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["鼓楼区妇幼保健所服务项目及价目表"]
["序号","编码","项目名称","项目内涵","除外内容","计价\n单位","价格","说          明"]
[]
[]
[1,110500001,"体检费                              ","含内、外(含皮肤)、妇(含宫颈刮片)、五官等科的常规检查；写总检报告","影像、化验及特殊检查","次",15,"不另收诊察费"]
[2,110200008,"方便门诊费","指对只取药及慢性病病人定期检查、不需另外提供新的治疗方案的病人提供的诊疗服务。",null,"次",1]
[3,120400002,"静脉注射","包括静脉采血",null,"次",5]
[4,130100001,"婴幼儿健康体检",null,null,"次",5]
[5,130200001,"儿童龋齿预防保健","含4岁至学龄前儿童按齿科常规检查",null,"次",1]
[6,130200002,"氟导入儿童龋齿预防","含口腔检查、氟离子导入及相关材料",null,"次",10,"3-13周岁的儿童龋齿预防"]
[7,170200002,"营养干预","由专业营养师制定个性化营养干预方案，通过营养手段对特殊生理时期人群或代谢失衡患者进行饮食追踪指导、体重管理、纠正代谢紊乱，预防并发症，促进健康。",null,"次",50,"2019.3.12鼓卫健批"]
[8,210102008,"牙片",null,"一次性拍片支架","片数",3]
[9,210102009,"咬合片",null,"一次性拍片支架","片数",3]
[10,210102015,"数字化摄影(DR)                     ","含数据采集、存贮、图象显示","胶片（包括各类介质、材质）","曝光次数",60,"不得加收滤线器费（210102-b)"]
[11,220201001,"单脏器B超检查",null,null,"每个脏器",10]
[12,220301001,"彩色多普勒超声常规检查",null,null,"部位",60]
[13,220301002,"浅表器官彩色多普勒超声检查",null,null,"每个部位",60]
[14,220302011,"腔内彩色多普勒超声检查","包括经阴道、经直肠",null,"次",45]
[15,220302013,"超声弹性成像",null,null,"次",45]
[16,220800001,"黑白热敏打印照片",null,null,"片",10]
[17,220800008,"计算机图文报告",null,null,"次",15]
[18,220800008,"计算机图文报告","含计算机图文处理、储存及图文报告；包括内镜图文报告",null,"次",15]
[19,220800009,"彩色胶片报告","含计算机图文处理、储存",null,"片",20,"与“计算机图文报告（220800008）”不能同时收取"]
[20,230200055,"骨密度测定",null,null,"次",40]
[21,250102021,"尿妊娠试验",null,null,"项",6,"金标法"]
[22,250102035,"尿常规化学检测","指仪器法，8－11项",null,"次",4.5,"含镜检"]
[23,250103001,"粪便常规","指手工操作，含外观、镜检",null,"次",5,"不得再收粪寄生虫镜检（编码250601001）费"]
[24,250104014,"阴道分泌物检查","含清洁度、滴虫、霉菌检查",null,"次",7]
[25,250302001,"葡萄糖测定","包括血清、脑脊液、尿标本",null,"次",4,"各种酶法、酶电极法"]
[26,250303004,"血清高密度脂蛋白胆固醇测定",null,null,"项",8,"其他方法"]
[27,250304013,"微量元素测定","包括铜、硒、锌、锶、镉、汞、铝、锰、钼、锂、砷等",null,"次",30,"每种元素计费一次。本所开展5项，收30.00元"]
[28,250305001,"血清总胆红素测定",null,null,"项",4,"化学法或酶促法"]
[29,250305002,"血清直接胆红素测定",null,null,"项",4,"化学法或酶促法"]
[30,250305007,"血清丙氨酸氨基转移酶测定",null,null,"项",10,"干化学法"]
[31,250305014,"血清胆碱脂酶测定",null,null,"项",5,"速率法"]
[32,250305029,"甘胆酸（CG）检测",null,null,"项",25]
[33,250307001,"尿素测定","血清或尿标本分别参照执行",null,"项",4,"化学法、酶促动力学法"]
[34,250307002,"肌酐测定","包括血清或尿标本",null,"项",4,"酶促动力学法"]
[35,250307005,"血清尿酸测定",null,null,"项",3]
[36,250402062,"抗甲状腺过氧化物酶抗体检测",null,null,"项",70,"电化学发光法"]
[37,250403004,"乙型肝炎表面抗原测定(HBsAg)",null,null,"项",8,"ELISA法"]
[38,250403005,"乙型肝炎表面抗体测定(Anti-HBs)",null,null,"项",8,"ELISA法"]
[39,250403006,"乙型肝炎e抗原测定(HBeAg)",null,null,"项",4,"免疫学法"]
[40,250403007,"乙型肝炎e抗体测定(Anti-HBe)",null,null,"项",4,"免疫学法"]
[41,250403009,"乙型肝炎核心抗体测定(Anti-HBc)",null,null,"项",8,"ELISA法"]
[42,250403014,"丙型肝炎抗体测定(Anti-HCV)",null,null,"项",25]
[43,250403020,"弓形体抗体测定","包括IgG、IgM",null,"项",25,"各种免疫学方法"]
[44,250403021,"风疹病毒抗体测定","包括IgG、IgM",null,"项",20,"各种免疫学方法"]
[45,250403022,"巨细胞病毒抗体测定","包括IgG、IgM",null,"项",25]
[46,250403024,"单纯疱疹病毒抗体测定","包括IgG、IgM",null,"项",25]
[47,250403054,"快速血浆反应素检测",null,null,"项",20,"快速血清（浆）梅素环状试验（定性）"]
[48,250403089,"淋病奈瑟菌抗原检测","包括沙眼衣原体抗原检测",null,"项",135,"免疫学方法（苏价医〔2017〕7号增加）"]
[49,250404032,"血清HER-2/neu蛋白检测",null,null,"次",510,"发光法"]
