Servico | TABELA CEMED - MEDICAMENTO | AMITRIPTILINA 25MG C/30 + 33,80 X 30 = 1.014,00 - 66 = 344,70 AMITRIPTILINA 75 MG C/30 + CX + 67,24 X 30 = 2.017,20 - 66 = 685,80 CLORPROMAZINA 100MG + CX + 10,56 X 400 = 4.224,00 - 66 = 1.392,00 DORSANOL 750MG C/200 + CX + 194,61 X 10 = 1.946,10 - 66 =539,30 FENOBARBITAL 100MG C/200 + CX + 64,84 X 20 = 1.296,80 - 66 = 441,00 LEVETIRACETAM 500 MG C/30 + CX + 116,60 X 30 = 3.498,00 - 66 = 1.189,20 LEVOMEPRAZINA 25 MG C/200 + CX + 110,26 X 5 = 551,30 - 66 = 187,45 NORTRIPTILINA 50MG C/30 + CX + 66,76 X 100 = 6.676,00 - 66 = 2.270,00 PAMERGAM 25 MG C/200 + CX + 120,12 X 10 = 1.201,20 - 66 = 408,40 QUETIAPINA 25MG C/30 + CX + 57,08 X 100 = 5.708,00 - 66 = 1.941,00 RISPERIDONA 1MG C/30 + CX + 104,76 X 100 = 10.476,00 - 66 = 3.664,00 RISPERIDONA 2MG C/30 + CX + 217,34 X 200 = 43.468,00 - 66 = 14.780,00 OLANZAPINA 5MG C/30 + CX + 387,00 X 20 = 7.740,00 - 66 = 2.633,80 OLANZAPINA 10MG C/30 + CX + 774,66 X 20 = 15.493,20 - 66 = 5.267,60 DESVENLAFAXINA 50MG + CX + 167,09 X 30 = 5.012,70 - 66 = 1.704,30 DESVENLAFAXINA 100 MG + CX + 207,72 X 30 = 6.231,60 - 66 = 2.118,60 TRAZODONA 50MG C/60 + CX + 82,44 X 50 = 4.422,00 - 66 = 2.803,00 TRAZODONA 100MG C/30 + CX + 81,66 X 100 = 8.166,00 - 66 = 1.388,50 | 1,0000 | R$ 142.954,85 | R$ 48.604,65 |