upper-GI) |
EA |
0 |
37 |
|
2 |
1,200 |
| 檢查費 |
LA20 |
安泰聽力檢查(Pure Tone
Audiometry) |
EA |
0 |
37 |
|
2 |
400 |
| 檢查費 |
LA21 |
安泰視力檢查 |
EA |
0 |
37 |
|
2 |
50 |
| 檢查費 |
LIPID |
Blood Lipid |
EA |
0 |
37 |
|
2 |
975 |
| 檢查費 |
150901 |
HPV DNA Test |
EA |
0 |
38 |
|
2 |
1,200 |
| 檢查費 |
150902 |
健檢：子宮頸癌HPV檢測 |
EA |
0 |
38 |
|
2 |
1,500 |
| 檢查費 |
305901 |
體脂肪測定 |
EA |
0 |
38 |
|
2 |
30 |
| 檢查費 |
190901 |
3D超音波(含VCD) |
EA |
0 |
45 |
|
2 |
1,200 |
| 檢查費 |
550901 |
AIH人工受精 |
EA |
0 |
50 |
|
2 |
2,000 |
| 檢查費 |
550902 |
CVS絨毛取樣 |
EA |
0 |
50 |
|
2 |
8,500 |
| 檢查費 |
550903 |
避孕器裝置技術費 |
EA |
0 |
50 |
|
2 |
1,200 |
| 檢查費 |
3307281 |
健檢：冠狀動脈鈣化指數(不打顯影劑) |
EA |
0 |
52 |
|
2 |
6,000 |
| 檢查費 |
3307282 |
健檢：心臟冠狀動脈CTA(打含顯影劑)+心臟鈣化分析 |
EA |
0 |
52 |
|
2 |
14,000 |
| 檢查費 |
3307283 |
健檢：超低輻射肺部CT(不打顯影劑) |
EA |
0 |
52 |
|
2 |
6,000 |
| 檢查費 |
3307284 |
健檢:胸腔+動脈檢查(打顯影劑) |
EA |
0 |
52 |
|
2 |
9,000 |
| 檢查費 |
3307285 |
健檢:腦部(C.T) |
EA |
0 |
52 |
|
2 |
6,000 |
| 檢查費 |
3307286 |
健檢:頭頸部+動脈檢查(打顯影劑) |
EA |
0 |
52 |
|
2 |
9,000 |
| 檢查費 |
3307287 |
健檢:腦部+頭頸部+動脈檢查(打顯影劑) |
EA |
0 |
52 |
|
2 |
12,000 |
| 檢查費 |
3307288 |
健檢:腹部+骨盆腔+動脈檢查(打含碘顯影劑) |
EA |
0 |
52 |
|
2 |
9,000 |
| 檢查費 |
3307289 |
健檢:肝臟動態掃描(打含碘顯影劑) |
EA |
0 |
52 |
|
2 |
9,000 |
| 檢查費 |
3307290 |
健檢:C.T 虛擬大腸鏡檢查 |
EA |
0 |
52 |
|
2 |
10,000 |
| 檢查費 |
3307291 |
健檢：下肢血管+動脈檢查(打含碘顯影劑) |
EA |
0 |
52 |
|
2 |
14,000 |
| 檢查費 |
3307292 |
健檢：肝臟+腹部+骨盆腔+動脈檢查(打含碘顯影劑) |
EA |
0 |
52 |
|
2 |
12,000 |
| 檢查費 |
3307293 |
健檢：虛擬大腸鏡+肝臟動態掃描+全腹部骨盆腔(打含碘顯影劑) |
EA |
0 |
52 |
|
2 |
21,000 |
| 檢查費 |
3307294 |
健檢：胸主動脈+肺部+動脈檢查(打含碘顯影劑) |
EA |
0 |
52 |
|
2 |
12,000 |
| 檢查費 |
3307295 |
健檢:腹部+骨盆腔+胸腔檢查(打含碘顯影劑) |
EA |
0 |
52 |
|
2 |
9,000 |
| 檢查費 |
3307296 |
健檢:腹部(打含碘顯影劑) |
EA |
0 |
52 |
|
2 |
6,000 |
| 檢查費 |
33070X1 |
64切Brain C.T without
contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070X2 |
64切Neck C.T without
contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070X3 |
64切Chest C.T without
contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070X4 |
64切Abdomen C.T
without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070X5 |
64切Pelvis C.T without
contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070X7 |
64切Sinus C.T without
contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070X8 |
64切心血管鈣化分析-不打顯影劑 |
