1385-08-01 N226

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درماني خدمات بيمه سازمان تعهد مورد داروهاي قيمت فهرست

‘ ميباشد شده احراز قيمت حداقل اعالمي قيمتهاي

قيمت دارو تغيير دارو دوز دارو شكل نام

:--- 226شماره: ارسال 1385/08/01تاریخ

يا و كننده توليد نامكننده توزيع

تغيير اجراي تاريختوسط قيمت

استان) ريال ) قيمت

Page 2

Infu )500ml( GELATIN MODIFIED 66000البرز

پخش ML Infu AMINOACID 10% 1385/07/087000066990500داروپخش ML Infu AMINOACID 5% 1385/07/084700045,000500دارو )IU Inj ERYTHROPOIETIN)EPOETIN 1385/07/082430002480004000رازیدارو IU/Dose Nasal Spray CALCITONIN SALMON 1385/07/0890000100سینا

368500200 IU/Dose Nasal Spray CALCITONIN SALMON

احمر mg Scored.Tab LEVODOPA - B FORTE 1385/07/0532203069250هاللاحمر Oral sol or syrup CARNITINE 1385/07/051000010160هالل

1384/07/121385/07/01

6600097000

ایران قاسمدارو 1385/07/11سینا

368500120000

Page 3

احمر mg/10ml For inj. MILRINONE 1385/07/0932420033540010هاللاحمر mg/5 ml Inj DOXAPRAM HCL 1385/07/094780050000100هالل

700,0006mu inj INTERFERON BETA ) AVONEX(

mg Cap. CICLOSPORIN 30025هجرت

mg Cap. CICLOSPORIN 1,200100هجرت

احمر mg/ml Infu. 1ml CICLOSPORIN 1385/07/15400004080050هاللاحمر )g For inj. PIPERACILLIN)AS SODIUM 1385/07/1633500254502هالل

احمر mg Tab. THIOGUANINE 1385/07/159570987040هالل

رازیفردوس

1384/12/161385/07/09

700000500000

1384/08/281385/07/12

300500

1384/08/281385/07/12

12002000

Page 4

mg Scored.Tab SOTALOL HCL 1385/07/0975074580رازی Rectal.Oint. ANTIHEMORRHOID 1385/07/1545003600مختلف mg Inj. BIPERIDEN LACTATE 1385/07/1522501,8005مختلف mg Ped. Supp. BISACODYL 1385/07/153002205مختلف mg/2 ml Inj. BROMHEXINE HCL 1385/07/15160013004مختلف Top. Cream CALAMINE-D %1385/07/15320030008مختلف )mg/2 ml Inj CITICOLINE )AS SODIUM 1385/07/1540003,740250مختلف )ml Inj CLEMASTINE )AS FUMARATE 1385/07/1513501,1002مختلف Infu.1000ml DEXTROSE 5% NACI 0.9% 1385/07/1573006,900مختلف )mg/ml Inj. HALOPERIDOL)AS LACTATE 1385/07/1515001,2005مختلف

Page 5

mg/2 ml Inj DIAZEPAM 1385/07/1512501,00010مختلف Inj.)5 ml( LIDOCAINE HCL %1385/07/15210020002مختلف U/g Top. Oint. NYSTATIN 1385/07/1534002,700100,000مختلف )mg/ml inj. PENTAZOCINE)AS LACTATE 1385/07/151800145030مختلف mg/5 ml inj. PHENYTOIN SODIUM 1385/07/1522002100250مختلف mg/ ml Inj. PROGESTERONE 1385/07/1515501,25025مختلف mg/ ml Inj. PROGESTERONE 1385/07/1517501,40050مختلف mg/ ml inj. PROPRANOLOL HCL 1385/07/1516001,3001مختلف mg/ ml Inj.2 ml PROMETHAZINE HCL 1385/07/1516001,30025مختلف )mg/ ml Inj.)2ml( RANITIDINE)AS HCL 1385/07/1512501,00025مختلف

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Infu. 1000ml SODIUM CHLORIDE %1385/07/1565006,4000/9مختلف mg/ml Inj. TESTOSTERONE ENANTATE 1385/07/1524002,200100مختلف Ophth oint TETRACYCLINE HCL %1385/07/15240022001مختلف )mg/ml Inj.)IM( THIETHYLPERAZINE)AS OIMALEATE 1385/07/1512501,0006/5مختلف mg/ml Inj )5 ml( TRANEXAMIC ACID 1385/07/1535002,800100مختلف inj.)5ml( WATER 1385/07/15600510مختلف Inj.)5 ml( LIDOCAINE HCL %1385/07/15200019001مختلف

پخش mg/ml Inj. TRIAMCINOLONE ACETONIDE 1385/07/0613000300040دارو 1385/07/166855Eqto 50 mg Fe F .C. Tab. FERROUS SULFATEاسوه

هورمون )mg Tab. VITAMIN B6)PYRIDOXINE HCL 1385/07/13554540ایران

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)mg/10 ml Inj. FENTANYL)AS CITRATE 1385/07/1112200121000,5داروپخشاحمر 1385/07/08500005300050mg/ml Inj EDEDATE CALCIUM DISUDIUMهالل

احمر mg Cap. BETACAROTENE 1385/07/1586076015هالل Oral Drops MULTIVITAMIN 1385/07/1125001,320حکیم

Infu.1000ml DEXTROSE %1385/07/1573006,9005مختلف )mg/2 ml Inj CIMETIDIME)AS HCL 1385/07/1512501,000200مختلف

احمر mg/10ml For inj. MILRINONE 1385/07/0932420033540010هالل

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20% Infu.)50 ml( ALBUMIN)HUMAN(

mg/ml Syrup DIGOXIN % 1385/07/1798000820005رازیاحمر )mg For inj . CARMOSTINE)BICNU 1385/07/18187,000242,260100هالل

احمر Inj SODIUM TETRADECYL SULFATE %1385/07/18884095501هالل mg Tab. METOPROLOL TARTRARE 1385/07/2511012050داروپخش

سهامی )mg Tab. TRANYLCYPROMINE )AS SULFATE 1385/07/241450133710شرکتاحمر mg/10 ml Inj METHYLENEBLUE 1385/07/227760074,570100هالل

رازیرازیرازی

داروپخش

1385/05/081385/06/081385/07/161385/07/11

230000238500290000210000

223672205000

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احمر Sterile Eye Drops CYCLOPENTOLATE HCL %1385/07/2217,50018,0301هالل )1385/07/26445000400000200mg inj GEMCITABINE )GEMZARداروپخش )1385/07/26192000019000001g inj GEMCITABINE )GEMZARداروپخش

