住院費用清單

婁底市中心醫(yī)院住院費用總清單,,,,,,,,

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姓名：丁艷清,,,住院號：40089,,,出院科室：精神科,,

病房號：501,,,床位號：2,,,,,

入院日期：2013-09-23,,,出院日期：2013-12-26,,,,,

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項目編碼,,收費項目,,規(guī)格,單位,單價,數(shù)量,金額

639489-ZX,,利培酮,,10mg*6,盒,13.60,5,68.00

100001-a,,神經(jīng)阻滯劑,,250mg,次,6.92,15,373.68

10505401,,血常規(guī),,--,次,10.00,1,10.00

21150006,,血脂四項,,--,次,30.00,1,30.00

12410007,,CT,,--,次,470.00,1,470.00

13140016,,凝血四項,,--,次,20.00,1,20.00

120005-B,,住院診查費,,--,次,4.00,27,108.00

11070001,,取暖費,,--,天,4.00,27,108.00

110901-B,,普通床位費（普通間）,,--,天,30.00,93,324.00

12010004,,二級護理,,--,天,6.60,27,178.20

120006-A,,靜脈輸液（正常）,,--,次,3.30,27,89.10

15060009,,和奧氮平,,75mg*12,盒,13.80,5,69.00

20010006,,啊米替林,,10mg*6,盒,17.80,4,71.20

22030015,,維生素C片,,100mg*100,瓶,5.80,2,11.60

22060041,,維生素C注射液,,1.0g,支,4.62,81,374.22

2501070A,,苯甲酰胺,,100mg*100,瓶,189.62,,

250105-D,,血細胞分析（儀器檢測法）,,--,次,27.50,1,27.50

25010700,,麥普替林,,4mg*18,盒,17.60,4,70.40

208007-B,,過敏原檢測,,--,次,280.00,1,280.00

250365-B,,吩噻嗪,,10g*10,盒,30.50,5,152.50

203002-L,,硫雜蒽,,20ML,支,22.80,54,"1,231.20"

30150006,,丁酰苯,,100mg,瓶,3.20,4,12.80

30150007,,哌泊噻嗪,,100mg,支,21.80,4,87.20

31600001,,氟奮乃靜,,2mg/100片,瓶,59.10,2,87.20

31600001,,氟哌啶醇,,25mg,支,31.20,5,87.20

31600012,,五氟利多,,60mg,支,23.80,3,87.20

31600045,,舒必利,,200mg,瓶,23.30,5,87.20

31600021,,氫溴酸東莨菪堿,,100mg,瓶,78.70,1,87.20

22600031,,三氟拉嗪,,100mg,瓶,78.70,1,87.20

5000022LB-4,,一次性注射器20ML,,威高、新華,支,0.85,54,45.90

5000022LB-5,,一次性輸液器,,山東威高,支,1.05,54,56.70

5000022LB-7,,一次性采血針,,靜脈洪達,支,0.41,2,0.82

5000023LB-6,,真空采血管,,浙江友利,支,1.63,2,3.26