| 项目编码 | 名称 | 计价单位 | 价格(元) | |
| 1 | D0000001706 | 血管内覆膜支架系统(商品名:GORE VIABAHN)[7mm*10cm VBC071002] | 套 | 26244.00 |
| 2 | D0000001710 | 血管内覆膜支架系统(商品名:GORE VIABAHN)[7mm*15cm VBC071502] | 套 | 32381.00 |
| 3 | D0000001695 | 血管内覆膜支架系统(商品名:GORE VIABAHN)[7mm*2.5cm VBC070202] | 套 | 22710.00 |
| 4 | D0000001689 | 血管内覆膜支架系统(商品名:GORE VIABAHN)[7mm*5cm VBC070502] | 套 | 22710.00 |
| 5 | D0000001701 | 血管内覆膜支架系统(商品名:GORE VIABAHN)[8mm*10cm VBC081002] | 套 | 26244.00 |
| 6 | D0000001709 | 血管内覆膜支架系统(商品名:GORE VIABAHN)[8mm*15cm VBC081502] | 套 | 32381.00 |
| 7 | D0000001696 | 血管内覆膜支架系统(商品名:GORE VIABAHN)[8mm*2.5cm VBC080202] | 套 | 22710.00 |
| 8 | D0000001690 | 血管内覆膜支架系统(商品名:GORE VIABAHN)[8mm*5cm VBC080502] | 套 | 22710.00 |
| 9 | D0000001704 | 血管内覆膜支架系统(商品名:GORE VIABAHN)[9mm*10cm VBC091002] | 套 | 26244.00 |
| 10 | D0000001697 | 血管内覆膜支架系统(商品名:GORE VIABAHN)[9mm*2.5cm VBC090202] | 套 | 22710.00 |
| 11 | D0000001688 | 血管内覆膜支架系统(商品名:GORE VIABAHN)[9mm*5cm VBC090502] | 套 | 22710.00 |
| 12 | D0000000646 | 血管内药物(雷帕霉素)洗脱支架系统[2.5*12] | 付 | 8141.00 |
| 13 | D0000000618 | 血管内药物(雷帕霉素)洗脱支架系统[2.5*15] | 付 | 8141.00 |
| 14 | D0000000617 | 血管内药物(雷帕霉素)洗脱支架系统[2.5*18] | 付 | 8141.00 |
| 15 | D0000000627 | 血管内药物(雷帕霉素)洗脱支架系统[2.5*21] | 付 | 8141.00 |
| 16 | D0000000625 | 血管内药物(雷帕霉素)洗脱支架系统[2.5*24] | 付 | 8141.00 |
| 17 | D0000000645 | 血管内药物(雷帕霉素)洗脱支架系统[2.5*29] | 付 | 8141.00 |
| 18 | D0000000652 | 血管内药物(雷帕霉素)洗脱支架系统[2.5*33] | 付 | 8141.00 |
| 19 | D0000000616 | 血管内药物(雷帕霉素)洗脱支架系统[2.5*36] | 付 | 8141.00 |
| 20 | D0000000642 | 血管内药物(雷帕霉素)洗脱支架系统[2.75*12] | 付 | 8141.00 |