Meds PR

Republic of the Philippines PR-003-1
Department of Health
CAGAYAN VALLEY MEDICAL CENTER
Dalan Na Pagayaya, Regional Government Center
Carig Sur, Tuguegarao City, Cagayan
PURCHASE REQUEST
METRODRUG INC Fund Cluster: __________________
Office/Section : PR No.: M-2018-01-089 Date: January 09, 2018

PHARMACY
SECTION
Responsibility Center Code : ___________
Stock/
Property Unit Item Description Quantity Unit Cost Total Cost
No.
Levofloxacin 5mg/ml solution for IV infusion, 100ml vial,
DM-76 vial 25 250 6,250.00
LOXEVA
DM-96 vial Oxacillin 500mg, WYDOX 750 23.00 17,250.00
Amlodipine 5mg tablet (as Besylate or Camsylate),
DM-120 tab 2,500 1.08 2,700.00
AMLODAC
Losartan + Hydrochlorothiazide 50mg +12.5mg tablet,
DM-191 tab 1,000 1.29 1,290.00
LOSACAR
DM-288 tab Chlorpromazine 100mg tablet (as HCl), ZYCLORAN 10,000 1.51 15,100.00
DM-289 tab Chlorpromazine 200mg tablet (as HCl), ZYCLORAN 23,750 2.13 50,587.50
DM-292 tab Clonazepam 2mg tablet, CLONOTRIL-2 7,500 9.97 74,775.00
DM-293 tab Clozapine 100mg tablet, CLOPIXENE 15,000 5.50 82,500.00
DM-367 tab Olanzapine 10mg tablet, OLANDUS-10 5,000 9.92 49,600.00
DM-393 tab Quetiapine 25mg tablet, QTIPINE 200 19.00 3,800.00
Silver Sulfadiazine Cream 1% 500g jar (micronized),
DM-405 jar 2 895.00 1,790.00
SILVEDERMA
DM-436 vial Cyclophosphamide 1g vial (IV), CYPHOS-1 150 350.00 52,500.00
********************************
Winning Bidder, Public Bidding CY 2017 358,142.50
BASED ON APP CY 2018
Purpose: FOR USE IN CVMC - PHARMACY SECTION
_______________________________________________________________
Requested by: Approved by:

Signature :
Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Designation : CHIEF MEDICAL PROFESSIONAL STAFF II MEDICAL CENTER CHIEF II
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-437 vial Cyclophosphamide 500mg vial (IV), CYPHOS-500 100 254.00 25,400.00
DM-442 vial Docetaxel 20mg/0.5ml, 0.5ml (IV infusion), VEXDO20 20 820.00 16,400.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-445 vial Doxorubicin powder 50mg vial (IV) (as HCl), DOXVEX50 100 594.75 59,475.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
GETZ BROS. PHIL. INC. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Clarithromycin 125mg/5ml, 70ml granules/powder for
DM-39 bot 50 185.00 9,250.00
suspension, CLARIGET
Co-Amoxiclav 250mg/62.5mg/5ml,60ml granules/powder
DM-50 bot 50 180.00 9,000.00
for suspension, AUGET
Co-Amoxiclav 400mg/57mg/5ml,70ml granules/powder
DM-51 bot 50 190.00 9,500.00
for suspension, AUGET
DM-133 tab Candesartan 8mg, ATASART 125 10.84 1,355.00
DM-138 tab Carvedilol 6.25mg, XICARD 1,500 2.27 3,405.00
Isophane Insulin Human (intermediate, acting, Neutral)
DM-182 vial 10 205.91 2,059.10
inj. 100IU/ml, 10ml vial (IM,SC), INSUGET-N
Losartan + Hydrochlorothiazide 100mg +25mg tablet,
DM-190 tab 500 7.36 3,680.00
GETZAR PLUS
DM-231 tab Simvastatin 40mg tablet, SIMVOGET 1000 4.00 4,000.00
DM-338 bot Lactulose 3.3g/5ml (66% syrup), 120ml bottle, LILAC 200 80.00 16,000.00
********************************
BASED ON PPMP CY 2018
*Re-PR 01/09/18

_______________________________________________________________

Signature :

PURCHASE REQUEST
DYNASTY PHARMACEUTICAL Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-21 vial Cefepime 1g vial (IM,IV) (as Hcl), SEFPIME 300 180.00 54,000.00
Ceftriaxone 1g vial (as Disodium/ Sodium salt),
DM-28 vial 2,000 20.00 40,000.00
GENERIC
DM-33 vial Cefuroxime 750mg vial (IM,IV) (as Sodium salt) 1,000 20.00 20,000.00
Tramadol 50mg/ml, 2ml ampule (IM,IV, SC) (as HCl),
DM-423 amp 4,000 10.00 40,000.00
DYNATRAM
********************************
Winning Bidder, Public Bidding CY 2017
BASED ON APP CY 2018 154,000.00

_______________________________________________________________

Signature :

PURCHASE REQUEST
RBC-MDC CORPORATION Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Cefuroxime 250mg/5ml, 70ml granules/suspension (as

DM-31 bot 50 243.25 12,162.50
Axetil), SUNCETIN-250
********************************
*Re-PR 01/09/18

_______________________________________________________________

Signature :

PURCHASE REQUEST
OXFORD Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Cetirizine 1mg/ml syr, 60ml (as Dihydrochloride),
DM-286 bot 50 38.73 1,936.50
GENERIC
DM-343 tab Loratadine 10mg, GENERIC 500 1.70 850.00
DM-429 bot Zinc 20mg/5ml syr, IMMUZINE 50 41.00 2,050.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
MARK ERICSON ENT. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-325 amp Hydroxyzine 50mg/ml, 1ml (IM,IV), DROXIEM 200 495.00 99,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
GENACE PHARMA Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-433 tab Capecitabine 500mg tablet, CETAGEN500 100 62.00 6,200.00
DM-451 vial Gemcitabine 200mg vial, OMNICURE 50 795.00 39,750.00
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_______________________________________________________________

Signature :

PURCHASE REQUEST
NATRAPHARM Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-127 tab Atorvastatin 40mg tablet, ATORVAST 1,500 20.00 30,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
VIZCARRA PHARMACEUTICAL INC. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-323 vial Human Albumin 20%, 50ml, ALBUMAX 50 2175.00 108,750.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
GOOD FELLOW PHARMA Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
prefilled Epoetin Alfa 10,000 IU/ml, IV,SC (Recombinant human
DM-305 20 1280.00 25,600.00
syringe erythropoetin), EPOSINO
********************************
*Re-PR 01/09/18

_______________________________________________________________

Signature :

PURCHASE REQUEST
SERAPH ENTERPRISES Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-69 bot Isoflurane 100ml, ISORANE 25 1975.00 49,375.00
Hydroxyethyl starch 6% solution 500ml bottle (IV

DM-480 bot 200 580.00 116,000.00
infusion), NIRHES 130
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_______________________________________________________________

Signature :

PURCHASE REQUEST
SANNOVEX PHARMA INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-178 Hydrocortisone 125mg/ml, 2ml vial (IV) (as Sodium

vial 500 140.00 70,000.00
Succinate) act o vial, HYDROVEX
Hydrocortisone 50mg/ml, 2ml vial (IV) (as Sodium
DM-179 vial 1,500 75.00 112,500.00
Succinate) act o vial, HYDROVEX
********************************
remarks: unapproved, more than stocks

_______________________________________________________________

Signature :

PURCHASE REQUEST
QUALIFIRST HEALTH INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-52 tab Co-Amoxiclav 625mg (As Trihydrate), AGCOMEN 2,500 7.80 19,500.00
DM-87 vial Metronidazole 5mg/ml, 100 ml IV infusion, GENERIC 2,000 15.77 31,540.00
********************************
*Re-PR 01/09/18

_______________________________________________________________

Signature :

PURCHASE REQUEST
EUROMED Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-78 polyamp Lidocaine 2%, 5ml (asHCI), EUROCAINE 2,000 11.00 22,000.00
DM-130 nebule Budesonide 250mcg/ml, 2ml (unit dose), BROMEX 200 24.00 4,800.00
DM-278 ampule Calcium Gluconate 10%, 10ml (IV), GENERIC 100 19.00 1,900.00
Potassium Chloride 2mEq/ml, 20ml (IV infusion),
DM-387 vial 1,250 26 32,500.00
GENERIC
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
PHIL PHARMAWEALTH Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-01 tab Aciclovir 400mg tablet, CICLOX 500 13.11 6,555.00
DM-19 vial Cefazolin 1g vial (IM,IV) (as Sodium salt), GENERIC 1000 21.22 21,220.00
DM-26 vial Cefoxitin 1g vial (IM,IV) (as Sodium salt), HAXOTIN 2000 99.44 198,880.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Water for injection (triple distilled water), 50ml vial,
DM-484 vial 3,000 17.88 53,640.00
GENERIC
Dextrose 5% in Lactated Ringers 1000ml (Pink),
DM-475 set 6,000 45.00 270,000.00
GENERIC
DM-482 set Plain Lactated Ringers Solution 1000ml (Blue), GENERIC 3,600 45.00 162,000.00
********************************
BASED ON APP CY 2018 485,640.00

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-07 cap Amoxicillin 500mg/cap. (as Trihydrate), HARBIMOX 2500 1.16 2,900.00
Chloramphenicol 1g vial (IM,IV) (as Sodium Succinate),
DM-35 vial 200 27.88 5,576.00
KLORFEN
Epinephrine 1:1000 1mg/ml, 1ml amp (IM,SC) (as
DM-159 amp 2000 37.22 74,440.00
Hydrochloride), GENERIC
Epoetin Alfa 4,000 IU/ 0.4ml, prefilled syringe IV,SC
DM-304 amp/vial 500 269.44 134,720.00
(Recombinant human erythropoetin), EPOGEN
********************************
BASED ON APP CY 2018 217,636.00

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Ciprofloxacin 500mg tablet (as Hydrochloride),

DM-37 tab 2500 1.24 3,100.00
CIPRODEX
DM-166 amp Furosemide 10mg/ml, 2ml amp (IM,IV), GENERIC 6000 6.48 38,880.00
Ketorolac 30mg/ml, 1ml (IM,IV) (asTrometamol),
DM-337 amp 6000 21.44 128,640.00
KETRAL
********************************
BASED ON APP CY 2018 170,620.00

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-123 tab Aspirin 80mg tablet, GENERIC 1000 0.88 880.00
DM-375 vial Paracetamol 150mg/ml, 2ml (IM,IV), FEBRINIL 12500 6.33 79,125.00
Ranitidine 25mg/ml, 2ml amp(IM,IV, IV infusion) (as HCl),
DM-396 amp 500 3.89 1,945.00
ZANTOL
********************************
BASED ON APP CY 2018 81,950.00

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-273 supp Bisacodyl 10mg adult suppository, DULXATIVE 1000 22.32 22,320.00
DM-279 tab Carbamazepine 200mg tablet, TEGREPIN 7500 2.11 15,825.00
DM-306 tab Escitalopram 10mg tab (as oxalate), ESCAPRO 5000 4.74 23,700.00
DM-348 tab Mefenamic Acid 500mg cap/tab, FENAMAX 15000 0.52 7,800.00
DM-377 tab Paracetamol 500mg tablet, FEBRIL-FREE 4,000 0.27 1,080.00
DM-457 vial Paclitaxel 100mg vial, PACLIZEL 200 1,198.22 239,644.00
DM-458 vial Paclitaxel 30mg vial, PACLIZEL 100 398.33 39,833.00
DM-427 tab Vitamin B Complex, BERNAOIN 10,000 1.67 16,700.00
********************************
BASED ON APP CY 2018 366,902.00

