部分乙类药品个人自付比例目录.docx

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1、部分乙类药品个人自付比例目录序号中文通用名标注剂型自付比例1曲匹布通口服常释剂型02格列喳酮口服常释剂型03格列齐特口服常释剂型04阿法骨化醇口服常释剂型05复合维生素B口服常释剂型06碳酸钙D3口服常释剂型07维生素A口服常释剂型08富马酸亚铁口服常释剂型09利可君口服常释剂型010地巴喋口服常释剂型011可乐定口服常释剂型012烟酸口服常释剂型013曲克芦丁口服常释剂型014非洛地平口服常释剂型015拉西地平口服常释剂型016洛伐他汀口服常释剂型017非诺贝特口服常释剂型018尼尔雌醇口服常释剂型019倍他米松口服常释剂型020泼尼松龙口服常释剂型021琥乙红霉素口服常释剂型022罗红霉素

2、口服常释剂型023乙酰螺旋霉素口服常释剂型024鲨肝醇口服常释剂型025维生素B4（腺喋吟）口服常释剂型026美洛昔康口服常释剂型027复方对乙酰氨基酚口服常释剂型028佐匹克隆口服常释剂型029谷维素口服常释剂型030艘甲司坦口服常释剂型031右美沙芬口服常释剂型032茶茶海明口服常释剂型033酮替芬口服常释剂型034西替利嗪口服常释剂型035毗拉西坦（乙酰胺哦咯烷酮）口服常释剂型036格列齐特II口服常释剂型037维生素B1口服常释剂型038维生素C口服常释剂型039氨咖黄敏胶囊硬胶囊040氨咖黄敏片片剂041复方氨酚烷胺胶囊硬胶囊042复方氨酚烷胺片片剂043复方硫酸双月井屈嗪口服常释剂

3、型044维C银翘片片剂、胶囊、丸剂045芽菊上清丸片剂、胶囊、丸剂046通便灵胶囊片剂、胶囊、丸剂047麻仁丸片剂、胶囊、丸剂048清宁丸片剂、胶囊、丸剂049一清胶囊片剂、胶囊、丸剂050复方益肝灵片片剂、胶囊、丸剂051利胆片片剂、胶囊、丸剂052固本咳喘片片剂、胶囊、丸剂053固肾定喘丸片剂、胶囊、丸剂054咳喘宁片剂、胶囊、丸剂055百合固金丸片剂、胶囊、丸剂056参芭降糖片片剂、胶囊、丸剂057黄杨宁片片剂、胶囊、丸剂058心可舒胶囊片剂、胶囊、丸剂059心可宁胶囊片剂、胶囊、丸剂060大黄蟋虫丸片剂、胶囊、丸剂061加味逍遥丸片剂、胶囊、丸剂062舒肝丸片剂、胶囊、丸剂063颠茄片

4、片剂、胶囊、丸剂064加味左金丸片剂、胶囊、丸剂065王氏保赤丸片剂、胶囊、丸剂066小儿化食丸片剂、胶囊、丸剂067珍菊降压片片剂、胶囊、丸剂068脑立清丸片剂、胶囊、丸剂069大活络丸片剂、胶囊、丸剂070天麻胶囊片剂、胶囊、丸剂071小活络丸片剂、胶囊、丸剂072二妙丸片剂、胶囊、丸剂073胆舒胶囊片剂、胶囊、丸剂074金胆片片剂、胶囊、丸剂075妇炎平胶囊片剂、胶囊、丸剂076辛夷鼻炎丸片剂、胶囊、丸剂077诺迪康胶囊片剂、胶囊、丸剂078更年安胶囊片剂、胶囊、丸剂079仙灵骨葆片片剂、胶囊、丸剂080感冒清热胶囊片剂、胶囊、丸剂081蛤蛤定喘胶囊片剂、胶囊、丸剂082血塞通片片剂、胶

5、囊、丸剂083血塞通胶囊片剂、胶囊、丸剂084血栓通胶囊片剂、胶囊、丸剂085银杏叶胶囊片剂、胶囊、丸剂086银杏叶片片剂、胶囊、丸剂087胃乐宁片片剂、胶囊、丸剂088糠留醇口服常释剂型589硫糖铝口服常释剂型590二甲硅油口服常释剂型591澳丙胺太林口服常释剂型592苯丙醇口服常释剂型593葡醛内酯口服常释剂型594干酵母口服常释剂型595硒酵母口服常释剂型596门冬氨酸钾镁口服常释剂型597碳酸钙口服常释剂型598司坦嗖醇口服常释剂型599阿魏酸哌嗪口服常释剂型5IOO卡络磺钠（肾上腺色腺）口服常释剂型5101单硝酸异山梨酯口服常释剂型5102阿魏酸钠口服常释剂型5103酚不明口服常释剂

