Formulario Terapéutico Ambulatorio Monotributistas - OSPRERA

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NOMBRE Y PRESENTACION Concentracion Monodroga y Forma LABORATORIO PVP MF Monotributista % Cob NOZINAN MINOR gts.x 30 ml levomepromazina gotas x 30ml Sanofi-Aventis 37,89 13,15 35% NOZINAN 100 mg comp.x 50 levomepromazina 100mg comp. x 50 Sanofi-Aventis 125,36 46,67 37% NOZINAN 2.5% iny.x 5 x 1 ml levomepromazina 2.5% iny. x 5 Sanofi-Aventis 58,5 22,24 38% NOZINAN 25 mg comp.x 30 levomepromazina 25mg comp. x 30 Sanofi-Aventis 65,37 22,69 35% TOGREL 25 mg comp.x 50 levomepromazina 25mg comp. x 50 Ivax Arg. 82,55 28,62 35% NOZINAN 2 mg comp.x 30 levomepromazina 2mg comp. x 30 Sanofi-Aventis 20,96 7,63 36% TOGREL 2 mg comp.x 50 levomepromazina 2mg comp. x 50 Ivax Arg. 30,71 11,43 37% MICROLUT grag.x 35 levonorgestrel 0,03mg comp. x 35 Bayer (BSP) 40,44 13,63 34% OVULOL 0.75 mg comp.x 2 levonorgestrel 0,75mg comp. x 2 Microsules Arg. 19,21 7,32 38% SECUFEM 0.75 0.75 mg comp.x 2 levonorgestrel 0,75mg comp. x 2 Elea 23,97 8,31 35% SEGURITE 0.75 mg comp.x 2 levonorgestrel 0,75mg comp. x 2 Raffo 21,58 8,03 37% OVULOL UD 1.5 mg comp.x 1 levonorgestrel 1,5mg comp. x 1 Microsules Arg. 19,21 7,32 38% SECUFEM 1.5 mg 1.5 mg comp.x 1 levonorgestrel 1,5mg comp. x 1 Elea 26,89 8,60 32% SEGURITE UD 1.5 mg comp.x 1 levonorgestrel 1,5mg comp. x 1 Raffo 24,62 9,16 37% CICLOCUR blist.grag.x 21 levonorgestrel+estradiol 50mcg comp. x 21 Bayer (BSP) 71,99 25,11 35% DOS DIAS N comp.x 2 levonorgestrel+etinilestradiol comp. x 2 Elea 45,78 15,86 35% EVELEA M.D. comp.x 21 levonorgestrel+etinilestradiol comp. x 21 Elea 13,09 4,86 37% FEMEXIN comp.x 21 levonorgestrel+etinilestradiol comp. x 21 Elea 18,65 6,46 35% MICROGYNON blist.grag.x 21 levonorgestrel+etinilestradiol comp. x 21 Bayer (BSP) 34,56 9,02 26% MICROVLAR grag.x 21 levonorgestrel+etinilestradiol comp. x 21 Bayer (BSP) 22,45 7,83 35% MIRANOVA grag.x 21 levonorgestrel+etinilestradiol comp. x 21 Bayer (BSP) 16,01 5,58 35% NEOGYNON blist.grag.x 21 levonorgestrel+etinilestradiol comp. x 21 Bayer (BSP) 41,61 9,02 22% TRIQUILAR blist.grag.x 21 levonorgestrel+etinilestradiol comp. x 21 Bayer (BSP) 36,68 9,02 25% FEMEXIN 28 comp.x 28 levonorgestrel+etinilestradiol comp.x 28 Elea 18,65 6,46 35% NORFEN comp.x 28 levonorgestrel+etinilestradiol comp.x 28 Bagó 16,16 5,90 37% SYNTHROID 100 mcg comp.x 60 levotiroxina 100 mcg comp.x 60 Abbott 31,95 11,10 