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项目名称 | 计价单位 | 价格 | 收费依据 | 规格 | 国家医保编码 | 北京医保编码 | 备注 |
---|---|---|---|---|---|---|---|
滨滨型血管塞雅培9-础痴笔2-008 | 套 | 13333.00 | 京价收字99-390号 | 9-AVP2-008 | C02064306500000054050000004 | C02064306500000 | |
滨滨型血管塞雅培9-础痴笔2-010 | 套 | 13333.00 | 京价收字99-390号 | 9-AVP2-010 | C02064306500000054050000008 | C02064306500000 | |
滨滨型血管塞雅培9-础痴笔2-018 | 套 | 13333.00 | 京价收字99-390号 | 9-AVP2-018 | C02064306500000054050000002 | C02064306500000 | |
滨滨型血管塞雅培9-础痴笔2-016 | 套 | 13333.00 | 京价收字99-390号 | 9-AVP2-016 | C02064306500000054050000005 | C02064306500000 | |
8002 IT XLPE liner捷迈00-8752-009-28 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED HH 28 | C03440610702001075510000004 | C03440610702001075510000004 | |
8002 IT XLPE liner捷迈00-8751-012-40 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 56 KK X 40 | C03440610702001075510000001 | C03440610702001075510000001 | |
8002 IT XLPE liner捷迈00-8752-017-32 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED PP 32 | C03440610702001075510000002 | C03440610702001075510000002 | |
8002 IT XLPE liner捷迈00-8752-010-32 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED II 32 | C03440610702001075510000003 | C03440610702001075510000003 | |
8002 IT XLPE liner捷迈00-8751-017-36 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 66 PP X 36 | C03440610702001075510000005 | C03440610702001075510000005 | |
8002 IT XLPE liner捷迈00-8752-019-32 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED RR 32 | C03440610702001075510000007 | C03440610702001075510000007 | |
8002 IT XLPE liner捷迈00-8752-015-32 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED NN 32 | C03440610702001075510000006 | C03440610702001075510000006 | |
8002 IT XLPE liner捷迈00-8751-017-40 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 66 PP X 40 | C03440610702001075510000012 | C03440610702001075510000012 | |
8002 IT XLPE liner捷迈00-8752-008-32 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED GG 32 | C03440610702001075510000009 | C03440610702001075510000009 | |
8002 IT XLPE liner捷迈00-8751-016-40 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 64 OO X 40 | C03440610702001075510000013 | C03440610702001075510000013 | |
8002 IT XLPE liner捷迈00-8751-015-40 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 62 NN X 40 | C03440610702001075510000014 | C03440610702001075510000014 | |
8002 IT XLPE liner捷迈00-8751-012-36 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 56 KK X 36 | C03440610702001075510000008 | C03440610702001075510000008 | |
8002 IT XLPE liner捷迈00-8752-018-32 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED QU 32 | C03440610702001075510000010 | C03440610702001075510000010 | |
8002 IT XLPE liner捷迈00-8752-008-28 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED GG 28 | C03440610702001075510000017 | C03440610702001075510000017 | |
8002 IT XLPE liner捷迈00-8752-013-32 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED LL 32 | C03440610702001075510000011 | C03440610702001075510000011 | |
8002 IT XLPE liner捷迈00-8752-009-32 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED HH 32 | C03440610702001075510000016 | C03440610702001075510000016 |