Assay record ASY-EC-0E6VMDJ0R1 · Cite as: Assay Systems, “Ecuador: public contracts won without a rival, page 125 of 1456”, https://assay-systems.com/register/ec/uncontested/125/
Buyer and supplier pairs, most uncontested awards first. 12,401–12,500 of 145,571.
CENTRO DE SALUD A GUALAQUIZA gave TOTALCARE PHARMA S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2022-11-23, latest 2025-03-17.
CENTRO DE SALUD C - MATERNO INFANTIL Y EMERGENCIAS - ZARUMA gave HOSPIMEDIKKA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-09-15, latest 2023-06-13.
CORPORACION ELECTRICA DEL ECUADOR CELEC EP gave LETERAGO DEL ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2019-11-13, latest 2022-07-08.
CENTRO CLINICO QUIRURGICO AMBULATORIO HOSPITAL DEL DIA EL BATAN gave CHINA SINOPHARM INTERNATIONAL CORPORATION 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-03-06, latest 2019-10-07.
COMANDO DE APOYO LOGISTICO N 1 EL ORO gave ITALCHEM ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2018-02-21, latest 2024-08-23.
HOSPITAL HOMERO CASTANIER CRESPO gave COMERCIOSA S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-11, latest 2017-03-14.
DIRECCION DISTRITAL 19D02 CENTINELA DEL CONDOR-NANGARITZA-PAQUISHA-SALUD gave GRUNENTHAL ECUATORIANA CIA LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-17, latest 2020-02-13.
UNIVERSIDAD ESTATAL DEL SUR DE MANABÍ gave VIBAG C.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2018-05-23, latest 2018-07-19.
CENTRO DE SALUD A - PAJAN gave FARMALIGHT S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-06-22, latest 2024-12-11.
DIRECCION DISTRITAL 02D02 - CHILLANES - SALUD gave GRUNENTHAL ECUATORIANA CIA LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-26, latest 2019-03-14.
CENTRO DE SALUD B - ALAUSI gave LABORATORIOS G.M. SUCESORES DEL DR. JULIO GONZALEZ MOSQUERA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-03-03, latest 2019-10-25.
HOSPITAL DE ALAUSI gave ITALCHEM ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-15, latest 2022-05-03.
DIRECCION DISTRITAL 02D04-CALUMA-ECHEANDIA-LAS NAVES-SALUD gave IMPORTADORA Y DISTRIBUIDORA MEDICA FERBOVASA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-17, latest 2020-02-14.
HOSPITAL GENERAL FRANCISCO DE ORELLANA gave GENECOM CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2018-02-02, latest 2025-02-19.
HOSPITAL GENERALPROVINCIAL LUIS G DAVILA gave CENTRO DE INMUNOLOGÍA MOLECULAR, CIM 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-01-26, latest 2019-12-09.
HOSPITAL REPUBLICA DEL ECUADOR gave LIMERICKPHARMA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-09-13, latest 2017-01-17.
UNIVERSIDAD NACIONAL DE CHIMBORAZO gave PHARMABRAND S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2018-08-13, latest 2018-11-20.
I.E.S.S. UNIDAD DE ATENCION AMBULATORIA DE SANTA CRUZ gave QUIMICA ARISTON ECUADOR CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-17, latest 2016-06-27.
CENTRO DE SALUD B - CARIAMANGA gave LABORATORIOS INDUSTRIALES FARMACEUTICOS ECUATORIANOS LIFE C.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-04-04, latest 2025-03-11.
DIRECCION DISTRITAL 06D02 ALAUSI CHUNCHI SALUD gave FARMALIGHT S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-02-07, latest 2024-07-24.
HOSPITAL DE ALAUSI gave IMPORTADORA Y DISTRIBUIDORA MEDICA FERBOVASA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-15, latest 2025-02-27.
CENTRO DE SALUD B - BUCAY gave ETICAL LABORATORIOS ETICAL S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-10-25, latest 2025-07-31.
COORDINACION ZONAL 7-ARCSA gave TRANS VILCAMIXTO CIA LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-08-11, latest 2018-12-05.
DIRECCION DISTRITAL 21D01-CASCALES-GONZALO PIZARRO-SUCUMBIOS SALUD gave IMPORTADORA Y DISTRIBUIDORA MEDICA FERBOVASA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-03-23, latest 2020-02-18.