[50,250405001,"总IgE测定",null,null,"项",20,"各种免疫学方法同价"]
[51,250405002,"吸入物变应原筛查",null,null,"项",30,"各种免疫学方法同价。本所检查10项300.00元。"]
[52,250405003,"食入物变应原筛查",null,null,"项",30,"各种免疫学方法同价，本所检查8项240.00元。"]
[53,250501034,"支原体培养及药敏",null,null,"项",70]
[54,250503003,"病原体乳胶凝集试验快速检测","　","　","项",60]
[55,250900003,"乙肝两对半定性检测",null,null,"套",32]
[56,260000004,"Rh血型鉴定","指仅鉴定RhD(o)，不查其他抗原",null,"次",10]
[57,270200004,"脱落细胞学检查与诊断","包括子宫内膜、宫颈、阴道、痰、乳腺溢液、窥镜刷片及其他脱落细胞学的各种涂片检查及诊断加口腔粘液涂片",null,"例",39]
[58,270300003,"局部切除组织活检检查与诊断","包括切除组织、咬取组织、切除肿块部分组织的活检",null,"每个部位",78,"以两个蜡块为基价"]
[59,270500002,"免疫组织化学染色诊断","　","　","每个标本，每种染色",80]
[60,270700003,"脱氧核糖核酸（DNA）测序","　","　","项",400]
[61,270800004,"病理图文报告","含图像采集、加工和打印报告",null,"次",30]
[62,310300001,"普通视力检查","含远视力、近视力、光机能（包括光感及光定位）、伪盲检查",null,"次（双眼）",3.9]
[63,310300002,"特殊视力检查","包括儿童图形视力表，点视力表，条栅视力卡，视动性眼震仪",null,"项",3.9]
[64,310300003,"选择性观看检查",null,null,"次（双眼）",20]
[65,310300004,"视网膜视力检查",null,null,"次（双眼）",26]
[66,310300007,"验光","包括检影，散瞳，云雾试验，试镜",null,"次",26]
[67,310300010,"主导眼检查",null,null,"次（双眼）",2.6]
[68,310300012,"复视检查",null,null,"次（双眼）",13]
[69,310300013,"斜视度测定","含九个注视方向双眼分别注视时的斜度，看远及看近",null,"次（双眼）",13]
[70,310300014,"三棱镜检查",null,null,"次（双眼）",5.2]
[71,310300015,"线状镜检查",null,null,"次（双眼）",7.8]
[72,310300017,"调节/集合测定",null,null,"次（双眼）",10]
[73,310300018,"牵拉试验","含有无复视及耐受程度，被动牵拉，主动收缩",null,"次（双眼）",13]
[74,310300019,"双眼视觉检查","含双眼同时知觉、双眼同时视、双眼融合功能、立体视功能",null,"次（双眼）",13]
[75,310300020,"色觉检查","包括普通图谱法，FM-100Hue测试盒法，色觉仪法",null,"次（双眼）",6.5]
[76,310300025,"注视性质检查",null,null,"次（双眼）",6.5]
[77,310300033,"上睑下垂检查",null,null,"次（双眼）",6.5]
[78,310300039,"角膜曲率测量",null,null,"次（双眼）",13]
[79,310300043,"角膜知觉检查",null,null,"次（双眼）",13]
[80,310300045,"人工晶体度数测量",null,null,"次（双眼）",52]
[81,310300051,"眼位照相",null,null,"次（双眼）",26]
[82,310300056,"眼底检查","包括直接、间接眼底镜法，不含散瞳",null,"次（双眼）",6.5]
[83,310300069,"眼外肌功能检查","含眼球运动、歪头试验、集合与散开",null,"次（双眼）",6.5]
[84,310300098,"协调器治疗",null,null,"次",13]
[85,310300099,"后象治疗",null,null,"次",13]
[86,310300107,"双眼单视功能训练","含双眼同时视、辐辏外展、融合",null,"次",9.1]
[87,310300108,"弱视训练",null,null,"次",9.1]
[88,310300110,"散瞳","含药物",null,"单眼",10]
[89,310401001,"听性脑干反应",null,null,"次",91]
[90,310401010,"声导抗测听","包括鼓室图、镫骨肌反射试验",null,"次",65]
[91,310401015,"耳声发射检查","包括自发性、诱发性和畸变产物耳声发射",null,"次",130]
[92,310401025,"听力筛选试验","含耳声发射、脑干听觉诱发电位测听",null,"次",65]
[93,310401027,"定向条件反射测定","含游戏测定和行为观察",null,"次",39]
[94,310401027,"定向条件反射测定","含游戏测定和行为观察","　","次",39]
[95,310501001,"全口牙病系统检查与治疗设计","包括各专业检查表，不含错畸形诊断设计、种植治疗设计",null,"次",12]
[96,310501002,"咬合检查","不含咀嚼肌肌电图检查",null,"次",2.4]
[97,310501004,"咀嚼功能检查",null,null,"次",6]
[98,310501007,"口腔模型制备","含口腔印模制取、石膏模型灌制、普通藻酸盐印摸材、普通石膏","硅橡胶、琼脂材料，进口石膏材料","单颌",24]
[99,310501008,"记存模型制备","含印模制取、模型灌制、修正及取蜡型","硅橡胶、琼脂材料，进口石膏材料","单颌",3.6]
[100,310501011,"口腔内镜检查",null,null,"每牙",12]
[101,310502001,"牙髓活力检查","包括冷测、热测、牙髓活力电测",null,"每牙",2.4]
[102,310502002,"根管长度测量","含使用根管长度测量仪或插诊断丝确定工作长度",null,"每根管",4.8]
[103,310502003,"口腔X线一次成像(RVG)",null,null,"每牙",36,"含图文报告"]
[104,310503003,"咬合动度测定",null,null,"次",2.4]
[105,310503004,"龈上菌斑检查","含牙菌斑显示及菌斑指数确定",null,"次",6]
