diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/appservice/IDiagTreatMAppService.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/appservice/IDiagTreatMAppService.java
index c8e6d1ff..6e04b9c3 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/appservice/IDiagTreatMAppService.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/appservice/IDiagTreatMAppService.java
@@ -130,4 +130,13 @@ public interface IDiagTreatMAppService {
      * @return 结果
      */
     R<?> updatePricingFlag(List<Long> ids, Integer pricingFlag);
+
+    /**
+     * 诊疗目录下拉列表（轻量级，用于套餐设置）
+     *
+     * @param statusEnum 状态（2=启用）
+     * @param searchKey 搜索关键词（可选）
+     * @return 只包含 id, name, busNo, retailPrice
+     */
+    R<?> getDiagnosisTreatmentSimpleList(Integer statusEnum, String searchKey);
 }
\ No newline at end of file
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/appservice/impl/DiagTreatMAppServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/appservice/impl/DiagTreatMAppServiceImpl.java
index 900a670d..ad523bb4 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/appservice/impl/DiagTreatMAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/appservice/impl/DiagTreatMAppServiceImpl.java
@@ -822,4 +822,20 @@ public class DiagTreatMAppServiceImpl implements IDiagTreatMAppService {
         }
         return activityDefinition;
     }
+
+    /**
+     * 诊疗目录下拉列表（轻量级，用于套餐设置）
+     * 只查询必要字段，减少JOIN，提高查询速度
+     * 支持搜索关键词过滤
+     *
+     * @param statusEnum 状态（2=启用）
+     * @param searchKey 搜索关键词
+     * @return 只包含 id, name, busNo, retailPrice
+     */
+    @Override
+    public R<?> getDiagnosisTreatmentSimpleList(Integer statusEnum, String searchKey) {
+        Integer tenantId = SecurityUtils.getLoginUser().getTenantId();
+        List<DiagnosisTreatmentDto> list = activityDefinitionManageMapper.getDiagnosisTreatmentSimpleList(statusEnum, tenantId, searchKey);
+        return R.ok(list);
+    }
 }
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/controller/DiagnosisTreatmentController.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/controller/DiagnosisTreatmentController.java
index 03b4e89d..e18af678 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/controller/DiagnosisTreatmentController.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/controller/DiagnosisTreatmentController.java
@@ -207,4 +207,21 @@ public class DiagnosisTreatmentController {
                     .orderByAsc(InspectionType::getSortOrder);
         return R.ok(inspectionTypeService.list(queryWrapper));
     }
+
+    /**
+     * 诊疗目录下拉列表（轻量级，用于套餐设置）
+     * 只查询必要字段，减少JOIN，提高查询速度
+     * 支持搜索关键词过滤
+     *
+     * @param statusEnum 状态（2=启用）
+     * @param searchKey 搜索关键词
+     * @return 只包含 id, name, busNo, retailPrice
+     */
+    @GetMapping("/simple-list")
+    public R<?> getDiagnosisTreatmentSimpleList(@RequestParam(required = false) Integer statusEnum, @RequestParam(required = false) String searchKey) {
+        if (statusEnum == null) {
+            statusEnum = 2;
+        }
+        return diagTreatMAppService.getDiagnosisTreatmentSimpleList(statusEnum, searchKey);
+    }
 }
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/mapper/ActivityDefinitionManageMapper.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/mapper/ActivityDefinitionManageMapper.java
index f0318f37..eed60d09 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/mapper/ActivityDefinitionManageMapper.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/datadictionary/mapper/ActivityDefinitionManageMapper.java
@@ -8,6 +8,8 @@ import com.openhis.web.datadictionary.dto.DiagnosisTreatmentDto;
 import org.apache.ibatis.annotations.Param;
 import org.springframework.stereotype.Repository;
 
+import java.util.List;
+
 /**
  * 诊疗定义管理
  *
@@ -36,4 +38,14 @@ public interface ActivityDefinitionManageMapper {
      */
     DiagnosisTreatmentDto getDiseaseTreatmentOne(@Param("id") Long id, @Param("tenantId") Integer tenantId);
 
