Strona 1. Załącznik nr 2

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1 Załącznik nr 2.. /Nazwa i adres Wykonawcy/ FORMULARZ CENOWY na dostawy produktów leczniczych i wyrobów medycznych dla Domu Pomocy Społecznej w Grudziądzu (po wypełnieniu staje się załącznikiem do formularza ofertowego i umowy) Lp. Nazwa produktu farmaceutycznego Odpłatność Ilość Cena jednost. netto Cena jednost. brutto Wartość brutto (kol. 4 x kol. 6) LACTI - 20 kaps. 100% 20 2 ABILIFY 15 mg - 28 tabl. R 29 3 ACARD 150 mg - 30 tabl. 100% 88 4 ACARD 150 mg - 60 tabl. 100% 5 5 ACARD 75 mg - 30 tabl. 100% ACARD 75 mg - 60 tabl. 100% 33 7 ACC tab. musujących 100% 18 8 ACC MAX 200 mg - 20 tabl. mus. 100% 1 9 ACC MAX, 20 sasz. 100% 6 10 ACCU-CHEK ACTIVE 50 pasków R ACCU-CHEK ACTIVE 50 pasków 30% ACCU-CHEK ACTIVE 50 pasków 100% 1 13 ACCU-CHEK PERFORMA - 50 paski 30% 3 14 ACCU-CHEK PERFORMA - 50 paski 100% 1 15 ACCU-CHEK PERFORMA - 50 paski R ACENOCUMAROL 1 mg - 60 tabl. 100% ACENOCUMAROL 4 mg - 60 tabl. R ACIDUM FOLICUM 15 mg - 30 tabl. 100% ACIDUM FOLICUM 15 mg - 30 tabl. R 1 20 ACIDUM FOLICUM 5 mg - 30 tabl. 100% ACTIVELLE 1+0,5 mg - 28 tabl. 100% ACURENAL 10 mg - 30 tabl. R 4 23 ADAVIN 10 mg - 30 tabl. 100% ADEKSA 100 mg - 30 tabl. 30% ADIPINE 5 mg - 30 tabl. 30% AESCIN 20 mg - 30 tabl. 100% 2 27 AESCIN żel 40 g 100% 2 28 AFOBAM 0,25 mg - 30 tabl. 100% 6 29 AGAPURIN SR 400 mg - 20 tabl. 100% AGASTIN 20 mg - 28 kaps. 50% AGEN 10 mg - 30 tabl. 30% AGEN 5 mg - 30 tabl. 30% 5 33 AGLAN 15 mg - 20 tabl. 50% 4 34 AKINETON 2 mg - 50 tabl. 30% AKINETON 2 mg - 50 tabl. 100% AKINETON 2 mg - 50 tabl. R 6 37 ALANTAN krem 35 g 100% 23 Strona 1

2 38 ALANTAN maść 20 mg/g- 30 g 100% ALAX - 20 tabl. 100% ALERIC LORA 10 mg - 30 tabl. 30% 1 41 ALERIC LORA 10 mg - 30 tabl. 100% 5 42 ALERMED 10 mg - 30 tabl. 30% 5 43 ALFABAX 10 mg - 30 tabl. R 3 44 ALFADIOL 0,25 qg kaps. R 8 45 ALFADIOL 1 qg- 100 kaps. R ALLERTEC 10 mg - 30 tabl. 30% 2 47 ALLERTEC 10 mg - 20 tabl. 100% ALTACET 6 tabl. 100% 6 49 ALTACET ŻEL 75 g 100% ALTAZIAJA 75 g 100% 7 51 ALUGASTRIN 340mg/5 ml - 250ml 100% 2 52 ALVESCO 160 aerozol 120 dawek R AMANTIX 100 mg - 30 tabl. 100% AMARYL 1 mg - 30 tabl. R AMARYL 2 mg - 30 tabl R AMARYL 4 mg- 30 tabl. R 9 57 AMBROSOL 300 mg ml 100% 4 58 AMERTIL 10 mg - 30 tabl. 30% AMITRYPTILINUM 25 mg - 60 tabl. B AMIZEPIN 200 mg - 50 tabl. R AMIZEPIN 200 mg - 50 tabl. B AMIZEPIN 200 mg - 50 tabl. 100% AMLODIPINUM 10 mg - 30 tabl. 30% 4 64 AMLODIPINUM 5 mg - 30 tabl. 30% 4 65 AMLOMYL 10 mg - 30 tabl. 30% 5 66 AMLOMYL 5 mg - 30 tabl. 30% 6 67 AMLONOR 10 mg - 30 tabl. 30% AMLONOR 5 mg - 30 tabl. 30% AMLOPIN 10 mg - 30 tabl. 30% AMLOPIN 10 mg - 30 tabl. 100% 2 71 AMLOPIN 5 mg - 30 tabl. 30% AMLOPIN 5 mg - 30 tabl. 100% 1 73 AMLOZEK 10 mg - 30 tabl. 30% AMLOZEK 5 mg - 30 tabl. 30% AMLOZEK 5 mg - 30 tabl. 100% 6 76 AMOKSIKLAV tabl. 50% 2 77 AMOKSIKLAV0,5+0,125g - 14 tabl. 50% 6 78 AMOTAKS 1 g - 16 tabl. R AMOTAKS DIS 1 g - 16 tabl. 100% AMOTAX 1 g - 16 tabl. R 2 81 AMOTAX 1 g - 16 tabl. 100% 3 82 ANAFRANIL SR 75 mg - 20 tabl. B ANAPRAN 275 mg - 20 tabl. 50% ANAPRAN 275 mg - 60 tabl. 50% 7 85 ANAPRAN 550 mg - 60 tabl. 50% 2 Strona 2

3 86 ANESTELOC 20 mg - 28 tabl. 50% 6 87 ANESTELOC 40 mg - 28 tabl. 50% APAP 100 tabl. 100% APAP 50 tabl. 100% APAP EXTRA 50 tabl. 100% 9 91 APARAT DO PRZETOCZEŃ 100% APHTIN płyn 10g 100% APO - NAPRO 250 mg - 30 tabl. 50% 3 94 APO -DOXAN 2 mg - 30 tabl. R 4 95 APO-AMLO 10, 10 mg - 30 tabl. 30% APO-ATORVA 20 mg - 30 tabl. 30% 1 97 APO-ATORVA 20 mg - 30 tabl. 100% 1 98 APO-ATORVA 40 mg - 30 tabl. 30% 5 99 APO-DOXAN 4 mg - 30 tabl. R APO-FENO 200 M, 200 mg- 30 kaps. 30% APO-FENO 100, 100 mg- 50 kaps. 30% APO-FINA 5 mg - 30 tabl. R APO-INDAP 2,5 mg - 30 tabl. 30% APO-NAPRO 500 mg - 30 tabl. 50% APO-NAPRO 500 mg - 30 tabl. 100% APOPATRAM 30 tabl. 100% APO-PENTOX 400 SR 40 mg - 30 tabl. 100% APO-PERINDOX 4 mg - 30 tabl. 100% APO-RAMI 2,5 mg - 28 tabl. R APO-RAMI 5 mg - 28 tabl. R APO-SIMVA 20, 20 mg - 30 tabl. 30% APO-SIMVA 40, 40 mg - 30 tabl. 30% AQUA PRO INIEKTION 250 ml 100% AQUA PRO INJ. 10 amp a 5ml 100% ARAVA 20 mg - 30 tabl. R ARECHIN 250 mg - 30 tabl. 30% AREPLEX 75 mg - 28 tabl. 100% AREPLEX 75 mg - 28 tabl. 30% ARGOSULFAN krem 2%, 40g 100% ARKETIS 20 mg - 30 tabl. 100% AROPILO 1 mg- 21 tabl. 30% AROPILO SR 2 mg - 28 tabl. 30% ARTEMISOL 100 ml 100% ASAMAX 500 mg tabl. 30% ASAMAX 500 mg tabl. 100% ASARIS 100mcg+50mcg 60 daw. R ASCOFER - 50 tabl. 100% ASENTRA 50 mg- 28 tabl. 30% ASERTIN 50 mg - 30 tabl. 30% ASMAG B 50 tabl. 100% ASMENOL 0,01-28 tabl. 100% ASPARGIN 50 tabl. 100% ASPARGIN 75 tabl. 100% 7 Strona 3

