Приложение N 1
Утверждено
приказом Минздрава РФ и Федерального фонда ОМС
от 13 ноября 2003 г. N 542/58
+--------------------------------------------------------------------------------------------------+
| ОТРАСЛЕВАЯ СТАТИСТИЧЕСКАЯ ОТЧЕТНОСТЬ |
+--------------------------------------------------------------------------------------------------+
+--------------------------------------------------------------------------------------------------+
|"Сведения о реализации Программы государственных гарантий оказания гражданам Российской Федерации |
| бесплатной медицинской помощи" |
| за _______ год |
+--------------------------------------------------------------------------------------------------+
+-------------------------------------------------+---------------------+ +----------------------+
|Порядок представления: |Сроки представления | | Форма N 62 |
+-------------------------------------------------+---------------------+ +----------------------+
|Учреждения здравоохранения, участвующие в| | Утверждена приказом
|реализации Программы государственных гарантий| | Минздрава России и
|оказания гражданам Российской Федерации| | ФОМС
|бесплатной медицинской помощи, представляют: | | от 13.11.2003 N
|- органу управления здравоохранением| | 542/58
|муниципального образования; | |
| | | +----------------------+
|- ТФ ОМС; | | | Годовая |
| | | +----------------------+
|Орган управления здравоохранением муниципального|в установленные|
|образования - органу управления здравоохранением|органом управления|
|субъекта Российской Федерации |здравоохранением |
| |субъекта Российской|
| |Федерации сроки |
| | |
|ТФ ОМС сводный отчет представляет: |в установленные|
| |органом управления|
| |здравоохранением |
| |субъекта Российской|
| |Федерации сроки |
| | |
|- органу управления здравоохранением субъекта|в установленные|
|Российской Федерации, |органом управления|
| |здравоохранением |
| |субъекта Российской|
| |Федерации сроки |
| | |
|- ФОМС. |1 марта |
| | |
|Орган управления здравоохранением субъекта|1 марта |
|Российской Федерации представляет сводный отчет,| |
|согласованный с ТФ ОМС | |
|- Минздраву России. | |
| | |
|Учреждения здравоохранения федерального|20 февраля |
|подчинения, подведомственные Минздраву России -| |
|Минздраву России. | |
| | |
|Учреждения здравоохранения федерального|20 февраля |
|подчинения, подведомственные РАМН - в РАМН. | |
| | |
|РАМН представляет сводный отчет - Минздраву|1 марта |
|России | |
| | |
|ФОМС сводный годовой отчет в целом по России и|1 апреля |
|субъектам Российской Федерации - Минздраву России| |
| | |
|Минздрав России представляет сводный годовой|1 октября |
|отчет в целом по Российской Федерации и субъектам| |
|Российской Федерации, согласованный с ФОМС, в| |
|Правительство Российской Федерации | |
+-------------------------------------------------+---------------------+
+--------------------------------------------------------------------------------------------------+
|Наименование отчитывающейся организации: |
+--------------------------------------------------------------------------------------------------+
|Почтовый адрес: |
+----------+---------------------------------------------------------------------------------------+
|Код формы | Коды проставляет отчитывающаяся организация |
| по ОКУД | |
| +----------+----------+-----------+-----------+------------+-----------+----------+-----+
| |отчитываю-| вида |отрасли по |территории |министерства|организаци-| формы | |
| | щейся |деятельно-| ОКОНХ | по ОКАТО |(ведомства),|онно-право-|собствен- | |
| |организа- | сти по | | | органа | вой формы | ности по | |
| | ции по | ОКДП | | | управления | по ОКОПФ | ОКФС | |
| | ОКПО | | | | по ОКОГУ | | | |
+----------+----------+----------+-----------+-----------+------------+-----------+----------+-----+
| 1 | 2 | 3 | 4 | 5 | 6 | 1 | 8 | 9 |
+----------+----------+----------+-----------+-----------+------------+-----------+----------+-----+
| | | | | | | | | |
+----------+----------+----------+-----------+-----------+------------+-----------+----------+-----+
(1000) Учреждения здравоохранения, участвующие в реализации территориальной программы государственных гарантий (на 31.12. отчетного года)
+---------------------+-------+--------------------------------------------------------------------+
| Типы учреждений | N | Учреждения здравоохранения по уровням управления и источникам |
| |строки | финансирования: |
| | +-------------------+----------+-----------+---------+---------------+
| | | Муниципальные | Субъекта |Федеральные| Других | Всего |
| | +-------+-----------+ РФ |(подведомс-| минис- | учреждений |
| | | Всего | в т.ч. | | твенные |терств и |здравоохранения|