+    /**
+     * 诊疗目录下拉列表（轻量级，只查4个字段）
+     *
+     * @param statusEnum 状态
+     * @param tenantId 租户ID
+     * @param searchKey 搜索关键词（可选）
+     * @return id, name, busNo, retailPrice
+     */
+    List<DiagnosisTreatmentDto> getDiagnosisTreatmentSimpleList(@Param("statusEnum") Integer statusEnum, @Param("tenantId") Integer tenantId, @Param("searchKey") String searchKey);
+
 }
diff --git a/openhis-server-new/openhis-application/src/main/resources/mapper/datadictionary/ActivityDefinitionManageMapper.xml b/openhis-server-new/openhis-application/src/main/resources/mapper/datadictionary/ActivityDefinitionManageMapper.xml
index 98b7a520..91b7b594 100644
--- a/openhis-server-new/openhis-application/src/main/resources/mapper/datadictionary/ActivityDefinitionManageMapper.xml
+++ b/openhis-server-new/openhis-application/src/main/resources/mapper/datadictionary/ActivityDefinitionManageMapper.xml
@@ -78,6 +78,36 @@
         ORDER BY T1.id DESC
     </select>
 
+    <!-- 诊疗目录下拉列表（轻量级，只查4个字段，1个JOIN） -->
+    <select id="getDiagnosisTreatmentSimpleList" resultType="com.openhis.web.datadictionary.dto.DiagnosisTreatmentDto">
+        SELECT 
+            T1.id,
+            T1.bus_no,
+            T1.name,
+            T2.price as retail_price
+        FROM wor_activity_definition T1
+        INNER JOIN adm_charge_item_definition T2
+            ON T1.id = T2.instance_id
+            AND T2.instance_table = 'wor_activity_definition'
+        WHERE T1.delete_flag = '0'
+            AND T1.status_enum = #{statusEnum}
+            AND T1.tenant_id = #{tenantId}
+            <if test="searchKey != null and searchKey != ''">
+                AND (
+                    T1.name LIKE '%' || #{searchKey} || '%'
+                    OR T1.bus_no LIKE '%' || #{searchKey} || '%'
+                    OR T1.py_str LIKE '%' || #{searchKey} || '%'
+                )
+            </if>
+        ORDER BY T1.id DESC
+        <if test="searchKey != null and searchKey != ''">
+            LIMIT 1500
+        </if>
+        <if test="searchKey == null or searchKey == ''">
+            LIMIT 500
+        </if>
+    </select>
+
     <select id="getDiseaseTreatmentOne" resultType="com.openhis.web.datadictionary.dto.DiagnosisTreatmentDto">
         SELECT
         T1.id,
diff --git a/openhis-ui-vue3/src/views/catalog/diagnosistreatment/components/diagnosistreatment.js b/openhis-ui-vue3/src/views/catalog/diagnosistreatment/components/diagnosistreatment.js
index 2cb3f46b..71bb4689 100644
--- a/openhis-ui-vue3/src/views/catalog/diagnosistreatment/components/diagnosistreatment.js
+++ b/openhis-ui-vue3/src/views/catalog/diagnosistreatment/components/diagnosistreatment.js
@@ -123,4 +123,13 @@ export function updatePricingFlag (ids, pricingFlag) {
   });
 }
 
+// 诊疗目录下拉列表（轻量级，用于套餐设置）
+export function getDiagnosisTreatmentSimpleList (statusEnum, searchKey) {
+  return request ({
+    url: '/data-dictionary/diagnosis-treatment/simple-list',
+    method: 'get',
+    params: { statusEnum, searchKey },
+  });
+}
+
 