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-483 set Plain NSS 1000ml (Green), GENERIC 10,800 41.99 453,492.00
********************************

BASED ON APP CY 2018 453,492.00

_______________________________________________________________

Signature :

PURCHASE REQUEST
MPA PHARMACARE Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-86 tab Metronidazole 500mg tablet, METROZOLE 4,500 1.28 5,760.00
DM-266 tab Ascorbic Acid 500mg tablet, VITCEE 15000 0.78 11,700.00
DM-281 cap Celecoxib 200mg capsule, COXTO 7500 2.81 21,075.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - MULTICARE PHARMACEUTICALS INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Salbutamol 2mg/ml, 2.5ml (unit dose) (asSulfate),

DM-228 tab 6000 7.25 43,500.00
PROVEXEL
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - ABBOTT INTERNATIONAL Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Valproate disodium/ Valproic Acid 250mg/tab. (as
DM-425 tab 8,000 29.00 232,000.00
disodium salt or as valproic acid), EPIVAL
********************************
*Re-PR 01/09/18

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - PFIZER , INC. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Ampicillin Sulbactam (1000mg Ampicillin + 500mg

DM-10 vial 3000 107.10 321,300.00
Sulbactam) (as Sodium Salt), UNASYN
Clindamycin 150mg/ml, 4ml ampule (IM,IV) (as PO4),
DM-43 amp 2,000 140.00 280,000.00
DALACIN-C
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - FRESENIUS KABI Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-110 bot Sevoflurane 250ml, SOJOURN 20 5,600.00 112,000.00
DM-434 vial Carboplatin 450mg vial, KEMOCARB 100 1,199.00 119,900.00
********************************
BASED ON PPMP CY 2018 231,900.00
*Re-PR 01/09/18

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - ASTRAZENECA
Fund Cluster: __________________
PHARMACEUTICALS(PHILS.)

PHARMACY
SECTION
Stock/
No.
Budesonide + Formoterol 160/4.5mcg/ unit dose,
DM-129 canister 10 681.35 6,813.50
SYMBICORT TURBUHALE
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. ASPEN PHILIPPINES IN Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-197 tab Methyldopa 250mg, ALDOMET 2000 16.07 32,140.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - ONE PHARMA
Fund Cluster: __________________
COMPANY INC.

PHARMACY
SECTION
Stock/
No.
DM-203 tab Metoprolol100mg (as Tatrate), CARDIOSTAT 3000 1.90 5,700.00
DM-270 tab Baclofen 10mg, TRILAXANT 500 14.95 7,475.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - SANOFI-PASTEUR Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Rabbies Vaccine (0.5ml of 4% Sodium Chloride),
DM-221 amp 10 1,250.00 12,500.00
VENORAB
********************************
*Re-PR 01/09/18

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - MUNDIPHARMA
Fund Cluster: __________________
DISTRIBUTION GMBH

PHARMACY
SECTION
Stock/
No.
DM-354 tab Morphine 10mg CR tab (as Sulfate), MST-CONTINUS 500 24.24 12,120.00
DM-356 tab Morphine 30mg CR tab (as Sulfate), MST-CONTINUS 500 55.28 27,640.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - A. MENARINI
Fund Cluster: __________________
PHILIPPINES, INC.

PHARMACY
SECTION
Stock/
No.
Neostigmine 500mcg/ml, 1ml ampule (IM,IV,SC) (as

DM-366 amp 20 116.99 2,339.80
Methylsulfate), PROSTIGMINE
DM-424 cap Ursodeoxycholic Acid 250mg capsule, URSOFALK 300 36.07 10,821.00
********************************
*Re-PR 01/09/18

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - HOSPIRA
Fund Cluster: __________________
PHILIPPINES INC

PHARMACY
SECTION
Stock/
No.
Phenobarbital 130mg/ml, 1ml ampule (IM,IV) (as
DM-379 amp 200 509.28 101,856.00
Sodium), LUMINAL
********************************
*Re-PR 01/09/18

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - PHARMALINK-
Fund Cluster: __________________
INTERPHIL LABORATORIES INC

PHARMACY
SECTION
Stock/
No.
Potassium 750mg durules (approx. equiv. to 10 mEq),
DM-386 tab 800 15.00 12,000.00
KALIUM DURULE
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-346 amp Mecobalamin 500mcg/ml, 1ml (IM/IV) 300 164.80 49,440.00
********************************
No Bidder, Public Bidding CY 2017

_______________________________________________________________

Signature :

PURCHASE REQUEST
CANOMED Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Diphenhydramine HCl 50mg/ml, 1ml amp (IM,IV) (as

DM-301 amp 500 34.00 17,000.00
HCl), BEXIL
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
PHILCARE PHARMA INCORPORATION Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Norepinephrine 1mg/ml, 4ml amp (IV infusion) (as
DM-212 bot 300 298.00 89,400.00
Bitartrate), SANDINE
Paracetamol 10mg/ml, 100ml solution for intrusion (IV),
DM-374 vial 50 248.00 12,400.00
TAMIN
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
UNITED LABORATORIES INCORPORATED Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-11 vial 3,000 39.00 117,000.00
Sulbactam) vial (IM,IV) (as Sodium salt), AMPIMAX
DM-22 vial Cefepime 500mg vial (IM,IV) (as Hcl), AXERA 100 192.00 19,200.00
Piperacillin+Tazobactam (4g Piperacillin+500mg
DM-104 vial Tazobactam) per vial (IV infusion) (as Sodium salt), 800 96.00 76,800.00
PIPTAZ
Nicardipine 1mg/ml, 10ml amp (IV) (as HCl),
DM-207 amp 300 611.04 183,312.00
CARDEPINE
DM-254 tab Acetylcisteine 600mg, EXFLEM 300 15.00 4,500.00
Isoxsuprine 5mg/ml, 2ml amp (IM, IV infusion )(as HCl),
DM-334 amp 50 119.34 5,967.00
ISOXILAN
********************************
BASED ON APP CY 2018 406,779.00

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZYRE PHARMACEUTICAL Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-276 amp Butorphanol 2mg/ml, 1ml (IM,IV) (as Tartrate) 1,000 567.07 567,070.00
********************************
BASED ON APP CY 2018 567,070.00

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
set Intravenous Administration Set (Macoset) 20 drops/ml 5,000 30.90 154,500.00
set Intravenous Administration Set (Micoset) 60 drops/ml 2,000 36.05 72,100.00
set IV Cannula G18 with injection port 5,000 71.00 355,000.00
set Blood Transfusion Set 2000 40.00 80,000.00
set Soluset 2000 150.00 300,000.00
********************************
No Bidder, Public Bidding CY 2017
BASED ON PPMP CY 2018 1,778,100.00

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP. - PFIZER , INC. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-155 amp/vial Dopamine 40mg/ml, 5ml (IV) (as HCI), GENERIC 500 59.89 29,945.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
DELEX PHARMA INTERNATIONAL INC. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-353 amp Midazolam 5mg/ml, 3ml (IM,IV), MIDAZOLEX 500 136.33 68,165.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
GLOBO ASIATICO Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-449 amp/vial Fluorouracil 50mg/ml, 10ml (IV, IV infusion), FLUONCO 300 103.00 30,900.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
VIZCARRA Fund Cluster: __________________
Office/Section : PR No.: M-2018-01-0223 Date: February 08, 2018

PHARMACY
SECTION
Stock/
No.
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-142 amp Cobra Anti-venom 100 1350.00 135,000.00
********************************
No Bidder/Failed Bidding, Public Bidding CY 2017 135,000.00

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Co-Amoxiclav 156.25mg/5ml, powder for suspension,

DM-48 bot 75 154.00 11,550.00
NATRAVOX
Co-Amoxiclav 228.5mg/5ml, powder for suspension,
DM-49 bot 75 175.00 13,125.00
NATRAVOX
DM-73 bot Isoniazid 200mg/5ml, 120ml syrup, CURAZID FORTE 10 78.00 780.00
DM-106 bot Pyrazynamide 250mg/5ml, 120ml suspension, ZCURE 10 90.00 900.00
DM-127 tab Atorvastatin 40mg, ATORVAST 500 20.00 10,000.00
DM-162 tab Felodipine 5mg, FELODIPIN 50 9.75 487.50
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-78 polyamp Lidocaine 2%, 5ml (as HCI),EUROCAINE 1,000 11.00 11,000.00
DM-130 neb Budesonide 250mcg/ml, 2ml (unit dose), BROMEX 200 24.00 4,800.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA- PFIZER INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Clindamycin 150mg/ml, 4ml (IM,IV) (as PO4), DALACIN-
DM-43 amp 500 140.00 70,000.00
C
DM-282 cap Celecoxib 400mg, CELEBREX 1,020 21.00 21,420.00
Sodium Bicarbonate 1mEq/ml, 50ml (IV infusion),
DM-407 amp 500 84.21 42,105.00
GENERIC
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA- ASPEN PHILIPPINES INC. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-145 tab Digoxin 250mcg (0.25mg), LANOXIN 2,000 4.16 8,320.00
DM-147 bot Digoxin 50mcg (0.05mg)/ml elixir, 60ml, LANOXIN 10 716.22 7,162.20
DM-197 tab Methyldopa 250mg, ALDOMET 1,000 16.07 16,070.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - PHARMALINK-INTERPHIL Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.

DM-386 tab 1,200 15.00 18,000.00
KALIUM DURULE
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
DYNASTY Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-21 vial Cefepime 1g (IM,IV) (as HCl), SEFPIME 200 180.00 36,000.00
DM-28 vial Ceftriaxone 1g (as Disodium/ Sodium salt), GENERIC 2,000 20.00 40,000.00
DM-33 vial Cefuroxime 750mg (IM,IV) (as Sodium salt) 500 20.00 10,000.00
Tramadol 50mg/ml, 2ml (IM,IV, SC) (as HCl),
DM-423 amp 1,000 10 10,000.00
DYNATRAM
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
PHILCARE PHARMA Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Norepinephrine 1mg/ml, 4ml (IV infusion) (as Bitartrate),

DM-212 amp 500 298.00 149,000.00
SANDINE
********************************
Re-PR: M-2018-02-0231(02/08/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST
MARK ERICSON ENT. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-325 amp Hydroxyzine 50mg/ml, 1ml (IM,IV), DROXIEM 100 495.00 49,500.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM+301 amp Diphenhydramine HCl 50mg/ml, 1ml (IM,IV) (as HCl), 1,000 34.00 34,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
GLOBO-ASIATICO Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-439 vial Cytarabine 500mg/10ml, MPL-CYTE 100 691.00 69,100.00
DM-446 amp/vial Etoposide 20mg/ml, 5ml (IV), ETOPA 50 429.55 21,477.50
DM-449 amp Fluorouracil 50mg/ml, 10ml (IV, IV Infusion), FLUONCO 200 103.00 20,600.00
DM-452 tab Hydroxyurea 500mg, MPL HI-OXY 200 20.25 4,050.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-433 tab Capecitabine 500mg, CETAGEN500 100 62.00 6,200.00
DM-450 vial Gemcitabine 1g, OMNICURE-1 50 2975.00 148,750.00
DM-459 tab Tamoxifen 20mg (as Citrate), TAMOXIGEN 20 700 6.50 4,550.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Amoxicillin 100mg/ml granules/ powder for drops 10ml

