Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
(RM)
TAHUN 2016
(RM)
TAHUN 2017
(RM)
TAHUN 2018 [Kos
perkhidmatan
(RM)]
1 RAWATAN PESAKIT DALAM INPATIENT TREATMENT 37 sehari 55 sehari 73 sehari 100 sehari
2 RAWATAN PSIKIATRIK PSYCHIATRIC TREATMENT975 setiap kali
dimasukkan ke
hospital.
1,125 setiap kali
dimasukkan ke
hospital.
1,275 setiap kali
dimasukkan ke
hospital.
1,500 setiap kali
dimasukkan ke
hospital.
BERSALIN DELIVERY CHARGES
3 Caesarean Caesarean 1,606 2,011 2,415 3,021
Bersalin dengan bantuan : Delivery with help:
4 Forsep/ breech/vakum Forcep/Breech/Vacuum 1,198 1,597 1,995 2,593
5 Bersalin Kembar Twin 1,338 1,697 2,055 2,593
6 Bersalin Biasa Spontaneous Vertex Delivery 1,128 1,547 1,965 2,593
CAJ RAWATAN ATAU PROSEDUR OTHER TREATMENT
7 Kardiotokograf Cardiotocograph 57 75 93 120
8 Toilet & Suture per stich Toilet & suture per stich 50 50 50 50
9 Fine needle aspiration Fine needle aspiration 111 158 205 275
10 Incision & drainage Incision & drainage 118 163 208 275
11 Catheterisation Catheterisation 61 68 75 85
RADIOTERAPI RADIOTHERAPY TREATMENT
SIMULASI DAN PERANCANGAN BERKOMPUTERSIMULATION AND COMPUTERIZED PLANNING
12 Penandaan Setempat/Mark on set Mark on set 15 25 35 50
13 Simulasi Konvensional/Conventional Simulation Conventional Simulation 300 500 700 1,000
14Simulasi CT/CT Simulation - Biasa (tanpa contrast)/Normal (without contrast)
CT Simulation - Normal (without contrast) 450 750 1,050 1,500
15Simulasi CT/CT Simulation - Kompleks (dengan contrast)/Complex (with contrast)
CT Simulation - Complex (with contrast) 900 1,500 2,100 3,000
16Simulasi CT/CT Simulation - IMRT/Rapid Arc. , TBI, TNI, TBE
CT Simulation - IMRT/Rapid Arc. , TBI, TNI, TBE
1,500 2,500 3,500 5,000
17Simulasi CT/CT Simulation - Stereotactic Radiosurgery (SRT)
CT Simulation - Stereotactic Radiosurgery (SRT)
6,000 10,000 14,000 20,000
RAWATAN RADIOTERAPI RADIOTHERAPY TREATMENT
18 2D/Single field/parallel opposed per fraction 2D/Single field/parallel opposed per fraction 105 175 245 350
19 3D/any plans with 3 or more fields per fraction3D/any plans with 3 or more fields per fraction
135 225 315 450
20 IMRT/Rapid Arc per fraction IMRT/Rapid Arc per fraction 150 250 350 50021 TBI per fraction TBI per fraction 150 250 350 50022 TNI per fraction TNI per fraction 210 350 490 70023 SRT per fraction SRT per fraction 150 250 350 500
JADUAL 3FI RAWATAN
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Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
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TAHUN 2016
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TAHUN 2017
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TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
24 SRS (Rawatan pakej- sekali caj sahaja) SRS (package treatment - onetime charge) 9,000 15,000 21,000 30,000
AKSESORI PAKAI BUANG (CONSUMABLES) CONSUMABLES
25 Topeng Cegah Gerak (Beam Direction Shell) Beam Direction Shell 75 125 175 25026 Vac-Lock Vac-Lock 75 125 175 25027 Cerroband Cerroband 150 250 350 50028 Wax Wax 90 150 210 300
RAWATAN BRAKITERAPI BRACHYTHERAPY TREATMENT
29Intra-cavitari : Dhobbies/single line source per session
Intra-cavitari : dhobbies/single line source per session
1,500 2,500 3,500 5,000
30 Intra-cavitari : Paired Ovoids per session Intra-cavitari : paired ovoids per session 1,500 2,500 3,500 5,000
31 Intra-cavitari : Full Intra- cavitary per session Intra-cavitari : full intra- cavitary per session 1,500 2,500 3,500 5,000
32Intra-cavitari : For Nasopharyngeal Cancer (NPC) per session
Intra-cavitari : for nasopharyngeal cancer (NPC) per session
2,100 3,500 4,900 7,000
33Intra-luminal : Esophagus, bronchus, ano-rectal per session
Intra-luminal : Esophagus, bronchus, ano-rectal per session
90 150 210 300
34Interstitial brachytherapy implants : Breast brachytherapy implants per implant
Interstitial brachytherapy implants : Breast brachytherapy implants per implant
1,950 3,250 4,550 6,500
35Interstitial brachytherapy implants : Extremities implants per implant
Interstitial brachytherapy implants : Extremities implants per implant
1,800 3,000 4,200 6,000
36Interstitial brachytherapy implants : Oral cavity/anorectal/prostate implants per implant
Interstitial brachytherapy implants : Oral cavity/anorectal/prostate implants per implant
2,250 3,750 5,250 7,500
37 Prostate brachytherapy procedure Prostate brachytherapy procedure 3,000 5,000 7,000 10,000
38 Iodine-131 therapy (not Iodine scan) per sessionIodine-131 therapy (not Iodine scan) per session
240 400 560 800
KEMOTERAPI CHEMOTHERAPYSingle Agent Single AgentJenis A Type A
39 Low dose cisplatin Low dose cisplatin 20 33 46 6540 Methotrexate Methotrexate 20 33 46 6541 Doxorubicin Doxorubicin 20 33 46 6542 Vinorelbine Vinorelbine 20 33 46 65
Jenis B Type B 43 Carboplatin Carboplatin 78 130 182 26044 Paclitaxel Paclitaxel 78 130 182 26045 Fluorouracil Fluorouracil 78 130 182 26046 Oxaliplatin Oxaliplatin 78 130 182 26047 High dose cisplatin High dose cisplatin 78 130 182 260
Page 2
Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
(RM)
TAHUN 2016
(RM)
TAHUN 2017
(RM)
TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
Jenis C Type C48 Gemcitabine Gemcitabine 330 550 770 1,10049 Bleomycin Bleomycin 330 550 770 1,10050 Docetaxel Docetaxel 330 550 770 1,10051 Ifosphamide Ifosphamide 330 550 770 1,10052 Mitoxantrone Mitoxantrone 330 550 770 1,10053 Mitomycin Mitomycin 330 550 770 1,10054 Irinotecan Irinotecan 330 550 770 1,100
Jenis D Type D55 Pemetrexed Pemetrexed 1,650 2,750 3,850 5,50056 Pegylated Liposomal Doxorubicin Pegylated Liposomal Doxorubicin 1,650 2,750 3,850 5,500
Double Agents Double Agents57 Doxorubicin + Cyclophosphamide Doxorubicin + Cyclophosphamide 21 35 49 7058 Doxorubicin + Ifosphamide Doxorubicin + Ifosphamide 198 331 463 66159 Doxorubicin + Cisplatin Doxorubicin + Cisplatin 27 45 62 8960 Doxorubicin + Docetaxel Doxorubicin + Docetaxel 291 486 680 97161 Doxorubicin + Paclitaxel Doxorubicin + Paclitaxel 68 114 159 22762 Doxorubicin + Gemcitabine Doxorubicin + Gemcitabine 98 163 228 32563 Carboplatin + Fluorouracil Carboplatin + Fluorouracil 44 74 104 14864 Carboplatin + Paclitaxel Carboplatin + Paclitaxel 119 199 279 39865 Carboplatin + Etoposide Carboplatin + Etoposide 32 53 74 10566 Carboplatin + Gemcitabine Carboplatin + Gemcitabine 169 282 395 56467 Carboplatin + Docetaxel Carboplatin + Docetaxel 310 517 723 1,03368 Carboplatin + Vinorelbine Carboplatin + Vinorelbine 88 146 204 29269 Cisplatin + Paclitaxel Cisplatin + Paclitaxel 69 116 162 23170 Cisplatin + Etoposide Cisplatin + Etoposide 40 67 93 13371 Cisplatin + Fluorouracil Cisplatin + Fluorouracil 38 63 88 12672 Cisplatin + Pemetrexed Cisplatin + Pemetrexed 1,848 3,080 4,312 6,16073 Cisplatin + Gemcitabine Cisplatin + Gemcitabine 178 296 414 59274 Cisplatin + Vinorelbine Cisplatin + Vinorelbine 21 35 48 6975 Cisplatin + Ifosphamide Cisplatin + Ifosphamide 305 509 713 1,01876 Cisplatin + Methotrexate Cisplatin + Methotrexate 13 22 31 4477 Cisplatin + Cyclophosphamide Cisplatin + Cyclophosphamide 20 34 48 6878 Cyclophosphamide + Vincristine Cyclophosphamide + Vincristine 10 17 23 3379 Cyclophosphamide + Epirubicin Cyclophosphamide + Epirubicin 100 167 234 33480 Etoposide + Fluorouracil Etoposide + Fluorouracil 44 74 103 14781 Gemcitabine + Vinorelbine Gemcitabine + Vinorelbine 95 159 223 31882 Gemcitabine + Paclitaxel Gemcitabine + Paclitaxel 223 371 519 74283 Gemcitabine + Oxaliplatin Gemcitabine + Oxaliplatin 130 217 303 43384 Ifosphamide + Vinorelbine Ifosphamide + Vinorelbine 232 387 542 77485 Ifosphamide + Epirubicin Ifosphamide + Epirubicin 417 695 972 1,38986 Irinotecan + Fluorouracil Irinotecan + Fluorouracil 158 264 370 52887 Mitomycin + Fluorouracil Mitomycin + Fluorouracil 202 337 472 674
Page 3
Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
(RM)
TAHUN 2016
(RM)
TAHUN 2017
(RM)
TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
88 Oxaliplatin (130 mg/m2) + Capecitabine Oxaliplatin (130 mg/m2) + Capecitabine 388 647 905 1,293
89 Oxaliplatin + Fluorouracil Oxaliplatin + Fluorouracil 95 159 222 31790 Paclitaxel + Fluorouracil Paclitaxel + Fluorouracil 91 152 213 304
91 Capecitabine + Irinotecan (240 mg/m2) Capecitabine + Irinotecan (240 mg/m2) 468 780 1,092 1,560
Triple Agent Triple Agent
92 Doxorubicin + Cyclophosphamide + EtoposideDoxorubicin + Cyclophosphamide + Etoposide
66 110 154 220
93 Doxorubicin + Cisplatin + Ifosphamide Doxorubicin + Cisplatin + Ifosphamide 146 244 342 48894 Doxorubicin + Dacarbazine + Ifosphamide Doxorubicin + Dacarbazine + Ifosphamide 494 823 1,152 1,64595 Bleomycin + Etoposide + Cisplatin Bleomycin + Etoposide + Cisplatin 371 618 865 1,236
96 Doxorubicin + Cyclophosphamide + Cisplatin Doxorubicin + Cyclophosphamide + Cisplatin 28 46 64 92
97 Cyclophosphamide + Methotrexate + FluorouracilCyclophosphamide + Methotrexate + Fluorouracil
19 31 43 62
98 Epirubicin + Cisplatin + Fluorouracil Epirubicin + Cisplatin + Fluorouracil 93 155 217 310
99 Fluorouracil + Doxorubicin + CyclophosphamideFluorouracil + Doxorubicin + Cyclophosphamide
20 34 48 68
100 Fluorouracil + Epirubicin + CyclophosphamideFluorouracil + Epirubicin + Cyclophosphamide
83 139 195 278
101 Ifosphamide + Carboplatin + Etoposide Ifosphamide + Carboplatin + Etoposide 338 563 788 1,125
102 Ifosphamide + Dactinomycin + Vincristine Ifosphamide + Dactinomycin + Vincristine 336 560 784 1,120
103 Gemcitabine + Paclitaxel + Carboplatin Gemcitabine + Paclitaxel + Carboplatin 277 462 647 924
104 Procarbazine + Lomustine + Vincristine Procarbazine + Lomustine + Vincristine 742 1,236 1,730 2,472
105 Ifosphamide + Cisplatin + Etoposide Ifosphamide + Cisplatin + Etoposide 306 510 713 1,019
106 Docetaxel + Doxorubicin + CyclophosphamideDocetaxel + Doxorubicin + Cyclophosphamide
266 444 622 888
107 Paclitaxel + Ifosphamide + Cisplatin Paclitaxel + Ifosphamide + Cisplatin 305 508 711 1,015108 Docetaxel + Cisplatin + Fluorouracil Docetaxel + Cisplatin + Fluorouracil 321 535 749 1,070109 Paclitaxel + Carboplatin + Etoposide Paclitaxel + Carboplatin + Etoposide 274 456 638 912110 Paclitaxel + Carboplatin + Fluorouracil Paclitaxel + Carboplatin + Fluorouracil 294 491 687 981111 Mitomycin + Ifosphamide + Cisplatin Mitomycin + Ifosphamide + Cisplatin 230 383 536 766
112 Vincristine + Doxorubicin + CyclophosphamideVincristine + Doxorubicin + Cyclophosphamide
27 45 63 90
113 Vincristine + Dactinomycin + CyclophosphamideVincristine + Dactinomycin + Cyclophosphamide
155 258 361 515
114 Vincristine + Epirubicin + Cyclophosphamide Vincristine + Epirubicin + Cyclophosphamide 77 129 181 258
115 Vincristine + Etoposide + Carboplatin Vincristine + Etoposide + Carboplatin 174 291 407 581116 Etoposide + Cisplatin + Ifosphamide Etoposide + Cisplatin + Ifosphamide 224 373 522 745
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Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
(RM)
TAHUN 2016
(RM)
TAHUN 2017
(RM)
TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
117 Vinblastine + Ifosphamide + Cisplatin Vinblastine + Ifosphamide + Cisplatin 209 348 487 695118 Vinorelbine + Ifosphamide + Cisplatin Vinorelbine + Ifosphamide + Cisplatin 344 574 804 1,148
Complex Regime Complex Regime
119Etoposide + Dactinomycin + Methotrexate + Vincristine + Cyclophosphamide
Etoposide + Dactinomycin + Methotrexate + Vincristine + Cyclophosphamide
101 169 237 338
120Etoposide + Cisplatin + Dactinomycin + Methotrexate
Etoposide + Cisplatin + Dactinomycin + Methotrexate
65 109 152 217
121Etoposide + Vincristine + Doxorubicin + Ifosphamide + Dactinomycin
Etoposide + Vincristine + Doxorubicin + Ifosphamide + Dactinomycin
333 555 777 1,110
122Ifosphamide + Vincristine + Dactinomycin + Doxorubicin
Ifosphamide + Vincristine + Dactinomycin + Doxorubicin
293 488 683 975
123Vincristine + Doxorubicin + Cyclophosphamide + Dactinomycin
Vincristine + Doxorubicin + Cyclophosphamide + Dactinomycin
118 196 274 392
124Vincristine + Doxorubicin + Ifosphamide + Dactinomycin
Vincristine + Doxorubicin + Ifosphamide + Dactinomycin
347 579 810 1,157
125Vincristine + Ifosphamide + Carboplatin + Etoposide
Vincristine + Ifosphamide + Carboplatin + Etoposide
283 472 661 944
126Vincristine + Ifosphamide + Doxorubicin + Etoposide
Vincristine + Ifosphamide + Doxorubicin + Etoposide
342 571 799 1,141
127Methotrexate + Dactinomycin + Chlorambucil + Cyclophosphamide
Methotrexate + Dactinomycin + Chlorambucil + Cyclophosphamide
106 177 248 354
128Methotrexate + Vinblastine + Doxorubicin + Cisplatin
Methotrexate + Vinblastine + Doxorubicin + Cisplatin
70 116 162 232
Oral Agents Oral Agents
129 Capecitabine 1250mg/m2 Capecitabine 1250mg/m2 197 329 461 658
130 Capecitabine 1000mg/m2 Capecitabine 1000mg/m2 160 267 374 534
131 Capecitabine 850mg/m2 Capecitabine 850mg/m2 132 221 309 441
132 Chlorambucil Chlorambucil 28 47 66 95133 Cyclophosphamide Cyclophosphamide 1 2 2 3134 Etoposide Etoposide 122 203 284 405135 Procarbazine Procarbazine 155 258 361 516136 Tegafur Tegafur 77 128 179 255137 Temozolomide Temozolomide 1,622 2,703 3,784 5,405
TARGETED THERAPY TARGETED THERAPY138 Erlotinib 100mg Erlotinib 100mg 1,412 2,353 3,294 4,705139 Erlotinib 150mg Erlotinib 150mg 1,740 2,900 4,060 5,800140 Imatinib 100mg Imatinib 100mg 1,348 2,246 3,144 4,492141 Gefitinib Gefitinib 1,513 2,522 3,530 5,043142 Imatinib 400mg Imatinib 400mg 2,763 4,605 6,447 9,210143 Pazopanib 200mg Pazopanib 200mg 554 924 1,294 1,848144 Pazopanib 400mg Pazopanib 400mg 837 1,395 1,953 2,790
Page 5
Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
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TAHUN 2016
(RM)
TAHUN 2017
(RM)
TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
145 Trastuzumab (loading dose) Trastuzumab (loading dose) 2,093 3,489 4,884 6,977146 Trastuzumab (maintainence dose) Trastuzumab (maintainence dose) 1,522 2,537 3,552 5,074147 Cetuximab (2 weekly regime) Cetuximab (2 weekly regime) 1,834 3,056 4,278 6,112
HORMONE THERAPY HORMONE THERAPY148 Anastrazole Anastrazole 22 37 52 74149 Bicalutamide Bicalutamide 22 37 52 74150 Exemestane Exemestane 239 398 557 796151 Flutamide Flutamide 27 46 64 91152 Letrozole Letrozole 38 63 88 126153 Leuprolide Acetate 3.75mg Leuprolide Acetate 3.75mg 95 158 221 316154 Leuprolide Acetate 11.25mg Leuprolide Acetate 11.25mg 291 486 680 971155 Medroxyprogesterone acetate (IM) Medroxyprogesterone acetate (IM) 8 13 18 26156 Megestrole Acetate Megestrole Acetate 240 400 560 800157 Tamoxifen Tamoxifen 5 8 11 16158 Goserelin 10.8 Depot (setiap 3 bulan) Goserelin 10.8 Depot (setiap 3 bulan) 298 496 694 992159 Goserelin 3.6 Depot Goserelin 3.6 Depot 80 133 186 265
IMMUNO THERAPY IMMUNO THERAPY160 Interfelon Alfa Interfelon Alfa 341 568 795 1,136
PERUBATAN NUKLEAR NUCLEAR MEDICINE161 Teknetium-99M Pirauan Kardiak Teknetium-99M Cardiac Shunt 91 105 119 140
162 Teknetium-99M Kajian Pirofosfat Teknetium-99M Phyrophosphate Study 156 180 204 240
163 Teknetium-99MIBI kajian Latihan dan Rehat Teknetium-99MIBI Exercise & Rest Study 1,105 1,275 1,445 1,700
164 Talium-201 Kajian Latihan dan Rehat Talium-201 Exercise & Rest Study 1,170 1,350 1,530 1,800165 Imbasan Limpahan Hati Berlawang Gated Heart Pool Scan 884 1,020 1,156 1,360166 Pengimejan Tertangguh 24 jam 24 Hours Delay Imaging 260 300 340 400
NEFROLOGY NEPHROLOGY
167 Intermitent peritoneal dialysis bagi setiap rawatan Intermitent peritoneal dialysis per treatment 265 275 285 300
168 Rawatan CAPD sebulan CAPD treatment (monthly) 980 1,300 1,620 2,100169 Renal biopsy (tidak termasuk laporan) Renal biopsy (excluding report) 185 275 365 500170 Femoral/Subclavian Catherisation Femoral/subclavian catherisation 335 525 715 1,000171 Haemoperfusion Haemoperfusion 475 625 775 1,000172 Implantation of tenchoff catheter Implantation of tenchoff catheter 130 150 170 200173 Pretransplant dialysis treatment Pretransplant dialysis treatment 1,300 1,500 1,700 2,000
174 Lawatan di rumah bagi setiap haemodilaisis Home visit per Haemodialysis 130 setiap lawatan.
150 setiap lawatan.
170 setiap lawatan.
200 setiap lawatan.