diff --git a/openhis-ui-vue3/src/views/maintainSystem/checkprojectSettings/components/PackageSettings.vue b/openhis-ui-vue3/src/views/maintainSystem/checkprojectSettings/components/PackageSettings.vue
index 18f17fac..127b86ee 100644
--- a/openhis-ui-vue3/src/views/maintainSystem/checkprojectSettings/components/PackageSettings.vue
+++ b/openhis-ui-vue3/src/views/maintainSystem/checkprojectSettings/components/PackageSettings.vue
@@ -75,7 +75,12 @@
           <el-col :xs="24" :sm="12" :md="8" :lg="6">
             <el-form-item label="卫生机构">
               <el-select v-model="formData.organization" placeholder="请选择卫生机构" style="width: 100%" :disabled="isReadOnly">
-                <el-option label="演示医院" value="演示医院" />
+                <el-option 
+                  v-for="org in organizationOptions" 
+                  :key="org.value" 
+                  :label="org.label" 
+                  :value="org.value" 
+                />
               </el-select>
             </el-form-item>
           </el-col>
@@ -225,13 +230,13 @@
                 </el-option>
                 <template #empty>
                   <div style="padding: 10px; text-align: center; color: #999;">
-                    <div v-if="diagnosisTreatmentList.length === 0">
-                      暂无项目数据<br/>
-                      <small>请先在【系统管理-目录管理-诊疗项目】中添加项目</small>
+                    <div v-if="diagnosisTreatmentList.length > 0">
+                      无匹配项目<br/>
+                      <small>请尝试其他关键词</small>
                     </div>
                     <div v-else>
-                      无匹配项目<br/>
-                      <small>支持：名称模糊搜索、首字母搜索、编号搜索</small>
+                      暂无项目数据<br/>
+                      <small>请先在【系统管理-目录管理-诊疗项目】中添加项目</small>
                     </div>
                   </div>
                 </template>
@@ -388,10 +393,11 @@ import {ElMessage, ElMessageBox} from 'element-plus'
 import {getDicts} from '@/api/system/dict/data'
 import {listDept} from '@/api/system/dept'
 import {addCheckPackage, updateCheckPackage} from '@/api/system/checkType'
-import {getDiagnosisTreatmentList} from '@/views/catalog/diagnosistreatment/components/diagnosistreatment'
+import {getDiagnosisTreatmentSimpleList} from '@/views/catalog/diagnosistreatment/components/diagnosistreatment'
+import {getTenantPage} from '@/api/system/tenant'
 import useUserStore from '@/store/modules/user'
-import request from '@/utils/request' // 导入request工具用于调用Organization API
-import cache from '@/plugins/cache' // 导入缓存工具
+import request from '@/utils/request'
+import cache from '@/plugins/cache'
 
 // 接收props
 const props = defineProps({
@@ -439,7 +445,7 @@ const formData = reactive({
   department: '',
   user: '',
   packageName: '',
-  organization: '演示医院',
+  organization: '',
   packagePrice: '0.00',
   discount: '',
   creator: userStore.name || '当前用户',
@@ -469,6 +475,8 @@ const formRules = {
 const packageLevelOptions = ref([])
 // 科室选项
 const departments = ref([])
+// 卫生机构选项
+const organizationOptions = ref([])
 // 诊疗项目列表
 const diagnosisTreatmentList = ref([])
 // 过滤后的诊疗项目列表（用于搜索）
@@ -684,8 +692,11 @@ onMounted(async () => {
       }
     }
 
-    // 加载诊疗项目列表（优先使用缓存）
-    await loadDiagnosisTreatmentList(true)
+    // 加载诊疗项目列表（默认加载500条）
+    await loadDiagnosisTreatmentList(false)
+
+    // 加载卫生机构列表（只获取启用的租户）
+    await loadOrganizationList()
 
     // 初始化一行空数据
     if(props.mode === 'add'){
@@ -697,109 +708,103 @@ onMounted(async () => {
   }
 })
 
-// 诊疗项目列表缓存key和过期时间（30分钟）
-const DIAGNOSIS_TREATMENT_CACHE_KEY = 'check_package_diagnosis_treatment_list'
+// 加载卫生机构列表（从租户列表获取，只获取启用的）
+async function loadOrganizationList() {
+  try {
+    const response = await getTenantPage({
+      pageNo: 1,
+      pageSize: 1000,
+      status: '0'
+    })
+    
+    if (response && response.code === 200) {
+      const records = response.data?.records || response.data || []
+      organizationOptions.value = records.map(item => ({
+        value: item.tenantName || item.name,
+        label: item.tenantName || item.name,
+        tenantId: item.tenantId
+      }))
+      console.log('✓ 卫生机构数据加载成功:', organizationOptions.value.length)
+      
+      // 优先使用当前登录账号的机构名称作为默认值
+      const currentOrgName = userStore.tenantName
+      if (currentOrgName && organizationOptions.value.find(o => o.value === currentOrgName)) {
+        formData.organization = currentOrgName
+      } else if (!formData.organization && organizationOptions.value.length > 0) {
+        // 其次设置为列表第一个
+        formData.organization = organizationOptions.value[0].value
+      }
+    }
+  } catch (error) {
+    console.error('✗ 获取卫生机构列表失败:', error)
+  }
+}
+// 诊疗项目缓存key和过期时间
+const DIAGNOSIS_TREATMENT_CACHE_KEY = 'check_package_diagnosis_treatment_cache'
 const CACHE_EXPIRE_TIME = 30 * 60 * 1000 // 30分钟
 
