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[]
["江门市基本医疗保险门诊特定病种服务资格申请表"]
["申请单位（盖章）：开平正信中医诊所"]
["序号","病种名称","申请资格"]
[null,null,"诊断\n（待遇认定）","治疗"]
[1,"高血压病","□","R"]
[2,"糖尿病","□","R"]
[3,"冠心病","□","R"]
[4,"慢性心功能不全","□","R"]
[5,"脑血管疾病后遗症","□","R"]
[6,"帕金森病","□","R"]
[7,"癫痫","□","R"]
[8,"支气管哮喘","□","R"]
[9,"慢性阻塞性肺疾病","□","R"]
[10,"肺动脉高压","□","R"]
[11,"肝硬化","□","R"]
[12,"慢性乙型肝炎","□","R"]
[13,"丙型肝炎（HCVRNA阳性）","□","R"]
[14,"艾滋病","□","□"]
[15,"活动性肺结核","□","□"]
[16,"耐多药肺结核","□","□"]
[17,"类风湿关节炎","□","R"]
[18,"强直性脊柱炎","□","R"]
[19,"多发性硬化","□","R"]
[20,"骨髓纤维化","□","R"]
[21,"系统性红斑狼疮","□","R"]
[22,"再生障碍性贫血","□","□"]
[23,"骨髓增生异常综合症","□","□"]
[24,"血友病","□","□"]
[25,"地中海贫血（海洋性贫血或珠蛋白生成障碍性贫血）","□","R"]
[26,"C型尼曼匹克病","□","□"]
[27,"肢端肥大症","□","□"]
[28,"银屑病","□","R"]
[29,"克罗恩病","□","□"]
[30,"溃荡性结肠炎","□","□"]
[31,"湿性年龄相关性黄斑变性","□","□"]
[32,"糖尿病黄斑水肿","□","□"]
[33,"脉络膜新生血管","□","□"]
[34,"视网膜静脉阻塞所致黄斑水肿","□","□"]
[35,"精神分裂症","□","□"]
[36,"分裂情感性障碍","□","□"]
[37,"持久的妄想性障碍（偏执性精神病）","□","□"]
[38,"双相（情感）障碍","□","□"]
[39,"癫痫所致精神障碍","□","□"]
[40,"精神发育迟滞伴发精神障碍","□","□"]
[41,"心脏移植术后抗排异治疗","□","□"]
[42,"肝脏移植术后抗排异治疗","□","□"]
[43,"肺脏移植术后抗排异治疗","□","□"]
[44,"肾脏移植术后抗排异治疗","□","□"]
[45,"造血干细胞移植后抗排异治疗","□","□"]
[46,"慢性肾功能不全（非透析治疗）","□","R"]
[47,"慢性肾功能不全（血透治疗）","□","□"]
[48,"慢性肾功能不全（腹透治疗）","□","□"]
[49,"恶性肿瘤（非放化疗）","□","R"]
[50,"恶性肿瘤（化疗，含生物靶向药物、内分泌治疗、免疫治疗）","□","R"]
[51,"恶性肿瘤（放疗）","□","R"]
[52,"新冠肺炎出院患者门诊康复治疗","□","R"]
[53,"重型β地中海贫血","□","□"]
[54,"小儿脑性瘫痪（含0-3岁精神运动发育迟缓儿童）","□","□"]
[55,"精神病（重性精神疾病除外）","□","□"]
[56,"其他器官移植术后抗排异治疗","□","□"]
[57,"儿童孤独症","□","□"]
["备注：请在申请开展的门诊特定病种对应的“申请资格栏□“中打√”。"]