원내 비급여 항목


분류수가코드청구코드품목명수가
투약료659901460659901460오라팡정1,300
투약료641502650641502650맥세렌디정_(1정)1,430
투약료659900010659900010노자임캡슐(판크레아틴장용성제피정)900
투약료662502820662502820넥스콜론정625
투약료643900250643900250리박트과립2,860
투약료641604660641604660이지에프새살연고 10g28,000
투약료653301141653301141엠라5%크림7,000
투약료644803690644803690실버케어크림10,000
투약료642703970642703970후시딘연고 10g7,000
투약료643800380643800380신신케토크린24플라스타2,500
주사료INJB1-1INJB1-1마이어스칵테일주사 I80,000
주사료INJB1-2INJB1-2마이어스칵테일주사 II100,000
주사료INJB2INJB2마늘주사35,000
주사료INJB2-11INJB2-11마늘주사 패키지(10+1)350,000
주사료INJB3-1INJB3-1백옥주사30,000
주사료INJB3-2INJB3-2백옥주사(고함량)50,000
주사료INJB3-11INJB3-11백옥주사 패키지(10+1)300,000
주사료INJB4-1INJB4-1신데렐라주사30,000
주사료INJB4-2INJB4-2신데렐라주사(고함량)50,000
주사료INJB4-11INJB4-11신데렐라주사 패키지(10+1)300,000
주사료INJB5INJB5감초주사30,000
주사료INJB5-10INJB5-10감초주사 패키지(10회)270,000
주사료INJB6-1INJB6-1메가비타C 주사Ⅰ30,000
주사료INJB6-2INJB6-2메가비타C 주사Ⅱ50,000
주사료INJB7-1INJB7-1감기 주사40,000
주사료INJB7-2INJB7-2감기 몸살 주사60,000
주사료INJB8INJB8아토피 피부개선 주사40,000
주사료INJB8-11INJB8-11아토피 피부개선 주사 패키지(10+1)400,000
주사료INJB9681100020태반주사20,000
주사료INJB9-10INJB9-10태반주사 패키지(10회)180,000
주사료INJB10INJB10멀티미네랄 주사60,000
주사료INJB11INJB11아연주사50,000
주사료INJB11-10INJB11-10아연주사 패키지(10회)450,000
주사료645104341645104341대한엘아르기닌염산염주10%(L-아르기닌염산염)_(10g/100mL/병)50,000
주사료654400571654400571삭센다펜주6mg/ml120,000
주사료665900111665900111아다셀주(성인용 흡착 디프테리아, 파상풍톡소이드 및 정제 백일해 혼합백신)_(0.5mL)50,000
주사료648902270648902270프리베나13주 0.5ml/1관130,000
주사료655500900655500900조스타박스주(대상포진생바이러스백신)170,000
주사료643605311643605311녹십자티디백신프리필드주 0.5ml30,000
주사료668900920668900920유박스비주 B형간염백신(성인용) 1ml(생)20,000
주사료668902161668902161유박스비프리필드주[B형간염백신(유전자재조합)]20,000
주사료655501940655501940프로디악스-23 PFS(폐렴구균백신)50,000
주사료056400041056400041스카이조스터주(대상포진생바이러스백신)150,000
주사료650001420650001420프리오릭스주(홍역,유행성이하선염및풍진혼합생바이러스백신)25,000
주사료650001960650001960부스트릭스프리필드시린지40,000
주사료665900180665900180아박심160U성인용주(A형간염백신)70,000
주사료690300381690300381멀티블루5주70,000
주사료645906061645906061본디업주30,000
주사료653402050653402050베노스틴주 10ml70,000
주사료669907081669907081바이타디주 300,000IU50,000
주사료647801080647801080삼진타우로린주사2% 250ml75,000
주사료659900341659900341아큐판주사액 2ml3,500
주사료651602261651602261네포큐어주(네포팜염산염)_(20mg/2ml)3,500
주사료655501751655501751브리디온주 2ml170,000
