{"text_format":"1","workbook":"xlsx","n_sheets":20,"sheets":["様式目次","第1号様式","第1号様式別紙1（サイバーセキュリティ）","第1号様式別紙1（電カルモデル）","第1号様式別紙2（サイバーセキュリティ）","第1号様式別紙2（電カルモデル）","第1号様式別紙2（事業計画書Aタイプ）","Sheet3","第1号様式別紙2（事業計画書 後発タイプ）","第2号様式","第2号様式別紙1（サイバーセキュリティ確保事業）","第2号様式別紙1(電カルモデル)","第2号様式別紙2（サイバーセキュリティ確保事業）","第2号様式別紙2 (電カルモデル)","第2号様式別紙2（後発タイプ）","第3号様式","第4号様式","第4号様式別紙1","第4号様式別紙2（Aタイプ）","第4号様式別紙2 (後発タイプ)"],"not_rendered":{"charts":0,"images":0,"macros":0,"external_links":1,"defined_names":20,"comments":1,"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":"様式目次","index":0,"n_rows":3,"n_cols":11,"rows_kept":3,"cut":false,"hidden":false,"merged":[]}
["事業名","第１号様式","別紙1","別紙2","第２号様式","別紙１","別紙２","第３号様式","第４号様式","別紙１","別紙２"]
["医療機関におけるサイバーセキュリティ確保事業","第1号様式","サイバーセキュリティ","サイバーセキュリティ","第２号様式","サイバーセキュリティ","サイバーセキュリティ","第３号様式","第４号様式","別紙１","Aタイプ"]
["電子カルテ情報共有サービスのモデル事業および効果検証事業","第1号様式","電カルモデル","電カルモデル","第２号様式","電カルモデル","電カルモデル","第３号様式","第４号様式","別紙１","Aタイプ"]

{"sheet":"第1号様式","index":1,"n_rows":31,"n_cols":10,"rows_kept":31,"cut":false,"hidden":false,"merged":[[10,0,10,6]]}
["第１号様式"]
[null,null,null,null,null,null,"番　　　　　　　　　号",null,null,"電子カルテ情報共有サービスのモデル事業および効果検証事業"]
[null,null,null,null,null,null,"　　年　　月　　日"]
[]
["厚生労働大臣　殿"]
[null,null,null,null,"所在地"]
[null,null,null,null,"事業者名"]
[null,null,null,null,"代表者氏名"]
[]
[]
["令和８年度（令和７年度からの繰越分）地域診療情報連携推進費補助金（変更）交付申請書"]
[]
[]
["標記について、次のとおり交付されるよう関係書類を添えて申請する。"]
[]
["１　補助金申請額　　　　金　　　　　　　　　　　　　円"]
[]
["２　所要額調書（別紙１）"]
[]
["３　事業計画書（別紙２）"]
[]
["４　添付書類"]
["　　収入支出予算書抄本"]
[]
["５　変更申請の場合は、１に関わらず次のとおりとする。"]
["　　申請額　　　　　　　　金　　　　　　　　　　　　円　(A)"]
[]
["　　前回までの交付決定額　金　　　　　　　　　　　　円　(B)"]
[]
["　　差引今回変更増減額　　金　　　　　　　　　　　　円　(A)－(B)"]
[" "]

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[]
[]
[null,null,null,"別紙１"]
[null,null,null,"所要額調書"]
[]
[]
[null,null,null,"1　医療機関におけるサイバーセキュリティ確保事業所要額"]
[null,null,null,"総事業費","寄附金その\n他の収入額","差引額","対象経費の\n支出予定額","基準額","選定額","国庫補助\n基本額","国庫補助\n所要額","仕入れに係る\n消費税等相当額","要国庫補助額","交付\n決定額","差引追加交付\n（一部取消）\n申請額"]
[null,null,null,"Ａ","Ｂ","Ｃ（Ａ－Ｂ）","Ｄ","Ｅ","Ｆ","Ｇ","Ｈ","Ｉ","Ｊ（Ｈ－Ｉ）","Ｋ","Ｌ"]
[null,null,null,"円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 "]
[null,null,null,null,0,{"$f":"D11-E11","v":0},{"$f":"F28","v":0},null,{"$f":"MIN(G11,H11)","v":0},{"$f":"MIN(F11,I11)","v":0},{"$f":"ROUNDDOWN(J11/2,-3)","v":0},null,{"$f":"K11-L11","v":0}]
[]
[null,null,null,"２　対象経費の支出予定額算出内訳"]
[null,null,null,"区分",null,"支出予定額","算出内訳"]
[null,null,null,null,null,"円"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,"合　　　　　計",null,{"$f":"SUM(F16:F27)","v":0}]
[]
[null,null,null,"（参考）対象外経費の支出予定額算出内訳"]
[null,null,null,"区　　　　　　分",null,"支出予定額"]
[null,null,null,null,null,"円 "]
[]
[]
[]
[null,null,null,"合　　　　　計",null,{"$f":"SUM(F33:F35)","v":0},null,null,null,{"$f":"SUM(J35:J35)","v":0}]
[]
[null,null,null,"総事業費",null,{"$f":"F28+F36","v":0}]
[]
[null,null,null,"※Ｉ欄及びＪ欄については、交付要綱の８による変更交付申請手続の他は斜線を引くこと。"]

