BẢNG GIÁ THUỐC BHYT VÀ DỊCH VỤ

15:53 04/07/2023

(Ban hành kèm theo QĐ số: 01/QĐ-BVMLX ngày 01/01/2023) (Phụ lục 2)

Stt	Tên Thuốc	Hoạt Chất	Hàm lượng	ĐVT	Giá nhập	Giá bán
I. BẢO HIỂM
1	Acetazolamid	Acetazolamid	250mg	Lọ	693	797
2	Agiclovir 200	Aciclovir	200mg	Lọ	340	391
3	Phosphalugel	Aluminum Phosphat	12,38g/gói 20g	Lọ	3,751	4,126
4	Augbidil 625	Amoxicilin + Acid Clavulanic	500mg + 125mg	Lọ	1,699	1,869
5	Klamentin 875/125	Amoxicilin + Acid Clavulanic	875mg + 125mg	Lọ	3,800	4,180
6	Ofmantine-Domesco 625Mg	Amoxicilin + Acid Clavulanic	500mg + 125mg	Viên	1,729	1,902
7	Lumigan 0,3Mg/3Ml	Bimatoprost	0,3mg/3ml	Viên	252,079	264,683
8	Alphagan P	Brimonidin Tartrat	7,5mg/5ml	Viên	103,335	108,502
9	Combigan	Brimonidin Tartrat + Timolol	2mg/ml + 5mg/ml	Viên	183,514	192,690
10	Azopt Drop	Brinzolamid	10mg/ml	Viên	116,700	122,535
11	Azarga	Brinzolamid + Timolol	10mg/ml + 5mg/ml	Viên	310,800	326,340
12	Bronuck Ophthalmic Solution 0.1%	Bromfenac	1mg/mL	Viên	128,000	134,400
13	Agi-Calci	Calci Carbonat + Vitamin D3	1250mg + 200IU	Lọ	840	966
14	Scd Cefaclor 250Mg	Cefaclor	250mg	Viên	3,360	3,696
15	Negacef 250	Cefuroxim	250mg	Lọ	3,340	3,674
16	Ciprofloxacin	Ciprofloxacin	500mg	Lọ	878	1,010
17	Đan Sâm – Tam Thất	Đan Sâm, Tam Thất.	52,5mg +20mg	Viên	576	662
18	Nexium Mups	Esomeprazol	40mg	Viên	22,456	24,028
19	Danapha – Telfadin	Fexofenadin	60mg	Lọ	1,840	2,024
20	Flumetholon 0,1	Fluorometholon	1mg/ml	Lọ	30,072	32,177
21	Diamicron Mr	Gliclazid	30mg	Lọ	2,765	3,042
22	Syseye	Hydroxypropylmethylcellulose	45mg/15ml	Lọ	30,000	32,100
23	Indocollyre	Indomethacin	0,1%	Viên	68,000	72,760
24	Kaldyum	Kali Clorid	600mg	Viên	2,000	2,200
25	Kalium Chloratum Biomedica	Kali Clorid	500 mg	Viên	1,500	1,650
26	Eyaren Ophthalmic Drops	Kali Iodid + Natri Iodid	(3mg+3mg)/1ml; 10ml	Lọ	29,190	31,233
27	Eyexacin	Levofloxacin	25mg/5ml (0,5%)	Lọ	9,849	10,538
28	Cravit 1.5%	Levofloxacin	15mg/ml	Lọ	115,999	121,799
29	Cravit 0.5%	Levofloxacin	25mg/5ml	Lọ	88,515	94,711
30	Medlon 4	Methyl Prednisolon	4mg	Chai	767	882
31	Medrol 16Mg	Methyl Prednisolon	16mg	Chai	3,672	4,039
32	Medrol 4Mg	Methyl Prednisolon	4mg	Chai	983	1,130
33	Moxifloxan 5Mg/Ml Eye Drops Solution	Moxifloxacin	0,5%, 5ml	Lọ	83,000	88,810
34	Moxifloxacin 0,5%	Moxifloxacin	25mg/5ml	Lọ	13,635	14,589
35	Refresh Tears	Natri Carboxymethylcellulose (Natri Cmc)	0,5%	Lọ	64,102	68,589
