北京市基本医疗保险社区卫生用药报销范围

编号中文名称英文名称剂型报销限制内容1抗微生物药物1.1抗生素类1.1.1青霉素类1.1.1.1窄谱青霉素甲1青霉素Benzylpenicillin注射剂甲2青霉素VPhenoxymethylpenicillin口服常释剂型甲★(2)青霉素VPhenoxymethylpenicillin颗粒剂甲3苄星青霉素BenzathineBenzylpenicillin注射剂甲4普鲁卡因青霉素ProcaineBenzylpenicillin注射剂1.1.1.2耐青霉素酶青霉素及酶抑制剂甲5苯唑西林Oxacillin注射剂甲6氯唑西林Cloxacillin注射剂1.1.1.3广谱青霉素及复方制剂甲9阿莫西林Amoxicillin口服常释剂型甲10氨苄西林Ampicillin注射剂甲11哌拉西林Piperacillin注射剂甲12阿洛西林Azlocillin注射剂甲13美洛西林Mezlocillin注射剂甲14阿莫西林克拉维酸AmoxicillinandClavulanate口服常释剂型甲15氨苄西林舒巴坦AmpicillinandSulbactam注射剂[适]1.严重感染；2.产酶耐药菌引起的细菌感染。1.1.2头孢菌素1.1.2.1第一代头孢菌素甲21头孢氨苄Cefalexin口服常释剂型甲★(21)头孢氨苄Cefalexin缓释控释剂型甲★(21)头孢氨苄Cefalexin颗粒剂甲22头孢拉定Cefradine口服常释剂型甲★(22)头孢拉定Cefradine注射剂甲23头孢羟氨苄Cefadroxil口服常释剂型甲★(23)头孢羟氨苄Cefadroxil颗粒剂甲24头孢唑林Cefazolin注射剂1.1.2.2第二代头孢菌素甲26头孢呋辛Cefuroxime口服常释剂型甲★(26)头孢呋辛Cefuroxime注射剂甲27头孢克洛Cefaclor口服常释剂型甲★(27)头孢克洛Cefaclor颗粒剂甲★(27)头孢克洛Cefaclor干混悬剂限儿童。1.1.2.3第三代头孢菌素附件北京市基本医疗保险社区卫生用药报销范围一、西药部分分类3编号中文名称英文名称剂型报销限制内容分类甲37头孢曲松Ceftriaxone注射剂1.1.4氨基糖苷类甲50阿米卡星Amikacin注射剂甲51庆大霉素Gentamicin口服常释剂型甲★(51)庆大霉素Gentamicin注射剂甲52妥布霉素Tobramycin注射剂1.1.6四环素类甲58多西环素Doxycycline口服常释剂型甲59四环素Tetracycline口服常释剂型甲60土霉素Oxytetracycline口服常释剂型甲61米诺环素Minocycline口服常释剂型甲★(61)米诺环素Minocycline颗粒剂1.1.7大环内酯类甲62红霉素Erythromycin口服常释剂型甲★(62)红霉素Erythromycin注射剂甲63琥乙红霉素ErythromycinEthylsuccinate口服常释剂型甲★(63）琥乙红霉素ErythromycinEthylsuccinate颗粒剂甲64罗红霉素Roxithromycin口服常释剂型甲65乙酰螺旋霉素Acetylspiramycin口服常释剂型甲66交沙霉素Josamycin口服常释剂型甲67麦迪霉素Midecamycin口服常释剂型甲68克拉霉素Clarithromycin口服常释剂型甲69环酯红霉素ErythromycinCydocarbonate片剂甲70阿奇霉素Azithromycin口服常释剂型甲★(70)阿奇霉素Azithromycin颗粒剂1.1.9林可酰胺类甲75林可霉素Lincomycin口服常释剂型甲★(75)林可霉素Lincomycin注射剂甲76克林霉素Clindamycin口服常释剂型甲★(76)克林霉素Clindamycin注射剂1.1.10其他甲77磷霉素Fosfomycin注射剂甲78多粘菌素B（多粘菌素）PolymyxinB注