Western Cape



ANNEXURE B1

ORTHOTIC AIDS: 1 April 2016

|NATURE OF APPLIANCE |SYSTEM CODE |EACH/PAIR |FULL PAYING PATIENTS (Externally Funded, |

| | | |Foreigners, RGP & Patients with Private |

| | | |Doctor incl) |

|1. ARTIFICIAL ARMS | | |R |

|(Upper Extremity Prosthesis) | | | |

|1.1 Through shoulder | | | |

| (b) Non-functional |X0002 |Each |14 058 |

|1.2 Through elbow | | | |

| (b) Non-functional |X0004 |Each |14 058 |

|1.3 Through wrist |X0005 |Each |17 264 |

|1.4 Above elbow | | | |

| (b) Non-functional |X0007 |Each |14 058 |

|1.5 Below elbow | | | |

| (b) Non-functional |X0009 |Each |8 548 |

|1.6 Congenital/Cosmetic | | |Quote Actual Manuf. |

| | | |Cost @ R56.00 per hour plus material, |

| | | |plus 30 % overhead charges |

|2. ARTIFICIAL LEGS | | |R |

|(Lower Extremity Prosthesis) | | | |

|2.1 Symes/Choparts (excl. boots) |X0010 |Each |4 439 |

|2.2 Below knee (excluding boots) | | | |

| (a) PTB/PTS |X0011 |Each |4 275 |

| (b) Conventional |X0012 |Each |9 373 |

| (c) P.T.B./P.T.S. modular |X0013 |Each |5 838 |

| (d) Pylon |X0014 |Each |5 838 |

|2.3 Through knee (excluding boots) | | | |

| (a) Conventional |X0015 |Each |10 357 |

| (b) Modular |X0016 |Each |24 992 |

|2.4 Above knee (excl. boots) | | | |

| (a) Conventional (+ simplex) |X0017 |Each |14 305 |

| (b) Modular |X0018 |Each |14 305 |

| (c) Pylon |X0019 |Each |5 755 |

|2.5 Tilting Table/Hip |X0020 |Each |28 773 |

|Disarticulation (excl. boots) | | | |

|2.6 Stump socks |X0021 |Each |118 |

|2.7 Sheaths |X0022 |Each |118 |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|2.8 Congenital/Cosmetic | | |Quote |

| | | |Actual Manuf. |

| | | |Cost @ |

| | | |R56.00 p/hour plus material, plus |

| | | |30 % overhead charges) |

|2.9 Refit prosthesis | | | |

| (a) Above knee | |Each |Quote |

| | | |Actual Manuf. |

| | | |Cost @ |

| | | |R56.00 p/hour plus material, plus |

| | | |30 % overhead charges) |

| (b) Through knee | |Each |Quote |

| | | |Actual Manuf. |

| | | |Cost @ |

| | | |R56.00 p/hour plus material, plus |

| | | |30 % overhead charges) |

| (c) Below knee | |Each |Quote |

| | | |Actual Manuf. |

| | | |Cost @ |

| | | |R56.00 p/hour plus material, plus |

| | | |30 % overhead charges) |

|3. SPINAL ORTHOSIS | | |R |

|3.1 COLLARS | | | |

| (a) Soft |X0023 |Each |147 |

| (b) Plastic |X0024 |Each |197 |

| (c) SOMI |X0025 |Each |1 773 |

| (d) ABCO |X0026 |Each |5 918 |

| (e) HALO |X0027 |Each |3 617 |

| (f) HALO jacket |X0028 |Each |1 020 |

| | | | |

|3.2 CORSETS | | | |

| (a) L/S male |X0029 |Each |740 |

| (b) L/S female |X0030 |Each |740 |

| (c) L/D male |X0031 |Each |740 |

| (d) L/D female |X0032 |Each |740 |

| (e) Abdominal male |X0033 |Each |740 |

| (f) Abdominal female |X0034 |Each |740 |

| (g) Abdominal binder |X0035 |Each |740 |

| (h) L/S X-Strap |X5051 |Each |740 |

| | | | |

|4. BRACE | | |R |

|4.1 Milwaukee |X0036 |Each |6 412 |

|4.2 Boston |X0037 |Each |2 466 |

|4.3 T.L.S.O. |X0038 |Each |2 466 |

|4.4 Bennet's plastic |X0039 |Each |2 466 |

|4.5 Fichers/Jordan |X0040 |Each |2 466 |

|4.6 Bakers/Jewett |X0041 |Each |2 466 |

|4.7 Taylors Extension |X0042 |Each |42 |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|4.8 (a) Bivalved TLSO |X0043 |Each |3 124 |

