{"text_format":"1","workbook":"xlsx","n_sheets":27,"sheets":["記入前にご一読下さい","①請求書（記載例）","②明細書（記載例）","③明細書(画像診断)（記載例）","①請求書","②明細書","③明細書(画像診断)","②明細書(2人目)","③明細書(画像診断)(2人目)","②明細書(3人目)","③明細書(画像診断)(3人目)","②明細書(4人目)","③明細書(画像診断)(4人目)","②明細書(5人目)","③明細書(画像診断)(5人目)","②明細書(6人目)","③明細書(画像診断)(6人目)","②明細書(7人目)","③明細書(画像診断)(7人目)","②明細書(8人目)","③明細書(画像診断)(8人目)","②明細書(9人目)","③明細書(画像診断)(9人目)","②明細書(10人目)","③明細書(画像診断)(10人目)","11人目以降","Sheet16"],"not_rendered":{"charts":0,"images":0,"macros":1,"external_links":0,"defined_names":24,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"記入前にご一読下さい","index":0,"n_rows":58,"n_cols":1,"rows_kept":58,"cut":false,"hidden":false,"merged":[]}
["お世話になっております。"]
["横浜市役所医療局健康安全課の結核担当です。"]
["日頃から、接触者健康診断及び精密検査業務委託に御協力いただきましてありがとうございます。"]
["これまで、当業務における請求書提出作業について、筆記のみとさせていただいておりましたが、PCを使用した入力方法を追加しました。"]
["今後は、筆記・PC入力のいずれかを選択し、必要事項をご記載のうえ、担当区へご提出いただくようにお願いいたします。"]
["なお、「横浜市保健カード（接触者健康診断）（第１号様式）」、「横浜市精密検査カード（管理健診）（第２号様式）」については、"]
["これまでと取扱いに変更はなく筆記による提出をお願いいたします。"]
[]
[]
["PC入力の場合は下記を参照"]
[]
[]
["◎初めに"]
["・今までの請求書から書式の変更はございますが、内容については変更点はございません。"]
["・PC入力の場合は、下記シートの「②明細書」「③明細書（画像診断）」のうち、"]
["　実施した検査方法に☑を入れていただくことで金額が自動計算される仕組みに変更しております。"]
["・なお、提出についてはこれまでどおり紙による提出となりますので、入力後は出力のうえ、担当区役所へご提出をお願いします。"]
[]
[]
["◎記入必要箇所当注意点"]
["（全体）"]
["・本請求書は、下記シートのうち「①請求書」、「②明細書」「③明細書（画像診断）」の３シートで１セットです。"]
["・２人目以降は、下記シートにある「②明細書（２人目）」「③明細書（画像診断）（２人目）」、「③明細書（３人目）」「③明細書（画像診断）（３人目）」～"]
["　へ記入を行ってください。最大で10人分あります（人数ごとに色分けしてあります）。11人目以降はお手数ですが、改めて請求書の作成をお願いします。"]
["・各シートのうち入力が必要となる欄（セル）については、薄紅色となっています。"]
["・記入が不要となる欄（セル）は、入力制限の設定を掛けております。"]
[]
["（①請求書）"]
["・薄紅色の欄（セル）のみに入力をお願いします。"]
["・契約（実施）医療機関の項目のうち所在地（郵便番号を除く）、名称、代表者役職氏名は全角のみ入力受付が可能です。"]
["・振込先の項目のうち口座名義のフリガナは半角カタカナのみ入力受付が可能です。"]
["・中段あたりの請求日記入欄については請求書を送付する日を入力ください。"]
["・これまでは押印を必須としてきましたが、基本的に押印は不要です。"]
["・請求書下段に記載した注意書のとおり押印は原則不要です。ただし、口座名義人が契約書記載の受諾者と異なる場合には押印下さい。"]
["　その場合、代表者印は、契約書と同一の印を押印してください。"]
[]
["（②明細書）"]
["・薄紅色の欄（セル）のみに入力をお願いします。"]
["・実施した検査内容に応じて、チェック欄の□をクリックいただくことによって☑となり、明細書の一番右列（L列）に金額が加算されます。"]
["　初診料や加算内容等を含めチェックを入れていただくことによって、金額も加算されていきます。"]
["・合計金額は明細書の一番右列（L列）の43行目合計欄に表示されるとともに、１枚目のシート「①請求書」の請求額欄に反映されます。"]
[]
["（③明細書（画像診断））"]
["・薄紅色の欄（セル）のみに入力をお願いします。なお、「②明細書」の22行目「画像診断」をクリックいただくと、「③明細書（画像診断）」へ"]
["　シートを移動できるように設定しております。"]
["・実施した検査内容に応じて、チェック欄の□をクリックいただくことによって☑となり、明細書の一番右列（L列）に金額が加算されます。"]
["・金額は明細書（画像診断）の一番右列（L列）の47行目合計欄に表示されます。"]
["・金額は「②明細書」の22行目の「画像診断」、L列の金額欄へ反映されます。"]
[]
["◎入力後"]
["・上記入力後は、医療機関において、必ず控えをお取りください。"]
["・電子による提出はお手数ですがお控えください。出力後、担当区役所へ「横浜市保健カード（接触者健康診断）（第１号様式）」、"]
["　「横浜市精密検査カード（管理健診）（第２号様式）」のうち、依頼のあったカードと合わせて紙によるご提出をお願いします。"]
["・提出いただいた書類内容を確認後、不備不足等に応じてご連絡させていただくことがあります。"]
[]
["◎その他"]
["ご不明な点がありましたら、横浜市役所医療局健康安全課の結核担当（045-671-2729）へご連絡下さい。"]
["お手数をおかけしますがよろしくお願いします。"]

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["(請求書番号　　　　　　　　)"]
[null,"結核健診等委託料請求書"]
[]
[null,null,null,"※ ￥"]
[]
[null,"ただし、令和７年７月分の結核　　　　　　　 に関する費用として"]
[]
[null,null,"区分",null,"件数","金　　　額",null,"消費税額","合　　計　　額"]
[null,null,"請求額",null,1,{"$f":"+'②明細書（記載例）'!L43","v":13930},null,{"$f":"+F9*0.1","v":1393},{"$f":"+F9+H9","v":15323}]
[null,null,"決定額",null,"※","※",null,"※","※"]
[]
[null,null,"上記のとおり請求します。"]
[]
[null,null,null,null,"令和 ７ 年 ７ 月 ７ 日"]
[null,"契約（実施）医療機関  "]
[null,"所　 在　 地  ",null,"〒　123-456"]
[null,null,null,"横浜市中区〇〇１丁目１"]
[null,null,null,"横浜ビル４Ｆ"]
[null,"名　　　  称",null,"医療法人横浜Ａクリニック"]
[]
[null,"代表者役職氏名\n（請 求 人）",null,"理事長　横浜　太郎"]
[]
[null,"電 話 番 号",null,"tel 045-〇〇〇-1111                 /fax　045-〇〇〇-2222"]
[]
[null,"振込先"]
[null,"振　込　先\n銀　行　名",null,"〇〇〇",null,"銀行 ・ 信用金庫",null,"〇〇",null,"本店","□ 当座\n\n□ 普通"]
[null,null,null,null,null,"信用組合 ・ 農協",null,null,null,"支店"]
[null,null,null,null,null,"労働金庫",null,null,null,"出張所"]
[null,"口　座　番　号",null,null,1,2,3,4,5,6,7]
[null,"口座名義","フリガナ","ｲ)ﾖｺﾊﾏｴ-ｸﾘﾆﾂｸ"]
[]
[null,null,"医療法人横浜Ａクリニック"]
[]
[]
[null,"横 浜 市 長　様",null,null,"（請求人と口座名義人が違う場合、下記に記名押印してください）\n\n◎上記口座へお振り込みください。\n　　　　代表者役職氏名\n　　　　（請 求 人）\n"]
[]
[]
["(注１)※の箇所は記入しないでください。\n(注２)押印は原則不要です。ただし、口座名義人が契約書記載の受諾者と異なる場合には押印下さい。その場合、\n　　　代表者印は、契約書と同一の印を押印してください。\n(注３)医療機関において、必ず控えをお取りください。"]

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["結　核　健　診　等　委　託　料　請　求　明　細　書"]
["（　令　和 ７ 年 ７ 月分）　"]
["医　療　機　関　名　称",null,null,"医療法人横浜Aクリニック"]
["　　接触者健診　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　管理検診"]
["　　 　（保健カード）　　　　  　　　　　　　　　　　　　　　　　　　　　　　　　　　　（管理検診カード）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区"]
["患 者  氏 名\n年齢・性別",null,null,null,null,"　　　　　　　　　　　横浜　花子　　　　　　　　　　　　　満　50　歳　（　　男　・　　女　）　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鶴見"]
["保健・管理\nカード番号",null,null,null,null,null,"福祉保健センター　　　第　　　　　　　　　　号　　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"神奈川"]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西"]
["共通\n\n","初\n診\n料",null,null,true,2910,null,null,"乳幼児加算（６歳未満）",true,750,{"$f":"+SUM(IF(E9,F9,0))+(IF(J9,K9,0))","v":3660},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"中"]
[null,"再\n診\n料","診療所",null,false,750,null,null,"乳幼児加算（６歳未満）",null,380,{"$f":"+SUM(IF(E10,F10,0)+(IF(E11,F11,0)+(IF(E12,F12,0)+(IF(J11,K10,0)))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旭"]
[null,null,"病　院\n(200床未満)",null,false,750,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"磯子"]
[null,null,"病 　院\n(200床以上)\n『外来診療料』",null,false,760,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金沢"]
[null,"往診料",null,null,false,7200,null,null,null,null,null,{"$f":"+SUM(IF(E13,F13,0)+(IF(J14,K14)+(IF(J15,K15,0)+(IF(J17,K17,0)+(IF(J19,K19)+(IF(J21,K21,0)))))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"港北"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"青葉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都筑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"戸塚"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"栄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"泉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"瀬谷"]
[]
["画像診断",null,null,null,null,null,null,null,null,null,null,{"$f":"+'③明細書(画像診断)（記載例）'!L47","v":2100},null,null,"　"]
["ツベルクリン\n反 応 検 査","皮内反応検査料＋\n精製ツベルクリン\n(薬価･一般診断用0.25ug)",null,null,false,"（新生児）",null,"・[皮内反応検査料]＋[精製ツベルクリン(薬価･一般診断用0.25ug)]\n　　精製ツベルクリン薬剤料（点数）　274点（2,735円を五捨五超入）\n   　160円＋2,735円＝2,900円（10円未満を四捨五入）\n　★検査料に係る加算\n　　新生児加算　　…　100分の100を加算\n　　３歳未満乳幼児加算…100分の70を加算\n\n*新生児のツベルクリン反応検査\n　160円×2.0＋2,735円＝3,055円（10円未満を四捨五入）3,060円\n *３歳未満乳幼児のツベルクリン反応検査\n　160円×1.7＋2,735円＝3,007円（10円未満を四捨五入）3,010円",null,null,null,{"$f":"+SUM(IF(E23,F24,0)+(IF(E25,F26,0)+(IF(E27,F28,0))))","v":0}]
[null,null,null,null,null,3060]
[null,null,null,null,false,"（３歳未満）"]
[null,null,null,null,null,3010]
[null,null,null,null,false,"（３歳以上）"]
[null,null,null,null,null,2900]
["T-スポット.TB検査","検　　査　　料",null,null,false,"（６歳未満）",null,"・[検査料]＋[採血採取]\n　　5,930円＋　400円＝6,330円\n　★血液採取に係る加算\n　　６歳未満の乳幼児に対して行った場合：350円加算\n\n・QFT検査を実施した場合、同額を算定できる。",null,null,null,{"$f":"+SUM(IF(E29,F30,0)+(IF(E31,F32,0)+(IF(E33,F33,0)+IF(E34,F34,0))))","v":8170}]
[null,null,null,null,null,6680]
[null,null,null,null,true,"（６歳以上）"]
[null,null,null,null,null,6330]
[null,"検体検査判断料",null,null,true,1440,null,"・検査の種類、回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,true,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["喀痰検査","検査料","塗抹",null,false,670,null,"・１回の検査で、どちらかひとつを算定",null,null,null,{"$f":"+SUM(IF(E35,F35,0)+IF(E36,F36,0)+IF(E37,F38,0)+IF(E39,F40,0)+IF(E41,F41,0)+IF(E42,F42,0))","v":0}]
[null,null,"蛍光",null,false,500]
[null,null,"培養",null,false,"（液体培地法）",null,"・請求時は、「液体培地法」又は「それ以外」と記載をしてください。"]
[null,null,null,null,null,3000]
[null,null,null,null,false,"（それ以外）"]
[null,null,null,null,false,2090]
[null,"検体検査判断料",null,null,false,1500,null,"・検査の種類・回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["合　　　　　　　　　計",null,null,null,null,null,null,null,null,null,null,{"$f":"+SUM(L9:L42)","v":13930}]
["※１　ツベルクリンの判定を行った場合のみ、初診料と再診料（１回分）を併せて請求できます。"]
["　　（画像診断、喀痰検査及びT-スポット.TB検査の検査結果は、区福祉保健センターから受診対象者へお知らせします）"]
["※２　複数の検査を実施した場合も、初診料を重ねて請求することはできません。"]
["※３　計画的な訪問診療時に検査を行った場合は、往診料を請求することはできません。"]
["　 　 基準単価は令和８年４月１日時点の診療報酬点数表を基にしたものとなります。"]

{"sheet":"③明細書(画像診断)（記載例）","index":3,"n_rows":47,"n_cols":12,"rows_kept":47,"cut":false,"hidden":false,"merged":[[34,1,36,2],[46,10,47,10],[46,11,47,11],[37,3,39,3],[37,4,39,4],[37,5,39,6],[40,1,45,6],[40,11,43,11],[44,7,45,7],[44,8,45,8],[44,9,45,9],[44,10,45,11],[25,11,39,11],[28,1,30,2],[28,3,30,3],[28,5,30,6],[31,4,33,4],[22,5,22,6],[24,5,24,6],[31,5,33,6],[9,0,24,0],[9,1,9,2],[9,5,9,6],[31,1,33,2],[31,3,33,3],[23,5,23,6],[25,0,45,0],[25,1,27,2],[25,3,27,3],[25,4,27,4],[25,5,27,6],[34,3,36,3],[34,4,36,4],[34,5,36,6],[37,1,39,2],[28,4,30,4],[10,11,13,11],[14,1,24,1],[14,5,14,6],[14,7,24,7],[14,8,24,8],[14,9,24,9],[14,10,24,10],[14,11,24,11],[15,5,15,6],[16,5,16,6],[17,5,17,6],[18,5,18,6],[19,2,19,6],[20,5,20,6],[21,5,21,6],[9,7,9,10],[10,1,13,2],[10,3,13,3],[10,4,13,4],[10,5,13,6],[10,7,10,8],[3,11,6,11],[7,1,8,2],[7,3,8,3],[7,4,8,4],[7,5,8,6],[7,7,8,7],[7,9,8,9],[7,10,8,10],[7,11,8,11],[1,1,1,2],[1,5,1,6],[2,0,8,0],[2,1,2,2],[2,5,2,6],[2,7,2,10],[3,1,6,2],[3,3,6,3],[3,4,6,4],[3,5,6,6],[3,7,3,8]]}
[]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額"]
["胸部エックス線検査（デジタル撮影）※正面１枚のみ請求可能です。","診断料",null,null,true,850,null,null,null,null,null,{"$f":"+SUM(IF(E3,F3,0))","v":850}]
[null,"デジタル撮影料",null,null,true,680,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E4,F4,0)+IF(J5,K5,0)+IF(J6,K6,0)+IF(J7,K7,0))","v":680}]
[null,null,null,null,null,null,null,null,"新生児",false,540]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,340]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,200]
[null,"電子画像管理加算（電子化保存）",null,null,true,570,null,null,"画像診断管理加算１（施設基準あり）",false,700,{"$f":"+SUM(IF(E8,F8,0)+(IF(J8,K8,0)))","v":570}]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
["胸部エックス線検査（アナログ撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E10,F10,0))","v":0}]
[null,"アナログ撮影料",null,null,false,600,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E11,F11,0)+IF(J12,K12,0)+IF(J13,K13,0)+IF(J14,K14,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,480]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,300]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,180]
[null,"フィルム料","半切",null,false,120,null,null,"画像診断管理加算１（施設基準あり）\nただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。",false,700,{"$f":"+SUM(IF(E15,F15,0)+IF(E16,F16,0)+IF(E17,F17,0)+IF(E18,F18,0)+IF(E19,F19,0)+IF(E21,F21,0)+IF(E22,F22,0)+IF(E23,F23,0)+IF(E24,F24,0)+IF(E25,F25,0)+IF(J15,K15,0))","v":0}]
[null,null,"大角",null,false,"115円"]
[null,null,"大四ツ切",null,false,76]
[null,null,"四ツ切",null,false,62]
[null,null,"六ツ切",null,false,48]
[null,null,"６歳未満の場合"]
[null,null,"半切",null,false,130]
[null,null,"大角",null,false,130]
[null,null,"大四ツ切",null,false,80]
[null,null,"四ツ切",null,false,70]
[null,null,"六ツ切",null,false,50]
["胸部エックス線検査\n※福祉保健センターから指示があった場合のみ、請求可能","マルチスライス型（64列以上）共同施設において行われる場合",null,null,false,15900,null,null,"新生児",false,8160,{"$f":"+SUM(IF(E26,F26,0)+IF(E29,F29,0)+IF(E32,F32,0)+IF(E35,F35,0)+IF(E38,F38,0)+IF(J26,K26,0)+IF(J27,K27,0)+IF(J28,K28,0)+IF(J29,K29,0)+IF(J30,K30,0)+IF(J31,K31,0)+IF(J32,K32,0)+IF(J33,K33,0)+IF(J34,K34,0)+IF(J35,K35,0))+IF(J36,K36,0)+IF(J37,K37,0)+IF(J38,K38,0)+IF(J39,K39,0)+IF(J40,K40,0)","v":0}]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5100]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3060]
[null,"マルチスライス型（64列以上）その他の場合",null,null,false,15700,null,null,"新生児",false,8000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5000]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3000]
[null,"マルチスライス型（16列以上64列未満）",null,null,false,14700,null,null,"新生児",false,7200]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,4500]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2700]
[null,"マルチスライス型（４列以上16列未満）",null,null,false,13200,null,null,"新生児",false,6000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,3750]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2250]
[null,"その他",null,null,false,11300,null,null,"新生児",false,4480]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,2800]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,1680]
[null,null,null,null,null,null,null,null,"画像診断管理加算１",false,700,{"$f":"+SUM(IF(J41,K41,0)+IF(J42,K42,0)+IF(J43,K43,0)+IF(J44,K44,0))","v":0}]
[null,null,null,null,null,null,null,null,"画像診断管理加算２",false,1750]
[null,null,null,null,null,null,null,null,"画像診断管理加算３",false,2350]
[null,null,null,null,null,null,null,null,"画像診断管理加算４",false,3400]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
[]
[null,null,null,null,null,null,null,null,null,null,"合　計",{"$f":"SUM(L3:L46)","v":2100}]