-// 加载诊疗项目列表（支持缓存）
+// 诊疗项目ID到项目信息的映射缓存（用于选择后获取详情）
+const diagnosisTreatmentCache = ref({})
+
+// 加载诊疗项目详情到缓存
+async function loadDiagnosisTreatmentItem(itemId, itemData) {
+  if (!itemData) return
+  diagnosisTreatmentCache.value[itemId] = itemData
+}
+
+// 加载诊疗项目列表（默认加载500条，支持缓存）
 async function loadDiagnosisTreatmentList(forceRefresh = false) {
-  // 如果不是强制刷新，先尝试从缓存加载
-  if (!forceRefresh) {
-    try {
-      const cachedData = cache.session.getJSON(DIAGNOSIS_TREATMENT_CACHE_KEY)
-      if (cachedData && cachedData.data && cachedData.timestamp) {
-        const now = Date.now()
-        const cacheAge = now - cachedData.timestamp
-        
-        // 检查缓存是否过期
-        if (cacheAge < CACHE_EXPIRE_TIME) {
-          diagnosisTreatmentList.value = cachedData.data
-          // 静默加载，不显示消息
-          return
-        }
+  // 如果不是强制刷新且已有数据且未过期，直接返回
+  if (!forceRefresh && diagnosisTreatmentList.value.length > 0) {
+    return
+  }
+  
+  // 从session缓存读取
+  try {
+    const cachedData = cache.session.getJSON(DIAGNOSIS_TREATMENT_CACHE_KEY)
+    if (cachedData && cachedData.timestamp) {
+      const now = Date.now()
+      const cacheAge = now - cachedData.timestamp
+      
+      if (cacheAge < CACHE_EXPIRE_TIME) {
+        diagnosisTreatmentList.value = cachedData.data || []
+        return
       }
-    } catch (error) {
-      // 缓存读取失败，继续从API加载
-      console.error('读取缓存失败:', error)
     }
+  } catch (error) {
+    console.error('读取缓存失败:', error)
   }
   
   // 从API加载数据
   loading.value = true
   try {
-    let allItems = []
-    const maxBatches = 3
-    const batchSize = 50
+    const response = await getDiagnosisTreatmentSimpleList(2)
     
-    for (let page = 1; page <= maxBatches; page++) {
-      try {
-        const treatmentResponse = await getDiagnosisTreatmentList({
-          pageNo: page,
-          pageSize: batchSize
-        })
-        
-        let batchData = []
-        if (treatmentResponse) {
-          if (treatmentResponse.data && treatmentResponse.data.records) {
-            batchData = treatmentResponse.data.records
-          } else if (treatmentResponse.data && Array.isArray(treatmentResponse.data)) {
-            batchData = treatmentResponse.data
-          } else if (treatmentResponse.records && Array.isArray(treatmentResponse.records)) {
-            batchData = treatmentResponse.records
-          }
-        }
-        
-        if (batchData.length > 0) {
-          allItems = allItems.concat(batchData)
-          if (batchData.length < batchSize) {
-            break
-          }
-        } else {
-          break
-        }
-      } catch (batchError) {
-        console.error(`第${page}批加载失败:`, batchError)
-        if (page === 1) {
-          throw batchError
-        }
-        break
-      }
+    let allItems = []
+    if (response && response.code === 200 && response.data) {
+      allItems = Array.isArray(response.data) ? response.data : response.data.records || []
     }
     
     if (allItems.length > 0) {
       diagnosisTreatmentList.value = allItems
       
       // 保存到缓存
-      try {
-        cache.session.setJSON(DIAGNOSIS_TREATMENT_CACHE_KEY, {
-          data: allItems,
-          timestamp: Date.now()
-        })
-      } catch (cacheError) {
-        console.error('保存缓存失败:', cacheError)
-      }
+      cache.session.setJSON(DIAGNOSIS_TREATMENT_CACHE_KEY, {
+        data: allItems,
+        timestamp: Date.now()
+      })
       