36	Optive	Natri Carboxymethylcellulose + Glycerin	5mg/ml + 9mg/ml	Viên	82,850	88,650
37	Natri Clorid 0,9%	Natri Clorid	0,9%/10ml	Tuýp	1,210	1,331
38	Nước Muối Sinh Lý Natri Clorid 0,9 %	Natri Clorid	0,9%,1000ml	Lọ	9,072	9,707
39	Nước Muối Sinh Lý Natri Clorid 0,9 %	Natri Clorid	0,9%,500ml	Viên	6,153	6,584
40	Diquas	Natri Diquafosol	30mg/ml	Gói	129,657	136,140
41	Vitol	Natri Hyaluronat	21.6mg/12ml (0,18%)	Gói	53,000	56,710
42	Sanlein 0,1	Natri Hyaluronat	1mg/ml	Gói	56,901	60,884
43	Nifedipin T20 Retard	Nifedipin	20mg	Gói	555	638
44	Oflovid Ophthalmic Ointment	Ofloxacin	0,3%	Viên	74,530	79,747
45	Olevid	Olopatadin Hydroclorid	2mg/ml	Viên	88,000	94,160
46	Hapacol 325	Paracetamol (Acetaminophen)	325mg	Viên	190	219
47	Hapacol 150	Paracetamol (Acetaminophen)	150mg	Lọ	870	1,001
48	Hapacol 250	Paracetamol (Acetaminophen)	250mg	Lọ	1,490	1,639
49	Agimol 80	Paracetamol (Acetaminophen)	80mg	Ống	289	332
50	Acepron 250 Mg	Paracetamol (Acetaminophen)	250mg	Lọ	335	385
51	Panalganeffer 500	Paracetamol (Acetaminophen)	500mg	Chai	533	613
52	Partamol Tab	Paracetamol (Acetaminophen)	500mg	Chai	480	552
53	Dopagan 500Mg	Paracetamol (Acetaminophen)	500mg	Lọ	226	260
54	Alegysal	Pemirolast Kali	1mg/ml	Lọ	76,760	82,133
55	Kary Uni	Pirenoxin	0,25mg/5ml	Lọ	30,294	32,415
56	Novotane Ultra	Polyethylen Glycol + Propylen Glycol	(0.4%+0.3%) -5ml	Lọ	45,000	48,150
57	Systane Ultra 5Ml	Polyethylen Glycol + Propylen Glycol	0,4%+0,3%	Tuýp	60,100	64,307
58	Povidone	Povidon Iodin	10%/125ml	Lọ	10,500	11,235
59	Pred Forte	Prednisolon Acetat (Natri Phosphate)	1% w/v (10mg/ml)	Lọ	31,762	33,985
60	Taflotan	Tafluprost	0,015mg/ml	Lọ	244,799	257,039
61	Timolol Maleate Eye Drops 0.5%	Timolol	5mg/ml	Lọ	42,200	45,154
62	Biracin-E	Tobramycin	0,3%/5ml	Viên	2,856	3,142
63	Tobrex	Tobramycin	3 mg/ml	Viên	39,999	42,799
64	Tobradex	Tobramycin + Dexamethason	3mg/1gram + 1mg/1gram	Viên	49,900	53,393
65	Tobradex	Tobramycin + Dexamethason	3mg/1ml + 1mg/1ml	Viên	45,100	48,257
66	Travatan	Travoprost	0,04mg/ml	Lọ	252,300	264,915
67	Duotrav	Travoprost + Timolol	0,04mg/ml + 5mg/ml	Lọ	320,000	336,000
68	Mydrin-P	Tropicamide + Phenylephrine Hydroclorid	50mg + 50mg	Lọ	67,500	72,225
69	Vitamin A 5000 Iu	Vitamin A	5000UI	viên	249	286
70	Vina-Ad	Vitamin A + D2	2000UI +400UI	viên	576	662
71	Magnesi B6	Vitamin B6 + Magnesi Lactat	5mg + 470mg	viên	117	135