DM-04 bot 50 15.30 765.00
(as Trihydrate), MOXYLOR
Amoxicillin 250mg/5ml granules/ powder for suspension
DM-05 bot 250 19.88 4,970.00
60ml (as Trihydrate), MOXYLOR
DM-18 cap Cefalexin 500mg (as Monohydrate), DIACEF 2,500 2.55 6,375.00
DM-47 cap Cloxacillin 500mg, FLACTAMACIN 500 1,500 3.24 4,860.00
DM-54 cap/tab Co-Trimoxazole 400mg/80mg, DIAZOLE 300 1.13 339.00
Co-Trimoxazole 400mg/80mg/5ml suspension, 60ml,
DM-55 bot 25 23.00 575.00
DIAZOLE
DM-226 bot Salbutamol 2mg/5ml, 60ml syrup (as Sulfate), ALBULEM 50 14.90 745.00
DM-229 tab Sambong 250mg 1000 2.25 2,250.00

DM-357 bot Multivitamins 120ml syrup, DIAVIT 25 38.00 950.00
DM-360 cap Multivitamins capsule, DIAVIT 5000 1.21 6,050.00
Paracetamol 250mg/5ml (alcohol free), 60ml
DM-376 bot 100 15.20 1,520.00
syrup/suspension, ALGESIC
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - MULTICARE PHARMACEUTICALS INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Salbutamol 2mg/ml, 2.5ml (unit dose) (as Sulfate),
DM-228 neb 4,000 7.25 29,000.00
PROVEXEL
Prednisolone eye drops suspension 0.5%,5ml(as
DM-389 bot 10 200.00 2,000.00
acetate), VENPRED
DM-430 tab Zolpidem 10mg, STILNOX 25 64.00 1,600.00
Calcium Folinate(Leucoverin Calcium) 10mg/ml,
DM-432 amp 900 215.75 194,175.00
5ml(IM,IV), CAFONATE
DM-438 vial Cytarabine 1g/10ml, CANCYT 75 1,275.00 95,625.00
DM-440 vial Dacarbazine 200mg, ARZI-200 75 689.00 51,675.00
DM-444 vial Doxorubicin powder 10mg (IV) (as HCl), ALDROSAL 200 182.75 36,550.00
Methotrexate 25mg/ml, 2ml (IM,IV, Intrathecal) (as base),
DM-453 amp 250 145.75 36,437.50
ALLTREX
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
UNITED LABORATORIES Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.

DM-11 vial 1,000 39.00 39,000.00
Sulbactam) (IM,IV) (as Na salt), AMPIMAX
DM-22 vial Cefepime 500mg (IM,IV) (as HCl), AXERA 100 192.00 19,200.00
DM-104 vial 200 96.00 19,200.00
Tazobactam)(IV infusion) (as Na), PIPTAZ
DM-163 tab Fenofibrate 160mg, FENOFLEX 500 33.80 16,900.00
DM-183 cap/tab Isosorbide- 5- Mononitrate 30mg, MONTRA 2,000 13.04 26,080.00
DM-207 amp Nicardipine 1mg/ml, 10ml (IV) (as HCl), CARDEPINE 700 611.04 427,728.00
Cetirizine 10mg/ml drops, 10ml (as Dihydrochloride),
DM-284 bot 50 126.74 6,337.00
ALLERKID
********************************
BASED ON APP CY 2018 564,945.00

_______________________________________________________________

Signature :

PURCHASE REQUEST
METRODRUG Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-192 tablet Losartan 100mg (as Potassium salt) - (100's), LOSACAR 1,300 3.20 4,160.00
DM-193 tablet Losartan 50mg (as Potassium salt) - (70's), LOSACAR 3,780 1.02 3,855.60
DM-196 tablet Methimazole 5mg - (100's), TAPDIN 200 5.40 1,080.00
DM-251 tablet Acetazolamide 250mg - (100's), CETAMID 100 20.00 2,000.00
DM-252 sachet Acetylcisteine 200mg - (30's),FLUIMICIL 510 11.38 5,803.80
DM-255 bottle Acetylcystein 100mg soln for inj - (5's), FLUIMUCIL 25 118.00 2,950.00
DM-256 bottle Acetylcystein 100mg/ml, inhalation - (5's), FLUIMUCIL 15 118.00 1,770.00
DM-262 tablet Alprazolam 250mcg - (100's), ALTROX250 300 5.25 1,575.00
Calcium Carbonate (equiv. to 500mg & 600mg elemental
DM-277 tablet 240 4.00 960.00
ca) - (120's), CALVIN PLUS
DM-313 cap/tab Fluoxetin 20mg dispersal - (30's), DRAFZIN 600 5.00 3,000.00
DM-352 ampule Midazolam 1mg/ml, 5ml (IM,IV) - (1's), SEDOZ 1,000 84.00 84,000.00
DM-369 ampule Omeprazole 40mg + 10ml solvent (IV) - (1's), ZYOM 3,000 37.00 111,000.00
DM-404 tab Sertraline 50mg (as HCl) - (50's), DEPERIN 500 4.50 2,250.00
DM-443 vial Docetaxel 40mg/ml, 2ml (IV infusion) - (1's), VEXDO80 50 3,465.00 173,250.00
Doxorubicin powder 50mg (IV) (as HCl) - (1's),
DM-445 vial 100 594.75 59,475.00
DOXVEX50
********************************
Re-PR: M-2018-02-0239(02/08/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST
PHIL PHARMAWEATLH Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-07 capsule Amoxicillin 500mg (as Trihydrate), HARBIMOX 2,500 1.16 2,900.00
Bupivacaine 0.5%, 4ml (spinal) w/ 8 dextrose (as HCl)
DM-15 ampule 900 102.22 91,998.00
HEAVY, SENPIVAC 0.5%
DM-19 vial Cefazolin 1g (IM,IV) (as Sodium salt), GENERIC 500 21.22 10,610.00
DM-27 vial Ceftazidime 1g (as Pentahydrate), CEFTIBAC 4,000 34.12 136,480.00
DM-32 tablet Cefuroxime 500mg (as Axetil), AXEFIME 1,250 8.88 11,100.00
Chloramphenicol 1g (IM,IV) (as Sodium Succinate),
DM-35 vial 200 27.88 5,576.00
KLORFEN
DM-42 tablet Clarithromycin 500mg tablet as base, KLARCYN 500 9.49 4,745.00
Erythromycin Ophthalmic Ointment 0.5%, 3.5g,
DM-63 tube 40 148.44 5,937.60
ERYCORTIN
DM-83 vial Meropenem 1g (IV) (as Trihydrate), MEPENEM 600 167.23 100,338.00
DM-84 vial Meropenem 500mg (IV) (as Trihydrate), MEPENEM 500 99.78 49,890.00
DM-123 tablet Aspirin 80mg, GENERIC 1,500 0.88 1,320.00
DM-125 tablet Atenolol 50mg, MYOVASC 500 1.98 990.00
Epinephrine 1:1000 1mg/ml, 1ml (IM,SC) (as
DM-159 ampule 1,000 37.22 37,220.00
DM-166 ampule Furosemide 10mg/ml, 2ml (IM,IV), GENERIC 4,000 6.48 25,920.00
DM-267 ampule Atracurium Besylate 10mg/ml, 2.5ml (IV), ACURIUM 500 85.22 42,610.00
Epoetin Alfa 4,000 IU/ 0.4ml, IV,SC (Recombinant
DM-304 amp/vial/p 500 269.44 134,720.00
human erythropoetin), EPOGEN
DM-368 capsule Omeprazole 20mg, AZIBLOC 3,000 0.84 2,520.00
DM-371 sachet Oral Rehydration Solution, GLUCOSOL 1,000 4.24 4,240.00
********************************

_______________________________________________________________
Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-326 tablet
Hyoscine 10mg (as N- Butyl Bromide), PASBUTYL 200 5.45 1,090.00
Ketorolac 30mg/ml, 1ml (IM,IV) (as Trometamol),
DM-337 ampule 9,000 21.44 192,960.00
KETRAL
Ranitidine 25mg/ml, 2ml(IM,IV, IV infusion) (as HCl),
DM-396 ampule 1,500 3.89 5,835.00
ZANTOL
Suxamethonium (succinyl Choline) 20mg/ml, 10ml IV (as
DM-413 vial 100 112.33 11,233.00
Chloride), ANEKTIL
DM-427 tablet Vitamin B Complex, BERNAOIN 10,000 1.67 16,700.00
DM-447 vial Filgrastim 300mcg, RECOMBICYTE 250 818.33 204,582.50
DM-456 vial Oxaliplatin 100mg, MESLATIN 100 1,622.00 162,200.00
Water for injection (triple distilled water), 50ml vial (steriile
DM-484 vial 3,000 17.88 53,640.00
water for injection), GENERIC
********************************
Winning Bidder, Public Bidding CY 2017 1,152,120.50

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-245 cap Tranexamic Acid 500mg 1,500 5.40 8,100.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Magnesium Sulfate 250mg/ml, 20ml (IM,IV) (as

DM-345 amp 1,000 28.00 28,000.00
Heptahydrate), GENERIC
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-454 amp Ondansetron 1mg/ml, 4ml (IM,IV), ONSIA 300 400.00 120,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
RBC-MDC CORPORATION Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-370 cap Omeprazole 40mg, WILOM 1,000 12.39 12,390.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-475 set 4,800 45.00 216,000.00
GENERIC
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Dexamethasone 4mg/ml, 2ml (IM,IV) (as Sodium
DM-144 amp/vial 500 24.00 12,000.00
Phosphate), DEXTICORT
DM-220 tab Propylthiouracil 50mg, GENERIC 500 11.00 5,500.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - PFIZER INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-10 vial 1,500 107.10 160,650.00
Sulbactam) vial (IM,IV) (as Sodium salt), UNASYN
DM-67 vial Fluconazole 2mg/ml, 100ml vial (IV infusion), DIFLUCAN 20 522.00 10,440.00
DM-155 amp/vial Dopamine 40mg/ml, 5ml (IV) (as HCI) 200 59.89 11,978.00
********************************

_______________________________________________________________

Signature :

Designation : CHIEF MEDICAL PROFESSIONAL STAFF II ioi
PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Nutritional Food Supplements for:
can Tube Feeding 360 1072.00 385,920.00
can Diabetes 1,176 1176.00 1,382,976.00
********************************
BASED ON APP CY 2018 1,768,896.00
Purpose: FOR USE IN CVMC - NUTRITION AND DIETETICS SERVICE

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________
NUTRITION AND
DIETETICS SERVICE Responsibility Center Code : ___________
Stock/
No.
can Ensure NutriVigor, Vanilla 850 grms/can 36 1271.367 45,769.21
can Prosure, Vanilla 380grms/can 72 594.536 42,806.59
can Nepro HP, Vanilla 237ml/can 120 142.372 17,084.64
sach AliTraq Powder, 76grms/sachet 200 211.163 42,232.60
********************************
BASED ON APP CY 2018 147,893.04
*please see attached exclusivity and price quotation

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-337 ampule 4,000 21.44 85,760.00
KETRAL
DM-396 ampule 1,500 3.89 5,835.00
ZANTOL
DM-456 vial Oxaliplatin 100mg, MESLATIN 100 1,622.00 162,200.00
********************************
Re-PR: M-2018-02-0249(02/08/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
********************************
Re-PR: M-2018-02-0249(02/08/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-470 set Dextrose 5% 0.3 NaCl 500ml (Light Blue), GENERIC 2,880 40.89 117,763.20
DM-477 set Dextrose 5% in Water 500ml (Red), GENERIC 2,880 42.33 121,910.40
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-469 set Dextrose 10% in Water 500ml, GENERIC 2,400 45.00 108,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________
Office/Section : PR No.: M-2018-03-00289 Date: March 14, 2018

PHARMACY
SECTION
Stock/
No.
DM-46 capsule Clindamycin HCl 300mg 500 11.54 5,781.54
DM-59 capsule Doxycycline 100mg (as Hyclate) 100 17.88 1,805.88
********************************
Re-PR: M-2018-03-0289(03/01/2018)
Purpose: FOR USE IN CVMC - PHARMACY SECTION (Cluster I)