)1385/07/186500450075mg Tab. CLOPIDOGREL )PLAVIXاسوه

mg For Infu. CISPLATIN 1385/07/1815,0409,80010رازي mg For Infu. CISPLATIN 1385/07/18440402930050رازي

احمر mg Tab. OXANDROLONE 1385/07/2559206,9002/5هالل mg/4 ml Inj.)IM( CHLORPROMAZINE HCL 1385/07/2516001,30050مختلف

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1385/07/2550400,2mg Scored Tab. CLONIDINE HCIمختلف Infu 500 ml DEXTROSE %1385/07/2568006,10010مختلف Infu.500ml DEXTROSE %1385/07/2565005,3005مختلف Infu 500 ml DEXTROSE 5% NACI 0.9% 1385/07/2565005,300مختلف mg Supp. DICLOFENAC SODIUM 1385/07/25600525100مختلف mg Supp. DICLOFENAC SODIUM 1385/07/2548038550مختلف mg Coated Tab. DICYCLOMINE HCL 1385/07/25504010مختلف mg/2 ml Inj DICYCLOMINE HCL 1385/07/2512501,10020مختلف mg Tab. ISOSORBIDE DINITRATE 1385/07/25504010مختلف mg S . L. Tab. ISOSORBIDE DINITRATE 1385/07/2546375مختلف

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mg Scored.Tab LEVODOPA - C 1385/07/25600500100مختلف mg Scored.Tab LEVODOPA - C FORTE 1385/07/2514001,200250مختلف 1385/07/2562500,1mg Tab. LEVOTHYROXINE SODIUMمختلف mg Scored F .C. Tab METHYLDOPA 1385/07/25315250250مختلف U/ ml For Susp Drops NYSTATIN 1385/07/2542003,500100,000مختلف U Coated Tab. NYSTATIN 1385/07/25450400500,000مختلف mg/ml inj. PHENOBARBITAL SODIUM 1385/07/2513001,000200مختلف mg/ml Inj DIHYDROERGOTAMINE MESYLATE 1385/07/2513501,1001مختلف )mg F .C. Tab. ERYTHROMYCIN)AS ETHYLSUCCINATE 1385/07/251000800400مختلف 1385/07/2512501,00010mg/ml Inj ESTRADIOL. VALERATEمختلف

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mg Coated Tab. FLUPHENAZINE 2HCL 1385/07/2540311مختلف 1385/07/2560502,5mg Coated Tab. FLUPHENAZINE 2HCLمختلف mg Tab. FURAZOLIDONE 1385/07/257055100مختلف Sterile Eye Drops HOMATROPINE HBR %1385/07/2552004,0002مختلف mg/ml inj HYOSCINE .N. BUTYL BROMIDE 1385/07/2516001,30020مختلف mg/2 ml Inj IMIPRAMINE HCL 1385/07/2512501,00025مختلف Sterile Eye Drops PHENYLEPHRINE ZINC %1385/07/2527501,65010مختلف Scored.Tab PHENYTOIN COMPOUND 1385/07/25125100مختلف mg Cap. PHENYTOIN SODIUM 1385/07/25150120100مختلف Infu.)500ml( RINGER LACTATE 1385/07/2561005,700مختلف

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Infu.1000ml RINGER S 1385/07/2567006450مختلف Infu. 500 ml SODIUM CHLORIDE %1385/07/2557504,6000/9مختلف mg/10 ml Inj AMINOPHYLLNE 1385/07/2522501,800250مختلف )m g ped supp ACETAMINOPHEN)PARACETAMOL 1385/07/25420330125مختلف )mg Supp. ACETAMINOPHEN )PARACETAMOL 1385/07/25520410325مختلف Supp ANTIHEMORRHOID 1385/07/25500400مختلف mg/1 ml Inj ATROPINE SULFATE 1385/07/2512501,0000,5مختلف Tab. BELLADONNA PB 1385/07/255040مختلف mg Tab. BIPERIDEN HCL 1385/07/253302902مختلف mg Supp. BISACODYL 1385/07/2540030010مختلف

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mg E. C. Tab. BISACODYL 1385/07/2560485مختلف mg Tab. BROMHEXINE HCL 8 1385/07/255043مختلف Inj ) 10 ml( CALCIUM GLUCONATE %1385/07/2525002,00010مختلف

احمر g For inj. PRALIDOXIME CHLORIDE 1385/07/281100021,2001هالل Infu. 500ml RINGER S 1385/07/2560005000مختلف )mg F .C. Tab. ERYTHROMYCIN)AS ETHYLSUCCINATE 1385/07/25600500200مختلف mg/ml inj. MORPHINE SULFATE 1385/07/2512501,00010مختلف mg/ml Inj CHLORPHENIRAMINE MALEATE 1385/07/251350110010مختلف

g Inj.)IV( IMMUNE GLOBULIN 400000 1385/02/244000005رازی2035660

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2000002.5 g Inj.)IV( IMMUNE GLOBULIN رازییاب شفا

1385/02/242000001933000

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درماني خدمات بيمه سازمان تعهد مورد داروهاي قيمت فهرست

بيمه تعهد دارو شرط كد

فدير

Page 17

00583681بيمارستاني

0005658بيمارستاني 0005759بيمارستاني

متخصص 04485574تجويزتوسطمتخصص توسط 01415213تجويز

متخصص توسط 01738214تجويز

00746888متخصص توسط 01422237تجويز

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018771016بيمارستاني متخصص توسط 01329531تجويز






Page 19

متخصص توسط 011641422تجويز000969600165180001681820017619600190210

متخصص توسط 00303329تجويز003073320039247000620719

Page 20

0041847100753906بيمارستاني

009231108013571170

009951210بيمارستاني 010571284010581285

019491298بيمارستاني 010611288010941336

Page 21

011411400012001464012061475012161484012381512013111612

01573905بيمارستاني 01247152100531613012971594

Page 22


متخصص توسط 02111164تجويز0087110380041346300291312


Page 23


00439495متخصص توسط 00219236تجويزمتخصص توسط 011361415تجويز

توليد شرط 023191002به012411514


Page 24

0036741202136682انکولوژیست 02135683انکولوژیست

01788358

متخصص توسط 00301323تجويزمتخصص توسط 00302324تجويزمتخصص 018781128تجويزتوسط

00277299

مدت به استنت از 28بعدحداکثر و 90روز

يا روزباتجویزمتخصصتخصصقلب فوق

Page 25

00324357004114600041446200393469004274850042848400429489004314910071785100719850

Page 26

00747890007488910075189400832991009251107009261106009771196004404990049657000502580