175 Cycle-PD / Automated PD Cycle-PD / Automated PD 800 800 800 800176 Intermitent Peritoneal Dialysis Stab Intermitent peritoneal dialysis stab 800 800 800 800
177 Intermitent Peritoneal Dialysistenckhoff Intermitent peritoneal dialysis tenckhoff 800 800 800 800
Page 6
Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
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TAHUN 2016
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TAHUN 2017
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TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
178 Continuous Arteriovenous Haemofiltration Continuous arteriovenous haemofiltration 800 800 800 800
179 Continuous Venovenous Haemodiafiltration Continuous venovenous haemodiafiltration 1,160 1,400 1,640 2,000
180 Continuous Venovenous Haemodialysis Continuous venovenous haemodialysis 1,160 1,400 1,640 2,000
181 Continuous Venovenous Haemofiltration Continuous venovenous haemofiltration 827 845 863 890
182 Nightly Intermitent Peritoneal Dialysis Nightly intermitent peritoneal dialysis 1,190 1,450 1,710 2,100183 Plasma Exchange Plasma exchange 1,130 1,350 1,570 1,900184 Plasmapharesis Plasmapharesis 1,130 1,350 1,570 1,900185 Haemofiltration Haemofiltration 300 300 300 300186 Haemodialysis Single Use Kidney Haemodialysis single use kidney 148 163 178 200
187 Haemodialysis Single Use Kidney High-Flux Haemodialysis single use kidney high-flux 148 163 178 200
188 Haemodialysis Single Use Kidney Low-Flux Haemodialysis single use kidney low-flux 148 163 178 200
189 Haemo Single Use Kidney Middle- Flux Haemodialysis single use kidney middle- flux 148 163 178 200
190Catheter Insertion Surgical Tenckhoff Peritoneal Sco
Catheter insertion surgical tenckhoff peritoneal sco
855 1,325 1,795 2,500
191 Catheter Removal Medical Tenckhoff (Non OT)Catheter removal medical tenckhoff (Non OT)
255 325 395 500
192 Catheter Removal Surgical Tenckhoff ( No OT)Catheter removal surgical tenckhoff ( Non OT)
255 325 395 500
193 Kt/v (CAPD) Kt/v (CAPD) 150 150 150 150194 Catheter Insertion Central Venous Catheter insertion central venous 335 525 715 1,000
195 Catheter Insertion CV Under US Guidance Catheter insertion CV under US guidance 335 525 715 1,000
196Catheter Insertion Femoral Double Lumen (non cuffed)
Catheter insertion femoral double lumen (non cuffed)
275 425 575 800
197 Catheter Insertion Femoral Single Lumen Catheter insertion femoral single lumen 335 525 715 1,000
198 Catheter Insertion Permenant Catheter insertion permanent 785 1,275 1,765 2,500199 Haemodiafiltration Online Haemodiafiltration online 125 175 225 300200 Haemodialysis Reuse Kidney Haemodialysis reuse kidney 138 150 162 180201 Haemodialysis Reuse Kidney High-Flux Haemodialysis reuse kidney high-flux 138 150 162 180202 Haemodialysis Reuse Kidney Low-Flux Haemodialysis reuse kidney low-flux 138 150 162 180
203 Haemodialysis Reuse Kidney Middle-Flux Haemodialysis reuse kidney middle-flux 138 150 162 180
204 Renal Biopsy- Biopty Gun Renal biopsy- biopty gun 185 275 365 500205 Renal Biopsy-Cooks Renal biopsy-cooks 185 275 365 500206 Renal Biopsy-Tru Cut Renal biopsy-tru cut 185 275 365 500
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Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
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TAHUN 2016
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TAHUN 2017
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TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
207 Slow Continuous Ultrafiltration Slow continuous ultrafiltration 335 per hari. 525 per hari. 715 per hari. 1,000 per hari.
208 Ultrafiltration Ultrafiltration 95 125 155 200209 Catheter Removal Central Venous Catheter removal central venous 95 125 155 200
210 Catheter Removal Femoral Double Lumen Catheter removal femoral double lumen 95 125 155 200
211 Catheter Removal Central Venous Under US Catheter removal central venous under US 95 125 155 200
212 Catheter Removal Femoral Single Lumen Catheter removal femoral single lumen 95 125 155 200213 Renal Allograft Ultrasound Renal allograft ultrasound 65 75 85 100214 Renal Allograft Ultrasound Doppler Renal allograft ultrasound doppler 80 100 120 150
FISIOTERAPI PHYSIOTHERAPY
ELECTROTHERAPY MODALITIES ELECTROTHERAPY MODALITIES215 Biofeedback/ myofeedback Biofeedback/ myofeedback 24 40 56 80216 Direct current/ Iontophorosis Direct current/ iontophorosis 24 40 56 80217 Didynamic Current Didynamic current 24 40 56 80218 Interrupted Direct Current (IDC) Interrupted Direct Current (IDC) 24 40 56 80219 Interferential Therapy (IT) Interferential Therapy (IT) 24 40 56 80220 Shortwave Diathermy (SWD) Shortwave Diathermy (SWD) 38 50 62 80
221Transcutaneous Electrical Nerve Stimulation (TENS)
Transcutaneous Electrical Nerve Stimulation (TENS)
24 40 56 80
222 Ultrasound Therapy (US) Ultrasound Therapy (US) 24 40 56 80223 Realtime Ultrasound Realtime ultrasound 24 40 56 80224 Functional Electrical Stimulation Functional electrical stimulation 24 40 56 80225 Shockwave Therapy Shockwave therapy 24 40 56 80
THERMAL THERAPY/ CRYOTHERAPY THERMAL THERAPY/ CRYOTHERAPY
226 Hot Pack Hot pack 12 20 28 40227 Wax Bath Wax bath 19 25 31 40228 Infrared Radiation Infrared radiation 12 20 28 40229 Cryotherapy Cryotherapy 12 20 28 40
PHOTOTHERAPY PHOTOTHERAPY230 Laser Therapy Laser therapy 24 40 56 80231 Ultraviolet Light Therapy Ultraviolet light therapy 38 50 62 80
CARDIORESPIRATORY THERAPY CARDIORESPIRATORY THERAPY
232 Active Cycle Breathing Technique (ACBT Active Cycle Breathing Technique (ACBT) 18 30 42 60
233 Breathing exercise Breathing exercise 32 40 48 60234 Bronchial Suction Bronchial suction 18 30 42 60235 Flutter/incentive Spirometer Flutter/incentive spirometer 18 30 42 60236 Inspiratory Muscle Training Inspiratory Muscle Training 18 30 42 60237 Inhalation Therapy Inhalation Therapy 18 30 42 60238 Percussion/Vibration Percussion/Vibration 18 30 42 60
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Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
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TAHUN 2017
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TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
239 Positive Expiratory Pressure Positive expiratory pressure 18 30 42 60240 Postural Drainage Postural drainage 18 30 42 60
MECHANO THERAPY MECHANO THERAPY241 Cervical Traction Cervical traction 31 45 59 80242 Lumbar Traction Lumbar traction 31 45 59 80243 Sequential Pump Sequential pump 24 40 56 80
HYDROTHERAPY HYDROTHERAPY 43 65 87 120244 Pool Exercise Pool exercise 36 60 84 120245 Whirlpool Whirlpool 43 65 87 120
MANUAL THERAPY MANUAL THERAPY246 Soft Tissue Manipulation Soft tissue manipulation 36 60 84 120247 Myofascial Release Myofascial release 36 60 84 120248 Manual Lymphatic Drainage Manual lymphatic drainage 36 60 84 120249 Accupressure Accupressure 36 60 84 120250 TAPING/BANDAGING/STRAPPING TAPING/BANDAGING/STRAPPING 36 60 84 120
251 COMPRESSION THERAPY (LYMPHOEDEMA)COMPRESSION THERAPY (LYMPHOEDEMA)
24 40 56 80
SPECIAL TECHNIQUES SPECIAL TECHNIQUES252 Canalith Repositioning Technique Canalith repositioning technique 24 40 56 80253 Gaze Stabilisation Exercise Gaze stabilisation exercise 24 40 56 80254 Icing/brushing Icing/Brushing 24 40 56 80255 Joint mobilisation Joint mobilisation 31 45 59 80256 McKenzie technique McKenzie technique 24 40 56 80257 Motor relearning programme (MRP) Motor Relearning Programme (MRP) 24 40 56 80258 Accupuncture Accupuncture 24 40 56 80259 Neurodevelopmental technique Neurodevelopmental technique 24 40 56 80
260 Proprioceptive Neuromuscular Facilitation (PNF)Proprioceptive Neuromuscular Facilitation (PNF)
24 40 56 80
EXERCISE THERAPY EXERCISE THERAPY261 Active, passive, resisted Active, passive, resisted 24 40 56 80262 Ambulation/Gait training Ambulation/Gait training 24 40 56 80263 Ante/Postnatal Exercise Ante/Postnatal Exercise 24 40 56 80264 Balance Training Balance training 24 40 56 80265 Bladder/bowel training Bladder/bowel training 24 40 56 80266 Circuit Training/Gymnic ball exercise Circuit training/Gymnic ball exercise 24 40 56 80267 Counter bracing Technique Counter bracing technique 24 40 56 80268 Functional Activities Functional activities 24 40 56 80269 Group Exercise Group exercise 24 40 56 80270 Isokinetic Exercise Isokinetic exercise 24 40 56 80271 Mechanical Exercise Mechanical exercise 24 40 56 80272 Pelvic Floor Exercise Pelvic floor exercise 24 40 56 80
273 Pelvic Floor Exercise -with PFX educator Pelvic floor exercise -with PFX educator 24 40 56 80
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FI RAWATAN
274 Relaxation Techniques Relaxation techniques 24 40 56 80275 Sensory re-education Sensory re-education 24 40 56 80276 Special Hand Regime Special hand regime 24 40 56 80277 Treadmill Treadmill 24 40 56 80
278CONSULTATION/STRUCTURED PATIENT EDUCATION/CAREER TRAINING
CONSULTATION/STRUCTURED PATIENT EDUCATION/ CAREER TRAINING
12 20 28 40
SPECIAL TEST – DIAGNOSTIC TOOL SPECIAL TEST – DIAGNOSTIC TOOL279 Berg’s Balance Test Berg’s Balance Test 36 60 84 120
280Clinical Test for Sensory Interaction & Balance (CTSIB)
Clinical Test for Sensory Interaction & Balance (CTSIB)
36 60 84 120
281 Computerized Dynamic Posturography Computerized dynamic posturography 36 60 84 120282 Computerized Hand Evaluation Computerized hand evaluation 36 60 84 120283 Dix-hall Pike Test Dix-Hall Pike Test 36 60 84 120284 Dynamic Gait Index Dynamic Gait Index 36 60 84 120285 Oculomotor Assessment Oculomotor assessment 36 60 84 120
286 Pelvic Floor Per Vagina/Per Rectal AssessmentPelvic Floor Per Vagina/Per Rectal Assessment
36 60 84 120
287 Perionometer Perionometer 36 60 84 120288 Sensory Testing Sensory testing 36 60 84 120289 Strength Duration Curve Strength duration curve 36 60 84 120290 Voluntary Muscle Testing Voluntary muscle testing 36 60 84 120291 Vestibular Test Vestibular test 36 60 84 120
CAJ RAWATAN PERGIGIAN DENTAL292 Cabutan Sebatang gigi kekal Extraction permanent tooth 29 35 41 50
293 Cabutan Gigi supernumerari /tunggul akar Extraction supernumerary/retained root 33 38 43 50
294 Cabutan Sebatang gigi desidus Extraction deciduous tooth 25 25 25 25
295 Cabutan -Komplikasi - Rawatan soket terinfeksi Extraction - complication - treatment of infected socket
29 35 41 50
296 Cabutan - Komplikasi -Pemberhentian pendarahan Extraction - complication - control of haemorrage
29 35 41 50
297 Cabutan - Komplikasi Extraction - complication 29 35 41 50
298 Tampalan Gigi kekal – satu permukaan Restoration permanent tooth - single surface 47 55 63 75
299Tampalan gigi kekal – permukaan berganda/dengan pin retensi
Restoration permanent tooth - multiple surface/with pin retention
55 68 81 100
300 Tampalan - gigi desidus Restoration - deciduous tooth 30 30 30 30301 Tampalan sementara Temporary restoration 20 23 26 30302 Penskaleran dan penggilapan Scaling and polishing per arch 89 125 160 214
303Dentur penuh (akrilik) - setiap rahang - termasuk bahan
Full denture (acrylic) - per jaw including materials
340 500 660 900
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304 Dentur separa (akrilik) - setiap rahang gigi pertama Partial denture (acrylic) - per jaw - first tooth 185 275 365 500
305 Dentur separa (akrilik) -maksimum Partial denture (acrylic) - maximum 366 490 614 800306 Dentur separa – setiap gigi tambahan Partial denture – per additional tooth 13 15 17 20
307Pembaikan plat dentur (tidak termasuk penggantian setiap gigi)
Repair of denture plate (not including replacement of tooth)
35 45 55 70
308 Pembaikan dentur (setiap gigi tambahan) Repair of denture (per additional tooth) 13 15 17 20
309 Relining/Rebasing – setiap denture Relining/Rebasing – per denture 50 70 90 120310 Pelindung mulut Mouth guard 15 25 35 50311 Soft Splint Soft splint 15 25 35 50312 Hard Splint Hard splint 60 100 140 200313 Splint lain : eg Oyster Splint lain : eg. oyster 15 25 35 50314 Obturator - acrylic Obturator - acrylic 83 88 93 100315 Obturator - molloplast Obturator - molloplast 130 150 170 200316 Feeding plate Feeding plate 15 25 35 50317 Aplians Lain Other dental appliances 83 88 93 100318 Prostesis muka Facial prosthesis 148 163 178 200
319 Jahitan semula kecederaan tisu lembut orofasial Resuture of soft tissue injury orofacial 54 73 92 120
320 Buka jahitan kecederaan tisu lembut orofasial Open suture soft tissue injury orofacial 18 30 42 60
321 Rawatan semula kecederaan tisu lembut orofasial Revision of soft tissue injury - orofacial 54 73 92 120
322 Insisi dan saliran – abses orofasial Incision and drainage - orofacial abscess 50 70 90 120
323Inlai/Onlai - setiap gigi (tidak termasuk caj bahan dan makmal)
Inlay/onlay- per tooth (excluding material and laboratory charges)
36 60 84 120
324Korona/venir - setiap unit (termasuk korona sementara tetapi tidak termasuk caj bahan dan makmal)
Crown/veneer - per unit (inclusive of temporary crown but excluding material and laboratory charges)
165 175 185 200
325Jambatan setiap abutmen/pontik (termasuk jambatan sementara tetapi tidak termasuk caj bahan dan makmal)
Bridge per abutment/pontic (inclusive of temporary bridge but excluding material and laboratory charges)
60 100 140 200
326 Korona keluli nirkarat - setiap unit Stainless steel crown - per unit 15 25 35 50327 Korona Strip - setiap unit Strip crown - per unit 9 15 21 30328 Pembaikan korona/jambatan Repair of crown/bridge 15 25 35 50329 Tiang dan teras - sebatang gigi Post and core per tooth 45 75 105 150330 Restorasi provisional - setiap gigi Provisional restoration - per tooth 9 15 21 30331 Rawatan kanal akar – Anterior Root canal treatment - anterior 80 100 120 150332 Rawatan kanal akar – Premolar Root canal treatment - premolar 200 200 200 200333 Rawatan kanal akar – Molar Root canal treatment - molar 300 300 300 300334 Rawatan kanal akar semula – Anterior Root canal retreatment - anterior 250 250 250 250
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335 Rawatan kanal akar semula – Premolar Root canal retreatment - premolar 300 300 300 300336 Rawatan kanal akar semula – Molar Root canal retreatment - molar 400 400 400 400337 Apeksifikasi - setiap gigi Apexification - per tooth 60 100 140 200338 Pemberhentian resopsi gigi – setiap gigi Arrest of tooth resorption - per tooth 45 75 105 150
339 Coronal Pulpotomi - Setiap gigi kekal Coronal Pulpotomy - per permanent tooth 45 75 105 150
340 Cvek Pulpotomi - setiap gigi kekal Cvek Pulpotomi - per permanent tooth 45 75 105 150
341 Pulpotomi - Setiap gigi Decidous Pulpotomy - per deciduous tooth 45 75 105 150342 Pulpektomi -setiap gigi Pulpectomy - per tooth 60 100 140 200
343Pelapikan pulpa (termasuk tampalan sementara) - Langsung/tidak Langsung
Pulp capping (includes temporary restoration) – Direct/Indirect
20 23 26 30
344 Rawatan pembuangan pulpa (extirpasi pulpa) Treatment of pulp removal (extirpasi pulp) 15 25 35 50
345 Pengeluaran alat yang terpisah/patah Retrieval of separated/broken instrument 60 100 140 200
346 Pemutihan gigi (luaran) – setiap rahang Tooth bleaching (external) - per arch 150 250 350 500347 Pemutihan gigi (dalaman) – setiap gigi Tooth bleaching (internal) - per tooth 15 25 35 50348 Mikroabrasi – setiap gigi Microabrasion- per tooth 15 25 35 50349 Fluorida topikal - setiap rahang Topical fluoride - per arch 15 25 35 50350 Pengapan fisur - setiap gigi Fissure sealant - per tooth 12 20 28 40351 Desensitisasi - setiap gigi Desensitisation- per tooth 9 15 21 30
352 Aplians tetap – pakej rawatan dua rahangFixed appliance – treatment package - both arches
4,450 4,750 5,050 5,500
353 Aplians tetap – pakej rawatan satu rahangFixed appliance – treatment package - single arch
2,210 2,350 2,490 2,700
354 Aplians fungsi tetap – setiap rahang Functional fixed appliance - per arch 600 1,000 1,400 2,000
355Pembukaan komponen aplians tetap - setiap rahang
Debonding of fixed appliance - per arch 90 150 210 300
356 Aplians penyambung rahang tetap Fixed expansion appliance -per arch 111 185 259 370
357 Aplians penyambung – setiap rahang – penggantiFixed expansion appliance - replacement –per arch
111 185 259 370
358Aplians penyambung tetap – setiap rahang – pembaikan
Fixed expansion appliance - repair - per arch 30 50 70 100
359Aplians penyambung tetap – simen semula - setiap rahang
Fixed expansion appliance - recementation 30 50 70 100
360 Retainer tetap - setiap rahang Fixed retainers - per arch 90 150 210 300
361 Retainer tetap - setiap rahang - Pengganti Fixed retainers -replacement -per arch 60 100 140 200362 Retainer tetap - setiap gigi - pembaikan Fixed retainers – repair - per tooth 30 50 70 100363 Retainer tetap - setiap rahang - penanggalan Fixed retainer - removal - per arch 60 100 140 200
364 Aplian fungsi boleh tanggal - setiap rahang Functional removable appliance - per arch 600 1,000 1,400 2,000
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365 Aplian fungsi boleh tanggal - PenggantiFunctional removable appliance - replacement
600 1,000 1,400 2,000
366 Aplian fungsi boleh tanggal - Pembaikan Functional removable appliance - repair 75 125 175 250
367 Aplian boleh tanggal – pakej rawatan setiap rahangRemovable appliance -treatment package -per arch
450 750 1,050 1,500
368Aplian boleh tanggal aktif - setiap rahang – Pengganti
Active removable appliance - replacement - per arch
120 200 280 400
369Aplian boleh tanggal pasif - setiap rahang – Pengganti
Passive removable appliance -replacement - per arch
120 200 280 400
370 Penyenggara ruang boleh tanggal - setiap rahang Removable space maintainer per arch 365 375 385 400
371Aplian aktif boleh tanggal - satu rahang – Pembaikan
Active removable - repair - per arch 75 125 175 250
372 Retainer boleh tanggal – setiap rahang - pembaikan Removable retainers – repair - per arch 75 125 175 250
373Penyenggara ruang boleh tanggal - setiap rahang – pembaikan
Passive removable appliance (space maintainers) – repair - per arch
75 125 175 250
374 Essix retainer Essix retainer 90 150 210 300375 Aksesori rahang palatal/lingual Palatal/Lingual Accessory Arch 75 125 175 250
376 Aksesori - rahang palatal/lingual - PenggantiPalatal/Lingual Accessory Arch – replacement
75 125 175 250
377Peralatan traction on plant rahang setiap alat – setiap rahang
Placement of traction device (on plant) – per device
120 200 280 400