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-114 amp/vial Anti-Tetanus Serum (equine) 1,500IU/ml, 1ml (IM) 500 84.62 42,310.00
DM-134 tablet Captopril 25mg 1,000 3.85 3,850.00
DM-141 tablet Clopidogrel 75mg 1,000 22.12 22,120.00
DM-143 tablet Dexamethasone 4mg 200 21.73 4,346.00
DM-167 tablet Furosemide 20mg 500 1.54 770.00
********************************
Re-PR: M-2018-03-0290(03/01/2018)
Purpose: FOR USE IN CVMC - PHARMACY SECTION (Cluster II)

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-243 ampule Tranexamic Acid 100mg/ml, 5ml (IM,IV) 300 100.00 30,000.00
********************************
Re-PR: M-2018-03-0291(03/01/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-165 p.syringe Fondaparinux 2.5mg/0.5ml solution (as Sodium salt) 100 1,604.29 160,429.00
********************************
Re-PR: M-2018-03-0292(03/01/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Ipratropium + Salbutamol UDV 2.5ml/ unit dose,
nebule 9,000 13.75 123,750.00
DM-181 MULTIVENT
Nalbuphine 10mg/ml, 1ml (IM,IV,SC) (as HCl),
ampule 1,500 58.25 87,375.00
DM-362 NALBUPHINE HCL
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-208 capsule Nifedipine 10mg 300 4.62 1,386.00
DM-209 tablet Nifedipine 30mg MR 300 42.69 12,807.00
********************************
Re-PR: M-2018-03-0294(03/01/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-257 can
Activated Charcoal 1kg 4 3500.00 14,000.00
DM-275 tablet
Bisacodyl 5mg 100 15.38 1,538.00
DM-283 tablet
Cetirizine 10mg (as Dihydrochloride) 300 16.71 5,013.00
DM-300 capsule
Diphenhydramine HCl 50mg 500 1.21 605.00
DM-303 ampule
Ephedrine Sulfate 50mg/ml, 1ml (IM,IV) 500 80.34 40,170.00
DM-321 ampule
Haloperidol 5mg/ml, 1ml (IM) 500 46.23 23,115.00
DM-327 ampule
Hyoscine 20mg/ml, 1ml (IM,IV,SC) (as N-Butyl Bromide) 1,000 15.11 15,110.00
Methylergometrine Maleate 200mcg/ml, 1ml(IM,IV) (as
DM-350 ampule 500 17.80 8,900.00
Hydrogen Maleate or Maleate)
DM-351 ampule Metoclopromide 5mg/ml, 2ml (IM,IV) (as Base & HCl) 1,500 4.00 6,000.00
DM-355 ampule Morphine 15mg/ml, 1ml (IM,IV,SC) (as Sulfate) 300 66.96 20,088.00
DM-380 tablet Phenobarbital 15mg (1/4 grain) 500 1.95 975.00
DM-381 tablet Phenobarbital 60mg (1 grain) 2,000 2.05 4,100.00
DM-382 tablet Phenobarbital gr 1/2 (30mg) 1,300 2.27 2,951.00
DM-392 tablet Quetiapine 100mg 600 32.27 19,362.00
********************************
Re-PR: M-2018-03-0295(03/01/2018)
Purpose: FOR USE IN CVMC - PHARMACY SECTION (Cluster III)

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-314 bottle Fluphenazine 25mg/ml, 10ML 30 520.87 15,626.10
********************************
Re-PR: M-2018-03-0296(03/01/2018)
Purpose: FOR USE IN CVMC - PHARMACY SECTION (Cluster III)

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-431 vial Bleomycin Sulfate 15 units 10 1828.25 18,282.50
DM-441 vial Dactinomycin 500mcg 10 360.50 3,605.00
DM-460 bottle Vinblastin 10mg/10ml 10 716 7,160.00
DM-462 vial Vincristine 2mg/2ml, 1ml (IV) (as Sulfate) 30 252.87 7,586.10
********************************
No Bidder/Failed Bidding, Public Bidding CY 2017
Re-PR: M-2018-03-0295(03/01/2018)
Purpose: FOR USE IN CVMC - PHARMACY SECTION (Cluster IV)

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-449 vial Fluorouracil 50mg/ml, 10ml (IV, IV Infusion), FLUONCO 300 103.00 30,900.00
********************************
Purpose: FOR USE IN CVMC - PHARMACY SECTION (Cluster IV)

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-175 ampule Hydralazine 20mg/ml, 1ml (IM,IV) (as HCl), APREZAL 400 87.33 34,932.00
DM-294 tablet Diazepam 5mg, VEXEPAM 300 8.88 2,664.00
DM-295 ampule Diazepam 5mg/ml, 2ml (IM,IV), ANXIOL 1,500 81.89 122,835.00
DM-308 ampule Fentanyl 50mcg/ml, 2ml (IV) (as Citrate), SUBLIMAX 1,000 74.44 74,440.00
Heparin Standard 1000IU/ml, 5ml (IV as Sodium salt),
ampule 100 51.88 5,188.00
DM-322 HEPRIN
DM-361 tube Mupirocin 2%, 5g, BACTRIDERM 200 49.88 9,976.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-358 bottle Multivitamins 15ml drops, 30 28.00 840.00
********************************
BASED ON APP CY 2018 840.00

_______________________________________________________________

Signature :

PURCHASE REQUEST
NUTRITION AND
DIETETICS SERVICE Responsibility Center Code : ___________
Stock/
No.
tab Amlodipine 5mg tablet (as Besylate) 3,000 963.90 2,891,700.00
vial Ampicillin 1g vial (IM,IV) (as Sodium salt) 1,500
vial Ampicillin 500mg vial (IM,IV) (as Sodium salt) 500 2,891,700.00
tab Azithromycin 500mg tablet (as base) 1,500
tab Biperiden 2mg/tablet (as Hcl) 10,000
vial Ciprofloxacin 2mg/ml, 100ml vial (as Lactate) IV infusion 2,500
vial Dobutamine 12.5mg/ml, 20ml (IV) (as HCl) 1,000

amp Famotidine 10mg/ml, 2ml amp (IM,IV) 500
amp Gentamycin 40mg/ml, 2ml amp/vial (IM,IV) (as SO4) 2500
amp Ketorolac 30mg/ml, 1ml (IM,IV) (asTrometamol) 5000
tab Mefenamic Acid 500mg cap/tab 5000
vial Oxaliplatin 100mg (5mg/ml, 20ml) 100
vial Paclitaxel 100mg vial 100
Phytomenadione (Phytonadione, vit.K1)10mg/ml, 1ml
tab 2000
(IM,IV)
tab Risperidone 2mg tablet 4000
vial Streptomycin 1g vial IM (as Sulfate) 300
amp Tranexamic Acid 100mg/ml, 5ml ampule (IM,IV) 2500
vial 300

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-119 tab Amlodipine 10mg tablet (as Besylate), AMLODIBLOC 3,000 0.78 2,340.00
DM-08 vial Ampicillin 1g vial (IM,IV) (as Sodium salt), AMPITREX 1,500 11.88 17,820.00
Ampicillin 500mg vial (IM,IV) (as Sodium salt),
DM-09 vial 500 7.78 3,890.00
AMPITREX
DM-13 tab Azithromycin 500mg tablet (as base), TROXIN 1,500 8.34 12,510.00
DM-272 tab Biperiden 2mg/tablet (as Hcl), AKETON 10,000 4.28 42,800.00
Ciprofloxacin 2mg/ml, 100ml vial (as Lactate) IV infusion,
DM-37 vial 2,500 26.49 66,225.00
FLOXIL
DM-151 vial Dobutamine 12.5mg/ml, 20ml (IV) (as HCl), DOBUCARD 1,000 112.22 112,220.00
DM-307 amp Famotidine 10mg/ml, 2ml amp (IM,IV), HISTA-BLOC 500 130.89 65,445.00
DM-337 amp 5000 21.44 107,200.00
KETRAL
DM-348 tab Mefenamic Acid 500mg cap/tab, FENAMAX 5000 0.52 2,600.00
DM-456 vial Oxaliplatin 100mg (5mg/ml, 20ml), MESLATIN 100 1,622.00 162,200.00
DM-385 tab 2000 21.22 42,440.00
(IM,IV), HEMA-K
DM-399 tab Risperidone 2mg tablet, RISPEDIN-2 4000 1.49 5,960.00
DM-111 vial Streptomycin 1g vial IM (as Sulfate), STREPTOCIN 300 12.88 3,864.00
DM-113 vial Vancomycin 500mg vial (IV) (as HCl), VANCIN 300 153.22 45,966.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Nalbuphine 10mg/ml, 1ml (IM,IV,SC) (as HCI),

DM-362 amp 1,500 58.25 87,375.00
NALBUPHINE HCL
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - PFIZER INC. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-10 vial 2,000 107.10 214,200.00
Sulbactam) vial (as Sodium salt), UNASYN
Clindamycin 150mg/ml, 4ml ampule (IM,IV) (as PO4),
DM-43 amp 1,000 140.00 140,000.00
DALACIN-C
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
METRODRUG INC. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-126 tab Atorvastatin 20mg, ZYDUSATORVA-20 4,000 3.80 15,200.00
DM-320 tab Haloperidol 20mg, ZUREDEL 4,000 20.75 83,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
SANNOVEX Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.

DM-178 vial 500 140.00 70,000.00
Succinate, HYDROVEX
DM-179 vial 1,500 75.00 112,500.00
Succinate), HYDROVEX
********************************

_______________________________________________________________

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PURCHASE REQUEST
UNITED LABORATORIES INC. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-11 vial 2,000 39.00 78,000.00
Sulbactam) vial (IM,IV) (as Sodium salt), AMPIMAX
Nicardipine 1mg/ml, 10ml amp (IV) (as HCl),
DM-207 amp 500 611.04 305,520.00
CARDEPINE
********************************

_______________________________________________________________

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PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-128 tab Atorvastin 80mg, ATORVAST 2,000 23.00 46,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
GETZ BROS. INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-338 bot Lactulose 3.3g/5ml (66% syrup), 120ml, LILAC 500 80.00 40,000.00
********************************

_______________________________________________________________

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PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-80 bot Lidocaine spray 10%, 50ml (as HCl), 5 2953.00 14,765.00
********************************

_______________________________________________________________

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PURCHASE REQUEST
ZUELLIG PHARMA - FRESENIUS KABI Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-110 bot Sevoflurane 250ml, SOJOURN 20 5600.00 112,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
EURO-MED LABORATORIES Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-78 polyamp Lidocaine 2%, 5ml (as HCI), EUROCAINE 3,000 11.00 33,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - ASPEN PHILIPPINES INC. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-146 amp Digoxin 250mcg/ml, 2ml (IM,IV), LANOXIN 1,000 160.16 160,160.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - ONE PHARMA COMPANY INC. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-316 tab Folic Acid 5mg, FOLIMAX 1,000 2.65 2,650.00
********************************

_______________________________________________________________

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PURCHASE REQUEST
ZUELLIG PHARMA - GLAXOSMITHKLINE PHILS. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-186 amp Isosorbide dinitrate 1mg/ml, 10ml (IV), ISOKET 500 533.99 266,995.00
********************************

_______________________________________________________________

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PURCHASE REQUEST
ZUELLIG PHARMA - PFIZER Fund Cluster: __________________

PHARMACY
SECTION
Stock/
Property Unit Item Description Unit Cost Total Cost
No.
Sodium Bicarbonate 1mEq/ml, 50ml (IV Infusion),
DM-407 amp 1,000 84.21 84,210.00
GENERIC
********************************