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[]
[]
[null,null,null,"別紙１"]
[null,null,null,"所要額調書"]
[]
[]
[null,null,null,"１　電子カルテ情報共有サービスのモデル事業および効果検証事業所要額"]
[null,null,null,"区分","総事業費","寄附金その\n他の収入額","差引額","対象経費の\n支出予定額","基準額","選定額","国庫補助\n基本額","国庫補助\n所要額","仕入れに係る\n消費税等相当額","要国庫補助額","交付\n決定額","差引追加交付\n（一部取消）\n申請額"]
[null,null,null,null,"Ａ","Ｂ","Ｃ（Ａ－Ｂ）","Ｄ","Ｅ","Ｆ","Ｇ","Ｈ","Ｉ","Ｊ（Ｈ－Ｉ）","Ｋ","Ｌ"]
[null,null,null,null,"円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 ",null,null,"円 ","円 "]
[null,null,null,"文書及び臨床情報早期検証対応事業",null,null,{"$f":"E11-F11","v":0},{"$f":"G20","v":0},null,{"$f":"MIN(H11,I11)","v":0},{"$f":"MIN(G11,J11)","v":0},{"$f":"ROUNDDOWN(K11,-3)","v":0},null,{"$f":"L11-M11","v":0}]
[null,null,null,"文書及び臨床情報検証対応事業",null,null,{"$f":"E12-F12","v":0},{"$f":"G21","v":0},null,{"$f":"MIN(H12,I12)","v":0},{"$f":"MIN(G12,J12)","v":0},{"$f":"ROUNDDOWN(K12,-3)","v":0},null,{"$f":"L12-M12","v":0}]
[null,null,null,"健診文書検証事業",null,null,0,0,null,0,0,0,null,0]
[null,null,null,"薬局検証事業",null,null,0,0,null,0,0,0,null,0]
[null,null,null,"合計",{"$f":"G51","v":0},{"$f":"F11+F12+F13+F14","v":0},{"$f":"G11+G12+G13+G14","v":0},{"$f":"H11+H12+H13+H14","v":0},{"$f":"I11+I12+I13+I14","v":0},{"$f":"J11+J12+J13+J14","v":0},0,0,{"$f":"M11+M12+M13+M14","v":0},{"$f":"N11+N12+N13+N14","v":0},0,0]
[]
[null,null,null,"２　対象経費の支出予定額算出内訳"]
[null,null,null,"区分",null,null,"支出予定額","算出内訳"]
[null,null,null,null,null,null,"円"]
[null,null,null,"（文書及び臨床情報早期検証対応事業）",null,null,{"$f":"SUM(G21:G22)","v":0}]
[]
[]
[null,null,null,"（文書及び臨床情報検証対応事業）",null,null,{"$f":"SUM(G24:G25)","v":0}]
[]
[]
[null,null,null,"（健診文書検証事業）",null,null,{"$f":"SUM(G27:G28)","v":0}]
[]
[]
[null,null,null,"（薬局検証事業）",null,null,{"$f":"SUM(G30:G31)","v":0}]
[]
[]
[null,null,null,"合　　　　　計",null,null,{"$f":"G20+G27","v":0}]
[]
[null,null,null,"（参考）対象外経費の支出予定額算出内訳"]
[null,null,null,"区　　　　　　分",null,null,"支出予定額"]
[null,null,null,null,null,null,"円 "]
[null,null,null,"（文書及び臨床情報早期検証対応事業）",null,null,{"$f":"SUM(G38:G39)","v":0}]
[]
[]
[null,null,null,"（文書及び臨床情報検証対応事業）",null,null,{"$f":"SUM(G41:G42)","v":0}]
[]
[]
[null,null,null,"（健診文書検証事業）",null,null,{"$f":"SUM(G44:G45)","v":0}]
[]
[]
[null,null,null,"（薬局検証事業）",null,null,{"$f":"SUM(G47:G48)","v":0}]
[]
[]
[null,null,null,"合　　　　　計",null,null,{"$f":"G37+G40+G43+G46","v":0},null,null,null,{"$f":"SUM(K48:K48)","v":0}]
[]
[null,null,null,"総事業費",null,null,{"$f":"G32+G49","v":0}]
[]
[null,null,null,"※Ｉ欄及びＪ欄については、交付要綱の８による変更交付申請手続の他は斜線を引くこと。"]