35% T4 MONTPELLIER 100 100 mcg comp.x 50 levotiroxina 100mcg comp. x 50 Montpellier 26,95 8,95 33% EUTHYROX 100 mcg comp.birran.x 50 levotiroxina 100mcg comp. x 50 Merck Serono 21,99 8,20 37% LEVOTIROXINA 100 mcg comp.x 50 levotiroxina 100mcg comp. x 50 GlaxoSmithKline 25,65 8,95 35% SYNTHROID 112 mcg comp.x 60 levotiroxina 112 mcg comp.x 60 Abbott 43,43 15,09 35% T4 MONTPELLIER 112 112 mcg comp.x 50 levotiroxina 112mcg comp. x 50 Montpellier 35,9 12,10 34% EUTHYROX 112 mcg comp.birran.x 50 levotiroxina 112mcg comp. x 50 Merck Serono 32,23 12,02 37% LEVOTIROXINA 112 mcg comp.x 50 levotiroxina 112mcg comp. x 50 GlaxoSmithKline 34,87 12,10 35% SYNTHROID 125 mcg comp.x 60 levotiroxina 125 mcg comp.x 60 Abbott 46,12 16,02 35% T4 MONTPELLIER 125 125 mcg comp.x 50 levotiroxina 125mcg comp. x 50 Montpellier 38,28 12,93 34% EUTHYROX 125 mcg comp.birran.x 50 levotiroxina 125mcg comp. x 50 Merck Serono 32,01 11,94 37% LEVOTIROXINA 125 mcg comp.x 50 levotiroxina 125mcg comp. x 50 GlaxoSmithKline 37,03 12,93 35% T4 MONTPELLIER 137 137 mcg comp.x 50 levotiroxina 137mcg comp. x 50 Montpellier 40,46 14,13 35% EUTHYROX 137 mcg comp.birran.x 50 levotiroxina 137mcg comp. x 50 Merck Serono 35,06 13,08 37% LEVOTIROXINA 137 mcg comp.x 50 levotiroxina 137mcg comp. x 50 GlaxoSmithKline 40,47 14,13 35%

NOMBRE Y PRESENTACION Concentracion Monodroga y Forma LABORATORIO PVP MF Monotributista % Cob SYNTHROID 150 mcg comp.x 60 levotiroxina 150 mcg comp.x 60 Abbott 50,7 17,62 35% T4 MONTPELLIER 150 150 mcg comp.x 50 levotiroxina 150mcg comp. x 50 Montpellier 41,25 13,24 32% EUTHYROX 150 mcg comp.birran.x 50 levotiroxina 150mcg comp. x 50 Merck Serono 32,94 12,28 37% LEVOTIROXINA 150 mcg comp.x 50 levotiroxina 150mcg comp. x 50 GlaxoSmithKline 40,68 13,24 33% T4 MONTPELLIER 175 175 mcg comp.x 50 levotiroxina 175 mcg comp.x 50 Montpellier 46,51 16,14 35% EUTHYROX 175 mcg comp.birran.x 50 levotiroxina 175 mcg comp.x 50 Merck Serono 37,99 14,17 37% LEVOTIROXINA 175 mcg comp.x 50 levotiroxina 175 mcg comp.x 50 GlaxoSmithKline 46,25 16,14 35% T4 MONTPELLIER 200 200 mcg comp.x 50 levotiroxina 200 mcg comp. x 50 Montpellier 49,13 15,46 31% EUTHYROX 200 mcg comp.birran.x 50 levotiroxina 200 mcg comp. x 50 Merck Serono 41,47 15,46 37% SYNTHROID 25 mcg comp.x 60 levotiroxina 25 mcg comp.x 60 Abbott 27,24 9,46 35% EUTHYROX 25 mcg comp.birran.x 50 levotiroxina 25mcg comp. x 50 Merck Serono 14,37 5,36 37% LEVOTIROXINA 25 mcg