_______________________________________________________________

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PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-475 set 6,000 45.00 270,000.00
GENERIC
DM-483 set Dextrose Plain NSS 1000ml (Green), GENERIC 12,000 41.99 503,880.00
DM-329 bot Ibuprofen 100mg/5ml, 60ml suspension 50 38.33 1,916.50
Penicillin G Crystalline (Benzylpenicillin) 5M "u" vl. (IM,IV)
DM-100 vial 500 17.22 8,610.00
(as Sodium), HARBIPEN
Water for injection (triple distilled water), 50ml vial (sterile
DM-484 vial 1,000 17.88 17,880.00
********************************

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PHARMACY
SECTION
Stock/
No.
DM-435 vial Cisplatin 50mg, CISTEEN 50 570.00 28,500.00
********************************

_______________________________________________________________

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PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-149 vial Diltiazem 60mg (as Hydrochloride) 1,000 19.00 19,000.00
********************************

_______________________________________________________________

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PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-330 tab Ibuprofen 400mg, ALAXPRO 500 1.25 625.00
********************************
Winning Bidder, Public Bidding CY 2017 625.00

_______________________________________________________________

Signature :

PURCHASE REQUEST
UNITED LABORATORIES INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-104 tab 1,000 96.00 96,000.00
Tazobactam) (IV infusion) (as Na), PIPTAZ
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-156 tab Dydrogesteone 10mg 1,000 56.24 56,240.00

********************************
No/Failed Bidder, Public Bidding CY 2017 56,240.00

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________
Office/Section : PR No.: M-2018-04-00380 Date: April 12, 2018
DIETARY Responsibility Center Code : ___________
Stock/
No.
Nutritional Oral Supplement for:
can Post-operative Patients - Vanilla Flavor 850g/can 36 1271.37 45,769.32
can Cancer Patients - Vanilla Flavor 380g/can 72 594.54 42,806.88
can Renal Patients - Vanilla Flavor 237ml/can 120 142.37 17,084.40
High Protein for Burn/Malnourish Patients (semi-
sach 200 211.16 42,232.00
elemental diet) - 76g/sachet
********************************
BASED ON APP CY 2018 147,892.60

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-260 tablet Allopurinol 100mg 500 0.87 435.00
DM-301 ampule Diphenhydramine HCl 50mg/ml, 1ml (IM,IV) (as HCl) 1,500 34.00 51,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-264 bottle Ascorbic Acid 100mg/5ml, 60ml syrup, VITCEE 30 16.80 504.00
DM-265 bottle Ascorbic Acid 100mg/ml, 15ml drops, VITCEE 30 16.80 504.00
DM-266 tablet Ascorbic Acid 500mg, VITCEE 2,000 0.78 1,560.00
DM-144 amp/vial 1,000 24 24,000.00
Phosphate), DEXON
DM-86 tablet Metronidazole 500mg, METROZOLE 2,000 1.28 2,560.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-14 ampule Bupivacaine 0.5%, 10ml/amp (as HCl), BUPICAN 500 67.88 33,940.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-15 ampule 1,500 102.22 153,330.00
DM-279 tablet Carbamazepine 200mg , TEGREPIN 10,000 2.11 21,100.00
DM-26 vial Cefoxitin 1g (IM,IV) (as Sodium salt), HAXOTIN 1,000 99.44 99,440.00
Chlorpheniramine 10mg/ml, 1ml (IM,IV) (as Maleate),
DM-287 ampule 100 11.32 1,132.00
GENERIC
DM-140 tablet Clonidine 75mcg (as HCl), CATAPIN 1,000 4.11 4,110.00
DM-159 ampule 5,000 37.22 186,100.00
DM-304 amp/vial/ 500 269.44 134,720.00
DM-322 ampule 200 51.88 10,376.00
HEPRIN
DM-372 ampule Oxytocin 10 "IU"/ml, 1ml (IM,IV), GENERIC 1,000 10.89 10,890.00
DM-375 vial Paracetamol 150mg/ml, 2ml (IM,IV), FEBRINIL 15,000 6.33 94,950.00
Rabbies Vaccine Lyophillyzed powder 2.5 IU/ml 1 dose +
DM-222 vial 12 873.22 10,478.64
1 ml Diluent (ID,IM), INDIRAB
********************************

_______________________________________________________________

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PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-278 amp Calcium Gluconate 10%, 10ml (IV), GENERIC 300 19.00 5,700.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - ONE PHARMA COMP. INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-137 tab Carvedilol 25mg , CARVEDOL 500 4.60 2,300.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-383 tab Phenytoin 100mg (as Sodium salt), DILANTIN 300 10.14 3,042.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-181 neb 9,000 13.75 123,750.00
MULTIVENT
DM-211 tab Nimodipine 30mg , NIMOTOP 1,200 37.89 45,468.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - PHARMALINK INTERPHIL Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-386 tab 2,000 15.00 30,000.00
KALIUM DURULE
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-21 vial Cefepime 1g (IM,IV) (as HCl), SEFPIME 300 180.00 54,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Levofloxacin 5mg/ml solution for IV infusion, 100ml,
DM-76 vial 100 250.00 25,000.00
LOXEVA
DM-205 tab Montelukast 10mg (as Sodium), MONTEZYD 10 510 5.79 2,952.90
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-127 tablet Atorvastatin 40mg , ATORVAST 2,000 20.00 40,000.00
DM-162 tablet Felodipine 5mg, FELODIPIN 200 9.75 1,950.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-323 vial Human Albumin 20%, 50ml, ALBUMAX 500 2175.00 1,087,500.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-187 tab Isosorbide dinitrate 5mg SL 1,000 11.31 11,310.00
********************************
Failed/No Bidder, Public Bidding CY 2017 11,310.00
Purpose: FOR USE IN CVMC - PHARMACY SECTION (CLUSTER II)

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-257 can Activated Charcoal 1kg 5 3500.00 17,500.00
DM-290 tab Cinnarizine 25mg 500 1.49 745.00
DM-310 bot Ferrous Sulfate 15mg elemental iron/0.6ml drops, 30ml 30 24.10 723.00
DM-311 bot Ferrous Sulfate 30mg elemental iron/5ml syrup, 60ml 30 28.08 842.40
DM-321 amp Haloperidol 5mg/ml, 1ml (IM) 200 46.23 9,246.00
********************************
Purpose: FOR USE IN CVMC - PHARMACY SECTION (CLUSTER III)

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
********************************
***Re-PR (M-2018-04-00409, 04/13/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-290 tab Cinnarizine 25mg 500 1.49 745.00
DM-310 bot Ferrous Sulfate 15mg elemental iron/0.6ml drops, 30ml 30 24.10 723.00
DM-311 bot Ferrous Sulfate 30mg elemental iron/5ml syrup, 60ml 30 28.08 842.40
********************************
***Re-PR (M-2018-04-00410, 04/13/2018)

***Re-PR (M-2018-04-00419, 04/18/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST
East Avenue Medical Center Fund Cluster: __________________
Office/Section : PR No.: M-2018-04-00419-A Date: April 26, 2018

PHARMACY
SECTION
Stock/
No.
DM-257 can Activated Charcoal 1kg 5 3500.00 17,500.00
********************************
*Note: Government to Government
***Re-PR (M-2018-04-00410, 04/13/2018)

***Re-PR (M-2018-04-00419, 04/18/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
nebule 9,000 13.75 123,750.00
DM-181 MULTIVENT
********************************
***Re-PR (M-2018-03-00293), 03/01/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-399 tab Risperidone 2mg tablet, RISPEDIN-2 4000 1.49 5,960.00
DM-279 tablet Carbamazepine 200mg , TEGREPIN 10,000 2.11 21,100.00
********************************
***Re-PR (M-2018-3-345, 3/16/2018 & M-2018-4-397, 4/13/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Ampicillin 500mg vial (IM,IV) (as Sodium salt),
DM-09 vial 500 7.78 3,890.00
AMPITREX
DM-13 tab Azithromycin 500mg tablet (as base), TROXIN 1,500 8.34 12,510.00
Ciprofloxacin 2mg/ml, 100ml vial (as Lactate) IV infusion,
DM-37 vial 2,500 26.49 66,225.00
FLOXIL
DM-113 vial Vancomycin 500mg vial (IV) (as HCl), VANCIN 300 153.22 45,966.00
********************************
***Re-PR (M-2018-04-00345), 03/16/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-15 ampule 1,500 102.22 153,330.00
DM-304 amp/vial/ 500 269.44 134,720.00
Rabbies Vaccine Lyophillyzed powder 2.5 IU/ml 1 dose +
DM-222 vial 12 873.22 10,478.64
1 ml Diluent (ID,IM), INDIRAB
********************************
***Re-PR (M-2018-04-00397), 03/13/2018)

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-433 tab Capecitabine 500mg, CETAGEN-500 1,000 62.00 62,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - ABBOTT INT'L Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Valproate disodium/ Valproic Acid 250mg (as disodium
DM-425 tab 5,000 29.00 145,000.00
salt or as valproic acid), EPIVAL
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - MULTICARE PHARMACEUTICALS INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Salbutamol 1mg/ml, 2.5ml (unit dose) (as Sulfate),
DM-228 neb 5,000 7.25 36,250.00
PROVEXEL NS
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-212 amp 2,000 298.00 596,000.00
SANDINE
********************************
BASED ON APP CY 2018 596,000.00

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-343 tab Loratadine 10mg, GENERIC 300 1.70 510.00
********************************
BASED ON APP CY 2018 510.00

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Hydrocortisone 125mg/ml, 2ml (IV) (as Sodium
DM-178 vial 300 140.00 42,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-213 bot Prednisone 10mg/5ml suspension, 60ml 30 104.00 3,120.00
********************************
******************

_______________________________________________________________

Signature :

PURCHASE REQUEST
GOODFELLOW Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Epoetin Alfa 10,000 IU/ ml IV,SC (Recombinant human

DM-305 p. syr 30 1280.00 38,400.00
erythropoetin), EPOSINO
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
QUALIFIRST Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-52 tab Co-Amoxiclav 625mg (as Trihydrtate), QUALICLAV 5,000 7.80 39,000.00
DM-87 vial Metronidazole 5mg/ml, 100ml IV infusion, GENERIC 3,000 15.77 47,310.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-33 vial Cefuroxime 750mg (IM,IV) (as Sodium salt), 2,000 20.00 40,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
GETZ BROS. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Dextrose 5% Balance Multiple Maint. Sol'n 500ml,
DM-472 set 1,200 46.00 55,200.00
EUROSOL-M IN D5W
DM-387 vial 1,080 26.00 28,080.00
GENERIC
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-120 tab Amlodipine 5mg (as Besylate or Camsylate), AMLODAC 2,000 1.08 2,160.00
DM-141 tab Clopidogrel 75mg, ARTHEOGREL 3,000 1.59 4,770.00
DM-293 tab Clozapine 100mg, CLOPIXENE 2,000 5.50 11,000.00
DM-192 tab Losartan 100mg (as Potassium salt), LOSACAR 1,000 3.2 3,200.00
DM-369 amp Omeprazole 40mg + 10ml solvent (IV), ZYOM 6,000 37.00 222,000.00
Silver Sulfadiazine Cream 1% 500g (micronized),
DM-405 jar 2 895.00 1,790.00
SILVEDERMA
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-119 tablet Amlodipine 10mg (as Besylate), AMLODIBLOC 3,000 0.78 2,340.00
DM-123 tablet Aspirin 80mg, GENERIC 2,000 0.88 1,760.00
DM-13 tablet Azithromycin 500mg (as base/as dihydrate), TROXIN 2,000 8.34 16,680.00
DM-273 suppositoBisacodyl 10mg adult, DULXATIVE 500 22.32 11,160.00
DM-38 tablet Ciprofloxacin 500mg (as Hydrochloride), CIPRODEX 2,000 1.24 2,480.00
DM-307 ampule Famotidine 10mg/ml, 2ml (IM,IV), HISTA-BLOC 500 130.89 65,445.00
DM-332 ampule Iron Sucrose 20mg/ml, FERON 50 162.33 8,116.50
DM-337 ampule 6,000 21.44 128,640.00
KETRAL
DM-455 ampule Ondansetron 2mg/ml, 4ml (IM,IV), EMITRON 500 149.88 74,940.00
DM-377 tablet Paracetamol 500mg, FEBRIL-FREE 1,000 0.27 270.00
DM-385 ampule 2,000 21.22 42,440.00
(IM,IV), HEMA-K
DM-399 tablet Risperidone 2mg, RISPEDIN-2 2,000 1.49 2,980.00
DM-401 amp/vial Rocuronium Bromide 10mg/ml, 5ml (IV), NEUMERON 100 198.88 19,888.00
DM-113 vial Vancomycin 500mg (IV) (as HCl), VANCIN 300 153.22 45,966.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-36 cap Chloramphenicol 500mg 500 2.68 1,340.00
DM-45 cap Clindamycin HCl 150mg 500 2.10 1,050.00
DM-46 cap Clindamycin HCl 300mg 3,000 2.85 8,550.00
********************************
Purpose: FOR USE IN CVMC - PHARMACY SECTION - CLUSTER I

