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新泰宜醫院自費項目--非健保給付品名單位自費單價甘油球(久仁浣腸)20CC/個個8SINDINEOINTMENT(POVIDONE-IODINE)SINP盒2普康(兒科)嬰兒DHA葡萄糖盒180*ADRENALINEINJ.(BOSMIN)1MG/1ML/AMPAMP20AMOCLAVUNIN1.2G/vial艾摩克寧靜脈注射劑瓶250CLINCININJECTION300MG/2ML/AMPAMP150DEXAMETHASONEInj.1ml0.5%5MG/MLAMP10Depo-provera150mg1mlAmp500DEXAMETHASONEINJECTION0.4%AMPAMP5*DOPMININJECTION200MG/5ML/AMP針180右旋糖注射液５％袋150OVIDRELINJECTION250UG/VIALVIAL1800HEPACINJECTION5000UNITS/MLN.K瓶96*POTASSIUMCHLORIDE(KCL)INJ.15%(150MGAMP10FUROSEMIDE20MG/2ML/AMP利尿、高血壓、AMP20*LIDOCAINEINJECTION2%400MG/20MLML0*MARCAINEINJECTION20ML0.5%ML0*MAGNESIUMSULFATE(MgSO4)INJ.S.T.100M瓶50**NOVOMIX30PENFILL100U/ML3ML/支糖支330YFNO.1INJECTION500ML/瓶(台大1號)瓶150TPNNO.3INJECTION500ML/瓶瓶150**UZOLAMINTRAVENOUSINJECTION5MG/1ML/AAMP35流行性感冒疫苗接種(自費)瓶380VENACALO-B6INJECTION5ML/AMP美鈉鈣樂-AMP20VITACALINJ.20ML美達加祿針瓶20**Xylocaine2%20ml10Rotarix1DRFS(第一劑)羅特律輪狀病毒疫次2500Rotarix1DRFS(第二劑)羅特律輪狀病毒疫苗次2500RotaTeq輪狀病毒疫苗(第一劑)盒2000RotaTeq輪狀病毒疫苗第二劑次2000RotaTeq輪狀病毒疫苗第三劑次2000CERVARIXHPV第一劑16/18TYPE針3900CERVARIXHPV第二劑16/18TYPE針3900CERVARIXHPV第三劑16/18TYPE針3900六合一混合疫苗(自費-1)INFANRIXINJECTIO瓶2000六合一混合疫苗(自費-2)INFANRIXINJECTIO瓶2000六合一混合疫苗(自費-3)INFANRIXINJECTIO瓶2000六合一混合疫苗(自費-4)INFANRIXINJECTIO瓶2000HIN1新型流感疫苗(第一劑)針0ENGERIX-B(成人自費B肝疫苗)瓶300HIBERIX(賀百克)VACCINE瓶800HIBERIX(賀百克)VACCINEB型流感嗜血桿菌瓶800HIBERIX(賀百克)VACCINEB型流感嗜血桿菌瓶800HIBERIX(賀百克)VACCINEB型流感嗜血桿菌瓶800GARDASILHPV(第1劑)6,11,16,18TYPE瓶3500GARDASILHPV(第2劑)6,11,16,18TYPE瓶3500GARDASILHPV(第3劑)6,11,16,18TYPE瓶3500MMRVACCINE(麻疹、腮腺炎、德國麻疹混合針40肺炎鏈球菌疫苗(自費-1)PREVENARINJECTIO瓶3000肺炎鏈球菌疫苗(自費-2)PREVENARINJECTION瓶3000肺炎鏈球菌疫苗(自費-3)PREVENARINJECTIO次3000肺炎鏈球菌疫苗(自費-4)PREVENARINJECTION次3000肺炎疫苗(2歲以上)PNEUMOVAX23VACCINE2瓶1200肺炎鏈球菌疫苗