       // 只在强制刷新时显示成功消息
       if (forceRefresh) {
         ElMessage.success(`成功加载${allItems.length}个诊疗项目`)
       }
-    } else {
-      if (forceRefresh) {
-        ElMessage.warning({
-          message: '未获取到诊疗项目数据。请先在【系统管理-目录管理-诊疗项目】中添加数据',
-          duration: 6000,
-          showClose: true
-        })
-      }
+    } else if (forceRefresh) {
+      ElMessage.warning('未获取到诊疗项目数据')
     }
   } catch (error) {
     console.error('获取诊疗项目列表失败:', error)
     if (forceRefresh) {
-      ElMessage.error({
-        message: '获取诊疗项目列表失败，请检查网络连接或联系管理员',
-        duration: 6000,
-        showClose: true
-      })
+      ElMessage.error('获取诊疗项目列表失败')
     }
   } finally {
     loading.value = false
@@ -932,53 +937,65 @@ function getPinYinFirstLetter(str) {
   return result
 }
 
-// 初始化搜索列表
+// 初始化搜索列表（聚焦时显示默认加载的500条数据）
 function initializeSearchList(row) {
-  if (!row.filteredList) {
-    row.filteredList = diagnosisTreatmentList.value
-  }
+  row.filteredList = diagnosisTreatmentList.value
 }
 
-// 项目搜索处理（支持首字母和模糊搜索）
-function handleProjectSearch(query, row) {
+// 项目搜索处理（支持名称/编号/拼音模糊搜索）
+async function handleProjectSearch(query, row) {
 
+  // 如果输入为空，显示默认列表
   if (!query || query.trim() === '') {
     row.filteredList = diagnosisTreatmentList.value
     return
   }
   
-  const searchText = query.trim().toUpperCase()
+  const searchText = query.trim()
   
-  row.filteredList = diagnosisTreatmentList.value.filter(item => {
-    const name = (item.name || item.itemName || '').toUpperCase()
-    const code = (item.busNo || item.code || '').toUpperCase()
+  // 调用后端接口搜索
+  loading.value = true
+  try {
+    const response = await getDiagnosisTreatmentSimpleList(2, searchText)
     
-    // 1. 名称模糊匹配
-    if (name.includes(searchText)) {
-      return true
+    let items = []
+    if (response && response.code === 200 && response.data) {
+      items = Array.isArray(response.data) ? response.data : []
     }
     
-    // 2. 编号模糊匹配
-    if (code.includes(searchText)) {
-      return true
+    // 如果搜索结果为空，显示默认列表
+    if (items.length === 0) {
+      row.filteredList = diagnosisTreatmentList.value
+    } else {
+      row.filteredList = items
     }
     
-    // 3. 拼音首字母匹配
-    const pinyin = getPinYinFirstLetter(item.name || item.itemName || '')
-    if (pinyin.includes(searchText)) {
-      return true
-    }
-    
-    return false
-  })
-  
-  console.log(`搜索"${query}"找到 ${row.filteredList.length} 个结果`)
+    console.log(`搜索"${searchText}"找到 ${items.length} 个结果`)
+  } catch (error) {
+    console.error('搜索失败:', error)
+    row.filteredList = diagnosisTreatmentList.value
+  } finally {
+    loading.value = false
+  }
 }
 
-// 项目选择处理
+// 项目选择处理（从搜索结果或缓存中获取）
 function handleItemSelect(row) {
   console.log('选择项目ID:', row.itemId)
-  const item = diagnosisTreatmentList.value.find(i => i.id === row.itemId)
+  
+  // 优先从搜索结果中获取
+  let item = row.filteredList?.find(i => i.id === row.itemId)
+  
+  // 其次从缓存中获取
+  if (!item) {
+    item = diagnosisTreatmentCache.value[row.itemId]
+  }
+  
+  // 最后从诊断列表中获取
+  if (!item) {
+    item = diagnosisTreatmentList.value.find(i => i.id === row.itemId)
+  }
+  
   console.log('找到的项目:', item)
   
   if (item) {
@@ -986,6 +1003,10 @@ function handleItemSelect(row) {
     row.code = item.busNo || item.code || item.itemCode || ''
     row.unitPrice = parseFloat(item.retailPrice || item.unitPrice || item.price || 0)
     console.log('设置单价:', row.unitPrice)
+    
+    // 缓存选中的项目
+    loadDiagnosisTreatmentItem(row.itemId, item)
+    
     calculateAmount(row)
   } else {
     ElMessage.warning('未找到该项目信息')