4 134 ASPICAM 15 mg - 30 tabl. 100% ASPIFOX 150 mg - 30 tabl. 100% ASPIFOX 150 mg - 60 tabl. 100% ASPIFOX 75 mg - 30 tabl. 100% ASPIFOX 75 mg - 56 tabl. 100% ATARAX 10 mg - 25 tabl. 100% ATARAX 25 mg - 25 tabl. 100% ATENOLOL 25 mg - 60 tabl. R ATIMOS 12 mcg aerozol R ATOPRA emulsja 200 ml 100% ATORIS 20 mg - 30 tabl. 30% ATORIS 40 mg - 30 tabl. 30% ATORIS 80 mg - 30 tabl. 30% ATORVASTATIN 40 mg - 30 tabl. 30% ATORVASTEROL 10 mg - 30 tabl. 30% ATRAM 12,5 mg - 30 tabl. 30% ATRAM 12,5 mg - 30 tabl. 100% ATRAM 6,25 mg - 30 tabl. 100% ATRAM 6,25 mg - 30 tabl. 30% ATROVENT 25 mcg/ ml - 20 ml płyn R ATROVENT N aerozol (200 Dawek) R ATROVENT N aerozol (200 Dawek) 100% ATROX 20, 20 mg - 30 tabl. 100% ATROX 20, 20 mg- 30 tabl. 30% ATROX 40, 40 mg- 30 tabl. 30% AUGLAVIN 1,0 g - 14 tabl. 100% AUGMENTIN mg - 14 tabl. 50% AUGMENTIN mg -14 tabl. 50% AVAMINA 1000, 1000 mg- 30 tabl. R AVAMINA 500, 500 mg - 30 tabl. R AVAMINA 850, 850 mg - 30 tabl. R AVAMYS AEROZOL 120 dawek 100% AVEDOL 12,5 mg - 30 tabl. 30% AVEDOL 25 mg - 30 tabl. 30% AVEDOL 6,25 mg - 30 tabl. 30% AVEDOL 6,25 mg - 30 tabl. 100% AVILIN 75 ml spray 100% AXOLAN 30 kaps. 100% AXTIL 2,5 mg - 30 tabl. R AXTIL 5 mg - 30 tabl. R BACLOFEN 10 mg - 50 tabl. 100% BACLOFEN 25 mg - 50 tabl. 100% BACTRIM tabl. 100% BACTROBAN krem 2% 15 g 100% BAZETHAM 0,4 mg - 30 tabl. R BAZETHAM RETARD 0,4 mg - 30 tabl. R BEDICORT G 15 g maść 100% BELLERGOT 30 tabl. 100% 7 Strona 4

5 182 BELOGENT maść 15g 100% BEMECOR 0,1 mg - 30 tabl. R BEROTEC N aerozol 200 daw. R BESPRES 160 mg - 28 tabl. 30% BESPRES 80 mg - 28 tabl. 30% BETAHISTYNE PLIVA 16 mg - 60 tabl. 100% BETAHISTYNE PLIVA 24 mg - 50 tabl. 100% BETALOC ZOK tabl. 100% BETALOC ZOK tabl. 100% BETNOVATE C maść 15 g 100% BETO 25 ZK - 28 tabl. 100% BETO 50 ZK - 28 tabl. 100% BIBLOC 2,5 mg - 30 tabl. 100% BIBLOC 5 mg - 30 tabl. 100% BILAXTEN 0,02 30 tabl. 100% BIO BŁONNIK 60 tabl. 100% BIODACYNA krople do oczu 5 ml 100% BIOFENAC 100 mg- 20 tabl. 100% BIOMENTIN 10 mg - 28 tabl. 100% BIOMENTIN 10 mg - 56 tabl. 100% BIOPRAZOL 20 mg - 14 tabl. 50% BIOPRAZOL 20 mg - 28 kaps. 50% BIORACEF 500 mg - 10 tabl. 50% BIORACEF 500 mg - 14 tabl. 50% BIOTROPIL 1200 mg - 60 tabl. 100% BIOTROPIL 800 mg - 60 tabl. 100% BIOTYK 30 kaps. 100% BI-PROFENID, 150 mg- 20 tabl. 50% BISACODYL 5 mg - 30 tabl. 100% BISACODYL CZOPKI 10 mg - 5 szt. 100% BISEPTOL 960, mg - 10 tabl. 50% BISOCARD 10 mg - 30 tabl. 100% BISOCARD 2,5 mg -30 tabl. 100% BISOCARD 5 mg - 30 tabl. 100% BISORATIO 5 mg - 30 tabl. R BISORATIO 5 mg - 30 tabl. 100% BLUMAG JEDYNY - 30 tabl. 100% BŁONNIK tabl. 100% BOLDALOIN - 30 tabl. 100% BROMERGON 2,5 mg - 30 tabl. R BUDERHIN aerozol 10 ml 100% BUDESONIDE EASYHALER 100mcg/daw 200 daw. 100% BUTAPIRAZOL 5% maść 30 g 100% CALCIUM 180 mg - 12 tabl. mus. 100% CALCIUM 300, 84 g - 20 tabl. mus. 100% CALCIUM ALERGO PLUS - 16 tabl. 100% CALCIUM DOBESILATE 250 mg - 30 tabl. 100% 97 Strona 5

6 229 CALPEROS kaps. 100% CALPEROS kaps. 100% CALPEROS 500, 200 mg - 30 kaps. 100% CALPEROS D3-10 tabl. mus. 100% CAPTOPRIL 25 mg - 30 tabl. R CAPTOPRIL12,5 mg - 30 tabl. R CARBO ACTIV 20 kaps. 100% CARBO MEDICINALIS 300 mg - 20 tabl. 100% CARDIOL C krople 40 g 100% CAVINTON FORTE 10 mg - 90 tabl. 100% CENTRUM SILVER 30 tabl. 100% CERKODERM 15, krem 75 ml 100% CERUMEX MD, 15 ml 100% CEWNIK D.ODSSYSANIA GÓRNYCH DRÓG ODDECH."16" CEWNIK FOLEYA "22" 100% CEWNIKI FOLEYA "16" 100% CEWNIKI FOLEYA "18" 100% CEWNIKI FOLEYA "20" 100% CHELAMAG B6-30 kaps. 100% CHLORPROTHIXEN 15 mg - 50 tabl. R CHLORPROTHIXEN 15 mg - 50 tabl. 30% CHLORPROTHIXEN 50 mg - 50 tabl R CHLORPROTHIXEN 50 mg - 50 tabl. 30% CHOLAMID - 30 tabl. 100% CHOLESTIL 50 tabl. 100% CHOLINEX - 16 tabl. 100% CINCOL 2 x 5 ml 100% CINNARIZINUM 25 mg - 50 tabl. 100% CIPRONEX 500 mg - 10 tabl. 50% CIPRONEX 250 mg - 10 tabl. 50% CIPRONEX tabl. 100% CIPROPOL 0,5 g - 10 tabl. 50% CITABAX 10 mg - 28 tabl. 100% CITAL 20 mg - 30 tabl. 100% CITROPEPSIN 180g 100% CLATRA 20 mg - 10 tabl. 100% CLATRA 20 mg - 30 tabl. 100% CLEMASTINUM - 30 tabl. 100% CLEXANE 40 mg/0,4 ml - 10 amp. R CLEXANE 60 mg/0,6 ml- 10 amp. R CLINDAMYCIN MIP 300 mg 16 tabl. 50% CLONAZEPAMUM 0,5 mg- 30 tabl. R CLONAZEPAMUM 0,5 mg- 30 tabl. 100% CLONAZEPAMUM 1 mg/ ml-10 amp. 100% CLONAZEPAMUM 2 mg- 30 tabl. R CLONAZEPAMUM 2 mg- 30 tabl. 100% 344 Strona 6