{"sheet":"第1号様式別紙2（サイバーセキュリティ）","index":4,"n_rows":32,"n_cols":5,"rows_kept":32,"cut":false,"hidden":false,"merged":[[3,2,3,14],[9,4,9,13],[14,2,23,14],[5,2,5,3],[6,2,6,3],[7,2,7,3],[8,2,8,3],[9,2,9,3],[5,4,5,13],[6,4,6,13],[7,4,7,13],[8,4,8,13]]}
[]
[]
[null,null,"別紙２"]
[null,null,"医療機関におけるサイバーセキュリティ確保事業　事業計画書"]
[null,null,"１．申請者情報"]
[null,null,"医療機関名（病院名）"]
[null,null,"病床数"]
[null,null,"補助上限区分",null,"□ 399床以下（2，000千円）／ □ 400床以上（3，500千円）"]
[null,null,"外部接続回線数 "]
[null,null,"接続ベンダー数"]
[]
[]
[null,null,"２．適正化（回線集約等）計画"]
[]
[null,null,"（外部接続点の集約、管理、セキュリティ強化に関する実施内容を記載願います）"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,"３．添付資料"]
[null,null,"①見積書"]
[null,null,"②購入する商品・ソフトウェアのカタログ、概要書等"]
[null,null,"③構築工事、撤去工事等の仕様書"]
[null,null,"④その他、外部接続点集約、管理に関する資料等"]

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[]
[]
[null,null,"別紙２"]
[null,null,"電子カルテ情報共有サービスのモデル事業および効果検証事業　事業計画書"]
[]
[]
[null,null,"１．応募者情報"]
[null,null,"施設名",null,"医療機関等種別",null,"開設者",null,null,"所在地",null,null,null,null,null,null,null,null,"病院（400床以上）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"病院（399床以下）"]
[null,null,"病床数（病院・診療所のみ）",null,null,"担当者名（部署名）",null,null,null,"担当者電話番号",null,null,"担当者メールアドレス",null,null,null,null,null,"診療所"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"薬局"]
[null,null,"電子カルテベンダ（製品名）",null,null,"（あれば）電子カルテ導入ベンダ",null,null,null,"文書管理システムベンダ（製品名）",null,null,"健診文書システムベンダ（製品名）"]
[]
[]
["《病院・診療所　記載事項》"]
[null,null,"    2．オンライン資格確認システム導入状況（応募要件）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"導入済み"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"未導入"]
[null,null,"    ３．電子カルテ情報共有サービス導入状況（応募要件）"]
[null,null,"技術解説書1.3.0版対応状況",null,"電子カルテ情報共有サービス導入状況確認リストの提出"]
[null,null,null,null,"別紙、導入状況確認リストをご提出ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,"導入済み","提出済み"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"未導入","未提出"]
[null,null,"    ４．電子カルテ情報共有サービスの運用テストの実施計画（応募要件）"]
[null,null,"別紙、運用テストチェックリストを踏まえ、現状の準備状況から、運用テスト実施・完了に至るまでの予定を詳細にご記載ください。"]
[]
[]
[]
[]
[]
[null,null,"    ５．電子カルテ情報共有サービスの連携テストの実施計画（応募要件）"]
[null,null,"連携テスト相手先医療機関（※）",null,null,"連携テスト相手先医療機関の電子カルテ情報共有サービスの導入状況"]
[]
[]
[]
[null,null,"※想定している医療機関すべて記入してください。行が足りない場合は、行を追加してください。"]
[null,null,"別紙、医療機関間連携テスト実施ガイドを踏まえ、現状の準備状況から、連携テスト実施・完了に至るまでの予定を詳細にご記載ください。"]
[]
[]
[]
[]
[]
[null,null,"    ６．事業実施体制（応募要件）"]
[null,null,"公募要領「３　応募資格」≪共通要件≫④をご確認のうえ、医療機関での事業実施体制を詳細に記載願います。"]
[]
[]
[]
[]
[]
[null,null,"    ７．事業実施体制（応募要件）"]
[null,null,"公募要領「３　応募資格」≪共通要件≫⑤をご確認のうえ、医療機関での事業実施体制を詳細に記載願います。"]
[]
[]
[]
[]
[]
[]
[]
[null,null,"    ８．事業別応募要件"]
[null,null,"実施を予定する事業の計画等を記載願います。"]
[null,null,"　　（１）文書（診療情報提供書等・退院時サマリ）及び臨床情報早期検証対応事業"]
[null,null,"　　　　ア　必要要件①②の記載を踏まえ、技術解説書2.0.0版の改修対応及び本番環境における文書および臨床情報の登録・閲覧にかかる計画を"]
[null,null,"             スケジュール感を含め詳細に記載願います。　　"]
[]
[]
[]
[]
[]
[null,null,"　　　　イ　必要要件③の記載を踏まえ、事業実施期間中の技術解説書更新版が発出された際の医療機関及び医療機関ベンダの対応予定について記載願います。"]
[]
[]
[]
[]
[]
[null,null,"　　　　ウ　必要要件④の記載を踏まえ医療機関の事業実施体制を詳細に記載願います。"]
[]
[]
[]
[]
[]
[null,null,"　　（２）文書（診療情報提供書等・退院時サマリ）及び臨床情報検証対応事業"]
[null,null,"　　　　必要要件①の記載を踏まえ、技術解説書2.0.0版の改修対応及び本番環境における文書および臨床情報の登録・閲覧にかかる計画をスケジュール感を"]
[null,null,"        含め詳細に記載願います。　　"]
[]
[]
[]
[]
[]
[null,null,"　 　（３）健診文書検証事業"]
[null,null,"　　　　　健診事業を実施していることが分かる資料をご提出ください。"]
[null,null,"　　　　　（例：年度別健診実施件数一覧、健診請求・支払実績、健診実績報告書等 ※個人情報等が含まれる場合はマスキングすること）"]
[]
["《薬局　記載事項》"]
[null,null,"    ９．電子カルテ情報共有サービスの運用テストの実施計画（応募要件）"]
[null,null,"　　　　別紙、運用テストチェックリストを踏まえ、現状の準備状況から、運用テスト実施・完了に至るまでの予定を詳細にご記載ください。"]
[]
[]
[]
[]
[]
[null,null,"   １０．本番運用開始までの計画"]
[null,null,"　　　　技術解説書2.0.0版を踏まえた機能を利用した運用の整備、本番環境における文書および臨床情報の閲覧実績がある状態に向けた計画を詳細に記載ください。"]
[]
[]
[]
[]
[]
[null,null,"    １１．電子カルテ情報共有サービス導入医療機関との処方箋実績"]
[null,null,"処方箋のやりとりがある電子カルテ情報共有サービス導入医療機関名",null,null,null,null,null,"実績資料の提出"]
[null,null,null,null,null,null,null,null,"年間を通じて処方箋のやりとりがあることが分かる資料をご提出ください。"]
[null,null,null,null,null,null,null,null,"年間を通じて処方箋のやりとりがあることが分かる資料をご提出ください。"]
[null,null,null,null,null,null,null,null,"年間を通じて処方箋のやりとりがあることが分かる資料をご提出ください。"]
[]
[null,null,"    １２．事業実施体制（応募要件）"]
[null,null,"　　　　公募要領「３　応募資格」をご確認のうえ、薬局での事業実施体制を詳細に記載願います。"]
[]
[]
[]
[]
[]
[null,null,"１３．事業計画・内容"]
[null,null,"「４　補助対象事業」を踏まえた、事業計画と内容を詳細に記載ください。"]
[null,null,"文書（診療情報提供書等・退院時サマリ）及び臨床情報早期検証対応事業もしくは文書（診療情報提供書等・退院時サマリ）及び臨床情報検証対応事業に"]
[null,null,"申請いただいた病院・診療所のうち健診文書検証事業について申請する場合は、２事業についてそれぞれ、事業計画と内容を記載ください。"]
[]
[null,null,"実施事業",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"文書（診療情報提供書等・退院時サマリ）及び臨床情報早期検証対応事業"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"文書（診療情報提供書等・退院時サマリ）及び臨床情報検証対応事業"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"健診文書検証事業"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"薬局検証事業"]
[]
[]
[]
[null,null,"実施事業"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"文書（診療情報提供書等・退院時サマリ）及び臨床情報検証対応事業"]

