宜宾居民基本医疗保险门诊特殊疾病医疗费用报销范围.docx

1、宜宾居民基本医疗保险门诊特殊疾病医疗费用报销范围宜宾市居民基本医疗保险门诊特殊疾病医疗费用报销范围一、宜宾市居民基本医疗保险门诊特殊疾病药品费用报销范围一类系统性硬化病（硬皮病）药品剂型药品剂型贝诺酯口服常释剂型右旋糖酐注射液吲哚美辛缓释控释剂型泼尼松口服常释剂型缓控释颗粒剂倍他米松口服常释剂型口服常释剂型注射剂栓剂环磷酰胺注射剂地尔硫口服常释剂型甲氨蝶呤注射剂缓释控释剂型口服常释剂型洛索洛芬口服常释剂型青霉胺口服缓释剂型美洛昔康口服常释剂型哌唑嗪口服常释剂型氯诺昔康注射剂硝苯地平口服常释剂型奥美拉唑口服常释剂型缓释控释剂型复方曲马多口服常释剂型地塞米松口服常释剂型曲马多口服常释剂型注射剂缓释

2、控释剂型甲泼尼龙口服常释剂型口服液体剂注射剂注射剂环磷酰胺口服常释剂型去痛片（索米痛）口服常释剂型尼美舒利口服常释剂型泼尼松龙注射剂塞来昔布口服常释剂型口服常释剂型洛芬待因（布洛芬可待因）口服常释剂型安乃近口服常释剂型缓释控释剂型注射剂氨酚羟考酮（对乙酰氨基酚羟考酮）口服常释剂型罗通定注射剂舒芬太尼注射剂妥拉唑啉注射剂来氟米特口服常释剂型青霉胺口服常释剂型吡罗昔康口服常释剂型司坦唑醇口服常释剂型缓释控释剂型酚氨咖敏口服常释剂型芬布芬口服常释剂型白芍总苷口服常释剂型芬太尼注射剂氨酚待因【号、号】口服常释剂型曲安奈德注射剂复方丙氧氨酚口服常释剂型布桂嗪口服常释剂型依地酸钙钠注射剂注射剂舒林酸口服常

3、释剂型草乌甲素口服常释剂型缓释控释剂型氨酚曲马多口服常释剂型萘丁美酮口服常释剂型氢化可的松口服常释剂型缓释控释剂型注射剂氯唑沙宗口服常释剂型苯丁酸氮芥口服常释剂型双氢可待因口服常释剂型可的松口服常释剂型缓释控释剂型氨糖美辛口服常释剂型双氯芬酸凝胶剂酚美愈伪麻口服常释剂型醋氯芬酸口服常释剂型秋水仙碱口服常释剂型氨酚双氢可待因（对乙酰氨基酚双氢可待因）口服常释剂型尼群地平口服常释剂型精氨酸布洛芬颗粒剂曲安西龙注射剂口服散剂口服常释剂型布洛芬口服液体剂羟考酮口服常释剂型缓释混悬剂缓释控释剂型复方丹参颗粒（胶囊、片、滴丸）消栓再造丸消栓通络颗粒（胶囊、片）鳖甲煎丸大黄蟅虫丸（胶囊、片）逐瘀通脉胶囊活血

4、通脉胶囊（片）复方血栓通胶囊、颗粒（片）复方鳖甲软肝片风湿性心脏病药品剂型药品剂型奥美拉唑口服常释剂型卡托普利口服常释剂型青霉素注射剂贝那普利口服常释剂型泼尼松口服常释剂型比索洛尔口服常释剂型辛伐他汀口服常释剂型美托洛尔口服常释剂型滴丸剂缓释控释剂型华法林口服常释剂型普萘洛尔口服常释剂型阿托伐他汀口服常释剂型缓释控释剂型呋塞米口服常释剂型阿替洛尔口服常释剂型地高辛口服常释剂型拉贝洛尔口服常释剂型口服液体剂硫糖铝口服常释剂型阿司匹林口服常释剂型口服液体剂螺内酯口服常释剂型混悬凝胶剂曲美布汀口服常释剂型脑心清胶囊（片）通心络胶囊（片)心脑宁胶囊消栓颗粒（肠溶胶囊）原发性高血压（伴有靶器官损害或临床