EA |
0 |
52 |
|
2 |
7,000 |
| 檢查費 |
33070X9 |
64切(OTHER)CT-不打顯影劑 |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070Y1 |
64切C.T C-spine |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070Y2 |
64切C.T T-spine |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070Y3 |
64切C.T L-spine |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070Y6 |
64切C.T whole spine |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070Y7 |
64切C.T Sacrum |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070Y8 |
64切Sinus C.T without
contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070Z1 |
64切C.T myelography
C-spine |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070Z2 |
64切C.T myelography
T-spine |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070Z3 |
64切C.T Myolography
L-spine |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33070Z6 |
64切C.T myelography
whole spine |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33071X8 |
64切心血管(含鈣化分析)CT-打顯影劑 |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33071X9 |
64切(OTHER)CT-打顯影劑 |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33071Z1 |
64切C.T C-spine/with
contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072X0 |
64切Brain C.T-A
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072X1 |
64切Brain C.T
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072X2 |
64切Neck C.T
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072X3 |
64切Chest C.T
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072X4 |
64切Abdomen C.T
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072X5 |
64切Pelvis C.T
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072X6 |
64切Extremity C.T
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072X7 |
64切Sinus C.T
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072X8 |
64切 CTA-打顯影劑 |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072X9 |
64切(OTHER)CT-(不打+打)顯影劑 |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072Z1 |
64切C.T C-spine
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072Z2 |
64切C.T T-spine
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072Z3 |
64切C.T L-spine
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
33072Z6 |
64切C.T Whole
with/without contrast |
EA |
0 |
52 |
|
2 |