7 275 CLOPIDOGREL 75 mg - 28 tabl. 30% CLOPIXOL 10 mg tabl. B CLOPIXOL 25 mg- 100 tabl. B CLOPIXOL DEPOT 200mg/ml,1 amp. B CLOTRIMAZOLUM 1% krem 20 g 100% CLOTRIMAZOLUM 6 tabl. dopochow. 50% CO PRESTARIUM 5mg+10 mg -30 tabl. R COAXIL 12,5 mg - 30 tabl. 30% CODIPAR 500 mg - 12 tabl. 100% COFFECORN forte - 12 tabl. 100% COGITON 10 mg - 28 tabl. 30% COGITON 5 mg - 28 tabl. 30% COGITON 5 mg - 28 tabl. 100% CONCOR -COR 5, 5 mg - 56 tabl. 100% CONCOR -COR 2,5, 2,5 mg - 56 tabl. 100% CONCOR-COR 1,25 mg- 28 tabl. 100% CONTIX tabl. 50% CONTIX tabl. 50% CONTOUR TS paski test. 50 szt. 30% CONTOUR TS paski test. 50 szt. 100% CONTROLOC tabl. 50% CONTROLOC 20, 20 mg 28 tabl. 100% CONTROLOC 20, 20 mg - 28 tabl. 50% CONTROLOC tabl. 100% CONTROLOC 40, 40 mg - 14 tabl. 50% CONTROLOC 40, 40 mg - 28 tabl. 100% CONTROLOC 40, 40 mg - 28 tabl. 50% CONVULEX 150 mg tabl. R CONVULEX 150 mg tabl. B CONVULEX 300 mg tabl. R CONVULEX 300 mg tabl. B CONVULEX 300 mg tabl. 100% CONVULEX 500 mg tabl. B CONVULEX 500 mg tabl. R CONVULEX 500 mg tabl. 100% CORECTIN 5 mg - 30 tabl. 100% CORONAL 5, 5 mg- 30 tabl. 100% CORONAL 5, 5 mg- 30 tabl. R CORTARE areozol 100 mcq/daw., 200 daw. R CO-VALSACOR mg - 28 tabl. 30% CROTAMITON płyn 100 g 100% CYCLO 3 FORT 150 mg - 30 kaps. 100% CYCLONAMINE 250 mg - 30 tabl. 100% CYCLOVENA 150 mg - 30 kaps. 100% CZOPKI GLICERYNOWE 2g -10 szt. 100% DAKTARIN 2% krem - 30 g 100% DAKTARIN 20 g puder 100% 2 Strona 7

8 322 DALACIN C 300 mg - 16 tabl. 50% DALACIN C 300 mg - 16 tabl. 100% DANEB 5 mg - 28 tabl. 100% DANEB 5 mg - 28 tabl. R DAVERCIN żel 2,5% 30 g 100% DEBRETIN 10 mg tabl. 100% DEBRIDAT- 30 tabl. 100% DECALDOL 50 mg / 1 ml, 5 ampułek 100% DECALDOL 50 mg/1 ml 5 amp. B DEFLEGMIN 30 mg - 20 tabl. 100% DEFUR 1 mg - 28 tabl. 100% DEFUR 2 mg - 28 tabl. 100% DELMUNO 5 mg - 28 tabl. R DEPAKINE 288,2 mg/5 ml - 150ml R DEPAKINE CHRONO tabl. R DEPAKINE CHRONO tabl. B DEPAKINE CHRONO tabl. 100% DEPAKINE CHRONO tabl 100% DEPAKINE CHRONO tabl. B DEPAKINE CHRONO tabl. R DEPREXOLET 10 mg - 30 tabl. 30% DEPREXOLET 30 mg - 30 tabl. 30% DERMOVATE maść 25 g 100% DERMOVATE maść 25 g 50% DETREOMYCYNA 2% maść 5 g 100% DEXAK 0,025 g - 30 tabl. 100% DEXAMETHASON 0,1 % 5 ml 100% DEXAPOLCORT aerozol 16,25 g 100% DEXAVEN 4 mg/ ml 10 amp. 100% DEXAVEN 8 mg/ 2 ml 10 amp. 100% DIAGEN 30 mg - 60 tabl. R DIAPREL MR 30 mg - 60 tabl. R DIAPREL MR 60 mg - 30 tabl. R DICLAC 50 mg - 50 tabl. 50% DICLAC DUO 75 mg - 20 tabl. 100% DICLAC DUO 75 mg - 20 tabl. 50% DICLOBERL RETARD 100 mg-20 kaps. 100% DICLORATIO UNO 150 mg -10 tabl. 50% DICOFLOR sasz. 100% DICORTINEFF 5 ml 100% DIGOXIN 0,1 mg - 30 tabl. R DIGOXIN 0,25 mg - 30 tabl. R DIH 500 mg - 30 tabl. 100% DILZEM 120 RETARD - 30 tabl. R DILZEM 90 RETARD - 30 tabl. R DIOHESPAN MAX - 30 tabl. 100% DIOSMINEX 500 mg - 60 tabl. 100% DIPHERGAN 10 mg - 20 tabl. 100% 1 Strona 8

9 370 DIPROBASE maść 50 g 100% DIPROMAL 200 mg - 40 tabl. R DIPROPHOS 7 mg /ml 5 amp. a 1 ml 100% DITROPAN 5 mg - 30 tabl. 100% DITROPAN 5 mg - 30 tabl. 30% DIURESIN SR 1,5 mg - 30 tabl. 30% DIUVER 0,1 g - 30 tabl. 100% DIUVER 5 mg - 30 tabl. 100% DONECEPT 5 mg - 28 tabl. 30% DONESYN 5 mg - 28 tabl. 100% DORETA 37,5+325 mg, 30 tabl. 100% DOXAR 2 mg- 30 tabl. R DOXAR 4 mg - 30 tabl. R DOXAR 4 mg - 30 tabl. 30% DOXEPIN 25 mg - 30 tabl. 100% DOXYCYCLINUM 100 mg - 10 kaps. 50% DOXYCYCLINUM 100 mg - 10 kaps. 100% DRIPTANE 5 mg - 60 tabl. 30% DROPZOL 20 mg/ml 5 ml R DUOMOX 1 g- 20 tabl. 100% DUOMOX 1 g- 20 tabl. R DUOMOX 500 mg- 20 tabl. R DUOMOX 750 mg - 20 tabl. 100% DUPHALAC 667 mg/ ml 300 ml 100% DURACEF 1 g - 10 tabl. 50% EBIVOL 5 mg - 30 tabl. 100% ECOMER kaps. 100% EFFOX 10, 10 mg - 60 tabl. R EFFOX 20, 20 mg- 50 tabl. R EFFOX LONG 50 mg - 30 tabl. R EGIRAMLON 5 mg+10 mg 30 kaps. 100% EGOLANZA 10 mg - 28 tabl. R EGOLANZA 5 mg - 28 tabl. R ELOCOM 1mg/1g 15g 100% ENARENAL 10 mg - 30 tabl. R ENARENAL 10 mg - 60 tabl. R ENARENAL 20 mg - 60 tabl. R ENARENAL 5 mg - 30 tabl. R ENARENAL 5 mg - 60 tabl. R ENCORTON 10 mg - 20 tabl. R ENCORTON 10 mg - 20 tabl. 100% ENCORTON 20 mg - 20 tabl. 100% ENCORTON 20 mg - 20 tabl. R ENCORTON 5 mg - 20 tabl. R ENEMA 150 ml 100% ENGERIX 20 mcq/ml amp. 100% ENTEROL kaps. 100% ENTEROMAX 10 kaps. 100% 9 Strona 9

10 418 ERDOMED 0,3 g - 20 kaps. 100% ESBERITOX N - 50 tabl. 100% ESPUMISAN 40 mg tabl. 100% ESTAZOLAM 2 mg - 20 tabl. 100% ESTMAR 0,15 mg + 0,02 mg, 21 tabl. 100% ETFORM 500, 500 mg- 60 tabl. R ETFORM 500, 500 mg- 90 tabl. R ETFORM 850, 850 mg- 60 tabl. R EUPHYLINUM LONG 200 mg - 30 tabl. R EUPHYLLIN CR retard 250 mg - 30 tabl. R EUPHYLLIN LONG 300 mg- 30 tabl. R EUTHYROX N tabl. R EUTHYROX N tabl. R EUTHYROX N tabl. R EUTHYROX N tabl. R EUTHYROX N tabl. R EUTHYROX N tabl. R EUTHYROX N tabl. R EUTHYROX N tabl. R EUTHYROX N tabl. 100% EUTHYROX N tabl. R EUTHYROX N tabl. R EUTHYROX N tabl. R EUTHYROX N tabl. R EVERCARE test paskowy, 50 pas. R EVERCARE test paskowy, 50 pas. 30% EXACYL 500 mg - 20 tabl. 50% EXELON 0, kaps. 100% EXELON 0, kaps. 100% FALVIT - 60 tabl. 100% FAMOGAST 40 mg - 30 tabl. R FANIPOS 50 mcq/daw., 120 dawek 100% FANIPOS 50 mcq/daw., 120 dawek 50% FASTUM 2,5 % żel 120 g 100% FASTUM żel 50 g 100% FAXIGEN XL 37,5 mg - 28 tabl. 30% FENISTIL krople 1 g/ml 20 ml 100% FENORATIO kaps. 100% FERRUM syrop 100 ml 100% FILOMAG B6 50 tabl. 100% FILOMAG B6 75 tabl. 100% FINAMEF 0,005 g - 30 tabl. R FINARAN 5 mg - 30 tabl. R FINASTER 5 mg - 30 tabl. R FINLEPSIN 200 mg - 50 tabl. R FINLEPSIN 200 mg- 50 tabl. B FINLEPSIN RETARD 400 mg- 30 tabl. R FINLEPSIN RETARD 400 mg-50 tabl. R 36 Strona 10