射剂甲79粘菌素（黏菌素）Colistin口服常释剂型1.2合成抗菌药1.2.1磺胺类甲82复方磺胺甲噁唑CompoundSulfamethoxazole口服常释剂型甲★(82)复方磺胺甲噁唑CompoundSulfamethoxazole注射剂甲83磺胺嘧啶Sulfadiazine口服常释剂型4编号中文名称英文名称剂型报销限制内容分类甲★(83)磺胺嘧啶Sulfadiazine注射剂甲84磺胺嘧啶锌SulfadiazineZinc外用散剂甲★(84)磺胺嘧啶锌SulfadiazineZinc软膏剂甲85磺胺嘧啶银SulfadiazineSilver外用散剂甲★(85)磺胺嘧啶银SulfadiazineSilver软膏剂甲86甲氧苄啶Trimethoprim口服常释剂型甲87联磺甲氧苄啶SulfamethoxazoleSulfadiazineandTrimethoprim口服常释剂型1.2.2喹诺酮类甲88吡哌酸PipemidicAcid口服常释剂型甲89环丙沙星Ciprofloxacin口服常释剂型甲★(89)环丙沙星Ciprofloxacin注射剂甲90诺氟沙星Norfloxacin口服常释剂型甲91氧氟沙星Ofloxacin口服常释剂型甲★(91)氧氟沙星Ofloxacin注射剂甲93洛美沙星Lomefloxacin口服常释剂型甲★(93)洛美沙星Lomefloxacin注射剂甲94培氟沙星Pefloxacin注射剂甲95左氧氟沙星Levofloxacin口服常释剂型甲★(95)左氧氟沙星Levofloxacin注射剂1.2.3硝基咪唑类甲98甲硝唑Metronidazole口服常释剂型甲★(98)甲硝唑Metronidazole注射剂甲99替硝唑Tinidazole口服常释剂型甲★(99)替硝唑Tinidazole注射剂甲100甲硝唑维B6Metronidazoleand　VitaminB6口服常释剂型1.2.4硝基呋喃类甲103呋喃妥因Nitrofurantoin口服常释剂型甲104呋喃唑酮Furazolidone口服常释剂型1.3抗分枝杆菌药1.3.1抗结核病类甲105吡嗪酰胺Pyrazinamide口服常释剂型甲106对氨基水杨酸钠SodiumAminosalicylate口服常释剂型甲★(106)对氨基水杨酸钠SodiumAminosalicylate注射剂甲107利福平Rifampicin口服常释剂型甲★(107)利福平Rifampicin注射剂甲108链霉素Streptomycin注射剂5编号中文名称英文名称剂型报销限制内容分类甲109乙胺丁醇Ethambutol口服常释剂型甲110异烟肼Isoniazid口服常释剂型甲★(110)异烟肼Isoniazid注射剂甲111丙硫异烟胺Protionamide口服常释剂型甲112利福喷丁（利福喷汀）Rifapentine口服常释剂型甲113异烟肼/利福平IsoniazidandRifampicin口服常释剂型甲114异烟肼/利福平/吡嗪酰胺Isoniazid,RifampicinandPyrazinamide口服常释剂型甲115对氨基水杨酸异烟肼AminosalicylateandIsoniazid口服常释剂型1.3.2抗麻风病类甲122氨苯砜Dapsone口服常释剂型1.4抗真菌药1.4.1吡咯类1.4.1.1咪唑类甲126克霉唑Clotrimazole口服常释剂型甲127咪康唑Miconazole口服常释剂型甲★(127)咪康唑Miconazole注射剂1.4.1.2三唑类甲128氟康唑Fluconazol口服常释剂型1.4.2多烯类甲131制霉素Nysfungin口服常释剂型1.4.4其他甲134氟胞嘧啶Flucytosine口服常释剂型甲★(134)氟胞嘧啶Flucytosine注射剂1.5抗病毒药1.5.1广谱类甲137阿昔洛韦Aciclovir口服常释剂型甲★(137)阿昔洛韦Aciclovir注射剂甲138利