DIRECCION DISTRITAL 07D03-ATAHUALPA-PORTOVELO-ZARUMA-SALUD gave IMPORTADORA Y DISTRIBUIDORA MEDICA FERBOVASA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-06, latest 2019-02-22.
IESS SEGURO DE SALUD CENTRO A.A. CENTRAL LOJA gave PSICOFARMA DEL ECUADOR S.A. PSICODELCU 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-07, latest 2021-06-01.
DIRECCION DISTRITAL 10D02 ANTONIO ANTE-OTAVALO-SALUD gave LABVITALIS S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-10-04, latest 2024-12-04.
UNIDAD DE ATENCIÓN AMBULATORIA IESS BANOS gave QUIFATEX S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-17, latest 2018-08-09.
HOSPITAL OSKAR JANDL gave GINSBERG ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-29, latest 2017-02-23.
DIRECCION DISTRITAL DE SALUD NO 09D14 gave HOSPIMEDIKKA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-11, latest 2022-03-03.
DIRECCION DISTRITAL 03D03- LA TRONCAL- SALUD gave LABORATORIOS ACFARMA S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-08-05, latest 2022-01-28.
UNIDAD DE ATENCION AMBULATORIA DE TABACUNDO gave LABORATORIOS G.M. SUCESORES DEL DR. JULIO GONZALEZ MOSQUERA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-03-07, latest 2019-11-08.
HOSPITAL BASICO 1 BI EL ORO gave CHINA SINOPHARM INTERNATIONAL CORPORATION 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-10-28, latest 2019-03-27.
DIRECCION DISTRITAL 19D02 CENTINELA DEL CONDOR-NANGARITZA-PAQUISHA-SALUD gave LIMERICKPHARMA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-20, latest 2016-11-15.
BATALLÓN DE OPERACIONES ESPECIALES EN SELVA NO. 54 "CAPT. CALLES" gave COMERCIALIZADORA NUTRI MED NUTRIMEDECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2018-02-17, latest 2021-08-14.
CENTRO DE SALUD B - TULCÁN gave LABORATORIOS LACFARMA S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2022-09-20, latest 2025-03-13.
I.E.S.S. UNIDAD DE ATENCION AMBULATORIA DE SANTA CRUZ gave FARMALIGHT S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-05-08, latest 2025-03-19.
HOSPITAL DE ALAUSI gave SIONPHARM CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-12, latest 2016-12-06.
HOSPITAL NICOLAS COTTO INFANTE gave PFIZER CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-10, latest 2019-02-28.
DIRECCION DISTRITAL 02D01- GUARANDA-SALUD gave FRESENIUS KABI S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-29, latest 2021-12-10.
CENTRO DE ESPECIALIDADES LA ECUATORIANA gave LABORATORIOS LACFARMA S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2022-11-09, latest 2025-05-29.
CENTRO DE SALUD B -HUAQUILLAS gave LIMERICKPHARMA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-27, latest 2016-12-16.
IESS UNIDAD DE ATENCION AMBULATORIA DEL CAÑAR gave LABORATORIOS G.M. SUCESORES DEL DR. JULIO GONZALEZ MOSQUERA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-22, latest 2019-11-12.
DIRECCION DISTRITAL 07D03-ATAHUALPA-PORTOVELO-ZARUMA-SALUD gave SIONPHARM CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-12, latest 2016-09-23.
CENTRO DE SALUD A-MACHACHI gave LIMERICKPHARMA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-20, latest 2016-10-21.
DIRECCIÓN DISTRITAL 19D01 YACUAMBI-ZAMORA-SALUD gave HOSPIMEDIKKA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-13, latest 2023-03-02.
DIRECCION DISTRITAL DE SALUD NO.09D12 gave TECNOQUIMICAS DEL ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-10-11, latest 2021-12-08.
DIRECCION DISTRITAL DE SALUD NO. 01D05 gave JUAN PEÑA RODAS CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-09-15, latest 2017-06-13.
DIRECCION DISTRITAL 19D03-CHINCHIPE-PALANDA-SALUD gave SIONPHARM CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-14, latest 2017-01-25.
CENTRO DE ESPECIALIDADES CENTRAL GUAYAS gave TECNOQUIMICAS DEL ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-06-12, latest 2021-02-17.