Page 27

005536520055465300568670006307340065575800663777009921205009961207009931208011071345

Page 28

0110413480114413990006161000066000088000979500119126001361490016417800166183

Page 29

001671810017819700200220

016431259بيمارستاني 0110513470049556901600103200275294


Page 30


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20001,700 Syrup PEDIATRIC GRIPPE 8003104250 mg Scored F. C. Tab. PENICILLAMINE 19001,500 For inj. PENICILLINE 6-3-3 23001,5001,200,000 U For inj. PENICILLIN G BENZATHINE)PENICILLIN LA(

600,000 U For inj. PENICILLIN G BENZATHINE)PENICILLIN LA( 15001,250400,000 U For inj. PENICILLIN G PLUD PROCAINE 17501,400800,000 U For inj. PENICILLIN G PLUD PROCAINE

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2,0001,000,000 U For inj. PENICILLIN G POTASSIUM 60002,3005,000,000 U For inj. PENICILLIN G POTASSIUM 50003,993400,000 IU/5 ml For Susp PENICILLIN V BENZATHINE 37002,970200,000 IU/5 ml For Susp PENICILLIN V BENZATHINE 300250500 mg)800,000 U( F .C. Tab. PENICILLIN V POTASSIUM

2,900125 mg )200,000U(/5ml For Oral Sol,)100ml( PENICILLIN V POTASSIUM

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58004,700250 mg )400,000U(/5ml For Oral Sol,)100ml( PENICILLIN V POTASSIUM

0,2 mg/ml Inj.)2ml( PENTAGASTRIN -300 mg For inj. PENTAMIDINE ISOETHIONATE

1800145030 mg/ml inj. PENTAZOCINE)AS LACTATE( 73050 mg Tab. PENTAZOCINE HCL

1000929400 mg Tab. PENTOXFYLLINE

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0.5 lit Sol. PERITONEAL DIALYSIS I 1 lit Sol. PERITONEAL DIALYSIS I

900010,3002 lit Sol. PERITONEAL DIALYSIS I 0.5 lit Sol. PERITONEAL DIALYSIS II 1 lit Sol. PERITONEAL DIALYSIS II

900010,3002 lit Sol. PERITONEAL DIALYSIS II 0.5 lit Sol. PERITONEAL DIALYSIS III

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1 lit Sol. PERITONEAL DIALYSIS III 900010,3002 lit Sol. PERITONEAL DIALYSIS III

-1% w/w Cream)Rince( PERMETHRIN 1% )100 ml( Shampoo PERMETHRIN

480025001% )60 ml( Shampoo PERMETHRIN 40302 mg Coated Tab. PERPHENAZINE 45354 mg Coated Tab. PERPHENAZINE

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50418 mg Coated Tab. PERPHENAZINE 10008005 mg/ml inj. PERPHENAZINE 5341522050 mg/ml inj. 1 ml PETHIDINE HCL 5714559050 mg/ml Inj. 2 ml PETHIDINE HCL 275200100 mg F .C. Tab. PHENAZOPYRIDINE HCL 7370100 mg Tab. PHENOBARBITAL 363015 mg Tab. PHENOBARBITAL

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605060 mg Tab. PHENOBARBITAL 36100 mg/ml inj. PHENOBARBITAL SODIUM

13001,000200 mg/ml inj. PHENOBARBITAL SODIUM Bulk PHENOL

6 mg/ml inj. PHENOLSULFONPHTHALEIN 5450505710 mg Cap. PHENOXYBENZAMINE HCL 102201144010 mg/ml inj. PHENTOLAMINE MESYLATE

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14320010 mg/ml inj. PHENYLEPHRINE HCL

17001,5400,25% Nasal Drops PHENYLEPHRINE HCL 19001,6500,5% Nasal Drops PHENYLEPHRINE HCL 50002,3105% Sterile Eye Drops PHENYLEPHRINE HCL 27501,65010% Sterile Eye Drops PHENYLEPHRINE ZINC 45002,20030 mg/5 ml Susp. PHENYTOIN 125100 Scored.Tab PHENYTOIN COMPOUND

143200155400

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150120100 mg Cap. PHENYTOIN SODIUM 50 mg Cap. PHENYTOIN SODIUM

22002100250 mg/5 ml inj. PHENYTOIN SODIUM 1,8701% Top cream PHENYTOIN SODIUM

inj. PHOSPHATE POTASSIUM 1598760500 mg Tab. PHOSPHATE POTASSIUM MONOBASIC

- Bulk PHOSPHATE POTASSIUM MONOBASIC )KH2PO4(

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14001340 Eff .Tab. PHOSPHATE SODIUM - Bulk PHOSPHATE SODIUM DIBASIC)NA2HPO4( - Bulk PHOSPHATE SODIUM MONOBASIC)NAH2PO4(

730060001% Sterile Eye Drops PILOCARPINE HCL OR NITRATE 100004,1252% Sterile Eye Drops PILOCARPINE HCL OR NITRATE 170007,0954% Sterile Eye Drops PILOCARPINE HCL OR NITRATE 15521,5252 mg Scored.Tab PIMOZIDE

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27,9504 mg For inj. PIPECURONIUM BROMIDE 211645,7951 g For inj. PIPERACILLIN)AS SODIUM( 33500254502 g For inj. PIPERACILLIN)AS SODIUM( 14058500 mg Tab. PIPERAZINE HEXAHYDRATE

1,650583. 5 mg/5 ml Syrup PIPERAZINE HEXAHYDRATE)AS CITRATE ( 18,00011,00033/ 33% Liquid PIRACETAM 350193800 mg Scored F. C. Tab. PIRACETAM

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1008810 mg Cap. PIROXICAM 100075020 mg/ml Inj. PIROXICAM 37503,3000,5% w/w Top . Gel. PIROXICAM 1218801338000.5 mg inj.)Vacclne( PNEUMOCOCCAL VACCINE POLYVALENT

- Bulk PODOPHYLLIN - inj.)Vacclne( POLIOMYELITIS. TRIVALENT KILLED)SALK( - Oral.)Vacclne( POLIOVIRES VACCINE LIVE

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- Bulk POLYETHYLENE GLYCOL 3,284500,000 U For IV .Or For Ophth . Sol POLYMYXIN B SULFATE

4888011,480 Otic.Drops POLYMYXIN-NH - Bulk POLYSORBATE 80

65003,344100 mEo/50ml For infu. POTASSIUM CHLORIDE 1,25020 mEo/10ml For infu. POTASSIUM CHLORIDE

20 mEo/Sachel Powder POTASSIUM CHLORIDE

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50500 Mg Tab. POTASSIUM CHLORIDE SR 182 1g Bulk POTASSIUIM CITRATE - Bulk POTASSIUIM IODIDE - Bulk POTASSIUIM PERMANGANATE