{"sheet":"①請求書","index":4,"n_rows":38,"n_cols":11,"rows_kept":38,"cut":false,"hidden":false,"merged":[[29,1,32,1],[28,1,28,3],[15,1,17,2],[18,1,19,2],[20,1,21,2],[22,1,22,2],[25,1,27,2],[29,2,30,2],[29,3,29,10],[30,3,30,10],[31,2,31,10],[16,3,16,10],[17,3,17,10],[21,3,21,10],[22,3,22,10],[32,2,32,10],[0,0,0,10],[25,7,27,8],[25,10,27,10],[25,5,25,6],[26,5,26,6],[27,5,27,6],[25,3,27,4],[13,4,13,6],[15,3,15,10],[37,0,39,11],[1,1,1,10],[5,1,5,10],[7,2,7,3],[8,2,8,3],[9,2,9,3],[7,5,7,6],[8,5,8,6],[9,5,9,6],[7,8,7,9],[8,8,8,9],[9,8,9,9],[34,4,36,10],[18,3,18,10],[19,3,19,10],[20,3,20,10]]}
["(請求書番号　　　　　　　　)"]
[null,"結核健診等委託料請求書"]
[]
[null,null,null,"※ ￥"]
[]
[null,"ただし、　年　　月分の結核　　　　　　　 に関する費用として"]
[]
[null,null,"区分",null,"件数","金　　　額",null,"消費税額","合　　計　　額"]
[null,null,"請求額",null,null,{"$f":"+②明細書!L43+'②明細書(2人目)'!L43+'②明細書(3人目)'!L43+'②明細書(4人目)'!L43+'②明細書(5人目)'!L43+'②明細書(6人目)'!L43+'②明細書(7人目)'!L43+'②明細書(8人目)'!L43+'②明細書(9人目)'!L43+'②明細書(10人目)'!L43","v":0},null,{"$f":"+F9*0.1","v":0},{"$f":"+F9+H9","v":0}]
[null,null,"決定額",null,"※","※",null,"※","※"]
[]
[null,null,"上記のとおり請求します。"]
[]
[null,null,null,null,"　　　　　年　　　月　　　日"]
[null,"契約（実施）医療機関  "]
[null,"所　 在　 地  ",null,"〒　"]
[]
[]
[null,"名　　　  称"]
[]
[null,"代表者役職氏名\n（請 求 人）"]
[]
[null,"電 話 番 号",null,"tel 　　　　　　　                /fax　"]
[]
[null,"振込先"]
[null,"振　込　先\n銀　行　名",null,null,null,"銀行 ・ 信用金庫",null,null,null,"本店","当座\n\n普通"]
[null,null,null,null,null,"信用組合 ・ 農協",null,null,null,"支店"]
[null,null,null,null,null,"労働金庫",null,null,null,"出張所"]
[null,"口　座　番　号"]
[null,"口座名義","フリガナ"]
[]
[]
[]
[]
[null,"横 浜 市 長　様",null,null,"（請求人と口座名義人が違う場合、下記に記名押印してください）\n\n◎上記口座へお振り込みください。\n　　　　代表者役職氏名\n　　　　（請 求 人）\n"]
[]
[]
["(注１)※の箇所は記入しないでください。\n(注２)押印は原則不要です。ただし、口座名義人が契約書記載の受諾者と異なる場合には押印下さい。その場合、\n　　　代表者印は、契約書と同一の印を押印してください。\n(注３)医療機関において、必ず控えをお取りください。"]

{"sheet":"②明細書","index":5,"n_rows":111,"n_cols":27,"rows_kept":111,"cut":false,"hidden":false,"merged":[[49,1,49,10],[40,1,40,2],[40,7,40,10],[41,1,41,2],[41,7,41,10],[42,0,42,10],[43,0,43,8],[34,0,41,0],[34,1,39,1],[34,7,35,10],[28,0,33,0],[28,1,31,2],[28,3,29,3],[28,4,29,4],[28,7,31,10],[34,11,41,11],[36,2,39,2],[36,4,37,4],[36,7,39,10],[38,4,39,4],[28,11,33,11],[30,3,31,3],[30,4,31,4],[32,1,32,2],[32,7,32,10],[33,1,33,2],[33,7,33,10],[22,11,27,11],[24,4,25,4],[26,4,27,4],[22,7,27,10],[21,5,21,10],[9,10,11,10],[9,11,11,11],[12,1,20,2],[12,3,20,3],[12,4,20,4],[12,5,20,5],[12,11,20,11],[9,1,11,1],[9,8,11,8],[12,7,20,10],[7,1,7,2],[7,5,7,6],[8,0,11,0],[22,0,27,0],[22,1,27,2],[22,4,23,4],[8,1,8,2],[4,0,4,11],[6,6,6,11],[0,0,0,11],[1,0,1,11],[2,0,2,2],[2,3,2,11],[3,0,3,11],[5,0,5,3],[6,0,6,3],[5,5,5,8],[5,10,5,11]]}
["結　核　健　診　等　委　託　料　請　求　明　細　書"]
["（　　　　　　　　年　　　　　月分）　"]
["医　療　機　関　名　称"]
["　　接触者健診　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　管理検診"]
["　　 　（保健カード）　　　　  　　　　　　　　　　　　　　　　　　　　　　　　　　　　（管理検診カード）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区"]
["患 者  氏 名\n年齢・性別",null,null,null,null,"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　満　　　　　　歳　　",null,null,null,null,"（　　男　・　　女　）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鶴見"]
["保健・管理\nカード番号",null,null,null,null,null,"福祉保健センター　　　第　　　　　　　　　　号　　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"神奈川"]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西"]
["共通\n\n","初\n診\n料",null,null,false,2910,null,null,"乳幼児加算（６歳未満）",false,750,{"$f":"+SUM(IF(E9,F9,0))+(IF(J9,K9,0))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"中"]
[null,"再\n診\n料","診療所",null,false,750,null,null,"乳幼児加算（６歳未満）",false,380,{"$f":"+SUM(IF(E10,F10,0)+(IF(E11,F11,0)+(IF(E12,F12,0)+(IF(J11,K10,0)))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旭"]
[null,null,"病　院\n(200床未満)",null,false,750,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"磯子"]
[null,null,"病 　院\n(200床以上)\n『外来診療料』",null,false,760,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金沢"]
[null,"往診料",null,null,false,7200,null,null,null,null,null,{"$f":"+SUM(IF(E13,F13,0)+(IF(J14,K14)+(IF(J15,K15,0)+(IF(J17,K17,0)+(IF(J19,K19)+(IF(J21,K21,0)))))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"港北"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"青葉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都筑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"戸塚"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"栄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"泉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"瀬谷"]
[]
["画像診断",null,null,null,null,null,null,null,null,null,null,{"$f":"+'③明細書(画像診断)'!L47","v":0},null,null,"　"]
["ツベルクリン\n反 応 検 査","皮内反応検査料＋\n精製ツベルクリン\n(薬価･一般診断用0.25ug)",null,null,false,"（新生児）",null,"・[皮内反応検査料]＋[精製ツベルクリン(薬価･一般診断用0.25ug)]\n　　精製ツベルクリン薬剤料（点数）　274点（2,735円を五捨五超入）\n   　160円＋2,735円＝2,900円（10円未満を四捨五入）\n　★検査料に係る加算\n　　新生児加算　　…　100分の100を加算\n　　３歳未満乳幼児加算…100分の70を加算\n\n*新生児のツベルクリン反応検査\n　160円×2.0＋2,735円＝3,055円（10円未満を四捨五入）3,060円\n *３歳未満乳幼児のツベルクリン反応検査\n　160円×1.7＋2,735円＝3,007円（10円未満を四捨五入）3,010円",null,null,null,{"$f":"+SUM(IF(E23,F24,0)+(IF(E25,F26,0)+(IF(E27,F28,0))))","v":0}]
[null,null,null,null,null,3060]
[null,null,null,null,false,"（３歳未満）"]
[null,null,null,null,null,3010]
[null,null,null,null,false,"（３歳以上）"]
[null,null,null,null,null,2900]
["T-スポット.TB検査","検　　査　　料",null,null,false,"（６歳未満）",null,"・[検査料]＋[採血採取]\n　　5,930円＋　400円＝6,330円\n　★血液採取に係る加算\n　　６歳未満の乳幼児に対して行った場合：350円加算\n\n・QFT検査を実施した場合、同額を算定できる。",null,null,null,{"$f":"+SUM(IF(E29,F30,0)+(IF(E31,F32,0)+(IF(E33,F33,0)+IF(E34,F34,0))))","v":0}]
[null,null,null,null,null,6680]
[null,null,null,null,false,"（６歳以上）"]
[null,null,null,null,null,6330]
[null,"検体検査判断料",null,null,false,1440,null,"・検査の種類、回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["喀痰検査","検査料","塗抹",null,false,670,null,"・１回の検査で、どちらかひとつを算定",null,null,null,{"$f":"+SUM(IF(E35,F35,0)+IF(E36,F36,0)+IF(E37,F38,0)+IF(E39,F40,0)+IF(E41,F41,0)+IF(E42,F42,0))","v":0}]
[null,null,"蛍光",null,false,500]
[null,null,"培養",null,false,"（液体培地法）",null,"・請求時は、「液体培地法」又は「それ以外」と記載をしてください。"]
[null,null,null,null,null,3000]
[null,null,null,null,false,"（それ以外）"]
[null,null,null,null,null,2090]
[null,"検体検査判断料",null,null,false,1500,null,"・検査の種類・回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["合　　　　　　　　　計",null,null,null,null,null,null,null,null,null,null,{"$f":"+SUM(L9:L42)","v":0}]
["※１　ツベルクリンの判定を行った場合のみ、初診料と再診料（１回分）を併せて請求できます。"]
["　　（画像診断、喀痰検査及びT-スポット.TB検査の検査結果は、区福祉保健センターから受診対象者へお知らせします）",null,null,null,false]
["※２　複数の検査を実施した場合も、初診料を重ねて請求することはできません。"]
["※３　計画的な訪問診療時に検査を行った場合は、往診料を請求することはできません。"]
["　 　 基準単価は令和８年４月１日時点の診療報酬点数表を基にしたものとなります。"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,false]

{"sheet":"③明細書(画像診断)","index":6,"n_rows":47,"n_cols":12,"rows_kept":47,"cut":false,"hidden":false,"merged":[[2,7,2,10],[34,5,36,6],[46,10,47,10],[46,11,47,11],[37,1,39,2],[37,3,39,3],[37,4,39,4],[37,5,39,6],[40,1,45,6],[40,11,43,11],[44,7,45,7],[44,8,45,8],[44,9,45,9],[44,10,45,11],[25,11,39,11],[10,11,13,11],[25,0,45,0],[25,1,27,2],[25,3,27,3],[25,4,27,4],[25,5,27,6],[28,1,30,2],[28,3,30,3],[28,4,30,4],[28,5,30,6],[31,1,33,2],[31,3,33,3],[31,4,33,4],[31,5,33,6],[34,1,36,2],[34,3,36,3],[34,4,36,4],[14,11,24,11],[15,5,15,6],[16,5,16,6],[19,2,19,6],[20,5,20,6],[21,5,21,6],[22,5,22,6],[23,5,23,6],[14,5,14,6],[14,7,24,7],[14,8,24,8],[14,9,24,9],[9,0,24,0],[9,1,9,2],[9,5,9,6],[9,7,9,10],[10,1,13,2],[10,3,13,3],[10,4,13,4],[10,5,13,6],[17,5,17,6],[18,5,18,6],[10,7,10,8],[24,5,24,6],[14,10,24,10],[14,1,24,1],[3,11,6,11],[7,1,8,2],[7,3,8,3],[7,4,8,4],[7,5,8,6],[7,7,8,7],[7,9,8,9],[7,10,8,10],[7,11,8,11],[3,7,3,8],[1,1,1,2],[1,5,1,6],[2,0,8,0],[2,1,2,2],[2,5,2,6],[3,1,6,2],[3,3,6,3],[3,4,6,4],[3,5,6,6]]}
[]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額"]
["胸部エックス線検査（デジタル撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E3,F3,0))","v":0}]
[null,"デジタル撮影料",null,null,false,680,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E4,F4,0)+IF(J5,K5,0)+IF(J6,K6,0)+IF(J7,K7,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,540]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,340]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,200]
[null,"電子画像管理加算（電子化保存）",null,null,false,570,null,null,"画像診断管理加算１（施設基準あり）",false,700,{"$f":"+SUM(IF(E8,F8,0)+(IF(J8,K8,0)))","v":0}]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
["胸部エックス線検査（アナログ撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E10,F10,0))","v":0}]
[null,"アナログ撮影料",null,null,false,600,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E11,F11,0)+IF(J12,K12,0)+IF(J13,K13,0)+IF(J14,K14,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,480]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,300]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,180]
[null,"フィルム料","半切",null,false,120,null,null,"画像診断管理加算１（施設基準あり）\nただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。",false,700,{"$f":"+SUM(IF(E15,F15,0)+IF(E16,F16,0)+IF(E17,F17,0)+IF(E18,F18,0)+IF(E19,F19,0)+IF(E21,F21,0)+IF(E22,F22,0)+IF(E23,F23,0)+IF(E24,F24,0)+IF(E25,F25,0)+IF(J15,K15,0))","v":0}]
[null,null,"大角",null,false,115]
[null,null,"大四ツ切",null,false,76]
[null,null,"四ツ切",null,false,62]
[null,null,"六ツ切",null,false,48]
[null,null,"６歳未満の場合"]
[null,null,"半切",null,false,130]
[null,null,"大角",null,false,130]
[null,null,"大四ツ切",null,false,80]
[null,null,"四ツ切",null,false,70]
[null,null,"六ツ切",null,false,50]
["胸部エックス線検査\n※福祉保健センターから指示があった場合のみ、請求可能","マルチスライス型（64列以上）共同施設において行われる場合",null,null,false,15900,null,null,"新生児",false,8160,{"$f":"+SUM(IF(E26,F26,0)+IF(E29,F29,0)+IF(E32,F32,0)+IF(E35,F35,0)+IF(E38,F38,0)+IF(J26,K26,0)+IF(J27,K27,0)+IF(J28,K28,0)+IF(J29,K29,0)+IF(J30,K30,0)+IF(J31,K31,0)+IF(J32,K32,0)+IF(J33,K33,0)+IF(J34,K34,0)+IF(J35,K35,0))+IF(J36,K36,0)+IF(J37,K37,0)+IF(J38,K38,0)+IF(J39,K39,0)+IF(J40,K40,0)","v":0}]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5100]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3060]
[null,"マルチスライス型（64列以上）その他の場合",null,null,false,15700,null,null,"新生児",false,8000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5000]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3000]
[null,"マルチスライス型（16列以上64列未満）",null,null,false,14700,null,null,"新生児",false,7200]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,4500]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2700]
[null,"マルチスライス型（４列以上16列未満）",null,null,false,13200,null,null,"新生児",false,6000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,3750]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2250]
[null,"その他",null,null,false,11300,null,null,"新生児",false,4480]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,2800]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,1680]
[null,null,null,null,null,null,null,null,"画像診断管理加算１",false,700,{"$f":"+SUM(IF(J41,K41,0)+IF(J42,K42,0)+IF(J43,K43,0)+IF(J44,K44,0))","v":0}]
[null,null,null,null,null,null,null,null,"画像診断管理加算２",false,1750]
[null,null,null,null,null,null,null,null,"画像診断管理加算３",false,2350]
[null,null,null,null,null,null,null,null,"画像診断管理加算４",false,3400]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
[]
[null,null,null,null,null,null,null,null,null,null,"合　計",{"$f":"SUM(L3:L46)","v":0}]