72	Agi-Vitac	Vitamin C	500mg	Viên	140	161
II. DỊCH VỤ
1	A.T Zinc Siro	Zinc Gluconate	10mg/5ml	Ống	4,400	4,840
2	Acetazolamid 250Mg	Acetazolamid 250Mg	250mg	Viên	693	797
3	Acyclovir 200Mg	Acyclovir	200mg	Viên	1,300	1,430
4	Acyclovir 400Mg	Acyclovir	400mg	Viên	2,500	2,750
5	Acyclovir 800Mg	Acyclovir	800mg	Viên	4,000	4,400
6	Acyclovir Cream 5G	Acyclovir	5g	Tube	16,000	17,120
7	Acyclovir Cream 5G	Acyclovir	5g	Tube	17,000	18,190
8	Adapalen + Benzoyl Peroxide	Epiduo 0.1%/2.5% Gel	0,1% + 2,5%; 15g	Lọ	140,600	147,630
9	Adapalene	Differin Cream 0.1%	0,1%; 30g	Tuýp	134,209	140,919
10	Agi Neurin	Vitamin B1 125Mgvitamin B6 125Ngvitamin B12 125Mg		Viên	1,200	1,320
11	Agimepzol	Omeprazol	20mg	Viên	800	920
12	Agimesin7.5	Meloxicam	7.5mg	Viên	750	862
13	Agimetpred 4	Methyl Prednisolon	4mg	Viên	750	863
14	Agimfast 120Mg	Fexofenadin	120mg	Viên	2,300	2,530
15	Agimfast 60Mg	Fexofenadin Hcl	60mg	Viên	1,400	1,540
16	Agimol 150	Paracetamol (Acetaminophen)	150mg	Gói	1,375	1,513
17	Agimol 325	Paracetamol (Acetaminophen)	325mg	Gói	1,450	1,595
18	Agintidin 300Mg	Cimetidin	300mg	Viên	679	781
19	Agirenyl 5000Iu	Vitamin A	5000IU	Viên	430	494
20	Agi-Vitac 500Mg	Vitamin C	500mg	Viên	140	161
21	Aipenxin Ointment	Mupirocin	10g	Tube	69,792	74,677
22	Aklevo 500	Levofloxacin	500mg	Viên	9,000	9,630
23	Alegysal 0.1%	Pemirolast Kali	0.1%,5ml	Lọ	76,759	82,132
24	Alphachymotrypsine Choay	Alphachymotrypsine	4200IU	Viên	2,011	2,212
25	Alphatrypa 4200Iu	Alpha Chymotrypsin	4200IU	Viên	640	736
26	Apisolvat	Clobetasol Propionate	10g	Tube	24,000	25,680
27	Azimax 500	Azithromycin	500mg	Viên	10,500	11,235
28	Azoltel 400	Albendazole	400mg	Viên	4,000	4,400
29	Azopt Drop 1%	Brinzolamid	1%,5ml	Lọ	116,700	122,535
30	Besalicyd 15G	Betamethason + Acid Salicylic	7.5mg +450mg	Tube	18,500	19,795
31	Bicelor 500	Cefaclor Monohydrate	500mg	Viên	8,100	8,667
32	Bronuck Opthalmic Solution 0.1%	Bromfenac	0.1%,5ml	Lọ	127,999	134,399
33	Butidec	Sodium Hyaluronate	5ml	Lọ	36,799	39,375
34	Cefaclor 250	Cefaclor	250mg	Viên	3,360	3,696
35	Cefuroxim 500	Cefuroxim	500mg	Viên	6,000	6,420
36	Cefuroxim 500Mg	Cefuroxim	500mg	Viên	7,500	8,025
37	Cipogip 500Mg	Ciprofloxacin	500mg	Viên	3,538	3,892
38	Clanoz	Loratidin	10mg	Viên	700	805
39	Clarithromycin 500Mg	Clarithromycin	500mg	Viên	5,500	5,885
40	Combigan	Brimonidin Tartrat + Timolol	2mg/ml + 5mg/ml	Lọ	183,514	192,689