| (b) Bivalved TLSO with SOLMI Ext. |X0044 |Each |4 306 |

|4.9 C.A.S.H. brace |X0045 |Each |1 481 |

|4.10 C.A.S.H. brace (local) |X0046 |Each |774 |

| | | | |

|5. FOOTWEAR | | |R |

|5.1 Boots | | | |

| (a) Infants |X0047 |Pair |618 |

| (b) Childs |X0048 |Pair |679 |

| (c) Youths/Maids |X0049 |Pair |707 |

| (d) Mens |X0050 |Pair |828 |

| | | | |

|5.2 SHOES | | | |

| (a) Nurses |X0051 |Pair |472 |

| | | | |

|5.3 TARSO PRONATOR | | | |

| (a) 000 – 3 |X0052 |Pair |936 |

| (b) 4 – 6 |X0053 |Pair |936 |

| (c) 7 – 9 |X0054 |Pair |936 |

| (d) 10 – 12 |X0055 |Pair |936 |

| (e) 13 - 3 Youths |X0056 |Pair |936 |

| (f) 4 - 5 Adults |X0057 |Pair |936 |

| | | | |

|5.4 TARSO SUPINATOR | | | |

| (a) 3½ - 6½ Infants |X0058 |Pair |936 |

| (b) 7 - 1½ Child |X0059 |Pair |936 |

| (c) 2 - 9 Youths |X0060 |Pair |936 |

| | | | |

|5.5 SURGICAL | | | |

| (a) Boot |X3700 |Pair |3 369 |

| (b) Boot |X3701 |Single |1 677 |

| (c) Shoes |X3702 |Pair |3 207 |

| (d) Shoes |X3703 |Single |1 611 |

| (e) Forest Town Boot |X0061 |Pair |1 332 |

| (f) O'Connor extension |X0062 |Single |2 992 |

| (g) Reverse Sole Boots |X0063 |Pair |1 530 |

| (h) Choparts Extension |X0064 |Single |1 332 |

|5.6 FOOTWEAR ALTERATIONS | | | |

| The following items or any combination thereof: | | | |

| (a) C & E Heel |X0065 |Pair |395 |

| (b) Thomas Heel |X0066 |Pair |395 |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

| (c) Flared Heel or sole |X0067 |Pair |395 |

| (d) Wedges H & S |X0068 |Pair |395 |

| (e) Wedges H or S |X0069 |Pair |395 |

| (f) Met Bars |X0070 |Pair |395 |

| (g) Rocker Soles |X0071 |Each |395 |

| (h) Toe Caps |X0072 |Pair |172 |

| (i) Long & Met Insoles |X0073 |Pair |172 |

| (j) Long Insole |X0074 |Pair |172 |

| (k) Met Insole |X0075 |Pair |172 |

| (l) Moulded Insoles |X0076 |Each |172 |

| (m) Cork Raises |X0077 |Each |641 |

| (n) Heel & Sole Raise leather/feather foam |X0078 |Each |197 |

| (o) Patten Raises |X0079 |Each |559 |

|(excl. boots) | | | |

| (p) Toe Filler |X0080 |Each |172 |

| (q) Socket with Back or Front Stop fixed (excl. boots) |X0081 |Each |172 |

| (r) T/Straps |X0082 |Pair |172 |

| (s) Heel Raise |X0083 |Pair |395 |

| (t) Torque Heels |X0084 |Each |312 |

| (u) Buttress boot |X0085 |Pair |641 |

| (v) Heel Pads |X0086 |Pair |172 |

| (w) Excavated Heel |X0087 |Pair |172 |

| (x) Inside Heel Lift |X0088 |Pair |172 |

| (y) Sach Heel |X0089 |Pair |172 |

| (z) Stuck-in arch Support |X0090 |Pair |172 |

| (aa) UCBL |X0091 |Each |460 |

| (bb) SMO |X0092 |Each |460 |

| | | | |

|6. BELOW KNEE ORTHOSIS | | |R |

|6.1 Air Cast ankle brace |X0093 |Each |354 |

|6.2 Night Splints |X0094 |Each |823 |

|6.3 BK Irons Single (child) |X0095 |Each |363 |

|(Excl. boots)) | | | |

|6.4 BK Irons Single (adult) |X0096 |Each |363 |

|(Excl. boots) | | | |

|6.5 BK Irons Double (child) |X0097 |Each |460 |

|(Excl. boots) | | | |

|6.6 BK Irons Double (adult) |X0098 |Each |460 |

|(Excl. boots) | | | |

|6.7 BK Irons Bil. Single (child) (Excl. boots) |X0099 |Each |641 |

|6.8 BK Irons Bil. Single (adult) (Excl. boots) |X0100 |Each |641 |

|6.9 BK Irons Bil. Double (child) (Excl. boots) |X0101 |Each |905 |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|6.10 BK Irons Bil. Double (adult) (Excl. boots) |X0102 |Each |905 |