378 Traction chain untuk gigi terimpak Placement of traction chain – impacted tooth 240 400 560 800
379Traction chain untuk pergerakan gigi minor – setiap gigi
Placement of traction chain for minor tooth movement per tooth
60 100 140 200
380Impresi bagi model kerja - setiap rahang (atas/bawah)
Impression for working model per arch (upper/lower)
60 100 140 200
381 Gegelang ortodontik – pengganti Orthodontic bands - replacement 30 50 70 100
382 Braket ortodontik - satu gigi - pengantianOrthodontic brackets - replacement per tooth
30 50 70 100
383Dawai ortodontik - setiap rahang – pengantian (atas/bawah)
Orthodontic wire - replacement per arch upper/lower
60 100 140 200
384Komponen boleh tanggal - setiap rahang – Pembaikan
Repair of metal/acrylic component of removable appliance per arch
30 50 70 100
385 Rawatan Facemask Facemask treatment 120 200 280 400386 Rawatan Chin cup Chin cup treatment 120 200 280 400387 Rawatan palatal expander Palatal expander treatment 120 200 280 400388 Rawatan headgear Headgear treatment 120 200 280 400
389Periodontik - Pembedahan flap dengan pembedahan tulang
Flap surgery with osseous surgery 202 337 472 674
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390 Pembedahan flap dengan regenerasi tulang Flap surgery with bone regeneration 240 400 560 800391 Pembedahan mukogingiva Mucogingival surgery 150 250 350 500392 Pemanjangan korona – dengan ostektomi Crown lengthening with ostectomy 185 308 432 617393 Pemanjangan korona – tanpa ostektomi Crown lengthening without ostectomy 165 275 385 550394 Hemiseksi gigi Tooth hemisection 394 656 919 1,312395 Regenerasi tulang dipandu Guided bone regeneration 311 518 725 1,036396 Regenerasi tisu dipandu Guided tissue regeneration 494 824 1,154 1,648397 Pembedahan flap Flap surgery 202 337 472 674398 Gingivektomi Gingivectomy 120 200 280 400399 Gingivoplasti Gingivoplasty 120 200 280 400400 Pembedahan baji Wedge surgery 120 200 280 400401 Furkasionplasti – Penembusan Furcationplasty - tunnelling 426 710 993 1,419402 Furkasionplasti – Grufplasti Furcationplasty - grooveplasty 426 710 993 1,419403 Reseksi akar Root resection 394 656 919 1,312
404Pengetaman akar setiap kuadran (Debridmen Subgingiva)
Root debridement per quadran (debridement subgingiva)
126 211 295 421
405Pengetaman akar keseluruhan mulut (Debridmen Subgingiva)
Root debridement whole mouth (debridmen subgingiva)
191 319 446 637
406 Pensplinan gigi Splinting of teeth 47 79 111 158407 Venir gingiva labial Labial gingival veneer 90 150 210 300408 Perisisi ligamen periodontium Pericision of periodontal ligament 45 75 105 150409 Pengubahsuaian morfologi gigi Modification of tooth morphology 45 75 105 150
410 Pengkonturan semulsa restorasi sedia ada Recontouring of pre-existing restoration 45 75 105 150
411 Penyelarasan oklusal Occlusal adjustment 40 67 94 134412 Frenotomi/Frenektomi Frenotomy/Frenectomy 299 399 498 647
413Sendi Temporomandibel (TMJ)Reduksi – tertutup
Close reduction temporomandible joint (TMJ)
45 75 105 150
414Antralplasti maksila - sinus lift – dengan autograf (graf tulang)
Antralplasty maxillary (sinus lift) with autograft-bone graft
300 500 700 1,000
415Antraplasti maksila(sinus lift) – dengan alograf
Maxillary antralplasty (sinus lift) with allograft
120 200 280 400
416 Penutupan fistula oro-antral Closure of oro-antral fistula 300 500 700 1,000417 Pencucian antrum Caldwell – Luc (sebelah) Antral washout caldwell-luc (per side) 60 100 140 200
418Eksisi lesi maksilofasial – dengan rekonstruksi – alograf
Excision lesion maxillofacial - with reconstruction-allograft
225 375 525 750
419 Eksisi lesi maksilofasial Excision of maxillofacial lesion 60 100 140 200
420 Marsupialisasi lesi tulang maksilofasial Marsupialisation of bony maxillofaciallesion 60 100 140 200
421 Marsupialisasi lesi tisu lembut mulut Marsupialisation of oral soft tissue lesion 30 50 70 100
422Reduksi dan fiksasi fraktur tulang maksilofasial – tertutup
Reduction and fixation of bony maxillofacial fracture - closed
180 300 420 600
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423Reduksi dan fiksasi tulang maksilofasial – sementara
Reduction and fixation of bony maxillofacial fracture – temporary
6 10 14 20
424 Vestibuloplasti oral (setiap rahang)-dengan graf Oral vestibuloplasty (per arch) with graft 225 375 525 750
425 Vestibuloplasti mulut -setiap rahang Oral vestibuloplasty (per arch) 90 150 210 300
426 Penanggalan fiksasi dalaman – maksilofasial Removal of internal fixation – maxillofacial 90 150 210 300
427 Sekuestrektomi – maksilofasial Maxillofacial sequestrectomy 36 60 84 120
428 Pembuangan kalkulus duktus liur – terbuka Removal of salivary duct calculus- open 120 200 280 400
429 Pembuangan kalkulus duktus liur – tertutup Removal of salivary duct calculus- closed 9 15 21 30
430 Miatoplasti bukaan duktus kelenjar liur Meatoplasty of salivary duct orifice 60 100 140 200431 Duktus kelenjar liur- Dilasitasi Salivary duct dilation 45 75 105 150432 Duktus kelenjar liur- Peligaturan Salivary duct ligation 45 75 105 150
433 Eksisi lesi tisu lembut mulut dengan laser Excision of oral soft tissue lesion with laser 60 100 140 200
434 Eksisi lesi tisu lembut mulut – 2 cm atau kurangExcision of oral soft tissue lesion – 2cm or less
36 60 84 120
435 Saraf trigeminal – krioterapi/keratan Trigeminal nerve - cryotherapy/sectioning 90 150 210 300
436 Penanggalan benda asing – orofasial – mudah Removal of foreign body – orofacial – simple 36 60 84 120
437 Biopsi tulang maksilofasial Biopsy - bony – maxillofacial 60 100 140 200438 Biopsi tisu lembut mulut Biopsy - soft tissue – oral 36 60 84 120439 Biopsi lesi tru-cut Biopsy lesion tru-cut 15 25 35 50440 Ablasi lesi mukosa oral Ablation of oral mucosal lesion 60 100 140 200441 Frenoplasti Frenoplasty 51 85 119 170442 Frenotomi/Frenektomi dengan laser Frenotomi/frenectomy with laser 51 85 119 170
443Apisektomi - setiap gigi – gigi belakang – dengan tampalan retrograde
Apicectomy (per tooth) - posterior tooth with retrograde filling
300 500 700 1,000
444 Apisektomi -setiap gigi – gigi belakang Apicectomy (per tooth) - posterior tooth 225 375 525 750
445Apisektomi -setiap gigi – gigi anterior dengan tampalan retograd
Apicectomy (per tooth) - anterior tooth with retrograde filling
90 150 210 300
446 Apisektomi -setiap gigi – gigi hadapan Apicectomy (per tooth) - anterior tooth 36 60 84 120
447Pengeluaran gigi terimpak melalui pembedahan -setiap gigi – rumit
Surgical removal of impacted/unerupted tooth (per tooth) – complicated
300 500 700 1,000
448Pengeluaran melalui pembedahan-Gigi/Akar -setiap gigi
Surgical removal of tooth/root (per tooth) 120 200 280 400
449Pengeluaran melalui pembedahan- Gigi/Akar tersesar -setiap gigi
Surgical removal of displaced tooth/root (per tooth)
120 200 280 400
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450Pengeluaran melalui pembedahan- Gigi terimpak/enrupted -setiap gigi – mudah
Surgical removal of impacted/unerupted tooth (per tooth) – simple
120 200 280 400
451 Transplantasi gigi Transplantation tooth 225 375 525 750
452Peletakan semula dan/atau penstabilan gigi – pembedahan
Repositioning and/or stabilization of tooth – surgical
120 200 280 400
453Peletakan semuladan/atau penstabilan gigi – tanpa pembedahan
Repositioning and/or stabilization of tooth –non-surgical
45 75 105 150
454 Penanaman semulagigi Reimplantation of tooth 60 100 140 200
455Pembedahan pendedahan gigi -setiap gigi – dengan penempatan penyambung
Surgical exposure of tooth (per tooth) with placement of attachment
120 200 280 400
456Pembedahan pendedahan gigi -setiap gigi – tanpa penempatan penyambung
Surgical exposure of tooth (per tooth) without placement of attachment
45 75 105 150
457Implan pergigian -setiap implan-pembedahan peringkat pertama dengan autograph
Dental Implant (per implant) – first stage surgery with autograft
180 300 420 600
458Implan pergigian -setiap implan – pembedahan peringkat pertama
Dental Implant (per implant) – first stage surgery
120 200 280 400
459Implan pergigian -setiap implan-pembedahan peringkat pertama dengan pengganti tulang
Dental Implant (per implant) – first stage surgery with bone substitute
120 200 280 400
460Implan pergigian (setiap implan) – pembedahan peringkat kedua
Dental Implant (per implant) – second stage surgery
15 25 35 50
461Implan maksilofasial -setiap implan – pembedahan peringkat pertama
Maxillofacial implant (per implant) – first stage surgery
120 200 280 400
462Implan maksilofasial (setiap implan) – pembedahan peringkat kedua
Maxillofacial implant (per implant – second stage surgery
15 25 35 50
463Penanggalan implan pergigian/maksilofasial – rumit
Removal of dental/maxillofacial implants - complicated
90 150 210 300
464Penanggalan implan pergigian/maksilofasial – mudah
Removal of dental/maxillofacial implants – simple
23 38 53 75
465 Debridemen tisu lembut orofasial Debridement of oro-facial soft tissue 18 30 42 60466 Pendawaian pergigian -setiap rahang Dental wiring – per jaw 23 38 53 75
467 Pemberhentian pendarahan – selepas pembedahan Control of haemorrhage – post-surgery 23 38 53 75
468 Pemberhentian pendarahan – lesi Control of haemorrhage –lesion 15 25 35 50
469 Pemberhentian pendarahan – selepas cabutan Control of haemorrhage – post-extraction 9 15 21 30
470 Terapi – orofasial Laser lembut – setiap kitaran Orofacialsoft laser therapy - per course 23 38 53 75
471 Terapi – oromaksilofasial ultrasound Oromaxillofacial ultrasound therapy 23 38 53 75472 Obturator prosthesis Prosthesis-obturator 36 60 84 120
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473 Sitologi aspirasi jarum halus – orofasial Fine needle aspiration cytology-orofacial 15 25 35 50
474 Operkulektomi mulut Oral operculectomy 23 25 27 30
475 Penanggalan pendawaian pergigian (setiap rahang) Removal of dental wires (per jaw) 9 15 21 30
476 Suntikan ubatan – orofasial Injection of medication –orofacial 30 30 30 30
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CAJ ANGGOTA TIRUAN ARTIFICIAL LIMBS / PROSTHESISPeralatan Upper Limb Prosthesis Upper Limb Prosthesis Item
477 Cosmetic Silicone Glove Cosmetic silicone glove 840 1,400 1,960 2,800
478 Cosmetic fingers Cosmetic fingers 360 600 840 1,200
479 Trans Radius Cosmetic Trans radius cosmetic 1,200 2,000 2,800 4,000
480 Trans Radius Mechanical Function Hand Trans radius mechanical function hand 1,890 3,150 4,410 6,300
481 Trans Humerus Cosmetic Trans humerus cosmetic 2,250 3,750 5,250 7,500
482 Trans Humerus Mechanical Functional Hand Trans humerus mechanical functional hand 2,850 4,750 6,650 9,500
Peralatan Lower Limb Prosthesis Lower Limb Prosthesis Item
483 Chopart Chopart 540 900 1,260 1,800
484 Symes Prosthesis Symes prosthesis 1,140 1,900 2,660 3,800
485 Transtibial Prosthesis K1 Berjalan dalam rumah (Indoor Walker)
Transtibial prosthesis indoor walker 1,065 1,775 2,485 3,550
486 Transtibial Prosthesis K2 Limited Outdoor Transtibial prosthesis K2 limited outdoor 1,650 2,750 3,850 5,500
487 Transtibial Prosthesis K3 Active Walker Transtibial prosthesis K3 active walker 2,850 4,750 6,650 9,500
488 Transtibial Prosthesis K4 Very Active/Sport Transtibial prosthesis K4 very active/Sport 5,640 9,400 13,160 18,800489 Through Knee Prosthesis K1 hingga K4 Through knee prosthesis K1 to K4 4,140 6,900 9,660 13,800490 Transfemoral Prostesis K1 Berjalan dalam rumah (Indoor Walker)Transfemoral prostesis K1 indoor walker 2,250 3,750 5,250 7,500491 Transfemoral Prostesis K2 Limited Outdoor Transfemoral prostesis K2 limited outdoor 2,700 4,500 6,300 9,000492 Transfemoral Prostesis K3 Active Walker Transfemoral prostesis K3 cctive walker 4,500 7,500 10,500 15,000493 Transfemoral Prostesis K4 Very Active/Sport Transfemoral prostesis K4 very active/sport 10,500 17,500 24,500 35,000494 Hip Disarticulated Prostesis K1 hingga K4 Hip disarticulated prostesis K1 to K4 4,500 7,500 10,500 15,000495 Knee Orthoses Hinge Knee Knee orthoses hinge knee 135 225 315 450496 Knee Orthoses Weekender Knee Brace Knee orthoses weekender knee brace 330 550 770 1,100497 Knee Orthoses Revolution Brace Knee orthoses revolution brace 210 350 490 700
498 Knee Orthoses Knee Ranger post operation braceKnee orthoses knee ranger post operation brace
135 225 315 450
499 Knee Orthoses Fracture hinges Knee orthoses fracture hinges 120 200 280 400
500Lower limb Orthoses Knee Ankle Foot Orthoses (KAFO)
Lower limb orthoses knee ankle foot orthoses (KAFO)
1,140 1,900 2,660 3,800
501 Ankle Foot Orthoses Ankle foot orthoses 105 175 245 350502 Super Lite Ankle Foot Orthoses Super lite ankle foot orthoses 75 125 175 250
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503 Ankle Foot Orthoses Sweeder Ankle Brace Ankle foot orthoses sweeder ankle brace 120 200 280 400
504 Suprameleolar Prosthesis 500 seunit Suprameleolar prosthesis 500 per unit 150 250 350 500
505Ankle Foot Orthosis- Ankle Foot Orthosis (Custom made/polypropelyne)
Ankle foot orthosis- ankle foot orthosis (custom made/polypropelyne)
105 175 245 350
506 Foot care Wonder Spur Foot care wonder spur 21 35 49 70507 Foot care Wonder Cup Foot care wonder cup 21 35 49 70508 Foot care Wonder Sport Foot care wonder sport 39 65 91 130509 Foot care Soft sock Foot care soft sock 60 100 140 200510 Foot care Gel Squares Foot care gel squares 42 70 98 140511 Paediatric Orthoses Pavlic Harness Paediatric orthoses pavlic harness 135 225 315 450
512Paediatric Orthoses Dennis Brown Shoes (Straight Last) full set
Paediatric orthoses dennis brown shoes (straight last) full set
210 350 490 700
513Paediatric Orthoses Dennis Brown Shoes (Full Abduction) full set
Paediatric orthoses Dennis Brown Shoes (full abduction) full set
210 350 490 700
514 Cervical Soft Collar Cervical soft collar 17 28 39 55
515 Cervical Adjustable Collar (Plastik) Cervical adjustable collar (plastic) 20 33 46 65516 Philadelphia A Series Collar Philadelphia A series collar 84 140 196 280517 Atlas Collar Atlas collar 90 150 210 300518 Philadelphia Collar Philadelphia collar 39 65 91 130519 Minerva Cervical Support Minerva cervical support 300 500 700 1,000520 Philadelphia Collar with Stabilizer & Halo Philadelphia collar with stabilizer & halo 165 275 385 550521 S.O.M.I Brace S.O.M.I Brace 270 450 630 900522 USMC Halo System USMC halo system 900 1,500 2,100 3,000523 Halo Liner Halo liner 330 550 770 1,100524 PMT Halo System PMT halo system 900 1,500 2,100 3,000525 Torque Screw Driver Torque screw driver 300 500 700 1,000526 Cervical- Thoracic Lumbar-sacral- Orthosis Cervical- thoracic lumbar-sacral- orthosis 840 1,400 1,960 2,800527 Juwett Brace Juwett brace 210 350 490 700528 Knight Taylor Brace (TLSO) Knight taylor brace (TLSO) 240 400 560 800529 Knight Taylor Brace (LSO) Knight taylor brace (LSO) 195 325 455 650530 Kydex Knight Taylor Brace Kydex knight taylor brace 270 450 630 900531 Kydex Chair Back Brace Kydex chair back brace 210 350 490 700
532 TLSO Body Jacket (Moulded Polypropelyne) TLSO body jacket (moulded polypropelyne) 840 1,400 1,960 2,800
533 Sacro-Lumbar Support (Fabric) Sacro-lumbar support (fabric) 45 75 105 150
534 Scoliosis Boston Brace (Moulded Polypropelyne)Scoliosis boston brace (moulded polypropelyne)
900 1,500 2,100 3,000
Peralatan Rehabilitasi Rehabilitation Accessories535 Aluminium Axilla Crutch Aluminium Axilla Crutch : 17 28 39 55536 Kanak-kanak (S) Children (S) 17 28 39 55
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FI RAWATAN
537 Remaja (M Teenage (M) 17 28 39 55538 Dewasa (L) Adult (L) 17 28 39 55539 Dewasa bersaiz besar (XL) Adult big size (XL) 17 28 39 55540 Adjustable elbow crutch Adjustable elbow crutch 42 70 98 140
541Adjustable aluminium walking stick with strap in bronze colour
Adjustable aluminium walking stick with strap in bronze colour
14 23 32 45
542Adjustable aluminium crooked handle walking stick in bronze colour
Adjustable aluminium crooked handle walking stick in bronze colour
17 28 39 55
543 Adjustable folding walking frame in bronze colourAdjustable folding walking frame in bronze colour
38 63 88 125
544 Quadruped walking aid Quadruped walking aid 17 29 41 58545 Quadruped walking aid- Narrow Base Quadruped walking aid- narrow base 17 29 41 58
546Standard wheel chair 18” with detachable armrest and footrest
Standard wheel chair 18” with detachable armrest and footrest
204 340 476 680
547 Standard wheel chair 18” Standard wheel chair 18” 84 140 196 280548 Semi light weight wheel chair Semi light weight wheel chair 240 400 560 800
549Reclining wheel chair with detachable armrest and elevating footrest
Reclining wheel chair with detachable armrest and elevating footrest
360 600 840 1,200
550 Light weight wheel chair Light weight wheel chair 420 700 980 1,400551 Commode wheel chair Commode wheel chair 420 700 980 1,400552 Major buggy Major buggy 450 750 1,050 1,500553 Commode chair Commode chair 60 100 140 200
PERKHIDMATAN PERUBATAN TRADISIONAL DAN KOMPLEMENTARI
TRADITIONAL AND COMPLEMENTARY MEDICINE SERVICES
PERUBATAN TRADISIONAL MELAYU/ PRIBUMITRADITIONAL MEDICINE FOR MALAY/PRIBUMI
Urut Tradisional Melayu/ PribumiTraditional Massage for Malay/Pribumi
554 Rawatan Kesakitan Kronik Chronic disease treatment 15 per sesi. 25 per sesi. 35 per sesi. 50 per sesi.555 Rawatan Pasca Angin Ahmar Post-stroke treatment 15 per sesi. 25 per sesi. 35 per sesi. 50 per sesi.
Rawatan Penjagaan Ibu Selepas Bersalin Post-natal mother care556 Rawatan Urut Selepas Bersalin Post natal massage treatment 15 per sesi. 25 per sesi. 35 per sesi. 50 per sesi.
557Pakej Rawatan Pemulihan Selepas Bersalin – Urut, Tungku & Bengkung
Post natal recovery treatment packages - massage, furnase and bengkung
45 per sesi. 75 per sesi. 105 per sesi. 150 per sesi.
558 Rawatan Pemulihan Selepas Bersalin – Tangas Post natal recovery treatment - tangas 15 per sesi. 25 per sesi. 35 per sesi. 50 per sesi.
Perubatan Tradisional Cina TRADITIONAL CHINESE MEDICINEAkupunktur Acupuncture
559 Rawatan Kesakitan Kronik Chronic disease treatment 15 per sesi. 25 per sesi. 35 per sesi. 50 per sesi.560 Rawatan Pasca Angin Ahmar Post-stroke treatment 15 per sesi. 25 per sesi. 35 per sesi. 50 per sesi.
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561Akupunktur dan tambahan moxibustion untuk rawatan kesakitan kronik dan pasca angin ahmar
Acupuncture and moxibustion in addition to the treatment of chronic pain and post stroke
18 per sesi. 30 per sesi. 42 per sesi. 60 per sesi.