HOSPITAL DE ATENCION INTEGRAL DEL ADULTO MAYOR gave IMPORTADORA Y DISTRIBUIDORA MEDICA FERBOVASA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-04, latest 2024-03-22.
DIRECCION DISTRITAL DE SALUD NO.09D12 gave MERCK C.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2018-02-15, latest 2023-07-13.
CENTRO DE SALUD A-ZUMBA gave TOTALCARE PHARMA S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2022-09-12, latest 2025-03-18.
DIRECCION DISTRITAL 17D12 - PEDRO VICENTE MALDONADO - PUERTO QUITO - SAN MIGUEL DE LOS BANCOS - SALUD gave QUIFATEX S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-12, latest 2019-02-12.
CENTRO DE SALUD A-ZUMBA gave VIBAG C.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-09-22, latest 2018-03-26.
HOSPITAL GENERAL III DE TARQUI gave LETERAGO DEL ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-06, latest 2024-06-11.
DIRECCION DISTRITAL 17D12 - PEDRO VICENTE MALDONADO - PUERTO QUITO - SAN MIGUEL DE LOS BANCOS - SALUD gave SIONPHARM CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-05, latest 2016-08-17.
DIRECCION DISTRITAL 07D06-SANTA ROSA-SALUD gave SUMINISTROS Y DISTRIBUCIONES IVAN QUINTANILLA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-08-02, latest 2018-02-16.
DIRECCION DISTRITAL DE SALUD NO. 01D05 gave CHINA SINOPHARM INTERNATIONAL CORPORATION 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-08-30, latest 2019-02-22.
CENTRO DE SALUD B CELICA gave IMPORTADORA Y DISTRIBUIDORA MEDICA FERBOVASA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-05-26, latest 2025-03-12.
CENTRO DE SALUD A - PAJAN gave LABORATORIOS CHALVER DEL ECUADOR CIA LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-09-26, latest 2024-12-11.
DIRECCION DISTRITAL DE SALUD NO. 09D21 gave IMPORTADORA Y DISTRIBUIDORA MEDICA FERBOVASA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-11, latest 2019-01-02.
HOSPITAL GENERAL - PORTOVIEJO gave LABORATORIOS LANSIER SAC 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-09-16, latest 2018-11-20.
CENTRO DE SALUD A GUALAQUIZA gave SIONPHARM CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-27, latest 2017-02-10.
DIRECCION DISTRITAL DE SALUD NO. 09D21 gave SUMINISTROS Y DISTRIBUCIONES IVAN QUINTANILLA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-04, latest 2018-02-09.
HOSPITAL NICOLAS COTTO INFANTE gave TECNOQUIMICAS DEL ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-01-17, latest 2021-05-20.
CENTRO DE SALUD B - BUCAY gave CORPORACION MAGMA ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-11-25, latest 2025-10-08.
PATRONATO PROVINCIAL DE SERVICIO SOCIAL DE PASTAZA gave QUIFATEX S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-07-03, latest 2019-08-21.
UNIVERSIDAD ESTATAL DE BOLIVAR gave COMERCIALIZADORA NUTRI MED NUTRIMEDECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-04-21, latest 2019-07-24.
HOSPITAL DERMATOLOGICO MARIANO ESTRELLA gave CHINA SINOPHARM INTERNATIONAL CORPORATION 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-27, latest 2018-02-15.
BASE AEREA COTOPAXI gave LETERAGO DEL ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-03-01, latest 2025-03-24.
DIRECCION DISTRITAL 09D09 - TARQUI 3 - SALUD gave TECNOQUIMICAS DEL ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-02-09, latest 2019-10-08.
HOSPITAL NAVAL DE ESMERALDAS gave TOTALCARE PHARMA S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2022-08-01, latest 2026-05-22.
DIRECCION DISTRITAL 03D01 -AZOGUES-BIBLIAN-DELEG-SALUD gave LABORATORIOS ACFARMA S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-10-17, latest 2020-02-19.
FUERTE MILITAR MIGUEL ITURRALDE gave COMERCIALIZADORA NUTRI MED NUTRIMEDECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2018-03-26, latest 2020-03-17.
PROCURADURIA GENERAL DEL ESTADO gave PROAÑO MORALES PATRICIO XAVIER 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-02-17, latest 2017-03-29.