16,000 |
| 檢查費 |
A070 |
64切CT健保差額 |
EA |
0 |
52 |
|
2 |
10,000 |
| 代收血液救濟金 |
930901 |
代收血液救濟金 |
EA |
0 |
53 |
|
2 |
4 |
| 代收血液救濟金 |
930902 |
代收捐血中心救濟金 |
EA |
0 |
53 |
|
2 |
6 |
| 代收血液救濟金 |
930903 |
代收捐血中心救濟金 |
EA |
0 |
53 |
|
2 |
13 |
| 代收血液救濟金 |
930904 |
代收捐血中心救濟金 |
EA |
0 |
53 |
|
2 |
3 |
| 代收血液救濟金 |
930905 |
代收捐血中心救濟金 |
EA |
0 |
53 |
|
2 |
3 |
| 代收血液救濟金 |
930910 |
代收捐血中心救濟金 |
EA |
0 |
53 |
|
2 |
3 |
| 代收血液救濟金 |
930911 |
代收捐血中心救濟金 |
EA |
0 |
53 |
|
2 |
2 |
| 代收血液救濟金 |
930913 |
代收捐血中心救濟金 |
EA |
0 |
53 |
|
2 |
5 |
| 其他 |
A9023 |
數位像機相片(病人帶回) |
EA |
0 |
53 |
|
2 |
30 |
| 其他 |
A9028 |
代客傳真 |
EA |
0 |
53 |
|
2 |
10 |
| 健檢費 |
180901 |
健檢：心臟超音波 |
EA |
0 |
54 |
|
2 |
3,600 |
| 健檢費 |
180902 |
健檢：運動心電圖 |
EA |
0 |
54 |
|
2 |
1,500 |
| 健檢費 |
180903 |
健檢：四肢動脈血流測定 |
EA |
0 |
54 |
|
2 |
2,000 |
| 健檢費 |
190903 |
健檢：頸動脈超音波檢查 |
EA |
0 |
54 |
|
2 |
1,500 |
| 健檢費 |
190904 |
健檢：乳房超音波檢查 |
EA |
0 |
54 |
|
2 |
1,000 |
| 健檢費 |
190905 |
健檢：婦科骨盆超音波檢查 |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
190906 |
健檢：男性攝護腺超音波檢查 |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
306917 |
安養中心住民健檢 |
EA |
0 |
54 |
|
2 |
1,500 |
| 健檢費 |
A03L01 |
國泰X光檢查 |
EA |
0 |
54 |
|
2 |
300 |
| 健檢費 |
A03L02 |
國泰EKG檢查 |
EA |
0 |
54 |
|
2 |
200 |
| 健檢費 |
A03L03 |
國泰血液常規 |
EA |
0 |
54 |
|
2 |
80 |
| 健檢費 |
A03L04 |
國泰肝功能檢查 |
EA |
0 |
54 |
|
2 |
970 |
| 健檢費 |
A03L05 |
國泰尿液常規檢查 |
EA |
0 |
54 |
|
2 |
60 |
| 健檢費 |
A03L06 |
國泰腎機能檢查 |
EA |
0 |
54 |
|
2 |
150 |
| 健檢費 |
A03L07 |
國泰血糖檢查 |
EA |
0 |
54 |
|
2 |
50 |
| 健檢費 |
A03L08 |
國泰T4檢查 |
EA |
0 |
54 |
|
2 |
250 |
| 健檢費 |
A03L09 |
國泰HbA1C |
EA |
0 |
54 |
|
2 |
250 |
| 健檢費 |
A03L10 |
國泰VDRL |
EA |
0 |
54 |
|
2 |
100 |
| 健檢費 |
A03L11 |
國泰T/G |
EA |
0 |
54 |
|
2 |
200 |
| 健檢費 |
A03L12 |
國泰Cholesterol |
EA |
0 |
54 |
|
2 |
70 |
| 健檢費 |
A2001 |
義守大學健檢 |
EA |
0 |
54 |
|
2 |
1,060 |
| 健檢費 |
A2002 |
慈濟護專健檢 |
EA |
0 |
54 |
|
2 |
1,260 |
| 健檢費 |
A2003 |
虎尾技術學院健檢 |
EA |
0 |
54 |
|
2 |
960 |
| 健檢費 |
A2004 |
元培醫專體檢 |
EA |
0 |
54 |
|
2 |
1,450 |
| 健檢費 |
A2005 |
中興大學體檢 |
EA |
0 |
54 |
|
2 |
1,050 |
| 健檢費 |
A2101 |
國華人壽一般體格檢查 |
EA |
0 |
54 |
|
2 |
300 |
| 健檢費 |
A2102 |
人壽公司一般體格檢查 |
EA |
0 |
54 |
|
2 |
350 |
| 健檢費 |
A2103 |
安泰人壽一般體格檢查 |
EA |
0 |
54 |
|
2 |
400 |
| 健檢費 |
A2201 |
中醫師特考 |
EA |
0 |
54 |
|
2 |
940 |
| 健檢費 |
A2202 |
公務人員考試體檢 |
EA |
0 |
