附表一27种甲类药品补充剂型规格国家计委制定最高零售.doc

附表一：27种甲类药品补充剂型规格国家计委制定最高零售价格表 单位：元序号原序号名称剂型规格单位初步拟定最高零售价专家建议最高零售价地方建议最高零售价最高零售价备注GMP非GMPGMP非GMPGMP非GMPGMP非GMP11阿莫西林(羟氨苄青霉素)片剂100mg*12片盒3.52.3片剂100mg*24片盒6.84.5片剂125mg*6片盒2.01.5片剂250mg*30片盒16.410.9片剂250mg*36片盒19.613.1片剂250mg*48片盒26.217.4分散片125mg*12片盒10.26.8分散片125mg*24片盒20.013.3胶囊250mg*60粒盒21.614.4胶囊250mg*36粒盒20.013.3胶囊250mg*60粒盒33.523.0胶囊500mg*10粒盒11.37.5颗粒剂125mg*6袋盒6.04.0颗粒剂125mg*18袋盒16.811.2冲剂125mg*15袋盒13.89.0冲剂125mg*18袋盒16.510.8阿莫西林钠(羟氨苄青霉素钠)注射剂2g瓶27.019.322氨苄西林(氨苄青霉素)胶囊125mg*12粒盒4.22.8胶囊125mg*24粒盒8.05.3胶囊250mg*36粒盒19.212.8干混悬剂1.5g/60ml瓶17.411.635青霉素钠注射剂800万单位支6.004.346青霉素V钾片剂250mg*36片盒28.622.057头孢氨苄片剂250mg*20片盒11.79.0缓释片250mg*10片盒19.214.8缓释片250mg*20片盒37.528.8胶囊125mg*30粒盒10.17.8胶囊125mg*10粒*8板盒26.020.0胶囊250mg*20粒盒11.58.8颗粒剂50mg*20袋盒10.58.1颗粒剂125mg*20袋盒13.510.468头孢拉定片剂250mg*12片盒10.88.3片剂250mg*24片盒21.216.3冲剂125mg*12包盒8.86.8干混悬剂125mg*10袋盒11.08.5710头孢唑啉钠注射剂2g支12.08.6811硫酸阿米卡星(丁胺卡那霉素)注射剂100mg/1ml支1.20 0.98 2.00 1.20 1.50 1.10 1.330.95注射剂200mg,冻干粉支4.02.9912硫酸庆大霉素片剂40mg*50片瓶7.05.4干糖浆剂4万单位*10袋盒9.87.5注射剂2万单位/1ml*10支盒3.00 2.50 3.80 3.20 3.00 2.50 2.31.8注射剂4万单位/2ml*10支盒3.22.31013氯霉素片剂250mg*24片盒5.24.0片剂250mg*500片瓶71.555.0胶囊250mg*10粒盒2.21.7胶囊250mg*80粒瓶13.710.51114盐酸四环素片剂50mg*1000片瓶23.418.0片剂125mg*600片瓶21.316.4片剂125mg*1000片瓶40.331.01215盐酸多西环素片剂100mg*24片盒4.83.7胶囊50mg*30粒盒5.64.3胶囊100mg*6粒盒2.21.71316红霉素片剂125mg*12片*5板盒15.612.0片剂250mg*48片盒18.514.2肠溶胶囊125mg*12粒*2板盒13.010.0肠溶胶囊250mg*12粒*2板盒24.719.0注射剂25万单位瓶1.000.751.401.001.401.001.41.0注射剂30万单位瓶1.61.11417盐酸林可霉素片剂250mg*100片瓶26.020.0胶囊150mg*24粒盒5.03.8胶囊250mg*10粒盒3.62.8胶囊250mg*20粒盒7.25.5胶囊250mg*24粒盒8.36.4胶囊250mg*40粒盒13.510.4胶囊500mg*12粒*2板盒15.912.2注射剂20万单位/2ml*10支盒5.63.7注射剂80万单位/2ml*10支盒12.58.9注射剂160万单位/2ml*10支盒21.015.01518复方磺胺甲恶唑注射剂2ml*6支盒5.505.504.605.504.603.92.8片剂400mg/80mg*10片盒2.11.6片剂400mg/80mg*12片袋2.01.5片剂400mg/80mg*12片*2板盒4.83.7片剂400mg/80mg*400片瓶54.642.0片剂400mg/80mg*12片*40板盒96.074.0分散片400mg/80mg*12片盒10.88.3胶囊200mg/40mg*12粒*2板盒3.42.6混悬剂100ml盒4.53.51619磺胺嘧啶片剂500mg*500片瓶52.040.0片剂500mg*1000片瓶101.478.0混悬剂12g/120ml瓶6.55.0混悬剂50g/500ml瓶14.311.01720环丙沙星盐酸盐，乳酸盐片剂200mg*12片盒8.76.7片剂200mg*24片盒16.913.0阴道泡腾片100mg*4片盒7.35.6阴道泡腾片100mg*8片盒14.010.8阴道泡腾片250mg*4片盒9.87.5阴道泡腾片250mg*8片盒18.914.5胶囊200mg*10粒盒6.85.2胶囊200mg*12粒盒8.16.2胶囊200mg*20粒盒12.59.6胶囊200mg*24粒盒15.011.5注射剂100mg/2ml支4.73.4注射剂100mg/5ml支5.03.6注射剂100mg/10ml支5.43.9注射剂200mg/20ml支7.55.41821诺氟沙星胶囊100mg*10粒板1.71.3胶囊100mg*12粒*20板盒33.826.0胶囊100mg*12粒*25板盒42.332.5栓剂200mg*8粒盒26.720.5注射剂200mg/100ml瓶4.33.1注射剂200mg/200ml瓶4.63.3注射剂200mg/250ml瓶4.83.41922氧氟沙星片剂100mg*10片盒7.005.5012.009.507.005.505.94.5胶囊100mg*12粒盒7.65.8胶囊100mg*24粒盒14.811.4胶囊100mg*36粒盒22.117.02023甲硝唑注射剂50mg/10ml*5支盒4.53.2注射剂100mg/20ml*5支盒5.03.6注射剂125mg/250ml瓶4.23.0注射剂500mg/20ml瓶4.02.9片剂200mg*21片*2板盒3.02.3阴道泡腾片200mg*12片盒12.19.3胶囊200mg*12粒*2板盒3.62.802124呋喃妥因(呋喃坦啶)片剂50mg*500片瓶19.515.0片剂100mg*1000片瓶37.729.02225呋喃唑酮片剂10mg*100片瓶1.71.3片剂30mg*100片瓶1.81.42326乌洛托品注射剂40%,5ml*5支盒3.52.5马尿酸乌洛托品片剂500mg*20片盒35.127.0片剂500mg*40片盒67.652.02427盐酸小檗碱(黄连素)片剂25mg*1000片盒45.535.0片剂