11 466 FLAMOZIL żel 75 g 100% FLAVAMED 30 mg - 20 tabl. 100% FLAVAMED 60 mg - 10 tab mus. 100% FLEGAMINA 120 ml 100% FLEGAMINA 8 mg - 20 tabl. 100% FLONIDAN 10 mg - 60 tabl. 100% FLONIDAN 10 mg- 60 tabl. 30% FLUANXOL 3 mg - 50 tabl R FLUANXOL DEPT. 20 mg/ ml amp. R FLUCINAR ŻEL 0,25 mg/g 15 g 100% FLUCOFAST 100 mg - 7 tabl. 50% FLUCONAZOLE 100 mg- 7 tabl. 100% FLUCONAZOLE 50 mg- 7 tabl. 50% FLUOKSETYNA 10 mg - 28 kaps. 100% FLUOKSETYNA 20 mg - 28 kaps. 30% FLUOXETIN 20 mg - 30 tabl. 30% FLUTIXON (250 mcg/dawkę), 60 kaps. R FOKUSIN 0,4 mg - 30 tabl. 100% FOKUSIN 0,4 mg - 90 tabl. R FOLACID 5 mg - 30 tabl. 100% FOLIC - 30 tabl. 100% FORADIL 12 mcg - 60 kaps. R FORASTMIN 12 mcg, 60 kaps. R FORCID mg - 14 tabl. 50% FORCID mg - 14 tabl. 50% FORMETIC 500 mg - 30 tabl. R FORTRANS 74 g - 4 sasz. 100% FOSTEX aerozol- 180 dawek R FRAGMIN j.m/ 0,2 ml - 10 amp. R FRAXIPARINE 3800 j.m/0,4 ml - 10 amp. R FRAXIPARINE5700 j.m./0,6 ml - 10 amp. R FROMILID UNO 500 mg - 7 tabl. 100% FURAGINUM 50 mg- 30 tabl. 50% FURAGINUM 50 mg- 30 tabl. 100% FUROSEMIDUM 40 mg - 30 tabl. R FUROXIN - 30 tabl. 100% GALPENT 100 mg - 30 szt. 100% GALVENOX 0,5 mg - 30 tabl. 100% GASTROLIT 15 sasz. 100% GASTROLIT 15 sasz. R GAZA 100 cm x 100 cm niejałowa 100% GAZA 50 cm x 50 cm niejałowa 100% GAZIK "LEKO" 10 szt GAZIKI NIEJAŁOWE 5 x 5, 100 szt. 100% GENSULIN M 30-5 wkł.a 3 ml. R GENSULIN M 40-5 wkł. a 3 ml R GENSULIN M 50-5wkł. a 3 ml. R GENSULIN N 100j/1ml. 5 wkł.a 3 ml R 16 Strona 11

12 514 GENSULIN R 100j/1ml. 5 wkł.a 3 ml R GENTAMICIN 40 mg/1ml - 10 amp. 50% GENTAMICIN 80 mg/2 ml - 10 amp. 100% GENTAMICIN 80 mg/2 ml - 10 amp. 50% GLIBETIC 1 mg - 30 tabl. R GLIBETIC 4 mg - 30 tabl. R GLICLADA 30 mg - 60 tabl. R GLICLADA 30 mg - 90 tabl. R GLOSAL aerozol - 25 ml 100% GLUCAGEN 1 mg 1 ml R GLUCOBAY 100 mg - 30 tabl. 30% GLUCOBAY 100 mg - 30 tabl. 100% GLUCOSUM 5%, 500 ml. 100% GLUCOSUM 20% 10 amp. x10ml 100% GLUKOZA 75 g 100% GLUKOZA PŁYNNA 1WW, 10 sasz. 100% GRANUFLEX plastry 20x20 100% GRIPEX MAX - 10 tabl. 100% GROFIBRAT 100 mg - 50 kaps. 30% GUTRON 2,5 mg - 20 tabl. 100% GYNALGIN tabl. dopoch.10 szt 100% GYNOFLOR 6 tabl. dopoch. 100% HALIDOR 100 mg - 60 tabl. 100% HALOPERIDOL 1 mg - 40 tabl. B HALOPERIDOL 5 mg - 30 tabl. B HALOPERIDOL 5 mg/1 ml- 10 amp. 100% HALOPERIDOL krople 2 mg/ml 10 ml 100% HALOPERIDOL krople 2 mg/ml 10 ml B HALOPERIDOL krople 2mg/ml 10 ml 30% HASCOFUNGIN 10 mg/ml - 30 ml 100% HASCOFUNGIN krem 1% 30 g 100% HELICID 20 mg - 28 tabl. 50% HELICID FORTE 40 mg - 28 kaps. 50% HELIGEN 20 mg - 28 tabl. 50% HEMOFER PROLONG 105mg -30 tabl. 100% HEMORECTAL czopki - 10 szt. 100% HEPAREGEN 100 mg - 30 tabl. 100% HEPAREGEN 100 mg -100 tabl. 100% HEPATIL 40 tabl. 100% HEVIRAN 800 mg - 30 tabl. 50% HISTIGEN 24 mg - 20 tabl 100% HUMALOG MIX 25-5 a 3 ml R HYABAK krople 10 ml 100% HYDROCHLOROTHIAZIDUM 12,5 mg- 30 tabl. 100% HYDROCHLOROTHIAZIDUM 25 mg- 30 tabl. 100% HYDROCORTISONUM 1% krem 15 g 100% 15 Strona 12

13 560 HYDROCORTISONUM 0,5 % krem 15 g 100% HYDROCORTISONUM 1% krem 15 g 50% HYDROFILM 15 cm x 10 cm 100% HYDROFILM 25 cm x 12 cm 100% HYDROXIZINUM 100 mg/2 ml 5 amp. 100% HYDROXIZINUM syrop 200 ml 100% HYDROXYZINUM 25 mg - 30 tabl. 100% HYDROYIZINUM 10 mg - 30 tabl. 100% HYGROTON 50 mg - 20 tabl. 100% HYLOSEPT krem 15 g 100% IBANDRONIC ACID TEVA 150 mg - 3 tabl. 100% IBUPROFEN 200 mg- 60 tabl. 100% IBUPROFEN 200 mg- 60 tabl. R IBUPROM 200 mg - 10 tabl. 100% IBUPROM zatoki - 12 tabl. 100% IFAPIDIN 250 mg - 60 tabl. 30% IGŁA 0,45 x 25 mm 100 szt. 100% IGŁA 0,5 x 25 mm 100 szt. 100% IGŁA 0,6 x 25 mm 100 szt. 100% IGŁA 0,7 x 30 mm 100 szt. 100% IGŁA 0,7 x 40 mm 100 szt. 100% IGŁA 0,8 x 40 mm 100 szt. 100% IGŁA 0,9 x 40 mm 100 szt. 100% IGŁA 1,1-100 szt. 100% IGŁA 1,2-100 szt. 100% INDAPAMIDE SR 1,5 g - 30 tabl. 30% INDAPAMIDUM 123 ratio 1,5 mg- 30 tabl. 100% INDAPEN 2,5 mg - 20 tabl. 30% INDAPEN SR 1,5 mg - 30 tabl. 30% INDIX SR 1,5 mg - 30 tabl. 30% INDIX SR 1,5 mg - 30 tabl. 100% INFLUVAC 0,5 ml 100% INHIBACE 0,5 mg - 30 tabl. 100% INHIBACE 1 mg - 30 tabl. 100% INSULATARD PENFIL 5 wkł. a 3 ml R IPOREL 75 mcg- 50 tabl. 30% IPP 20 mg - 28 tabl. 100% IPP 20 mg - 28 tabl. 50% IPRES long 1,5 mg - 30 tabl. 30% IRUXOL MONO 20 g 50% ISOPTIN SR tabl. 100% ixell paski testowe 50 szt. R ixell paski testowe 50 szt. 30% ixell paski testowe 50 szt. 100% KALDYUM 600 mg kaps. 100% KALDYUM 600 mg - 50 kaps. 100% 64 Strona 13