5、相关病变）药品剂型药品剂型尼群地平口服常释剂型维拉帕米口服常释剂型硝苯地平口服常释剂型缓释控释剂型缓释控释剂型乐卡地平口服常释剂型地尔硫口服常释剂型非洛地平口服常释剂型缓释控释剂型缓释控释剂型拉西地平口服常释剂型氨氯地平口服常释剂型哌唑嗪口服常释剂型L-门冬氨酸氨氯地平口服常释剂型美托洛尔口服常释剂型左旋氨氯地平口服常释剂型缓释控释剂型贝尼地平口服常释剂型坎地沙坦口服常释剂型普萘洛尔口服常释剂型比索洛尔口服常释剂型缓释控释剂型卡托普利口服常释剂型拉贝洛尔口服常释剂型依那普利口服常释剂型索他洛尔口服常释剂型米诺地尔口服常释剂型西拉普利口服常释剂型吲达帕胺口服常释剂型厄贝沙坦氢氯噻嗪口服常释剂型缓

6、释控释剂型缓释控释剂型地巴唑口服常释剂型氯沙坦钾氢氯噻嗪口服常释剂型氢氯噻嗪口服常释剂型厄贝沙坦口服常释剂型呋塞米口服常释剂型缓释控释剂型螺内酯口服常释剂型缬沙坦口服常释剂型特拉唑嗪口服常释剂型布美他尼口服常释剂型阿司匹林口服常释剂型乌拉地尔口服常释剂型辛伐他汀口服常释剂型缓释控释剂型滴丸剂甲基多巴口服常释剂型阿托伐他汀口服常释剂型阿替洛尔口服常释剂型氟伐他汀口服常释剂型肼屈嗪口服常释剂型普伐他汀口服常释剂型洛伐他汀口服常释剂型瑞舒伐他汀口服常释剂型吲哚美辛缓释控释剂型利血平口服常释剂型缓控释颗粒剂尼卡地平口服常释剂型口服常释剂型缓释控释剂型栓剂可乐定口服常释剂型胞磷胆碱口服常释剂型酚苄明口服

7、常释剂型甲氯芬酯口服常释剂型复方利血平（复方降压片）口服常释剂型多沙唑嗪口服常释剂型缓释控释剂型氨苯蝶啶口服常释剂型复方利血平氨苯蝶啶口服常释剂型阿罗洛尔口服常释剂型硝酸甘油口服常释剂型卡维地洛口服常释剂型舌下片剂阿呋唑嗪口服常释剂型氯吡格雷口服常释剂型缓释控释剂型门冬氨酸钾镁口服常释剂型福辛普利口服常释剂型贝那普利口服常释剂型雷米普利口服常释剂型赖诺普利口服常释剂型培哚普利口服常释剂型咪达普利口服常释剂型阿米洛利口服常释剂型氯沙坦钾口服常释剂型西尼地平口服常释剂型替米沙坦口服常释剂型托拉塞米口服常释剂型珍菊降压片银杏叶口服制剂包括杏灵颗粒（胶囊、片）、银杏叶丸（颗粒、胶囊、片、滴丸、口服液）

8、、银杏叶提取物片（滴剂）、银杏蜜环口服溶液、银杏酮酯滴丸复方罗布麻颗粒（片）清脑降压颗粒（胶囊、片）松龄血脉康胶囊牛黄降压丸（胶囊、片）清肝降压胶囊安宫降压丸脉君安片脑心清胶囊（片）消栓颗粒（肠溶胶囊）心脑宁胶囊糖尿病（伴并发症）药品剂型药品剂型格列本脲口服常释剂型米格列醇口服常释剂型二甲双胍口服常释剂型格列喹酮口服常释剂型缓释控释剂型格列美脲口服常释剂型格列吡嗪口服常释剂型格列齐特口服常释剂型缓释控释剂型缓释控释剂型那格列奈口服常释剂型瑞格列奈口服常释剂型吡格列酮口服常释剂型罗格列酮口服常释剂型阿卡波糖口服常释剂型甘精胰岛素注射剂门冬胰岛素注射剂赖脯胰岛素注射剂重组人胰岛素注射剂动物源胰岛素