562 Lain-lain Indikasi Other indication 15 per sesi. 25 per sesi. 35 per sesi. 50 per sesi.Herba Herbs
563Rawatan sampingan untuk pesakit onkologi (termasuk kos herba)
Ancillary treatment for oncology patient (including the cost of herbs)
75 per kitaran. (1
kitaran = 2 minggu)
125 per kitaran. (1
kitaran = 2 minggu)
175 per kitaran. (1
kitaran = 2 minggu)
250 per kitaran. (1
kitaran = 2 minggu)
Perubatan Tradisional India TRADITIONAL INDIAN MEDICINEAyurveda Ayurveda
564 Shirodhara Shirodhara 45 per sesi. 75 per sesi. 105 per sesi. 150 per sesi.565 Abhyanga Abhyanga 45 per sesi. 75 per sesi. 105 per sesi. 150 per sesi.
Terapi Komplementari Complementary Therapy566 Kiropraktik Chiropractic 45 per sesi. 75 per sesi. 105 per sesi. 150 per sesi.567 Osteopatik Osteopatic 60 per sesi. 100 per sesi. 140 per sesi. 200 per sesi.
BEKALAN DARAH DAN HASIL DARAH BLOOD SUPPLY AND BLOOD PRODUCT
568 Sel Darah Utuh Packed Red Cell 36 60 84 120569 Darah lengkap Whole Blood 36 60 84 120570 Pati platelet Platelet Concentrate 36 60 84 120571 Krioendapan Cryoprecipitate 36 60 84 120572 Plasma beku segar Fresh frozen plasma 36 60 84 120573 Kriosupernatan Cryosupernatant 36 60 84 120574 Platelet aferes Platelet apheresis 189 315 441 630575 Sel Darah Utuh Pediatrik Paediatric packed cells 33 55 77 110576 Filtered Red Cell Filtered red cell 60 100 140 200577 Irradiated sel Irradiated sel 48 80 112 160578 Patogen Inactivated Plasma Patogen inactivated plasma 180 300 420 600579 Patogen Inactivated Platelet Patogen inactivated platelet 240 400 560 800580 Patogen Inactivated Platelet Aferesis Patogen inactivated platelet aferesis 405 675 945 1,350581 Irradiated Aferasis Platelet Irradiated aferasis platelet 207 345 483 690582 Irradiated Platelet Irradiated platelet 48 80 112 160
Produk Pecahan Plasma Plasma Breakdown Product
583 High Purity Factor VIII Concentrate - 250 IU/vialHigh purity factor VIII concentrate - 250 IU/vial
162 270 378 540
584 Intermediate Purity Factor VIII - 250 IU/vial Intermediate purity factor VIII - 250 IU/vial 90 150 210 300
585 Pure Factor IX -500 IU/vial Pure factor IX -500 IU/vial 237 395 553 790
586 Prothrombin Complex Concentrate - 500 IU/vialProthrombin complex concentrate - 500 IU/vial
177 295 413 590
587 Recombinant Factor VIIa - 60 KIU/vial Recombinant factor VIIa - 60 KIU/vial 891 1,485 2,079 2,970588 Albumin - 20% 100ml Albumin - 20% 100ml 54 90 126 180
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589 Intravenous Immune Globulin (IV) - 3g/50ml Intravenous immune globulin (IV) - 3g/50ml 210 350 490 700
590 Recombinant VIII - 250 IU/vial Recombinant VIII - 250 IU/vial 201 335 469 670591 Recombinant IX - 500 IU/vial Recombinant IX - 500 IU/vial 357 595 833 1,190592 Autologous Plasma Eye Drop Autologous plasma eye drop 135 225 315 450
KLINIK PEMULIHAN CARA KERJA OCCUPATIONAL THERAPY
ASSESSMENT ASSESSMENTADL Assessment ADL Assessment 12 20 28 40
593Canadian Occupational Therapy Performance Measure (C.O.P.M)
Canadian Occupational Therapy Performance Measure (C.O.P.M)
12 20 28 40
594Camberwell Assessment of Needs Short Schedule (CANSAS)
Camberwell Assessment of Needs Short Schedule (CANSAS)
12 20 28 40
595 Functional Ability Assessment (FAA) Functional Ability Assessment (FAA) 12 20 28 40
596 Functional Independence Measure (FIM) Functional Independence Measure (FIM) 12 20 28 40
597 Kohlman Evaliation of Living Skill (KELS) Kohlman Evaliation of Living Skill (KELS) 12 20 28 40
598 Modified Barthel Index Modified Barthel Index 12 20 28 40
599 Pediatric Evaluation Disabilities Inventory (PEDI)Pediatric Evaluation Disabilities Inventory (PEDI)
12 20 28 40
600 Self Care Skills (PASS) Self Care Skills (PASS) 12 20 28 40601 Kohlmens Kohlmens 12 20 28 40602 AMPS AMPS 12 20 28 40
Physical Assesment Physical Assesment603 Muscle Manual Test (MMT) Muscle Manual Test (MMT) 12 20 28 40604 Strength-dynamometer/pinch gauge Strength-dynamometer/pinch gauge 12 20 28 40605 2 point discrimination test 2 point discrimination test 12 20 28 40606 9 hole peg test 9 hole peg test 12 20 28 40607 Berg Balance Test Berg Balance Test 12 20 28 40608 Grooved Peg board Grooved peg board 12 20 28 40609 Jebsen Taylor Hand Function Test Jebsen Taylor Hand Function Test 12 20 28 40610 Minnesota Manual Dexterity Test Minnesota Manual Dexterity Test 12 20 28 40611 O’connor Finger Dexterity Test O’connor Finger Dexterity Test 12 20 28 40612 O’connor Tweezer Dexterity Test O’connor Tweezer Dexterity Test 12 20 28 40613 Pain visual analog scale Pain visual analog scale 12 20 28 40614 Purdue pegboard test Purdue Pegboard Test 12 20 28 40615 Range of Motion – Goniometer Range of Motion – goniometer 12 20 28 40616 Roeder manipulative aptitude test Roeder Manipulative Aptitude Test 12 20 28 40
617 Semmes-Weinstein Monofilaments test Semmes-Weinstein Monofilaments Test 12 20 28 40
618 Sensory profile Sensory profile 12 20 28 40619 Stereognosis test Stereognosis test 12 20 28 40620 Vibration Vibration 12 20 28 40
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621 Volumeter Volumeter 12 20 28 40622 Tinnetti balance Test Tinnetti balance test 12 20 28 40
623 Microcomputer Upper Limb Exerciser (MULE)Microcomputer Upper Limb Exerciser (MULE)
12 20 28 40
Development Assessment Development Assessment624 Bruiniks Oseretsky Test Bruiniks Oseretsky Test 12 20 28 40625 Denver Denver 12 20 28 40626 Oral motor rating scale Oral motor rating scale 12 20 28 40627 Peabody Peabody 12 20 28 40
Perceptual and Cognitive Assessment Perceptual and Cognitive Assessment
628 Berry VMI Berry VMI 12 20 28 40
629Chessington Occupational Therapy Neurological Assessment Battery (C.O.T.N.A.B)
Chessington Occupational Therapy Neurological Assessment Battery (C.O.T.N.A.B)
12 20 28 40
630 Hospital Anxiety Depression Scale Hospital Anxiety Depression Scale 12 20 28 40
631Lowerstein Occupational Therapy Cognitive assessment (L.O.T.C.A)
Lowerstein Occupational Therapy Cognitive assessment (L.O.T.C.A)
12 20 28 40
632 Mini Mental State Examination Mini Mental State Examination 12 20 28 40
633 Rivermead Perceptual Assessment Battery Rivermead Perceptual Assessment Battery 12 20 28 40
Preschool Assesment Preschool Assesment634 Miller Assessment Pre Schoolers Miller Assessment Pre Schoolers 12 20 28 40635 School Function Assessment (SFA) School Function Assessment (SFA) 12 20 28 40636 Test of Handwriting skill Test of handwriting skill 12 20 28 40
Behavior assessment Behavior assessment 12 20 28 40637 Threshold Assessment Grid (TAG) Threshold Assessment Grid (TAG) 12 20 28 40638 Hospital Anxiety and Depression scale Hospital anxiety and depression scale 12 20 28 40639 Irritability - depression anxiety scale Irritability - depression anxiety scale 12 20 28 40640 Shaan's Function Questionaire Shaan's Function Questionaire 12 20 28 40641 The Beck Depression scale The Beck Depression scale 12 20 28 40642 Wheel Chair Assessment Wheel Chair Assessment 12 20 28 40
Driving Assessment Driving Assessment643 Pre-driving assessment Pre-driving assessment 120 200 280 400644 Stroke driving screening assessment Stroke driving screening assessment 120 200 280 400
Home/Work Place/School Assessment Home/Work Place/School Assessment
645 Home Fast Tool Home fast tool 12 20 28 40
Work/Vocational assessment Work/Vocational assessment646 *BTE *BTE 120 200 280 400647 Laser Laser 120 200 280 400648 *LIDO *LIDO 120 200 280 400649 Role check list Role check list 120 200 280 400650 T pal T pal 120 200 280 400
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651 Valpar Valpar 120 200 280 400652 Work Cube Work cube 120 200 280 400
ACTIVITIES OF DAILY LIVING (ADL) TRAININGACTIVITIES OF DAILY LIVING (ADL) TRAINING
Instrumental Activities of Daily Living Instrumental Activities of Daily Living
653 Ability to use telephone Ability to use telephone 12 20 28 40654 Early ambulation Early ambulation 12 20 28 40655 Self hygiene Self hygiene 12 20 28 40656 Transfer Transfer 12 20 28 40657 Ability to handle Finance Ability to handle Finance 12 20 28 40658 Bathing Bathing 12 20 28 40659 Bladder management Bladder management 12 20 28 40660 Bower management Bower management 12 20 28 40661 Cleaning work Cleaning work 12 20 28 40662 Device care Device care 12 20 28 40663 Domestic skill Domestic skill 12 20 28 40664 Dressing Dressing 12 20 28 40665 Eating/feeding Eating/feeding 12 20 28 40666 Food/meal preparation Food/meal preparation 12 20 28 40667 Functional communication Functional communication 12 20 28 40668 Functional mobility Functional mobility 12 20 28 40669 Grooming Grooming 12 20 28 40670 Health eminence Health eminence 12 20 28 40671 Household maintenance Household maintenance 12 20 28 40672 Housekeeping Housekeeping 12 20 28 40673 Laundry Laundry 12 20 28 40674 Mode of transportation Mode of transportation 12 20 28 40675 Money management Money management 12 20 28 40676 Responsibility for medication Responsibility for medication 12 20 28 40677 Safety procedure Safety procedure 12 20 28 40678 Sexual expression Sexual expression 12 20 28 40679 Shopping Shopping 12 20 28 40680 Toileting Toileting 12 20 28 40
Aids and Adaptation (bagi setiap peralatan modifikasi yang dibekalkan)
Aids and Adaptation (for each modification equipment supplied)
681 Cooking utensil Cooking utensil 24 40 56 80682 Dressing Dressing 24 40 56 80683 Feeding/drinking utensil Feeding/drinking utensil 24 40 56 80684 Mobility Mobility 24 40 56 80685 Bathing Bathing 24 40 56 80686 Reading/writing Reading/writing 24 40 56 80687 Wheel chair seating Wheel chair seating 24 40 56 80
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688 Behavioral therapy Behavioral therapy 12 20 28 40
Cognitive & Perceptual Training Cognitive & Perceptual Training689 Basic concepts Basic concepts 12 20 28 40690 Body part identification Body part identification 12 20 28 40691 Cognitive stimulation Cognitive stimulation 12 20 28 40692 Educational activities Educational activities 12 20 28 40693 Right/left discrimination Right/left discrimination 12 20 28 40694 Figure ground disrimination Figure ground disrimination 12 20 28 40695 Reality orientation Reality orientation 12 20 28 40696 Topographical orientation Activities Topographical orientation Activities 12 20 28 40697 Sequencing Sequencing 12 20 28 40698 Categration Categration 12 20 28 40
699Dynamic Splint - Harga mekanisme (mengikut harga pasaran) + harga statik splint
Dyanamic Splint - the price of mechanism (according to market price) + the price of static splint
72 120 168 240
Creative Therapy Creative Therapy700 Art therapy Art therapy 12 20 28 40701 Drama/role play Drama/role play 12 20 28 40702 Music therapy Music therapy 12 20 28 40
Social Skill Training Social Skill Training703 Assertive training Assertive training 12 20 28 40704 Coping skill training Coping skill training 12 20 28 40705 Group support Group support 12 20 28 40706 Group therapy Group therapy 12 20 28 40707 Individual therapy Individual therapy 12 20 28 40708 Interpersonal skill Interpersonal skill 12 20 28 40709 Self awareness activities Self awareness activities 12 20 28 40710 Self control Self control 12 20 28 40711 Self expression Self expression 12 20 28 40712 Social conduct Social conduct 12 20 28 40713 Social skill training Social skill training 12 20 28 40
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714 Time management Time management 12 20 28 40715 Role checklist Role checklist 12 20 28 40
Patients and Career Education Patients and Career Education716 Body mechanic & ergonomic Body mechanic & ergonomic 12 20 28 40717 Edema control Edema control 12 20 28 40
718 Energy conservation/work Simplication Energy conservation/work Simplication 12 20 28 40
719 Environment therapy Environment therapy 12 20 28 40720 Joint protection techniques Joint protection techniques 12 20 28 40
Play and Leisure Play and Leisure721 Leisure check list Leisure check list 12 20 28 40722 Play and leisure exploration Play and leisure exploration 12 20 28 40723 Play and Leisure training Play and leisure training 12 20 28 40
Relaxation Relaxation724 Bio-feedback Bio-feedback 12 20 28 40725 Deep breathing Deep breathing 12 20 28 40726 Diaphragmatic breathing Diaphragmatic breathing 12 20 28 40727 Imaginary relaxation Imaginary relaxation 12 20 28 40
728 Progressive muscular relaxation techniques Progressive muscular relaxation techniques 12 20 28 40
Sensory Training Sensory Training729 Sensory desensitization Sensory desensitization 12 20 28 40730 Sensory integration Sensory integration 12 20 28 40731 Sensory re-education Sensory re-education 12 20 28 40732 Sensory stimulation Sensory stimulation 12 20 28 40733 Fluidotherapy Fluidotherapy 12 20 28 40
Motor Training Motor Training734 Above elbow prothesis Above elbow prothesis 12 20 28 40735 Above knee prothesis Above knee prothesis 12 20 28 40736 Active assisted exercise Active assisted exercise 12 20 28 40737 Below elbow prothesis Below elbow prothesis 12 20 28 40738 Below knee prothesis Below knee prothesis 12 20 28 40739 Bilateral integration Bilateral integration 12 20 28 40740 Crossing midline Crossing midline 12 20 28 40741 Ergonomic training Ergonomic training 12 20 28 40742 Fine motor skills Fine motor skills 12 20 28 40743 Finger prosthesis Finger prosthesis 12 20 28 40744 Gait training Gait training 12 20 28 40745 Gross motor activities Gross motor activities 12 20 28 40746 Hand-eye coordination Hand-eye coordination 12 20 28 40747 Improve Balance Improve balance 12 20 28 40748 Motor re-education Motor re-education 12 20 28 40749 Neuro developmental technique Neuro developmental technique 12 20 28 40
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750 Normalize muscle tone Normalize muscle tone 12 20 28 40751 Oral muscle stimulation Oral muscle stimulation 12 20 28 40752 Strengthening exercise Strengthening exercise 12 20 28 40753 Endurance training Endurance training 12 20 28 40754 Reduce muscle tone Reduce muscle tone 12 20 28 40755 Above elbow prothesis Above elbow prothesis 12 20 28 40
Compression Therapy Compression Therapy756 Corban bandage Corban bandage 12 20 28 40757 Pressure splint Pressure splint 12 20 28 40758 Tubigrip Tubigrip 12 20 28 40
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PERIHAL
Pressure Garment Pressure Garment759 Finger strap Finger strap760 Gauntlet Gauntlet761 Glove Glove762 Forearm A Sleeve Forearm A Sleeve763 Full length arm sleeve Full length arm sleeve764 Vest with long sleeve Vest with long sleeve765 Vest with short sleeve Vest with short sleeve766 Chin strap Chin strap767 Mask Mask768 Short pants Short pants769 Long pants Long pants770 Thigh strap Thigh strap771 Calf strap Calf strap772 Socks (1 unit) Socks (1 unit)
Static Splint Static Splint 773 Finger toe Finger toe774 Hand/foot Hand/foot775 Hand to forearm Hand to forearm776 Finger to forearm Finger to forearm777 Forearm to upper arm Forearm to upper arm778 Hand to upper arm Hand to upper arm779 Upper arm Upper arm780 Hard collar Hard collar781 Foot to calf Foot to calf782 Foot to mid thigh Foot to mid thigh783 Mid calf to mid thigh Mid calf to mid thigh784 Plaztozote Insole Plaztozote Insole785 Tennis Elbow Tennis Elbow786 Ulnar driff Ulnar driff787 Ergonomic A sling Ergonomic A sling788 Foot drop check Foot drop check789 Buddy strap Buddy strap790 Body brace Body brace791 Pelvis harness Pelvis harness
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IMPLAN BAGI PERKHIDMATAN OFTALMOLOGIIMPLANT CHARGES FOR OPHTALMOLOGY SERVICES
Paediatric and strabismus Paediatric and Strabismus792 Frontalis sling; silastic material Frontalis sling; silastic material 180 300 420 600793 Frontalis sling; ptose up Frontalis sling; ptose up 338 563 788 1,125794 Lacrimal intubation; Ritleng tube Lacrimal intubation; ritleng tube 180 300 420 600795 Lacrimal intubation; Crawford tube Lacrimal intubation; crawford tube 182 304 426 608796 Mini Monoka Mini monoka 180 300 420 600797 Glaucoma; Baerveldt implant Glaucoma; baerveldt implant 617 1,028 1,439 2,055798 Glaucoma; Ahmad valve implant Glaucoma; Ahmad Valve Implant 720 1,200 1,680 2,400799 Medpor orbital sphere implant Medpor orbital sphere implant 585 975 1,365 1,950800 Customised artificial eye Customised artificial eye 1,170 1,950 2,730 3,900801 Ready-made artificial eye Ready-made artificial eye 36 60 84 120802 Conformer Conformer 144 240 336 480803 Silicone band for squint surgery Silicone band for squint surgery 36 60 84 120804 Low vision optical devices Low vision optical devices 900 1,500 2,100 3,000