{"sheet":"②明細書(2人目)","index":7,"n_rows":111,"n_cols":27,"rows_kept":111,"cut":false,"hidden":false,"merged":[[7,1,7,2],[7,5,7,6],[0,0,0,11],[1,0,1,11],[2,0,2,2],[2,3,2,11],[3,0,3,11],[4,0,4,11],[5,0,5,3],[5,5,5,8],[5,10,5,11],[6,0,6,3],[6,6,6,11],[22,11,27,11],[8,0,11,0],[9,1,11,1],[9,8,11,8],[9,10,11,10],[9,11,11,11],[12,1,20,2],[12,3,20,3],[12,4,20,4],[12,5,20,5],[12,11,20,11],[8,1,8,2],[12,7,20,10],[21,5,21,10],[24,4,25,4],[26,4,27,4],[28,11,33,11],[30,3,31,3],[30,4,31,4],[32,1,32,2],[32,7,32,10],[33,1,33,2],[33,7,33,10],[28,1,31,2],[28,3,29,3],[28,4,29,4],[28,7,31,10],[34,11,41,11],[36,2,39,2],[36,4,37,4],[36,7,39,10],[38,4,39,4],[40,1,40,2],[40,7,40,10],[41,1,41,2],[41,7,41,10],[42,0,42,10],[43,0,43,8],[49,1,49,10],[34,0,41,0],[34,1,39,1],[34,7,35,10],[28,0,33,0],[22,0,27,0],[22,1,27,2],[22,4,23,4],[22,7,27,10]]}
["結　核　健　診　等　委　託　料　請　求　明　細　書"]
["（　　　　　　　　年　　　　　月分）　"]
["医　療　機　関　名　称"]
["　　接触者健診　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　管理検診"]
["　　 　（保健カード）　　　　  　　　　　　　　　　　　　　　　　　　　　　　　　　　　（管理検診カード）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区"]
["患 者  氏 名\n年齢・性別",null,null,null,null,"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　満　　　　　　歳　　",null,null,null,null,"（　　男　・　　女　）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鶴見"]
["保健・管理\nカード番号",null,null,null,null,null,"福祉保健センター　　　第　　　　　　　　　　号　　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"神奈川"]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西"]
["共通\n\n","初\n診\n料",null,null,false,2910,null,null,"乳幼児加算（６歳未満）",false,750,{"$f":"+SUM(IF(E9,F9,0))+(IF(J9,K9,0))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"中"]
[null,"再\n診\n料","診療所",null,false,750,null,null,"乳幼児加算（６歳未満）",false,380,{"$f":"+SUM(IF(E10,F10,0)+(IF(E11,F11,0)+(IF(E12,F12,0)+(IF(J11,K10,0)))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旭"]
[null,null,"病　院\n(200床未満)",null,false,750,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"磯子"]
[null,null,"病 　院\n(200床以上)\n『外来診療料』",null,false,760,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金沢"]
[null,"往診料",null,null,false,7200,null,null,null,null,null,{"$f":"+SUM(IF(E13,F13,0)+(IF(J14,K14)+(IF(J15,K15,0)+(IF(J17,K17,0)+(IF(J19,K19)+(IF(J21,K21,0)))))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"港北"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"青葉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都筑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"戸塚"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"栄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"泉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"瀬谷"]
[]
["画像診断",null,null,null,null,null,null,null,null,null,null,{"$f":"+'③明細書(画像診断)(2人目)'!L47","v":0},null,null,"　"]
["ツベルクリン\n反 応 検 査","皮内反応検査料＋\n精製ツベルクリン\n(薬価･一般診断用0.25ug)",null,null,false,"（新生児）",null,"・[皮内反応検査料]＋[精製ツベルクリン(薬価･一般診断用0.25ug)]\n　　精製ツベルクリン薬剤料（点数）　274点（2,735円を五捨五超入）\n   　160円＋2,735円＝2,900円（10円未満を四捨五入）\n　★検査料に係る加算\n　　新生児加算　　…　100分の100を加算\n　　３歳未満乳幼児加算…100分の70を加算\n\n*新生児のツベルクリン反応検査\n　160円×2.0＋2,735円＝3,055円（10円未満を四捨五入）3,060円\n *３歳未満乳幼児のツベルクリン反応検査\n　160円×1.7＋2,735円＝3,007円（10円未満を四捨五入）3,010円",null,null,null,{"$f":"+SUM(IF(E23,F24,0)+(IF(E25,F26,0)+(IF(E27,F28,0))))","v":0}]
[null,null,null,null,null,3060]
[null,null,null,null,false,"（３歳未満）"]
[null,null,null,null,null,3010]
[null,null,null,null,false,"（３歳以上）"]
[null,null,null,null,null,2900]
["T-スポット.TB検査","検　　査　　料",null,null,false,"（６歳未満）",null,"・[検査料]＋[採血採取]\n　　5,930円＋　400円＝6,330円\n　★血液採取に係る加算\n　　６歳未満の乳幼児に対して行った場合：350円加算\n\n・QFT検査を実施した場合、同額を算定できる。",null,null,null,{"$f":"+SUM(IF(E29,F30,0)+(IF(E31,F32,0)+(IF(E33,F33,0)+IF(E34,F34,0))))","v":0}]
[null,null,null,null,null,6680]
[null,null,null,null,false,"（６歳以上）"]
[null,null,null,null,null,6330]
[null,"検体検査判断料",null,null,false,1440,null,"・検査の種類、回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["喀痰検査","検査料","塗抹",null,false,670,null,"・１回の検査で、どちらかひとつを算定",null,null,null,{"$f":"+SUM(IF(E35,F35,0)+IF(E36,F36,0)+IF(E37,F38,0)+IF(E39,F40,0)+IF(E41,F41,0)+IF(E42,F42,0))","v":0}]
[null,null,"蛍光",null,false,500]
[null,null,"培養",null,false,"（液体培地法）",null,"・請求時は、「液体培地法」又は「それ以外」と記載をしてください。"]
[null,null,null,null,null,3000]
[null,null,null,null,false,"（それ以外）"]
[null,null,null,null,null,2090]
[null,"検体検査判断料",null,null,false,1500,null,"・検査の種類・回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["合　　　　　　　　　計",null,null,null,null,null,null,null,null,null,null,{"$f":"+SUM(L9:L42)","v":0}]
["※１　ツベルクリンの判定を行った場合のみ、初診料と再診料（１回分）を併せて請求できます。"]
["　　（画像診断、喀痰検査及びT-スポット.TB検査の検査結果は、区福祉保健センターから受診対象者へお知らせします）",null,null,null,false]
["※２　複数の検査を実施した場合も、初診料を重ねて請求することはできません。"]
["※３　計画的な訪問診療時に検査を行った場合は、往診料を請求することはできません。"]
["　 　 基準単価は令和８年４月１日時点の診療報酬点数表を基にしたものとなります。"]
[]
[]
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[]
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[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,false]

{"sheet":"③明細書(画像診断)(2人目)","index":8,"n_rows":47,"n_cols":12,"rows_kept":47,"cut":false,"hidden":false,"merged":[[2,7,2,10],[3,1,6,2],[3,3,6,3],[3,4,6,4],[3,5,6,6],[3,7,3,8],[1,1,1,2],[1,5,1,6],[2,0,8,0],[2,1,2,2],[2,5,2,6],[3,11,6,11],[7,1,8,2],[7,3,8,3],[7,4,8,4],[7,5,8,6],[7,7,8,7],[7,9,8,9],[7,10,8,10],[7,11,8,11],[9,7,9,10],[10,1,13,2],[10,3,13,3],[10,4,13,4],[10,5,13,6],[10,7,10,8],[10,11,13,11],[14,1,24,1],[14,5,14,6],[14,7,24,7],[14,8,24,8],[14,9,24,9],[14,10,24,10],[14,11,24,11],[15,5,15,6],[16,5,16,6],[17,5,17,6],[18,5,18,6],[19,2,19,6],[20,5,20,6],[21,5,21,6],[9,0,24,0],[9,1,9,2],[9,5,9,6],[31,1,33,2],[31,3,33,3],[23,5,23,6],[25,0,45,0],[25,1,27,2],[25,3,27,3],[25,4,27,4],[25,5,27,6],[34,3,36,3],[34,4,36,4],[34,5,36,6],[37,1,39,2],[28,4,30,4],[28,5,30,6],[31,4,33,4],[22,5,22,6],[24,5,24,6],[31,5,33,6],[34,1,36,2],[46,10,47,10],[46,11,47,11],[37,3,39,3],[37,4,39,4],[37,5,39,6],[40,1,45,6],[40,11,43,11],[44,7,45,7],[44,8,45,8],[44,9,45,9],[44,10,45,11],[25,11,39,11],[28,1,30,2],[28,3,30,3]]}
[]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額"]
["胸部エックス線検査（デジタル撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E3,F3,0))","v":0}]
[null,"デジタル撮影料",null,null,false,680,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E4,F4,0)+IF(J5,K5,0)+IF(J6,K6,0)+IF(J7,K7,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,540]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,340]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,200]
[null,"電子画像管理加算（電子化保存）",null,null,false,570,null,null,"画像診断管理加算１（施設基準あり）",false,700,{"$f":"+SUM(IF(E8,F8,0)+(IF(J8,K8,0)))","v":0}]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
["胸部エックス線検査（アナログ撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E10,F10,0))","v":0}]
[null,"アナログ撮影料",null,null,false,600,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E11,F11,0)+IF(J12,K12,0)+IF(J13,K13,0)+IF(J14,K14,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,480]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,300]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,180]
[null,"フィルム料","半切",null,false,120,null,null,"画像診断管理加算１（施設基準あり）\nただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。",false,700,{"$f":"+SUM(IF(E15,F15,0)+IF(E16,F16,0)+IF(E17,F17,0)+IF(E18,F18,0)+IF(E19,F19,0)+IF(E21,F21,0)+IF(E22,F22,0)+IF(E23,F23,0)+IF(E24,F24,0)+IF(E25,F25,0)+IF(J15,K15,0))","v":0}]
[null,null,"大角",null,false,115]
[null,null,"大四ツ切",null,false,76]
[null,null,"四ツ切",null,false,62]
[null,null,"六ツ切",null,false,48]
[null,null,"６歳未満の場合"]
[null,null,"半切",null,false,130]
[null,null,"大角",null,false,130]
[null,null,"大四ツ切",null,false,80]
[null,null,"四ツ切",null,false,70]
[null,null,"六ツ切",null,false,50]
["胸部エックス線検査\n※福祉保健センターから指示があった場合のみ、請求可能","マルチスライス型（64列以上）共同施設において行われる場合",null,null,false,15900,null,null,"新生児",false,8160,{"$f":"+SUM(IF(E26,F26,0)+IF(E29,F29,0)+IF(E32,F32,0)+IF(E35,F35,0)+IF(E38,F38,0)+IF(J26,K26,0)+IF(J27,K27,0)+IF(J28,K28,0)+IF(J29,K29,0)+IF(J30,K30,0)+IF(J31,K31,0)+IF(J32,K32,0)+IF(J33,K33,0)+IF(J34,K34,0)+IF(J35,K35,0))+IF(J36,K36,0)+IF(J37,K37,0)+IF(J38,K38,0)+IF(J39,K39,0)+IF(J40,K40,0)","v":0}]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5100]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3060]
[null,"マルチスライス型（64列以上）その他の場合",null,null,false,15700,null,null,"新生児",false,8000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5000]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3000]
[null,"マルチスライス型（16列以上64列未満）",null,null,false,14700,null,null,"新生児",false,7200]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,4500]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2700]
[null,"マルチスライス型（４列以上16列未満）",null,null,false,13200,null,null,"新生児",false,6000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,3750]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2250]
[null,"その他",null,null,false,11300,null,null,"新生児",false,4480]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,2800]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,1680]
[null,null,null,null,null,null,null,null,"画像診断管理加算１",false,700,{"$f":"+SUM(IF(J41,K41,0)+IF(J42,K42,0)+IF(J43,K43,0)+IF(J44,K44,0))","v":0}]
[null,null,null,null,null,null,null,null,"画像診断管理加算２",false,1750]
[null,null,null,null,null,null,null,null,"画像診断管理加算３",false,2350]
[null,null,null,null,null,null,null,null,"画像診断管理加算４",false,3400]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
[]
[null,null,null,null,null,null,null,null,null,null,"合　計",{"$f":"SUM(L3:L46)","v":0}]

{"sheet":"②明細書(3人目)","index":9,"n_rows":111,"n_cols":27,"rows_kept":111,"cut":false,"hidden":false,"merged":[[7,1,7,2],[7,5,7,6],[0,0,0,11],[1,0,1,11],[2,0,2,2],[2,3,2,11],[3,0,3,11],[4,0,4,11],[5,0,5,3],[5,5,5,8],[5,10,5,11],[6,0,6,3],[6,6,6,11],[22,11,27,11],[8,0,11,0],[9,1,11,1],[9,8,11,8],[9,10,11,10],[9,11,11,11],[12,1,20,2],[12,3,20,3],[12,4,20,4],[12,5,20,5],[12,11,20,11],[8,1,8,2],[12,7,20,10],[21,5,21,10],[24,4,25,4],[26,4,27,4],[28,11,33,11],[30,3,31,3],[30,4,31,4],[32,1,32,2],[32,7,32,10],[33,1,33,2],[33,7,33,10],[28,1,31,2],[28,3,29,3],[28,4,29,4],[28,7,31,10],[34,11,41,11],[36,2,39,2],[36,4,37,4],[36,7,39,10],[38,4,39,4],[40,1,40,2],[40,7,40,10],[41,1,41,2],[41,7,41,10],[42,0,42,10],[43,0,43,8],[49,1,49,10],[34,0,41,0],[34,1,39,1],[34,7,35,10],[28,0,33,0],[22,0,27,0],[22,1,27,2],[22,4,23,4],[22,7,27,10]]}
["結　核　健　診　等　委　託　料　請　求　明　細　書"]
["（　　　　　　　　年　　　　　月分）　"]
["医　療　機　関　名　称"]
["　　接触者健診　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　管理検診"]
["　　 　（保健カード）　　　　  　　　　　　　　　　　　　　　　　　　　　　　　　　　　（管理検診カード）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区"]
["患 者  氏 名\n年齢・性別",null,null,null,null,"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　満　　　　　　歳　　",null,null,null,null,"（　　男　・　　女　）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鶴見"]
["保健・管理\nカード番号",null,null,null,null,null,"福祉保健センター　　　第　　　　　　　　　　号　　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"神奈川"]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西"]
["共通\n\n","初\n診\n料",null,null,false,2910,null,null,"乳幼児加算（６歳未満）",false,750,{"$f":"+SUM(IF(E9,F9,0))+(IF(J9,K9,0))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"中"]
[null,"再\n診\n料","診療所",null,false,750,null,null,"乳幼児加算（６歳未満）",false,380,{"$f":"+SUM(IF(E10,F10,0)+(IF(E11,F11,0)+(IF(E12,F12,0)+(IF(J11,K10,0)))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旭"]
[null,null,"病　院\n(200床未満)",null,false,750,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"磯子"]
[null,null,"病 　院\n(200床以上)\n『外来診療料』",null,false,760,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金沢"]
[null,"往診料",null,null,false,7200,null,null,null,null,null,{"$f":"+SUM(IF(E13,F13,0)+(IF(J14,K14)+(IF(J15,K15,0)+(IF(J17,K17,0)+(IF(J19,K19)+(IF(J21,K21,0)))))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"港北"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"青葉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都筑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"戸塚"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"栄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"泉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"瀬谷"]
[]
["画像診断",null,null,null,null,null,null,null,null,null,null,{"$f":"+'③明細書(画像診断)(3人目)'!L47","v":0},null,null,"　"]
["ツベルクリン\n反 応 検 査","皮内反応検査料＋\n精製ツベルクリン\n(薬価･一般診断用0.25ug)",null,null,false,"（新生児）",null,"・[皮内反応検査料]＋[精製ツベルクリン(薬価･一般診断用0.25ug)]\n　　精製ツベルクリン薬剤料（点数）　274点（2,735円を五捨五超入）\n   　160円＋2,735円＝2,900円（10円未満を四捨五入）\n　★検査料に係る加算\n　　新生児加算　　…　100分の100を加算\n　　３歳未満乳幼児加算…100分の70を加算\n\n*新生児のツベルクリン反応検査\n　160円×2.0＋2,735円＝3,055円（10円未満を四捨五入）3,060円\n *３歳未満乳幼児のツベルクリン反応検査\n　160円×1.7＋2,735円＝3,007円（10円未満を四捨五入）3,010円",null,null,null,{"$f":"+SUM(IF(E23,F24,0)+(IF(E25,F26,0)+(IF(E27,F28,0))))","v":0}]
[null,null,null,null,null,3060]
[null,null,null,null,false,"（３歳未満）"]
[null,null,null,null,null,3010]
[null,null,null,null,false,"（３歳以上）"]
[null,null,null,null,null,2900]
["T-スポット.TB検査","検　　査　　料",null,null,false,"（６歳未満）",null,"・[検査料]＋[採血採取]\n　　5,930円＋　400円＝6,330円\n　★血液採取に係る加算\n　　６歳未満の乳幼児に対して行った場合：350円加算\n\n・QFT検査を実施した場合、同額を算定できる。",null,null,null,{"$f":"+SUM(IF(E29,F30,0)+(IF(E31,F32,0)+(IF(E33,F33,0)+IF(E34,F34,0))))","v":0}]
[null,null,null,null,null,6680]
[null,null,null,null,false,"（６歳以上）"]
[null,null,null,null,null,6330]
[null,"検体検査判断料",null,null,false,1440,null,"・検査の種類、回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["喀痰検査","検査料","塗抹",null,false,670,null,"・１回の検査で、どちらかひとつを算定",null,null,null,{"$f":"+SUM(IF(E35,F35,0)+IF(E36,F36,0)+IF(E37,F38,0)+IF(E39,F40,0)+IF(E41,F41,0)+IF(E42,F42,0))","v":0}]
[null,null,"蛍光",null,false,500]
[null,null,"培養",null,false,"（液体培地法）",null,"・請求時は、「液体培地法」又は「それ以外」と記載をしてください。"]
[null,null,null,null,null,3000]
[null,null,null,null,false,"（それ以外）"]
[null,null,null,null,null,2090]
[null,"検体検査判断料",null,null,false,1500,null,"・検査の種類・回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["合　　　　　　　　　計",null,null,null,null,null,null,null,null,null,null,{"$f":"+SUM(L9:L42)","v":0}]
["※１　ツベルクリンの判定を行った場合のみ、初診料と再診料（１回分）を併せて請求できます。"]
["　　（画像診断、喀痰検査及びT-スポット.TB検査の検査結果は、区福祉保健センターから受診対象者へお知らせします）",null,null,null,false]
["※２　複数の検査を実施した場合も、初診料を重ねて請求することはできません。"]
["※３　計画的な訪問診療時に検査を行った場合は、往診料を請求することはできません。"]
["　 　 基準単価は令和８年４月１日時点の診療報酬点数表を基にしたものとなります。"]
[]
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[]
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[]
[]
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[]
[]
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[]
[]
[]
[]
[]
[]
[]
[]
[]
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[]
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[]
[]
[null,null,null,null,false]