[106,310503005,"菌斑微生物检测","含菌斑采集及微生物检测；包括：刚果红负染法；暗视野显微镜法；Periocheck法","Periocheck试剂盒","次",4.8]
[107,310506001,"颞颌关节系统检查设计","含专业检查表，包括颞颌关节系统检查；不含关节镜等特殊检查",null,"每人次",12]
[108,310510001,"调合牙合",null,null,"每牙",3.6]
[109,310510002,"氟防龋治疗","包括局部涂氟、氟液含漱、氟打磨","氟保护漆","每牙",1.2]
[110,310510003,"牙脱敏治疗","包括氟化钠、酚制剂等药物","高分子脱敏剂","每牙",3.6]
[111,310510004,"口腔局部冲洗上药","含冲洗、含漱；包括牙周袋内上药、粘膜病变部位上药",null,"每牙",1.2]
[112,310510005,"不良修复体拆除","包括不良修复体及不良充填体",null,"每牙",4.8]
[113,310510006,"牙开窗助萌术","包括各类阻生恒牙",null,"每牙",36]
[114,310510007,"口腔局部止血","包括拔牙后出血、各种口腔内局部出血的清理创面、填塞或缝合","特殊填塞或止血材料","每牙",12]
[115,310510009,"口内脓肿切开引流术",null,null,"例",9.6]
[116,310510010,"牙外伤结扎固定术","含局麻、复位、结扎固定及调牙合；包括牙根折、挫伤、脱位；不含根管治疗","特殊结扎固定材料","每牙",36]
[117,310510011,"拆除固定装置","包括去除由各种原因使用的口腔固定材料",null,"每牙",3.6]
[118,310511001,"简单充填术","含备洞、垫底、洞型设计、国产充填材料；包括I、V类洞的充填","特殊材料","每牙",14]
[119,310511002,"复杂充填术","含龋齿的特殊检查(如检知液、光纤透照仪等)、备洞、垫底、洞形设计和充填；包括II、III、IV类洞及大面积缺损的充填","特殊材料","每牙",18]
[120,310511003,"牙体桩钉固位修复术","含备洞、垫底、洞形设计、打桩(钉)、充填；包括大面积缺损的充填","各种特殊材料、桩、钉","每牙",22]
[121,310511004,"牙体缺损粘接修复术","含牙体预备、酸蚀、粘接、充填","特殊材料","每牙",22]
[122,310511005,"充填体抛光术","包括各类充填体的修整、抛光",null,"每牙",0.6]
[123,310511007,"树脂嵌体修复术","含牙体预备和嵌体修复","各种特殊材料","每牙",24]
[124,310511008,"橡皮障隔湿法","含一次性橡皮布",null,"次",6]
[125,310511011,"盖髓术","含备洞、间接盖髓或直接盖髓、垫底、安抚；包括龋齿的特殊检查","特殊盖髓剂","每牙",4.8]
[126,310511012,"牙髓失活术","含麻醉、开髓、备洞、封药",null,"每牙",24]
[127,310511013,"开髓引流术","含麻醉、开髓",null,"每牙",24]
[128,310511014,"干髓术","含揭髓顶、切冠髓、FC浴、放置干髓剂等",null,"每牙",12]
[129,310511015,"牙髓摘除术","含揭髓顶、拔髓、荡洗根管",null,"每根管",12]
[130,310511016,"根管预备","含髓腔预备、根管预备、根管冲洗","机用镍钛锉（按实际确定；仅限于使用机用镍钛锉预备，手用器械预备不得收费）","每根管",30]
[131,310511017,"根管充填术",null,"特殊充填材料(如各种银尖、钛尖等)","每根管",30]
[132,310511019,"髓腔消毒术","包括：1．髓腔或根管消毒；2．瘘管治疗",null,"每根管",12]
[133,310511021,"根管再治疗术","包括：1．取根管内充物；2．疑难根管口的定位；3．不通根管的扩通。",null,"每根管",36]
[134,310511022,"髓腔穿孔修补术","包括髓腔或根管穿孔","特殊材料","每根管",24]
[135,310511026,"劈裂牙治疗","包括1.取劈裂牙残片；2.劈裂牙结扎","根管治疗","每牙",24]
[136,310511027,"后牙纵折固定术","含麻醉固定、调牙合","根管治疗、带环结扎丝","每牙",7.2]
[137,310512001,"根尖诱导成形术","指年青恒牙牙根继续形成；含拔髓(保留牙乳头)、清洁干燥根管、导入诱导糊剂、充填","特殊充填材料","每根管",48]
[138,310512002,"窝沟封闭","指预防恒前磨牙及磨牙窝沟龋；含清洁窝沟、酸蚀、涂封闭剂、固化、调磨，","特殊窝沟封闭剂","每牙",24]
[139,310512003,"乳牙预成冠修复","含牙体预备、试冠、粘结；包括合金冠修复乳磨牙大面积牙体缺损或做保持器的固位体","树脂冠、金属冠","每牙",84]
[140,310512004,"儿童前牙树脂冠修复","含牙体预备、试冠、粘结；包括树脂冠修复前牙大面积牙体缺损(外伤及龋患)","树脂冠、金属冠","每牙",9.6]
[141,310512005,"制戴固定式缺隙保持器","指用于乳牙早失，使继承恒牙正常萌出替换；含试冠、牙体预备、试带环、制作、粘结、复查","印模、模型制备、下颌舌弓、导萌式保持器、丝圈式保持器","次",26]
[142,310512006,"制戴活动式缺隙保持器","指恒牙正常萌出替换","印模、模型制备","次",42]
[143,310512007,"制戴活动矫正器","包括乳牙列或混合牙列部分错牙合畸形的矫治","印模、模型材料、特殊矫正装置","次",54]
[144,310512010,"全牙列牙合垫固定术","指用于恒牙外伤的治疗；含外伤牙的复位、固定、制作全牙列牙合垫、试戴、复查","透明压模垫、硬石膏、超硬石膏印模、模型料、印模、模型制备","单颌",120]
[145,310512011,"活髓切断术",null,null,"每牙",12]
[146,310513001,"洁治","包括超声洁治或手工洁治，不含洁治后抛光",null,"每牙",2.4]
[147,310513002,"龈下刮治","包括龈下超声刮治或手工刮治",null,"每牙",2.4]
[148,310513005,"牙面光洁术","包括洁治后抛光；喷砂","特殊材料","每牙",1.2]
[149,310513006,"牙龈保护剂塞治","含牙龈表面及牙间隙","特殊保护剂","每牙",6]
[150,310513007,"急性坏死性龈炎局部清创","包括局部清创、药物冲洗及上药",null,"每牙",12]
[151,310513008,"根面平整术","包括手工根面平整",null,"每牙",8.4]
[152,310515001,"颞下颌关节复位","指限制下颌运动的手法复位",null,"次",42]