54 |
|
2 |
1,040 |
| 健檢費 |
A2301 |
郵政勞工一般體檢 |
EA |
0 |
54 |
|
2 |
800 |
| 健檢費 |
A2302 |
門診勞工供膳健康檢查 |
EA |
0 |
54 |
|
2 |
800 |
| 健檢費 |
A23021 |
麥當勞(門診勞工供膳健康檢查) |
EA |
0 |
54 |
|
2 |
650 |
| 健檢費 |
A23022 |
肯德基(門診勞工供膳健康檢查) |
EA |
0 |
54 |
|
2 |
700 |
| 健檢費 |
A23023 |
月眉育樂世界(門診勞工供膳健康檢查) |
EA |
0 |
54 |
|
2 |
550 |
| 健檢費 |
A23024 |
三商巧福供膳健康檢查 |
EA |
0 |
54 |
|
2 |
650 |
| 健檢費 |
A2303 |
幼稚園司機體檢 |
EA |
0 |
54 |
|
2 |
100 |
| 健檢費 |
A2304 |
門診勞工一般體格健康檢查 |
EA |
0 |
54 |
|
2 |
660 |
| 健檢費 |
A23041 |
達航達鵬達利(勞工一般體格健康檢查) |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
A23042 |
穩合(勞工一般體格健康檢查) |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
A23043 |
野寶、月眉育樂世界(勞工一般體格健康檢查) |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
A23044 |
旭東(勞工一般體格健康檢查) |
EA |
0 |
54 |
|
2 |
550 |
| 健檢費 |
A23045 |
勞工健檢(含B肝) |
EA |
0 |
54 |
|
2 |
700 |
| 健檢費 |
A23046 |
志工一般體格健康檢查 |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
A2305 |
勞工一般體檢查(無X光) |
EA |
0 |
54 |
|
2 |
400 |
| 健檢費 |
A2306 |
領養小孩體檢 |
EA |
0 |
54 |
|
2 |
100 |
| 健檢費 |
A2309 |
一般體檢 |
EA |
0 |
54 |
|
2 |
200 |
| 健檢費 |
A23091 |
一般體檢(加X光) |
EA |
0 |
54 |
|
2 |
400 |
| 健檢費 |
A2310 |
外勞體檢(男生) |
EA |
0 |
54 |
|
2 |
1,500 |
| 健檢費 |
A2311 |
外勞體檢(女生) |
EA |
0 |
54 |
|
2 |
1,600 |
| 健檢費 |
A2312 |
外籍老師(不分性別) |
EA |
0 |
54 |
|
2 |
1,500 |
| 健檢費 |
A2313 |
居留男生 |
EA |
0 |
54 |
|
2 |
1,300 |
| 健檢費 |
A2314 |
居留女生 |
EA |
0 |
54 |
|
2 |
1,600 |
| 健檢費 |
A2315 |
港澳工作證 |
EA |
0 |
54 |
|
2 |
1,900 |
| 健檢費 |
A2316 |
異常複檢(安非、嗎啡) |
EA |
0 |
54 |
|
2 |
1,000 |
| 健檢費 |
A2317 |
異常複檢(寄生蟲) |
EA |
0 |
54 |
|
2 |
150 |
| 健檢費 |
A2318 |
異常複檢(梅毒) |
EA |
0 |
54 |
|
2 |
750 |
| 健檢費 |
A2319 |
異常複檢(愛滋) |
EA |
0 |
54 |
|
2 |
3,000 |
| 健檢費 |
A23901 |
福-健康檢查 |
EA |
0 |
54 |
|
2 |
2,800 |
| 健檢費 |
A23902 |
祿男-健康檢查 |
EA |
0 |
54 |
|
2 |
3,800 |
| 健檢費 |
A23903 |
祿女-健康檢查 |
EA |
0 |
54 |
|
2 |
3,800 |
| 健檢費 |
A23904 |
壽男-健康檢查 |
EA |
0 |
54 |
|
2 |
5,000 |
| 健檢費 |
A23905 |
壽女-健康檢查 |
EA |
0 |
54 |
|
2 |
5,000 |
| 健檢費 |
A23906 |
美滿男-健康檢查 |
EA |
0 |
54 |
|
2 |
7,000 |
| 健檢費 |
A23910 |
健康99-男 |
EA |
0 |
54 |
|
2 |
3,500 |
| 健檢費 |
A23911 |
健康99-女 |
EA |
0 |
54 |
|
2 |
3,500 |
| 健檢費 |
A23912 |
愛心保心方案一 |
EA |
0 |
54 |
|
2 |
21,000 |
| 健檢費 |
A23913 |
愛心保心方案二 |
EA |
0 |
54 |
|
2 |
17,500 |
| 健檢費 |
A23914 |
基礎心臟血管篩檢 |
EA |
0 |
54 |
|
2 |
