| 1 | 12160000 | 12162200 | 12162201 | Ácido ascórbico | ACIDO ASCORBICO (VITAMINA C) 500MG, INY. | Unidad | 3,600 | 5.00 | 0.00 | 0.00 | 0.00 | 18,000.00 |
| 2 | 51100000 | 51101500 | 51101594 | Cefepima | CEFEPIME INY 1G | Unidad | 3,000 | 140.00 | 0.00 | 0.00 | 0.00 | 420,000.00 |
| 3 | 51100000 | 51101500 | 51101578 | Cefazolina | CEFAZOLINA 1G VIAL | Unidad | 2,400 | 70.00 | 0.00 | 0.00 | 0.00 | 168,000.00 |
| 4 | 51180000 | 51181700 | 51181704 | Dexametasona | DEXAMETAZONA 8MG/2ML AMP | Unidad | 12,000 | 7.50 | 0.00 | 0.00 | 0.00 | 90,000.00 |
| 5 | 51160000 | 51161600 | 51161620 | Difenhidramina | DIFENHIDRAMINA 20 MG AMP. | Unidad | 3,000 | 8.00 | 0.00 | 0.00 | 0.00 | 24,000.00 |
| 6 | 51100000 | 51101500 | 51101528 | Tirotricina | ENTEROGERMINA, 2MM/5ML, | Unidad | 1,600 | 35.00 | 0.00 | 0.00 | 0.00 | 56,000.00 |
| 7 | 51180000 | 51181700 | 51181706 | Hidrocortisona | HIDROCORTIZONA SUCCINATO SODICO 100MG AMP, | Unidad | 3,000 | 24.00 | 0.00 | 0.00 | 0.00 | 72,000.00 |
| 8 | 51140000 | 51142100 | 51142108 | Ketoprofeno | KETOROLACO 60 MG/2ML AMP IM-IV | Unidad | 9,000 | 28.00 | 0.00 | 0.00 | 0.00 | 252,000.00 |
| 9 | 51140000 | 51141500 | 51141518 | Levetiracetam | LEVETIRACETAM 500MG/5ML INY | Unidad | 900 | 400.00 | 0.00 | 0.00 | 0.00 | 360,000.00 |
| 10 | 51100000 | 51101600 | 51101611 | Meropenem | MEROPENEM 1G AMP, | Unidad | 1,800 | 240.00 | 0.00 | 0.00 | 0.00 | 432,000.00 |
| 11 | 51140000 | 51142000 | 51142001 | Acetaminofén | PARACETAMOL 10MG / 100ML, INFUSION (BOLSA), | Unidad | 12,000 | 90.00 | 0.00 | 0.00 | 0.00 | 1,080,000.00 |
| 12 | 51140000 | 51142000 | 51142001 | Acetaminofén | PARACETAMOL 500 MG TABL | Unidad | 3,000 | 0.65 | 0.00 | 0.00 | 0.00 | 1,950.00 |