{"sheet":"③明細書(画像診断)(3人目)","index":10,"n_rows":47,"n_cols":12,"rows_kept":47,"cut":false,"hidden":false,"merged":[[2,7,2,10],[3,1,6,2],[3,3,6,3],[3,4,6,4],[3,5,6,6],[3,7,3,8],[1,1,1,2],[1,5,1,6],[2,0,8,0],[2,1,2,2],[2,5,2,6],[3,11,6,11],[7,1,8,2],[7,3,8,3],[7,4,8,4],[7,5,8,6],[7,7,8,7],[7,9,8,9],[7,10,8,10],[7,11,8,11],[9,7,9,10],[10,1,13,2],[10,3,13,3],[10,4,13,4],[10,5,13,6],[10,7,10,8],[10,11,13,11],[14,1,24,1],[14,5,14,6],[14,7,24,7],[14,8,24,8],[14,9,24,9],[14,10,24,10],[14,11,24,11],[15,5,15,6],[16,5,16,6],[17,5,17,6],[18,5,18,6],[19,2,19,6],[20,5,20,6],[21,5,21,6],[9,0,24,0],[9,1,9,2],[9,5,9,6],[31,1,33,2],[31,3,33,3],[23,5,23,6],[25,0,45,0],[25,1,27,2],[25,3,27,3],[25,4,27,4],[25,5,27,6],[34,3,36,3],[34,4,36,4],[34,5,36,6],[37,1,39,2],[28,4,30,4],[28,5,30,6],[31,4,33,4],[22,5,22,6],[24,5,24,6],[31,5,33,6],[34,1,36,2],[46,10,47,10],[46,11,47,11],[37,3,39,3],[37,4,39,4],[37,5,39,6],[40,1,45,6],[40,11,43,11],[44,7,45,7],[44,8,45,8],[44,9,45,9],[44,10,45,11],[25,11,39,11],[28,1,30,2],[28,3,30,3]]}
[]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額"]
["胸部エックス線検査（デジタル撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E3,F3,0))","v":0}]
[null,"デジタル撮影料",null,null,false,680,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E4,F4,0)+IF(J5,K5,0)+IF(J6,K6,0)+IF(J7,K7,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,540]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,340]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,200]
[null,"電子画像管理加算（電子化保存）",null,null,false,570,null,null,"画像診断管理加算１（施設基準あり）",false,700,{"$f":"+SUM(IF(E8,F8,0)+(IF(J8,K8,0)))","v":0}]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
["胸部エックス線検査（アナログ撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E10,F10,0))","v":0}]
[null,"アナログ撮影料",null,null,false,600,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E11,F11,0)+IF(J12,K12,0)+IF(J13,K13,0)+IF(J14,K14,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,480]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,300]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,180]
[null,"フィルム料","半切",null,false,120,null,null,"画像診断管理加算１（施設基準あり）\nただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。",false,700,{"$f":"+SUM(IF(E15,F15,0)+IF(E16,F16,0)+IF(E17,F17,0)+IF(E18,F18,0)+IF(E19,F19,0)+IF(E21,F21,0)+IF(E22,F22,0)+IF(E23,F23,0)+IF(E24,F24,0)+IF(E25,F25,0)+IF(J15,K15,0))","v":0}]
[null,null,"大角",null,false,115]
[null,null,"大四ツ切",null,false,76]
[null,null,"四ツ切",null,false,62]
[null,null,"六ツ切",null,false,48]
[null,null,"６歳未満の場合"]
[null,null,"半切",null,false,130]
[null,null,"大角",null,false,130]
[null,null,"大四ツ切",null,false,80]
[null,null,"四ツ切",null,false,70]
[null,null,"六ツ切",null,false,50]
["胸部エックス線検査\n※福祉保健センターから指示があった場合のみ、請求可能","マルチスライス型（64列以上）共同施設において行われる場合",null,null,false,15900,null,null,"新生児",false,8160,{"$f":"+SUM(IF(E26,F26,0)+IF(E29,F29,0)+IF(E32,F32,0)+IF(E35,F35,0)+IF(E38,F38,0)+IF(J26,K26,0)+IF(J27,K27,0)+IF(J28,K28,0)+IF(J29,K29,0)+IF(J30,K30,0)+IF(J31,K31,0)+IF(J32,K32,0)+IF(J33,K33,0)+IF(J34,K34,0)+IF(J35,K35,0))+IF(J36,K36,0)+IF(J37,K37,0)+IF(J38,K38,0)+IF(J39,K39,0)+IF(J40,K40,0)","v":0}]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5100]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3060]
[null,"マルチスライス型（64列以上）その他の場合",null,null,false,15700,null,null,"新生児",false,8000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5000]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3000]
[null,"マルチスライス型（16列以上64列未満）",null,null,false,14700,null,null,"新生児",false,7200]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,4500]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2700]
[null,"マルチスライス型（４列以上16列未満）",null,null,false,13200,null,null,"新生児",false,6000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,3750]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2250]
[null,"その他",null,null,false,11300,null,null,"新生児",false,4480]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,2800]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,1680]
[null,null,null,null,null,null,null,null,"画像診断管理加算１",false,700,{"$f":"+SUM(IF(J41,K41,0)+IF(J42,K42,0)+IF(J43,K43,0)+IF(J44,K44,0))","v":0}]
[null,null,null,null,null,null,null,null,"画像診断管理加算２",false,1750]
[null,null,null,null,null,null,null,null,"画像診断管理加算３",false,2350]
[null,null,null,null,null,null,null,null,"画像診断管理加算４",false,3400]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
[]
[null,null,null,null,null,null,null,null,null,null,"合　計",{"$f":"SUM(L3:L46)","v":0}]

{"sheet":"②明細書(4人目)","index":11,"n_rows":111,"n_cols":27,"rows_kept":111,"cut":false,"hidden":false,"merged":[[42,0,42,10],[43,0,43,8],[49,1,49,10],[34,0,41,0],[34,1,39,1],[34,7,35,10],[34,11,41,11],[36,2,39,2],[36,4,37,4],[36,7,39,10],[38,4,39,4],[40,1,40,2],[40,7,40,10],[41,1,41,2],[41,7,41,10],[28,7,31,10],[28,11,33,11],[30,3,31,3],[30,4,31,4],[32,1,32,2],[32,7,32,10],[33,1,33,2],[33,7,33,10],[26,4,27,4],[28,0,33,0],[28,1,31,2],[28,3,29,3],[28,4,29,4],[22,0,27,0],[22,1,27,2],[22,4,23,4],[22,7,27,10],[22,11,27,11],[8,0,11,0],[9,1,11,1],[9,8,11,8],[9,10,11,10],[9,11,11,11],[12,1,20,2],[12,3,20,3],[12,4,20,4],[12,5,20,5],[8,1,8,2],[12,7,20,10],[12,11,20,11],[21,5,21,10],[24,4,25,4],[7,1,7,2],[7,5,7,6],[0,0,0,11],[1,0,1,11],[2,0,2,2],[2,3,2,11],[3,0,3,11],[4,0,4,11],[5,0,5,3],[5,5,5,8],[5,10,5,11],[6,0,6,3],[6,6,6,11]]}
["結　核　健　診　等　委　託　料　請　求　明　細　書"]
["（　　　　　　　　年　　　　　月分）　"]
["医　療　機　関　名　称"]
["　　接触者健診　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　管理検診"]
["　　 　（保健カード）　　　　  　　　　　　　　　　　　　　　　　　　　　　　　　　　　（管理検診カード）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区"]
["患 者  氏 名\n年齢・性別",null,null,null,null,"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　満　　　　　　歳　　",null,null,null,null,"（　　男　・　　女　）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鶴見"]
["保健・管理\nカード番号",null,null,null,null,null,"福祉保健センター　　　第　　　　　　　　　　号　　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"神奈川"]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西"]
["共通\n\n","初\n診\n料",null,null,false,2910,null,null,"乳幼児加算（６歳未満）",false,750,{"$f":"+SUM(IF(E9,F9,0))+(IF(J9,K9,0))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"中"]
[null,"再\n診\n料","診療所",null,false,750,null,null,"乳幼児加算（６歳未満）",false,380,{"$f":"+SUM(IF(E10,F10,0)+(IF(E11,F11,0)+(IF(E12,F12,0)+(IF(J11,K10,0)))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旭"]
[null,null,"病　院\n(200床未満)",null,false,750,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"磯子"]
[null,null,"病 　院\n(200床以上)\n『外来診療料』",null,false,760,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金沢"]
[null,"往診料",null,null,false,7200,null,null,null,null,null,{"$f":"+SUM(IF(E13,F13,0)+(IF(J14,K14)+(IF(J15,K15,0)+(IF(J17,K17,0)+(IF(J19,K19)+(IF(J21,K21,0)))))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"港北"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"青葉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都筑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"戸塚"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"栄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"泉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"瀬谷"]
[]
["画像診断",null,null,null,null,null,null,null,null,null,null,{"$f":"+'③明細書(画像診断)(4人目)'!L47","v":0},null,null,"　"]
["ツベルクリン\n反 応 検 査","皮内反応検査料＋\n精製ツベルクリン\n(薬価･一般診断用0.25ug)",null,null,false,"（新生児）",null,"・[皮内反応検査料]＋[精製ツベルクリン(薬価･一般診断用0.25ug)]\n　　精製ツベルクリン薬剤料（点数）　274点（2,735円を五捨五超入）\n   　160円＋2,735円＝2,900円（10円未満を四捨五入）\n　★検査料に係る加算\n　　新生児加算　　…　100分の100を加算\n　　３歳未満乳幼児加算…100分の70を加算\n\n*新生児のツベルクリン反応検査\n　160円×2.0＋2,735円＝3,055円（10円未満を四捨五入）3,060円\n *３歳未満乳幼児のツベルクリン反応検査\n　160円×1.7＋2,735円＝3,007円（10円未満を四捨五入）3,010円",null,null,null,{"$f":"+SUM(IF(E23,F24,0)+(IF(E25,F26,0)+(IF(E27,F28,0))))","v":0}]
[null,null,null,null,null,3060]
[null,null,null,null,false,"（３歳未満）"]
[null,null,null,null,null,3010]
[null,null,null,null,false,"（３歳以上）"]
[null,null,null,null,null,2900]
["T-スポット.TB検査","検　　査　　料",null,null,false,"（６歳未満）",null,"・[検査料]＋[採血採取]\n　　5,930円＋　400円＝6,330円\n　★血液採取に係る加算\n　　６歳未満の乳幼児に対して行った場合：350円加算\n\n・QFT検査を実施した場合、同額を算定できる。",null,null,null,{"$f":"+SUM(IF(E29,F30,0)+(IF(E31,F32,0)+(IF(E33,F33,0)+IF(E34,F34,0))))","v":0}]
[null,null,null,null,null,6680]
[null,null,null,null,false,"（６歳以上）"]
[null,null,null,null,null,6330]
[null,"検体検査判断料",null,null,false,1440,null,"・検査の種類、回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["喀痰検査","検査料","塗抹",null,false,670,null,"・１回の検査で、どちらかひとつを算定",null,null,null,{"$f":"+SUM(IF(E35,F35,0)+IF(E36,F36,0)+IF(E37,F38,0)+IF(E39,F40,0)+IF(E41,F41,0)+IF(E42,F42,0))","v":0}]
[null,null,"蛍光",null,false,500]
[null,null,"培養",null,false,"（液体培地法）",null,"・請求時は、「液体培地法」又は「それ以外」と記載をしてください。"]
[null,null,null,null,null,3000]
[null,null,null,null,false,"（それ以外）"]
[null,null,null,null,null,2090]
[null,"検体検査判断料",null,null,false,1500,null,"・検査の種類・回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["合　　　　　　　　　計",null,null,null,null,null,null,null,null,null,null,{"$f":"+SUM(L9:L42)","v":0}]
["※１　ツベルクリンの判定を行った場合のみ、初診料と再診料（１回分）を併せて請求できます。"]
["　　（画像診断、喀痰検査及びT-スポット.TB検査の検査結果は、区福祉保健センターから受診対象者へお知らせします）",null,null,null,false]
["※２　複数の検査を実施した場合も、初診料を重ねて請求することはできません。"]
["※３　計画的な訪問診療時に検査を行った場合は、往診料を請求することはできません。"]
["　 　 基準単価は令和８年４月１日時点の診療報酬点数表を基にしたものとなります。"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,false]

{"sheet":"③明細書(画像診断)(4人目)","index":12,"n_rows":47,"n_cols":12,"rows_kept":47,"cut":false,"hidden":false,"merged":[[31,5,33,6],[34,1,36,2],[46,10,47,10],[46,11,47,11],[37,3,39,3],[37,4,39,4],[37,5,39,6],[40,1,45,6],[40,11,43,11],[44,7,45,7],[44,8,45,8],[44,9,45,9],[44,10,45,11],[25,11,39,11],[28,1,30,2],[28,3,30,3],[28,4,30,4],[28,5,30,6],[31,4,33,4],[22,5,22,6],[24,5,24,6],[25,0,45,0],[25,1,27,2],[25,3,27,3],[25,4,27,4],[25,5,27,6],[34,3,36,3],[34,4,36,4],[34,5,36,6],[37,1,39,2],[9,0,24,0],[9,1,9,2],[9,5,9,6],[31,1,33,2],[31,3,33,3],[23,5,23,6],[10,11,13,11],[14,1,24,1],[14,5,14,6],[14,7,24,7],[14,8,24,8],[14,9,24,9],[14,10,24,10],[14,11,24,11],[15,5,15,6],[16,5,16,6],[17,5,17,6],[18,5,18,6],[19,2,19,6],[20,5,20,6],[21,5,21,6],[9,7,9,10],[10,1,13,2],[10,3,13,3],[10,4,13,4],[10,5,13,6],[10,7,10,8],[3,11,6,11],[7,1,8,2],[7,3,8,3],[7,4,8,4],[7,5,8,6],[7,7,8,7],[7,9,8,9],[7,10,8,10],[7,11,8,11],[1,1,1,2],[1,5,1,6],[2,0,8,0],[2,1,2,2],[2,5,2,6],[2,7,2,10],[3,1,6,2],[3,3,6,3],[3,4,6,4],[3,5,6,6],[3,7,3,8]]}
[]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額"]
["胸部エックス線検査（デジタル撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E3,F3,0))","v":0}]
[null,"デジタル撮影料",null,null,false,680,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E4,F4,0)+IF(J5,K5,0)+IF(J6,K6,0)+IF(J7,K7,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,540]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,340]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,200]
[null,"電子画像管理加算（電子化保存）",null,null,false,570,null,null,"画像診断管理加算１（施設基準あり）",false,700,{"$f":"+SUM(IF(E8,F8,0)+(IF(J8,K8,0)))","v":0}]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
["胸部エックス線検査（アナログ撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E10,F10,0))","v":0}]
[null,"アナログ撮影料",null,null,false,600,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E11,F11,0)+IF(J12,K12,0)+IF(J13,K13,0)+IF(J14,K14,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,480]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,300]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,180]
[null,"フィルム料","半切",null,false,120,null,null,"画像診断管理加算１（施設基準あり）\nただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。",false,700,{"$f":"+SUM(IF(E15,F15,0)+IF(E16,F16,0)+IF(E17,F17,0)+IF(E18,F18,0)+IF(E19,F19,0)+IF(E21,F21,0)+IF(E22,F22,0)+IF(E23,F23,0)+IF(E24,F24,0)+IF(E25,F25,0)+IF(J15,K15,0))","v":0}]
[null,null,"大角",null,false,115]
[null,null,"大四ツ切",null,false,76]
[null,null,"四ツ切",null,false,62]
[null,null,"六ツ切",null,false,48]
[null,null,"６歳未満の場合"]
[null,null,"半切",null,false,130]
[null,null,"大角",null,false,130]
[null,null,"大四ツ切",null,false,80]
[null,null,"四ツ切",null,false,70]
[null,null,"六ツ切",null,false,50]
["胸部エックス線検査\n※福祉保健センターから指示があった場合のみ、請求可能","マルチスライス型（64列以上）共同施設において行われる場合",null,null,false,15900,null,null,"新生児",false,8160,{"$f":"+SUM(IF(E26,F26,0)+IF(E29,F29,0)+IF(E32,F32,0)+IF(E35,F35,0)+IF(E38,F38,0)+IF(J26,K26,0)+IF(J27,K27,0)+IF(J28,K28,0)+IF(J29,K29,0)+IF(J30,K30,0)+IF(J31,K31,0)+IF(J32,K32,0)+IF(J33,K33,0)+IF(J34,K34,0)+IF(J35,K35,0))+IF(J36,K36,0)+IF(J37,K37,0)+IF(J38,K38,0)+IF(J39,K39,0)+IF(J40,K40,0)","v":0}]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5100]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3060]
[null,"マルチスライス型（64列以上）その他の場合",null,null,false,15700,null,null,"新生児",false,8000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5000]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3000]
[null,"マルチスライス型（16列以上64列未満）",null,null,false,14700,null,null,"新生児",false,7200]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,4500]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2700]
[null,"マルチスライス型（４列以上16列未満）",null,null,false,13200,null,null,"新生児",false,6000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,3750]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2250]
[null,"その他",null,null,false,11300,null,null,"新生児",false,4480]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,2800]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,1680]
[null,null,null,null,null,null,null,null,"画像診断管理加算１",false,700,{"$f":"+SUM(IF(J41,K41,0)+IF(J42,K42,0)+IF(J43,K43,0)+IF(J44,K44,0))","v":0}]
[null,null,null,null,null,null,null,null,"画像診断管理加算２",false,1750]
[null,null,null,null,null,null,null,null,"画像診断管理加算３",false,2350]
[null,null,null,null,null,null,null,null,"画像診断管理加算４",false,3400]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
[]
[null,null,null,null,null,null,null,null,null,null,"合　計",{"$f":"SUM(L3:L46)","v":0}]