14 606 KALIPOZ PROLONG. 60 tabl. R KALIPOZ-PROLONG. 391 mg K+, 30 tabl. R KALIUM EFFER.3 g x 20 sasz. 30% KAMIREN 4 mg - 30 tabl. R KARBAGEN 600 mg - 50 tabl. R KEPPRA 500 mg - 50 tabl. R KETOKONAZOL 200 mg - 10 tabl. 50% KETONAL 2,5% żel -100 g 100% KETONAL 50 mg - 30 kaps. 100% KETONAL 50 mg - 30 tabl. 50% KETONAL DUO 150 mg - 30 kaps. 100% KETONAL FORTE 100 mg- 30 tabl. 50% KETONAL FORTE 100 mg- 30 tabl. 100% KETONAL roztwór do wstrzykiwania 50 mg. 10 amp x 2 ml. 50% KETONAL roztwór do wstrzykiwania 50 mg. 10 amp x 2 ml. 100% KETREL 100 mg - 60 tabl. R KETREL 200 mg - 60 tabl. R KETREL 25 mg - 30 tabl. R KETREL 25 mg - 30 tabl. 100% KLABAX 500 mg - 14 tabl. 50% KLOZAPOL 100 mg- 50 tabl. B KLOZAPOL 25 mg- 50 tabl. B KOMPRES MEDICOMP 7,5-100 szt. 100% KOMPRESY GAZ Jałowy 5x5 50 szt. 100% KOMPRESY GAZ. Jałowy 5x5 3 szt. 100% KOMPRESY GAZ. Jałowy 7x7 3 szt. 100% KOMPRESY GAZ. Jałowy 9x9 3 szt. 100% KREON kaps. 100% KROPLE GORZKIE 35 g 100% KROPLE MIĘTOWE 35 g 100% KROPLE ŻOŁĄDKOWE 35 g 100% KVENTIAX 25 mg - 30 tabl. R KWETAPLEX 25 mg - 30 tabl. 100% KWETAPLEX 25 mg - 30 tabl. R LACIDAR 20 tabl 100% LACIDOENTER 20 kaps. 100% LACIDOFIL - 20 szt. 100% LACIDOFIL 60 tabl. 100% LACIPIL 2 mg - 28 tabl. 30% LACIPIL 4 mg - 28 tabl 30% LACTULOSUM syrop 150 ml 100% LAKCID 10 amp. 100% LAKCID 20 tabl. 100% LAMBRINEX tabl. 30% LAMBRINEX 20 mg - 30 tabl. 100% 2 Strona 14

15 651 LAMBRINEX 20, 20 mg- 30 tabl. 30% LAMBRINEX 40 mg - 30 tabl. 30% LAMILEPT tabl. R LAMITRIN 100 mg- 30 tabl R LAMITRIN 50 mg- 30 tabl R LAMOTRIX 100 mg - 90 tabl. R LAREMID 2 mg 10 tabl. 100% LARYNG UP - 16 tabl. 100% LATICORT 0,1% krem 15 g 100% LERIVON tabl. 30% LETROX 100, 100mcg - 50 tabl. R LETROX 150 mcg - 50 tabl. R LETROX tabl. R LEVETIRACETAM 500 mg - 50 tabl. R LEVOMINE 63 tabl. 100% LIGNOCAINUM ŻEL U 2% 30g. 100% LINOMAG krem 30 g 100% LINOMAG maść 30 g 100% LIOTON 1000 żel 50 g 100% LIPANTHYL 100 mg - 50 kaps. 30% LIPANTHYL 100 mg - 50 kaps. 100% LIPANTHYL 267 M - 30 kaps. 30% LISINORATIO 10, 10 mg- 30 tabl. R LISINORATIO 5, 5 mg - 30 tabl. R LISIPROL 5 mg- 28 tabl. R LITHIUM CARBONICUM 250 mg - 60 tabl. B LOPERAMID 2 mg - 30 tabl 100% LOPERAMID 2 mg - 30 tabl. 50% LORAFEN 1 mg - 25 tabl. 100% LORAFEN 2,5 mg - 25 tabl. 100% LORINDEN A maść 15 g 100% LORISTA 50 mg - 28 tabl. 30% LOSACOR 50 mg - 30 tabl. 30% LOZAP 50 mg - 30 kaps. 30% LOZAP HCT- 30 tabl. 30% LUCETAM 1200 mg - 60 tabl. 100% LUCETAM 800 mg - 30 tabl. 100% LUCETAM 400 mg - 60 tabl. 100% MADOPAR mg tabl. R MADOPAR 12, tabl. R MADOPAR HBS 125 mg -100 tabl. R MADOPAR HBS 125 mg -100 tabl. 100% MAGNE B6-50 tabl. 100% MAGNEZ B6-60 tabl. 100% MAJAMIL 500 mg - 20 tabl. 100% MARIMER spray 100 ML 100% MAŚĆ NAGIETKOWA z balsamem peruwiańskim 50 ml 100% 76 Strona 15

16 698 MATRIFEN 12 μg/h 5 plastrów R MATRIFEN 25 μg/h 5 plastrów R MEDIDERM krem 500 g 100% MEDIKET ICTAMO 75 ml szampon 100% MELOXICAM 15 mg - 30 tabl. 50% MEMOTROPIL 1200 mg - 60 tabl. 100% MEMOTROPIL 400 mg- 60 tabl. 100% MEMOTROPIL 800 mg - 60 tabl. 100% MENTHOLAXIN płyn 125 g 100% METEX 50 mg/ml 12 a 0,2 ml R METFORMAX 500 mg - 30 tabl. R METFORMAX 500 mg - 60 tabl. R METFORMAX 850 mg - 60 tabl. R METFORMAX 850 mg- 30 tabl. R METFORMAX SR 500, 500 mg - 30 tabl. R METHOTREXAT 2,5 mg - 50 tabl. 100% METHOTREXAT 2,5 mg - 50 tabl. R METIZOL 50 tabl. 100% METOCARD 50 mg - 30 tabl. R METOCARD 50 mg - 30 tabl. 100% METOCLOPRAMIDUM 10 mg -50 tabl. 100% METOGEN SC 23,75 mg- 28 tabl. 100% METOGEN SC 47,50 mg- 28 tabl. 100% METOPROLOL 50 mg - 30 tabl. 100% METRONIDAZOL 1% żel - 15g 100% METRONIDAZOL 250 mg- 20 tabl. 100% METYPRED 4 mg - 30 tabl. R MIANSEC 30, 30 mg - 20 tabl. 30% MIANSEGEN 10 mg - 30 tabl. 30% MIANSEGEN 10 mg - 90 tabl. 30% MIANSEGEN 30 mg - 30 tabl. 30% MICROGYNON 21 tabl. 100% MIFLONIDE 200 mcg - 60 kaps. R MIFLONIDE 200 mcg - 60 kaps. 30% MIFLONIDE 400 mcg - 60 kaps. R MIFLONIDE 400 mcg - 60 kaps. 30% MILOCARDIN 15 g 100% MILURIT 100 mg- 50 tabl. R MILURIT 100 mg- 50 tabl. 100% MIRTAGEN 30 mg - 30 tabl. 100% MITRIP tabl. R MITRIP tabl. 100% MITRIP 2,5-30 tabl. R MITRIP 5-30 tabl. R MIXTARD 30 Penfil 5 wkł. a 3 ml R MIXTARD 50 PENFIL 5 a 3 ml R MOLSIDOMINA 2 mg -30 tabl. 100% MOLSIDOMINA 4 mg- 30 tabl. 100% 28 Strona 16

17 746 MOMEDERM 1 % maść 15 g 100% MONO MACK DEPOT 14 tabl. 100% MONO MACK DEPOT 14 tabl. R MONO MACK DEPOT 28 tabl. 100% MONONIT 10 mg - 60 tabl. R MONONIT 20 mg - 60 tabl. R MOXALOLE 20 szasz. 100% MOZARIN 10 mg - 28 tabl. 100% MUKOLINA 120 ml 30% MULTIWITAMINUM 50 draż. 100% MYDOCALM 50 mg - 30 tabl. 100% MYDOCALM FORTE 150 mg - 30 tabl. 100% NaCl 0,9% 10 ml 100% NaCl 0,9% 500 ml 100% NAPROXEN EMO żel 100 g 100% NAPROXEN żel 10% 50 g 100% NASEN 10 mg - 20 tabl. 100% NEBILENIN 5 mg -28 tabl. R NEBILET 5 mg - 28 tabl. 100% NEBILET 5 mg - 28 tabl. R NEBISPES 5 mg - 28 tabl. 100% NEBISPES 5 mg - 28 tabl. R NEDAL 5 mg - 28 tabl. R NEOANGIN 24 tabl. 100% NEOMYCINUM areozol 30 ml 100% NEOMYCINUM areozol 55 ml 100% NEUROTOP RETARD 300 mg - 50 tabl. R NEUROTOP RETARD 600 mg - 50 tabl. R NEUROTROP RETARD 300 mg - 50 tabl. B NEUROVIT 100 tabl. 100% NEUROVIT 20 tabl. 100% NEVANAC 0,3 % 5 ml 100% NIFUROKSAZYD 100 mg - 24 tabl. 100% NIFUROKSAZYD 200 mg -12 tabl. 100% NILOGRIN 10 mg- 30 tabl. 100% NILOGRIN 30 mg- 30 tabl. 100% NIMESIL 100 mg/2 g - 9 szasz. 100% NIMESIL 2 g x 30 sasz. 50% NIMVASTID 3 mg - 28 tabl. 30% NITRAZEPAM 5 mg - 20 tabl. 100% NITRENDYPINA 10 mg - 30 tabl. R NITRENDYPINA 10 mg - 60 tabl. R NITRENDYPINA 20 mg - 30 tabl. 100% NITRENDYPINA 20 mg -30 tabl. R NITROMINT areozol 11 g 200 dawek R NITROMINT areozol 11 g 200 dawek 100% NIZORAL 6 ml - 6 szaszetek 100% 16 Strona 17