|6.11 O'Gormans Uni-lateral |X0103 |Each |436 |

|(Excl boots) | | | |

|6.12 O'Gormans Bi-lateral |X0104 |Each |872 |

|(Excl boots) | | | |

|6.13 A.F.O. |X0105 |Each |805 |

|6.14 Hinged A.F.O. |X0106 |Each |1 366 |

|6.15 Legging Gaiter – Leather |X0107 |Each |757 |

|6.16 Legging Gaiter – Plastic |X0108 |Each |1 152 |

| | | | |

|7. KNEE ORTHOSIS | | |R |

|7.1 Knee Hinged supports (short) |X0109 |Each |345 |

|7.2 Knee Hinged Supports (long) |X0110 |Each |880 |

|7.3 Moulded with Joints |X0111 |Each |2 630 |

|7.4 Moulded no Joints |X0112 |Each |1 215 |

|7.5 Night Splint |X0113 |Each |610 |

|7.6 Crawling pads |X0114 |Each |363 |

|7.7 Canvas gaiters |X0115 |Each |297 |

|7.8 Swedish knee cage |X0116 |Each |1 135 |

| | | | |

|8. ABOVE KNEE ORTHOSIS | | |R |

|Straight Leg Caliper Uni-lat, |X0117 |Each | |

|(adults)(Excl boots) |X0118 | |1 020 |

|(childs)(Excl boots) | | |922 |

|Straight Leg Caliper Bi-lat. |X0119 |Each | |

|(adults)(Excl boots) |X0120 | |1 907 |

|(childs)(Excl boots) | | |1 808 |

|With pelvic band Uni-lateral |X0121 |Each | |

|(adults)(Excl boots) |X0122 | |1 431 |

|(childs)(iExcl boots) | | |2 532 |

|With pelvic band Bi-lateral |X0123 |Each | |

|(adults)(Excl boots) |X0124 | |2 894 |

|(childs)Excl boots) | | |2 532 |

|8.5 Knee Jointed Caliper Uni-lateral (Excl boots) |X0125 |Each |2 894 |

|8.6 Knee jointed Caliper Bi-lateral (Excl boots) |X0126 |Pair |5 788 |

|8.7 With Hip Joints Uni-lateral (Escl boots) |X0127 |Each |3 617 |

|8.8 With Hip Joints Bi-lateral (Excl boots) |X0128 |Each |6 872 |

|8.9 Plastic K.A.F.O. Uni-lateral |X0129 |Each |3 898 |

|8.10 Plastic K.A.F.O. Bi-lateral |X0130 |Each |7 777 |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|8.11 Perthes Caliper (childs) |X0131 |Each |1 446 |

|(Excl boots) | | | |

|8.12 Conradie Leg Braces |X0132 |Each |658 |

|9. HIP ORTHOSIS | | |R |

|9.1 CDH (Paulik van Rosson Barlow) |X0133 |Each |724 |

|9.2 Hip Spika |X0134 |Each |1 250 |

|9.3 Hip Spika & Hip Joint |X0135 |Each |1 629 |

|9.4 Abduction/Flexion Cushion |X0136 |Each |363 |

|10. UPPER EXTREMITY ORTHOSIS | | |R |

|10.1 Hand/Wrist | | | |

| (a) Elastic issue |X0137 |Each |156 |

| (b) Static |X0138 |Each |542 |

| (c) Dynamic |X0139 |Each |542 |

| | | | |

|10.2 Elbow | | | |

| (a) Static |X0140 |Each |493 |

| (b) Dynamic |X0141 |Each |2 072 |

| | | | |

|10.3 Shoulder | | | |

| (a) Static |X0142 |Each |542 |

| (b) Dynamic |X0143 |Each |905 |

| (c) Arm Immobilliser Sling |X0144 |Each |147 |

| | | | |

|11. MISCELLANEOUS | | |R |

|11.1 Elastic stockings | | | |

| (a) Below Knee |X0145 |Pair |51 |

| (b) Above Knee |X0146 |Pair |186 |

| (c) Panty Hose |X0147 |Each |114 |

| (d) Anti Embolism | | | |

| Below knee |X0148 |Each |45 |

| Full |X0149 |Each |63 |

| Full & belt |X0150 |Each |96 |

|11.2 Trusses | | | |

| (a) Inguinal Single |X151 |Each |493 |

| Double |X0152 |Each |493 |

| (b) Scrotal Single |X0153 |Each |493 |

| Double |X0154 |Each |724 |

| (c) Suspension Briefs |X0155 |Each |230 |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|11.3 Crutches | | | |