9、注射剂地特胰岛素注射剂重组甘精胰岛素注射剂伏格列波糖口服常释剂型依帕司他口服常释剂型贝那普利口服常释剂型阿托伐他汀口服常释剂型硫辛酸注射剂甲钴胺口服常释剂型阿司匹林口服常释剂型参芪降糖颗粒（胶囊、片）糖脉康颗粒（胶囊、片）金芪降糖丸（颗粒、胶囊、片）玉泉丸（颗粒、胶囊、片）降糖宁胶囊消渴丸消渴康颗粒十味玉泉胶囊（片）天芪降糖胶囊芪蛭降糖胶囊（片）津力达颗粒渴络欣胶囊芪明颗粒天麦消渴片脑血管意外后遗症药品剂型药品剂型麦角胺咖啡因口服常释剂型西洛他唑口服常释剂型尼莫地平口服常释剂型己酮可可碱口服常释剂型口服常释剂型缓释控释剂型倍他司汀口服常释剂型托莫西汀口服常释剂型丁咯地尔口服常释剂型辛伐他汀口服

10、常释剂型氟桂利嗪口服常释剂型滴丸剂桂利嗪口服常释剂型阿托伐他汀口服常释剂型尼麦角林口服常释剂型阿米三嗪萝巴新口服常释剂型缓释控释剂型噻氯匹定口服常释剂型双氢麦角胺口服常释剂型华法林口服常释剂型二氢麦角碱口服常释剂型氯吡格雷口服常释剂型缓释控释剂型曲克芦丁口服常释剂型吡拉西坦口服常释剂型口服液体剂甲氯芬酯口服常释剂型双嘧达莫口服常释剂型哌甲酯口服常释剂型茴拉西坦口服常释剂型丁苯酞口服常释剂型颗粒剂阿司匹林口服常释剂型银杏叶口服制剂包括杏灵颗粒（胶囊、片）、银杏叶丸（颗粒、胶囊、片、滴丸、口服液）、银杏叶提取物片（滴剂）、银杏蜜环口服溶液、银杏酮酯滴丸胞磷胆碱口服常释剂型三七皂苷口服制剂包括血塞通

11、片（胶囊、软胶囊）、血栓通胶囊、三七通舒胶囊活络丸复方丹参颗粒（胶囊、片、滴丸）中风回春丸（颗粒、胶囊、片）消栓颗粒（肠溶胶囊）活血通脉胶囊（片）消栓再造丸心脑康胶囊（片）灯盏花素片安脑丸（片）大活络丸（胶囊）人参再造丸脉络宁颗粒（口服液）华佗再造丸利脑心胶囊（片）通心络胶囊（片）脑心通丸（胶囊、片）松龄血脉康胶囊血栓心脉宁胶囊（片）乐脉丸（颗粒、胶囊、片）癫痫苯妥英钠口服常释剂型加巴喷丁口服常释剂型注射剂拉莫三嗪口服常释剂型丙戊酸钠口服常释剂型扑米酮口服常释剂型缓释控释剂型托吡酯口服常释剂型奥卡西平口服常释剂型乙琥胺口服常释剂型口服液体剂口服液体剂卡马西平口服常释剂型左乙拉西坦口服常释剂型缓释控释剂型丙戊酸镁缓释控释剂型肺结核病药品剂型药品剂型异烟肼口服常释剂型对氨基水杨酸钠注射剂注射剂口服常释剂型链霉素注射剂乙胺丁醇口服常释剂型吡嗪酰胺口服常释剂型利福喷汀口服常释剂型利福平口服常释剂型利福霉素注射剂注射剂莫西沙星注射剂阿米卡星注射剂口服常释剂型加替沙星注射剂左氧氟沙星注射剂口服常释剂型口服常释剂型丙硫异烟胺口服常释剂型异福（异烟肼/利福平）口服常释剂型利福布汀口服常释剂型乙胺利福异烟口服常释剂型异福酰胺（异烟肼/利福平/吡嗪酰胺）口服常释剂型乙胺吡嗪利福异烟口服常释剂型帕司烟肼口服常释剂型结核丸益肺胶囊类风湿关节炎药品剂型药品剂型贝诺酯口服常释剂型氢化可的松注射剂吲哚美辛