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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）：开平市三埠街道办事处社区卫生服务中心、开平市长沙街道办事处社区卫生服务中心、开平市月山镇卫生院、开平市沙塘镇卫生院、开平市苍城镇中心卫生院、开平市龙胜镇卫生院、开平市大沙镇卫生院、开平市马冈镇卫生院、开平市塘口镇卫生院、开平市赤坎镇中心卫生院、开平市百合镇卫生院、开平市蚬冈镇卫生院、开平市金鸡镇卫生院、开平市赤水镇卫生院\n"]
["序号","病种名称","申请资格"]
[null,null,"诊断\n（待遇认定）","治疗"]
[1,"精神分裂症","□","R"]
[2,"分裂情感性障碍","□","R"]
[3,"持久的妄想性障碍（偏执性精神病）","□","R"]
[4,"双相（情感）障碍","□","R"]
[5,"癫痫所致精神障碍","□","R"]
[6,"精神发育迟滞伴发精神障碍","□","R"]
[7,"精神病（重性精神疾病除外）","□","R"]