41	Cravit 0.5%	Levofloxacin	0.5%,5ml	Lọ	88,515	94,711
42	Cravit 1.5%	Levofloxacin	1.5%,5ml	Lọ	115,999	121,799
43	Daivobet	Calcipotriol + Betamethasone	50mcg/g + 0,5mg/g	Tube	288,750	303,188
44	Daivonex	Calcipotriol	50mcg/g	Tube	300,300	315,315
45	Diamicron Mr 30Mg	Gliclazid	30mg	Viên	2,765	3,042
46	Diquas	Natri Diquafosol	30mg/ml	Lọ	129,656	136,139
47	Doxycyclin	Doxycyclin	100mg	Viên	940	1,081
48	Dropstar	Levofloxacin	0.5%,10ml	Lọ	60,000	64,200
49	Duotrav	Travoprost+Timolol	0,04mg/ml + 5mg/ml	Lọ	320,000	336,000
50	Emanera 20Mg	Esomeprazole	20mg	Viên	8,925	9,550
51	Eporon	Fluorometholon	5ml	Lọ	25,282	27,052
52	Eyaren	Potassium Iodide + Sodium Iodide	10ml	Lọ	36,750	39,323
53	Eyexacin	Levofloxacin	0.5%,5ml	Lọ	9,849	10,538
54	Eytanac	Diclofenac Sodium	10ml	Lọ	47,250	50,558
55	Fabafixim 200	Cefixim	200mg	Viên	7,300	7,811
56	Farinceft-500Mg	Cefuroxim	500mg	Viên	8,150	8,721
57	Fexofenadin 60	Fexofenadin	60mg	Viên	1,200	1,320
58	Fexoviphat 180	Fexofenadine Hydrochloride	180mg	Viên	1,667	1,833
59	Flumetholon 0.1	Flumetholon	0.1%,5ml	Lọ	30,072	32,177
60	Fucicort	Acid Fucidic + Betamethasone	15g	Tube	98,340	105,224
61	Fucidin	Acid Fusidic	15g	Tube	75,075	80,330
62	Fucidin H	Acid Fusidic + Hydrocortisione Acetate	15g	Tube	97,129	103,928
63	Fucipa 2% 10G	Acid Fusidic	2%,10g	Tube	30,000	32,100
64	Fucipa-B 10G	Acid Fusidic + Betamethason	10g	Tube	33,000	35,310
65	Fucipa-B 5G	Acid Fusidic + Betamethason	5g	Tube	22,500	24,075
66	Galobar Tab	Ginko Biloba	80mg	Viên	3,800	4,180
67	Gilovit	Ginko Biloba + Vitamin B1 + Vitamin B6	40mg	Viên	2,300	2,530
68	Ginkokup 40	Ginko Biloba	40mg	Viên	2,600	2,860
69	Hafixim 100 Kids	Cefixim	100mg	Gói	3,780	4,158
70	Hafixim 50 Kids	Cefixim	50mg	Gói	2,376	2,614
71	Hameron	Sodium Hyaluronate	5mg/5ml	Lọ	43,800	46,866
72	Iana 0.1%	Sodium Hyaluronate	0.1%,10ml	Lọ	115,500	121,275
73	Iba-Mentin 1000Mg/62.5Mg	Amoxicillin Trihydrat + Acid Clavulanic	1000mg + 62.5mg	Viên	15,981	17,100
74	Imexofen 180	Fexofenadin	180mg	Viên	3,990	4,389
75	Immulimus 0.03%	Tacrolimus	10g	Tube	80,000	85,600
76	Immulimus 0.1%	Tacrolimus	10g	Tube	88,000	94,160
77	Indocollyre	Indomethacin	0.1%,5ml	Lọ	67,999	72,759
78	Jasunny 50G	Ketoconazol + Clobetasol Propionate	50g	Tube	55,000	58,850
79	Jasunny K 10G	Ketoconazol	10g	Tube	16,000	17,120
80	Kaleorid 600Mg	Kali Clorid	600mg	Viên	2,300	2,530