[153,310515002,"冠周炎局部治疗","含药液冲洗盲袋及上药",null,"次",9.6]
[154,310515003,"干槽症换药","含清理拔牙创、药物冲洗、骨创填塞","止血膏、灭滴灵粉","次",17]
[155,310516003,"调磨牙合垫",null,null,"每次",6]
[156,310517001,"冠修复","含牙体预备，药线排龈蜡牙合记录，测色，技工室制作全冠，试戴修改全冠；包括全冠、半冠、3/4冠",null,"每牙",96,"指铸造冠、锤造冠。"]
[157,310517002,"嵌体修复","含牙体预备，药线排龈，制取印模、模型，蜡牙合记录，技工室制作嵌体，试戴修改嵌体；包括嵌体、高嵌体、嵌体冠",null,"每牙",144]
[158,310517003,"桩核根帽修复","含牙体预备，牙合记录，制作蜡型，技工室制作桩核、根帽，试戴修改桩核、根帽",null,"每牙",96]
[159,310517004,"贴面修复","含牙体预备，药线排龈，测色，技工室制作贴面，试戴贴面",null,"每牙",84]
[160,310517005,"桩冠修复","含牙体预备，牙合记录，制桩蜡型，技工室制作桩，试桩，制冠蜡型，技工室制作完成桩冠，试戴桩冠；包括简单桩冠，铸造桩冠",null,"每牙",38]
[161,310517006,"固定桥","含牙体预备和药线排龈，蜡牙合记录，测色，技工室制作固定桥支架，固定桥支架试戴修改、技工室制作完成固定桥，固定桥试戴修改，金属固位体电解蚀刻处理；包括双端、单端固定桥、粘结桥(马里兰桥)",null,"每牙",120]
[162,310517008,"咬合重建","含全牙列固定修复咬合重建，改变原牙合关系，升高垂直距离咬合分析，X线头影测量，研究模型设计与修整，牙体预备，转移面弓与上颌架；包括复杂冠桥修复",null,"次",96]
[163,310517009,"粘结","包括嵌体、冠、桩核粘结(酸蚀、消毒、粘固)","特殊粘接剂","每牙",3.6]
[164,310518001,"活动桥","包括普通弯制卡环、整体铸造卡环及支托活动桥",null,"每牙",60]
[165,310518002,"塑料可摘局部义齿","含牙体预备，义齿设计，制作双重印模，模型，咬合关系记录，技工室制作义齿排牙蜡型，试排牙，技工室制作完成义齿，义齿试戴、修改，咬牙合检查；包括普通弯制卡环塑料可摘局部义齿，无卡环塑料可摘局部义齿，普通覆盖义齿，弹性隐形义齿",null,"每牙",96]
[166,310518003,"铸造可摘局部义齿","含牙体预备，制双重印模、模型，模型观测，蜡咬合关系记录，技工室制作铸造支架，试支架及再次蜡咬合关系记录，技工室制作义齿排牙蜡型，试排牙，技工室制作完成义齿，义齿试戴、修改，咬合检查；包括覆盖义齿",null,"每牙",240]
[167,310518005,"即刻义齿","含拔牙前制作印模，制作模型及特殊修整，各类义齿的常规制作及消毒；包括拔牙前制作，拔牙后即刻或数日内戴入的各类塑料义齿和暂时义齿",null,"每牙",19]
[168,310518006,"附着体义齿","含牙体预备制个别托盘 ，双重印模，模型，咬合关系记录，模型观测，固位体平行度测量，平行研磨，试排牙，试附着体，复诊三次调改义齿；包括可摘义齿，固定义齿，活动固定联合修复",null,"每牙",180,"活动固定联合修复是指胶连式塑料可摘义齿、铸造可摘义齿、总义齿的基本结构以外加用各种附着体"]
[169,310518007,"总义齿","含义齿设计，制个别托盘，制作双重印模、模型、牙合托，正中牙合关系记录，面弓转移，试排牙，总义齿试戴、修改，咬牙合检查，调整咬；包括覆盖义齿，无唇翼义齿","铸造金属基托、金属加强网","单颌",360]
[170,310519001,"拆冠桥","包括锤造冠",null,"每牙",12]
[171,310519002,"拆桩","包括预成桩、各种材料的桩核",null,"每牙",12]
[172,310519007,"取局部牙合关系记录","指义齿组织面压痛衬印检查；含取印模、检查用衬印材料等","硅橡胶","次",12]
[173,310519008,"取正中牙合关系记录",null,null,"次",36]
[174,310519009,"加人工牙",null,"各种人工牙材料","每牙",18]
[175,310519010,"义齿接长基托","包括边缘、游离端、义齿鞍基","自凝、热凝材料","次",12]
[176,310519011,"义齿裂纹及折裂修理","含加固钢丝","自凝、热凝材料","次",24]
[177,310519012,"义齿组织面重衬","包括硬衬、软衬","各种材料费(自凝塑料、热凝塑料、光固化树脂、软塑料、橡胶)","每厘米",6]
[178,310519013,"加卡环","含单臂、双臂、三臂卡环；包括加钢丝或铸造卡环","各种卡环材料(钢丝弯制卡环，铸造钴铬合金、贵金属合金卡环)","每卡环",12]
[179,310519014,"增加铸造基托",null,"各种基托材料(钢、金合金)","5＋5",26]
[180,310519015,"加牙合颌支托",null,"各种牙合支托材料(钢丝支托、扁钢丝支托、铸造钴铬合金支托、铸造金合金支托)","次",18]
[181,310519016,"加铸颌牙合面",null,null,"次",48]
[182,310519017,"增加加固装置","包括加固钢丝、网","各种加固装置材料(金属丝，扁钢丝，尼龙网、预成不锈钢网、铸造不锈钢网、金网)","次",8.4]
[183,310519018,"加连接杆",null,"各种材料(预成杆、铸造不锈钢杆、铸造金杆)","次",8.4]
[184,310519019,"塑料牙合颌面加高咬合",null,"材料费(自凝塑料、热凝塑料)","次",30]
[185,310519020,"弹性假牙龈",null,null,"每牙",18]
[186,310519021,"镀金加工",null,null,"每牙",36]
[187,310519022,"铸造加工","指患者自带材料加工；包括所有铸造修复体",null,"每件",72]
[188,310519023,"配金加工",null,null,"每牙",36,"仅限患者自备材料"]
[189,310519024,"黄金材料加工",null,null,"每牙",36]
[190,310519025,"加磁性固位体",null,null,"每牙",300]
[191,310519026,"附着体增换","包括附着体增加或更换","附着体材料","每附着体",24]
[192,310520001,"牙合垫","含牙体预备，调牙合，制印模、模型，蜡合记录，技工室制作；不含疗效分析专用设备检查","铸造支架、牙合垫材料、咬合板材料(塑料，树脂，铸造不锈钢，铸造金合金，铸造不锈钢或铸造金合金网+塑料，铸造不锈钢或铸造金合金网+树脂)","每件",144]
