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    Divine Mercy

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    divine mercy

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    Divine Mercy

    Uploaded by

    divine mercy
    1 views4 pages

    Copyright

    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    1 views4 pages

    Divine Mercy

    Uploaded by

    divine mercy

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    of 4

    Department of Health

    Center for Health Development - I

    Monitoring Tool for Medicines under the Maximum Retail Price

    Name of Facility: DIVINE MERCY FOUNDATION OF URDANETA HOSPITAL (ST. ANNE PHARMACY)
    Classification: ✘ Hospital
    Drugst
    ore
    Address: #25 High School Drive, San Vicente West, City of Urdaneta, PANGASINAN
    Monitored through:
    Actual Telephone
    Visit Interview ✘ Email
    For actual visit, please put a check if there is an IEC material posted in a conspicuous area
    Yes No
    Date monitored:
    No. Generic name Dosage Form/Strength Brand name MRP
    1 Levamlodipine 2.5 mg tablet* 11.84
    Indapamide + 2.5 mg + 10 mg film-
    2 30.51
    Perindopril coated tablet*
    3 Metolazone 5 mg tablet 25.89
    4 Parecoxib 40 mg ampule 478.01
    5 Triflusal 300 mg capsule 45.57
    6 Palonosetron 50 mcg/mL, 5 mL vial 3,666.00
    7 Desmopressin 0.1 mg tablet* 70.78
    8 Fosinopril 10 mg tablet 20.87
    9 Fosinopril 20 mg tablet 25.56
    10 Exemestane 25 mg tablet* 326.75
    11 Alteplase 50 mg, 50 mL vial 38,186.81
    12 Everolimus 10 mg tablet 3,628.09
    0.5 mg prolonged-release
    13 Tacrolimus 67.19
    capsule
    14 Beractant 25 mg/mL, 8 mL vial 19,600.27
    15 Quinapril 5 mg tablet 15.01
    16 Apixaban 2.5 mg film-coated tablet 91.17
    17 Apixaban 5 mg film-coated tablet 90.98
    10.8 mg pre-filled syringe
    18 Goreselin 19,725.85
    (SC)

    19 Calcitonin (Salmon) 100 IU/mL, 1 mL ampule 466.79


    20 Nimodipine 10 mg, 50ml vial* 1,886.29
    21
    22
    23
    24
    Monitored by: Respondent:
    MA. SOCORRO R. MENDOZA, R
    ERWIN G. FLORES CHIEF PHARMACIS
    Administrative Assistant III Name and Designation of person inte

    DOH-PD-MOP-06 Form 1 Rev


    nt - I

    ximum Retail Price

    SPITAL (ST. ANNE PHARMACY)

    cuous area

    Time monitored:
    Actual Price Remarks
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A
    N/A N/A

    N/A N/A
    N/A N/A
    MA. SOCORRO R. MENDOZA, RPh.
    CHIEF PHARMACIS
    Name and Designation of person interviewed

    DOH-PD-MOP-06 Form 1 Rev. 0

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