81	Kali Clorid	Kali Clorid	500mg	Viên	700	805
82	Kary Uni	Pirenoxine	5ml	Lọ	30,294	32,414
83	Kefcin 125	Cefaclor	125mg	Gói	1,696	1,865
84	Kefcin 125Mg	Cefaclor	125mg	Gói	1,623	1,785
85	Ketofen	Ketotifen Fumarat	0.5mg,5ml	Lọ	25,000	26,750
86	Laci-Eye 10Ml	Hydroxypropyl Methylcellulose	10ml	Lọ	24,900	26,643
87	Lacrifresh Moisture Unidose	Sodium Hyaluronate	0.1%	Tép	9,155	9,796
88	Letdion	Levofloxacin	0.5%,5ml	Lọ	84,000	89,880
89	Logpatat	Retinyl Acetate 2500I.U, Pyridoxine 25Mg, L-Citrulline 10Mg…		Viên	3,900	4,290
90	Lucentis 2.3Mg	Ranibizumab	2.3mg	Hộp	13,125,020	13,387,520
91	Lumigan 0.3Mg/3Ml	Bimatoprost	0.3mg/3ml	Lọ	252,079	264,683
92	Magisix	Magnesi Lactat Dihydrat + Pyridoxin Hydroclorid	470mg + 5mg	Viên	500	575
93	Mecefix-B.E 50	Cefixim	50mg	Gói	4,300	4,730
94	Mecefix-B.E 75	Cefixim	75mg	Gói	5,700	6,099
95	Medrol 16Mg	Methyl Prednisolon	16mg	Viên	3,672	4,039
96	Medrol 4Mg	Methyl Prednisolon	4mg	Viên	983	1,130
97	Medsolu 4Mg	Methyl Prednisolon	4mg	Viên	890	1,024
98	Metformin 500Mg	Metformin	500mg	Viên	800	920
99	Motilium-M 10Mg Tab B/100	Domperidon	10mg	Viên	2,145	2,360
100	Moxifloxan 5Mg/Ml	Moxifloxacin	0,5%, 5ml	Lọ	83,000	88,810
101	Myo Drops	Atropin Sulfat	0.01%,0.4ml	Ống	6,500	6,955
102	Negacef 250	Cefuroxim	250mg	Viên	2,990	3,289
103	Nevanac	Nepafenac	5ml	Lọ	152,999	160,649
104	Newpicetam	Levofloxacin	0.5%,5ml	Lọ	45,800	49,006
105	Nifedipin T20	Nifedipin	20mg	Viên	680	782
106	Novotane Ultra 5Ml	Polyethylen Glycol + Propylen Glycol	(0.4%+0.3%) -5ml	Lọ	45,000	48,150
107	Oflovid Ophthalmic Ointment 0.3%	Ofloxacin	0.3%,5g	Tube	74,529	79,746
108	Ofloxacin 300	Ofloxacin	300mg	Viên	2,835	3,119
109	Olotedin	Olopatadine Hydrochloride	1.11mg/ml 5ml	Lọ	42,000	44,940
110	Para-Api 500	Paracetamol	500mg	Viên	480	552
111	Philevomels	Levofloxacin	0.5%,5ml	Lọ	43,800	46,866
112	Philoclex	Tobramycin + Dexamethason	15mg + 5mg	Lọ	35,999	38,519
113	Philtoberan	Tobramycin	3mg/ml	Viên	34,800	37,236
114	Phosphalugel	Aluminum Phosphat	12,38g/ 20g	Gói	3,751	4,126
115	Posod Eye Drops	Potassium Iodide + Sodium Iodide	10ml	Lọ	32,592	34,873
116	Posod Eye Drops	Potassium Iodide + Sodium Iodide	10ml	Lọ	30,600	32,742
117	Pred Forte 5Ml	Prednisolon Acetat (Natri Phosphate)	5ml	Lọ	31,761	33,985
118	Prednisolon	Prenisolone	5mg	Viên	300	345
119	Prednison 5Mg	Prenisolone	5mg	Viên	398	458