18 793 NIZORAL szampon 60 ml 100% NOBAXIN 500 mg - 3 tabl. 100% NOLICIN 400 mg - 20 tabl. 100% NOLICIN 400 mg- 20 tabl. 50% NOLPAZA tabl. 100% NOLPAZA tabl. 50% NOLPAZA tabl. 50% NOLPAZA tabl. 100% NOLPAZA 40 mg - 28 tabl. 50% NOLPAZA 40 mg - 56 tabl. 100% NOLPAZA 40 mg - 90 tabl. 50% NOOTROPIL 1200 g - 60 tabl. 100% NOOTROPIL 1200 g -30 tabl. 100% NOOTROPIL 800 mg - 30 tabl. 100% NORMEG 500 mg - 50 tabl. R NORMODIPINE 10 mg - 30 tabl. 30% NORMODIPINE 5 mg - 30 tabl. 30% NO-SPA 40 mg - 20 tabl. 100% NO-SPA forte - 20 tabl. 100% NOVATE maść 30 g 100% NOVO RAPID PENFIL - 5 wkł. a 3 ml R NOVOMIX 30-5 wkł. a 3 ml. R NOVOMIX 50 PENFIL 5 wkł. a 3 ml R NUTRIDRINK 200 ml waniliowy 100% NUTROF 36 kaps. 100% NYSTATYNA zawiesina 100% OCTENISEPT prep. do dezynf. 250 ml 100% OCTENISEPT prep. do dezynf. 450 ml 100% OFTENSIN 2,5 mg/ml - 5 ml 30% OFTENSIN 2,5 mg/ml - 5 ml 100% OILATUM emulsja d. kapieli 500 ml 100% OLANZAPINE APOTEX 5 mg - 28 tabl. R OLANZIN 10 mg - 28 tabl. R OLANZIN 5 mg - 28 tabl. R OLFEN 100 SR - 20 tabl. 100% OLFEN 75 mg 5 a 2 ml 50% OLFEN 75 SR - 30 tabl. 50% OLFEN UNO 150 mg - 10 tabl. 50% OLFEN żel - 50 g 100% OLIPROX pianka 150 ml 100% OLIPROX szampon 200 ml 100% OLIWKA 200 ml 100% OLZAPIN 10 mg - 28 tabl. R OLZAPIN 5 mg - 28 tabl. R OLZIN 10 mg - 28 tabl. R OLZIN 5 mg - 28 tabl. R OMEGA 3-60 kaps. 100% OMNIC 0,4-30 tabl. R 10 Strona 18

19 841 OMNIC OCAS 0,4 mg- 30 tabl. R OMNIFIX E 10 cm x 10 m 100% ONE TOUCH SELECT - 50 pasków R OPAMID 1,5 mg - 30 tabl. 30% OPASKA DZIANA 4 m x 10 cm 100% OPASKA DZIANA 4 m x 15 cm 100% OPASKA DZIANA 4 m x 5 cm 100% OPASKA ELAST. 4m x 10 cm 100% OPASKA ELAST. 4m x 15 cm 100% OPATRUNEK DO KANIUL 100% ORSALIT - 10 saszetek 100% OSPAMOX 500 mg - 16 tabl. R OSPEN tabl. R OSTENIL 70-4 tabl. 30% OXAZEPAM 10 mg - 20 tabl. 100% OXODIL 12 mcg - 60 kaps. R OXYCARDIL 180 mg - 30 tabl. R OXYCORT aerozol 30 ml 100% OXYCORT maść 10 g 100% OZZION 20 mg - 28 tabl. 50% OZZION 40 mg - 28 tabl. 50% PANGROL tabl. 100% PANTOGEN 20, 20 mg- 28 tabl. 50% PANTOGEN 40, 40 mg- 28 tabl. 50% PANTOPRAZOL 20 mg - 28 tabl. 50% PANTOPRAZOL 40 mg - 28 tabl. 50% PANZOL 20 mg - 28 tabl. 50% PANZOL 40 mg -28 tabl. 50% PARACETAMOL 500 mg - 10 czopk. 100% PARACETAMOL 500 mg - 20 tabl. 100% PARACETAMOL 500 mg - 50 tabl. 100% PARAFINA CIEKŁA 100 g 100% PARANIT LOTION ml 100% PEGOREL 75 mg - 28 tabl. 30% PELETHROCIN - 30 tabl. 100% PENESTER 5 mg - 30 tabl. R PENESTER 5 mg - 90 tabl. R PENTOHEXAL 600 RETARD - 30 tabl. 100% PERAZIN 100 mg - 30 tabl. B PERAZIN 25 mg- 20 tabl. B PERINDOPRILUM 123 RATIO 0,01 g - 30 tabl. 100% PERINDOPRILUM 5 mg - 30 tabl. 100% PERITOL - 20 tabl. 100% PERNAZINUM 100 mg- 30 tabl. B PERNAZINUM 25 mg - 20 tabl. B PHENYTOINUM 100 mg - 60 tabl. R PIMAFUCIN krem 30 g 100% 13 Strona 19

20 888 PIMAFUCORT maść 15 g 100% PINEXET 25 mg - 30 tabl. 100% PINEXET 25 mg - 30 tabl. R PIRAMIL 2,5 mg - 30 tabl. R PLENDIL 5 mg - 28 tabl. 30% PŁESZNIK 60 kaps. 100% PŁYN ABE na odciski - 8 g 100% PŁYN WIELOELEKTROLITOWY 500 ml 100% POJEMNIK NA KAŁ 100% POJEMNIK NA MOCZ JALOWY. 100 ml 100% POJEMNIK NA MOCZ NIESTER. 100 ml 100% POLFILIN PROLONGATUM 400 mg - 20 tabl. 100% POLFILIN PROLONGATUM 400 mg- 60 tabl. 100% POLHUMIN MIX 5 5 a 3 ml R POLHUMIN R 5 a 3 ml R POLOCARD 150 mg - 30 tabl. 100% POLOCARD 150 mg - 60 tabl. 100% POLOCARD 75 mg - 30 tabl. 100% POLOCARD 75 mg - 60 tabl. 100% POLOPIRYNA S 20 tabl. 100% POLPAZOL 40 mg - 28 tabl. 50% POLPIX SR 2 mg - 28 tabl. 100% POLPRAZOL 20 mg - 28 tabl. 100% POLPRAZOL 20 mg - 28 tabl. 50% POLPRIL 10 mg - 28 kaps. R POLPRIL 2,5 mg - 28 tabl. R POLPRIL 2,5 mg - 28 tabl. 100% POLPRIL 5 mg - 28 kaps. R POLTRAM 50 mg - 20 kaps. 30% POLTRAM 50 mg - 20 kaps. 100% POLTRAM COMBO 37,5 mg mg - 30 tabl. 100% POLTRAM COMBO 37,5 mg mg - 60 tabl. 100% POLVERTIC 24 mg - 60 tabl. 100% POSTERISAN H czopki 10 sztuk 100% PRADAXA 110 mg - 30 kaps. R PRADAXA 110 mg - 30 kaps. 100% PRADAXA 150 mg - 30 kaps. 100% PRENESSA 8 mg - 30 tabl. 100% PRENESSA 8 mg - 30 tabl. R PRESTARIUM 10 mg - 30 tabl. R PRESTARIUM 5 mg - 30 tabl. R PRIDINOL 5 mg - 50 tabl. 100% PROCTO - HEMOLAN czopki - 10 szt. 100% PROCTO - HEMOLAN krem 20 g 100% 3 Strona 20