| | | |расположен-| | Минздраву |ведомств | (гр.3 + 5 + 6 |
| | | | ные в | | России) | | + 7) |
| | | | сельской | | | | |
| | | | местности | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|1. Учреждения скорой| 01 | | | | | | |
|медицинской помощи | | | | | | | |
| Всего| | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|в том числе| 02 | | | | | | |
|работающие в системе| | | | | | | |
|ОМС | | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|2. | 03 | | | | | | |
|Амбулаторно-поликли- | | | | | | | |
|нические учреждения | | | | | | | |
| Всего| | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|в том числе| 04 | | | | | | |
|работающие в системе| | | | | | | |
|ОМС | | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|3. Больничные| 05 | | | | | | |
|учреждения, клиники и| | | | | | | |
|диспансеры | | | | | | | |
| Всего| | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|в том числе| 06 | | | | | | |
|работающие в системе| | | | | | | |
|ОМС | | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|А. Центры | 07 | | | | | | |
| Всего| | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|в том числе| 08 | | | | | | |
|работающие в системе| | | | | | | |
|ОМС | | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|5. Учреждения охраны| 09 | | | | | | |
|материнства и детства| | | | | | | |
| Всего| | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|в том числе| 10 | | | | | | |
|работающие в системе| | | | | | | |
|ОМС | | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|6. | 11 | | | | | | |
|Санаторно-курортные | | | | | | | |
|учреждения | | | | | | | |
| Всего| | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|в том числе| 12 | | | | | | |
|работающие в системе| | | | | | | |
|ОМС | | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|7. Прочие учреждения | 13 | | | | | | |
| Всего| | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|в том числе| 14 | | | | | | |
|работающие в системе| | | | | | | |
|ОМС | | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|8. ИТОГО (сумма строк| 15 | | | | | | |
|01 + 03 + 05 + 07 +| | | | | | | |
|09 + 11 + 13) | | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
|в том числе| 16 | | | | | | |
|работающие в системе| | | | | | | |
|ОМС (02 + 04 + 06 +| | | | | | | |
|08 + 10 + 12 + 14) | | | | | | | |
+---------------------+-------+-------+-----------+----------+-----------+---------+---------------+
(2000) Формирование и выполнение территориальной Программы госгарантий
+--------------+-------------+-------+-------------------------------------------------------------------------------------------------------------------+
| Виды | Единицы | N | Объемы медицинской помощи и финансирования за счет: |
| медицинской | измерения |строки +------------------+------------------+------------------+-------------------+-------------------+------------------+
| помощи |(число в тыс)| | Муниципального | Бюджета субъекта | Муниципального | Бюджета субъекта |Средств ОМС на тер.| Всего |
| | | | бюджета | Российской | бюджета на | Российской | программу ОМС | |
| | | | | Федерации | содержание ЛПУ, | Федерации на | | |
| | | | | | работающих в | содержание ЛПУ, | | |
| | | | | | системе ОМС | работающих в | | |
| | | | | | | системе ОМС | | |
| | | +-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
| | | |расч.| утв. |факт.|расч. |утв. |факт.|расч.| утв. |факт.|расч. |утв. |факт. |расч.| утв. |факт. |расч. |утв. |факт.|
| | | | | | | | | | | | | | | | | | |гр.4 +|гр.5 |гр.6 |
| | | | | | | | | | | | | | | | | | |7 + 10|+ 8 +|+ 9 +|
| | | | | | | | | | | | | | | | | | |+ 11 +|11 + |12 + |
| | | | | | | | | | | | | | | | | | | 16 |14 + |15 + |
| | | | | | | | | | | | | | | | | | | | 17 | 18 |
+--------------+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 |
+--------------+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|1. Скорая|вызовов | 01 | | | | | | | X | X | X | X | X | X | | | | | | |
|медицинская +-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|помощь |обслуж. лиц | 02 | | | | | | | Х | X | X | X | X | X | | | | | | |
| +-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
| |рублей | 03 | | | | | | | | | | | | | | | | | | |
+--------------+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|2. |посещений | 04 | | | | | | | X | X | X | X | X | X | | | | | | |
|Амбулаторно- +-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|поликлиничес- |рублей | 05 | | | | | | | | | | | | | | | | | | |
|кая помощь | | | | | | | | | | | | | | | | | | | | |
+--------------+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|3 Стационарная|к/дней | 06 | | | | | | | Х | X | X | X | X | X | | | | | | |