6、型5104卡维地洛口服常释剂型5105门冬氨酸氨氯地平口服常释剂型5106贝尼地平口服常释剂型5107西尼地平口服常释剂型5108咪达普利口服常释剂型5109替米沙坦口服常释剂型5110非诺贝特II口服常释剂型5111非诺贝特III口服常释剂型5112吉非罗齐口服常释剂型5113戊酸雌二醇口服常释剂型5114快诺酮口服常释剂型5115快雌醇环丙孕酮口服常释剂型5116甲泼尼龙口服常释剂型5117可的松口服常释剂型5118甲氧苇咤口服常释剂型5119联磺甲氧节咤口服常释剂型5120帕司烟阴（对氨基水杨酸异烟阴）口服常释剂型5121丙硫异烟胺口服常释剂型5122异福（利福平异烟肿）口服常释剂型51

7、23异福酰胺口服常释剂型5124氨肽素口服常释剂型5125氨糖美辛口服常释剂型5126醋氯芬酸口服常释剂型5127舒林酸口服常释剂型5128毗罗昔康口服常释剂型5129蔡普生口服常释剂型5130氨酚待因I口服常释剂型5131氨酚待因II口服常释剂型5132米格来宁口服常释剂型5133罗通定口服常释剂型5134扑米酮口服常释剂型5135氟奋乃静口服常释剂型5136氯普睡吨口服常释剂型5137硫必利口服常释剂型5138硝西泮口服常释剂型5139扎来普隆口服常释剂型5140喋毗坦口服常释剂型5141马普替林口服常释剂型5142桂利嗪口服常释剂型5143哌嗪口服常释剂型5144双羟蔡酸睡喘咤口服常释剂

8、型5145丙卡特罗口服常释剂型5146氯丙那林口服常释剂型5147二羟丙茶碱口服常释剂型5148曲尼司特口服常释剂型5149去氯羟嗪口服常释剂型5150依巴斯汀口服常释剂型5151左西替利嗪口服常释剂型5152安乃近口服常释剂型5153咪达哇仑口服常释剂型5154三磷酸腺首口服常释剂型5155维生素KI口服常释剂型5156林可霉素口服常释剂型5157庆大霉素口服常释剂型5158口引跺美辛口服常释剂型5159布洛伪麻胶囊硬胶囊5160维生素B12口服常释剂型5161辅酶Q1o口服常释剂型5162感冒疏风片片剂、胶囊、丸剂5163小儿至宝丸片剂、胶囊、丸剂5164柴黄胶囊片剂、胶囊、丸剂5165柴

9、黄片片剂、胶囊、丸剂5166复方感冒灵片片剂、胶囊、丸剂5167桑菊感冒片片剂、胶囊、丸剂5168重感灵片片剂、胶囊、丸剂5169参苏胶囊片剂、胶囊、丸剂5170参苏丸片剂、胶囊、丸剂5171六合定中丸片剂、胶囊、丸剂5172大黄通便胶囊片剂、胶囊、丸剂5173大黄通便片片剂、胶囊、丸剂5174麻仁胶囊片剂、胶囊、丸剂5175牛黄清火丸片剂、胶囊、丸剂5176牛黄清胃丸片剂、胶囊、丸剂5177上清丸片剂、胶囊、丸剂5178小儿导赤片片剂、胶囊、丸剂5179冬凌草片片剂、胶囊、丸剂5180活血解毒丸片剂、胶囊、丸剂5181清热散结片片剂、胶囊、丸剂5182清瘟解毒片片剂、胶囊、丸剂5183清瘟解

10、毒丸片剂、胶囊、丸剂5184夏枯草胶囊片剂、胶囊、丸剂5185新清宁片片剂、胶囊、丸剂5186肿节风片片剂、胶囊、丸剂5187清肺抑火片片剂、胶囊、丸剂5188清肺抑火丸片剂、胶囊、丸剂5189利肝隆胶囊片剂、胶囊、丸剂5190利肝隆片片剂、胶囊、丸剂5191乙肝健片片剂、胶囊、丸剂5192茵陈五苓丸片剂、胶囊、丸剂5193香连化滞丸片剂、胶囊、丸剂5194桂附理中丸片剂、胶囊、丸剂5195良附丸片剂、胶囊、丸剂5196温胃舒片片剂、胶囊、丸剂5197乌梅丸片剂、胶囊、丸剂5198二陈丸片剂、胶囊、丸剂5199镇咳宁胶囊片剂、胶囊、丸剂5200克咳片片剂、胶囊、丸剂5201止咳丸片剂、胶囊、丸剂5202牛黄蛇胆川贝胶囊片剂、胶囊、丸剂5203枇杷止咳胶囊片剂、胶囊、丸剂5204清气化痰丸片剂、胶囊、丸剂5205矽肺宁片片剂、胶囊、丸剂5206止咳橘红胶囊片剂、胶囊、丸剂5207止嗽化痰丸片剂、胶囊、丸剂5208复方川贝精片片剂、胶囊、丸剂5209万氏牛黄清心丸片剂、胶囊、丸剂5210金锁固精丸片剂、胶囊、丸剂5211刺五加胶囊片剂、胶囊、丸剂5212刺五加片片剂、胶囊、丸剂5213补脾益肠丸片剂、胶囊、丸剂5214健脾丸片剂、胶囊、丸剂5215启脾丸片剂、胶囊、丸剂5216人参健脾丸