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{"sheet":"Ryby","index":0,"n_rows":102,"n_cols":12,"rows_kept":102,"merged":[[0,0,0,11],[1,0,1,11],[2,0,2,11],[3,0,3,11],[91,4,91,7],[92,0,92,1],[94,0,94,11],[96,0,96,11],[100,7,100,11],[101,7,101,11]],"flags":["formulas_cached_only"]}
["Załącznik nr 3/1.4               "]
["nr sprawy ZP.12.PN.2017"]
["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,"acenokumarol","4 mg","tabl.","op.",12]
[2,"amiloryd + hydrochlorotiazyd","5 mg + 50 mg","tabl.","op.",24]
[3,"amiloryd + hydrochlorotiazyd","2,5 mg + 25 mg","tabl.","op.",15]
[4,"warfaryna","3mg","tab.","op.",43,"op.100szt"]
[5,"warfaryna","5mg","tab.","op.",81,"op.100szt"]
[6,"arcalen lub podobne",null,"maść","op.",20]
[7,"klonidyna","0,075mg","tab","op.",4]
[8,"furosemid","0,02 g/2 ml","inj.","op.",1,"op a 5 amp."]
[9,"bisoprolol","2,5 mg","tabl.powl.","op.",108,"op.28 tabl."]
[10,"cardiol C ",null,"krople","op.",226]
[11,"digoksyna","0,25mg","tabl.","op.",12]
[12,"digoksyna","0,5g/2ml","inj.","op.",8]
[13,"diltiazem","120 mg","tabl","op.",1]
[14,"diltiazem","60 mg","tabl.","op.",3]
[15,"dopamina","4%/5ml","inj.","op.",3]
[16,"enalapryl","20 mg","tabl.","op.",2]
[17,"enalapryl","10 mg","tabl.","op.",10]
[18,"enalapryl","5 mg","tabl.","op.",11]
[19,"epinefryna","1mg/1ml","inj.","op.",5]
[20,"etamsylat","250 mg","tabl.","op.",132]
[21,"fitomenadion","10 mg","tabl.","op.",3]
[22,"furosemid","0,02 g/2 ml","inj.","op.",190,"op a 50 amp."]
[23,"furosemid","40 mg","tabl.","op.",1085]
[24,"hemorectal",null,"czopki","op.",22]
[25,"heparyna","25000j.m./5ml","inj.","op.",1,"i.v."]
[26,"heparyna","300j.m./g","żel ","op.",90,"35 g."]
[27,"hydrochlorotiazyd","25 mg","tabl.","op.",25]
[28,"kaptopryl","12,5 mg","tabl.","op.",8]
[29,"kaptopryl","25 mg","tabl.","op.",25]
[30,"kwas acetylosalicylowy","75 mg","tabl. powl.","op.",600,"op a 60 szt."]
[31,"kwas acetylosalicylowy","150 mg","tabl. powl.","op.",80,"op a 60 szt."]
[32,"kwas acetylosalicylowy+magnez","150mg+21mg","tab.","op.",1,"op.50szt"]
[33,"kwas foliowy","5 mg","tabl.","op.",1]
[34,"kwas foliowy","15 mg","tabl.","op.",41]
[35,"mannitol 100ml",{"v":0.2,"d":"20%"},"roztwór do wlewów i.v.","op.",5]
[36,"mannitol 250 ml",{"v":0.2,"d":"20%"},"roztwór do wlewów i.v.","op.",1]
[37,"metoprolol","100 mg","tabl.","op.",3]
[38,"metoprolol","50 mg","tabl.","op.",94]
[39,"metoprolol","5mg/5ml","inj.","op.",19]
[40,"digoksyna","0,1 mg","tabl.  ","op.",6]
[41,"midodryna","2,5 mg","tabl.","op.",6]
[42,"molsydomina","4 mg","tabl.","op.",2]
[43,"hydrochlorohiazyd","12,5mg","tab","op.",5]
[44,"monoazotan izosorbidu","50 mg","tabl.prolong.","op.",11]
[45,"nicergolina","10mg","tabl.","op.",15]
[46,"nitrendypina","10 mg","tabl.","op.",1]
[47,"nitrendypina","20 mg","tabl.","op.",4]
[48,"pentoksyfilina","0,4g","tabl.prolong.","op.",30]
[49,"pentoksyfilina","0,1g","tabl.","op.",1]
[50,"propafenon","150 mg","tabl.","op.",24]
[51,"propranolol","40 mg","tabl.","op.",1]
[52,"siarczan magnezu",{"v":0.2,"d":"20%"},"inj.","op.",5,"amp.po 10ml"]
[53,"spironolakton","100 mg","tabl.","op.",36]
[54,"spironolakton","25 mg","tabl.","op.",64,"op.100szt"]
[55,"gąbka hemostatyczna","80 x 50 x 10 mm","gąbka hem.standard","op.",12,"op. a 10 szt."]