주사료640006700640006700오마프원페리주 362ml100,000
주사료640006860640006860오마프원리피드주  250ml80,000
주사료642404060642404060뉴클레오주 3ml80,000
주사료642004631642004631리보뉴앤주 3ml80,000
주사료670605290670605290하이주사 2ml65,000
주사료659901231659901231팜토미딘주 2ml60,000
주사료653102550653102550말린다주 1500IU50,000
주사료670603333670603333휴온스벤조산나트륨카페인주 2ml15,000
주사료642404441642404441데노넥스주 100ml/백20,000
주사료645100110645100110뉴트리헥스주 250ml50,000
주사료645103360645103360뉴트리헥스주 100ml/병20,000
주사료670608301670608301원더톡스주100단위(클로스트리디움보툴리눔독소A형)100,000
주사료659900820659900820모노퍼주 2ml60,000
주사료659900830659900830모노퍼주 5ml150,000
주사료651602591651602591싸이알파주(싸이모신알파1)50,000
주사료647400361647400361독감)코박스플루4가PF주(프리필드시린지)(인플루엔자분할백신)_(0.5mL)35,000
주사료670500860670500860독감)보령플루Ⅴ테트라백신주(프리필드시린지)(인플루엔자분할백신)35,000
주사료643605131643605131독감)지씨플루쿼드리밸런트프리필드시린지주(인플루엔자분할백신)35,000
주사료641906831641906831독감)비알플루텍I테트라백신주(프리필드시린지)(인플루엔자분할백신)35,000
주사료645103490645103490아미노헥스주 250/200ml30,000
처치 및 수술료PRPPRPPRP(자가혈소판 풍부혈장치료술)180,000
재료대BK7101VK.BK7101VK.COLD ELASTIC BANDAGE20,000
재료대BM2000JI2BM2000JI2실리콘테이프 O210,000
재료대BM2000JI1BM2000JI1실리콘테이프 ET20,000
재료대BM2000JI4BM2000JI4실리콘테이프 Eye20,000
재료대BM2000JI3BM2000JI3실리콘테이프 ECG30,000
재료대BM5104BL.BM5104BL.SUPER FIX-15cm*10cm15,000
재료대BM5103BL.BM5103BL.SUPER FIX 10cm*10cm10,000
재료대BM5102BL.BM5102BL.SUPER FIX 5cm*10cm5,500
재료대BM5101LX3BM5101LX.3M 픽스롤 (15cm)-cm당250
재료대BM5101LX2BM5101LX23M 픽스롤 (10cm)-cm당200
재료대BM5101LX1BM5101LX13M 픽스롤 (5cm)-cm당150
재료대BM5006SOBM5006SO하이퍼포아 보더 포스트 오피10,000
재료대BM5001GA.BM5001GA.SECUEX1,000
재료대BM2101QT.BM2101QT.MEDICLORE 1.5cc300,000
재료대BM2600VT.BM2600VT.ACE COL200,000
재료대BM2001QT.BM2001QT.CG PASTE 1cc150,000
재료대BM5000AE.BM5000AE.SCARGEN200,000
재료대BM5300YY.BM5300YY.JUVENCOLL 1cc160,000
재료대BM5300YY1BM5300YY1JUVENCOLL 3cc350,000
재료대BM2601OP.BM2601OP.COLLASHIELD, COLLASHIELD BLACK230,000
재료대RGS301BM2601QQ1REGENSEAL 301230,000
재료대RGS303BM2601QQ2REGENSEAL 303450,000
재료대RGS601BM2601QQ3REGENSEAL 6011,200,000
재료대RGS603BM2601QQ4REGENSEAL 6032,000,000
재료대BM5001XW.BM5001XW.SCAR GEL 15g65,000
재료대BM5002XH.BM5002XH.STRATAMED 20g90,000
재료대BM5002QT.BM5002QT.이지듀MD 보습크림38,000
재료대BM5003QT.BM5003QT.이지듀MD 보습로션40,000
재료대BM5002AX.BM5002AX.MEDI-PROTECT BAND-6*8500
