| Servico | TABELA CEMED - MEDICAMENTO | DELLER 50MG COM VER LIB PROL CT BL AL PLAST PVDC X 60 = CX 16 X 307,81 17 = 4.087,68 DIOVAM 320MG COM VER CT BL AL AL X 28 = CX 14 X 85,79 17 = 996,80 DIOVANHCT 320/12,5MG COM VER CT BL AL AL X 28 = CX 14 X 89,20 17 = 1.036,42 DONAREN 50MG COM VER CT BLAL PLAS TRANSX 60 = CX 12 X 76,27 17 = 759,60 EFEXOR XR 150MG CAP DURA LIB PROL CT BL AL PLAS TRANS X 30 = CX 24 X 429,19 17 = 8.549,28 ELIQUIS 5MG COM VER CT BL AL PLAS TRANS X 60 = CX 24 X 240,12 17 = 4.782,96 FORXIGA 10MG COM VER CT BL ALAL X30 = CX 20 X 134,50 17 = 2.232,60 KEPPRA 250MG COM VER CT BL AL PLAS PVC TRNS X 60= CX 70 X 485,24 17 = 28.191,80 KEPPRA 750MG COM VER CT BL AL PLAS PVC TRANS X 60= CX 40 X 116,91 17 = 3.881,20 LAMICTAL 50MG COM CT BL AL PLAS TRANS X 30 = CX 25 X 207,15 17 = 4.298,25 LAMITOR CCD 100MG COM SUS CT BL AL/AL X 60= CX 24 X 688,87 17 = 13.722,24 LEPONEX 100MG COM CT BL AL PLAS PVC TRANS X 30= CX 16 X 258,94 17 = 3.438,72 LEXAPRO 10MG COM VER CT BL AL PLAS TRANS X 60 = CX 14 X 486,25 17 = 5.650,12 LYRICA 75MG CAP DURA CT BL AL PLAS PVC TRANS X 30 = CX 16 X 134,48 17 = 1.785,76 NATRILIX 1,5MGCOM VER CT BL AL PLAWS INC X 30 = CX 18 X 34,45 17 = 513,18 PONDERA 25MG COM VER CT BL AL PLAS TRANS X 20 = CX 14 X 86,62 17 = 1.006,46 PRADAXA 150MG CAP DURA CT BL AL AL X 60 = CX 18 X 237,54 17 = 3.548,70 QUEROPAX 25MG COM VER CT BL AL PLAST OPC X 30 = CX 16 X 133,16 17 = 1.768,32 SEROQUELXR 50MG COM VER LIB PROL CT BL AL PLAS PVC OPC X30=CX 20 X247,06 17 = 4.101,00 STANGLIT 15MG COM CT FR PLAS OPC X 60 = CX 18 X 121,07 17 = 1.808,64 STILNOX 12,5MG CO LIB PROL CT BL AL PLASTRANS X 30 + CX + 87,92 X 18 -17 = 1.313,46 SULPAM MG CAP GEL DURA CT BL AL PLAS PVC TRANSX 20 + CX + 25,15 X 24 -17 = 500,88 TEGRETOL 400MG COM LIB PROL CT BL PLASPVDC TRANS X 60 + CX + 134,03 X 22 17 = 2.447,28 TRILEPTAL 300MGCOM VER CT BL AL AL PLAS TRANS X 60 + CX + 143,59 X 20 17 = 2.383,40 VIMPAT 200MG COM VER CT AL PLAST TRANSX 56 + CX + 847,42 X 20 17 = 14.067,00 ZYPREXA 10MG COM VER CT BL AL AL X 30 + CX + 1.033,72 X 20 -17 = 17.159,60 | 1,0000 | R$ 161.483,55 | R$ 134.031,35 |