NOMBRE: JUDITH ACOPA FLORES

MEDICO: DRA. MARIA RUBI MONTOYA GOMEZ

Articulo Cant. P. U. Importe IVA Total

QUIROFANO

1 PRIMER HORA DE QUIROFANO 1.00 1,149.13 1,149.13 183.86 1,332.99

SUBTOTAL QUIROFANO: 1,149.13 183.86 1,332.99

HOSPITALIZACION

1 ESTANCIA HOSPITALARIA 1.00 1,982.76 1,982.76 317.24 2,300.00

SUBTOTAL HOSPITALIZACION: 1,982.76 317.24 2,300.00

MEDICAMENTOS

SOL1 AGUA INYECTABLE 500 ML FCO 2.00 69.60 139.20 0.00 139.20

MED35 BUVACAINA PESADA 15MG/3ML 1.00 174.00 174.00 0.00 174.00

PISA

MED22 CEFTRIAXONA 1.0 G PISA 1.00 290.00 290.00 0.00 290.00

MED22 CEFTRIAXONA 1.0 G PISA 1.00 290.00 290.00 0.00 290.00

MED52 DEXAMETASONA 8MG/2ML PISA 1.00 100.00 100.00 0.00 100.00

MED104 GLUCONATO DE CALCIO 10ML 1.00 81.20 81.20 0.00 81.20

MED91 KETOROLACO 30MG/1ML PISA 2.00 92.80 185.60 0.00 185.60

MED91 KETOROLACO 30MG/1ML PISA 1.00 92.80 92.80 0.00 92.80

MED91 KETOROLACO 30MG/1ML PISA 1.00 92.80 92.80 0.00 92.80

MED75 METOCLOPRAMIDA 10MG/2ML PISA 1.00 81.20 81.20 0.00 81.20

MED75 METOCLOPRAMIDA 10MG/2ML PISA 1.00 81.20 81.20 0.00 81.20

MED121 OXITOCINA 5UL/1ML (OXITOPISA) 8.00 50.00 400.00 0.00 400.00

MED123 ROPIVACAINA 7.5MG/ML 1.00 400.00 400.00 0.00 400.00

(ROPICONEST)