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-234 tab Spironolactone 50mg 1,000 33.15 33,150.00
********************************
Purpose: FOR USE IN CVMC - PHARMACY SECTION - CLUSTER II

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-261 tab Allopurinol 300mg 300 2.11 633.00
DM-268 amp Atropine 1mg/ml, 1ml (IM,IV) (as SO4) 200 8.45 1,690.00
DM-291 tube Clobetasol cream 0.05% , 5g (as Propionate) 50 74.04 3,702.00
DM-303 amp Ephedrine Sulfate 50mg/ml, 1ml (IM,IV) 500 80.34 40,170.00
DM-350 amp 500 17.80 8,900.00
DM-355 amp Morphine 15mg/ml, 1ml (IM,IV,SC) (as Sulfate) 400 66.96 26,784.00
DM-397 tab Ranitidine 300mg (as HCl) 1,000 2.72 2,720.00
DM-406 tube Silver Sulfadiazine Cream 1%, 50g 200 147.28 29,456.00
********************************
Purpose: FOR USE IN CVMC - PHARMACY SECTION - CLUSTER III

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-460 bot Vinblastin 10mg/10ml 50 716.00 35,800.00
DM-461 vial Vincristine 1mg/ml, 1ml (IV) (as Sulfate) 50 151.93 7,596.50
********************************
Purpose: FOR USE IN CVMC - PHARMACY SECTION - CLUSTER IV

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Cetirizine 10mg/ml drops, 10ml (as Dihydrochloride),
DM-284 bot 15 126.74 1,901.10
ALLERKID
DM-163 tab Fenofibrate 160mg, FENOFLEX 500 33.80 16,900.00
DM-104 vial 2,000 96.00 192,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Cefalexin 250mg/5ml, 60ml suspension/syrup (as
DM-17 bot 15 24.75 371.25
Monohydrate), DIACEF
DM-220 tab Propylthiouracil 50mg, GENERIC 500 11.00 5,500.00
DM-427 tab Vitamin B Complex, BERNAOIN 6,000 1.67 10,020.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORP Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-285 bot Cetirizine 1mg/ml syr, 30ml (as Dihydrochloride), VIRLIZ 15 108.80 1,632.00
DM-435 vial Cisplatin 50mg (IV), CISTEEN 50 570.00 28,500.00

********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - MUNDIPHARMA DIST. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-354 tab Morphine 10mg CR (as Sulfate), MST-CONTINUS 1,920 24.24 46,540.80
DM-356 tab Morphine 30mg CR (as Sulfate), MST-CONTINUS 1,920 55.28 106,137.60
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - A. MENARINI PHILS Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-411 amp Somatostatin 3mg (IV, IV infusion), GENERIC 10 4796.10 47,961.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - PFIZER Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Azithromycin 500mg powder (IV infusion) (as base/ as
DM-12 vial 30 548.00 16,440.00
Dihydrate), ZITHROMAX
DM-282 cap Celecoxib 400mg, CELEBREX 1,000 21.00 21,000.00
DM-67 vial Fluconazole 2mg/ml, 100ml (IV infusion), DIFLUCAN 20 522.00 10,440.00
DM-199 vial Methylprednisolone 1g/16ml, SOLU-MEDROL 10 3126.93 31,269.30
DM-200 vial Methylprednisolone 500mg/7.7ml, SOLU-MEDROL 10 2,378.28 23,782.80
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
vial Asparaginase 10,000 IU (IV) powder 20 1500.00 30,000.00
tab Cilostazole 100mg 100 12.85 1,285.00
p.syr Epoetin Beta 5000 IU/0.3ml (Recombinant erythropoetin) 10 1272.12 12,721.20
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Office/Section : PR No.: M-2018-05-00501 Date: May 2, 2018

PHARMACY
SECTION
Stock/
No.
DM-178 vial 200 140.00 28,000.00
Vitamin B Complex 100mg+100mg+1mg per 3ml (IV),
DM-426 ampule 500 75.00 37,500.00
NEUROBEX
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-433 tab Capecitabine 500mg, CETAGEN 500 2,000 62.00 124,000.00
DM-450 vial Gemcitabine 1g, OMNICURE-1 100 2975.00 297,500.00
DM-451 vial Gemcitabine 200mg, OMNICURE 50 795.00 39,750.00
********************************

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PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-449 amp Fluorouracil 50mg/ml, 10ml (IV, IV Infusion), FLUONCO 300 103.00 30,900.00
********************************

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PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-212 amp 1,000 298.00 298,000.00
SANDINE
********************************

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PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-14 amp Bupivacaine 0.5%, 10ml/amp (as HCl), BUPICAN 300 67.88 20,364.00
********************************

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Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-210 cap Nifedipine 5mg 500 2.20 1,100.00
DM-245 cap Tranexamic Acid 500mg 2,000 5.40 10,800.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORPORATION Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-181 neb 9,000 13.75 123,750.00
MULTIVENT
DM-211 tab Nimodipine 30mg, NIMOTOP 900 37.89 34,101.00
********************************

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Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Nalbuphine 10mg/ml, 1ml (IM,IV,SC) (as HCl),
DM-362 amp 5,000 58.25 291,250.00
NALBUPHINE HCL
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORPORATION - ASPEN PHILS Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-145 tab Digoxin 250mcg (0.25mg), LANOXIN 2,000 4.16 8,320.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORPORATION - ABBOTT INT Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Valproate disodium/ Valproic Acid 250mg (as disodium

DM-425 tab 5,000 29.00 145,000.00
salt or as valproic acid), EPIVAL
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORPORATION - MULTICARE Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Calcium Folinate(Leucoverin Calcium) 10mg/ml,
DM-432 amp 500 215.75 107,875.00
5ml(IM,IV), CAFONATE
DM-444 vial Doxorubicin powder 10mg (IV) (as HCl), ALDROSAL 50 182.75 9,137.50
Salbutamol 1mg/ml, 2.5ml (unit dose) (as Sulfate) ,
DM-228 neb 6,000 7.25 43,500.00
PROVEXEL NS
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORPORATION - MULTICARE Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Methotrexate 25mg/ml, 2ml (IM,IV, Intrathecal) (as base),
DM-453 amp 200 145.75 29,150.00
ALLTREX
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
GETZ BROS Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-127 tab Atorvastatin 40mg, ATORVAST 2,000 20.00 40,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
PHARMACY SECTION Responsibility Center Code : ___________
Stock/
No.
DM-78 polyamp Lidocaine 2%, 5ml (as HCl) (20mg/ml), EUROCAINE 2,000 11.00 22,000.00
Magnesium Sulfate 250mg/ml, 20ml (IM,IV) (as
DM-345 amp 2,000 28.00 56,000.00
Heptahydrate), GENERIC
DM-387 vial 1,000 26.00 26,000.00
GENERIC
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Stock/
No.
DM-266 tab
Ascorbic Acid 500mg, VITCEE 1,500 0.78 1,170.00
DM-144 amp/vial 1,000 24.00 24,000.00
Phosphate), DECSON
DM-86 tab Metronidazole 500mg, METROZOLE 1,000 1.28 1,280.00
DM-220 tab Propylthiouracil 50mg, GENERIC 2,000 11.00 22,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Calcium Carbonate (equiv. to 500mg & 600mg elemental
DM-277 tab 1,080 4.00 4,320.00
ca), CALVIN PLUS
DM-141 tab Clopidogrel 75mg, ARTHEOGREL 2,000 1.59 3,180.00
DM-445 vial Doxorubicin powder 50mg (IV) (as HCl), DOXVEX 50 20 594.75 11,895.00
DM-75 tab Levofloxacin 500mg, LEVODAY 500 540 5.20 2,808.00
DM-192 tab Losartan 100mg (as Potassium salt), LOSACAR 1,000 3.20 3,200.00
DM-369 amp Omeprazole 40mg + 10ml solvent (IV), ZYOM 6,000 37.00 222,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-76 vial 100 250.00 25,000.00
LOXEVA
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
QUALIFIRST Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-52 tab Co-Amoxiclav 625mg (as Trihydrtate), QUALICLAV 2,000 7.80 15,600.00
DM-87 vial Metronidazole 5mg/ml, 100ml IV infusion, GENERIC 3,000 15.77 47,310.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
UNITED LABORATORIES INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-254 tab Acetylcisteine 600mg, EXLFEM 1,500 15.00 22,500.00
DM-207 amp Nicardipine 1mg/ml, 10ml (IV) (as HCl), CARDEPINE 500 611.04 305,520.00
DM-104 vial 2,000 96.00 192,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORPORATION - PFIZER INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.