21001,8001% Mouthwash POVIDONE IODINE -7/ 5% Shampoo)140 ml( POVIDONE IODINE

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-7/ 5% POVIDONE IODINE



20001,25010% Top.Oint. POVIDONE IODINE

SurglcalScrub 1000ml

SurgicalScrub 250ml

SurgicalScrub 3. 8liter

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40003,00010% TOP.SOL 60ml POVIDONE IODINE 40,00010% TOP.SOL 1000ml POVIDONE IODINE

100009,00010% TOP.SOL 250ml POVIDONE IODINE

140,00010% POVIDONE IODINE

180001200010% Vag.Douche POVIDONE IODINE 7000710010% Vag. gel)80 g( POVIDONE IODINE

TopSol 3,8liter

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1100021,2001 g For inj. PRALIDOXIME CHLORIDE 20502200600 mg Scored.Tab PRAZIQUANTEL 1301005 mg Scored.Tab PRAZOSIN)AS HCL( 75451 mg Tab. PRAZOSIN)AS HCL(

15010 mg Cap. PREDNIMUSTINE 54550 mg Cap. PREDNIMUSTINE

100 mg Scored.Tab PREDNIMUSTINE

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20 mg Scored.Tab PREDNIMUSTINE 10 mg Tab. PREDNIMUSTINE

16550 mg Tab. PREDNIMUSTINE

1005 mg Tab. PREDNISOLONE

500038001% Sterile Eye Drops PREDNISOLONE ACETATE MICROFINE 60050050 mg Scored.Tab PREDNISOLONE FORTE

7090

Page 49

1631 mg Tab. PREDNISONE 29250 mg Tab. PREDNISONE - Cartridge)Carpool( PRILOCAINE-F 3915 mg Tab. PRIMAQUINE)AS PHOSPHATE(

7/5 mg Tab. PRIMAQUINE)AS PHOSPHATE( 125 mg/5 ml Llquld PRIMIDONE

5000057000250 mg/5 ml Susp. PRIMIDONE

Page 50

220250 mg Tab. PRIMIDONE -500 mg Cap. PROCAINAMIDE HCL

42500835001000 mg/10 ml Inj. PROCAINAMIDE HCL 6400175050 mg Cap. PROCARBAZINE)AS HCL(

- Bulk PROGESTERONE 15501,25025 mg/ ml Inj. PROGESTERONE 17501,40050 mg/ ml Inj. PROGESTERONE

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1002925 mg Coated Tab. PROMETHAZINE HCL 130090025 mg/ ml Inj.1 ml PROMETHAZINE HCL 16001,30025 mg/ ml Inj.2 ml PROMETHAZINE HCL 20001,430113 mg/100 ml Syrup)60ml( PROMETHAZINE HCL

1 g For inj. PROPACETAMOL HCL 17001770150 mg Tab. PROPAFENONE HCL 30003050300 mg Tab. PROPAFENONE HCL

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10,6000/1% Sterile Eye Drops PROPAMIDINE ISETHIONATE

1003615 mg Coated Tab. PROPANTHELINE BROMIDE

341553107520 mg/ml inj. PROPOFOL 737007644450 mg/ml inj. PROPOFOL 402210 mg F .C. Tab. PROPRANOLOL HCL 16001,3001 mg/ ml inj. PROPRANOLOL HCL 453340 mg Scored F. C. Tab. PROPRANOLOL HCL

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3580 mg Scored F. C. Tab. PROPRANOLOL HCL -160 mg Tab. PROPRANOLOL HCL SR - Bulk PROPYLENE GLYCOL

18015550 mg Tab. PROPYLTHIOURACIL 104220011154400,5 mg/ml inj. PROSTAGLANDIN E1)ALPROSTADIL( 341350318,850 5 mg/0. 5 ml inj. PROSTAGLANDIN E2)DINOROSTONE(

Vag. gel PROSTAGLANDIN E2)DINOROSTONE(

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1483001385003 mg Vag Tab PROSTAGLANDIN E2)DINOROSTONE( 2880023,2201000 UAH /ml inj.)10ml( PROTAMINE SULFATE

-250 mg Coated Tab. PROTHIONAMIDE -125 mg Tab. PROTHIONAMIDE

1918001842000,2 mg/ml inj. PROTIRELIN)TRH( 2000180030 mg/5 ml Syrup PSEUDOEPHEDRINE HCL 605030 mg Tab. PSEUDOEPHEDRINE HCL

Page 55

50 mg Cap. PYGEUM AFRICANUM 3,500250 mg/5 ml Susp. PYRANTEL)AS PAMOATE(

125 mg Tab. PYRANTEL)AS PAMOATE( 160450500 mg Scored.Tab PYRAZINAMIDE 40041060 mg Coated Tab. PYRIDOSTIGMINE BROMIDE

11410 mg Tab. PYRIDOSTIGMINE BROMIDE 85077025 mg Tab. PYRIMETHAMINE

Page 56

-2% Shampoo)cream( PYRITHIONE ZINC -2% Shampoo)Lotion( PYRITHIONE ZINC

45020050 mg Coated Tab. PYRVINIUM)AS PAMOATE( 6,0005,00050 mg/5 ml Susp. PYRVINIUM)AS PAMOATE(

900100 mg Tab. QUINACRINE 2HCL 403318250 mg Tab. QUINIDINE BISULFATE)EO.TO200 mg SULFATE(SR 1560164200 mg Tab. QUINIDINE SULFATE

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250 mg/ ml Inj. QUININE 100 mg Cap. QUININE HCL 100 mg Tab. QUININE HCL 250 mg Tab. QUININE HCL

- Inj.)Vacclne( RABIES)FREEZE – DRIED KILLED VIRUS( HOC 114,356 Inj. RABIES IMMUNE GLOBULIN)HUMAN( - Inj.)Vacclne( RABIES VERO

Page 58

150130150 mg F .C. Tab. RANITIDINE)AS HCL( 12501,00025 mg/ ml Inj.)2ml( RANITIDINE)AS HCL(

60,1 mg Tab. RESERPINE - Bulk RESORCINOL)RESORCIN(

5003,080100mg Tab. RIBAVIRINE

725660200mg Tab. RIBAVIRINE

400340150 mg Cap. RIFAMPIN)REFAMPICIN(

Page 59

700630300 mg Cap. RIFAMPIN)REFAMPICIN( 166100138100600 mg For inj RIFAMPIN)REFAMPICIN( 50002,310153 mg/ml Oral Drop RIFAMPIN)REFAMPICIN( 61005,700 Infu.)500ml( RINGER LACTATE