120	Refresh Tears	Natri Carboxymethylcellulose (Natri Cmc)	15ml	Lọ	64,101	68,589
121	Repraz-20	Rabeprazol	20mg	Viên	1,400	1,540
122	Samil-Flurone	Fluorometholone	1mg/ml,5ml	Lọ	28,980	31,009
123	Sancoba	Cyanocobalamin	5ml	Lọ	51,996	55,636
124	Sanlein 0.1	Natri Hyaluronat	0.1%,5ml	Lọ	56,901	60,884
125	Scanax 500	Ciprofloxacin	500mg	Viên	1,140	1,254
126	Scanneuron-Forte	Vitamin B1 250Mgvitamin B6 250Ngvitamin B12 1000Mg		Viên	1,952	2,147
127	Sodyal Protect	Hyaluronic Acid + Ginko Biloba	10ml	Lọ	121,200	127,260
128	Spulit	Itraconazole	100mg	Viên	16,800	17,976
129	Stadeltine	Levocetirizine Dihydrochloride	5mg	Viên	1,000	1,150
130	Superkan-F	Ginko Biloba	80mg	Viên	3,000	3,300
131	Supirocin	Mupirocin	5g	Tuýp	37,500	40,125
132	Syseye 15Ml	Hydroxypropylmethylcellulose	15ml	Lọ	30,000	32,100
133	Systane Ultra 5Ml	Polyethylen Glycol + Propylen Glycol	0,4% + 0,3%	Lọ	60,100	64,307
134	Taflotan	Tafluprost	2.5ml	Lọ	244,800	257,040
135	Tam Thất Opc	Tam Thất	750mg	Viên	6,300	6,741
136	Tanakan	Ginko Biloba	40mg	Viên	4,233	4,656
137	Taptiqom	Tafluprost + Timolol	0.3ml	Tép	12,600	13,482
138	Tearidone Eye Drops	Povidone	5ml	Lọ	35,499	37,984
139	Tezkin 10G	Terbinafin Hydroclorid	10g	Tube	16,000	17,120
140	Tezkin 15Ml	Terbinafin Hydroclorid	15ml	Lọ	22,000	23,540
141	Timolol Maleate Eye Drops 05%	Timolol	0.5%,5ml	Lọ	42,200	45,154
142	Tobradex Drop	Tobramycin + Dexamethason	0.3%+0.1% 5ml	Lọ	47,299	50,610
143	Tobrex Drop 0.3%	Tobramycin	3 mg/ml	Lọ	39,999	42,799
144	Travatan 2.5Ml	Travoprost	2.5ml	Lọ	252,300	264,915
145	Uni-Atropin 0.5%	Atropin Sulfat	0.5%,0.4ml	Ống	12,600	13,482
146	Vataxon	Clobetasol Propionat	15g	Tube	35,000	37,450
147	Vigadexa 5Ml	Moxifloxacin + Dexamethason	5mg/1ml + 1mg/1ml	Lọ	110,600	116,130
148	Vigamox	Moxifloxacin	0.5%,5ml	Lọ	90,000	96,300
149	Vinocyclin 100	Minocyclin	100mg	Viên	14,800	15,836
150	Violevo	Levocetirizin Dihydrochloride	5mg	Viên	735	845
151	Vit Pp 500Mg	Vitamin Pp	500mg	Viên	500	575
152	Vitamin E 400Iu	Vitamin E	400IU	Viên	1,260	1,386
153	Vitol	Natri Hyaluronat	21.6mg/12ml (0.18%)	Lọ	39,000	41,730
154	Xamiol	Calcipotriol + Betamethasone	50mcg + 0.5mg	Tube	282,479	296,603
155	Zanimex 500	Cefuroxim	500mg	Viên	8,800	9,416
156	Zentel	Albendazol	200mg	Viên	6,100	6,527
157	Zinc	Zinc Gluconate	70mg	Viên	680	782
158	Zinc 70	Zinc Gluconate	70mg	Viên	693	797

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