| (a) Wooden / Polymer Axilla (kiddies small) |X0156 |Each |84 |

| | | | |

| (b) Aluminium: Axilla |X4166 |Each |71 |

| | | | |

| (c) Wooden, Ring Top |X0158 |Each |182 |

| |X0159 |Pair |363 |

| | | | |

| (d) Aluminium, Ring Top |X0160 |Each |297 |

| |X0161 |Pair |593 |

| (e) (i) Adult Elbow (General duty) |X4168 |Each |95 |

| (ii) Adult Elbow (General duty, soft grip) |X4379 |Each |112 |

| (iii) Adult Elbow (Heavy duty, non-adjustable) |X4170 |Each |101 |

| (iv) Kiddies Elbow (General duty) |X4178 |Each |95 |

| (v) Paediatric Elbow (General duty) |X4180 |Each |95 |

| (f) Gutter | | | |

| (i) Gutter / RA (issue) (adult/child) |X4184 |Each |341 |

| (ii) Gutter (manufactured) |X0165 |Each |304 |

|11.4 Walking stick and aids | | | |

| (a) Aluminium Adjustable |X3704 |Each |86 |

| (b) Quadruped |X0167 |Each |199 |

| (c) Pulpit (folding) | | | |

|(i) Adult |X4381 |Each |387 |

|(ii) Child |X4382 |Each |387 |

|(iii) Adult pulpit with wheels |X4215 |Each |445 |

|(iv) Child pulpit with wheels |X4216 |Each |445 |

| (d) Rolator (This is a buy-out) | | | |

| Actual cost plus 15% | |Each |100 % |

| | | | |

| (e) Paediatric reverse walker (This is a buy-out) | | | |

| Actual cost plus 15% | |Each |100 % |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|11.4.1 PVC ferrules | | | |

| (i) For wooden crutch |X4573 |Each |6 |

|(ii) For elbow and gutter crutches, walking sticks, paediatric|X4574 |Each |6 |

|rollators and reverse walkers | | | |

|(iii) Tripods and quodrupods |X4575 |Each |6 |

|(iv) Pulpit walkers with/without wheels |X4576 |Each |6 |

|11.4.2 Wooden crutch arm pads | | | |

|(i) Paediatric |X4577 |Each |14 |

|(ii) Adult |X4578 |Each |13 |

| | | | |

|11.4.3 Soft grip | | | |

|(i) Adult |X4579 |Each |10 |

|11.5 Knee braces | | | |

| (PAU) |X4189 |Each |264 |

| | | | |

|11.6 Helmets | | | |

| (a) Helmets Issue |X0175 |Each |279 |

| (b) Moulded Helmets |X0176 |Each |542 |

| | | | |

|11.7 Seats | | | |

| Moulded |X0177 |Each |1 973 |

|(b) Taxi commode ( with 4 x small castors) |X4614 |Each |1843 |

|(c) Aluminium wheelchair commode |X4615 |Each |3481 |

| | | | |

|12. ITEMS NOT LISTED | | |R |

| (Actual cost plus 15 %) | |Each |100 % |

| | | | |

|13. ITEMS ESPECIALLY ORDERED | | |R |

| (a) Spectacles |X0185 | |704 |

| |Note: When spectacles are ex-stock the tariff to be raised is the actual cost plus 15 %. |

| (b) Contact lenses ex stock | | | |

| (Actual cost plus 15 %) | |Pair |100 % |

| (c) Artificial Eye |X0190 |Each |487 |

| (d) Hearing aids (Actual cost plus 15 %) | |Each |100 % |

| (e) Hearing aid moulds (Actual cost plus 15 %) | |Each |100 % |

| |NOTE: Full paying patients should not be issued mobility assistive devices by provincial hospitals, but should access the private |

| |sector with the support and advice of the therapists treating them and prescribing the necessary devices. |

| |14. REPAIRS TO APPLIANCES: | |100 % of |

| |Actual cost @ R56.00 per hour plus materials plus 30 % overhead | |Actual Cost |

| |charges | | |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|15. OCCUPATIONAL THERAPY: ASSISTIVE DEVICES | | |R |