[193,310522018,"牙周病伴错牙合畸形活动矫治器正畸治疗","包括局部牙周炎的正畸治疗",null,"次",120]
[194,310522019,"牙周病伴错牙合畸形固定矫治器正畸治疗","包括局部牙周炎的正畸治疗",null,"次",198]
[195,310522020,"牙合创伤正畸治疗","包括：1．由咬合因素引起的创伤；2．用活动矫治器或固定矫治器治疗",null,"次",162]
[196,310522022,"早期颜面不对称正畸治疗","包括：1．替牙期由错牙合引起或颜面不对称伴错牙合的病例；2．使用活动矫治器和固定矫治器",null,"次",180]
[197,310522023,"恒牙期颜面不对称正畸治疗","包括：1．恒牙期由错牙合引起或颜面不对称伴错的早期正畸治疗；2．用活动矫治器或固定矫治器","活动矫治器增加部件或其他附加装置","次",180]
[198,310522024,"颅面畸形正畸治疗","包括：1．Crouzon综合征、Apert综合征、Treacher-Collins综合征；2．用活动矫治器或固定矫治器治疗","活动矫治器增加其他部件、固定矫治器增加其他附加装置另加","次",180]
[199,310522027,"睡眠呼吸暂停综合征(OSAS)正畸治疗","包括各种表现的睡眠呼吸暂停及相应错牙合的正畸治疗","常规OSAS矫治器以外的附件","次",144]
[200,310522028,"正畸保持器治疗","含取模型、制作用材料","特殊材料及固定保持器、正位器、透明保持器","每副",48]
[201,310701027,"指脉氧监测",null,null,"小时",2.4]
[202,311000043,"蛋白质的营养评估",null,null,"次",23]
[203,311201002,"外阴活检术",null,null,"次",26]
[204,311201005,"阴道填塞",null,null,"次",39]
[205,311201006,"阴道灌洗上药",null,null,"次",10]
[206,311201008,"宫颈活检术",null,null,"次",39]
[207,311201009,"宫颈注射","包括宫颈封闭、阴道侧穹窿封闭、上药",null,"次",13]
[208,311201010,"宫颈扩张术","含宫颈插管",null,"次",39]
[209,311201011,"宫颈内口探查术",null,null,"次",52]
[210,311201013,"子宫内膜活检术",null,null,"次",78]
[211,311201018,"宫腔粘连分离术",null,null,"次",52]
[212,311201020,"妇科特殊治疗","包括外阴、阴道、宫颈等疾患","纳米银妇女外用抗菌器、高价银活性银离子抗菌液、高价银活性银离子抗菌凝胶、壳聚糖宫颈抗菌膜","每个部位",26,"激光、微波、电熨、冷冻等法同价"]
[213,311201023,"产前检查","含测量体重、宫高、腹围、血压、骨盆内外口测量等；不含化验检查和超声检查",null,"次",10]
[214,311201026,"胎心监测",null,null,"次",26]
[215,311201048,"宫内节育器放置术","包括取出术","各类节育器具（计划生育机构免费发放的不得收费）","次",26]
[216,311201050,"刮宫术","含常规刮宫；包括分段诊断性刮宫；不含产后刮宫、葡萄胎刮宫",null,"次",104]
[217,311201053,"人工流产术","含宫颈扩张","一次性宫腔组织流产、吸引管","次",78]
[218,311202011,"新生儿经皮胆红素测定",null,null," 次",6.5]
[219,311501001,"精神科A类量表测查","气质量表、丹佛小儿智能发育筛查表、儿童孤独行为检查量表（19.02.18）",null,"次",39,"测查时间30分钟以内"]
[220,311501003,"精神科C类量表测查","儿童发育量表（PEP）（19.02.25）",null,"次",65,"测查时间60分钟以上"]
[221,311503008,"行为观察和治疗",null,null,"次",13]
[222,311503015,"感觉统合治疗",null,null,"次",26]
[223,311503018,"音乐治疗",null,null,"次",13]
[224,311503022,"听力整合及语言训练",null,null,"次",39,"每次不少于30分钟"]
[225,330100001,"局部浸润麻醉","含表面麻醉",null,"次",18]
[226,330604001,"乳牙拔除术",null,null,"每牙",8.6]
[227,330604002,"前牙拔除术","包括该区段多生牙",null,"每牙",18]
[228,330604003,"前磨牙拔除术","包括该区段多生牙",null,"每牙",24]
[229,330604004,"磨牙拔除术","包括该区段多生牙",null,"每牙",30]
[230,330604005,"复杂牙拔除术","指死髓或牙体治疗后其脆性增加所致的拔除困难",null,"每牙",48]
[231,330604006,"阻生牙拔除术","包括低位阻生、完全骨阻生的牙及多生牙",null,"每牙",120]
[232,330604007,"拔牙创面搔刮术","包括干槽症、拔牙后出血、拔牙创面愈合不良","填塞材料","每牙",30]
[233,330604010,"牙槽骨修整术",null,null,"每牙",60]
[234,330604012,"颌骨隆突修整术","包括腭隆突、下颌隆突、上颌结节肥大等",null,"次",180]
[235,330604013,"上颌结节成形术","不含取皮术","创面用材料、固定材料","次",108]
[236,330604018,"阻生智齿龈瓣整形术","含切除龈瓣及整形",null,"每牙",60]
[237,330604026,"根尖切除术","含根尖搔刮、根尖切除、倒根充、根尖倒预备，不含显微根管手术","充填材料","每牙",180]
[238,330604027,"根尖搔刮术",null,null,"每牙",97]
[239,330604029,"牙龈翻瓣术","含牙龈切开、翻瓣、刮治及根面平整、瓣的复位缝合","牙周塞治","每牙",108]
[240,330604030,"牙龈再生术",null,null,"每组",108]
[241,330604031,"牙龈切除术","包括牙龈切除及牙龈成形","牙周塞治","每牙",48]
[242,330604033,"牙周骨成形手术","含牙龈翻瓣术+牙槽骨切除及成形；不含术区牙周塞治",null,"每牙",60]
[243,330604034,"牙冠延长术","含牙龈翻瓣、牙槽骨切除及成形、牙龈成形；不含术区牙周塞治",null,"每牙",97]
