1、头孢替安等药品补充剂型规格最高零售价格表金额:元序号药品通用名剂型规格单位最高零售价备注1头孢替安注射剂500mg瓶46.5仅指执行YBH10162009标准的制剂注射剂1.0g瓶79.02氯普噻吨注射剂2ml:30mg支18.03艾司唑仑注射剂1ml:2mg支15.84氨氯地平滴丸剂5mg*14粒盒58.3滴丸剂5mg*15粒盒62.35奥硝唑分散片250mg*24片盒53.6片剂250mg*8片盒14.36缩宫素注射剂1ml:5单位支12.6生物提取7氯化铵片剂300mg*1000片瓶13.08氯化钠溶液剂500ml塑瓶6.5冲洗剂500ml塑瓶6.5溶液剂3000ml(软袋,双阀)袋25
2、.3冲洗剂3000ml(软袋,双阀)袋25.39氯霉素胶囊剂250mg*100粒瓶17.010丁酸氢化可的松乳膏剂15g:15mg支21.311兰索拉唑肠溶片15mg*12片盒59.5肠溶片15mg*20片盒97.412羟乙基淀粉130/0.4注射剂250ml:15g瓶65.2注射剂500ml:30g瓶113注射剂500ml:30g袋11713阿奇霉素干混悬剂100mg*7袋盒18.6干混悬剂100mg*12袋盒31.3干混悬剂100mg*15袋盒38.814地氯雷他定干混悬剂500mg:2.5mg*10袋盒28.8干混悬剂500mg:2.5mg*14袋盒39.815尼莫地平胶囊剂20mg*3
3、0粒盒18.1海南普利制药有限公司16萘普生片剂125mg*100片瓶14.117维A酸乳膏剂25g:6.25mg支16.618利培酮口腔崩解片1mg*30片盒86.519阿伐斯汀胶囊剂8mg*20粒盒30.120维胺酯胶囊剂25mg*60粒盒70.121重组人干扰素2b注射剂1ml:100万IU支21.4注射剂1ml:300万IU支51.0注射剂1ml:500万IU支75.922氢化泼尼松(泼尼松龙)注射剂2ml:10mg(可供静脉注射)支29.223泮托拉唑肠溶胶囊40mg*10粒盒91.4肠溶胶囊40mg*20粒盒178肠溶片40mg*28片盒24724氟罗沙星片剂100mg*16片盒4
4、1.1注射剂100mg(冻干粉)瓶23.0注射剂100ml:400mg塑瓶74.225玻璃酸钠滴眼剂10mg:10ml支74.126吡贝地尔缓释片50mg*30片盒101施维雅（天津）制药有限公司27溴己新注射剂100ml:4mg瓶39.028重组人粒细胞刺激因子注射剂75ug:0.3ml支357麒麟鲲鹏(中国)生物药业有限公司注射剂150ug:0.6ml支731注射剂300ug:1.2ml支935注射剂300ug:0.9ml(预充式)支39929多西环素肠溶胶囊(微丸)100mg*20粒盒50.7注射剂100mg(冻干粉)瓶87.630脂肪乳中链及长链复合剂注射剂500ml:50g(10%)
5、瓶136贝朗公司31氧氟沙星滴耳剂10ml:30mg支10.332富马酸喹硫平片剂25mg*20片盒156阿斯利康制药有限公司(进口分包装)片剂200mg*20片盒278片剂300mg*20片盒37933戈舍瑞林植入剂3.6mg支236334复方对乙酰氨基酚片剂12片盒1.8片剂100片瓶7.835二硫化硒洗剂10g:0.25g瓶3.7洗剂150g:3.75g瓶29.136硝苯地平缓释片()10mg*48片盒20.737尼美舒利分散片100mg*30片盒70.3分散片50mg*30片盒41.4颗粒剂25mg*10袋盒7.838单硝酸异山梨酯缓释胶囊()40mg*10粒盒24.9片剂20mg*6