{"sheet":"第1号様式別紙2（事業計画書Aタイプ）","index":6,"n_rows":23,"n_cols":15,"rows_kept":23,"cut":false,"hidden":true,"merged":[[14,2,17,14],[3,2,3,14],[8,2,8,4],[8,5,8,8],[8,9,8,14],[9,2,9,4],[9,5,9,8],[9,9,9,14]]}
[]
[]
[null,null,"別紙２"]
[null,null,{"$f":"CONCATENATE(第1号様式!$J$2,\"　事業計画書\")","v":"電子カルテ情報共有サービスのモデル事業および効果検証事業　事業計画書"}]
[]
[]
[]
[]
[null,null,"施設名",null,null,"開設者",null,null,null,"所在地"]
[]
[]
[]
[null,null,"１．事業計画・内容"]
[]
[]
[]
[]
[]
[]
[]
[null,null,"２．スケジュール"]
[]
[null,null,null,"4月","5月","6月","7月","8月","9月","10月","11月","12月","1月","2月","3月"]

{"sheet":"Sheet3","index":7,"n_rows":11,"n_cols":5,"rows_kept":11,"cut":false,"hidden":true,"merged":[]}
[]
[]
[]
[null,"新設","６アミノペニシラン酸",null,"該当なし"]
[null,"改修","７アミノセファロスポラン酸",null,"鉄筋コンクリート造"]
[null,"新設・改修","バンコマイシン",null,"鉄骨造（鉄筋コンクリート造と同等の強度）"]
[null,null,"その他（）",null,"鉄骨造（ブロック造と同等の強度）"]
[null,null,null,null,"ブロック造"]
[null,null,null,null,"木造"]
[null,null,null,null,"プレハブ造"]
[null,null,null,null,"その他"]