(75歲以上)次90十價肺炎鏈球菌疫苗SYNFLORIX自費1針3000十價肺炎鏈球菌疫苗SYNFLORIX自費2針3000十價肺炎鏈球菌疫苗SYNFLORIX自費3針3000十價肺炎鏈球菌疫苗SYNFLORIX自費4針3000VARILRIXINJECTION(水痘疫苗)針50兒科CEFAZOLINSODIUM1G瓶100ROCEPHIN500MGIV瓶500PORO80MG顆2BOKEY100MGE.M.CAPSULES顆3DOMPE10MG/TAB顆2*RUMIL30MGTABLET陸眠兒錠顆2ACLOVIRCREAM5G艾剋樂芙乳膏條180(兒)TETRACYCLINEEYEOINTMENT5G鹽酸四瓶60SINBABYBABYLOTION120ML/瓶金貝比嬰兒條120IDEFENSUSPENSION(20MG/ML)60ML/瓶炎ML30PEACESYRUP(兒科)鼻福ML50顆40AVERINE40MG/TAB.痙寧錠顆10ESPIN100MGE.M.CAP.安心平顆2.5CALLATE950mgTABLET鈣悅錠TAB5CBFR組3900DIPHENIDOLS.C.50MG/TAB.待芬朵顆5*CYTOTEC200UG/TAB顆35EP225mg顆3EP325mg顆3EASYFORSRCapsule75mg悅康個40*爾可利錠ERGOLATE0.2MG/TAB顆1.5*NAKASSER30MGTAB.顆4.5CEFACLOR250MGCAPSULE顆12*LOMEDIL150MGTABLET洛脈達膜衣錠顆17MayPul(90顆/盒)信東媚寶盒900MELIANEOC21TABS/盒玫麗安避孕藥(X)盒300(婦科)MAGNESIUMOXIDE250MG/TAB顆2.5NOOPOL400MG/CAP腦寶膠囊顆8CRIPTINE(PARLODEL)2.5MG/TAB顆20MEFEN500MG/TAB.莫炎膜衣錠顆1.3PRAMETFATABLETS30顆/瓶盼納補瓶300PRAMETFATABLETS盼納補6顆/瓶瓶60(贈品用)PRAMETFATABLETS30顆/瓶盼納補瓶0EYZU(premarin)0.625MG/TAB依汝膜衣錠顆5THROUGHF.C.TABLETSC.M.12MG(便通樂顆2.5MEITAN50MG漠疼膜衣錠顆2.5六鵬高單位B群30顆/瓶瓶500六鵬健多龍粉劑60G/瓶350杏輝沛多兒童維他命60顆/瓶瓶380杏輝沛多大豆異黃酮60顆/盒盒1200杏輝沛多仕女綜合維他命軟膠囊60顆/瓶瓶480杏輝沛多仕女綜合維他命軟膠囊10顆/瓶瓶80FRUKUCAL50TAB/瓶六鵬鈣片膜衣錠瓶500六鵬普惠膠囊(鐵劑)30顆/盒盒600惠幼軟糖-瓶裝80G/瓶瓶100惠幼(兒科)軟糖-袋裝120G/袋袋100六鵬維他命水果軟糖80G/瓶瓶100六鵬退熱貼150MMX50MM/片(6片/盒)盒150六鵬乳鐵蛋白乳酸菌50包/盒盒600六鵬惠普軟膠囊30顆/盒PROWELLB-CAROTE盒300惠幼兒童成長鈣40顆/盒盒300L.PARACASEI33120顆/盒(輔克敏膠囊)盒3500蔓越莓信東媚寶MayPul(60顆/盒)盒1000TOFIPAN60CAPS/盒(更年益膠囊)盒1500金牌獎羊乳鈣片150顆/瓶瓶100TOFIPAN-Z30錠/盒特補健(formaleadult盒1500惠幼(兒科)益兒壯Kinderlyte500mL/瓶瓶50惠幼益兒壯Kinderlyte360ML/瓶(4瓶一組)組150惠幼(兒科)A+LSORS310ML/瓶(4瓶/組)組150惠幼(兒科)玫瑰棗精華露500ML瓶100凡士林瓶80康敏加強型乳酸菌膠囊120x2+40Caps/組(C組7000康敏加強型乳酸菌膠囊120Caps/盒(Come-Mi盒3600康敏加強型乳酸菌膠囊40Caps/盒(Come-Mi盒1500利骨加液鈣膠囊食品瓶600骨力康(BONESAVE)750mg/tab瓶