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[]
["Sprawa nr.ZP.16.PN.2018                                                                                                                                                                                                                                 Załącznik nr.3/1,5"]
["FORMULARZ ASORTYMENTOWO-CENOWY"]
["(zamawiający zastrzega sobie prawo do zakupu mniejszych ilości towaru)"]
[null,"Nazwa asortymentu","dawka","postać leku","J.m.","Ilość","Uwagi","Cena jedn. Netto (zł)","Wart. netto (zł)","VAT %","VAT (zł)","Wartość brutto (zł)"]
[1,"acyklowir","0,8g ","tabl.","op.",1,"op.30 szt."]
[2,"acyklowir","0,2g","tabl.","op.",1,"op.30 szt."]
[3,"acyklowir","0,4g","tabl.","op.",1,"op.30 szt."]
[4,"amikacyna","0,25g/2ml","inj.","fiol.",10,"op.1amp"]
[5,"amikacyna","0,5g/2ml","inj.","fiol.",300,"op.1amp"]
[6,"amoksycylina","0,25g","tabl.","op.",3,"op.16 szt."]
[7,"amoksycylina","0,5g","tabl.","op.",28,"op.16 szt."]
[8,"amoksycylina","1,0g","tabl.","op.",40,"op.16 szt."]
[9,"amoksycylina","0,75g","tabl.","op.",8,"op.16 szt."]
[10,"amoksycylina","0,25g/5ml","proszek do sporz.zaw.doustnej","op.",11,"op.60ml"]
[11,"amoksycylina + kwas klawulanowy","0,25g+0,125g","tabl.","op.",1,"op.21szt"]
[12,"amoksycylina+kwas klawulanowy","0,5g+0,125g","tabl.","op.",26,"op.14szt."]
[13,"amoksycylina+kwas klawulanowy","0,875g+0,125g","tabl.","op.",128,"op.14 szt."]
[14,"amoksycylina+kwas klawulanowy","0,4g+0,057g/5ml","proszek do sporz.zaw.doustnej","op.",39,"op.140ml"]
[15,"kloksacylina","500 mg","tabl.powl.","op.",5,"op.16 szt."]
[16,"kloksacylina","1 g","fiol.","szt.",10,"op.1fiol."]
[17,"amoksycylina+kwas klawulanowy","1g+0,2g","proszek do sporz.rozt. do wstrz. i wlewów krop","op.",185,"op.1fiol."]
[18,"cefadroksyl","0,25g/5ml","proszek do sporz.zaw.doustnej","op.",1,"op. 60ml"]
[19,"cefaklor","0,25g/5ml","proszek do sporz.zaw.doustnej","op.",1,"op.75ml"]
[20,"ceftriakson","1 g","inj.","fiol.",3165,"op.1fiol."]
[21,"cefuroksym","0,75g","inj.","fiol.",10,"op.1fiol."]
[22,"cefuroksym","0,125g/5ml","proszek do sporz.zaw.doustnej","op.",6,"op.50ml"]
[23,"cefuroksym","0,25g/5ml","proszek do sporz.zaw.doustnej","op.",1,"op.50ml"]
[24,"cefuroksym","0,25g","tabl.","op.",11,"op.10szt"]
[25,"cefuroksym","0,5g","tabl.","op.",99,"op.10szt"]
[26,"lincomycyn","600mg/2ml","inj.","fiol.",10,"op.1fiol."]
[27,"cyprofloksacyna","100mg/10ml","inj.","op.",1,"op.10amp"]
[28,"cyprofloksacyna","0,5g","tabl.","op.",60,"op.10szt"]
[29,"doksycyklina","0,1g","kaps.","op.",12,"op.10szt"]
[30,"gentamycyna","0,04g/1ml","inj.i.m.i.v.","op.",65,"op.10szt"]
[31,"gentamycyna","0,08g/2ml","inj.i.m.i.v.","op.",6,"op.10szt"]
[32,"inozyna pranobeks","0,5g","tabl.","op.",71,"op.20szt"]
[33,"ketokonazol","0,2g","tabl.","op.",1,"op.10 szt."]
[34,"klarytromycyna","0,5g","tabl.","op.",17,"op.14szt."]
[35,"klarytromycyna","0,25g/5ml","proszek do sporz.zaw.doustnej","op.",30,"op. 100ml"]
[36,"klarytromycyna","0,125g/5ml","proszek do sporz.zaw.doustnej","op.",1,"op.100ml"]
[37,"klarytromycyna","0,25g","tabl.","op.",1,"op.14szt."]
[38,"klindamycyna","0,3g","tabl.powlekane","op.",42,"op,16szt"]
[39,"klindamycyna","0,3g/2ml","inj.","amp.",20,"op.5amp"]
[40,"klindamycyna","0,6g/2ml","inj.","amp.",660,"op.5amp"]
[41,"kwas pipemidowy","0,2g","kaps.","op.",1,"op.20szt"]
[42,"metronidazol","0,25g","tabl.","op.",30,"op.20szt"]
[43,"penicylina fenoksymetylowa","1,5 mln jedn.","tabl.","op.",101,"op.12szt"]
[44,"penicylina fenoksymetylowa","1 mln jedn.","tabl.","op.",1,"op.12szt"]
[45,"sulfametoksazol+trimetoprim","480mg/5ml","inj.","op.",34,"op.10amp"]
[46,"sulfametoksazol+trimetoprim","0,8g+0,16g","tabl.","op.",86,"op.10szt"]
[47,"sulfametoksazol+trimetoprim","0,4g+0,08g","tabl.","op.",1,"op.20szt"]
[48,"sulfametoksazol+trimetoprim","0,2g+0,04g/5ml","zaw.doustna","op.",1,"op.100ml"]
[49,"cefadroksyl","0,5 g","kaps.","op.",1,"op.12szt"]
[50,"ceftazydym","1 g.","inj.","op.",10,"op.1amp"]
[51,"cyprofloksacyna","200mg/100ml","wlew dożylny","fl.",838,"op.100ml"]
[52,"Ampicylina + sulbaktam","1,5g","inj.","fiol.",10,"op.1fiol."]
[53,"sultamycylina","0,375g","tabl.powl.","op.",1,"op.12szt"]
[54,"ryfaksymina","200mg","tabl.powlekane","op.",21,"op.14 szt."]
[55,"norfloksacyna","0,4g","tabl.","op.",19,"op.20szt"]
[56,"inozyna pranobeks","50mg/ml","syrop","op.",47,"op.150ml,"]
[57,"kolistyna","1000000 j.m.","fiol.","fiol.",20,"op.20szt"]
[58,"penicyllinum crystallisatum","3000000 j.m.","fiol.","szt.",10,"op.1fiol."]
[59,"penicylina fenoksymetylowa","750000jm/5ml","zaw.doustna","op.",18,"op.150ml,"]
[60,"nystatyna","500,000j","draż.","op.",46,"op.16 szt."]
[61,"nystatyna","100000j/1ml","zawiesina","op.",5,"op.28 ml"]
[62,"azytromycyna","200mg/5ml","zawiesina","op.",15,"op.30ml"]
[63,"azytromycyna","500mg","tab.powlekane","op..",15,"op.6 szt."]
[{"$nulls":3},"Razem (zł)"]