599 |
| 健檢費 |
A23915 |
進階心臟血管篩檢 |
EA |
0 |
54 |
|
2 |
999 |
| 健檢費 |
A23916 |
高階心臟血管篩檢 |
EA |
0 |
54 |
|
2 |
1,999 |
| 健檢費 |
A23917 |
全方位健康檢查 |
EA |
0 |
54 |
|
2 |
3,000 |
| 健檢費 |
A23918 |
健康防癌專案-男 |
EA |
0 |
54 |
|
2 |
3,300 |
| 健檢費 |
A23919 |
健康防癌專案-女 |
EA |
0 |
54 |
|
2 |
3,600 |
| 健檢費 |
A239201 |
父親專案-健康檢查 |
EA |
0 |
54 |
|
2 |
5,288 |
| 健檢費 |
A239202 |
健康99-全國公教特惠健檢(男) |
EA |
0 |
54 |
|
2 |
3,500 |
| 健檢費 |
A239203 |
健康99-全國公教特惠健檢(女) |
EA |
0 |
54 |
|
2 |
3,500 |
| 健檢費 |
A239204 |
99年度鄉鎮代表、村里長健檢(男) |
EA |
0 |
54 |
|
2 |
16,000 |
| 健檢費 |
A239205 |
99年度鄉鎮代表、村里長健檢(女) |
EA |
0 |
54 |
|
2 |
16,000 |
| 健檢費 |
A23922 |
鎮瀾宮社會福利基金會-健康檢查 |
EA |
0 |
54 |
|
2 |
2,800 |
| 健檢費 |
A239901 |
新尊爵男-健康檢查 |
EA |
0 |
54 |
|
2 |
9,900 |
| 健檢費 |
A239902 |
尊爵女-健康檢查 |
EA |
0 |
54 |
|
2 |
9,900 |
| 健檢費 |
A239903 |
新美滿男-健康檢查 |
EA |
0 |
54 |
|
2 |
7,000 |
| 健檢費 |
A239904 |
新美滿女-健康檢查 |
EA |
0 |
54 |
|
2 |
7,000 |
| 健檢費 |
A239905 |
壽男-健康檢查 |
EA |
0 |
54 |
|
2 |
5,000 |
| 健檢費 |
A239906 |
壽女-健康檢查 |
EA |
0 |
54 |
|
2 |
5,000 |
| 健檢費 |
A239907 |
祿男-健康檢查 |
EA |
0 |
54 |
|
2 |
3,800 |
| 健檢費 |
A239908 |
祿女-健康檢查 |
EA |
0 |
54 |
|
2 |
3,800 |
| 健檢費 |
A239909 |
福-健康檢查 |
EA |
0 |
54 |
|
2 |
2,800 |
| 健檢費 |
A239921 |
高健加選-胸部 X 光檢查 |
EA |
0 |
54 |
|
2 |
400 |
| 健檢費 |
A239922 |
高健加選-胸部(側面) X 光檢查 |
EA |
0 |
54 |
|
2 |
400 |
| 健檢費 |
A239923 |
高健加選-腹部 X 光檢查 |
EA |
0 |
54 |
|
2 |
400 |
| 健檢費 |
A239924 |
高健加選-上消化攝影 |
EA |
0 |
54 |
|
2 |
2,000 |
| 健檢費 |
A239925 |
高健加選-下消化攝影 |
EA |
0 |
54 |
|
2 |
3,000 |
| 健檢費 |
A239926 |
高健加選-乳房 X 光攝影檢查 |
EA |
0 |
54 |
|
2 |
1,800 |
| 健檢費 |
A239927 |
高健加選-骨質密度檢查 |
EA |
0 |
54 |
|
2 |
1,200 |
| 健檢費 |
A239928 |
高健加選-腹部超音波檢查 |
EA |
0 |
54 |
|
2 |
1,200 |
| 健檢費 |
A239929 |
高健加選-乳房超音波檢查 |
EA |
0 |
54 |
|
2 |
1,200 |
| 健檢費 |
A239930 |
高健加選-乳房超音波檢查 |
EA |
0 |
54 |
|
2 |
1,200 |
| 健檢費 |
A239931 |
高健加選-心臟超音波檢查 |
EA |
0 |
54 |
|
2 |
3,500 |
| 健檢費 |
A239932 |
高健加選-攝護腺超音波檢查 |
EA |
0 |
54 |
|
2 |
1,200 |
| 健檢費 |
A239934 |
高健加選-胃鏡(上消化道內視鏡) |
EA |
0 |
54 |
|
2 |
2,000 |
| 健檢費 |
A239935 |
高健加選-乙狀結腸內視鏡檢查 |
EA |
0 |
54 |
|
2 |
1,800 |
| 健檢費 |
A239936 |
高健加選-大腸內視鏡檢查 |
EA |
0 |
54 |
|
2 |
3,000 |
| 健檢費 |
A239937 |
高健加選-運動心電圖 |
EA |
0 |
54 |
|
2 |
2,000 |
| 健檢費 |
A239938 |
高健加選-腦波 |
EA |
0 |
54 |
|
2 |
1,500 |
| 健檢費 |
A239939 |
高健加選-週邊動脈血管檢查儀 |
EA |
0 |
54 |
|