재료대BM5003AX.BM5003AX.MEDI-PROTECT BAND-7*91,000
재료대BM5006AX.BM5006AX.MEDI-PROTECT BAND-9*151,500
재료대BM5007AX.BM5007AX.MEDI-PROTECT BAND-9*202,000
재료대BM5003MV1BM5003MV1ABSORBENT DRESSING 7*918,000
재료대BM5003MV2BM5003MV2ABSORBENT DRESSING 10*1026,000
재료대BM5003MV3BM5003MV3ABSORBENT DRESSING 10*2036,000
재료대BM5001MV1BM5001MV1SURGICAL DRESSING 5*7.24,000
재료대BM5001MV2BM5001MV2SURGICAL DRESSING 8*105,500
재료대BM5001MV3BM5001MV3SURGICAL DRESSING 8*158,000
재료대BM5001MV4BM5001MV4SURGICAL DRESSING 10*2010,000
재료대BM5001MV5BM5001MV5SURGICAL DRESSING 10*2513,000
재료대BM5001MV6BM5001MV6SURGICAL DRESSING 10*3015,000
재료대ZNLGZNLG제노라겐 15g60,000
재료대BK7101TI.BK7101TI.VENDARI HAFT 4*410,000
재료대BK7101TI1BK7101TI1VENDARI HAFT 6*410,000
재료대BK7101TI2BK7101TI2VENDARI HAFT 8*410,000
재료대BK7000GS1BK7000GS1PLIO 4*10020,000
재료대BK7000GS.BK7000GS.PLIO 6*9030,000
재료대BK7000GS2BK7000GS2PLIO 6*12030,000
재료대BK7000GS3BK7000GS3PLIO 8*12030,000
재료대BK7101EA.BK7101EA.3M COBAN SELF-ADHERENT WRAP8,000
재료대BM5103JN.BM5103JN.엠엑스에스밴드부직반창고5,500
재료대BM2001HF1BM2001HF1이지텍 5*7.512,000
재료대BM2001HF2BM2001HF2이지텍 10*7.515,000
재료대BK7102TS.BK7102TS.친우메드압박용밴드15,000
재료대BM5001BF1BM5001BF1레노스카데일리(4*9)/30pcs170,000
재료대BM5001BF6BM5001BF6레노스카데일리(4*12)/10pcs70,000
재료대BM5001BF3BM5001BF3레노스카데일리(4*17)/30pcs230,000
재료대BM5001BF5BM5001BF5레노스카데일리(4*9)/10pcs60,000
재료대BM5001BF4BM5001BF4레노스카데일리(12*18)/30pcs350,000
재료대BM5001BF2BM5001BF2레노스카데일리(4*12)/30pcs200,000
재료대BK7000CM3BK7000CM3사네스코 4*140cm35,400
재료대BK7000CM1BK7000CM1사네스코 2*80cm24,500
재료대BK7000CM4BK7000CM4사네스코 5*180cm43,100
재료대BK7000CM2BK7000CM2사네스코 3*100cm29,400
재료대BK7000MS1BK7000MS1압박용밴드 2*25(숏암)16,000
재료대BK7000MS2BK7000MS2압박용밴드 3*35(숏암)20,000
재료대BK7000MS3BK7000MS3압박용밴드 3*70(롱암)32,000
재료대BK7000MS4BK7000MS4압박용밴드 4*55(숏레그)30,000
재료대BK7000MS5BK7000MS5압박용밴드 4*90(롱레그)32,000
재료대BM0301VS.BM0301VS.SPM FILTER-(5㎛)(필터수액세트)10,000
재료대BJ1011PV.BJ1011PV.CATHETER-HOLDER(M FIX)10,000
재료대WALKERWALKERWALKER 구동보행기50,000
재료대JM204BC1226PV.KNEE BRACE40,000
재료대BC1212PV.BC1212PV.AIR CAST60,000
재료대BC1006PV.BC1006PV.KNEE IMMOBILIZER80,000
재료대BC1205XW.BC1205XW.NIGHT SPLINT80,000
재료대BC1101XW.BC1101XW.PEDIA WALKER80,000
재료대BC1202PV.BC1202PV.MIAMI BRACE150,000