{"sheet":"②明細書(5人目)","index":13,"n_rows":111,"n_cols":27,"rows_kept":111,"cut":false,"hidden":false,"merged":[[42,0,42,10],[43,0,43,8],[49,1,49,10],[34,0,41,0],[34,1,39,1],[34,7,35,10],[34,11,41,11],[36,2,39,2],[36,4,37,4],[36,7,39,10],[38,4,39,4],[40,1,40,2],[40,7,40,10],[41,1,41,2],[41,7,41,10],[28,7,31,10],[28,11,33,11],[30,3,31,3],[30,4,31,4],[32,1,32,2],[32,7,32,10],[33,1,33,2],[33,7,33,10],[26,4,27,4],[28,0,33,0],[28,1,31,2],[28,3,29,3],[28,4,29,4],[22,0,27,0],[22,1,27,2],[22,4,23,4],[22,7,27,10],[22,11,27,11],[8,0,11,0],[9,1,11,1],[9,8,11,8],[9,10,11,10],[9,11,11,11],[12,1,20,2],[12,3,20,3],[12,4,20,4],[12,5,20,5],[8,1,8,2],[12,7,20,10],[12,11,20,11],[21,5,21,10],[24,4,25,4],[7,1,7,2],[7,5,7,6],[0,0,0,11],[1,0,1,11],[2,0,2,2],[2,3,2,11],[3,0,3,11],[4,0,4,11],[5,0,5,3],[5,5,5,8],[5,10,5,11],[6,0,6,3],[6,6,6,11]]}
["結　核　健　診　等　委　託　料　請　求　明　細　書"]
["（　　　　　　　　年　　　　　月分）　"]
["医　療　機　関　名　称"]
["　　接触者健診　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　管理検診"]
["　　 　（保健カード）　　　　  　　　　　　　　　　　　　　　　　　　　　　　　　　　　（管理検診カード）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区"]
["患 者  氏 名\n年齢・性別",null,null,null,null,"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　満　　　　　　歳　　",null,null,null,null,"（　　男　・　　女　）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鶴見"]
["保健・管理\nカード番号",null,null,null,null,null,"福祉保健センター　　　第　　　　　　　　　　号　　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"神奈川"]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西"]
["共通\n\n","初\n診\n料",null,null,false,2910,null,null,"乳幼児加算（６歳未満）",false,750,{"$f":"+SUM(IF(E9,F9,0))+(IF(J9,K9,0))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"中"]
[null,"再\n診\n料","診療所",null,false,750,null,null,"乳幼児加算（６歳未満）",false,380,{"$f":"+SUM(IF(E10,F10,0)+(IF(E11,F11,0)+(IF(E12,F12,0)+(IF(J11,K10,0)))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旭"]
[null,null,"病　院\n(200床未満)",null,false,750,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"磯子"]
[null,null,"病 　院\n(200床以上)\n『外来診療料』",null,false,760,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金沢"]
[null,"往診料",null,null,false,7200,null,null,null,null,null,{"$f":"+SUM(IF(E13,F13,0)+(IF(J14,K14)+(IF(J15,K15,0)+(IF(J17,K17,0)+(IF(J19,K19)+(IF(J21,K21,0)))))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"港北"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"青葉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都筑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"戸塚"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"栄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"泉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"瀬谷"]
[]
["画像診断",null,null,null,null,null,null,null,null,null,null,{"$f":"+'③明細書(画像診断)(5人目)'!L47","v":0},null,null,"　"]
["ツベルクリン\n反 応 検 査","皮内反応検査料＋\n精製ツベルクリン\n(薬価･一般診断用0.25ug)",null,null,false,"（新生児）",null,"・[皮内反応検査料]＋[精製ツベルクリン(薬価･一般診断用0.25ug)]\n　　精製ツベルクリン薬剤料（点数）　274点（2,735円を五捨五超入）\n   　160円＋2,735円＝2,900円（10円未満を四捨五入）\n　★検査料に係る加算\n　　新生児加算　　…　100分の100を加算\n　　３歳未満乳幼児加算…100分の70を加算\n\n*新生児のツベルクリン反応検査\n　160円×2.0＋2,735円＝3,055円（10円未満を四捨五入）3,060円\n *３歳未満乳幼児のツベルクリン反応検査\n　160円×1.7＋2,735円＝3,007円（10円未満を四捨五入）3,010円",null,null,null,{"$f":"+SUM(IF(E23,F24,0)+(IF(E25,F26,0)+(IF(E27,F28,0))))","v":0}]
[null,null,null,null,null,3060]
[null,null,null,null,false,"（３歳未満）"]
[null,null,null,null,null,3010]
[null,null,null,null,false,"（３歳以上）"]
[null,null,null,null,null,2900]
["T-スポット.TB検査","検　　査　　料",null,null,false,"（６歳未満）",null,"・[検査料]＋[採血採取]\n　　5,930円＋　400円＝6,330円\n　★血液採取に係る加算\n　　６歳未満の乳幼児に対して行った場合：350円加算\n\n・QFT検査を実施した場合、同額を算定できる。",null,null,null,{"$f":"+SUM(IF(E29,F30,0)+(IF(E31,F32,0)+(IF(E33,F33,0)+IF(E34,F34,0))))","v":0}]
[null,null,null,null,null,6680]
[null,null,null,null,false,"（６歳以上）"]
[null,null,null,null,null,6330]
[null,"検体検査判断料",null,null,false,1440,null,"・検査の種類、回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["喀痰検査","検査料","塗抹",null,false,670,null,"・１回の検査で、どちらかひとつを算定",null,null,null,{"$f":"+SUM(IF(E35,F35,0)+IF(E36,F36,0)+IF(E37,F38,0)+IF(E39,F40,0)+IF(E41,F41,0)+IF(E42,F42,0))","v":0}]
[null,null,"蛍光",null,false,500]
[null,null,"培養",null,false,"（液体培地法）",null,"・請求時は、「液体培地法」又は「それ以外」と記載をしてください。"]
[null,null,null,null,null,3000]
[null,null,null,null,false,"（それ以外）"]
[null,null,null,null,null,2090]
[null,"検体検査判断料",null,null,false,1500,null,"・検査の種類・回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["合　　　　　　　　　計",null,null,null,null,null,null,null,null,null,null,{"$f":"+SUM(L9:L42)","v":0}]
["※１　ツベルクリンの判定を行った場合のみ、初診料と再診料（１回分）を併せて請求できます。"]
["　　（画像診断、喀痰検査及びT-スポット.TB検査の検査結果は、区福祉保健センターから受診対象者へお知らせします）",null,null,null,false]
["※２　複数の検査を実施した場合も、初診料を重ねて請求することはできません。"]
["※３　計画的な訪問診療時に検査を行った場合は、往診料を請求することはできません。"]
["　 　 基準単価は令和８年４月１日時点の診療報酬点数表を基にしたものとなります。"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,false]

{"sheet":"③明細書(画像診断)(5人目)","index":14,"n_rows":47,"n_cols":12,"rows_kept":47,"cut":false,"hidden":false,"merged":[[31,5,33,6],[34,1,36,2],[46,10,47,10],[46,11,47,11],[37,3,39,3],[37,4,39,4],[37,5,39,6],[40,1,45,6],[40,11,43,11],[44,7,45,7],[44,8,45,8],[44,9,45,9],[44,10,45,11],[25,11,39,11],[28,1,30,2],[28,3,30,3],[28,4,30,4],[28,5,30,6],[31,4,33,4],[22,5,22,6],[24,5,24,6],[25,0,45,0],[25,1,27,2],[25,3,27,3],[25,4,27,4],[25,5,27,6],[34,3,36,3],[34,4,36,4],[34,5,36,6],[37,1,39,2],[9,0,24,0],[9,1,9,2],[9,5,9,6],[31,1,33,2],[31,3,33,3],[23,5,23,6],[10,11,13,11],[14,1,24,1],[14,5,14,6],[14,7,24,7],[14,8,24,8],[14,9,24,9],[14,10,24,10],[14,11,24,11],[15,5,15,6],[16,5,16,6],[17,5,17,6],[18,5,18,6],[19,2,19,6],[20,5,20,6],[21,5,21,6],[9,7,9,10],[10,1,13,2],[10,3,13,3],[10,4,13,4],[10,5,13,6],[10,7,10,8],[3,11,6,11],[7,1,8,2],[7,3,8,3],[7,4,8,4],[7,5,8,6],[7,7,8,7],[7,9,8,9],[7,10,8,10],[7,11,8,11],[1,1,1,2],[1,5,1,6],[2,0,8,0],[2,1,2,2],[2,5,2,6],[2,7,2,10],[3,1,6,2],[3,3,6,3],[3,4,6,4],[3,5,6,6],[3,7,3,8]]}
[]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額"]
["胸部エックス線検査（デジタル撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E3,F3,0))","v":0}]
[null,"デジタル撮影料",null,null,false,680,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E4,F4,0)+IF(J5,K5,0)+IF(J6,K6,0)+IF(J7,K7,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,540]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,340]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,200]
[null,"電子画像管理加算（電子化保存）",null,null,false,570,null,null,"画像診断管理加算１（施設基準あり）",false,700,{"$f":"+SUM(IF(E8,F8,0)+(IF(J8,K8,0)))","v":0}]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
["胸部エックス線検査（アナログ撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E10,F10,0))","v":0}]
[null,"アナログ撮影料",null,null,false,600,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E11,F11,0)+IF(J12,K12,0)+IF(J13,K13,0)+IF(J14,K14,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,480]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,300]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,180]
[null,"フィルム料","半切",null,false,120,null,null,"画像診断管理加算１（施設基準あり）\nただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。",false,700,{"$f":"+SUM(IF(E15,F15,0)+IF(E16,F16,0)+IF(E17,F17,0)+IF(E18,F18,0)+IF(E19,F19,0)+IF(E21,F21,0)+IF(E22,F22,0)+IF(E23,F23,0)+IF(E24,F24,0)+IF(E25,F25,0)+IF(J15,K15,0))","v":0}]
[null,null,"大角",null,false,115]
[null,null,"大四ツ切",null,false,76]
[null,null,"四ツ切",null,false,62]
[null,null,"六ツ切",null,false,48]
[null,null,"６歳未満の場合"]
[null,null,"半切",null,false,130]
[null,null,"大角",null,false,130]
[null,null,"大四ツ切",null,false,80]
[null,null,"四ツ切",null,false,70]
[null,null,"六ツ切",null,false,50]
["胸部エックス線検査\n※福祉保健センターから指示があった場合のみ、請求可能","マルチスライス型（64列以上）共同施設において行われる場合",null,null,false,15900,null,null,"新生児",false,8160,{"$f":"+SUM(IF(E26,F26,0)+IF(E29,F29,0)+IF(E32,F32,0)+IF(E35,F35,0)+IF(E38,F38,0)+IF(J26,K26,0)+IF(J27,K27,0)+IF(J28,K28,0)+IF(J29,K29,0)+IF(J30,K30,0)+IF(J31,K31,0)+IF(J32,K32,0)+IF(J33,K33,0)+IF(J34,K34,0)+IF(J35,K35,0))+IF(J36,K36,0)+IF(J37,K37,0)+IF(J38,K38,0)+IF(J39,K39,0)+IF(J40,K40,0)","v":0}]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5100]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3060]
[null,"マルチスライス型（64列以上）その他の場合",null,null,false,15700,null,null,"新生児",false,8000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5000]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3000]
[null,"マルチスライス型（16列以上64列未満）",null,null,false,14700,null,null,"新生児",false,7200]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,4500]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2700]
[null,"マルチスライス型（４列以上16列未満）",null,null,false,13200,null,null,"新生児",false,6000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,3750]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2250]
[null,"その他",null,null,false,11300,null,null,"新生児",false,4480]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,2800]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,1680]
[null,null,null,null,null,null,null,null,"画像診断管理加算１",false,700,{"$f":"+SUM(IF(J41,K41,0)+IF(J42,K42,0)+IF(J43,K43,0)+IF(J44,K44,0))","v":0}]
[null,null,null,null,null,null,null,null,"画像診断管理加算２",false,1750]
[null,null,null,null,null,null,null,null,"画像診断管理加算３",false,2350]
[null,null,null,null,null,null,null,null,"画像診断管理加算４",false,3400]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
[]
[null,null,null,null,null,null,null,null,null,null,"合　計",{"$f":"SUM(L3:L46)","v":0}]

{"sheet":"②明細書(6人目)","index":15,"n_rows":111,"n_cols":27,"rows_kept":111,"cut":false,"hidden":false,"merged":[[42,0,42,10],[43,0,43,8],[49,1,49,10],[34,0,41,0],[34,1,39,1],[34,7,35,10],[34,11,41,11],[36,2,39,2],[36,4,37,4],[36,7,39,10],[38,4,39,4],[40,1,40,2],[40,7,40,10],[41,1,41,2],[41,7,41,10],[28,7,31,10],[28,11,33,11],[30,3,31,3],[30,4,31,4],[32,1,32,2],[32,7,32,10],[33,1,33,2],[33,7,33,10],[26,4,27,4],[28,0,33,0],[28,1,31,2],[28,3,29,3],[28,4,29,4],[22,0,27,0],[22,1,27,2],[22,4,23,4],[22,7,27,10],[22,11,27,11],[8,0,11,0],[9,1,11,1],[9,8,11,8],[9,10,11,10],[9,11,11,11],[12,1,20,2],[12,3,20,3],[12,4,20,4],[12,5,20,5],[8,1,8,2],[12,7,20,10],[12,11,20,11],[21,5,21,10],[24,4,25,4],[7,1,7,2],[7,5,7,6],[0,0,0,11],[1,0,1,11],[2,0,2,2],[2,3,2,11],[3,0,3,11],[4,0,4,11],[5,0,5,3],[5,5,5,8],[5,10,5,11],[6,0,6,3],[6,6,6,11]]}
["結　核　健　診　等　委　託　料　請　求　明　細　書"]
["（　　　　　　　　年　　　　　月分）　"]
["医　療　機　関　名　称"]
["　　接触者健診　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　管理検診"]
["　　 　（保健カード）　　　　  　　　　　　　　　　　　　　　　　　　　　　　　　　　　（管理検診カード）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区"]
["患 者  氏 名\n年齢・性別",null,null,null,null,"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　満　　　　　　歳　　",null,null,null,null,"（　　男　・　　女　）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鶴見"]
["保健・管理\nカード番号",null,null,null,null,null,"福祉保健センター　　　第　　　　　　　　　　号　　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"神奈川"]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西"]
["共通\n\n","初\n診\n料",null,null,false,2910,null,null,"乳幼児加算（６歳未満）",false,750,{"$f":"+SUM(IF(E9,F9,0))+(IF(J9,K9,0))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"中"]
[null,"再\n診\n料","診療所",null,false,750,null,null,"乳幼児加算（６歳未満）",false,380,{"$f":"+SUM(IF(E10,F10,0)+(IF(E11,F11,0)+(IF(E12,F12,0)+(IF(J11,K10,0)))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旭"]
[null,null,"病　院\n(200床未満)",null,false,750,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"磯子"]
[null,null,"病 　院\n(200床以上)\n『外来診療料』",null,false,760,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金沢"]
[null,"往診料",null,null,false,7200,null,null,null,null,null,{"$f":"+SUM(IF(E13,F13,0)+(IF(J14,K14)+(IF(J15,K15,0)+(IF(J17,K17,0)+(IF(J19,K19)+(IF(J21,K21,0)))))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"港北"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"青葉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都筑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"戸塚"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"栄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"泉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"瀬谷"]
[]
["画像診断",null,null,null,null,null,null,null,null,null,null,{"$f":"+'③明細書(画像診断)(6人目)'!L47","v":0},null,null,"　"]
["ツベルクリン\n反 応 検 査","皮内反応検査料＋\n精製ツベルクリン\n(薬価･一般診断用0.25ug)",null,null,false,"（新生児）",null,"・[皮内反応検査料]＋[精製ツベルクリン(薬価･一般診断用0.25ug)]\n　　精製ツベルクリン薬剤料（点数）　274点（2,735円を五捨五超入）\n   　160円＋2,735円＝2,900円（10円未満を四捨五入）\n　★検査料に係る加算\n　　新生児加算　　…　100分の100を加算\n　　３歳未満乳幼児加算…100分の70を加算\n\n*新生児のツベルクリン反応検査\n　160円×2.0＋2,735円＝3,055円（10円未満を四捨五入）3,060円\n *３歳未満乳幼児のツベルクリン反応検査\n　160円×1.7＋2,735円＝3,007円（10円未満を四捨五入）3,010円",null,null,null,{"$f":"+SUM(IF(E23,F24,0)+(IF(E25,F26,0)+(IF(E27,F28,0))))","v":0}]
[null,null,null,null,null,3060]
[null,null,null,null,false,"（３歳未満）"]
[null,null,null,null,null,3010]
[null,null,null,null,false,"（３歳以上）"]
[null,null,null,null,null,2900]
["T-スポット.TB検査","検　　査　　料",null,null,false,"（６歳未満）",null,"・[検査料]＋[採血採取]\n　　5,930円＋　400円＝6,330円\n　★血液採取に係る加算\n　　６歳未満の乳幼児に対して行った場合：350円加算\n\n・QFT検査を実施した場合、同額を算定できる。",null,null,null,{"$f":"+SUM(IF(E29,F30,0)+(IF(E31,F32,0)+(IF(E33,F33,0)+IF(E34,F34,0))))","v":0}]
[null,null,null,null,null,6680]
[null,null,null,null,false,"（６歳以上）"]
[null,null,null,null,null,6330]
[null,"検体検査判断料",null,null,false,1440,null,"・検査の種類、回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["喀痰検査","検査料","塗抹",null,false,670,null,"・１回の検査で、どちらかひとつを算定",null,null,null,{"$f":"+SUM(IF(E35,F35,0)+IF(E36,F36,0)+IF(E37,F38,0)+IF(E39,F40,0)+IF(E41,F41,0)+IF(E42,F42,0))","v":0}]
[null,null,"蛍光",null,false,500]
[null,null,"培養",null,false,"（液体培地法）",null,"・請求時は、「液体培地法」又は「それ以外」と記載をしてください。"]
[null,null,null,null,null,3000]
[null,null,null,null,false,"（それ以外）"]
[null,null,null,null,null,2090]
[null,"検体検査判断料",null,null,false,1500,null,"・検査の種類・回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["合　　　　　　　　　計",null,null,null,null,null,null,null,null,null,null,{"$f":"+SUM(L9:L42)","v":0}]
["※１　ツベルクリンの判定を行った場合のみ、初診料と再診料（１回分）を併せて請求できます。"]
["　　（画像診断、喀痰検査及びT-スポット.TB検査の検査結果は、区福祉保健センターから受診対象者へお知らせします）",null,null,null,false]
["※２　複数の検査を実施した場合も、初診料を重ねて請求することはできません。"]
["※３　計画的な訪問診療時に検査を行った場合は、往診料を請求することはできません。"]
["　 　 基準単価は令和８年４月１日時点の診療報酬点数表を基にしたものとなります。"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
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[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,false]