Surgical Vitreoretina Surgical Vitreoretina805 Silicone oil Silicone oil 203 338 473 675806 Gas C3F8 Gas C3F8 68 113 158 225807 Gas SF6 Gas SF6 68 113 158 225808 Silicone band Silicone band 36 60 84 120809 Silicone sponge Silicone sponge 135 225 315 450810 Silicone tyre Silicone tyre 45 75 105 150
Glaucoma Glaucoma811 Baerveldt implant (standard) Baerveldt implant (standard) 617 1,028 1,439 2,055812 Baerveldt implant (pars plana) Baerveldt implant (pars plana) 617 1,028 1,439 2,055813 Ahmad Valve (standard) Ahmad Valve (standard) 720 1,200 1,680 2,400814 Ahmad Valve (pars plana) Ahmad Valve (pars plana) 990 1,650 2,310 3,300815 Molteno implant Molteno implant 585 975 1,365 1,950816 Amniotic membrane Amniotic membrane 225 375 525 750817 Implant tube extender Implant tube extender 360 600 840 1,200818 Cataract and refractive surgery Cataract and refractive surgery 360 600 840 1,200819 Capsular tension ring Capsular tension ring 158 263 368 525820 Aniridia ring Aniridia ring 338 563 788 1,125
Cornea Cornea821 Corneal –precut Corneal –precut 1,800 3,000 4,200 6,000822 Corneal-tissue in optisol Corneal-tissue in optisol 810 1,350 1,890 2,700823 Corneal tissue-tissue in glycerol Corneal tissue-tissue in glycerol 450 750 1,050 1,500824 Amniotic membrane Amniotic membrane 225 375 525 750825 Bandage contact lens - weekly Bandage contact lens - weekly 5 8 11 15826 Bandage contact lens - monthly Bandage contact lens - monthly 14 23 32 45827 Keratoprosthesis - Ocular Landers Keratoprosthesis - ocular landers 899 1,499 2,098 2,997828 Keratoprosthesis - Boston Keratoprosthesis - Boston 3,600 6,000 8,400 12,000
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829 Intrastromal corneal ring segment - INTACS Intrastromal corneal ring segment - INTACS 1,350 2,250 3,150 4,500
830Optical Cylinder for Osteo-odonto-Keratoprostesis (OOKP)
Optical Cylinder for Osteo-Odonto-Keratoprostesis (OOKP)
900 1,500 2,100 3,000
831 Symblepharon ring Symblepharon ring 176 293 410 585Oculoplastic Oculoplastic
832 Crawford lacrimal intubation Crawford lacrimal intubation 131 218 305 435833 O'Donoghue lacrimal intubation O'Donoghue lacrimal intubation 113 188 263 375834 Ritleng intubation set Ritleng intubation set 180 300 420 600835 Bicanaliculus intubation set Bicanaliculus intubation set 68 113 158 225836 Snug plug - punctal plug Snug plug - punctal plug 90 150 210 300837 Ptosis probe – silicone Ptosis probe – silicone 180 300 420 600838 Ptosis probe – gortex Ptosis probe – gortex 297 495 693 990839 Conformer - silicone, perforated Conformer - silicone, perforated 144 240 336 480840 Symblepharon ring Symblepharon ring 176 293 410 585841 Titanium plate Titanium plate 428 713 998 1,425842 Titanium screw Titanium screw 68 113 158 225843 Gold weight implant Gold weight implant 945 1,575 2,205 3,150844 Platinum weight implant Platinum weight implant 1,170 1,950 2,730 3,900845 Silicone tyre 276 Silicone tyre 276 45 75 105 150846 Fixation sleeve Fixation sleeve 23 38 53 75847 Sponge Sponge 135 225 315 450848 Mini monoka Mini monoka 180 300 420 600849 Monoka Monoka 180 300 420 600850 Upper eyelid spacer Upper eyelid spacer 405 675 945 1,350851 Lower eyelid spacer Lower eyelid spacer 405 675 945 1,350852 Acrylic implant Acrylic implant 23 38 53 75853 Hydroxyapatite orbital implant Hydroxyapatite orbital implant 720 1,200 1,680 2,400854 MEDPOR - micro thin sheet MEDPOR - micro thin sheet 315 525 735 1,050855 MEDPOR - ultra thin sheet MEDPOR - ultra thin sheet 315 525 735 1,050856 MEDPOR - sheets MEDPOR - sheets 315 525 735 1,050857 MEDPOR - titanium sheets MEDPOR - titanium sheets 428 713 998 1,425858 MEDPOR Enophthalmos wedges MEDPOR enophthalmos wedges 585 975 1,365 1,950859 MEDPOR Orbital conical implant MEDPOR orbital conical implant 608 1,013 1,418 2,025860 MEDPOR Orbital sphere implant MEDPOR orbital sphere implant 585 975 1,365 1,950861 MEDPOR blocks MEDPOR blocks 351 585 819 1,170862 Orbital sphere tissue expander Orbital sphere tissue expander 810 1,350 1,890 2,700863 PESS implant PESS implant 990 1,650 2,310 3,300864 Customised artificial eye Customised artificial eye 1,170 1,950 2,730 3,900865 Ready-made artificial eye Ready-made artificial eye 36 60 84 120
IMPLAN UNTUK PERKHIDMATAN ORTOPEDIKIMPLANT CHARGES FOR ORTHOPAEDICS SERVICES
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8661.5mm Cortical Screw, 0.5mm Pitch, Full Thread (Length Range: 6mm-30mm )
1.5mm cortical screw, 0.5mm pitch, full thread (length range: 6mm-30mm )
5 8 11 15
8672.0mm Cortical Screw, 0.6mm Pitch, Full Thread (Length Range: 6mm-40mm)
2.0mm cortical screw, 0.6mm pitch, full thread (length range: 6mm-40mm)
5 8 11 16
8682.7mm Cortical Screw, 1.0mm Pitch, Full Thread (Length Range: 8mm – 50mm)
2.7mm cortical screw, 1.0mm pitch, full thread (length range: 8mm – 50mm)
5 9 12 17
8692.7mm Cortical Screw, 1.0mm Pitch, Self Tapping, Full Thread (Length Range: 6mm – 40mm )
2.7mm cortical screw, 1.0mm pitch, self tapping, full thread (length range: 6mm – 40mm )
5 9 13 18
870Epiphysis Mini Plates 2.0mm (Range: Left/Right L-Obligue, Left/Right 90 Degree T-Plate)
Epiphysis mini plates 2.0mm (range: left/right L-Obligue, left/right 90 Degree T-Plate)
20 34 47 67
871Quarter Tubular Plate 2.7mm (Hole Range: 3mm – 8mm)
Quarter tubular plate 2.7mm (hole range: 3mm – 8mm)
23 39 54 77
872Self Compression Plates 2.0mm (Hole Range: 4mm – 8mm)
Self compression plates 2.0mm (hole range: 4mm – 8mm)
31 52 73 104
873Self Compression Plates 2.7mm (Hole Range: 2mm – 12mm)
Self compression plates 2.7mm (hole range: 2mm – 12mm)
42 71 99 141
874Straight Mini Plate 2.0mm (Hole Range: 3mm – 6mm)
Straight mini plate 2.0mm (hole range: 3mm – 6mm)
28 47 66 94
8754.0mm Cancellous Screws, 1.75mm Pitch, Full Thread (Length Range: 10mm – 70mm)
4.0mm cancellous screws, 1.75mm pitch, full thread (length range: 10mm – 70mm)
5 9 13 18
8764.0mm Cancellous Screws, 1.75mm Pitch, Long Thread (Length Range: 16mm – 72mm)
4.0mm cancellous screws, 1.75mm pitch, long thread (length range: 16mm – 72mm)
4 7 9 13
8774.0mm Cancellous Screws, 1.75mm Pitch, Short Thread (Length Range: 10mm – 80mm)
4.0mm cancellous screws, 1.75mm pitch, short thread (length range: 10mm – 80mm)
3 6 8 11
8783.5mm Cortical Screws, 1.25mm Pitch, Full Thread (Length Range: 10mm– 70mm)
3.5mm cortical screws, 1.25mm pitch, full thread (length range: 10mm– 70mm)
5 8 11 16
8793.5mm Cortical Screws, 1.25mm Pitch, Self Tapping, Full Thread (Length Range: 10mm – 65mm)
3.5mm cortical screws, 1.25mm pitch, self tapping, full thread (length range: 10mm – 65mm)
5 9 12 17
880 Clover Leaf Plate 3.5mm (Hole Range: 3mm – 5mm)Clover leaf plate 3.5mm (hole range: 3mm – 5mm)
100 167 234 334
881LC-Self Compression Plate 3.5mm (Hole Range: 2mm – 12mm)
LC-self compression plate 3.5mm (hole range: 2mm – 12mm)
77 128 179 256
882One Third Tubular Plate 3.5mm (Hole Range: 2mm – 12mm)
One third tubular plate 3.5mm (hole range: 2mm – 12mm)
21 36 50 71
883Self Compression Plate 3.5mm (Hole Range: 2mm – 12mm)
Self compression plate 3.5mm (hole range: 2mm – 12mm)
28 47 66 94
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FI RAWATAN
884Small T-Plate (Obligue Angled) 3.5mm (Hole Range: 3mm – 5mm)
Small T-Plate (obligue angled) 3.5mm (hole range: 3mm – 5mm)
50 84 118 168
885Small T-Plate (Right Angled) 3.5mm (Hole Range: 3mm – 6mm)
Small T-Plate (right angled) 3.5mm (hole range: 3mm – 6mm)
50 84 118 168
8866.5mm Cancellous Screw, 2.75mm Pitch, 32mm Thread Length (Length Range: 30mm – 110mm)
6.5mm cancellous screw, 2.75mm pitch, 32mm thread length (length range: 30mm – 110mm)
9 15 21 30
8876.5mm Cancellous Screw, 2.75mm Pitch, Full Thread (Length Range: 16mm – 110mm)
6.5mm cancellous screw, 2.75mm pitch, full thread (length range: 16mm – 110mm)
9 16 22 31
8884.5mm Cortical Screw, 1.75mm Pitch, Full Thread (Length Range: 14mm – 80mm)
4.5mm cortical screw, 1.75mm pitch, full thread (length range: 14mm – 80mm)
5 8 11 16
8894.5mm Cortical Screw, 1.75mm Pitch, Self Tapping, Full Thread (Length Range: 14mm – 80mm)
4.5mm cortical screw, 1.75mm pitch, self tapping, full thread (length range: 14mm – 80mm)
5 9 12 17
8904.5mm Malleolar Screw, 1.75mm Pitch, Threaded Length (Length Range: 25mm – 100mm)
4.5mm malleolar screw, 1.75mm pitch, threaded length (length range: 25mm – 100mm)
10 17 23 33
891Broad Self Compression Plate 4.5mm (Holes Range: 4mm – 18mm)
Broad self compression plate 4.5mm (holes range: 4mm – 18mm)
63 106 148 211
892Butress L-Plate (Right Angled) 4.5mm (Hole Range: 3mm – 6mm)
Butress L-Plate (right angled) 4.5mm (hole range: 3mm – 6mm)
84 141 197 281
893Buttress L-Plate (Left Angled) 4.5mm (Hole Range: 3mm – 8mm)
Buttress L-Plate (left angled) 4.5mm (hole range: 3mm – 8mm)
84 141 197 281
894 Buttress T-Plate 4.5mm (Hole Range: 3mm – 8mm)Buttress T-Plate 4.5mm (hole range: 3mm – 8mm)
70 117 164 234
895Cobra Head Plate 4.5mm (Hole Range: 8mm – 11mm)
Cobra head plate 4.5mm (hole range: 8mm – 11mm)
200 334 467 667
896Condylar Buttress Plate (Left Angled) 4.5mm (Hole Range: 7mm – 15mm)
Condylar buttress plate (left angled) 4.5mm (hole range: 7mm – 15mm)
176 293 410 585
897Condylar Buttress Plate (Right Angled) 4.5mm (Hole Range: 7mm – 15mm)
Condylar buttress plate (right angled) 4.5mm (hole range: 7mm – 15mm)
176 293 410 585
898 Large T-Plate 4.5mm (Hole Range: 3mm – 9mm)Large T-Plate 4.5mm (hole range: 3mm – 9mm)
98 164 230 328
899Lateral Tibia Plate (Left Angled) 4.5mm (Hole Range: 5mm – 13mm)
Lateral tibia plate (left angled) 4.5mm (hole range: 5mm – 13mm)
176 293 410 585
900Lateral Tibia Plate (Right Angled) 4.5mm (Hole Range: 5mm – 13mm)
Lateral tibia plate (right angled) 4.5mm (hole range: 5mm – 13mm)
176 293 410 585
901Limited Contact - Broad Self Compression Plate 4.5mm (Holes Range: 6mm – 18mm)
Limited contact - broad self compression plate 4.5mm (holes range: 6mm – 18mm)
127 211 295 422
Page 32
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FI RAWATAN
902Limited Contact - Narrow Self Compression Plate 4.5mm (Holes Range: 2mm – 16mm)
Limited contact - narrow self compression plate 4.5mm (holes range: 2mm – 16mm)
113 188 263 375
903Narrow Self Compression Plate 4.5mm (Holes Range: 2mm – 18mm)
Narrow self compression plate 4.5mm (holes range: 2mm – 18mm)
46 77 107 153
904Semi-Tubular Plate 4.5mm (Hole Range: 2mm- 12mm)
Semi-tubular plate 4.5mm (hole range: 2mm- 12mm)
23 39 55 78
905 Spoon Plate 4.5mm (Hole Range: 5mm – 6mm)Spoon plate 4.5mm (hole range: 5mm – 6mm)
94 156 218 312
906Bone Screw Washers (Range: Outer 6.5mm, 7.2mm, 10.0mm, 13.0mm)
Bone screw washers (range: outer 6.5mm, 7.2mm, 10.0mm, 13.0mm)
3 5 7 10
9074.0mm Cannulated Screw, 16mm Thread Length (Length Range: 25mm – 50mm)
4.0mm cannulated screw, 16mm thread length (length range: 25mm – 50mm)
62 103 144 206
9084.5mm Cannulated Screw, 16mm Thread Length (Length Range: 20mm -80mm)
4.5mm cannulated screw, 16mm thread length (length range: 20mm -80mm)
62 103 144 206
9096.5mm Cannulated Screw, Full Thread (Length Range: 25mm – 115mm)
6.5mm cannulated screw, full thread (length range: 25mm – 115mm)
62 103 144 206
9107.0mm Cannulated Screw, 16mm Thread Length (Length Range: 30mm – 130mm)
7.0mm cannulated screw, 16mm thread length (length range: 30mm – 130mm)
62 103 144 206
9117.0mm Cannulated Screw, 32mm Thread Length (Length Range: 45mm)
7.0mm cannulated screw, 32mm thread length (length range: 45mm)
65 109 152 217
9127.0mm Cannulated Screw, Full Thread (Length Range: 20mm – 130mm)
7.0mm cannulated screw, full thread (length range: 20mm – 130mm)
65 109 152 217
913Curved Reconstruction Plate 3.5mm (Holes Range: 6mm- 18mm)
Curved reconstruction plate 3.5mm (holes range: 6mm- 18mm)
123 205 287 410
914Straight Reconstruction Plate 3.5mm (Hole Range: 5mm – 22mm)
Straight reconstruction plate 3.5mm (hole range: 5mm – 22mm)
70 117 164 234
915Straight Reconstruction Plate 4.5mm (Hole Range: 3mm – 16mm)
Straight reconstruction plate 4.5mm (hole range: 3mm – 16mm)
98 164 230 328
916 DHS Plate 130 (Hole Range: 2mm – 9mm) DHS Plate 130 (hole range: 2mm – 9mm) 176 293 410 585
917 DHS Plate 135 (Hole Range: 2mm – 9mm) DHS Plate 135 (hole range: 2mm – 9mm) 176 293 410 585
918 DHS Plate 140 (Hole Range: 2mm – 12mm) DHS Plate 140 (hole range: 2mm – 12mm) 211 351 491 702
919 DHS Plate 145 (Hole Range: 2mm – 12mm) DHS Plate 145 (hole range: 2mm – 12mm) 211 351 491 702
920 DHS Plate 150 (Hole Range: 2mm – 12mm) DHS Plate 150 (hole range: 2mm – 12mm) 211 351 491 702
Page 33
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FI RAWATAN
921 Hexagonal Head Compression Screw, Length 36mmHexagonal head compression screw, length 36mm
13 22 30 43
922Lag Screw, Thread 12.5mm, Thread Length 22.0mm (Length Range: 50mm – 145mm)
Lag screw, thread 12.5mm, thread length 22.0mm (length range: 50mm – 145mm)
70 117 164 234
923 Calibrated Guide Wires, 2.5mm, Length 230mmCalibrated guide wires, 2.5mm, length 230mm
28 47 66 94
924Austin Moore Narrow Stem Stainless Steel (Head Size Range: 38mm – 56mm)
Austin Moore Narrow Stem Stainless Steel (head size range: 38mm – 56mm)
286 477 667 953
925Austin Moore Standard Stem Stainless Steel (Head Size Range: 38mm – 56mm)
Austin Moore Standard Stem Stainless Steel (head size range: 38mm – 56mm)
286 477 667 953
926Austin Moore Standard Stem Titanium (Head Size Range: 38mm – 56mm)
Austin Moore Standard Stem Titanium (head size range: 38mm – 56mm)
456 761 1,065 1,521
927Thompson Standard Stem Stainless Steel (Head Size Range: 38mm – 56mm)
Thompson Standard Stem Stainless Steel (head size range: 38mm – 56mm)
286 477 667 953
928Thompson Standard Stem Titanium (Head Size Range: 38mm – 55mm)
Thompson Standard Stem Titanium (head size range: 38mm – 55mm)
456 761 1,065 1,521
929130 Angled Blade Plates (Hole Range: 4mm – 12mm)
130 Angled Blade Plates (hole range: 4mm – 12mm)
190 317 444 634
93095 Angled Blade Plates (Condylar Plate 95) (Hole Range: 5mm – 18mm)
95 Angled Blade Plates (Condylar Plate 95) (hole range: 5mm – 18mm)
334 556 778 1,112
931Supracondylar Plates 95 Degress (Hole Range: 6mm – 16mm)
Supracondylar plates 95 degress (hole range: 6mm – 16mm)
274 457 639 913
932Carbon Fibre Rods 11.0mm (Length Range: 100mm – 600mm)
Carbon fibre rods 11.0mm (length range: 100mm – 600mm)
46 77 107 153
933Schanz Screws 4.0mm (Length Range: 100mm – 250mm)
Schanz screws 4.0mm (length range: 100mm – 250mm)
17 29 40 57
934Schanz Screws 4.0mm/3.0mm (Length Range: 80mm – 100mm)
Schanz screws 4.0mm/3.0mm (length range: 80mm – 100mm)
16 26 36 52
935Schanz Screws 5.0mm (Length Range: 100mm – 250mm)
Schanz screws 5.0mm (length range: 100mm – 250mm)
17 29 40 57
936Schanz Screws 6.0mm (Length Range: 100mm – 250mm)
Schanz screws 6.0mm (length range: 100mm – 250mm)
34 57 79 113
937Tube to Pin Clamp, Connection Schanz Screw 5.0mm to 11.0mm Tube
Tube to pin clamp, connection Schanz Screw 5.0mm to 11.0mm Tube
67 112 156 223
938Tube to Tube Clamp, End Connector 11.0mm to 11.0mm Tube
Tube to tube clamp, end connector 11.0mm to 11.0mm tube
67 112 156 223
939Tube to Tube Clamp, Mid Shaft Connector 11.0mm to 11.0mm Tube
Tube to tube clamp, mid shaft connector 11.0mm to 11.0mm tube
67 112 156 223
940Ender Nails 4.5mm (Length Range: 420mm – 520mm)
Ender nails 4.5mm (length range: 420mm – 520mm)
59 98 137 195
941Ender Nails 4.8mm (Length Range: 220mm – 520mm)
Ender nails 4.8mm (length range: 220mm – 520mm)
48 81 113 161
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FI RAWATAN
942Kuntcher Nails 10.0 mm (Length Range: 20 cm – 52 cm)
Kuntcher nails 10.0 mm (length range: 20 cm – 52 cm)
116 193 270 385
943Kuntcher Nails 11.0mm (Length Range: 20 cm – 52 cm)
Kuntcher nails 11.0mm (length range: 20 cm – 52 cm)