{"sheet":"第1号様式別紙2（事業計画書 後発タイプ）","index":8,"n_rows":33,"n_cols":15,"rows_kept":33,"cut":false,"hidden":true,"merged":[[3,2,3,14],[8,2,8,4],[8,5,8,8],[8,9,8,14],[9,2,9,4],[9,5,9,8],[9,9,9,14],[25,2,26,14],[14,2,16,14],[19,3,19,14],[20,3,20,14],[21,3,21,14]]}
[]
[]
[null,null,"別紙２"]
[null,null,"後発医薬品産業構造改革支援事業　事業計画書"]
[]
[]
[]
[]
[null,null,"事業者の名称",null,null,"代表者",null,null,null,"所在地"]
[]
[]
[]
[null,null,"１．品目統合等の計画概要"]
[null,null,"１）企業間連携と品目統合等の方法"]
[]
[]
[]
[null,null,"※品目又は製造体制の統合のどちらの統合となるのかがわかるように記載すること、また、企業間の連携手法についても記載すること。"]
[null,null,"２）品目統合等を行う後発医薬品の概要"]
[null,null,"統合対象成分の概要"]
[null,null,"申請者の品目"]
[null,null,"統合対象品目"]
[null,null,"※統合対象品目が複数ある場合は全て記載すること。また品目名の後ろに（）で企業名を入れること。"]
[]
[null,null,"３）品目統合等による効果"]
[]
[]
[]
[null,null,"２．スケジュール"]
[]
[null,null,null,"4月","5月","6月","7月","8月","9月","10月","11月","12月","1月","2月","3月"]
[]
[null,null,"※調査計画、設備整備計画毎に作成すること。"]

{"sheet":"第2号様式","index":9,"n_rows":25,"n_cols":7,"rows_kept":25,"cut":false,"hidden":false,"merged":[[10,0,10,6]]}
["第２号様式"]
[null,null,null,null,null,null,"番　　　　　　　　　号"]
[null,null,null,null,null,null,"　　年　　月　　日"]
[]
["厚生労働大臣　殿"]
[null,null,null,null,"所在地"]
[null,null,null,null,"事業者名"]
[null,null,null,null,"代表者氏名"]
[]
[]
["令和８年度（令和７年度からの繰越分）地域診療情報連携推進費補助金実績報告書"]
[]
[]
["標記について、次のとおり関係書類を添えて報告する。　　　　　　　"]
[]
["１　補助金精算額　　　　金　　　　　　　　　　　　　円"]
[]
["２　所要額精算書（別紙１）"]
[]
["３　実績報告書（別紙２）"]
[]
["４　添付書類"]
["　収入支出決算書抄本"]
[]
[" "]

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[]
[]
[null,null,null,"別紙１"]
[null,null,null,"所要額精算書"]
[]
[]
[null,null,null,"１　医療機関におけるサイバーセキュリティ確保事業　所要精算額"]
[null,null,null,"総事業費","寄附金その\n他の収入額","差引額","対象経費の\n支出済額","基準額","選定額","国庫補助\n基本額","国庫補助\n所要額","仕入れに係る\n消費税等相当額","要国庫補助額","交付\n決定額","国庫補助\n受入済額","差引過\n△不足額"]
[null,null,null,"Ａ","Ｂ","Ｃ（Ａ－Ｂ）","Ｄ","Ｅ","Ｆ","Ｇ","Ｈ","Ｉ","Ｊ（Ｈ－Ｉ）","Ｋ","Ｌ","Ｋ（Ｌ－Ｈ）"]
[null,null,null,"円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 "]
[null,null,null,{"$f":"F37","v":0},null,{"$f":"D11-E11","v":0},{"$f":"F27","v":0},null,{"$f":"MIN(G11,H11)","v":0},{"$f":"MIN(F11,I11)","v":0},{"$f":"ROUNDDOWN(J11/2,-3)","v":0},null,{"$f":"K11-L11","v":0},null,null,{"$f":"O11-K11","v":0}]
[]
[null,null,null,"２　対象経費の支出済額算出内訳"]
[null,null,null,"区分",null,"支出済額","算出内訳"]
[null,null,null,null,null,"円"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,"　　合　　　　　　計",null,{"$f":"SUM(F22:F26)","v":0}]
[]
[null,null,null,"（参考）対象外経費の支出済額算出内訳"]
[null,null,null,"　区　　　　　　分",null,"支出済額"]
[null,null,null,null,null,"円 "]
[]
[]
[]
[null,null,null,"合　　　　　計",null,{"$f":"SUM(F32:F34)","v":0},null,null,null,{"$f":"SUM(J34:J34)","v":0}]
[]
[null,null,null,"総事業費",null,{"$f":"F27+F35","v":0}]