DM-10 vial 2,000 107.10 214,200.00
Sulbactam) (as Sodium salt), UNASYN
Dopamine 40mg/ml, 5ml (IV) (as HCl) (Sterile Dopamine
DM-155 amp/vial 500 59.89 29,945.00
200mg/5ml),
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA CORPORATION - PFIZER INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Azithromycin 500mg powder (IV infusion) (as base/ as
DM-12 vial 50 548.00 27,400.00
Dihydrate), ZITHROMAX
DM-67 vial Fluconazole 2mg/ml, 100ml (IV infusion), DIFLUCAN 50 522.00 26,100.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-21 vial Cefepime 1g (IM,IV) (as HCl), SEFPIME 1,000 180.00 180,000.00
DM-33 vial Cefuroxime 750mg (IM,IV) (as Sodium salt) 2,000 20.00 40,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-475 set Dextrose 5% in Lactated Ringers 1000ml, GENERIC 6,000 45.00 270,000.00
DM-483 set Dextrose Plain NSS 1000ml, GENERIC 12,000 41.99 503,880.00
DM-473 set Dextrose 5% Balance Multiple Maint. Sol'n 500ml 1,200 45.00 54,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-272 tab Biperiden 2mg (as HCl), AKETON 10,000 4.28 42,800.00
DM-279 tab Carbamazepine 200mg, TEGREPIN 5,000 2.11 10,550.00
DM-399 tab Risperidone 2mg, RISPEDIN-2 2,000 1.49 2,980.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-375 vial Paracetamol 150mg/ml, 2ml (IM,IV), FEBRINIL 15,000 6.33 94,950.00
Penicillin G Crystalline (Benzylpenicillin) 5M "u" vl. (IM,IV)
DM-100 vial 500 17.22 8,610.00
(as Sodium), HARBIPEN
DM-457 vial Paclitaxel 100mg, PACLIZEL 200 1198.22 239,644.00
DM-458 vial Paclitaxel 30mg, PACLIZEL 100 398.33 39,833.00
DM-377 tablet Paracetamol 500mg, FEBRIL-FREE 2,000 0.27 540.00
DM-385 ampule 3,000 21.22 63,660.00
(IM,IV), HEMA-K
DM-240 ampule Tetanus Toxoid 0.5ml (IM), GENERIC 1,000 28.33 28,330.00
DM-113 vial Vancomycin 500mg (IV) (as HCl), VANCIN 1,000 153.22 153,220.00
DM-484 vial Water for injection (triple distilled water), 50ml vial, GENE 5,000 17.88 89,400.00
DM-427 tab Vitamin B Complex, VITABIT 5,000 1.67 8,350.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Stock/
No.
DM-08 vial Ampicillin 1g (IM,IV) (as Sodium salt), AMPITREX 2,000 11.88 23,760.00
DM-09 vial Ampicillin 500mg (IM,IV) (as Sodium salt), AMPITREX 1,000 7.78 7,780.00
DM-123 tablet Aspirin 80mg, GENERIC 1,000 0.88 880.00
DM-13 tablet Azithromycin 500mg (as base/as dihydrate), TROXIN 1,000 8.34 8,340.00
DM-273 suppositor Bisacodyl 10mg adult, DULXATIVE 1,000 22.32 22,320.00
Ciprofloxacin 2mg/ml, 100ml (as Lactate) IV Infusion,
DM-37 vial 2,000 26.49 52,980.00
FLOXIL
DM-38 tablet Ciprofloxacin 500mg (as Hydrochloride), CIPRODEX 1,000 1.24 1,240.00
DM-42 tablet Clarithromycin 500mg tablet as base, KLARCYN 1,000 9.49 9,490.00
DM-159 ampule 10,000 37.22 372,200.00
amp/vial/ Epoetin Alfa 4,000 IU/ 0.4ml, IV,SC (Recombinant
DM-304 500 269.44 134,720.00
PFS human erythropoetin), EPOGEN
DM-68 amp/vial Gentamycin 40mg/ml, 2ml (IM,IV) (as SO4), MAXIGEN 2,000 4.38 8,760.00
DM-322 ampule 200 51.88 10,376.00
HEPRIN
DM-337 ampule 6,000 21.44 128,640.00
KETRAL
DM-481 bottle Mannitol 20%, 500ml (IV), RENIMAX 1,000 84.22 84,220.00
DM-455 ampule Ondansetron 2mg/ml, 4ml (IM,IV), EMITRON 1,000 149.88 149,880.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-46 cap Clindamycin HCl 300mg 1,000 3.61 3,610.00
DM-59 cap Doxycycline 100mg (as Hyclate) 300 1.27 381.00
********************************
Purpose: FOR USE IN CVMC - PHARMACY SECTION (CLUSTER I)

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________
Stock/
No.
DM-114 amp/vial Anti-Tetanus Serum (equine) 1,500IU/ml, 1ml (IM) 2,000 73.93 147,860.00
DM-134 tab Captopril 25mg 1,000 0.78 780.00
DM-143 tab Dexamethasone 4mg 500 22.92 11,460.00
DM-165 p.syringe Fondaparinux 2.5mg/0.5ml solution (as Sodium salt) 200 1268.60 253,720.00
DM-167 tab Furosemide 20mg 500 1.40 700.00
DM-209 tab Nifedipine 30mg MR 900 45.24 40,716.00
DM-214 tab Prednisone 20mg 1,000 6.42 6,420.00
DM-234 tab Spironolactone 50mg 2,000 33.15 66,300.00
DM-243 amp Tranexamic Acid 100mg/ml, 5ml (IM,IV) 1,000 16.45 16,450.00
********************************
BASED ON APP CY 2018 555,716.00

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-268 amp Atropine 1mg/ml, 1ml (IM,IV) (as SO4) 500 8.45 4,225.00
bot Fluphenazine Decanoate 25mg/ml, 10ML 200 520.87 104,174.00
DM-327 amp Hyoscine 20mg/ml, 1ml (IM,IV,SC) (as N-Butyl Bromide) 1,000 15.11 15,110.00
DM-350 amp 500 17.80 8,900.00
DM-351 amp Metoclopromide 5mg/ml, 2ml (IM,IV) (as Base & HCl) 1,000 4.00 4,000.00
DM-355 amp Morphine 15mg/ml, 1ml (IM,IV,SC) (as Sulfate) 500 66.96 33,480.00
********************************
BASED ON APP CY 2018 274,063.00

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-431 vial Bleomycin Sulfate 15 units 20 1828.25 36,565.00
DM-460 bot Vinblastin 10mg/10ml 20 716.00 14,320.00
********************************
Purpose: FOR USE IN CVMC - PHARMACY SECTION (CLUSTER IV)

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-475 set Dextrose 5% in Lactated Ringers 1000ml, GENERIC 6,000 45.00 270,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
EURO-MED Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Dextrose 5% Balance Multiple Maint. Sol'n 500ml,
DM-472 set 1,200 46.00 55,200.00
EUROSOL-M IN D5W
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Amikacin 125mg/ml,( 250mg/2ml) (IM, IV) (as SO4),
DM-03 amp/vial 500 21.33 10,665.00
CINMIK
DM-32 tablet Cefuroxime 500mg (as Axetil), AXEFIME 500 8.88 4,440.00
DM-151 vial Dobutamine 12.5mg/ml, 20ml (IV) (as HCl), DOBUCARD 500 112.22 56,110.00
Erythromycin Ophthalmic Ointment 0.5%, 3.5g,
DM-63 tube 30 148.44 4,453.20
ERYCORTIN
DM-307 ampule Famotidine 10mg/ml, 2ml (IM,IV),HISTA-BLOC 500 130.89 65,445.00
DM-175 ampule Hydralazine 20mg/ml, 1ml (IM,IV) (as HCl), APREZAL 100 87.33 8,733.00
DM-348 tablet Mefenamic Acid 500mg, FENAMAX 5,000 0.52 2,600.00
DM-83 vial Meropenem 1g (IV) (as Trihydrate), MEPENEM 1,000 167.23 167,230.00
DM-84 vial Meropenem 500mg (IV) (as Trihydrate), MEPENEM 500 99.78 49,890.00
DM-395 tablet Ranitidine 150mg (as HCl), ULCI-BLOC 500 0.83 415.00
DM-396 ampule 500 3.89 1,945.00
ZANTOL
DM-401 amp/vial Rocuronium Bromide 10mg/ml, 5ml (IV), NEUMERON 50 198.88 9,944.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-11 vial 2,000 39.00 78,000.00
Sulbactam) (IM,IV) (as Na salt), AMPIMAX
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-137 tablet Carvedilol 25mg, CARVEDOL 200 4.60 920.00
Cefuroxime 125mg/5ml, 70ml granules/suspension (as
DM-029 bottle 15 228.00 3,420.00
Axetil), CIMEX
DM-285 bottle Cetirizine 1mg/ml syr, 30ml (as Dihydrochloride), VIRLIX 10 108.80 1,088.00
DM-435 vial Cisplatin 50mg (IV), CISTEEN 30 570 17,100.00

DM-316 tablet Folic Acid 5mg, FOLIMAX 500 2.65 1,325.00
DM-091 bottle Ofloxacin 0.3%, 5ml ear drops solution, DIZOFLOX 10 230.00 2,300.00
Ofloxacin Ophthalmic Drop 0.3%, 5ml solution,
DM-094 bottle 10 160.00 1,600.00
DIZOFLOX
DM-383 capsule Phenytoin 100mg (as Sodium salt), DILANTIN 300 10.14 3,042.00
Sodium Bicarbonate 1mEq/ml, 50ml (IV infusion),
DM-407 ampule 300 84.21 25,263.00
GENERIC
DM-411 ampule Somatostatin 3mg (IV, IV infusion), GENERIC 20 4,796.10 95,922.00
DM-419 bottle Tobramycin Ophthalmic drops 0.3%, 3.5g, MYTOCIN 10 320.00 3,200.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
GETZ BROS. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Clarithromycin 125mg/5ml, 70ml granules/powder for

DM-39 bottle 20 185.00 3,700.00
suspension , CLARIGET
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
METRO DRUG INCORPORATION Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-252 sachet Acetylcisteine 200mg, FLUIMICIL 510 11.38 5,803.80
Amlodipine 5mg (as Besylate or Camsylate),
DM-120 tablet 500 243.04 121,520.00
CORDARONE
DM-126 tablet Atorvastatin 20mg, ZYDUSATORVA 20 2,000 3.80 7,600.00
Clarithromycin 250mg/5ml, powder for suspension,
DM-40 bottle 20 450.00 9,000.00
CLARITHROCID
DM-293 tablet Clozapine 100mg, CLOPIXENE 1,000 5.50 5,500.00
DM-202 tablet Methyprednisolone 16mg, PREDNIVEX 16 120 8.20 984.00
DM-205 tablet Montelukast 10mg (as Sodium), MONTEZAYD 10 510 5.79 2,952.90
DM-96 vial Oxacillin 500mg, OXAL 1,000 23.00 23,000.00
DM-404 tablet Sertraline 50mg (as HCl), DEPERIN 500 4.50 2,250.00
Silver Sulfadiazine Cream 1% 500g (micronized),
DM-405 jar 2 895.00 1,790.00
SILVEDERMA
DM-246 tablet Trimetazidine 35mg, ANGIMAX MR 300 11.88 3,564.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-43 ampule 1,000 140.00 140,000.00
C
DM-282 capsule Celecoxib 400mg, CELEBREX 540 21.00 11,340.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-264 bottle Ascorbic Acid 100mg/5ml, 60ml syrup, VITCEE 20 16.80 336.00
DM-265 bottle Ascorbic Acid 100mg/ml, 15ml drops, VITCEE 20 16.80 336.00
DM-271 tablet Betahistine 24mg, VERT 300 59.80 17,940.00
DM-281 capsule Celecoxib 200mg, COXTO 2,000 2.81 5,620.00
DM-47 capsule Cloxacillin 500mg, FLACTAMACIN 500 2,000 3.24 6,480.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-69 bottle Isoflurane 100ml, ISORANE 12 1975.00 23,700.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-149 tablet Diltiazem 60mg (as Hydrochloride) 500 19.00 9,500.00
DM-301 ampule Diphenhydramine HCl 50mg/ml, 1ml (IM,IV) (as HCl) 500 34.00 17,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-179 vial 3,000 75.00 225,000.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - ASPEN PHILS INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-197 tablet Methyldopa 250mg, ALDOMET 1,000 16.07 16,070.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
GOODFELLOW PHARMA Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-235 capsule Tamsulosin 200mcg (as HCl), TAMMAX 500 18.08 9,040.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA-ONE PHARMA CORP. Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-270 tablet Baclofen 10mg, TRILAXANT 100 14.95 1,495.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-278 ampule Calcium Gluconate 10%, 10ml (IV), GENERIC 200 19.00 3,800.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
OXFORD DISTRIBUTIONS Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-343 tablet Loratadine 10mg, GENERIC 500 1.70 850.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - A. MENARINI PHILS Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Neostigmine 500mcg/ml, 1ml (IM,IV,SC) (as
DM-366 ampule 20 116.99 2,339.80
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
ZUELLIG PHARMA - PHARMALINK INTERPHIL Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-386 tablet 1,000 15.00 15,000.00
KALIUM DURULE
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-92 vial Ofloxacin 2mg/ml, 100ml (IV infusion) 20 512.17 10,243.40
DM-93 tablet Ofloxacin 400mg 300 10.18 3,054.00
********************************
Purpose: FOR USE IN CVMC - PHARMACY SECTION (CLUSTER I)