117 195 273 390
944Kuntcher Nails 13.0mm (Length Range: 20 cm – 52 cm)
Kuntcher nails 13.0mm (length range: 20 cm – 52 cm)
124 207 289 413
945Kuntcher Nails 14.0mm (Length Range: 30 cm – 52 cm)
Kuntcher nails 14.0mm (length range: 30 cm – 52 cm)
128 213 298 425
946Kuntcher Nails 15.0mm (Length Range: 30 cm – 52 cm)
Kuntcher nails 15.0mm (length range: 30 cm – 52 cm)
131 218 305 436
947Kuntcher Nails 16.0mm (Length Range: 30 cm – 52 cm)
Kuntcher nails 16.0mm (length range: 30 cm – 52 cm)
138 230 321 459
948Kuntcher Nails 6.0mm (Length Range: 14 cm – 40 cm)
Kuntcher nails 6.0mm (length range: 14 cm – 40 cm)
99 166 232 331
949Kuntcher Nails 7.0mm (Length Range: 14 cm – 40 cm)
Kuntcher nails 7.0mm (length range: 14 cm – 40 cm)
103 172 241 344
950Kuntcher Nails 8.0mm (Length Range: 20 cm – 52 cm)
Kuntcher nails 8.0mm (length range: 20 cm – 52 cm)
107 178 249 356
951Kuntcher Nails 9.0mm (Length Range: 20 cm – 52 cm)
Kuntcher nails 9.0mm (length range: 20 cm – 52 cm)
110 184 257 367
952Cerclage Wires (10's) (Diameter Range: 1.0mm - 1.2mm)
Cerclage wires (10's) (diameter range: 1.0mm - 1.2mm)
421 702 983 1,404
953Cerclage Wires, Length 10 Meters (Diameter Range: 1.0mm - 1.2mm)
Cerclage wires, length 10 meters (diameter range: 1.0mm - 1.2mm)
40 67 94 134
954Kirchner Wires 0.9mm, Trocar Tip Single or Double (Length Range: 70mm – 150mm)
Kirchner wires 0.9mm, trocar tip single or double (length range: 70mm – 150mm)
2 3 4 6
955Kirchner Wires 1.2mm, Trocar Tip Single or Double (Length Range: 150mm – 280mm)
Kirchner wires 1.2mm, trocar tip single or double (length range: 150mm – 280mm)
2 3 4 6
956Kirchner Wires 1.0mm, Trocar Tip Single or Double (Length Range: 150mm – 280mm)
Kirchner wires 1.0mm, trocar tip single or double (length range: 150mm – 280mm)
2 3 4 6
957Kirchner Wires 1.4mm, Trocar Tip Single or Double (Length Range: 150mm – 280mm)
Kirchner wires 1.4mm, trocar tip single or double (length range: 150mm – 280mm)
2 3 4 6
958Kirchner Wires 1.5mm, Trocar Tip Single or Double (Length Range: 150mm – 300mm)
Kirchner wires 1.5mm, trocar tip single or double (length range: 150mm – 300mm)
2 4 6 8
959Kirchner Wires 1.6mm, Trocar Tip Single or Double (Length Range: 150mm – 280mm)
Kirchner wires 1.6mm, trocar tip single or double (length Range: 150mm – 280mm)
2 4 6 8
Page 35
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FI RAWATAN
960Kirchner Wires 1.8mm, Trocar Tip Single or Double (Length Range: 150mm – 280mm)
Kirchner wires 1.8mm, trocar tip single or double (length Range: 150mm – 280mm)r
2 4 6 8
961Kirchner Wires 2.0mm, Trocar Tip Single or Double (Length Range: 150mm – 400mm)
Kirchner wires 2.0mm, trocar tip single or double (length range: 150mm – 400mm)
3 5 6 9
962 Rush Pins 2.4mm (Length Range: 25mm – 254mm)Rush pins 2.4mm (length range: 25mm – 254mm)
25 42 59 84
963Rush Pins 3.2mm (Length Range: 102mm – 356mm)
Rush pins 3.2mm (length range: 102mm – 356mm)
31 51 71 102
964Rush Pins 4.8mm (Length Range: 203mm – 356mm)
Rush pins 4.8mm (length range: 203mm – 356mm)
31 51 71 102
965Rush Pins 6.4mm (Length Range: 298mm – 431mm)
Rush pins 6.4mm (length range: 298mm – 431mm)
38 64 89 127
966Steinmann Pins 3.5mm with Trocar Tip (Length Range: 125mm – 150mm)
Steinmann pins 3.5mm with trocar tip (length range: 125mm – 150mm)
10 17 24 34
967Steinmann Pins 4.0mm/5.0mm Mid Thread (Length Range: 175mm – 200mm)
Steinmann pins 4.0mm/5.0mm mid thread (length range: 175mm – 200mm)
42 71 99 141
968Steinmann Pins 4.0mm with Trocar Tip (Length Range: 150mm – 175mm)
Steinmann pins 4.0mm with trocar tip (length range: 150mm – 175mm)
10 17 24 34
969Steinmann Pins 4.5mm with Trocar Tip (Length Range: 125mm – 250mm)
Steinmann pins 4.5mm with trocar tip (length range: 125mm – 250mm)
10 17 24 34
970Steinmann Pins 5.0mm with Trocar Tip (Length Range: 150mm – 300mm)
Steinmann pins 5.0mm with trocar tip (length range: 150mm – 300mm)
10 17 24 34
971 Interlocking Femoral Nail Interlocking femoral nail 264 440 616 880972 Interlocking Tibia Nail Interlocking tibia nail 264 440 616 880973 Distal Tibia Plate Distal tibia plate 990 1,650 2,310 3,300974 Osteotomy Plate Osteotomy plate 858 1,430 2,002 2,860975 Calcaneal Plates Calcaneal plate 660 1,100 1,540 2,200976 Bone Staples Bone staples 33 55 77 110977 Stainless Steel Elastic Nail Stainless steel elastic nail 528 880 1,232 1,760978 Bone Cement (plain) Bone cement (plain) 66 110 154 220979 External Fixator 2 tubes and 8 clamps External fixator 2 tubes and 8 clamps 1,485 2,475 3,465 4,950980 Wrist External Fixator Wrist external fixator 1,485 2,475 3,465 4,950
981 Reconstruction External Fixator Set Tibia Reconstruction external fixator set tibia 2,640 4,400 6,160 8,800
982 Reconstruction External Fixator Set Femur Reconstruction external fixator set femur 3,960 6,600 9,240 13,200
IMPLAN KAKI DAN BUKU LALI FOOT AND ANKLE IMPLANT
983Suture anchor – 2.4mm - 5.5mm (titanium, bio absorbable, PEEK)
Suture anchor – 2.4mm - 5.5mm (titanium, bio absorbable, PEEK)413 688 963 1,375
984 Syndesmosis tightrope Syndesmosis tightrope 525 875 1,225 1,750
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FI RAWATAN
985 Bio tenodesis screw Bio tenodesis screw 507 845 1,183 1,690986 Break away screw Break away screw 108 180 252 360987 Triple threaded screw 6.0mm Triple threaded screw 6.0mm 270 450 630 900
988Cannulated screw 2.4mm, 3.0mm, 4.0mm, 6.5mm, 7.0mm & 7.3mm (titanium)
Cannulated screw 2.4mm, 3.0mm, 4.0mm, 6.5mm, 7.0mm & 7.3mm (titanium) 158 263 368 525
989 Locking plate (mini & calcaneum) Locking plate (mini & calcaneum) 705 1,175 1,645 2,350990 Compression staple Compression staple 143 238 333 475991 Pilon plate (distal end tibia) Pilon plate (distal end tibia) 600 1,000 1,400 2,000992 Ankle distractor (external fixator) Ankle distractor (external fixator) 1,800 3,000 4,200 6,000993 Bone graft (Bonalive) Bone graft (bonalive) 840 1,400 1,960 2,800
994 Radiofrequency coblation probe (Topaz) Radiofrequency coblation probe (topaz) 390 650 910 1,300
995 Arthroscopic radiofrequency probe (Covac) Arthroscopic radiofrequency probe (covac) 285 475 665 950
996 Arthroereisis screw Arthroereisis screw 773 1,288 1,803 2,575997 Total ankle replacement Total ankle replacement 4,650 7,750 10,850 15,500998 Taylor spatial frame Taylor spatial frame 3,600 6,000 8,400 12,000999 Hind foot nail Hind foot nail 1,005 1,675 2,345 3,350
1000Metatarsophalangeal joint arthroplasty (hemi & total)
Metatarsophalangeal joint arthroplasty (hemi & total)
1,838 3,063 4,288 6,125
GENERAL/TRAUMA IMPLANTS GENERAL/TRAUMA IMPLANTS
1001 DHS DHS 195 325 455 6501002 Interlocking Femoral Nail Interlocking femoral nail 209 348 487 6951003 Interlocking Tibial Nail Interlocking tibial nail 209 348 487 6951004 Kuntscher Intramedullary Nail Tibia Kuntscher intramedullary nail tibia 59 98 137 1951005 Kuntscher Intramedullary Nail Femur Kuntscher intramedullary nail femur 59 98 137 1951006 Steinman Pin Steinman pin 12 20 27 391007 Schanz Screw Schanz screw 18 30 41 591008 Cortical Screw 3.5mm Cortical screw 3.5mm 3 5 7 101009 Cortical Screw 4.5mm Cortical screw 4.5mm 4 7 9 131010 Circlage Wire 0.2mm - 1.5mm Circlage wire 0.2mm - 1.5mm 32 53 74 105
1011 6.5mm Cancellous screw (16/32/Full Thread) 6.5mm cancellous screw (16/32/full thread) 7 11 15 22
1012 4.0mm Cancellous screw (Full/Short Thread) 4.0mm cancellous screw (full/short thread) 5 9 12 17
1013 Cannulated Screw 4.0mm, 6.5mm, 7.0mm Cannulated screw 4.0mm, 6.5mm, 7.0mm 57 95 133 190
1014 Mini Plates Mini plates 51 85 118 1691015 Mini Screws 1.5mm, 2.0mm, 2.7mm Mini screws 1.5mm, 2.0mm, 2.7mm 7 12 17 241016 Angle Blade Plate Angle blade plate 225 375 525 7501017 K-Wires various sizes and length K-Wires various sizes and length 4 7 9 131018 Rush Nails Rush nails 195 325 454 6491019 Straight Reconstruction Plate 2.7mm Straight reconstruction plate 2.7mm 47 79 111 158
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FI RAWATAN
1020 Reconstruction Plate 3.5mm (Straight/Curved) Reconstruction plate 3.5mm 82 137 191 2731021 Reconstruction Plate 4.5mm (Straight/Curved) Reconstruction plate 4.5mm 83 138 193 2751022 Broad DCP Plate (4.5mm) Broad DCP plate (4.5mm) 44 74 103 1471023 Narrow DCP (4.5mm) Narrow DCP (4.5mm) 34 57 79 1131024 Small Fragments Plate (3.5mm) Small fragments plate (3.5mm) 27 45 63 901025 One Third Tubular Plate (3.5mm) One third tubular plate (3.5mm) 16 26 36 521026 Semi Tubular Plate (4.5mm) Semi tubular plate (4.5mm) 21 36 50 711027 T-Buttress Plate 4H - 6H (4.5mm) T-buttress plate 4H - 6H (4.5mm) 54 90 125 1791028 T - Plate (4.5mm) T - plate (4.5mm) 64 106 148 2121029 L- Buttress Plate 4H - 6H (4.5mm) L- buttress plate 4H - 6H (4.5mm) 59 98 137 195
1030 Small T- Plate (3.5mm) :Oblique/Right/Left Small T- plate (3.5mm) :oblique/Right/Left 36 60 84 120
1031 Condylar Buttress Plate (4.5mm) Condylar buttress plate (4.5mm) 135 225 315 4501032 Clover Leaf Plate Clover leaf plate 80 133 186 2651033 Spoon Plate Spoon plate 69 115 160 2291034 Distal Tibial Plate Distal tibial plate 338 563 788 1,1251035 Osteotomy Plate Osteotomy plate 195 325 455 6501036 LC-DCP Plate (3.5mm, 4.5mm) LC-DCP plate (3.5mm, 4.5mm) 68 113 158 2251037 Calcanel Plate Calcanel plate 158 263 368 5251038 Y-Plate Y-plate 68 113 158 2251039 Bone Staples Bone staples 12 20 28 401040 Washer Washer 5 8 11 15
JOINT ARTHROPLASTY JOINT ARTHROPLASTY
1041 Hemi Hip Prosthesis (Austin Moore/Thompson)Hemi hip prosthesis (Austin Moore/Thompson)
218 363 508 725
MISCELLANEOUS MISCELLANEOUS1042 Bone Cement (Plain) Bone cement (plain) 75 125 175 250
BASIC LCP SMALL FRAGMENT 3.5mm BASIC LCP SMALL FRAGMENT 3.5mm
1043 LCP Straight Plate 3.5mm: (Stainless Steel) : LCP Straight Plate 3.5mm: (Stainless Steel) :
1044 6-9 holes (1 set) 1 Plate and Screws 6-9 holes (1 set) 1 Plate and Screws 240 400 560 8001045 10-12 holes 10-12 holes 330 550 770 1,1001046 LCP Metaphyseal 3.5mm (Titanium) : LCP Metaphyseal 3.5mm (Titanium) :1047 6-9 holes (1 set) 1 Plate and Screws 6-9 holes (1 set) 1 Plate and Screws 540 900 1,260 1,8001048 10-12 holes 10-12 holes 600 1,000 1,400 2,000
LCP T Plate 3.5mm: (Stainless Steel) LCP T Plate 3.5mm: (Stainless Steel)1049 - Right Angled (3-6 holes) - Right Angled (3-6 holes) 240 400 560 8001050 - Obloque Angle (3-5 holes) - Obloque Angle (3-5 holes) 240 400 560 800
1051LCP Reconstruction Plate 3.5mm (6-9 holes) Stainless Steel
LCP Reconstruction Plate 3.5mm (6-9 holes) Stainless Steel
255 425 595 850
1052LCP Plate (1.0mm, 1.3mm, 1.5mm, 2.0mm, 2.4mm) - 1 plate & screw
LCP Plate (1.0mm, 1.3mm, 1.5mm, 2.0mm, 2.4mm) - 1 plate & screw
480 800 1,120 1,600
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1053 Screw only Screw only 45 75 105 1501054 Proximal Humeral Locking Plate Proximal Humeral Locking Plate 900 1,500 2,100 3,0001055 Distal Humeral Locking Plate Distal Humeral Locking Plate 1,170 1,950 2,730 3,9001056 Distal Radius Locking Plate (volar) Distal Radius Locking Plate (volar) 660 1,100 1,540 2,2001057 Distal Radius Locking Plate (dorsal) Distal Radius Locking Plate (dorsal) 690 1,150 1,610 2,3001058 LCP Distal Radius Plate 2.4mm : LCP Distal Radius Plate 2.4mm :1059 - Dorsal Plate (2 Plates) - Dorsal Plate (2 Plates) 690 1,150 1,610 2,300
1060 - Volar Plate (Extraarticular or Juxta Articular) - Volar Plate (Extraarticular or Juxta Articular)
540 900 1,260 1,800
1061 - Extra Long Volar Plate (10 holes) - Extra Long Volar Plate (10 holes) 810 1,350 1,890 2,7001062 - LCP Wrist Fusion 2.7mm/3.5mm - LCP Wrist Fusion 2.7mm/3.5mm 840 1,400 1,960 2,8001063 - LCP Ulna Hook 2.0mm - LCP Ulna Hook 2.0mm 480 800 1,120 1,600
1064 - 3.0mm Headless Compression Screw - 3.0mm Headless Compression Screw 210 350 490 700
1065 Variable Angle 2 column Distal Radius Plate 2.4mmVariable Angle 2 column Distal Radius Plate 2.4mm
750 1,250 1,750 2,500
LOCKING PLATE (Upper Limb)(Stainless Steel)LOCKING PLATE (Upper Limb)(Stainless Steel)
1066 Clavicular Locking Plate Clavicular Locking Plate 540 900 1,260 1,8001067 Proximal Humeral Locking Plate Proximal Humeral Locking Plate 660 1,100 1,540 2,2001068 Distal Humeral locking plate Distal Humeral locking plate 1,170 1,950 2,730 3,900
1069LCP Extra-Articular Distal Humerus Plate 3.5mm(6 holes, 8 holes, 9 holes, 10 holes)
LCP Extra-Articular Distal Humerus Plate 3.5mm(6 holes, 8 holes, 9 holes, 10 holes)
1,170 1,950 2,730 3,900
1070 LCP Hook Plate 3.5mm LCP Hook Plate 3.5mm 360 600 840 1,2001071 Olecranon locking plate Olecranon locking plate 900 1,500 2,100 3,0001072 Unreamed Humeral Nail Unreamed Humeral Nail 480 800 1,120 1,6001073 Without End Caps Without End Caps 360 600 840 1,2001074 with End Caps with End Caps 480 800 1,120 1,600
1075LCP Compact hands (1.0mm, 1.3mm, 1.5mm, 2.0mm, 2.4mm)
LCP Compact hands (1.0mm, 1.3mm, 1.5mm, 2.0mm, 2.4mm)
480 800 1,120 1,600
BASIC LCP LARGE FRAGMENT 4.5mm/5.0mmBASIC LCP LARGE FRAGMENT 4.5mm/5.0mm
LCP Narrow 4.5mm/5.0mm humerus/tibia : LCP Narrow 4.5mm/5.0mm humerus/tibia :
1076 - 6-9 holes - 6-9 holes 300 500 700 1,0001077 - 10-16 holes - 10-16 holes 480 800 1,120 1,6001078 - 8-9 holes - 8-9 holes 330 550 770 1,1001079 - 10-14 holes - 10-14 holes 495 825 1,155 1,6501080 - 16 holes - 16 holes 600 1,000 1,400 2,000
1081 LCP T-Buttress Plate 4.5mm/5.0mm (4-5 holes)LCP T-Buttress Plate 4.5mm/5.0mm (4-5 holes)
270 450 630 900
1082 LCP T Plate 4.5mm/5.0mm (4-6 holes) LCP T Plate 4.5mm/5.0mm (4-6 holes) 270 450 630 900
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1083 LCP L-Buttress Plate 4.5mm/5.0mm (4-6 holes)LCP L-Buttress Plate 4.5mm/5.0mm (4-6 holes)
270 450 630 900
1084LCP Metaphyseal 3.5mm/4.5mm/5.0mm BROAD ( 3-9 holes)
LCP Metaphyseal 3.5mm/4.5mm/5.0mm BROAD ( 3-9 holes)
660 1,100 1,540 2,200
1085LCP Reconstruction Plate 4.5mm/5.0mm (6-10 holes)
LCP Reconstruction Plate 4.5mm/5.0mm (6-10 holes)
600 1,000 1,400 2,000
INTERLOCKING NAIL (Stainless Steel) INTERLOCKING NAIL (Stainless Steel)
LCP Dynamic Hip Screw 4.5mm/5.0mm 2-6 holes:LCP Dynamic Hip Screw 4.5mm/5.0mm 2-6 holes:
1086 - 1 Plate and Srews - 1 Plate and Srews 300 500 700 1,000
1087 - 1 Plate + 1 Lag Screw + 1 Compression Screw + Screws
- 1 Plate + 1 Lag Screw + 1 Compression Screw + Screws
360 600 840 1,200
1088 - 8 -10 holes - 8 -10 holes 420 700 980 1,4001089 - 12-14 holes - 12-14 holes 540 900 1,260 1,8001090 Femur Interlocking Nail Femur Interlocking Nail 255 425 595 8501091 Retrograde Nail Retrograde Nail 450 750 1,050 1,5001092 Femur Reconstruction nail Femur Reconstruction nail 450 750 1,050 1,5001093 Proximal Femoral Nail (Standard) Proximal Femoral Nail (Standard) 540 900 1,260 1,8001094 Proximal Femoral Nail (Long Stem) Proximal Femoral Nail (Long Stem) 750 1,250 1,750 2,5001095 Gamma Nail Gamma Nail 540 900 1,260 1,8001096 Distal Femoral Nail Distal Femoral Nail 720 1,200 1,680 2,4001097 Tibial Interlocking Nail Tibial Interlocking Nail 255 425 595 8501098 LCP Hook Plate 3.5mm LCP Hook Plate 3.5mm 360 600 840 1,200
LCP 1/3 Tubular 1.3mm : LCP 1/3 Tubular 1.3mm :1099 - 5-7 holes - 5-7 holes 360 600 840 1,2001100 - 8-10 holes - 8-10 holes 420 700 980 1,400
1101 LCP Medial Proximal Tibia Plate 3.5mm (4-8 holes)LCP Medial Proximal Tibia Plate 3.5mm (4-8 holes)
720 1,200 1,680 2,400
LCP Medial Distal Tibia Plate 3.5mm LCP Medial Distal Tibia Plate 3.5mm1102 - low bend 6-8 holes - low bend 6-8 holes 630 1,050 1,470 2,1001103 - 12-14 holes - 12-14 holes 780 1,300 1,820 2,600
1104LCP Anterolateral Distal Tibial Plate 3.5mm (5-11 holes)
LCP Anterolateral Distal Tibial Plate 3.5mm (5-11 holes)
630 1,050 1,470 2,100
1105LCP Compact Foot : (LCP Plate 2.0mm/2.4mm/2.7mm)
LCP Compact Foot : (LCP Plate 2.0mm/2.4mm/2.7mm)
480 800 1,120 1,600
1106LCP 2 Hole Plate 2.7mm (consists of 1 Plate & Screws)
LCP 2 Hole Plate 2.7mm (consists of 1 Plate & Screws)
240 400 560 800
1107 Screw only (2.0mm, 2.4mm, 2.7mm) Screw only (2.0mm, 2.4mm, 2.7mm) 45 75 105 1501108 LCP Calcaneal Plate 3.5mm LCP Calcaneal Plate 3.5mm 600 1,000 1,400 2,0001109 Midfoot Fusion Bolt Midfoot Fusion Bolt 540 900 1,260 1,800
INTERLOCKING NAIL (Titanium) INTERLOCKING NAIL (Titanium)