{"sheet":"③明細書(画像診断)(6人目)","index":16,"n_rows":47,"n_cols":12,"rows_kept":47,"cut":false,"hidden":false,"merged":[[31,5,33,6],[34,1,36,2],[46,10,47,10],[46,11,47,11],[37,3,39,3],[37,4,39,4],[37,5,39,6],[40,1,45,6],[40,11,43,11],[44,7,45,7],[44,8,45,8],[44,9,45,9],[44,10,45,11],[25,11,39,11],[28,1,30,2],[28,3,30,3],[28,4,30,4],[28,5,30,6],[31,4,33,4],[22,5,22,6],[24,5,24,6],[25,0,45,0],[25,1,27,2],[25,3,27,3],[25,4,27,4],[25,5,27,6],[34,3,36,3],[34,4,36,4],[34,5,36,6],[37,1,39,2],[9,0,24,0],[9,1,9,2],[9,5,9,6],[31,1,33,2],[31,3,33,3],[23,5,23,6],[10,11,13,11],[14,1,24,1],[14,5,14,6],[14,7,24,7],[14,8,24,8],[14,9,24,9],[14,10,24,10],[14,11,24,11],[15,5,15,6],[16,5,16,6],[17,5,17,6],[18,5,18,6],[19,2,19,6],[20,5,20,6],[21,5,21,6],[9,7,9,10],[10,1,13,2],[10,3,13,3],[10,4,13,4],[10,5,13,6],[10,7,10,8],[3,11,6,11],[7,1,8,2],[7,3,8,3],[7,4,8,4],[7,5,8,6],[7,7,8,7],[7,9,8,9],[7,10,8,10],[7,11,8,11],[1,1,1,2],[1,5,1,6],[2,0,8,0],[2,1,2,2],[2,5,2,6],[2,7,2,10],[3,1,6,2],[3,3,6,3],[3,4,6,4],[3,5,6,6],[3,7,3,8]]}
[]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額"]
["胸部エックス線検査（デジタル撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E3,F3,0))","v":0}]
[null,"デジタル撮影料",null,null,false,680,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E4,F4,0)+IF(J5,K5,0)+IF(J6,K6,0)+IF(J7,K7,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,540]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,340]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,200]
[null,"電子画像管理加算（電子化保存）",null,null,false,570,null,null,"画像診断管理加算１（施設基準あり）",false,700,{"$f":"+SUM(IF(E8,F8,0)+(IF(J8,K8,0)))","v":0}]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
["胸部エックス線検査（アナログ撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E10,F10,0))","v":0}]
[null,"アナログ撮影料",null,null,false,600,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E11,F11,0)+IF(J12,K12,0)+IF(J13,K13,0)+IF(J14,K14,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,480]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,300]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,180]
[null,"フィルム料","半切",null,false,120,null,null,"画像診断管理加算１（施設基準あり）\nただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。",false,700,{"$f":"+SUM(IF(E15,F15,0)+IF(E16,F16,0)+IF(E17,F17,0)+IF(E18,F18,0)+IF(E19,F19,0)+IF(E21,F21,0)+IF(E22,F22,0)+IF(E23,F23,0)+IF(E24,F24,0)+IF(E25,F25,0)+IF(J15,K15,0))","v":0}]
[null,null,"大角",null,false,115]
[null,null,"大四ツ切",null,false,76]
[null,null,"四ツ切",null,false,62]
[null,null,"六ツ切",null,false,48]
[null,null,"６歳未満の場合"]
[null,null,"半切",null,false,130]
[null,null,"大角",null,false,130]
[null,null,"大四ツ切",null,false,80]
[null,null,"四ツ切",null,false,70]
[null,null,"六ツ切",null,false,50]
["胸部エックス線検査\n※福祉保健センターから指示があった場合のみ、請求可能","マルチスライス型（64列以上）共同施設において行われる場合",null,null,false,15900,null,null,"新生児",false,8160,{"$f":"+SUM(IF(E26,F26,0)+IF(E29,F29,0)+IF(E32,F32,0)+IF(E35,F35,0)+IF(E38,F38,0)+IF(J26,K26,0)+IF(J27,K27,0)+IF(J28,K28,0)+IF(J29,K29,0)+IF(J30,K30,0)+IF(J31,K31,0)+IF(J32,K32,0)+IF(J33,K33,0)+IF(J34,K34,0)+IF(J35,K35,0))+IF(J36,K36,0)+IF(J37,K37,0)+IF(J38,K38,0)+IF(J39,K39,0)+IF(J40,K40,0)","v":0}]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5100]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3060]
[null,"マルチスライス型（64列以上）その他の場合",null,null,false,15700,null,null,"新生児",false,8000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5000]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3000]
[null,"マルチスライス型（16列以上64列未満）",null,null,false,14700,null,null,"新生児",false,7200]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,4500]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2700]
[null,"マルチスライス型（４列以上16列未満）",null,null,false,13200,null,null,"新生児",false,6000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,3750]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2250]
[null,"その他",null,null,false,11300,null,null,"新生児",false,4480]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,2800]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,1680]
[null,null,null,null,null,null,null,null,"画像診断管理加算１",false,700,{"$f":"+SUM(IF(J41,K41,0)+IF(J42,K42,0)+IF(J43,K43,0)+IF(J44,K44,0))","v":0}]
[null,null,null,null,null,null,null,null,"画像診断管理加算２",false,1750]
[null,null,null,null,null,null,null,null,"画像診断管理加算３",false,2350]
[null,null,null,null,null,null,null,null,"画像診断管理加算４",false,3400]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
[]
[null,null,null,null,null,null,null,null,null,null,"合　計",{"$f":"SUM(L3:L46)","v":0}]

{"sheet":"②明細書(7人目)","index":17,"n_rows":111,"n_cols":27,"rows_kept":111,"cut":false,"hidden":false,"merged":[[42,0,42,10],[43,0,43,8],[49,1,49,10],[34,0,41,0],[34,1,39,1],[34,7,35,10],[34,11,41,11],[36,2,39,2],[36,4,37,4],[36,7,39,10],[38,4,39,4],[40,1,40,2],[40,7,40,10],[41,1,41,2],[41,7,41,10],[28,7,31,10],[28,11,33,11],[30,3,31,3],[30,4,31,4],[32,1,32,2],[32,7,32,10],[33,1,33,2],[33,7,33,10],[26,4,27,4],[28,0,33,0],[28,1,31,2],[28,3,29,3],[28,4,29,4],[22,0,27,0],[22,1,27,2],[22,4,23,4],[22,7,27,10],[22,11,27,11],[8,0,11,0],[9,1,11,1],[9,8,11,8],[9,10,11,10],[9,11,11,11],[12,1,20,2],[12,3,20,3],[12,4,20,4],[12,5,20,5],[8,1,8,2],[12,7,20,10],[12,11,20,11],[21,5,21,10],[24,4,25,4],[7,1,7,2],[7,5,7,6],[0,0,0,11],[1,0,1,11],[2,0,2,2],[2,3,2,11],[3,0,3,11],[4,0,4,11],[5,0,5,3],[5,5,5,8],[5,10,5,11],[6,0,6,3],[6,6,6,11]]}
["結　核　健　診　等　委　託　料　請　求　明　細　書"]
["（　　　　　　　　年　　　　　月分）　"]
["医　療　機　関　名　称"]
["　　接触者健診　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　管理検診"]
["　　 　（保健カード）　　　　  　　　　　　　　　　　　　　　　　　　　　　　　　　　　（管理検診カード）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区"]
["患 者  氏 名\n年齢・性別",null,null,null,null,"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　満　　　　　　歳　　",null,null,null,null,"（　　男　・　　女　）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鶴見"]
["保健・管理\nカード番号",null,null,null,null,null,"福祉保健センター　　　第　　　　　　　　　　号　　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"神奈川"]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西"]
["共通\n\n","初\n診\n料",null,null,false,2910,null,null,"乳幼児加算（６歳未満）",false,750,{"$f":"+SUM(IF(E9,F9,0))+(IF(J9,K9,0))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"中"]
[null,"再\n診\n料","診療所",null,false,750,null,null,"乳幼児加算（６歳未満）",false,380,{"$f":"+SUM(IF(E10,F10,0)+(IF(E11,F11,0)+(IF(E12,F12,0)+(IF(J11,K10,0)))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旭"]
[null,null,"病　院\n(200床未満)",null,false,750,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"磯子"]
[null,null,"病 　院\n(200床以上)\n『外来診療料』",null,false,760,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金沢"]
[null,"往診料",null,null,false,7200,null,null,null,null,null,{"$f":"+SUM(IF(E13,F13,0)+(IF(J14,K14)+(IF(J15,K15,0)+(IF(J17,K17,0)+(IF(J19,K19)+(IF(J21,K21,0)))))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"港北"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"青葉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都筑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"戸塚"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"栄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"泉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"瀬谷"]
[]
["画像診断",null,null,null,null,null,null,null,null,null,null,{"$f":"+'③明細書(画像診断)(7人目)'!L47","v":0},null,null,"　"]
["ツベルクリン\n反 応 検 査","皮内反応検査料＋\n精製ツベルクリン\n(薬価･一般診断用0.25ug)",null,null,false,"（新生児）",null,"・[皮内反応検査料]＋[精製ツベルクリン(薬価･一般診断用0.25ug)]\n　　精製ツベルクリン薬剤料（点数）　274点（2,735円を五捨五超入）\n   　160円＋2,735円＝2,900円（10円未満を四捨五入）\n　★検査料に係る加算\n　　新生児加算　　…　100分の100を加算\n　　３歳未満乳幼児加算…100分の70を加算\n\n*新生児のツベルクリン反応検査\n　160円×2.0＋2,735円＝3,055円（10円未満を四捨五入）3,060円\n *３歳未満乳幼児のツベルクリン反応検査\n　160円×1.7＋2,735円＝3,007円（10円未満を四捨五入）3,010円",null,null,null,{"$f":"+SUM(IF(E23,F24,0)+(IF(E25,F26,0)+(IF(E27,F28,0))))","v":0}]
[null,null,null,null,null,3060]
[null,null,null,null,false,"（３歳未満）"]
[null,null,null,null,null,3010]
[null,null,null,null,false,"（３歳以上）"]
[null,null,null,null,null,2900]
["T-スポット.TB検査","検　　査　　料",null,null,false,"（６歳未満）",null,"・[検査料]＋[採血採取]\n　　5,930円＋　400円＝6,330円\n　★血液採取に係る加算\n　　６歳未満の乳幼児に対して行った場合：350円加算\n\n・QFT検査を実施した場合、同額を算定できる。",null,null,null,{"$f":"+SUM(IF(E29,F30,0)+(IF(E31,F32,0)+(IF(E33,F33,0)+IF(E34,F34,0))))","v":0}]
[null,null,null,null,null,6680]
[null,null,null,null,false,"（６歳以上）"]
[null,null,null,null,null,6330]
[null,"検体検査判断料",null,null,false,1440,null,"・検査の種類、回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["喀痰検査","検査料","塗抹",null,false,670,null,"・１回の検査で、どちらかひとつを算定",null,null,null,{"$f":"+SUM(IF(E35,F35,0)+IF(E36,F36,0)+IF(E37,F38,0)+IF(E39,F40,0)+IF(E41,F41,0)+IF(E42,F42,0))","v":0}]
[null,null,"蛍光",null,false,500]
[null,null,"培養",null,false,"（液体培地法）",null,"・請求時は、「液体培地法」又は「それ以外」と記載をしてください。"]
[null,null,null,null,null,3000]
[null,null,null,null,false,"（それ以外）"]
[null,null,null,null,null,2090]
[null,"検体検査判断料",null,null,false,1500,null,"・検査の種類・回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["合　　　　　　　　　計",null,null,null,null,null,null,null,null,null,null,{"$f":"+SUM(L9:L42)","v":0}]
["※１　ツベルクリンの判定を行った場合のみ、初診料と再診料（１回分）を併せて請求できます。"]
["　　（画像診断、喀痰検査及びT-スポット.TB検査の検査結果は、区福祉保健センターから受診対象者へお知らせします）",null,null,null,false]
["※２　複数の検査を実施した場合も、初診料を重ねて請求することはできません。"]
["※３　計画的な訪問診療時に検査を行った場合は、往診料を請求することはできません。"]
["　 　 基準単価は令和８年４月１日時点の診療報酬点数表を基にしたものとなります。"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
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[]
[]
[]
[]
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[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
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[]
[]
[]
[]
[]
[null,null,null,null,false]

{"sheet":"③明細書(画像診断)(7人目)","index":18,"n_rows":47,"n_cols":12,"rows_kept":47,"cut":false,"hidden":false,"merged":[[31,5,33,6],[34,1,36,2],[46,10,47,10],[46,11,47,11],[37,3,39,3],[37,4,39,4],[37,5,39,6],[40,1,45,6],[40,11,43,11],[44,7,45,7],[44,8,45,8],[44,9,45,9],[44,10,45,11],[25,11,39,11],[28,1,30,2],[28,3,30,3],[28,4,30,4],[28,5,30,6],[31,4,33,4],[22,5,22,6],[24,5,24,6],[25,0,45,0],[25,1,27,2],[25,3,27,3],[25,4,27,4],[25,5,27,6],[34,3,36,3],[34,4,36,4],[34,5,36,6],[37,1,39,2],[9,0,24,0],[9,1,9,2],[9,5,9,6],[31,1,33,2],[31,3,33,3],[23,5,23,6],[10,11,13,11],[14,1,24,1],[14,5,14,6],[14,7,24,7],[14,8,24,8],[14,9,24,9],[14,10,24,10],[14,11,24,11],[15,5,15,6],[16,5,16,6],[17,5,17,6],[18,5,18,6],[19,2,19,6],[20,5,20,6],[21,5,21,6],[9,7,9,10],[10,1,13,2],[10,3,13,3],[10,4,13,4],[10,5,13,6],[10,7,10,8],[3,11,6,11],[7,1,8,2],[7,3,8,3],[7,4,8,4],[7,5,8,6],[7,7,8,7],[7,9,8,9],[7,10,8,10],[7,11,8,11],[1,1,1,2],[1,5,1,6],[2,0,8,0],[2,1,2,2],[2,5,2,6],[2,7,2,10],[3,1,6,2],[3,3,6,3],[3,4,6,4],[3,5,6,6],[3,7,3,8]]}
[]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額"]
["胸部エックス線検査（デジタル撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E3,F3,0))","v":0}]
[null,"デジタル撮影料",null,null,false,680,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E4,F4,0)+IF(J5,K5,0)+IF(J6,K6,0)+IF(J7,K7,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,540]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,340]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,200]
[null,"電子画像管理加算（電子化保存）",null,null,false,570,null,null,"画像診断管理加算１（施設基準あり）",false,700,{"$f":"+SUM(IF(E8,F8,0)+(IF(J8,K8,0)))","v":0}]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
["胸部エックス線検査（アナログ撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E10,F10,0))","v":0}]
[null,"アナログ撮影料",null,null,false,600,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E11,F11,0)+IF(J12,K12,0)+IF(J13,K13,0)+IF(J14,K14,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,480]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,300]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,180]
[null,"フィルム料","半切",null,false,120,null,null,"画像診断管理加算１（施設基準あり）\nただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。",false,700,{"$f":"+SUM(IF(E15,F15,0)+IF(E16,F16,0)+IF(E17,F17,0)+IF(E18,F18,0)+IF(E19,F19,0)+IF(E21,F21,0)+IF(E22,F22,0)+IF(E23,F23,0)+IF(E24,F24,0)+IF(E25,F25,0)+IF(J15,K15,0))","v":0}]
[null,null,"大角",null,false,115]
[null,null,"大四ツ切",null,false,76]
[null,null,"四ツ切",null,false,62]
[null,null,"六ツ切",null,false,48]
[null,null,"６歳未満の場合"]
[null,null,"半切",null,false,130]
[null,null,"大角",null,false,130]
[null,null,"大四ツ切",null,false,80]
[null,null,"四ツ切",null,false,70]
[null,null,"六ツ切",null,false,50]
["胸部エックス線検査\n※福祉保健センターから指示があった場合のみ、請求可能","マルチスライス型（64列以上）共同施設において行われる場合",null,null,false,15900,null,null,"新生児",false,8160,{"$f":"+SUM(IF(E26,F26,0)+IF(E29,F29,0)+IF(E32,F32,0)+IF(E35,F35,0)+IF(E38,F38,0)+IF(J26,K26,0)+IF(J27,K27,0)+IF(J28,K28,0)+IF(J29,K29,0)+IF(J30,K30,0)+IF(J31,K31,0)+IF(J32,K32,0)+IF(J33,K33,0)+IF(J34,K34,0)+IF(J35,K35,0))+IF(J36,K36,0)+IF(J37,K37,0)+IF(J38,K38,0)+IF(J39,K39,0)+IF(J40,K40,0)","v":0}]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5100]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3060]
[null,"マルチスライス型（64列以上）その他の場合",null,null,false,15700,null,null,"新生児",false,8000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5000]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3000]
[null,"マルチスライス型（16列以上64列未満）",null,null,false,14700,null,null,"新生児",false,7200]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,4500]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2700]
[null,"マルチスライス型（４列以上16列未満）",null,null,false,13200,null,null,"新生児",false,6000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,3750]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2250]
[null,"その他",null,null,false,11300,null,null,"新生児",false,4480]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,2800]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,1680]
[null,null,null,null,null,null,null,null,"画像診断管理加算１",false,700,{"$f":"+SUM(IF(J41,K41,0)+IF(J42,K42,0)+IF(J43,K43,0)+IF(J44,K44,0))","v":0}]
[null,null,null,null,null,null,null,null,"画像診断管理加算２",false,1750]
[null,null,null,null,null,null,null,null,"画像診断管理加算３",false,2350]
[null,null,null,null,null,null,null,null,"画像診断管理加算４",false,3400]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
[]
[null,null,null,null,null,null,null,null,null,null,"合　計",{"$f":"SUM(L3:L46)","v":0}]