|помощь | | | | | | | | | | | | | | | | | | | | |
| +-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
| |выбыв. больн.| 07 | | | | | | | X | X | X | X | X | X | | | | | | |
| +-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
| |рублей | 08 | | | | | | | | | | | | | | | | | | |
+--------------+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|4. Медицинская|дней леч. | 09 | | | | | | | X | X | X | X | X | X | | | | | | |
|помощь в+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|дневных |выбыв. больн.| 10 | | | | | | | X | X | X | X | X | X | | | | | | |
|стационарах | | | | | | | | | | | | | | | | | | | | |
| +-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
| |рублей | 11 | | | | | | | | | | | | | | | | | | |
+--------------+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|5. Санаторная|к/дней | 12 | | | | | | | х | X | X | X | х | X | | | | | | |
|помощь | | | | | | | | | | | | | | | | | | | | |
| +-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
| |выбыв. больн.| 13 | | | | | | | X | X | X | X | X | X | | | | | | |
| +-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
| |рублей | 14 | | | | | | | | | | | | | | | | | | |
+--------------+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|6. Прочие виды|рублей | 15 | | | | | | | | | | | | | | | | | | |
|медицинской | | | | | | | | | | | | | | | | | | | | |
|помощи | | | | | | | | | | | | | | | | | | | | |
+--------------+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|7. Затраты на|рублей | 16 | X | X | X | X | X | X | X | X | X | X | X | X | | | | | | |
|ведение дела в| | | | | | | | | | | | | | | | | | | | |
|системе ОМС -| | | | | | | | | | | | | | | | | | | | |
|нормированный | | | | | | | | | | | | | | | | | | | | |
|страховой | | | | | | | | | | | | | | | | | | | | |
|полис | | | | | | | | | | | | | | | | | | | | |
+--------------+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|8. Затраты|рублей | 17 | | | | | | | | | | | | | | | | | | |
|субъекта | | | | | | | | | | | | | | | | | | | | |
|Российской | | | | | | | | | | | | | | | | | | | | |
|Федерации на| | | | | | | | | | | | | | | | | | | | |
|оказание | | | | | | | | | | | | | | | | | | | | |
|высокотехноло-| | | | | | | | | | | | | | | | | | | | |
|гичных видов| | | | | | | | | | | | | | | | | | | | |
|медицинской | | | | | | | | | | | | | | | | | | | | |
|помощи в| | | | | | | | | | | | | | | | | | | | |
|учреждениях | | | | | | | | | | | | | | | | | | | | |
|здравоохране- | | | | | | | | | | | | | | | | | | | | |
|ния Минздрава| | | | | | | | | | | | | | | | | | | | |
|России, других| | | | | | | | | | | | | | | | | | | | |
|министерств и| | | | | | | | | | | | | | | | | | | | |
|ведомств | | | | | | | | | | | | | | | | | | | | |
| +-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|в учреждениях|рублей | 18 | | | | | | | | | | | | | | | | | | |
|здравоохране- | | | | | | | | | | | | | | | | | | | | |
|ния субъекта| | | | | | | | | | | | | | | | | | | | |
|Российской | | | | | | | | | | | | | | | | | | | | |
|Федерации | | | | | | | | | | | | | | | | | | | | |
+--------------+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
|7.# Итого |рублей | 19 | | | | | | | | | | | | | | | | | | |
|сумма строк| | | | | | | | | | | | | | | | | | | | |
|03 + 05 + 08 | | | | | | | | | | | | | | | | | | | | |
|+ 11 + 14 + 15| | | | | | | | | | | | | | | | | | | | |
|+ 16 + 17 +| | | | | | | | | | | | | | | | | | | | |
|18) | | | | | | | | | | | | | | | | | | | | |
+--------------+-------------+-------+-----+------+-----+------+-----+-----+-----+------+-----+------+-----+------+-----+------+------+------+-----+-----+
(2001) Утверждено бюджетом ТФ ОМС на выполнение территориальной программы
ОМС (тыс.руб) Всего___________________________________________________(1)
(2002) Фактически поступило средств ОМС (тыс.руб.) Всего____________(1),
в т.ч. за счет: единого социального налога (2), единого налога на
вмененный доход для определенных видов деятельности, единого налога,
взимаемого в связи с применением упрощенной системы налогообложения,
единого сельскохозяйственного налога ___________(3), страховых взносов на
ОМС неработающего населения _________(4), прочих поступлений _________(5)
(2000-ф) Виды медицинской помощи, финансируемые из федерального бюджета*
+-------------+-------+---------------+-----------------------+-----------------------+-----------------------+-------------------------------+-------+--------+
| Субъекты | N |Амбулаторно-по-| Стационарная помощь | Дневные стационары | Санаторная помощь | Дорогостоящие виды помощи |Прочие | Всего |