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1110 Femur Interlocking Nail Femur Interlocking Nail 480 800 1,120 1,6001111 Gamma Nail Gamma Nail 660 1,100 1,540 2,2001112 Distal Femoral Nail Distal Femoral Nail 600 1,000 1,400 2,0001113 Spiral locking Spiral locking 720 1,200 1,680 2,4001114 Tibial Interlocking Nail Tibial Interlocking Nail 255 425 595 8501115 Expert Tibial Nail (Cannulated) Expert Tibial Nail (Cannulated) 600 1,000 1,400 2,0001116 Expert A2FN Standard locking Expert A2FN Standard locking 540 900 1,260 1,8001117 Periarticular plate LCP Tomofix 3.5mm Periarticular plate LCP Tomofix 3.5mm 780 1,300 1,820 2,600
1118LCP Distal Fibula Plate 2.7mm/3.5mm (lateral/posterolateral)
LCP Distal Fibula Plate 2.7mm/3.5mm (lateral/posterolateral)
870 1,450 2,030 2,900
1119 LCP Proximal Tibia Plate 3.5mm, lateral (6-8 holes)LCP Proximal Tibia Plate 3.5mm, lateral (6-8 holes)
720 1,200 1,680 2,400
OTHERS OTHERS1120 Expert nail Expert nail 540 900 1,260 1,800
DISTAL FEMUR /PROXIMAL & DISTAL TIBIA FRACTURES
DISTAL FEMUR /PROXIMAL & DISTAL TIBIA FRACTURES
4,740 7,900 11,060 15,800
1121
(Consist of: Posts, 3 Hole Wire Clamps, 2 Hole Wire Clamp, Supplementary Screw Holder Bar & Clamps, HA Coated Orthofix Tapered Cortical Screws)
(Consist of: Posts, 3 Hole Wire Clamps, 2 Hole Wire Clamp, Supplementary Screw Holder Bar & Clamps, HA Coated Orthofix Tapered Cortical Screws)
ACUTE TRAUMA/POST-TRAUMATIC STIFFNESSACUTE TRAUMA/POST-TRAUMATIC STIFFNESS
4,500 7,500 10,500 15,000
1122(Consist of: Complete Orthofix Elbow Fixator Kit With HA Coated Orthofix Tapered Cortical Screws )
(Consist of: Complete Orthofix Elbow Fixator Kit With HA Coated Orthofix Tapered Cortical Screws )
GENU VARUM/GENU VALGUM/LLD/ ANKLE VALGUS etc.(Consist of : Brand : Orthofix, Italy)
GENU VARUM/GENU VALGUM/LLD/ ANKLE VALGUS etc.(Consist of : Brand : Orthofix, Italy)
1123 Trauma Paediatric Orthopedik Trauma Paediatric Orthopedik 720 1,200 1,680 2,400Titanium Elastic Nail (TEN) Titanium Elastic Nail (TEN)
1124- Without End Caps (consists of 2 pcs TEN only)
- Without End Caps (consists of 2 pcs TEN only)
360 600 840 1,200
1125- With End caps (consists of 2 pcs TEN & 2 pcs End Cap)
- With End caps (consists of 2 pcs TEN & 2 pcs End Cap)
480 800 1,120 1,600
1126Capos 3.5mm & 4.5mm (consists of 1 Plate & Screw) (Stainless Steel)
Capos 3.5mm & 4.5mm (consists of 1 Plate & Screw) (Stainless Steel)
360 600 840 1,200
1127Paediatric Hip Plate (3.5mm & 5.0mm) 1 Plate & Screw (Stainless Steel)
Paediatric Hip Plate (3.5mm & 5.0mm) 1 Plate & Screw (Stainless Steel)
660 1,100 1,540 2,200
1128 Telescopic nail Telescopic nail 2,700 4,500 6,300 9,0001129 Paediatric Hip Locking Plate Paediatric Hip Locking Plate 750 1,250 1,750 2,5001130 8 Plate 8 Plate 750 1,250 1,750 2,500
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1131 Paediatric Limb reconstruction System Paediatric Limb reconstruction System 4,500 7,500 10,500 15,000
1132 Arthrodiastasis Arthrodiastasis 4,500 7,500 10,500 15,0001133 Scoliosis Instrumentation (Anterior) Scoliosis Instrumentation (Anterior) 9,000 15,000 21,000 30,000
1134 Scoliosis Instrumentation (Anterior-Posterior)Scoliosis Instrumentation (Anterior-Posterior)
9,000 15,000 21,000 30,000
1135 Scoliosis Instrumentation (Posterior) Scoliosis Instrumentation (Posterior) 7,500 12,500 17,500 25,000
1136 Anterior Cervical Fusion System (single level)Anterior Cervical Fusion System (single level)
1,800 3,000 4,200 6,000
1137 Posterior Cervical Fusion Posterior Cervical Fusion 3,000 5,000 7,000 10,0001138 Spinal Cages Spinal Cages 900 1,500 2,100 3,0001139 Anterior Spinal Instrumentations Anterior Spinal Instrumentations 3,000 5,000 7,000 10,000
1140 Lower Back Instrumentations (single level) Lower Back Instrumentations (single level) 2,700 4,500 6,300 9,000
1141 Artificial Discs (Cervical) Artificial Discs (Cervical) 3,300 5,500 7,700 11,0001142 Artificial Discs (lumbar) Artificial Discs (lumbar) 3,300 5,500 7,700 11,0001143 Kyphoplasty (per level) Kyphoplasty (per level) 2,363 3,938 5,513 7,8751144 Vertebroplasty (per level) Vertebroplasty (per level) 1,350 2,250 3,150 4,5001145 Halo Vest System Halo Vest System 2,835 4,725 6,615 9,4501146 Scoliosis Bracing Scoliosis Bracing 252 420 588 8401147 Juwett, SOMI,TLSO, LSO Bracing Juwett, SOMI,TLSO, LSO Bracing 299 499 699 9981148 Pedicle Screws Pedicle Screws 347 578 809 1,155
Sports Surgery and Arthroscopy : Sports Surgery and Arthroscopy :
1149 Primary ACL reconstruction (single bundle) Primary ACL reconstruction (single bundle) 1,393 2,322 3,250 4,643
1150 Primary ACL reconstruction (double bundle) Primary ACL reconstruction (double bundle) 2,083 3,472 4,860 6,943
1151 Primary PCL reconstruction (single bundle) Primary PCL reconstruction (single bundle) 1,793 2,988 4,183 5,976
1152 Primary PCL reconstruction (double bundle) Primary PCL reconstruction (double bundle) 2,120 3,534 4,948 7,068
1153 Primary PLC reconstruction (single bundle) Primary PLC reconstruction (single bundle) 1,355 2,258 3,161 4,515
1154 Primary PLC reconstruction (double bundle) Primary PLC reconstruction (double bundle) 2,102 3,503 4,904 7,005
1155 Primary MCL reconstruction (single bundle) Primary MCL reconstruction (single bundle) 1,355 2,258 3,161 4,515
1156 Primary MCL reconstruction (double bundle) Primary MCL reconstruction (double bundle) 2,102 3,503 4,904 7,005
Multiligament reconstruction without allograftMultiligament reconstruction without allograft
1157 - 2 ligaments - 2 ligaments 2,362 3,937 5,511 7,8731158 - 3 ligaments - 3 ligaments 3,032 5,054 7,076 10,108
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1159 - 4 ligaments - 4 ligaments 4,067 6,779 9,491 13,558
Multiligament reconstruction with allograft Multiligament reconstruction with allograft
1160 - 2 ligaments - 2 ligaments 5,062 8,437 11,811 16,8731161 Patella stabilization surgery Patella stabilization surgery 1,203 2,005 2,807 4,0101162 Knee malalignment surgery Knee malalignment surgery 1,320 2,200 3,080 4,4001163 Meniscus repair surgery Meniscus repair surgery 1,303 2,172 3,040 4,3431164 Meniscus transplantation surgery Meniscus transplantation surgery 8,177 13,628 19,079 27,2551165 Shoulder stabilization surgery Shoulder stabilization surgery 1,350 2,250 3,150 4,5001166 Anterior and Posterior stabilization Anterior and Posterior stabilization 2,317 3,862 5,406 7,7231167 Single Row (small or medium size tear) Single Row (small or medium size tear) 3,750 6,250 8,750 12,5001168 Single Row (massive tear) Single Row (massive tear) 1,401 2,335 3,269 4,670
1169 Double Row (small or medium size tear) Double Row (small or medium size tear) 2,384 3,973 5,562 7,945
1170 Double Row (massive tear) Double Row (massive tear) 2,211 3,685 5,159 7,3701171 Biceps tendon repair or tenodesis Biceps tendon repair or tenodesis 2,099 3,498 4,897 6,9951172 ACJ repair ACJ repair 3,239 5,398 7,557 10,7951173 ACJ reconstruction ACJ reconstruction 1,054 1,757 2,459 3,5131174 Osteochondral transplantation surgery Osteochondral transplantation surgery 1,331 2,219 3,107 4,438
Implants for Arthroscopy and Sport SurgeryImplants for Arthroscopy and Sport Surgery
1175 Bioabsorbable Interference Screw Bioabsorbable Interference Screw 374 623 872 1,2451176 Extracortical button Extracortical button 401 668 935 1,3351177 Suture Anchor Suture Anchor 411 685 959 1,3701178 Meniscus repair Meniscus repair 330 550 770 1,1001179 Tight rope repair kit Tight rope repair kit 263 438 613 8751180 AC graftrope AC graftrope 450 750 1,050 1,5001181 Meniscus implant Meniscus implant 7,500 12,500 17,500 25,0001182 Allograft tissue (Freeze-Dried) Allograft tissue (Freeze-Dried) 1,800 3,000 4,200 6,0001183 Allograft tissue (Fresh Frozen) Allograft tissue (Fresh Frozen) 3,450 5,750 8,050 11,5001184 Osteochondral implant Osteochondral implant 900 1,500 2,100 3,0001185 Force fibrewire Force fibrewire 63 105 147 2101186 Knee Brace Knee Brace 450 750 1,050 1,5001187 Shoulder Brace Shoulder Brace 143 238 333 4751188 Osteotomy Plate Osteotomy Plate 750 1,250 1,750 2,5001189 Bone Substitute Bone Substitute 420 700 980 1,400
OSTEOTITE HA COATED SCREWS:- OSTEOTITE HA COATED SCREWS:-
1190Osteotite bone screw 180mm/50mm diameter 6mm, thread 6-5mm
Osteotite bone screw 180mm/50mm diameter 6mm, thread 6-5mm
108 180 252 360
1191Osteotite bone screw 180mm/60mm diameter 6mm, thread 6-5mm
Osteotite bone screw 180mm/60mm diameter 6mm, thread 6-5mm
108 180 252 360
1192Osteotite bone screw 200mm/50mm diameter 6mm, thread 6-5mm
Osteotite bone screw 200mm/50mm diameter 6mm, thread 6-5mm
108 180 252 360
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1193Osteotite bone screw 150mm/30mm diameter 6mm, thread 6-5mm
Osteotite bone screw 150mm/30mm diameter 6mm, thread 6-5mm
108 180 252 360
1194Osteotite bone screw 150mm/40mm diameter 6mm, thread 6-5mm
Osteotite bone screw 150mm/40mm diameter 6mm, thread 6-5mm
108 180 252 360
1195Osteotite bone screw 170mm/40mm diameter 6mm, thread 6-5mm
Osteotite bone screw 170mm/40mm diameter 6mm, thread 6-5mm
108 180 252 360
1196Osteotite bone screw 170mm/60mm diameter 6mm, thread 6-5mm
Osteotite bone screw 170mm/60mm diameter 6mm, thread 6-5mm
108 180 252 360
1197Osteotite bone screw 170mm/80mm diameter 6mm, thread 6-5mm
Osteotite bone screw 170mm/80mm diameter 6mm, thread 6-5mm
108 180 252 360
1198Osteotite bone screw 160mm/70mm diameter 6mm, thread 6-5mm
Osteotite bone screw 160mm/70mm diameter 6mm, thread 6-5mm
108 180 252 360
BASIC LRS COMPONENTS BASIC LRS COMPONENTS 1199 LRS Extra Short Rail Length 12cm LRS Extra Short Rail Length 12cm 728 1,214 1,699 2,4271200 LRS Standard Rail Length 30cm LRS Standard Rail Length 30cm 767 1,279 1,791 2,5581201 LRS Long Rail Length 40cm LRS Long Rail Length 40cm 1,060 1,767 2,474 3,5341202 LRS Straight Central Clamp LRS Straight Central Clamp 1,250 2,084 2,917 4,1671203 LRS Straight Outer Clamp LRS Straight Outer Clamp 910 1,517 2,123 3,0331204 LRS T-Clamp LRS T-Clamp 871 1,452 2,033 2,904
1205 Sandwich Clamp With C/D Unit for LRS Sandwich Clamp With C/D Unit for LRS 1,103 1,838 2,573 3,676
1206 Compression Distraction Unit Long Clicker Model Compression Distraction Unit Long Clicker Model
673 1,121 1,569 2,242
1207 Compression Distraction Unit Short Compression Distraction Unit Short 396 660 923 1,319
1208 Compression Distraction Unit STD Clicker Model Compression Distraction Unit STD Clicker Model
273 455 636 909
1209 Dyna-Ring with C/D Unit Attach For LRS Dyna-Ring with C/D Unit Attach For LRS 317 528 739 1,055
ACUTE/GRADUAL CORRECTION CLAMPS ACUTE/GRADUAL CORRECTION CLAMPS
1210 LRS Multiplanar Clamp LRS Multiplanar Clamp 1,361 2,269 3,176 4,5371211 Micrometric Swivelling Clamp for LRS Micrometric Swivelling Clamp for LRS 1,060 1,767 2,474 3,5341212 LRS Hinged Rail Coupling LRS Hinged Rail Coupling 1,124 1,873 2,622 3,7451213 LRS of-Garches T-Clamp LRS of-Garches T-Clamp 1,182 1,971 2,759 3,941
1214 Of-Garches Standard Compression/Distraction Unit Of-Garches Standard Compression/Distraction Unit
296 493 690 985
1215 Of-Garches Long Compression/Distrraction Unit Of-Garches Long Compression/Distrraction Unit
296 493 690 985
1216 Pelvic Fixator Long Model Kit with 6pcs of ScrewsPelvic Fixator Long Model Kit with 6pcs of Screws
3,450 5,750 8,050 11,500
1217 Hand/forearm applications Hand/forearm applications 1,650 2,750 3,850 5,5001218 Articulated hip distraction/perthes Articulated hip distraction/perthes 4,800 8,000 11,200 16,000
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1219 Orthofix dynamic wrist fixator system with screwsOrthofix dynamic wrist fixator system with screws
1,950 3,250 4,550 6,500
(Kit No: 37000 or 37001) (Kit No: 37000 or 37001)
1220 SS Half Rings (Diameter 80mm - 240mm) SS Half Rings (Diameter 80mm - 240mm) 48 80 112 160
1221 SS 5/8 Rings (Diameter 80mm - 220mm) SS 5/8 Rings (Diameter 80mm - 220mm) 54 90 126 180
1222 Carbon Fibre Half Ring (Diameter 80mm – 240mm)
Carbon Fibre Half Ring (Diameter 80mm – 240mm)
96 160 224 320
SS Italian Femoral Arches SS Italian Femoral Arches1223 - 90 degree Arch, small/large size - 90 degree Arch, small/large size 60 100 140 2001224 - 120 degree Arch, small/large size - 120 degree Arch, small/large size 60 100 140 200
1225 - Threaded Rods (Size: 40mm - 450mm) - Threaded Rods (Size: 40mm - 450mm) 10 17 24 34
1226 - Slotted Threaded Rods (Size: 40mm – 100mm) - Slotted Threaded Rods (Size: 40mm – 100mm)
19 31 43 62
Telescopic Rods Telescopic Rods 1227 Telescopic Rods: 100mm Telescopic Rods: 100mm 28 47 66 941228 Telescopic Rods: 150mm Telescopic Rods: 150mm 33 55 76 1091229 Telescopic Rods: 200mm Telescopic Rods: 200mm 38 63 88 1251230 Telescopic Rods: 250mm Telescopic Rods: 250mm 47 78 109 1561231 Telescopic Rods: 300mm Telescopic Rods: 300mm 56 94 131 1871232 Telescopic Rods: 350mm Telescopic Rods: 350mm 56 94 131 1871233 Telescopic Rods: 400mm Telescopic Rods: 400mm 56 94 131 1871234 Posts Female (Size: 2-4 Holes) Posts Female (Size: 2-4 Holes) 18 30 41 591235 Male Post (Size: 2-4 Holes) Male Post (Size: 2-4 Holes) 18 30 41 591236 Hinges Female Standard Hinges Female Standard 18 30 41 591237 Hinges Male Standard Hinges Male Standard 18 30 41 591238 Hinges-90 degree Standard Hinges-90 degree Standard 18 30 41 591239 Hinges-90 degree Low profile Hinges-90 degree Low profile 18 30 41 59
Short Connection Plates Short Connection Plates
1240 Short Connection Plate 2 Holes Length 35mm Short Connection Plate 2 Holes Length 35mm
19 31 43 62
1241 Short Connection Plate 3 Holes Length 45mm Short Connection Plate 3 Holes Length 45mm
19 31 43 62
1242 Short Connection Plate 4 Holes Length 55mm Short Connection Plate 4 Holes Length 55mm
19 31 43 62
1243 Short Connection Plate 5 Holes Length 65mm Short Connection Plate 5 Holes Length 65mm
19 31 43 62
1244 Short Connection Plate 6 Holes Length 75mm Short Connection Plate 6 Holes Length 75mm
19 31 43 62
1245 Short Connection Plate 7 Holes Length 85mm Short Connection Plate 7 Holes Length 85mm
28 47 66 94
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1246 Short Connection Plate 8 Holes Length 95mm Short Connection Plate 8 Holes Length 95mm
28 47 66 94
1247 Short Connection Plate 9 Holes Length 105mm Short Connection Plate 9 Holes Length 105mm
28 47 66 94
1248 Short Connection Plate 10 Holes Length 115mm Short Connection Plate 10 Holes Length 115mm
28 47 66 94
Long Connection Plate Long Connection Plate
1249 Long Connection Plate Size: 8 Holes Length 155mm
Long Connection Plate Size: 8 Holes Length 155mm
28 47 66 94
1250 Long Connection Plate Size: 12 Holes Length 235mm
Long Connection Plate Size: 12 Holes Length 235mm
28 47 66 94
1251 Long Connection Plate Size: 17 Holes Length 335mm
Long Connection Plate Size: 17 Holes Length 335mm
33 55 76 109
Connected Plates with Threaded Ends Connected Plates with Threaded Ends
1252 Connection Plates with threaded ends: 5 Holes Length 135mm
Connection Plates with threaded ends: 5 Holes Length 135mm
28 47 66 94
1253 Connection Plates with threaded end: 7 Holes Length 175mm
Connection Plates with threaded end: 7 Holes Length 175mm
28 47 66 94
1254 Connection Plates with threaded ends: 9 Holes Length 215mm
Connection Plates with threaded ends: 9 Holes Length 215mm
38 63 88 125
1255 Connection Plates with threaded ends: 11 Holes Length 255mm
Connection Plates with threaded ends: 11 Holes Length 255mm
38 63 88 125
Twisted Plates Twisted Plates 1256 Twisted Plates: 2 Holes Length 45mm Twisted Plates: 2 Holes Length 45mm 15 25 35 501257 Twisted Plates: 3 Holes Length 65mm Twisted Plates: 3 Holes Length 65mm 15 25 35 501258 Twisted Plates: 4 Holes Length 85mm Twisted Plates: 4 Holes Length 85mm 15 25 35 501259 Curved Plates: 3 Holes Curved Plates: 3 Holes 19 31 43 621260 Bushing (for Big RFS) Bushing (for Big RFS) 9 16 22 311261 Threaded Sockets (20mm - 60mm) Threaded Sockets (20mm - 60mm) 12 20 28 40