|15.1 Mobility | | | |

|(a) Wheelchair table (Adult/Child) |X0254 |Each |142 |

|(b) Wheelchair bags (Adult/Child) |X0255 |Each |49 |

|(c) Wheelchair gloves (Adult/Child) |X0256 |Pair |88 |

| | | | |

|15.2 Self Care | | | |

|15.2.1 Toiletting | | | |

|(a) Free standing Wooden commode (Adult/Child) |X0261 |Each |347 |

|(b) Wooden raised toilet seat (Adult/Child) |X0262 |Each |287 |

|(c) Plastic raised toilet seat (Adult/Child) |X4409 |Each |343 |

|(d) Toilet wiping aid (Adult/Child) |X0263 |Each |46 |

|(e) Wheelchair commode seat (Adult/Child) |X4410 |Each |121 |

|15.2.2 Bathing/Washing | | | |

|(a) Bathboard: (all designs, wooden) (Adult/Child) |X0265 |Each |228 |

|(b) Bath Seat: (all designs, wooden) (Adult/Child) |X0266 |Each |167 |

|(c) Backwasher (Adult/Child) |X0267 |Each |75 |

|(d) Tap Turners: all designs (Adult/Child) |X0268 |Each |42 |

|(e) Wash mitten (Adult/Child) |X0269 |Each |72 |

|(f) Nail clipper (own clipper) (Adult/Child) |X0270 |Each |41 |

|(g) Nail brush (own brush) (Adult/Child) |X0271 |Each |41 |

|(h) Towel with handles (Adult/Child) |X4560 |Each |24 |

|15.2.3 Dressing | | | |

|(a) Dressing stick (Adult/Child) |X0274 |Each |46 |

|(b) Shoehorn (Adult/Child) |X0276 |Each |51 |

|(c) Stocking aid (Adult/Child) |X0278 |Each |72 |

|(d) Button hook (Adult/Child) |X0279 |Each |38 |

|(e) Elastic Shoelaces (Adult/Child) |X4411 |Pair |71 |

| | | | |

|15.2.4 Feeding/eating | | | |

|(a) Built-up grip (Adult/Child) |X0280 |Each |30 |

|(b) Universal Cuff (Adult/Child) |X4412 |Each |42 |

|(c) Plate Guard (Adult/Child) |X4413 |Each |71 |

|(d) Dycem (Adult/Child) |X4414 |Each |21 |

|(e) Weighted Cuffs (Adult/Child) |X4415 |Each |84 |

| | | | |

|15.3 Domestic/kitchen/laundry | | | |

|(a) Oven aid (Pusher/Puller) (Adult/Child) |X0287 |Each |98 |

|(b) Tap turner (Adult/Child) |X0288 |Each |24 |

|(c) One-hand vegetable/bread board (Adult/Child) |X0289 |Each |88 |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|(d) Helping hand (Adult/Child) |X0290 |Each |164 |

|(e) Kettle-tipper (Adult/Child) |X0291 |Each |144 |

|(f) Washing board (Adult/Child) |X0292 |Each |142 |

|(g) One handed jar opener (Adult/Child) |X0293 |Each |121 |

|(j) Multipurpose winder (window opener) (Adult/Child) |X0296 |Each |42 |

|(k) Potholder (Adult/Child) |X0297 |Each |88 |

|(l) Adapted plug (Adult/Child) |X0298 |Each |38 |

| | | | |

|15.4 Positioning/transfers | | | |

|(a) Ejector seat (Adult/Child) |X0299 |Each |263 |

|(b) Transfer board (Adult/Child) |X0300 |Each |109 |

|(c) Amputation board (Adult/Child) |X0301 |Each |98 |

|(d) Webbing ladder (bed chain) (Adult/Child) |X4416 |Each |166 |

| | | | |

|15.5 Leisure/work/sundry | | | |

|(a) Bookstand (Adult/Child) |X0303 |Each |55 |

|(b) Card rack (Adult/Child) |X0304 |Each |38 |

|(c) Typing stick (Adult/Child) |X0305 |Each |41 |

|(d) Mouth stick (Adult/Child) |X4417 |Each |51 |

|15.6 Pressure garments | | | |

|15.6.1 Face mask | | | |

|(a) Adult |X0318 |Each |147 |

|(b) Child |X0319 |Each |147 |

| | | | |

|15.6.2 Chin piece | | | |

|(a) Adult |X0320 |Each |120 |

|(b) Child |X0321 |Each |98 |

| | | | |

|15.6.3 Mitten | | | |

|(a) Adult |X0322 |Each |42 |

|(b) Child |X0323 |Each |42 |

|15.6.4 Glove | | | |

|(a) Adult |X0324 |Each |94 |

|(b) Child |X0325 |Each |94 |

| | | | |

|15.6.5 Vest | | | |

|(a) Adult |X0329 |Each |318 |

|(b) Child |X0330 |Each |235 |

|15.6.6 Long sleeve jacket | | | |

|(a) Adult |X0331 |Each |519 |

|(b) Child |X0332 |Each |382 |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|15.6.7 Short sleeve jacket | | | |