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-156 tablet Dydrogesteone 10mg 500 56.24 28,120.00
Tetanus Immune Globulin Human (TIG) 250”u”/ml, 2ml
DM-239 vial 10 659.20 6,592.00
(IM)
DM-248 ampule Verapamil 2.5mg/ml, 2ml (IV) (as Hydrochloride) 30 169.25 5,077.50
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-269 bottle Atropine Sulfate Ophthalmic drops 1%, 10ml 10 173.50 1,735.00
DM-291 tube Clobetasol cream 0.05% , 5g (as Propionate) 100 74.04 7,404.00
DM-312 tablet Ferrous sulfate 325mg 2,000 1.59 3,180.00
DM-344 bottle Loratadine 5mg/5ml syrup, 30ml 20 52.22 1,044.40
Methylergometrine Maleate 125mcg (as Hydrogen
DM-349 tablet 500 3.35 1,675.00
Maleate or Maleate)
DM-363 ampule Naloxone 20mcg/ml, 2ml (IM,IV,SC) (as HCl) 20 401.70 8,034.00
DM-397 tablet Ranitidine 300mg (as HCl) 500 2.72 1,360.00
DM-406 tube Silver Sulfadiazine Cream 1%, 50g 50 147.28 7,364.00
DM-420 tube Tobramycin Ophthalmic Ointment 0.3%,3.5g 10 411.65 4,116.50
DM-422 capsule Tramadol 50mg (as HCl) 1,000 2.64 2,640.00
********************************

_______________________________________________________________

Signature :

PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
********************************

_______________________________________________________________

Signature :
Printed Name : CHERRY LOU M. ANTONIO, MD, DPPS GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS
Designation :OIC - CHIEF MEDICAL PROFESSIONAL STAFF II MEDICAL CENTER CHIEF II
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-179 vial 1,000 75.00 75,000.00
********************************

_______________________________________________________________

Signature :
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-08 vial Ampicillin 1g (IM,IV) (as Sodium salt), AMPITREX 2,000 11.88 23,760.00
DM-159 ampule 4,000 37.22 148,880.00
DM-68 amp/vial Gentamycin 40mg/ml, 2ml (IM,IV) (as SO4), MAXIGEN 2,000 4.38 8,760.00
DM-337 ampule 6,000 21.44 128,640.00
KETRAL
DM-481 bottle Mannitol 20%, 500ml (IV), RENIMAX 1,000 84.22 84,220.00
DM-456 vial Oxaliplatin 100mg (5mg/ml, 20ml, MESLATIN 50 1,622.00 81,100.00
DM-385 ampule 2,000 21.22 42,440.00
(IM,IV), HEMA-K
********************************

_______________________________________________________________

Signature :
Designation O
: IC - CHIEF MEDICAL PROFESSIONAL STAFF II MEDICAL CENTER CHIEF II
PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
********************************
No/Failed Bidder, Public Bidding CY 2017

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-43 amp 1,000 140.00 140,000.00
C
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-76 vial 25 250.00 6,250.00
LOXEVA
DM-96 vial Oxacillin 500mg, WYDOX 1,000 23.00 23,000.00
DM-404 tab Sertraline 50mg (as HCl), DEPERIN 500 4.50 2,250.00
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST
Office/Section : PR No.: M-2018-06-00608 Date: June 04, 2018

PHARMACY
SECTION
Stock/
No.
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST
ZUELLIG PHARMA - PHARMALINK-INTERPHIL Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.

DM-386 tab 1,000 15.00 15,000.00
KALIUM DURULE
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.

DM-10 vial 2,000 107.10 214,200.00
Sulbactam) (as Sodium salt), UNASYN
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST
ZUELLIG PHARMA - A MENARINI PHILS Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
Neostigmine 500mcg/ml, 1ml (IM,IV,SC) (as

DM-366 amp 50 116.99 5,849.50
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST
ZUELLIG PHARMA - ASPEN PHILS INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-197 tab Methyldopa 250mg, ALDOMET 1,000 16.07 16,070.00
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-454 amp Ondansetron 1mg/ml, 4ml (2mg/2ml) (IM,IV), ONSIA 200 400.00 80,000.00
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-178 vial 300 140.00 42,000.00
Succinate) , HYDROVEX
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_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-384 amp Phenytoin 50mg/ml, 2ml (IV)(as Sodium salt), SANTON 50 118.00 5,900.00
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Amikacin 125mg/ml,( 250mg/2ml) (IM, IV) (as SO4),
DM-03 amp/vial 1,000 21.33 21,330.00
CINMIK
DM-123 tablet Aspirin 80mg , GENERIC 3,000 0.88 2,640.00
DM-32 tablet Cefuroxime 500mg (as Axetil), AXEFIME 1,250 8.88 11,100.00
DM-141 tablet Clopidogrel 75mg, ARTHEOGREL 2,500 1.59 3,975.00
DM-304 amp/vial/ 350 269.44 94,304.00
DM-348 tablet Mefenamic Acid 500mg, FENAMAX 5,000 0.52 2,600.00
DM-377 tablet Paracetamol 500mg, FEBRIL-FREE 10,000 0.27 2,700.00
DM-396 ampule 1,000 3.89 3,890.00
ZANTOL
DM-427 tablet Vitamin B Complex, VITABIT 5,000 1.67 8,350.00
Water for injection (triple distilled water), 50ml vial (steriile
DM-484 vial 2,000 17.88 35,760.00
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_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-428 bot Zinc 10mg/ml drops, IMMUZINE 30 40.00 1,200.00
DM-429 bot Zinc 20mg/5ml syrup, IMMUZINE 30 41.00 1,230.00
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-266 tablet Ascorbic Acid 500mg, VITCEE 3,000 0.78 2,340.00
DM-271 tablet Betahistine 24mg, VERT 200 59.80 11,960.00
DM-281 capsule Celecoxib 200mg, COXTO 5,000 2.81 14,050.00
DM-86 tablet Metronidazole 500mg, METROZOLE 3,000 1.28 3,840.00
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST
METRO DRUG INC Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-126 tablet Atorvastatin 20mg, ZYDUSATORVA 20 4,000 3.80 15,200.00
DM-318 capsule Gabapentine 100mg, GABAVEX 100 500 5.50 2,750.00
DM-189 tablet Levothyroxine 50mcg (as Anhydrous Sodium), THYDIN 1,000 4.05 4,050.00
DM-193 tablet Losartan 50mg (as Potassium salt), LOSACAR 1,050 1.02 1,071.00
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-338 bot Lactulose 3.3g/5ml (66% syrup), 120ml, LILAC 300 80.00 24,000.00
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-78 polyamp Lidocaine 2%, 5ml (as HCl) (20mg/ml), EUROCAINE 1,000 11.00 11,000.00
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
`
Stock/
No.
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-127 tab Atorvastatin 40mg, ATORVAST 2,000 20.00 40,000.00
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-43 amp Clindamycin 150mg/ml, 4ml (IM,IV) (as PO4), DALACIN-C 500 140.00 70,000.00
Dobutamine 2mg/ml, 250ml D5W (pre-mixed) (IV) (as HCI),
DM-152 vial 50 726.00 36,300.00
GENERIC
********************************

_______________________________________________________________

Signature :
PURCHASE REQUEST
ZUELLIG PHARMA - FRESENIUS KABI Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-110 bot Sevoflurane 250ml, SOJOURN 8 5600.00 44,800.00
********************************
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST
ZUELLIG PHARMACORP Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-411 amp Somatostatin 3mg (IV, IV Infusion), GENERIC 4 4796.10 19,184.40
********************************
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-207 amp Nicardipine 1mg/ml, 10ml amp (IV) (as HCl), CARDEPINE 80 611.04 48,883.20
********************************
********************************

_______________________________________________________________

Signature :
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-76 vial 25 250.00 6,250.00
LOXEVA
DM-96 vial Oxacillin 500mg, WYDOX 500 23.00 11,500.00
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-446 amp/vial Etoposide 20mg/ml, 5ml, ETOPA 20 429.55 8,591.00
********************************
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
Clarithromycin 500mg tab OD Modified Release tablet,

DM-41 tab 300 33.00 9,900.00
CLARIGET OD
********************************
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST

PHARMACY
SECTION
Stock/
No.
DM-08 vial Ampicillin 1g vial (IM,IV) (as Sodium salt), AMPITREX 500 11.88 5,940.00
DM-26 vial Cefoxitin 1g (IM,IV) (as Sodium Salt), HAXOTIN 500 99.44 49,720.00
Epinephrine 1:1000 1mg/ml, 1ml amp (IM,SC) (as
DM-159 amp 1,500 37.22 55,830.00
DM-166 amp Furosemide 10mg/ml, 2ml amp (IM,IV), GENERIC 2,000 6.48 12,960.00
Gentamycin 40mg/ml, 2ml amp/vial (IM,IV) (as SO4),
DM-68 amp 1,000 4.38 4,380.00
MAXIGEN
DM-337 amp 1,500 21.44 32,160.00
KETRAL
DM-375 vial Paracetamol 150mg/ml, 2ml (IM,IV), FEBRINIL 3000 6.33 18,990.00
Penicilllin G Crystalline (Benzylpenicillin) 5M "u" vl.
DM-100 vial 200 17.22 3,444.00
(IM.IV) (as Sodium), HARBIPEN
DM-385 amp 1000 21.22 21,220.00
amp(IM,IV), HEMA-K
Rabbies Vaccine Lyophillyzed powder 2.5 IU/ml, 1 dose
DM-222 vial 15 873.22 13,098.30
vial + 1ml Diluent (ID,IM), INDIRAB
********************************

_______________________________________________________________

Signature :
PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.
DM-477 set Dextrose 5% in Water 500ml, GENERIC 480 42.33 20,318.40
DM-470 set Dextrose 5% 0.3 NaCl 500ml, GENERIC 480 40.89 19,627.20
********************************

_______________________________________________________________

Signature :
Designation O
PURCHASE REQUEST
Fund Cluster: __________________

PHARMACY
SECTION
Stock/
No.

_______________________________________________________________

Signature :
Designation O

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Republic of the Philippines PR-003-1

Office/Section : PR No.: M-2018-01-089 Date: January 09, 2018

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-090 Date: January 09, 2018

Winning Bidder, Public Bidding CY 2017 41,800.00

BASED ON APP CY 2018

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-091 Date: January 09, 2018

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-092 Date: January 31, 2018

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-093 Date: January 09, 2018

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-094 Date: January 31, 2018

Cefuroxime 250mg/5ml, 70ml granules/suspension (as

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-095 Date: January 09, 2018

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-096 Date: January 09, 2018

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-097 Date: January 09, 2018

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-098 Date: January 09, 2018

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-099 Date: January 09, 2018

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-100 Date: January 31, 2018

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-101 Date: January 09, 2018

DM-69 bot Isoflurane 100ml, ISORANE 25 1975.00 49,375.00

Hydroxyethyl starch 6% solution 500ml bottle (IV

Purpose: FOR USE IN CVMC - PHARMACY SECTION

Requested by: Approved by:

Printed Name : EDUARDO M. BADUA III, MD GLENN MATHEW G. BAGGAO,MD,MHA,MSN,FPSMS

Office/Section : PR No.: M-2018-01-102 Date: January 09, 2018

DM-178 Hydrocortisone 125mg/ml, 2ml vial (IV) (as Sodium