2 |
2,200 |
| 健檢費 |
A239940 |
高健加選- A型肝炎檢查 |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
A239941 |
高健加選- B型肝炎抗原檢查 |
EA |
0 |
54 |
|
2 |
300 |
| 健檢費 |
A239942 |
高健加選-B型肝炎抗體檢查 |
EA |
0 |
54 |
|
2 |
300 |
| 健檢費 |
A239943 |
高健加選-C型肝炎檢查 |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
A239944 |
高健加選-胃幽門桿菌抽血檢查 |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
A239945 |
高健加選-T3 |
EA |
0 |
54 |
|
2 |
400 |
| 健檢費 |
A239946 |
高健加選-Free T4 |
EA |
0 |
54 |
|
2 |
400 |
| 健檢費 |
A239947 |
高健加選-TSH |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
A239948 |
高健加選-CEA |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
A239949 |
高健加選-AFP |
EA |
0 |
54 |
|
2 |
400 |
| 健檢費 |
A239950 |
高健加選-CA19-9 |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
A239951 |
高健加選-CA153 |
EA |
0 |
54 |
|
2 |
800 |
| 健檢費 |
A239952 |
高健加選-CA125 |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
A239953 |
高健加選-PSA |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
A239954 |
高健加選-EBIgA |
EA |
0 |
54 |
|
2 |
800 |
| 健檢費 |
A239955 |
高健加選-VDRL |
EA |
0 |
54 |
|
2 |
200 |
| 健檢費 |
A239956 |
高健加選-VDRL |
EA |
0 |
54 |
|
2 |
200 |
| 健檢費 |
A239957 |
高健加選-HIV |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
A239958 |
高健加選- Chlamydia IgM
(披衣菌免疫球蛋白M) |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
A239959 |
高健加選- Chlamydia IgG
(披衣菌免疫球蛋白G) |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
A239960 |
高健加選-HbEp |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
A239961 |
高健加選- G-6-P-D |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
A239962 |
高健加選- Rubella IgG |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
A239963 |
高健加選- 精液檢查 (男性) |
EA |
0 |
54 |
|
2 |
400 |
| 健檢費 |
A239964 |
高健加選-Anti-HAV lgM |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
A2401 |
機車體檢 |
EA |
0 |
54 |
|
2 |
90 |
| 健檢費 |
A2402 |
汽車體檢 |
EA |
0 |
54 |
|
2 |
150 |
| 健檢費 |
A2404 |
駕照審驗 |
EA |
0 |
54 |
|
2 |
90 |
| 健檢費 |
A24041 |
駕照審驗 |
EA |
0 |
54 |
|
2 |
550 |
| 健檢費 |
A24042 |
汽車體檢 |
EA |
0 |
54 |
|
2 |
90 |
| 健檢費 |
A2501 |
漁船體檢 |
EA |
0 |
54 |
|
2 |
450 |
| 健檢費 |
A2601 |
院內員工體檢 |
EA |
0 |
54 |
|
2 |
200 |
| 健檢費 |
H09002C |
健檢加選-BUN |
EA |
0 |
54 |
|
2 |
300 |
| 健檢費 |
H09005C |
健檢加選-Glucose AC |
EA |
0 |
54 |
|
2 |
200 |
| 健檢費 |
H09021C |