| Российской |строки | ликлиническая | | | | | виды | рублей |
| Федерации | | помощь | | | | |помощи | (сумма |
| | +--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+гр.4, 7,|
| | |посеще- |рублей|выбыв- | ими |рублей |выбыв- | ими |рублей |выбыв- | ими |рублей | квот |выбыв- | ими |рублей |рублей |10, 13, |
| | | ний | | ших |прове- | | ших |прове- | | ших |прове- | |(боль- | ших |прове- | | |17, 18) |
| | | | |больных| дено | |больн. | дено | |больных| дено | | ных) |больных| дено | | | |
| | | | | |к/дней | | | дней | | |к/дней | | | |к/дней | | | |
| | | | | | | | |лечения| | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Всего | 1 | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Центральный | 2 | | | | | | | | | | | | | | | | | |
|ФО | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Белгородская | 3 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Брянская | 4 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Владимирская | 5 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Воронежская | 6 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Ивановская | 7 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Калужская | 8 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Костромская | 9 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Курская | 10 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Липецкая | 11 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Московская | 12 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Орловская | 13 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Рязанская | 14 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Смоленская | 15 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Тамбовская | 16 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Тверская | 17 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Тульская | 18 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Ярославская | 19 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|г.Москва | 20 | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Северо-Запад-| 21 | | | | | | | | | | | | | | | | | |
|ный ФО | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 22 | | | | | | | | | | | | | | | | | |
|Карелия | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 23 | | | | | | | | | | | | | | | | | |
|Коми | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Архангельская| 24 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Вологодская | 25 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Калининградс-| 26 | | | | | | | | | | | | | | | | | |
|кая область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Ленинградская| 27 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Мурманская | 28 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Новгородская | 29 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Псковская | 30 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|г. | 31 | | | | | | | | | | | | | | | | | |
|Санкт-Петер- | | | | | | | | | | | | | | | | | | |
|бург | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Ненецкий авт.| 32 | | | | | | | | | | | | | | | | | |
|округ | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
------------------------------
* Форма 2000-ф заполняется только федеральными учреждениями здравоохранения всех министерств и ведомств
(2000-ф) Виды медицинской помощи, финансируемые из федерального бюджета
+--------------+------+---------------+-----------------------+-----------------------+-----------------------+-------------------------------+-------+--------+
| Субъекты | N |Амбулаторно-по-| Стационарная помощь | Дневные стационары | Санаторная помощь | Дорогостоящие виды помощи |Прочие | Всего |
| Российской |строки| ликлиническая | | | | | виды | рублей |
| Федерации | | помощь | | | | |помощи | (сумма |
| | +--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+гр.4, 7,|
| | |посеще- |рублей|выбыв- | ими |рублей |выбыв- | ими |рублей |выбыв- | ими |рублей | квот |выбыв- | ими |рублей |рублей |10, 13, |
| | | ний | | ших |прове- | | ших |прове- | | ших |прове- | |(боль- | ших |прове- | | |17, 18) |
| | | | |больных| дено | |больных| дено | |больн. | дено | | ных) |больных| дено | | | |
| | | | | |к/дней | | | дней | | |к/дней | | | |к/дней | | | |
| | | | | | | | | леч. | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Южный ФО | 33 | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 34 | | | | | | | | | | | | | | | | | |
|Адыгея | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 35 | | | | | | | | | | | | | | | | | |
|Дагестан | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 36 | | | | | | | | | | | | | | | | | |