6、0片盒57.539环丙沙星栓剂200mg*5枚盒15.0滴眼剂8ml:24mg支7.240倍他司汀注射剂250ml:20mg瓶4.541吡格列酮口腔崩解片15mg*10片盒45.1口腔崩解片15mg*12片盒53.8口腔崩解片15mg*20片盒88.0口腔崩解片15mg*30片盒13042布美他尼注射剂2ml:1mg支22.843云芝胞内糖肽胶囊剂500mg*36粒盒10544葡醛酸钠注射剂0.133g(冻干粉)瓶3.745三磷酸腺苷肠溶片20mg*24片盒2.846奈福泮片剂20mg*48片盒25.3片剂20mg*100片盒51.347哈西奈德涂膜剂10g:10mg瓶9.148重组人生长激素
7、注射剂8单位(冻干粉)瓶19049重组人红细胞生成素注射剂2000IU:0.4ml(预充式)支43.0注射剂3000IU:0.6ml(预充式)支57.0注射剂4000IU:0.8ml(预充式)支70.0注射剂5000IU:0.5ml(预充式)支79.6注射剂6000IU:0.6ml(预充式)支93.0注射剂2500IU:1ml支45.1注射剂5000IU:1ml支76.650氨基葡萄糖片剂250mg*24片盒60.051双歧杆菌三联活菌肠溶胶囊210mg*24粒盒32.4片剂0.5g*24片盒29.152四环素眼膏剂2g支0.7053丙酸氯倍他索搽剂10ml支6.054尼麦角林片剂5mg*36
8、片盒39.0片剂10mg*36片盒66.355重组人白介素-2注射剂100万IU:0.8ml(预充式)支153注射剂100万IU:0.8ml支150注射剂50万IU:0.4ml支87.056美罗培南注射剂250mg瓶93.2注射剂500mg瓶16057羧甲司坦口服溶液剂10ml:500mg*6支盒17.458泛昔洛韦颗粒剂125mg*12袋盒63.6颗粒剂125mg*8袋盒43.059右旋糖酐铁片剂25mg*40片盒35.6片剂25mg*60片盒45.7片剂50mg*20片盒27.060倍氯米松气雾剂250ug*200揿瓶10661高渗羟乙基淀粉200/0.5注射剂250ml:羟乙基淀粉200
9、/0.515g与氯化钠18g袋38862克拉霉素颗粒剂100mg*6袋盒14.463托瑞米芬片剂60mg*14片盒11564布洛芬缓释混悬剂50ml(100ml:3g)盒23.1缓释混悬剂60ml(100ml:3g)盒27.565咪康唑阴道泡腾片200mg*8片盒26.5阴道泡腾片200mg*12片盒39.266天麻素注射剂100mg (冻干粉)盒9.5注射剂200mg (冻干粉)盒16.167木糖醇注射剂250ml:12.5g袋12.268吲达帕胺片剂2.5mg*36片盒24.469头孢克肟干混悬剂50mg*12袋盒50.1胶囊剂50mg*14粒盒37.3胶囊剂50mg*16粒盒42.5胶囊
10、剂50mg*18粒盒47.6胶囊剂50mg*20粒盒52.670复方雷尼替丁胶囊剂12粒盒26.8胶囊剂24粒盒52.3片剂12片盒26.871非诺贝特胶囊剂()100mg*12粒盒28.6胶囊剂()100mg*20粒盒46.872甲氯芬酯胶囊剂200mg*18粒盒26.173甲硝唑注射剂0.915g瓶4.174两性霉素B脂质体注射剂50mg（冻干粉）瓶103975果糖二磷酸钠注射剂50ml:5g袋48.876甲氨蝶呤注射剂50ml:5.0g瓶618注射剂5ml:50mg支17.677大蒜素肠溶胶丸20mg*24粒盒20.478铝碳酸镁颗粒剂2g:500mg*24袋盒27.579加兰他敏分散片4mg*14片盒65.680消旋山莨菪碱注射剂1ml:5mg支0.5