{"sheet":"第2号様式別紙1(電カルモデル)","index":11,"n_rows":51,"n_cols":17,"rows_kept":51,"cut":false,"hidden":false,"merged":[[42,3,42,5],[45,3,45,5],[47,3,47,5],[36,3,36,5],[38,3,38,5],[39,3,39,5],[20,3,20,5],[23,3,23,5],[26,3,26,5],[29,3,29,5],[17,7,17,16],[19,7,30,16]]}
[]
[]
[null,null,null,"別紙１"]
[null,null,null,"所要額精算書"]
[]
[]
[null,null,null,"１　電子カルテ情報共有サービスのモデル事業および効果検証事業　所要精算額"]
[null,null,null,"区分","総事業費","寄附金その\n他の収入額","差引額","対象経費の\n支出済額","基準額","選定額","国庫補助\n基本額","国庫補助\n所要額","仕入れに係る\n消費税等相当額","要国庫補助額","交付\n決定額","国庫補助\n受入済額","差引過\n△不足額"]
[null,null,null,null,"Ａ","Ｂ","Ｃ（Ａ－Ｂ）","Ｄ","Ｅ","Ｆ","Ｇ","Ｈ","Ｉ","Ｊ（Ｈ－Ｉ）","Ｋ","Ｌ","Ｍ（Ｌ－Ｈ）"]
[null,null,null,null,"円 ","円 ","円 ","円 ","円 ","円 ","円 ","円 ",null,null,"円 ","円 ","円 "]
[null,null,null,"文書及び臨床情報早期検証対応事業",null,null,{"$f":"E11-F11","v":0},{"$f":"G20","v":0},null,{"$f":"MIN(H11,I11)","v":0},{"$f":"MIN(G11,J11)","v":0},{"$f":"ROUNDDOWN(K11,-3)","v":0},null,{"$f":"L11-M11","v":0},null,null,{"$f":"P11-L11","v":0}]
[null,null,null,"文書及び臨床情報検証対応事業",null,null,{"$f":"E12-F12","v":0},{"$f":"G26","v":0},null,{"$f":"MIN(H12,I12)","v":0},{"$f":"MIN(G12,J12)","v":0},{"$f":"ROUNDDOWN(K12,-3)","v":0},null,{"$f":"L12-M12","v":0},null,null,{"$f":"P12-L12","v":0}]
[null,null,null,"健診文書検証事業",null,null,0,0,null,0,0,0,null,0,null,null,0]
[null,null,null,"薬局検証事業",null,null,0,0,null,0,0,0,null,0,null,null,0]
[null,null,null,"合計",{"$f":"G51","v":0},{"$f":"F11:F14","v":0},{"$f":"SUM(G11:G14)","v":0},{"$f":"SUM(H11:H14)","v":0},0,0,0,0,null,null,0,0,0]
[null,null,null,null,null,0]
[null,null,null,"２　対象経費の支出済額算出内訳",null,0]
[null,null,null,"区分",null,0,"支出済額","算出内訳"]
[null,null,null,null,null,null,"円"]
[null,null,null,"（文書及び臨床情報早期検証対応事業）",null,null,{"$f":"SUM(G21:G22)","v":0}]
[]
[]
[null,null,null,"（文書及び臨床情報検証対応事業）",null,null,{"$f":"SUM(G24:G25)","v":0}]
[]
[]
[null,null,null,"（健診文書検証事業）",null,null,{"$f":"SUM(G27:G28)","v":0}]
[]
[]
[null,null,null,"（薬局検証事業）",null,null,{"$f":"SUM(G30:G31)","v":0}]
[]
[]
[null,null,null,"合　　　　　計",null,null,{"$f":"G20+G23+G26+G29","v":0}]
[]
[null,null,null,"（参考）対象外経費の支出済額算出内訳"]
[null,null,null,"区　　　　　　分",null,null,"支出済額"]
[null,null,null,null,null,null,"円 "]
[null,null,null,"（設備整備事業）",null,null,{"$f":"SUM(G38:G39)","v":0}]
[]
[]
[null,null,null,"（文書及び臨床情報検証対応事業）",null,null,{"$f":"SUM(G41:G42)","v":0}]
[]
[]
[null,null,null,"（健診文書検証事業）",null,null,{"$f":"SUM(G44:G45)","v":0}]
[]
[]
[null,null,null,"（薬局検証事業）",null,null,{"$f":"SUM(G47:G48)","v":0}]
[]
[]
[null,null,null,"合　　　　　計",null,null,{"$f":"G37+G40+G43+G46","v":0}]
[]
[null,null,null,"総事業費",null,null,{"$f":"G32+G49","v":0}]

{"sheet":"第2号様式別紙2（サイバーセキュリティ確保事業）","index":12,"n_rows":23,"n_cols":15,"rows_kept":23,"cut":false,"hidden":false,"merged":[[14,2,17,14],[3,2,3,14],[8,2,8,4],[8,5,8,8],[8,9,8,14],[9,2,9,4],[9,5,9,8],[9,9,9,14]]}
[]
[]
[null,null,"別紙２"]
[null,null,{"$f":"CONCATENATE([1]第1号様式!$J$2,\"　実績報告書\")","v":"医療機関におけるサイバーセキュリティ確保事業　実績報告書"}]
[]
[]
[]
[]
[null,null,"施設名",null,null,"開設者",null,null,null,"所在地"]
[]
[]
[]
[null,null,"１．事業計画・内容"]
[]
[]
[]
[]
[]
[]
[]
[null,null,"２．スケジュール"]
[]
[null,null,null,"4月","5月","6月","7月","8月","9月","10月","11月","12月","1月","2月","3月"]