|Ингушетия | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Кабард.-Бал- | 37 | | | | | | | | | | | | | | | | | |
|кар. | | | | | | | | | | | | | | | | | | |
|республика | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 38 | | | | | | | | | | | | | | | | | |
|Калмыкия | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Карач.-Черкес.| 39 | | | | | | | | | | | | | | | | | |
|республика | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 40 | | | | | | | | | | | | | | | | | |
|Северная | | | | | | | | | | | | | | | | | | |
|Осетия | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Чеченская | 41 | | | | | | | | | | | | | | | | | |
|республика | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Краснодарский | 42 | | | | | | | | | | | | | | | | | |
|край | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Ставропольс- | 43 | | | | | | | | | | | | | | | | | |
|кий край | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Астраханская | 44 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Волгоградская | 45 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Ростовская | 46 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Приволжский | 47 | | | | | | | | | | | | | | | | | |
|ФО | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 48 | | | | | | | | | | | | | | | | | |
|Башкортостан | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 49 | | | | | | | | | | | | | | | | | |
|Марий Эл | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 50 | | | | | | | | | | | | | | | | | |
|Мордовия | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 51 | | | | | | | | | | | | | | | | | |
|Татарстан | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 52 | | | | | | | | | | | | | | | | | |
|Удмуртия | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 53 | | | | | | | | | | | | | | | | | |
|Чувашия | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Кировская | 54 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Нижегородская | 55 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Нижегородская | 56 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
|(г.Саров) | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Оренбургская | 57 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Пензенская | 58 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Пермская | 59 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Самарская | 60 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Саратовская | 61 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Ульяновская | 62 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Коми-Пермяц- | 63 | | | | | | | | | | | | | | | | | |
|кий авт.| | | | | | | | | | | | | | | | | | |
|округ | | | | | | | | | | | | | | | | | | |
+--------------+------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
------------------------------
* Форма 2000-ф заполняется только федеральными учреждениями здравоохранения всех министерств и ведомств
(2000-ф) Виды медицинской помощи, финансируемые из федерального бюджета
+-------------+-------+---------------+-----------------------+-----------------------+-----------------------+-------------------------------+-------+--------+
| Субъекты | N |Амбулаторно-по-| Стационарная помощь | Дневные стационары | Санаторная помощь | Дорогостоящие виды помощи |Прочие | Всего |
| Российской |строки | ликлиническая | | | | | виды | рублей |
| Федерации | | помощь | | | | |помощи | (сумма |
| | +--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+гр.4, 7,|
| | |посеще- |рублей|выбыв- | ими |рублей |выбыв- | ими |рублей |выбыв- | ими |рублей | квот |выбыв- | ими |рублей |рублей |10, 13,|
| | | ний | | ших |прове- | | ших |прове- | | ших |прове- | |(боль- | ших |прове- | | |17, 18) |
| | | | |больных| дено | |больн. | дено | |больн. | дено | | ных) |больных| дено | | | |
| | | | | |к/дней | | | дней | | |к/дней | | | |к/дней | | | |
| | | | | | | | | леч. | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Уральский ФО | 64 | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Курганская | 65 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Свердловская | 66 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Тюменская | 67 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Челябинская | 68 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Ханты-Мансий-| 69 | | | | | | | | | | | | | | | | | |
|ский авт.| | | | | | | | | | | | | | | | | | |
|округ | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Ямало-Ненец- | 70 | | | | | | | | | | | | | | | | | |
|кий авт.| | | | | | | | | | | | | | | | | | |
|округ | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Сибирский ФО | 71 | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 72 | | | | | | | | | | | | | | | | | |