SOL6 SOLUCION FISIOLOGICA 100 ML 1.00 70.00 70.00 0.00 70.00

SOL6 SOLUCION FISIOLOGICA 100 ML 1.00 70.00 70.00 0.00 70.00

SOL5 SOLUCION FISIOLOGICA 250 ML 1.00 80.00 80.00 0.00 80.00

SOL8 SOLUCION HARMAN 1000 ML 1.00 120.00 120.00 0.00 120.00

SOL8 SOLUCION HARMAN 1000 ML 1.00 120.00 120.00 0.00 120.00

SOL15 SOLUCION MIXTA 1000 ML 1.00 120.00 120.00 0.00 120.00

MED144 XYLOCAINA AL 2% (PISACAINA) 1.00 80.00 80.00 0.00 80.00

MED91 KETOROLACO 30MG/1ML PISA 1.00 92.80 92.80 0.00 92.80

MED91 KETOROLACO 30MG/1ML PISA 1.00 92.80 92.80 0.00 92.80

SUBTOTAL MEDICAMENTOS: 3,253.60 0.00 3,253.60

MATERIAL

5 AGUJA NEGRA 22G X 1 1/4 1.00 12.93 12.93 2.07 15.00

4 AGUJA ROSA 18G X 38 MM 2.00 17.00 34.00 5.44 39.44

10 AGUJA WHITACRE 25 LARGA 1.00 301.72 301.72 48.28 350.00

388 APOSITOS ESTERILES 1.00 38.79 38.79 6.21 45.00

388 APOSITOS ESTERILES 1.00 38.79 38.79 6.21 45.00

388 APOSITOS ESTERILES 1.00 38.79 38.79 6.21 45.00

27 BOLSA CISTOFLO (UREOTEK) 1.00 112.07 112.07 17.93 130.00

26 BOMBA HOME PUMP DE 125 ML 1.00 818.97 818.97 131.04 950.00

40 BRAZALATE IDENTIFICACION 1.00 43.10 43.10 6.90 50.00

ADULTO BLANCO

397 CEPILLO QUIRURGICOS 4.00 60.35 241.40 38.62 280.02

485 COMPRESA ESTERIL 1.00 327.59 327.59 52.41 380.00

55 CONECTOR SIMS GRUESO MCA 1.00 34.48 34.48 5.52 40.00

KORTEX

508 CUBREBOCAS TRICAPA 2.00 8.62 17.24 2.76 20.00

63 ENVASE PARA MUESTRA 1.00 34.48 34.48 5.52 40.00

64 EQUIPO P/VENOCLISIS S/A 1.00 51.72 51.72 8.28 60.00
FLEBOTEK

119 GASA S/TRAMA PROTEC 1.00 43.10 43.10 6.90 50.00

119 GASA S/TRAMA PROTEC 1.00 43.10 43.10 6.90 50.00

119 GASA S/TRAMA PROTEC 1.00 43.10 43.10 6.90 50.00

68 GUANTE ESTERIL 6 1/2 2.00 60.35 120.70 19.31 140.01

70 GUANTE ESTERIL 7 1/2 2.00 60.35 120.70 19.31 140.01

69 GUANTE ESTERIL 8 2.00 60.35 120.70 19.31 140.01

73 GUANTE ESTERIL P/EXPLORACION 4.00 25.86 103.44 16.55 119.99

73 GUANTE ESTERIL P/EXPLORACION 6.00 25.86 155.16 24.83 179.99

73 GUANTE ESTERIL P/EXPLORACION 6.00 25.86 155.16 24.83 179.99

74 GUANTE NO ESTERIL 4.00 21.55 86.20 13.79 99.99

P/EXPLORACION

131 HOJA DE BISTURI NO. 21 1.00 25.86 25.86 4.14 30.00

97 JERINGA 10ML 3.00 30.17 90.51 14.48 104.99

97 JERINGA 10ML 1.00 30.17 30.17 4.83 35.00

99 JERINGA 20 ML 1.00 34.48 34.48 5.52 40.00

99 JERINGA 20 ML 2.00 34.48 68.96 11.03 79.99

98 JERINGA 3ML 1.00 25.86 25.86 4.14 30.00

96 JERINGA 5ML 1.00 25.86 25.86 4.14 30.00

100 JERINGA DE INSULINA 1ML 1.00 30.17 30.17 4.83 35.00

87 LAPIZ DE ELECTRO 1.00 215.52 215.52 34.48 250.00

512 MICROCLAVE SELLO 1.00 86.21 86.21 13.79 100.00

300 MONOCRYL 3-0 24MM ETHICON 1.00 413.79 413.79 66.21 480.00

175 PAÑAL PARA ADULTO CUBRECAMA 1.00 68.97 68.97 11.04 80.01

175 PAÑAL PARA ADULTO CUBRECAMA 1.00 68.97 68.97 11.04 80.01

175 PAÑAL PARA ADULTO CUBRECAMA 1.00 68.97 68.97 11.04 80.01
175 PAÑAL PARA ADULTO CUBRECAMA 1.00 68.97 68.97 11.04 80.01

66 PERIFIX NO. 18 1.00 517.24 517.24 82.76 600.00

160 PUNZOCAT ROSA NO. 20 1.00 68.97 68.97 11.04 80.01

161 PUNZOCAT VERDE NO. 18 1.00 68.97 68.97 11.04 80.01

167 RASTRILLO DESECHABLE 1.00 51.72 51.72 8.28 60.00

189 SONDA FOLEY NO. 16 1.00 129.31 129.31 20.69 150.00

504 TEGADERM I.V. 1.00 68.97 68.97 11.04 80.01

217 TIRAS REACTIVAS P/GLUCOMETRO 1.00 30.17 30.17 4.83 35.00

ACCU-CHEK P

369 TUBO PARA ASPIRAR 2.00 73.28 146.56 23.45 170.01

235 VENDA ELASTICA 10CM 2.00 30.17 60.34 9.65 69.99

239 VENDA ELASTICA 30CM 1.00 43.10 43.10 6.90 50.00

239 VENDA ELASTICA 30CM 1.00 43.10 43.10 6.90 50.00

119 GASA S/TRAMA PROTEC 1.00 43.10 43.10 6.90 50.00

73 GUANTE ESTERIL P/EXPLORACION 2.00 25.86 51.72 8.28 60.00

97 JERINGA 10ML 1.00 30.17 30.17 4.83 35.00

175 PAÑAL PARA ADULTO CUBRECAMA 1.00 68.97 68.97 11.04 80.01

SUBTOTAL MATERIAL: 5,883.11 941.30 6,824.41

TIPO DE PAGO IMPORTE

TRANSFERENCIA 13,711.00