[244,330606001,"系带成形术","包括唇或颊或舌系带成形术",null,"次",108]
[245,331303001,"宫颈息肉切除术","包括子宫内膜息肉、宫颈管息肉；包括宫颈病灶活检术、宫颈赘生物切除术",null,"次",60]
[246,340100001,"红外线治疗","包括远、近红外线：TDP、近红外线气功治疗、红外线真空拔罐治疗红、外线光浴治疗、远红外医疗舱治疗，包括远红外电热理疗、远红外电热理疗仪","　","每个照射区",5,"每区照射不少于20分钟"]
[247,340100009,"低频脉冲电治疗","包括感应电治疗、神经肌肉电刺激治疗、间动电疗、经皮神经电刺激治疗、功能性电刺激治疗、温热电脉冲治疗、微机功能性电刺激治疗",null,"每部位",8]
[248,340100013,"微波治疗","包括分米波、厘米波、毫米波、微波组织凝固、体腔治疗",null,"每部位",10]
[249,340100018,"电子生物反馈疗法","包括肌电、皮温、皮电、脑电、心率各种生物反馈",null,"次",20]
[250,340100028,"多频振动治疗",null,null,"次",40]
[251,340200004,"等速肌力测定",null,null,"每关节",26]
[252,340200005,"手功能评定","包括徒手和仪器",null,"次",13]
[253,340200005,"手功能评定","包括徒手和仪器",null,"次",13]
[254,340200008,"言语能力评定","包括一般失语症检查、构音障碍检查、言语失用检查",null,"次",13]
[255,340200012,"认知知觉功能检查","包括计算定向思维推理检查",null,"次",13]
[256,340200020,"运动疗法","包括全身肌力训练、各关节活动度训练、徒手体操、器械训练、步态平衡功能训练",null,"45分钟/次",13]
[257,340200024,"平衡功能训练",null,null,"次",7.8]
[258,340200025,"手功能训练",null,"支具","次",20]
[259,340200026,"关节松动训练","包括小关节（指关节）、大关节",null,"次",33]
[260,340200028,"文体训练",null,null,"45分钟/次",13]
[261,340200029,"引导式教育训练",null,null,"次",13]
[262,340200029,"引导式教育训练","　","　","次",13]
[263,340200030,"等速肌力训练",null,null,"次",20]
[264,340200031,"作业疗法","含日常生活动作训练","自助具","45分钟/次",20]
[265,340200034,"言语训练",null,null,"30分钟/次",26]
[266,410000003,"中药涂擦治疗","含药物调配","　","10%体表面积",13]
[267,410000004,"中药热奄包治疗","含药物调配","　","每个部位",13]
[268,410000005,"中药封包治疗","含药物调配",null,"每个部位",13]
[269,410000006,"中药熏洗治疗","含药物调配","　","局部",26]
[270,410000007,"中药蒸汽浴治疗","含药物调配",null,"次",39,"每次30分钟"]
[271,410000008,"中药塌渍治疗","含药物调配","　","10%体表面积",13]
[272,420000005,"关节脱位手法整复术",null,null,"次",78]
[273,420000013,"中医定向透药疗法","含仪器使用,药物                                  ","　","部位",32]
[274,430000001,"普通针刺","包括体针、快速针、磁针、金针、姜针、药针等","一次性银针","次",23]
[275,430000003,"手指点穴","　","　","次",15]
[276,430000007,"头皮针",null,null,"次",23]
[277,430000009,"梅花针",null,null,"次",15]
[278,430000011,"埋针治疗","穴位包埋、穴位埋线、穴位结扎分别参照执行",null,"每个穴位",12]
[279,430000016,"电针","包括普通电针、电热针灸、电冷针灸",null,"次",15]
[280,430000021,"放血疗法","包括穴位放血、静脉放血",null,"每个穴位",15]
[281,430000022,"穴位注射","包括穴位封闭、自血疗法","药物","二个穴位",15]
[282,430000023,"穴位贴敷治疗","含药物调配、纳米敷贴等敷贴药物及材料","药物","每个穴位",7.5]
[283,440000001,"灸法","包括艾条灸、艾柱灸、艾箱灸、天灸等","　","次",15]
[284,440000002,"隔物灸法","包括隔姜灸、药饼灸、隔盐灸等","　","次",15]
[285,440000004,"拔罐疗法","包括火罐、电火罐、闪罐、着罐、电罐、磁疗罐、真空拔罐等",null,"3罐",15]
[286,440000005,"药物罐","包括水罐","　","单罐",15]
[287,440000008,"雷火灸","包括太乙神针灸",null,"部位",53]
[288,450000002,"颈椎病推拿治疗",null,null,"次",49]
[289,450000003,"肩周炎推拿治疗",null,null,"次",35]
[290,450000005,"急性腰扭伤推拿治疗",null,null,"次",35]
[291,450000006,"腰椎间盘突出推拿治疗",null,null,"次",63]
[292,450000007,"膝关节骨性关节炎推拿治疗",null,null,"次",35]
[293,450000008,"内科疾病推拿治疗","包括II型糖尿病、慢性胃病、便秘、腹泻、胃下垂、失眠、月经不调、痛经等",null,"次",49,"每次20分钟"]
[294,450000009,"其他推拿治疗","　","　","次",42,"指原发性高血压、冠心病、痛（闭经）等内科、妇科疾病推拿。每次20分钟"]
[295,450000010,"小儿捏脊治疗",null,null,"次",21]
[296,450000012,"脊柱小关节紊乱推拿治疗","含手法理筋治疗和手法调整关节",null,"部位",36,"颈椎、胸椎、腰椎分别计价"]
[297,450000013,"小儿斜颈推拿治疗","含手法理筋治疗和手法调整关节",null,"次",28]
[298,470000012,"刮痧治疗","　","　","每个部位",12]
[299,470000013,"烫熨治疗","　","　","每个部位",12]