巴韦林Ribavirin口服常释剂型甲★(138)利巴韦林Ribavirin颗粒剂甲★(138)利巴韦林Ribavirin注射剂甲139阿糖腺苷Vidarabine注射剂甲140泛昔洛韦Famciclovir口服常释剂型1.5.4其他抗病毒药物甲154抗艾滋病用药◇1.6其他甲155小檗碱(黄连素)Berberine口服常释剂型甲157鱼腥草素Houttuyfonate口服常释剂型2抗寄生虫病药2.1抗吸虫病药甲159吡喹酮Praziquantel口服常释剂型2.2抗疟药6编号中文名称英文名称剂型报销限制内容分类甲161伯氨喹Primaquine口服常释剂型甲164氯喹Chloroquine口服常释剂型甲★(164)氯喹Chloroquine注射剂甲171青蒿素类药物◇2.3驱肠虫药甲172甲苯咪唑Mebendazol口服常释剂型甲173氯硝柳胺Niclosamide口服常释剂型甲174双羟萘酸噻嘧啶PyrantelPamoate口服常释剂型甲★(174)双羟萘酸噻嘧啶PyrantelPamoate软膏剂甲175阿苯达唑Albendazole口服常释剂型甲176哌嗪Piperazine口服常释剂型2.4抗丝虫病及抗黑热病药甲★(178)葡萄糖酸锑钠SodiumStibogluconate注射剂3解热镇痛及非甾体抗炎药3.1解热镇痛及非甾体抗炎药甲182阿司匹林Aspirin口服常释剂型甲183布洛芬Ibuprofen口服常释剂型甲★(183)布洛芬Ibuprofen缓释控释剂型乙★(183)布洛芬Ibuprofen口服液体剂费用需由个人部分负担。乙★(183)布洛芬Ibuprofen颗粒剂费用需由个人部分负担。甲★(183)布洛芬Ibuprofen软膏剂限门诊使用。甲★(183)布洛芬Ibuprofen凝胶剂限门诊使用。甲184去痛片（索米痛）CompoundAminopyrinePhenacetinTablets（Somedon）口服常释剂型甲185吲哚美辛Indometacin栓剂甲186安乃近Metamizole口服常释剂型甲187白芍总苷Totalglycosidesofpaeony口服常释剂型甲188吡罗昔康Piroxicam口服常释剂型甲★(188)吡罗昔康Piroxicam缓释控释剂型甲189对乙酰氨基酚Paracetamol口服常释剂型甲★(189)对乙酰氨基酚Paracetamol缓释控释剂型甲★(189)对乙酰氨基酚Paracetamol咀嚼片剂甲★(189)对乙酰氨基酚Paracetamol颗粒剂甲★(189)对乙酰氨基酚Paracetamol口服液体剂甲★(189)对乙酰氨基酚Paracetamol注射剂甲190复方阿司匹林CompoundAspirin口服常释剂型甲191复方氨基比林(复方氨林巴比妥)CompoundAminophenazone(Antondine)注射剂甲192复方对乙酰氨基酚CompoundParacetamol口服常释剂型7编号中文名称英文名称剂型报销限制内容分类甲194氨糖美辛IndometacinandGlucosamine口服常释剂型甲195洛索洛芬Loxoprofen口服常释剂型甲197美洛昔康Meloxicam口服常释剂型甲198萘丁美酮Nabumetone口服常释剂型甲★(198)萘丁美酮Nabumetone缓释控释剂型甲199萘普生Naproxen口服常释剂型甲★(199)萘普生Naproxen缓释控释剂型甲200尼美舒利Nimesulide口服常释剂型甲201舒林酸Sulindac口服常释剂型甲★(201)舒林酸Sulindac缓释控释剂型甲202双氯芬酸Diclofenac口服常释剂型甲★(202)双氯芬酸Diclofenac缓释控释剂型甲★(202)双氯芬酸Diclofenac凝胶剂甲★(202)双氯芬酸Diclofenac软膏剂甲★(185)吲哚美辛Indometacin口服常释剂型甲★(185)吲哚美辛Indomet