comp.x 50 levotiroxina 25mcg comp. x 50 GlaxoSmithKline 21,87 6,50 30% SYNTHROID 50 mcg comp.x 60 levotiroxina 50 mcg comp.x 60 Abbott 27,24 9,46 35% T4 MONTPELLIER 50 50 mcg comp.x 50 levotiroxina 50mcg comp. x 50 Montpellier 18,3 6,50 36% EUTHYROX 50 mcg comp.birran.x 50 levotiroxina 50mcg comp. x 50 Merck Serono 14,39 5,37 37% LEVOTIROXINA 50 mcg comp.x 50 levotiroxina 50mcg comp. x 50 GlaxoSmithKline 21,87 6,50 30% SYNTHROID 75 mcg comp.x 60 levotiroxina 75 mcg comp.x 60 Abbott 28,34 9,84 35% T4 MONTPELLIER 75 75 mcg comp.x 50 levotiroxina 75mcg comp. x 50 Montpellier 23,37 7,94 34% EUTHYROX 75 mcg comp.birran.x 50 levotiroxina 75mcg comp. x 50 Merck Serono 19,57 7,30 37% LEVOTIROXINA 75 mcg comp.x 50 levotiroxina 75mcg comp. x 50 GlaxoSmithKline 22,74 7,94 35% T4 MONTPELLIER 88 88 mcg comp.x 50 levotiroxina 88 mcg comp.x 50 Montpellier 24,76 8,09 33% EUTHYROX 88 mcg comp.birran.x 50 levotiroxina 88 mcg comp.x 50 Merck Serono 22,21 8,19 37% LEVOTIROXINA 88 mcg comp.x 50 levotiroxina 88 mcg comp.x 50 GlaxoSmithKline 23,18 8,09 35% SYNTHROID 88 mcg comp.x 60 levotiroxina 88 mcg comp.x 60 Abbott 28,87 10,03 35% EXLUTON comp.x 28 linestrenol comp. x 28 Organon 55,12 19,43 35% TRI IODO TIRONINA comp.x 20 liotironina comp. x 20 GlaxoSmithKline 14,09 5,26 37% LITHIUN 150 mg comp.x 50 litio.carbonato 150mg comp. x 50 Elisium 34,05 12,67 37% CEGLUTION 300 tab.x 20 litio.carbonato 300mg comp. x 20 Ariston 29,71 10,96 37% CEGLUTION 300 tab.x 50 litio.carbonato 300mg comp. x 50 Ariston 66,36 20,07 30% LITHIUN 300 mg comp.x 50 litio.carbonato 300mg comp. x 50 Elisium 46,53 16,16 35% CEGLUTION 300 tab.x 90 litio.carbonato 300mg comp. x 90 Ariston 97,29 35,20 36% CEGLUTION XR comp.x 30 litio.carbonato 450mg comp. x 30 Ariston 52,08 18,44 35% ESKALIT SR 450 mg comp.x 50 litio.carbonato 450mg comp. x 60 GlaxoSmithKline 90,29 33,68 37% CUSTEY 2 mg comp.x 10 loperamida 2mg comp. x 10 Microsules Arg. 16 6,10 38% ELCOMAN comp.x 10 loperamida 2mg comp. x 10 Sandoz 12,58 4,69 37% LANSEKA 2 mg comp.x 10 loperamida 2mg comp. x 10 Investi 22,8 7,42 33% LOPERAMIDA VANNIER 2 mg comp.x 10 loperamida 2mg comp. x 10 Vannier 16,59 6,06 37% MINICAM 2 mg comp.x 10 loperamida 2mg comp. x 10 Sanofi-Aventis O 9,9 3,68 37% PLEXOL 2 mg comp.ran.x 10 loperamida 2mg comp. x 10 Sandoz 15,75 5,87 37% REGULANE comp.x 10 loperamida 2mg comp. x 10 Finadiet 38,81 7,42 19%

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