Infu.)1000ml( RINGER LACTATE 60005000 Infu. 500ml RINGER S 67006450 Infu.1000ml RINGER S

Page 60

831 mg Tab. RISPERIDONE 1212 mg Tab. RISPERIDONE 10,20010 mg/ml Inj)5ml( RITODRINE HCL

2000184010 mg Scored.Tab RITODRINE HCL

20550166961.5 mg Tab RIVASTIGMINE )EXELON(

20550166961.5 mg Cap RIVASTIGMINE )EXELON(

Page 61

20550179963 mg Tab RIVASTIGMINE )EXELON(

20550179963 mg Cap RIVASTIGMINE )EXELON(

20550179964.5 mg Tab RIVASTIGMINE )EXELON(

20550179964.5 mg Cap RIVASTIGMINE )EXELON(

Page 62

20550179966 mg Tab RIVASTIGMINE )EXELON(

20550179966 mg Cap RIVASTIGMINE )EXELON(

- For inj.)vaccine( RUBELLA VIRUS VACCINE LIVE -13-16 mg Pellet SACCHARIN SODIUM

1500013,200100 mcg/dose Aerosol)200dose( SALBUTAMOL 10008000,5 mg/ml Inj)1ml( SALBUTAMOL)AS SULFATE(

Page 63

28752850 5 mg/ml Sol, For Inhalation SALBUTAMOL)AS SULFATE( 35002,1502 mg/5 ml Syrup SALBUTAMOL)AS SULFATE( 40252 mg Tab. SALBUTAMOL)AS SULFATE(

- Bulk SALICYLIC ACID -40 mg Plaster SALICYLIC ACID - Top Sol SALICYLIC ACID

308285000025 mcg/dose Inhaler SALMETEROL)AS XINAFOATE(

Page 64

50 mcg/dose Inhaler SALMETEROL)AS XINAFOATE( - Inj)diagnostic( SARCOIDOSIS TEST - Inj)diagnostic( SCHICK TEST

100 U For inj SECRETIN 7007705 mg Tab. SELEGILIN

-1% Shampoo)Lotion( SELENIUM SULFIDE -2.50% Shampoo)Lotion( SELENIUM SULFIDE

Page 65

2,010 SET OF SERUM - Bulk SILVER NITRATE -25 mg F .C. Tab. SILDENAFIL)AS CITRATE( -50 mg F .C. Tab. SILDENAFIL)AS CITRATE( -100 mg F .C. Tab. SILDENAFIL)AS CITRATE( - Bulk SILVER NITRATE STICKS

45002,86010 mg/g Top. Cream 50g SILVER SULFADIAZINE

Page 66

25,00010 mg/g Top. Cream 500g SILVER SULFADIAZINE 13001,100 Ophth Oint SIMPLE EYE OINT 1000120020 mg Scored.Tab SIMVASTATIN

- Sol For Contact Lens SOAKING 2,000500 mg Coated Tab. SODIUM AMINOSALICYLATE - Bulk SODIUM BICARBONATE

6500267507/5 % 50ML For Infu SODIUM BICARBONATE

Page 67

- Powder SODIUM CELLULOSE PHOSPHATE - Bulk SODIUM CHLORIDE

47003,9600/9% IRRIGATION 500 ml SODIUM CHLORIDE 67004,9500/9% IRRIGATION 1000 ml SODIUM CHLORIDE

12,0000/9% IRRIGATION 3000 ml SODIUM CHLORIDE 0/9% Infu. 100 ml SODIUM CHLORIDE

57504,6000/9% Infu. 500 ml SODIUM CHLORIDE

Page 68

65006,4000/9% Infu. 1000ml SODIUM CHLORIDE 1,870%0/65 Nasal Drops SODIUM CHLORIDE

32002,8605% Drop Opth SODIUM CHLORIDE 60003,0805% ViaL 50ml SODIUM CHLORIDE

5% ViaL 500ml SODIUM CHLORIDE 1,1005% Ophth. Oint. SODIUM CHLORIDE

0/45 % Infu.)500 ml( SODIUM CHLORIDE)1/2 NORMAL SALINE(

Page 69

650064000/45 % Infu.)1000 ml( SODIUM CHLORIDE)1/2 NORMAL SALINE( - Bulk. SODIUM CITRATE

3058001485001% Intraoccular Inj. SODIUM HYALURONATE

- Sol SODIUM HYPOCHLORITE

1/6 Molar Inj SODIUM LACTATE 668600300 mg / 10ml Inj SODIUM NITRITE

0,5%5)available chloride(

Page 70

110000141330454 g For Susp SODIUM POLYSTYRENE SULFONATE 300mg E.C.Tab SODIUM SALICYLATE

884095501% Inj SODIUM TETRADECYL SULFATE 955085703% Inj SODIUM TERADECYL SULFATE

- BuIk SODIUM THIOSULFATE )SODIUM HYPOSULFITE( 47380015420012.5 g - 50 ml For inj SODIUM THIOSULFATE )SODIUM HYPOSULFITE(

0/25 mg For inj SOMATOSTAIN

Page 71

118000349704 U For inj SOMATROPIN )OR BIOSYNTHESIS( 4002125 g/ Sachol Powder SORBITOL 75074580 mg Scored.Tab SOTALOL HCL

40 mg Tab. SOTALOL HCL 3971038550 2 g For inj SPECTINOMYCIN )AS 2HCL( 23822429500 mg Scored.Tab SPIRAMYCIN 25023025 mg Scored.Tab SPIRONOLACTONE

Page 72

750900100 mg Scored.Tab SPIRONOLACTONE - Bulk STARCH - Bulk STEARIC ACID

100 mg/ml Inj

250,000 IU For inj STREPTOKINASE

250000750,000 IU For inj STREPTOKINASE

STIBOGLUCONATE SODIUM )EQ.TO PENTAVALENT ANTIMONY(

12100058090

Page 73

22001,150 1 g For inj STREPTOMYCIN)AS SULFATE( 91000036,600 1 g For inj STREPTOZOCIN

-10% Toothpaste STRONTIUM CHLORIDE 2046029,860100 mg For inj)2( SUCCINYLCHOLINE CHLORIDE 2986046,8101000 mg For inj SUCCINYLCHOLINE CHLORIDE 2388018920500 mg For inj SUCCINYLCHOLINE CHLORIDE

100 mg/ml Inj)10 ml( SUCCINYLCHOLINE CHLORIDE

Page 74

50 mg/ml Inj)2 ml( SUCCINYLCHOLINE CHLORIDE 50 mg/ml Inj)10 ml( SUCCINYLCHOLINE CHLORIDE