{"sheet":"②明細書(8人目)","index":19,"n_rows":111,"n_cols":27,"rows_kept":111,"cut":false,"hidden":false,"merged":[[42,0,42,10],[43,0,43,8],[49,1,49,10],[34,0,41,0],[34,1,39,1],[34,7,35,10],[34,11,41,11],[36,2,39,2],[36,4,37,4],[36,7,39,10],[38,4,39,4],[40,1,40,2],[40,7,40,10],[41,1,41,2],[41,7,41,10],[28,7,31,10],[28,11,33,11],[30,3,31,3],[30,4,31,4],[32,1,32,2],[32,7,32,10],[33,1,33,2],[33,7,33,10],[26,4,27,4],[28,0,33,0],[28,1,31,2],[28,3,29,3],[28,4,29,4],[22,0,27,0],[22,1,27,2],[22,4,23,4],[22,7,27,10],[22,11,27,11],[8,0,11,0],[9,1,11,1],[9,8,11,8],[9,10,11,10],[9,11,11,11],[12,1,20,2],[12,3,20,3],[12,4,20,4],[12,5,20,5],[8,1,8,2],[12,7,20,10],[12,11,20,11],[21,5,21,10],[24,4,25,4],[7,1,7,2],[7,5,7,6],[0,0,0,11],[1,0,1,11],[2,0,2,2],[2,3,2,11],[3,0,3,11],[4,0,4,11],[5,0,5,3],[5,5,5,8],[5,10,5,11],[6,0,6,3],[6,6,6,11]]}
["結　核　健　診　等　委　託　料　請　求　明　細　書"]
["（　　　　　　　　年　　　　　月分）　"]
["医　療　機　関　名　称"]
["　　接触者健診　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　管理検診"]
["　　 　（保健カード）　　　　  　　　　　　　　　　　　　　　　　　　　　　　　　　　　（管理検診カード）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区"]
["患 者  氏 名\n年齢・性別",null,null,null,null,"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　満　　　　　　歳　　",null,null,null,null,"（　　男　・　　女　）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鶴見"]
["保健・管理\nカード番号",null,null,null,null,null,"福祉保健センター　　　第　　　　　　　　　　号　　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"神奈川"]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西"]
["共通\n\n","初\n診\n料",null,null,false,2910,null,null,"乳幼児加算（６歳未満）",false,750,{"$f":"+SUM(IF(E9,F9,0))+(IF(J9,K9,0))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"中"]
[null,"再\n診\n料","診療所",null,false,750,null,null,"乳幼児加算（６歳未満）",false,380,{"$f":"+SUM(IF(E10,F10,0)+(IF(E11,F11,0)+(IF(E12,F12,0)+(IF(J11,K10,0)))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旭"]
[null,null,"病　院\n(200床未満)",null,false,750,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"磯子"]
[null,null,"病 　院\n(200床以上)\n『外来診療料』",null,false,760,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金沢"]
[null,"往診料",null,null,false,7200,null,null,null,null,null,{"$f":"+SUM(IF(E13,F13,0)+(IF(J14,K14)+(IF(J15,K15,0)+(IF(J17,K17,0)+(IF(J19,K19)+(IF(J21,K21,0)))))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"港北"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"青葉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都筑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"戸塚"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"栄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"泉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"瀬谷"]
[]
["画像診断",null,null,null,null,null,null,null,null,null,null,{"$f":"+'③明細書(画像診断)(8人目)'!L47","v":0},null,null,"　"]
["ツベルクリン\n反 応 検 査","皮内反応検査料＋\n精製ツベルクリン\n(薬価･一般診断用0.25ug)",null,null,false,"（新生児）",null,"・[皮内反応検査料]＋[精製ツベルクリン(薬価･一般診断用0.25ug)]\n　　精製ツベルクリン薬剤料（点数）　274点（2,735円を五捨五超入）\n   　160円＋2,735円＝2,900円（10円未満を四捨五入）\n　★検査料に係る加算\n　　新生児加算　　…　100分の100を加算\n　　３歳未満乳幼児加算…100分の70を加算\n\n*新生児のツベルクリン反応検査\n　160円×2.0＋2,735円＝3,055円（10円未満を四捨五入）3,060円\n *３歳未満乳幼児のツベルクリン反応検査\n　160円×1.7＋2,735円＝3,007円（10円未満を四捨五入）3,010円",null,null,null,{"$f":"+SUM(IF(E23,F24,0)+(IF(E25,F26,0)+(IF(E27,F28,0))))","v":0}]
[null,null,null,null,null,3060]
[null,null,null,null,false,"（３歳未満）"]
[null,null,null,null,null,3010]
[null,null,null,null,false,"（３歳以上）"]
[null,null,null,null,null,2900]
["T-スポット.TB検査","検　　査　　料",null,null,false,"（６歳未満）",null,"・[検査料]＋[採血採取]\n　　5,930円＋　400円＝6,330円\n　★血液採取に係る加算\n　　６歳未満の乳幼児に対して行った場合：350円加算\n\n・QFT検査を実施した場合、同額を算定できる。",null,null,null,{"$f":"+SUM(IF(E29,F30,0)+(IF(E31,F32,0)+(IF(E33,F33,0)+IF(E34,F34,0))))","v":0}]
[null,null,null,null,null,6680]
[null,null,null,null,false,"（６歳以上）"]
[null,null,null,null,null,6330]
[null,"検体検査判断料",null,null,false,1440,null,"・検査の種類、回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["喀痰検査","検査料","塗抹",null,false,670,null,"・１回の検査で、どちらかひとつを算定",null,null,null,{"$f":"+SUM(IF(E35,F35,0)+IF(E36,F36,0)+IF(E37,F38,0)+IF(E39,F40,0)+IF(E41,F41,0)+IF(E42,F42,0))","v":0}]
[null,null,"蛍光",null,false,500]
[null,null,"培養",null,false,"（液体培地法）",null,"・請求時は、「液体培地法」又は「それ以外」と記載をしてください。"]
[null,null,null,null,null,3000]
[null,null,null,null,false,"（それ以外）"]
[null,null,null,null,null,2090]
[null,"検体検査判断料",null,null,false,1500,null,"・検査の種類・回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["合　　　　　　　　　計",null,null,null,null,null,null,null,null,null,null,{"$f":"+SUM(L9:L42)","v":0}]
["※１　ツベルクリンの判定を行った場合のみ、初診料と再診料（１回分）を併せて請求できます。"]
["　　（画像診断、喀痰検査及びT-スポット.TB検査の検査結果は、区福祉保健センターから受診対象者へお知らせします）",null,null,null,false]
["※２　複数の検査を実施した場合も、初診料を重ねて請求することはできません。"]
["※３　計画的な訪問診療時に検査を行った場合は、往診料を請求することはできません。"]
["　 　 基準単価は令和８年４月１日時点の診療報酬点数表を基にしたものとなります。"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,false]

{"sheet":"③明細書(画像診断)(8人目)","index":20,"n_rows":47,"n_cols":12,"rows_kept":47,"cut":false,"hidden":false,"merged":[[31,5,33,6],[34,1,36,2],[46,10,47,10],[46,11,47,11],[37,3,39,3],[37,4,39,4],[37,5,39,6],[40,1,45,6],[40,11,43,11],[44,7,45,7],[44,8,45,8],[44,9,45,9],[44,10,45,11],[25,11,39,11],[28,1,30,2],[28,3,30,3],[28,4,30,4],[28,5,30,6],[31,4,33,4],[22,5,22,6],[24,5,24,6],[25,0,45,0],[25,1,27,2],[25,3,27,3],[25,4,27,4],[25,5,27,6],[34,3,36,3],[34,4,36,4],[34,5,36,6],[37,1,39,2],[9,0,24,0],[9,1,9,2],[9,5,9,6],[31,1,33,2],[31,3,33,3],[23,5,23,6],[10,11,13,11],[14,1,24,1],[14,5,14,6],[14,7,24,7],[14,8,24,8],[14,9,24,9],[14,10,24,10],[14,11,24,11],[15,5,15,6],[16,5,16,6],[17,5,17,6],[18,5,18,6],[19,2,19,6],[20,5,20,6],[21,5,21,6],[9,7,9,10],[10,1,13,2],[10,3,13,3],[10,4,13,4],[10,5,13,6],[10,7,10,8],[3,11,6,11],[7,1,8,2],[7,3,8,3],[7,4,8,4],[7,5,8,6],[7,7,8,7],[7,9,8,9],[7,10,8,10],[7,11,8,11],[1,1,1,2],[1,5,1,6],[2,0,8,0],[2,1,2,2],[2,5,2,6],[2,7,2,10],[3,1,6,2],[3,3,6,3],[3,4,6,4],[3,5,6,6],[3,7,3,8]]}
[]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額"]
["胸部エックス線検査（デジタル撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E3,F3,0))","v":0}]
[null,"デジタル撮影料",null,null,false,680,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E4,F4,0)+IF(J5,K5,0)+IF(J6,K6,0)+IF(J7,K7,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,540]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,340]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,200]
[null,"電子画像管理加算（電子化保存）",null,null,false,570,null,null,"画像診断管理加算１（施設基準あり）",false,700,{"$f":"+SUM(IF(E8,F8,0)+(IF(J8,K8,0)))","v":0}]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
["胸部エックス線検査（アナログ撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E10,F10,0))","v":0}]
[null,"アナログ撮影料",null,null,false,600,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E11,F11,0)+IF(J12,K12,0)+IF(J13,K13,0)+IF(J14,K14,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,480]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,300]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,180]
[null,"フィルム料","半切",null,false,120,null,null,"画像診断管理加算１（施設基準あり）\nただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。",false,700,{"$f":"+SUM(IF(E15,F15,0)+IF(E16,F16,0)+IF(E17,F17,0)+IF(E18,F18,0)+IF(E19,F19,0)+IF(E21,F21,0)+IF(E22,F22,0)+IF(E23,F23,0)+IF(E24,F24,0)+IF(E25,F25,0)+IF(J15,K15,0))","v":0}]
[null,null,"大角",null,false,115]
[null,null,"大四ツ切",null,false,76]
[null,null,"四ツ切",null,false,62]
[null,null,"六ツ切",null,false,48]
[null,null,"６歳未満の場合"]
[null,null,"半切",null,false,130]
[null,null,"大角",null,false,130]
[null,null,"大四ツ切",null,false,80]
[null,null,"四ツ切",null,false,70]
[null,null,"六ツ切",null,false,50]
["胸部エックス線検査\n※福祉保健センターから指示があった場合のみ、請求可能","マルチスライス型（64列以上）共同施設において行われる場合",null,null,false,15900,null,null,"新生児",false,8160,{"$f":"+SUM(IF(E26,F26,0)+IF(E29,F29,0)+IF(E32,F32,0)+IF(E35,F35,0)+IF(E38,F38,0)+IF(J26,K26,0)+IF(J27,K27,0)+IF(J28,K28,0)+IF(J29,K29,0)+IF(J30,K30,0)+IF(J31,K31,0)+IF(J32,K32,0)+IF(J33,K33,0)+IF(J34,K34,0)+IF(J35,K35,0))+IF(J36,K36,0)+IF(J37,K37,0)+IF(J38,K38,0)+IF(J39,K39,0)+IF(J40,K40,0)","v":0}]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5100]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3060]
[null,"マルチスライス型（64列以上）その他の場合",null,null,false,15700,null,null,"新生児",false,8000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5000]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3000]
[null,"マルチスライス型（16列以上64列未満）",null,null,false,14700,null,null,"新生児",false,7200]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,4500]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2700]
[null,"マルチスライス型（４列以上16列未満）",null,null,false,13200,null,null,"新生児",false,6000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,3750]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2250]
[null,"その他",null,null,false,11300,null,null,"新生児",false,4480]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,2800]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,1680]
[null,null,null,null,null,null,null,null,"画像診断管理加算１",false,700,{"$f":"+SUM(IF(J41,K41,0)+IF(J42,K42,0)+IF(J43,K43,0)+IF(J44,K44,0))","v":0}]
[null,null,null,null,null,null,null,null,"画像診断管理加算２",false,1750]
[null,null,null,null,null,null,null,null,"画像診断管理加算３",false,2350]
[null,null,null,null,null,null,null,null,"画像診断管理加算４",false,3400]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
[]
[null,null,null,null,null,null,null,null,null,null,"合　計",{"$f":"SUM(L3:L46)","v":0}]

{"sheet":"②明細書(9人目)","index":21,"n_rows":111,"n_cols":27,"rows_kept":111,"cut":false,"hidden":false,"merged":[[42,0,42,10],[43,0,43,8],[49,1,49,10],[34,0,41,0],[34,1,39,1],[34,7,35,10],[34,11,41,11],[36,2,39,2],[36,4,37,4],[36,7,39,10],[38,4,39,4],[40,1,40,2],[40,7,40,10],[41,1,41,2],[41,7,41,10],[28,7,31,10],[28,11,33,11],[30,3,31,3],[30,4,31,4],[32,1,32,2],[32,7,32,10],[33,1,33,2],[33,7,33,10],[26,4,27,4],[28,0,33,0],[28,1,31,2],[28,3,29,3],[28,4,29,4],[22,0,27,0],[22,1,27,2],[22,4,23,4],[22,7,27,10],[22,11,27,11],[8,0,11,0],[9,1,11,1],[9,8,11,8],[9,10,11,10],[9,11,11,11],[12,1,20,2],[12,3,20,3],[12,4,20,4],[12,5,20,5],[8,1,8,2],[12,7,20,10],[12,11,20,11],[21,5,21,10],[24,4,25,4],[7,1,7,2],[7,5,7,6],[0,0,0,11],[1,0,1,11],[2,0,2,2],[2,3,2,11],[3,0,3,11],[4,0,4,11],[5,0,5,3],[5,5,5,8],[5,10,5,11],[6,0,6,3],[6,6,6,11]]}
["結　核　健　診　等　委　託　料　請　求　明　細　書"]
["（　　　　　　　　年　　　　　月分）　"]
["医　療　機　関　名　称"]
["　　接触者健診　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　管理検診"]
["　　 　（保健カード）　　　　  　　　　　　　　　　　　　　　　　　　　　　　　　　　　（管理検診カード）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区"]
["患 者  氏 名\n年齢・性別",null,null,null,null,"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　満　　　　　　歳　　",null,null,null,null,"（　　男　・　　女　）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鶴見"]
["保健・管理\nカード番号",null,null,null,null,null,"福祉保健センター　　　第　　　　　　　　　　号　　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"神奈川"]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西"]
["共通\n\n","初\n診\n料",null,null,false,2910,null,null,"乳幼児加算（６歳未満）",false,750,{"$f":"+SUM(IF(E9,F9,0))+(IF(J9,K9,0))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"中"]
[null,"再\n診\n料","診療所",null,false,750,null,null,"乳幼児加算（６歳未満）",false,380,{"$f":"+SUM(IF(E10,F10,0)+(IF(E11,F11,0)+(IF(E12,F12,0)+(IF(J11,K10,0)))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旭"]
[null,null,"病　院\n(200床未満)",null,false,750,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"磯子"]
[null,null,"病 　院\n(200床以上)\n『外来診療料』",null,false,760,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金沢"]
[null,"往診料",null,null,false,7200,null,null,null,null,null,{"$f":"+SUM(IF(E13,F13,0)+(IF(J14,K14)+(IF(J15,K15,0)+(IF(J17,K17,0)+(IF(J19,K19)+(IF(J21,K21,0)))))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"港北"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"青葉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都筑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"戸塚"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"栄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"泉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"瀬谷"]
[]
["画像診断",null,null,null,null,null,null,null,null,null,null,{"$f":"+'③明細書(画像診断)(9人目)'!L47","v":0},null,null,"　"]
["ツベルクリン\n反 応 検 査","皮内反応検査料＋\n精製ツベルクリン\n(薬価･一般診断用0.25ug)",null,null,false,"（新生児）",null,"・[皮内反応検査料]＋[精製ツベルクリン(薬価･一般診断用0.25ug)]\n　　精製ツベルクリン薬剤料（点数）　274点（2,735円を五捨五超入）\n   　160円＋2,735円＝2,900円（10円未満を四捨五入）\n　★検査料に係る加算\n　　新生児加算　　…　100分の100を加算\n　　３歳未満乳幼児加算…100分の70を加算\n\n*新生児のツベルクリン反応検査\n　160円×2.0＋2,735円＝3,055円（10円未満を四捨五入）3,060円\n *３歳未満乳幼児のツベルクリン反応検査\n　160円×1.7＋2,735円＝3,007円（10円未満を四捨五入）3,010円",null,null,null,{"$f":"+SUM(IF(E23,F24,0)+(IF(E25,F26,0)+(IF(E27,F28,0))))","v":0}]
[null,null,null,null,null,3060]
[null,null,null,null,false,"（３歳未満）"]
[null,null,null,null,null,3010]
[null,null,null,null,false,"（３歳以上）"]
[null,null,null,null,null,2900]
["T-スポット.TB検査","検　　査　　料",null,null,false,"（６歳未満）",null,"・[検査料]＋[採血採取]\n　　5,930円＋　400円＝6,330円\n　★血液採取に係る加算\n　　６歳未満の乳幼児に対して行った場合：350円加算\n\n・QFT検査を実施した場合、同額を算定できる。",null,null,null,{"$f":"+SUM(IF(E29,F30,0)+(IF(E31,F32,0)+(IF(E33,F33,0)+IF(E34,F34,0))))","v":0}]
[null,null,null,null,null,6680]
[null,null,null,null,false,"（６歳以上）"]
[null,null,null,null,null,6330]
[null,"検体検査判断料",null,null,false,1440,null,"・検査の種類、回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["喀痰検査","検査料","塗抹",null,false,670,null,"・１回の検査で、どちらかひとつを算定",null,null,null,{"$f":"+SUM(IF(E35,F35,0)+IF(E36,F36,0)+IF(E37,F38,0)+IF(E39,F40,0)+IF(E41,F41,0)+IF(E42,F42,0))","v":0}]
[null,null,"蛍光",null,false,500]
[null,null,"培養",null,false,"（液体培地法）",null,"・請求時は、「液体培地法」又は「それ以外」と記載をしてください。"]
[null,null,null,null,null,3000]
[null,null,null,null,false,"（それ以外）"]
[null,null,null,null,null,2090]
[null,"検体検査判断料",null,null,false,1500,null,"・検査の種類・回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["合　　　　　　　　　計",null,null,null,null,null,null,null,null,null,null,{"$f":"+SUM(L9:L42)","v":0}]
["※１　ツベルクリンの判定を行った場合のみ、初診料と再診料（１回分）を併せて請求できます。"]
["　　（画像診断、喀痰検査及びT-スポット.TB検査の検査結果は、区福祉保健センターから受診対象者へお知らせします）",null,null,null,false]
["※２　複数の検査を実施した場合も、初診料を重ねて請求することはできません。"]
["※３　計画的な訪問診療時に検査を行った場合は、往診料を請求することはできません。"]
["　 　 基準単価は令和８年４月１日時点の診療報酬点数表を基にしたものとなります。"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,false]

