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药品及医疗服务项目价格查询| 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 |
|---|---|---|---|---|---|---|---|
| 8002 IT XLPE liner捷迈00-8751-014-36 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER NEUTRAL MM 36 | C03440610702001075510000019 | C03440610702001075510000019 | |
| 8002 IT XLPE liner捷迈00-8752-014-32 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED MM 32 | C03440610702001075510000020 | C03440610702001075510000020 | |
| 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00-8751-018-36 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 68 QU X 36 | C03440610702001075510000023 | C03440610702001075510000023 | |
| 8002 IT XLPE liner捷迈00-8752-006-28 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED EE 28 | C03440610702001075510000025 | C03440610702001075510000025 | |
| 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00-8752-011-28 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED JJ 28 | C03440610702001075510000022 | C03440610702001075510000022 | |
| 8002 IT XLPE liner捷迈00-8752-013-28 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED LL 28 | C03440610702001075510000021 | C03440610702001075510000021 | |
| 8002 IT XLPE liner捷迈00-8751-015-36 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 62 NN X 36 | C03440610702001075510000024 | C03440610702001075510000024 | |
| 8002 IT XLPE liner捷迈00-8752-010-28 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED II 28 | C03440610702001075510000032 | C03440610702001075510000032 | |
| 8002 IT XLPE liner捷迈00-8752-016-32 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED OO 32 | C03440610702001075510000030 | C03440610702001075510000030 | |
| 8002 IT XLPE liner捷迈00-8752-012-28 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED KK 28 | C03440610702001075510000026 | C03440610702001075510000026 | |
| 8002 IT XLPE liner捷迈00-8751-011-36 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 54 JJ X 36 | C03440610702001075510000028 | C03440610702001075510000028 | |
| 8002 IT XLPE liner捷迈00-8751-013-40 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 58 LL X 40 | C03440610702001075510000031 | C03440610702001075510000031 | |
| 8002 IT XLPE liner捷迈00-8751-010-36 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 52 II X 36 | C03440610702001075510000029 | C03440610702001075510000029 | |
| 8002 IT XLPE liner捷迈00-8751-019-36 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER NEUTRAL RR 36 | C03440610702001075510000027 | C03440610702001075510000027 | |
| 8002 IT XLPE liner捷迈00-8752-012-32 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED KK 32 | C03440610702001075510000033 | C03440610702001075510000033 | |
| 8002 IT XLPE liner捷迈00-8751-016-36 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 64 OO X 36 | C03440610702001075510000035 | C03440610702001075510000035 | |
| 8002 IT XLPE liner捷迈00-8751-013-36 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER, NEUT, 58 LL X 36 | C03440610702001075510000034 | C03440610702001075510000034 | |
| 8002 IT XLPE liner捷迈00-8752-007-28 | 个 | 1069.00 | 京医保发〔2019〕9号 | HXPE LINER ELEVATED FF 28 | C03440610702001075510000036 | C03440610702001075510000036 |