-1 g/sachol For Susp SUCRALFATE 3001051 g Scored.Tab SUCRALFATE 15055500 mg Scored.Tab SUCRALFATE 7000069,00050 mcg/10 ml Inj SUFENTANIL)AS CTTRATE(

25001,67210% Sterile Eye Drops SULFACETAMIDE SODIUM

Page 75

27001,80420% Sterile Eye Drops SULFACETAMIDE SODIUM 700750500 mg Tab. SULFADIAZINE

Tab. SULFADOXINE-P 405450500 mg E .C. Tab. SULFASALAZINE

3 g/100 ml Enema SULFASALAZINE -10% Soap )100 g( SULFUR - Bulk SULFUR )PRECIPITATED(

Page 76

- Sol. For Hard Contact Lens TAM 26013010 mg Tab. TAMOXIFEN)AS CITRATE(

- Bulk TARTARIC ACID 9850091,75010 mg/ml Inj.)5ml( TENIPOSIDE

10,4501% Top. Cream TERBINAFINE HCL

2500250 mg scored Tab TERBINAFINE )AS HCL( 250027000

Page 77

0/ 5 mg/ml Inj. TERBUTALIN SULFATE 110855 mg Scored.Tab TERBUTALIN SULFATE

19,000 Sol. For Nebulisation TERBUTALIN 14560 mg Scored.Tab TERFENADINE

24002,200100 mg/ml Inj. TESTOSTERONE ENANTATE 42001,600250 mg/ml Inj. TESTOSTERONE ENANTATE

40 mg Cap. TESTOSTERONE UNDECANOATE

Page 78

Inj)Antitoxin( TETANUS ANTITOXIN EQUINE 7170082810 Inj. TETANUS IMMUNE GLOBULIN

- Inj Toxoid TETANUS TOXOUID ADSORBED)TT( 7800784025 mg Scored.Tab TETRABENAZINE

3,4401% Inj. TETRACAINE HCL 3,0002,0000,5% Sterile Eye Drops TETRACAINE HCL 6,0008,5301 mg/ml Inj. TETRACOSACTRIN

Page 79

195250 mg Cap. TETRACYCLINE HCL 240022001% Ophth oint TETRACYCLINE HCL 215018003% Top.Oint TETRACYCLINE HCL

52200 mg Scored.Tab THEOPHILLINE 110200 mg Cap THEOPHILLINE SR. 110200 mg Tab THEOPHILLINE SR.

100 mg Tab. THEOPHILLINE SR.

Page 80

30002,497120mg Syrup THEOPHILLINE G. 61600234500 mg Chewable.Tab THIABENDAZOLE

1106/5 mg Coated Tab. THIETHYLPERAZINE)AS OIMALEATE( 12501,0006/5 mg/ml Inj.)IM( THIETHYLPERAZINE)AS OIMALEATE( 9570987040 mg Tab. THIOGUANINE 17000155801 g For Inj THIOPENTAL SODIUM 1280011700500 mg For Inj THIOPENTAL SODIUM

Page 81

1006010 mg Coated Tab. THIORIDAZINE HCL 600250100 mg Coated Tab. THIORIDAZINE HCL 2009025 mg Coated Tab. THIORIDAZINE HCL 4501765 mg Cap. THIOTHIXENE

12,50010 U For Inj THYROTROPIN

18701,860250 mg Tab. TICLOPIDINE HCL

Page 82

3000 FCCU Tab. TILACTASE)LACTASE( 3,0000,5% Sterile Eye Drops TIMOLOL)AS MALEATE( - Bulk TITANIUM DIOXIDE - Lotion TITANIUM DIOXIDE

10 mg/ml Inj)2 ml( TOBRAMYCIN )AS SULFATE( 11,78640 mg/ml Inj)2 ml( TOBRAMYCIN )AS SULFATE( 5,08010 mg For Inj TOLAZOLINE HCL

Page 83

700550200 mg Tab. TOLMETIN)AS SODIUM( 1,6001% Top.Cream TOLNAFTATE 1,9001% Top.Sol TOLNAFTATE

5001,54025 mg Coated Tab. TOPIRAMATE 12005950100 mg Coated Tab. TOPIRAMATE 97001600200 mg Coated Tab. TOPIRAMATE

120050 mg/ml Inj)1 ml( TRAMADOL HCL

Page 84

1700120050 mg/ml Inj)2 ml( TRAMADOL HCL 500250 mg Cap. TRANEXAMIC ACID

28001,87050 mg/ml Inj )5 ml( TRANEXAMIC ACID 2,266100 mg/ml Inj )10 ml( TRANEXAMIC ACID

35002,800100 mg/ml Inj )5 ml( TRANEXAMIC ACID 500 mg Scored.Tab TRANEXAMIC ACID

1450133710 mg Tab. TRANYLCYPROMINE )AS SULFATE(

Page 85

25350 mg Scored F. C. Tab. TRAZODONE HCL - Bulk TRETINOIN

240020000,05% Top.Cream TRETINOIN 260024000,025% Top.Gel TRETINOIN

27000,05% Top.Gel TRETINOIN 30002,5000,05% sol TRETINOIN 13000300040 mg/ml Inj. TRIAMCINOLONE ACETONIDE

Page 86

32380 Oral Paste TRIAMCINOLONE ACETONIDE

24001,250 Top.Cream TRIAMCINOLONE ACETONIDE 24001,2000,1% Top Olnt TRIAMCINOLONE ACETONIDE 26001,700 Top Olnt TRIAMCINOLONE N.N 6050 Tab. TRIAMTERENE-H

250mg Tab. TRICLABENDAZOLE -1% Soap)100 g( TRICHLORICARBAN

35450

Page 87

45401 mg Coated Tab. TRIFLLOPERAZINE)AS 2HCL( 10 mg Coated Tab. TRIFLUOPERAZINE)AS 2HCL(

55502 mg Coated Tab. TRIFLUOPERAZINE)AS 2HCL( 65605 mg Coated Tab. TRIFLUOPERAZINE)AS 2HCL( 10008001 mg/ml Inj.)IM( TRIFLUOPERAZINE)AS 2HCL( 4500038,500%1% Sterile Eye Drops TRIFLURIDINE

5 mg Scored.Tab TRIHEXYPHENIDYL HCL

Page 88

40332 mg Tab. TRIHEXYPHENIDYL HCL 50 mg/ml Inj.)10 ml( TRIMETHAPHAN CAMSYLATE

66100 mg Scored.Tab TRIMETHOPRIM 800154100 mg Scored.Tab TRIMIPRAMINE)AS MALEATE( 2206125 mg Tab. TRIMIPRAMINE)AS MALEATE(