{"sheet":"③明細書(画像診断)(9人目)","index":22,"n_rows":47,"n_cols":12,"rows_kept":47,"cut":false,"hidden":false,"merged":[[31,5,33,6],[34,1,36,2],[46,10,47,10],[46,11,47,11],[37,3,39,3],[37,4,39,4],[37,5,39,6],[40,1,45,6],[40,11,43,11],[44,7,45,7],[44,8,45,8],[44,9,45,9],[44,10,45,11],[25,11,39,11],[28,1,30,2],[28,3,30,3],[28,4,30,4],[28,5,30,6],[31,4,33,4],[22,5,22,6],[24,5,24,6],[25,0,45,0],[25,1,27,2],[25,3,27,3],[25,4,27,4],[25,5,27,6],[34,3,36,3],[34,4,36,4],[34,5,36,6],[37,1,39,2],[9,0,24,0],[9,1,9,2],[9,5,9,6],[31,1,33,2],[31,3,33,3],[23,5,23,6],[10,11,13,11],[14,1,24,1],[14,5,14,6],[14,7,24,7],[14,8,24,8],[14,9,24,9],[14,10,24,10],[14,11,24,11],[15,5,15,6],[16,5,16,6],[17,5,17,6],[18,5,18,6],[19,2,19,6],[20,5,20,6],[21,5,21,6],[9,7,9,10],[10,1,13,2],[10,3,13,3],[10,4,13,4],[10,5,13,6],[10,7,10,8],[3,11,6,11],[7,1,8,2],[7,3,8,3],[7,4,8,4],[7,5,8,6],[7,7,8,7],[7,9,8,9],[7,10,8,10],[7,11,8,11],[1,1,1,2],[1,5,1,6],[2,0,8,0],[2,1,2,2],[2,5,2,6],[2,7,2,10],[3,1,6,2],[3,3,6,3],[3,4,6,4],[3,5,6,6],[3,7,3,8]]}
[]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額"]
["胸部エックス線検査（デジタル撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E3,F3,0))","v":0}]
[null,"デジタル撮影料",null,null,false,680,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E4,F4,0)+IF(J5,K5,0)+IF(J6,K6,0)+IF(J7,K7,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,540]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,340]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,200]
[null,"電子画像管理加算（電子化保存）",null,null,false,570,null,null,"画像診断管理加算１（施設基準あり）",false,700,{"$f":"+SUM(IF(E8,F8,0)+(IF(J8,K8,0)))","v":0}]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
["胸部エックス線検査（アナログ撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E10,F10,0))","v":0}]
[null,"アナログ撮影料",null,null,false,600,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E11,F11,0)+IF(J12,K12,0)+IF(J13,K13,0)+IF(J14,K14,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,480]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,300]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,180]
[null,"フィルム料","半切",null,false,120,null,null,"画像診断管理加算１（施設基準あり）\nただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。",false,700,{"$f":"+SUM(IF(E15,F15,0)+IF(E16,F16,0)+IF(E17,F17,0)+IF(E18,F18,0)+IF(E19,F19,0)+IF(E21,F21,0)+IF(E22,F22,0)+IF(E23,F23,0)+IF(E24,F24,0)+IF(E25,F25,0)+IF(J15,K15,0))","v":0}]
[null,null,"大角",null,false,115]
[null,null,"大四ツ切",null,false,76]
[null,null,"四ツ切",null,false,62]
[null,null,"六ツ切",null,false,48]
[null,null,"６歳未満の場合"]
[null,null,"半切",null,false,130]
[null,null,"大角",null,false,130]
[null,null,"大四ツ切",null,false,80]
[null,null,"四ツ切",null,false,70]
[null,null,"六ツ切",null,false,50]
["胸部エックス線検査\n※福祉保健センターから指示があった場合のみ、請求可能","マルチスライス型（64列以上）共同施設において行われる場合",null,null,false,15900,null,null,"新生児",false,8160,{"$f":"+SUM(IF(E26,F26,0)+IF(E29,F29,0)+IF(E32,F32,0)+IF(E35,F35,0)+IF(E38,F38,0)+IF(J26,K26,0)+IF(J27,K27,0)+IF(J28,K28,0)+IF(J29,K29,0)+IF(J30,K30,0)+IF(J31,K31,0)+IF(J32,K32,0)+IF(J33,K33,0)+IF(J34,K34,0)+IF(J35,K35,0))+IF(J36,K36,0)+IF(J37,K37,0)+IF(J38,K38,0)+IF(J39,K39,0)+IF(J40,K40,0)","v":0}]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5100]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3060]
[null,"マルチスライス型（64列以上）その他の場合",null,null,false,15700,null,null,"新生児",false,8000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5000]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3000]
[null,"マルチスライス型（16列以上64列未満）",null,null,false,14700,null,null,"新生児",false,7200]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,4500]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2700]
[null,"マルチスライス型（４列以上16列未満）",null,null,false,13200,null,null,"新生児",false,6000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,3750]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2250]
[null,"その他",null,null,false,11300,null,null,"新生児",false,4480]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,2800]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,1680]
[null,null,null,null,null,null,null,null,"画像診断管理加算１",false,700,{"$f":"+SUM(IF(J41,K41,0)+IF(J42,K42,0)+IF(J43,K43,0)+IF(J44,K44,0))","v":0}]
[null,null,null,null,null,null,null,null,"画像診断管理加算２",false,1750]
[null,null,null,null,null,null,null,null,"画像診断管理加算３",false,2350]
[null,null,null,null,null,null,null,null,"画像診断管理加算４",false,3400]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
[]
[null,null,null,null,null,null,null,null,null,null,"合　計",{"$f":"SUM(L3:L46)","v":0}]

{"sheet":"②明細書(10人目)","index":23,"n_rows":111,"n_cols":27,"rows_kept":111,"cut":false,"hidden":false,"merged":[[42,0,42,10],[43,0,43,8],[49,1,49,10],[34,0,41,0],[34,1,39,1],[34,7,35,10],[34,11,41,11],[36,2,39,2],[36,4,37,4],[36,7,39,10],[38,4,39,4],[40,1,40,2],[40,7,40,10],[41,1,41,2],[41,7,41,10],[28,7,31,10],[28,11,33,11],[30,3,31,3],[30,4,31,4],[32,1,32,2],[32,7,32,10],[33,1,33,2],[33,7,33,10],[26,4,27,4],[28,0,33,0],[28,1,31,2],[28,3,29,3],[28,4,29,4],[22,0,27,0],[22,1,27,2],[22,4,23,4],[22,7,27,10],[22,11,27,11],[8,0,11,0],[9,1,11,1],[9,8,11,8],[9,10,11,10],[9,11,11,11],[12,1,20,2],[12,3,20,3],[12,4,20,4],[12,5,20,5],[8,1,8,2],[12,7,20,10],[12,11,20,11],[21,5,21,10],[24,4,25,4],[7,1,7,2],[7,5,7,6],[0,0,0,11],[1,0,1,11],[2,0,2,2],[2,3,2,11],[3,0,3,11],[4,0,4,11],[5,0,5,3],[5,5,5,8],[5,10,5,11],[6,0,6,3],[6,6,6,11]]}
["結　核　健　診　等　委　託　料　請　求　明　細　書"]
["（　　　　　　　　年　　　　　月分）　"]
["医　療　機　関　名　称"]
["　　接触者健診　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　管理検診"]
["　　 　（保健カード）　　　　  　　　　　　　　　　　　　　　　　　　　　　　　　　　　（管理検診カード）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区"]
["患 者  氏 名\n年齢・性別",null,null,null,null,"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　満　　　　　　歳　　",null,null,null,null,"（　　男　・　　女　）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"鶴見"]
["保健・管理\nカード番号",null,null,null,null,null,"福祉保健センター　　　第　　　　　　　　　　号　　　　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"神奈川"]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西"]
["共通\n\n","初\n診\n料",null,null,false,2910,null,null,"乳幼児加算（６歳未満）",false,750,{"$f":"+SUM(IF(E9,F9,0))+(IF(J9,K9,0))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"中"]
[null,"再\n診\n料","診療所",null,false,750,null,null,"乳幼児加算（６歳未満）",false,380,{"$f":"+SUM(IF(E10,F10,0)+(IF(E11,F11,0)+(IF(E12,F12,0)+(IF(J11,K10,0)))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旭"]
[null,null,"病　院\n(200床未満)",null,false,750,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"磯子"]
[null,null,"病 　院\n(200床以上)\n『外来診療料』",null,false,760,null,null,null,false,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金沢"]
[null,"往診料",null,null,false,7200,null,null,null,null,null,{"$f":"+SUM(IF(E13,F13,0)+(IF(J14,K14)+(IF(J15,K15,0)+(IF(J17,K17,0)+(IF(J19,K19)+(IF(J21,K21,0)))))))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"港北"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"緑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"青葉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都筑"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"戸塚"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"栄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"泉"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"瀬谷"]
[]
["画像診断",null,null,null,null,null,null,null,null,null,null,{"$f":"+'③明細書(画像診断)(10人目)'!L47","v":0},null,null,"　"]
["ツベルクリン\n反 応 検 査","皮内反応検査料＋\n精製ツベルクリン\n(薬価･一般診断用0.25ug)",null,null,false,"（新生児）",null,"・[皮内反応検査料]＋[精製ツベルクリン(薬価･一般診断用0.25ug)]\n　　精製ツベルクリン薬剤料（点数）　274点（2,735円を五捨五超入）\n   　160円＋2,735円＝2,900円（10円未満を四捨五入）\n　★検査料に係る加算\n　　新生児加算　　…　100分の100を加算\n　　３歳未満乳幼児加算…100分の70を加算\n\n*新生児のツベルクリン反応検査\n　160円×2.0＋2,735円＝3,055円（10円未満を四捨五入）3,060円\n *３歳未満乳幼児のツベルクリン反応検査\n　160円×1.7＋2,735円＝3,007円（10円未満を四捨五入）3,010円",null,null,null,{"$f":"+SUM(IF(E23,F24,0)+(IF(E25,F26,0)+(IF(E27,F28,0))))","v":0}]
[null,null,null,null,null,3060]
[null,null,null,null,false,"（３歳未満）"]
[null,null,null,null,null,3010]
[null,null,null,null,false,"（３歳以上）"]
[null,null,null,null,null,2900]
["T-スポット.TB検査","検　　査　　料",null,null,false,"（６歳未満）",null,"・[検査料]＋[採血採取]\n　　5,930円＋　400円＝6,330円\n　★血液採取に係る加算\n　　６歳未満の乳幼児に対して行った場合：350円加算\n\n・QFT検査を実施した場合、同額を算定できる。",null,null,null,{"$f":"+SUM(IF(E29,F30,0)+(IF(E31,F32,0)+(IF(E33,F33,0)+IF(E34,F34,0))))","v":0}]
[null,null,null,null,null,6680]
[null,null,null,null,false,"（６歳以上）"]
[null,null,null,null,null,6330]
[null,"検体検査判断料",null,null,false,1440,null,"・検査の種類、回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["喀痰検査","検査料","塗抹",null,false,670,null,"・１回の検査で、どちらかひとつを算定",null,null,null,{"$f":"+SUM(IF(E35,F35,0)+IF(E36,F36,0)+IF(E37,F38,0)+IF(E39,F40,0)+IF(E41,F41,0)+IF(E42,F42,0))","v":0}]
[null,null,"蛍光",null,false,500]
[null,null,"培養",null,false,"（液体培地法）",null,"・請求時は、「液体培地法」又は「それ以外」と記載をしてください。"]
[null,null,null,null,null,3000]
[null,null,null,null,false,"（それ以外）"]
[null,null,null,null,null,2090]
[null,"検体検査判断料",null,null,false,1500,null,"・検査の種類・回数にかかわらず月１回に限り算定"]
[null,"検体検査管理加算",null,null,false,400,null,"・月１回（地方厚生局長等に届け出た保険医療機関のみ）"]
["合　　　　　　　　　計",null,null,null,null,null,null,null,null,null,null,{"$f":"+SUM(L9:L42)","v":0}]
["※１　ツベルクリンの判定を行った場合のみ、初診料と再診料（１回分）を併せて請求できます。"]
["　　（画像診断、喀痰検査及びT-スポット.TB検査の検査結果は、区福祉保健センターから受診対象者へお知らせします）",null,null,null,false]
["※２　複数の検査を実施した場合も、初診料を重ねて請求することはできません。"]
["※３　計画的な訪問診療時に検査を行った場合は、往診料を請求することはできません。"]
["　 　 基準単価は令和８年４月１日時点の診療報酬点数表を基にしたものとなります。"]
[]
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[null,null,null,null,false]

{"sheet":"③明細書(画像診断)(10人目)","index":24,"n_rows":47,"n_cols":12,"rows_kept":47,"cut":false,"hidden":false,"merged":[[31,5,33,6],[34,1,36,2],[46,10,47,10],[46,11,47,11],[37,3,39,3],[37,4,39,4],[37,5,39,6],[40,1,45,6],[40,11,43,11],[44,7,45,7],[44,8,45,8],[44,9,45,9],[44,10,45,11],[25,11,39,11],[28,1,30,2],[28,3,30,3],[28,4,30,4],[28,5,30,6],[31,4,33,4],[22,5,22,6],[24,5,24,6],[25,0,45,0],[25,1,27,2],[25,3,27,3],[25,4,27,4],[25,5,27,6],[34,3,36,3],[34,4,36,4],[34,5,36,6],[37,1,39,2],[9,0,24,0],[9,1,9,2],[9,5,9,6],[31,1,33,2],[31,3,33,3],[23,5,23,6],[10,11,13,11],[14,1,24,1],[14,5,14,6],[14,7,24,7],[14,8,24,8],[14,9,24,9],[14,10,24,10],[14,11,24,11],[15,5,15,6],[16,5,16,6],[17,5,17,6],[18,5,18,6],[19,2,19,6],[20,5,20,6],[21,5,21,6],[9,7,9,10],[10,1,13,2],[10,3,13,3],[10,4,13,4],[10,5,13,6],[10,7,10,8],[3,11,6,11],[7,1,8,2],[7,3,8,3],[7,4,8,4],[7,5,8,6],[7,7,8,7],[7,9,8,9],[7,10,8,10],[7,11,8,11],[1,1,1,2],[1,5,1,6],[2,0,8,0],[2,1,2,2],[2,5,2,6],[2,7,2,10],[3,1,6,2],[3,3,6,3],[3,4,6,4],[3,5,6,6],[3,7,3,8]]}
[]
["検査種別","項目",null,"チェック欄",null,"基準単価\n（診療報酬点数表による）",null,"チェック欄","加算内容",null,"加算額","金　額"]
["胸部エックス線検査（デジタル撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E3,F3,0))","v":0}]
[null,"デジタル撮影料",null,null,false,680,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E4,F4,0)+IF(J5,K5,0)+IF(J6,K6,0)+IF(J7,K7,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,540]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,340]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,200]
[null,"電子画像管理加算（電子化保存）",null,null,false,570,null,null,"画像診断管理加算１（施設基準あり）",false,700,{"$f":"+SUM(IF(E8,F8,0)+(IF(J8,K8,0)))","v":0}]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
["胸部エックス線検査（アナログ撮影）※正面１枚のみ請求可能です。","診断料",null,null,false,850,null,null,null,null,null,{"$f":"+SUM(IF(E10,F10,0))","v":0}]
[null,"アナログ撮影料",null,null,false,600,null,"撮影料に係る加算",null,null,null,{"$f":"+SUM(IF(E11,F11,0)+IF(J12,K12,0)+IF(J13,K13,0)+IF(J14,K14,0))","v":0}]
[null,null,null,null,null,null,null,null,"新生児",false,480]
[null,null,null,null,null,null,null,null,"３歳未満乳幼児",false,300]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,180]
[null,"フィルム料","半切",null,false,120,null,null,"画像診断管理加算１（施設基準あり）\nただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。",false,700,{"$f":"+SUM(IF(E15,F15,0)+IF(E16,F16,0)+IF(E17,F17,0)+IF(E18,F18,0)+IF(E19,F19,0)+IF(E21,F21,0)+IF(E22,F22,0)+IF(E23,F23,0)+IF(E24,F24,0)+IF(E25,F25,0)+IF(J15,K15,0))","v":0}]
[null,null,"大角",null,false,115]
[null,null,"大四ツ切",null,false,76]
[null,null,"四ツ切",null,false,62]
[null,null,"六ツ切",null,false,48]
[null,null,"６歳未満の場合"]
[null,null,"半切",null,false,130]
[null,null,"大角",null,false,130]
[null,null,"大四ツ切",null,false,80]
[null,null,"四ツ切",null,false,70]
[null,null,"六ツ切",null,false,50]
["胸部エックス線検査\n※福祉保健センターから指示があった場合のみ、請求可能","マルチスライス型（64列以上）共同施設において行われる場合",null,null,false,15900,null,null,"新生児",false,8160,{"$f":"+SUM(IF(E26,F26,0)+IF(E29,F29,0)+IF(E32,F32,0)+IF(E35,F35,0)+IF(E38,F38,0)+IF(J26,K26,0)+IF(J27,K27,0)+IF(J28,K28,0)+IF(J29,K29,0)+IF(J30,K30,0)+IF(J31,K31,0)+IF(J32,K32,0)+IF(J33,K33,0)+IF(J34,K34,0)+IF(J35,K35,0))+IF(J36,K36,0)+IF(J37,K37,0)+IF(J38,K38,0)+IF(J39,K39,0)+IF(J40,K40,0)","v":0}]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5100]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3060]
[null,"マルチスライス型（64列以上）その他の場合",null,null,false,15700,null,null,"新生児",false,8000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,5000]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,3000]
[null,"マルチスライス型（16列以上64列未満）",null,null,false,14700,null,null,"新生児",false,7200]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,4500]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2700]
[null,"マルチスライス型（４列以上16列未満）",null,null,false,13200,null,null,"新生児",false,6000]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,3750]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,2250]
[null,"その他",null,null,false,11300,null,null,"新生児",false,4480]
[null,null,null,null,null,null,null,null,"３歳児未満乳幼児",false,2800]
[null,null,null,null,null,null,null,null,"３歳以上６歳未満幼児",false,1680]
[null,null,null,null,null,null,null,null,"画像診断管理加算１",false,700,{"$f":"+SUM(IF(J41,K41,0)+IF(J42,K42,0)+IF(J43,K43,0)+IF(J44,K44,0))","v":0}]
[null,null,null,null,null,null,null,null,"画像診断管理加算２",false,1750]
[null,null,null,null,null,null,null,null,"画像診断管理加算３",false,2350]
[null,null,null,null,null,null,null,null,"画像診断管理加算４",false,3400]
[null,null,null,null,null,null,null,null,"ただし、画像診断を専ら担当する常勤の医師が報告した文書の写しを添付した場合に限り算定できるものとする。"]
[]
[null,null,null,null,null,null,null,null,null,null,"合　計",{"$f":"SUM(L3:L46)","v":0}]

{"sheet":"11人目以降","index":25,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":false,"merged":[]}

{"sheet":"Sheet16","index":26,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":false,"merged":[]}