|(a) Adult |X0333 |Each |404 |

|(b) Child |X0334 |Each |302 |

| | | | |

|15.6.8 Arm piece (Short/Long sleeve) | | | |

|(a) Adult |X0335 |Each |88 |

|(b) Child |X0336 |Each |68 |

|15.6.9 Corset | | | |

|(a) Adult |X0339 |Each |369 |

|(b) Child |X0340 |Each |272 |

| | | | |

|15.6.10 Long pants | | | |

|(a) Adult |X0341 |Each |205 |

|(b) Child |X0342 |Each |155 |

|15.6.11 Short pants | | | |

|(a) Adult |X0343 |Each |136 |

|(b) Child |X0344 |Each |103 |

|15.6.12 Amputation pants | | | |

|(a) Adult |X0345 |Each |351 |

|(b) Child |X4418 |Each |268 |

| | | | |

|15.6.13 Leg piece | | | |

|(a) Adult |X0346 |Each |123 |

|(b) Child |X0347 |Each |94 |

|15.6.14 Sock | | | |

|(a) Adult |X0348 |Each |47 |

|(b) Child |X0349 |Each |47 |

| | | | |

|15.6.15 Miscellaneous Pressure Garments | | | |

|(a) Prune belly baby grower |X0352 |Each |106 |

|15.6.16 Scrotal Supports | | | |

|(a) Adult |X4419 | |76 |

|(b) Child |X4420 | |71 |

|15.6.17 Cica-Care | | | |

| (a) 15 x 12 cm (Adult/Child) |X0354 |Each |689 |

| (b) 7,5 x 6 cm (Adult/Child) |X0355 |Each |172 |

| (c) 3,8 x 6 cm (Adult/Child) |X0356 |Each |90 |

| (d) 4 x 3 cm (Adult/Child) |X0357 |Each |46 |

| (e) 2 x 3 cm (Adult/Child) |X0358 |Each |24 |

| (f) 1,9 x 2 cm (Adult/Child) |X0359 |Each |17 |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|15.7 Splinting | | | |

|15.7.1 Static Splints – fingers and wrist | | | |

|(a) Circumferential Thumb Abduction Static Splint Hand-Based |X0196 |Each |94 |

|(Combined Anti-claw) Adult |X4421 | |84 |

|Child | | | |

|(b) Radial Thumb Opposition/Abduction & Dorsal MP Flexion & IP |X0198 |Each |186 |

|Extension Static splint Hand-based (combined anti-claw) Adult |X4422 | |140 |

|Child | | | |

|(c) Dorsal PIP & DIP Extension Static splint Finger-Based: Adult|X4198 |Each |71 |

|Child |X4423 | |56 |

|(d) Dorsal Wrist Extension Static Progressive Splint Fore-Arm |X4199 |Each |299 |

|Based: Adult |X4424 | |268 |

|Child | | | |

|(e) Dorsal thumb abduction static splint Fore-Arm Based: Adult |X0218 |Each |268 |

|Child |X4425 | |198 |

|(f) Dorsal MP Flexion & IP Extension Static Splint Fore-Arm Based |X0201 |Each |384 |

|(Duran / Kleinert): Adult |X4426 | |279 |

|Child | | | |

|(g) Bi-Valve PIP & DIP Extension Static Splint Finger-Based: |X0202 |Each |72 |

|Adult |X4427 | |63 |

|Child | | | |

|(h) Dorsal MP Flexion & IP Extension Static Splint Hand-Based |X4200 |Each |153 |

|(Knuckle-Duster) Adult |X0249 | |119 |

|Child | | | |

|(i) Volar Thumb Opposition Static Splint Fore-Arm-Based |X4201 |Each |378 |

|(Thumb-Spica) |X4428 | |277 |

|Adult | | | |

|Child | | | |

|(j) Volar Thumb Opposition with Dorsal MP Flexion & IP Extension|X4212 |Each |424 |

|Static Splint Fore-Arm-Based: Adult |X4429 | |310 |

|Child | | | |

|(k) Bi-Valve DIP Extension Static Splint Finger-Based (Mallet): |X0204 |Each |65 |

|Adult |X0247 | |51 |

|Child | | | |

|(l) Volar/Dorsal Wrist Extension, MP Flexion & IP Extension Static|X0205 |Each |322 |