2,2004% Oral Drops TRIMIPRAMINE)AS MALEATE( 100005,500 Vag.Cream. TRIPLE SULFA

Page 89

450350 Vag.Tab. TRIPLE SULFA

2400003.75 mg For Inj TRIPTORELIN

60005,7750,5% Sterile Eye Drops TROPICAMIDE 100009,2401% Sterile Eye Drops TROPICAMIDE

20,8505 mg Cap. TROPESETRON)AS HCL( 49,7001 mg/ml Inj.)5 ml( TROPESETRON)AS HCL(

240000258280

Page 90

- Inj.)Diagnostic( TUBERCULIN PPD - Oral )Vacclne( TIPHOID - Bulk UREA -75 IU FST For Inj)IM( UROFOLLITROPIN

250,000 IU For Inj UROKINASE 11,65075,000 IU For Inj UROKINASE

22501990250 mg Tab. URSODEOXYCHOLIC ACID

Page 91

22501990250 mg Cap. URSODEOXYCHOLIC ACID - Powder)15 g( V.M.PROTEIN

330200 mg E .C. Tab. VALPROATE SODUIM

33002,750200 mg/5 ml Syrup)60 ml( VALPROATE SODUIM 20,000200 mg/5 ml Syrup)240 ml( VALPROATE SODUIM

500 mg E .C. Tab. VALPROATE SODUIM SR

210330

Page 92

2000016,500500 mg For Inj VANCOMYCIN)AS HCL( 500 mg/6 ml ForSusp.)120ml( VANCOMYCIN)AS HCL(

- inj.)vaccine( VARICELLA)CHICIKEN POX( 20 Pressor U/ml inj. VASOPRESSIN)OR LYPRESSIN(

907540 mg Coated Tab. VERAPAMIL.HCL. 12011080mg Coated Tab. VERAPAMIL.HCL.

2,4715 mg/2 ml inj. VERAPAMIL.HCL.

Page 93

240 mg F .C. Tab. VERAPAMIL.HCL.SR

360280CM VIBRIL

185001852010 mg For Inj VINBLASTINE SULFATE 1 mg For Inj , powder VINCRISTINE

11000111001 mg/ ml Inj VINCRISTINE

Page 94

17,3105 mg For Inj VINDESINE SULFATE 1064525,000 U Cap VITAMIN A 854525,000 U Coated Chewable Tab VITAMIN A 19012050,000 U Cap VITAMIN A 1406850,000 U Coated Chewable Tab VITAMIN A

-250 U/g Ophth.oint VITAMIN A -50000 U Amp VITAMIN A

Page 95

-50,000 U/ml Oral Drops)10 ml( VITAMIN A)RETINOL( 35001,775 Oral Drops VITAMIN A+D

- Top.Oint. VITAMIN A+D - Cap VITAMIN B COMPLEX - Coated Tab. VITAMIN B COMPLEX - Inj VITAMIN B COMPLEX - Syrup)60 ml( VITAMIN B COMPLEX

Page 96

8060100 mg Scored.Tab VITAMIN B1)THIAMINE HCL( 190140300 mg Tab. VITAMIN B1)THIAMINE HCL(

-100 mcg/ml Inj VITAMIN B12)CYANOCOBALAMIN( 5 mg/ml inj.)2ml( VITAMIN B1)RIBOFLAVIN(

1100800150 mg/ml inj.)2ml( VITAMIN B6)PYRIDOXINE HCL( 105079050 mg/ml inj.)2ml( VITAMIN B6)PYRIDOXINE HCL( 554540 mg Tab. VITAMIN B6)PYRIDOXINE HCL(

Page 97

-1000 mg Eff.Tab. VITAMIN C)ASCORBIC ACID( -100 mg/ml inj.)5ml( VITAMIN C)ASCORBIC ACID( -500mg/Sachel Powder VITAMIN C)ASCORBIC ACID( -100 mg Tab. VITAMIN C)ASCORBIC ACID( -250 mg Tab. VITAMIN C)ASCORBIC ACID( 20050,000 U Cap. VITAMIN D3 )COLECALCIFEROL(

12501,000300,000 U inj. VITAMIN D3 )COLECALCIFEROL(

Page 98

-100 IU Coated Tab. VITAMIN E -100 IU inj. VITAMIN E -50 IU/ml Oral Drops VITAMIN E

70025710 mg F .C. Tab. VITAMIN K)PHYTONADIONE( 110090010 mg/ml inj. VITAMIN K)PHYTONADIONE( 10008001 mg/0.5ml inj.)0.5ml( VITAMIN K)PHYTONADIONE( 3701085 mg Scored.Tab WARFARIN SODIUM

Page 99

2.5 mg Scored.Tab WARFARIN SODIUM inj.)2ml( WATER

320 inj.)3ml( WATER 600510 inj.)5ml( WATER

- Sol. For WETTING - Bulk WHITE WAX - inj.)vaccine( YELLOW FEVER VACCINE

Page 100

-2 mg Tab. YOHIMBIN HCL 2,000100 mg Cap. ZIDOVUOINE

400013,350300 mg Cap. ZIDOVUOINE 50 mg/5ml Syrup ZIDOVUOINE

- Bulk ZINC OXIDE 35002750%20% Top.Oint ZINC OXIDE

- Bulk ZINC SULFATE

Page 101

7560220 mg Cap. ZINC SULFATE

Page 102


009681156009581157016281158009611159009621160

Page 103

009591161009601162009651163009641164009661165

016291166

Page 104

009631167

متخصص توسط 009691168تجويزأي بيمه 016301169غير

013571170013561171


Page 105

006881173بيمارستاني 006891174بيمارستاني 006901175بيمارستاني 006911176بيمارستاني 006921177بيمارستاني 006931178بيمارستاني 015481179بيمارستاني

Page 106


توليد شرط 016321182به016311183017791184009721185009731186

Page 107

009751187009741188013541189013551190009761191009791192009801193

Page 108

009821194016331195009771196009831197016341198

متخصص توسط 009841199تجويز009861200بيمارستاني

Page 109

016351201

009881202009891203009911204009921205009941206009961207

Page 110

009931208016371209

009951210بيمارستاني 009971211


009991214

Page 111

متخصص توسط 023971215تجويز010011216010001217010061218010071219010081220


Page 112

019621222بيمارستاني 010101223بيمارستاني 010111224بيمارستاني

010131225010121226

متخصص توسط 010151227تجويزمتخصص توسط 010141228تجويز

Page 113

010171229010181230010161231

متخصص توسط 010201232تجويزمتخصص توسط 010211233تجويزأي بيمه 016391234غيرأي بيمه 016401235غير