|Алтай | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 73 | | | | | | | | | | | | | | | | | |
|Бурятия | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 74 | | | | | | | | | | | | | | | | | |
|Тува | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 75 | | | | | | | | | | | | | | | | | |
|Хакассия | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Алтайский | 76 | | | | | | | | | | | | | | | | | |
|край | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Красноярский | 77 | | | | | | | | | | | | | | | | | |
|край | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Иркутская | 78 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Кемеровская | 79 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Новосибирская| 80 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Омская | 81 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Томская | 82 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Читинская | 83 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Агинский | 84 | | | | | | | | | | | | | | | | | |
|Бурят. авт.| | | | | | | | | | | | | | | | | | |
|округ | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Таймырский | 85 | | | | | | | | | | | | | | | | | |
|авт. округ | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Усть-Ордын. | 86 | | | | | | | | | | | | | | | | | |
|Бурят. авт.| | | | | | | | | | | | | | | | | | |
|округ | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Эвенкийский | 87 | | | | | | | | | | | | | | | | | |
|авт. округ | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Дальневосточ-| 88 | | | | | | | | | | | | | | | | | |
|ный ФО | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Республика | 89 | | | | | | | | | | | | | | | | | |
|Саха (Якутия)| | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Приморский | 90 | | | | | | | | | | | | | | | | | |
|край | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Хабаровский | 91 | | | | | | | | | | | | | | | | | |
|край | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Амурская | 92 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Камчатская | 93 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Магаданская | 94 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Сахалинская | 95 | | | | | | | | | | | | | | | | | |
|область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Еврейская | 96 | | | | | | | | | | | | | | | | | |
|авт. область | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Корякский | 97 | | | | | | | | | | | | | | | | | |
|авт. округ | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Чукотский | 98 | | | | | | | | | | | | | | | | | |
|авт. округ | | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
|Байконур | 99 | | | | | | | | | | | | | | | | | |
+-------------+-------+--------+------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+-------+--------+
------------------------------
* Форма 2000-ф заполняется только федеральными учреждениями здравоохранения всех министерств и ведомств
(3000) Целевые программы
+-----------------+-------+----------------------------------------------------------------------------------------------------------------------------+
| Программы | N | Финансовое обеспечение за счет (тыс.руб.): |
| |строки | |
| | +---------------------------------------------------------+--------------------------+----------+----------------------------+
| | | средств бюджетов | средств ОМС | Прочих | Всего |
| | +------------------+-------------------+------------------+-----------------+--------+источников| |
| | | федерального |субъекта Российской| муниципального | ТФ ОМС | ФОМС |финансиро-| |
| | | | Федерации | образования | | | вания | |
| | +---------+--------+---------+---------+---------+--------+--------+--------+--------+----------+------------+---------------+
| | |утвержд. | фактич.|утвержд. | фактич. |утвержд. | фактич.|утвержд.|фактич. |фактич. | фактич. | утвержд. | фактич. |
| | | | | | | | | | | | |(сумма граф |(сумма гр. 4 + |
| | | | | | | | | | | | |3 + 5 + 7 + |6 + 8 + 10 + 11|
| | | | | | | | | | | | | 9) | + 12) |
+-----------------+-------+---------+--------+---------+---------+---------+--------+--------+--------+--------+----------+------------+---------------+
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 |
+-----------------+-------+---------+--------+---------+---------+---------+--------+--------+--------+--------+----------+------------+---------------+
|Всего: | 01 | | | | | | | | | | | | |
+-----------------+-------+---------+--------+---------+---------+---------+--------+--------+--------+--------+----------+------------+---------------+