BRIGADA DE INFANTERIA N 7 LOJA gave FARMABION DEL ECUADOR C.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2018-02-19, latest 2024-08-13.
DIRECCION DISTRITAL 11D09-ZAPOTILLO-SALUD gave FRESENIUS KABI S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-04-12, latest 2021-09-21.
CENTRO DE SALUD B - SUCÚA gave QUIFATEX S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-09-29, latest 2021-03-10.
HOSPITAL DE ESPECIALIDADES FUERZAS ARMADAS NO. 1 gave FARMAYALA PHARMACEUTICAL COMPANY S.A. FPC 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2022-11-08, latest 2026-03-02.
PATRONATO PROVINCIAL DE SERVICIO SOCIAL DE PASTAZA gave FARMALIGHT S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-09-27, latest 2018-10-02.
DIRECCION DISTRITAL 20D01 - SAN CRISTOBAL - SANTA CRUZ - ISABELA - SALUD gave LIMERICKPHARMA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-08, latest 2016-09-21.
UNIVERSIDAD NACIONAL DE LOJA gave VIBAG C.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-12-07, latest 2017-12-07.
DIRECCION DISTRITAL 02D04-CALUMA-ECHEANDIA-LAS NAVES-SALUD gave LABORATORIOS ACFARMA S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-10-12, latest 2019-02-22.
DIRECCION DISTRITAL 02D02 - CHILLANES - SALUD gave LABORATORIOS ACFARMA S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-08-02, latest 2019-07-18.
CENTRO DE SALUD B - BUCAY gave CEDIMED CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2018-02-06, latest 2025-10-08.
CENTRO DE SALUD A - PILLARO gave HOSPIMEDIKKA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-01-16, latest 2023-06-21.
ESCUELA SUPERIOR POLITECNICA DE CHIMBORAZO gave COMERCIALIZADORA NUTRI MED NUTRIMEDECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-08-14, latest 2021-03-29.
PUESTO DE SALUD CHUNCHI gave SIONPHARM CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-08-18, latest 2016-11-11.
DIRECCION DISTRITAL 09D16 - EL TRIUNFO -GNAL ANTONIO ELIZALDE - SALUD gave SUMINISTROS Y DISTRIBUCIONES IVAN QUINTANILLA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-11-14, latest 2018-03-05.
HOSPITAL DE ESPECIALIDADES FUERZAS ARMADAS NO. 1 gave FARMALIGHT S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-07-12, latest 2026-09-15.
ESCUELA SUPERIOR MILITAR DE AVIACION COSME RENNELLA BARBATTO gave LETERAGO DEL ECUADOR S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-03-17, latest 2023-04-04.
HOSPITAL BASICO 11 BCB GALAPAGOS gave LIMERICKPHARMA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-07-28, latest 2016-10-17.
UNIDAD DE ATENCION AMBULATORIA DEL IESS SAN GABRIEL gave CHINA SINOPHARM INTERNATIONAL CORPORATION 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-09-12, latest 2019-10-24.
DIRECCION DISTRITAL DE SALUD NO. 01D05 gave FRESENIUS KABI S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-10, latest 2020-02-03.
HOSPITAL DE ALAUSI gave PFIZER CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2016-02-15, latest 2019-03-15.
DIRECCION DISTRITAL 16D02-ARAJUNO-SALUD gave FRESENIUS KABI S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-02-06, latest 2022-10-25.
EMPRESA PUBLICA METROPOLITANA DE RASTRO QUITO gave PHARMABRAND S.A 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-03-29, latest 2018-05-24.
UNIVERSIDAD ESTATAL DE BOLIVAR gave NEOETHICALS CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2017-04-21, latest 2020-11-06.
CENTRO DE SALUD B - CAÑAR gave HOSPIMEDIKKA CIA. LTDA 12 awards: 12 without a competition, 0 after a competition with a single bid. First 2018-05-21, latest 2023-06-20.
Source: contract awards published by the National Public Procurement Service of Ecuador (SERCOP) in the Open Contracting Data Standard (data.open-contracting.org), licensed under CC BY 3.0 EC; awards from January 2016 to 30 September 2026, accessed 15 October 2026. Awards are matched to their buyer and supplier as published. Values in these notices often state a framework ceiling rather than a contract amount, so awards are counted, not summed. Updated 17 October 2026.