健檢加選-Sodium(Na) |
EA |
0 |
54 |
|
2 |
150 |
| 健檢費 |
H09022C |
健檢加選-Potassium(K) |
EA |
0 |
54 |
|
2 |
150 |
| 健檢費 |
H100 |
懷孕試驗(beta-HCG) |
EA |
0 |
54 |
|
2 |
100 |
| 健檢費 |
H1000A |
(非特約)-勞工體檢 |
EA |
0 |
54 |
|
2 |
1,000 |
| 健檢費 |
H1100A |
(非特約)-供膳體檢 |
EA |
0 |
54 |
|
2 |
1,100 |
| 健檢費 |
H1200 |
船員 |
EA |
0 |
54 |
|
2 |
1,200 |
| 健檢費 |
H150 |
汽車體檢、職業貨車體檢、大型重機 |
EA |
0 |
54 |
|
2 |
150 |
| 健檢費 |
H1500 |
安養院全套(新住民) |
EA |
0 |
54 |
|
2 |
1,500 |
| 健檢費 |
H1500A |
護理之家全套(新住民) |
EA |
0 |
54 |
|
2 |
1,500 |
| 健檢費 |
H1800 |
安養院全套(新進人員) |
EA |
0 |
54 |
|
2 |
1,800 |
| 健檢費 |
H1800A |
護理之家(新進人員) |
EA |
0 |
54 |
|
2 |
1,800 |
| 健檢費 |
H1900 |
(非特約)-勞工+供膳體檢 |
EA |
0 |
54 |
|
2 |
1,900 |
| 健檢費 |
H2000 |
安養院(新進供膳) |
EA |
0 |
54 |
|
2 |
2,000 |
| 健檢費 |
H200A |
院內員工/志工(X-光) |
EA |
0 |
54 |
|
2 |
200 |
| 健檢費 |
H2200 |
博愛照顧服務勞動合作社(供膳+生化) |
EA |
0 |
54 |
|
2 |
2,200 |
| 健檢費 |
H250 |
一般體檢 |
EA |
0 |
54 |
|
2 |
250 |
| 健檢費 |
H250A |
申請報告、X-光片 |
EA |
0 |
54 |
|
2 |
200 |
| 健檢費 |
H2800 |
台中縣私立鎮瀾宮兒童家園(高檢+福項目) |
EA |
0 |
54 |
|
2 |
2,800 |
| 健檢費 |
H300 |
X光(X-ray) |
EA |
0 |
54 |
|
2 |
300 |
| 健檢費 |
H300A |
梅毒(VDRL) |
EA |
0 |
54 |
|
2 |
300 |
| 健檢費 |
H450 |
特約-勞工體檢-A(月眉救生員) |
EA |
0 |
54 |
|
2 |
450 |
| 健檢費 |
H500 |
健檢中心-Amphetamine (定性) |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
H500A |
健檢中心-Morphine(定性) |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
H500B |
健檢中心-STOOL CULTURE |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
H500C |
健檢中心-阿米巴檢查 |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
H600 |
心電圖(EKG) |
EA |
0 |
54 |
|
2 |
600 |
| 健檢費 |
H600A |
安養中心(半套) |
EA |
0 |
54 |
|
2 |
500 |
| 健檢費 |
H800 |
特約-供膳體檢 |
EA |
0 |
54 |
|
2 |
800 |
| 健檢費 |
H90 |
機車體檢 |
EA |
0 |
54 |
|
2 |
90 |
| 健檢費 |
H900B |
特約-勞工體檢-B |
EA |
0 |
54 |
|
2 |
900 |
| 健檢費 |
H90A |
60歲以下汽車審驗 |
EA |
0 |
54 |
|
2 |
90 |
| 健檢費 |
H990 |
60歲以上汽車審驗(X-光+EKG) |
EA |
0 |
54 |
|
2 |
990 |
| 醫技謢理隨行費 |
A5000 |
救護車隨車護理人員費(每小時) |
EA |
0 |
59 |
|
2 |
600 |
| 新生兒篩檢費 |
A0307 |
新生兒篩檢(自費)手續費 |
EA |
0 |
68 |
|
2 |
450 |
| 新生兒篩檢費 |
A03071 |
有補助新生兒篩檢(自費)手續費 |
EA |
0 |
68 |
|
2 |
200 |
| 新生兒篩檢費 |
A03072 |
龐貝氏症及法布瑞氏症篩檢 |
EA |
0 |
68 |
|
2 |
300 |
| 新生兒篩檢費 |
190902 |
新生兒腎臟超音波篩檢 |
EA |
0 |
68 |
|
2 |
500 |
| ●若實際品項與價格有異動，以醫院最後異動之品項及價格為主。 最後修正日期：100/6/20第二版 |
|
|
|
|
|
|
|
|
|