21 932 PROKIT 50 mg -100 tabl. 100% PROMAZIN 100 mg - 60 tabl. 100% PROMAZIN 25 mg - 60 tabl. 100% PROMAZIN 50 mg - 60 tabl. 100% PRONORAN 50 mg - 30 tabl. 30% PROPRANOLOL 40 mg - 50 tabl. 100% PROPRANOLOL 40 mg - 50 tabl. R PROSTAMNIC 0,4 mg - 30 tabl. R PROSTAMOL UNO 320 mg - 30 kaps. 100% PROSTATIC 2 mg- 30 tabl. R PROSTATIC 2 mg- 30 tabl. 30% PROTIFAR 225 g 100% PRURIGO L3 maść 25 g 100% PRZYLEPIEC 250 mm x 5 m 100% PRZYLEPIEC 500 mm x 5 m 100% PRZYLEPIEC 125 mm x 5 m 100% PRZYLEPIEC Z GAZĄ 6 cm x 1 m 100% PRZYLEPIEC Z GAZĄ 8 cm x 1 m 100% PUDRODERM 140 g 100% PULMICORT ZAWIESINA 0,25 mg/ml - 20 poj. a 2 ml R PULMOTEROL 60 kaps. R PULVERIL 25 qg/dawkę dawek R PYRALGIN 1 g/ 2 ml - 5 amp. 100% PYRALGINUM 500 mg- 6 tabl. 100% RADIREX - 20 tabl. 100% RAMIPIL 5 mg - 28 tabl. 100% RAMISTAD 5 mg - 28 tabl. R RANIGAST 150 mg - 60 tabl. R RANLOC 20 mg- 28 tabl. 50% RANLOC 40 mg- 28 tabl. 50% RANLOSIN 0,4 mg - 30 tabl. R RANOFREN 10 mg - 28 tabl. R RANOFREN 5 mg - 28 tabl. 100% RANOPRIL 5 mg - 28 tabl. R RAWEL SR 1,5 mg - 30 tabl. 30% RECALVIT D - 20 tabl. mus.. 100% RECTANAL 14 g + 5 g /100 ml 150 ml 100% RELANIUM 10 mg/ 2 ml, 5 amp. 100% RELANIUM 2 mg - 20 tabl. 100% RELANIUM 5 mg - 20 tabl. 100% RELSED 10 mg/2,5-5 wlewek R RIDLIP 10 mg - 28 tabl. 30% RISENDROS 35 mg - 4 tabl. 30% RISPERON 1 mg - 20 tabl.. R RISPERON 1 mg - 60 tabl. R RISPERON 2 mg - 60 tabl. R RISPERON 2 mg- 20 tabl. R 55 Strona 21

22 979 RISPERON 3 mg - 20 tabl.. R RISPERON 3 mg - 60 tabl. R RISPERON 4 mg- 20 tabl. R RISPOLEPT 1 mg - 20 tabl. R RISPOLEPT 2 mg - 20 tabl. R RISPOLEPT 3 mg - 20 tabl. R RISPOLEPT 4 mg - 20 tabl. R RISPOLEPT CONSTA 35,5 mg amp. R RISPOLEPT CONSTA 50 mg amp. R RIVALDO 3 mg - 56 kaps. 30% RIVALDO 3 mg - 56 kaps. 100% RIVALDO 4,5 mg - 28 tabl. 100% RIVANOLUM 5 tabl. 100% ROLICYN 150 mg - 10 tabl. 50% ROMAZIC 5 mg - 30 tabl. 100% ROSWERA 10 mg - 28 tabl. 30% ROSWERA 10 mg - 28 tabl. 100% ROSWERA 20 mg - 28 tabl. 30% ROSWERA 40 mg - 28 tabl. 30% ROZACOM krople 5 ml R RULID 150 mg- 10 tabl. 50% RUPAFIN 10 mg - 30 tabl. 100% RUTINACEA 120 tabl. 100% RUTINACEA COMPLETE - 90 tabl 100% RUTINOSCORBIN 30 tabl. 100% RUTINOSCORBIN 60 tabl 100% RUTINOSCORBIN 90 tabl. 100% RYSPOLIT 1 mg/ml 100 ml R SALICYLOL 100 g 100% SALMEX /daw dawek R SCOPOLAN 10 mg - 30 tabl. 100% SCORBOLAMID - 20 tabl. 100% SEBIDIN PLUS - 16 tabl. 100% SEBIDIN PLUS- 24 tabl. 100% SEGAN 5 mg - 60 tabl. R SEGAN 5 mg - 60 tabl. 100% SEREVENT dysk - 60 dawek R SERTAGEN 100 mg - 28 tabl. 30% SETALOFT 50 mg - 30 tabl. 30% SIGNOPAM 10 mg - 20 tabl. 100% SIMCOVAS 20 mg - 28 tabl. 30% SIMGAL 20 mg - 28 tabl. 30% SIMGAL 40 mg - 28 tabl. 30% SIMRATIO 20 mg - 28 tabl. 30% SIMVACARD 10 mg - 28 kaps. 30% SIMVACARD 20 mg - 28 kaps. 30% SIMVACARD 40 mg - 28 tabl. 30% SIMVACOR 10 mg -30 tabl. 30% 2 Strona 22

23 1027 SIMVACOR 20 mg - 30 tabl. 30% SIMVAGAMMA 10 mg - 30 tabl. 30% SIMVAGAMMA tabl. 30% SIMVAGAMMA 40 mg - 30 tabl. 30% SIMVASTEROL 10 mg - 28 tabl. 30% SIMVASTEROL 10 mg - 28 tabl. 100% SIMVASTEROL 20 mg - 28 tabl. 30% SIMVASTEROL 40 mg - 28 tabl. 30% SINUPRET - 50 draż. 100% SIOFOR tabl. R SIOFOR tabl. R SIOFOR tabl. 100% SIOFOR 1000 mg - 90 tabl. R SIOFOR tabl. R SIOFOR tabl. R SIOFOR 850 mg - 90 tabl. R SIRDALUD 4 mg - 30 tabl. 100% SKIN PROTECT 120 ml 100% SOLCOSERYL maść 5% - 20 g 100% SOLIAN 200 mg - 30 tabl. R SOLIAN 400 mg- 30 tabl. R SORBIFER DURULES 50 tabl. 100% SORBONIT - 60 tabl. 100% SPIRIVA 18 mcg 30 kaps. 30% SPIRIVA 18 mcg 30 kaps. R SPIRONOL 100 mg - 20 tabl. 30% SPIRONOL 25 mg - 20 tabl. 30% SPIRYTUS SALICYLOWY 2% 100 g 100% STAVERAN 120 mg - 20 tabl. R STAVERAN 40 mg - 20 tabl. R STEDIRIL tabl. 100% STIEPROX 100 ml 100% STORVAS 10 mg - 30 tabl. 30% STORVAS 20 mg - 30 tabl. 30% STORVAS 40 mg - 30 tabl. 30% STRUCTUM 500 mg - 60 tabl. 100% STRZYK. 100 ml z końc.d/cewn. z łączn. L 100% STRZYKAWKA "ŻANETA" 150 ml 100% STRZYKAWKA 10 ml a 100 szt. 100% STRZYKAWKA 2 ml a 100 szt. 100% STRZYKAWKA 20 ml 100% STRZYKAWKA 5 ml 100% SUDOCREM 125 g 100% SUDOCREM 250 g 100% SULFACETAMIDUM 10% HEC 2x5 ml 100% SULFASALAZIN EN tabl. R SULPIRYD 100 mg - 24 kaps. B SULPIRYD 50 mg - 24 kaps. B 154 Strona 23

24 1075 SULPIRYD 50 mg - 24 kaps. 100% 17 SYMBICORT TURBUHAREL 160 μg ,5 μg 60 dawek R SYMGIC 6 mg - 30 tabl. R SYMGLIC 2 mg - 30 tabl. R SYMGLIC 4 mg - 30 tabl. R SYMGLIC 6 mg - 30 tabl. R SYMLOSIN SR 0,4 mg - 30 tabl. R SYMLOSIN SR 0,4 mg - 30 tabl. 100% SZELAZO SR - 30 tabl. 100% TAMOXIFEN 20 mg - 30 tabl. B TARDYFERON 30 tabl. 100% TARDYFERON FOL 30 tabl. 100% TAROMENTIN 0,875+0,125 g - 14 tabl. 50% TEGRETOL CR tabl. B TEGRETOL CR tabl. R TEGRETOL CR tabl. B TEGRETOL CR tabl. R TELFEXO 120 mg - 20 tabl. 100% TELMISARTAN EGIS 40 mg - 28 tabl. 30% TENOX 10 mg - 30 tabl. 30% TENOX 5 mg - 30 tabl. 30% TENSART 160 mg - 28 tabl. 30% TERTENSIF SR 1,5 mg - 30 tabl. 30% TERTENSIF SR 1,5 mg - 30 tabl. 100% THEOSPIREX RETARD 300 mg - 50 tabl. 100% THEOSPIREX RETARD 300 mg - 50 tabl. R THEOVENT 300 mg - 50 tabl. R THIOCODIN 10 tabl. 100% THYROZOL 10 mg - 50 tabl. 100% THYROZOL 20 mg - 50 tabl. 100% THYROZOL 5 mg - 50 tabl. 100% TIALORID 5+50 mg - 50 kaps. 30% TIALORID 5+50 mg - 50 kaps. 100% TIALORID MITE 2,5+25 mg-50 kaps. 30% TIAPRIDAL100 mg - 20 tabl. 100% TISERCIN 25 mg - 50 tabl. B TOLPERIS 50 mg - 30 tabl. 100% TOPAMAX 25 mg - 28 tabl. R TOPAMAX 25 mg - 60 tabl. R TORAMIDE 2,5 mg - 30 tabl. 100% TORAMIDE 5 mg - 30 tabl. 100% TORECAN czopki 6,25 mg 6 szt. 100% TORVACARD 20 mg - 30 tabl. 30% TORVACARD 20 mg - 30 tabl. 100% TORVACARD 40 mg - 30 tabl. 30% TORVALIPIN 10 mg - 30 tabl. 100% TORVALIPIN 20 mg - 30 tabl. 30% 5 Strona 24