900寶兒壯(兒科)KIDANGELGRANULES150G/瓶瓶500S-26嬰兒奶粉瓶0亞培心美力奶粉瓶0亞培心美力無乳糖奶粉罐270ANISE安妮科技成長奶粉900gm瓶500雀巢AL-110無乳糖奶粉瓶260舒摩兒極效嫩白修護組組480舒摩兒清潔組組399薄荷油(兒科)10ML/瓶瓶100惠幼(兒科)嬰兒順暢按摩膏30G瓶100舒摩兒潤澤凝露57G/條EVELUBRICATINGJE條250舒逸敏異敏防護潔膚露250ml(forsensitive瓶600舒摩兒舒粉SUMMER'SEVEMEDICATEDPOWDER瓶290舒摩兒浴潔露EVEWASH瓶399舒摩兒護理噴劑Evecleansingmist瓶180菲蘇德美控油消痘調理化妝水瓶580舒摩兒異敏舒緩防護露SKINTONER(sensitv瓶350雅佛莉露荔妍嫩白洗顏露瓶500雅佛莉露防曬隔離霜SPF35瓶750雅佛莉露荔妍嫩白精華液瓶1500BURT'BEES3小瓶/GiftBox瓶300EMNGAIN(兒科)醫敏家20ECFU/CAP120S/BOX盒3000舒摩兒私密嫩白露條400EVE舒摩兒瞬潔防護組盒520優生(兒科)綠茶萃取凡士林50ml/瓶瓶100新寶納多30粒/瓶瓶250CENTRUM新寶納多200粒/瓶瓶1000安妮嬰兒奶粉(900g)瓶520安妮順暢配方成長奶粉(900g)瓶500安妮生力軍成長奶粉(900g)瓶490舒摩兒夏日全效防護組組799雀巢水解蛋白奶粉瓶300乾洗手噴劑瓶100舒摩兒異敏泡浴乳(EVEBABYBATH)瓶400惠幼棗順暢300ML瓶65SAFEPLAN0.75MG/TAB2顆/盒愉婷錠事後盒300(綠)賽吉兒菁萃潔浴凝露250ml(加強型)瓶500(粉)賽吉兒菁萃潔浴凝露250ml(黃金女郎型)瓶520(小藍)賽吉兒30ML保濕凝膠(日用型)瓶680(小綠)賽吉兒30ml高效保濕凝膠(加強型)瓶700(小粉)賽吉兒30ml菁萃柔嫩乳霜(熟齡婦女)瓶850好力鈣CALCICHEWD3瓶699吉賽兒男性專用沐浴拿鐵250ML/瓶瓶580BABYGELLA寶貝吉兒沐浴露250ML/瓶瓶450Polyxal玻麗舒疤痕護理凝膠15G條1890(兒科)DHA50%120CAP.新速力聰魚油瓶1000PRObiotics易湧康60包/盒盒4000ANCE-CURE艾思美抗痘乳膏15GMGM120ANTISCARCREAM條150B-I優碘(酒精性)杏輝SINDINEALCOHOLICSML0金碘藥水(外用)200MLSINDINESOLUTION瓶120B-I優碘榮民3800ML/瓶PROVIDONE-IODINEML900CIVIDOID2.5G/條喜美凝膠條0CIVIDOID20GM/條喜美凝膠條150DICLOFEGEL1%ROOT40G克炎平凝膠克200FLIXONASEAQUEOUSNASALSPRAY50MCG/SPRA瓶500MEFUGELVAGINALGEL0.75%35gm美婦寧條350MYCONXINCREAM0.5%10g瑪克癬乳膏條200NEOMYCINOINTMENT新黴素軟膏條50NICOTINELL貼片4片/盒盒400NICOTINELL貼片4片/盒(部分負擔用)盒180NINCORTORALGEL6g寧康口內膠條120SmokfreePatch5cm(4.2mg/天)7片盒650XYLMOLOINTMENTHEMORRHOIDALPREPARETION條100SINBABY(兒科)BABYLOTION120ML/瓶金貝瓶120ULWYCONSuspension欣胃立康懸濁液包12ULSTALSUSPENSION胃立舒泰懸濁液包10ALUMGELLIQUID4G/100ML胃乳ML0.5保兒力500ML維持液瓶100KLARICIDPAEDIATRICSUSPENSION(兒科)ml6LACTULSYRUP60ML/瓶(樂多糖漿)ML1SPIZSYRUP60ML/瓶(舒鼻適複方糖漿)