|в том числе: | 02 | | | | | | | | | | | | |
|- федеральные | | | | | | | | | | | | | |
+-----------------+-------+---------+--------+---------+---------+---------+--------+--------+--------+--------+----------+------------+---------------+
|- субъекта| 03 | | | | | | | | | | | | |
|Российской | | | | | | | | | | | | | |
|Федерации | | | | | | | | | | | | | |
+-----------------+-------+---------+--------+---------+---------+---------+--------+--------+--------+--------+----------+------------+---------------+
|- муниципального| 04 | | | | | | | | | | | | |
|образования | | | | | | | | | | | | | |
+-----------------+-------+---------+--------+---------+---------+---------+--------+--------+--------+--------+----------+------------+---------------+
(4000) Платные медицинские услуги и ДМС (фактические данные)
+---------------------+------------+-------+-------------------------------------------------------+
| Виды медицинской | Единицы | N | Объемы медицинской помощи и финансирования за счет: |
| помощи | измерения |строки +-------------+----------+-----------------+------------+
| | (число, в | | Платных | ДМС |Прочих источников|Всего (гр.4 |
| | тыс.) | | медицинских | | финансирования | + 5 + 6) |
| | | | услуг | | | |
+---------------------+------------+-------+-------------+----------+-----------------+------------+
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
+---------------------+------------+-------+-------------+----------+-----------------+------------+
|1. Скорая медицинская|вызовов | 01 | | | | |
|помощь | | | | | | |
| +------------+-------+-------------+----------+-----------------+------------+
| |обслуж. лиц | 02 | | | | |
| +------------+-------+-------------+----------+-----------------+------------+
| |рублей | 03 | | | | |
+---------------------+------------+-------+-------------+----------+-----------------+------------+
|2. |посещений | 04 | | | | |
|Амбулаторно-поликли- +------------+-------+-------------+----------+-----------------+------------+
|ническая помощь |рублей | 05 | | | | |
+---------------------+------------+-------+-------------+----------+-----------------+------------+
|3. Стационарная|к/дней | 06 | | | | |
|помощь | | | | | | |
| +------------+-------+-------------+----------+-----------------+------------+
| |выбыв. | 07 | | | | |
| |больн. | | | | | |
| +------------+-------+-------------+----------+-----------------+------------+
| |рублей | 08 | | | | |
+---------------------+------------+-------+-------------+----------+-----------------+------------+
|4. В условиях дневных|дней леч. | 09 | | | | |
|стационаров | | | | | | |
| +------------+-------+-------------+----------+-----------------+------------+
| |выбыв. | 10 | | | | |
| |больн. | | | | | |
| +------------+-------+-------------+----------+-----------------+------------+
| |рублей | 11 | | | | |
+---------------------+------------+-------+-------------+----------+-----------------+------------+
|5. Санаторная помощь |к/дней | 12 | | | | |
| +------------+-------+-------------+----------+-----------------+------------+
| |выбыв. | 13 | | | | |
| |больн. | | | | | |
| +------------+-------+-------------+----------+-----------------+------------+
| |рублей | 14 | | | | |
+---------------------+------------+-------+-------------+----------+-----------------+------------+
|6. Прочие услуги |рублей | 15 | | | | |
+---------------------+------------+-------+-------------+----------+-----------------+------------+
|7. Итого (сумма строк|рублей | 16 | | | | |
|03 + 05 + 08 + 11 +| | | | | | |
|14 + 15) | | | | | | |
+---------------------+------------+-------+-------------+----------+-----------------+------------+
(5000) Территориальная программа государственных гарантий оказания
гражданам бесплатной медицинской помощи утверждена постановлением
(Законом)________________________________________________________________
N ___________ от "__"________________________200__г.
(5001) Численность постоянного населения (на 01.01. отчетного года)
субъекта Российской Федерации (тыс.чел.) всего_____________(1).
(5002) Застраховано граждан по ОМС (тыс.чел.) всего ___________ (1),
работающих _____________________(2), в том числе постоянно проживающих на
территории субъекта Российской Федерации _____ (3), неработающих ___ (4).
"__"_________200__ г. ______________________________
Ф.И.О., N телефона исполнителя
Для ЛПУ
Подпись ответственного лица
В сводном отчете Исполнительный директор
Руководитель органа управления территориального фонда ОМС
здравоохранением субъекта
Российской Федерации
_____________________________ __________________________