Connection Bolts and Nuts Connection Bolts and Nuts 1262 Connection Bolts: 10mm Connection Bolts: 10mm 3 5 6 91263 Connection Bolts: 16mm Connection Bolts: 16mm 3 5 6 91264 Connection Bolts: 20mm Connection Bolts: 20mm 7 11 15 221265 Connection Bolts: 30mm Connection Bolts: 30mm 7 11 15 221266 Nut 6mm Nut 6mm 1 2 2 31267 Nut 13mm Nut 13mm 2 3 4 51268 Thin Nut Thin Nut 1 2 3 41269 Nylon Insert Nut Nylon Insert Nut 2 3 4 61270 Square Nut Square Nut 5 8 11 161271 Spacing Washers 1.5mm Spacing Washers 1.5mm 1 2 3 41272 Spacing Washers 2.0mm Spacing Washers 2.0mm 1 2 3 41273 Split Locking Washer 2.0mm Split Locking Washer 2.0mm 2 3 4 6
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1274 Flat Sided Washers 2.0mm Flat Sided Washers 2.0mm 2 4 5 71275 Flat Sided Washers 4.0mm Flat Sided Washers 4.0mm 2 4 5 71276 Slotted Washers 4.0mm Slotted Washers 4.0mm 3 5 6 91277 Conical Washer Couple Conical Washer Couple 9 16 22 311278 Wire fixation Bolt Slotted Wire fixation Bolt Slotted 10 17 24 341279 Wire fixation Bolt Cannulated Wire fixation Bolt Cannulated 10 17 24 341280 Pin fixation Bolts for 3mm Pins Pin fixation Bolts for 3mm Pins 19 31 43 621281 Pin fixation Bolts for 4mm Pins Pin fixation Bolts for 4mm Pins 19 31 43 621282 Pin fixation Bolts for 5mm Pins Pin fixation Bolts for 5mm Pins 19 31 43 621283 Pin fixation Bolts for 6mm Pins Pin fixation Bolts for 6mm Pins 19 31 43 621284 Single Pin Fixation Bolt Single Pin Fixation Bolt 38 63 88 1251285 Multiple Pin Fixation Clamp Multiple Pin Fixation Clamp 122 203 284 4061286 Wire Fixation Buckle Wire Fixation Buckle 65 109 153 218
Blocks for Half Pins (Rancheo Cubes) Blocks for Half Pins (Rancheo Cubes)
1287 Blocks for Half Pins: 1 Hole Blocks for Half Pins: 1 Hole 12 20 27 391288 Blocks for Half Pins: 2 Holes Blocks for Half Pins: 2 Holes 12 20 27 391289 Blocks for Half Pins: 3 Holes Blocks for Half Pins: 3 Holes 12 20 27 391290 Blocks for Half Pins: 4 Holes Blocks for Half Pins: 4 Holes 17 28 39 561291 Blocks for Half Pins: 5 Holes Blocks for Half Pins: 5 Holes 19 31 43 62
1292 Blocks for Half Pins for Centre Sleeve: 1 HolesBlocks for Half Pins for Centre Sleeve: 1 Holes
13 21 29 42
1293 Blocks for Half Pins for Centre Sleeve: 2 HolesBlocks for Half Pins for Centre Sleeve: 2 Holes
13 21 29 42
1294 Blocks for Half Pins for Centre Sleeve: 3 HolesBlocks for Half Pins for Centre Sleeve: 3 Holes
13 21 29 42
1295 Blocks for Half Pins for Centre Sleeve: 4 HolesBlocks for Half Pins for Centre Sleeve: 4 Holes
17 28 39 56
1296 Blocks for Half Pins for Centre Sleeve: 5 HolesBlocks for Half Pins for Centre Sleeve: 5 Holes
19 31 43 62
Centre Sleeve for Block for Half Pins Centre Sleeve for Block for Half Pins
1297 Centre Sleeve for Block for Half Pins - 3mm Centre Sleeve for Block for Half Pins - 3mm 4 6 8 12
1298 Centre Sleeve for Block for Half Pins - 4mm Centre Sleeve for Block for Half Pins - 4mm 4 6 8 12
1299 Centre Sleeve for Block for Half Pins - 5mm Centre Sleeve for Block for Half Pins - 5mm 4 6 8 12
1300 Centre Sleeve for Block for Half Pins - 6mm Centre Sleeve for Block for Half Pins - 6mm 4 6 8 12
1301 Universal Joint Universal Joint 56 94 131 1871302 Rotational Translation Device Rotational Translation Device 81 135 189 2701303 Oblique Support Connection Oblique Support Connection 16 27 37 53
Wires Wires
Page 47
Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
(RM)
TAHUN 2016
(RM)
TAHUN 2017
(RM)
TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
1304 K-Wires-Cortical 1.5mm x 300mm K-Wires-Cortical 1.5mm x 300mm 8 13 18 251305 K-Wires-Cortical 1.8mm x 370mm K-Wires-Cortical 1.8mm x 370mm 8 13 18 251306 K-Wires-Cancellous 1.5mm x 300mm K-Wires-Cancellous 1.5mm x 300mm 8 13 18 251307 K-Wires-Cancellous 1.8mm x 370mm K-Wires-Cancellous 1.8mm x 370mm 8 13 18 25
1308 Olive Wires-(Bayonet Point) 1.5 x 300mm Olive Wires-(Bayonet Point) 1.5 x 300mm 9 15 20 29
1309 Olive Wires-(Bayonet Point) 1.8 x 400mm Olive Wires-(Bayonet Point) 1.8 x 400mm 9 15 20 29
1310 Set Screws 3.0mm Set Screws 3.0mm 2 3 4 61311 Schanz Screws 5 x 175mm Schanz Screws 5 x 175mm 11 18 25 351312 Schanz Screws 5 x 150mm Schanz Screws 5 x 150mm 11 18 25 351313 Proximal Humerus Endoprosthesis Proximal Humerus Endoprosthesis 5,250 8,750 12,250 17,5001314 Distal Humerus Endoprosthesis Distal Humerus Endoprosthesis 10,500 17,500 24,500 35,0001315 Total Humerus Endoprosthesis Total Humerus Endoprosthesis 12,000 20,000 28,000 40,0001316 Proximal Femur Endoprosthesis Proximal Femur Endoprosthesis 6,300 10,500 14,700 21,0001317 Total Femur Endoprosthesis Total Femur Endoprosthesis 12,450 20,750 29,050 41,5001318 Proximal Tibia Endoprosthesis Proximal Tibia Endoprosthesis 9,900 16,500 23,100 33,0001319 Bone Cement Bone Cement 105 175 245 3501320 Expandable Endoprosthesis Expandable Endoprosthesis 29,100 48,500 67,900 97,0001321 Long Stem Bipolar Long Stem Bipolar 2,175 3,625 5,075 7,2501322 Shoulder arthroplasty Shoulder arthroplasty 2,370 3,950 5,530 7,9001323 Radio-capitellum prosthesis Radio-capitellum prosthesis 2,550 4,250 5,950 8,5001324 Total wrist prosthesis Total wrist prosthesis 3,600 6,000 8,400 12,0001325 Distal ulnar head prosthesis Distal ulnar head prosthesis 1,680 2,800 3,920 5,6001326 Sigmoid notch (DRUJ) prosthesis Sigmoid notch (DRUJ) prosthesis 1,440 2,400 3,360 4,8001327 Radial head modular Co Ci/Ti Radial head modular Co Ci/Ti 1,950 3,250 4,550 6,5001328 Radial head prosthesis Radial head prosthesis 1,500 2,500 3,500 5,0001329 Bipolar radial head Bipolar radial head 1,800 3,000 4,200 6,0001330 Silicone PIP, MCP, MCP Preflex Silicone PIP, MCP, MCP Preflex 300 500 700 1,000
1331 Silicone PIP, MCP, MCP Preflex with bone cementSilicone PIP, MCP, MCP Preflex with bone cement
345 575 805 1,150
1332 Semi constrained PIP Arthoplasty Semi constrained PIP Arthoplasty 1,890 3,150 4,410 6,3001333 Semi constrained MCP Arthoplasty Semi constrained MCP Arthoplasty 1,680 2,800 3,920 5,6001334 Surface replacement PIP Arthoplasty Surface replacement PIP Arthoplasty 1,410 2,350 3,290 4,7001335 Surface replacement MCP Arthoplasty Surface replacement MCP Arthoplasty 1,080 1,800 2,520 3,6001336 CMC Thumb Arthroplasty CMC Thumb Arthroplasty 1,575 2,625 3,675 5,2501337 Carpal fusion plate 3 holes Carpal fusion plate 3 holes 510 850 1,190 1,7001338 Carpal fusion plate 4 holes Carpal fusion plate 4 holes 630 1,050 1,470 2,1001339 Carpal fusion plate 5 holes Carpal fusion plate 5 holes 735 1,225 1,715 2,4501340 Hunter’s rod (Silastic rods) Hunter’s rod (Silastic rods) 240 400 560 800
Stainless Steel Mini plates Stainless Steel Mini plates1341 Straight 1.5mm 20 holes Straight 1.5mm 20 holes 93 155 217 3101342 Straight 2.0mm 20 holes Straight 2.0mm 20 holes 84 140 196 280
Page 48
Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
(RM)
TAHUN 2016
(RM)
TAHUN 2017
(RM)
TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
1343 Condylar plate 1.5mm R/L Condylar plate 1.5mm R/L 134 223 312 4451344 Condylar plate 2.0mm R/L Condylar plate 2.0mm R/L 150 250 350 5001345 Condylar plate 2.7mm R/L Condylar plate 2.7mm R/L 132 220 308 440
1346 T plate 1.5mm; shaft 9 holes; 3/4 holes T plate 1.5mm; shaft 9 holes; 3/4 holes 150 250 350 500
1347 T plate 2.0mm; shaft 9 holes; 3/4 holes T plate 2.0mm; shaft 9 holes; 3/4 holes 126 210 294 420
1348 H plate 2.0mm H plate 2.0mm 102 170 238 3401349 H plate 1.5mm H plate 1.5mm 48 80 112 160
1350 Reconstruction plate 2.7mm, 5-8 holes Reconstruction plate 2.7mm, 5-8 holes 120 200 280 400
1351 Reconstruction plate 2.7mm 5-8 holes Reconstruction plate 2.7mm 5-8 holes 156 260 364 5201352 Adaptation plate 2.0mm 20 holes Adaptation plate 2.0mm 20 holes 90 150 210 300
Low Profile Titanium Plates Low Profile Titanium Plates1353 1.3mm 1.5mm 1.3mm 1.5mm 480 800 1,120 1,6001354 Condylar blade plate Condylar blade plate 480 800 1,120 1,6001355 Y, T plate Y, T plate 480 800 1,120 1,6001356 H, Extended H plate H, Extended H plate 480 800 1,120 1,6001357 Straight plate Straight plate 480 800 1,120 1,600
1358 1.0mm, 1.3mm, 1.5mm, 2.0mm, 2.4mm screws1.0mm, 1.3mm, 1.5mm, 2.0mm, 2.4mm screws
480 800 1,120 1,600
Scaphoid Screws Scaphoid Screws1359 Accutrac micro 2.8mm/2.2mm Accutrac micro 2.8mm/2.2mm 360 600 840 1,2001360 Accutrac mini 3.8mm/3.2mm Accutrac mini 3.8mm/3.2mm 300 500 700 1,0001361 Headless compression screw 3.0mm Headless compression screw 3.0mm 210 350 490 7001362 Autofix 2.0mm/2.5mm Autofix 2.0mm/2.5mm 180 300 420 6001363 Autofix 3.0mm/4.0mm Autofix 3.0mm/4.0mm 180 300 420 6001364 3.0mm cannulated screw 3.0mm cannulated screw 135 225 315 450
Locking Plates Locking Plates1365 Dorsal Dorsal 690 1,150 1,610 2,3001366 Volar (extra/intra articular) Volar (extra/intra articular) 540 900 1,260 1,8001367 10 holes 10 holes 810 1,350 1,890 2,7001368 Variable angle Variable angle 750 1,250 1,750 2,5001369 Wrist fusion 2.7mm/3.5mm Wrist fusion 2.7mm/3.5mm 840 1,400 1,960 2,8001370 3.5mm LCP 6-9 holes 3.5mm LCP 6-9 holes 240 400 560 8001371 3.5mm LCP 10-12 holes 3.5mm LCP 10-12 holes 330 550 770 1,100
1372 3.5mm locking reconstruction plate 6-9 holes 3.5mm locking reconstruction plate 6-9 holes 255 425 595 850
1373 3.5mm LCP metaphyseal plate 6-9 holes 3.5mm LCP metaphyseal plate 6-9 holes 540 900 1,260 1,800
1374 3.5mm LCP metaphyseal plate 10 holes 3.5mm LCP metaphyseal plate 10 holes 600 1,000 1,400 2,000
1375 3.5mm LCP T plate 3-6 holes 3.5mm LCP T plate 3-6 holes 240 400 560 800
1376 Proximal humerus internal locking system Proximal humerus internal locking system 660 1,100 1,540 2,200
Page 49
Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
(RM)
TAHUN 2016
(RM)
TAHUN 2017
(RM)
TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
1377LCP distal humerus 2.7mm/3.5mm 3-9 holes (2 plates)
LCP distal humerus 2.7mm/3.5mm 3-9 holes (2 plates)
1,170 1,950 2,730 3,900
1378 LCP olecranon 3.5mm 2-8 holes LCP olecranon 3.5mm 2-8 holes 810 1,350 1,890 2,700Anchor Sutures Anchor Sutures
1379 Minilok 2.3mm absorbable Minilok 2.3mm absorbable 255 425 595 8501380 Microfix 1.6mm absorbable Microfix 1.6mm absorbable 255 425 595 8501381 Hinged Elbow External Fixator Hinged Elbow External Fixator1382 1 Hinge, 4 Clamps, 4 Schantz screws 1 Hinge, 4 Clamps, 4 Schantz screws 2,250 3,750 5,250 7,500
Surgery System Surgery SystemTotal Knee Replacement System Total Knee Replacement System
1383 - Total Knee Replacement System for Young - Total Knee Replacement System for Young 3,600 6,000 8,400 12,000
1384 - Total Knee Replacement System Mobile Bearing - Total Knee Replacement System Mobile Bearing
2,400 4,000 5,600 8,000
1385 - Ts Tibial Total Knee Replacement System - Ts Tibial Total Knee Replacement System 3,900 6,500 9,100 13,000
1386 - Total Stabilization Total Knee Revision Replacement System
- Total Stabilization Total Knee Revision Replacement System
5,700 9,500 13,300 19,000
1387 - Modular Rotating Hinged (MRH) Total Knee Replacement System
- Modular Rotating Hinged (MRH) Total Knee Replacement System
6,600 11,000 15,400 22,000
1388 - Global Modular Replacement System (GMRS) Proximal Femur Total Knee Replacement System
- Global Modular Replacement System (GMRS) Proximal Femur Total Knee Replacement System
14,400 24,000 33,600 48,000
1389 - Global Modular Replacement System (GMRS) Proximal Tibial Total Knee Replacement System
- Global Modular Replacement System (GMRS) Proximal Tibial Total Knee Replacement System
10,500 17,500 24,500 35,000
1390 - Global Modular Replacement System (GMRS) Distal Femur Total Knee Replacement System
- Global Modular Replacement System (GMRS) Distal Femur Total Knee Replacement System
10,500 17,500 24,500 35,000
1391 - Global Modular Replacement System (GMRS) Total Femur Total Knee Replacement System
- Global Modular Replacement System (GMRS) Total Femur Total Knee Replacement System
14,400 24,000 33,600 48,000
Total Hip Replacement System Total Hip Replacement System
1392 - Bipolar Hemi Hip Replacement System - Bipolar Hemi Hip Replacement System 1,230 2,050 2,870 4,100
1393 - Total Hip Replacement System (Cemented) - Total Hip Replacement System (Cemented) 2,250 3,750 5,250 7,500
1394 - Total Hip Replacement System for Young Adult - Total Hip Replacement System for Young Adult
3,900 6,500 9,100 13,000
1395 - Total Hip Replacement System (Cementless) - Total Hip Replacement System (Cementless)
3,225 5,375 7,525 10,750
1396 - Total Hip Replacement System -Long Stem (Cemented)
- Total Hip Replacement System -Long Stem (Cemented)
2,400 4,000 5,600 8,000
Page 50
Bil. Prosedur (BM) Procedure (BI)TAHUN 2015
(RM)
TAHUN 2016
(RM)
TAHUN 2017
(RM)
TAHUN 2018
[Kos
perkhidmatan (RM)]
FI RAWATAN
1397 - Total Hip Replacement System -Gap Ii and Mesh (Cemented)
- Total Hip Replacement System -Gap Ii and Mesh (Cemented)
3,930 6,550 9,170 13,100
1398 - Total Elbow Replacement System - Total Elbow Replacement System 2,550 4,250 5,950 8,500
1399 - Hemi Shoulder Replacement System - Hemi Shoulder Replacement System 2,175 3,625 5,075 7,250
1400 - Total Shoulder Replacement System - Total Shoulder Replacement System 2,400 4,000 5,600 8,000
1401 - Reversed Shoulder - Reversed Shoulder 5,100 8,500 11,900 17,0001402 - Total Ankle Replacement - Total Ankle Replacement 2,850 4,750 6,650 9,500
Revision Accessories Revision Accessories1403 - Acetabulum Reconstruction Ring - Acetabulum Reconstruction Ring 1,350 2,250 3,150 4,5001404 - Revision Stems - Revision Stems 2,400 4,000 5,600 8,0001405 - Mesh Femoral - Mesh Femoral 600 1,000 1,400 2,0001406 - Mesh Acetabulum - Mesh Acetabulum 600 1,000 1,400 2,0001407 - Cables - Cables 150 250 350 5001408 - Pulse Lavage - Pulse Lavage 90 150 210 3001409 - Plate - Plate 450 750 1,050 1,5001410 - Cement - Cement 81 135 189 2701411 - Antibiotic Bone Cement - Antibiotic Bone Cement 105 175 245 350
1412 - Antibiotic Bone Cement (Tobramycin) - Antibiotic Bone Cement (Tobramycin) 330 550 770 1,100
1413 - Trabecular Metal Cone/Wedges - Trabecular Metal Cone/Wedges 1,050 1,750 2,450 3,5001414 - Constraint Cup with Head - Constraint Cup with Head 1,050 1,750 2,450 3,5001415 - Cement Joint Spacer - Cement Joint Spacer 1,200 2,000 2,800 4,0001416 - Trochanteric Hook Plate - Trochanteric Hook Plate 3,600 6,000 8,400 12,000
Page 51
Kadar Caj
Semasa
Warga Asing (RM)
Kos
Perkhidmatan
(RM)
TAHUN
2015
(RM)
TAHUN
2016
(RM)
TAHUN
2017
(RM)
TAHUN
2018
(RM)
Kadar Caj Semasa
Warga
Asing
(RM)
Kos
Perkhidmatan
(RM)
TAHUN
2015
(RM)
TAHUN
2016
(RM)
TAHUN
2017
(RM)
TAHUN
2018
(RM)
5 10 7 8 9 10 5 10 7 8 9 1010 20 13 15 17 20 10 30 16 20 24 3015 30 20 23 26 30 15 40 23 28 33 4010 20 13 15 17 20 10 30 16 20 24 3015 30 20 23 26 30 15 40 23 28 33 4030 60 39 45 51 60 30 80 45 55 65 8020 40 26 30 34 40 20 60 32 40 48 6010 20 13 15 17 20 10 20 13 15 17 2020 40 26 30 34 40 20 60 32 40 48 6020 40 26 30 34 40 20 60 32 40 48 6030 60 39 45 51 60 30 80 45 55 65 8015 30 20 23 26 30 15 40 23 28 33 4015 30 20 23 26 30 15 40 23 28 33 4015 30 20 23 26 30 15 40 23 28 33 40
5 10 7 8 9 10 5 10 7 8 9 1010 20 13 15 17 20 10 20 13 15 17 2015 30 20 23 26 30 15 50 26 33 40 5015 30 20 23 26 30 15 60 29 38 47 6015 30 20 23 26 30 15 60 29 38 47 6030 60 39 45 51 60 30 120 57 75 93 12020 40 26 30 34 40 20 60 32 40 48 6020 40 26 30 34 40 20 80 38 50 62 8030 60 39 45 51 60 30 120 57 75 93 12060 120 78 90 102 120 60 160 90 110 130 16020 40 26 30 34 40 20 120 50 70 90 1205 10 7 8 9 10 5 20 10 13 16 200 40 12 20 28 40 0 70 21 35 49 705 10 7 8 9 10 5 20 10 13 16 20
15 60 29 38 47 60 15 60 29 38 47 6010 60 25 35 45 60 10 30 16 20 24 305 10 7 8 9 10 5 10 7 8 9 10
100 100 100 100 100 100 100 250 145 175 205 250180 360 234 270 306 360 0 10 3 5 7 10
Kanak-kanak (1 hingga 18 tahun)Bayi (0hingga 12 bulan)
Page 52
Kadar Caj Semasa
Warga
Asing
(RM)
Kos
Perkhidmatan
(RM)
TAHUN
2015
(RM)
TAHUN
2016
(RM)
TAHUN
2017
(RM)
TAHUN
2018
(RM)
5 10 7 8 9 1010 30 16 20 24 3015 40 23 28 33 4010 40 19 25 31 4015 50 26 33 40 5030 120 57 75 93 12020 100 44 60 76 10010 30 16 20 24 3020 80 38 50 62 8020 80 38 50 62 8030 120 57 75 93 12015 50 26 33 40 5015 50 26 33 40 5015 50 26 33 40 50
5 10 7 8 9 1010 30 16 20 24 3015 80 35 48 61 8015 120 47 68 89 12015 120 47 68 89 12030 240 93 135 177 24020 160 62 90 118 16020 160 62 90 118 16030 160 69 95 121 16060 300 132 180 228 30020 160 62 90 118 1605 30 13 18 23 300 70 21 35 49 705 30 13 18 23 30
15 70 32 43 54 7010 40 19 25 31 405 10 7 8 9 10
100 500 220 300 380 5000 0 0 0 0 0
Dewasa (18 tahun ke atas)
Page 53