{"sheet":"第2号様式別紙2 (電カルモデル)","index":13,"n_rows":21,"n_cols":19,"rows_kept":21,"cut":false,"hidden":false,"merged":[[14,3,14,8],[15,2,18,14],[20,3,20,8],[21,2,24,14],[7,2,7,8],[7,9,7,11],[7,12,7,14],[8,2,8,8],[8,9,8,11],[8,12,8,14],[6,2,6,3],[6,4,6,5],[6,9,6,14],[3,2,3,14],[5,2,5,3],[5,4,5,5],[5,6,5,8],[5,9,5,14]]}
[]
[]
[null,null,"別紙２"]
[null,null,"電子カルテ情報共有サービスのモデル事業および効果検証事業 実績報告書"]
[]
[null,null,"施設名",null,"医療機関等種別",null,"開設者",null,null,"所在地"]
[]
[null,null,"担当者名（部署名）",null,null,null,null,null,null,"担当者電話番号",null,null,"担当者メールアドレス"]
[]
[]
[null,null,"１．事業実績・内容"]
[null,null,"実施した事業毎に実施した内容や時期を詳細に記載ください。別紙にまとめた場合は、「別紙のとおり」と記載ください。"]
[null,null,"※事業計画書に記載した事項を踏まえた報告内容としてください。"]
[]
[null,null,"実施事業"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"文書（診療情報提供書等・退院時サマリ）及び臨床情報早期検証対応事業"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"文書（診療情報提供書等・退院時サマリ）及び臨床情報検証対応事業"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"健診文書検証事業"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"薬局検証事業"]
[]
[null,null,"実施事業"]

{"sheet":"第2号様式別紙2（後発タイプ）","index":14,"n_rows":33,"n_cols":15,"rows_kept":33,"cut":false,"hidden":true,"merged":[[25,2,26,14],[14,2,16,14],[19,3,19,14],[20,3,20,14],[3,2,3,14],[21,3,21,14],[8,2,8,4],[8,5,8,8],[8,9,8,14],[9,2,9,4],[9,5,9,8],[9,9,9,14]]}
[]
[]
[null,null,"別紙２"]
[null,null,"後発医薬品産業構造改革支援事業　実績報告書"]
[]
[]
[]
[]
[null,null,"事業者の名称",null,null,"代表者",null,null,null,"所在地"]
[]
[]
[]
[null,null,"１．品目統合等の計画概要"]
[null,null,"１）企業間連携と品目統合等の方法"]
[]
[]
[]
[null,null,"※品目又は製造体制の統合のどちらの統合となるのかがわかるように記載すること、また、企業間の連携手法についても記載すること。"]
[null,null,"２）品目統合等を行う後発医薬品の概要"]
[null,null,"統合対象成分の概要"]
[null,null,"申請者の品目"]
[null,null,"統合対象品目"]
[null,null,"※統合対象品目が複数ある場合は全て記載すること。また品目名の後ろに（）で企業名を入れること。"]
[]
[null,null,"３）品目統合等による効果"]
[]
[]
[]
[null,null,"２．スケジュール"]
[]
[null,null,null,"4月","5月","6月","7月","8月","9月","10月","11月","12月","1月","2月","3月"]
[]
[null,null,"※調査計画、設備整備計画毎に作成すること。"]

{"sheet":"第3号様式","index":15,"n_rows":28,"n_cols":10,"rows_kept":28,"cut":false,"hidden":false,"merged":[[13,0,15,9],[10,0,10,9],[11,0,11,9]]}
["第３号様式"]
[null,null,null,null,null,null,null,null,null,"番　　　　　　　　　号"]
[null,null,null,null,null,null,null,null,null,"　　年　　月　　日"]
[]
["厚生労働大臣　殿"]
[null,null,null,null,null,null,"所在地"]
[null,null,null,null,null,null,"事業者名"]
[null,null,null,null,null,null,"代表者氏名"]
[]
[]
["令和８年度（令和７年度からの繰越分）地域診療情報連携推進費補助金"]
["消費税及び地方消費税に係る仕入控除税額報告書"]
[]
["　　　年　月　日厚生労働省発産情　　　第　号により交付決定があった令和８年度（令和７年度からの繰越分）医薬品安定供給支援補助金について、当該交付要綱６の（８）の規定に基づき、次のとおり報告する。"]
[]
[]
[]
["１　補助金等に係る予算の執行の適正化に関する法律（昭和30年法律第179号）"]
["　　第15条の規定による確定額又は事業実績報告による精算額"]
[null,null,null,null,null,null,"金　　　　　　　　円"]
[]
["２　消費税及び地方消費税の申告により確定した消費税及び地方消費税に係る"]
["　　仕入控除税額（要国庫補助金返還相当額）"]
[null,null,null,null,null,null,"金　　　　　　　　円"]
[]
["３　添付書類"]
["記載内容を確認するための書類（確定申告書の写し、課税売上割合等が把握できる資料、"]
["特定収入の割合を確認できる資料）を添付する。"]