재료대BC1219PV.BC1219PV.THUMB BRACE20,000
재료대BC1208PV.BC1208PV.ANKLE BRACE30,000
재료대BC1102XWBC1102XW.AIR WALKING BOOT [STANDARD]250,000
재료대BC1102XW.BC1102XW.AIR WALKING BOOT [SHORT]250,000
재료대BC1005PV.BC1005PV.MCL ROM BRACE250,000
재료대BC1201XW.BC1201XW.ROM WALKER[SHORT]280,000
재료대BC1201XWBC1201XW.ROM WALKER[STANDARD]280,000
재료대JM304ABC1004PV.ACL BRACE250,000
재료대JM304PBC1004PV.PCL BRACE250,000
재료대BC1001PVBC1001PV.MCL BRACE120,000
재료대BC1210XW.BC1210XW.ROM ELBOW BRACE280,000
재료대JM207BC1226PV1ELBOW COUNTER BRACE25,000
재료대JM208BC1226PV2ELBOW BAND30,000
재료대BC1205PV.BC1205PV.WRIST SOFT BRACE30,000
재료대BC1227PV.BC1227PV.WRIST RIGID BRACE40,000
재료대BC1224PV.BC1224PV.BACK BRACE150,000
재료대BC1200IT.BC1200IT.유밴드35,000
재료대BC1004YQ.BC1004YQ.Knee Sleeve85,000
재료대BC1209YQ.BC1209YQ.Shoulder Sleeve85,000
재료대BC1225PV.BC1225PV.SOFT COLLAR10,000
재료대BC1200AS.BC1200AS.Multi Fix total care pack10,000
재료대ASLINGASLINGARM SLING8,000
재료대MSLINGMSLINGMULTI SLING40,000
재료대LSLINGLSLINGL SLING150,000
재료대CASTSCASTSCAST SHOE10,000
재료대CRUTCHCRUTCHCRUTCH10,000
재료대FBFBFINGER BRACE10,000
재료대TOESTOESTOE SPREADERS10,000
재료대SHCSHCSILICONE HEEL CUP40,000
재료대SISSISSILICONE INSOLE40,000
재료대THBRTHBRTHERA BAND(RED)12,000
재료대THBGTHBGTHERA BAND(GREEN)12,000
재료대BJ1002WH.BJ1002WH.SAFETY LOCK15,000
재료대BJ1000JI.BJ1000JI.INNO-FIX15,000
재료대BJ1002GS.BJ1002GS.MSFIX12,000
재료대BJ1004BX.BJ1004BX.SW-SC CLIP6,600
재료대BJ1000SU.BJ1000SU.NEOFIX CLIP6,000
재료대BJ1002XJ.BJ1002XJ.드레인클립15,000
재료대BJ1001XJ.BJ1001XJ.폴리클립10,000
재료대BJ1001NC.BJ1001NC.GALIO-K120,000
재료대BF0100AJ.BF0100AJ.ARTQ 1.5cc300,000
재료대BTT01113.BTT01113.CG REALLO INJECT 1cc300,000
재료대BTT011130BTT011130CG REALLO INJECT 0.5cc200,000
재료대BJ7000DS.BJ7000DS.INOSTOP200,000
재료대BM5000SQ.BM5000SQ.닥터 씨에스케어(DR .CS CARE)150,000
재료대BTS01079BTS01079MYDERM IMPLANT2,000,000
재료대BTS010191BTS01019.MEGADERM(4*5cm)1,750,000
재료대BTS010190BTS01019.MEGADERM(2*3cm)594,000
재료대BC0103BU.BC0103BU.RAFUGEN DBM GEL PRO600,000
재료대BC0201KJ.BC0201KJ.DEMIOS600,000
이학요법료FESWT1SZ084-1FESWT [1000타]50,000
이학요법료FESWT2SZ084-2FESWT [1500타]75,000
이학요법료FESWT3SZ084-3FESWT [2000타]100,000
이학요법료FESWT4SZ084-4FESWT [3000타]150,000
이학요법료FESWT5SZ084-5FESWT [4000타]200,000