25 1122 TORVALIPIN 20 mg - 30 tabl. 100% TRAMAL 100 mg/ml, 10 ml 30% TRAMAL 100 mg/ml, 96 ml 100% TRAMAL RETARD 100, 30 tabl. 30% TRAMAL RETARD 100, 30 tabl. 100% TRAMAL RETARD 100, 50 tabl. 100% TRAMAL RETARD 100, 50 tabl. 30% TRAMAPAR 37,5 mg mg - 60 tabl. 100% TRAVOCORT krem 15 g 100% TRAVOGEN 20 g krem 100% TRIBIOTIC maść 14 g 100% TRIBUX FORTE - 30 tabl. 100% TRIDERM maść 15 g 100% TRIDERM maść 15 g 100% TRIFAS 10, 10 mg - 30 tabl. 100% TRIFAS COR 5 mg - 30 tabl. 100% TRIMESAN 100 mg - 40 tabl. 100% TRITACE 10 mg - 28 tabl. R TRITACE 2,5 mg - 28 tabl. R TRITACE 5 mg - 28 tabl. R TRITTICO CR 150 mg - 20 tabl. 30% TRITTICO CR 150 mg - 60 tabl. 30% TRITTICO CR 75 mg - 30 tabl. 30% TRUSOPT 2% 5 ml 100% TRUSOPT 2% 5 ml R UNIDOX 100 mg - 10 tabl. 50% UPROX 0,4 mg - 30 tabl. R URINAL 60 kaps. 100% URO UP - 30 tabl. 100% UROFLOW 1, 1 mg - 28 tabl. 100% UROFLOW 2, 2 mg - 28 tabl. 100% UROFLOW 2, 2 mg - 28 tabl. 30% UROSEPT 30 tabl. 100% UROSEPT 60 tabl. 100% UROSTAD 0,4 mg - 30 tabl. R VALSACOR 160 mg - 28 tabl. 30% VALSACOR 80 mg - 28 tabl. 30% VALTAP HCT mg - 28 tabl. 30% VANATEX 160 mg - 28 tabl. 30% 13 VANATEX HTC 160 mg+ 12,5 mg tabl. 100% VASILIP 10 mg - 28 tabl. 30% VASILIP 20 mg - 28 tabl. 30% VASILIP 40 mg - 28 tabl. 100% VASTAN 20 mg - 28 tabl. 30% VENESCIN - 30 tabl. 100% VENFLON 0,8/25 mm niebieski 100% 28 Strona 25

26 1168 VENFLON 1,0/32 mm różowy 100% VENLECTINE 75 mg - 28 tabl. 30% 11 VENTOLIN aerozol, 100 µg/dawkę, dawek R 23 VENTOLIN aerozol, 100 µg/dawkę, dawek 100% VEROSPIRON 25 mg - 20 tabl. 30% VEROSPIRON 50 mg - 30 tabl. 30% VEROSPIRON 50 mg - 30 tabl. 100% VERTIX tabl. 100% VICEBROL 5 mg tabl. 100% VICEBROL 5 mg - 50 tabl. 100% VICEBROL forte - 30 tabl. 100% VICEBROL forte - 90 tabl. 100% VIDOTIN 4 mg - 30 tabl. R VIGAMOX 5 mg/ml, 5 ml 100% VIGANTOLETTEN tabl. 100% VIGANTOLETTEN 500 mg - 30 tabl. 100% VINPOCETINE 5 mg- 50 tabl. 100% VINPOTON 5 mg - 50 tabl. 100% VINPOTON 5 mg- 90 tabl. 100% VIPROSAL maść 50 g 100% VIREGYT- K kaps. 100% VIREGYT-K 100 mg - 50 kaps. 30% VIRLIX 10 mg - 20 tabl. 100% VIT A+D3 100 tabl. 100% VIT B COMPLEX 50 tabl. 100% VIT B µg/ml, 10 amp a 1 ml 100% VIT B µg/ml, 5 amp a 2 ml 30% VIT B µg/ml, 5 amp a 2 ml 30% VIT B6, 500 mg - 50 tabl. 100% VIT C 200 mg - 50 tabl. 100% VIT C 200 mg - 60 tabl. 100% VIT. B COMPOSITUM 50 tabl. 100% VIT. B1 3 mg - 50 tabl. 100% VIT. B6 50 mg - 50 tabl. 100% VIT. C 1000 mg- 10 tabl. 100% VIT. C 1000 mg- 20 tabl. 100% VIT. PP 200 mg - 20 tabl. 50% VIT. PP 200 mg- 20 tabl. 100% VIT. PP 50 mg- 20 tabl. 100% VITARAL - 30 tabl. 100% VITARAL - 60 tabl. 100% VITREOLENT krople 10 ml 100% VITRUM OSTEO - 60 tabl. 100% VIVACE 10 mg - 30 tabl. R VIVACE 2,5 mg - 30 tabl. R VIVACE 5 mg - 30 tabl. R 141 Strona 26

27 1214 VIVACOR 12,5 mg - 30 tabl. 100% VIVACOR 12,5 mg - 30 tabl. 30% VIVACOR 6,25 mg - 30 tabl. 30% VIVACOR 6,25 mg - 60 tabl. 30% VIVACOR 6,25 mg- 30 tabl. 100% WARFIN 3 mg tabl. R WARFIN 5 mg tabl. R WIT B tabl. 100% WODA UTLENIONA 3 % płyn 100 g 100% WOREK NA MOCZ 100% XALATAN 0,05 mg/ ml, 2,5 ml R XARELTO 20 mg - 28 tabl. 100% XARTAN 50 mg - 30 tabl. 30% XEFO-RAPID 8 mg - 10 tabl. 100% XEFO-RAPID 8 mg - 20 tabl. 100% XETANOR 20 mg - 30 tabl. 100% XETANOR 20 mg - 30 tabl. 30% XIMVE 10 mg - 30 tabl. 30% XOTEPIC 20 mg - 28 tabl. 50% YELLOX 5 ml 100% ZAFIRON 12 mcg - 60 kaps. R ZAHRON 20 mg - 28 tabl. 30% ZALDIAR 30 tabl. 100% ZINACEF 1500 mg -10 fiol. 50% ZINNAT 500 mg - 10 tabl. 50% ZOCOR 20, 20 mg - 28 tabl. 30% ZOCOR 40, 40 mg - 28 tabl. 30% ZOFENIL 7,5-28 tabl. 100% ZOLAFREN 10 mg - 30 tabl. R ZOLAFREN 5 mg - 30 tabl. R ZOLAFREN SWIFT 20 mg - 28 tabl. R ZOLAREN SWIFT 10 mg - 28 tabl. R ZOLAREN SWIFT 15 mg - 28 tabl. R ZOLAXA 10 mg - 30 tabl. R ZOLAXA 5 mg - 30 tabl. R ZOLERILIS 50 mg - 56 tabl. R ZOLOFT 100 mg - 28 tabl. 30% ZOXON 4, 4 mg - 30 tabl. R ZYLLT 75 mg - 28 tabl. 30% ZYLLT 75 mg - 28 tabl. 100% ZYRTEC 10 mg - 20 tabl. 30% ZYRTEC 10 mg - 20 tabl. 100% ZYRTEC 10 mg - 30 tabl. 100% ZYX 5 mg - 28 tabl. 30% ZYX 5 mg - 28 tabl. 100% 9 Razem x x x x Strona 27

28 podpis Wykonawcy Strona 28