[300,480000009,"中医体质辨识","指通过问诊结合“舌面脉信息采集体质辨识系统”收集中医四诊信息，依据中医理论进行辩证分析病因、病位、病性及病机转化，作出体质状态、易患疾病的诊断结果，并提出养生治疗方案。含中医体质养生报告",null,"次",150]
[301,"110100001-b","门诊病历手册",null,null,"册",1]
[302,"110200006-a","普通门诊诊察费","指主治及以下医师提供的普通门诊诊疗服务。",null,"次",10]
[303,"110200006-b","副主任医师门诊诊察费","指由副主任医师在专家门诊提供技术劳务的诊疗服务。",null,"次",15]
[304,"110200006-c","主任医师门诊诊察费","指由主任医师在专家门诊提供技术劳务的诊疗服务。",null,"次",25]
[305,"110200007-a","普通门诊中医辩证论治费","指主治及以下中医或中西医结合医师在中医普通门诊提供的诊疗服务。",null,"次",12]
[306,"110200007-b","副主任医师门诊中医辩证论治费","指由具有副高级职称的中医或中西医结合医师在专家门诊提供的诊疗服务。",null,"次",17]
[307,"110200007-c","主任医师门诊中医辩证论治费","指由具有正高级职称的中医或中西医结合医师在专家门诊提供的诊疗服务。",null,"次",27]
[308,"210102008-a",{"$nulls":3},"片数",2,"使用感绿片加收"]
[309,"210102009-a","咬合片",null,null,"片数",20,"进口胶片"]
[310,"210102015-b","数字化摄影(DR)加收",null,null,"曝光次数",30,"数字化摄影（DR）从第二次曝光开始加收，最多不超过60元"]
[311,"220201001-a","单脏器B超检查",null,null,"次",5,"每增加一个脏器检查加收"]
[312,"250101001-a","血红蛋白测定",null,null,"项",10,"干化学法"]
[313,"250101015-b","血细胞分析",null,null,"次",18,"五分类仪器检测法"]
[314,"250102035-a","尿液分析",null,null,"次",2,"使用抗维生素C试剂条加收"]
[315,"250102035-b","尿碘快速测定",null,null,"项",25,"当场出检测结果"]
[316,"250103004-b","乳糖耐受试验",null,null,"项",35]
[317,"250104014-a","细菌性阴道炎检查","包括唾液酸苷酶、白细胞酯酶、过氧化氢浓度、凝固酶、β-葡萄糖醛酸苷酶、脯氨酸氨基肽酶、乙酰氨基葡萄糖苷酶",null,"次",60,"　本所开展五项收60.00元"]
[318,"250301001-a","血清总蛋白测定",null,null,"项",4,"化学法"]
[319,"250301002-a","血清白蛋白测定",null,null,"项",4,"化学法"]
[320,"250302001-a","葡萄糖测定",null,null,"次",12,"干化学法"]
[321,"250302003-a","糖化血红蛋白测定",null,null,"次",60,"色谱法"]
[322,"250303001-a","血清总胆固醇测定",null,null,"项",4,"化学法、酶法"]
[323,"250303002-a","血清甘油三酯测定",null,null,"项",5,"化学法、酶法"]
[324,"250303005-a","血清低密度脂蛋白胆固醇测定",null,null,"项",4,"其他方法"]
[325,"250304009-a","全血铅测定",null,null,"项",20,"原子法"]
[326,"250305007-b","血清丙氨酸氨基转移酶测定",null,null,"项",5,"速率法"]
[327,"250305008-b","血清天门冬氨酸氨基转移酶测定",null,null,"项",5,"速率法"]
[328,"250305009-b","血清γ-谷氨酰基转移酶测定",null,null,"项",5,"速率法"]
[329,"250305011-b","血清碱性磷酸酶测定",null,null,"项",5,"速率法"]
[330,"250305013-b","血清骨型碱性磷酸酶质量测定","包括骨源性碱性磷酸酶测定",null,"项",30,"干化学法"]
[331,"250306001-a","血清肌酸激酶测定",null,null,"项",5,"速率法"]
[332,"250306005-a","乳酸脱氢酶测定",null,null,"项",5,"速率法"]
[333,"250309001-a","25羟维生素D测定","指定量分析",null,"项",85,"ELISA法"]
[334,"250309003-a","叶酸测定",null,null,"项",40,"化学发光法"]
[335,"250310001-a","血清促甲状腺激素测定",null,null,"项",40,"化学发光法、荧光免疫法"]
[336,"250310002-a","血清泌乳素测定",null,null,"项",45,"化学发光法、荧光免疫法"]
[337,"250310004-a","血清促卵泡刺激素测定",null,null,"项",40,"化学发光法、荧光免疫法"]
[338,"250310005-a","血清促黄体生成素测定",null,null,"项",40,"化学发光法、荧光免疫法"]
[339,"250310010-a","血清甲状腺素(T4)测定",null,null,"项",40,"化学发光法、荧光免疫法"]
[340,"250310011-a","血清三碘甲状原氨酸(T3)测定",null,null,"项",40,"化学发光法、荧光免疫法"]
[341,"250310013-a","血清游离甲状腺素(FT4)测定",null,null,"项",40,"化学发光法、荧光免疫法"]
[342,"250310014-a","血清游离三碘甲状原氨酸(FT3)测定",null,null,"项",40,"化学发光法、荧光免疫法"]
[343,"250310030-a","睾酮测定",null,null,"项",60,"化学发光法、荧光免疫法"]
[344,"250310036-a","雌二醇测定",null,null,"项",60,"化学发光法、荧光免疫法"]
[345,"250310037-a","孕酮测定",null,null,"项",60,"化学发光法、荧光免疫法"]
[346,"250310038-a","血清人绒毛膜促性腺激素测定",null,null,"项",40,"化学发光法、荧光免疫法"]
[347,"250402017-a","抗甲状腺球蛋白抗体测定(TGAb)","　","　","项",35,"化学发光法、荧光免疫法"]
