| 淺股動脈支架 | CBC0490204BA | “路透尼斯”巴德路透尼斯035經皮穿刺血管成形術藥物塗層球囊導管”Lutonix”Bard Lutonix 035 Drug Coated Balloon PTA Catheter | 巴德 | 支 | 75,600 | 28,773 | 46,827 |
| 淺股動脈支架 | CBC04APDCBM4 | “美敦力”愛德米羅紫杉醇塗藥周邊球囊導管”MEDTRONIC”IN.PACT ADMIRAL PACLITAXEL-COATED PTA BALLOON CATHETER | 美敦力 | 支 | 81,000 | 28,773 | 52,227 |
| 淺股動脈支架 | CBC04ELUT1SB | “波士頓科技”艾路米亞塗藥支架系統”Boston Scientific”Eluvia Drug-Eluting Vascular Stent System D:6-7MM;L:40-120MM | 波士頓 | 組 | 85,725 | 28,773 | 56,952 |
| 淺股動脈支架 | CBC04ELUT2SB | “波士頓科技”艾路米亞塗藥支架系統”Boston Scientific”Eluvia Drug-Eluting Vascular Stent System L:150MM | 波士頓 | 組 | 97,200 | 44,293 | 52,907 |
| 淺股動脈支架 | CBC04PASLXBK | “百多力”帕西歐樂思紫杉醇釋放周邊血管氣球擴張導管(直徑>=4mm) BIOTRONIK”Passeo-18 Lux Paclitaxel releasing PTA Balloon Catheter | 百多力 | 支 | 54,000 | 28,773 | 25,227 |
| 淺股動脈支架 | CBC04PPDCBM4 | “美敦力”派斯飛克紫杉醇塗藥周邊球囊導管”Medtronic”IN.PACT Pacific Paclitaxel-eluting PTA Balloon Catheter | 美敦力 | 支 | 47,250 | 28,773 | 18,477 |
| 淺股動脈支架 | CBC04RASFASB | “波士頓科技”藍吉紫杉醇塗藥周邊氣球導管”BOSTON SCIENTIFIC”RANGER AND RANGER SL PACLITAXEL-COATED PTA BALLOON CATHETER | 波士頓 | 支 | 48,773 | 28,773 | 20,000 |
| 淺股動脈支架 | CBC04Z1SV6CK | “曲克”利弗爾周邊血管支架”Cook”Zilver PTX Drug Eluting Peripheral Stent | 曲克 | 組 | 74,250 | 28,773 | 45,477 |