|Splint Fore-Arm-Based (Resting / Post-Box): |X0246 | |242 |

|Adult | | | |

|Child | | | |

|(m) Volar Thumb Opposition Static Splint Hand-Based(Thumb-Spica): |X0206 |Each |200 |

|Adult |X4430 | |155 |

|Child | | | |

|(n) Circumferential Thumb Abduction Static Splint Fore-Arm-Based: |X4202 |Each |232 |

|Adult |X4431 | |175 |

|Child | | | |

|(o) Volar PIP Extension & Dorsal DIP Flexion |X4203 |Each |65 |

|Static Splint Finger-Based: Adult |X4432 | |51 |

|Child | | | |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|(p) Dorsal DIP Extension & Volar PIP Flexion |X4204 |Each |65 |

|Static Splint Finger-Based: Adult |X4433 | |51 |

|Child | | | |

|(q) Volar PIP & DIP Extension Static Splint Finger-Based |X0210 |Each |65 |

|(Gutter): Adult |X4434 | |51 |

|Child | | | |

|(r) Volar Wrist Extension Static Splint Fore-Arm-Based: Adult |X0211 |Each |278 |

|Child |X0244 | |217 |

|(s) Radial Thumb Abduction Static Splint (Web-Spacer): |X0212 |Each |178 |

|Adult |X0245 | |133 |

|Child | | | |

|(t) Bi-Valve Wrist Extension Static Splint |X0213 |Each |369 |

|Fore-Arm-Based ( Wrist Sandwich): Adult |X4435 | |268 |

|Child | | | |

|15.7.2 Dynamic Splints – fingers and wrist | | | |

|(a) Dorsal DIP Extension & Volar PIP Flexion (3-Point) Dynamic |X0219 |Each |190 |

|Splint Finger-Based |X0243 | |170 |

|(Bouteniere): Adult | | | |

|Child | | | |

|(b) Volar/Dorsal MP Flexion Dynamic Splint |X0220 |Each |445 |

|Fore-Arm-Based: Adult |X0248 | |354 |

|Child | | | |

|c) Volar/Dorsal PIP Flexion Dynamic Splint |X0221 |Each |384 |

|Fore-Arm-Based: Adult |X4436 | |321 |

|Child | | | |

|(d) Radial MP Flexion & Extension Dynamic Splint Fore-Arm-Based:|X0222 |Each |472 |

|Adult |X4437 | |369 |

|Child | | | |

|(e) Dorsal PIP Flexion & DIP Extension with MP Block Dynamic |X0223 |Each |517 |

|Splint Fore-Arm-Based: Adult |X4438 | |394 |

|Child | | | |

|(f) Volar/Dorsal MP Flexion Dynamic Splint |X4439 |Each |354 |

|Hand-Based: Adult |X4440 | |275 |

|Child | | | |

|(g) Volar/Dorsal PIP Flexion Dynamic Splint |X4441 |Each |354 |

|Hand-Based: Adult |X4442 | |275 |

|Child | | | |

|(h) Radial MP Flexion & Extension |X4443 |Each |354 |

|Dynamic Splint Hand-Based: Adult |X4444 | |275 |

|Child | | | |

|15.7.3 Shoulder splints | | | |

|(a) Shoulder Abduction Static Splint |X0226 |Each |1021 |

|(Splint Material)(Aeroplane/ Axilla Splint): Adult |X4445 | |747 |

|Child | | | |

|(b) Shoulder Abduction Static Splint |X0225 |Each |795 |

|(Splint Material & Aluminium)(Aeroplane/ Axilla Splint): |X4446 | |347 |

|Adult | | | |

|Child | | | |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|15.7.4 Elbow splints | | | |