{"sheet":"第4号様式","index":16,"n_rows":16,"n_cols":9,"rows_kept":16,"cut":false,"hidden":false,"merged":[[15,0,16,8],[12,0,12,8]]}
["第４号様式"]
[null,null,null,null,null,null,null,null,"番　　　　　　　　　号"]
[null,null,null,null,null,null,null,null,"　　年　　月　　日"]
[]
["厚生労働大臣　　殿"]
[null,null,null,null,null,null,"所在地"]
[null,null,null,null,null,null,"事業者名"]
[null,null,null,null,null,null,"代表者氏名"]
[]
[]
[]
[]
["令和８年度（令和７年度からの繰越分）地域診療情報連携推進費補助金遂行状況報告書"]
[]
[]
["  標記について、補助金等に係る予算の執行の適正化に関する法律第１２条の規定により、別紙１、２のとおり報告する。"]

{"sheet":"第4号様式別紙1","index":17,"n_rows":32,"n_cols":4,"rows_kept":32,"cut":false,"hidden":false,"merged":[]}
[]
[]
[null,"別紙１"]
[]
[null,"遂行状況報告書"]
[]
[null,{"$f":"CONCATENATE(\"（\",第1号様式!$J$2,\"）\")","v":"（電子カルテ情報共有サービスのモデル事業および効果検証事業）"}]
[null,"１　対象経費の支出済額算出内訳",null,"（　　年　　月　　日現在）"]
[null,"区分","支出済額","支出内訳"]
[null,null,"円 "]
[]
[null,"人件費"]
[]
[null,"旅費"]
[]
[null,"翻訳料"]
[]
[null,"通信運搬費"]
[]
[null,"委託費"]
[]
[null,"合　　　計",{"$f":"SUM(C15:C21)","v":0}]
[]
[null,"（参考）対象外経費の支出済額算出内訳"]
[null,"区分","支出済額"]
[null,null,"円 "]
[]
[]
[]
[null,"合　　　計",{"$f":"SUM(C27:C29)","v":0}]
[]
[null,"総事業費",{"$f":"SUM(C22,C30)","v":0}]

{"sheet":"第4号様式別紙2（Aタイプ）","index":18,"n_rows":23,"n_cols":15,"rows_kept":23,"cut":false,"hidden":false,"merged":[[14,2,17,14],[3,2,3,14],[8,2,8,4],[8,5,8,8],[8,9,8,14],[9,2,9,4],[9,5,9,8],[9,9,9,14]]}
[]
[]
[null,null,"別紙２"]
[null,null,{"$f":"CONCATENATE(第1号様式!$J$2,\"　遂行状況報告書\")","v":"電子カルテ情報共有サービスのモデル事業および効果検証事業　遂行状況報告書"}]
[]
[]
[]
[]
[null,null,"施設名",null,null,"開設者",null,null,null,"所在地"]
[]
[]
[]
[null,null,"１．事業計画・内容"]
[]
[]
[]
[]
[]
[]
[]
[null,null,"２．スケジュール"]
[]
[null,null,null,"4月","5月","6月","7月","8月","9月","10月","11月","12月","1月","2月","3月"]

{"sheet":"第4号様式別紙2 (後発タイプ)","index":19,"n_rows":33,"n_cols":15,"rows_kept":33,"cut":false,"hidden":true,"merged":[[25,2,26,14],[14,2,16,14],[19,3,19,14],[20,3,20,14],[3,2,3,14],[21,3,21,14],[8,2,8,4],[8,5,8,8],[8,9,8,14],[9,2,9,4],[9,5,9,8],[9,9,9,14]]}
[]
[]
[null,null,"別紙２"]
[null,null,"後発医薬品産業構造改革支援事業　遂行状況報告書"]
[]
[]
[]
[]
[null,null,"事業者の名称",null,null,"代表者",null,null,null,"所在地"]
[]
[]
[]
[null,null,"１．品目統合等の計画概要"]
[null,null,"１）企業間連携と品目統合等の方法"]
[]
[]
[]
[null,null,"※品目又は製造体制の統合のどちらの統合となるのかがわかるように記載すること、また、企業間の連携手法についても記載すること。"]
[null,null,"２）品目統合等を行う後発医薬品の概要"]
[null,null,"統合対象成分の概要"]
[null,null,"申請者の品目"]
[null,null,"統合対象品目"]
[null,null,"※統合対象品目が複数ある場合は全て記載すること。また品目名の後ろに（）で企業名を入れること。"]
[]
[null,null,"３）品目統合等による効果"]
[]
[]
[]
[null,null,"２．スケジュール"]
[]
[null,null,null,"4月","5月","6月","7月","8月","9月","10月","11月","12月","1月","2月","3月"]
[]
[null,null,"※調査計画、設備整備計画毎に作成すること。"]