이학요법료Cryo1MZ007-1Cryotherapy 120,000
이학요법료Cryo2MZ007-2Cryotherapy 230,000
이학요법료MZ012MZ012비침습적 무통증 신호요법100,000
이학요법료PRO1MY142-1Prolotherapy 110,000
이학요법료PRO3MY142-2Prolotherapy 330,000
이학요법료PRO11MY142-3Prolotherapy 11110,000
이학요법료SMT1MX122-1도수치료 30분70,000
이학요법료SMT2MX122-2도수치료 60분140,000
이학요법료SMT3MX122-3도수치료 90분210,000
MRIMRISHAMRISHAMRI Shoulder Arthrogram(비급여)470,000
MRIMRISHMRISHMRI Shoulder(비급여)350,000
MRIMRIELBMRIELBMRI Elbow(비급여)350,000
MRIMRIWRMRIWRMRI Wrist(비급여)350,000
MRIMRIHDMRIHDMRI Hand(비급여)350,000
MRIMRIKNEEMRIKNEEMRI Knee(비급여)350,000
MRIMRIANKMRIANKMRI Ankle(비급여)350,000
MRIMRIFTMRIFTMRI Foot(비급여)350,000
MRIMRIPELMRIPELMRI Pelvic(비급여)350,000
MRIMRIHIPMRIHIPMRI Hip(비급여)350,000
MRIMRISACMRISACMRI Sacroiliac joint(비급여)350,000
MRIMRICSPMRICSPMRI C-spine(비급여)350,000
MRIMRITSPMRITSPMRI T-spine(비급여)350,000
MRIMRILSPMRILSPMRI L-spine(비급여)350,000
MRIMRITLSPMRITLSPMRI T-L spine(비급여)450,000
MRIMRIWSPMRIWSPMRI Whole spine(비급여)600,000
MRIMRIABDMRIABDMRI Abdomen(비급여)350,000
MRIMRILIVMRILIVMRI 간정밀(간탄성도, 지방량) (비급여)230,000
MRIMRIEHMRIEHMRI 조영제(비급여)100,000
MRIMRIFUMRIFUMRI F/U(비급여)220,000
검사료CZ394CZ394인플루엔자 A·B 바이러스항원검사 [현장검사]30,000
검사료ESCOPYESCOPY위내시경 수면관리료(비급여)50,000
검사료CSCOPYCSCOPY대장내시경 수면관리료(비급여)60,000
검사료ECSCOPYECSCOPY위,대장내시경 수면관리료(비급여)80,000
검사료EZ868EZ868동맥경화도검사(맥파전달속도측정)40,000
검사료USSHCBUSSHCBUS Shoulder 양측, complex(비급여)120,000
검사료USSHCUSSHCUS Shoulder 편측, complex(비급여)60,000
검사료USSHSBUSSHSBUS Shoulder 양측, simple(비급여)50,000
검사료USSHSUSSHSUS Shoulder 편측, simple(비급여)30,000
검사료USELCBUSELCBUS Elbow 양측, complex(비급여)120,000
검사료USELCUSELCUS Elbow 편측, complex(비급여)60,000
검사료USELSBUSELSBUS Elbow 양측, simple(비급여)50,000
검사료USELSUSELSUS Elbow 편측, simple(비급여)30,000
검사료USWRCBUSWRCBUS Wrist 양측, complex(비급여)120,000
검사료USWRCUSWRCUS Wrist 편측, complex(비급여)60,000
검사료USWRSBUSWRSBUS Wrist 양측, simple(비급여)50,000
검사료USWRSUSWRSUS Wrist 편측, simple(비급여)30,000
검사료USHACBUSHACBUS Hand 양측, complex(비급여)120,000
검사료USHACUSHACUS Hand 편측, complex(비급여)60,000
검사료USHASBUSHASBUS Hand 양측, simple(비급여)50,000
검사료USHASUSHASUS Hand 편측, simple(비급여)30,000
검사료USHICBUSHICBUS Hip 양측, complex(비급여)120,000
검사료USHICUSHICUS Hip 편측, complex(비급여)60,000