[56,"gąbka hemostatyczna","80x50x1mm","gąbka hem.specjal","op.",1,"op. a 20 szt."]
[57,"tiklopidina","250 mg","tabl.","op.",1]
[58,"trokserutyna","200 mg","kaps.","op.",6]
[59,"werapamil","80 mg","tabl.","op.",1]
[60,"żelaza (II) siarczan","105mg","tabl.prolong.","op.",283]
[61,"norepinefryna","1mg /1ml","inj.","op.",2]
[62,"fitomenadion","10mg/ 1ml","inj.","op.",3]
[63,"propranolol","10mg","tab.","op.",1]
[64,"propafenon","70mg/20ml","inj.","op.",1]
[65,"triazotan glicerylu","0,4mg","aerozol","op.",4]
[66,"triazotan glicerylu","10mg/10ml","inj.","inj.",1]
[67,"torazemid","10mg","tab.","op.",200]
[68,"molsidomina","2mg","tab","op.",1]
[69,"chlortalidon","50mg","tab.","op.",9]
[70,"metoprolol","23,75 mg","tab.o przedłuż.uwaln.","op.",85]
[71,"metoprolol","47,5mg","tab.o przedłuż.uwaln.","op.",170,"."]
[72,"metoprolol","95mg","tab.o przedłuż.uwaln.","op.",180]
[73,"monoazotan izosorbidu","75mg","tab o przedł.uwal.","op.",1]
[74,"werapamil","40mg","tab powl.","op.",1]
[75,"diltiazem","90mg","tab powl.","op.",3]
[76,"walsartan","160mg","tabl.powl.","op.",10,"op.28 tabl."]
[77,"bisoprolol","5 mg","tab.powl.","op.",424,"op30 tabl."]
[78,"bisoprolol","10  mg","tab.powl.","op.",47,"op.30 tabl."]
[79,"carvedilol","6,25mg","tab","op.",33]
[80,"carvedilol","12,5 mg","tab","op.",28]
[81,"etamsylat","125mg/ml","inj.","op.",14,"op.5amp."]
[82,"etamsylat","125mg/ml","inj.","op.",13,"op 50 amp."]
[83,"urapidyl","5mg/ml.","inj.","op.",1]
[84,"nebivolol","5mg","tabl.","op.",39]
[85,"sól sodowa dalteparyny","5000jm/0,2ml","amp-strzyk","op.",1]
[86,"sól sodowa dalteparyny","7500jm/0,3ml","amp-strzyk","op.",1]
[{"$nulls":4},"Razem (zł)"]
["SŁOWNIE (zŁ)"]
[]
["Netto:…………………………………………………………………………………………………………………….........................                                                 "]
[]
["VAT:……………………………………………………………………………………………………………………..........................."]
[]
["Brutto:…………………………………………………………………………………………………………………............................"]
[]
[{"$nulls":7},"………………………………………………"]
[{"$nulls":7},"Pieczęć i podpis wykonawcy"]