|(a) Anterior Elbow Extension Static Splint |X0227 |Each |422 |

|(Gutter): Adult |X4447 | |321 |

|Child | | | |

|(b) Lateral Elbow Flexion 90 Degree Static Splint: Adult |X0228 |Each |445 |

|Child |X4448 | |343 |

|(c) Anterior & Posterior Elbow Extension |X0229 |Each |517 |

|(3-point) Static Progressive Splint: Adult |X4449 | |394 |

|Child | | | |

|(d) Circumferential/Bi-valve Humeral Brace Static Upper Arm |X4561 |Each |444 |

|Splint: Adult |X4562 | |263 |

|Child | | | |

|15.7.5 Knee splints | | | |

|(a) Anterior & Posterior Knee Extension |X0233 |Each |565 |

|(3-point) Static Progressive Splint: Adult |X4450 | |373 |

|Child | | | |

|(b) Posterior Knee Extension Static Splint (Gutter): Adult |X4451 |Each |765 |

|Child |X4452 | |560 |

|15.7.6 Commercial splints and slings | | | |

|(a) Immobilising sling: Adult |X4205 |Each |76 |

|(b) Soft collars: Adult |X4206 |Each |38 |

|(c) Volar/Dorsal Thumb Abduction (Brace) |X0216 |Each |578 |

|Static Splint Hand-Based: Adult | | | |

|(d) Volar/Dorsal Wrist Extension (Brace) |X4207 |Each |75 |

|Static Splint Hand-Based: Adult | | | |

|15.7.7 Slings (made in Department) | | | |

|Anti-foot drop dynamic sling: Adult |X0235 |Each |49 |

| |X4453 | |49 |

|Child | | | |

| (b) Figure-of-8 axilla sling: Adult |X0236 |Each |63 |

|Child |X4454 | |49 |

|(c) Flail arm sling (webbing): Adult |X0237 |Each |94 |

| |X4455 | |84 |

|Child | | | |

| Master sling: Adult |X0234 |Each |194 |

| |X4456 | |160 |

|Child | | | |

| (e) Shoulder cuff (Hemi): Adult |X0238 |Each |126 |

| |X4457 | |103 |

|Child | | | |

|(f) Robert Jones Knee Immobilising Bandage: |X4563 |Each |122 |

|Adult |X4564 | |90 |

|Child | | | |

|15.7.8 Soft and Miscellaneous splints | | | |

|(a) Circumferential Elbow Anti Spasticity Static Progressive |X0242 |Each |141 |

|Splint (Foam): Adult |X4458 | |98 |

|Child | | | |

|(b) Volar MP, PIP & DIP Abduction Anti Spasticity Static Splint |X0240 |Each |71 |

|Hand-Based |X4459 | |56 |

|(Foam): Adult | | | |

|Child | | | |

|NATURE OF APPLIANCE | |EACH/PAIR |FULL PAYING PATIENTS (Externally |

| | | |Funded, Foreigners, RGP & Patients |

| | | |with Private Doctor incl) |

|(c) Circumferential MP Anti Ulnar Deviation |X0197 |Each |94 |

|Static Progressive Splint Hand-Based |X4460 | |84 |

|(Neoprene) : Adult | | | |

|Child | | | |

|(d) Radial Thumb Abduction Static Splint |X0214 |Each |72 |

|Hand-Based (Neoprene): Adult |X4461 | |63 |

|Child | | | |

|Circumferential Wrist Extension Static Splint (Neoprene): |X4462 |Each |144 |

|Adult |X4463 | |121 |

|Child | | | |

|(f) Thumb Abduction Strap (Neoprene) : Adult |X0217 |Each |41 |

|Child |X4464 | |41 |

|(g) Dorsal MP & IP’s Flexion Cuff Static Progressive Splint |X4465 |Each |72 |

|Hand-Based (Flexion Glove/Strap): Adult |X4466 | |63 |

|Child | | | |

|(h) Circumferential IP Flexion/Extension |X4467 |Each |49 |

|Dynamic Splint Finger/Hand-Based Buddy Strap: |X4468 | |45 |

|Adult | | | |

|Child | | | |

|(i) Circumferential Elbow Static Progressive Splint (Gaiter): |X4469 |Each |200 |

|Adult |X4470 | |155 |

|Child | | | |

|(j) Circumferential Knee Static Progressive Splint (Gaiter): |X4471 |Each |247 |

|Adult |X4472 | |189 |

|Child | | | |

|(k) Knee Hyper-Extension Soft Splint: Adult |X0232 |Each |135 |

|Child |X4473 | |90 |

|(l) Neck Collar (Soft) : Adult |X4474 |Each |84 |

|Child |X4475 | |72 |

|(m) Neck Collar (Splint Material) : Adult |X4476 |Each |877 |

|Child |X4477 | |692 |

|(n) Helmet (Splint Material) : Adult |X4478 |Each |632 |

|Child |X4479 | |472 |

|15.7.9 Ankle/Foot Splints | |Each | |

|Dorsi-Flexion Ankle 90 Degree Static Splint : Adult |X4480 |Each |585 |

|Child |X4481 | |436 |

|16 Speech therapy: Voice prosthesis | | | |

|(a) Blomsinger Duckbill (16fr) |X4208 |Each |335 |

|(b) Blomsinger Low Pressure (16fr) |X4209 |Each |528 |

|(c) Blomsinger indwelling (20fr) starter kit |X4210 |Each |1065 |

|(d) Blomsinger indwelling (20fr) replacement kit |X4211 |Each |881 |

NOTE: (1) Interest will be charged on overdue invoices

(2) Legal costs incurred and

(3) Any ancillary costs which may be levied by third parties may also be added

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