{"text_format":"3","workbook":"xlsx","n_sheets":1,"sheets":["机构反馈表"],"read":"whole","date_system":"1900"}

{"sheet":"机构反馈表","index":0,"n_rows":31,"n_cols":10,"rows_kept":31,"merged":[[0,0,0,9],[1,0,1,3],[1,6,1,9],[29,0,29,1],[29,3,29,5],[29,8,29,9],[30,0,31,9]]}
["定点医药机构价格预警处置调价与结果反馈情况表"]
["填报单位（盖章）：",{"$nulls":5},"预警时段：       年    月"]
["序号","药品（耗材、医疗服务）通用名","国家编码","规格型号","生产厂家","当前挂网价（同地市民营医疗机构销售平均价、同地市同级公立医疗机构同编码医疗服务项目价格）","调价前价格（元）","调价后价格（元）","调价幅度（%）=（调价后价格-  调价前价格）/  调价前价格","备注"]
["一","定点药店因“医药机构量价比较指数过高”调价与结果反馈情况"]
["（一）","药品调价情况"]
[1,"按调价项目逐项填写"]
[2]
["（二）","耗材调价情况"]
[1,"按调价项目逐项填写"]
[2]
["二","定点民营医疗机构因“医药机构量价比较指数过高”调价与结果反馈情况"]
["（一）","药品调价情况"]
[1,"按调价项目逐项填写"]
[2]
["（二）","耗材调价情况"]
[1,"按调价项目逐项填写"]
[2]
["三","定点民营医疗机构因“民营医疗机构药品销售价格与挂网价格差异过大”调价与结果反馈情况"]
[1,"按调价项目逐项填写"]
[2]
["四","定点民营医疗机构因“民营医疗机构耗材销售价格与挂网价格差异过大”调价与结果反馈情况"]
[1,"按调价项目逐项填写"]
[2]
["五","定点民营医疗机构因“民营医疗机构销售未挂网药品价格过高”调价与结果反馈情况"]
[1,"按调价项目逐项填写"]
[2]
["六","定点民营医疗机构因“民营医疗机构医疗服务项目价格过高”调价与结果反馈情况"]
[1,"按调价项目逐项填写"]
[2]
["负责人签字：",null,null,"负责人联系电话：",{"$nulls":4},"填报时间：       年    月    日"]
["填报说明：\n1、本表由相关定点医药机构填报；\n2、相关定点医药机构收到调价通知后，应于每月25日前完成药品、医用耗材及医疗服务价格调整工作，并将该表电子版及盖章扫描版反馈至所属区市医保局。"]