[348,"250403019-a","人免疫缺陷病毒抗体测定(Anti-HIV)",null,null,"项",35,"印迹法、酶免法、干免疫法"]
[349,"250403053-d","梅毒螺旋体特异抗体测定",null,null,"项",25,"ELISA法"]
[350,"250403066-b","人乳头瘤病毒（HPV)分型检测",null,null,"次",300,"最多不超过300元，各种方法同价。"]
[351,"250404001-a","癌胚抗原测定(CEA)",null,null,"项",45,"化学发光法、荧光免疫法"]
[352,"250404002-a","甲胎蛋白测定(AFP)",null,null,"项",40,"化学发光法、荧光免疫法"]
[353,"250404005-a","总前列腺特异性抗原测定(TPSA)",null,null,"项",65,"化学发光法、荧光免疫法"]
[354,"250404006-a","游离前列腺特异性抗原测定(FPSA)",null,null,"项",65,"化学发光法、荧光免疫法"]
[355,"250404009-a","神经元特异性烯醇化酶测定(NSE)",null,null,"项",65,"化学发光法、荧光免疫法"]
[356,"250404010-a","细胞角蛋白19片段测定(CYFRA21-1)",null,null,"项",65,"化学发光法、荧光免疫法"]
[357,"250404011-a","糖类抗原测定","包括CA-27、CA-29、CA-50、CA-125、CA15－3、CA130、CA19－9、CA24－2、CA72－4等等",null,"项",65,"化学发光法、荧光免疫法。CA125、153、199、724四种。"]
[358,"250404015-a","铁蛋白测定",null,null,"项",55,"各种发光法，定量测定"]
[359,"250501009-b","细菌培养及鉴定","含培养、鉴定","　","项",100,"仪器法"]
[360,"250501031-a","衣原体检查",null,null,"项",25,"培养法"]
[361,"250700010-a","唐氏综合症筛查","含孕妇外周血AFP、hcg或F-β-hcg定量测定及唐氏综合症风险率计算",null,"次",110]
[362,"250700010-b","胎儿染色体非整倍体无创基因检测","指高通量基因测序评估21-三体、18-三体、13-三体胎儿",null,"次",1200,"限符合《江苏省临床基因扩增检验技术管理规范（试行）》实验室，且获得卫生计生委高通量基因测序产前筛查与诊断临床应用试点单位开展。"]
[363,"260000001-a","ABO红细胞定型",null,null,"次",5,"血清学法"]
[364,"2702-a","细胞病理学检查与诊断",null,null,"张",10,"每超过1张加收，最高不超过90元。"]
[365,"270300003-a","局部切除组织活检检查与诊断",null,null,"个",10,"超过基价每个加收，最多不超过90元"]
[366,"270800007-a","液基薄层细胞采集术","包括液基薄层细胞制片术",null,"次",150,"液基细胞学薄片技术(Thin Prep)、液基细胞学超薄片技术(Auto Cyte)180元/次，利普细胞特殊处理技术（LPT）120元/次，上述技术限二甲及二甲以上医疗机构开展"]
[367,"310511017-a","根管充填术",null,null,"每根管",42,"使用特殊仪器(螺旋充填器、热牙胶装置等)"]
[368,"310511017-b","根管热塑牙胶垂直加压充填术",null,null,"每根管",75]
[369,"310511019-a","髓腔消毒术",null,null,"每根管",18,"使用特殊仪器(微波仪等)"]
[370,"310513008-a","根面平整术",null,null,"每牙",12,"超声根面平整"]
[371,"310517001-b","冠修复",null,null,"每牙",48,"烤塑冠、塑胶冠"]
[372,"310518001-a",{"$nulls":3},"每牙",24,"每增加牙、卡环加收"]
[373,"310519001-a","拆冠桥",null,null,"每牙",18,"铸造冠拆除"]
[374,"310522018-a","牙周病伴错牙合畸形活动矫治器正畸治疗（重度牙周炎的正畸治疗）",null,null,"次",132,"重度牙周炎的正畸治疗"]
[375,"310522019-a","牙周病伴错牙合畸形固定矫治器正畸治疗（伴开、深覆等疑难病加收）",null,null,"次",42,"伴开、深覆等疑难病加收"]
[376,"310522019-b","牙周病伴错牙合畸形固定矫治器正畸治疗（拔牙矫治加收）",null,null,"次",18,"拔牙矫治加收"]
[377,"310522021-a","牙合创伤正畸治疗（双侧完全性唇腭裂加收）",null,null,"次",96,"双侧完全性唇腭裂加收"]
[378,"310701001-b","常规心电图检查",null,null,"次",36,"十二通道"]
[379,"310701001-c",{"$nulls":3},"次",2.4,"附加导联加收"]
[380,"310904005-a","盆底表面肌电评估",null,null,"次",90,"生物反馈疗法"]
[381,"311201-a","电子阴道镜加收",null,null,"次",100]
[382,"330100002-a","神经阻滞麻醉",null,null,"次",36]
[383,"330604005-a","微创复杂牙拔除术",null,null,"每牙",166]
[384,"340200045-a","营养状况评定",null,null,"次",70,"生物阻抗测量法，不得与诊查费同时收取"]
[385,"340200047-a","全身脂肪分布检测",null,null,"次",52,"非放射性生物阻抗测量方法"]
[386,"340200047-c","下肢肌肉分布检测",null,null,"项",13,"非放射性生物阻抗测量方法"]
[387,"340200047-f","下肢肌肉力均衡性检测",null,null,"项",13,"仪器法"]
[388,"410000003-a","中药涂擦治疗","　","　","次",19,"大于全身体表面积10％"]
[389,"410000006-a","中药熏洗治疗","　","　","半身",32]
[390,"410000006-b","中药熏洗治疗","　","　","全身",45]
[391,"410000007-a","中药蒸汽浴治疗",null,null,"次",6,"超过30分钟加收"]
[392,"410000008-a","中药塌渍治疗","　","　","次",26,"大于全身体表面积10％"]