검사료USHISBUSHISBUS Hip 양측, simple(비급여)50,000
검사료USHISUSHISUS Hip 편측, simple(비급여)30,000
검사료USKNCBUSKNCBUS Knee 양측, complex(비급여)120,000
검사료USKNCUSKNCUS Knee 편측, complex(비급여)60,000
검사료USKNSBUSKNSBUS Knee 양측, simple(비급여)50,000
검사료USKNSUSKNSUS Knee 편측, simple(비급여)30,000
검사료USANCBUSANCBUS Ankle 양측, complex(비급여)120,000
검사료USANCUSANCUS Ankle 편측, complex(비급여)60,000
검사료USANSBUSANSBUS Ankle 양측, simple(비급여)50,000
검사료USANSUSANSUS Ankle 편측, simple(비급여)30,000
검사료USFOCBUSFOCBUS Foot 양측, complex(비급여)120,000
검사료USFOCUSFOCUS Foot 편측, complex(비급여)60,000
검사료USFOSBUSFOSBUS Foot 양측, simple(비급여)50,000
검사료USFOSUSFOSUS Foot 편측, simple(비급여)30,000
검사료USAPPUSAPPUS Appendix(비급여)80,000
검사료USABDUSABDUS 하복부(비급여)50,000
검사료USBRUSBRUS Breast(비급여)100,000
검사료USBONUSBONUS Bone age(uterus, ovary)(비급여)50,000
검사료USLIVUSLIVUS Liver(비급여)80,000
검사료USLGPKUSLGPKUS Liver, GB, pancreas and kidney(비급여)100,000
검사료USCARDUSCARDUS Cardiac(비급여)130,000
검사료USCAROUSCAROUS Carotid(비급여)90,000
검사료USKBUSKBUS Kidney & bladder(비급여)80,000
검사료USUUSUUS 하복부- 전립선, 방광(비급여)80,000
검사료USTHYNUSTHYNUS Thyroid & neck(비급여)80,000
검사료USTHYUSTHYUS Thyroid(비급여)60,000
검사료USSOTUSSOTUS Soft tissue(비급여)70,000
검사료USRIBUSRIBUS Rib(비급여)60,000
검사료USDVTUSDVTUS DVT(비급여)120,000
검사료USDOPUUSDOPUUS 상지doppler(비급여)120,000
검사료USDOPLUSDOPLUS 하지doppler(비급여)120,000
검사료USGUSGUS Guided(3)30,000
검사료USG1USG1US Grided(1)10,000
검사료USMUSM근골격 초음파10,000
검사료USGOR3USGOR3마취 초음파(3)30,000
검사료USGORUSGOR마취 초음파(OR)60,000
제증명료ZZ101ZZ101일반진단서10,000
제증명료ZZ102ZZ102입퇴원확인서3,000
제증명료ZZ103ZZ103통원치료확인서3,000
제증명료ZZ104ZZ104진료확인서3,000
제증명료ZZ104-1ZZ104-1건강검진확인서3,000
제증명료ZZ105ZZ105수술확인서10,000
제증명료ZZ106ZZ106소견서10,000
제증명료ZZ106-2ZZ106-2지체장애용 소견서10,000
제증명료ZZ107ZZ107진료기록부 복사(1-5매)1,000
제증명료ZZ108ZZ108진료기록부 복사(6매부터)100
제증명료ZZ109ZZ109진단서, 확인서 사본(1장당)1,000
제증명료ZZ110ZZ110국민연금장애진단서15,000
제증명료ZZ111ZZ111건강진단서15,000
제증명료ZZ111-1ZZ111-1공무원 신체검사서15,000
제증명료ZZ112ZZ112병사용진단서20,000
제증명료ZZ113ZZ113후유장애진단서100,000
제증명료ZZ114ZZ114상해진단서(3주 미만)100,000
제증명료ZZ115ZZ115상해진단서(3주 이상)150,000
제증명료ZZ116ZZ116영문진단서20,000
제증명료ZZ119ZZ119근로능력평가용 진단서10,000
재료대CDCOPYCDCOPYCD copy10,000
식대D12D12보호자식대(공기밥)1,000
식대D11D11보호자식대(한상)5,000
입원료BC100BC1001인실 병실차액150,000
입원료BC200BC2002인실 병실차액100,000