Page 114

أي بيمه 010221236غيرپزشك وباتجويزچشم 010231237بيمارستاني

010241238010251239009411240016411241021751242

Page 115

توليد شرط 010271243بهمتخصص توسط 010281244تجويز

010291245010301246010371247

أي بيمه 016421248غير

Page 116




010391252

Page 117




018431257010381258

Page 118


010431261010421262

متخصص توسط 021761263تجويزمتخصص توسط 021771264تجويزمتخصص توسط 016451265تجويز

Page 119


010451269

010461270010441271

Page 120

021781272010481273

أي بيمه 010491274غير010501275016491276016501277010521278

Page 121

010511279توليد شرط 023981280به


أي بيمه 010561283غير010571284010581285

Page 122

010621286020951287010611288010601289

توليد شرط 010631290بهمتخصص توسط 017771291تجويزمتخصص توسط 017781292تجويز

Page 123


010661294


010671297019491298بيمارستاني

010681299

Page 124

010691300توليد شرط 016541301به

010711302010721303


Page 125

متخصص توسط 004511307تجويز010731308بيمارستاني أي بيمه 016571309غيرأي بيمه 016561310غير

متخصص توسط 010741311تجويز010761312010751313

Page 126

توليذ شرط 016591314به021811315021801316010781317010801318010791319010831320

Page 127

أي بيمه 020971321غيرأي بيمه 010841322غير

010861323010851324016601325010871326010881327

Page 128

010911328020421329010891330010901331

أي بيمه 016611332غير010921333


Page 129

010931335010941336010951337010961338



011011341

Page 130

011031342011001343بيمارستاني

011021344011071345011061346011051347011041348

Page 131

متخصص توسط 017731349تجويزمتخصص توسط 017741350تجويزمتخصص توسط 011091351تجويزمتخصص توسط 011081352تجويز

019021353

019981354

و اعصاب و متخصصمغزدرمان برای فقط روانپزشکی

و آلزایمر اعصاب و متخصصمغزدرمان برای فقط روانپزشکی

آلزایمر

Page 132

019031355

019991356

019041357

020001358





آلزایمر

Page 133

019311359

027381360


011151363011131364بيمارستاني



آلزایمر

Page 134

016671365بيمارستاني 011121366011141367011161368

أي بيمه 016691369غير016681370


Page 135

متخصص توسط 011181372تجويزأي بيمه 016701373غيرأي بيمه 016711374غير

متخصص توسط 011201375تجويز011211376


Page 136

666611379011261380

أي بيمه 020981381غيرأي بيمه 017811382غيرأي بيمه 017801383غير

أي بيمه 011271384غير011301385

Page 137

011281386011341387


016741390011381391011401392

Page 138

016751393011501394011451395011421396011431397024591398011441399

Page 139

011411400011461401011471402011481403 _1404011101405

توليد شرط 021861406به

Page 140

توليد شرط 011491407به011511408

متخصص تجويز با و 016761409بيمارستاني



Page 141

011561413016801414




Page 142

انديكاسيون ذكر با متخصص توسط 011611420تجويز011621421


011661424011681425011691426

Page 143

توليد شرط 020991427به011701428011711429

013241430



Page 144


أي بيمه 011751435غير016811436بيمارستاني 011761437بيمارستاني 011771438بيمارستاني 024021439بيمارستاني

Page 145


توليد شرط 021881442بهتوليد شرط 011781443به

011791444013661445

011801446

Page 146

011811447011821448016821449011831450


011851453

Page 147

أي بيمه 016851454غير011931455011941456



Page 148

016861460011981461

016871462بيمارستاني 011991463012001464012011465


Page 149

016881467012021468

أي بيمه 016891469غيرمتخصص توسط 012031470تجويز



Page 150

012071474012061475012081476012101477022031478012091479


Page 151

012111481012141482012151483012161484

متخصص توسط 012171485تجويز012181486بيمارستاني 012191487بيمارستاني

Page 152

012201488012211489012221490012231491


012251493متخصص توسط تجويز

) داخی یا وعروق )قلب

Page 153

توليد شرط 016941494به012261495

أي بيمه 012281496غيرأي بيمه 021041497غير021891498بيمارستاني 012291499بيمارستاني


Page 154

012341501012351502012361503

مغزواعصاب متخصصین توسط 018851504تجويزمغزواعصاب متخصصین توسط 018831505تجويزمغزواعصاب متخصصین توسط 018841506تجويز

020131507

Page 155

020131508012391509012401510021051511012381512

توليد شرط 021061513به012411514

Page 156


012451517012441518

توليد شرط 016961519به012461520012471521

Page 157

012501522

012481523012491524012511525012521526016971527


Page 158

012531529توليد شرط 021911530به

012551531012561532012541533

متخصص توسط 012571534تجويزتوليد شرط 016981535به

Page 159

012581536012621537بيمارستاني

012631538012591539012601540012611541012641542

Page 160

012651543


متخصص توسط 012671545تجويزمتخصص توسط 017421546تجويزمتخصص توسط 016991547تجويزمتخصص توسط 012681548تجويز

Page 161


012691551أي بيمه 012701552غير012711553بيمارستاني 012721554بيمارستاني


Page 162


012751558

017241559028051560


Page 163


أي بيمه 017041564غير012771565بيمارستاني

012791566توليد شرط 017061567به

012801568

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یا , و عمومی جراح ارتوپدتخصص وسایر عمومی پزشکدی - بیمارستان مهر با ها

درمانگاه- کلینیک

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متخصص توسط 012851574تجويز013721575012871576013711577012891578


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توليد شرط 017081581به012901582

أي بيمه 012911583غيرأي بيمه 021951584غيرأي بيمه 001271585غيرأي بيمه 001251586غيرأي بيمه 001241587غير

Page 167

012921588012931589

أي بيمه 017461590غيرمتخصص توسط 017091591تجويز

012961592012951593012971594

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أي بيمه 012981595غيرأي بيمه 013011596غيرأي بيمه 013001597غيرأي بيمه 021961598غيرأي بيمه 012991599غير

013041600018141601

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أي بيمه 013051602غيرأي بيمه 013061603غيرأي بيمه 013081604غير

010051605010031606010041607013091608

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021991609013101610013701611013111612

أي بيمه 017101613غير013121614


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أي بيمه 013731616غيرمتخصص توسط 013141617تجويزمتخصص توسط 050781618تجويزمتخصص توسط 017121619تجويز

013151620013161621013171622

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013181623

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1385-08-01 N226